[Coronary flow velocity measurement by intravascular Doppler method--Doppler catheter and Doppler guidewire].
Explore the source record for details and available documents.
Blood Flow Velocity↗
Biomedical subjects
M Hashimoto
Publications and source records attributed to M Hashimoto.
Susceptibility of methicillin-resistant Staphylococcus aureus clinical isolates to various antimicrobial agents. IV. Aminoglycoside-modifying enzyme AAC(6')/APH(2") is responsible for arbekacin-resistance enhanced by bleomycin.
Resistance patterns against various antimicrobial agents including beta-lactams, aminoglycosides, tetracyclines, fluoroquinolones, macrolides were examined for 58 strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated at Hiroshima University Hospital from April to November 1992. All the MRSA strains produced type II-coagulase but not beta-lactamase. Regarding aminoglycoside-modifying enzymes, 7 strains (12%) appeared to be producing aminoglycoside 4',4"-adenyltransferase AAD(4',4") encoded by aadD without coproduction of bifunctional aminoglycoside 6'-acetyltransferase/2"-phosphotransferase AAC(6')/APH(2") encoded by aacA-aphD (referred to as tobramycin-resistant type, TOBr). The remaining 51 strains (88%) were phenotypically producers of both enzymes (i.e., mix-resistant type, Mixr). AAD(4',4"), encoded by aadD which was reported to be closely linked with bleomycin (BLM)-resistance determinant, could be seen in 100% MRSA strains and ca. 90% strains expressed AAC(6')/APH(2"). BLM endowed Mixr-type but not TOBr-type MRSA strain with enhanced resistance to arbekacin (ABK) dose-dependently, presumably by modifying the production of AAC(6')/APH(2"). The manifestation of ABK-resistant phenotype by Mixr-type MRSA required the coexistence of BLM. Therefore, ABK must be administered carefully to cure MRSA infection in patients who have been treated with BLM.
Acetyltransferases↗
[In vitro synergistic effects of tazobactam/piperacillin with various antibiotics].
We investigated in vitro synergistic effects of tazobactam/piperacillin (TAZ/PIPC), a combination drug of tazobactam (TAZ) and piperacillin (PIPC) in the ratio of 1:4, with several other antibiotics against Pseudomonas aeruginosa, Serratia marcescens and methicillin-resistant Staphylococcus aureus (MRSA). Synergistic effects of TAZ/PIPC with each of tobramycin (TOB), netilmicin (NTL), fosfomycin (FOM), ciprofloxacin, minocycline or cefoperazone were observed against all bacteria tested in the checkerboard dilution method. No antagonistic effect was observed in combination of TAZ/PIPC with other antibiotics. Against P. aeruginosa, a combination of TAZ/PIPC with NTL was the most effective, with an average fractional inhibitory concentration (FIC) index of 0.459. And a combination of TAZ/PIPC with FOM was the most the effective against S. marcescens and MRSA. TAZ/PIPC combined with TOB or FOM showed bactericidal effect against P. aeruginosa No. 11, S. marcescens No. 39 and S. aureus O-62 at concentrations of the drugs that showed only bacteriostatic activity individually. Phase-contrast micrographic observations of P. aeruginosa No. 11 and S. marcescens No. 39 demonstrated that the bacterial cells treated with TAZ/PIPC were in filamentous forms and those treated with TOB or FOM were nearly normal. The combination of TAZ/PIPC with TOB or FOM induced filamentous cells with spheroplast-like structures and lysis. Those results suggest that the combination of TAZ/PIPC with aminoglycosides or FOM were useful in the treatment of infections by P. aeruginosa, S. marcescens and MRSA, especially those caused by beta-lactamase-producing strains.
Drug Synergism↗
Different effects of an angiotensin converting enzyme inhibitor and a calcium antagonist on protein metabolism in rats with right ventricular hypertrophy.
