[Modified Appleby procedure for gastric cancer with reconstruction of hepatic artery: preliminary report].
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Hepatic Artery↗
Biomedical subjects
S Oshima
Publications and source records attributed to S Oshima.
[A case of unstable angina pectoris associated with an active phase of polymyositis].
We report a case of unstable angina in an active phase of polymyositis. A 51 year-old man was admitted with a diagnosis of polymyositis and unstable angina with ST elevation on prolonged rest chest pain. Rest anginal attack which had been refractory to conventional antianginal medications was controlled by high dose of glucocorticosteroid. Electrocardiography revealed multifocal premature ventricular contraction. Since silent ischemia on exercise persisted, percutaneous transluminal coronary angioplasty (PTCA) was performed on a stenotic lesion in the left anterior descending artery. Since there was recurrent anginal attack, re-PTCA was carried out at the same site. He was discharged in a good condition. This case is considered to be associated with cardiac involvement of polymyositis because of ventricular arrhythmia, persistent increased serum levels of CPK-MB, and the marked benefits of corticosteroid against unstable angina. In addition, clinical manifestations, coronary arteriographic findings, and increased plasma levels of thrombin-antithrombin III complex suggest that cardiac involvement in polymyositis accelerates intracoronary thrombus formation and/or coronary spasm.
Angina, Unstable↗
[Pharmacological studies of intravaginally applied dehydroepiandrosterone sulfate (DHA-S)].
The ripening effect of dehydroepiandrosterone sulfate (DHA-S) on the uterine cervix was studied after intravaginal application. A 100-mg suppository containing 0, 5, 10 or 20% (w/w) DHA-S was applied to the vagina of pregnant rats 3 times on days 14-16 of gestation. Wet weight and water content of the uterine cervix increased dose-dependently. To measure the elasticity of the uterine cervix, the tension causing an expansion of 1 mm or 2 mm was determined; this was reduced by the application of 20% DHA-S, and the difference in the length of the cervix produced by tensions of 5 g and 25 g was increased. Application of 20% DHA-S decreased the collagen content of the uterine cervix and the total collagenase activity was increased. Furthermore, histochemical changes, coarsening and edema were observed in the uterine cervix. These findings suggest that intravaginal application of DHA-S would produce ripening effects similar to those after intravenous injection.
Administration, Intravaginal↗
Effects of the new anti-ulcer agent KB-5492 on experimental gastric mucosal lesions and gastric mucosal defensive factors, as compared to those of teprenone and cimetidine.
Effects of KB-5492, a new anti-ulcer agent, on various experimental gastric mucosal lesions and mucosal defensive factors in rats were compared with those of teprenone and cimetidine. KB-5492 administered orally at 12.5-200 mg/kg inhibited water-immersion stress- and indomethacin-induced gastric mucosal lesions in a dose-dependent manner with ED50 values of 46 and 27 mg/kg, respectively, indicating that KB-5492 was more potent than teprenone but less potent than cimetidine. KB-5492, administered orally at 12.5-100 mg/kg, also inhibited ethanol-induced gastric mucosal lesions in a dose-dependent manner with an ED50 of 23 mg/kg, so KB-5492 was 3 times more potent than teprenone, whereas cimetidine produced no obvious inhibition. In addition, KB-5492, administered orally at 25 and 50 mg/kg twice daily for 10 consecutive days, significantly accelerated the healing of acetic acid-induced gastric ulcers more potently than teprenone and cimetidine. KB-5492 at anti-ulcer doses significantly increased gastric mucosal blood flow in normal anesthetized rats and inhibited the reduction of gastric mucosal hexosamine content induced by aspirin, but did not affect gastric acid secretion in pylorus-ligated rats. These results indicate that KB-5492 has potent and broad anti-ulcer properties, which are probably exerted by its enhancement of gastric mucosal defensive factors through increasing gastric mucosal blood flow and/or retaining gastric mucus, and not by its inhibition of gastric acid secretion.
Administration, Oral↗
[The effect of abnormal lipid metabolism to glomerular injury].
To clarify the effect of abnormal lipid metabolism and lipid deposition in glomerular injuries, we conducted clinical and pathological examination of various glomerulonephritis. There was no relationship between serum TC, TG or apo B and renal deposition of apo B or TG in glomerulonephritis. Apo B staining was intense for MCNS but was very weak for FGS. The staining was more intense in higher grade of glomerular injury in IgAN. Apo B demonstrated a specific pattern for MN, MPGN and lupus nephritis. These data suggest that apo B deposition reflects disturbance of glomerular permselectivity of macromolecules including abnormal influx, transport and endocytosis of macromolecules.
