Hematometra and ruptured hematosalpinx with ipsilateral renal agenesis presenting as diffuse peritonitis: a case report.
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Abdomen, Acute↗
Biomedical subjects
T Kasai
Publications and source records attributed to T Kasai.
[Useful treatment modality for postoperative duodenal fistula with somatostatin analogue].
A case with leakage of duodenal stump treated by a somatostatin analogue (SMS 201-995,SMS) effectively was reported. A 39-year-old man had underwent gastric resection (Billroth I) and distal pancreaticojejunostomy for transsection of duodenal bulbus and pancreatic body. After 14 days later duodenal diverticulization was performed due to anastomotic stricture of the gastro-duodenostomy, which resulted in leakage of duodenal stump and voluminous fluids from drains were lasting about 5 weeks. Amylase (AMY) value was shown as high as 703,812 U/l in the exudate. SMS was injected by 100 micrograms, s, c, by three times a day for 24 days. The volume of exudate decreased immediately after the administration of SMS and to one-half in volume in 2 weeks. AMY also fell to 42, 378 U/l. The drain was removed two months after the third surgery. The patient was discharged on post operative day 200. SMS was known to inhibit secretion of bile and intestinal as well as pancreatic juice and its usefulness for leakage of the intestinal tract, especially of the duodenum, is suggested.
Accidents, Traffic↗
Models of HTLV-I-induced diseases. Infectious transmission of HTLV-I in inbred rats and HTVL-I env-pX transgenic rats.
To examine the pathogenic roles of HTLV-I in HTLV-I-induced diseases, we developed two models; namely HTLV-I carrier rats and HTLV-I env-pX transgenic rats. Among life long HTLV-I carriers in seven rat strains, only WKAH rats with the RT1k haplotype developed chronic progressive myeloneuropathy, resembling HAM/TSP clinically and histologically in humans, designated as HAM rat disease and after long incubation periods. Apoptosis of myelin forming cells, oligodendrocytes and Schwann cells associated with HTLV-I infection appears to be the primary cause of HAM rat disease. Local activation of the pX gene and TNF alpha gene was evident in these rats. WKAH rats transgenic for HTLV-I env-pX gene were established and at age 5 weeks, swelling of the bilateral ankle joints began to develop and histological features of the affected joints resembled findings in cases of rheumatoid arthritis (RA): high-titers of rheumatoid factors were present in these rats. A series of vascular collagen diseases such as polyarteritis nodosa-like angiitis, polymyositis, myocarditis, and Sjögren's syndrome-like sialodenitis together with RA were present, even in one individual animal. These transgenic rats as well as HAM rats appear to be suitable animal models for elucidating pathogenic mechanisms implicated in HTLV-I-induced diseases and also various demyelinating vascular collagen diseases of unknown etiology.
Animals↗
HTLV-I induced myeloneuropathy in WKAH rats: apoptosis and local activation of the HTLV-I pX and TNF-alpha genes implicated in the pathogenesis.
To investigate the pathogenesis of HTLV-I associated diseases, we established a rat model for HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) in WKAH rats. In the spinal cords of WKAH rats carrying HTLV-I, chronological histopathology revealed the occurrence of apoptotic cell death starting at 9 months after the infection, followed by demyelination, macrophage infiltration, and the activation of astrocytes starting at 12, 15 and 20 months, respectively. Apoptosis of the Schwann cells was also observed in the peripheral nerves of these rats. By RT-PCR, pX mRNA of HTLV-I was selectively expressed in the diseased spinal cords and peripheral nerves, but not in the unaffected cerebra, cerebella, even though provirus DNAs were consistently identified in these tissues. Among several cytokines examined, mRNA expression and production of TNF-alpha were frequently detected in the spinal cord and the cerebrospinal fluid. The collective evidence suggests that the selective activation of HTLV-I, in particular Tax expression, and/or the production of TNF-alpha in target spinal cord and peripheral nerves are causally related to apoptotic death of the oligodendrocytes and Schwann cells, a major pathogenetic pathway of HTLV-I induced myeloneuropathy in the WKAH rat.
Animals↗
Anti-inflammatory cytokine levels in patients with septic shock.
