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Biomedical subjects

S Kosaka

Publications and source records attributed to S Kosaka.

At least 55 records · Page 3Linked to original sources

[Low dose cyclosporin treatment for ocular lesions of Behçet's disease].

Cyclosporin is an immunosuppressant that has recently been used for the treatment of Behçet's disease. We evaluated the clinical effect of low doses of cyclosporin (5 mg/kg/day) on 20 patients of Behçet's disease with refractory ocular involvement. The therapeutic effect of cyclosporin was judged by the frequency of ocular inflammatory attacks. It was effective in more than 70% of the patients. On the other hand, it had some adverse side effects such as renal dysfunction, indigestion, and neurological disorders. Most side effects were mild with low dose treatment, but neurological side effects were similar in frequency and severity to those seen with 10 mg/kg/day usage. These findings indicate that low dose cyclosporin (5 mg/kg/day) administration may be acceptable as a standard plan for treatment of Behçet's disease, but that we have to use cyclosporin with great attention to its side effects, especially neurological symptoms.

Adult↗

Detection of antibodies against Borrelia burgdorferi in patients with uveitis.

We determined the antibody response against Borrelia burgdorferi strains isolated from Japanese Ixodes ovatus and Ixodes persulcatus ticks by enzyme-linked immunosorbent assay and indirect immunofluorescence assay of serum specimens from 127 patients with uveitis. We examined samples of serum from Japanese patients with unclassified uveitis, iridocyclitis caused by herpes zoster virus, Behçet's disease, Vogt-Koyanagi-Harada syndrome, sarcoidosis, or other conditions (sympathetic ophthalmia, Posner-Schlossman syndrome and acute anterior uveitis with ankylosing spondylitis). Serum from healthy individuals and patients with Lyme disease served as negative and positive control samples, respectively. Significantly higher antibody titers were demonstrated in patients with uveitis than in control subjects. Of 29 patients with unclassified uveitis, nine (31) had significantly increased antibody titers against B. burgdorferi strain H014 by ELISA testing. Five patients also showed higher IgG and IgM responses than in three control subjects with Lyme disease. All positive controls showed joint problems characteristic of rheumatoid arthritis. One of three patients had uveitis. The patients were diagnosed as having Lyme disease on the basis of their history and serologic tests. A positive antibody response was recognized in several patients with Behçet's disease, Vogt-Koyanagi-Harada syndrome, sarcoidosis, and other conditions (acute anterior uveitis with ankylosing spondylitis), but not in control subjects.

Antibodies, Bacterial↗

[Mediastinal hematoma due to thymoma hemorrhage--a case report].

A 70-year-old man came to our hospital complaining mainly of acute dyspnea. A chest X-ray, echocardiogram, and chest CT showed a mediastinal mass, and pericardial and pleural effusions. A thoracotomy revealed a cystic tumor along the thymus. The tumor contained bloody fluid, coagula, and fibrin calculi. Rapid specimens showed no tumor cells and the hematoma was assumed to have been caused by the thymus. Therefore, a thymectomy was performed and as much of the hematoma as possible was removed. After the operation, a careful pathological examination revealed a thymoma with a diameter of about 7 mm. In addition, coagula and fibrin calculi contained some tissue from the thymoma, and the diagnosis was made that a mediastinal hematoma had formed due to hemorrhage from the thymoma. Several cases of mediastinal tumor of cyst hemorrhages in the thorax have been reported. However, only a few cases of thymomal hemorrhages in the thorax have been reported; one case each of mediastinal hematoma, hemothorax, and cardiac tamponade. Great care is necessary when dealing with atraumatic mediastinal hematomas if malignant tumors such as thymoma are present.

Aged↗

[A case of malignant mesothelioma of the pleura].

An operative case of malignant localized mesothelioma of the pleura, a 63-year-old male, came to our clinic with the chief complaint of hemosputa. On suspicion of lung tumor, right upper lobectomy and lymph node cleaning were performed. The tumor was embedded in the lung; there was no infiltration into the chest wall. After the operation, radiotherapy was added but tumor recurrence occurred in the 5th month, and the patient died 7 months after surgery. From the form of the recurrence it was considered a diffuse-type transition case. The prognosis of this disease is known to be poor, but since there have also been cases of long survival, cases of resection are studied in Japan. Based on macroscopic tumor findings, cases of occurrence in the visceral pleura have poor prognosis if embedded in the lung, while cases of occurrence in the parietal pleura have varied prognoses, but the differentiation line is yet unclear. Among six cases of diffuse-type transition, including this case, five cases were of the histological type which included the epithelial component. Further study of these cases is necessary in the near future.

