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Biomedical subjects

K Hiroshige

Publications and source records attributed to K Hiroshige.

At least 55 records · Page 3Linked to original sources
PubMed1988

Necrotizing myelopathy associated with hepatocellular carcinoma.

A 43-year-old Japanese male with hepatocellular carcinoma suddenly developed paraplegia. The spinal cord signs first progressed rapidly but then gradually subsided. The patient died of hepatic failure ten months later. The autopsy disclosed cavitation and softening of the spinal cord from the level of C6 to T10, a characteristic of necrotizing myelopathy. Neither local nor apparent systemic causes to explain the spinal cord lesion were disclosed at the autopsy. This seems to be the first documented rare paraneoplastic syndrome, associated with hepatocellular carcinoma.

Adult↗
PubMed1988

[Recurrent postictal pulmonary edema--a case report].

A 32-year-old woman was examined in the Department of Internal Medicine at Saiseikai Fukuoka General Hospital after a grand mal seizure on December 29, 1985. She had a history of eclampsia 5 years before but had had no evidence of convulsive seizure. Chest examination revealed rales over the bilateral chest. The cardiac examination revealed no abnormalities. Laboratory data on admission included a total white blood cell count of 13000/mm3. The electrocardiogram also failed to reveal any abnormalities. Analysis of arterial blood with the patient breathing room air revealed a PaO2 of 51.2 mmHg, PaCO2 of 33.1 mmHg and a pH of 7.426. The chest film showed diffuse bilateral nodular-appearing alveolar infiltrate and a normal cardiac size. Cardiac function test using Swan-Ganz catheter was performed after 10 hours of onset. However, no abnormalities in pulmonary arterial pressure (PAP) and pulmonary capillary wedge pressure (PCWP) were noted. She was treated with Latamoxef and supplementally inspired oxygen. A repeat chest roentgenogram taken 7.5 hours after admission showed marked improvement. She was discharged without any residual symptoms and continued as an outpatient under the administration of sodium valproate. However, the drug was discontinued because of the presence of seizure was under suspicion. On August 24, 1986, she was readmitted for pulmonary edema after another grand mal seizure. The clinical course was uneventful and was almost the same as the previous episode. She was treated with oxygen only, via nasal catheter.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Nodular regenerative hyperplasia of the liver associated with idiopathic membranous glomerulonephritis.

Nodular regenerative hyperplasia of the liver was found in a 67-yr-old man who had been suffering from nephrotic syndrome for years. Main clinical symptoms and signs were edema, proteinuria, hypertension, and abnormal studies of electrocardiogram. His renal disease had been relatively well controlled by administration of corticosteroids, but he died suddenly on March 12, 1986. Autopsy revealed fresh and old myocardial infarct and membranous glomerulonephritis. The liver weighed 1530 g and showed a diffuse nodular configuration except for in the area of Zahn's red infarct. Fibrosis was minimal in most areas, and each nodule was circumscribed by compressed atrophic parenchyma. However, this case was unusual compared to most cases of nodular regenerative hyperplasia because there was prominent fibrosis in the perihilar portion. Paucity of interlobular arterial branches was confirmed by a crude morphometry. We describe herein this somewhat unusual nodular regenerative hyperplasia case with some discussion concerning the histogenesis.

Aged↗
PubMed1970

Quantitative and metabolic changes of hepatic collagens in rats after carbon tetrachloride poisoning.

1. The collagen hydroxyproline in rat liver was composed of 3.5% neutral-soluble collagen, 4.9% acid-soluble collagen and 91.6% insoluble collagen. In labelling studies with [(14)C]proline in vitro, the specific radioactivities of neutral-soluble, acid-soluble and insoluble collagens in rat liver were found to be 233000, 69000 and 830d.p.m./mumol of hydroxyproline respectively after 1h. 2. During subacute carbon tetrachloride poisoning the hepatic content of insoluble collagen markedly increased, whereas those of soluble collagens did not change. During recovery from subacute poisoning hepatic contents of soluble collagens were markedly decreased. 3. After 8 weeks of carbon tetrachloride poisoning the specific radioactivities of hepatic soluble collagens increased, while that of insoluble collagen decreased. During recovery from subacute poisoning, the specific radioactivities of soluble collagens decreased to the normal range and that of insoluble collagen further decreased. 4. Hepatic collagenolytic activity solubilizing insoluble collagen, which differs from mammalian collagenase, decreased under the conditions of the subacute poisoning and also during recovery from subacute poisoning.

