Search PubMed⌕ Search

Biomedical subjects

T Kawaguchi

Publications and source records attributed to T Kawaguchi.

At least 289 records · Page 16Linked to original sources
PubMed1994

[Primary plasma cell leukemia complicated with high-output cardiac failure and hyperammonemia].

A 23-year-old male patient with plasma cell leukemia showed characteristic clinical features: accelerating heart failure and consciousness disturbance accompanied with an increase of plasma cells in peripheral blood. Evaluation of cardiac function revealed a hyperdynamic cardiac state with low somatic vascular resistance, indicating high-output cardiac failure. However no disorders causing high-output cardiac failure were found. Consciousness disturbance and hyperammonemia with serum amino acid abnormality of unknown origin were also demonstrated. After intensive combined chemotherapy (MVD + VAD), high-output cardiac failure and hyperammonemia improved with disappearance of plasma cells, suggesting that these symptoms were closely related with progression of plasma cell leukemia.

Adult↗
PubMed1994

[Withdrawal characteristics following frequent intravenous administration of several opioids in rats].

Characteristics of withdrawal signs of several opioids were compared in rats after short-term frequent intravenous infusions. Male Sprague-Dawley rats with catheters implanted in the jugular veins were infused with a fixed dose of a drug hourly for 72 hrs. Thirty min after the final infusion, naloxone 4 mg/kg, s.c. was administered and withdrawal signs were observed for 1 hr and the severity of the withdrawal signs was scored, classified into a behavioral sign score, autonomic sign score, and body weight loss score. As a result, total withdrawal scores of morphine, methadone, d-propoxyphene, loperamide, tramadol, and pentazocine were significantly higher than that of saline, with the highest score being observed for 4 mg/kg or more of morphine. The total score of ethylketocyclazocine was slightly but significantly higher than that of saline. Buprenorphine and thebaine produced no observable withdrawal signs. The behavioral sign score tended to be higher than the other 2 scores in the drugs showing relatively low but significant total scores such as tramadol, pentazocine, and ethylketocyclazocine, while the score of autonomic signs or the body weight loss tended to be higher in drugs showing high total scores. Thus, in the case of opioids, it is considered that the severity of withdrawal signs was mainly derived from the autonomic signs including diarrhea which may result in body weight loss.

Animals↗
PubMed1994

[Drug-resistant multiple myeloma with high serum levels of lactate dehydrogenase and neutrophil infiltration in pleural effusion].

A 57-year-old male patient with multiple myeloma showed an aggressive course with characteristic clinical features: rapid progression of plasmacytoma in the thoratic cavity, high serum levels of lactate dehydrogenase (LDH), which is usually not elevated in myeloma patients, and neutrophil infiltration in pleural effusion. Despite treatment with vincristine, doxorubicin and dexamethasone, the tumor mass had become non-responsive to chemotherapy and been increasing in size in correlating with the increase of serum levels of LDH. The patient died of respiratory failure 4 months after treatment. Thus the serum level of LDH is thought to be a useful clinical marker to monitor disease activity as well as other markers such as monoclonal immunoglobulin and beta 2-microglobulin. To investigate the cause of neutrophil infiltration into pleural effusion, we cultured plasma cells obtained from the effusion for 3 days in serum-free medium and examined the activity of neutrophil chemotaxis in the culture supernatant. The results showed chemotactic activity in the supernatant as high as in positive controls stimulated with a chemotactic factor, formyl-methionyl leucyl phenyl-alanine, suggesting that tumor cells produced neutrophil chemotactic factor(s).

Chemotaxis, Leukocyte↗
PubMed1993

Sequential process of blood-borne lung metastases of spontaneous mammary carcinoma in C3H mice.

We examined the correlation between growth characteristics and the incidence of lung metastases of spontaneous mammary tumors in C3H mice. The growth pattern of the mammary tumors was composed of initial rapid growth, declining growth, and further exponential growth (re-growth). The "re-growth" was closely associated with loss of differentiation and progressive increase of the incidence of lung metastases. In addition, we observed the sequential process of blood-borne lung metastases. The findings involved (i) "passive" intravasation: carcinoma nests encased in newly formed endothelial cells are released into sinusoidal vessels within primary tumors; (ii) "mechanical" arrest and proliferation of multicellular tumor emboli in pulmonary arterioles; (iii) "active" extravasation: carcinoma cells rushed out to the lung parenchyma through the arteriolar walls ruptured by initial minimal penetration of carcinoma cells and intravascular pressure. The results indicate a stable progression in the natural history of C3H mouse mammary carcinomas characterized by growth characteristics, the incidence of lung metastases, and histological change generating a poorly differentiated clone which can successfully complete a sequential process of blood-borne lung metastasis.