Apolipoproteins↗
Selective signal transduction through the CD3 or CD2 complex is required for class II MHC expression by human T cells.
Ag-dependent activation of human T cells results in high level expression of class II MHC molecules. As part of this process, Ag recognition by TCR generates a series of second signals including protein kinase C, tyrosine kinase, and Ca2+ mobilization. To investigate the role of these second messengers in class II MHC expression, purified T cells were first stimulated by PMA, ionomycin, OKT3 accompanied by IL-2, or the mitogenic anti-CD2 antibodies T112 and T113 and were then stained with FITC-conjugated anti-class I and -class II MHC antibodies for analysis by flow cytometry. OKT3 and IL-2 induced optimal expression of HLA-DR (DR) on 70% of T cells with high density. Despite their high mitogenicity, induction of class II MHC expression by PMA, even with co-stimulation by ionomycin, was reduced to less than 20% of T cells, with an intensity 50-fold lower than in OKT3/IL-2-stimulated T cells. Furthermore, PMA inhibited class II MHC expression by OKT3/IL-2-stimulated T cells in a dose-dependent manner and additional stimuli, such as IL-1, IL-4, IFN-gamma, TCR cross-linkers, or monocytes, did not restore class II MHC expression by PMA-activated T cells. DR beta mRNA analysis showed that the low induction of class II molecules by PMA extends to the transcriptional level. Interestingly, anti-T112 and anti-T113 induced not only proliferation of T cells but also DR expression on more than 90% of T cells. These results indicate that transduction of a specific signal, probably selective phosphorylation of the CD3 molecule, contributes to class II MHC induction in the process of T cell activation.
Antigens, Differentiation, T-Lymphocyte↗
Coronary spastic angina precipitated by the administration of an anticholinesterase drug (distigmine bromide).
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Aged↗
Selective expression of class II MHC isotypes by MLC-activated human T lymphocytes.
Although activated human T cells express class II MHC molecules, the biologic significance of this event is not understood. Using two-color flow cytometry, we have analyzed the expression of HLA-DR, -DQ, and -DP isotypes by T cells following activation by allogeneic lymphoblastoid B-cell lines. Within the CD3+ population, transient expression was observed at 1 day following initiation of culture, which preceded a dramatic and sustained increase around 6-7 days. DR expression was always highest, followed by DP and DQ with DP expression usually somewhat higher than DQ. At day 8, three populations were observed consisting of DR+DP+DQ+ (60%), DR+DP+ (69%), and DR+ (75%) T cells. Interestingly, DQ+ or DP+ but DR- T cells were not observed. These patterns of class II isotype expression were similar in CD2+, CD4+, and CD8+ subgroups and suggest that class II molecules are selectively expressed on T cells and may play a role in the regulation of T-cell responses to alloantigens.
Antibodies, Monoclonal↗
Intra-operative pulmonary embolism after intravesical instillation of formalin.
Intra-operative pulmonary embolism is a rare and severe complication which is difficult to diagnose. A case is reported in which this condition occurred after intravesical instillation of formalin during radical cystectomy under general anaesthesia. Formalin may be related to formation of intravascular thrombi and result in pulmonary embolism.
Anesthesia, General↗
Fibrinopeptide A is released into the coronary circulation after coronary spasm.
To examine whether acute myocardial ischemia activates the coagulation system and platelet activation in the coronary circulation, we measured plasma levels of fibrinopeptide A and beta-thromboglobulin in the coronary sinus and the aortic root simultaneously in 15 patients with coronary spastic angina before and after the left coronary spasm induced by intracoronary injection of acetylcholine and in 15 patients with stable exertional angina before and after acute myocardial ischemia induced by rapid atrial pacing. Fifteen patients with chest pain but normal coronary arteries and no coronary spasm served as controls. The coronary sinus-arterial difference of fibrinopeptide A increased markedly (p less than 0.001) from 0.1 +/- 0.2 to 4.3 +/- 0.7 ng/ml after the anginal attacks in the coronary spastic angina group. However, fibrinopeptide A levels remained unchanged after the attacks in the stable exertional angina group and after intracoronary injection of acetylcholine in the control group. Plasma beta-thromboglobulin levels remained unchanged after the attacks in both patient groups and after acetylcholine in the control group. Our data indicate that coronary spasm induces thrombin generation and may lead to thrombus formation in the coronary artery involved, but pacing-induced ischemia does not activate the coagulation system.
Angina Pectoris↗
[Development of a semi-closed underwater breathing apparatus, the "eOBA"].
