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Biomedical subjects

S Hashimoto

Publications and source records attributed to S Hashimoto.

At least 307 records · Page 17Linked to original sources

[Indication of tracheostomy for advanced oral or mesopharyngeal cancer resection].

In advanced oral or mesopharyngeal cancer requiring reconstruction, preventive tracheostomy have been performed to insure an airway postoperatively. However, tracheostomy often causes difficulty in swallowing and stress in the postoperative period for the patients. We have devised a strategy to avoid tracheostomy as much as possible in the cases requiring reconstruction except for the cases with over 2/3 resection of the base of the tongue or with prospective difficulty of re-intubation. Eleven cases were treated without tracheostomy out of 20 cases operated on with reconstruction in our hospital from 1995 through 1997. These patients were managed under nasal intubation for less than 2 days on average with careful observation postoperatively. In 11 non-tracheostomized cases, 1 case experienced venous thrombosis of a free flap and tracheostomy was performed at the salvage operation. Other 10 non-tracheostomized case were compared with 10 tracheostomized cases who were treated from 1991 though 1995. It was revealed that non-tracheostomized cases tended to have shorter periods until they could speak or eat, and also have a shorter postoperative admission term. In these cases, we have not experienced serious complications such as aspiration pneumonia or dyspnea, instead, special care in the postoperative period was needed. Thus, certain advanced cases who undergo curative resection followed by reconstruction can be managed without tracheostomy. The indication of tracheostomy in surgery for oral or mesopharyngeal cancer should be decided carefully.

Adult↗

WF14861, a new cathepsins B and L inhibitor produced by Colletotrichum sp. II. Biological properties.

WF14861, 3-(N-(1-(N-(4-aminobutyl)-N-(3-aminopropyl)carbamoyl)-2-(4-hydroxyphenyl )ethyl)carbamoyl)oxirane-2-carboxylic acid, was obtained from the culture mycelium of Colletotrichum sp. as a novel cathepsins B and L inhibitor. WF14861 also showed inhibitory activities against bone derived crude protease and other cysteine proteases in vitro. The compound ameliorated the tissue damage and the bone destruction models of low-calcium-diet-fed mouse and adjuvant arthritis rat model.

Animals↗

[A case of giant transitional cell carcinoma of the prostate].

A 69-year-old man presented with a complaint of pollakisuria, dysuria and anal pain. Digital rectal examination, transrectal ultrasonography and tumor marker of the prostate indicated a giant benign prostate hypertrophy (BPH), but urethrocystogram and magnetic resonance imaging (MRI) of the prostate was not typical of BPH. A diagnosis of giant BPH was made by transrectal needle biopsy of the prostate. However, symptoms of dysuria and anal pain became severe and then a catheter was indwelt into his bladder. A biopsy performed, 3 months later revealed transitional cell carcinoma in the specimens, but he suddenly died of pulmonary infarction.

Aged↗

Hydrolytic activity is essential for aceclofenac to inhibit cyclooxygenase in rheumatoid synovial cells.

To investigate the mechanisms of action underlying the anti-inflammatory effects of the nonsteroidal anti-inflammatory drug aceclofenac in humans, we studied the metabolism of aceclofenac in detail in primary cultured synovial cells of 10 patients with rheumatoid arthritis. Aceclofenac and 4'-hydroxyaceclofenac are the major compounds in human blood after the administration of aceclofenac, but they had no inhibitory effects on cyclooxygenase (COX) activity or COX expression in the rheumatoid synovial cells. In contrast, aceclofenac and 4'-hydroxyaceclofenac reduced prostaglandin E2 (PGE2) production by the rheumatoid synovial cells. We also observed that aceclofenac and 4'-hydroxyaceclofenac were hydrolyzed into the COX inhibitors diclofenac and 4'-hydroxydiclofenac, respectively, by the rheumatoid synovial cells. However, the hydrolytic activity differed markedly among the cell preparations. Because the suppressive potency of aceclofenac and 4'-hydroxyaceclofenac against the PGE2 production was proportionally correlated with the hydrolytic activity in rheumatoid synovial cell preparations, we suggest that the suppressive effects of aceclofenac and 4'-hydroxy aceclofenac on PGE2 production are facilitated by the hydrolytic activity in rheumatoid synovial cells.

