Biomedical subjects
Publications and source records attributed to M Kitamura.
A 62-year-old female had unresectable stage 4 gastric cancer with ascites. She was treated with suppository administration of tegafur 750 mg/day. Endoscopical examination before treatment showed Borrmann 4 gastric cancer. After 3 months' treatment, the lesion almost disappeared. The patient survived for 9 months after the diagnosis.
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Orthotopic heart transplantation with sinus venosus incision of right atrium was aimed to preserve the sinus node, terminal crista, sinus node artery and whole right atrial muscle of the transplanted heart. This transplant procedure was performed in eight mongrel dogs and electrocardiogram was followed up to five postoperative months. Direct cross circulation technique was employed as an alternative of cardiopulmonary bypass. Donors and recipients were 6 to 8 kg mongrel puppies, and 19 to 25 kg adult dogs supported the cross circulation. Myocardial protection of the donor heart was carried out by low-flow continuous potassium cardioplegia and topical cooling. Right atrial incision of the donor heart was made longitudinally in the posterior wall of sinus venosus. After a median sternotomy, ascending aorta and superior and inferior venae cavae of the recipient were cannulated and connected respectively with carotid artery and jugular vein of the cardiopulmonary support dog. Electrocardiogram, arterial pressure and central venous pressure of the recipient were monitored, and an electro-magnetic flow meter was employed for measuring the blood flow of direct cross circulation. The native heart was resected after aortic cross-clamping, and left atrium and atrial septum were sutured continuously. Sinus venosus incision of the donor heart was anastomosed to the recipient's right atrium. Ascending aorta and pulmonary trunk were reconstructed in the standard fashion. Aortic cross-clamp time was less than one hour and sinus rhythm of the transplanted heart was continued in all cases. Five of the eight dogs were alive postoperatively for one week to five months.(ABSTRACT TRUNCATED AT 250 WORDS)
Para-esophageal anastomosis of left atrium was examined in orthotopic heart transplantation as a new surgical technique for transesophageal electrophysiologic study of the transplanted heart. Seven orthotopic heart transplantations were performed in mongrel dogs. Left atrial appendage of the donor heart was trimmed as a flap and the sinus venosus of right atrium was incised posteriorly. An upper midline incision was made in the posterior wall of left atrium of the recipient after native ventricles were resected. Left atrial appendage flap of the donor heart was anastomosed to the posterior incision of native left atrium, and the remains of left atrium were sutured continuously. Sinus venosus incision of the donor heart was anastomosed to the right atrium of recipient. Ascending aorta and pulmonary trunk were reconstructed in the standard fashion. Transesophageal atrial pacing was possible during and after weaning from cardiopulmonary bypass in all seven cases. The appendage flap was found to occupy one third of the posterior wall of left atrium at the time of sacrifice. It was suggested that para-esophageal anastomosis of left atrium would be an useful technique for transesophageal electrophysiologic study of the transplanted heart.
Prognostic factors in patients with carcinoma of the thoracic esophagus were analysed. From May 1972 to February 1989, 361 cases were resected in our department. Cases of histological curability 0, double cancer, death within 30 days after operation, death due to other diseases and cancer except squamous cell carcinoma were excluded, and 170 were chosen for this study. We classified these cases into two groups according to the survival period; Group 1: cases died within 2 years after operation, Group 2: cases lived more than 2 years. Factors analyzed were as follows; sex, age, location of the lesion, radiological classification, radiological vertical extension, axial deviation of the esophagus, endoscopic classification, endoscopic horizontal location, resectability, longitudinal diameter, histologic differentiation, depth of invasion, degree of lymphnode metastasis, range of lymphnode metastasis, lymphatic invasion, blood vessel invasion, intraepitherial spread, intramural metatasis, histologic stage and histologic curability. Factors related to prognosis were age, radiologic classification, depth of invasion, degree of lymphnode metastasis, histologic stage and histologic curability. In the next step, these cases were also classified into three groups according to the degree of lymphnode metastasis (n(-), n1 + 2(+), n3 + 4(+) and factors which influenced prognosis were analysed in each group. In the group without lymphnode metastasis, there was a statistical difference in survival rate between cases with intramural metastasis and cases without that. In groups with lymphnode metastasis (n1 + 2(+), n3 + 4(+), any factors such as the degree and range of metastasis or intramural metastasis had no influence on prognosis. So it was concluded that lymphnode metastasis itself was an important factor for prognosis.
In this study, we measured anti-microsomal (same as anti-thyroid peroxidase) and anti-thyroglobulin antibodies (anti-TPOAb and anti-TgAb) in sera by new RIA kits and compared with the conventional particle agglutination (PA) kits. Two of 80 normals (2.5%) showed anti-TPOAb positive activity (greater than or equal to 0.3 unit/ml), and 9 of same samples (11.3%) showed anti TgAb positive activity (greater than or equal to 0.3 unit/ml). Sixty of 67 patients with Graves' disease (89.6%), and 14 of 22 with Hashimoto's disease (63.6%) were anti-TPOAb positive, and 42 (62.7%), and 18 (81.8%) were anti-TgAb positive respectively. Samples of 5 non-autoimmune disease were all negative by TPOAb and TgAb assays, suggesting the high specificity of new RIA kits to the autoimmune thyroid diseases. The RIA and PA methods showed a good correlation (anti-TPOAb:rs = 0.9134, anti-TgAb:rs = 0.7016). However, several negative sera in PA assay showed positive values in the RIA, so it was showed that new RIA kits were more sensitive than the PA assays.
