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Biomedical subjects

S Murakami

Publications and source records attributed to S Murakami.

At least 559 records · Page 31Linked to original sources
PubMed1992

[Two cases of familial pulmonary arteriovenous fistula].

Two cases of familial pulmonary arteriovenous fistula are reported. Case 1: A 54-year-old woman was admitted with exertional dyspnea. An abnormal shadow on chest X-ray had been noted since the age of 37 years. Pulmonary angiography demonstrated bilateral pulmonary arteriovenous fistulas. Case 2: A 25-year-old man, the son of Case 1, was admitted for operation for the same disease. The mother and son both suffered from repeated epistaxis due to Rendu-Osler-Weber disease. In order to reserve pulmonary function, fistulectomy was performed in both cases, and their subsequent clinical courses were good.

Adult↗
PubMed1992

[Adult T cell leukemia with cytomegalovirus retinitis].

A 49-year old female in the course of chemotherapy for adult T-cell leukemia (ATL) noticed blurred vision and visual field defect in her right eye on February 26, 1991. Ophthalmoscopic findings showed exudative necrotizing retinitis with white exudative patches and scattered retinal hemorrhages in both eyes. CMV was isolated from the urine by the shell vial cell culture assay. Anti-viral therapy was commenced using ganciclovir and gamma-globulin, which are rich in anti-CMV antibodies. The exudative lesions were absorbed gradually. The ocular signs and symptoms agreed with the patient's systemic immunosuppressed T cell function state. CMV retinitis should be considered in the differential diagnosis of retinitis in immunocompromised patients. CMV retinitis will certainly be found more frequently in accordance with the increasing number of immunocompromised hosts who have received immunosuppressive therapy or transplantation.

Cytomegalovirus↗
PubMed1992

[Auer rods-positive neutrophils observed at diagnosis increased after remission induction in patient with acute promyelocytic leukemia].

50-year-old male was admitted to our hospital because of gingival bleeding and fever in August 1987. The leukocyte count was 13,300/microliters with 80.5% leukemic promyelocytes and bone marrow was hypercellular with 86.4% leukemic promyelocytes. A small number of mature neutrophils containing Auer rods were seen in bone marrow. On a diagnosis of acute promyelocytic leukemia and treated with induction chemotherapy consisting of behenoyl-arabinofuranosyl cytosine (BHAC), daunorubicin, 6-mercaptopurine (6-MP) and prednisolone (PSL) was reformed. After cytoreduction, leukemic cells reappeared in the peripheral blood, concomitant with mature neutrophils having Auer rods. Vitamin D3 was not effective as a differentiation inducing agent. Complete remission was obtained in November 1987 by the reinduction chemotherapy consisting of BHAC, aclarubicin, 6-MP and PSL. In this case, neutrophils with Auer rods might have been derived from the leukemic clone and differentiation of leukemic promyelocytes by intensive chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Circadian variation in the latency of auditory brainstem response].

The auditory brainstem response (ABR) has been found to reflect many pathological conditions within the auditory system and brainstem. And now, many neurosurgeons are using it to monitor the integrity of the auditory pathway during neurosurgical procedures. It is said that ABR shows little variation from person to person or laboratory to laboratory, nor is it easily affected by anesthesia, level of consciousness, fluctuation of blood pressure or hypoxemia. On the other hand, previous studies have shown that component waves of the ABR increase in latency and decrease in amplitude with lowered temperature. We reported here that naturally occurring circadian variations in body temperature were correlated with similar changes in the latency of the ABR. Tympanic temperature (Tty), deep forehead temperature (Thd) and ABR were recorded every 3 hours during a 24-hour period for a total of 8 recording sessions from each of 6 healthy persons (2 males and 4 females, mean age 24.3 years). The subjects were free to come and go during the day but slept overnight in the laboratory. All subjects had circadian variations in each temperature on the order of one degree. Thd had a tendency to fluctuate and its range of difference from Tty was -0.5-0.4 degree C. There was a more significant negative correlation between the latency of the ABR and Tty than that of Thd. It has become apparent that ABR latency is affected by small temperature changes such as circadian variation. The rate of a latency change in the ABR was 0.15msec per degree (C).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Quality of life for older people under oncological treatment].

