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Biomedical subjects

M Haraguchi

Publications and source records attributed to M Haraguchi.

178 records · Page 10Linked to original sources
PubMed1978

Clinical evaluation of a pre-set ultrafiltration rate controller available for single pass and hemodiafiltration systems.

Introduction of high flux-type dialyzers, such as the RP-6, makes it necessary to devise an ultrafiltration rate controller for a single pass system. For this purpose, a new pre-set ultrafiltration rate controller has been developed and examined experimentally and clinically. The controller has twin chambers, each of which is divided into two symmetrical parts by a vertically-placed diaphragm. The diaphragm shifts repeatedly from right to left, aspirating in and driving out fresh or used dialysate alternately. If one removes a certain amount of used dialysate from a branch of the efferent line, negative pressure develops and aspirates an equal amount of water from the dialyzer. Therefore, extra dialysate obtained by a pump precisely reflects ultrafiltration rate. The controller has been used on five patients. The scheduled ultrafiltration rate was easily obtainable. The apparatus is also available for hemodiafiltration. Initial clinical trial has been promising.

Body Fluids↗
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Prognostic value of depth and pattern of stomach wall invasion in patients with an advanced gastric carcinoma.

We reviewed data on 467 patients with advanced gastric carcinoma, taking into consideration tumor size, shape and depth of invasion, and growth pattern, either expanding or infiltrative. Three patterns of penetration were identified: i.e., funnel, column, and mountain patterns. The funnel pattern was predominant in tumors extending into the muscularis propria (pm) or subserosa (ss), and were more widely distributed than the column pattern. The majority of the column type tumors were less than 8 cm in pm or ss, and the mountain type was found in only one case in ss, but their size was widely distributed once cancer cells penetrated the serosa. Patients with the funnel type had a better prognosis than the column or the mountain type, and the difference was significant when cancer invasion extended to the serosa.

Gastric Mucosa↗
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Surgery for gastric carcinoma is feasible for patients over 80 years of age.

We report here the outcome of surgical treatment for gastric cancer in 54 patients over 80 years of age presenting from 1967 to 1989. The mean observation interval of the postoperative period was 24 days. In most cases, preoperative examinations revealed pulmonary, renal or cardiac disturbances. The postoperative morbidity rate was 40.7%, most commonly as a result of pulmonary complications. In the 2 patients with multiple organ disturbances, 1 died 1 day after operation following myocardial infarction and the other died of pneumonia 12 days postoperatively. Intensive care treatments were needed in the early postoperative period. The increased morbidity rate proved to be related to wide resectional procedures such as total gastrectomy, operative time in excess of 3 hours, and intraoperative blood loss greater than 300 ml (p less than 0.05). When adjustment for confounding variables was made in the multivariate discriminant analysis, the type of surgery proved to be a major independent risk factor related to postoperative complications. The majority of tumors (92.6%) could be removed by standard resectional procedures and curative operation was feasible for 36 (66.7%) patients. There were 24 deaths due to progression of the cancer. The crude overall 5-year actuarial survival rate was 23.8%, while the rate was 36.9% when correction was made for sex and age. The probability of long-term survival for patients in a relatively early stage of disease (T1-2, N0-1) was statistically better than for those with a more advanced disease (T3-4, N2, M1). Thus, even for patients in the 8th decade of life, gastric surgery can be considered, for carefully selected patients.

Aged↗
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Pelizaeus-Merzbacher-like disease: female case report.

We experienced a 15-year-old female, whose healthy parents were second cousins, who was suspected of having dysmyelinating disease involving only the central nervous system (CNS). She was noticed to have congenital pendula nystagmus, and spastic gait disturbance developed at the age of 10 years. Mild athetosis of the upper limbs and ataxia were recognized at age 13 years, and dysarthria presented at age 15. MRI and electrophysiological findings showed the characteristics of Pelizaeus-Merzbacher disease (PMD), although the extensive nerve conduction slowing of the CNS was less severe than that in male patients with PMD. No promoter or exonic mutations of proteolipid protein (PLP) gene were detected. Although this patient might be heterozygous for a mutation of the extraexonic PLP gene sequences or of other unknown X-linked PLP associated genes, we speculate that this case had a dysmyelinating disease with an autosomal recessive trait characterized by the same phenotype as that of PMD.

Adolescent↗
PubMedDate not supplied

Relation of ethanol self-administration to feeding and drinking in a nonrestricted access situation in rats initiated to self-administer ethanol using the sucrose-fading technique.

Free-feeding male Long-Evans rats (N = 8) were initiated to self-administer 10% ethanol using a sucrose-fading procedure. Following initiation, they were placed into chambers which allowed for the continuous monitoring of feeding, water drinking and ethanol self-administration. All rats continued to daily self-administer ethanol in the continuous access situation. Ethanol drinking at certain times during the day appeared to be related to feeding bouts (prandial drinking). However, at other times, nonprandial ethanol self-administration occurred. These nonprandial ethanol drinking episodes, while not at levels of excessive ethanol intakes, were at levels well above water intake when water was substituted for ethanol. These findings suggest that ethanol intake in continuous access conditions is not solely a function of feeding behavior and that following initiation, ethanol-seeking behavior was maintained in a continuous access situation.

Alcohol Drinking↗
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Rate of eating and body weight in patients with type 2 diabetes or hyperlipidaemia.

This preliminary investigation, involving 422 patients, tested the hypothesis that rate of eating is associated with obesity in patients with type 2 diabetes or hyperlipidaemia at all ages. The patients' eating habits were determined using a questionnaire, and the patients were classified as quick, normal or slow eaters. The body mass indices of the three groups were compared. The body mass indices of the male patients who ate quickly (25.4 +/- 0.2 kg/m2) were significantly higher than those of the patients who ate at a normal rate (24.4 +/- 0.3 kg/m2) or slowly (24.1 +/- 0.5 kg/m2). No difference between body mass indices in the female groups was found. It was speculated that rate of eating affects body weight in male patients with type 2 diabetes or hyperlipidaemia.

