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Biomedical subjects

M Hashimoto

Publications and source records attributed to M Hashimoto.

At least 541 records · Page 30Linked to original sources

Effects of estrogen on atherosclerosis formation and serum nitrite/nitrate concentrations in cholesterol-fed ovariectomized rabbits.

This study was to examine the effects of estrogen replacement on atherosclerosis formation in ovariectomized cholesterol-fed rabbits. We also examined serum levels of nitrite/nitrate, stable metabolites of nitric oxide, to investigate the involvement of nitric oxide. Female New Zealand White rabbits were ovariectomized and divided into 3 groups; 1) fed a normal diet (ND group, n=5), 2) fed a 1% cholesterol diet (CD group, n=6), or 3) fed a 1% cholesterol diet and received estrogen replacement (CD+E group, n=7). After 3 months, the rabbits were sacrificed to examine atherosclerosis formation. Atherosclerosis was not observed in ND. The oil red 0 positive area in the aorta was significantly greater in CD than in CD+E (CD, 17.3+/-2.2; CD+E, 9.3+/-0.8%, p<0.05). Stenosis of the coronary artery was also significantly greater in CD than in CD+E (CD, 30.6+/-9.7; CD+E, 6.7+/-2.9%, p <0.05). There was no significant difference in serum lipids between CD and CD+E. Serum nitrite/nitrate levels were significantly lower in CD than in ND (ND, 37.6+/-3.6; CD, 25.3+/-3.1 microM, p<0.05). There was a non-significant trend towards higher nitrite/nitrate levels after estrogen replacement (CD+E, 34.4+/-3.8 microM, p=0.08 vs. CD). These results suggest that direct actions on vascular wall including nitric oxide production contribute to the anti-atherogenic effects of estrogen.

Animals↗

[Modifications of fractional uptake method for 123I-IMP].

We intended to improve the fractional uptake (FU) method which was developed to quantify cerebral blood flow using 123I-IMP without blood sampling. The quantification of cardiac output (CO) using first-pass data was adapted to FU method while the original FU method used CO which was estimated from the body surface area of patients. Time-radioactivity curves of the lungs and brain were separately obtained by a small-field-of-view gamma camera. In 24 cases, mean cerebral blood flow (mCBF) obtained by the modified FU method showed the better correlation (r = 0.833, P< 0.001) to mCBF measured by the Patlak plot with 99mTc-HMPAO than the original FU method (r=0.667, p<0.01). With these modifications, the reliability of FU method could be improved and the modified FU method might be performed in the other institutions.

Adult↗

[Analysis of specificity of resected esophageal cancer patients with a history of apoplexy].

We studied 15 resected cases with a history of apoplexy (2.5%) among 599 cases of esophageal cancer admitted between 1972 and 1993. Fourteen were male, and female, aged 48 to 77 years. Twelve had suffered from cerebral infarction, 2 intracerebral hemorrhage, and one subarachnoid hemorrhage. Duration from apoplexy to operation was between 2 months and 19 years in the cerebral infarction cases, between 8 and 10 years in the intracerebral hemorrhage cases and 4 years in the subarachnoid hemorrhage case. Preoperative neurological disturbance was found in 7 of the 12 cerebral infarction cases, and in both intracerebral hemorrhage cases. Four cases showed hemiplegia, and the other 5 cases showed partial paralysis of limbs. Preoperative complications were found in 7 of the 15 cases, and consisted of diabetes mellitus in 5, hypertension in 4, bronchial asthma in one, and renal dysfunction in one case. Intra- and postoperative complications were found in 11 of the 15 cases, and consisted of anastomotic leakage in 5, delirium in 3, apoplexy in 2, peritonitis in one, ARDS in one, intraoperative cardiac arrest in one, and wound infection in one. Postoperative disorders of consciousness were found in 5 cases, consisting of delirium in 3, and excitation at awakening of anethesia in 2 cases. Rate of direct operative death was 6.7% in preoperative apoplectic patients, and 8.5% in non-apoplectic patients, and there was no significant difference between the 2 groups. On the other hand, rate of postoperative apoplexy was 13.3% in the preoperative apoplectic patients, and 0.4% in non-apoplectic patients. There was a significant difference between them (p < 0.01). But they were cured of it, and left our hospital. It is concluded that active surgical treatment can be indicated for esophageal cancer patients with a history of apoplexy, if more attention is given to the management of diabetes mellitus or hypertension.

