Biomedical subjects

M Kawada

Publications and source records attributed to M Kawada.

At least 91 records · Page 5Linked to original sources

PubMed1994

Henoch-Schönlein purpura with rapidly progressive glomerulonephritis and fatal intraperitoneal hemorrhage in an adult.

We report here the autopsy findings in a 51-year-old man who had been admitted with Henoch-Schönlein purpura (HSP) accompanied by rapidly progressive glomerulonephritis and massive intraperitoneal hemorrhage, leading to death. While the intraperitoneal hemorrhage was the primary cause of death, the patient may have suffered widespread intraperitoneal vasculitis due to HSP, or hemorrhagic pancreatitis due to the concurrent administration of a steroid and furosemide. We emphasize the acute hemorrhagic pancreatitis is a possible complication in patients with generalized vasculitis, including HSP and collagen disease, during the concurrent administration of steroids and other agents.

Fatal Outcome↗

PubMed1993

Hyperpermeability of abdominal capillary vessels to endothelin-1 in patients with diabetes mellitus.

To elucidate the pathophysiologic significance of circulating endothelin-1 (ET-1) to the vascular lesions in diabetic patients, ET-1 levels in plasma and peritoneal dialysis fluid were measured in 11 patients receiving continuous ambulatory peritoneal dialysis (CAPD) [five with diabetic nephropathy (group A); six with chronic renal failure without diabetes mellitus (group B)]. ET-1 levels were determined by a highly sensitive and specific enzymeimmunoassay. Plasma ET-1 levels in group A were not significantly different from those in group B (3.3 +/- 0.9 versus 3.5 +/- 0.9 pg/ml). However, the amounts of ET-1 in peritoneal dialysis fluid in group A were significantly greater than those in group B (19.2 +/- 13.2 versus 10.4 +/- 6.3 ng/day). These results suggest that abdominal capillary vessels in diabetic patients are hyperpermeable to ET-1.

Abdominal Muscles↗

PubMed1993

Spontaneous coronary arteriolosclerosis in broiler chickens.

Arteriolosclerotic changes were found in 202 out of 203 randomly collected heart specimens of broiler chickens. These chickens were reared in a poultry farm and killed at a poultry meat processing plant at 60 days of age with healthy appearance. Cellular intimal thickening due to a proliferation of smooth muscle cells of small arteries or arterioles were found mostly in the innermost layer of the left ventricle. Severity of the thickening varied from slight to severe. In 2 cases, myocardial necrotic changes were found in the proximity of severely affected small arteries and arterioles.

Animals↗

PubMed1993

Inhibition of Abelson oncogene function by erbstatin analogues.

The authors examined the effect of a tyrosine kinase inhibitor, erbstatin, and its analogues on abl oncogene functions. Erbstatin and its stable analogue methyl 2,5-dihydroxycinnamate (2,5-MeC) inhibited the growth of v-ablts-NIH3T3 cells at the permissive temperature (33 degrees C) at lower concentrations than at the non-permissive temperature (39 degrees C). 2,5-MeC inhibited the morphological transformation and the activation of v-abl tyrosine kinase by the temperature shift (39 degrees C to 33 degrees C) more effectively than erbstatin. Previously the authors reported that erbstatin induced erythroid differentiation of K562 human chronic myelogenous leukaemia cells, so they examined the effect of erbstatin analogues on the erythroid differentiation. Among eight erbstatin analogues studied, ethyl 2,5-dihydroxycinnamate induced erythroid differentiation of K562 cells most effectively. Ethyl 2,5-dihydroxycinnamate also inhibited bcr-abl tyrosine kinase. These results indicate that the stable analogues of erbstatin suppress oncogene functions of Abl by inhibiting its tyrosine kinase.

Abelson murine leukemia virus↗

PubMed1993

Increase in cell responses and protein phosphorylation of neutrophils induced by synthetic diacylglycerols.

