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Biomedical subjects

K Yoshimura

Publications and source records attributed to K Yoshimura.

At least 91 records · Page 5Linked to original sources

[A case of solitary bronchial papilloma with elevated serum CEA concentration].

A rare case of solitary bronchial papilloma was reported. A 57-year-old male was admitted to our hospital because of an abnormal shadow on chest X-ray film which was discovered on regular health check up. Bronchoscopic examination revealed a polypoid tumor which obstructed the left B4 bronchus. Serum concentration of CEA was elevated up to 14 ng/ml by Z-GEL method. Left upper lobectomy was performed. On macroscopic examination of the excised specimen, the tumor arose in B4 bronchus and was yellowish white in color and was cauliflower-like in shape sized 3.5 X 1.5 cm. Histopathologically, the tumor consisted of papillary proliferation of stratified squamous epithelium with ciliated columnar epithelial covering. Findings suggestive of inflammation or malignancy were not observed.

Bronchial Neoplasms

[Clinical experience with ceftibuten in complicated urinary tract infections].

Twenty-four patients with complicated urinary tract infections (UTI) were received ceftibuten (CETB) 400 mg b.i.d. orally for 5 days, and the following results were obtained. One of the recipients was excluded for negative bacteriuria before treatment. According to the criteria for evaluation of clinical efficacy of antimicrobial agents on UTI, 23 patients were assessed: 9 of them were judged to show excellent responses, 6 to have moderate responses and 8 poor responses. The overall efficacy was 65%. Four patients with indwelling catheter failed to show positive clinical response, but 15 out of 19 patients without indwelling catheter responded positively. As to bacteriological responses, organisms included Gram-positive cocci were eradicated in 28, replaced in 9 and persisted in 6 strains. Of 24 Gram-negative rods except 1 strain of Pseudomonas sp., 23 (96%) were eradicated. Safety evaluation was made in all 24 patients received CETB. No adverse reactions were observed in any cases. As to laboratory test results, slight, transient elevations of GOT, GPT and Al-P of serum were noted in 1 patient. Their values, however, returned to normal levels in 4 weeks.

Adult

[Proliferating patterns of basal cell carcinoma--immunohistological study by means of anti-BrdU monoclonal antibody].

The proliferating patterns of basal cell carcinoma were investigated by means of BrdU (bromodeoxyuridine), which is analogue of thymidine and by means of anti-BrdU monoclonal antibody. We classified 8 cases of basal cell carcinoma into three groups; 1) 21 nests of solid type basal cell carcinoma without retraction space 2) 6 nests of solid type basal cell carcinoma with retraction space 3) 5 nests of superficial type basal cell carcinoma without retraction space. The labeling index was obtained in each area of the outermost cells and inner cells in each nest of the three groups. The results indicated that when there was no retraction space, the labeling index of the outermost cells was high, and when there was some retraction space, the labeling index of the outermost cells was low. In other words, the proliferation of basal cell carcinoma cells occurs in the outermost cells of a nest. When there was retraction space, the role of the outermost cells of a nest diminished or disappeared.

Aged

Dexamethasone in the treatment of acute mountain sickness.

Cerebral edema occurs in fatal cases of acute mountain sickness. Dexamethasone, commonly used to treat cerebral edema due to other causes, also reduces the symptoms of acute mountain sickness when given prophylactically. However, the efficacy of dexamethasone in the treatment of established acute mountain sickness remains uncertain. To investigate this question, we exposed six men in a hypobaric chamber to a simulated altitude of 3700 m (barometric pressure, 64 kPa [481 mm Hg]) for 48 hours on two occasions. Acute mountain sickness was diagnosed with use of a symptoms questionnaire, and dexamethasone (4 mg every six hours) or placebo was then given in a randomized, double-blind, crossover fashion. Dexamethasone reduced the symptoms of acute mountain sickness by 63 percent (P less than 0.05), whereas placebo had a minimal effect (reduction by 23 percent; P not significant). In spite of this response, one subject had mild cerebral edema on brain CT after both placebo and dexamethasone. Dexamethasone had no effect on fluid shifts, oxygenation, sleep apnea, urinary catecholamine levels, the appearance of chest radiographs or perfusion scans, serum electrolyte levels, hematologic profiles, or the results of psychometric tests. Dexamethasone treatment was complicated by mild hyperglycemia in all subjects (mean [+/- SE] glucose level, 7.3 +/- 1.3 mmol per liter [132 +/- 23 mg per deciliter]). We conclude that dexamethasone effectively reduces the symptoms of acute mountain sickness. However, it did not improve objective physiologic abnormalities related to exposure to high altitudes. We therefore recommend that dexamethasone be used only when descent is impossible, or to facilitate cooperation in evacuation efforts.

