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Biomedical subjects

T Miyano

Publications and source records attributed to T Miyano.

At least 181 records · Page 10Linked to original sources
PubMed1989

[Clinical study on splenic autotransplantation after splenectomy in idiopathic thrombocytopenic purpura].

Splenic autotransplantation after splenectomy for idiopathic thrombocytopenic purpura (ITP) is one of the effective treatments for maintaining the patients' immunity in children. We investigated this surgical method in 10 adult ITP patients. This method was extremely effective for thrombocytopenia. Cellular immunity of the patients was maintained as evidenced by the normal response of peripheral lymphocytes to phytohemagglutinin (PHA) and concanavalin-A (Con-A) after the operation. The mitogenic response of peripheral lymphocytes to PHA and Con-A might be a useful indication for predicting the effect of splenectomy.

Adult↗
PubMed1989

[Severe aplastic anemia successfully treated with cyclosporin A and prednisolone].

A 7-year-old boy was admitted to our department complaining pale face and subcutaneous bleeding in August, 1987. Peripheral blood analysis showed pancytopenia of WBC 2,600/microliter, RBC 148 x 10(4)/microliter and platelets 5,000/microliter. Bone marrow biopsy revealed hypocellularity. Granulocytes 104/microliter, reticulocytes 4,290/microliter and platelets 5,000/microliter were compatible with the diagnosis of severe aplastic anemia based on the criteria of the Ministry of Public Welfare in Japan. Prednisolone (PDN) was initially indicated and bolus methylprednisolone, metenolone and ALG therapy followed with no hematological improvement. Fifteen months after admission, in addition to 0.5-1 mg/kg/day of metenolone, Cyclosporin A (CyA) was started at a dose of 12 mg/kg/day for a week and 6 mg/kg/day thereafter. After a week from administration of CyA, 1 mg/kg/day of PDN was given because his bleeding tendency became worse. But this combination was complicated with liver damage and hyperglycemia to discontinue both drugs. These adverse effects were subsided within 7 days by cessation of the drugs. CyA was started again at a dose of 6 mg/kg/day without any response for 4 weeks. Then PDN was added together at a reduced dose of 0.5-1 mg/kg/day. Hematological response was obtained promptly. Granulocytes reached 1,500/microliter, hemoglobin 10.2 g/dl and platelets 26,000/microliter after 3 months of therapy. Afterward the patient became transfusion independent. The most effective method of CyA administration for aplastic anemia is still controversial. Alternative use of CyA, considering combination of steroids or anabolic steroids, in patients who failed to respond to conventional immunosuppressive treatments should be further investigated.

Anemia, Aplastic↗
PubMed1988

[Problems and difficulties in adapting period in infants and children after massive intestinal resection].

In the period of intestinal adaptation following massive resection of intestine, patients have several difficulties and problems. This study was done in 17 survivals of 31 infants and children received massive intestinal resection (residual intestine; less than 75 cm) between 1966-1987 to define these problems and difficulties. 1) Postoperative hepatic dysfunction occurred in 11 of the 17 survivals. The relationship between relapsing frequency of hepatic dysfunction and length of remaining ileal segment suggested that the reduced ileal length may be one of the etiologic factors of the hepatic dysfunction. 2) Evaluation of serum bile acid levels suggested that the disturbance of bile acid reabsorption and its rapid turn over might still remain even after catch-up growth of these patients. 3) Abnormal levels of serum minerals (Ca, InP, Mg, Zn and Cu) were observed in 4 cases during TPN, and these abnormalities disappeared by discontinuation of parenteral nutrition and beginning of oral feeding. 4) Serum vitamin levels (Vit.A, Vit.E, 25-OH-D3, and Vit.B12) still remained in abnormal even after the patients reached school age. These results suggested that very long-term nutritional cares, especially in lipid and vitamin nutrition, are necessary for the children with massive intestinal resection.

Bile Acids and Salts↗
PubMed1987

Clinicopathologic and experimental studies on cases of abnormal pancreatico-choledocho-ductal junction.

An abnormal pancreatico-choledocho-ductal junction, in which free communication between the pancreatic duct and the common bile duct was present, was observed in 17 out of 120 cases (14.2%) of biliary tract carcinoma and in all of four cases of congenital biliary dilatation, but in noe of about 200 control patients without biliary tract disease. Outstanding findings in the pancreas, such as degeneration of the ductal epithelium and interlobular fibrosis, were found in 6 of 21 cases of abnormal junction. In an experimental study using 63 puppies given choledocho-pancreatic end-to-side ductal anastomosis, dilatation of the bile duct of varying degree occurred and mucosal hyperplasia of the biliary tract was observed in 12 of 25 anastomosed dogs for a duration of more than one month. Cell kinetics in biliary tract mucosa observed by the use of monoclonal antibody against bromodeoxyuridine (BrdU) was obviously elevated in dogs subject to long-term follow-up. As for pancreatic lesions, the incidence and histologic findings were similar to those of human studies, as follows: chronic pancreatitis in only a few animals, mild periductal parenchymatous change in 15 puppies and no significant change in 44 puppies. Therefore, an abnormal pancreatico-choledocho-ductal junction may be one of the significant factors producing biliary dilatation, biliary tract carcinoma and pancreatitis.

