Transanal surgery with a new anal retractor and a stapler for tumours in the proximal rectum.
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Anal Canal↗
Biomedical subjects
K Maeda
Publications and source records attributed to K Maeda.
The inhibitory effect of TMK688, a novel anti-allergic drug having both 5-lipoxygenase inhibitory activity and anti-histamine activity, against bronchoconstriction, leukotriene production and inflammatory cell infiltration in sensitized guinea pigs.
BACKGROUND: TMK688 is being developed as an anti-allergic drug having both 5-lipoxygenase inhibitory activity and anti-histamine activity. METHOD: We compared the inhibition of the late asthmatic responses by TMK688 with that by other anti-allergic agents in actively sensitized guinea pigs, and examined the relationship between 5-lipoxygenase inhibition and the late asthmatic responses. RESULTS: At 1-3.2 mg/kg, TMK688 inhibited the increases in respiratory resistance, leukotriene (LT) B4 and C4 production in the lungs and eosinophil infiltration into the alveoli during the late asthmatic response, whereas the effects tended to lessen at the dose of 10 mg/kg. These effects are thought to be caused by the 5-lipoxygenase inhibitory activity of TMK688 because Azelastine, an anti-allergic drug having potent antihistamine activity, exhibited no effect. ONO-1078, a peptide LT antagonist, inhibited the late-phase bronchoconstriction at a dose of 100 mg/kg p.o., but not the increase in the infiltration of inflammatory cells into the alveoli, suggesting that the late-phase bronchoconstriction is induced, in part, by peptide LTs, i.e. LT C4, D4 and E4 and that the inflammatory cell infiltration may be caused by LTB4. TMK688 inhibited the immediate bronchoconstriction dose-dependently, and the effect was significant at a dose of 10 mg/kg orally. Since Azelastine, Ketotifen and Oxatomide suppressed the bronchoconstriction at far lower doses than did TMK688, the inhibitory effect was mainly caused by its antihistamine activity. CONCLUSIONS: TMK688 appears to be a novel anti-allergic drug having inhibitory effects on both the bronchoconstriction and the infiltration of inflammatory cells during late asthmatic responses.
Animals↗
[A ruptured aneurysm of the distal posterior inferior cerebellar artery associated with acute subdural hematoma of the posterior fossa: a case report].
We report a case of distal posterior inferior cerebellar artery (PICA) aneurysm associated with acute subdural hematoma (SDH). The patient was a 68-year-old female who was found unconscious at home and transferred to the emergency medical center in a state of deep coma. Her consciousness on admission to the center was 200P (Japan coma scale), E1V1M2 (Glasgow Coma Scale), and the Hunt & Kosnik grade was grade IV. She was in a state of decerebrate condition. Computed tomography (CT) scans revealed diffuse subarachnoid hemorrhage that was located mainly in the posterior fossa, as well as intraventricular hemorrhage in the third and fourth ventricles. It also disclosed an intracerebellar hematoma (ICH) of the vermis and an acute SDH of the left posterior fossa. The first cerebral angiographic examinations on admission demonstrated no aneurysm. However, emergency surgery was performed immediately in order to improve her poor condition. Ventricular drainage and removal of the acute SDH were carried out. Postoperatively, her consciousness improved gradually to 20P. Ventricular peritoneal shunt was performed three weeks later. Her consciousness improved up to 3P and she showed only slight truncal ataxia. She was admitted to our hospital for rehabilitation at two months after the first surgery. Repeated angiography was performed and demonstrated an aneurysm in the telovelotonsillar segment of the left PICA. The aneurysm was successfully clipped via a midline suboccipital approach. Her postoperative course was uneventful, and she continues to undergo rehabilitation. Aneurysms of the posterior fossa associated with acute SDH are extremely rare. Only two cases have been reported for distal PICA aneurysm cases. The CT scans in our patient revealed not only SAH but also SDH in the posterior fossa and ICH in the vermis. Over 100 cases of distal PICA aneurysms have been described in the literature. We analyzed the relationship between the portions with the ruptured aneurysms and CT findings. Aneurysms which were located at the proximal portion of the distal PICA mainly showed SAH and IVH. On the other hand, ICHs of the vermis and cerebellum were characteristic CT findings of ruptured aneurysms which were located more distal to the telovelotonsillar segment, and were evident in 14% of cases of such aneurysms. ICH and SDH were not found in aneurysms which were located in portions more proximal to the telovelotonsillar segment. These characteristic findings were related to the complex anatomical courses of the PICA. The distal portions of the PICA run between the vermis and cerebellar hemisphere, so that if an aneurysm ruptures at these portions, ICHs in the vermis and cerebellum tend to occur. In cases such as ours, because of the characteristic CT findings, effort to detect a distal PICA aneurysm should be made at first surgery, along with ventricular drainage and removal of the SDH. The surgical procedures and outcome of cases with distal PICA aneurysms are also discussed.