Animals↗
PubMed1969

Hepatic collagenolytic activity in rats after carbon tetrachloride poisoning.

1. Collagenolytic activity towards acid-soluble collagen labelled with [(14)C]-proline was assayed in rat liver with and without carbon tetrachloride poisoning. The products of enzymic digestion were found to be free amino acids and peptides. 2. The hepatic collagenolytic activity increased under conditions of single-dose and subacute carbon tetrachloride poisoning, and correlated with hydroxyproline content. The highest activity was found during recovery from subacute poisoning. 3. Under the same experimental conditions, hepatic acid-proteinase activity changed independently of the collagenolytic activity and also of hepatic hydroxyproline content. 4. The increased collagenolytic activity during carbon tetrachloride poisoning was found mainly in the supernatant fraction. 5. The ratio of the collagenolytic activity to hepatic hydroxyproline content increased during recovery from single-dose and subacute poisoning, and decreased during subacute poisoning.

Animals↗
PubMedDate not supplied

Oral contraceptive-dependent growth of focal nodular hyperplasia.

A 22 year old woman was incidentally found to have a hepatic small haemangioma-like mass, measuring 1.4 cm in diameter, by an ultrasonographic examination. The mass demonstrated no change in size or appearance for 6 months until the patient began to take oral contraceptives. Eventually, the mass increased to 2.0 cm in diameter after using oral contraceptives for 6 months. A histological examination suggested the mass to be typical focal nodular hyperplasia, and not hepatic adenoma. There was no further change in either size or appearance in the ensuing 1 year after the discontinuation of oral contraceptives.

Adult↗
PubMedDate not supplied

Rise of plasma myeloperoxidase during interferon therapy.

The plasma myeloperoxidase (MPO) level was evaluated using a specific radio-immunoassay (RIA) for MPO in alpha 2b-interferon (IFN)-treated patients with chronic viral hepatitis. The plasma MPO was checked before and after the initial 2 weeks use of IFN at a dose of 6 x 10(6) U/day. The mean concentration of plasma MPO was found to be markedly higher after IFN therapy than that before the therapy (421.7 +/- 34.3 vs 242.9 +/- 23.0 ng/mL, P < 0.001). The plasma MPO negatively correlated with the granulocyte count (r = -0.37, P < 0.02) and the platelet count (r = 0.49, P < 0.01, while it positively correlated with serum alkaline phosphatase (ALP; r = 0.41, P < 0.03). The plasma MPO also showed a strong correlation with plasma polymorphonuclear granulocyte elastase (PMN elastase; r = 0.73, P < 0.001). Our study thus suggests that the increased release of MPO from destroyed granulocytes is responsible for the high concentrations of the plasma MPO in patients during IFN therapy, because the plasma MPO, PMN elastase and ALP abundant in granulocytes all increased in spite of a decrease in the granulocyte count. Granulocytopenia during IFN therapy may therefore be due to the increased destruction of granulocytes in addition to a direct suppression of the bone marrow by IFN.

Agranulocytosis↗
PubMedDate not supplied

Elimination of iomeprol in patients undergoing continuous ambulatory peritoneal dialysis.

OBJECTIVE: To examine the elimination of iomeprol, its safety in clinical use, and its peritoneal permeability in continuous ambulatory peritoneal dialysis (CAPD) patients with variable degrees of residual renal function (RRF). DESIGN: A nonrandomized comparison study. SETTING: Hospitalized patients in CAPD unit of Chikuho and University Hospitals. PARTICIPANTS: Fourteen patients treated by CAPD and 6 by hemodialysis (HD). INTERVENTIONS: Total dialysate, blood, and 24-hour urine collections were obtained for 4 consecutive days after the administration of iomeprol. A peritoneal equilibration test was performed just before and after the administration of iomeprol. MEASUREMENTS: Iomeprol (iodine) concentration was measured. Residual renal function was estimated as the mean of renal creatinine and urea clearances. Dialysate-to-plasma ratios (D/P) of creatinine and iomeprol were also determined. RESULTS: In all CAPD patients, plasma iomeprol clearance was markedly slow, with a biological half-life (T1/2) of over 32 hours. However, no patients suffered from any adverse effects, and over 80% of plasma iomeprol was eliminated during the 4-hour HD. The plasma iomeprol elimination rate was significantly higher from 4 hours after the iomeprol administration in CAPD patients with RRF [mean estimated creatinine clearance (CCr) 3.8 mL/min, n = 7] compared to the remaining patients (mean estimated CCr 0.6 mL/min, n = 7); however, T1/2 in patients with RRF was over 24 hours. D/P creatinine was significantly correlated with D/P iomeprol, and peritoneal iomeprol permeability may depend on an individual's peritoneal solute transport properties. CONCLUSIONS: A prolonged elimination rate of iomeprol was documented in our CAPD patients both with and without RRF. A HD procedure or intensive peritoneal dialysis just after the use of iomeprol may be advisable to promptly remove circulating iomeprol.

