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Biomedical subjects

K Kawashima

Publications and source records attributed to K Kawashima.

At least 109 records · Page 6Linked to original sources
PubMed1999

[Actual situations and problems of patients receiving home IVH--trial use of an assessment chart for outpatients].

In order to improve the quality of life (QOL) and continue nursing, we used an assessment chart to investigate the actual situations and problems of the patients receiving home intravenous hyperalimentation (IVH). From January, 1997 to June, 1999, we investigated 20 patients with home IVH. To 7 patients among them, we asked questions using Kurihara's assessment chart for QOL, plus our original questions concerning IVH. The mean age of the patients was 61 years old, and 19 of them had advanced cancers. Forty percent of the patients maintained the IVH all by themselves and 10% of the patients needed the support of their family. The remaining 50% of the patients left all to their family. There were 9 incidents of trouble during the maintenance of the IVH. Almost all patients from whom informed consent had been received were satisfied with the home IVH. On the contrary, all patients who had not given informed consent were not satisfied with the home IVH. According to the results of the assessment chart, even if the total points were low, the points for the IVH were high in the patients had given informed consent. The main reason for lower QOL was pain. The points for the families were lower than those for the patients. They sometimes complained of uneasiness and dissatisfaction with the support they received. We conclude that therapies to improve symptoms and mental state are necessary to satisfy the patients, and that it is important to support not only the patients but also their families.

Adult↗
PubMed1999

[Prognosis and organ preservation in oropharyngeal cancer treated with radiotherapy].

The records of 102 patients with squamous cell carcinoma of the oropharynx treated at National Sapporo Hospital with external and/or interstitial radiotherapy between 1978 and 1996 were reviewed to evaluate the treatment results, focusing on primary control and functional preservation. Ninety-five patients had been primarily treated with curative intent initially. Of these 95 patients, 4% were in stage I, 19% in stage II, 42% in stage III and 34% in stage IV. Twenty-one patients (22%) had been treated with multidisciplinary chemotherapy, and 19 patients (20%) had been boosted with brachytherapy mainly using Au-198 grains. The cause-specific survival rates at 5 and 10 years were 63% and 52%, respectively. The local control rates at 5 and 10 years were 70% and 51%, respectively. The most important factors affecting local control were the subsite of the primary tumor and N stage. Based on these findings, it is considered that radiotherapy combined with/without chemotherapy except for N3 and the posterior wall type is an effective method of achieving tumor control and preserving organ function, compared with other methods including surgical procedures.

Adult↗
PubMed1999

Acute myeloid leukemia in the elderly:--159 Nagoya case studies--Nagoya Cooperative Study Group for Elderly Leukemia.

To obtain background information on elderly acute myeloid leukemia (AML), unselected data covering 159 patients aged 60 years or over with AML from 14 hospitals in Nagoya, Japan was analyzed retrospectively. Among these patients, 119 had de novo acute AML, 32 had AML which evolved from myelodysplastic syndrome (MDS-AML), and 8 had other types of leukemia. The survey showed that MDS-AML tended to be more prevalent in patients aged 70 years and older and that MDS-AML showed a significantly more severe degree of leukopenia and anemia than de novo AML. MDS-AML also showed a significantly lower complete remission (CR) rate than that of de novo AML [6.9% (2/29) vs 58.3% (67/11), P < 0.01] and significantly shorter survival times than those of de novo AML [median: 3.6 months vs 9.6 months, P < 0.01 (generalized Wilcoxon test; GW]. In de novo AML, the proportion of patients treated with conventional therapy (CT group) decreased significantly, and that of those with attenuated therapy (AT group) increased significantly as age elevated (P < 0.01). The CT group showed a significantly higher CR rate (65.4% vs 41.2%, P < 0.05) and a significantly longer survival period than those of the AT group [median: 11.6 months vs 4.8 months, P < 0.05 (GW)]. Overall survival rates of the older age groups became significantly shorter with aging [P < 0.01 (GW)].

Acute Disease↗
PubMed1998

Further evaluation of developmental toxicity of di-n-butyl phthalate following administration during late pregnancy in rats.