Nippon Sanso K.K developed a compact semi-closed underwater breathing apparatus, the eOBA. It consists of a mouthpiece, manifold with a purge valve, two spring-loaded flexible tubes, a small CO2 absorbent canister (net wt. = 190g), and two compact high pressure bottles (50ccx2: 190kg/cm2: 80%O2, 20%N2) with a regulator which supplies the gas at the constant flow rate of 1.5 l/min and lasts for 10 min. Thus, a counterlung is not incorporated. However, spring-loaded tubes act as a counterlung since its volume increases to 3.5 l when fully inflated. Dives to a depth of 5m are also recommended because of no bypass valve. This new eOBA was tested using the mechanical breathing machine and CO2 supply system to the circuit. For the various combinations of tidal volumes (0.5-2.5 l) and respiratory rates (10-20 breaths/min), the pressure at the mouthpiece, respiratory volume and the CO2 level were continuously monitored. The CO2 absorption rates were then calculated. The thin sloping P-V loops demonstrate that the eOBA is a flow dependent type of apparatus. It was found that the external work of breathing (0.1 kg.m/l at 30 l/min) were allowable. The CO2 absorption rates were sufficient when minute ventilation increased to 30 l/min. Thus, results show that the eOBA must be suitable for shallow and short dives.
Diving↗
[A case report of testicular tumor in a dialysis patient].
A hemodialysis patient suffering from testicular tumor is reported. The patient was a 43-year-old man who had been receiving hemodialysis for 1 year. The patient consulted our hospital complaining of left testicular swelling and mild pain. Because of hen-egg-size enlargement and irregular surface of the left testis, high orchiectomy was performed under the diagnosis of testicular neoplasm. The diagnosis made after the microscopic examination was seminoma with a portion suspected as choriocarcinoma. No metastasis was revealed by computer tomography and chest X-ray photography. Considering that the patient was on dialysis and clinical diagnosis was stage 1, we did not perform radiation therapy nor lymph node dissection and the patient has been under careful observation.
Adult↗
[Two cases of pulmonary alveolar proteinosis with increase of serum CEA].
Two cases of pulmonary alveolar proteinosis with increased serum CEA were reported. In both cases, the clinical diagnosis of pulmonary alveolar proteinosis was confirmed by transbronchial lung biopsy (TBLB). Immunohistochemical study of the lung biopsy specimen showed that CEA staining was present in the region of alveoli where type II alveolar epithelial cells proliferate. It was suggested that proliferative type II cells produced CEA in pulmonary alveolar proteinosis. The study of cell surface markers in their bronchoalveolar lavage fluid (BALF) revealed increase of CD8 and Leu7 positive cells and decrease of CD4 positive cells. In the case 2, there was significant increase of B lymphocytes marker positive cells. These results suggested that there may be abnormal regulation of both T and B lymphocytes and NK cells, leading to dysfunction of the pulmonary alveolar macrophage in pulmonary alveolar proteinosis.
Adult↗
[Monoclonal antibody analysis of glomerular, tubulo-interstitial infiltrating immune cells in various glomerulonephritis].
To investigate the role of cell-mediated immunity (CMI) in glomerulonephritis (GN), we identified the infiltrating immune cells both within the glomerulus and in the interstitium. Frozen sections from 103 patients with various forms of GN: 10 with minor glomerular abnormality (MGA) as control, 10 with minimal change nephrotic syndrome (MCNS), 10 with membranous nephropathy (MN), 9 with focal glomerulosclerosis (FGS), 30 with IgA nephropathy (IgAN), 22 with acute post streptococcal glomerulonephritis (APSGN), and 2 with rapidly progressive glomerulonephritis (RPGN) were examined using monoclonal antibodies (MoAb) by indirect immunoalkaline-phosphatase labelling. In most glomerulonephritis, monocyte/M phi and helper/inducer T cells were predominantly infiltrating in the interstitium, but intraglomerular infiltration was rare, except for APSGN. This interstitial infiltration increased proportionally to the level of serum creatinine, and was most prominent in RPGN. Apparently different distribution was seen in APSGN, that is, prominent increase in total number of intra-glomerular monocyte/M phi infiltration with slightly increased T cells. The change was correlated with time after onset; namely the more leucocytic infiltration was observed when the tissue was taken earlier. These data suggest that in APSGN, monocyte/M phi accumulate in glomeruli via cell mediated immunity in addition to humoral immune mechanism resulting in glomerular hypercellularity, whereas in most chronic glomerulonephritis interstitial leucocyte infiltration, particularly helper T cells and monocyte/M phi may play an important role in the progression of glomerulonephritis.
Adolescent↗
[Correlation of CT and pathologic findings of pulmonary lymphangioleiomyomatosis].