Aged↗

[In vitro direct antiproliferative activity and in vivo antitumor activity of bropirimine against bladder cancer].

Bropirimine is an antitumor agent currently used in clinical trials on bladder cancer. It is known to induce IFN, to activate NK cells and to inhibit the growth of tumor cells. In this study, we examined the in vitro and in vivo efficacy of bropirimine on human and murine bladder cancer. Bropirimine showed in vitro antiproliferative activity on the human bladder cancer cell lines, T 24 and KoTCC-1. This activity was not: affected by the neutralizing antibodies against IFN-alpha, TNF-alpha or IL-1 beta, indicating it is the direct activity of bropirimine without involvement of cytokine production by tumor cells. Bropirimine was active at the concentrations comparable to those in serum or urine attained in clinical trials, which suggests that this direct antiproliferative activity is one of the important antitumor mechanisms of bropirimine. In in vivo experiments, bropirimine reduced the growth of transplanted murine MBT-2 and human KoTCC-1 bladder cancers by oral administration every 4 days starting on day 1, but did not show efficacy when the drug treatment was started on day 8. The antitumor activity of bropirimine was dependent on the timing for drug treatment initiation.

Animals↗

[Treatment of advanced gastric carcinoma based on histologic type].

It is well known that clinicopathological characteristics in gastric carcinoma are different according to its histologic type, intestinal type or diffuse type. Multivariate analysis of advanced gastric carcinoma revealed that the histologic type significantly related to the type of recurrence, hematogenous metastasis or peritoneal dissemination. Therefore, we introduced a prospective randomized trial for treatment of advanced gastric carcinoma based on histologic type of carcinoma. Intraoperatively, 10 mg of mitomycin C was given via portal system in the intestinal type and given in peritoneal cavity in the diffuse type. As results, in the intestinal type, survival rate in patients with the chemotherapy was longer than that without the chemotherapy, but this did not reach to a significant difference. On the contrary, in the diffuse type, patients with the chemotherapy showed a significant longer survival rate compared to those without the chemotherapy. These results suggests the availability of treatment based on histologic type of carcinoma. Much more selective and effective improvements in this type of treatment will be required.

Antineoplastic Combined Chemotherapy Protocols↗

[A case of Jefferson fracture treated with the Sof'wire cable system method of fixation].

Jefferson fracture is a very rare disease which occurs in only 2-13% of all cervical spinal fracture cases and in only 1.3% of total spinal fracture cases. A combination of an atlas-axis fracture occurs relatively frequently and with a higher incidence of neurological morbidity than isolated fractures. However, a Jefferson fracture, which is an isolated C-1 fracture, occurs very rarely. A 58-year-old woman was involved in a traffic accident and admitted to our hospital. She had a large scalp laceration in the parietal region and complained of nuchal pain. Neurological examination revealed nothing abnormal. A cervical x-p (lateral view) revealed no abnormal findings, but an open-mouth view revealed an 8 mm displacement (in total) in the lateral mass of the atlas. A cervical CT revealed a Jefferson fracture. Crutchfield traction was performed for 9 days followed by external immobilization with a halo-vest to allow the patient to be ambulatory quickly. A posterior occipitocervical fusion was performed with an iliac bone autograft using the Sof'wire Cable system for late cervical stability and reducing the period of rigid external immobilization. The postoperative state was uneventful. The halo-vest was removed 10 weeks after surgery. An x-p obtained 3 months postoperatively showed good stability of the cervical spine. The Sof'wire Cable system proved to be very useful.

Accidents, Traffic↗

[A case of predominant right thalamic infarction with severe verbal memory disturbance].

