Biomedical subjects

M Fujishima

Publications and source records attributed to M Fujishima.

942 records · Page 53Linked to original sources

PubMedDate not supplied

Autoimmune cholangiopathy associated with rheumatoid arthritis.

We herein describe a patient with autoimmune cholangiopathy complicated with rheumatoid arthritis. A 58-year-old female was admitted to our hospital due to complications of arthralgia in her fingers, shoulders, elbows, knees and ankles. She presented with abnormally elevated levels of transaminases, alkaline phosphatase and was also negative for hepatitis B virus, hepatitis C virus and the serum mitochondrial antibody test, but had high titers of serum antinuclear antibody, rheumatoid factor and rheumatoid arthritis hemagglutination. A liver biopsy specimen showed chronic non-suppurative destructive cholangitis. She was thus diagnosed to have autoimmune cholangiopathy and rheumatoid arthritis. She began treatment with prednisolone 40 mg per day. After 20 days of steroid therapy, her hepatic function tests improved and the arthralgia symptoms disappeared. This is, to our knowledge, the first case of autoimmune cholangiopathy associated with rheumatoid arthritis, in which both symptoms improved with steroid therapy.

Anti-Inflammatory Agents↗

PubMedDate not supplied

Spontaneous regression of hepatocellular carcinoma--a case report.

We report a 72-year-old man with hepatocellular carcinoma, which showed spontaneous regression. He was diagnosed as having chronic hepatitis type C five years before admission. In January 1998, a liver mass was found by ultrasonography. In February, computed tomography showed a low-density mass, 3.5 cm in diameter in the S5 region. Although liver biopsy was not performed, findings obtained by computed tomography and ultrasonography indicated that the tumor was hepatocellular carcinoma. The levels of alpha-fetoprotein and PIVKA (protein induced by vitamin K antagonist)-II were increased to 1000 ng/mL and 2000 mAU/mL, respectively. The patient was admitted to our hospital in March 1998. At the time, the size of liver mass was reduced to 2.5 cm in diameter on computed tomography, and the tumor markers, alpha-fetoprotein and PIVKA-II, spontaneously decreased to the normal range. We considered that hepatocellular carcinoma of this patient regressed spontaneously. Because it was hard to exclude the possibility that the mass contained residual malignant cells, we resected the mass on April 28, 1998. Microscopically, the resected mass did not contain any malignant cells. The parenchyma surrounding tumor necrosis, which is reflected by severe inflammatory infiltration with lymphocytes, indicates spontaneous regression. Although the precise mechanism regarding spontaneous regression of hepatocellular carcinoma is not fully understood, either ischemia due to rapid growth of the tumor or some inflammatory mechanism may be involved in regression of hepatocellular carcinoma.

Aged↗

PubMedDate not supplied

Pressor responses to intracisternal administration of hypertonic NaCl in conscious normotensive and spontaneously hypertensive rats.

We evaluated the mechanisms of pressor responses to hypertonic NaCl solution administered intracisternally (i.c.) to conscious normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). In conscious rats of both strains, increases in mean arterial pressure (MAP) and heart rate (HR) induced by i.c. NaCl appeared immediately after the injection and MAP returned rapidly to the basal levels. In the urethane-anesthetized animals, the increases in MAP and HR occurred gradually and persisted. The early phase of the pressor actions of i.c. NaCl was considered to be mostly abolished by blockade of the sympathetic nervous system (SNS), and to be partly diminished by the vascular receptor blockade of vasopressin (AVP), in the conscious animals. The following phase of pressor responses to i.c. NaCl was not suppressed by the blockade of ganglionic transmission, alpha-adrenergic receptor, AVP or angiotensin II (AII). However, bilateral adrenalectomy practically abolished the pressor action of both early and late phases, thereby suggesting that catecholamines (CA), released from the adrenal gland, may play a major role in this pressor response to i.c. NaCl. The pressor responses to i.c. NaCl in conscious or anesthetized animals were slightly but significantly greater in SHR than in WKY. It is concluded that an early phase of increase in MAP, as induced by hypertonic NaCl administered i.c. to conscious SHR and WKY, may be attributed mainly to the increased activity of the SNS and partly to the increased release of AVP. The major part of the pressor effect of i.c. NaCl, including the late phase, may result from an enhanced secretion of CA from the adrenal gland. The present study also shows that the pressor action of i.c. NaCl in rats may be altered when the animals are anesthetized with urethane.

