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Biomedical subjects

T Kojima

Publications and source records attributed to T Kojima.

1,113 records · Page 62Linked to original sources

Endothelium-dependent relaxation of canine basilar arteries. Part 2: Inhibition by hemoglobin and cerebrospinal fluid from patients with aneurysmal subarachnoid hemorrhage.

The effects of hemoglobin and cerebrospinal fluid from patients with subarachnoid hemorrhage (CSF-SAH) on endothelium-dependent relaxation were studied. At 10(-6) M, hemoglobin somewhat inhibited the endothelium-dependent relaxation induced by A23187 in rings of canine basilar artery. At 3 X 10(-6) M, it almost completely inhibited the same response. At 3 X 10(-6) M, hemoglobin did not significantly inhibit smooth muscle relaxation mechanisms as papaverine-induced relaxation was not inhibited by hemoglobin. It was also demonstrated that pretreatment of arterial rings with CSF-SAH resulted in a dose-dependent inhibition of relaxation induced by A23187. The inhibitory effect of CSF-SAH was prominent in the case in which a high oxyhemoglobin concentration was measured by spectrophotometry. Normal CSF from patients without SAH did not affect endothelium-dependent relaxation. These results suggest that hemoglobin released from lysed erythrocytes inhibits endothelium-dependent relaxation of canine basilar arteries and may also play an important role in the pathogenesis of cerebral vasospasm after aneurysmal subarachnoid hemorrhage.

Animals↗

Plasmapheresis for a schizophrenic patient with drug-induced lupus anti-coagulant.

A 59-year-old patient with schizophrenia developed Sjögren's syndrome. She also presented with the lupus anticoagulant attributed to long-term medication with chlorpromazine. Serial plasmapheresis treatments were performed to decrease the anti-coagulant activity. As a result, the activated partial thromboplastin time was temporarily improved, but the lupus anti-coagulant activity did not change. Because of her unstable emotional state, she continued to require chlorpromazine, but took a low dose of aspirin (87 mg/day) and never manifested any signs of thrombotic events. In view of the potential anti-thrombotic effects of chlorpromazine, it may not be necessary to use plasmapheresis in an attempt to reduce anti-coagulant activity among patients with chlorpromazine-induced lupus anti-coagulant.

Antipsychotic Agents↗

Comparison of estimates of insulin sensitivity in pre- and postmenopausal women using the insulin tolerance test and the frequently sampled intravenous glucose tolerance test.

OBJECTIVE: We assessed insulin sensitivity in women comparing the insulin tolerance test (ITT) with the intravenous glucose tolerance test with frequent sampling and computer modeling (FSIVGTT) and evaluated the effects of hormonal therapy in postmenopausal women using both methods. METHODS: This prospective study tested 18 premenopausal women and ten postmenopausal women randomized to receive either estrogen alone or estrogen with a sequential progestin for 6 months at a menopause research clinic. All subjects received an ITT and an FSIVGTT within 48-72 hours of each other in random sequence. Postmenopausal women were then randomized to receive either 0.625 mg conjugated equine estrogen for 6 months or 0.625 mg conjugated equine estrogen with medroxyprogesterone acetate, 10 mg, for 10 days each month for 6 months. Both the ITT and the FSIVGTT were repeated following hormonal therapy at 2 and 6 months. Plasma insulin and glucose were measured; insulin sensitivity was calculated after the ITT (Kitt) and the FSIVGTT (Si) at each visit in each group. RESULTS: A close correlation was found between Kitt and Si values at initial testing in both pre- and postmenopausal women and following both types of hormonal therapy (r = 0.76 for all tests, P < .001). A reduction in insulin sensitivity was observed in postmenopausal compared to premenopausal women; this occurred in five of ten postmenopausal women using the Kitt measurement and in four of ten women using Si. Estrogen replacement had a beneficial effect on insulin sensitivity. While Kitt increased by 24.2 +/- 9.6% (P < .05), the increase in Si (6.7 +/- 18%) was not significant because of the variability with this measurement. An attenuation in insulin sensitivity was seen with added progestin. Kitt values decreased by 17.7 +/- 7.7% and Si values by 31.9 +/- 12%. Similar findings were noted at 2 and 6 months. CONCLUSIONS: The ITT and FSIVGTT provide quantitatively similar information regarding insulin sensitivity in healthy women. A mild degree of insulin resistance appears to be present in some healthy postmenopausal women. Estrogen appears to improve insulin sensitivity, while added progestin may attenuate this beneficial effect.

Adult↗

Saccular aneurysm associated with absence of the left cervical carotid arteries.

The authors report successful surgical treatment of a patient with an anterior communicating artery aneurysm associated with absence of all of the left cervical carotid arteries. A review of the previous reports of 15 cases of intracranial aneurysm in association with absence of the internal carotid artery emphasizes the rarity of this lesion. Aneurysms with such an association have a distinct distribution different from that observed in the usual population. The data suggest that intracranial aneurysm develops more frequently in the absence of the internal carotid artery as a result of altered hemodynamics.

