Color Doppler ultrasonography for evaluation of gastroesophageal reflux in a sick child.
Explore the source record for details and available documents.
Candidiasis, Oral↗
Biomedical subjects
N Kawamura
Publications and source records attributed to N Kawamura.
Postoperative chemotherapy may improve prognosis in unresectable gastric cancer.
We have retrospectively evaluated to prognosis of patients with unresectable gastric cancer (UGC) and the effect of postoperative chemotherapy on that prognosis. One hundred patients who died of UGC included 37 patients who received postoperative chemotherapy (chemotherapy group) and 63 patients who did not receive postoperative chemotherapy (control group). Chemotherapy regimens were as follows: intravenous mitomycin (MMC) plus 5-fluorouracil (5-FU) (n=15), oral 5-FU alone (n=10), intravenous methotrexate (MTX) plus 5-FU (n=8), intravenous cisplatin plus 5-FU (n=2), and hepatic arterial infusion of 5-FU plus oral 5-FU (n=2). No prior chemotherapy or radiation therapy was given. All patients' cancers were stage IV. Median survival of the chemotherapy group (238 days) was significantly longer than the control group (137 days). The 1-year survival rate in the treated group was 19.0% but only 2.4% in the control group (p < 0.01). Patients with palliative gastrojejunostomy did not survive significantly longer than those having laparotomy alone or ileal tube insertion. We conclude that the prognosis for patients with UGC remains very poor, but postoperative chemotherapy may contribute to prolonged survival in patients with UGC.
Adenocarcinoma↗
Toxic epidermal necrolysis with severe gastrointestinal mucosal cell death: a patient who excreted long tubes of dead intestinal epithelium.
TEN is a severe inflammatory disease which is characterized by generalized epithelial destruction. The epidermis is the most common target of TEN, however, any epithelium can be involved. We report a toxic epidermal necrolysis (TEN) patient who excreted long tubes of dead intestinal epithelium. Epidermal keratinocytes and intestinal epithelium were found to undergo extensive apoptosis by TUNEL method. Drugs were speculated as the causative agents for this case, the causative drug has not been identified. In contrast to marked improvement of cutaneous manifestation and hepatic function by methyl prednisolone pulse therapy, the gastrointestinal symptoms did not respond to therapies, and the patient died by heart failure. Present case suggested a pathogenetic mechanism targeting antigens commonly expressed on the gastrointestinal epithelium and epidermis.
Fatal Outcome↗
Power Doppler findings of adenoma malignum of uterine cervix.
Adenoma malignum (minimum deviation adenocarcinoma) is a rare neoplasma of the uterine cervix, the diagnosis of wich cannot be determined by cervical smear. Recently, magnetic resonance imaging (MRI) was reported as useful for its diagnosis, but differentiation of adenoma malignum from deep-seated nabothian cysts remains problematic. We report here a case of adenoma malignum of the uterine cervix, for which MRI findings could not neglect deep-seated nabothian cysts. However, transvaginal power Doppler ultrasonography clearly showed richness of small vessels, whose arterial flow had higher velocity in the diastolic phase, around the cystic lesion of the uterine cervix. These findings indicate that, at least in the case reported here, transvaginal power and pulsed Doppler ultrasonography is a useful tool for the diagnosis of adenoma malignum of the uterine cervix.
Adenocarcinoma↗
[Acute otitis media with bone conduction hearing loss associated with acute mastoiditis].
Acute otitis media, generally complicated by conductive hearing loss, sometimes shows raised bone conduction thresholds. Five patients with acute otitis media with mixed hearing loss and much otorrhea were reported. The chief complaints were otalgia in 3 patients, hearing loss in 4, ear fullness in 1 and tinnitus in 1. Four patients had moderate hearing loss. At the first examination, the tympanic membrane showed swelling and injection, while 2 showed bullous myringitis, with swelling of the tympanic mucosa and a yellowish serous discharge following myringotomy. Positive mastoidal CT of all patients without acute inflammatory symptoms in the external ear suggest the complication of acute mastoiditis. After treatment with antibiotics and myingotomy for all patients, steroidal administration for 4, and tympanostomy tube insertion for 3, the hearing levels of 4 patients improved. Sensorineural hearing loss (51.3 dB) remains in 1 patient with sever hearing loss at the first examination. It is important to determine the hearing level for patients with acute otitis media, especially if it is complicated by hearing difficulties.
Acute Disease↗
Total structures of colistin minor components.