Anesthesia↗

PubMedDate not supplied

Cerebral autoregulation in young spontaneously hypertensive rats. Effect of sympathetic denervation.

Autoregulation of cerebral blood flow was studied with the hydrogen clearance method during development of hypertension in young spontaneously hypertensive rats. To examine the influence of sympathetic nerves on autoregulatory range, the unilateral superior cervical ganglion was removed 2 hours or 2 or 5 weeks before the study. Wall-to-lumen ratio of cerebral arteries was determined with freeze substitution technique. Basal blood pressures were 87 +/- 1 mm Hg (mean +/- SEM) at 4 weeks of age, 105 +/- 2 at 6 weeks, and 126 +/- 3 at 9 weeks, although resting cerebral blood flow was unchanged. Initially, cerebral blood flow remained relatively constant when the blood pressure was raised by intravenous infusion of phenylephrine. The upper limits of cerebral blood flow autoregulation in these groups were 110 +/- 4 mm Hg, 126 +/- 7, and 159 +/- 6 respectively. Acute ganglionectomy significantly lowered the upper limits (p less than 0.05), but chronic denervation did not affect the autoregulatory range. The wall-to-lumen ratios of cerebral arteries were 0.136 +/- 0.007 at 4 weeks and 0.130 +/- 0.005 at 9 weeks. These differences were not significant, nor did sympathetic denervation alter the ratio. These results indicate that (1) the upward shift of the autoregulation is closely related to a rise in the basal blood pressure, (2) acute interruption of sympathetic nerves modulates the autoregulatory range, and (3) adaptation of cerebral blood flow autoregulation to early developmental hypertension may be attributed to factors other than vascular smooth muscle hypertrophy.

Animals↗

PubMedDate not supplied

Risk of cancer development in the rectal remnant of patients with familial adenomatous polyposis/Gardner's syndrome.

BACKGROUND/AIMS: Current treatment for familial adenomatous polyposis usually entails total colectomy. However, the question of whether or not to remove the rectum has yet answered decisively. This paper represents an attempt to clarify the position on whether the surgeon should remove the rectum. PATIENTS AND METHODS: Twenty patients from 16 families with the established diagnosis of FAP, or Gardner's syndrome, who had been treated by total colectomy with ileorectal anastomosis, were followed up by proctoscopy for at least 5 years. The clinical features were compared between the patients with histologically verified rectal cancer and those who had been free from cancer development. RESULTS: During the observation periods ranging from 5 to 27 years (mean, 11.4 years), five rectal cancers were identified in 4 patients. These cancers included two cancers in adenomas, two nonpolypoid cancers, and one invasively ulcerating tumor. While the clinical and pathologic features at surgery and the incidence of colonic cancer in the resected specimen had not differed between the patients with rectal cancer and those without cancer, the former group of patients had more colonic polyps and they tended to have been observed over longer periods than the latter group of patients. CONCLUSION: These findings suggest that clinical features at surgery of patients with FAP are not relevant for predicting the development of rectal cancer during follow-up.

Adenomatous Polyposis Coli↗

PubMedDate not supplied

Characteristic endoscopic features of intestinal lymphangiectasia: correlation with histological findings.

Six patients with histologically proven intestinal lymphangiectasia were evaluated for the endoscopic features. White villi and/or spots, previously reported as endoscopic findings, were seen. Furthermore, white nodules and submucosal elevations with or without white mucosa were observed. All patients demonstrated the appearance of submucosal elevations. The four characteristic endoscopic features were correlated with histological findings. It is considered that these endoscopic features are of value for the diagnosis of intestinal lymphangiectasia in patients with protein-losing enteropathy.

Adolescent↗