Hepatocellular carcinoma response to low-dose oral tegafur.
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Administration, Oral↗
Biomedical subjects
K Shindo
Publications and source records attributed to K Shindo.
Studies on free radical scavenging substances from microorganisms. II. Neocarazostatins A, B and C, novel free radical scavengers.
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Animals↗
Crusted scabies in acquired selective IgA deficiency.
Crusted scabies, an unusual clinical variant of human scabies mite infestation, is usually reported in cases of gross debility, mental deficiency, or immunosuppression. We report here the occurrence of crusted scabies in a 40-year-old man with acquired selective IgA deficiency suspected to be caused by long-term medication with phenytoin for epilepsy.
Adult↗
Simultaneous measurement of intestinal blood flow and plasma levels of vasoactive substances in a case of early dumping syndrome. Case report.
Increase in intestinal blood flow was observed in a patient with postprandial hypotension. Simultaneous measurement of hemodynamic parameters and plasma levels of gut hormones revealed that the release of various vasoactive substances and resulting vasodilation of abdominal organs were responsible for the vasomotor changes of early dumping syndrome.
Aged↗
[Sympathetic nerve activity in amyotrophic lateral sclerosis--analysis by microneurography].
Muscle sympathetic nerve activity (MSA) was quantitatively analyzed in amyotrophic lateral sclerosis (ALS) by using microneurography. Studies were conducted in 10 ALS patients (2 males, 8 females; mean age 56.4 SD 17.3 years; range 31-77 years). The duration of the disease after onset of symptoms was from 0.8 to 2.5 years. They were classified as a type of classical ALS having mild degree of bulbar signs, an ability to walk by themselves and no subjective breathing impairment. Control groups were selected from 16 healthy age-matched volunteers (8 males, 8 females; mean age 52.9, SD 15.5 years; range 29-76 years). MSA was recorded directly from peroneal nerve fascicles at the popliteal fossa by means of tungsten microelectrodes. The changes in MSA, blood pressure and heart rate were analyzed in the ALS groups and controls laid at recumbent and 30 degrees head-up tilted positions. The parasympathetic functions were evaluated by CVR-R and baroreflex latency. MSA bursts/minute, bursts/100 heart rate and total MSA at recumbent position were significantly higher (p less than 0.01), but their changes at 30 head-up tilted position were slightly lower in the ALS groups compared with the controls. Furthermore, a linear correlation between age of the subjects and MSA in the controls was not found in ALS groups. There were no differences between both groups in blood pressure and heart rate at the two positions. The parasympathetic function was normal in ALS groups. In ALS, sympathetic hyperfunction independent of cardiovascular systems was found especially at the recumbent position. These findings were considered specific to ALS, but the etiology was unclear.
Adult↗
Quantitative analysis of platelet activating factor treated with pentafluorobenzoyl chloride using gas chromatography/negative ion chemical ionization mass spectrometry.
To confirm that platelet activating factor (PAF) plays an important role as a mediator in acute inflammation and allergic reaction, it is necessary to develop a more sensitive and stable method for measuring trace amounts of PAF in various biological samples. For this reason, the authors have adapted gas chromatography/negative ion chemical ionization mass spectrometry (GC/NICI-MS) (developed by Ramesha and Pickett in 1985) by employing an SPB-1 column and isobutane as the reagent gas. Furthermore, with this method the authors attempted an investigation of the time course of hexadecyl- and octadecyl-PAF production and release from human polymorphonuclear leukocytes (PMNs) stimulated by Ca-ionophore A23187. PMNs were obtained from venous blood from a human donor by centrifugation and were stimulated by 5 microM of Ca-ionophore A23187. PAF was purified using a SEP-PAK silica column and thin layer chromatography, and then was hydrolyzed with phospholipase C. The extract was treated with pentafluorobenzoyl chloride. Using 1-O-hexadecyl-2-acetyl (perdeuterated)-sn-phosphocholine) as an internal standard, the following results were obtained: The standard curve for this quantitative analysis was linear with a correlation coefficient of 0.9997 from 1 pg to 200 ng. The authors assumed that quantities as low as a few picograms of PAF could be measured by the method. The production of hexadecyl-PAF in the cell pellet peaked (8.1 +/- 1.34 ng/10(7) cells) at 2 min after stimulation and that in the supernatant peaked (6.3 +/- 0.97 ng/10(7) cells) at approximately 7 min after stimulation. Octadecyl-PAF could not be detected in this experiment.(ABSTRACT TRUNCATED AT 250 WORDS)
Benzoates↗
[Adverse effects of branched chain amino acid transfusion on type-II citrullinemia--report of an adult case].
