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Biomedical subjects

M Kitamura

Publications and source records attributed to M Kitamura.

At least 451 records · Page 25Linked to original sources
PubMed1990

[Evaluation of the liver and peritoneal metastasis in the treatment of gastric carcinoma with intra-arterial injection in terms of survival period].

We used treatment with intra-arterial injection in cases of liver and peritoneal metastasis in progressive or recurrent gastric cancer patients. The investigation of the relationship between efficiency of therapy and survival period was evaluated. The effective rate of sequential treatment of peritoneal metastasis with MTX.5-FU in 34 cases was 35.3%, while that of liver metastasis with MMC combined with DSM in 12 cases was 50%. Although the effective rate among 16 cases treated with MMC.5-FU combined with Angiotensin II was 50%, no effect was recognized in the groups treated with AF and MF. In cases of peritoneal metastasis with MTX.5-FU, the prognosis PR cases was significantly better than that of NC.PD. For treatment of liver metastasis with MMC combined with DSM and MMC.5-FU combined with Angiotensin II, the PR prognosis was unsatisfactory and the survival period did not significantly improve compared with that of NC.PD. In future cases of liver metastasis, these results indicate the extreme difficulty in maintaining therapy and controlling the lesion after PR. We speculated that sequential treatment of peritoneal metastasis with MTX.5-FU was useful because it significantly extended the survival period in PR cases.

Angiotensin II↗
PubMed1990

[Early diastolic dysfunction of the left ventricle affected by hypertrophy and abnormal histopathology in hypertrophic cardiomyopathy].

In this study, we investigated correlations of left ventricular hypertrophy and its histopathology with diastolic dysfunction in patients with hypertrophic cardiomyopathy. Nine control subjects and 14 hypertrophic cardiomyopathy (HCM) patients with asymmetrical septal hypertrophy were evaluated. M-mode echocardiography was used to assess fractional shortening (FS), isovolumic relaxation time (IRT), and the left ventricular filling volume index during rapid and slow filling periods and atrial contraction period (RFVI, SFVI and ACVI). End-diastolic thickness of the interventricular septum and posterior wall was determined using biventriculography. Right ventricular endomyocardial biopsies were performed to calculate the diameters of myocytes, the percentage of fibrosis and the eccentricity e which indicates the degree of myocardial disarrangement including disorganization. The FS was normal in the two groups. The IRT of the HCM group was significantly greater and the RFVI significantly less than those of the controls. The left ventricular wall thickness, the diameters of myocytes and the percentage of fibrosis in the HCM group were significantly greater; and the eccentricity e was significantly less, suggesting that myocardial disarrangement was significantly more severe than that in the controls. Significant positive correlations were observed between the IRT and the wall thickness (r = 0.647), between the diameter of myocytes (r = 0.681) and the percentage of fibrosis (r = 0.628), and there was a significantly negative correlation between the IRT and the eccentricity e (r = -0.759). There was a significantly negative correlation between the RFVI and the wall thickness (r = -0.663); and a significantly positive correlation between the RFVI and the eccentricity e (r = 0.579). Multiple regression analyses showed that the diameter of myocytes, the percentage of fibrosis and the eccentricity e all correlated significantly with the IRT (R = 0.821) and the RFVI (R =0.604). The standard regression coefficients of the diameter of myocytes, the percentage of fibrosis and the eccentricity e were 0.253, 0.278 and -0.431 in respect to IRT, and those of the percentage of fibrosis and the eccentricity e were -0.204 and 0.469 in respect to RFVI, respectively. These results indicated that diastolic dysfunction in hypertrophic cardiomyopathy is related not only to the degree of left ventricular hypertrophy, but also to the degree of myocardial hypertrophy, increased interstitial fibrosis, and especially to myocardial disarrangement including disorganization.

Adult↗
PubMed1990

[Surgical salvage of cardiac rupture: a case report].