Aged↗
[An epidemiologic examination on the prevalence of the periodontal diseases and oral pigmentation in Yusho patients in 1996].
An epidemiologic examination was carried out to reveal the prevalence of the periodontal diseases and oral pigmentation in patients with Yusho 28 years after PCB exposure. The results obtained were as follows. 1) 162 teeth out of a total of 309 examined teeth had a periodontal pocket deeper than 3 mm, although 32 teeth out of 162 teeth had a periodontal pocket deeper than 4 mm. 2) Oral pigmentation was observed in 47 out of 82 patients with Yusho. It was particularly noteworthy that gingival pigmentation was observed at a much higher frequency in younger patients while pigmentation of the buccal mucosa, the lips or the palate was observed at a much higher frequency in older patients.
Adult↗
[Chinese herbs nephropathy in the Kansai area: a warning report].
In 1993, Vanherweghem and his associates reported cases of rapidly progressive renal interstitial fibrosis in young women who were administered a slimming regimen including Chinese herbs. Subsequently, similar cases have been reported. In Japan, especially in the Kansai area, several cases of Chinese herbs nephropathy have already been reported. We experienced a patient suffering from Chinese herbs nephropathy (CHN), and further detected aristolochic acids from the Chinese herbs taken by the patient. Aristolochic acids are known to be causative agents of CHN. The danger of CHN should be noted as soon as possible and drugs containing aristolochic acids should be prohibited.
Aristolochic Acids↗
[Large cystic neurinoma: a case report].
We report a case of large cystic acoustic neurinoma. A 52-year-old male was admitted to hospital with a history of progressive dysphagia, gait disturbance and diplopia for 2 months. On admission, neurological examinations revealed Bruns' type nystagmus to the left side, hypesthesia in the distribution of the second and third divisions of the left trigeminal nerve, and partial paresis of cranial nerves IX, X, and XII on the left side, and truncal ataxia. A pure-tone threshold audiogram indicated the presence of 32 dB hearing loss in the left ear. Speech discrimination was 80%. Caloric vestibular responses were absent on the left side. Skull radiographs with polytomographs of the internal auditory canal (IAC) were normal. Bony changes in the IAC were not found by high-resolution bone-window computed tomography (CT) scan. A plain CT scan revealed a large low-attenuated cystic mass in the left cerebellopontine angle (CPA), which was associated with displacement of the fourth ventricle. An enhanced CT scan demonstrated a thin rim-enhancement in the cyst wall. Magnetic resonance imaging (MRI) scans disclosed a large rim-enhanced cystic mass extending superiorly into the tentorial incisura and inferiorly into the foramen magnum. At surgery via a left suboccipital approach, a large cystic mass was found at the left CPA arising from the VIIIth nerve, and compressing the Vth, VIth, VIIth and lower cranial nerves. The cyst was filled with a xanthochromic fluid and was firmly attached to the internal auditory meatus (IAM). However no tumor extension into the IAM was confirmed. The tumor was excised completely. The postoperative course was uneventful, except for impairment of the VIIth and VIIIth nerves. At 6 months after the first operation, the facial nerve had improved up to grade III (Hause-Brackmann stage). Histological examinations revealed a typical benign acoustic neurinoma with predominant representation of Antoni B tissues. The cyst wall contained numerous abnormal sinusoid and telangiectasia-like vessels which showed occasional thromboses. The vessel walls displayed endothelial proliferations and were frequently hyalinized. Hemosiderin deposits and hemosiderin-containing phagocytes were also found near these vessels. Myxoid degeneration and necrosis were evident in vast areas. These degenerative changes appeared to be the principal causes of the large cystic formation. 16 cases including our case have been reported. The broad characteristics of the clinical symptoms and radiological findings of these tumors are discussed.
