Biomedical subjects

K Nishimura

Publications and source records attributed to K Nishimura.

At least 703 records · Page 39Linked to original sources

PubMed1991

Principles of total care for children with leukemia--psychosocial interventions.

Today about 70% of children with leukemia are cured by intensive chemotherapy. Therefore how to deal with the children and their families before, during, and after the treatment has become a major concern for caregivers. And it is a fact that there are still a few patients who relapse and are destined to die. We are now taking care of two groups of patients. One group is truly cured and one group is dying. We have been trying to establish a good total care system that fits our society. We have formed medical teams which consist of doctors, nurses, and care workers. From our experience, we think the most important principle for the caregivers is frankness. Sometimes this is very difficult. Other important points of total care, especially from psychosocial aspects, are mentioned.

Adolescent↗

PubMed1991

Existence of two components in the tonic contraction of rat aorta mediated by alpha 1-adrenoceptor activation.

1. The mechanisms involved in the contraction of rat aorta induced by the activation of alpha 1-adrenoceptors were studied. Phenylephrine induced a phasic contraction in the aorta incubated in Ca2(+)-free medium containing 0.5 mM EGTA. Subsequent addition of Ca2+ induced a tonic contraction, which exhibited a stepwise development, an initial phase lasting 3 to 6 min (tonic-I) followed by a superimposing second phase (tonic-II). 2. 2-Nitro-4-carboxyphenyl-N,N-diphenylcarbamate, which has been reported to inhibit phosphatidylinositol turnover, and H-7, a protein kinase C inhibitor, inhibited the tonic-I phase more effectively than the tonic-II phase. On the other hand, the tonic-II phase was more sensitive to nifedipine and cromakalim. 3. The rate of 45Ca2+ influx during the tonic-I phase in phenylephrine-treated muscles was not different from that in untreated muscles, while that during the tonic-II phase was significantly greater. Nifedipine inhibited the increased 45Ca2+ influx during the tonic-II phase, whereas H-7 did not affect the uptake during either phase. 4. These results suggest that the tonic contraction of rat aorta following alpha 1-adrenoceptor activation involves two different mechanism: one is directly related to consequences of the polyphosphoinositide cascade, probably to protein kinase C, and the other dependent on Ca2+ influx through nifedipine-sensitive Ca2+ channels.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗

PubMed1991

Endometrial cysts: diagnosis with MR imaging.

The value of 1.5-T magnetic resonance (MR) imaging in diagnosing endometrial cysts and differentiating them from other gynecologic masses was prospectively evaluated in 374 female patients with clinically suspected adnexal masses. A suggestive diagnosis of endometrial cyst was made when a cyst that was hyperintense on T1-weighted images exhibited homogeneous hyperintensity on T2-weighted images. A definitive diagnosis was made when a cyst that was hyperintense on T1-weighted images exhibited hypointense signal on T2-weighted images (shading) or when the lesion consisted of multiple hyperintense cysts on T1-weighted images (multiplicity) regardless of the signal intensity on T2-weighted images. Surgery was performed in 293 patients, and confirmation was obtained in 354 lesions. MR imaging enabled accurate diagnosis of 77 of 86 endometrial cysts and exclusion of the diagnosis of endometrial cyst in 263 of 268 other gynecologic masses with or without internal hemorrhage. The overall diagnostic sensitivity, specificity, and accuracy were 90%, 98%, 96%, respectively. MR imaging seems to be an acceptable diagnostic test on which clinical decisions can be based in selecting treatment.

Adnexal Diseases↗

PubMed1991

VAB-6 chemotherapy causes spurious elevation of alpha-fetoprotein associated with liver dysfunctions.

In order to elucidate the mechanism of elevation of alpha-fetoprotein (AFP) which we often observed during VAB-6 chemotherapy, we analyzed sequential changes of AFP, liver enzymes and bilirubin in 10 patients with evaluable disseminated testicular cancer who were treated with VAB-6 chemotherapy. None of the patients had previous liver disease or hepatic involvement. During the early phase of each course of chemotherapy, AFP showed a temporary elevation associated with reversible increase in liver enzymes and bilirubin. These changes returned to normal before the next course of chemotherapy. In each patient, marked tumor regression occurred as a result of VAB-6 chemotherapy. Nine of the 10 patients remain free of disease after treatment. We conclude that during VAB-6 chemotherapy, a temporary elevation of AFP is common, associated with reversible liver dysfunctions, and that this spurious elevation of the tumor marker, most likely caused by a heavy dose of cisplatin, should not be interpreted as related treatment failure.

Adult↗

PubMed1991

Neurofibroma of the clitoris. A case report.