A 24-year-old man was admitted to our hospital, because two days before the admission he had abruptly lost consciousness following generalized convulsive seizures. He had a past history of transient amnesia and a favor for peanuts. His grandparents had a record of consanguinity. On admission, he was comatose and flaccid with his four extremities. Laboratory examination revealed the followings; mild degree of abnormal liver function, slight elevation of blood ammonia, irregular theta basic rhythm on EEG, marked brain edema on CT and a normal liver ultrasonography. From the second hospital day, in addition to antiepileptic drugs and adrenocorticosteroids, branched chain amino acid was administered to reactivate damaged brain functions. Thereafter, the concentration of blood ammonia increased to more than 3,000 micrograms/dl, and as a result he fell into status epilepticus. On the fourth hospital day, the levels of citrulline in the plasma and urine taken on the first hospital day were found to have increased by 20 and 100 times, respectively. Although the transfusion of branched chain amino acid was stopped, he died while in coma on the 12th hospital day. Enzymatic analyses of necropsied liver specimens revealed that the quantitative activity of argininosuccinate synthetase had decreased to less than 10% in his urea cycle. In this patient, it was noted that, after transfusion of branched chain amino acid, his brain activities turned worse and blood ammonia was markedly elevated. There is a possibility that intravenous administration of branched chain amino acid may interrupt the urea cycle balance in an adult patient of citrullinemia with dysfunction of the brain, kidney and muscle, especially with brain edema.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[A case of Kearns-Sayre-Shy syndrome with abnormal signal intensity on MRI in cerebral white matter and brainstem].
A 42-year-old woman was admitted for complaining of gait disturbance lasting for 2 years. She had a past history of hearing loss and bilateral ocular ptosis since her age of 21 years. Neurological examinations revealed severe external ophthalmoplegia, ptosis and muscular weakness of neck and extremities, but no dementia. Laboratory examinations showed high level of serum CK and slight elevations of CSF protein, lactate and pyruvate. The QT interval on ECG was prolonged. The EEG finding was slightly abnormal. The neurogenic pattern on EMG was noted. Muscle biopsy was performed at the quadriceps muscle. Its specimens demonstrated mixed changes of muscular atrophy and ragged red fibers. From these findings, Kearns-Sayre-Shy syndrome was diagnosed. It was noted in this case that brain MRI (T2-weighted image) revealed bilateral diffuse high signal intensity areas on cerebral white matter and brainstem. It seems that the lesions of central nervous system may progress subclinically for many years in cases of KSS, as our case shows.
Adult↗
[Does the pelvic nodes dissection for the rectal cancer patients make any contribution to the end-results of surgery?].
Extended pelvic nodes dissection (PND) was adopted to 182 curatively resected rectal cancer patients from 1978 to 1986 at Kinki University Hospital. All patients were diagnosed preoperatively that the depth of cancer invasion were the proper muscular layer or more. Dissected lymph nodes were examined in detail by the clearing method. Pelvic nodes involvement was found in 19 patients or 10.3% out of 182 with PND, and 5-year survival of 19 patients was 26.3%. All over 5-year survival of 182 patients with PND was 69.0% while 62.2% without PND before 1978. There was no significance in the rates of local recurrence between 13.2% with PND and 13.7% without PND. Urinary and sexual dysfunction was increased from 41% and 38% without PND to 66.7% and 88% with PND respectively. It is difficult to evaluate the meaning of PND in the rectal cancer surgery from this non-randomized study. As 80% of the pelvic nodes involvement, however, were found in the cancer with deeper penetration from the muscular layer (a2) and with the location of the middle or lower rectum, PND should be considered only to these two conditions.