Humans↗

In vitro fertilization and development of in vitro matured bovine follicular oocytes.

Bovine follicular oocytes matured in vitro were fertilized in vitro using epididymal spermatozoa from five different bulls and then cultured to the blastocyst stage in vitro. The fertilization rate, based on one pair of pronuclei and presence of one sperm tail, ranged from 55.2 to 64.3%. Embryo development (cleavage to blastocyst stage) ranged from 21.4 to 31.0% of the cultured ova reaching 8 cells at 3 to 4 d after insemination to 1.3 to 3.7% reaching hatched blastocysts at 9 to 10 d. It is concluded that individual variation among bulls is not a significant factor in fertilization and development rates of bovine follicular oocytes when epididymal spermatozoa are used.

Animals↗

Pregnancies after co-culture of cumulus cells with bovine embryos derived from in-vitro fertilization of in-vitro matured follicular oocytes.

Bovine follicular oocytes surrounded by cumulus cells for more than one-third of their surface were matured, fertilized and developed in vitro utilizing a co-culture system with bovine cumulus cells. Embryos developed into blastocysts were non-surgically transferred to the uteri of cows at Day 6, 7 or 8 (Day 0 = oestrus). Out of 6 recipient cows (19 blastocysts transferred), 3 became pregnant. One of the 3 pregnant cows carried twins. The results of this study demonstrated the viability of embryos obtained from in-vitro maturation of bovine oocytes followed by in-vitro fertilization and culture to the blastocyst stage in vitro.

Animals↗

[A new treatment of simple renal cyst: percutaneous instillation of minocycline hydrochloride into simple renal cyst].

Minocycline hydrochloride was percutaneously instilled into simple renal cysts to prevent recurrence of renal cysts after the puncture and aspiration of cystic fluid. Fifty-six simple renal cysts in 51 patients were punctured with an 18-gauge needle under ultrasonographic guidance, and the cystic fluid was aspirated under fluoroscopic control. A single 100 mg or 200 mg dose of minocycline hydrochloride dissolved in 5 ml of distilled water was instilled through the needle into the renal cyst. The patients were followed up by computed tomographic (CT) scan and ultrasonography 1, 3, 6 and 12 months after the treatment. Efficacy was evaluated after 3 months or longer. Of 20 renal cysts instilled with 100 mg of minocycline, efficacy was excellent in 10, good in 6 and poor in 4. Of 22 renal cysts instilled with 200 mg of minocycline, efficacy was excellent in 10, good in 9 and poor in 3. No significant difference was noted between the efficacy rate of 100 mg and 200 mg treatments. Complications attributable to treatment were observed in 15 patients: moderate pain in one, slight pain in 6, slight fever in 8 and slight hematuria in one. Neither severe adverse reactions nor infections were observed in any of the patients. These results suggest that the percutaneous instillation of minocycline into simple renal cysts is a new, simple, safe and effective treatment to prevent recurrence of the cyst and additionally to prevent infection following the puncture.

Administration, Cutaneous↗

[Clinical effect of UFT on prostatic cancer].

A phase II study of UFT, a mixture of futraful and uracil in a rate of 1:4, was performed for prostatic cancer in 5 cooperative institutions. UFT was orally administered at a daily dose of 600 mg (t.i.d.) for 4 weeks. Twenty-two patients treated with UFT were evaluated according to Koyama-Saito's criteria. Tumor staging determined by transrectal ultrasonography and other methods revealed stage B in 4 patients, stage C in 7, and stage D in 11. The overall response rate was 18.2%. Complete response was obtained in 1 patient with stage B disease, partial response in 3, minor response in 1, no change in 15, and progressive disease in 2. With respect to toxicity, anorexia was observed in 9 patients, nausea and vomiting in 8, stomatitis in 4, and diarrhea in 3. White blood cell count was less than 3,000 cells per mm3 in 1 patient, and in another case, hepatic function disorder was observed. From the results obtained, the use of UFT is TS considered desirable for prostatic cancer.

Adenocarcinoma↗

Purification and characterization of a lectin from the beetle, Allomyrina dichotoma.

