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Biomedical subjects

K Kamiya

Publications and source records attributed to K Kamiya.

At least 271 records · Page 15Linked to original sources
PubMed1988

Management of elderly patients with aneurysmal subarachnoid hemorrhage.

A total of 299 patients with aneurysmal subarachnoid hemorrhage (SAH) were classified into three age groups, that is, those aged 59 years or younger (Group 1: 159 patients, 53%), those aged 60 to 69 years (Group 2: 85 patients, 28%), and those aged 70 years or older (Group 3: 55 patients, 18%). A comparison was made of the surgical indications and their overall management outcome in these age groups. The overall outcome at 1 year after SAH of Group 3 was significantly poorer than that of Group 1 (p less than 0.01) or Group 2 (p less than 0.01), but no significant difference could be demonstrated between Groups 1 and 2. Overall, 104 of the 299 patients died, for a mortality rate of 35%. The mortality rate by age group was 29% for Group 1, 33% for Group 2, and 55% for Group 3. Surgery was performed on 122 patients (77%) in Group 1, 56 (66%) in Group 2, and 25 (45%) in Group 3. The overall operative outcome at 1 year after SAH in Group 3 was significantly poorer than that of Group 1 (p less than 0.01), but no significant difference was observed in this regard between Groups 1 and 2. The operative mortality rate of the patients in Groups 1, 2, and 3 who were preoperatively in Hunt and Hess Grades I and II was 1%, 7%, and 22%, respectively (no significant difference). By life-table analysis the 5-year survival probability was 65% for Group 1, 60% for Group 2, and 37% for Group 3. The rate of patients surviving in good condition or in a disabled but independent condition at 1 year after SAH was 93% and no statistically significant difference in survival probability was observed among the three age groups.

Aged↗
PubMed1988

[Cranial metastasis of hepatocellular carcinoma: case report].

A case of cranial metastasis of hepatocellular carcinoma is reported. A 62-year-old man was admitted due to an elastic hard tumor in the left occipital region. On admission, neurological findings were normal and general condition was good. However, liver function was moderately abnormal. Plain craniography showed osteolytic change in the left occipital region. Computerized tomography showed bone destruction and well circumscribed high-density tumor in the left occipital region. The margin of the tumor was strongly enhanced. Left common carotid angiography revealed a hypervascular mass which was fed by the left occipital artery and the left posterior meningeal artery. A total removal of the tumor was performed, and histological diagnosis was cranial metastasis of hepatocellular carcinoma. The postoperative course was uneventful, and the patient was under medical treatment for the primary lesion.

Carcinoma, Hepatocellular↗
PubMed1988

[Studies on the clinical significance concerning the changes in serum pepsinogen-I and gastrin levels in aged patients with chronic gastritis].

Of 86 cases of aged patients with chronic gastritis treated with Trimebutine or Flutazolam, we evaluated the changes of serum pepsinogen-I and gastrin levels in their clinical courses from the points of the correlation with severity of chronic gastritis, aging phenomenon and the changes of symptom and endoscopic findings. In order to elucidate the multidimensional interrelation among these items, we used Hayashi's quantification theory II as a conventional analysis method. In aged patients, generally, although the serum gastrin levels were rather high compared with younger generation, the serum pepsinogen-I levels were consistently low throughout their clinical courses. There were some correlation between the levels of serum gastrin and the severity of chronic gastritis. When the drugs were effective on improving the condition of the disease, the level of gastrin revealed gradual decrease. These changes of gastrin were more typical in patients treated with Trimebutine.

Aged↗
PubMed1988

[A case of ruptured mycotic cerebral aneurysm associated with repeated arterial narrowing and remission].

The patient is a 23-year-old male in whom aortic valve regurgitation was pointed out at the age of about 13. From July 26, 1985 he developed a high fever of 39.7 degrees C and on August 5 he suddenly became unconscious with left hemiparesis. On August 10, his consciousness became further disturbed and he was admitted to this Department on the following day. Computed tomographic scan showed subarachnoid hemorrhage and a low density area in the right temporoparietal lobe. Carotid angiography (CAG) revealed an aneurysm 10 mm in size at the end of the horizontal portion of the right middle cerebral artery (MCA) and severe narrowing of the arteries, mainly the right MCA. A mycotic aneurysm due to bacterial endocarditis was diagnosed. In the CAG conducted on August 14, aneurysm had been almost disappeared, but arterial narrowing had been further increased. On September 4, there was a remission of the narrowing, but the aneurysm could again be visualized to be 7 mm in size, which increased to 14 mm on September 20. A neck clipping of the aneurysm and an aneurysmectomy were performed on September 27. Operative findings showed degeneration and thickening of the walls of the aneurysm and arteries with inflammatory reaction. An arterial blood culture conducted at the time of a recurrence of bacterial endocarditis demonstrated non-hemolytic Streptococcus. CAG conducted on November 1 showed remarkable narrowing of the right MCA, but CAG performed on April 1, 1986 showed the narrowing to be alleviated. There is a danger of rupture in mycotic aneurysm due to bacterial endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Rebleeding of ruptured intracranial aneurysms in the acute stage.

