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Biomedical subjects

T Konishi

Publications and source records attributed to T Konishi.

At least 145 records · Page 8Linked to original sources

[Adenocarcinoma of the bladder 19 years after the augmentation ileocystoplasty: report of a case].

We report a case of adenocarcinoma of the augmented bladder 19 years after ileocystolasty. The patient was a 53-year-old man who underwent right nephrectomy and ileocystoplasty (Pyrah's method) for contracted bladder due to tuberculosis in 1965. In another hospital, transurethral resection (TUR) was performed against a tumor in the anastomotic site between the bladder and the ileal segment in 1996. Histopathological examination of the specimen obtained by TUR revealed poorly-differentiated mucinous adenocarcinoma. In our hospital, partial cystectomy with total resection of ileal segment and ileocystoplasty were performed. The tumors located in the anastomotic site between the bladder and ileal segment as well as in the ileal segment. Histopathological examination revealed poorly-differentiated mucinous adenocarcinoma. The patient has survived 12 months without any evidence of tumor recurrence. To our knowledge, this is the eighth case report in Japan.

Adenocarcinoma, Mucinous↗

[Tuberous sclerosis associated with renal angiomyolipoma, pulmonary lymphangioleiomyomatosis and subungual fibroma: report of a case].

We report a case of tuberous sclerosis associated with bilateral renal angiomyolipomas (AMLs), pulmonary lymphangioleiomyomatosis (LAM) and subungual fibroma of hands and feet. A 42-year-old woman who was diagnosed as tuberous sclerosis at the age of 18 complained of left flank pain and abdominal fullness. Bilateral renal AMLs were pointed out when complete examinations were performed for hypertension at the age of 32. She suffered from severe left flank pain and abdominal distension due to the left renal tumor. Left nephrectomy and excision of the renal hilar tumor were performed. The left renal tumor weighed 1120 g, the perirenal space was filled with the tumor. histopathological diagnosis of the left renal tumor and renal hilar tumor was AML. In our case, bilateral pneumothorax appeared, and chest CT scan revealed bilateral multiple pulmonary cysts. Histopathological diagnosis of pulmonary cysts was LAM. Other complications of our case are intracranial calcification and adenoma sebaceum.

Adenoma↗

Effects of hyper +Gz acceleration on cardiovascular function, visual evoked potentials and cerebral blood flow in anesthetized rats.

Sustained hyper-gravity acceleration, particularly along the long axis of the body of animals or man (Gz), produces significant mal-effects on subjects, and hence it has been well studied, The most common syndromes of Gz application were cardio-vascular de-conditioning, and black-out, red-out, and loss of consciousness, which finally lead subjects into death. However, in most previous studies, the duration of applied Gz was rather short. In the present experiments, we can use longer duration of 1000 seconds. In addition, recent technological innovation make it possible to record directly local cerebral blood flow at a target cortical area with a Laser Doppler flow meter. We used this innovated method to measure local cerebral blood flow of rats in relation to visual evoked potentials (VEPs) under hyper-Gz acceleration. Also we recorded cardio-vascular parameters like heart rate from ECG, systolic and diastolic blood pressure and correlated them with cerebral blood flow and VEPs.

Acceleration↗

[Chemotherapy of gastric cancer].

At present curative resection is the only radical treatment for gastric cancer, although recently developed combination chemotherapy shows increased activity in treating locally advanced and metastatic disease. Among several combination regimens, those based on biochemical modulation, such as sequential methotrexate/5-fluorouracil or low-dose CDDP/5-fluorouracil, are thought to provide increased efficacy with decreasing adverse reactions in unresectable gastric cancer. Therefore, a prospective randomized clinical trial comparing the prognosis of patients receiving adjuvant multi-agent chemotherapy with those treated only surgically should be pursued for estimation of the clinical benefit of these agents.

Antineoplastic Agents, Phytogenic↗

Disposition of a new nonsteroidal anti-inflammatory agent, S-2-[4-(3-methyl-2-thienyl)phenyl]propionic acid, in rats, dogs and monkeys.