We report an unusual case of clitoral hypertrophy due to neurofibromatosis of the external genitalia. Because of no definite skin signs or other nervous or osseous symptoms such as are commonly found in neurofibromatosis, the patient was at first suspected of being a case of hermaphroditism. Finally, the disorder was properly diagnosed after laparotomy followed by clitorectomy. This patient seems to be the 12th case of clitoral neurofibroma reported in the English literature.

Child, Preschool↗

PubMed1991

Young's syndrome: report of two Japanese cases.

Young's syndrome is characterized by azoospermia due to bilateral epididymal obstruction associated with chronic sinobronchial disease. We report two Japanese cases of Young's syndrome who were treated with microsurgical epididymovasostomy. The histopathology of the caput epididymis showed an obstruction at the most distal region of the ductuli efferentes. The incidence of Young's syndrome in patients with obstructive azoospermia was much lower for mongoloids than for Caucasians.

Adult↗

PubMed1991

Endotoxin- and inflammation-induced depression of the hepatic drug metabolism in rats.

Carrageenan-induced inflammation and exposure to endotoxin considerably decreased the content of cytochrome P-450 and activities of ethylmorphine N-demethylase and meperidine N-demethylase, but did not decrease the activities of aniline hydroxylase or NADPH-cytochrome c reductase, compared with the respective activities in rats treated with carrageenan alone. These results suggest that under these experimental conditions, the two host-related environmental factors interact and enhance a decrease in rat hepatic microsomal drug metabolizing enzymes depending on the substrate used.

Animals↗

PubMed1991

Separation of mounting-inducing pheromones of vaginal mucus from estrual heifers.

There is evidence that mucus of the female bovine genital tract contains pheromones that induce physiological and behavioral responses in other animals. To study these pheromones, vaginal mucus was collected from heifers either at estrus or during diestrus. The mucus was then applied to the hindquarters of the same animal during diestrus or to the hindquarters of herdmates during diestrus. The behaviors of the treated animal and its herdmates were then observed. To attempt to isolate the mounting-inducing substance, mucus was dialyzed or separated on ion-exchange resins. Diestrous heifers to which their own estrual mucus has been applied were nearly always mounted by herdmates (P less than .01). But, heifers to which another's estrous mucus had been applied were not mounted. This suggests that vaginal mucus contains not only estrus-related pheromones, but also individual distinctive odors. The dialyzable fraction of vaginal mucus and the neutral fraction, prepared by ion-exchange chromatography of the dialyzable solution of vaginal mucus, had a mounting-inducing activity on the herdmates, as did the application of an animal's own vaginal mucus. These findings suggest that mounting-inducing pheromones are relatively low molecular weight, neutral substances.

Animals↗

PubMed1991

[Primary carcinoid tumor of the testis with metastasis to the upper vertebrae. Report of a case].

A case of primary carcinoid tumor of the right testis with metastases to the cervical and thoracic vertebrae and epidural is reported. A 53-year-old man was first recognized as being with dysthesia of the left arm and shoulder in April 1986. In June, 1987, he was admitted to the Neurology service, complaining of sudden occurrence of abasia. Myelography and computerized tomography demonstrated an epidural mass and several high density areas in the vertebral bodies of Th1 and Th2. The patient underwent laminectomy from C7 to Th2. At operation, the neurosurgeons noticed a tumor mass in the right scrotum and requested our consultation. Thus right high orchiectomy was performed. Pathological examination including Grimerius' and Fontana-Masson's stain revealed carcinoid tumor of the right testis associated with metastases to the spinal column. Postoperatively, tumor maker studies revealed elevation of blood 5-hydroxytryptophan and marked increase of urinary 5-hydroxy-indoleacetic acid excretion. They showed remarkable decreases after a course of PVB chemotherapy. The patient has been under our observation as an out-patient for the past 27 months with metastases. This is the first case of primary carcinoid tumor of the testis with metastases so far reported in the domestic literature.

Carcinoid Tumor↗

PubMed1991

Effects of ulinastatin in experimental acute arterial occlusion in rats.

The effects of ulinastatin (human urinary trypsin inhibitor, UTI) were studied in experimental acute arterial occlusion in rats. The experimental model comprised concurrent cross-clamping of the abdominal aorta and bilateral femoral arteries for 4 hours. Blood was sampled for measurement of the enzymes 2 hours after release of the clamps. The rats were grouped according to method of infusing UTI and/or physiologic saline solution. When UTI was infused continuously from the start of clamping, the plasma creatine phosphokinase and plasma beta-glucuronidase levels were significantly lower than in the control rats (p less than 0.05). The results suggest that UTI prevents the destruction of the lysosomal membrane in acute arterial occlusion.