We encountered a 45-year-old right-handed man who had suffered a predominant right thalamic infarction and complained of memory loss. Performance on the Miyake Test (recall of ten pairs of related and unrelated words), the Rey Osterrieth Complex Figures, the Benton Test of Visual Retention and the Wechsler Memory Scale-R disclosed a severe verbal memory disturbance associated with a little, if any, visual memory disturbance. An MRI study revealed bilateral lesions limited to the thalamus involving most of the right anterior nucleus (AN), mediodorsal nucleus (MD), ventrolateral nucleus (VL), and centromedial nucleus (CM), as well as a small part of the left MD, and CM. HM-PAO-SPECT scans showed areas of decreased cerebral blood flow not only in the right thalamus but in the medial and basilar region of the right temporal lobe. It is noteworthy that our patient had a predominant right thalamic lesion and exhibited a severe verbal memory disturbance rather than visual memory disturbance. This suggests that the right hemisphere is dominant for verbal memory function in this patient.

Cerebral Infarction↗

[Medical services utilization of the elderly during the last six months of life].

The purpose of this study was to describe the characteristics of medical services utilization during the last six months of life. Subjects were 150 elderly who lived in a community and died in 1990. By each subject's medical claims during the last six months of life, the number of hospital days, the number of visits for ambulatory care, the number of physicians' and nurses' visits for home care, medical expenditure, and the utilization of medical care activities were measured as utilization variables. Subjects were classified into four subgroups by the combination of cancer and cerebrovascular disease. These diseases have an important impact on medical services utilization during the last six months of life. Utilization variables of each subgroup were compared. The findings were as follows; 1. During the last six months of life, hospital stays of cerebrovascular disease patients were for long periods, while cancer patients frequently and repeatedly changed the place of care between hospital and home. 2. The number of visits for ambulatory care and the number of medical care providers utilized by cancer patients were greater than that of cerebrovascular disease patients. Cerebrovascular disease patients whose stay at the hospital was short made greater use of physicians' and nurses' visit for home care. 3. The medical expenditure of cancer patients was higher than that of cerebrovascular disease patients, although the number of hospital days of cancer patients was less. 4. Most of the cancer patients utilized transfusion and urological treatment. These results suggest that the utilization of medical care activities of cancer patients was more intensive than that of cerebrovascular disease patients. However cancer patients made little use of resuscitation procedures.

Aged↗

Malignant lymphoma of the adrenal gland: its possible correlation with the Epstein-Barr virus.

Initial manifestation of malignant lymphoma in the adrenal gland is a rare event, and clinical and pathologic features are not fully understood. We conducted a nationwide study in Japan, and 20 patients with malignant lymphoma that showed initial and main manifestation in the adrenal gland were identified. Clinical and pathologic findings were summarized. In addition, the presence of the Epstein-Barr virus (EBV) genome in the tumor cells was examined by using polymerase chain reaction (PCR) and in situ hybridization (ISH), together with the immunohistochemical evaluation of the expression of latent membrane protein-1 (LMP-1). There were 13 men and seven women; their ages at admission ranged from 40 to 87 years (median, 65 yr). Fever, anemia, and elevation of lactic dehydrogenase levels were the common presenting findings. One patient had acquired immunodeficiency syndrome. Adrenal tumors were bilateral in 15 patients and unilateral (all in the left site) in five. Prognosis was very poor; all but two patients died within 1 year after admission. Histologically diffuse large cell type was the commonest type (14 specimens). Immunohistologically, 16 specimens were B-cell type, and one was T-cell type. Another three specimens showing no positive reaction for any antibodies were also judged as B-cell type on purely morphologic grounds. Prominent intravascular proliferation of tumor cells was found in five patients. PCR for EBV genomes gave positive results in five patients; the virus was subtyped as A in three patients and as B in two. The ISH provided positive signals in nine samples, including all five specimens positive for PCR. Four of the nine cases with detectable EBV by PCR and/or ISH expressed LMP-1. The present study shows that adrenal lymphoma is EBV associated and has a B-cell phenotype.

