Search PubMed⌕ Search

Biomedical subjects

T Kashiwagi

Publications and source records attributed to T Kashiwagi.

At least 73 records · Page 4Linked to original sources

Psychosocial and spiritual issues in terminal care.

The author has been working as a psychiatrist over the past 30 years, engaging in clinical work and in research. During his career as a psychiatrist the author began to develop a special interest in terminal care. This led to additional study in a residency program in internal medicine and oncology, and culminated in the establishment of a hospice in 1984. Through this close association with hospice patients the author has experienced approximately 2000 deaths over the past 10 years. These experiences have reinforced in his mind the viewpoints that people die as a whole person.

Aged↗

Angiomyxoid tumour in the renal peripelvic tissues with features of aggressive angiomyxoma.

A case of angiomyxoid tumour in the renal peripelvic soft tissue of a 45 year old woman is reported. The encapsulated tumour, measuring 12 x 9 x 6 cm, was solid and firm. The cut surface revealed a yellowish-white, gelatinous, and glistening tumour. Histologically, the tumour was composed of loosely textured spindle and stellate cells with prominent blood vessels of variable calibre. The tumour cells stained strongly for vimentin. These findings strongly resemble those associated with aggressive angiomyxoma in the vulva and perineum.

Female↗

[A technique for removal of entrapped intra-aortic balloon catheter through the left axillary artery].

A case of intra-aortic balloon pumping (IABP) entrapment in which the ruptured catheter could be removed through the left axillary artery was reported. A 68-year-old man was admitted with persistent chest pain, and because of his poor cardiac condition, an IAB catheter was inserted by the Seldinger technique. During attempted extraction of the IAB catheter resistance was encountered and it turned out to be entrapped. Then a guide-wire was passed through the IAB lumen to the left axillary artery, the artery was exposed, and the tip of the guide-wire and IAB catheter were led to the arteriotomy site. After the balloon was dissected, the IAB catheter could be removed through the axillary artery. Finally, left femoro-left branchial artery bypass was performed with e-PTFE graft because of the arterial injury and ischemia of the involved arm. The patient recovered from this episode.

Aged↗

Endothelin-1 is involved in the pathogenesis of ischemia/reperfusion liver injury by hepatic microcirculatory disturbances.

Hepatic microcirculatory perturbation is observed after ischemia/reperfusion. Endothelin-1, a potent vasoconstrictive peptide, is known to modulate local circulation. This study was designed to examine whether endothelin-1 participates in the mechanism of microcirculatory disturbance and damage of the liver after ischemia/reperfusion. Ischemia in the median and left lateral lobes of the liver was induced for 60 min; it was followed by reperfusion for 24 hr. In some rats, endothelin-1 antiserum or control serum without endothelin-1-blocking activity was administered intravenously just before reperfusion. Rats were divided into three groups: an ischemia/reperfusion group that was injected with control serum, an endothelin-1 antiserum-treated group and a sham-operated group. Endothelin-1 concentrations in blood collected from the suprahepatic vena cava were measured before and after ischemia/reperfusion by use of a sandwich enzyme immunoassay. Index of blood volume in regional hepatic tissue and index of blood oxygenation in regional hepatic tissue were assessed with an organ reflectance spectrophotometry system before and at 5 min and 1, 2, and 24 hr after reperfusion. The endothelin-1 concentration in the ischemia/reperfusion group started to rise immediately at onset of reperfusion from basal values around 1 pg/ml and reached a value of 5 to 6 pg/ml 5 min after reperfusion; it was maintained at significantly high levels during the reperfusion period compared with the sham-operated group. Hepatic microcirculatory disturbance indicated by lowered index of blood volume in regional hepatic tissue and index of blood oxygenation in regional hepatic tissue levels was observed in the early phase of reperfusion in the ischemia/reperfusion group.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine Transaminase↗

Jargonagraphia in Kanji and Kana in a Japanese crossed Wernicke's aphasic.

A right-handed Japanese crossed Wernicke's aphasic showed complete neologistic jargonagraphia in kanji and kana with anosognosia of his writing deficits. Prominent jargonagraphia in kanji is quite rare and has not been previously described in the literature. Marked dissociation between speaking and writing during the course suggested that his jargonagraphia might be unique to crossed aphasia. His condition was interpreted for the main part by Yokoyama, Okubo, Doseki, and Yamadori's hypothesis (1981) that free-running on of motor engrams of characters stored in the left hemisphere caused jargonagraphia in crossed aphasia. This case of jargonagraphia in kanji suggests that this hypothesis should be supplemented by the following points: (1) in kanji, not necessarily a character as a whole, but radicals or parts of radicals, function as motor units, which may be released to produce jargonagraphia in kanji; (2) free-running on of visual images as well as of kinesthetic images should be considered especially in written jargon in kanji.

Activities of Daily Living↗

Impaired gastric mucosal energy metabolism in congestive gastropathy in cirrhotic patients.

