Role of Fas-Fas ligand interaction in donor-specific transfusion-induced tolerance to H-Y antigen.
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Animals↗
Biomedical subjects
T Iwai
Publications and source records attributed to T Iwai.
Endoscopic mucosal resection using a cap: techniques for use and preventing perforation.
Endoscopic mucosal resection (EMR) is one of several local treatments that provide a specimen for histopathological analysis. The authors developed a technique of EMR using a transparent plastic cap (EMRC) in 1992. By using the EMRC procedure, any part of the gastrointestinal tract mucosa can be easily accessed. The technical details of EMRC are described. The authors have performed EMR in 380 cases of gastrointestinal lesions. The most serious complication may be perforation. Two perforations (one in the esophagus and one in the colon) have occurred. By evaluating recorded videotapes, it was determined that the lack of submucosal saline injection was the major cause. Therefore, large volume injection, which creates a large bleb and potentially reduces the risk of perforation, is recommended. Furthermore, target mucosa should be strangulated at the middle part of the created bleb (never strangulated at the base). Particularly in the colon, injecting a sufficient volume of saline and controlling the power of suction are extremely important, because the cap on the colonoscope is relatively large in size.
Digestive System Surgical Procedures↗
Image-navigated endoscopic surgery: introduction of the face-mounted display system with picture-in-picture capabilities.
BACKGROUND/AIMS: The face-mounted display system with picture-in-picture capabilities was evaluated for clinical usefulness in endoscopic surgery. METHODOLOGY: The device mounts two crystal liquid color panels, being shaped like a pair of glasses. It can provide us with an ultra-large virtual screen of the endoscopic view. Furthermore, a picture-in-picture capability can materialize a multi-image environment. Twenty-five patients were enrolled in this study. RESULTS: The view obtained by the surgeon consisted of the FMD screen of the upper two-thirds and the direct view of the lower one-third. The surgeon could concentrate more on the procedure, because he could face the target organ regardless of the display position. No complications attributable to the device were encountered. With a multi-image environment, endoscopic procedure was executed without taking one's eyes off the operative field. CONCLUSIONS: The face-mounted display system will conduct us to another sphere of endoscopic surgery, i.e., an image-navigated endoscopic surgery.
Cholecystectomy, Laparoscopic↗
Therapeutic strategy for postoperative liver metastasis from esophageal squamous cell carcinoma; clinical efficacy of and problem with hepatic arterial infusion chemotherapy.
BACKGROUND/AIMS: Despite recent advances in diagnosis and treatment, the prognosis for esophageal squamous cell carcinoma is unsatisfactory. Liver recurrence is frequent in postoperative esophageal squamous cell carcinoma patients, and the prognosis for patients with liver metastasis is poor. This report concerns the therapeutic strategy, especially the efficacy of and the problem with hepatic arterial infusion chemotherapy for liver metastasis from esophageal squamous cell carcinoma. METHODOLOGY: We performed a retrospective analysis of 8 patients who underwent hepatic arterial infusion between 1993 and 1998. All patients underwent esophagectomy and reconstruction with stomach roll without preoperative chemotherapy and/or radiotherapy. For 6 patients, preceding systemic chemotherapy was performed before hepatic arterial infusion. RESULTS: The overall response rate of hepatic arterial infusion was 50%, and for the responders, hepatic arterial infusion provided a good quality of life. Hepatic arterial infusion was effective for responders to preceding systemic chemotherapy, but ineffective for non-responders. A complete response was seen in 2 patients, and the liver tumors showed no re-growth after the completion of hepatic arterial infusion. Two patients developed stomach roll ulcers and one experienced the catheter thrombosis, but there were no instances of severe toxicity or complications. CONCLUSIONS: For postoperative liver recurrence of esophageal squamous cell carcinoma, hepatic arterial infusion is the favorable therapy in terms of efficacy and low-grade toxicity, but has a risk of causing severe complications. We consider it suitable that when preceding systemic chemotherapy is performed before hepatic arterial infusion, hepatic arterial infusion is performed in responders to preceding systemic chemotherapy, and that hepatic arterial infusion is continued as long as possible.
Aged↗
Influence of long-term arotinolol treatment on myocardial mechanics and ventricular myosin isoenzymes in spontaneously hypertensive rats.
Alterations in myocardial mechanics and left ventricular myosin isoenzymes by long-term treatment of hypertension with arotinolol were examined in spontaneously hypertensive rats. Approximately 20 mg/kg/day arotinolol was administered to 22-week-old male spontaneously hypertensive rats for 8-10 weeks. There was no significant difference in systolic blood pressure between arotinolol-treated and untreated rats. However, ventricular weight tended to decrease in the arotinolol-treated group, although not significantly. There were no significant differences in isometric developed tension and dT/dtmax of isolated left ventricular papillary muscles between the arotinolol-treated and untreated groups. The left ventricular myosin isoenzyme pattern, on the other hand, obtained by pyrophosphate gel electrophoresis, showed a significant shift toward VM-1 as a result of long-term arotinolol treatment.
Adrenergic beta-Antagonists↗
Effects of bunazosin on plasma glucose levels in hypertensive diabetic patients.
Twenty-nine hypertensive diabetic patients received 1.5 to 4.0 mg of bunazosin daily for three months. Both systolic and diastolic blood pressures were significantly reduced by the bunazosin treatment, while heart rate was unchanged. No significant changes were noted in fasting plasma glucose levels or in levels of hemoglobin A1c. Serum lipid levels remained unchanged during treatment. It is concluded that bunazosin does not adversely affect glucose metabolism or increase serum lipid levels in hypertensive diabetic patients.
Adrenergic alpha-Antagonists↗
Residual contamination of toothbrushes by microorganisms.