Diacylglycerols (DG) induced various stimulation-coupled responses of guinea pig peritoneal neutrophils (GPPMN), such as superoxide (O2-.) generation, luminol chemiluminescence response (LCL) and membrane depolarization. These activities induced by L-alpha-1,2-dioctanoyl glycerol (diC8) are quite similar to those induced by phorbol 12-myristate 13-acetate (PMA). The effects of diC8 were much stronger than those of L-alpha-1-oleoyl-2-acetylglycerol (OAG) and no effect was produced by L-alpha-1,2-dioleoyl glycerol (DO). Concentrations of diC8 and OAG for maximal O2-. generation were 1 and 10 microM, respectively. However, rat brain Ca(2+)- and phospholipid-dependent protein kinase (PKC) was activated by all DGs used, and the concentrations of OAG, DO and diC8 for half maximum stimulation were 0.2, 1.0 and 2.0 microM, respectively. Discrepancies between the concentrations of DGs required for O2-. release and PKC activation might be due to differences in their affinity for and permeability in the membrane. The generation of active oxygen and the PKC activity were both sensitive to PKC inhibitors, such as 1-(5-isoquinolinesulfonyl)-2-methyl-piperazine (H-7) and staurosporine. ID50 of H-7 and staurosporine for the inhibition of diC8-induced O2-. release were 150 nM and 10 nM, respectively. By contrast, staurosporine does not inhibit diC8 induced membrane depolarization. Phosphorylation of cytoplasmic proteins, such as the 47 kDa protein, was increased by DGs and this phosphorylation was also inhibited by H-7 or staurosporine. The capacities of stimulating the rates of 47 kDa protein phosphorylation were in the order diC8 > OAG > DO. These results suggest the involvement of protein phosphorylation in DG-induced O2-. generation. However, a part of the O2-. generation induced by high concentration of DG might have occurred via a PKC-independent pathway.

1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗

PubMed1993

[A case of advanced hepatocellular carcinoma, in which the tumor almost disappeared by orally administered UFT].

A 59-year-old male with liver cirrhosis was admitted to our hospital for further examination of general fatigue. A huge tumor was found in the right lobe of his liver with abdominal ultrasonography and computed tomography (CT). The titers of serum AFP (14,055 ng/ml) and PIVKA-II (more than 50.0 AU/ml) were extremely high. A tumor embolus was observed in the portal vein with abdominal angiography. According to these findings, he was diagnosed as having advanced hepatocellular carcinoma (HCC). He was treated by oral administration of UFT (600 mg/day) as an unresectable case of HCC. Three months later, the clinical symptoms were greatly improved and HCC was almost diminished with abdominal ultrasonography and CT, although a small tumor embolus was found by angiography. The titers of AFP and PIVKA-II were reduced to the normal range. This case suggests the clinical effectiveness of UFT for the treatment of HCC.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1993

[Biventricular repair with a modified Glenn shunt for the hypoplastic right ventricle].

Between 1982 and 1990, 14 patients with small right ventricle underwent biventricular repair with a modified Glenn shunt. The patients consisted of 8 cases of pulmonary atresia and intact ventricular septum, 2 with pulmonary stenosis and intact ventricular septum, 3 with tetralogy of Fallot, 1 with pulmonary atresia and straddling tricuspid valve. Nine patients had one or more prior preliminary palliative procedures. Repairs consisted of a modified Glenn shunt and closure of the intracardiac and extracardiac shunt, with right ventricular outflow reconstruction in 13, and pulmonary valvotomy in 1. In nine patients superior vena cava was not ligated. There was one operative death (7%). Preoperative RVEDV ranged from 19 to 70% of normal with a mean of 36.1% of normal. Preoperative pulmonary resistance ranged from 1.6 to 5.3 unit with a mean of 2.8 unit. Preoperative PA index ranged from 102 to 444 mm2/m2 with a mean of 234.3 mm2/m2. No patients died later. Follow-up 2 to 9 year after operation showed that 9 patients were in the New York Heart Association class I and 4 were in class II. Our experience shows that this procedure can be safely done for patients, who have hypoplastic right ventricle smaller than 40% of normal and are not candidate for Fontan procedure because of high pulmonary vascular resistance and inadequate size of pulmonary artery. In this procedure a modified Glenn shunt without ligation of SVC may effectively reduce the volume overload on the right ventricle.

Adolescent↗

PubMed1993

[Surgical repair in hearts with univentricular atrioventricular connection and subaortic stenosis].