Humans↗
Structure-activity relationships of spontaneous nitric oxide releasers, FK409 and its derivatives.
(+/-)-(E)-4-Ethyl-2-[(E)-hydroxyimino]-5-nitro-3-hexenamide (FK409) shows both potent in vitro vasorelaxant and antiplatelet activities via nitric oxide (NO) generated spontaneously from the compound. In this study, we measured spontaneous NO-releasing rates of a series of FK409 derivatives, of which chain lengths or substituents were systematically modified, in sodium-phosphate buffer solution at pH 7.4. Furthermore, we studied their in vitro antiplatelet and vasorelaxant effects to evaluate relationships between spontaneous NO-releasing activities of FK409 analogs and their biological activities. FK409 derivatives were found to possess different spontaneous NO-releasing rates and biological activities according to their structural modification. In addition, these studies revealed a close correlation between NO-releasing rates of FK409 derivatives and their in vitro antiplatelet activities in human platelet-rich plasma, whereas the in vitro vasorelaxant activities of these compounds in isolated rat aorta did not correlate with the rates of NO liberation. The vasorelaxant effects were supposed to be affected by the structural properties of FK409 derivatives as well as their NO-releasing abilities.
Animals↗
[Relationship between the dose of lidocaine administered endotracheally in small children and the serum lidocaine level--recommended dose prior to endotracheal intubation].
To determine the optimum dose of lidocaine administered in the trachea prior to endotracheal intubation, we divided 102 surgical patients 3-5 years of age into 3 groups, i.e., group 1; 1 mg.kg-1 was sprayed in the trachea, group 2; 2 mg.kg-1 was sprayed in the trachea, group 3; 1 mg.kg-1 was sprayed in the trachea, and 1 mg.kg-1 in the pharynx and the oral cavity simultaneously. The venous serum concentration of lidocaine was measured two times either 1.5, 3, 5, 10, 15, 20, 30 or 45 min after the spray in each case. In group 1, the mean concentration of lidocaine reached the maximum of 1.05 micrograms.ml-1 at 5 min and decreased gradually after that with a small inter-individual variation. In group 2, after reaching the mean maximum concentration of 3.51 micrograms.ml-1 at 3 min, the serum level dropped quickly and then gradually decreased. There were a few cases where serum level was over 7 micrograms.ml-1. In group 2, after reaching the mean maximum concentration of 1.38 micrograms.ml-1 at 5 min, the serum level decreased more slowly, suggesting a slow absorption from the pharynx and/or the oral cavity. We conclude that the recommended dose of lidocaine for endotracheal administration is less than 2 mg.kg-1.
Administration, Inhalation↗
[Apoptosis in uremic complication].
Chronic renal failure (CRF) is often complicated by lymphopenia and sometimes by hepatic dysfunction. To elucidate the involvement of apoptosis in these complications, we analyzed Fas antigen which mediates apoptosis on peripheral blood T cells and hepatic cells. T cells from uremic patients expressed Fas with higher intensity than control T cells. When cultured in vitro, uremic T cells were shown to undergo acceleratd apoptosis in correlation with Fas expression. Immunohistological analysis of liver tissues revealed that hepatocytes in patients both with chronic hepatitis and with CRF expressed higher levels of Fas than those in patients alone with chronic hepatitis. These results suggest that T cells and hepatocytes in CRF may undergo apoptosis by the Fas system.
Apoptosis↗
[Malignancy of colorectal cancer analyzed by expression of cyclin D1].
We evaluated the clinical significance of cyclin D1 expression in colorectal adenocarcinoma. One hundred twenty-three specimens resected from patients with colorectal cancers were investigated by staining with a monoclonal antibody against cyclin D1. The possible correlations among cyclin D1 expression, clinicopathologic factors and prognosis were studied. There was no significant association between cyclin D1 expression and various clinicopathological factors. However, disease-free survival was significantly worse in the patients with cyclin D1 strongly positive tumors than in those with cyclin D1 negative tumors. Cyclin D1 overexpression may be useful as a predictor of disease recurrence in patients with colorectal adenocarcinoma.