Procedures for maintaining the cleanliness of oral cleaning instruments have been discussed infrequently. S. mutans and pathogenic microorganisms can be transferred readily when a toothbrush is used, increasing the risk of dental caries and infectious diseases. It is suggested that sterilization equipment or specific detergents be used.
Bacteria↗
A new treatment for ischemic ulcers: foot bath therapy using high oxygen soluble fluid.
We devised a new treatment for ischemic ulcer in which the diseased foot is soaked in perfluorodecalin, a fluorocarbon. Pure oxygen bubbles emerge from the perfluorodecalin, and dissolved oxygen levels reach 35% by volume within 60 minutes. The solution is placed in a bath once or twice a day for 2-3 hours and pure oxygen is allowed to bubble through it (3-5 1/min). Nine patients were treated by this technique. Drugs which seemed to have an effect on ischemic ulcers were not used during the treatment. Ischemic ulcers in three patients (5 X 5 mm, 23 X 6 mm and 10 X 5 mm) healed completely within two weeks and there were no recurrences. In six patients, the ulcers showed 30-70% reductions in size within 4 to 14 days. Four of them later underwent arterial reconstruction, which resulted in complete healing of the ulcers. In two patients, the ulcers reverted to their former size 6 to 12 months after the cessation of perfluorodecalin bath therapy.
Adult↗
Fibromuscular dysplasia in the extremities.
Four patients had fibromuscular dysplasia of the extremities involving the brachial, deep femoral, popliteal, anterior and posterior tibial and peroneal arteries. One of them demonstrated a string-of-beads appearance in the superficial veins of the arm and this was pathologically confirmed as fibromuscular dysplasia. We believe this is the first report of this disease affecting the peripheral arteries and the superficial veins of the extremities. The sympathetic system seems to be related to the development of fibromuscular dysplasia.
Arterial Occlusive Diseases↗
Experimental and clinical studies of the inverted autogenous vein grafts.
The vein was inverted (inside-out) and used as a new arterial substitute. Experimental study showed more than 90% patency rate and clinical experiences were satisfactory. Autogenous inverted vein grafting is a safe procedure and should be considered another way to widen the indication of the vein.
Aged↗
Diagnostic and pathological considerations in the popliteal artery entrapment syndrome.
Four cases of the popliteal artery entrapment syndrome including two with bilateral lesions are reported. All limbs of these patients showed classical arterial entrapment due to the anomalous course of the popliteal artery in relation to the medial head of the gastrocnemius muscle. All cases were diagnosed preoperatively, and computed tomography demonstrated apparent separation of the popliteal artery and vein at the site of the insertion of the gastrocnemius muscle. All patients complained of gradually progressive intermittent claudication except for one who revealed acute leg ischemia following long periods of driving and Japanese-style sitting. Surgical treatment resulted in complete recovery in all limbs. Pathological characteristics in the popliteal artery were: (1) the presence of longitudinal smooth muscle bundles in the medial coat adjacent to the gastrocnemius muscle, and (2) intimal thickening and/or thrombus formation adjacent to the medial condyle of the femur.
Adolescent↗
Atherosclerotic abdominal aorta saccular protrusion.
Fourteen saccular abdominal aortic protrusion patients (ages ranged from 55 to 84, mean age 69.1 years) were reported. Their lesions were pathologically or bacteriologically suggested to be of atherosclerotic origin. Other origins were eliminated by using the patients past history or physical and diagnostic examination. All patients were classified into 1 of 3 types; solitary, adjacent to fusiform AAA, and independent of fusiform AAA. Diagnosis and surgical techniques were complicated when coexisting with a fusiform abdominal aortic aneurysm (AAA) and located in the AAA neck. The treatment of choice for 13 patients was surgery. Postoperatively two patients died of hepatic failure at 5 weeks, and from apoplexia at four months, after surgery, respectively. The remaining patients' prognosis is good after a 3-month to 6-year follow-up with a mean period of 2.9 years except 1 medically treated patient. Accordingly, atherosclerotic abdominal aorta saccular protrusion should be carefully diagnosed and be surgically treated in the usual AAA manner. Only juxtarenal saccular protrusions require careful reconstruction, preserving the renal or visceral function.
Aged↗
K+ channel-opening action contributes to the preventive effects of nicorandil on U46619-induced vasoconstriction of canine large coronary arteries in vivo.
The antispasmogenic effects of nicorandil on epicardial coronary artery vasoconstriction were compared with those of a K+ channel opener, cromakalim, and a nitrovasodilator, nitroglycerin, in open-chest dogs. Intracoronary administration of U46619 (0.5-1.0 micrograms), a stable thromboxane A2 analogue, reduced the external diameter of the left circumflex coronary artery with no marked alternations in systemic hemodynamics. This U46619-induced vasoconstriction of large epicardial coronary arteries was dose-dependently prevented by the intracoronary infusion of nicorandil (1-10 micrograms/kg/min), cromakalim (0.03 micrograms/kg/min) and nitroglycerin (1 micrograms/kg/min). After pretreatment with glibenclamide (3 mg/kg, i.v.), and ATP-sensitive K+ channel blocker, these effects of nicorandil and cromakalim were inhibited significantly, whereas the response to nitroglycerin remained unchanged. Nicorandil (3 micrograms/kg/min), cromakalim (0.03 micrograms/kg/min) and nitroglycerin (1 micrograms/kg/min) increased coronary blood flow. However, the inhibitory effects of each drug on the U46619-induced vasoconstriction were not influenced by the partial occlusion of the left circumflex coronary artery, which kept coronary blood flow constant. This indicates a direct antispasmogenic effect of K+ channel openers, which is independent of that mediated by the response to flow. Furthermore, our results suggest that, by this effect, nicorandil protects large coronary arteries from U46619-induced vasoconstriction.
15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