To clarify the characteristics of congestive gastropathy, we investigated gastric mucosal hemodynamics and energy metabolism in cirrhotic patients, using a reflectance spectrophotometry system and high performance liquid chromatography. The index of the gastric mucosal blood volume of cirrhotic patients with esophageal varices was significantly higher, and the index of gastric mucosal blood oxygenation significantly lower, than those in controls, thus indicating congestion and hypoxia in the gastric mucosa. Energy charge levels in the gastric mucosa of cirrhotic patients with esophageal varices were also significantly decreased. The energy charge level showed a strong linear correlation with the index of mucosal blood oxygenation in the antral (r = 0.996, P < 0.01) and body (r = 0.994, P < 0.01) mucosa of the stomach. These findings suggest that congestive gastropathy in a portal hypertensive state causes hypoxia in the gastric mucosa, leading to a mucosal energy deficit that may increase mucosal susceptibility to aggressive factors.

Chromatography, High Pressure Liquid↗

Vasoactive effect of endothelin-1 on rat liver in vivo.

The purpose of this study was to evaluate the role of endothelin-1 in modulating hepatic microcirculation and liver damage. Rats were infused with endothelin-1 at doses ranging from 30 to 1,000 pmol/kg over 1 min through an indwelling cannula placed in the portal vein. In control rats, saline solution was infused at the same rate. Alterations in hepatic microcirculation were measured with an in vivo microscopy system. Serum lactate dehydrogenase activity, an indicator of hepatic damage, was measured 1 hr after endothelin-1 infusion. Immediately after infusion of endothelin-1, we noted a rapid increase in portal pressure, which remained increased for up to 30 min after endothelin-1 infusion. In contrast, systemic blood pressure remained unchanged, even at 1,000 pmol/kg of endothelin-1. Sinusoidal width was reduced and sinusoidal erythrocyte velocity was diminished in a dose-dependent manner. Oxygen saturation of blood in sinusoids was decreased in a dose-dependent manner, reaching values around 40% of control with 1,000 pmol/kg endothelin-1. The degree of decrease in oxygen saturation of blood in sinusoids had an excellent correlation with the calculated blood flow in the liver tissue. Serum lactate dehydrogenase levels were three to four times control values when endothelin-1 was administered at 1,000 pmol/kg. Thus endothelin-1 decreased hepatic tissue oxygenation associated with sinusoidal vasoconstriction. At high concentrations of endothelin-1, this decrease results in hepatocellular damage.

Animals↗

Interaction of heparin with amphiphile assemblies and biocompatibility of the heparin complexes.

Addition of heparin to preformed vesicles of a cationic surface-active compound, dioctadecyldimethylammonium bromide (DODAB), resulted in fast precipitation of the heparin/DODAB complex. On the other hand, heparin stabilized the vesicle composed of dipalmitoyl L-alpha-phosphatidylcholine (DPPC) which is a neutral lipid. However, DPPC precipitated with heparin by the addition of a small amount of stearylamine (SA), which is a cationic substance. Differential scanning calorimetry of the heparin/amphiphile mixtures showed that the heparin/DODAB complex possess a structure different from that of the original DODAB vesicle. The structure of the DPPC vesicle was unaffected by the addition of heparin, while the structure of the heparin/DPPC-SA complex was found to be different from that of the DPPC-SA vesicle. The interaction of heparin with vesicles depended on the nature of amphiphiles. Heparin was solubilized in organic solvent when complexed with DODAB or DPPC-SA vesicles. Polyurethaneurea membranes blended with heparin/DODAB or heparin/DPPC-SA complexes were highly nonthrombogenic, but somewhat cytotoxic.

1,2-Dipalmitoylphosphatidylcholine↗

Hepatitis B virus carrier with low titer of antibody to hepatitis B core antigen.

Of 798 hepatitis B virus (HBV) carriers, 22 had low titers (lower than 80% inhibition in 200- or 400-fold diluted serum) of antibody to hepatitis B core antigen (anti-HBc). Among these 22 patients, there were 12 (1.50%) with viremia who were positive for hepatitis B e antigen and had a high titer of HBV-associated DNA polymerase activity. Among these 12 patients, four showed no significant change in the anti-HBc titer, while four others showed significant increases in the anti-HBc titer during the follow-up periods. The former all remained asymptomatic carriers (ASCs), while the latter all developed chronic hepatitis (CH). The liver histology of four patients (ASC: 2, CH: 2) showed mild inflammation, and the localization of hepatitis B core antigen (HBcAg) in the liver specimens showed a nuclear pattern in the two ASCs, but a nuclear plus cytoplasmic pattern in the two CH cases. In HBV carriers, the increase in anti-HBc titer seems to be closely correlated to the change in HBcAg localization from the nucleus to the cytoplasm in the liver. Therefore, rising titers of anti-HBc were assumed to be associated with increased expression of HBcAg on the hepatocyte, and hence increased immune-mediated hepatic damage and the onset of hepatitis in ASC with low titer of anti-HBc.