Recently, an argument over the medical treatment of older patients has arisen in the field of clinical oncology. In the past oncological treatment has been geared to young and middle-aged people. Currently, oncological treatment takes the peculiarities of older people into consideration. Firstly, it highlights the multidimensionality of Quality of Life (QOL) as an important element, with subjectivity the second element. This notion has gained a worldwide consensus. The domain of "multidimensionality" consists of: 1. Physical status and functional abilities 2. Psychological status and well-being 3. Social interaction 4. Economic status and factors With these factors in mind, different questions are asked, depending on the condition of each patient, in order to let the patient form his/her own judgment on possible medical treatment. However, it is sometimes difficult for older people to make such judgments due to problems such as depression or their diminishing mental ability. Also, it is impossible to define life satisfaction indiscriminately without regard to individual outlook. QOL for older people is generally characterized by "individuality" which includes: 1) A person's integrity; 2) independence; and 3) autonomy. Though these elements are taken into account in adopting the above-mentioned methodology, the field of clinical oncology's two concepts of QOL still apply in principle. Flexibility to put emphasis on different elements of the domain will be necessary. Even though QOL for older people is a matter of subjective judgment, the "sound judgment of professionals" (objective and scientific judgment of caregivers) can be adopted in cases when there is difficulty in communication.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1992

Collection of peripheral blood stem cells mobilized by high-dose Ara-C plus VP-16 or aclarubicin followed by recombinant human granulocyte-colony stimulating factor.

We developed an effective method for harvesting large numbers of peripheral blood stem cells (PBSC) for use in autotransplantation. Twenty patients with hematological malignancies were treated with high doses of Ara-C (12 g/m2) and VP-16/aclarubicin followed by administration of rhG-CSF (50 micrograms/m2). The optimal time for starting PBSC collection was determined by monitoring the CD34-positive stem cells in blood using immunomagnetic beads. PBSC were collected with a CS-3000 blood cell separator. A total blood volume between 7000 and 9000 ml was processed in each apheresis. Under these conditions, a total of 64 apheresis procedures was performed in the 20 patients. The mean numbers of mononuclear cells and of CFU-GM harvested per apheresis were 4.1 x 10(8)/kg and 110 x 10(4)/kg, respectively. A number of CFU-GM sufficient for engraftment (> 30 x 10(4)/kg) could be harvested by a single apheresis in 15 of the 20 patients. So far, 11 patients have been transplanted with PBSC and obtained rapid hematopoietic recovery. The median time to recover neutrophils more than 0.5 x 10(9)/l was 10 days, and that for platelets 50 x 10(9)/l was 11 days. This method for harvesting large numbers of PBSC allows safer autotransplantation in patients with chemoradiosensitive tumors, and is applicable to older patients.

Aclarubicin↗
PubMed1992

[A surgical case of coronary sinus ASD].

A case of coronary sinus ASD in a 56-years-old woman is reported. This defect was detected during operation for the first time. In this case, a LSVC was absent and coronary sinus opened into the left atrium. The defect was closed using a pericardial patch.

Coronary Vessel Anomalies↗
PubMed1992

[The effects of prostaglandin E1 on renal function].

The effects of prostaglandin E1 on renal function were studied in surgical patients under general anesthesia. The patients were over 20 years old, and had ischemic heart disease, hypertension and/or liver dysfunction. In 67 patients (PGE1 group), prostaglandin E1 (PGE1) was in fused at a rate of 0.02 mcg.kg-1.min-1. In 55 patients (control group), only lactated Ringer solution was infused at a rate of 10 ml.kg-1.h-1. Urine output and fractional sodium excretion in PGE1 group were significantly higher than those in control group. There were no significant differences in creatinine clearance and free water clearance between the two groups. The increase in urine output in PGE1 group could be attributed to the decrease in the water reabsorption in the proximal renal tubule.