OBJECTIVE: We examined the effects of a calcium antagonist and an angiotensin converting enzyme (ACE) inhibitor on contractile and non-contractile protein metabolism and cardiac function in a monocrotaline-induced right ventricular hypertrophy model, in order to define the effects of these drugs on cardiac hypertrophy. METHODS: One week after monocrotaline injection, male Sprague-Dawley rats were given either a calcium antagonist (nilvadipine; 3 mg/kg per day) or an ACE inhibitor (delapril-HCl; 30 mg/kg per day) for 2 weeks. Right ventricular pressure, the right ventricle: (left ventricle + interventricular septum) ratio, myosin isoenzymes, collagen concentration, collagen types and contractility of right ventricular free wall were examined. RESULTS: In untreated rats significant monocrotaline-induced right ventricular hypertrophy with an increase in the proportion of collagen types III and V was observed. There were no significant changes in collagen concentration. Both drugs reduced right ventricular pressure to the same degree and decreased right ventricular hypertrophy. However, the inhibitory effect of delapril on right ventricular hypertrophy was stronger than that of nilvadipine. Nilvadipine reduced the collagen concentration and reversed changes in collagen types, whereas delapril did not have any significant effect on collagen concentration or collagen types. Cardiac contractility was improved by delapril, but not by nilvadipine. CONCLUSIONS: The results show that a calcium antagonist disproportionately inhibited contractile and non-contractile protein metabolism, whereas an ACE inhibitor proportionally inhibited them and improved cardiac function in a model of right ventricular hypertrophy. The improvement in cardiac function may be due partly to the proportional inhibition of contractile and non-contractile proteins elicited by an ACE inhibitor.
Absorptiometry, Photon↗
[An autopsy study of the mode of cancer metastasis on the esophagectomied patients for esophageal cancer].
The records of autopsy on 43 patients underwent esophagectomy were evaluated retrospectively. Fifteen patients were performed palliative surgical treatment and 28 were curative, there were 41 men and 2 women in the series. The mean age at the first operation was 59.5 yr. The distribution of the primary lesions were 1 cervical, 40 thoracic (3 upper intra-thoracic, 28 middle intra-thoracic and 9 lower intra-thoracic) and 2 abdominal esophagus. There were 42 cases of squamous cell carcinoma (13 well differentiated types, 25 moderately differentiated types and 4 poorly differentiated types) and 1 adenosquamous cell carcinoma. Their stage classification were 0 for 2 patients, I for 1, III for 13 and IV for 27. In cases of palliative surgical treatment, the residual tumor were present on 6 cases in trachea or bronchus and 2 in aorta. Others were the rest of metastatic nodes in 3 cases, positive surgical margin in 3 and visceral metastasis and peritoneal dissemination in 1. At autopsy, 14 patients (93%) had distant organ metastases, 11 (73%) local recurrent tumor, 11 (73%) node metastases and 9 (60%) disseminations. In cases of curative surgical treatment, the first recurrent sites were as follows. Lymph node metastasis observed in 20 cases (71%), local recurrence in 9 cases (32%), distant organ metastases in 8 cases (28%) and disseminations in 5 cases (18%). While at autopsy, 24 patients (86%) had lymph node metastases, 20 (71%) distant organ metastases, 15 (54%) local recurrent tumors and 11 (39%) disseminations. On 10 cases whose first recurrent site was observed only at lymph node, 9 cases (90%) had distant organ metastases at autopsy. In both cases of palliative surgical treatment and of curative surgical treatment, the most dominant metastatic site at autopsy was distant organ metastasis. Therefore, in the future, distant organ metastasis must be an important target for esophageal cancer treatment.
Adult↗
Analysis of the genes encoding the variable regions of human IgG rheumatoid factor.
