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Biomedical subjects

T Kawamura

Publications and source records attributed to T Kawamura.

At least 361 records · Page 20Linked to original sources
PubMed1996

Surgical treatment of ventricular septal perforation with right ventricular infarction.

A 71-year-old woman underwent an emergency surgery for ventricular septal perforation together with right ventricular infarction. The perforation of the anterior septum was closed using. Dacron patch combined with a little larger bovine pericardium, the surplus of which was stitched in the surrounding viable muscle. This procedure was performed only through the infarct of the right ventricle. She has been doing well with no residual shunt and lives a normal life now.

Aged↗
PubMed1996

[Radiotherapy combined with daily administration of low dose cisplatin for head and neck cancer].

Radiotherapy combined with daily administration of low-dose cisplatin (CDDP) was applied to 12 cases with head and neck cancer. They consisted of 12 carcinomas, occurring in the epipharynx (3 cases), mesopharynx (3), oral cavity (1), larynx (3) and parasinuses (2). The total response rate (CR + PR) was 83.3%. There was a remarkable effect in reducing tumor size, particularly on patients with laryngeal or epipharyngeal carcinoma. Severe mucositis with ulcers as a side effect was seen in eight cases after the irradiation of 20 to 30 Gy. Six of them tolerated a full dose of irradiation, but CDDP administration was stopped except in one case. To continue the CDDP administration in cases having irradiation of over 40 Gy, it is necessary to reduce the frequency of CDDP administration and/or to give post-irradiative hydration with 500 ml saline. When this combination therapy is used as a preoperative treatment, daily administration should be continued. Incidence of nausea or vomiting was not so frequent and they could be easily controlled by a serotonin-antagonist. Leukopenia was not severe.

Aged↗
PubMed1996

[Current advancement of assay of tumor markers and the perspective in future].

Cancer has ranked first as regards the cause of death with the longest average life span. So the early cancer detection is very important to prevent cancer death. Tumor-secreted fetal antigens are already part of routine diagnosis of cancer and play an important role in the detection of cancers. However, the present methods for measurement of tumor markers don't have adequate sensitivity to detect early stage of cancer owing to their frequent elevation in benign disease and absence in some cases of malignancy. A cancer screening system with blood samples was devised for purposes of detecting unspecified various cancers. Namely, a modified combination assay with five tumor markers (AFP, CEA, CA19-9, CA125 or PAP, DUPAN-2, and cancer risk factors, pepsinogens (PG) I and II and I/II) was investigated in 50 patients with various cancers. The sensitivity of combination assay with these five tumor markers was 68% but that of modified combination assay with tumor markers and risk factors was as high as 87%. In particular its sensitivity to detect cancer of gastro-intestinal tract was highly improved. It was indicated as a subject of future studies that the sensitivity of modified combination assay could be improved further by the exchange and addition of new adequate tumor markers like as CYFRA 21-1 or ProGRP. So I described here the current advancement of assays of tumor markers and the perspective in future.

Biomarkers, Tumor↗
PubMed1996

Lichen planus-like contact dermatitis due to methacrylic acid esters.

We report a patient who had lichen planus-like lesions on sites repeatedly exposed to methacrylic acid esters used in the car industry. Histologically, the lesions showed all the features of classical lichen planus. Patch testing revealed positive reactions to methacrylic acid esters in concentrations as low as 5 x 10(-3)%. As dental devices contain methacrylic acid esters, it is possible to speculate that methacrylic acid esters may be one of the causative agents for oral lichen planus.

Dermatitis, Occupational↗
PubMed1996

[Significance of systemic inflammatory response syndrome at cardiopulmonary bypass].

Systemic Inflammatory Response Syndrome (SIRS) is a new concept of entry criteria for sepsis. This concept, when applied to area of Multiple Organ Failure (MOF), is considered to be a preparatory state for MOF. To study the significance of SIRS state at cardiac surgery, we measured the body temperature, white blood cell count, respiratory rate and heart rate of 18 patients who underwent elective cardiac surgery, from the 1st post-operative day to the 7th post-operative day. We also measured Interleukin-6 and 8 (IL-6 and IL-8) to understand the relationship between the SIRS state and inflammatory cytokines just after cardiopulmonary bypass (CPB), at the 1st, 3rd and 6th postoperative day. The result was as follows: Patients with CPB more than 120 minutes have more frequency and longer duration of SIRS than patients with CPB less than 120 minutes. Serum levels of IL-8 at SIRS state were revealed statistically higher than at non-SIRS case. Duration of SIRS state was related to CPB time and serum levels of IL-6 and IL-8 just after CPB. We concluded that SIRS state is an indication for anti-cytokine therapy to prevent MOF, and it is important to shorten CPB time in order to decrease the duration of SIRS.