Humans↗
Measurement of leukotriene C4 and D4 in arterial blood of asthmatic patients during remission.
We measured the amounts of leukotriene C4 and D4 in the arterial blood of asthmatic patients during remission and compared these with the amounts of leukotrienes in the arterial blood of asthmatic patients during acute asthma, which had been reported in our previous study. Leukotriene C4 and D4 was detected in five patients during remission at 50.68 +/- 8.28 and 36.68 +/- 17.31 pg/mL (mean +/- SD), respectively. In five control subjects, the amounts of leukotriene C4 and D4 were 78.22 +/- 34.65 and 55.06 +/- 13.54 pg/mL (mean +/- SD), respectively. As cited in our previous report, the amounts of leukotriene C4 and D4 in arterial blood of asthmatic patients during acute asthma were 523.33 +/- 737.06 and 495 +/- 304.48 pg/mL. Hence, there were no significant differences in the leukotriene C4 and D4 values between asthmatic patients during remission and control subjects, whereas there was a significant difference in the leukotriene D4 values between asthmatic patients during acute asthma and, asthmatic patients during remission or control subjects (P less than .01). In addition, the leukotriene C4 values in asthmatic patients during acute asthma were larger than in asthmatic patients during remission or control subjects without a significant difference. The amounts of leukotriene C4 and D4 in arterial blood of asthmatic patients may reflect the degree of severity of acute asthma.
Adult↗
[Flow cytometric DNA analysis of malignant potential in colorectal carcinoma--DNA ploidy pattern and liver metastasis].
On the purpose of elucidating the malignant potential, flow cytometric DNA analyses were carried out using paraffin-embedded materials of 82 subserosal, serosal and adventitial invasive colorectal carcinoma. The ratio of DNA diploidy against DNA aneuploidy was one to two. DNA ploidy pattern was not correlated with histological grade but with histopathological factors such as lymphatic permeation, lymph node metastasis and venous invasion. At the primary operation, the rate of the liver metastasis in DNA aneuploid cancer was 16.4% but in DNA diploid cancer the liver metastasis was not observed at all. On the liver metastasis, the 5-year disease free survival rates were lower in patients with DNA aneuploidy (72.8%) than those with DNA diploidy (95.2%). These results indicate that DNA ploidy pattern is related to liver metastasis. Furthermore, the 5-year survival rates in patients with absolute curative resection were lower significantly in DNA aneuploidy (62.5%) than DNA diploidy (92.9%). In conclusion flow cytometric DNA analysis is useful for evaluating the biological malignant potential and predicting the liver metastasis in colorectal carcinoma.
Adult↗
Measurement of leukotriene B4 in arterial blood of asthmatic patients during wheezing attacks.
To investigate whether leukotriene B4 is present in the arterial blood of asthmatic patients during wheezing attacks, 20 ml of arterial blood was drawn from the inguinal artery of five patients. Leukotriene B4 was detected in all five individuals, and its identity was confirmed by a combination of high pressure liquid chromatography and radioimmunoassay techniques. The concentration of leukotriene B4 was 48.34 +/- 16.27 pg ml-1 (mean value +/- SE). However, in five control subjects the leukotriene B4 concentration was found to be 9.43 +/- 5.44 pg ml-1. Thus there was a significant difference between the two groups (P less than 0.05). These results suggest that leukotriene B4 may be important in elucidation of the pathogenesis of bronchial asthma.