Between 1986 and 1990, fourteen patients with univentricular atrioventricular connection and subaortic stenosis underwent surgical treatment. The patients consisted of 7 cases of double inlet left ventricle, 4 with double inlet right ventricle, 3 with tricuspid atresia. The palliative operation was performed in 6 infants ranging in age from 17 days to 6 months. Four patients with mild subaortic stenosis underwent pulmonary artery banding, in two patients this was combined with repair of coarctation of the aorta. Two patients with severe subaortic stenosis underwent the Norwood operation. There were no operative deaths. One of two patients who underwent the Fontan operation 2 years after the Norwood operation died later. The definitive operation was performed in 8 children ranging in age from 4 to 11 years. Five of these 8 patients had previous pulmonary artery banding. Five children with double inlet left ventricle underwent septation combined with enlargement of bulboventricular foramen. Postoperatively all remained in sinus rhythm and had no pressure gradient between Aorta and left ventricle. A Fontan operation combined with a Damus operation was performed in 2 children, 1 of double inlet right ventricle and 1 of tricuspid atresia. In both cases, postoperative angiogram showed no pulmonary incompetence. One patient underwent enlargement of bulboventricular foramen after a Fontan operation. All survived later. Young infants and neonates with severe subaortic stenosis can survive by the Norwood operation. Infants with mild subaortic stenosis, although can survive by pulmonary artery banding, should be closely followed for the development of subaortic stenosis. For relief of subaortic stenosis, enlargement of bulboventricular foramen may be effective in septation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Coarctation↗

PubMed1993

[Definitive repair for double inlet ventricle and common atrio-ventricular valve].

From 1982 through 1990, 13 patients with double inlet ventricle and common atrio-ventricular valve underwent definitive cardiac surgery. Nine patients simultaneously had anomalous systemic venous connection and 4 had anomalous pulmonary venous connection. One patient with double inlet left ventricle underwent a successful partition of ventricle and atrio-ventricular valve. All other 12 patients underwent a Fontan operation, which utilized different techniques to deal with various forms of anomalous systemic and pulmonary venous connection. Four patients with common atrioventricular valve regurgitation underwent a Fontan operation combined with a concomitant circular annuloplasty of atrio-ventricular valve. In all 4 patients, the degree of regurgitation decreased postoperatively. There was one operative death (mortality 7.7%). Most of patients with double inlet ventricle and common atrio-ventricular valve now are considered to be suitable not for partition but for the Fontan operation. Because of the complexity of anatomic variables, however, the repair of anomalous systemic or pulmonary venous connections in conjunction with the Fontan operation requires an individualised plan in each patient to provide unobstructed systemic and pulmonary venous pathways. We think that a circular annuloplasty could effectively decrease the degree of atrio-ventricular valve regurgitation in most cases.

Adolescent↗

PubMed1992

Circumvention of multidrug resistance in human carcinoma KB cells by polyether antibiotics.

We examined the effect of various polyether antibiotics on colchicine resistance in multidrug-resistant KB-C4 cells which exhibit about 4,000-fold resistance to colchicine. As a result, 4 out of 14 polyether antibiotics were found to reverse colchicine resistance. Among them, laidlomycin was the most potent. It potentiated colchicine cytotoxicity on KB-C4 cells about 700-fold at 1 microgram/ml. Degree of potentiation was calculated by dividing of the IC50 value of colchicine in the absence of a polyether antibiotic by the IC50 value of colchicine in the presence of the polyether antibiotic. Monensin, dianemycin, and leuseramycin at 3 micrograms/ml also potentiated the cytotoxicity, about 100-fold. We previously reported that inostamycin is a potent chemosensitizer in KB-C4 cells. Although lysocellin has a structure very similar to that of inostamycin, it didn't reverse colchicine resistance. It slightly increased [3H]vinblastine accumulation in KB-C4 cells and weakly inhibited the [3H]vinblastine binding to KB-C4 plasma membranes.

Anti-Bacterial Agents↗

PubMed1992

[Urinary N-acetyl-beta-D-glucosaminidase and gamma-glutamyl-transpeptidase activities for evaluation of renal disturbance in patients with multiple myeloma].