Cardiopulmonary Bypass↗
PubMed1996

[Clinical significance of serum levels of human hepatocyte growth factor in patients with acute viral hepatitis].

We studied the relationship of serum levels of human hepatocyte growth factor (hHGF) to causative viruses and clinical features in 63 patients at our hospital with serologically diagnosed acute viral hepatitis. Serum levels of hHGF were not correlated with the type of hepatitis virus (A, B, and C) during the acute phase (p < 0.60) but were correlated with results of the hepaplastin test (p < 0.01). Furthermore, the difference in serum levels of hHGF between severe (levels on hepaplastin test < 40%) and nonsevere cases of hepatitis was significant (p < 0.001), and serum levels of hHGF became normal as levels of alanine aminotransferase decreased. However, serum levels of hHGF in prolonged cases of hepatitis (time until normalization of alanine aminotransferase > 13 weeks) tended to be slightly lower than in nonprolonged cases (p < 0.47). These results suggest that serum levels of hHGF are useful to determine the prognoses of patients with severe hepatitis and to estimate the time until liver damage heals.

Acute Disease↗
PubMed1996

[A study on cases diagnosed as pulmonary tuberculosis after admission to the general hospital lacking tuberculosis ward].

We analyzed retrospectively the clinical data of 12 patients diagnosed as pulmonary tuberculosis after admission to the National Himeji Hospital during the past 5 years. Ten out of 12 patients were male and were of elder age-groups (mean age: 65.5 years, range: 32-76 years). Seven patients at first visited the department of respiratory medicine, and the remaining three patients were admitted without consulting the department of respiratory medicine before admission. Only patient had a history of pulmonary tuberculosis. Two patients were suspected of pulmonary tuberculosis on admission. Tubercle bacilli were positive sputum smear in 6 patients, sputum culture in 1, smear of bronchial washing in 4, and smear of BALF in 1. It took 12.7 days on the average from the admission to make a final diagnosis as pulmonary tuberculosis patients into a general hospital lacking TB ward were as follows: (1) As pulmonary TB was not suspected, Chest X-ray and sputum examination were not performed. (2) The admission was done due to another disease and respiratory symptoms were scarce. (3) Tuberculosis lesions on chest X-ray were harbored by pleural effusions and diffuse shadows. (4) Though pulmonary tuberculosis was suspected, a patient was admitted because of general prostration as sputum smear was negative. After admission, however, repeated sputum culture revealed positive results. (5) Pulmonary tuberculosis developed after the admission.

Adult↗
PubMed1996

[Cytokines during the perisurgical period].

Systematic inflammatory response syndrome, SIRS, is one of the biological responses to surgical and anesthetic invasions. SIRS itself is a defense response, but excessive SIRS may result in post-operative failure of major organs. There is evidence that inflammatory cytokines play an important role in SIRS. Therefore it may be treated by regulating these inflammatory cytokines. Changes in inflammatory cytokines during the perisurgical period were discussed in relation to post-operative organ injury in patients who had undergone highly invasive procedures such as open heart surgery or resection of esophageal cancer to explore the possibility of anticytokine therapy.

Anti-Inflammatory Agents↗
PubMed1996

[Antioxidant defense capabilities of gastric mucosa induced by water immersion restraint stress of rat].

Lipid peroxidation mediated by free radicals is believed to be one of the important causes of membrane destruction and cell damage. Lipid peroxidation in gastric mucosa induced by the stress is also suggested to cause gastric lesions. However very little is known about the antioxidant mechanisms in gastric mucosa, which is thought to be accelerated by the stress as an adaptive response. So we investigated lipid peroxide (LPO) and the production of lipid hydroperoxides by 1,5-lipoxygenase, which might reflect the antioxidant capabilities in gastric mucosa. The analysis of lipid hydroperoxide was done by high performance liquid chromatography (HPLC) using chemiluminescence which we have established. The production of lipid hydroperoxide by lipoxygenase was done by the condition of Low-Ethanol method. The water immersion restraint stress induced significant rise of gastric mucosal LPO assayed by the thiobarbituric acid-reactive substances method but lipid hydroperoxide was not detected by HPLC. The production of lipid hydroperoxide by lipoxygenase was clearly found in the gastric mucosa before the stress but the stress of 2 or 4 hours depressed the production of lipid hydroperoxides significantly. These findings showed that the stress induced the increase of antioxidant capabilities in the gastric mucosa as an adaptive reaction and the lipid hydroperoxide induced by the stress might be scavenged quickly.

Animals↗
PubMed1996

[Chemohyperthermic peritoneal perfusion and high-dose chemotherapy followed by peripheral blood stem cell transplantation in advanced colon cancer--a case report].

