[Laboratory and clinical studies on Hetacillin].
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Adult↗
Biomedical subjects
M Takano
Publications and source records attributed to M Takano.
[Lactic dehydrogenase isozymes in serum and gastric mucosa in malignant diseases].
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Enzymes↗
[Study on synthetic cephalosporin C].
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Adult↗
Anoderm-preserving hemorrhoidectomy.
A newly-devised anoderm-preserving, semiclosed method of hemorrhoidectomy is described. The method has been applied to 1,030 patients with satisfactory results.
Adult↗
Release of calcitonin gene-related peptide (CGRP), substance P (SP), and vasoactive intestinal polypeptide (VIP) from rat spinal cord: modulation by alpha 2 agonists.
Release of calcitonin gene-related peptide (CGRP) and substance P (SP) from the rat lumbar dorsal spinal cord and vasoactive intestinal polypeptide (VIP) from the sacral spinal cord was examined under resting conditions (baseline release) and in the presence of capsaicin (CAP). Baseline rates of CGRP, SP, and VIP release were 1.71 +/- 0.19, 0.12 +/- 0.01, and 0.097 +/- 0.029 pg/mg/min, respectively. The addition of CAP (10 microM) to the perfusate had no effect upon resting VIP release, but elevated CGRP and SP release significantly by 11.1 +/- 0.8 and 0.19 +/- 0.03 pg/mg/min over baseline release rate, respectively. Addition of dexmedetomidine (10 microM), an alpha 2-adrenergic agonist, did not change the baseline release of either CGRP or SP, but significantly decreased the CAP-evoked release of both peptides. The attenuation of the CAP-evoked release by the agonists was antagonized by the concurrent administration of yohimbine (10 microM) or atipamezole (10 microM), but not by prazosin. ST-91 (10 microM) did not alter the release of CGRP but decreased the CAP-evoked release of SP. This inhibition was antagonized by yohimbine and prazosin, but not by atipamezole. These data suggest that the afferent-evoked release of SP and CGRP from CAP-sensitive terminals (presumably those associated with small primary afferents) is modulated by local alpha 2 receptors. The common sensitivity of the agonists to yohimbine and the differential effects of atipamezole and prazosin are consistent with the hypothesis that dexmedetomidine and ST-91 may interact with different subpopulations of spinal alpha 2 receptors, both of which may modulate afferent terminal release.(ABSTRACT TRUNCATED AT 250 WORDS)
Adrenergic alpha-Agonists↗
The role of computed tomography in management of patients with Crohn disease.
Twenty-five patients with Crohn disease were studied using computed tomography (CT). Assessment of bowel wall thickening, enlargement of the mesenteric lymph nodes, and clearness of the mesenteric vascular contour was carried out in all patients. Evidence of inflammatory reaction of the mesenteric fat was seen in 23 patients (92%) and fibrofatty proliferation was observed in seven patients (28%). Nine patients underwent surgery when symptoms and signs were severe and of long duration, while 16 patients were treated conservatively. Degree of increase in fat density, clearness of the mesenteric vascular bundles, and enlargement of the mesenteric lymph nodes were seen more frequently in the surgical group of patients. CT shows improvement of inflammatory changes after conservative therapy in some cases. A large pseudodiverticulum, pseudopolyps, and a fistula formation were also observed in some cases. CT is an important diagnostic tool in the management of patients with Crohn disease.
Adult↗
Neurotoxic effects of phenytoin on postnatal mouse brain development following neonatal administration.
Phenytoin (PHT) is a commonly used anticonvulsant drug. It has been reported that children exposed prenatally to PHT have brain malformations and psychomotor dysfunction. The neonatal development of the central nervous system (CNS) in mice corresponds to the last trimester in humans. To examine the neurotoxic effects of PHT on postnatal brain development, we administered PHT at doses of 10, 17.5, 25, or 35 mg/kg to newborn mice once a day during postnatal days (PD) 2-4. These dose levels result in plasma levels corresponding to the therapeutic ranges in humans. We measured the weight of total brain, cerebrum, cerebellum, and brain stem on PD 5 through 21, and examined early motor functions including head elevation, elevation of pelvis, pivoting, crawling, and righting reflex . Total brain weight, cerebral weight, and cerebellar weight in the group treated with 25 or 35 mg/kg were significantly reduced compared to controls from PD 5 to 21. Mice treated with PHT at 25 or 35 mg/kg showed decreased locomotor abilities and righting reflex on PD 5. In all phenytoin treatment groups, phenytoin levels in the brain were higher than those in the plasma on the third day of PHT treatment. We thus observed neurotoxic effects of PHT on postnatal brain development in mice. Our present data may provide useful implications for the management of PHT-induced developmental neurotoxicity and evaluation of psychomotor development in children exposed to PHT during the late fetal period.
Aging↗
Synchronous mucinous adenocarcinoma of the endometrium and mucinous cystadenoma of bilateral ovaries presenting during fertility therapy.