OBJECTIVE: To better understand the immunoglobulin variable (V) region repertoire of rheumatoid factors (RF). METHODS: We characterized the heavy (H) and light (L) chain gene segments utilized in a monospecific IgG RF secreting hybridoma (AEE111F) which were derived from a patient with rheumatoid arthritis (RA). The hybridoma was established by fusion of a mouse myeloma cell line with bone marrow derived mononuclear cells from a patient with RA. First strand complementary DNA (cDNA) was generated and used for a polymerase chain reaction amplification of the H and L chain V domains. The amplified V domains were sequenced and compared with an extensive database of germline and cDNA V gene segments. RESULTS: The VH sequence was found to be 96% homologous to a previously described fetal VH3 cDNA (60P2). The VL sequence was also highly homologous to the previously described V lambda II gene (96%) derived from a patient with systemic lupus erythematosus which correlated with an 8.12 idiotype (Id), and to an antibacterial antibody against the Haemophilus influenzae type b capsular polysaccharide (94.7%). CONCLUSION: The overlap among this RF VL gene and the 2 reported V lambda sequences of antibodies that expressed anti-DNA related Id and an environmental pathogen specificity suggests that a part of the IgG RF isolated from patients with RA may thus be derived from the physiological natural antibody repertoire during an abnormal immune response and then develop high affinity, monospecific RF by the selection of an antigen driven mechanism.
Amino Acid Sequence↗
[Influence of cytokines on ICAM-1 expression and soluble ICAM-1 production by human endothelial cells].
The present study was designed to clarify (1) the effects of cytokines on intercellular adhesion molecule-1 (ICAM-1) expression on human endothelial cells (EC) and soluble ICAM-1 (sICAM-1) production by these cells and (2) the effects of purified sICAM-1 on leukocyte-EC adhesion. IL-1 beta and TNF-alpha induced a parallel increase of both the ICAM-1 expression on EC and sICAM-1 production by EC, while IFN-gamma induced only the dose dependent enhancement of ICAM-1 expression, but not the production of sICAM-1, IL-4 and IL-6 did not show any effects on the ICAM-1 expression nor on the sICAM-1 production. IL-4 and IL-6 abolished the expression enhancing effect by IL-1 beta, while TNF-alpha showed a synergism with IL-1 beta to promote ICAM-1 expression on EC. The sICAM-1 continued to accumulate in the culture supernatant even at 48 h after stimulation of EC by IL-1 beta, whereas the ICAM-1 expression on EC reached the maximum at 40 h and declined thereafter under the stimulation by IL-1 beta. IL-1 beta treatment of EC resulted in an increase in adhesion of leukocytes to the EC. The sICAM-1, purified from the cell-free supernatant obtained after a 48 h culture of EC in IL-1 beta by affinity column chromatography using monoclonal ICAM-1 antibody coupled to Sepharose beads, significantly inhibited leukocyte-EC adhesion.(ABSTRACT TRUNCATED AT 250 WORDS)
Cell Adhesion↗
[A case of fistula-cancer response to arterial chemoembolization].
Arterial chemoembolization was performed three times preoperatively for cancer associated with fistula-in-ano for diminishing the postoperative surgical tissue defect of the perineum. Partial response of the tumor to this treatment was confirmed by computed tomography. A sixty-two-year-old male patient recognized a mass in the perineum one and a half years ago. He had suffered from fistula-in-ano for thirty years. The mass increased its size and formed a tumor in the bilateral buttocks (12 x 9 cm and 9 x 9 cm in diameter). Biopsy specimen showed a moderately differentiated adenocarcinoma. Angiography showed a hypervascular tumor stain. The main feeders to the tumor were the superior rectal artery and bilateral internal iliac artery. Arterial chemoembolization was performed three times through the right and left internal iliac artery with Gelfoam particle. Arterial infusion chemotherapy was added through inferior mesenteric artery and bilateral internal iliac artery with a total 120 mg of adriamycin and 1,500 mg of 5-FU simultaneously. The tumor decreased in size to 44% of the preoperative size by the treatment. A radical operation was performed following the preoperative treatment. Preoperative arterial chemoembolization for cancer associated fistula-in-ano was considered to be helpful for local control.
Adenocarcinoma↗
[A case of lobar atrophy with stereotypic unusual laughing].