Acute Disease

Protective immunity against Angiostrongylus cantonensis in rats following sensitizing infections.

Three strains (ACI, August and Wistar) of rats previously sensitized by oral infection with intact third-stage larvae of Angiostrongylus cantonensis developed significant protective immunity to challenge infections 6 weeks later. The degree of the immunity was highest in the August strain of rats, followed by Wistar and ACI rats. Protective immunity appears to affect both third-stage larvae and fourth- and/or fifth-stage worms. ACI rats showed poor antibody responses, especially in the IgE fraction. When 24-day-old young adult worms were transferred from the brain of donor rats into the peritoneal cavity of sensitized rodents, peritoneal eosinophils predominantly adhered to the worm surfaces in vivo.

Angiostrongylus

The detection of an antibody against IgA allotype A2M 2 and a study of the Am genetic marker among the Han Chinese population.

The serum of a woman was found by the Ouchterlony double-diffusion and the hemagglutination inhibition (HAI) methods to have immunoglobulin A (IgA) deficiency. Further investigation using the hemagglutination (HA) test with red cells coated with IgA myeloma proteins of different specificities showed that the serum agglutinated only IgA2-, A2M-1, and A2M 2-coated cells. The patterns of the HAI test with a reference panel confirmed the presence of two specificities. One was anti-IgA2 and the other was a rare antibody against the allotype A2M 2. The anti-A2M 2 was used for population studies. Testing of the Han Chinese population, including family studies, confirms that A2M.1 and A2M.2 have an autosomal dominant mode of inheritance and are controlled by a codominant allele. The distribution of the two Am genetic markers among the Han Chinese population demonstrated A2M.1 with a gene frequency of 0.553 and A2M.2 with a gene frequency of 0.447 (chi 2 = 0.145, 0.80 greater than p greater than 0.70).

Alleles

A high incidence of C9 deficiency among healthy blood donors in Osaka, Japan.

By the use of sucrose gelatin veronal buffer (SGVB), a simple screening test was developed by us to detect sera with low complement activity, including C9-deficient sera. Using this screening test, we were able to identify sera with low complement activity including C9-deficient sera among a large number of samples. Further examinations, estimation of the protein concentration of C9, C4, C3, etc., enabled classification of serum with low complement activity into C9-deficient serum, serum deficient in the other components, and serum with low complement activity caused by non-specific activation of complement through the classical pathway by low temperature in vitro. Among 145,640 sera from Osaka donors, 138 sera were found to be deficient in C9 by these methods. The whole complement activity (CH50) of the 138 sera was 13.1 +/- 3.0 U/ml. The C9 protein in these sera was undetectable, not only by the single radial immunodiffusion method, but also by the sensitive ELISA method. C9 activities in these sera were less than 0.1% of the level in pooled normal human serum. These findings and the family studies revealed that 138 blood donors unquestionably had a hereditary C9 deficiency. The incidence of C9 deficiency among Osaka donors was calculated to be 0.095%.

Blood Donors

A case of cross stimulation.

Cross stimulation in a dual chamber pacing system, in which the atrial stimulus intermittently captured the right ventricle, occurred immediately after pacemaker implantation in a 71-year-old man. It was prevented temporarily by reducing the pacing rate so that P wave synchronous ventricular (VDD) pacing resulted and by reducing the output of the atrial circuit from 5 to 4 volts. Cross stimulation disappeared spontaneously 14 days after surgery.