A 49-year-old woman who suffered from caecal cancer in 1988 underwent chemohyperthermic peritoneal perfusion for peritoneal and ovarian metastases in 1990, and high dose chemotherapy (HDC) with peripheral blood stem cell transplantation (PBSCT) for lung metastases in 1995. Heated saline containing anticancer drugs such as cisplatin, mitomycin C, etoposide (ETP), and pirarubicin, was intraperitoneally perfused at 43 degrees C for 60 minutes. The CD34 positive cells were mobilized by intravenous 500 micrograms G-CSF administration on five consecutive days. These cells were transplanted three days after the last day in the course of HDC, which included intravenous administration of 475 mg carboplatin, 2,020 mg cyclophosphamide, and 540 mg etoposide. The patient has survived with no sign of the disease.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Neuromagnetic evidence that the P100 component of the pattern reversal visual evoked response originates in the bottom of the calcarine fissure.

Visual evoked magnetic fields due to pattern reversal stimuli were measured in 5 normal subjects using a helmet-shaped 66 channel magnetoencephalography system linked to MRI. The magnetic topography of the prominent 100 ms response (P100m) evoked by fullfield visual showed a double-dipole pattern in the occipital areas of all subjects. Right or left half-field stimuli and upper or lower quadrant-field stimuli evoked a single-dipole pattern in the contralateral occipital area. The P100m sources were then localized using a current dipole model and superimposed on MRI images of each subject. The visual cortex was morphologically variable among the subjects, but the P100m dipoles were all localized at the lateral bottom of the calcarine fissure. Moreover, these P100m dipoles had similar orientations for both half-or quadrant-field stimuli. These results suggest that the P100m is located in a smaller part of the striate cortex than previously reported.

Adult↗
PubMed1996

[Cytokines in surgical stress].

The systemic inflammatory response is seen in association with various clinical conditions. Tumor necrosis factor, or other cytokines play an important role in systemic inflammatory response syndrome (SIRS). A frequent complication of SIRS is the development of organ system dysfunction, such as ARDS, DIC, renal failure, shock, and multiple organ dysfunction. Inflammatory cytokines become a trigger for the production of phospholipase A2, eicosnoids, NO, endothelin-1, thrombomodulin, polymorphonuclear leukocyte, and adhesion molecules. These mediators cause complex pathophysiologic condition in SIRS. In this study, we discuss a role of cytokines in surgical stress, hemorrhagic shock, burns, and septic shock.

Burns↗
PubMed1996

Clinical application of visual evoked fields using an MRI-linked whole head MEG system.

We have demonstrated anatomo-functional correlation of the brain visual function using an MRI-linked whole-head magnetoencephalography system. Visual evoked magnetic fields (VEFs) due to pattern reversal stimuli were measured in seven healthy subjects and 13 patients with intracranial structural lesions. Full-field stimuli evoked the most prominent peak around 100 ms latency (P100m) as a two-dipole pattern over the occipital area in all of the normal subjects and four patients with mild and partial hemianopsia. In five patients with homonymous hemianopsia due to unilateral occipital lesion, a single-dipole pattern of the P100m appeared over the normal occipital area only. In four patients with bitemporal hemianopsia due to pituitary tumors, a single-dipole pattern of the P100m appeared only over the ipsilateral occipital area to the stimulated eye. Using current dipole models, P100m sources were localized at the lateral bottom of the calcarine fissures. Although human occipital lobes are known to be morphologically variable, our results indicate excellent correlation of the cortical anatomy and human visual function. Full-field stimuli, requiring no strict visual fixation, are especially useful for clinical application. A clear two-dipole pattern in the normal VEFs enables us to compare two hemispheric activities.

Adult↗
PubMed1996

[A role for reactive oxygen species in the pathogenesis of focal glomerulosclerosis].

Previous studies have indicated that reactive oxygen species play a key role in puromycin aminonucleoside (PAN)-induced proteinuria in the acute nephrotic phase, and glomerular infiltration of macrophages (M phi) in the acute phase has a critical impact on the subsequent progression to glomerular sclerosis. In the present study, we examined the effect of deferoxamine (DFO), which is known to inhibit the generation of hydroxyl radical on the proteinuria, renal function and morphological changes in PAN-induced chronic glomerulopathy. Rats given a single dose of PAN (150 mg/kg BW, i.p.) were not treated (Group 1, n = 12) or treated with DFO (Group 2 and 3). In Group 2 rats (n = 12), 30 mg of DFO was given for 12 weeks after PAN injection (every day for the first 2 weeks, 3 times a week for the following 2 weeks, once a week for the last 8 weeks). In Group 3 rats (n = 14), DFO was given in an identical manner with Group 2 until 2nd week and was discontinued thereafter. 24-hour urinary protein excretion (UprV) was measured at 1st, 2nd, 4th, 8th, 12th, and 24th weeks. The percentage of segmentally sclerosed glomeruli (%SS), creatinine clearance (Ccr), and serum malondialdehyde levels (MDA) were determined at the 24th week. The average number of M phi per glomerulus (# M phi) was determined at the 4th, 8th and 24th weeks after PAN injection, by biopsy and autopsy. Compared to Group 1 rats, Group 2 rats had a significantly lower amount of UprV throughout the period with marked attenuation in %SS and Ccr. In contrast, UprV in Group 3 was comparable to that in Group 1 except for the 2nd week, and there was no significant difference in %SS or Ccr between Group 1 and 3. Of note, # M phi at 4th week, which significantly correlated with %SS, substantially decreased in Group 2 compared to Group 1 or Group 3 (p < 0.05). These data suggest that the oxidant stress persisting from the acute to the chronic phase of PAN nephropathy plays an important role in inducing glomerular sclerosis. The prevention of progressive glomerular sclerosis following DFO therapy might be associated with an improvement in early glomerular in filtration of M phi.