Adult↗

Induction of apoptosis in human stomach cancer cells by green tea catechins.

The exposure of human stomach cancer KATO III cells to green tea catechin extract and epigallocatechin gallate (EGCG), a main component of the extract led to both growth inhibition and the induction of programmed cell death (apoptosis). Morphological changes showing apoptotic body were observed in the cells treated with green tea catechin extract and EGCG. The fragmentation of DNA to oligonucleosomal-sized fragments, characteristic of apoptosis was determined to be concentration- and time-dependent. These data suggest that drinking of green tea in large amounts is recommended possibly to protect humans from stomach cancer.

Antineoplastic Agents↗

The usefulness and limits of magnetic resonance imaging in the differential diagnosis of pelvic tumors.

Three cases of benign pelvic tumors are presented (2 leiomyomas and 1 fibroma). All three tumors were suspected of being malignant neoplasms because they were visualized as heterogeneous high signal intensity on T2-weighted images, and thus they were difficult to diagnose preoperatively. One of the leiomyomas was located in the retroperitoneum and had been misdiagnosed as an ovarian tumor. All three tumors exhibited secondary myxoid changes, these changes may have been responsible for the high signal intensity on the T2-weighted MR images. Since benign tumors sometimes mimic malignant tumors on MR images, exploratory laparotomy is essential to make a definitive diagnosis.

Female↗

Primary peritoneal clear cell carcinoma: excellent results from paclitaxel and carboplatin combination chemotherapy.

While papillary serous adenocarcinomas are histocytologically common in primary peritoneal carcinomas, clear cell carcinomas are rare. We report a new regimen for the treatment of recurrent clear cell carcinomas of the peritoneum. A 45-year-old woman was referred to our hospital and underwent optimal debulking surgery. Thirty-two months after the operation, lymph node swelling and elevation of serum CA19-9 were detected and recurrence was diagnosed. Paclitaxel (175 mg/m(2)) in a 3-hour and carboplatin (300 mg/m(2)) in a 1-hour infusion were repeated at three-week intervals. After completion of four courses, abdominal CT and serum CA19-9 were undertaken and results compared. Lymph node swelling was significantly decreased and the serum CA19-9 level was decreased to within a normal range. Paclitaxel and carboplatin combination chemotherapy may be effective in preventing the recurrence of peritoneal carcinomas.

Adenocarcinoma, Clear Cell↗

Scalp vein detected using internal carotid angiography that did not result in venous sinus compromise.

We present an unusual case of a scalp vein detected by using angiography of the internal carotid artery. The vein arose from the superior sagittal sinus and drained into the deep posterior cervical vein via the parietal emissary vein. This scalp vein may be a collateral pathway for venous sinuses; however, the patient had no evidence of venous sinus occlusive disease or intracranial hypertension.

Aged↗

Gallbladder hematoma in a patient with hemophilia B, report of a case.

The authors report the case of a 49-year-old man, hematoma of the gallbladder associated with hemophilia B. The patient was diagnosed incidentally by abdominal computed tomography with a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed negative gallbladder and angiography showed no obvious abnormality in the cystic artery. Magnetic resonance imaging showed a mass of mixed intensity on T2-weighted image and a mass of mixed intensity on the lining of the gallbladder wall. Hemorrhage in the gallbladder was thought to be most likely, however, the gallbladder tumor could not to be neglected. Cholecystectomy was performed on the patient and the pathological diagnosis was of a hemorrhage in the gallbladder. Hematoma of the gallbladder is a rare complication in patients with hemophilia B, however, it leads sometimes to a fatal course and magnetic resonance imaging is very useful to diagnose hemorrhage in the gallbladder.

Cholangiopancreatography, Endoscopic Retrograde↗

Double cystic duct detected by endoscopic retrograde cholangiopancreatography and confirmed by intraoperative cholangiography in laparoscopic cholecystectomy: a case report.

A case of double cystic duct with cholecystolithiasis detected by preoperative endoscopic retrograde cholangiopancreatography and confirmed by intraoperative cholangiography which was treated successfully by laparoscopic surgery is reported. The patient was a 74-year-old woman who complained of abdominal pain in the right upper quadrant. On admission, ultrasonography revealed hyperechoic areas accompanied by obscure acoustic shadows in the gallbladder. Preoperative endoscopic retrograde cholangiopancreatography showed 2 cystic ducts; 1 branched from the common bile duct and the other from the right hepatic duct. After a diagnosis of double cystic ducts, we chose laparoscopic cholecystectomy. Intraoperative cholangiography via 1 of the cystic ducts revealed the presence of the other. We were able to perform laparoscopic cholecystectomy without any complications and the postoperative course was uneventful. This case suggests that preoperative endoscopic retrograde cholangiopancreatography and intraoperative cholangiography is required to avoid complications during laparoscopic cholecystectomy.

Aged↗

Epidermoid cyst of an intrapancreatic accessory spleen--a case report.