Adenocarcinoma↗
[Immunohistochemical study of p21 expression in gastric carcinoma].
In this study, the expression of p21 protein was investigated immunohistochemically in 152 patients with gastric cancer. Expression of p21 was detected in 64 tumors (42.1%). There were significant differences among the expression of p21, histologic type, depth of invasion, lymph node metastasis, liver metastasis, and peritoneal metastasis. The deeper the tumor invaded, the more frequent p21 expression increased. Of the 152 patients, lymph node, liver and peritoneal metastasis were found in 86, 13 and 23 patients, respectively. p21 expression was more frequently lost in tumors from patients with metastasis. In relation to prognosis, patients with p21-positive tumors had a significantly better prognosis than those with p21-negative tumors. In conclusion, this study suggested that expression of p21 has a prognostic value in gastric cancer.
Cyclin-Dependent Kinase Inhibitor p21↗
[Minute carcinoid tumor in the rectum with liver metastasis].
A 65-year-old woman was admitted to our hospital for evaluation of multiple liver tumors following endoscopic polypectomy for rectal polyp a year earlier. The polypectomy specimen was reexamined and showed inclusion of a carcinoid tumor 3 mm in diameter. The perirectal lymph node was palpated by digital examination on readmission. The patient died one mouth after readmission due to liver failure. Autopsy revealed metastatic carcinoid tumor in the liver and perirectal nodes.
Aged↗
[Uremic encephalopathy, uremic coma].
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Brain Diseases, Metabolic↗
[First dialysis syndrome, first-use syndrome].
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Anaphylaxis↗
[A case of drug-induced liver injury due to bukuryo-in-go-hange-koboku-to].
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Adult↗
Quercetin, a bioflavonoid, inhibits the induction of interleukin 8 and monocyte chemoattractant protein-1 expression by tumor necrosis factor-alpha in cultured human synovial cells.
OBJECTIVE: Tumor necrosis factor (TNF)-alpha is present in synovial fluid of patients with rheumatoid arthritis. It induces the expression of proinflammatory cytokines in synovial cells. Based on our recent finding that reactive oxygen intermediates play important roles in mediating TNF-alpha action, we examined the effect of an antioxidant bioflavonoid, quercetin, on TNF-alpha induced expression of interleukin 8 (IL-8) and monocyte chemoattractant protein-1 (MCP-1) in cultured human synovial cells. METHODS: The amounts of mRNA for IL-8 and MCP-1 were determined by Northern blot analysis. Electrophoretic mobility shift assays (EMSA) were performed for the detection of a transcription factor, nuclear factor-kappa B (NF-kappa B). RESULTS: Addition of quercetin suppressed TNF-alpha induced increase in the mRNA for IL-8 and MCP-1 in a dose dependent manner. Quercetin did not affect the stability of these mRNA. H2O2 mediated induction of IL-8 and MCP-1 genes was also inhibited by quercetin. EMSA revealed that quercetin inhibited the activation of NF-kappa B by TNF-alpha. CONCLUSION: Quercetin suppresses TNF-alpha mediated stimulation of IL-8 and MCP-1 expression, at least in part, by inhibiting the activation of NF-kappa B.
Arthritis, Rheumatoid↗
[Photomicrographs of a pleural biopsy specimen, showing malignant mesothelioma and necrosis--malignant pleural mesothelioma in a patient with sarcoidosis].
A 45-year-old woman was admitted to Nara Medical University Hospital because of right-sided chest pain. Both a chest X-ray film and a chest CT scan revealed bilateral hilar and mediastinal lymphadenopathy and right pleurisy. She underwent fiberoptic bronchoscopy and mediastinoscopy. Biopsy specimens of the lung and mediastinal lymph nodes showed non-caseous epithelioid cell granulomas. After on ophthalmologic examination, she was given a diagnosis of sarcoidosis with a pleural lesion and uveal involvement. The pleurisy become less severe and the lymph nodes shrank without any treatment. About one year later, she complained of right-sided chest pain again and a chest X-ray film revealed diffuse thickening of the pleural on the right side. Examination of pleural biopsy specimens revealed malignant mesothelioma. We know of no previous report from Japan of malignant pleural mesothelioma in a patient with sarcoidosis.
Biopsy↗