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Biomedical subjects

T Fujimoto

Publications and source records attributed to T Fujimoto.

At least 361 records · Page 20Linked to original sources
PubMed1993

Effect of vagotomy on ornithine decarboxylase activity in rat duodenal mucosa.

The aim of this study was to determine whether the circadian rhythm of ornithine decarboxylase (ODC) activity in rat small intestine is controlled by factors other than luminal nutrients. ODC activity in duodenal and jejunal mucosa of rats fed ad libitum was measured at four time points (0500, 1100, 1700, 2300 h; light period: 0800-2000 h). ODC activity in the jejunum increased in the dark period, which is when rats normally eat. In contrast, ODC activity in the duodenum began to increase at 1700 h, which is when rats do not normally eat, as indicated by the recorded feeding pattern. The increase in ODC activity in the duodenum at 1700 h, but not at other time points, was abolished by subdiaphragmatic vagotomy, whereas vagotomy had no effect on the feeding pattern of rats. Subdiaphragmatic vagotomy had no effect on ODC activity in the jejunum. ODC activity in the duodenum increased following glycoprivation of the central nervous system induced by infusion of 2-deoxyglucose into the third cerebroventricle. These results indicate that the increase in duodenal ODC activity at 1700 h is due to a signal from the upper brain structure through the vagal nerve and not to luminal nutrient factors.

Animals↗
PubMed1993

Cholesterol ester in corpus luteum of rat observed by analytical color fluorescence electron microscopy.

We used an analytical color fluorescence electron microscope to observe cathodoluminescence (CL) in the corpus luteum of rat. CL was emitted from lipid droplets and has a typical spectrum of two peaks at wavelengths of 320 and 430 nm. The intensity of CL at 320 nm (CL320) in the corpus luteum showed a regular change during an estrous cycle: it was very weak at the newly formed stage, gradually increased, reached the maximum at diestrus 2, and then began to diminish at proestrus except in the patches of degenerated cells. CL320 decreased during early stages of pregnancy or after prolonged treatment with 4-aminopyrazolo-pyrimidine; CL at 430 nm (CL430) remained clearly visible. CL320 showed a strong emission from degenerated luteal cells 10 days after hypophysectomy, but was diminished in cells rescued by injection of 50 IU pregnant mare's serum gonadotropin. In the luteal cells of luteinized ovary 2 hr after intravenous injection of 10 IU luteinizing hormone, CL was barely detected. CL320 in interstitial cells was also weak in the rats hypophysectomized and then treated with pregnant mare's serum gonadotropin, and in the 4-aminopyrazolo-pyrimidine-treated rats, although it has little change through a natural estrous cycle. The results are consistent with the assumption that the content of cholesterol ester is reflected by the intensity of CL320 emitted from the lipid droplets of rat luteal cells. The possibility was shown that the condition of steroidogenesis can be monitored through CL analysis by microscopy.

Adenine↗
PubMed1993

Frequency analysis of QRS complex with bundle branch block in patients with and without sustained ventricular tachycardia.

To distinguish patients with bundle branch block (BBB) and sustained ventricular tachycardia (s-VT) from patients with BBB but without s-VT, a frequency analysis of the QRS complex was performed in 71 patients. Frequency analysis of the QRS complex of patients with left bundle branch block (LBBB) showed that patients with s-VT had significantly larger areas and area ratios between 50 and 100 Hz in the X lead than patients without s-VT (area: -0.905 +/- 0.231 vs -1.195 +/- 0.286. area ratio: -0.783 +/- 0.230 vs -1.125 +/- 0.310; P < 0.05). The area and area ratios from 100 to 200 Hz in the Z lead were also larger in patients with s-VT. The highest predictive accuracy using the area ratio from 50 to 100 Hz in the X lead was 86%, with a sensitivity and specificity of 83% and 88%, respectively. In cases with LBBB, time domain analysis showed no significant difference between patients with s-VT and those without s-VT. Frequency analysis of the QRS complex may be useful for distinguishing LBBB patients with s-VT from those without s-VT.

Adult↗
PubMed1993

Nonpharmacologic treatment of common atrial flutter guided by transient entrainment.