Animals↗
PubMed1986

Essential fatty acid deficiency in congenital biliary atresia: successful treatment to reverse deficiency.

Supplementation of lipid intake by infusion of solutions of essential fatty acid (EFA)-rich powder through Suruga II enterostomy was carried out for the treatment of EFA deficiency in nine children with postoperative congenital biliary atresia (CBA). Infusion of EFA-rich powder dissolved in excreted bile was effective in six patients except for a case who had a total bile acid concentration in the excreted bile that was less than critical micellar level. Administration of EFA-rich powder dissolved in a mixture of the patient's own bile and 1 to 2 mmol/L taurocholate (TC) solution corrected EFA deficiency in three children with total bile acid concentration lower than the critical level. Our results therefore show that infusion of EEA-rich lipid through Suruga II enterostomy after dissolving in the excreted bile is an effective treatment for EFA deficiency in postoperative patients with CBA, and that 1 to 2 mmol/L TC solution used as artificial bile facilitates lipid absorption in cases with total bile acid in the bile less than the critical micellar level.

Bile Acids and Salts↗
PubMed1986

Sulfated and nonsulfated bile acids in urine of patients with biliary atresia: analysis of bile acids by high-performance liquid chromatography.

To elucidate urinary bile acid patterns in patients with biliary atresia (BA), 15 sulfated and nonsulfated bile acids in urine were separately measured by high-performance liquid chromatography. This relatively simple technique for fluorescence detection utilizes the enzyme 3 alpha-hydroxysteroid dehydrogenase (3 alpha-HSD) to reveal urinary bile acid patterns. By this method, recovery rates of sulfated and nonsulfated bile acids in urine were satisfactory, and this analysis was shown to be applicable to clinical situations. In 10 patients with BA, the mean level of total bile acids in urine (23.35 +/- 18.51 mumol/day) was seven times higher than the mean level in eight normal infants (3.05 +/- 2.05 mumol/day). In the infants with BA, the mean level of total sulfated bile acids was about half of the total bile acid level. The main components of urinary nonsulfated bile acids in BA were glycocholic acid (6.21 +/- 5.55 mumol/day) and taurocholic acid (2.28 +/- 1.33 mumol/day), whereas the main components of the urinary sulfated bile acids were glycochenodeoxycholic acid (4.58 +/- 6.97 mumol/day) and taurochenodeoxycholic acid (3.67 +/- 3.54 mumol/day). Chenodeoxycholic acid, which is relatively toxic to the liver, may more easily be conjugated with sulfate and, hence, excreted into urine at a faster rate than cholic acid. Marked individual variations in urinary bile acid patterns were observed not only in BA patients but also in normal controls.

Adult↗
PubMed1986

Cardiovascular effects of NPK-1886, a new dihydropyridine compound with calcium entry blocking activity.

The cardiovascular effect of NPK-1886 (NPK), a novel photostable dihydropyridine compound, was studied by comparing it with that of nifedipine (Nif). In normal Wistar rats (NWR), systolic blood pressure was only slightly depressed by NPK or Nif, while in three types of hypertensive rats (i.e., spontaneously hypertensive rats (SHR), renal hypertensive rats (RHR) and DOCA-saline-induced hypertensive rats (DOC-Na-R)), the hypotensive potency of NPK was more than or equal to that of Nif. The effectiveness of NPK on the normal and hypertensive models was in the following order: DOC-Na-R, RHR, SHR, NWR. Coronary perfusion flow in Langendorff's heart was increased almost the same extent by NPK and Nif. On isolated rabbit aortic strips, the antagonistic potencies of NPK, like those of Nif, were greater for calcium than for norepinephrine, serotonin and angiotensin II. The negative ino- and chronotropic potency of NPK in isolated guinea-pig right atria was less than that of Nif. The slow membrane action potentials of guinea-pig papillary muscle were suppressed by NPK, but less than by Nif, with manifestations of a reduction of Vmax and AP-duration. These results indicate that NPK has a potent hypotensive effect on hypertensive models and a weaker cardiac inhibition. The general toxicity of NPK was lower than that of Nif.

Action Potentials↗
PubMed1986

Biosynthesis of fluorothreonine and fluoroacetic acid by the thienamycin producer, Streptomyces cattleya.

An antimetabolite, THX, was isolated from fermentation broths of the thienamycin producer, Streptomyces cattleya, when the organism was grown in the presence of a fluorine-containing substrate. THX was subsequently identified as one of the four possible stereoisomers of 4-fluorothreonine. Inorganic fluoride or any one of a number of organofluorine compounds can be used as precursors of 4-fluorothreonine. In addition, 19F NMR has provided evidence that the organism synthesizes fluoroacetate under the same fermentation conditions. The in vitro antibacterial spectrum of 4-fluorothreonine is also presented.

Animals↗