Structural characterization of the colistin (CL) components were carried out using Frit-fast atom bombardment liquid chromatography/mass spectrometry (Frit-FAB LC/MS), tandem mass spectrometry (MS/MS) and the amino acid analysis proposed by MARFEY, and the total structures of 4 minor components including the absolute configuration of the constituent amino acids were proposed. The structures of the minor components were the same as those of the main component colistin A or B except that L-leucine is replaced by L-valine or L-isoleucine.
Anti-Bacterial Agents↗
[Study of T cell-directed gene transfer for a patient with ADA deficiency].
We have been undertaking the gene therapy for a 6 year-old boy with ADA deficiency and performed 11 cycles of the infusion of the peripheral T cells transduced with retroviral vector LASN since August 8th 1995. The percentage of the peripheral blood lymphocytes carrying the transduced ADA gene has remained stable at 10% to 20% since the 4th infusion. ADA enzyme activity in his circulating T cells increased to levels comparable to 1/3 of a heterozygous carrier individual and was associated with increased T lymphocytes counts and improvement in both humoral and cellular immune function. The results obtained in this clinical study support the usefulness of T lymphocyte-directed gene transfer in the treatment of ADA deficiency.
Adenosine Deaminase↗
Hemorrhage into a simple liver cyst: diagnostic implications of a recent case.
Hemorrhage complicating simple liver cyst is rare. On imaging studies, the differential diagnosis between intracystic hemorrhage and cystadenocarcinoma of the liver is unreliable, and hepatectomy has been performed for benign liver cyst in this situation. We describe the characteristics of hemorrhage into a liver cyst in a patient who underwent dome resection of the cyst. In our patient, important diagnostic findings included benign cytologic features in a cyst fluid specimen aspirated with ultrasonographic guidance and a fall in hemoglobin and hematocrit, suggestive of hemorrhage. Other informative features were absence of communication between the intrahepatic bile ducts and the cystic liver lesion upon endoscopic retrograde cholangiopancreatography, as well as benign intraoperative frozen-section histology.
Aged↗
Endoscopic nasobiliary drainage for bile duct injury after laparoscopic cholecystectomy.
Bile duct injuries are a potential complication of laparoscopic cholecystectomy (LC). A patient who underwent successful endoscopic nasobiliary drainage (ENBD) for a bile duct injury sustained during LC is presented. Of particular note, the patient also had Chilaiditi's syndrome. A 59-year-old woman was admitted with symptomatic cholecystolithiasis and Chilaiditi's syndrome. LC was performed. Postoperatively, the patient complained of abdominal discomfort. Laboratory examination revealed cholestasis. Bilious material began spilling from an intraabdominal drain. Subsequent endoscopic retrograde cholangiopancreatography (ERCP) showed bile leakage. ENBD was performed. Repeat ERCP 10 days later failed to show a bile leak or stenosis of the common bile duct. The patient improved rapidly and had no complaints after the procedure. ENBD is a useful endoscopic technique to prevent peritonitis from bile leakage after LC. Chilaiditi's syndrome is not a contraindication for LC.
Bile Ducts↗
Correlation between shrinkage of uterine leiomyoma treated with buserelin acetate and histopathologic findings of biopsy specimen before treatment.
OBJECTIVE: To analyze histopathologic features related to myoma volume reduction after treatment with a GnRH agonist, buserelin acetate, in needle biopsy specimens obtained before treatment. DESIGN: Prospective clinical study. SETTING: University teaching hospital. PATIENT(S): Twenty women with normal menstrual cycles and symptomatic uterine myomas. INTERVENTION(S): Buserelin acetate was administered intranasally (900 micrograms/d) for at least 16 weeks; transcervical needle biopsy of the uterine myoma was done before this treatment. MAIN OUTCOME MEASURE(S): The relation between histopathologic features (degree of cellularity, hyaline change, and collagen content) and the percent decrease in the volume of the largest myoma at 16 weeks measured by magnetic resonance imaging. RESULT(S): The correlation between the degree of hyaline change and the percent decrease in the myoma volume was significant, as was that with the proportion of collagenous tissue in the specimens. CONCLUSION(S): We predicted myoma volume reduction after treatment with a GnRH agonist by histologic analysis of the uterine leiomyoma before treatment.
Administration, Intranasal↗
Gelatin-specific humoral and cellular immune responses in children with immediate- and nonimmediate-type reactions to live measles, mumps, rubella, and varicella vaccines.