Anti-Inflammatory Agents, Non-Steroidal↗

The suppression of metastases and the change in host immune response after low-dose total-body irradiation in tumor-bearing rats.

We have shown that metastasis is suppressed by low-dose total-body irradiation (TBI) in tumor-bearing rats. We have evaluated the immunological effects of low-dose TBI. Total-body irradiation with 0.2 Gy was given 14 days after the implantation of 5 x 10(5) allogenic hepatoma cells (KDH-8) which produce transforming growth factor beta (TGF-beta). On day 21, the splenocytes and tumor-tissue infiltrating lymphocytes were analyzed by FACScan and RT-PCR for the mRNA of the genes that encode tumor necrosis factor alpha (TNF-alpha), interferon gamma (IFN-gamma), TGF-beta, interleukin (IL)-4, IL-10 and IL-6. The same procedure was conducted with untreated rats and with rats that underwent local irradiation with 0.2 Gy. The low-dose TBI significantly decreased the incidence of lung and lymph node metastasis (P < 0.01), whereas the same dose of local irradiation had no effect on the incidence of metastasis. The proportion of CD8+ cells in splenocytes increased in the low-dose TBI group (P < 0.01) compared to the locally irradiated and the untreated groups. The tumor-tissue infiltrating lymphocytes were also significantly increased after low-dose TBI (P < 0.01). The FACScan analysis revealed that 72% of the tumor-tissue infiltrating lymphocytes were CD8+. In both spleen and tumor tissue after low-dose TBI, mRNA expression of the genes that encode IFN-gamma and TNF-alpha increased, while that of the Tgfb gene decreased. There was no expression of the mRNAs of the Il4, Il6 and Il10 genes. CD8+ cells and the cytokine network may play an important role in the antitumor effect of low-dose TBI.

Animals↗

[Acute myelocytic leukemia and plasmacytoma secondary to chemotherapy and radiotherapy in a long-term survivor of small cell lung cancer].

A 68-year-old man was given a diagnosis of lung cancer of the right upper lobe (small cell carcinoma, T 4 N 2 M 0, stage IIIB) in February 1991. The tumor diminished after chemotherapy and radiotherapy. In February 1992, a partial resection of the lower lobe of the right lung was performed because of the appearance of a metastatic tumor. In September 1994, squamous cell carcinoma developed in the lower part of the esophagus, but disappeared after radiotherapy. In February 1998, a diagnosis of myelodysplastic syndrome was made. Two months later, the patient had an attack of acute myelocytic leukemia and died of cardiac tamponade. An autopsy determined that both the lung cancer and esophageal cancer had disappeared. Acute myelocytic leukemia and plasmacytoma of lymph nodes in the irradiated area were confirmed. These were regarded as secondary malignancies induced by chemotherapy and radiotherapy.

Aged↗

[Angiography of occlusive vascular disease].

Angiography is still "the gold standard" of diagnosis of arterial and venous disease. With improvement of equipment, materials and contrast media, angiography has become less invasive and increased its image quality. Because the resolution of digital subtraction angiography (DSA) has been improved and the size of image intensifier has become large enough, DSA is being substituted for conventional angiography. Rotational DSA and stepping DSA have made it possible to evaluate a vessel from multi-direction or the whole lower extremity with one injection of contrast media. Improvement of catheter, guide wire and contrast media has reduced complications and made angiography less invasive examination. Progress of angiography contributes to interventional radiology, which uses the technique of angiography for therapy.

Angiography↗

p38 Mitogen-activated protein kinase regulates IL-8 expression in human pulmonary vascular endothelial cells.

The aim of this study was to examine the role of p38 mitogen-activated protein (MAP) kinase in interleukin (IL)-8 expression in tumour necrosis factor (TNF)-alpha- and IL-1alpha-stimulated human pulmonary vascular endothelial cells. To this end, the phosphorylation and activation of p38 MAP kinase and the effect of SB 203580, a specific inhibitor of p38 MAP kinase activity, on p38 MAP kinase activity and IL-8 expression in TNF-alpha- and IL-1alpha-stimulated human pulmonary vascular endothelial cells were examined. TNF-alpha- and IL-1alpha- induced phosphorylation and activation of p38 MAP kinase and IL-8 expression in human pulmonary endothelial cells. Inhibition of TNF-alpha- and IL-1alpha-induced p38 MAP kinase activity by SB 203580 inhibited TNF-alpha- and IL-1alpha-induced IL-8 protein production as well as IL-8 messenger ribonucleic acid (mRNA) expression, indicating that SB 203580 was effective at the transcriptional level. These results indicate that p38 mitogen-activated protein kinase plays an important role in the tumour necrosis factor-alpha- and interleukin-1alpha-activated signalling pathway which regulates interleukin-8 expression in human pulmonary vascular endothelial cells.

