Biomedical subjects

T Kawamura

Publications and source records attributed to T Kawamura.

At least 253 records · Page 14Linked to original sources

PubMed1998

Alterations in the GyrA subunit of DNA gyrase and the ParC subunit of DNA topoisomerase IV associated with quinolone resistance in Enterococcus faecalis.

The gyrA and parC genes of 31 clinical isolates of Enterococcus faecalis, including fluoroquinolone-resistant isolates, were partially sequenced and analyzed for target alterations. Topoisomerase IV may be a primary target in E. faecalis, but high-level fluoroquinolone resistance was associated with simultaneous alterations in both GyrA and ParC.

4-Quinolones↗

PubMed1998

Transmission of human T-cell leukemia virus type 1 to mice.

Human T-cell leukemia virus type 1 (HTLV-1) is associated with adult T-cell leukemia/lymphoma, HTLV-1-associated myelopathy/tropical spastic paraparesis, and other diseases. For prevention of the transmission of HTLV-1 and manifestation of these diseases, a small-animal model, especially a mouse model, would be useful. We injected HTLV-1-producing T cells (MT-2) intraperitoneally into neonatal C3H/HeJ mice. While the antibody against HTLV-1 antigens was not detectable in C3H/HeJ mice, HTLV-1 provirus was frequently detected in the spleen, lymph nodes, and thymus by PCR. HTLV-1 provirus was present at the level of 0 to 30 molecules in 10(5) spleen cells at the age of 15 weeks. In addition, a 59-bp flanking sequence of the HTLV-1 integration site was amplified from the spleen DNA by linker-mediated PCR and was confirmed to be derived from the mouse genome. HTLV-1 provirus was found in the T-cell fraction of the mouse spleen. These results indicate that mice can be infected by HTLV-1 and could serve as an animal model for the study of HTLV-1 infection and its pathogenesis in vivo.

Animals↗

PubMed1998

Tracheal intubation through the intubating laryngeal mask airway (LMA-Fastrach) in patients with difficult airways.

The intubating laryngeal mask airway was used in 31 adult patients in whom tracheal intubation was known or suspected to be difficult. The intubating laryngeal mask airway was successfully inserted in 30 patients and provided a clinically patent airway. In the remaining one patient it was impossible to insert the device correctly. Tracheal intubation through the device was successful in 28 of 30 patients (93%). These results suggest that the intubating laryngeal mask airway has a potential role for tracheal intubation in adult patients with difficult airways.

Adolescent↗

PubMed1998

[Characteristics of medical institutions visited by patients with intractable diseases--analyses of patients receiving financial aid for treatment].

The Research Committee of Epidemiology of Intractable Diseases (Ministry of Health and Welfare, Japan) conducted a nationwide survey of 34 intractable diseases. Each of 47 prefectural governments reported information on all patients with the diseases who received financial aid for the disease from April 1992 to March 1993. Information collected on each patient included the identification number, sex, age, the code of the municipality where the patient lived, and the medical institution and department where the patient was being treated. Out of 247, 726 patients whose information was reported by prefectural governments, we analysed data of 208,945 patients whose medical institutions were reported. The results can be summarized as follows: 1) Aged patients and children who were less than ten years old tended to visit medical institutions located in their neighborhoods and be treated in small hospitals or clinics. 2) The proportion of patients who visited hospitals with 200 beds or more was 77 percent. 3) Patients with the diseases resulting in physical disabilities such as SMON and malignant rheumatoid arthritis tended to visit clinics. Patients with skin diseases as pemphigus, epidermolysis bullosa and pustular psoriasis tended to be treated in university hospitals. 4) Many patients living in prefectures near large cities such as Tokyo and Ishikawa visited medical institutions in the large cities. 5) The proportion of patients who visited university hospitals decreased during the eight years from 1984 to 1992. However, a quarter of these patients visited university hospitals.

Adolescent↗

PubMed1998

Surgery of angiomas in the brainstem with a stress on the presence of telangiectasia.

This report deals with the surgery of angiomas other than arteriovenous malformation in the brainstem. The surgical cases were three cavernomas, two telangiectasias, and two venous malformations. We performed surgery when an angioma bled and the resulting hematoma was situated near the surface of the brainstem or the fourth ventricle. The cases were operated on at the subacute or chronic stages after hemorrhage. Although a magnetic resonance (MR) image showed a subacute or chronic localized hematoma with a low intensity rim, the case was not always a cavernoma, but a telangiectasia. Cavernomas could be totally removed, but telangiectasia could not. In the cases of medullary venous malformation the diagnosis was obtained radiologically, and when the hematoma was large, only hematoma evacuation was performed. In all cases the postoperative Karnofsky scores were improved or unchanged. Postoperative rebleeding in the hematoma cavity continued insidiously in a case of telangiectasia. The abnormal vessels of telangiectasia in the brainstem were preoperatively not visualized by cerebral angiography or MR imaging, but became visualized by enhanced MR imaging after evacuation of hematoma in two cases. It is stressed that an angioma with a hematoma intensity core surrounded by a low intensity rim on MR images is not always a cavernoma, but possibly is a telangiectasia.

