SETTING AND OBJECTIVE: Erosive and ulcerous endobronchial tuberculosis (EBTB) is distinct from pulmonary tuberculosis in some aspects. We evaluated the clinical features of 56 patients (26 males and 30 females) with EBTB to characterize the clinical features of the disease. RESULTS: The chief complaint in 70% of patients was intractable cough, particularly in those with tracheal tuberculosis. The predominant radiological features were patchy bi-apical infiltrates of variable intensity without cavitation; for six patients, however, plain radiographs revealed no abnormalities. The ulcerous lesions could be classified into three stages: active, healing and scarring. Furthermore, we divided scarring stage into two subtypes, polypoid and non-polypoid. Most of the patients were treated with isoniazid, rifampin, and streptomycin (SM) or ethambutol. Approximately one-third of the patients, not randomly selected, were treated with aerosolized SM and corticosteroids in addition to conventional oral therapy. CONCLUSION: EBTB involves typical clinical and radiographic features. In this uncontrolled series, it was our impression that the period of time to healing of ulcerous lesions seemed to be shorter in those treated with aerosol therapy including streptomycin and corticosteroids.

Adolescent↗

PubMed1998

[Intra-arterial chemotherapy to improve quality of life in cases of unresectable advanced or recurrent breast cancer].

We performed repetitive intra-arterial infusion chemotherapy (I.A.) with epirubicin in order to improve the quality of life (QOL) in 3 cases with locally advanced or recurrent breast cancer which were diagnosed as surgically unresectable and seemed uncontrollable by outpatient systemic chemotherapy. The patients were admitted to our hospital for chest wall invasion, lymph node metastasis, bleeding, pain, or edema in upper extremity. Therapeutic effects included 1 case of CR and 2 cases of PR in the primary site, and similar effects were obtained in metastasized lymph nodes. We could perform mastectomy in both of the 2 cases with locally advanced cancer after I.A., Although leukocytopenia, which was the dose limiting factor in this regimen, was observed in all 3 cases, it was Grade 2 or 3 and recovered by G-CSF. With regard to their QOL, symptoms which had driven them to inpatient treatment remarkably improved in all of the cases. Thus, after 2 series of I.A. they could receive maintenance systemic chemotherapy as outpatients. Our findings showed that the I.A. as a local control treatment in patients with unresectable advanced or recurrent breast cancer is useful for the improvement of their QOL.

Antibiotics, Antineoplastic↗

PubMed1998

Effects of daunorubicin on cell growth, cell cycle and induction of apoptosis in HL-60 cells.

Administration of daunorubicin (DNR) at over 3.5 x 10(-8)M has been reported to block cells at G2 phase, but the precise mechanism of cell death induced by DNR is not well known. In this study effects of DNR at various concentrations on cell growth, cell cycle and induction of apoptosis in human leukemia cell line HL-60 cells were investigated. Administration of DNR at a high concentration (3.0 x 10(-8)M) inhibited cell growth to 3% as compared with untreated cells, blocked the cell cycle at G2 phase and induced cell-cycle non-specific apoptosis. Administration of DNR at a lower concentration (1.0 x 10(-8)M) inhibited cell growth to 77%, induced cell-cycle nonspecific apoptosis but did not produce G2 arrest. A longer duration of exposure to DNR was required to induce apoptosis by the lower concentration of DNR than by the higher concentration. These findings indicate that the effect of DNR on cell growth is caused by both G2 arrest and induction of apoptosis and that DNR induced apoptosis without G2 arrest. Moreover, continuous administration of a low concentration of DNR which has been considered to have no anticancer effect might be useful for treatment of leukemia and related diseases.

Apoptosis↗

PubMed1998

[Measurement of coronary flow reserve using adenosine 5'-triphosphate in dogs].

Adenosine 5'-triphospate (ATP) was compared with adenosine and papaverine for the measurement of coronary flow reserve in 12 anesthetized dogs. Intracoronary bolus injection of ATP (1 ml, 1-500 microM) produced a dose dependent increase in the blood flow of the left anterior descending artery, which attained the plateau at the dose of 100 microM. The ratio of peak to resting coronary flow volume (coronary flow reserve) with 100 microM of ATP (3.5 +/- 0.5) was similar to that with 200 microM of adenosine (4.0 +/- 0.7) and 50 mM of papaverine (3.7 +/- 0.8). Hemodynamic variables did not change after administration of each drug, except left ventricular regional wall motion abnormality during papaverine injection. The coronary flow reserve as measured after intracoronary ATP administration (100 microM) decreased as the grade of stenosis of the left anterior descending artery progressed. In addition, the flow reserve was similar to that of adenosine or papaverine administration at each stenosis grade. Intravenous administration of ATP (1,000 micrograms/min) caused a similar increase in coronary blood flow as intracoronary ATP injection (100 microM). However, premedication with 8-phenyltheophylline, an adenosine receptor blocker, significantly suppressed the coronary dilatory effect of intravenous ATP and intracoronary adenosine but not the effect of intracoronary ATP. These results indicate that intracoronary ATP is useful for measuring coronary flow reserve and that its coronary dilatory effect is not mediated by metabolysis to adenosine.