Aged

Role of venoconstriction in thromboxane-induced pulmonary hypertension and edema in lambs.

We evaluated the dose response to a stable thromboxane (Tx) A2 analogue (sTxA2; 0.3-30 micrograms) in the pulmonary circulation and its effect on the distribution of pressure gradients determined by the occlusion technique in isolated nonblood perfused newborn lamb lungs. The total pulmonary pressure gradient (delta Pt) was partitioned into pressure drops across the relatively indistensible arteries and veins (delta Pv) and relatively compliant vessels. We also evaluated the effects of prostacyclin (PGI2) and a Tx receptor antagonist (ONO 3708) on the sTxA2-induced pulmonary responses. Injection of sTxA2 caused a dose-related increase in the pulmonary arterial pressure, with the primary component of the increase in delta Pt (4.1 +/- 0.8 to 13.9 +/- 0.4 Torr) at 30 micrograms derived from the prominent rise in delta Pv (1.8 +/- 0.3 to 9.8 +/- 0.9 Torr). Infusion of PGI2 (0.4 microgram.kg-1.min-1) reduced the response to sTxA2 mainly by attenuating the delta Pv elevation. Infusion of ONO 3708 (100 micrograms.kg-1.min-1) completely abolished the sTxA2-induced pulmonary hypertension. Injection of sTxA2 resulted in pulmonary edema characterized by a significant increase in wet-to-dry lung weight ratio (9.13 +/- 0.35 vs. 7.15 +/- 0.41 in control lungs). The sTxA2-induced pulmonary edema was increased by PGI2 and inhibited by ONO 3708. We conclude that thromboxane-induced pulmonary hypertension is primarily produced by venoconstriction and prostacyclin may worsen the edema induced by thromboxane.

Animals

Inherited deficiencies of the late-acting complement components other than C9 found among healthy blood donors.

Among sera from 145,640 healthy blood donors in Osaka, 16 were found to have abnormalities in late-acting complement components other than C9. It was found that of these 16 sera, 2 were deficient in C5, 4 in C6, 6 in C7 and 4 in C8 alpha-gamma-subunit. The incidence of deficiency of each component among the Osaka blood donors was calculated as follows: C5 deficiency, 0.0014%; C6 deficiency, 0.0027%; C7 deficiency, 0.0041%; C8 alpha-gamma-subunit deficiency, 0.0027%. We confirmed that 13 donors were healthy and 12 had no past history related to a complement component deficiency. From these results, not only C9 deficiency but also deficiencies of the other late-acting complement components were found among the healthy blood donors, but no early-acting component deficiencies were noted.

Blood Donors

Effects of a thromboxane A2 analogue and prostacyclin on lung fluid balance in newborn lambs.

We have previously shown that the pulmonary venoconstriction produced by a stable thromboxane A2 analogue (STA2) is attenuated by prostacyclin (PGI2), but PGI2 increases the STA2-induced edema. The present study was designed to determine the effects of STA2 and PGI2 on the fluid balance in isolated blood-perfused newborn lamb lungs. Vascular permeability was evaluated by use of the fluid filtration coefficient (Kf) and the osmotic reflection coefficient for total proteins (sigma, hematocrit-protein double indicator technique), and pulmonary capillary pressure (Pc) was estimated by the double occlusion technique. All lungs had a period of hydrostatic stress induced by elevation of the left atrial pressure from 5 to 20 mm Hg to promote fluid filtration, and the rate of lung weight gain (delta W/delta T) during this period was determined. Studies were made in four groups; before the hydrostatic stress, lungs were given 1) STA2 (50 micrograms, n = 6), 2) PGI2 (0.4 micrograms/kg/min, n = 6), 3) both PGI2 and STA2 (n = 6), or 4) vehicles (control, n = 5). Measurements of Kf were made at the baseline period and after the hydrostatic stress. Kf was significantly increased by 76% with STA2, by 121% with PGI2, and by 157% with both PGI2 and STA2, but remained constant in controls. In comparison with control lungs, a similar delta W/delta T was observed with less of an increase in Pc during the hydrostatic stress in the STA2 group, and greater values of delta W/delta T were obtained with smaller elevations in Pc in the groups receiving PGI2 or both PGI2 and STA2.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

[VM-26 and VP-16 salvage therapy for refractory germinal testicular cancers].