A lectin was purified from the hemolymph of Allomyrina dichotoma larvae by affinity chromatography on acid-treated Sepharose 4B. The purified lectin showed two protein bands on polyacrylamide gel electrophoresis. These two lectin bands (allo A-I and -II) were separated by DEAE-Cellulofine column chromatography. By gel filtration on Sephadex G-100, the molecular weights of allo A-I and -II were estimated to be 65,000 and 66,500, respectively. On the other hand, by SDS-polyacrylamide gel electrophoresis after cross-linking of subunits with glutaraldehyde, they are estimated to be 38,000 and 39,000, respectively. On SDS-polyacrylamide gel electrophoresis, it was proved that both allo A-I and -II lectin consisted of two subunits, respectively. The molecular weights were 17,500 and 20,000 for allo A-I, and 19,000 and 20,000 for allo A-II. The isoelectric points of allo A-I and -II were estimated to be 6.4 and 5.9, respectively. On double immunodiffusion, allo A-I and -II gave single precipitin lines, which fused completely with each other, against the antibody to crude allo A. The hemagglutinating activity of allo A-I and -II was inhibited only by beta-linked D-galactose such as lactose and lactulose.

Animals↗

A case of insulin resistance associated with acanthosis nigricans.

We described here a 12-year-old male patient with the syndrome of insulin resistance and acanthosis nigricans type A. Insulin levels at fasting state and after glucose loading were 149 +/- 63 microU/ml (mean +/- S.D.) and over 1,000 microU/ml respectively, while the fasting level of blood glucose was 77.7 +/- 8.9 mg/ml (mean +/- S.D.). A marked resistance to exogenous insulin was observed. Circulating levels of insulin antagonists such as growth hormone, cortisol and glucagon were within the normal range. Proinsulin was less than 5% of the radioimmunoassayable insulin. No insulin antibody or antireceptor antibody was detected. Insulin binding to mononuclear cells was decreased to about 50% of the controls. Analysis of membrane receptors demonstrated the normal average affinity, dissociation kinetics and negative cooperativity with a decreased number of receptors. After two days fasting, plasma IRI levels decreased to 27 microU/ml, while insulin binding kinetics were not affected; which suggests that the receptor decrease was not secondary to hyperinsulinemia. These findings indicate that the decreased number of receptors was one of the causes for insulin resistance in this patient.

Acanthosis Nigricans↗

[The distribution of cefotiam in body fluid].

All subjects were patients with malignant tumors on the gastroenterological system and in whose cases there were marked ascites (Table 1). In the study, each patient was subjected to the intravenous drip infusion of CTM 1 g for a period of 1 hour. Samples of peripheral venous blood and ascites were taken 4 times, at 1 hour after completion of infusion, and at 2, 3 and 4 hours. The test samples were kept at -80 degrees C until the CTM contents were determined (Fig. 1). Determination results 1. Blood concentrations of CTM decreased with the passage of time (Fig. 2). 2. There was hardly any difference in the concentration of CTM in ascites between the 1 hour and 4 hour samples. Furthermore, the concentration was maintained which exceeded the MIC against intestinal flora, including Escherichia coli, without Pseudomonas and Bacteroides (Fig. 3, Table 2). 3. The higher serum creatinine levels were the greater the concentration of CTM in blood (Fig. 5). 4. The maximum blood and ascites concentration of CTM indicated a correlation coefficient of 0.809, P less than 0.01 (Fig. 6). These results led to the following conclusions: 1. If 1 hour intravenous drip infusion of CTM 1 g/100 ml is to be carried out against postoperative peritoneal infection, such administration at interval less than 5-hours would not be reasonable. 2. The peritoneal invasion of malignant tumor is not a factor in the inhibition of CTM transition from blood to ascites.

Adult↗

[Transfer of piperacillin into the body water and gallbladder tissue in cholestasis].

Acute inflammation becomes severe and the risk of perforation of the gallbladder increases every time gall stone colic occurs in patients with cholelithiasis. In the surgical treatment for these patients, interval operation is said to be preferable to emergency operation in the acute stage. Furthermore, the flow of bile into gallbladder is blocked by incarceration of stones at the neck of the gallbladder and other causes in the acute stage. In this case, therefore, how an antibacterial agent in blood moves to the gallbladder wall is important in suppressing infections of the gallbladder wall. We divided 15 patients with cholelithiasis into cases positive for cholecystogram and negative cases and made a comparative study of piperacillin (PIPC) levels after intravenous drip infusion. PIPC level in bile in the gallbladder was very low in the cases negative for cholecystogram compared with the positive cases. However, no definite difference in levels of the gallbladder tissue was observed between positive for cholecystogram and negative cases. Accordingly, it is concluded that administration of PIPC is not ineffective even in severe cholecystitis in which transference of an antibacterial agent from bile can hardly be expected.

Adult↗