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Biomedical subjects

M Kawashima

Publications and source records attributed to M Kawashima.

At least 199 records · Page 11Linked to original sources
PubMed1993

A case of herpes-associated erythema multiforme in a Japanese child.

A case of a five-year-old Japanese boy with herpes-associated erythema multiforme (HAEM) was reported. The patient had eleven recurrences of herpes labiaris within one year; four of these recurrences were accompanied by erythema multiforme. A study of the human leukocyte antigens revealed the presence of HLA-DQW3, which has been reported to be significantly frequent in Caucasian patients with HAEM. Oral administration of acyclovir at the onset of herpes labialis was effective in preventing HAEM. Early administration of oral steroids at the onset of HAEM also prevented its exacerbation.

Acyclovir↗
PubMed1993

Quantitative analysis of stratum corneum lipids in xerosis and asteatotic eczema.

Sphingolipids, a major constituent of intercellular lipids, are an important determinant for both water-holding and permeability barrier function in the stratum corneum. To assess the pathogenic role of sphingolipids in the stratum corneum of dry skin disorders such as xerosis and asteatotic eczema in leg skin, ceramides were quantified by thin layer chromatography after n-hexane/ethanol extraction of resin-stripped stratum corneum and evaluated as micrograms/mg stratum corneum. In healthy leg skin (n = 49), there was age-related decline in the total ceramide, whereas xerosis (n = 25) and asteatotic eczema (n = 16) suffering significantly reduced water-holding properties, exhibited no definite decrease, rather slight increase in ceramide quantity with the same composition of each individual ceramide as compared to healthy age-matched controls. These data indicate that the seemingly elevated level of ceramide is an artificial effect due to inflammatory processes which result from susceptibility to dryness. Analysis of sebum-derived lipids present in the stratum corneum revealed that there was a significant decline in free fatty acids in xerosis and asteatotic eczema as compared to age-matched healthy controls, and a similar decline in triglycerides in the above three groups when compared to younger controls. Although the observed decrease in the stratum corneum lipids may well explain the high incidence of winter dry skin in older people, the progression toward asteatotic eczema can not be accompanied solely by a decrease in ceramide quantity, suggesting that the evolution of xerotic skin is associated with other moisturizing factors and/or environmental stimuli.

Adult↗
PubMed1993

Nuclear DNA content and distribution of Ki-67 positive cells in nodular fasciitis.

Nodular fasciitis (NF) is regarded as a disease of reactive growth of fibroblasts, although it frequently shows clinically rapid growth and sometimes has to be histologically discriminated from fibrosarcoma. In order to confirm the position of NF as a benign tumor, we studied 5 cases of NF by a quantitative analysis of the nuclear DNA content using flow cytometry in paraffin-embedded specimens. In 3 of the 5 cases, an immunohistochemical study using Ki-67 monoclonal antibody was also conducted in frozen sections. In the analysis of nuclear DNA content, DNA histograms showed a diploid pattern in all cases, and G1, S and G2 + M periods were calculated as 96.7%, 2.5% and 0.8% (on the average), respectively. Although the labeling index of Ki-67 antibody (positive cells/tumor cells; %) was as scattered as 1.3-7.8 (5.6 on the average), the mean value was higher than that in already reported dermatofibroma and dermatofibrosarcoma protuberans and lower than that in malignant fibrous histiocytoma. These results endorse the hypothesis that NF is a reactive benign disease and reflect the biological behavior of this disease, which may frequently show rapid growth.

Adult↗
PubMed1993

Significance of pre-existent conditions in basal cell carcinoma on the lower extremities.

BACKGROUND: Basal cell carcinoma (BCC) rarely appears on the lower extremities; over 85% appear on the head and neck. CASE REPORTS: Five patients had BCC on the lower extremity. Histologically, this was of the superficial type. One patient developed a lesion of actinic keratosis. RESULTS: The presence of pre-existent cutaneous changes of BCC arising on the lower extremities was studied. Among 40 tumors reported in Japan, 10 cases (25%) had pre-existent cutaneous changes. This value is significantly higher than those of BCC over the whole body in both Japanese and Caucasian. CONCLUSIONS: Pre-existent cutaneous changes, thus, are thought to be a possible etiologic factor in the pathogenesis of BCC on the lower extremities.

