[Treatment of acute myelogenous leukemia in children with a multiple-drug protocol (MINI-COAP regimen) (author's transl)].
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Biomedical subjects
Publications and source records attributed to T Fujimoto.
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Pregnant C57BL mice were given a daily dose of 7.5, 6.0, 5.0 or 2.5 mg/kg methylmercuric chloride (MMC) orally from the sixth through the thirteenth day of pregnancy. Pregnant Wistar rats were given a daily dose of 7.5, 5.0 or 2.5 mg/kg MMC orally from the seventh through the fourteenth day of pregnancy. Fetal examinations were performed on days 18 and 20 in mice and rats, respectively. In mice, the dose of 7.5 mg/kg was embryocidal. The dose of 6.0 mg/kg also caused a high incidence of fetal death, decreased fetal weight and a marked increase in malformations. A dose of 5.0 mg/kg caused a decrease in fetal weight and a marked increase in the incidence of malformations. The most common malformations were cleft palate and fused thoracic vertebrae. In rats, the dose of 7.5 mg/kg caused a high incidence of fetal death and malformations. The most frequent malformations were cleft palate, generalized edema, brain lesions and wavy ribs. A dose of 5.0 mg/kg caused a significant decrease in fetal weight and a significant increase in the incidence of malformations.
To determine the clinical significance of serum bile acid measurements, changes in the serum bile acid composition in liver diseases and endogenous bile acid clearance due to test meal loads were investigated. In the case of changes in the serum bile acid composition, a characteristic pattern of a remarkable increase of chenodeoxycholic acid (CDCA) was found in fulminant hepatitis. In patients with acute hepatitis, increases in CDCA were somewhat greater than those of cholic acid (CA) and there was tendency for these changes to precede changes in other liver function tests. In cases of extrahepatic obstructive jaundice, the CA/CDCA ratio was a large value exceeding 1.0. In investigations of endogenous bile acid clearance, serum bile acid concentration two hours after the text meal load clearly reflected the hepatic disorder and it was useful in differentiating between active and inactive form in chronic hepatitis and compensation and decompensation in liver cirrhosis.
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Effects of atrial fibrillation on coronary circulation and on blood flow distribution across the left ventricular wall were studied in anesthetized open-chest dogs. Atrial fibrillation was induced by pressing down mechanically the left atrial appendage or by stimulating electrically the left atrial appendage. Heated cross-thermocouples were used for measuring regional myocardial blood flow. The results showed a marked decrease in coronary blood flow with a significant increase in coronary vascular resistance; average values (SD) of flow and resistance during control simus rhythm were 71.6 +/- 7.36 ml/min . 100g heart muscle and 1.38 +/- 0.15 mmHg/ml/min . 100g heart muscle, respectively, and 54.0 +/- 13.60 ml/min . 100g and 1.54 +/- 0.18 mmHg/ml/min . 100gjust prior to cessation of atrial fibrillation. The termination of fibrillation caused a remarkable rise in coronary flow and a fall in coronary resistance. Pacing-induced tachycardia, similar to the average ventricular rate during atrial fibrillation, increased coronary blood flow and decreased coronary vascular resistance. These show that active coronary vasodilatation and an increase in extravascular support of coronary bed are produced by atrial fibrillation. Subendocardial myocardial blood flow during atrial fibrillation was reduced 22.0 +/- 14.8% from control levels followed by marked increase in flow after cessation of fibrillation, while subepicardial flow decreased only slightly. Thus, atrial fibrillation itself diminishes coronary flow reserve, especially in the subendocardial layer, partly due to the increase in myocardial component of coronary vascular resistance, and it is possible that irregular ventricular rhythm may play an important part in a rise in extravascular support.
Mode of development of axial sclerosis and fibrosis of glomerular loops following proliferative glomerulitis was studied on the basis of renal biopsies. The analyses of biopsy specimens revealed that mild proliferative glomerulitis with preservation of capillary structure is followed by axial sclerosis or sclerosis of mesangial area of glomerular loops, whereas marked or severe proliferative glomerulitis characterized by disorganization of glomerular architecture due to proliferation of local fixed cells with reticular arrangement, chiefly of endothelial origin, following histolysis of loop walls results in crowding of proliferated cells accompanied by formation of fibers along them toward axis of the loop (axial fibrosis) and recanalization at its periphery. It was also clarified that when cell proliferation and following axial fibrosis of glomerulus are pronounced, lobulation of glomerular loops associated with further formation of centrolobular nodules is brought about, which is the lesion characteristic of lobular glomerulonephritis. Some clinical features concerning these processes were presented and discussed, and significance of glomerular lesions here presented for the nephrotic syndrome was considered.
Fourteen autopsied cases of malignant nephrosclerosis were classified into 6 of pure form in which syndrome of malignant hypertension developed from the beginning of the disease, and 8 of exacerbated form with appearance of the syndrome in the course of essential hypertension. Pathohistological study of these cases elucidated the differences in histologic manifestations between pure and exacerbated forms of malignant nephrosclerosis as to which little had been known as yet. In the pure form arterioles and small arteries characteristically demonstrated acute or recent lesions such as fibrinoid necrosis and hemorrhage into intima, and intimal cellular hyperplasia of somewhat longer duration, whereas in the exacerbated form coexistence of vascular lesions of various intensities and durations, acute (fibrinoid necrosis and hemorrhage), intermediate (intimal cellular hyperplasia) to chronic (sclerosis and lamellar elastosis), and superposition of more recent vascular lesions on more advanced or older ones were noted. Superposition of vascular alterations was interpreted to be not necessarily specific for exacerbated form but histologic manifestation of recurrence which is liable to be the case more frequently in exacerbated form than in pure form in the longer course of essential hypertension or of malignant hypertension. Some other related problems were also considered and discussed.
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The metabolism of cefoxitin, a new semi-synthetic cephamycin antibiotic, in rats with renal insufficiency was examined in comparison with that in control. Ascending urinary tract infection was produced in rats by intra-cystic inoculation with a virulent strain of Escherichia coli. In rats with severe infection progressed into purulent inflammation in the pelvis and medullar and cortical abscess formation, the urinary excretion of the antibiotic was reduced till the first 2 h after an i.v. dose of 40 mg/kg, while its serum levels and biliary excretion during this period were contrarily higher than those in rats with mild infection limited to pelvic inflammation and in control. On the other hand, in rats with renal arteriarctia produced by constriction of the renal artery with silver clip, blood levels of the antibiotic were higher than those in control. In the former animals, the urinary excretion was reduced to about a half, while the biliary excretion was increased up to twofold of that in control through the whole experimental period. In animals either with severe infection or with renal arteriarctia, the total recovery in the urine and the bile during 6 h of the experimental period was almost equal to those in mild infection or control groups.