Biomedical subjects
Publications and source records attributed to T Hamada.
A case of fixed drug eruption due to colchicine was reported. A 31-year-old man developed a dark purplish-red round macule on the glans penis 5 h after taking 2.5 mg of colchicine. An oral challenge test with 0.5 mg of colchicine provoked flare-up of the eruption.
A series of 4-aza-5 alpha-androstane compounds with one or two aromatic moieties in the carbamoyl group at the C-17 position were synthesized and their inhibitory activities for rat and human prostatic testosterone 5 alpha-reductase were tested in vitro. Compounds with one aromatic moiety in the carbamoyl group showed high inhibitory activity for rat 5 alpha-reductase, but little for human prostatic 5 alpha-reductase. On the other hand, compounds with two aromatic moieties had potent inhibitory activities for both rat and human 5 alpha-reductase. The structural requirements for potent inhibition for both enzymes are discussed in relation to the spatial arrangement of the C-17 carbamoyl group.
We investigated the characteristics of decreased heart rate variability (HRV) in diabetic patients with ischemic heart disease (IHD). Twenty-one healthy control subjects, 17 diabetic patients without IHD, and 33 diabetic patients with IHD were studied. The diabetic patients with IHD were subdivided into 2 groups according to the severity of their IHD: severe or mild. HRV was evaluated in all subjects using the spectral variables of the all-frequency, low-frequency, high-frequency (AF, LF, HF) components and the LF/HF ratio were determined from Holter recordings. The AF and LF components in patients with diabetes only or diabetes and severe IHD were significantly lower than in control group, but the HF component was significantly lower only in the group of patients with diabetes and severe IHD. The LF/HF ratio did not differ significantly among the 4 groups, but was the lowest in diabetic patients without IHD. Patients with diabetes and mild IHD showed a slight decrease in HRV, but this was not significant. With regard to the circadian rhythm of HRV, the AF and LF components in patients with diabetes-only or diabetes and severe IHD were significantly decreased and showed the same pattern throughout the day. However, the HF component was decreased during more time zones in patients with diabetes and severe IHD, whereas the LF/HF ratio was lower during more time zones in the diabetes-only group. All spectral variables showed a tendency to be inversely related to the duration of diabetes in all diabetic patients. In particular, the LF/HF ratio showed a significant negative correlation. The HRV of diabetic patients was characterized by a decreased LF/HF ratio. It was concluded that, although HRV in diabetic patients with severe IHD was reduced mainly as a result of diabetic neuropathy, this was also partly due to a decline in parasympathetic tone as a result of myocardial injury.
The temporal relation between the luteinizing hormone (LH) surge and the occurrence of two components of sexual behavior was investigated in female goats. Behavior observation and blood sampling were carried out every 2-6 hr from 26 hr before through 116 hr after prostaglandin (PG) administration which was given to induce luteolysis during the mid-luteal phase. The preovulatory LH surge appeared 30-100 hr after PG injection, and it continued for 6.5 +/- 0.4 hr. Although the interval from PG injection to the onset of the LH surge differed considerably among individuals, the proceptivity (defined as an approach to a male with vigorous tail-swishing) and the receptivity (defined as an acceptance of male's mounting or copulation) occurred well synchronized with the LH surge in each female. The proceptivity and receptivity were observed from -7.4 +/- 1.7 hr to 16.8 +/- 1.5 hr and from -2.6 +/- 1.6 hr to 13.0 +/- 2.0 hr, respectively, with regard to the LH surge onset (0 hr). Thus the proceptivity appeared first and lasted longest, and the receptivity was always seen around the time of the LH surge suggesting an existence of causal relationship between these two preovulatory events. The present results support the view that the female goat has evolved an efficient behavioral strategy such that it actively attracts males before it becomes fully receptive of male's approach to mate, when the LH surge occurs simultaneously to ensure a high conception rate at the subsequent ovulation.
The prevalence of Parkinson's disease (PD) was investigated in Hokkaido, the northernmost island of Japan. A pilot case-finding study was carried out to estimate the prevalence in the entire island of Hokkaido (population = 5,643,647) initially, then we surveyed the prevalence at one of the smaller cities, Iwamizawa City (population = 80,417). We ascertained 5,342 cases with PD in Hokkaido and 77 cases in Iwamizawa City, estimating the crude prevalence of 94.7/100,000 in Hokkaido (June 30, 1993) and 95.8/100,000 in Iwamizawa City (April 1, 1994), respectively. We calculated that the crude prevalence rate of PD in Japan in currently close to 100/100,000, but the age-adjusted prevalence is still low, compared with those in Europe and North America.