Acute Disease↗

PubMed1991

[Comparison of acute bronchodilator response between cases of diffuse panbronchiolitis and pulmonary emphysema].

Diffuse panbronchiolitis (DPB) is a disease characterized clinically by chronic airflow limitation, therefore patients with DPB are frequently treated with bronchodilators. However, there have been no reports on bronchodilator effects in patients with DPB. Because bronchodilator effects can be influenced by low baseline level of pulmonary function, we evaluated acute responses to inhaled metaproterenol (10 mg) in 31 patients with DPB and in 40 patients with pulmonary emphysema. Patients of both groups were clinically diagnosed, and, in addition, by usage of high-resolution computed tomography. All the subjects in both groups had a post-bronchodilator FEV1/FVC less than 0.7. There was no difference in baseline FEV1 between either group; FEV1 was 1.24 +/- 0.64 l (47.1 +/- 17.8% pred) in DPB vs. 1.24 +/- 0.64 l (51.0 +/- 19.0% pred) in pulmonary emphysema. Two indices, post FEV1/pre FEV1 and post FEV1-pre FEV1/predicted FEV1, were used for the judgement of bronchodilator response. Post FEV1/pre FEV1 was 110.3 +/- 9.3% in DPB and 119.9 +/- 17.1% in pulmonary emphysema. Post FEV1-pre FEV1/predicted FEV1 was 4.5 +/- 4.2% in DPB and 8.6 +/- 6.2% in pulmonary emphysema. Bronchodilator responses for both indices was larger in pulmonary emphysema than in DPB (both, p less than 0.01). It has been reported that post FEV1/pre FEV1 correlates negatively to baseline FEV1 and that post FEV1-pre FEV1/predicted FEV1 is positively correlated to baseline FEV1.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Agonists↗

PubMed1991

[Ocular hypotensive effects of topically applied bunazosin, an alpha 1-adrenoceptor blocker, in rabbits and cats].

Effects of topically applied bunazosin, an alpha 1-adrenoceptor blocker, on intraocular pressure (IOP) and pupillary diameter were investigated in normotensive rabbits and cats, in addition to experimentally hypertensive rabbits. Bunazosin (0.005% to 0.1%) applied to both eyes significantly lowered IOP in a concentration-dependent manner in normotensive rabbits and cats. The unilateral application of 0.1% bunazosin significantly lowered the IOP in the treated eye, whereas it caused no significant change in the contralateral eye, suggesting that the effect of bunazosin is due mainly to a direct and local action and is not systemic. Bunazosin was also effective in experimentally hypertensive models induced both by water-loading and by alpha-chymotrypsin in rabbits. There was a significant correlation between the IOP decrease caused by bunazosin and the IOP value before the application, indicating that the IOP-lowering action of bunazosin is dependent on the height of the original IOP level. Bunazosin had no influence on pupillary diameter even when 0.5% was applied to rabbits. Topically applied bunazosin may be useful as a new antiglaucoma agent.

Administration, Topical↗

PubMed1991

[Kyotorphin like substance in human cerebrospinal fluid of patients with persistent pain].

Kyotorphin is an analgesic neuropeptide isolated from the bovine brain in 1979. Further studies showed that kyotorphin produces an analgesia through an increased release of met-enkephalin in the brain and the spinal cord. We showed that it is also found in the human cerebrospinal fluid and the concentrations of kyotorphin in normal human CSF is 1.19 +/- 0.51 pmol.ml-1. We also found that it is lower in patients with persistent pain (0.24 +/- 0.04 pmol.ml-1). Above results suggest that kyotorphin acts as a putative neuromediator and/or an endogenous pain modulator in the human brain.

Adult↗

PubMed1991

[Young-Dees-Leadbetter's posterior urethral lengthening procedure for urinary incontinence: report of three cases].

Urinary incontinence caused by functional or anatomical incompetence of the urethral sphincter is one of the most challenging problems in urological surgery. Posterior urethral lengthening accomplished by tubularization of the trigonum, which was proposed by H. H. Young, J. E. Dees and G. W. Leadbetter, has been shown to improve the outcome in epispadia patients with incontinence. We report our experiences of Young-Dees-Leadbetter's operation in three patients. Case 1 was a 55-year-old woman who had undergone removal of the external genitalia to treat genital Paget's disease, resulting in total incontinence. About one half of the urethra had been removed, resulting in a shortened urethral length of 2.5 cm. Case 2 was a 6-year-old boy with penile epispadia, who had leadage of about a third of the total urine volume. Case 3, an 18 year-old female patient, suffered from total urinary incontinence which had resulted from a defect in the entire urethra and bladder neck following a motor vehicle accident. Posterior urethral lengthening together with ureteral reimplantation was performed on these three patients according to Leadbetter's or Dees' method. Subtotal continence was achieved in cases 1 and 3, and incontinence was completely cured in case 2. Based on our results with these three cases, we feel that Young-Dees-Leadbetter's operation is a useful method for treating sphincteric incontinence, particularly in female patients with an anatomical urethral defect.