Adult↗
PubMed1992

[Urinary excretion of parathyroid hormone-related protein in patients with adult T-cell leukemia and other hematologic disorders].

Urinary excretion of parathyroid hormone-related protein (PTH-rP) was measured by radioimmunoassay in 25 patients with adult T-cell leukemia (ATL), in 68 patients with other hematologic disorders and in 13 asymptomatic individuals seropositive for human T-cell leukemia virus type I (HTLV-I). The mean levels of urinary PTH-rP in ATL patients with hypercalcemia (11.01 micrograms/g.Cr) were higher than in ATL patients with normocalcemia (5.16 micrograms/g.Cr). The mean levels in patients with acute type (8.84 micrograms/g.Cr), lymphoma type (4.18 micrograms/g.Cr) and crisis ATL (18.20 micrograms/g.Cr) were significantly higher than in urine of healthy controls. However, all asymptomatic carriers of HTLV-I and patients with chronic and smoldering ATL had normal urinary PTH-rP levels. In 7 patients with acute myelogenous leukemia, 1 patient with blastic crisis of chronic myelogenous leukemia and 3 patients with malignant lymphoma, the urinary levels of PTH-rP were above the normal range. Urinary levels of PTH-rP of the ATL patients with hypercalcemia correlated with the serum calcium levels. Urinary levels of PTH-rP of the all ATL correlated with serum lactic dehydrogenase level. These findings suggest that the measurement of urinary levels of PTH-rP is useful for evaluation of ATL and that some tumor cells of other hematologic diseases may produce PTH-rP.

Hematologic Diseases↗
PubMed1992

Gene-environment interaction in hypertension, stroke and atherosclerosis in experimental models and supportive findings from a world-wide cross-sectional epidemiological survey: a WHO-cardiac study.

1. Genetic rat models of hypertension, such as spontaneously hypertensive rats (SHR) and in particular, stroke-prone SHR (SHRSP) are useful models for research on the genetic pathogenesis, gene-environment interaction and control of environmental factors for the prevention of hypertension and related cardiovascular diseases (CVD). 2. Since recent genetic analysis of hypertension in SHRSP indicated that one of the hypertensive genes related to salt-induced blood pressure (BP) rise was linked with the gene of the angiotensin-converting enzyme, gene-environment interaction is important in the humoral, neural, vascular and nutritional mechanisms of hypertension and CVD. 3. Extensive experimental studies in SHRSP by the authors have demonstrated nutritional factors counteracting directly or indirectly against the adverse effect of excess salt intake, such as K, Mg, Ca, dietary fibres, protein, some amino acids and fatty acids, etc.; they are therefore effective in preventing stroke, the typical complication of hypertension. 4. Experimental atherosclerotic models were established in SHRSP, which indicated also a gene-environment interaction in the pathogenesis of atherosclerosis at the cellular level of vascular smooth muscle cells. Excess salt intake accelerated cholesterol absorption from the intestine to induce arterial fat deposition as well as to active platelet aggregation by the mechanism of increased intracellular Ca2+ mobilization. 5. Based on such experimental findings on the hypertension and related CVD prevention, a cross-sectional multicentre epidemiological 'CVD and Alimentary Comparison' Study (WHO-CARDIAC Study) was designed to assess the relationship of biological markers of dietary factors with BP ('core' study) and major CVD mortalities ('complete' study) and has been successfully undertaken for the past 8 years in co-operation with 54 centres in 23 countries. 6. The results of 'core' study so far obtained by cross-centre simple linear regression analysis demonstrated adverse effects of body mass index and salt intake on BP in men and possible beneficial effects of Mg by within-centre multiple linear regression analysis. 7. Preliminary cross-centre simple linear regression analysis of the 'complete' study indicated a positive correlation of serum cholesterol levels and negative correlation of serum phospholipid poly-unsaturated to unsaturated fatty acid ratios and 24 h urinary taurine excretion with coronary heart diseases mortality; a positive correlation of 24 h urinary Na and Na/K ratios and a negative correlation of serum cholesterol levels with stroke mortalities was indicated. 8. These epidemiological data confirmed mostly the applicability of experimental findings to the nutritional prevention of hypertension and CVD prevention.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1992

[Total aortic arch replacement through a median approach].