BACKGROUND: This study was designed to investigate the development of both cellular and humoral immune responses to gelatin in patients with vaccine-related immediate and nonimmediate reactions. Our purpose was to define the nature of the responses in the different clinical states. METHODS: Six patients with immediate reactions and 21 patients with nonimmediate reactions after inoculation of various live vaccines were studied. Measurement of gelatin-specific IgE was performed in all subjects. Gelatin-specific T-cell responses detected by an in vitro lymphocyte proliferation assay and by an assay for IL-2 responsiveness were investigated to compare the immune response in patients with the two types of reaction. RESULTS: All six patients with immediate reactions had IgE responses to gelatin, whereas none of the 21 patients with nonimmediate reactions had any anti-gelatin IgE. All of the six patients with immediate reactions and 17 of the 21 patients with nonimmediate reactions exhibited positive T-lymphocyte responses specific to gelatin. CONCLUSIONS: Immediate and nonimmediate reactions are caused by different types of allergy to gelatin, and cell-mediated immunity to gelatin may play an important role in the pathogenesis of nonimmediate reactions.
Antibodies, Viral↗
Behaviors of nucleus, basal bodies and microtubules during eupyrene and apyrene spermiogenesis in the silkworm, Bombyx mori (Lepidoptera).
Observations with immunostaining for tubulin and electron microscopy revealed that silkworm eupyrene spermiogenesis was characterized by an attachment of the basal body to the nucleus except in the period of movement for unidirectional arrangement. In young eupyrene sperm, a microtubule basket caught the nucleus, which thereafter was transformed elliptically. Microtubules were also observed along the elongated acrosome and mitochondrial derivatives. During apyrene spermiogenesis, however, the basal body was not attached to the nucleus and approached the head cyst cell after the completion of unidirectional arrangement, leaving the round nucleus in the middle of the cell. The presence or absence of the phenomenon in which the basal body attaches to the nucleus seems to be essential in the course of diverse spermatogenesis of the silkworm.
Acrosome↗
Differential localization of the gamma 3 and gamma 12 subunits of G proteins in the mammalian brain.
The localization of two forms of the gamma subunit of G proteins, gamma 3 and gamma 12, was examined in the mammalian brain. Concentrations of these two gamma subunits increased markedly, as did those of glial fibrillary acidic protein, during postnatal development in the rat cerebral cortex. In aged human brains, by contrast, the concentration of gamma 3 tended to decrease with age, whereas that of gamma 12 in the temporal cortex increased slightly. An immunohistochemical study of human brains revealed that gamma 3 was abundant in the neuropil, whereas gamma 12 was localized in glial cells. In the hippocampal formation of aged human brains, levels of gamma 12-positive cells, as well as levels of glial fibrillary acidic protein- and vimentin-positive astrocytes, increased, in particular in the CA1 subfield and the prosubiculum, in which there was a decrease in the number of pyramidal cells. The appearance of gamma 12-positive cells associated with the loss of pyramidal cells was also observed in the hippocampus of rats that had been treated with kainic acid. These results indicate that gamma 12 is strongly expressed in reactive astrocytes. In a study of cultured neural cells, we found that gamma 12 was predominant in glioma cells, such as C6 and GA-1 cells, in contrast with the specific localization of gamma 3 in PC12 pheochromocytoma cells, which are neuron-like cells. Taken together, the results indicate that gamma 3 and gamma 12 are selectively expressed in neuronal and glial cells, respectively, and that concentrations of gamma 3 and gamma 12 in the brain are related to the numbers and/or extent of maturation of these cells.
Age Factors↗
Clinicopathologic features of submucosal carcinoma of the stomach.
A retrospective study of 155 patients with submucosal gastric carcinoma compared the clinicopathologic features with mucosal and muscularis proprial gastric carcinoma. Fifty-seven percent of the patients presented with gastrointestinal symptoms, whereas 36.1% had been detected by mass screening. The incidence of curative resection, lymph node metastasis, and complications were 96.1, 20.6, and 14.8%, respectively. Two patients died of sepsis and pulmonary infarction 30 days post-operatively. Five patients died of recurrent gastric cancer 1-5 years postresection. The overall 5-year survival rate was 90.2%. Recurrence patterns, histologic type, lymph node metastasis, lymphatic and venous infiltration, and growth pattern were similar to those of muscularis proprial carcinoma rather than mucosal carcinoma. Therefore, curative gastrectomy with extended lymphadenectomy (D2) may be feasible for submucosal carcinoma of the stomach.