We measured the plasma levels of anti-inflammatory cytokines, including interleukin 1 receptor antagonist (IL-1ra), IL-4 and IL-10; inflammatory cytokines, including IL-2, IL-6, IL-8 and tumor necrosis factor receptor I and II (TNFR I and TNFR II); and endotoxin in 11 patients with septic shock associated with gram-negative bacteria and 12 patients with sepsis not associated with shock. The plasma levels of IL-1ra and IL-10 were elevated in the septic shock group compared with the sepsis group. TNFR I and TNFR II levels tend to be higher in the septic shock group. The plasma level of TRNF-alpha was significantly correlated with levels of IL-1ra, IL-4, IL-10, TNFR I, and TNFR II. The elevated levels of the anti-inflammatory cytokines, TNFR I, and TNFR II, appeared to reflect an attempt to suppress the shock syndrome.
Adult↗
Assessment of inflammatory cytokines, nitrate/nitrite, type II phospholipase A2, and soluble adhesion molecules in systemic inflammatory response syndrome.
Plasma endotoxin levels, nitrate/nitrite (NOx), type II phospholipase A2 (PLA2), soluble adhesion molecules, and inflammatory cytokines were measured in 34 patients with systemic inflammatory response syndrome (SIRS). Significant correlations were found between NOx values, PLA2 values, soluble adhesion molecules, and inflammatory cytokines, suggesting the possibility that these factors were deeply affected each other. When the 34 SIRS patients were divided into the group with sepsis (n = 20) and with the group with trauma without documented infection (n = 14), despite the fact that the difference in APACHE II scores was not significant, all of the factors except endotoxin were significantly higher in the sepsis group than in the trauma group, and the outcome was death in 4 of the 14 patients in the trauma group (28.6%), as opposed to 14 of the 20 patients in the sepsis group (70.0%). The mediator values measured in this study seemed to reflect the difference in the severity of the patients' disease and their outcome.
Adult↗
Serum levels of pro-gastrin-releasing peptide for follow-up of patients with small cell lung cancer.
To assess the clinical usefulness of serum pro-gastrin-releasing peptide (Pro-GRP) as a tumor marker for small cell lung carcinoma (SCLC), we measured serum levels of Pro-GRP with a newly developed ELISA and measured serum levels of neuron-specific enolase (NSE) in 44 patients with untreated SCLC and 77 patients with untreated non-SCLC. We prospectively measured serum levels of Pro-GRP and NSE in SCLC patients after initial treatment until relapse. The sensitivity (70%) and specificity (91%) of Pro-GRP were similar to those of NSE (70 and 86%). Thirty-nine % of patients who had a partial response still had elevated serum levels of Pro-GRP at the time of restaging after initial treatment. In follow-up study, 94% of patients had elevated serum levels of Pro-GRP again at the time of relapse, whereas 37% of patients showed elevated levels of NSE. Levels of Pro-GRP increased a median of 35 (-95 to 151) days before clinical evidence of relapse was detected with successive physical examinations and imaging studies, whereas levels of NSE increased 20 (-85 to 124) days after relapse was detected (P < 0.05). Pro-GRP was helpful as a diagnostic aid and a marker for therapeutic effect and relapse in patients with SCLC, supplemented to serum NSE.
Adult↗
Growth of the cervical spine with special reference to its lordosis and mobility.
STUDY DESIGN: The cervical spine of the healthy Japanese children aged between 1 year and 18 years was radiographically examined. OBJECTIVES: To examine the correlation between growth of the cervical vertebral body and the facet joint and the development of the cervical lordosis and intervertebral motion. SUMMARY OF BACKGROUND DATA: Although the growth of body height and facet angle have been well documented, their correlation with curvature or mobility has not been elucidated. METHODS: We evaluated plain lateral radiographs of 180 boys and 180 girls regarding diameters and central heights of the cervical vertebra, the anterior and posterior vertebral height ratio, body height index, the facet joint angles, and tilting and sliding motions. Cervical length as the summation of the central height from C3 to C7 and the cervical lordosis angle (C3-C7 angle) were also measured. RESULTS: The mean C3-C7 angle and body height index gradually decreased until 9 years of age and then increased. The C3-C7 angle showed a significant correlation with cervical length, body height index, and facet joint angles before 9 years of age, and with cervical length and body height index after 9 years of age but not with facet joint angles. Facet joint angle decreased until 10 years of age and remained almost unchanged thereafter. Total sliding showed a significant age-related decrease and showed a significant correlation with facet joint angle. CONCLUSION: Although the lordosis angle showed a significant correlation with the other values, cervical length, body height index, and facet joint angle, the determinants of the lordosis could not be elucidate in the present study. As for the mobility of the cervical spine, changes of tilting motion were small, whereas changes of sliding motion were restricted by the change of orientation of the facet joints.