Adenocarcinoma↗
PubMed1993

Prediction of cardiovascular death in men undergoing noninvasive evaluation for coronary artery disease.

OBJECTIVE: To develop prediction rules from clinical and exercise test data identifying patients at high and low risk for cardiovascular events among a group of male veterans. DESIGN: Prognostic study with prospective gathering of data and routine follow-up of consecutive patients referred for exercise testing. Patients only underwent noninvasive evaluation for coronary artery disease. No validation cohort is yet available. SETTING: A 1200-bed Veterans Affairs Medical Center. PATIENTS: Of 3609 men referred for exercise testing between 1984 and 1990, 2546 patients remained evaluable after exclusion of those who underwent subsequent cardiac catheterization, those with significant valvular heart disease, and those who had previous coronary artery bypass surgery. MEASUREMENTS: Evaluation included recording of clinical data on a standardized form and a standard treadmill test followed by assessment of cardiovascular events. RESULTS: During a mean follow-up period (+/- SD) of 2.75 (+/- 18) years, 119 cardiovascular deaths and 44 nonfatal myocardial infarctions occurred in 2546 patients. The Cox proportional hazards model showed the following characteristics to be statistically independent predictors of time until cardiovascular death: history of congestive heart failure or digoxin use, exercise-induced ST depression, change in systolic blood pressure during exercise, and exercise capacity. Using a simple score based on one item of clinical information (history of congestive heart failure or digoxin use) and three exercise test responses (ST depression, exercise capacity, and change in systolic blood pressure), 77% of patients were categorized as low risk (annual cardiac mortality rate, less than 2%), 18% as moderate risk (annual cardiac mortality rate, 7%), and 6% as high risk (annual cardiac mortality rate, 15%; hazard ratio, 10; 95% confidence interval, 6 to 17). This model has not yet been validated. CONCLUSIONS: Variables available from the usual non-invasive work-up of patients with known or suspected coronary artery disease can be used to predict future risk for cardiovascular death.

Aged↗
PubMed1993

Impaired glycosylation of glycosylphosphatidylinositol-anchor synthesis in paroxysmal nocturnal hemoglobinuria leucocytes.

Metabolic labeling with [3H]sugars in vivo or [3H]sugar nucleotides in vitro of glycosylphosphatidylinositol (GPI)-anchor precursors in peripheral blood granulocytes and cultured T lymphocytes of paroxysmal nocturnal hemoglobinuria (PNH) patients showed a synthetic defect in the GPI-anchor. Among the GPI-anchor precursors, phosphatidylinositol (PI) was normally synthesized, while the synthesis of glucosaminylphosphatidylinositol (GlcN-PI) and subsequent mannosylation of GlcN-PI were inhibited in affected cells. The defect in the GPI-anchor synthesis in PNH is thus attributed to interrupted glycosylation at plural sites in the synthesis of the common carbohydrate structure of the anchor.

Carbohydrate Sequence↗
PubMed1993

Prodrugs of 2',3'-didehydro-3'-deoxythymidine.

Six ester prodrugs of 2',3'-didehydro-3'-deoxythymidine (D4T) were synthesized, and their physicochemical properties were evaluated. Marked differences were observed. All of the prodrugs were chemically stable within the pH range 2-7. Hydrolysis of these esters was observed in all cases for four rat enzyme systems (plasma, liver, duodenum, and kidney), with D4T being regenerated. D4T or the prodrug was administered orally to rats, and the plasma concentrations of D4T and a corresponding prodrug were measured. The half-life of D4T after intravenous administration was 35.9 min. The half-life calculated from the terminal phase and the maximum concentration in plasma following oral administration of D4T were 35.9 min and 48.4 microM, respectively. After oral prodrug administration (with water or olive oil as a solvent), though none of the prodrugs was detected in plasma except for 5'-hemisuccinyl D4T and 5'-hemiglutaryl D4T with olive oil as a solvent, retention time of plasma D4T concentration was extended and the elevated D4T concentration in plasma decreased.

Administration, Oral↗
PubMed1993

Pancreatic ductal cell carcinoma producing pancreatic elastase 1.