We describe a very rare case of synchronous mucinous tumor of the endometrium and ovaries presenting during ovulation induction. A 31-year-old woman received ovulation induction for 5-year primary infertility. Ultrasonography revealed mucus retention in the uterine cavity and bilateral multicystic ovaries during ovulation induction. Atypical hyperplasia was diagnosed by endometrial curettage. Repeated procedures including ovarian cystectomy, endometrial curettage and in vitro fertilization combined with progestine therapy resulted in no pregnancy but rapid recurrences. She finally underwent simple hysterectomy and bilateral salpingo-oophorectomy. Microscopic examination revealed mucinous cystadenoma in the both ovaries and well differentiated mucinous adenocarcinoma of the endometrium.
Adenocarcinoma, Mucinous↗
Preoperative needle biopsy and immunohistochemical analysis for gastrointestinal stromal tumor of the rectum mimicking vaginal leiomyoma.
Accurate preoperative diagnosis for gastrointestinal stromal tumor (GIST) was obtained using the endoscopic approach in about 50% of the cases. Preoperative assessment is quite important in reproductive women for the treatment of pelvic tumor. We report the first case of GIST of the rectum that was accurately diagnosed with preoperative needle biopsy from the vaginal wall. The case was a 38-year-old woman who presented with a history of genital bleeding. Internal examination revealed a round and elastic mass (7 x 7 cm) in the left pelvic cavity. The biopsy specimen from the left sidewall of the vagina using a manually manipulated biopsy needle showed strong reaction for CD34 and CD117 (c-KIT). The patient underwent low anterior resection of the rectum, tumor resection, and partial resection of the posterior vagina. Preoperative biopsy with vaginal approach might be helpful to make a diagnosis for pelvic tumor of unknown origin and unknown malignant potential.
Adult↗
Exploratory study of effective chemotherapy to clear cell carcinoma of the ovary.
Although clear cell carcinoma of the ovary is considered to be a tumor with poor prognosis, the clinical characteristics has not been defined. The aim of this study was to evaluate the response of clear cell carcinoma of the ovary to first and second-line chemotherapy and explore effective chemotherapy. Fifty-three patients with clear cell carcinoma of the ovary were enrolled between 1988 and 1997 at our department. Since taxol was not available in Japan at that time, cisplatin-based combination chemotherapy has been exclusively used as a standard first-line chemotherapy. Retrospective analyses of clinical characteristics and the response to first or second-line chemotherapy were performed. Median age was 52 years (range 27-71 years). Tumors were 34% (18/53) stage I, 19% (5/53) stage II, 38% (20/53) stage III, and 9% (5/53) stage IV. All patients with I or II stage disease had optimal cytoreduction. Out of 25 patients with III or IV stage disease 20% (5/25) had negative residual tumor, 36% (9/25) had <2 cm residual tumor, and 44% (11/25) had >/=2 cm residual tumor. All patients received postoperative platinum-based chemotherapy. Of 23 patients with measurable residual tumor 8.7% (2/23) completely and 13% (3/23) partially responded to first-line chemotherapy consisting of cisplatin, adriamycin and cyclophosphamide (CAP) or cisplatin and cyclophosphamide (CP) by CT scan or second look laparotomy. Presence of endometriosis was 55% (29/53) but was not a prognostic factor. Although overall response rate of ovarian clear cell carcinoma to first-line chemotherapy by CAP or CP was about 22%, EP or EJ consisting of etoposide and cisplatin or carboplatin used as a second-line chemotherapy showed 29% response rate, while CPT-P consisting of CPT-11 and cisplatin showed 40% response rate. Clear cell carcinomas were frequently present at early stage, with association of endometriosis and with poor overall prognosis. Although patients with advanced ovarian clear cell carcinoma seemed to have better response to CPT-P than conventional platinum-based chemotherapy, further studies are required with larger number of patients to draw firm conclusions.
Adenocarcinoma, Clear Cell↗
Relationship between microvessel quantification and inducibility of endogenous tumor necrosis factor in colorectal adenocarcinoma.
BACKGROUND: Although we have reported that the inducibility of endogenous tumor necrosis factor (en-TNF) by tumor cells is an independent prognostic factor in Dukes stage C colorectal cancer patients, the mechanism by which the patients having high inducibility of en-TNF show better prognosis is still unclear. We hypothesize that the inducibility of en-TNF by colorectal tumor cells affects the prognosis of patients through the modulation of angiogenesis. Thus, the aim of this study is to clarify the relationship between inducibility of en-TNF and tumor vascularity in colorectal cancer. PATIENTS AND METHODS: Histological sections from 62 Dukes stage C colorectal cancer patients who received curative operation were immunostained for CD34 antigen. Microvessels were counted in the photograph of x200 fields (0.298 mm2). The average count of five most vascular areas was determined as a microvessel density of each case. RESULTS: Two of 62 cases were excluded from the analysis, because of insufficient staining. A total of 60 patients were dichotomized by a median vessel count of 34 into two groups: 30 patients with lower microvessel density (Low MVD group) and 30 patients with higher microvessel density (High MVD group). There was no significance in the distribution of all clinicopathological factors among these two groups. Regarding en-TNF inducibility, no difference was shown between the two groups. The five year survival rate of Low MVD group and High MVD group were 58.7% and 68.0%, respectively. And, the 5 year relapse-free survival rate of Low MVD group and High MVD group were 59.7% and 52.2%, respectively. No significant difference was demonstrated between Low MVD group and High MVD group. CONCLUSION: Intratumoral microvessel density did not influence on the prognosis of colorectal cancer patients in Dukes stage C after curative operation. The inducibility of en-TNF showed no correlation with intratumoral microvessel density in Dukes stage C patients after curative operation.