A 39-year-old man suffered from acute myocardial infarction. Echo cardiography showed the presence of intra-pericardial fluid. We had emergent operation. We successfully salvaged cardiac rupture with fibrin glue and oxy-cellulose without cardiopulmonary bypass. His post-operative course was uneventful. The patient was discharged on the seventh week after the operation. The problems of acute cardiac rupture were discussed.

Adult↗
PubMed1989

LH action in the Leydig cell: modulation by angiotensin II and corticotropin releasing hormone, and regulation of P450(17) alpha mRNA.

Luteinizing hormone is the major regulator of Leydig cell differentiation and steroidogenic function. A number of hormones produced by the Leydig cell (e.g. estrogen, angiotensin, CRF, vasopressin) and the tubular compartment (inhibin, TGF beta), can influence both acute and long-term actions of LH. Conversely, hormones produced in the Leydig cells modulate tubular function (e.g. androgen, beta-endorphin, oxytocin). The LH stimulatory event can be negatively influenced by the action of angiotensin II through the guanyl nucleotide inhibitory unit of adenylate cyclase. We have recently discovered an action of corticotrophin releasing hormone through specific high-affinity low-capacity receptors in the Leydig cells which involves a pertussis toxin insensitive guanyl nucleotide regulatory unit with interaction between signalling pathways and resulting inhibition of LH induced cAMP generation and consequently of steroidogenesis. In contrast to other tissues the CRF receptor in the Leydig cells did not couple to Gs. CRF action is exerted through direct or indirect action of protein kinase C, at the level of the catalytic subunit of adenylate cyclase. Physiological increases in endogenous LH cause positive regulation of membrane receptors and steroidogenesis, while major elevations in circulating gonadotropin can induce down-regulation of LH receptors and desensitization of steroid responses in the adult cell. Gonadotropin-induced desensitization in adult rat tests include an estrogen mediated steroidogenic lesion of the microsomal enzymes 17 alpha-hydroxylase/17,20-desmolase. For further understanding of the regulation of this key enzyme of the androgen pathway the rat P450(17) alpha cDNA was cloned and sequenced. This cDNA expressed in COS-1 cells 17 alpha-hydroxylase/17,20-desmolase activities. From the deduced amino acid sequence, two transmembrane regions were identified, a signal peptide for insertion in the ER, and a 2nd transmembrane region separated from the first by 122 amino acids. The carboxy terminal non-transmembrane region possesses 4 hydrophobic clefts, of which cleft II would contain the putative steroid binding site for both hydroxylase and lyase activities. The rat cDNA was employed to evaluate the hormonal regulation of mRNA levels in adult and fetal Leydig cells. Low dose hCG treatment caused an early increase in mRNA levels followed by a return to control values at later times, while with higher desensitizing doses the initial increase in mRNA was followed by a marked reduction in mRNA at 24 h and a small recovery at 48 h. Fetal rat Leydig cells treated with E2 showed a 70% decrease in P450 mRNA levels, and testosterone production closely followed the changes in mRNA.(ABSTRACT TRUNCATED AT 400 WORDS)

Angiotensin II↗
PubMed1989

Primary amyloid tumors of the jejunum producing intestinal obstruction.

The proximal jejunum, containing four separate amyloid tumors, was resected from a chronically constipated 71-year-old male exhibiting IgG lambda monoclonal gammopathy. Amyloid was deposited in the jejunal wall, mesentery and regional lymph nodes, but was not seen in gastric and rectal biopsy samples. Two years after surgery, the patient is well, but the monoclonal gammopathy persists.

Aged↗
PubMed1989

Lactogen and LH receptors. Rat P-450 17 alpha, structural analysis and hormonal regulation of mRNA levels in the Leydig cell.