Seven patients underwent total aortic arch replacement only through a median approach since March 1990, in our institute. The woven Dacron graft with three side arm branches were used. After the proximal anastomosis at the ascending aorta, open distal anastomosis at the descending aorta was performed in five cases, under circulatory arrest of the lower body using separate perfusion to the brain. In two cases with true aneurysms involving the aortic arch, occlusion balloon catheters were employed for distal anastomosis. The anastomosis of the arch vessels was performed after coronary reperfusion. There was no early operative death, and our results demonstrate that total arch replacement can be safely accomplished through a median approach with an acceptably low operative risk.

Aged↗
PubMed1992

Interferon-gamma-dependent immunosuppressive effects of human gingival fibroblasts.

Immunoregulatory functions of human gingival fibroblasts (HGF) were examined. As in fibroblasts isolated from other tissues, HGF were activated with interferon-gamma (IFN-gamma) to express HLA-DR molecules. Despite the fact that the IFN-gamma-treated HGF showed phenotypical resemblance to so-called antigen-presenting cells (APC), the IFN-gamma-treated HGF were ineffective stimulators of alloreactive peripheral T cells. Conversely, IFN-gamma-treated HGF dramatically inhibited the proliferative responses of allogeneic APC (allo-APC) or phytohaemagglutinin (PHA)-stimulated T cells. Immunosuppressive effects of culture supernatant (CS) of IFN-gamma-treated HGF were low and were completely abrogated by the addition of indomethacin. Moreover, the production of prostaglandin E2 (PGE2) by HGF was not affected by IFN-gamma. These results suggest that IFN-gamma-dependent immunosuppressive effects of HGF were not due to PGE2 produced by HGF. In order to investigate further the mechanism(s) of IFN-gamma-dependent immunosuppressive effects of HGF, activated T cells and IFN-gamma-treated HGF were separately cultured in the same well by collagen films which were assembled in cylindrical cells and disturbed physical interactions between T cells and HGF. The proliferative responses of T cells which directly contacted with IFN-gamma-treated HGF were inhibited more significantly than those of T cells which did not contact with IFN-gamma-treated HGF. This suggests that IFN-gamma-dependent immunosuppressive effects of HGF were mediated by direct interactions between T cells and activated HGF. The present results suggest that IFN-gamma-stimulated HGF would modulate the immune responses of locally infiltrated T cells in periodontal lesions.

Cell Division↗
PubMed1991

Inhibition of gastric H+,K(+)-ATPase by the anti-ulcer agent, sofalcone.

Effects of the anti-ulcer agent, sofalcone, on gastric H+,K(+)-ATPase were studied as well as those of other chalcone derivatives, chalcone and sophoradin. These drugs inhibited pig gastric H+,K(+)-ATPase in a dose-dependent manner. They were 5-10-fold less inhibitory toward Na+,K(+)-ATPase than H+,K(+)-ATPase. The potencies of these drugs on the inhibition of enzymes were as follows: sophoradin greater than sofalcone greater than chalcone. Kinetic studies showed that the inhibition of H+,K(+)-ATPase by sofalcone was competitive with respect to ATP and was non-competitive with respect to K+. Sofalcone also inhibited H+,K(+)-ATPase mediated proton transport and reduced the phosphoenzyme level. These results suggest that sofalcone inhibits gastric H+,K(+)-ATPase competitively with ATP at the ATP site and thereby blocks the phosphorylation of the enzyme. This may be the cause of the anti-secretory activity of sofalcone.

Adenosine Triphosphatases↗