Calcium-Calmodulin-Dependent Protein Kinases↗

[Onset of acute eosinophilic pneumonia after resumption of smoking].

We report a case of acute eosinophilic pneumonia (AEP) apparently caused by the resumption of smoking. A 38-year-old woman was admitted to our hospital because of dry cough, high fever and chest pain. Arterial blood gas analysis revealed pronounced hypoxemia and chest X-ray film disclosed diffuse bilateral infiltrate throughout all lung fields. Eosinophils (43.7%) were significantly increased in bronchoalveolar lavage fluid (BALF). The patient was treated with pulse therapy consisting of methylprednisolone and improved quickly. AEP was diagnosed on the basis of BALF findings and the patient's clinical course. Prior to and after her illness, the only noteworthy change in the patient's environmental setting or habits was the resumption of smoking, 3 days after which the symptoms had appeared. We reasoned that the onset of AEP in this patient was strongly related to the resumption of smoking.

Adult↗

[Attitudes towards terminal care among the general population and medical practitioners in Japan].

OBJECTIVES: Assessment of attitudes held by the general population and medical practitioners in Japan regarding medical interventions in cases of painful terminal illness or a prolonged vegetative state. METHOD: A mail survey was conducted in 1998. The subjects were 5,000 persons randomly sampled members of the general population age 20 years or more, and 3,104 doctors and 6,059 nurses in hospitals, clinics, palliative units, and visiting nursing service stations randomly sampled. The response rates were 48% among general population, 51% among doctors, 56% among nurses. RESULTS: 1. 68-76% of the general population and medical practitioners expressed disapproval of life-extending medical treatment of terminal patients suffering pain. The application of euthanasia in certain cases was acceptable to 13% of the general population but only 1% of the medical practitioners. 2. Respondents in almost groups favored a home care setting for terminal patient in pain, and regarded relocation to a palliative unit as acceptable if necessary. 3. 46% of doctors and 22% of nurses indicated knowledge of the WHO method for cancer pain relief, and 45% of doctors and 25% of nurses showed that they were able to explain appropriate opioid administration. 4. 74-79% of general population and medical practitioners opposed life-extending medical intervention for patients in a vegetable state. 26% of the general population favored termination of all means of life support, while about 10% of the medical practitioners held this view. 5. Most medical practitioners felt that some medical treatments, such as bedsore care, should be continued in lieu of life support, but there were differences in opinion between practitioners at various types of medical facilities regarding the necessity of such specific measures as, for example, blood pressure monitoring by automatic sphygmomanometer among the medical facilities. CONCLUSION: Both the general population and the medical practitioners in Japan tended to oppose life-extending medical treatment for painful terminal cases and patients in a prolonged vegetable state. There are some differences in opinion between the general population and practitioners at various types of medical facilities regarding the extent of desirable medical care in such circumstances.

Attitude of Health Personnel↗

[The in vivo role of vascular chloride channels in the regulation of glomerular hemodynamics].