Adult↗
[Survey on clinical isolates from 13 hospitals in Akita Prefecture--changes in frequency and susceptibility of isolates by scale of hospital. Survey Group for Clinical Isolates, Chemotherapy Research Committee of Akita Prefecture].
Isolates from various clinical materials in 13 hospitals in Akita prefecture and their drug susceptibility were investigated by the Chemotherapy Research Committee of Akita Prefecture during the period from Dec., 1987 to Feb., 1988. The results were as follows: 1. The total number of isolates was 8,387, including Staphylococcus aureus (18.9%), Pseudomonas aeruginosa (10.9%), Staphylococcus epidermidis (7.3%) and Enterococcus faecalis (6.6%). S, aureus and P. aeruginosa were detected more frequently in the larger hospitals. 2. The detection frequency of S. aureus from the sputum, throat swab and pus exudate was also very high. There was a diversity in isolates from the urine and the frequency of Escherichia coli was low. More than half of the isolates from the blood were S. epidermidis and S. aureus. Many kinds of bacteria were detected from pleural fluid and ascites, but the isolate showed no particular tendency. 3. The susceptibility of S. aureus to oxacillin were variable in hospitals, and the susceptibility to cefazolin were even lower. Low susceptibility were also seen with norfloxacin. S. aureus showed the highest susceptibility to minocycline. The susceptibility was lower for inpatients than for outpatients. P. aeruginosa showed low susceptibility to cefsulodin. The number of ampicillin-resistant Haemophilus influenzae isolates tended to decrease. Enterobacter cloacae showed a low susceptibility for cephems. Serratia marcescens showed low susceptibility to many drugs. Based on the above results, we concluded that attention should be paid to S. aureus, P. aeruginosa and Enterobacter in clinical practice.
Anti-Bacterial Agents↗
Successful use of vancomycin hydrochloride in the treatment of lactulose resistant chronic hepatic encephalopathy.
Vancomycin hydrochloride (2 g daily) was administered to 12 patients with cirrhosis and lactulose resistant portal systemic encephalopathy in a double blind crossover trial. All 12 patients showed a remarkable clinical improvement after vancomycin treatment. The mean (SE) electroencephalographic (EEG) frequency changed from 6.3 (0.2) to 8.5 (0.2) cps (p less than 0.001) and the mean arterial ammonia concentration from 152 (4) micrograms/ml to 97 (8) micrograms/ml (p less than 0.001). Their clinical condition deteriorated when treatment was switched to lactulose, returning to the previous slower EEG frequency and high arterial ammonia concentrations. Vancomycin seems to be effective in chronic portal systemic encephalopathy in patients who are not helped by lactulose alone.
Ammonia↗
Treatment of cryptococcal meningitis with five anti-fungal drugs: the role of amphotericin B.
Experiments are described of the treatment of two patients with cryptococcal meningitis using antifungal drugs and amphotericin B. The first patient was a 56-year-old man with a slight azotaemia caused by hypertensive nephrosclerosis. Lumbar puncture revealed a positive India ink stain and a positive culture for Cryptococcus neoformans; serum titre for cryptococcal antigen was elevated. Amphotericin B was not administered because of the patient's slight azotaemia. After admission, the patient received oral and intravenous fluconazole (400 mg per day), for a total dose of 40 g of fluconazole over 103 days from October 1 while simultaneously receiving treatment with oral itraconazole (200 mg per day) from October 1 to December 5. In addition, he was given intravenous miconazole (600-1000 mg per day, total 74.4 g) and intrathecal miconazole (5-20 mg per day, total 375 mg) from December 1 to March 4 1990. Concomitantly, oral flucytosine (6 g per day) was given from December 5 to March 1 1990. Lumbar puncture performed at the completion of these treatments indicated the India ink stain still was positive and the serum titre for cryptococcal antigen high. Finally, amphotericin B alone was administered to the patient intravenously and intrathecally from March 4 to May 1, with an initial dose of 5 mg i.v. gradually increasing by 5 mg increments up to 50 mg per day. The patient's clinical symptoms immediately improved; the India ink stain became negative for the first time after admission and the serum titre for cryptococcal antigen also gradually decreased. On May 1, the patient was completely cured of cryptococcal meningitis.(ABSTRACT TRUNCATED AT 250 WORDS)
Amphotericin B↗
[Granulocyte beta-adrenoceptor density increased with methylprednisolone in patients receiving dopamine infusion].