The activities of N-acetyl-beta-D-glucosaminidase (NAG), gamma-glutamyl-transpeptidase (gamma-GTP) and NAG isoenzyme were measured in the urine of 20 patients with multiple myeloma (IgG/IgA type/Bense Jones type; 15/1/4 cases) and 25 healthy controls to evaluate these activities as indicators of renal disturbance in multiple myeloma. NAG isoenzyme fractions in urine were measured by agarose electrophoresis-m-cresol sulfonphthaleinyl-NAG reaction. Mean urinary NAG activity in the patients with myeloma was significantly higher than that in the controls (20.1 +/- 3.3 vs 4.3 +/- 0.3U/g. cr; p < 0.001). Urinary NAG activity in these patients correlated positively with the dose (mg/g. cr) of urinary protein (r = 0.755; p < 0.01), most of which were considered to be light chain protein, but not with creatinine clearance. Each urinary NAG isoenzyme fraction (NAG-1, -2, -3) was higher in the patients than that in the controls, and especially NAG-2 fraction (A form) showed a highly positive correlation with the dose of urinary protein. Urinary gamma-GTP activity in the patients did not differ from that in the controls, but urinary NAG/gamma-GTP ratio was higher in the patients, and reversely correlated with creatinine clearance (r = -0.721; p < 0.01). It is suggested that the elevation of urinary NAG activity results from the damage of lysosome in proximal tubular cells by urinary light chain protein and its degradation products. Therefore, urinary NAG activity may be a good index for proximal tubular disturbance, and NAG/gamma-GTP ratio may be an index for the extensive damage of nephrons in addition to the damage of tubular cells in multiple myeloma.

Acetylglucosaminidase↗

PubMed1992

[A case report--combined Jatene procedure and extended aortic arch reconstruction for the original Taussig-Bing malformation associated with hypoplastic aortic arch, subaortic stenosis and coarctation of the aorta].

A successful repair with combined Jatene procedure (Lecompte modification) and extended aortic arch reconstruction in a two-month-old boy with the original Taussig-Bing malformation, associated with hypoplastic aortic arch, subaortic stenosis and coarctation of the aorta was described. The ascending aorta was measuring 8 mm and the distal aortic arch was 4 mm in outer diameter. The interventricular rerouting was not feasible, because the infundibular septum was almost aligned to the interventricular septum. So that arterial switch operation was preferred. The primary interventricular foramen was enlarged by wedge resection and the secondary interventricular foramen was closed with a patch of preserved equire pericardium. An extensive patch angioplasty of entire aortic arch down to descending aorta was performed with a composite patch of Xenomedica (preserved equire pericardium) and Dacron velour. Hypertrophied muscle bundles were resected for relief of subaortic stenosis. Jatene procedure was then performed. During neo-pulmonary reconstruction, distal pulmonary orifice was shifted towards right to avoid kinking and compression on the coronary arteries. One stage correction consisting of Jatene procedure and extended aortic arch reconstruction was considered to be a procedure of choice in this type of complex anomalies.

Aorta, Thoracic↗

PubMed1992

[Surgical treatments of nonconfluent pulmonary arteries with congenital cardiac defects].

Pulmonary artery angioplasty or reconstruction was performed in seven patients with nonconfluent pulmonary arteries and congenital cardiac defects. Age of these patients were ranged from 6 months to 41 years old. Five of them had pulmonary truncal atresia and complex cardiac anomalies. Two of these five patients demonstrated nonconfluent pulmonary arteries due to deformities at ductal insertion of pulmonary arteries. Three patients had had previous systemic to pulmonary artery shunt operations which caused pulmonary artery distortions. Other two patients had intrapulmonary arterial obstructions due to pulmonary artery thrombosis. Patch pulmonary artery plasty was carried out in three patients, dilatation of severe stenotic pulmonary artery was done in one patient simultaneously with pulmonary valvotomy. Central shunt operation was added in one patient with the pulmonary artery which was unable to be reconstructed. Last two patients underwent intrapulmonary artery reconstruction with the rolled pericardial graft. Hospital death occurred in one patient with unproperly increased pulmonary blood flow by central shunt. Average follow-up period of these six survivors after operation was 1.4 +/- 0.8 years. As definite repairs, two patients had Fontan operation, two patients had right ventricle to pulmonary artery reconstruction. And remaining two patients are still to be followed until sufficient growth of pulmonary artery suitable for Fontan operation.

Adolescent↗

PubMed1992

[Successful Norwood operation for single left ventricle associated with severe subaortic stenosis, coarctation of aorta and hypoplastic aorta].

A 4 month-old boy who had double-inlet left ventricle, severe subaortic stenosis, hypoplastic ascending aorta and coarctation of the aorta revealed severe respiratory failure. An urgent Norwood operation was done. The procedure consisted of enlargement of the ascending aorta and main pulmonary artery and a systemic-pulmonary shunt using 5 mm PTFE tube. Postoperative course was uneventful.

Aorta↗

PubMed1991

Palliative repair of aortic atresia associated with tricuspid atresia and transposition of the great arteries.