Adolescent↗

PubMed1998

Estimated number of patients with chronic renal failure but not with end-stage renal disease in Japan: comparisons between two estimation methods.

We estimated the number of patients with chronic renal failure (CRF) but not with end-stage renal disease (ESRD) in Japan by two methods: a nationwide survey and an estimation using incidence rates of ESRD among CRF patients as well as the number of incident ESRD. The former estimated the number of patients with CRF but not with ESRD as 154,000 (95% confidence interval 139,000-168,000), while so did the latter as 142,000 (133,000-150,000). It follows that the number of CRF patients including ESRD could amount to more than 300,000, which would give a substantial impact on public health in Japan. Despite some own methodological issues in estimation, the two estimates were reasonably in good agreement: supporting their methodological validity in estimation, since sources of errors appeared to be quite independent of each other.

Adult↗

PubMed1998

Descriptive epidemiology of pancreatic cancer in Japan.

This paper aimed to explore descriptive epidemiological features of pancreatic cancer in Japan, by examining secular trends in mortality (1950-1995) and incidence rates (1975-1991), and also to discuss background factors possibly ascribable to the recent variation in mortality and incidence rates. The age-adjusted mortality rate (adjusted by the 1985 model population) has increased by approximately 9-fold in both males (from 1.4 to 12.5 per 100,000 population) and females (from 0.8 to 6.8 per 100,000 population) between 1950 and 1995. But it began to level off in both sexes since 1985. The age-adjusted incidence rate has remained plateau in both sexes, but likely showed a downward trend since 1988 in females. The older age groups showed the most steep increasing gradient in both age-specific mortality and incidence rates in both sexes, whereas a little or no apparent increase was observed in young age groups. Diagnostic improvement and increased cigarette consumption were believed to be the two major factors contributing to the increased mortality and incidence rates in Japan, but further epidemiological studies will be required to clarify possible background factors for the recent levelling-off of the mortality and incidence rates.

Adult↗

PubMed1998

[Clinical study on cystinuria in children--the stone management and the prevention of calculi recurrence].

BACKGROUND: Cystinuria is an autosomal recessive disorder, and primary manifestation is the repeated formation of cystine calculi. Little information is available regarding clinical course of pediatric cystinuria having followed into adulthood. We report our experience with the management and the clinical course on cystinuria in children, who have been followed up for relatively long time. MATERIALS AND METHODS: We retrospectively reviewed the records of all pediatric patients with cystinuria in whom urolithiasis was treated from 1970 to 1996. RESULTS: A total of 15 pediatric patients with cystine calculi (9 boys, 6 girls) were treated in our hospital. Average age at diagnosis was 3 years 4 months old. Mean follow-up was 104 months. Stone location was upper urinary tract in 11 cases, bladder in 3 cases and both upper urinary tract and bladder in 1 case. Medical treatments including hydration, urine alkalization and dissolution therapy were performed in all patients. In three cases whose urinary cystine level ranged from 138 to 326 mg/gCr, cystine calculi were disappeared by medical therapy alone. In one of 3 cases vesicoureteral reflux was identified. Side effects were noticed in 30.0% of patients with tiopronin and in 85.7% of those with D-penicillamine, especially in 1 case with tiopronin nephrotic syndrome being noticed. Surgical procedures were performed in 13 patients (lithotomy: 17 calculi, endourology: 7 calculi and ESWL: 7 calculi). The stone free rate was 100% with lithotomy, 80 to 100% with endourology and 43% with ESWL at an average of 5.9 procedures. No complications were recognized after the surgical treatments. The stone events of 15 patients ranged from 0 to 1.5 (average 0.55). In all six patients followed up over the age of 20 years, stone recurrences were observed exclusively between 17 and 20 years of age. CONCLUSION: Dissolution therapy is more effective for cystinuric patients in whom urinary cystine excretion is less than 330 mg/gCr. For those cases with low urinary cystine level it is necessary to evaluate structural abnormalities of the urinary tract to avoid stone recurrence. ESWL and endourology should be tried for pediatric cystinuria except for neonates and infants, considering its safety. The patients and their parents must have adequate knowledge about the disease itself and its management. Prevention of cystine calculi recurrences depends on patient compliance to the therapeutic regimens necessitating close follow up according to the clinical conditions, especially for those in pubertic or postpubertic age.

Adolescent↗

PubMed1998

[A case of bronchiectasis with abundant expectoration of Mycobacterium gordonae].