Adult↗
PubMed1993

Estrogen receptor binding in the hen hypothalamus and pituitary during the ovulatory cycle.

The equilibrium dissociation constant (Kd) and the maximum binding capacity (Bmax) of estrogen receptor in soluble (cytosolic) and insoluble (nuclear) fractions in a hypotonic buffer solution of hypothalamus containing preoptic (HPOA) and median eminence (HMEA) areas and of anterior pituitary (AP) of laying and nonlaying hens were examined by Scatchard analysis of specific [3H]estradiol-17 beta ([3H]-E2) binding. The Kd of receptor in all of the tissues was different neither between soluble and insoluble fractions, nor between laying and nonlaying hens. The Bmax in laying hens was greater in the insoluble fraction and lower in the soluble fraction than that in nonlaying hens, but the total binding capacity (sum of Bmax in the soluble and insoluble fractions) was not different between laying and nonlaying hens. In laying hens, the specific [3H]-E2 binding in the insoluble fraction of HPOA was found to increase at 21 h before ovulation and again at 8 to 6 h before ovulation, and of HMEA and AP at 18 to 11 h before ovulation. No change in the specific [3H]-E2 binding in the insoluble and soluble fractions was found in any of the tissues of nonlaying hens during a 24-h period. The results suggest that in laying hens, estrogen may act on the hypothalamus and pituitary at restricted hours during the ovulatory cycle.

Animals↗
PubMed1993

[Mechanical dilation of the internal thoracic artery graft by using balloon catheter].

We evaluated the free flow of the internal thoracic artery grafts (ITA) which were dilated with a balloon catheter. Further, we examined the postoperative angiographic findings and histology of the ITAs by scanning electron microscopy. In 25 patients with internal thoracic artery grafting, the artery was dilated with a balloon catheter (Fogarty IMAG kit) that was withdrawn at tensions of less than 30 gm. The mean free flow rate of the left ITAs (LITAs) increased from 64.2 ml/min to 101.9 ml/min by injection of papaverine to ITAs (p < 0.05). The mean free flow rate of the balloon dilated LITAs were 160.8 ml/min which was significantly higher when compared with that of control and papaverine (p < 0.01, p < 0.01). The mean free flow rate of the balloon dilated right ITAs (RITAs) showed 183.2 ml/min, it was significantly higher (p < 0.01, p < 0.05) compared with that of control (78.4 ml/min) and papaverine (129.2 ml/min). Irregularity was documented in 16% of the ITAs in spite of the great patency rate (100%) from the postoperative angiogram. Using scanning electron microscopy, endothelial cell borders were well demarcated in the proximal portion of the dilated ITA. However, the distal portion of the endothelium displayed gradual destruction. Although mechanical dilation of the ITA graft by balloon calibration is very effective in increasing the free flow rate of ITA, we should be prepared for the intimal damage of the ITA graft.

Adult↗
PubMed1993

[Serum and pleural SCC-antigen levels in patients with pulmonary tuberculosis].

We measured the serum and pleural levels of squamous cell carcinoma related antigen (SCC-Ag) in patients with active pulmonary tuberculosis and studied the relationship between SCC-Ag and tuberculosis. Serum levels of SCC-Ag in 63 patients with newly diagnosed untreated tuberculosis were 1.76 +/- 2.16 ng/ml, significantly higher than in 118 healthy controls (0.67 +/- 0.52 ng/ml) or in 11 patients with old tuberculosis (0.92 +/- 0.38 ng/ml; p < 0.01). Pleural effusion levels of SCC-Ag in 41 patients with tuberculosis pleurisy were 4.5 +/- 3.4 ng/ml, significantly higher than in 54 patients with non-malignant, non-tuberculous, pleurisy (2.3 +/- 1.7 ng/ml: p < 0.05). In patients who responded well to anti-tuberculous chemotherapy, serum levels of SCC-Ag decreased to the normal range (1.6 ng/ml) with clinical improvement, while in nonresponders they did not decrease. Isoelectolic focusing electrophoresis showed serum SCC-Ag to be composed of a neutral fraction as a single peak, which was corresponded to that of squamous cell carcinoma of the lung. The tuberculous lesions were stained with anti-SCC-Ag antibody in one case and weak SCC-Ag positive findings were observed in the intercellular spaces of the epidermoid cells in the area without necrosis. These results raise the possibility that SCC-Ag is produced in or released from not only squamous cell carcinoma of the lung but also pulmonary tuberculous lesions.