The disposition of S-2-[4-(3-methyl-2-thienyl)phenyl]propionic acid (CAS 155680-07-2, S-MTPPA, code: M-5011) was studied after oral administration to rats, dogs and monkeys using the 14C-labeled drug. After oral dosing, S-MTPPA was well absorbed from the gastrointestinal tract, to the extent of 97.7% in rats. The concentration of S-MTPPA in rat plasma reached a peak (Cmax: 13.07 micrograms/ml) at 15 min (tmax) after dosing and declined with a half-life (t1/2) of 2.5 h. The values of the parameters tmax, Cmax and t1/2 for dogs were 30 min, 26.2 micrograms/ml and 7.0 h, and those for monkeys were 15 min, 12.8 micrograms/ml and 3.0 h, respectively. The radioactivity was widely distributed in tissues and almost completely excreted in urine and feces within 48 h after oral administration to rats. The excretion of radioactivity in bile, urine and feces within 48 h after oral administration of 14C-S-MTPPA to bile duct-cannulated rats amounted to 75.0, 18.6 and 1.4% of the dose, respectively. The drug was metabolized mainly by oxidation of the thiophenyl moiety and by glucuronidation of the carboxyl group in rats and monkeys. The major urinary and fecal metabolite in dogs was identified as the taurine conjugate of MTPPA.

Animals↗

[Clinical evaluation of cholesterol embolization syndrome after cardiac catheterization].

The clinical features and outcomes of patients with cholesterol embolization syndrome after cardiac catheterization were evaluated. Among 4,920 patients undergoing cardiac catheterization during 1991 to 1996, the symptoms, signs, laboratory data, treatment and prognosis of eight (6 males and 2 females, mean age 69 years old) were reviewed who were pathologically or clinically diagnosed as having cholesterol embolization syndrome. All patients had more than two coronary risk factors. Mobile plaque of the aortic arch was detected in all five patients who underwent transesophageal echocardiography. All patients had one or more precipitating factors, including coronary angiography, percutaneous transluminal coronary angioplasty, cardiovascular surgery and cardiopulmonary resuscitation. The first symptom was renal dysfunction in four patients, skin findings of purple toes in two, muscle pain in one and new onset of refractory hypertension in one. The time after the precipitating factor to the onset of symptoms was 32 +/- 9 days on average. Eosinophilia was found in all patients and six patients revealed eosinophilia before the onset of symptoms. Four patients showed skin findings of purple toes which progressed in three of the four patients even after anticoagulant therapy was discontinued. Epidural anesthesia was markedly effective for skin findings of purple toes in two of the three patients. Diagnosis of cholesterol embolization syndrome is difficult because patients show various symptoms and there is an interval between the precipitating factor and the onset of symptoms. However, the conditions of the patients deteriorate rapidly and the prognosis is generally poor without supportive therapy in the early stage. Our study demonstrated that eosinophilia might be an important clue to early detection of cholesterol embolization syndrome. Furthermore, epidural anesthesia is effective for skin findings of purple toes in patients with cholesterol embolization syndrome. In conclusion, cholesterol embolization syndrome should be detected in the early stage based on eosinophilia or clinical symptoms after cardiac catheterization, and supportive therapy started as soon as possible, including discontinuance of anticoagulant therapy, hemodialysis for renal dysfunction and epidural anesthesia for skin findings of purple toes.

Aged↗

[Adjuvant chemotherapy with UFT or UFT with OK-432 to patients with gastric and colorectal cancer. Kanto Adjuvant Study Group].

In Japan, long-term oral therapy with tegafur in combination with immunopotentiators is commonly used as adjuvant therapy after curative resection of gastric or colorectal can for gastric and colorectal cancer. When the outcome was analyzed in terms of the relative performance (R.P.) and the individual dose intensity (I.D.I.) of OK-432, gastric cancer patients with a R.P. of 0.5 or higher tended to have a better survival curve. There were no marked differences in lymphocytes subsets, except that the Leu 7 level at 3 months after gastric cancer resection was significantly higher (p < 0.05) in group B than in group A. Thus, no inhibition of the anticancer effect of UFT was noted during long term combination therapy with UFT and an immunopotentiator as postoperative adjuvant therapy for patients who underwent curative resection of gastric or colorectal cancer. The results suggest that UFT combined with long-term OK-432 maintenance therapy may contribute to improve survival rates in gastric cancer patients.

Adjuvants, Immunologic↗

[Hypertrophic obstructive cardiomyopathy in an elderly patient manifesting as refractory congestive heart failure of acute onset: a case report].