Adolescent↗

PubMed1991

[Thallium-201 myocardial scintigraphy after intravenous infusion of adenosine triphosphate disodium: a preliminary study in the diagnosis of coronary artery disease].

The feasibility and safety of thallium-201 myocardial scintigraphy after the intravenous infusion of adenosine triphosphate disodium (ATP) (Adetphos, Kowa) were studied in eight patients with angina pectoris and/or old myocardial infarction. Coronary arteriography (CAG) was performed by the conventional method in all patients. ATP was infused for 5 min and thallium was injected at 3 min after the start of ATP infusion. ATP was given at 0.12 mg/min/kg in two patients (group A), 0.16 mg/min/kg in three patients (group B), 0.20 mg/min/kg in one patient (group C) and 0.28 mg/min/kg in two patients (group D). SPECT images were obtained at 10 min and 180 min after thallium injection. No significant hemodynamic changes were observed in group A and B. Severe hypotension was observed in group C and one member of group D. Chest pain was experienced by one patient in group A, two in group B, one in group C, and both of the two in group D. ST depression on the electrocardiogram (ECG) was documented in one patient each of groups B and C. In one group D patient, the study was discontinued because of complete atrioventricular block persistent for 5 beats. The correlation between thallium imaging and CAG was unclear in group A, reasonable in groups B and C, and obscure in group D because of side effects. None of the patients who developed side effects of ATP were administered sublingual nitroglycerin or intravenous aminophylline. Their symptoms or ECG changes improved spontaneously within 2 min and disappeared within 5 min after termination of infusion. In conclusion, the optimal ATP regimen for this purpose was considered to be a 5 min infusion at 0.16 mg/kg/min and this method was found to be feasible and safe.

Adenosine Triphosphate↗

PubMed1991

[Inferior vena caval resection for renal cell carcinoma: usefulness of renal venous pressure measurement].

Renal cell carcinoma with extended tumor thrombi densely adherent to the vena caval wall sometimes requires vena caval resection. If the tumor is on the right side and the collateral veins of the left renal vein are abundant, vena caval reconstruction may not be required. We recently performed radical nephrectomy and vena caval resection on 2 right renal cell carcinoma patients. To decide the necessity of vena caval reconstruction, left renal vein pressure was measured before and after clamping of the vena cava. In case 1, because the pressure was elevated from 21 cmH2O, to 61 cmH2O, total replacement with Gore-Tex graft was performed. In case 2, because the pressure change was from 22 cmH2O to 23 cmH2O, reconstruction was not performed. The most important test to decide the necessity of vena caval reconstruction is thought to be the change of renal venous pressure before and after clamping of the vena cava.

Aged↗

PubMed1991

[Le Duc-Camey antireflux ureteroileal reimplantation for continent ileal reservoir].

Le Duc-Camey antireflux ureteroileal reimplantation was used on 15 patients with 30 ureters reimplanted into the ileum as part of a bladder substitution procedure (Kock pouch or ileal neobladder: U-bladder) or augmentation cystoplasty (Goodwin ileocystoplasty). In our experience, no reflux was observed, while hydronephrosis was identified in one ureter of ileal neobladder (4%). Le Duc-Camey antireflux ureteroileal reimplantation is suitable for reconstruction with the ileal reservoir.

Aged↗

PubMed1991

Electron microscopical evaluation of connective tissue healing to periodontally involved teeth.

The present study was undertaken to examine if our novel root treatment for human periodontally involved teeth can facilitate a new connective tissue attachment. The novel treatment was in two parts: 1) planning and surface decalcification with citric acid on the coronal quarter of the exposed root corresponding to pocket, and 2) curettage of superficial cementum of the apical three quarters of the exposed root. The interface of the root surface and regenerating connective tissue was observed 2 and 3 weeks after surgery by light and electron microscopy. The apical migration of junctional epithelium was effectively prevented. The fibroblasts synthesized new fibrillar materials and collagen fibrils towards the curetted cementum. The results suggested the possibility that this treatment for periodontally involved teeth would provide ideal root surface conditions for the formation of new fibrous attachment.

Antacids↗