Chemical analysis, which had been used for routine test until enzymatic analysis was developed by Richmond in 1973, gave 10% or much higher systematic error on serum cholesterol level compared to orthodox reference method. Direct analysis without deproteinization, which was used widely in the 1960's because of ease of use, gave even more erroneous value caused by interference depending on each sample. Although cholesterol oxidase method is good, its reliability depends on reagent kit or instrument. Therefore, in reality, the method shows unexpected large interlaboratory differences. At this stage it is impossible to discuss the meaning of 10-20 mg/dl difference on serum cholesterol level.
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A human lactate dehydrogenase-B mutant gene was isolated from a genomic DNA library constructed from a patient with unstable LDH-B (heart) subunit. The nucleotide sequences of seven protein-coding exons were determined and a single nucleotide substitution of G by A at Arg codon CGC in exon 4 was found. This mutation results in an amino-acid replacement of a conserved arginine by histidine at the residue "173," which is involved in an anion-binding site at the P-axis of LDH subunits.
Sequential low-dose Methotrexate.5FU therapy was conducted on a total 52 cases of advanced or recurrent gastric carcinoma. Intra-aortic infusion therapy was performed in 31 cases and intravenous administrative therapy was employed in the remaining 21 cases. The two groups were compared in terms of the response rate and side effects. Thirty mg/m2 of Methotrexate (MTX) was given by bolus injection into the aorta or venous route, followed by 500 mg or 750 mg of 5FU by bolus injection 3 hours later. Twenty four hours after the injection of MTX, 30 mg of Leucovorin was given intravenously or orally. The major lesion of intra-aortic infusion group was primary site (stomach) in 10 cases, peritoneum and digestive tract in 9 cases, Douglas' pouch in 5 cases, liver in 3 cases, abdominal wall in 2 cases and retro-peritoneal lymph nodes in 2 cases. On the other hand, the major lesion of the intravenous administrative group was the primary site (stomach) in 5 cases, peritoneum and digestive tract in 6 cases, Virchow's lymph-node in one, hepatic hilus in one and lung in one. Response could be evaluated in 31 patients with intra-aortic therapy. Partial response was found in 9 cases and NC in 16. PD was found in 5 and so the rate of response was 29.0% (9/31). The major lesion of 9 responders was inoperable Borrmann's Type 4 gastric cancer in 2 cases, peritoneal recurrence with an abdominal mass in 4, recurrence in the abdominal wall in one, Douglas' pouch in one, and intestinal stenosis in one.(ABSTRACT TRUNCATED AT 250 WORDS)
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PT-01, a controlled-release insert, was developed for topical chemotherapy in periodontal disease. It is a soluble insert that consists of fast-release and sustained-release parts containing ofloxacin (OFLX) as an antibacterial agent. In this study, the release profile of OFLX from PT-01 was investigated in vitro. Twelve adult volunteers were administered OFLX as PT-01 or as an aqueous solution into their periodontal pockets, OFLX concentrations in gingival crevicular fluid (GCF) were evaluated from the viewpoint of pharmacokinetics. The in vitro release profile of OFLX from PT-01 showed a biphasic pattern. The release rate of OFLX was relatively rapid in the early phase and slow thereafter. When OFLX aqueous solution was administered into periodontal pockets, the OFLX level in GCF rapidly decreased to be about 1/100 after 30 minutes. When PT-01 was inserted into the pockets, the OFLX level in GCF immediately reached a peak (about 12 mg/ml), and gradually decreased until the 3rd day, and maintained a constant level above 2 micrograms/ml, the effective minimum antibacterial concentration for periodontopathic microorganisms, from the 3rd to 7th day after insertion. No side-effects were observed in the volunteers who received the PT-01 insert. The above results suggest that PT-01 is a suitable pharmaceutical preparation for periodontal chemotherapy.
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Oligonucleotides with 1-pyrenylmethyl substituent at the designated sugar residue were synthesized by using 5'-dimethoxytrityl 2'-(1-pyrenylmethyl)uridine 3'-phosphorobisdiethylamidite 1. It was shown that the pyrene-oligonucleotides have enhanced affinity in binding to the complementary polynucleotide sequence. The fluorescence yield and life time of the pyrene-oligonucleotide was drastically enhanced when bound by the complementary polynucleotide.
The oligothymidylate analogs, having several stereo regular phosphoramidate linkages, were synthesized. Melting temperatures(Tm) of complexes of the analogs and poly(dA) were measured by spectroscopic method. The abilities of the analogs to form the complexes with poly(dA) depended on their P-chirality of their modified linkages: one of the chiral isomers formed stable complexes, but another isomer formed less stable complexes.
One hundred and thirty-seven cases of stomach cancer given fluoropyrimidines (UFT: 66 cases, Tegafur: 58 cases, 5-FU: 13 cases) after gastrectomy as the adjuvant chemotherapy were examined as to appearance of macrocytic anemia. The mean corpuscular volume (MCV) gradually elevated in all cases but seven after administration. Macrocytic anemia, defined by the elevation over 20% compared with both pre-operative and pre-administrative values of MCV, was developed 30.3% in UFT group, 8.6% in tegafur group and 30.8% in 5-FU group. The incidence was statistically higher in UFT group (p less than 0.01) and 5-FU group (p less than 0.05) than in tegafur group. The cause was attributed to fluoropyrimidine administration because the serum folate and vitamin B12 levels remained normal and the value of MCV normalized after cessation of administration. Each total dose to induce macrocytic anemia was potentially about 70g in UFT. 100g in tegafur and 30 g in 5-FU. In conclusion, periodical hematological examination is necessary for the patients given fluoropyrimidine preparations.