A case control study was carried out in order to evaluate the various factors which may influence the occurrence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a skilled nursing home. From April 1991 to March 1994, bacterial cultures were performed in 55 out of 102 residents in a nursing home based on various clinical aspects. We divided 102 residents into following three groups; (1) the MRSA group (n = 10), residents whose materials for bacterial culture were positive for MRSA, (2) the non-MRSA group (n = 45), residents whose specimens were negative for MRSA but positive for other bacteria, (3) the control group (n = 47), residents who did not have to undergo a bacterial culture because they were free from moderate and severe infectious diseases. Compared with the control group, the activities of daily living score and the serum albumin level were significantly lower in the MRSA group and the non-MRSA group at the beginning of the study. In contrast, the number of antibiotics used prior to the bacterial culture and the proportion of hospitalization within 6 months prior to the bacterial culture were significantly larger in the MRSA group than in either the non-MRSA group, or the control group. These results thus suggest that a low activities of daily living score, the use of many kinds of antibiotics and a recent previous hospitalization may be risk factors of MRSA infection in a nursing home environment.
"Genroku-Sekenbanashi-Fubunshu" consists of eleven volumes and was written from 1694 to 1703, in the Edo Period. The original book was kept at the Faculty of Literature, Tokyo University. In 1994, this book was first published as one of the Iwanami-Bunko Series. I studied the tales recorded in this book and found that twenty-seven of them were concerned with medical and pharmaceutial sciences. In these medical and pharmaceutical tales, there were several kinds, relating to such matters as spells to cure or prevent illness, curious sicknesses, episodes regarding the origin of remedies, medicinal plants and crude drugs, medical books, doctors and surgeons, persons who lived long, and so forth. It was difficult to explain about the spells which were thought effective to cure illness, but I could gain an understanding that Japanese people lived such lives in the old days.
Crigler-Najjar syndrome is a rare inherited deficiency of bilirubin uridine diphosphate glucuronyl transferase, characterised by lifelong unconjugated hyperbilirubinemia. We report anesthetic and postoperative management of a patient with this syndrome. A 64-yr-old man with Crigler-Najjar syndrome type II underwent cholecystectomy. Preoperative laboratory values included total bilirubin 8.4 mg.dl-1 and direct-bilirubin 1.8 mg.dl-1. He received epidural anesthesia combined with general anesthesia with nitorous oxide and isoflurane. He had no remarkable perioperative complications.
We report a 19-year-old woman with the associated disorders of generalized pruritus, hypertrichosis and anorexia nervosa, all of which had been present for approximately 4 months. Psychotherapy induced both weight gain and resolution of the pruritus. We propose that anorexia-associated pruritus be considered one of the important cutaneous signs in anorexia nervosa.
A 28-year-old man presented with a bilateral visual loss of acute onset, and was diagnosed as having optic neuropathy by an ophthalmologist. It disappeared spontaneously within 2 months. A visual loss at the left side relapsed ten months later, followed by a dysarthria, horizontal defective saccade, ataxia, and mild weakness of four extremities, which also subsided within one month only by multi-vitamin therapy. These signs recurred episodically with characteristic clinical features of dysarthria, horizontal ophthalmoplegia, defective saccade, ataxia, and weakness, during the next year. Clinical features mimicked those of various neurological disorders, especially multiple sclerosis, Wernicke encephalopathy, brainstem encephalitis, Fisher syndrome, disorders of amino acid metabolism and episodic ataxia. Tablets of bromvalerylurea were incidentally found at the bedside and bromides were detected in his sera. Drugs containing bromides are now easily available without prescription, so we should keep the intoxications of those drugs in mind in facing undiagnosed patients with various episodic neurological symptoms.
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We report MRI changes in a spontaneous intracranial hypotension(SIH). The patient was 29-year-old woman, who developed headaches in upright position, nausea, and vomiting preceded by pressure feeling of ears. Neurological examination was unremarkable except for hyperreflexia in the lower extremities. Lumbar punctures revealed very low opening pressure, a mild elevated CSF protein and a mild pleocytosis. No evidence of underlying systemic or neoplastic diseases was noted. The brain and cervical MRI showed diffuse and continuous pachymeningeal enhancement with gadolinium. Her symptoms gradually improved within two months without any treatment, and follow-up MRI showed resolution of the abnormalities within five months. The dural enhancement with gadolinium seen in the SIH should be kept in mind in case of hypertrophic pachymeningitis of unknown etiology, and be differentiated from such diseases as hypertrophic pachymeningitis associated with infectious, neoplastic diseases or sarcoidosis.