The elevation of plasma pancreatic elastase 1 in patients with pancreatic cancer is caused by concomitant pancreatitis. There is no report that pancreatic ductal cell carcinoma tissue itself produced elastase 1. A 54-year-old woman underwent total pancreatectomy for pancreatic ductal cell carcinoma. Her plasma elastase 1 level subsequently decreased from the preoperative value of 406 ng/dl to values ranging between 96 ng/dl and 119 ng/dl, until 6 months after the operation, when it began to increase gradually to a maximum of 300 ng/dl in association with local recurrence and hepatic metastasis. Immunohistochemical staining of elastase 1 was positive in the primary tumor resected at operation as well as in the locally recurrent and hepatic metastatic tumors obtained at autopsy. These findings suggested that elastase 1 was produced by the tumor cells in this patient. This is the first case in which pancreatic ductal cell carcinoma cells produced elastase 1.

Adenocarcinoma↗
PubMed1993

Assignment of the human GTF2F1 gene to chromosome 19p13.3.

TFIIF (also termed FC) is a general transcription initiation factor that binds to RNA polymerase II and recruits it to a promoter. TFIIF is a heterodimer composed of 74-kDa (RAP74; gene symbol GTF2F1) and 30-kDa (RAP30; gene symbol GTF2F2) subunits. Here we report the mapping of the human GTF2F1 gene to band 19p13.3. Localization was performed by fluorescence in situ hybridization using the human RAP74 genomic cosmid clone as the probe.

Chromosome Banding↗
PubMed1993

Prediction of cardiovascular death by means of clinical and exercise test variables in patients selected for cardiac catheterization.

The objective of this report is the development of a population-specific prediction rule based on clinical and exercise test data that would estimate the risk of cardiovascular death in patients selected for cardiac catheterization. Prospective data and follow-up information were obtained from patients who underwent cardiac catheterization soon after clinical assessment and exercise testing. Males (n = 588) referred for evaluation of coronary heart disease from 1984 to 1990 were selected after exclusion of patients with significant valvular heart disease and patients with prior cardiac surgery. Half had a prior myocardial infarction and half complained of typical angina pectoris. All patients performed a treadmill test and were selected for clinical reasons to undergo coronary angiography within 3 months. Over a mean follow-up period of 2.5 years (+/- 1.4 years), there were 39 cardiovascular deaths and 45 nonfatal myocardial infarctions. The Cox proportional hazards model demonstrated the following characteristics to be statistically significant independent predictors of time until cardiovascular death: history of congestive heart failure (hazards ratio of 4), ST depression on the resting ECG (hazards ratio of 3), and a drop in systolic blood pressure below the resting value during exercise (hazards ratio of 5). Exercise-induced ST depression was not associated with either death or nonfatal myocardial infarction. A simple score based on one item of clinical information (history of congestive heart failure), a resting ECG finding (ST depression), and an exercise test response (exertional hypotension) stratified our patients for 4 years after testing from 75% with a low risk (annual cardiac mortality rate of 1%), 17% with a moderate risk (annual mortality rate of 7%), and 1% with a high risk (annual cardiac mortality rate of 12%, with a hazards ratio of 20 and 95% confidence interval from 6 to 70X). It was concluded that the variables available from the usual noninvasive workup of patients with known or suspected coronary artery disease enable prediction of risk of cardiovascular death. Three quarters of those usually undergoing cardiac catheterization can be identified by simple noninvasive variables as being at such low risk that invasive intervention is unlikely to improve prognosis.

Aged↗
PubMed1993

Hemodynamic determinants of exercise capacity in chronic atrial fibrillation.

To evaluate the response of patients with chronic atrial fibrillation (AF) to exercise, 79 male patients (mean age 64 +/- 1 years) with AF underwent resting two-dimensional and M-mode echocardiography and symptom-limited treadmill testing with ventilatory gas exchange analysis. Patients were classified by underlying disease into five subgroups: no underlying disease (LONE: n = 17), hypertension (HT: n = 11), ischemic heart disease (n = 13), cardiomyopathy or history of congestive heart failure (CHF: n = 26), and valvular disease (n = 12). A higher maximal heart rate than expected for age was observed (175 vs 157 beats/min), which was most notable in the LONE and HT subgroups. Maximal oxygen uptake (VO2 max) was lower than expected for age in all groups. Patients with CHF had a lower resting ejection fraction than all other patients (p < 0.001), a lower VO2 max, and a lower maximal heart rate than LONE and HT patients (p < 0.001). Stepwise regression analysis demonstrated that echocardiographic measurements at rest were poor predictors of VO2 max and VO2 at the ventilatory threshold. Among clinical, morphologic, and exercise variables, maximal systolic blood pressure accounted for the greatest variance in exercise capacity, but it explained only 35%. In patients with AF the higher than predicted maximal heart rates may be a compensatory mechanism for maintaining exercise capacity after the loss of normal atrial function. However, even in the absence of underlying disease, it does not appear to compensate fully for a compromised exercise capacity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

The dynamics of phase relationships of alpha waves during photic driving.