We report a case of a Pick's disease (frontal predominant type) with unusual laughing. The patient was a 54-year-old, right handed, female. The patient began to show low activity and inappropriate laughing at about 51 years. She did not speak at all and showed weird laughing with a voice "hi hi hi hi hi hi" frequently at first presentation. When asked some questions, she sometimes answered with a nod. Almost all of her laughing did not match with the situation and seemed to lack a relationship between affective change and observed expressions. The laughing could be elicited by non specific and varied stimuli. She often interrupt laughing voluntarily unlike pathological laughing. Neurological examination revealed visual rooting reflex and forced grasping reflex but there was no signs of pseudobulbar palsy often observed in patients with pathological laughing. Her electromyogram of facial expression during the laughing showed that electric discharge of M. corrugator supercilii was over 4 times as much as that in normal laughing. And it showed also that the duration of her laughing was several seconds as normal laughing. CT and MRI scans demonstrated atrophy in the fronto-temporo-parietal lobe bilaterally (L > R), most prominent in the frontal lobe. SPECT scan showed a significant diminution of blood flow in the atrophic region. An EEG was normal. We consider that the laughing of the present case is not due to an emotional disturbance but rather a disorder of affective expression as pathological laughing.
Dementia↗
An evaluation of symptoms and performance status in patients after esophagectomy for esophageal cancer from the viewpoint of the patient.
We used a questionnaire method to investigate the complaints and the life conditions of 81 patients after esophagectomy for esophageal cancer. Patients were separated into three groups according to their follow-up time: less than 2 years, more than 2 years but less than 5 years, and more than 5 years after surgery. The distribution of complaints was similar regardless of the time elapsed since surgery. Only 22% of all patients had no complaints. Abdominal fullness and stenotic sensation were the major complaints. Body weight was unstable for 2 years following surgery, but subsequently stabilized. The content of meals, volume of meals, and Performance Status (PS) did not differ significantly among the groups and were indicative of satisfactory recovery. Our results suggest that in contrast to other surgeries, postoperative symptoms persist in esophagectomyed patients with long survival and that about half of the cases whose follow-up time was less than 2 years have unstable body weight.
Adult↗
[The comparison of clinical features between early rheumatoid arthritis and established rheumatoid arthritis].
Clinical features between 69 early RA patients (within a year duration) and 79 established RA patients (more than 3 years duration) were compared retrospectively. There were no significant differences about frequencies of morning stiffness (68.2% vs 54.4%) and rheumatoid nodules (20.2% vs 15.2%) between early RA and established RA. There were also no significant differences between two groups about elevation of ESR (92.8% vs 97.4%), positivity of CRP (97.1% vs 94.9%) and rheumatoid factor (RF) (82.6% vs 93.7%), and Lansbury activity index (AI) (mean 68.8% vs 78.8%). After hospitalization and treatment, all clinical indices (ESR, CRP, RF, AI) improved significantly in both groups. There, however, were clinically more "marked improvement" (39.1% vs 16.4%) and "remission" (8.7% vs none) in early RA group. We conclude that by hospitalization and treatment, clinical improvement can be expected in both early and established RA, but to secure satisfactory improvement, early detection and intervention of RA would be recommended.
Adult↗
[A case of rheumatoid arthritis associated with agranulocytosis during bucillamine treatment].
Bucillamine has been reported to have beneficial effects in rheumatoid arthritis. This report concerns a case of RA in which agranulocytosis developed while on a course of bucillamine. A 52-year-old female with RA developed a rapid fall in white blood cell count after 4 weeks of bucillamine treatment at daily dose of 50 mg. Agranulocytosis was diagnosed (WBC 1300/mm3, granulocytes 5%). The administration of bucillamine was halted and she was treated with only prophylactic antibiotic regime. The peripheral granulocyte count result rapidly reversed within 3 days after discontinuation of the bucilamine treatment. Anti-leukocyte antibody was detected by the leukocyte lysis phenomenon method during the period of agranulocytosis. And high intrinsic G-CSF activities were detected in the patient serum before the recovery period of agranulocytosis. Agranulocytosis is a rare side effect of bucillamine but it is potentially more harmful than other side effects. In treatment with bucillamine, therefore, the drug should be carefully administered and regular blood examinations carried out to prevent the occurrence of this side effect.