We attempted nonpharmacologic treatment for common atrial flutter in 7 patients, with direct current catheter ablation (CA) in 5 cases and cryoablation in 2 cases under the guidance of transient entrainment. Transient entrainment during common atrial flutter by pacing from the mid or low lateral right atrium (LLRA) revealed a long conduction time between the LLRA and the orifice of the coronary sinus (CSo) (73% to 121% of flutter cycle length). In 2 cases, fragmented electrograms were recorded at the low right atrial septum with durations of 150 msec and 155 msec, respectively. Because these fragmented electrograms were transiently entrained by rapid atrial pacing in the same manner as other atrial electrograms and were recorded in an area of long conduction, we believe that fragmented electrograms represent critical slow conduction. In 5 cases, CA was directed at this area. Three cases were successfully treated with 3 to 4 DC shocks of 100 J (follow up periods of 11.3, 4.5 and 3 months). Two cases which received 1 to 2 DC shocks of 100 J had recurrence of atrial flutter 6 and 4.7 months later, respectively. Two cases which showed atrial septal defect received surgical treatment. They were successfully treated with extended cryoablation in this same area (follow up periods of 26 and 9.2 months). In conclusion, extended ablation of an area of fragmented electrograms using transient entrainment may be an effective treatment for common atrial flutter.

Aged↗
PubMed1993

Prognostic significance of atrial fibrillation in dilated cardiomyopathy.

We evaluated the relation of atrial rhythm to a clinical course of treatment in 147 patients diagnosed with dilated cardiomyopathy (DCM). Thirty-six of the patients (24%) had either transient (9 patients) or persistent (27 patients) atrial fibrillation (AF). Compared with DCM patients with sinus rhythm (SR), the AF patients did not differ in age, left ventricular (LV) dimension, fractional shortening, or hemodynamic parameters, but the AF patients had slightly larger left atria. After a mean follow-up of 3.8 +/- 2.9 years, the NYHA functional classifications in the AF patients improved in 20 of the 36 (56%), whereas those of the SR patients improved in only 30 (27%) (p < 0.01). The actuarial 5-year survival rate was significantly better for AF patients than for SR patients (93% versus 68%, p < 0.05). LV function remained unchanged in SR patients but improved significantly in AF patients, particularly in patients with transient AF and with "rate-controlled" AF (those with a mean heart rate of less than 90 beats/min). This study suggests that atrial fibrillation may result in significant LV dysfunction, which is reversible in some cases once the arrhythmia is controlled. Aggressive antiarrhythmic therapy should be considered for patients initially diagnosed with dilated cardiomyopathy and atrial fibrillation.

Actuarial Analysis↗
PubMed1993

Rapidly growing mucinous cholangiocarcinoma.

A 65-year-old man was hospitalized due to an abdominal tumor. Several imaging studies showed multilocular tumors in the right hepatic lobe and in the pancreatic head, 4 and 7 cm in size, respectively. The hepatic tumor rapidly grew to 9 cm in 4 weeks, associated with a rapid increase in the serum carcinoembryonic antigen level from 125 ng/ml to 1,000 ng/ml. The pathologic diagnosis of the resected liver tumor was mucinous cholangiocarcinoma. This hepatic tumor produced a large amount of mucin, but did not secrete mucin into the bile ducts. Therefore, there was no obstructive jaundice. The incidentally accompanied pancreatic tumor was a typical serous cystadenoma. The present case suggested that mucinous cholangiocarcinoma could present rapid growth of the tumor. The clinicopathological features of mucinous cholangiocarcinoma are demonstrated for the first time, and the differences between mucinous cholangiocarcinoma and mucin-producing papillary adenocarcinoma of duct-spreading type are discussed.

Adenoma, Bile Duct↗
PubMed1993

[Clinical study of recombinant human granulocyte-colony stimulating factor (KW-2228) in pediatric field. 1. Effectiveness on neutropenia by various causes and safety].

The effect of KW-2228, a derivative of recombinant human granulocyte colony stimulating factor, on neutropenia in children was studied in 23 cases of aplastic anemia, 13 cases of chronic benign neutropenia, 6 cases of congenital neutropenia (Kostmann type), 2 cases of cyclic neutropenia, 2 cases associated with glycogenosis type Ib and 1 cases associated with immune deficiency. KW-2228 was administered at 1-8 micrograms/kg subcutaneously and at 2-16 micrograms/kg intravenously. As a principle, the administration was started at low doses and continued for 7-28 days increasing the doses in the cases who didn't respond to the treatment well. The response rate of all the cases by the physicians in charge was 81. 8% (36/44). The mean absolute neutrophil count was increased from 304 to 1,300/microliters in aplastic anemia, from 204 to 3,027/microliters in chronic benign type, from 125 to 2,193/microliters in Kostmann type, and from 360 to 2,007 microliters in others. KW-2228 did not induce any noteworthy serious side effects. These results indicated that KW-2228 is a useful drug to treat neutropenia in children.