The calcium(Ca2+)-dependent chloride channel (CIC) may have a crucial role in the modulation of the effects of Angiotensin II (AII) on vascular smooth muscle cell and glomerular mesangium. We examined in vivo effects of a Ca(2+)-dependent chloride channel blocker, R(+)-methylindazone indanyloxy acetic acid 94 (IAA-94), on renal and glomerular hemodynamics in rats. A small needle was inserted from the kidney surface and the renal interstitium was directly perfused first with saline, control solution. For AII group, AII-concentrations were serially 10(-7) M, 10(-6) M, and 10(-5) M, and for AII and IAA-94 group, ratios of AII to IAA-94 (300 microM) the same serial concentrations. Perfusion with AII solution resulted in dose-dependent increase in renal vascular resistance (RVR), while no such elevation of RVR was observed under the perfusion with AII/IAA. To investigate the effects of Ca(2+)-dependent chloride channel on the regulatory mechanism of renal microcirculation, i.e., tubuloglomerular feed back (TGF) response, we performed micropuncture experiment. We measured proximal tubular stop-flow pressure (Psf) during the immersion of the corresponding nephron with drugs by the simultaneous perfusion of peritubular capillaries with the solutions containing AII (10(-7) M) or AII and IAA-94 (300 microM). TGF response was significantly enhanced by AII, while the increment in TGF response was completely abolished by concomitant IAA. Immersion with IAA-94 alone caused no alteration in TGF response. These data suggest that chloride channels could modulate AII action in renal and glomerular hemodynamics.

Angiotensin II↗

[Elastase anti-elastase imbalance in the pathogenesis of COPD].

Elastase anti-elastase imbalance theory is most important in the pathogenesis of COPD (pulmonary emphysema). Proteolytic activity of neutrophil elastase (NE) plays an important role because of the detachment of cells through proteolysis of extracellular matrix. In addition to proteolytic activity of NE, NE-induced activation of intracellular signaling (MAPK(Erk), Rho and MLCK) participates in NE-induced morphological changes in airway epithelial cells.

Disease Progression↗

[A case of glomangioma of the stomach].

Glomus tumor of the stomach is still a rare disease. In Japan, till now, only 78 cases have been reported as far as we look over the literatures. We report a case of glomangioma of the stomach. The patient is a 44-years old female who underwent a medical examination and pointed out a gastric submucosal tumor, but she had no symptoms and admitted for operation. The endoscopical finding was a submucosal tumor as large as 4 cm, and the result of biopsy was chronic atrophic gastritis. So typical gastrectomy was performed without a definite diagnosis. In the cross section, the tumor was clearly bounded gastric mucosa by a white membrane, and the center of the tumor was spongy. By patho-histological and electro-microscopic study, we diagnosed that the tumor was glomangioma in the classification of Weiss & Enzinger. The patient was getting on well after the operation and left the hospital on the 29th day.

Adult↗

[Contrast medium injection on CT during hepatic arteriography: comparison of two protocols].

To assess the optimum method of contrast medium injection on CT during hepatic arteriography (CTHA), we performed this procedure in 37 patients using two consecutive protocols (A and B) employing different concentrations of iodine (iohexol at 140 mgI/ml and 300-350 mgI/ml), flow rates (2 ml/sec and 1 ml/sec), and contrast medium volumes (60 ml and 30 ml). Mean parenchymal enhancement of the right lobe and left lateral segment were measured and compared. Enhancement varied significantly more with protocol B, especially in the left lateral segment. These results suggest that a low iodine concentration and high injection rate are suitable for CTHA, to avoid nonuniform parenchymal enhancement.

Adult↗

[Subcutaneous phaeohyphomycosis of the right thumb].

Black fungi are a group of fungi that are characterized by the development of a pale brown to black color in the cell walls of their vegetative cells, conidia, or both. A mycotic infection caused by a member of black fungi can be subdivided into three clinical entities: phaeohyphomycosis, chromoblastomycosis, and mycetoma. Phaeohyphomycosis is distinguished from mycetoma by the absence of grain (organized, interwoven mycelial aggregates) formation, and from chromoblastomycosis by the absence of sclerotic bodies (thick-walled muriform cells). Phaeohyphomycosis is a rare disease and has been sporadically reported. In the present report, phaeohyphomycosis of the right thumb of a 72-year-old man was presented. A precipitating trauma of two months earlier at the site was recalled. A solitary mass, 10 mm in diameter, was gradually formed in the palm side of the distal right thumb and finally resected. Histological examination disclosed a solitary granulomatous lesion surrounded by an incomplete fibrous capsule. The lesion mainly involved subcutaneous tissue and was composed of multiple pyogranulomas. Pigmented branched septate hyphae and yeast-like cells were sparsely found in the periphery of the abscess and within histiocytic cells of the granulomas. No sclerotic cells were detected. When pigmentation of black fungi in tissue is as faint as in the present case, Fontana-Masson staining is useful to accentuate the presence of melanin-like pigment of fungal cell walls.

Aged↗