Adolescent↗
Genotoxicity in vivo of phenazine and aminophenazines assayed in the wing spot test and the DNA-repair test with Drosophila melanogaster.
The genotoxicity and DNA-damaging activity of 6 phenazine and aminophenazine derivatives were assayed in the wing spot and DNA-repair tests in Drosophila melanogaster. Phenazine (Pz), and all aminophenazines tested, namely, 1-aminophenazine (APz), 2-APz, 2,3-diaminophenazine (DAPz), 2,7-DAPz and 2,7-diamino-3,8-dimethylphenazine (DADMPz), exhibited mutagenicity significantly in the wing spot test. The activities in the wing spot test were ranked in a sequence DADMPz > (2,7-DAPz, 2,3-DAPz) > (2-APz, 1-APz, Pz). In the DNA-repair test, 2,3-DAPz, 2,7-DAPz, and DADMPz clearly showed DNA-damaging activity, but Pz, 1-APz and 2-APz were inactive. Based on these results, we predict that DADMPz, 2,3-DAPz and 2,7-DAPz are likely to be more carcinogenic than 2-APz, 1-APz or Pz.
Animals↗
Construction of gene expression system in cultured tobacco cells.
To construct a gene expression system in cultured tobacco cells, useful regulatory elements of plant genes were studied. The promoter of the horseradish peroxidase gene, prxC2, showed high activity in tobacco cells, and it contained enhancer sequences and a cis element for wound induction. The heat shock promoter of the HSP18.2 gene from A. thaliana had strong activity of transcription when the incubation temperature of tobacco cells was shifted from 25 degrees C to 37 degrees C. These elements could be good candidates for foreign gene expression in tobacco cells.
Arabidopsis↗
Soleus H-reflex depression induced by ballistic voluntary arm movement in human.
A biomechanical and neurophysiological analysis of anticipatory postural adjustments associated with the early phase of a voluntary arm movement was carried out in normal human subjects. Arm elevation, performed at maximal velocity, was studied with unilateral arm movement in freely and counterbalanced (suspended in a safety harness) standing humans. The ground reaction force of both legs, tangential acceleration of the shank and electromyographic activity (EMG) of the anterior deltoid (AD), biceps femoris (BF) and soleus (Sol) muscles were recorded. Sol H-reflexes of both legs were also elicited. To examine how the Ia inhibitory and presynaptic inhibitory pathways are related to anticipatory postural adjustments, additional Sol H-reflexes were elicited using the classical conditioning-test technique (time interval 2 and 15 ms, respectively). In this study, we systematically described biomechanical and EMG phenomena that precede and follow the onset of voluntary arm movements. Prior to and during the arm movement (i.e. AD activation), a sequence of EMG modifications occurred in ipsilateral BF and Sol muscles. Those modifications preceding BF activation included silent phases in Sol EMG and depression of Sol H-reflexes. By comparing EMG modifications with depressions of the Sol H-reflex, we conclude that Ia and presynaptic inhibitory pathways do not play a specific role in those Sol H-reflex depressions. Moreover, because Sol H-reflex depression occurs in both freely standing and counterbalanced postures, anticipatory postural adjustment appear to be preprogrammed in the central nervous systems unrelated to peripheral neural mechanisms. Since changes of EMG activities of ipsilateral BF and Sol appeared simultaneously and Sol H-reflex depressions were dependent on EMG activities of ipsilateral BF, control commands to anticipatory postural adjustment would excite BF and inhibit Sol.
Adult↗
Increases in calcium absorption with ingestion of soluble dietary fibre, guar-gum hydrolysate, depend on the caecum in partially nephrectomized and normal rats.