We analyzed early aneurysmal rebleeding in 150 consecutive patients who suffered an aneurysmal subarachnoid hemorrhage (SAH) and who were admitted within 6 hours of the initial SAH. Of these patients, 33 patients rebled. The first rebleed occurred within 24 hours in 29 patients, among whom 23 cases rebled within 6 hours. The rebleeding rate within 6 hours after the initial SAH was not related to age or sex of the patient; blood pressure on admission; size, shape, or site of aneurysm; or presence or absence of intracerebral hematoma or intraventricular hemorrhage on computed tomography (CT) scan. The patients' clinical condition and SAH on CT scan were graded I-V. Evaluation of rebleeding of those patients with grade V was difficult. In examining the rebleeding rate in grades I-IV, the higher the grade, the greater the rebleeding. Rebleeding developed during angiography conducted within 6 hours from the initial SAH in four cases. This is approximately twofold higher than the rebleeding rate within 6 hours for the total series. It is concluded that rebleeding in the acute stage is predominant within 6 hours from the initial SAH and that this rebleeding rate is higher the more severe the initial SAH is.

Acute Disease↗
PubMed1987

Carcinogenic and co-carcinogenic effects of radiation in rat mammary carcinogenesis and mouse T-cell lymphomagenesis: a review.

The importance of the promotion stage and of the physiological condition of target cells at the time of initiation is illustrated in both the rat mammary carcinogenesis and the mouse T-cell lymphomagenesis. In the former, prolactin was shown to be a powerful promoter regardless of the initiating agent. Prolactin was also found to be useful in detecting the carcinogenicity of the small doses of carcinogens; a high r.b.e. of 2.0 MeV fission spectrum neutrons was demonstrated by the application of prolactin to radiation-initiated mammary carcinogenesis in rats. In the latter, total-body irradiation involving both bone marrow and thymus facilitates chemically-initiated T-cell lymphomagenesis in mice. This could be attributed to the amplification of the cell population susceptible to a chemical carcinogen in the target tissue during the recovery phase after irradiation. The dual effect of a carcinogen, acting in the different phases of carcinogenesis was suggested by the split administration of N-nitrosoethylurea (NEU) in the induction of T-cell lymphomas. It is emphasized, through these findings, that besides the initiation by a genotoxic agent, the availability of a promoter or an inhibitor determines the fate of initiated cells, and that a modifier of target cells also plays a crucial role in the efficient induction of a tumour.

Animals↗
PubMed1987

Modification of expression of the malignant phenotype in radiation-initiated cells.

Carcinogenesis is a multistage process consisting minimally of initiation and promotion/progression stages. Radiation and many environmental xenobiotics are potent initiating agents. We have shown that initiation of carcinogenesis in vivo by these agents is a common cellular event. In the irradiated thyroid (5 Gy) at least one in 20 cells is initiated. Initiation by both radiation and chemicals has also been shown to be a common cellular event in the mammary gland. Initiation therefore is most likely not the sole rate-limiting event in the carcinogenic process. The propensity of the initiated cell to express the malignant phenotype is modulated by many factors, including environmental chemicals and physiological and genetic factors. Scopal and abscopal physiological factors can either enhance or suppress the progression of initiated cells to a frank tumour. For example, prolactin enhances the rate of progression of radiation and chemically initiated mammary tumours while glucocorticoids suppress this progression. TSH enhances the progression of radiation-initiated thyroid tumours while a scopal factor associated with unirradiated thyroid cells suppresses progression of this tumour type.

Animals↗
PubMed1987

Frequency- and voltage-dependent effects of aprindine on the upstroke velocity of action potential in guinea pig ventricular muscles.

The effects of aprindine on transmembrane action potentials were examined in isolated papillary muscles of guinea pig. Aprindine (10(-6)-10(-5) M) caused a dose-dependent decrease in the Vmax of the action potential without affecting the resting potential. In the presence of aprindine, trains of stimuli at rates greater than 0.1 Hz led to an exponential decline in Vmax. This use-dependent block was enhanced at the higher stimulation frequency. The time constant for the recovery of Vmax from the use-dependent block (offset) was 6.2-7.8 s. In depolarized papillary muscles with high [K+]o, the inhibitory action of aprindine on Vmax after a long quiescent period (tonic block) was augmented markedly, but the rates of onset and offset of the use-dependent block were similar to those in normally polarized preparations. The curves relating membrane potential and Vmax were shifted by 7.3 mV with aprindine at 3 X 10(-6) M in the direction of more negative potentials. These findings suggest that aprindine has quinidinelike use-dependent inhibitory action on the fast sodium channels of cardiac muscles. This use-dependency and its greater inhibition of Vmax in depolarized muscles through the augmentation of tonic block may play a major role for the drug action to prevent ventricular arrhythmias.

Action Potentials↗
PubMed1987

"Giant pneumoaneurysm" after combined internal carotid artery occlusion and extracranial-intracranial anastomosis.

A patient with a giant aneurysm of the internal carotid artery (ICA) was treated by combined ICA occlusion in the neck and superficial temporal artery to middle cerebral artery anastomosis. Six months after complete closure of the ICA, the patient had episodes of nasal discharge mixed with dark red, old blood. Computed tomographic scan demonstrated that the lumen of the giant aneurysm was filled with a large amount of air, which communicated with the nasal cavity. Not finding a similar case in the literature, we named this entity "giant pneumoaneurysm." After direct operation, the giant pneumoaneurysm collapsed. This unusual complication may be due to a decrease of blood supply to the aneurysmal wall through the vasa vasorum.

Adult↗