Inter- and intrahemispheric phase relationships of alpha waves during photic driving with intermittent flash stimuli were successively calculated by our newly developed method and compared with the results obtained during the resting condition. Of 12 healthy subjects, 6 showed obvious photic driving responses in the occipital regions (driven group) but the remaining 6 did not (non-driven group). In the driven group, the interhemispheric phase differences decreased, especially when EEG frequencies coincided with stimulating frequencies. However, this was not maintained throughout the stimulation period but was accompanied by some fluctuation. The interhemispheric phase difference decreased in the posterior temporal and, in particular, in the occipital areas. The intrahemispheric phase difference for the occipito-frontal and the occipito-central pairs in each hemisphere tended to increase and remained at approximately pi radians, especially for the former pair. These findings suggest the presence of a specific response in the occipital area. Time ratios of the phase lead in longitudinal and transverse directions and the high similarity of the time courses of intrahemispheric phase differences between bilaterally homologous pairs at rest suggest that there exist phasing mechanisms which act in parallel between the left and right hemispheres with dominant antero-posterior time delay.

Adult↗
PubMed1993

Blade-deviated fenestrated clips for anterior communicating artery aneurysms.

Blade-deviated fenestrated clips developed by one of the authors were applied very successfully in 15 cases of A Com A aneurysms which corresponded to 32% of the aneurysms upon which were operated. Of the 15, 13 cases were projected superiorly, which is the most difficult and hazardous type if ruptured at the neck. The characteristic feature of the clip is the lateral deviation of occluding blades. The superiorly projecting type A Com A aneurysm is located posterolateral to the A Com A in the operative field, and the clips were extremely useful in the aneurysms in providing safer and more exact occlusion via parallel closure of the A Com A or the aneurysm neck.

Adult↗
PubMed1993

Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men.

OBJECTIVES: The goal of this study was to create a nomogram, based on maximal exercise capacity (in metabolic equivalents [METs]) and age, for assessing a patient's ability to perform dynamic exercise to quantify the level of physical disability or relative capacity for physical activity. BACKGROUND: Providing an estimation of exercise capacity relative to age is clinically useful. Such an estimate can be derived from measured or estimated maximal oxygen uptake (in METs) from treadmill exercise testing and age. It is an effective means of communicating to patients their cardiopulmonary status, encouraging improvement in exercise capacity and quantifying disability. METHODS: Exercise test results of 1,388 male patients (mean age 57 years, range 21 to 89) free of apparent heart disease who were referred for exercise testing for clinical reasons were retrospectively reviewed. This referral group as well as subgroups of active (n = 346) and sedentary (n = 253) patients were analyzed to determine norms for age and for age by decades for exercise test responses, including METs, maximal heart rate and maximal systolic blood pressure. Regression equations were calculated from this information, and a nomogram for calculating degree of exercise capacity from age and MET level achieved by a patient was created. A similar analysis was performed in a separate group of 244 apparently healthy, normal male volunteers (mean age 45 +/- 14 years, range 18 to 72) who underwent exercise testing with direct measurement of expired gases. RESULTS: Equations for predicted METs for age were derived for the entire clinical referral group (METs = 18.0-0.15[Age]) and for the subgroups of active (METs = 18.7-0.15[Age]) and sedentary (METs = 16.6-0.16[Age]) patients. All results achieved statistical significance, with p values < 0.001. In the volunteer group of normal men who performed exercise testing with ventilatory gas exchange, the decline in maximal heart rate and METs with age was not as steep as in the referral group. Although the normal group confirmed nomograms published previously among similar subjects, the equations derived from the patients differed from those previously reported; in contrast to previous studies using healthy volunteers, the equations and nomograms for the referral group are more appropriate for patients typically referred for testing in a hospital or office-based internal medicine practice. CONCLUSIONS: Norms for METs based on age are presented as well as population-specific nomograms that enable physicians to assess patients' exercise capacity relative to their age group.

Adult↗