Effects of feeding soluble dietary fibre on apparent Ca absorption and the contribution of the caecum to Ca absorption were examined in five-sixths nephrectomized (NPX) and normal rats with or without caecectomy in four experiments. It is known that Ca absorption is lowered by renal failure. In the first experiment the amounts of femur Ca increased linearly with increasing dietary Ca up to 3.0 g Ca/kg diet in intact rats. Partial nephrectomy decreased apparent Ca absorption in rats fed on diets containing 3-0 and 4.5 g Ca/kg diet. In the NPX groups, Ca absorption in rats fed on the diet containing guar-gum hydrolysate (GGH; 50 g/kg diet; 3.0 g Ca/kg diet) was significantly higher than that in rats fed on a fibre-free diet, and the increase in Ca absorption with GGH feeding was completely abolished by caecectomy. Also, ingestion of GGH increased Ca absorption in normal rats, but not in normal, caecectomized rats. Mg absorption was also increased with GGH feeding and was decreased with caecectomy in NPX and normal rats. In experiments which used caecectomized rats, coprophagy was prevented with an anal cup to avoid re-ingestion of faecal Ca. We conclude that ingestion of the soluble dietary fibre, GGH, increased apparent Ca absorption in NPX and non-NPX rats, and the caecum was responsible for these increases in Ca absorption.
Animals↗
Human T lymphocyte virus type I-induced myeloneuropathy in rats: implication of local activation of the pX and tumor necrosis factor-alpha genes in pathogenesis.
The pathogenetic roles of human T lymphocyte virus type I (HTLV-I) and cytokines were investigated in HTLV-I-induced myeloneuropathy in Wistar-King-Aptekman-Hokudai rats. In the nervous system, pX messenger RNAs of HTLV-I were selectively expressed in the diseased spinal cord and peripheral nerves but not in the unaffected cerebrum and cerebellum, even though proviral DNAs were consistently identified in these tissues. Among several cytokines examined, mRNA expression and production of tumor necrosis factor (TNF)-alpha in the spinal cord and cerebrospinal fluid correlated positively with the development of spinal cord lesions. The collective evidence strongly suggests that selective activation of HTLV-I, in particular Tax expression and production of TNF-alpha induced by HTLV-I infection in target spinal cord and peripheral nerves, is causally related to apoptotic death of oligodendrocytes and Schwann cells, a major pathogenetic pathway of the HTLV-I-induced myeloneuropathy.
Animals↗
Oxidized ethyl linoleate induces mucosal hypertrophy of the large intestine and affects cecal fermentation of dietary fiber in rats.
Oxidized ethyl linoleate (OEL) was prepared by aeration at low temperature. Peroxide value (POV, mEq/kg lipid) of OEL was 1400; the major oxidized compounds were 9-hydroperoxy-cis, trans- and 13-hydroperoxy-trans, cis-octadecadienoate. Rats fed fiber-free or sugar-beet fiber (SBF, 100g/kg diet) diets were divided into three groups for each diet, and administered OEL (high OEL group), OEL diluted with ethyl linoleate (low OEL group, POV 700) and nonoxidized ethyl linoleate (EL group) through gastric tubes each day at 1400-1600 h (2.5 g/kg body wt) for 16 d. The relative wet weight, and DNA and protein contents of the cecal mucosa were higher in the high OEL groups than in the low OEL and EL groups in rats fed the fiber-free diet and in rats fed the SBF diet except for mucosal protein content. Spermidine concentration in cecal mucosa of rats fed the fiber-free diet was greater in the high OEL group than in the EL group. These results suggest that metabolism related to mucosal proliferation of the cecum was affected by the high dose of OEL. The total short-chain fatty acid (SCFA) concentration in the cecal contents of SBF-fed rats was 100% higher than the concentration in rats fed the fiber-free diet in the EL group, but the administration of low dose and high dose OEL lowered the SCFA concentration in fiber-fed rats to that of rats fed the fiber-free diet. Butyric acid concentration was markedly lowered by ingestion of OEL in a dose-dependent manner in rats fed the SBF diet. In contrast, the isobutyric acid concentration was higher in the OEL-treated groups than in the EL groups. We conclude that a low dose of OEL depresses cecal fermentation of dietary fiber with changes in SCFA composition, and that a high dose of OEL induces mucosal hypertrophy in the cecum. These data show that dietary oxidized lipids affect cecal metabolism and may be associated with colon cancer.