Adolescent↗
PubMed1993

[Clinical study of recombinant human granulocyte-colony stimulating factor (KW-2228) in pediatric field. 2. Effectiveness on neutropenia associated with administration of anticancer agent and safety].

The effect of KW-2228, a derivative of recombinant human granulocyte colony stimulating factor, on neutropenia associated with chemotherapy was studied in pediatric patients with malignant tumor. To patients repeatedly treated with the same chemotherapy, KW-2228 was administered subcutaneously at 1 microgram/kg or intravenously at 2 micrograms/kg once a day in the 2nd course of the chemotherapy. During the administration term of KW-2228, the nadir of neutrophils went up, and the duration of neutrophil count under 500/microliters as well as the interval for recovery of the count to 500/microliters were remarkably shortened, compared with those during the observation term. Further, the duration of fever in patients and the administration days of antibacterial agent were also reduced. The effective rate judged by attending doctors was as high as 78.9%, consisting of 83.3% in 42 cases of subcutaneous administration and 73.5% in 34 cases of intravenous administration. Side effects such as slight skeletal pain and slight fever in one case each (2.3% in total) were improved without treatment. It is concluded that KW-2228 may be a useful drug for treatment of neutropenia associated with chemotherapy in pediatric patients with malignant tumor.

Adolescent↗
PubMed1993

[Evaluation of pulmonary venous flow patterns in left heart failure: a study using transesophageal Doppler echocardiography].

Pulmonary venous flow (PVF) patterns in left heart failure were evaluated using transesophageal pulsed Doppler echocardiography in 30 patients with dilated hearts (DH) and 30 normal subjects. Eighteen patients had myocardial infarction and 12 patients had dilated cardiomyopathy. The diagnostic criteria by using M-mode echocardiography were left ventricular end-diastolic dimensions (LVDd) of 5.5 cm or more and % LV fractional shortening (%FS) of less than 30%. Peak velocities of the first systolic (PVS1) and second systolic (PVS2) forward waves of PVF, %FS and total amplitude of mitral annular motion in the patient group were significantly decreased compared with the normal group. However, there were no differences in these parameters between the 22 patients (DH-1 group) with a mean pulmonary capillary wedge pressure (PCWP) of less than 18 mmHg and 8 patients (DH-2 group) with a PCWP of 18 mmHg or greater. Peak velocities of the diastolic forward wave of PVF and the early diastolic wave (D) of the LV inflow velocity in the DH-1 group were significantly decreased, and the peak velocity of the atrial contraction wave (A) of the LV inflow velocity was increased compared with those of the normal group. D of the LV inflow velocity, peak velocity of the diastolic forward wave, and peak velocity of the atrial systolic backward wave of the PVF in the DH-2 group were significantly increased compared with those of the DH-1 group. Significant positive correlations were observed between peak velocity of the diastolic forward wave and D or PCWP in the patient group, but the latter relationship was not linear. The A/D ratio of the LV inflow velocity was significantly decreased, and the ratio of the amplitudes of atrial contraction wave to total vertical deflection on the apexcardiogram of the DH-2 group were significantly increased compared with those of the DH-1 group. A patient with extensive myocardial infarction associated with development of severe LV dysfunction (PCWP = 23 mmHg) and a "pseudonormalization" pattern of LV inflow velocity demonstrated markedly increased peak velocities of the diastolic and atrial systolic forward wave, and decreased PVS2. However, the peak velocities of the diastolic and atrial systolic forward wave were decreased, and that of PVS2 was increased with fair improvement of LV dysfunction (PCWP = 10 mmHg) and with compensatory augmentation of the atrial contraction wave A of LV inflow velocity.(ABSTRACT TRUNCATED AT 400 WORDS)

Cardiomyopathy, Dilated↗
PubMed1993

Multi-institutional study of all-trans-retinoic acid as a differentiation therapy of refractory acute promyelocytic leukemia. Leukaemia Study Group of the Ministry of Health and Welfare.