Adrenal Gland Neoplasms↗

[MRI abnormalities of the brain in neurologic complications following treatment of cancer in children].

During a 3-year period, 6 of 50 children with systemic malignacies developed neurologic complications such as hemiparesis, convulsions and loss of consciousness. The children consisted of 1 boy and 5 girls, from 3 to 12 years old, 3 with acute lymphoblastic leukemia and 3 with malignant lymphoma. Four patients received induction treatment that included intravenous administration of L-asparaginase and/or intrathecal administration of methotrexate. One patient received induction treatment and consolidation treatment that included intravenous administration of L-asparaginase. One patient received induction and consolidation treatment, and the protocol for peripheral blood stem cell transplantation. Laboratory examinations revealed coagulation dysfunction in 3 patients treated with L-asparaginase and 1 patient with disseminated intravascular coagulation (DIC). Magnetic resonance imaging (MRI) was performed on a 1.5-T unit, using spin-echo or fast spin-echo sequences. T1-weighted, T2-weighted, and proton density-weighted images were obtained in the axial and/or coronal plane (section thickness, 4 mm; inter-section gap, 2 mm). MRI was initially performed within 36 hours after the onset in all patients, and follow-up MRIs were performed for 6 months. MRI showed lesions involving the cortex and subcortex in 4 patients with coagulation dysfunction. In 2 of these 4 patients, Gd-enhanced T1-weighted images showed contrast enhancement in the surface of the gyrus, suggesting focal vascular stasis. Serial MRI revealed nearly complete resolution of the lesions. Symptoms were relieved in every case. The lesions on MRI were presumed to be due to venous thrombosis related to the coagulation dysfunction caused by L-asparaginase or DIC. On the other hand, in 2 patients with onset after intrathecal administration of high-dose methotrexate and cytarabine, MRI revealed multiple lesions involving the centrum semiovale and periventricular white matter. No Gd-enhancement of the lesion was detected. This MRI finding was consistent with leukoencephalopathy. As time passed, the symptoms improved completely, and the lesions became better demarcated. MRI is useful for differentiating lesions related to coagulation dysfunction from leukoencephalopathy.

Adolescent↗

Changes in urinary enzyme activity and histochemical findings in experimental tubular injury induced by gold sodium thiomalate.

To elucidate the renal injury induced by gold treatment, we administered various doses of gold sodium thiomalate (GST) to Wistar rats and investigated alterations in the urinary enzyme activity, gamma-glutamyl transpeptidase (gamma GTP) and N-acetyl-beta-glucosaminidase (NAG) activity, and histochemical change of enzymes, gamma GTP, alkaline phosphatase (ALP) and acid phosphatase (ACP) activity in the renal tissue. The single administration of a large dose of gold salts induced acute tubular necrosis and enzyme leakage was detected histochemically without damage to the glomerulus. After chronic administration of small doses of gold salts, the urinary gamma GTP activities gradually increased, but urinary NAG activities did not. These findings suggested that the change in urinary enzyme activities, which leaked from inside of brushborder or lysosome, indicated the degree or localization of tubular damage, because renal tubules were selectively injured by gold salts.

Acetylglucosaminidase↗

[Bowel injury caused by a catheter for Intraperitoneal chemotherapy--a case report].

A case of bowel perforation caused by a catheter used for intraperitoneal chemotherapy is reported. A 46-year-old woman underwent bilateral salpingo-oophorectomy, total hysterectomy and infracolic omentectomy for treatment of stage II c endometrioid carcinoma of ovary. Subsequently, the patient was treated with intraperitoneal administration of CBDCA through Port-A-Cath as well as intravenous CPA infusion every 5-6 weeks. Ten days after the 5th course of chemotherapy, she complained of low abdominal pain and fever of 37.9 degrees C, which resolved during a 6-day hospital stay, although her appetite remained poor. In the 6th course, CBDCA was administrated intravenously, because the intraperitoneal catheter became obstructed. Secondary cytoreductive laparotomy, which was performed 14 months after the primary surgery, revealed that the catheter of Port-A-Cath had penetrated the descending colon. Although intraabdominal injury by the catheter may be rare, it should be noted as one of complications when a patient is treated with intraperitoneal chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗

[Longitudinal study on association between care conditions and mortality among frail elderly living at home].