The objective of this study was to further evaluate the developmental toxicity of di-n-butyl phthalate (DBP) administered during the second half of pregnancy. Pregnant rats were fed a diet containing DBP at a dose of 0 (control), 0.5, 1.0 or 2.0% ad libitum on days 11-21 of pregnancy. Average daily intakes of DBP were 331, 555 and 661 mg/kg for the 0.5, 1.0 and 2.0% groups, respectively. No significant changes induced by DBP were detected in the incidence of postimplantation loss and numbers of live fetuses and of resorptions and dead fetuses. The weights of male and female fetuses at 2.0% DBP were significantly decreased. The incidences of fetuses with cleft palate and fetuses with fusion of the sternebrae at 2.0% DBP and fetuses with undescended testes at 1.0 and 2.0% DBP were significantly increased. There were significant decreases in the anogenital distance (AGD) of male fetuses in the 1.0 and 2.0% DBP groups, also. AGD of female fetuses in the DBP-treated groups was comparable to that in the control group. It was concluded that DBP administered during the second half of pregnancy produced adverse effects on the reproductive development in male fetuses.

Abnormalities, Drug-Induced↗
PubMed1998

[Huge localized mesothelioma of the diaphragm in a 17-year-old female--a case report with calculated tumor volume doubling time].

An operative case of localized mesothelioma of the pleura developed in a 17-year-old female was reported. She was admitted to our hospital complaining of right chest pain. A chest X-ray film showed a huge mass in the right lower field of the lung. After the embolization of the right inferior phrenic artery, which was the main feeder to the tumor, it was then successfully resected combined with the right diaphragm and the right lower lobe of the lung. Histologically, the tumor was diagnosed as benign localized mesothelioma (solitary fibrous tumor of the pleura). Further histological and immunohistochemical study revealed that it had developed from the connective tissue under the parietal mesothelium of the diaphragm. As chest roentgenograms had been undertaken during past two years, the tumor volume doubling time was calculated at 153 days. Despite the short tumor volume doubling time as like primary lung cancer, she is alive without recurrence 5 years after the operation.

Adolescent↗
PubMed1998

Fibrin glue sandwich prevents pancreatic fistula following distal pancreatectomy.

Pancreatic fistula is a major form of morbidity following pancreatic resection. We conducted a nonrandomized clinical trial comparing the sealing and sandwich techniques of spraying fibrin glue to prevent pancreatic fistula following distal pancreatectomy. The pancreas was transected with a scalpel to identify and suture the main pancreatic duct and its small branches. In the sealing group, fibrin glue was sprayed over the closed pancreatic stump and sutures. Alternatively, in the sandwich group fibrin glue was sprayed so as to cover and join the cut surface of the pancreatic remnant, which was then held closed with sutures. Altogether 111 patients were included in the study (90 with gastric cancer, 10 with esophageal cancer, and 11 with pancreatic cancer). Patients were nonrandomly assigned to the sandwich or the sealing group. Morbidity was 21.8% for the patients in the sandwich group versus 33.9% in the sealing group. Pancreatic fistulas occurred in 9.0% of the sandwich group versus 26.8% of the sealing group. The incidence of fistula was thus significantly lower in the sandwich group. The incidence of fistula was also significantly lower in the sandwich group for gastric malignancy patients undergoing extended radical lymphadenectomy down to the paraaortic lymph nodes combined with left adrenalectomy. Of the patients with gastric malignancy, pancreatic fistulas occurred in 9.3% of the sandwich group versus 25.5% of the sealing group. The fibrin glue sandwich technique is simple and reliable and should be valuable for complementing other prophylactic methods of preventing pancreatic fistula.

Adult↗
PubMed1998

Staging and treatment for patients with pancreatic cancer. How small is an early pancreatic cancer?

To determine the tumor size that constitutes early pancreatic cancer, we reviewed and analyzed the English-language and Japanese literature (a total of 25 publications) on small pancreatic cancers less than 2 cm in diameter and/or stage 1 cancers. Reports on in situ carcinoma and intraductal carcinoma of the pancreas were also evaluated. The results were: (1) A total of 302 cases of small pancreatic cancer less than 2 cm in diameter reported at separate institutions were pooled from 15 reports. The rates for patients in stage I and those with no lymph node metastasis averaged 41.7% and 57.9%, respectively. The 5-year postoperative cumulative survival rate (5Y-PCR) was less than 50% in almost all these reports. Similar data were shown in the 7 collective reviews. (2) Another 33 cases of small pancreatic cancer of 1 cm or less in diameter were collected from three reports. The rates for stage I tumor and 5Y-PCR at one institution with two reports were 100% and 100% and the rates in the other report were 85% and 78%, respectively. (3) Twelve cases of in situ carcinoma and intraductal carcinoma of the pancreas were collected from four reports. All of the patients were stage I and were alive with no evidence of tumor recurrence for periods ranging from 6 to 78 months. Small pancreatic cancer less than 1 cm in diameter is better viewed as an early pancreatic cancer, and in situ carcinoma and intraductal carcinoma of the pancreas with minimal invasion to the pancreatic parenchyma may be defined as early pancreatic cancer, regardless of size.