Methylprednisolone (MP) is frequently used in shock states, its antishock mechanisms, however, have not been clarified. Effect of MP 10 mg.kg-1 on granulocyte beta-adrenoceptor density was studied in two patients who required dopamine infusion postoperatively. The granulocyte beta-adrenoceptor density was calculated from the binding of [3H] dihydroalprenolol. Arterial blood pressure and cardiac output increased 1 hr after MP administrations. Beta-adrenoceptor densities were low in both cases prior to the administration of MP (16.1 and 24.6 fmol.mg-1 protein), which increased 11 hr after MP (31.2 and 35.8 fmol.mg-1 protein, respectively). The effects of MP to improve status of cardiovascular system in patients receiving catecholamine-infusion may be associated with the increase in the density of myocardial "down-regulated" beta-adrenoceptor.
Dopamine↗
[Measurement of immunoreactive endothelin-1 in plasma of a patient with malignant hemangioendothelioma].
We measured immunoreactive endothelin-1 in plasma of a patient with malignant hemangioendothelioma. A 74-year-old female first visited our clinic in July, 1989. Physical examination revealed reddish nodule measured 4 x 5 x 1 cm and erythematous plaque with erosion on her scalp. A biopsy specimen showed extensive proliferation of atypical tumor cells intermingled with a large number of capillary vessels in dermis. Some of tumor cells were positively stained for factor VIII related antigen by PAP method. From these findings we diagnosed malignant hemangioendothelioma and resected the tumor on August 3. The measurement of immunoreactive endothelin-1 in plasma was performed by radio-immunoassay on August 2 (before operation), October 20 and December 27 (after operation). The results were 16.2, 4.3 and 5.6 pg/ml, respectively (normal range: 0.5 +/- 0.2 pg/ml). Plasma endothelin-1 level may be run parallel to quantity of tumor cells in malignant hemangioendothelioma.
Aged↗
[Colostomy devices for the extracorporeal organ].
Colostomy devices are classified as follows: One-piece and two-piece by structure; Closed, open-end or straight, open-top, drainable, and mini by pouch function. The one-piece device is simple and convenient (disposable) but not cheap; The two-piece one has various exchangeable pouches but some skill is necessary for fitting a pouch to the flange. A closed pouch is disposal en bloc, while an open pouch allows a hand to be inserted several times. The drainable pouch is useful for draining faeces easily with water, while a mini-pouch is unobtrusive and attractive. The skin barrier has been used frequently as a part of the device. Its contents are hydrophilic colloid, hydrophobic colloid and agglutinant. The barrier functioning is dependent on content-ratio and on structure. The latter is classified as blend, laminate, swiss-roll, polka-dot, and froth in type. The apparatus must be used for individual colostomy, utilizing the characteristics based on its specificity; an open-type one-piece unit is used with skin barrier for a postoperative colostomy in the first week, a drainable-type, two-piece unit for another week following suture removal or for diarrhea, and a closed type for rehabilitation. This procedure is called a pouch total system. The irrigation method is good for a scheduled defecation and for peri-stomal dermatitis and for a deformed stoma, but takes more than a half hour and needs a special toilet for irrigation. Indication of the method is for a young ostomate, a sportsman, a field worker, a neurotic or myosophobic person and so on. Today a pouch-free natural defecation method is becoming popular; a kind of stopper is used for a colostomy. This is a foam plug which expands to block feces and eliminates noise and odor. The method is good for pouch-free living, but fecal leakage is encountered in diarrhea.
Colostomy↗