Thirteen evaluable patients with germinal testicular cancers failing to be cured with first-line therapy (refractory) were treated by salvage chemotherapy. Ten patients received salvage chemotherapy with VM-26 (50 mg/m2, twice a week X 6 weeks) and cisplatin (CDDP, 20 mg/m2 for 5 consecutive days every 3 weeks for 3-4 times) (P-VM), 3 patients were also treated by radiation therapy, and 3 patients received VP-16 (100 mg/m2) and CDDP (20 mg/m2) (P-VP), all given daily for 5 consecutive days every 3-4 weeks for 4-5 courses. Of 13 evaluable patients, 6 (46%) had complete response (CR) (three cases were also treated with radiation therapy), 4 (31%) achieved partial response (PR), and 3 (23%) had no response. Limited to 7 patients treated with only P-VM therapy, there were 3 (43%) CR and 4 (57%) PR. Nine patients (69%) remained alive and were continuously disease free 18 to 84 months (median 48 months). Hematologic toxicity was severe, but with no death related to sepsis. Salvage chemotherapy with VM-26 or VP-16 and cisplatin offers potentially curative treatment to patients with refractory testicular cancer. The addition of radiation therapy to salvage chemotherapy was also effective.

Adult

[Production of IL-1 like cytokine by cultured bone cells: inducing effect of Haemophilus actinomycetemcomitans lipopolysaccharide on the cytokine production].

We have studies the role that interleukin-1 (IL-1) and IL-1-like cytokine play in the mechanism of bone resorption that occurs in periodontal disease. To determine whether the bone cell itself produces IL-1-like cytokine, we examined bone cells migrating from fragments of newborn mouse calvaria. These bone cells were cultured in alpha-MEM with of without fetal calf serum. IL-1-like cytokine activity was measured by incorporation of [3H] thymidine into C3H/HeJ thymocytes treated with lipopolysaccharide (LPS) from Haemophilus actinomycetemcomitans, a bacterium found in juvenile periodontopathy. The bone cells produced a significant amount of IL-1-like cytokine. The maximum production of IL-1-like cytokine was observed at 24 hours with the LPS in serum-free alpha-MEM. IL-1-like cytokine production stimulated by LPS was marked in the bone cells from LPS high-responder C3H/HeN mice, but not in those from low-responder C3H/HeJ mice. Peak of IL-1-like cytokine activity in culture supernatants of the bone cells was detected in fractions with a molecular weight corresponding to 15,000 daltons.

Animals

[Parasitic zoonoses in Japan, with special reference to the current topics].

The present situation of parasitic zoonoses in Japan is reviewed. A total of 51 species, i.e., 6 species of protozoan parasites, 14 species of trematode parasites, 11 species of cestode parasites, 18 species of nematode parasites and 2 species of acanthocephalan parasites are potential zoonotic parasites. Most (11 species) of the zoonotic nematodes provoke larva migrans. Habitats of zoonotic parasites vary greatly depending upon individual species. Some parasites cause heterotopic parasitism (e.g., Paragonimus westermani) and metastasis (Entamoeba histolytica). In larva migrans, parasites migrate through various parts of body tissues, affecting multiple organs (gnathostomiasis and sparganosis mansoni). The majority of parasitic zoonoses are food-borne infections. Some of them are an arthropod-borne (or -mediated) infection (dirofilariasis, thelaziasis and moniliformiasis), or acquired by percutaneous infection with cercariae (schistosome cercarial dermatitis) or 3rd-stage infective larvae (hookworm diseases). The diagnosis of parasitic zoonoses, especially larva migrans, is difficult; although some unique clinical symptoms and the presence of eosinophilia and/or increased level of serum IgE antibody are frequently seen in larva migrans, the application of various immunodiagnostic methods is usually required. For the prevention and control of parasitic zoonoses, the ingestion of not only strange food (e.g., snakes, frogs, slugs, etc.) but also raw fish and cuttlefish (sashimi) must be prohibited. Fishes and the meat of wild animals (e.g., bear and wild boar) should be frozen or thoroughly cooked before eating. Pets and domestic animals play an important role as a direct or indirect source of infection with various parasitic zoonoses. The treatment of those animals and/or the eradication of intermediate hosts (or vectors) of the parasites are thus required.