Carcinoma↗
PubMed1998

Acetylcholine synthesis and muscarinic receptor subtype mRNA expression in T-lymphocytes.

We used a sensitive and specific radioimmunoassay for acetylcholine (ACh), and detected significant amounts of ACh in the blood of various mammals, including humans. About 60% of human blood ACh was localized in mononuclear leukocytes. Human leukemic T-cell lines, used as T-lymphocyte models, contained both ACh and choline acetyltransferase (ChAT) activity. Furthermore, ChAT mRNA and protein were detected in the T-cell line MOLT-3. Phytohemagglutinin, a T-cell activator, increased both synthesis and release of ACh by MOLT-3 cells. Muscarinic receptor subtype mRNA expression was confirmed in various T-cell lines. These findings indicate that ACh synthesized by ChAT in T-lymphocytes acts on the muscarinic receptors on lymphocytes in autocrine and/or paracrine pathways and suggest that ACh in blood functions as a modulator of T-cell-dependent immune responses.

Acetylcholine↗
PubMed1998

Rat lymphocytes produce and secrete acetylcholine in dependence of differentiation and activation.

Previous data from this laboratory suggested for the first time that immune cells of the immune system of different species are capable to synthesize the neurotransmitter acetylcholine. In the present study we detected the RNA message for choline acetyltransferase in thymic, splenic and peripheral blood lymphocytes of rats using RT-PCR. Furthermore, using a sensitive radioimmunoassay, we measured acetylcholine in thymic, splenic and peripheral blood lymphocytes. T-cells were found to contain about three times the amount of acetylcholine as compared to B-cells, and CD4+ cells showed significantly higher levels as compared to CD8+ cells. Mitogenic stimulation with PHA increased the acetylcholine levels in lymphoid cells as well as the release into the supernatants.

Acetylcholine↗
PubMed1998

Effect of WAY-100135 on the hippocampal acetylcholine release potentiated by 8-OH-DPAT, a serotonin1A receptor agonist, in normal and p-chlorophenylalanine-treated rats as measured by in vivo microdialysis.

The mechanisms involved in the enhancement of acetylcholine (ACh) release in the rat hippocampus by 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT), a serotonin (5-HT)1A receptor agonist, were investigated using in vivo microdialysis. Administration of p-chlorophenylalanine (PCPA, 300 mg/kg, i.p.), a tryptophan hydroxylase inhibitor, 3 days before the dialysis experiments reduced the hippocampal 5-HT content to 30% of that in saline-treated rats, but did not affect basal ACh release in the hippocampus. 8-OH-DPAT administered systemically (0.5 mg/kg, s.c.) or applied locally (30 microM) into the hippocampus through the dialysis probe significantly enhanced the release of ACh in the hippocampus of PCPA-treated rats to the same degree as that in saline-treated rats. Pretreatment with (+)WAY-100135 (5 mg/kg, i.p.), a selective 5-HT1A receptor antagonist, completely eliminated the enhancement of ACh release induced by locally applied 8-OH-DPAT, but only partially reduced the effects induced by systemically administered 8-OH-DPAT, in both groups of rats. Systemically administered 8-OH-DPAT induced hyperlocomotion in the both saline- and PCPA-treated rats, but this was not eliminated by (+)WAY-100135. 8-OH-DPAT applied locally into the hippocampus did not elicit hyperlocomotion in either group of rats. These results suggest that the modification of endogenous 5-HT release via the 5-HT1A autoreceptor is not involved in the 8-OH-DPAT-induced increase of hippocampal ACh release, and that the increase of ACh release induced by locally applied 8-OH-DPAT involves mainly hippocampal postsynaptic 5-HT1A receptor stimulation. In addition, a possibility that subtypes of 5-HT receptors other than the 5-HT1A receptor, probably 5-HT7 receptor in the septum as well as postsynaptic 5-HT1A receptor in the hippocampus, are involved in the increased hippocampal ACh release induced by systemically administered 8-OH-DPAT is discussed.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1998

Orthokeratinized odontogenic cyst: a clinicopathological and immunocytochemical study of 15 cases.