We treated 70 acute promyelocytic leukemia (APL) patients with daily oral 45 mg/m2 all-trans-retinoic acid (ATRA) in two multi-institutional prospective studies. Of 64 evaluable patients, 21 were refractory to initial induction chemotherapy; 10 were refractory to salvage chemotherapy; 17, five, and four were in the first, second and, third relapse, respectively; and seven were previously untreated due to old age. In the first study with ATRA from China, 18 out of 22 (82%) evaluable patients achieved complete remission (CR). Initial peripheral leukemia cell counts were significantly less in the CR cases (p < 0.01); < 100/microliters in 17 out of 18 CR cases, and > or = 200/microliters in all failure cases. In the second study with ATRA from Hoffmann-La Roche, if initial leukemia cell counts were more than 200/microliters, chemotherapy was first given and then ATRA was started. Of 42 evaluable patients, 36 (86%) achieved CR. Morphological evidence of differentiation was noted in all CR cases. Patients achieving CR received standard consolidation and maintenance chemotherapies, and the 20-month predicted disease-free survival rate is 76% for cases achieving their first CR with ATRA. Toxicities attributable to ATRA were minimal and included cheilitis, xerosis, dermatitis, gastrointestinal disorders, bone pain, liver damage, and high serum triglyceridemia.

Adolescent↗
PubMed1993

[Antiemetic efficacy of granisetron in the treatment of pediatric cancer--(1). Clinical evaluation of granisetron at a dose of 40 micrograms/kg].

Seventeen children with various types of cancer were studied on the effectiveness of antiemetic drug, granisetron, by a crossover randomized trial; receiving granisetron (40 micrograms/kg; n = 53) or conventional antiemetics, during intensive chemotherapy. In the patients given granisetron nausea and vomiting were well controlled (83.0%), compared with 33.3% of conventional (non granisetron) group. The mean number of vomiting episodes for each 6h-period over 24h after chemotherapy was reduced markedly in the patients given granisetron, compared with conventional therapy. One patient developed paraesthesia of the hand after injection of granisetron as the adverse effect, which recovered to normal spontaneously after 3 hrs. Our data indicated that antiemetic effect of granisetron was superior to conventional antiemetic drugs, both in terms of clinical effectiveness and usefulness.

Adolescent↗
PubMed1993

[Antiemetic efficacy of granisetron in pediatric cancer treatment--(2). Comparison of granisetron and granisetron plus methylprednisolone as antiemetic prophylaxis].

A crossover clinical trial was carried out to compare the effectiveness and safety of granisetron alone (40 micrograms/kg) with that from a combination of granisetron plus methylprednisolone (MPL, 10 mg/kg) for control of emesis and vomiting induced by anticancer drugs in children with cancer. Complete control of emesis and vomiting were achieved in 95% (19/20 cases) of patients receiving the combination compared to 85% (17/20 cases) of patients receiving granisetron alone. There were no clinical toxicities or side effects in either treatment group. These data indicated that the combination of granisetron plus MPL was superior for control of emesis and vomiting in children receiving cytostatic anticancer drugs.

Adolescent↗
PubMed1993

Early invasive colorectal carcinomas metastatic to the lymph node with attention to their nonpolypoid development.

Clinicopathologic study of six cases of early invasive colorectal carcinoma metastatic to lymph node was performed in order to elucidate possible characteristics relating to the risk of metastasis, with particular attention to the growth pattern of the primary tumor. All of the cases had at least one of the well-known risk factors for lymph node metastasis, including moderately or poorly differentiated histologic characteristics, considerable degree of submucosal invasion, and lymphatic invasion. An interesting finding of the present study was the identification of a nonpolypoid growth pattern with no concomitant adenomatous tissue, which seemed to be different from that of "malignant polyps" of previously reported cases showing adenoma-carcinoma sequence. This unique growth feature was found in all of the cases. Therefore, in addition to the accepted risk factors, nonpolypoid growth pattern and absence of adenomatous component may be risk factors predictive of nodal metastasis in patients with early invasive colorectal carcinoma.

Adenocarcinoma↗
PubMed1993

[Mediastinal widening simulating relapse in a case of Hodgkin's disease].