Animals

[A case of exohepatic pedunculated hepatocellular carcinoma suspected of adrenal tumor].

A case of exohepatic pedunculated hepatocellular carcinoma that was clinically diagnosed as nonfunctioning adrenal tumor is reported. A 66-year-old man was admitted to our hospital for further examination of unstable angina pectoris. Abdominal echogram and CT scan revealed a large tumor in the right retroperitoneal space. Selective right renal arteriography demonstrated that the tumor was fed by the capsular branch of right renal artery and the right adrenal artery. Adrenal function was normal. Preoperative diagnosis of right nonfunctioning adrenal tumor was made. On operation we found that the tumor was pedunculated from the liver and adhered massively to both right kidney and vena cava. The tumor and right kidney were removed. A histopathological examination demonstrated well differentiated hepatocellular carcinoma (Edmondson's grade II type).

Adrenal Gland Neoplasms

[Clinical statistics on inpatients and operations at the Department of Urology, the Center for Adult Diseases, Osaka, 1984-1988].

Statistical observation on inpatients and operations at our department between January 1984 and December 1988 revealed the following results: 1) The total number of inpatients was 1962 (male: 1658, female: 304). The most frequent diseases were bladder cancer (30.0%), benign prostatic hypertrophy (19.2%), prostatic cancer (10.6%) and renal cancer (6.7%). 2) The total number of operations was 1699. The most frequent operations were transurethral resection (TUR) of bladder tumor (22.8%), TUR prostate (20.7%), TUR biopsy (6.5%) and total cystectomy (5.4%).

Female

[Successful treatment of a patient with fulminant psittacosis].

A previously healthy 40-year-old woman was admitted with severe dyspnea, cough and slight fever. Chest X-ray film revealed bilateral widespread opaque infiltration with ground glass shadows around it. The laboratory examination showed moderate hepatic and muscular injury with disseminated intravascular coagulation. In addition her arterial blood gas showed severe hypoxemia (PaO2: 25 Torr under room air). Moreover, about 1 week prior to admission, 2 baby budgerigars she had been raising for half a year died. Because of this history and multi-organ injuries, this disease was considered to be acute pneumonia owing to fulminant psittacosis causing acute respiratory failure. On the first day of admission, she was intubated and ventilated mechanically with an oxygen concentration (FIO2) of 100%. Subsequently, treatment with intravenous minocycline (400 mg/day), heparin for D.I.C. and corticosteroid were started. Abnormal findings in both chest X-ray and several laboratory parameters improved gradually though fever continued for a week. On the 14th day of her hospital stay, she was weaned from the ventilator successfully and the administration of corticosteroid and heparin tapered. On the 41st day, she was discharged without any symptoms. Results of complement fixation (CF) antibodies against chlamydia on paired sera showed a significant rise from 1:32 to 1:256. Moreover, both IgG and IgM antibodies for Chlamydia psittaci with microplate immunofluorescent antibody technique (MFA) showed an 8 times' rise during 10 days after admission. The definitive diagnosis was made with positive isolation of C. psittaci from both the throat swab of this patient and the spleen and liver of the dead budgerigar by the cell culture method. Psittacosis should always be borne in mind as a possible cause of fulminant pneumonia with acute respiratory failure, and such a situation can be handled successfully if emergency care including mechanical ventilation is available.

Acute Disease