AIMS: Intraosseous jaw cysts with a solely orthokeratinized lining epithelium have been suggested to differ from the typical odontogenic keratocysts (OKC) by exhibiting a less aggressive behaviour. We report 15 cases of such cyst type under the term of 'orthokeratinized odontogenic cyst (OOC)' and compared their clinical, histological and immunocytochemical features with that of OKC. METHODS AND RESULTS: The cysts of the present series were all solitary lesions, occurred mostly in young male patients, and showed a predilection for the posterior mandible areas. Follow-up of 14 patients, nine of whom were treated by simple enucleation, revealed no recurrence over a period of 3.5-12 years after surgery. None of the patients had any association with the naevoid basal cell carcinoma syndrome. Furthermore, histological and immunocytochemical comparison between OOC and OKC revealed marked differences in their morphology and epithelial expression. The lining epithelium of OOC lacked the typical features of OKC and appeared to show a lower proliferative activity. CONCLUSION: These findings suggest that OOC is clinicopathologically separate from other types of odontogenic cysts and may thus constitute a distinct clinical entity.

Adult↗
PubMed1998

Role of buttress reconstruction in zygomaticomaxillary skeletal defects.

The purpose of this study was to review eight patients undergoing midfacial skeletal reconstruction following extensive resection of tumors based on the principles of restoration of three maxillary buttresses, the nasomaxillary, zygomaticomaxillary, and pterygomaxillary. The zygomaticomaxillary skeletal defects were reconstructed with a three-dimensionally contoured piece of titanium mesh, vascularized costal cartilage, or vascularized bone flap of scapula and rib. Restoration of the zygomaticomaxillary buttress prevented the inferior deviation of the orbit and provided good zygomatic contour. Restoration of the nasomaxillary buttress prevented the superior and posterior deviation of the alar base of the nose, and restoration of the pterygomaxillary buttress prevented the superior and posterior deviation of the upper lip. Combination of the V-shaped scapular bone and the rib flap based on the thoracodorsal vascular system, which provides simultaneous reconstruction of all three buttresses, is a very versatile technique for reconstruction of extended midfacial skeletal defects. In this series, both of the patients reconstructed with titanium mesh presented with late persistent cutaneous fistulas. We now recommend a vascularized autologous soft and bony tissue reconstruction for midfacial composite defects.

Adult↗
PubMed1998

Enteric lesions induced by different pseudorabies (Aujeszky's disease) virus strains inoculated into closed intestinal loops of pigs.

Three different strains of pseudorabies (Aujeszky's disease) virus were inoculated into ligated closed loops in the jejunum and ileum of five specific-pathogen-free pigs. Infected areas were compared with respect to distribution of histologic lesions and pseudorabies virus antigen. Two wild-type strains of pseudorabies virus produced enteric lesions consisting of necrosis of the subepithelial macrophages in the basilar crypt epithelium, necrosis of the lymphoid follicles in the Peyer's patches, degeneration of the epithelial cells in the crypt and villi, degeneration of the neuronal cells in the myenteric plexuses, and formation of intranuclear inclusion bodies on postinoculation days 2-4. Pseudorabies virus antigen was initially detected in subepithelial macrophages of the dome of Peyer's patches on postinoculation day 2 and subsequently extended to superficial epithelium and deeper into the lymphoid follicles and myenteric plexuses on postinoculation days 3-4. Many pseudorabies virus particles were also detected in the center of their necrotic foci. However, 1 mutant strain (ara-T-resistant) of pseudorabies virus did not produce enteric lesions. The results suggest that the primary target of infection by wild-type strains of pseudorabies virus might be the macrophages distributed in the subepithelial area of the dome Peyer's patches.

Animals↗
PubMed1998

Stimulative effect of high-level hypergravity on differentiated functions of osteoblast-like cells.