Adenocarcinoma↗
Spontaneous carotid cavernous fistula presenting only with cranial nerve palsies.
PURPOSE: To discuss the differences in angiographic findings between cases of spontaneous carotid cavernous fistula with and without the classical triad of symptoms (pulsating exophthalmos, bruit, and conjunctival chemosis). METHODS: With CT, MR, and angiography, we examined 12 cases of spontaneous carotid cavernous fistula, five of whom presented only with cranial nerve palsies. RESULTS: In the seven cases with the triad, the main venous drainage from the cavernous sinus was the superior ophthalmic vein. Only one or two veins drained the cavernous sinus, and cortical venous drainage was not present in any case. In contrast, all but one case with only cranial nerve palsies had at least three venous drainage routes from the cavernous sinus, including cortical venous drainage. CONCLUSION: For the diagnoses of spontaneous carotid cavernous fistula, it is important to know that some patients do not show the classical triad of symptoms. In such patients, early diagnosis and treatment are particularly important because cortical venous drainage and a consequent risk of hemorrhage are frequently present.
Adult↗
Hydronephrosis caused by a left renal vein in a patient with horseshoe kidney: a case report.
We report a rare case of hydronephrosis secondary to ureteropelvic stenosis caused by a branch of the left renal vein in horseshoe kidney. We were unable to determine the etiology of hydronephrosis of the horseshoe kidney by means of radiological images. When radiological images fail to show any etiology of hydronephrosis in horseshoe kidney, the possibility of compression of the ureteropelvic junction by a branch of the renal vein should be borne in mind, and re-assessment of the venous phase of angiography and evaluation by coronal or sagittal images of MRI is recommended.
Adult↗
Preservation of metastatic ability of colorectal tumor cells stratified by inducibility of endogenous tumor necrosis factor after orthotopic transplantation in nude mice.
BACKGROUND: Inducibility of endogenous tumor necrosis factor (TNF) by colorectal tumor cells can be regarded as a novel prognostic factor in terms of distant metastasis or local recurrence following curative operation, especially at Duke's stage C. In this study, the metastatic ability of human colorectal tumor cells stratified by inducibility of endogenous TNF was analyzed by orthotopic transplantation in nude mouse. METHODS: Fifty three cases of freshly resected colorectal tumor specimens cut into about 50mg pieces were inoculated into the cecum wall of nude mice. Two to nine months after transplantation, tumor growth on this wall and metastases to the peritoneal wall as well as to the liver were assessed. RESULTS: Of forty one evaluable cases, successful transplantation was observed in twenty nine (70%), and metastases to the peritoneal wall or to the liver was found in thirteen (32%), or eight cases (20%), respectively. In the twenty nine cases with local tumor growth, incidence of the liver metastases in nude mice when tumor specimens from patients with liver metastases (4/8) were used was significantly higher than that from patients without liver metastases (4/21) (P = 0.096). Inducibility of endogenous TNF was separately analyzed in fourteen of the evaluable twenty nine cases. Seven cases belonged to the high group and seven to the low group in terms of the amount of endogenous TNF secreted by tumor cells. Incidence of metastases in mice was 1/7 in the high group and 6/7 in the low group, and there was a statistically significant difference between liver metastases in mice and inducibility of endogenous TNF by colorectal tumor cells (p = 0.0057). CONCLUSION: From these results, it is strongly suggested that inducibility of endogenous TNF by colorectal tumor cells can affect a patient's prognosis since it regulates metastatic ability to the liver.
Animals↗
A long-term survivor case of malignant mesothelioma treated by recombinant tumor necrosis factor-SAM2 (TNF-alpha mutein) and 5-fluorouracil (5-FU): a new therapeutic approach based on host-tumor relationship.
BACKGROUND: The prognosis of mesothelioma is very poor, and there is no established method to suppress tumor growth. Immunological approaches have recently been thought to be effective for mesothelioma and several studies using cytokines have been performed. We used a novel recombinant tumor necrosis factor-alpha (rTNF-alpha) we called rTNF-SAM2, in the treatment of a patient with this disease. PATIENT AND METHOD: A 48-year old male patient with ascites was diagnosed with malignant mesothelioma by cytological examination. TNF-SAM2 in an amount of 264 to 576 micrograms (1 to 2.2 x 10(6) U) was injected via a catheter several times. Five hundred mg of 5 fluorouracil (5-FU) was also given via catheter once a week and 5-FU derivative was given orally every day. RESULTS: No apparent tumor progression was observed for 6 years and 6 months and the patient led a normal life. During the therapy, the malignancy of tumor cells from the ascites changed from class V to class VI. CONCLUSION: TNF based therapy may be promising treatment for the suppression of malignant mesothelioma.
Antimetabolites, Antineoplastic↗