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Biomedical subjects

K Nagamine

Publications and source records attributed to K Nagamine.

At least 73 records · Page 4Linked to original sources

Analysis of antigen involved in circulating immune complexes in patients with idiopathic thrombocytopenic purpura.

Circulating immune complexes (CIC) were frequently observed in patients with idiopathic thrombocytopenic purpura (ITP). To analyse the pathogenic role of CIC, we studied the correlation between the disease activity and the CIC level, and whether platelet antigens were involved in CIC from ITP sera. Elevated CIC levels, measured by Clq, anti-C3 and spermatozoa micro-enzyme-linked immunosorbent assay, were found in 37%, 54% and 52% of the patients, respectively. However, there were no significant correlations (r = -0.11, -0.03 and -0.04, respectively) between the platelet count and the CIC level. Platelet antigens in CIC were detected with rabbit anti-human platelet serum. The CIC from 18%, 25% and 25%, respectively, of ITP sera contained platelet antigens, but the CIC from only 3%, 9% and 6% of SLE sera and from 3%, 2% and 5% of the sera of alloimmunized patients, respectively, contained these antigens. There were significant correlations (r = 0.51, 0.80 and 0.65, respectively) between the amount of platelet antigens and the CIC level in ITP sera. However, there were no correlations (r = -0.26, -0.29 and 0.08, respectively) between the platelet count and the amount of platelet antigens in the CIC. We detected platelet antigens in CIC from ITP sera, but surmise that these CIC perhaps do not play an important role in platelet destruction.

Antibody Specificity↗

Development of erosive gastritis in a canine model of esophageal varices.

We designed a reproducible canine model of esophageal varices, based on the concept of a regional hyperdynamic state in the upper stomach. Arterialization of the left gastric vein concomitant with the distal splenorenal shunt led to a stable hyperdynamic state and reproducible esophageal varices occurred. In the long-term follow-up of these dogs with varices, the erosive gastritis seen in the upper stomach clearly resembled clinically observed lesions. Hemodynamic and morphological studies revealed that gastric mucosa of these animals was in an ischemic state, even though there was a remarkable increase in blood flow in the submucosal area. It is suggested that the decrease in mucosal blood flow, as induced by the hyperdynamic state caused erosive gastritis.

Animals↗

Eradication of esophageal varices with repeated injection sclerotherapy in inoperable patients.

Esophageal varices in 50 cirrhotic patients were treated with repeated injection sclerotherapy. Eradication of varices was achieved in 27 patients (54.0%) with a mean of 4.5 injections (range 2-12) after a mean period of 3.1 months (range 1-11). There was no variceal bleeding in these 27 patients once eradication had been achieved, with a mean follow up period of 5.6 months, although bleeding occurred in 5 of the same group before eradication of the varices had been achieved, during an average of 3.1 months, and in 6 of the remaining 23 patients (10 episodes) with residual varices after a mean of 4.7 injections (range 2-12) in a mean period of 12.2 months (range 1-33). Esophageal varices can thus be eradicated with repeated injections and bleeding from recurrent esophageal varices can be prevented in many patients after eradication has been achieved.

Adult↗

[Clinical study of spinal cord compression due to metastatic epidural tumors].

Eleven patients with spinal cord compression due to metastatic epidural tumors were analyzed. Primary tumors were Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma (two patients each), cervical cancer, malignant melanoma, gastric cancer, lung cancer, and neuroblastoma (one patient each). It was felt that myelography is the most important diagnostic test, although CT scan and bone scan may give further diagnostic information in some patients. Six patients were treated with decompressive laminectomy and postoperative radiotherapy, and five with radiotherapy alone. Regardless of the pretreatment neurological status and the type of treatment given, the functional prognosis in our small series of patients appeared to be favorable for radiosensitive tumors such as malignant lymphoma and multiple myeloma.

Adult↗

Hyperdynamic circulation in the left gastric venous area in patients with portal hypertension: angiological assessment.

The time of appearance of the left gastric vein on serial celiac arteriograms in patients with portal hypertension and esophageal varices was compared with that of the portal vein to assess regional hemodynamics in the left venous portion of the stomach, an area located in close proximity to the varices. In two thirds of all the patients with cirrhosis or non-cirrhotic idiopathic portal hypertension (IPH), the left gastric vein was visualized earlier or simultaneously than or with the portal vein, while in all but one patient with prehepatic portal obstruction, there was a delayed opacification of the left gastric vein. These results suggest the presence of a hyperdynamic circulatory state which promotes venous hypertension in the left gastric venous area of the stomach of a considerable number of patients with cirrhosis or IPH. In such a hemodynamic state, selective decompression of varices can be achieved by a left gastric venous caval shunt.

Esophageal and Gastric Varices↗

Esophageal varices produced in dogs.

In attempts to produce esophageal varices in dogs, we designed a procedure based on the concept of hyperdynamic flow. The first stage operation involved the achievement of an arteriovenous shunt between the left renal artery and the proximal splenic vein, in concert with the distal splenic venous-left renal venous shunt. About one month after the initial operation, sixteen of the twenty-eight dogs had tolerated the manipulations. Both shunts proved to be functioning well in six of sixteen survivors, in which an ameroid constrictor was placed around the splenic vein just proximal to the confluence of the left gastric vein. Again one month later, in five of these six, esophageal varices were evidenced, both endoscopically and histologically. Arterialization of left gastric vein concomitant with the distal splenorenal shunt, gave rise to a hyperdynamic state in the upper stomach and resulting in reproducible esophageal varices.

Animals↗