Animals↗
PubMed1996

[Prognostic significance of histopathological findings (including lymphocyte infiltration) in renal cell carcinoma].

We compared the prognosis with the histopathological findings including intravenous invasion and lymphocytic infiltration inside or adjacent to the primary tumor in 50 renal cell carcinoma patients who underwent radical nephrectomy. We compared the primary tumor to intravenous invasion or metastases in histopathological findings. One-, three- and five-year survival rates for all patients were 91.7, 71.5 and 60.7%, respectively. Significant prognostic factors were tumor size, growth pattern, invasion of fat tissue into peripheral kidneys lymph nodes, distant metastases, intravenous invasion and tumor grade, especially lymph nodes and distant metastases (P < 0.001). Degree of lymphocytic infiltration inside or adjacent to primary tumor was divided into three groups. Five-year survival rates were 86.2% of the patients (n = 15) with apparent lymphocytic infiltration and 48.8% of the patients (n = 18) had few infiltrated lymphocytes. The patients with apparent lymphocytic infiltration showed a trend of better prognosis compared to the patients with few infiltrated lymphocytes (P < 0.1). Tumor grade was higher in 3 of the 28 patients with intravenous invasion and 6 of the 9 patients with distant metastases than in those with primary tumors. However, there was no significant correlation between prognosis and malignant potential of intravenous invasion or distant metastases.

Adult↗
PubMed1996

[A case of bilateral adrenal neuroblastomas detected by bone scintigraphy].

A 7-month-old girl, who had been resected the left adrenal neuroblastoma 20 days ago, underwent bone scintigraphy with 90mTc-HMDP to survey bone metastases. The bone scan demonstrated avid uptake in the right adrenal gland, in which 123I-MIBG also accumulated. However, the degree of 123-I-MIBG uptake in the right adrenal gland was not necessary higher compared to that in the normal adrenal glands in 7 patients after resection of hemilateral neuroblastomas. Reviewing the preoperative abdominal CT, a swelling of the right adrenal gland had been overlooked because of the small size of 10 x 12 mm in diameter. The follow-up CT after surgery revealed a more growth of the right adrenal gland, accompanied by reelevation of urine vanilmandelic acid. This patient was thus diagnosed as bilateral neuroblastomas. Because bone scintigraphy frequently shows abnormal uptake in primary neuroblastomas, it has potentially diagnostic value for early detection of bilateral adrenal neuroblastomas.

Adrenal Gland Neoplasms↗
PubMed1996

[Commencement and discontinuance of receiving financial aid for intractable disease treatment].

Data concerning all patients receiving financial aid for 26 types of intractable diseases in 1984, 1988 and 1992 were individually linked. Proportions of patients who discontinued financial aid in 1988 or 1992 among patients who were receiving aid in 1984 (ratio of discontinuance per patients); and ratios of the numbers of patients newly commencing aid in 1988 or 1992 to the numbers of patients who were receiving aid in 1984 (ratio of commencement per patients) were calculated. The results were as follows; 1. Among patients receiving financial aid in 1984, ratios of discontinuance per 100 patients were 28 in 1985-88 and 43 in 1985-92. Ratios of commencement per 100 patients were 96 in 1985-88 and 203 in 1985-92. 2. Ratios of discontinuance and of commencement per 100 patients in 1985-92 among 26 intractable diseases were 27-96 and 31-1,068, respectively. 3. Ratios of discontinuance per patients were higher an age groups 0-19 year and 60 year and over than in other age groups. Ratios of commencement per patients were higher in age groups 20-29 year and 70 year and over than in other age groups. Both ratios were higher among males than among females. 4. Ranges of ratios of discontinuance per patients and of ratios of commencement per patients were smaller among 47 prefectures than among diseases and age groups. The number of patients receiving financial aid in 1984 per population among prefectures was inversely correlated to ratios of commencement per patients, and were not correlated with ratios of discontinuance per patients.

Adolescent↗