An 84-year-old woman was admitted to our hospital because of left heart failure of acute onset. Transthoracic echocardiography showed diffuse hypertrophy of the normal sized hyperkinetic left ventricle and chordae-like fluttering echoes attached to the mitral valve with severe mitral regurgitation signals. Mosaic flow signals were seen at the left ventricular outflow tract, but the velocity could not be measured. Emergent transesophageal echocardiography detected no obvious mitral valve prolapse. Cardiac catheterization showed greater than 100 mmHg pressure gradient between the left ventricle and femoral artery. Pressures in the femoral artery and pulmonary capillary wedge changed reciprocally in the intensive care unit; a bisferient narrow pulse pressure of the femoral artery was associated with increased v wave of the pulmonary capillary wedge pressure, and a wide pulse pressure of the femoral artery with absent v wave of the pulmonary capillary wedge pressure. Pressure monitoring in the intensive care unit, catheterization laboratory and transesophageal echocardiography were useful to understand the pathophysiology of the patient.

Aged↗

[Phase I study of raltitrexed (ZD-1694)].

A multicenter cooperative phase I study of ZD-1694 (raltitrexed), a novel, folate-based thymidylate synthase (TS) inhibitor, was conducted with single and repeated doses in 30 patients with various malignant tumors. ZD-1694 was intravenously infused over 15 minutes. In the single-dose study, the initial dose was fixed at 1.0 mg/m2 (1n), and the dose was escalated stepwise up to 3.5 mg/m2 (3.5 n). Based on the results of the single-dose study, in the repeated-dose study, doses of 2.5 n and 3 n were infused every three weeks (3 weeks/one course). In principle, patients received 2 courses or more. Of the 29 eligible patients, 16 were in the single-dose study and 13 in the repeated-dose study. Adverse reactions were evaluated in all eligible patients. In the single-dose study, neutropenia, nausea/vomiting, diarrhea, and transaminase (GOT, GPT) increases, of grade 3 or higher, occurred at high doses of 3 n and 3.5 n. These were regarded as dose-limiting toxicities (DLT). DLT of grade 3 or higher were observed in 1 of 4 patients given 3 n and 2 of 4 patients given 3.5 n. These results suggested that the maximum tolerated dose (MTD) of ZD-1694 was 3.5 n (3.5 mg/m2). In the repeated-dose study, DLT of grade 3 or higher was observed in no more than one third of each dose group, 2 of the 6 patients given 2.5 n and 2 of the 7 patients given 3 n. These results suggested that 3 n (3.0 mg/m2), a dose nearer to MTD, was the recommended dose for the phase II study. Although transaminase increases were observed in all patients, in 12 of them the increase was grade 2 or lower and reversible. A pharmacokinetic investigation showed the mean elimination half life of ZD-1694 plasma concentration was 91.5 hours in the single-dose group and 119.1 hours in the repeated dose group. It was suggested that ZD-1694 is metabolized to polyglutamates after uptake and retained in the cells for a long duration. However, no accumulation was seen in plasma concentration of ZD-1694 following repeated doses at 3-weekly intervals. One PR was observed in a patient with colorectal cancer receiving 2.5 n in the repeated-dose study. Based on these results, the recommended dosage and administration for the phase II study of ZD-1694 was 3 n (3.0 mg/m2) intravenously infused over 15 minutes every 3 weeks.

Adult↗

The lipoic acid analogue 1,2-diselenolane-3-pentanoic acid protects human low density lipoprotein against oxidative modification mediated by copper ion.

1,2-Diselenolane-3-pentanoic acid, in which the sulfur atoms of alpha-lipoic acid are replaced with selenium, displayed markedly different antioxidant properties when compared to alpha-lipoic acid. 1,2-Diselenolane-3-pentanoic acid was unable to inhibit protein oxidative modification of human low density lipoprotein (LDL) and bovine serum albumin induced by copper ion or hydroxyl radical, whereas alpha-lipoic acid showed significant protection. However, 1,2-diselenolane-3-pentanoic acid was able to inhibit the formation of lipid peroxidation products in LDL after oxidation by copper, while alpha-lipoic acid did not. Hence the diselenium compound exerts its effects in a lipophilic environment whilst lipoic acid exerts its effects in a hydrophilic environment. These differences in antioxidant activities of the two compounds may be explained, at least in part, by their differing partition coefficients.

Antioxidants↗

Rapid growth of a left atrial myxoma. Serial two-dimensional echocardiographic observation over eighteen months.

We encountered a patient with rapid progressing left atrial myxoma in whom two-dimensional echocardiography was serially obtained over eighteen months. The horizontal and longitudinal diameters showed a linear 2.5 fold increase, while the size of the base attached to the left atrial wall remained unchanged. Therefore, the last echocardiogram obtained just before surgery showed the characteristic pendular motion of left atrial myxoma.