Adenosine↗

PubMed1998

Role of oxygen radical and lipid peroxidation in indomethacin-induced gastric mucosal injury.

Nonsteroidal antiinflammatory drugs such as aspirin and indomethacin are known to induce gastric mucosal damage including bleeding, ulceration, and perforation in humans and animals. Although it has been proposed that a deficiency of endogenous prostaglandins due to inhibition of cyclooxygenase by the drug is involved in these effects, the exact pathogenic mechanism remains to be elucidated. It has recently been proposed that neutrophil- and oxygen radical-dependent microvascular injuries may be important prime events that lead to mucosal injury induced by nonsteroidal antiinflammatory drugs. Lipid peroxidation mediated by oxygen radicals, especially hydroxyl radicals, plays a crucial role in the development of the gastric mucosal injury induced by indomethacin. Both allopurinol, an inhibitor of xanthine oxidase, and neutrophil depletion by intraperitoneal injection of antineutrophil antibody significantly attenuates indomethacin-induced gastric injury. In this paper, we have reviewed the recent data that assess the role of oxygen radical and lipid peroxidation in the pathogenesis of indomethacin-induced gastric mucosal injury in rats and humans.

Alanine↗

PubMed1998

In vitro studies indicating antioxidative properties of rebamipide.

Rebamipide is the first anti-gastric ulcer and antigastritis drug that not only increases endogenous prostaglandin in gastric mucosa but also scavenges oxygen-derived free radicals and inhibits their production. In the present paper, we have reviewed the antioxidative and antiinflammatory properties of rebamipide mainly demonstrated by in vitro studies. The study, using the electron paramagnetic resonance (EPR) spin trapping technique, showed that superoxide production was inhibited by rebamipide when isolated human neutrophils were stimulated with opsonized zymosan or Helicobacter pylori water extract in a dose-dependent manner. Chemiluminescence generated from neutrophils activated by H. pylori or formyl-methionyl-leucyl-phenylalanine was also decreased by the treatment with rebamipide. Rebamipide, at concentrations of 10(-5) and 10(-6) M, reduced the adherence of neutrophils to endothelial cells as well as the CD18 expression on neutrophils induced by H. pylori water extract. The EPR study also demonstrated the direct hydroxyl radical scavenging activity of rebamipide, and a kinetic study showed that the second-order rate constant for the reaction between rebamipide and hydroxyl radical was 2.24 x 10(10) M(-1)/s(-1). The inhibitory effect of rebamipide on lipid peroxidation induced by a free radical initiator was also demonstrated by the in vitro system using rat gastric mucosal homogenates. These data indicate that rebamipide offers a potential for protection against reactive oxygen- and activated neutrophil-associated gastric mucosal injury by scavenging hydroxyl radical and inhibiting neutrophil activation or lipid peroxidation.

Alanine↗

PubMed1998

Rebamipide protects against indomethacin-induced gastric mucosal injury in healthy volunteers in a double-blind, placebo-controlled study.

The aim of the present study was to evaluate rebamipide in the prevention of indomethacin-induced gastric mucosal injury in healthy volunteers. Twenty healthy males (mean age 21.8 years, range 20-26) participated. This is a randomized, double-blind, placebo-controlled study. The 20 subjects were randomized to either indomethacin 25 mg three times a day and placebo three times a day or indomethacin and rebamipide 100 mg three times a day for seven days. Endoscopy was performed at baseline and again after the treatment. In the placebo group, eight of 10 subjects (80%) developed symptoms compared to three of seven (43%) in the rebamipide group. The incidence of gastric lesions was 70% in the placebo group, which was significantly higher than that in the rebamipide group (14%). The lipid peroxide levels in the mucosa of the gastric body significantly increased in the placebo group. This increase was not inhibited by rebamipide. Myeloperoxidase activity in the gastric mucosa tended to increase in the placebo group, but tended to decrease in the rebamipide group. These results indicate that rebamipide may be an effective prophylaxis against indomethacin-induced gastropathy in humans.

Adult↗

PubMed1998

Effect of glutamate analogues and inhibitory neurotransmitters on the electroretinograms elicited by random sequence stimuli in rabbits.

OBJECTIVE: To study the origin of the different components of the electroretinogram (ERG) elicited by a random binary m-sequence stimulus. METHODS: Electroretinograms were recorded from pigmented rabbits before and after the injection of glutamate analogues (2-amino-4-phosphono-butyric acid [APB; DL form] and cis-2,3-piperidine-dicarboxylic acid [PDA]) and inhibitory neurotransmitters (glycine and gamma-aminobutyric acid [GABA]) to abolish the contribution of different cell types to the ERG. Two types of stimuli were used: conventional full-field stimulation with short- and long-duration flashes and a random binary m-sequence of flashes designed to mimic the pseudorandom binary m-sequence stimulation used in the multifocal ERG technique. RESULTS: The effects of APB and PDA on the first-order kernel of the random ERGs were similar to those on the photopic short-flash ERG. Glycine and GABA minimized the oscillatory potentials (OPs) of the photopic ERGs, and also reduced the amplitude of the positive wave of the first-order kernel slightly but caused a large reduction in the amplitude of the second-order kernel. CONCLUSIONS: The data suggest that the ON and OFF bipolar cells contribute significantly to the photopic short-flash ERG, as previously shown, and to the first-order kernel of the responses elicited by the pseudorandom binary sequence stimuli. The second-order kernel and the OPs receive a strong contribution from the cells of the inner retinal layers.