A complete amino acid sequence for rat testis P-450 17 alpha was deduced from nucleotide analysis of a cDNA clone isolated from a rat Leydig cell library. This cDNA expressed in COS-1 cells both 17 alpha-hydroxylase and 17,20 lyase activities. Rat P-450 17 alpha exhibited significant similarity to the nucleotide and deduced amino acid sequences of the bovine and human P-450 17 alpha, particularly with the highly conserved regions and secondary structure. The rat P-450 17 alpha is anchored to the ER by two transmembrane regions: the N-terminal insertion peptide and the stop-transfer sequence. The C-terminal is associated with the ER by four hydrophobic clefts including the steroid-binding site. We have demonstrated a dual effect of hCG, causing early increases of Leydig cell P-450 17 alpha mRNA levels at low doses, while higher desensitizing doses caused marked subsequent reduction of mRNA levels. Our studies demonstrate that gonadotropin stimulation and desensitization of P-450 17 alpha dependent enzymes (17 alpha-hydroxylase/17,20 desmolase) in the adult rat testis and E2 induced desensitization in fetal Leydig cells are related to levels of P-450 17 alpha mRNA.

Animals↗
PubMed1989

[Clinico-pathological study of solid poorly differentiated carcinoma of the stomach].

We have studied the clinico-pathological features of 42 autopsied cases involving solid, poorly differentiated carcinomas that histologically revealed a medullary growth pattern but none showing a tubular formation. Ninety percent of these 42 cases were male, and the 42 carcinomas were of 5 histological types as listed below: 1) small cell carcinoma-atypical carcinoid type (15 cases); 2) AFP-producing type (so-called "hepatoid carcinoma") (4 cases); 3) acinar type (8 cases); 4) signet ring cell-medullary type (2 cases); and, 5) large cell type (13 cases) The small cell carcinoma-atypical carcinoid type, the AFP-producing type, and the large cell type showed a severe hematogenous metastasis. In contrast, the acinar type had a lymphogenous metastasis the signet ring cell-medullary type, showed a lymphogenous and peritoneal metastasis. Each histological type well corresponded to the typical biological characteristics of each of these carcinomas of the stomach.

Adenocarcinoma, Mucinous↗
PubMed1989

[Arterial infusion chemotherapy in patients with gastric cancer in liver metastasis and long-term survival after treatment].

Fifty-five gastric cancer patients with liver metastasis received arterial infusion chemotherapy. In 14 patients who had lesions in the liver intra-hepatic artery infusion chemotherapy was performed, while in 41 patients who had lesions in the liver and other sites intra-aortic infusion chemotherapy was performed. Methods for inserting the catheter into the aorta or hepatic artery and treatment schedules were reported previously. Between 1975 to 1981, 33 gastric cancer patients with liver metastasis were treated with 5-FU only (4 cases). MMC.5-FU (18 cases) and ADM.5-FU (11 cases). No response was seen, but minor response was seen in two cases. Between 1982 to 1988, 22 gastric cancer patients with liver metastasis were treated using arterial MMC.5-FU therapy combined with angiotensin II (13 cases), arterial MMC therapy combined with degradable starch microsphere (6 cases) and sequential MTX.5-FU (3 cases). The response rate of MMC.5-FU therapy combined with angiotensin II was 5/13 (38%) including one complete response. The responders of MMC-combined DSM therapy were seen in 3 (50%) out of 6 patients. However, no response was seen in sequential MTX.5-FU therapy. In the present study, a 61-year-old patient treated with MMC.5-FU combined with angiotensin II therapy, survived for 49 months after treatment. In order to improve the prognosis of gastric cancer patients with liver metastasis, it is important to increase the delivery of anticancer drugs to the target tissues by using certain drugs like angiotensin II and DSM. In the future, further studies should be done to prolong the duration of remission by arterial chemotherapy.

Angiotensin II↗
PubMed1989

Syntheses and properties of oligodeoxyribonucleotide analogues having diastereochemically pure phosphoramidate linkages.

The oligothymidilate analogues, having stereoregular and alternative phosphormorpholidate/phosphodiester backbone, were synthesized from the diastereochemically pure dimer blocks by phosphorbisamidite method. The phosphormorpholidate linkage of the oligothymidilate analogues were resistant to snake venom phosphodiesterase, and no cleavage of the phosphodiester linkage of the analogues were slowly cleaved by the nuclease was slow. The abilities of isomers to form the complexes with poly(dA) greatly depended on their structures.