Adolescent↗

Pain control with morphine for vertebral metastases and sciatica in advanced cancer patients.

Morphine was administered to 56 advanced cancer patients; of that number spinal metastases had induced bone pain in 28 and malignant tumors had induced sciatica in 28. The sciatica was caused in 16 patients by direct invasion of the sacral plexus, in four by lumbar bone metastases, and in eight by pelvic bone metastases. Spinal bone pain was controlled adequately with morphine. However, sciatica required larger dosages of morphine than did bone pain. Among the group with sciatica, rectal cancer patients needed larger dosages of morphine than the other cancer patients. Even with high doses of morphine, it was occasionally difficult to control neuropathic pain of the sciatic nerve caused by intrapelvic cancer.

Adult↗

[Importance of Helicobacter pylori infection and pepsinogen titer in hemodialysis and renal transplantation patients in Japan].

Helicobacter pylori (Hp) infection is thought to play an important role in for the pathogenesis of atrophic gastritis and even gastric carcinoma. The ratio of Pepsinogen I/II (P I/II) also shows good correlation with atrophic gastritis and gastric ulcer. Since many hemodialysis (HD) and renal transplantation patients suffer from gastrointestinal problems, we investigated the importance of Hp infection and P I/II in these patients. Serum Hp IgG was measured by EIA. Pepsinogen titer was measured with antipepsinogen antibody-bearing beads and anti-pepsinogen antibody. Hp positive HD patients accounted for 50.7% of the subjects. Of the renal transplantation patients, 23.5% were positive with lower values than the HD patients. The value of P I/II in all patients with a high Hp positive titer also was low (under 3). In conclusion, serum IgG antibody to Hp and P I/II exhibit good correlation and both are useful for the diagnosis of atrophic gastritis in chronic renal failure.

Adult↗

Non-thrombogenicity of organic polymers by blending with alkylamine-heparin complexes.

Alkylamine-heparin complexes having alkylamines of different chain lengths were prepared. The complexes were slightly soluble in water, but soluble in many organic solvents. The solubilities of complexes in organic solvent were controlled by the chain length of the alkylamine. The intrinsic antithrombogenicity of heparin was not affected by complexing with alkylamines. The alkylamine-heparin complexes were blended with organic polymers or coated on the surface of polymer membranes. The blended or coated polymer membranes suppressed adhesion and activation of platelets and were highly non-thrombogenic by releasing the complexes in in vitro and ex vivo experiments.

Amines↗

Display of MR angiograms: maximum intensity projection versus three-dimensional rendering.

OBJECTIVE: The purpose of this study is to clarify the most useful technique of MR imaging in demonstrating the collateral venous pathways due to portal hypertension. SUBJECTS: Twenty-eight cirrhotic patients with collateral venous pathways due to portal hypertension and three patients without them were studied. We evaluated the detectability of collateral vessels of flow-enhanced transverse MR images by time of flight effect, projection MR angiography using the maximum intensity projection technique and three-dimensional (3D) computer graphic images, by using the arterial portography as the standard. RESULTS: Flow-enhanced transverse MR images showed 98% of the collateral vessels detected by angiography, however, the connection of each vessel was obscure. Fully 81% of the collateral vessels were seen by projection MR angiography, and 98% of them by the 3D computer graphic images. CONCLUSION: The detectability of collateral vessels of 3D computer graphic imaging was better than that of the projection MR angiography and was as accurate as that of transverse MR imaging. 3D Computer graphic images provided complex anatomical information in a more easily understood fashion than either transverse MR images or projection MR angiography.

Adolescent↗

Comparison of infrared electronic endoscopy using reflection and transmission.

Twelve subjects were examined using both the reflecting type of infrared electronic endoscopy and the transmission method to visualize submucosal gastric architecture. Under transmission infrared illumination, submucosal structures were more clearly observed than by using the reflecting type. Using the transmission method, only the anterior wall of the antrum could be fully visualized, although the anterior wall of the lower corpus was recognized in only 33% of the cases. Furthermore, the upper or middle corpus and the entire posterior wall were not properly recognized using transmission illumination. The entire gastric circumference was visualized with the reflecting type illumination. Both types of infrared illumination of the gastric wall can be used complementarily for visualizing submucosal gastric architecture.

Aged↗

Metastasis of hepatocellular carcinoma to the colon demonstrated by Tc-99m PMT scintigraphy.

A 57-year-old man was found to have a tumor in the ascending colon after hepatic segmentectomy for ruptured hepatocellular carcinoma. Colonoscopy was performed, and metastasis of the hepatocellular carcinoma to the ascending colon was suspected based on the biopsy specimens obtained from the tumor. On hepatobiliary scintigraphy using Tc-99m PMT performed to confirm this diagnosis, Tc-99m PMT was clearly observed to accumulate in the tumor. Thus, the tumor was diagnosed as metastasis of hepatocellular carcinoma.

Carcinoma, Hepatocellular↗