In order to elucidate the association between care conditions and mortality rate, a two year longitudinal study was performed on 115 frail elderly living at home. The main results were as follows; 1. Of the 115 frail elderly, 45 persons (39.1%) died during the two years. 2. A multiple logistic regression analysis revealed that the following factors were correlated to their death: age, activities of daily living (ADL), type of bedding. 3. Although ADL level was lower in the bed group than the Japanese style bed (futon) group at the first survey, survival rate was 69.8% in bed group and 47.5% in futon group. The relative risk of death with beds was 0.61 (95% confidence intervals 0.38-0.96) and was statistically significant.

Activities of Daily Living↗

Effects of a high-protein diet on mineral metabolism and struvite activity product in clinically normal cats.

OBJECTIVE: To examine effects of high-protein diets (> 50% crude protein of dry matter) on urinary mineral excretion and struvite activity product ([Mg2+] x [NH4+] x [PO(4)3-]). ANIMALS: 14 clinically normal cats, 4 adult female and male cats for experiments 1 and 2, respectively, and 6 female kittens aged 4 months for experiment 3. PROCEDURE: Relations between dietary protein amount (25.9, 38.3, 51.4, and 65.4% crude protein [dry matter]) and urinary excretion of Mg, P, and Ca were examined in a 4 x 4-Latin square design (experiment 1). Struvite activity product, the index of solubility of struvite crystals, was determined when a high-protein diet (54.9%) was fed (experiment 2). Utilization of minerals in cats fed a high-protein diet long term was examined (experiment 3). RESULTS: Water intake and urine volume increased with increasing dietary protein concentration. Urinary Mg2+ excretion was not affected (experiment 1) or was decreased (experiment 3) by higher protein intake, leading to lower urine Mg2+ concentration in groups fed higher protein amounts. Urine pH was decreased by high-protein intake. As a result, PO(4)3- concentration was decreased by high-protein intake (experiment 2), although total daily urinary excretion of P was increased. Consequently, struvite activity product tended to decrease in cats fed high-protein diets, indicating increase in struvite solubility. High-protein intake decreased Ca and P retention by increasing their fecal and urinary excretions, respectively. CONCLUSION: As a consequence of the increase in urine volume and urine acidification, high-protein diets have potential ability to increase solubility of struvite crystals.

Animals↗

Superficial siderosis and episodic fourth nerve paresis. Report of a case with clinical and magnetic resonance imaging findings.

We describe a patient with superficial siderosis who had an episodic unilateral fourth nerve paresis. The superficial siderosis was caused by small repeated intraventricular hemorrhages from a periventricular cavernous angioma. T2-weighted magnetic resonance images demonstrated a rim of low signal intensity at the brain surface, characteristic of hemosiderin deposition. These low-signal-intensity deposits included the dorsal brain stem around the anterior medullary velum. We suggest that the hemosiderin deposits affected the proximal portion of the fourth nerve where it contains central myelin and that this in some way caused unstable conduction of nerve impulses through the nerve.

Adult↗

[A case of coronary perforation after directional coronary atherectomy].

Directional coronary atherectomy was performed on a 69-year-old female with angina pectoris. She suffered from coronary perforation as a result of cardiac tamponade and shock. Pericardial drainage and hemostasis were performed immediately using a perfusion catheter. The patient was transferred to the operating room for perforation repair and coronary artery bypass grafting to the distal portion of the left anterior descending artery. The procedure was performed successfully. Although acute coronary perforation associated with directional coronary atherectomy is rare, it can be managed temporarily by a perfusion catheter and we successfully performed coronary artery bypass grafting.

Aged↗