Adult↗
PubMed1993

[A case of spontaneous pneumothorax due to rupture of bleb infected with aspergillosis].

A 17-year-old male was diagnosed as having left spontaneous pneumothorax by chest X-ray. Chest CT scan showed a cystic shadow with a thick wall in the left apex. Thoracotomy was performed, and the bleb was resected. Histologically, aspergillus was found in the cavity and the wall of the resected bleb. In this case, we consider that focal aspergillus infection in the bleb caused spontaneous pneumothorax. In cases of spontaneous pneumothorax in which the bleb wall is thick, the bleb should be evaluated by histological and bacteriological examination. Such a case has been rarely reported in Japan.

Adolescent↗
PubMed1993

[Comparative study in graft patency of individual and sequential grafting as coronary bypass].

We analyzed the graft patency rates of the individual saphenous vein graft (SVG) group and those of the sequential SVG group. In the individual SVG group, 184 SVGs were anastomosed to 184 coronary arteries. Twenty-six SVGs were used sequentially to 52 coronary arteries in the sequential group. The patency rates of all the SVGs in both groups showed no significant differences. The patency of left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA) and diagonal branch (Dx) was 96%, 67%, 90% and 63% respectively in the individual SVG group. In the sequential SVG group, the patency rates of LCX (95%) were much higher than those (67%) of the individual SVG group (p < 0.05). The patency rates of side-to-side anastomoses (SSAs) were 92% and those of the distal end-to-side anastomoses (ESAs) were 96% in the sequential SVG group. There were no significant differences between SSAs and ESAs. While, the patency rates of SSAs-Dx, ESAs-Dx, SSAs-LCX and ESAs-LCX were 89%, 100%, 100%, and 93% respectively in the sequential SVG group. There were no significant differences between two groups. These results showed that the sequential grafting is useful and effective for LCX coronary arteries in coronary artery bypass surgery. In conclusion, it seems that in LCX coronary arteries, the patency rates obtained by the sequential SVG technique are better than those obtained by using the individual SVG technique.

Coronary Artery Bypass↗
PubMed1993

[Clinical preeminence of single aortic cross-clamping for proximal anastomoses in coronary artery bypass surgery].

We evaluated the preeminence of the construction of proximal anastomoses during single aortic cross-clamping periods in coronary artery bypass surgery. Twenty-six patients were divided into two groups; single aortic cross-clamping (SAX) group: 13 patients, partial aortic clamping (PAC) group: 13 patients. In this study, these two groups were compared in terms of aortic cross-clamping time (AXT), total extracorporeal circulation (ECC) time (TECCT), ECC weaning time (WT), amount of cardioplegic solution, total levels of serum CPK and CPK-MB, and graft patency. The results were analyzed by ANOVA and chi-square test. AXT was longer in the SAX group compared with the PAC group (78.2 +/- 5 versus 63.2 +/- 4 min; p < 0.05). TECCT (120.4 +/- 6 versus 109 +/- 5 min) and WT (37.4 +/- 2 versus 41 +/- 2 min) were not significant between the two groups. The total amount of cardioplegic solution was greater in the SAX group compared with the PAC group (1100 +/- 60 versus 927 +/- 43 ml; p < 0.05). The levels of serum CPK and CPK-MB were a little lower in the SAX group, but there were no significant differences between the SAX group and the PCA group. The graft patency of both two groups were excellent. From these results, SAX is not critical in the routine of coronary artery bypass surgery. Clinically, the SAX technique allows us to select more suitable areas of the ascending aorta for placement of all the proximal grafts if the ascending aorta is short.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1993

[Surgical treatment of cardiac cachexia with mitral valve disease: the effect of preoperative IVH and left atrial plication on postoperative respiratory condition].