The X-ray CT findings of two cases of pulmonary lymphangioleiomyomatosis were reported. The correlation between high-resolution CT findings and inflated biopsy specimens was studied. The X-ray CT findings are 1) multiple low attenuation areas, 2) diffuse areas of slightly increased density and 3) irregular enlargement of pulmonary vascular images. Each low attenuation are turned out to correspond to emphysematous lesions. Slightly increased densities on CT images seemed to be caused by a summation of many small nodules of a proliferation of smooth muscle cells located in the wall of respiratory bronchioles and alveolar ducts, with or without intraalveolar hemosiderosis. Some nodular lesions in bronchiolar walls were so close to neighboring vessels that they could not be separated from vascular images on CT, so peripheral vascular images were irregularly thickened. X-ray CT reflected more actual pathological findings than routine chest radiographs. As low attenuation areas on CT images have been reported to be representative of pulmonary emphysema, it is thought that the above CT findings must be differentiated from those of pulmonary emphysema. While pulmonary vascular images were thin and stretched on the CT in patients with emphysema, they were irregularly thickened on the CT of patients with LAM. Furthermore, while CT of emphysema often revealed overinflation or decreased density, diffuse areas of slightly increased density were never found in emphysema.
Adult↗
[An open lung biopsy case of follicular bronchiolitis in rheumatoid arthritis].
A 49 year-old Japanese female with a clinical history of rheumatoid arthritis for 15 years developed fever, cough, sputa and exertional dyspnea. A chest x-ray showed right-sided pleural lesions in addition to persistent hyperinflation of the lungs for about four years. Pulmonary function tests showed combined obstructive and restrictive dysfunction, increased residual volume and reduced diffusing capacity. After an improvement of the pleural lesions, she underwent a right open lung biopsy in December 1988 which revealed follicular bronchiolitis and fibrino-fibrous pleural thickening. The pulmonary lesion of follicular bronchitis/bronchiolitis was reported in 1985 as a newly recognized pulmonary disorder among open lung biopsy cases. The present case was the second biopsy proven case of follicular bronchiolitis among the Japanese.
Arthritis, Rheumatoid↗
[Effect of erythromycin on the generation of neutrophil chemiluminescence in vitro].
In order to elucidate the therapeutic mechanisms of low dose-long term erythromycin (EM) therapy in patients with diffuse panbronchiolitis (DPB), the authors evaluated the effect of in vitro EM treatment on neutrophil (PMN) oxygen radicals production. EM has potent capacity to suppress PMN chemiluminescence (CL) induced by the N-formyl Met-leu-phe (FMLP), opsonized zymosan, and calcium ionophore A23187 stimulation. In marked contrast, phorbol myristate acetate (PMA)-induced PMN CL were much less affected by EM treatment. The suppressive activity of EM was dependent on the EM concentration and at a EM concentration of 25 micrograms/ml, FMLP-induced PMN CL were suppressed by 45.3 +/- 5.6% (n = 7), but PMA-induced CL were suppressed only marginally, 11.9 +/- 3.7% (n = 7). The onset of inhibitory activity of EM is rapid and at 5 min., 60.1% of the maximum suppression at 60 min. was observed. This EM-induced suppression was found to be reversible and dependent on the EM-pretreatment temperature since the suppressive activity of EM were observed only at 37 degrees C but not at 0 degrees C. These results suggest that actively transported intracellular EM exerts its suppressive activity by inhibiting the process of Ca++ transfer or Ca++ utilization by cells. In addition, these results were consistent with the concept that EM might act as an anti-inflammatory agent in chronic bacterial airway infections such as bronchiectasis and DPB where the PMN appear to play an important role in the generation of airway destruction.
Erythromycin↗
Effect of ozagrel (OKY-046), a thromboxane synthetase inhibitor, on theophylline pharmacokinetics in asthmatic patients.
The effect of ozagrel (OKY-046), a selective thromboxane A2 synthetase inhibitor, on theophylline disposition was studied in 12 asthmatic patients. Ozagrel was administered at a dose of 200 mg twice daily for 24 weeks to 4 outpatients receiving oral theophylline medication. Blood samples were drawn from each patient visiting the hospital at one to four-week intervals. There were no clinical significant changes between the time course profiles of serum theophylline concentration during the treatment and those after the cessation of ozagrel dosing. In addition, another 8 hospitalized patients received a single intravenous infusion of aminophylline (200 mg as theophylline) before and after ozagrel treatment of 200 mg twice daily for 7 days. No statistical significant alteration in elimination half-life, total body clearance or volume of distribution of theophylline was observed by the administration of ozagrel. These results suggest that ozagrel does not inhibit the metabolism of theophylline despite having an imidazole ring in its chemical structure.
Acrylates↗