We report an extremely rare case of a splenic epidermoid cyst of the pancreas in a 51-year-old Japanese male with no clinical symptoms. A cystic tumor of the pancreatic tail was detected incidentally by abdominal ultrasonography. The patient was referred to the Gunma University Hospital for further examination of the pancreatic tumor. Upon diagnosis of a benign cystic tumor, a distal pancreatectomy with splenectomy was performed. Microscopically, the multicystic tumor, which was surrounded by the splenic tissue, was located within the pancreatic tissue. The cysts were lined by non-keratinizing squamous epithelium. The diagnosis of an epidermoid cyst occurring in an intrapancreatic accessory spleen was confirmed. To our knowledge, this is the 4th case ever reported in the English literature.

Choristoma↗

Integration of 3-D shapes of dentition and facial morphology using a high-speed laser scanner.

PURPOSE: The purpose of this study was to develop a method to integrate three-dimensional data of dentition and facial morphology measured by a high-speed laser scanner, and visualize them by computer graphics. The accuracy of integration was also examined. MATERIALS AND METHODS: The 3-D shapes of upper and lower dental casts and the face of a subject were measured by a high-speed laser scanner with zoom lens facility. As an interface to integrate the coordinates between dentition and face, an extraoral marker plate attached to the occlusal record plate was devised. It was applied between the upper and lower dental casts, and with the subject, and measured. Integration was attempted by coinciding the data of the interface. The accuracy of integration was examined using the conditions of the marker plate such as surface shape and attachment angle. RESULTS: Integration of the data of dentition and face was accomplished. The 3-D relationship between them could be visualized in any direction or section by computer graphics. For optimal accuracy of integration, the marker plate with a mixed shape of flat and sinusoidal wave attached at 45 degrees to the occlusal record plate showed the most appropriate results. CONCLUSION: An original method to integrate the 3-D data of dentition and face measured by 3-D laser scanner was developed and shown to have acceptable accuracy.

Adult↗

Immunosuppressive acidic protein (IAP) level in serum and peritoneal washings, and its implication in determining multidisciplinary treatments.

In this study we examined the efficacy of the measurement of IAP (serum ancl peritoneal washings) during the treatment of colorectal cancers, and determined the possible benefits of using the IAP measurements from both serum and peritoneal washings. One hundred and six patients (peritoneal washings: 58, peritoneal fluid: 67) were investigated. Serum IAP levels were significantly higher in patients who underwent complicated surgical procedures which involved greater time and blood loss compared to those patients who underwent less involved surgical procedures with little loss of blood and time. In peritoneal washings, up to 66. 7% of cases with peritoneal dissemination showed elevated levels of IAP in the peritoneal cavity, while 37% of cases with no dissemination at surgery macroscopically had positive IAP levels (8 mg/g protein). The results suggest the value of IAP in determining the need for combined immunochemotherapy for patients in an immunosuppressive environment.

Adult↗

Effect of alpha-tocopherol on cytotoxicity induced by UV irradiation and antioxidants.

The addition of DL-alpha-tocopherol (vitamin E) at the time of UV irradiation only marginally protects cells from UV-induced cytotoxicity. However, a protective effect of alpha-tocopherol emerged when it was added to the cells before UV irradiation, alpha-Tocopherol was progressively and dose-dependently incorporated into the cells. Washout experiments showed that the intracellular concentration of alpha-tocopherol decreased with an approximate half-life of 14-20 hours, due to the release from the cells and dilution by cell proliferation. Pretreatment of the cells with alpha-tocopherol significantly increased the resistancy against the cytotoxic action of UV irradiation and antioxidants such as sodium ascorbate, gallic acid, n-propyl gallate and caffeic acid. ESR spectroscopy showed that alpha-tocopherol enhanced the ascorbyl radical intensity, whereas it reduced caffeic acid radical intensity, without affecting the radical intensity of gallic acid and n-propyl gallate. Both control and treated cell lysates scavenged superoxide anion (generated by xanthine-xanthine oxidase reaction) and hydroxyl radical (generated by Fenton reaction) to a comparable extent. The present study suggests that the protective effect of alpha-tocopherol might be derived from its incorporation into the cell membranes rather than its scavenging activity.

Antioxidants↗

Effect of methionine depletion on growth and apoptosis in various tumor cell lines.

Sodium ascorbate, sodium 5,6-benzylidene-L-ascorbate (SBA), gallic acid and caffeic acid induced apoptotic cell death in human myelogenous leukemic cell lines, and stimulated oxidation of methionine into methionine sulfoxide in the culture medium. When various tumor cell lines were cultured in methionine-free medium, their growth was nearly terminated at G1 phase of the cell cycle, producing much smaller number of apoptotic cells. Addition of methionine sulfoxide to the methionine-free medium did not stimulate the apoptosis induction. These data suggest that induction of apoptosis by ascorbates, gallate or by caffeate cannot be simply explained by methionine oxidation.

Antioxidants↗