Twenty-four patients with cardiac cachexia associated with mitral valve disease were evaluated from the point of postoperative respiratory management. Our previous study suggested that preoperative intravenous hyperalimentation (IVH) had just a effect on postoperative respiratory management, but another study suggested that left atrial plication (LAP) for giant left atrium might improve the postoperative respiratory function. Therefore, four groups could be identified: (1) IVH group (17 patients), (2) No-IVH group (7 patients), (3) LAP group (6 patients), (4) No-LAP group (18 patients). The hospital mortality was 18% in IVH group and was not related to the postoperative respiratory distress. On the contrary, the mortality in No-IVH group was 57%, related to the postoperative respiratory distress. The mortality of LAP group was 67%, and was related to the respiratory distress except one patient. In No-LAP group which had undertaken preoperative IVH, the mortality was 17%. As a result, preoperative IVH therapy may consider to be a favorite procedure in order to get the good postoperative respiratory condition, but LAP itself would be suspicious for this purpose.

Adult↗
PubMed1993

[Prosthetic valve endocarditis after double valve replacement].

This is a report of a patient who underwent re-AVR due to prosthetic valve endocarditis after double valve replacement (MVR, AVR). A 54-year-old female was admitted to other hospital on April 14, 1990, because of high fever, progressive anemia, and cardiomegaly. The patient was hospitalized to our department urgently with the diagnosis of prosthetic valve endocarditis. Arterial blood culture grew methicillin-resistant Staphylococcus epidermidis. Echocardiography showed a vegetation at the disc of the mechanical valve in the mitral position, but we could not find any vegetation or thrombus there at the reoperation, and the aortic mechanical valve seemed to be intact. Signs of inflammation continued to be positive after reoperation. On the 33rd hospital day, a diastolic murmur was heard, and emergency cardiac catheterization was done. Detachment of the prosthetic aortic valve and rupture of the sinus of Valsalva due to mycotic aneurysm, and the dissection of the aorta had occurred. We performed re-AVR and replacement of the ascending aorta. The patient died of multiple organ failure following drug-induced hepatic failure. It is suggestive that we missed the prosthetic aortic valve endocarditis during the reoperation. Our thoughts and introspections on the echocardiographic diagnosis of the prosthetic valve endocarditis after double valve replacement were discussed.

Aneurysm, Infected↗
PubMed1992

Molecular cloning of a novel human papillomavirus (type 60) from a plantar cyst with characteristic pathological changes.

In a plantar cyst composed of the wall of the squamous cell layer and the horny inner substance in the lower dermis, we found characteristic pathological changes, such as cytoplasmic eosinophilic inclusions and vacuolated structure, and, immunohistochemically, the papillomavirus capsid antigen. The human papillomavirus (HPV) DNA cloned from the cyst showed no homology with other known prototypes of HPV (HPV 1 through HPV 59) by Southern blot analysis under stringent conditions and was named as HPV 60. HPV 60 DNA was found in three other cases of plantar cyst with the identical pathological changes, but not in a plantar cyst without such changes. The results suggest that HPV 60 has unique biological properties to induce a plantar cyst as a distinct type of cutaneous HPV.

Blotting, Southern↗
PubMed1992

Comparative study of Ki-67 immunostaining and nuclear DNA content in histiofibrous tumors.

A comparative assessment was made of dermatofibroma, dermatofibrosarcoma protuberans, and malignant fibrous histiocytoma. The study was comprised of an immunohistochemical investigation using the Ki-67 monoclonal antibody and a quantitative analysis of cell nuclear DNA using flow cytometry. It was found that the index of Ki-67 monoclonal antibody labeling, the histogram pattern, and DNA index correlated with clinical malignancy, suggesting the usefulness of these indices for differential diagnosis and evaluation of prognosis.

Adult↗