UNLABELLED: Endoscopic therapy of gastric cancer has been mainly performed to early cancer of nonresectable cases, for example patients having severe complications, high aged group and patients refusing the operation. Recently, endoscopic mucosal resection (EMR) made it possible to do radical resection for small gastric cancer of resectable cases. 112 patients of small cancers which diagnosed as a cancer limited to the mucosa were investigated. Indication to perform EMR instead of surgery were determined pathologically as follows, 1. depressed type of cancer not accompanying with converging folds measuring 1 cm or less in size, 2. elevated type of cancer measuring 2 cm or less in size, 3. differentiated type of carcinomas. According to those indications, 112 cases with 129 lesions of early gastric cancer were resected. The incision procedure consisted in EMR using two-channel fiberscope, a large chating forceps and a snare, the tissue being ablated with a high frequency electrical current. 2-6 ml of phisocal saline was locally infused at the submucosal level before resection to do it safely. RESULTS: Relationship between the prognosis and the histological distance from the edge of the specimen to the margin of the cancer were discussed. All of 81 cases having the distance more than 2 mm, it's called 'complete radical resection', were not recurrent, on the other hand 4 of 24 cases having the distance less than 2 mm, called 'incomplete radical resection', were recurrent at the site of resection and 12 of 24 cases obviously cancer spread to the edge of the specimen, called 'non-radical resection', were recognized the recurrence. conclusion, 1) On endoscopical resection for small gastric cancer, the distance more than 2 mm between the edge of the specimen and the margin of the cancer was necessary to get a complete radical resection. 2) Technical and mechanical problems still remained at the case of the cancer located in the angular region and gastric body.
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The concentration-dependent effects of copper acting either as an antioxidant or as a prooxidant were examined in vitro using Tween 20-induced hemolysis. When cupric ion concentration was more than 10 microM, free copper(II) acted as a prooxidant; both extensive hemolysis and production of unknown thiobarbituric acid-reactive substance occurred in hamster and pig erythrocytes irrespective of vitamin E status. However, when cupric ion concentration was 2-4 microM in the incubation medium, copper showed a clear antioxidant activity, reducing both hemolysis and malondialdehyde production induced either by diluted peroxide-containing Tween 20 with ascorbic acid and sodium azide in vitamin E-deficient hamster erythrocytes, or by peroxide-containing Tween 20 in pig erythrocytes containing marginal amounts of vitamin E. Copper(II) is taken up by the erythrocytes, where copper(I)-complexes may contribute to the protection of cells with membrane vitamin E against oxidative radical attack.
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Serum levels of hydroxylysyl pyridinoline and lysyl pyridinoline were quantified in uremic patients undergoing maintenance hemodialysis and in healthy subjects. Pre-hemodialysis serum levels of hydroxylysyl pyridinoline and lysyl pyridinoline in the hemodialyzed patients were significantly higher than those in healthy subjects. Serum levels of hydroxylysyl pyridinoline and lysyl pyridinoline decreased significantly after hemodialysis with reduction rates of about 40%. Pre-hemodialysis serum levels of hydroxylysyl pyridinoline and lysyl pyridinoline correlated significantly with intact parathyroid hormone, osteocalcin and bone-specific alkaline phosphatase. Lysyl pyridinoline showed better correlations with these parameters than hydroxylysyl pyridinoline. Parathyroidectomy markedly decreased serum levels of hydroxylysyl pyridinoline and lysyl pyridinoline. These results indicate that serum pyridinolines, especially lysyl pyridinoline, may be used as specific biochemical markers of bone resorption in hemodialyzed patients.
A rare case of ovarian mucinous cystadenocarcinoma with sarcoma-like mural nodules is reported. Macroscopically, nodular or granular lesions were scattered over the inner surface of a huge, multilocular tumor in the left ovary. The histopathological features were consistent with those of previously documented cases, except significant squamous metaplasia in the present case. The pleomorphic sarcoma-like cells showed a positive reaction for vimentin and alpha-antichymotrypsin but were negative for carcinoembryonic antigen and common epithelial membrane antigen by immunohistochemistry. Electron microscopically, the tumor cells had neither desmosomes nor secretory granules, but they possessed abundant intermediate filaments. Both immunostaining and ultrastructure suggested that the sarcoma-like nodules were derived from reactive proliferation of fibrohistiocytic cells. The fibrohistiocytic reaction seemed to occur in response to hemorrhage, because hemorrhage was reported to be associated with the mural nodules in most of the previous cases as well as ours.