The exposure of freshly isolated osteoblasts and osteoblast-like cells to high-level hypergravity caused the inhibition of cell growth, elevation of cAMP content, and the stimulation of differentiated functions such as alkaline phosphatase activity, collagen synthesis, and osteocalcin synthesis. Blockage of elevation of cAMP by SQ22536, an inhibitor of adenylate cyclase, resulted in the inhibition of the hypergravity-stimulated alkaline phosphatase activity, indicating that cAMP is the intracellular mediator of this action of hypergravity. H89, an inhibitor of cAMP-dependent protein kinase (PKA), further inhibited the cell growth that was already inhibited by the hypergravity, and further stimulated the alkaline phosphatase activity that was already stimulated by hypergravity. If cAMP acts through the PKA system, H89 should have blocked the changes in cell function effected by the exposure to hypergravity. Therefore the elevated intracellular cAMP by the exposure of hypergravity caused the changes in cell function by a PKA-independent pathway.

Adenine↗
PubMed1998

[Clinical evaluation for radiotherapy of metastatic brain tumors in lung cancer: prognostic analyses relevant to QOL].

From 1986 through 1992, 144 patients with metastatic brain tumors of lung cancer were treated with X-ray irradiation to whole brain or a comparatively wide field of the brain. To identify the subset of patients indicated for boost therapy like a stereotactic radiotherapy, we have analyzed the treatment results concerning both survival and performance status (PS). Median survival time of the patients in good PS (0-2) was 6.7 months, which was significantly better than 2.3 months in poor PS (3-4). Complete tumor-resectability, age, steroid therapy and condition within two months after the beginning of brain irradiation, seemed to be important prognostic indicators correlated with PS by both univariate and multivariates analyses.

Adolescent↗
PubMed1998

Effects of taltirelin hydrate (TA-0910), a novel thyrotropin-releasing hormone analog, on in vivo dopamine release and turnover in rat brain.

Effects of taltirelin hydrate (CAS 103300-74-9, TA-0910), a novel thyrotropin-releasing hormone (TRH) analog, on the cerebral monoamine systems, especially the release and turnover of dopamine (DA) in rat brain were compared with those of TRH by intraperitoneal administration. Taltirelin hydrate (1-10 mg/kg) increased the extracellular levels of DA and its metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the nucleus accumbens and corpus striatum for 3 h in a microdialysis study. TRH (30 mg/kg) also increased the levels of these substances, the potency of TRH being the same as that of taltirelin hydrate at doses of 1-3 mg/kg. Taltirelin hydrate (10 mg/kg) also caused an increase in 3-methoxytyramine (3-MT: DA metabolite) until 6 h after the treatment and L-3-dihydroxyphenylalanine (DOPA: precursor of DA and noradrenaline). Taltirelin hydrate also increased the 3-methoxy-4-hydroxyphenylglycol (MHPG: noradrenaline metabolite) level in the frontal cortex and hypothalamus, and 5-hydroxytryptophan (5-HTP: serotonin precursor) accumulation and 5-hydroxyindoleacetic acid (5-HIAA: serotonin metabolite) level in the nucleus accumbens or corpus striatum. These results suggest that taltirelin hydrate possesses not only an enhancing effect on DA release, but also a stimulating effect on the monoamine system. Moreover, these actions were 10-30 times stronger and also longer-lasting than those of TRH. In addition, the mechanisms of DA release induced by these drugs were different from those induced by methamphetamine.

5-Hydroxytryptophan↗
PubMed1998

[Advanced gastric cancer curatively resected following combined neoadjuvant chemotherapy--report of a case].

An advanced gastric cancer patient with T3N1M0 successfully underwent a curatively total gastrectomy combined with distal pancreatectomy and lymphnode dissection following ELF-P combined chemotherapy. The patient received two courses of etoposide (75 mg/m2, Day 1-5, i.v.), leucovorin (30 mg/body, Day 2-5, i.v.), 5-FU (500 mg/m2, Day 2-5, i.v.) and CDDP (60 mg/m2, Day 1, i.v.). A partial response for the primary lesion and lymphnode metastasis was obtained, and a successful curative resection of the stomach was performed. No drug adverse responses occurred. The effect of ELF-P chemotherapy was confirmed with grade 1b by histopathological examinations. Neoadjuvant chemotherapy with ELF-P may be useful as an inductive approach for advanced gastric cancer.

Adenocarcinoma↗