Disease Progression↗

Selective expression of HSP70-1 gene in the adrenal cortex but not in the medulla of thermally stressed rats.

The heat shock protein 70 (HSP70) gene expression in rat adrenal glands was investigated. In situ hybridization and Northern blotting revealed a marked increase of inducible HSP70 (HSP70-1) gene expression in the adrenal cortex, but not in the medulla, after whole body hyperthermia. In vivo footprinting assay of HSP70-1 promoter region suggested a possible involvement of other factor(s) in addition to the heat shock factor (HSF). We also detected significant increases of both ACTH and corticosterone in the plasma of the hyperthermic rats. These results suggested some physiological factors other than HSF may also participate in the tissue-specific induction of HSP70-1 gene in vivo.

Adrenal Cortex↗

Oral vancomycin hydrochloride therapy for postoperative methicillin-cephem-resistant Staphylococcus aureus enteritis.

The postoperative development of methicillin-cephem-resistant Staphylococcus aureus (MRSA) enteritis can be fatal unless it is detected at an early stage and treated with effective antibacterial agents. We report herein a Japanese multicenter collaborative clinical study on the efficacy and safety of oral vancomycin hydrochloride (VCM) in the treatment of MRSA enteritis. A total of 49 patients who had been diagnosed as having, or were strongly suspected of having, MRSA enteritis during the early postoperative period, were given oral VCM as four standard doses of 0.5 g per day. The VCM concentrations in the blood, urine, and feces were then measured. No side effects were observed and the clinical efficacy of oral VCM in the 31 evaluable patients was excellent. There was a 100% clinical response rate and a 95.8% bacterial elimination rate in the feces. The clinical complete response (CR) rate to oral VCM differed significantly between patients in whom MRSA was detected only in the feces (100%) and those in whom MRSA was isolated from an additional source (57%) (P < 0.01). Although VCM concentrations in the stools were extremely high, the levels in the blood and urine were very low. These results demonstrate that oral VCM should be the treatment of choice for postoperative MRSA enteritis due to its safety and efficacy.

Adult↗

Association of p53 protein expression in stage I lung adenocarcinoma with reference to cytological subtypes.

Since the nuclear accumulation of p53 protein is known to correspond well with mutation of the p53 tumor-suppressor gene, we analyzed the p53 protein immunohistochemically with the anti-p53 mouse monoclonal antibody, DO-7, in 105 stage I lung adenocarcinomas. The p53 immunoreactivity was detected in the nuclei of cancer cells in 51 cases (49%). The p53-positive cases had a significantly poorer prognosis compared with the p53-negative cases (log-rank test; P < .001) When p53 expression was compared among the cytological subtypes of adenocarcinoma, the incidence of p53 expression in the bronchial surface epithelial cell type (11 of 15) was significantly higher than in the goblet cell type (1 of 6) and tended to be higher than the Clara cell/alveolar type II pneumocyte type (27 of 59). These findings indicate that immunohistochemical examination of the p53 protein is a potential prognostic factor in stage 1 lung adenocarcinomas, and that p53 expression has been associated with the cytological subtype.

Adenocarcinoma↗

Event-related potentials (P300) and EEG activity in childhood partial epilepsy.

To clarify the relationship between the cognitive function and EEG activity, auditory event-related potentials (P300) were examined in 72 patients with partial epilepsy. Twenty-six patients (67 trials) had idiopathic partial epilepsies (IPE), and 46 (118 trials) symptomatic or cryptogenic partial epilepsies (SPE). For this study, patients undergoing carbamazepine monotherapy with a dose of less than 16 mg/kg/day were selected to rule out the effects of anti-epileptic drugs. The results were as follows: (1) The P300 latency tended to be prolonged in association with the EEG slowing in both epileptic groups. (2) There was no clear relationship between the frequency of paroxysmal discharges and the P300 latency. (3) The P300 latency was slightly prolonged in the patients with temporal foci compared with that in ones with extra-temporal foci. (4) There was no significant relationship between the generalization of focal paroxysmal discharges and the P300 latency. These results suggested that the influence of EEG abnormalities (particularly paroxysmal discharges) on the P300 latency is relatively little, and the cognitive dysfunction in partial epilepsies mainly originates from other factors such as the epileptogenic lesion itself.

Adolescent↗