A 68 year old woman consulted our hospital because of 6 month history of dry cough. Her chest X-ray revealed bronchiectasis in the left lung. Three sputum specimens were culture positive for acid fast bacilli (AFB) 200 colonies. The bacilli were scotochromogenic, niacin test was negative and hydrolysis of tween 80 was positive, and they were identified as M. gordonae. M. gordonae is rarely implicated as a pathogen but a few reports suggest it may be pathogenic. Though our patient had clinical symptom and expected abundant M. gordonae, her chest X-ray revealed no progression. Thus, it was hardly possible to consider this case as a case caused by the infection with M. gordonae. In previous reports of M. gordonae pulmonary disease, chest X-ray findings showed cavity, infiltration and consolidation, however, no case with bronchiectasis was reported and chest X-ray findings of this case are interesting.

Aged↗

PubMed1998

[Estimated numbers of patients with intractable respiratory diseases].

To estimate the number of patients with intractable respiratory diseases, we conducted a two-stage nationwide epidemiological survey in 1997. The first survey was performed at randomly sampled hospitals to identify the number of patients treated. The second survey sought detailed clinico-epidemiological data on the patients reported in the first survey. The response rates were 54% for the first survey and 62% for the second. Based on the survey findings, we derived the following nationwide estimates: 450 patients (95% confidence interval: 360-530) with chronic thromboembolic pulmonary hypertension; 230 (200-260) with primary pulmonary hypertension; 180 (150-210) with obesity-associated hypoventilation syndrome; 40 (30-50) with primary alveolar hypoventilation syndrome; 160 (140-180) with histiocytosis X; and 190 (150-230) with juvenile pulmonary emphysema.

Chronic Disease↗

PubMed1998

A case of intraductal papilloma of breast in advanced age.

Breast tumors have their various biological characteristics as to advanced age of patients. Intraductal papilloma is a benign tumor of the breast which is known to occur in the premenopausal young females. Tumors of the breast in the senile females are found mainly to be breast cancers. No any cases of intraductal papilloma over 80-years were reported in Japan to date. We have recognized mammary tumors in old aged patients to be cancers, but it is necessary to put it into mind there are a few intraductal papillomas even if advanced in age. In this report, we present the most senile case with intraductal papilloma in our institute.

Aged↗

PubMed1998

[Design and application of oral sustained-release anticancer drug--a new oral dosage form of cisplatin].

As compared to the conventional standard chemotherapy of solid cancer such as lung, biochemical modulation (BCM) therapy has been proven to have a good therapeutic efficiency. BCM therapy uses the low dose and low infusion rate of anti-cancer drug. To increase of the QOL of cancer patients, oral BCM therapy is needed. For this purpose, two kinds of new oral sustained-release cisplatin preparations were developed, micro-porous CDDP capsule made of ethylcellulose(EC) and CDDP-EC-stearic acid solid dispersion. After oral administrations of these preparations, serum CDDP levels were maintained over 0.2 microgram/ml for 24h. Experimental therapy using P815 tumor cells transplanted mice suggested the usefulness of CDDP solid dispersion preparation.

Administration, Oral↗

PubMed1998

[Renal damage in a chronic active hepatitis C patient receiving interferon-alpha therapy].

A 68-year-old male patient with chronic active hepatitis C was treated with interferon-alpha (IFN-alpha) for a period of 5 months. The patient responded well to the IFN therapy showing substantial improvement in liver function and disappearance of HCV-RNA. However, one year after the treatment he was found to have developed proteinuria and showed a reduction in Ccr. Renal biopsy findings were as follows: Light microscopy showed diffuse expansion of mesangial cells with a focal/local increase in cellularity accompanied by capillary loop thickening. Splitting of the basement membrane was also present. An immunofluorescent study showed that IgA was localized predominantly in the peripheral capillary wall. Electron microscopy showed that there was mesangial cell interposition between the peripheral capillary wall and endothelial cells. Furthermore, endothelial cells were expanded and numerous platelets were seen in the capillary lumen. These findings were compatible with focal MPGN accompanied by activation of endothelial cells. These histological data suggest two clinical disease entities: late-onset renal damage induced by IFN-alpha alone, and HCV-induced renal damage possibly modified by the direct effect of IFN-alpha on the endothelium. The present case suggests that IFN therapy for HCV may produce a particular type of renal damage, under the influence of either IFN or HCV infection, and/or both.

Aged↗

PubMed1998

Three-dimensional surface display of dynamic pulmonary xenon-133 SPECT in patients with obstructive lung disease.