Agranulocytosis↗
[Caregiving burden of elderly caregivers who provide at home care for infirm elderly].
In order to elucidate the degree of feeling burdened and factors affecting caregiving burden of elderly caregivers, a questionnaire survey was performed on 241 female caregivers of infirm elderly. The surveyed group consisted of 138 caregivers under 60 years of age (young group) and 103 aged 60 and over (old group). The major results of this survey were as follows, 1) Conditions perceived as unfavorable in the old group were related to caregiving assistants, number of the family members and health condition of the caregiver. 2) Greater number of infirm elderly with serious ADL problems and higher average body weight of the elderly cared for were seen for the old group than the young group. 3) The old group had a larger number of problem incidents and expressed more eager desire for transfer of elderly to institutional care than providing the young group. 4) A feeling of burden in daily care appeared larger for night care, body discharge disposal and bathing care of the elderly and was more frequent in those above 70 than under 70 years of age. 5) Hours in bed were longer and range of movement by wheel chair was more limited for infirm elderly as the caregiver's age increased. These results suggest that the above-mentioned unfavorable conditions in elderly caregivers promote a state of becoming bedridden and a lowering of ADL ability of infirm elderly.
Activities of Daily Living↗
[The comparison of IRV and PEEP on gas exchanges in RDS dogs].
The purpose of this study was to determine effects of inverse ratio ventilation (IRV) on gas exchanges and circulatory systems in 47 dogs in which bronchi were lavaged with 20 ml.kg-1 saline. The dogs were classified into 6 groups and were ventilated with IE ratio of 1:2 (control), 2:1 (2:1 IRV), 3:1 (3:1 IRV), 1:2 with 5 cmH2O PEEP (1:2 PEEP 5), 2:1 with 5 cmH2O PEEP (2:1 PEEP 5), and 3:1 with 5 cmH2O PEEP (3:1 PEEP 5), using Servo ventilator 900C. In all the groups, PaO2 decreased from about 140 mmHg to about 50 mmHg by bronchial lavage. In both 2:1 IRV and 3:1 IRV groups, PaO2 increased gradually during 8 hours. In the 3 PEEP groups, PaO2 increased markedly compared with the groups without PEEP after their ventilatory modes were used. In all the groups, PaCO2 increased after lavaging. Although PaCO2 did not change during 8 hours in control and 1:2 PEEP 5 groups, PaCO2 decreased slightly with 4 or 5 hours after RDS was induced in 3:1 IRV and 2:1 PEEP 5 groups. In 2:1 IRV and 3:1 PEEP 5 groups, PaCO2 decreased with time. Extravascular thermal volume index (ETVI) significantly decreased in IRV groups compared with control group. The peak airway pressure was much lower in IRV groups, when it was compared with the group whose IE ratio was 1:2. Although cardiac index decreased slightly in all groups, there was no significantly differences among them.
Animals↗
Exocrine pancreatic ductograms in insulin-dependent diabetes mellitus.
OBJECTIVES: To examine the prevalence of abnormal pancreatic ductograms in patients with insulin-dependent diabetes mellitus (IDDM) and to determine the clinical characteristics of those patients. METHODS: Pancreatic exocrine morphology was studied by endoscopic retrograde pancreatography (ERP) in 43 patients with IDDM, 12 patients with islet cell antibody (ICA)-positive non-insulin-dependent diabetes mellitus (NIDDM), and 22 patients with ICA-negative NIDDM. RESULTS: ERP revealed a significantly higher prevalence of abnormal pancreatic ducts (dilation and stenosis, tortuosity, obstruction, and intraductal calculi) in the patients with IDDM (17/43, 40%) than in the patients with ICA-negative NIDDM (2/22, 9%, p = 0.018). IDDM patients who slowly progressed to insulin dependency more than 13 months after the onset of diabetes had a higher frequency of abnormal pancreatic ducts (13/22, 59%) than those who needed insulin therapy within 12 months after the onset (4/21, 19%, p = 0.016). There was no difference in duration of diabetes between the two groups. ICA-positive NIDDM patients also had a higher frequency of abnormal pancreatic ducts (7/12, 58%) than ICA-negative NIDDM patients (2/22, 9%, p = 0.0074). CONCLUSIONS: These results indicate that a high proportion of IDDM patients who have prolonged histories of non-insulin dependency with ICA suffer pancreatic exocrine impairment. A similarity between IDDM with a slowly progressive clinical course and fibrocalculous pancreatic diabetes seen in tropical countries also was suggested.