Animals↗
Oral supplementation with branched-chain amino acids improves transthyretin turnover in rats with carbon tetrachloride-induced liver cirrhosis.
The hypothesis that dietary branched-chain amino acid (BCAA) supplementation improves the impaired protein turnover in male Donryu rats with carbon tetrachloride-induced liver cirrhosis was tested. We supplemented cirrhotic rats orally for 2 wk with BCAA solution [26.67 mg BCAA/(100 g body weight . d)], a conventional amino acid mixture [4.25 mg BCAA/(100 g body weight . d)] or saline and fed these three groups the AIN76 basal diet to have similar intakes of total energy and total nitrogen. Normal rats without liver cirrhosis were fed the basal diet similar to the above (noncirrhotic controls). After supplementation, rats were fed intravenous transthyretin (thyroxine-binding prealbumin) doubly labeled with 125I-tyramine-cellobiose and 131I. Kinetic indices including production rate of transthyretin were analyzed from plasma transthyretin disappearance curves. Tissue sites of transthyretin degradation were assayed using a trapped ligand technique by measuring 125I-tyramine-cellobiose levels. The production rate of transthyretin was significantly lower in cirrhotic rats supplemented with saline (mean 25.46 X 10(-3) . h(-1)) compared with noncirrhotic controls (45.08 X 10(-3) . h(-1)) (P < 0.05). This was corrected by supplementing cirrhotic rats with BCAA (37.05 X 10(-3) . h(-1), P < 0.05) but not with conventional amino acid mixture (22.49 X 10(-3) . h(-1)). The accelerated degradation of transthyretin in muscles of cirrhotic rats was improved by BCAA (P < 0.05). In conclusion, dietary supplementation with BCAA improves the impaired transthyretin turnover in rats with liver cirrhosis.
Administration, Oral↗
Retrospective analysis of the treatment of patients with small cell lung cancer showing poor performance status.
To assess the feasibility of treatments for patients with small cell lung cancer (SCLC) showing a poor performance status (PS, Eastern Cooperative Oncology Group; ECOG 3 or 4), we retrospectively reviewed the outcome for 13 SCLC patients showing poor PS treated at the National Cancer Center Hospital between January 1984 and May 1994. The main factors which contributed to poor prognosis were superior vena cava (SVC) syndrome, massive pleural effusion, tracheal stenosis due to lymph node swelling, pericardial effusion and pulmonary fibrosis (causing dyspnea in combination), brain metastasis resulting in neurological disturbance, cachexia, Eaton-Lambert syndrome causing muscle weakness, retroperitoneal lymph node metastasis causing abdominal pain, peritoneal effusion due to abdominal lymph node swelling, vertebral metastasis causing paraplegia, and dermatomyositis/polymyositis (DM/PM) causing muscle weakness. All of the patients received chemotherapy with or without radiotherapy. The PS of 8 patients improved with treatment, but no improvement was seen in 5. We analyzed these 13 patients and considered the treatments for those with poor PS. Chemo-radiotherapy was tolerable in SCLC patients showing PS 3, and improved their PS if severe conditions or combined disease did not arise concurrently. It was further suggested that PS 4 patients with severe conditions or combined disease should not be given the treatments.
Adult↗
Epstein-Barr virus-associated gastric carcinoma.
Epstein-Barr virus (EBV) is associated with certain types of gastric carcinoma. We report a case of EBV-positive undifferentiated carcinoma of the stomach in a 59-year-old woman with a well-demarcated ulcerating tumor in the gastric body. Examination of the resected stomach revealed that the tumor was undifferentiated carcinoma with lymphoid stroma, or lymphoepithelioma-like carcinoma. Tumor cells were positive for EBV by in situ hybridization. Gastroenterologists must keep in mind that localized ulcerating tumors of the stomach histologically seen as undifferentiated carcinnoma with lymphoid stroma are linked to EBV infection.
Carcinoma↗
Mucinous cystadenocarcinoma with sarcoma-like mural nodules arising in a mature cystic teratoma of the ovary: a case report.
Almost all cases with malignant transformation of a mature cystic teratoma of the ovary have been reported to be associated with squamous cell carcinoma. We describe a very rare case of mucinous cystadenocarcinoma with sarcoma-like mural nodules arising in an ovarian teratoma.
Antineoplastic Combined Chemotherapy Protocols↗