UNLABELLED: To better perceive abnormal regional ventilation in patients with obstructive lung disease, a three-dimensional display was applied to dynamic pulmonary 133Xe SPECT. METHODS: Dynamic SPECT was performed using a triple-detector SPECT system in 30 patients with obstructive disease, 13 patients with restrictive disease and 7 normal subjects. After reconstructing color-illuminated, surface-rendered three-dimensional images of equilibrium and 3-min washout (WO3), a single three-dimensional fusion display was created from these two different time-course image sets in which a three-dimensional WO3 image indicating 133Xe retention was transparently visible through three-dimensional equilibrium image delineating lung contours. The three-dimensional equilibrium and WO3 images were created by a 25% threshold of the 133Xe maximal pixel activity (MPA) in equilibrium data. Besides, a three-dimensional WO3 image with a 18% threshold [mean + 2 s.d. ratios (%) of the MPA in WO3 data to that in equilibrium data in normal subjects] was used for assessing the presence of retention compared to normal lungs. RESULTS: The 18% threshold three-dimensional WO3 image showed abnormal retention in obstructive diseases but not in restrictive diseases. The three-dimensional fusion display provided an overview of localized retention in obstructive diseases and enhanced the perception of their spatial relationships and extent compared to those on multislice tomograms. The extent of retention correlated well with %FEV1 (r = 0.813) and 133Xe clearance-time (T(1/2)) (r = 0.912). CONCLUSION: This topographic modality for 133Xe SPECT is helpful for the better perception of anatomic distributions of 133Xe retention and interstudy comparisons of ventilation abnormality in patients with obstructive disease.

Aged↗

PubMed1998

[The expression of cMET/hepatocyte growth factor receptor in colorectal cancer].

In this study, we estimated the expression of c-MET/Hepatocyte Growth Factor receptor in colorectal cancers by immunohistochemistry. In 118 patients, c-MET wee expressed in 65 patients (55%). About the clinicopathological findings of metastasis, the proportion of c-MET-positive in the patients with liver metastasis, 78% (18/23), was significantly higher than that without liver metastasis, 49% (47/95), but there was no significant difference about lymph node metastasis and peritoneal dissemination. About the pathological findings of primary lesion, the proportion of c-MET-positive in the patients with infiltration into lymphatic vessels, 63% (48/76), was significantly higher than that without infiltration, 40% (17/42), but there was no significant difference about infiltration into veins. The proportion of c-MET-positive increased as the tumor stage proceeded from t1 to t4 and as the histopathological stage proceeded from I to IV. These results suggest that c-MET may play an important role in the growth and scattering of colorectal cancer cells.

Adenocarcinoma↗

PubMed1998

[Radiotherapy combined with daily administration of low-dose cisplatin for squamous cell carcinomas of the head and neck].

The effects of radiotherapy combined with daily administration of low-dose cisplatin (CD DP) and radiotherapy alone for squamous cell carcinomas of the head and neck were compared clinically and histologically. There was no difference in the response rate between two groups with and without CDDP for pre-operative irradiation (30-40 Gy). However, the complete response rate in the radical irradiation group (60-70 Gy) with CDDP was significantly higher than without CDDP. In the histologic effect assessed by the classification of Shimozato in 9 of 19 patients undergoing radical irradiation with CDDP, 3 patients in this group showed a grade III effect, and the other 6 a grade IV effect. Only 5 of 11 patients having irradiation alone showed grade III or IV effect. In conclusion, full-dose radiotherapy combined with CDDP provided a high level of organ preservation and local control because of the high clinical and histological complete response rate at the primary site.

Adult↗

PubMed1998

[Nutritional therapy].

This article describes nutritional therapy for hemorrhagic gastro-intestinal diseases. The aim of this therapy is to protect and to accelerate cure of hemorrhagic lesion with rapid recovery of general condition. The accurate judgement for fluid therapy and contents, volume and timing of dietetic therapy is very difficult. However, it should always be considered, that excellent nutritional therapy influences prognosis of hemorrhagic digestive diseases to a great degree for its medication.

Diet Therapy↗

PubMed1998

Newly developed diabetic retinopathy and its preceding changes in biological markers.

To disclose the chronological changes prior to the manifestation of diabetic retinopathy (DR), we analyzed the time course of biological markers among apparently healthy diabetic subjects in a case-control study of 21,579 adults who had undergone comprehensive health examinations for > or = 10 years. We identified 54 cases who had newly developed DR, and selected 108 adults without fundus abnormalities, matching them for sex, age, and fasting plasma glucose (FPG) at the onset of the patient group's retinopathy as a referent group from the same population. In a multivariate analysis, a high average FPG (> 175 mg/dl) and a final-year FPG reduction (< -3%) were significantly associated with a 5.4 (95% CI, 1.8-15.7)- and 5.0 (95% CI, 1.0-24.7)-fold increased risk of DR, respectively. Thus, we surmised that sustained hyperglycemia and a subsequent drop in FPG might promote retinopathy in non-insulin dependent diabetes mellitus.

Biomarkers↗