Adult↗
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Jejunal perforation in a patient with adult T-cell leukemia.

We present a case of adult T-cell leukemia (ATL) with jejunal perforation at the site of intestinal involvement by ATL. A 39-year-old woman presented with sudden-onset abdominal pain. Physical examination showed generalized severe abdominal tenderness and intraabdominal free air was seen on radiographic examination. Under a diagnosis of peritonitis due to intestinal perforation, an emergency operation was performed. A pinhole-like perforation was found in the jejunum 80 cm distal to Treitz's ligament, and the patient underwent partial resection of the affected jejunum. Microscopic examination revealed diffuse infiltration of abnormal lymphocytes into the entire wall of the jejunum and mesenteric lymph nodes. A diagnosis of ATL was confirmed by the presence of antibody to human T-lymphotropic virus type 1 (HTLV-1) in the serum, a positive result for T-cell markers and the HTLV-1 proviral genome in the mononuclear cells in the specimens. The final diagnosis was thus lymphoma subtype of ATL. Combination chemotherapy was repeated until the patient died 14 months postoperatively. Emergent surgery followed by intense chemotherapy might improve survival in patients with ATL and perforated intestine.

Adult↗
PubMedDate not supplied

The detection of colorectal cancer at an asymptomatic stage by screening is useful.

BACKGROUND/AIMS: The validity of mass screening using fecal occult blood testing remains controversial. In addition, no controlled clinical study has yet been performed to show the usefulness of sigmoidoscopy. The purpose of the present study was to compare the surgical results achieved in asymptomatic patients with colorectal cancer detected by screening with those in symptomatic individuals. METHODOLOGY: A total of 285 patients underwent a surgical resection of colorectal cancer between 1991 and 1997 at our institution. Among them, 233 patients had complaints related to cancer at the time of diagnosis. In contrast, 52 were asymptomatic. In those 52 patients, colorectal cancer had been suspected based on routine screening including fecal occult blood testing, colonoscopy and/or elevated serum levels of carcinoembryonic antigen. RESULTS: Early stage of colorectal cancer was more frequently seen in asymptomatic patients than in symptomatic patients P < 0.01. The survival rates for asymptomatic patients was also superior to those of symptomatic patients P < 0.05. CONCLUSIONS: Screening using fecal occult blood testing, colonoscopy and tumor markers is thus considered to be beneficial for the early detection of colorectal carcinoma, which also tends to demonstrate good surgical results.

Aged↗
PubMedDate not supplied

Neuropathological changes induced by total cerebral ischemia (TCI) in a new experimental model.

We describe a new model of human ischemia encephalopathy in rabbits by means of cross-clamping the ascending aorta in combination with blood exsanguination from the right atrium. Rabbit hippocampal CAI pyramidal cells and cerebellar Purkinje cells showed only a few changes in the early period after ischemia, but 4 days after ischemia a significant decrease in cell count and marked degeneration of the remaining cells were observed. When the pathological findings 4 days after TCI in the hippocampal area and cerebellar area were compared, the rate of cytoclasis was found to be significantly higher in the latter than in the former.

Animals↗
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Surgical management of patients with radiation enteritis.

To improve the surgical outcome in patients with radiation enteritis, 18 female cases were analyzed. Out of the 18 cases, 3 (16.7%) were treated conservatively while 15 (83.3%) underwent surgical procedures. Thirteen out of 14 patients (92.8%) with ileus underwent an operation. The overall mortality was 22.2% (4 out of 18 cases). However, no significant difference in the mortality between the operated and non-operated cases was observed. Although an analysis of the 15 operated cases did not reveal any significant factors that might have affected the prognosis, all four patients who underwent a bypass operation showed a good postoperative course, with only one excepting being a patient suffering from malnutrition. Although only a small number of patients were included in this study, these results suggest that 1) surgeons should not hesitate to operate on patients with radiation enteritis demonstrating ileus, and 2) a bypass operation may be one surgical alternative in the presence of massive adhesion or for patients at high risk for a standard operation.

Adult↗
PubMedDate not supplied

Expression of the MAGE gene family in human gastric carcinoma.

MAGE genes code tumor antigens that are recognized by cytolytic T lymphocytes and have been shown to be expressed in various malignant tumors. However, there is still little information on the expression of the MAGE gene family except for reports of MAGE-1 and -3. In this study, we therefore investigated the expression of MAGE-4, -6, -8, -9, -10, -11 and -12, as well as MAGE-1, -2 and -3 in both cell lines and surgical samples of gastric carcinoma, using reverse transcriptionPCR. Of the investigated 11 cell lines, MAGE-4, -6, -8, -9, -10, -11 and -12 were detected in 8 (73%), 6 (55%), 2 (18%), 59 (44%), 6 (55%), 4 (36%), and 7 (64%), respectively. No expression of these genes was seen in any of the 54 samples of normal gastric tissue. In contrast, the tumor tissue samples were found to express MAGE-4, -6, -8, -9, -10, -11, and -12 in 18 (33%), 13 (24%), 6 (11%), 10 (19%), 5 (9%), 13 (24%), and 10 (19%), respectively. Forty-four (82%) of 54 gastric tumors expressed at least one of these genes. No significant correlation was observed between the expression of MAGE genes and any specific clinicopathological factors. These results may hopefully prove to be useful in developing strategies for tumor-specific immunotherapy of gastric carcinoma using MAGE gene products.

Antigens, Neoplasm↗