Successful palliative repair of aortic atresia and hypoplastic aortic arch associated with tricuspid atresia in a neonate is described. The repair consisted of reconstruction of the hypoplastic aortic arch with an equine pericardial patch, division of the patient ductus arteriosus, connection of the pulmonary artery to the aorta, implantation of the proximal part of the ascending aorta into the main pulmonary artery, and anastomosis of a polytetrafluoroethylene graft 5 mm in diameter between the right ventricular outflow tract and the central pulmonary artery, which was transferred anteriorly to the main pulmonary artery.

Abnormalities, Multiple↗

PubMed1991

Long-lasting accumulation of vinblastine in inostamycin-treated multidrug-resistant KB cells.

Inostamycin, a novel polyether compound, reverses multidrug resistance in KB cells. The mechanism of its action was studied by use of radioactively labeled vinblastine. Inostamycin dose-dependently increased the accumulation of [3H]vinblastine in multidrug-resistant KB-C4 cells at 0.5-2 micrograms/ml, while it did not enhance accumulation in the drug-sensitive KB-3-1 cells. At a concentration of 1 microgram/ml inostamycin inhibited active [3H]vinblastine efflux from KB-C4 cells, but not from KB-3-1 cells, and inhibited [3H]vinblastine binding to KB-C4 membranes with an IC50 of 0.94 microgram/ml (1.3 microM). Furthermore, [3H]vinblastine accumulated by treatment with 1 microgram/ml of inostamycin was resistant to efflux from KB-C4 cells, even after the removal of inostamycin.

Biological Transport↗

PubMed1991

[Fontan type procedure in patient with borderline hemodynamics: using a temporary R-L shunt in early postoperative period].

Fontan type procedure was successfully performed to a 14-year-old patient with borderline hemodynamics using a temporary R-L shunt in early post operative period. Preoperative diagnosis was DORV (ILD), small RV, PS, ASD, juxtaposition of atrial appendages and post bilateral B-T shunts. Preoperative catheterization studies showed low PARI but insufficient pulmonary arterial size (PA-index 220). In the Fontan procedure, RA was partitioned obliquely with a composite patch of xenograft and Dacron velour. A 5.5 mm hole was created only in xenograft to allow a temporary R-L shunt. During rewarming period, systemic pressure hovering around 60 mmHg with 10 micrograms/kg/min of dopamine and dobutamine. Then a R-L shunt was created by a side to side anastomosis between the appendages with the orifice diameter of 10 mm, followed by a rise in the systemic pressure up to about 80 mmHg. One post operative day, a readjustable occluder was applied at the site of appendage anastomosis to control R-L shunt flow. According as CVP decreased, the occluder was tightened up step by step. Finally, the occluder was fully tightened up in 10 post operative days. This experience suggests that a temporary R-L shunt in early post operative period may be applicable in patient with borderline hemodynamics for Fontan type procedure.

Adolescent↗

PubMed1991

[Conotruncal repair of tetralogy of Fallot under 2 years old].

From October 1985 to September 1990, a repair within the conotruncal portion of the right ventricle-Conotruncal repair-was used for the primary repair of consecutive 34 patients with tetralogy of Fallot under the age of 2 years. There were three summarized points of this maneuver: the first was non-use of the tricuspid septal leaflet for closure of the ventricular septal defect, the second was short patch infundibuloplasty with a large monocusp, and the last was total resection of the infundibular septum. Length of the patch infundibuloplasty was just 30% of the right ventricle length according to our formula: 30% of RV (cm) = 1.28 X BSA (m2) + 1.10. The VSD patch was placed between the pulmonary annulus and the ventricular septal crest, consisting of the membranous flap and the posterior extension of the trabecula septomarginalis. The right ventricular (RV) to systemic arterial pressure ratio was 0.49 +/- 0.15 (N = 33) and central venous pressure was 10.2 +/- 1.9 cmH2O (N = 33) six hours after ICU admission and 8.4 +/- 1.5 cmH2O (N = 7) 18 days after operation. RV end-diastolic volume showed no increase after operation: 105 +/- 31 before repair to 104 +/- 23% of Normal after repair in the same patients. Post-operative intubation period was 14 +/- 8 hours and hospital admission period was 17 +/- 6 days after operation. All patients were in sinus rhythm. The 28% of patients showed incomplete right bundle branch block (RBBB) and other 28% of patients showed complete RBBB.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Surgical Procedures↗