The appearance of a mediastinal mass in a patient with Hodgkin's disease in remission frequently indicates recurrence. However, benign processes such as rebound hyperplasia of the thymus gland should be included in the differential diagnosis. The authors present a case in which an anterior mediastinal mass was revealed by a routine chest radiograph 3 months after completion of combined modality treatment with low-dose radiation and MOPP chemotherapy for cervical Hodgkin's disease, stage I, nodular sclerosis. As the patient was clinically well with no other laboratory evidence of disease, recurrence was considered unlikely. Benign thymic enlargement was strongly suspected on the basis of striking resolution of the mediastinal mass after treatment with a short course of oral prednisolone. Thymic rebound in our case occurred coincidentally with the restoration of normal immune functions after removal of the stress imposed by antineoplastic treatment. The patient has remained free of disease recurrence for more than 20 months after cessation of therapy. Awareness of the possible benign etiology of a mediastinal mass may avert a diagnostic surgical exploration and also unnecessary adjuvant therapy.

Child↗
PubMed1993

[Evaluation of colorectal hepatic metastases with combined modality therapy].

We treated synchronous hepatic metastases in colorectal cancers with combined modality therapy including hepatic resection, selective intra-arterial infusion chemotherapy, and thermocoagulation therapy using a microwave tissue coagulator and compared the value of such therapies. Synchronous hepatic metastases were noted in 563 patients with colorectal cancer who had undergone surgery in our department over the past ten years. Forty-four patients were studied. Six patients underwent hepatic resection only (group A). Another six were subjected to hepatic resection and the residual lesions were treated with selective intra-arterial infusions and thermocoagulation therapy (group B). Fourteen patients were treated with either selective or subselective intra-arterial infusions (group C). The remaining 18 patients were treated in other ways (group D). Cumulative survival, estimated by the Kaplan-Meier method, was compared. One- and three-year cumulative survival rates of patients were 100% and 74% in group A, 100% and 67% in group B, 62% and 0% in group C, and 38% and 5% in group D, respectively. H1 patients accounted for 83% in group A, 33% in group B, 7% in group C, and 22% in group D. The high rate of survival in group A was because of the greater number of H1 patients. One- and three-year survival rated among H2-H3 patients were 100% and 54% in group B, 62% and 0% in group C, and 35% and 14% in group D, respectively. Survival of H2-H3 patients was higher in group B than in group C or D.

Antineoplastic Agents↗
PubMed1993

[Liver metastases from breast cancer: survival and an attempt at cauterization and thermocoagulation therapy combined with selective intra-arterial infusion chemotherapy].

During the past thirteen years, 599 patients with primary breast cancer underwent surgery in our hospital. Nine of them died of liver metastases and the median survival time after detection of liver metastases was five months (range 1-32 months). Four are still alive with liver metastases. Based upon these results, we attempted intraoperative, ultrasound-guided cauterization and thermocoagulation for three patients to improve their prognosis and postoperatively treated them with hepatic arterial infusion chemotherapy. During surgery, a monopolar electrode was inserted with an ultrasonic guide. One round of cauterization lasted for 10 seconds at 100 W, and was repeated until the tissue around the tumor became hyperechoic. The antitumor effect of the therapy was assessed by histological examination of resected liver tissues. Tumor coagulation and necrosis were observed to be consistent with the cauterized area. On CT scanning, treated areas were shown to be of low density and homogeneous. Since this therapeutic approach acts directly on unresectable tumors and is safe, it seems to provide a useful means for intraoperative regional treatment of tumors.

Breast Neoplasms↗
PubMed1993

[Evaluation of subselective intraarterial infusion chemotherapy in far advanced gastric and colorectal cancer].

We investigated the usefulness of subselective intraarterial infusion chemotherapy in far advanced gastric and colorectal cancer. Among gastric and colorectal cancer cases undergoing surgery at our hospital for the past ten years, patients with and without palliative resection were studied. Forty gastric cancer patients and 29 colorectal cancer patients were treated by subselective intraarterial infusion chemotherapy. In gastric cancer cases without resection, a significantly longer survival was noted in patients undergoing this therapy with over 5 g of 5-FU than those treated with conventional chemotherapy. In gastric cancer patients with palliative resection and colorectal cancer patients, survival time was longer by intraarterial infusion with over 5 g of 5-FU, but not significant. Partial response was obtained in 5 cases of gastric cancer and 3 cases of colorectal cancer, and clinical symptoms were improved in 44% of the patients. The main complications of this therapy were myelosuppression and occlusion of the catheter, but none of them were serious. For the improved quality of life of cancer patients, subselective intraarterial infusion chemotherapy is considered a safe and useful form of treatment.

Antineoplastic Combined Chemotherapy Protocols↗