Amides↗
PubMed1989

[Radical operation for carcinoma of gastric cardia--lymph node dissection by laparosternophrenotomy approach].

The adequate esophago-gastric resection and lymph node dissection can be performed without the necessity of a thoracotomy, by using the laparosternophrenotomy approach. For tumors restricted to lower esophagus of 4cm in localized tumors or 3cm in invaded tumors above the EG junction, the sternotomy approach is utilized. However, if the tumor extends to more than the above criteria, the thoracoabdominal approach must be utilized. For 14 years, 85 cases with tumor of gastric cardia were performed by sternotomy approach and 76 cases were performed by thoracotomy approach. The lymph node metastatic rate in the lower thoracic cavity was 26% in total. The lymph node metastatic rate of No. 110 was 22.6%, No. 111 was 17.4% and No. 112 was 12.5%. These results show the lymph node dissection in the lower thoracic cavity is very important in tumors of gastric cardia. The five year survival rate was 41% in patients who undergone curative operation by the sternotomy approach, and 45% in patients performed by the thoracotomy approach. According to our study of the lymph fluid stream in gastric cardia tumors using carbon, the lymph node dissection around the renal vein is important. This approach has less respiratory disturbance than the thoracotomy. This procedure is one of the best approaches for carcinoma of gastric cardia according to our criteria.

Cardia↗
PubMed1989

[Renal failure in paroxysmal nocturnal hemoglobinuria].

UNLABELLED: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare, acquired hemolytic disorder characterized by a membrane abnormality of red cells, and characterized by two major clinical features of gross hemoglobinuria and diffuse venous thrombosis. In Japan, the present report records the first case of acute renal failure complicating PNH with treated by hemodialysis and was almost completely reversible. CASE: A 41 year-old woman was admitted for high fever (39.8 degrees C), dyspnea and clinical signs of a respiratory infection. She was started on Cefotax 1,000 mg 3 times daily. She subsequently developed acute renal failure and which treated by hemodialysis and was almost completely reversible. Following treatment of her renal failure, respiratory infection and anemia, she initially made good progress and was discharged.

Acute Kidney Injury↗
PubMed1989

[A case of congenital absence of the right coronary aortic cusp].

A 12-year-old boy with absence of the right coronary cusp underwent aortic valve replacement with a 21 mm St. Jude Medical prosthetic valve. He was known to have noncyanotic congenital heart disease at the age of 2 months. The diagnosis of aortic insufficiency was first made when he was 1 1/4 years old. Intensive medical treatment was continued while he was growing up. Cardiac catheterization was performed repeatedly at ages 3 1/2 and 7. The findings on the fourth cardiac catheterization at 12 years of age were pulmonary arterial pressure of 90/60 mmHg, left ventricular end-diastolic pressure of 25 mmHg and poor contraction of the left ventricle. Although IABP support was necessary for treatment of severe low cardiac output state in the early postoperative period, he was discharged at 1 month after operation, Now, he goes to school under anticoagulant therapy. Intensive medical care followed by elective aortic valve replacement may be a useful treatment for isolated congenital absence of the aortic valve cusp.

Aortic Valve↗
PubMed1989

[A case report of Bentall procedure for annulo-aortic ectasia associated with right coronary artery dissection].

A 30-year-old man who had annuloaortic ectasia associated with aortic insufficiency owing to marked annular dilatation was treated by replacement of the ascending aorta and aortic valve with a composite graft. It was necessary to transpose the origin of the coronary artery because of the development of dissection to right coronary ostia. We have applied the Bentall procedure with aorta coronary bypass between the right coronary artery and the aortic prosthesis with the use of saphenous vein graft. His post operative course is uneventful and engaging full work 18 month after operation. This technique is useful for the case of annuloaortic ectasia associated with difficulty coronary anastomosis such as coronary artery dissection, obstruction or dislocation.

Adult↗