Aminobutyrates↗

PubMed1998

[Neutrophil-endothelial cell interactions in gastrointestinal diseases].

The adherence of neutrophils to the endothelium is a crucial early event in the inflammatory and immunological reaction. Neutrophil-endothelial cell interactions are known to be mediated by adhesion molecules that are expressed on each cell. Among the adhesion molecules expressed on leukocytes, the CD11/CD18 integrin family plays a major role in the adhesion and transendothelial migration of neutrophils. The two most extensively characterized endothelial cell adhesion molecules are intercellular adhesion molecule-1 and E-selectin. These adhesion molecules are involved in the pathogenesis of several digestive diseases such as Helicobacter pylori, non steroidal anti inflammatory drug- or stress-induced gastric mucosal injury, inflammatory bowel diseases.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed1998

[Anaphylaxis in a myelodysplastic syndrome patient during platelet transfusion with a leukocyte-reduction filter].

A 77-year-old woman with myelodysplastic syndrome required platelet transfusion. However, she complained of facial flushing and dyspnea immediately after the initiation of an infusion of platelet concentrations (PC) utilizing a Pall PL-PXL8H filter with a negatively charged surface. The same symptoms recurred following a transfusion of washed PC with saline. However, an infusion utilizing a Sepacell PLX5A-W with a positively charged surface caused no problems. Furthermore, the patient demonstrated the same adverse reaction after administration of prostaglandin F2 alpha. This case suggested that special caution is warranted when patients who have an allergic history receive PC infusions through leukocyte-reduction filters with negatively charged surfaces.

Aged↗

PubMed1998

[Autoimmune neutropenia].

Explore the source record for details and available documents.

Antibodies, Antineutrophil Cytoplasmic↗

PubMed1998

[Clinical efficacy of MRCP for diagnosis of patients with pancreatic neoplasm].

We examined the usefulness of MRCP in pancreatic cancer compared with ERCP. Moreover, it examined in the same way in focal pancreatitis, too. We compare three findings of 1) main pancreatic duct, 2) branches of the stricture part, 3) side of tail main pancreatic duct about ERCP and MRCP. As for the branches of the stricture part, MRCP was poor compared with ERCP but as for the property of the side of the tail main pancreatic duct, MRCP excelled. The study of mass forming chronic pancreatitis was a similar result and was not the one, which excels ERCP in case of qualitative diagnosis. However, we thought that it was not invasively, suitable behind the digestive operation and digestive passage fault, in case of elapse observation and moreover that MRCP is suitable for pick up the pancreatic cancer in our clinic.

Adenocarcinoma↗

PubMed1998

[A case of thoracic extradural spinal cord teratoma with neurological sequelae more than 10 years after surgery].

We describe a rare case of a 42-year-old man with extradural spinal cord teratoma who presented with left Brown-Séquard syndrome more than 10 years after surgery for a left posterior mediastinal tumor. When he was 29 years old, he underwent an operation for a posterior mediastinal tumor. Histological findings showed adenocarcinoma in teratoma. Ten years after the operation, the patient developed left leg weakness. Three years later, he developed superficial sensory disturbance in his right leg. MRI showed extradural tumor formation at the level of the Th 9 vertebra, which compressed the spinal cord from the left posterior side. At surgery, the tumor was well encapsulated and extended to the left posterior side of the spinal cord through the intervertebral foramen. The histological findings were almost identical to those from the mediastinal tumor. This dumbbell tumor apparently developed from the remainder of the posterior mediastinal tumor over a period of more than 10 years.

Adenocarcinoma↗

PubMed1998

[Effect of heparin on airway goblet cell secretion in sensitized guinea pigs].

Heparin and related proteoglycans are released from mast cells and possess anti-inflammatory and anti-complement activities. To elucidate whether heparin affects goblet cell secretion in asthmatic airways and, if so, what the mechanism of action is, we studied guinea pigs sensitized with ovalbumin (OVA) by determining the mucus score (MS) of tracheal goblet cells stained with Alcian blue and PAS. Inhalation of OVA caused a rapid decrease in MS in a dose-dependent manner, with the maximal decrease being from 545 +/- 26 to 192 +/- 35 (p < 0.001), indicating an increase in goblet cell mucus discharge. This effect was selectively inhibited by the histamine H2 receptor blockade with cimetidine. Prior inhalation of heparin inhibited OVA-induced goblet cell secretion in a dose-dependent fashion, but had no effect on histamine-induced goblet cell secretion. The OVA-induced histamine release from the tracheal tissue was likewise inhibited by heparin. These results suggest that allergic challenge stimulates airway goblet cell secretion mainly through the release of histamine and the concomitant activation of histamine H2 receptors on goblet cells, and that heparin protects against this effect by inhibiting the histamine release from mast cells.

Animals↗