Autoantibodies↗
Factors predictive of response to interferon-alpha therapy in hepatitis C virus infection.
To determine the patient-dependent and virus-related factors that may predict sustained response to interferon-alpha therapy, we prospectively evaluated 60 consecutive patients with chronic hepatitis C who received a standardized treatment schedule of interferon-alpha. Twenty-eight patients achieved a long-term sustained remission, 14 patients had temporary responses during treatment but relapsed after completing it and 14 patients did not respond. Four patients dropped out because of severe side effects and were excluded from evaluation of efficacy. Twenty-one variables were chosen as possible predictors of sustained response and were analyzed by means of multivariate analysis. Variables related to the hepatitis C virus included genotype and concentration in serum before treatment. The former was determined by means of the polymerase chain reaction with genotype-specific primers for genotypes PT, K1, K2a and K2b, which were deduced from nonstructural region 5 of the hepatitis C virus genome. The latter was measured with a competitive polymerase chain reaction technique. Three variables were statistically significant (p < 0.05) on univariate analysis: viral genotype, pretreatment level of viremia and Knodell's fibrosis score. In multivariate analysis viral genotype and Knodell's fibrosis score were correlated independently with a sustained response (p < 0.05 for both). Incidence of sustained response was 40% and 91% in patients with genotypes K1 and K2a, respectively. We conclude that with the treatment schedule used, viral genotype was the most useful predictor of a sustained response to treatment with interferon-alpha.
Adult↗
[Studies on clinical usefulness of new tumor markers of ovarian cancer, CA54/61 and CA602--III. Measurement of serum samples from patients with various benign or malignant diseases].
Serum samples from patients with benign or malignant diseases were measured for the newly developed tumor markers CA54/61 and CA602 with the respective EIA kits for assessment of their utility as tumor markers. A total of 5236 patients were entered into the study, consisting of ovarian cancer patients, those with other cancers, pregnant women, and healthy volunteers. The CA54/61-positive rate with a cut-off value of 12 U/ml was 61.2% for ovarian cancers (50.4% with a cut-off value of 20 U/ml). A positive rate of 75.0% (64.4%) was achieved for mucinous cystadenocarcinoma, which was high, compared with that for CA125. On the other hand, the false-positive rate was 12.2%(5.9%) for benign ovarian tumors, and as low as 18.5%(8.7%) for endometriosis. The CA602-positive rate with a cut-off value of 63 U/ml was as high as 76.0% for ovarian cancers (69.8% with a cut-off value of 90 U/ml). On the other hand, the false-positive rate was relatively high at 21.9% (12.6%) for benign ovarian tumors, and 56.7% (40.0%) for endometriosis. These positive rates were therefore similar to those for CA 125. The levels of both CA54/61 and CA602 antigens well reflected the postoperative prognosis. These results suggest the utility of CA54/61 and CA 602 as tumor markers of ovarian cancers.
Antigens, Tumor-Associated, Carbohydrate↗
[Ossified epidural hematomas: report of two cases].
Two cases of ossified epidural hematomas were reported. Patients were nine and twelve year-old boys. Initially they were both followed up conservatively after injuries. Subsequently they were found on CT scan to have calcifications in the capsules of epidural hematomas which were found four months after injury in one case and twelve days after injury in the other. Both underwent craniotomy and histological ossification was found in the capsules of the hematomas. Epidural hematomas in children are known to ossify, and this condition may prevent natural absorption of epidural hematomas. Therefore, careful follow up of hematomas seems to be mandatory on conservative therapy of epidural hematomas in children.
Child↗