Contrast Media↗
PubMedDate not supplied

Predictors of the efficacy of intravenous natural interferon-beta treatment in chronic hepatitis C.

INTRODUCTION: Several pretreatment factors have been reported to be useful in predicting patients with a high probability for a sustained response to IFN-alpha treatment, however, predictors of the efficacy of interferon-beta treatment in chronic hepatitis C have not been fully assessed. MATERIAL AND METHODS: To clarify this issue, a prospective study of 52 patients with chronic hepatitis C was conducted. Patients were treated with human natural interferon-beta by drip infusion at doses of 6 MU/day for 8 weeks. The following characteristics were compared between patients with sustained response (SR) and no response (NR): gender, age, source of HCV infection, mean pretreatment serum ALT levels, liver histology, pretreatment serum HCV-RNA levels and HCV genotype. RESULTS: Seventeen of 52 patients (32.7%) demonstrated SR. The proportion of patients with undetectable HCV-RNA levels determined by branched DNA assay (< 0.5 x 10(6) eq/ml) was higher in patients with SR than in those with NR (88.2% vs. 22.9%; p = 0.0001). Pretreatment HCV RNA levels determined by multicyclic reverse transcriptase polymerase chain reaction were lower in patients with SR than in those with NR (10(5.1 +/- 1.5) vs. 10(7.1 +/- 1.3) copies/ml; p = 0.0001). The rate of SR was higher in patients with genotype 2a or 2b than in genotype 1b (43.8% vs. 15.0%; p = 0.0382). Multivariate stepwise logistic regression analysis showed that a younger age and low pretreatment serum levels of HCV RNA were independent predictors of SR to treatment. This prospective study demonstrated that a younger age, low pretreatment viral load and HCV genotype 2a or 2b were factors influencing the SR to interferon-beta treatment, but a younger age and low pretreatment viral load were most important predictors of the efficacy of the treatment.

Adolescent↗
PubMedDate not supplied

Rapid decline of residual renal function in patients on automated peritoneal dialysis.

OBJECTIVE: To determine the effect of peritoneal dialysis modalities such as nightly intermittent peritoneal dialysis (NIPD), continuous cyclic peritoneal dialysis (CCPD), and continuous ambulatory peritoneal dialysis (CAPD) on residual renal function. DESIGN: A six-month prospective, nonrandomized comparison study. SETTING: Outpatient CAPD unit of a university hospital. PARTICIPANTS: Eighteen end-stage renal disease patients treated by peritoneal dialysis (8 by NIPD, 5 by CCPD, and 5 by CAPD). INTERVENTIONS: Samples from the total dialysate, blood, and 24-hour urine collection were obtained monthly. MEASUREMENTS: Urea, creatinine, and beta2-microglobulin concentrations were measured. Renal and peritoneal clearances of each substance and KT/V urea were calculated. Residual renal function (RRF) was estimated by renal creatinine clearance (RCcr). RESULTS: No significant differences in age, sex, and primary renal disease among the three groups were noted. In all groups, anemic and hypertensive states were controlled identically, and mean weekly total (renal + peritoneal) KT/V urea (over 2.1/wk) and total creatinine clearance (over 60 L/wk/1.73 m2) were maintained during the whole experimental period. Starting mean RCcr was near 4.0 mL/min/1.73 m2 in all groups. Thereafter, a rapid and significant decline in RRF was demonstrated on NIPD and CCPD. The declining rates of RCcr values at 6 months after starting NIPD and CCPD were -0.29 and -0.34 mL/min/month, respectively, which were much greater than those of CAPD (+0.01 mL/min/month). CONCLUSION: Because of a possibly characteristic progressive loss of RRF in automated peritoneal dialysis (APD), strict regular assessment of RRF should be performed from the start of APD.

Adult↗