Adenocarcinoma↗
Multiple hilar cysts of the liver in patients with alcoholic cirrhosis: report of three cases.
The present report concerns the clinicopathological study of three patients with alcoholic cirrhosis (a 40-year-old man, a 52-year-old woman and a 48-year-old man) who had multiple cysts along their intrahepatic bile ducts. The cysts were visible on gross examination of the liver and, in two cases, an enlargement of the cysts had been detected in abdominal computed tomography scans performed 1 year apart. Histologically, the cysts consisted of proliferating and dilated peribiliary glands. The cysts occasionally compressed the original bile ducts. The latter showed mucosal hyperplasia with antral-type gland metaplasia. Neoplastic changes and necroinflammation were not seen. Immunohistochemical assays revealed that the peribiliary glands and antral-type glands expressed not only cytokeratin and carbohydrate antigen 19-9, but also c-MET protein, the hepatocyte growth factor receptor which may be related, at least in part, to the cystic dilatation of the peribiliary glands.
Adult↗
Double squamous cell carcinomas, verrucous type and poorly differentiated type, of the urinary bladder unassociated with bilharzial infection.
A case of a 66-year-old Japanese woman with two synchronous urinary bladder tumors, namely verrucous carcinoma and poorly differentiated squamous cell carcinoma, is described. Both tumors were accompanied by widespread squamous metaplasia in the background and unassociated with bilharzial infection. The poorly differentiated squamous cell carcinoma, having a satellite tumor in its proximity, was large and in an advanced stage. The verrucous carcinoma was small with minimal invasion to the muscularis propria. The boundary between both tumors was well defined, suggesting colliding growth appearance. Immunoexpression of cytokeratins of verrucous carcinoma was similar to that of squamous metaplasia, and significant differences between verrucous carcinoma and poorly differentiated squamous cell carcinoma were demonstrated in their immunoexpression of cytokeratins.
Aged↗
Extremely high serum level of IgE during immunosuppressive therapy: paradoxical effect of cyclosporine A and tacrolimus.
A case of X-linked autoimmune enteropathy was successfully treated with cyclosporine A (CsA) or tacrolimus (FK506) and developed extremely high serum levels of IgE during the immunosuppressive therapy. Serum IgE levels increased from 190 to 1,000-2,500 IU/ml with CsA therapy and as high as 80,000 IU/ml with subsequent FK506 therapy. Serum IgG2 and IgG4 levels were slightly elevated compared to serum IgE levels. Thereafter, serum IgE levels progressively decreased in parallel with a reduced dosage of FK506. Total serum IgG levels and peripheral eosinophil counts, however, showed no significant changes during the course. These observations suggest that both CsA and FK506, potent immunosuppressants, could paradoxically enhance some immune responses, possibly through the action of CsA-/FK506-resistant immune systems.
Anemia, Hemolytic↗
Decreased cytotoxic lymphocyte counts in alexithymia.
BACKGROUND: Alexithymia is a psychological trait characterized by a difficulty in verbalizing feelings, which has been associated with a number of illnesses, including bronchial asthma and cancer. METHODS: In order to understand how psychological variables such as alexithymia affect physical health, we compared the lymphocyte subsets of men (n = 97, mean 30.6) rated as high and low alexithymic when measured by the Toronto Alexithymia Scale (TAS). We analyzed our data by considering alexithymia a categorical variable, using TAS scores of 62 and below, and 74 and above, and by considering alexithymia a continuous variable, using the mean TAS score (64.01) separating high from low alexithymia. RESULTS: When alexithymia was considered a categorical variable, highly alexithymic men had significantly lower numbers of the most cytotoxic natural killer (NK) subset, (CD57-CD16+ cells). When alexithymia was considered a continuous variable, in addition to the NK subset, killer effector T cell (CD8+CD11a+ cells) count was also significantly lower. These results were obtained after controlling for possible effects of smoking and alcohol intake. CONCLUSIONS: These results suggest that the negative modulation of cellular immunity, especially the cytotoxic lymphocytes, may be one mechanism which, combined with other factors that have a negative effect on the immune system such as stress, results in the association between alexithymia and ill health. It is suggested that future studies should, in addition to cell counts, attempt to identify the effects of psychological variables on the cytolytic activity of cytotoxic lymphocytes. Furthermore, follow-up studies should monitor the subjects over the years to demonstrate that alexithymia-mediated negative modulation of the immune system results in clinical pathologies.
Adult↗