Tuberculous arthritis of the sternoclavicular joint. A report of three cases.
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Aged↗
Biomedical subjects
T Yasuda
Publications and source records attributed to T Yasuda.
Acromegalic gigantism with low serum level of growth hormone and elevated serum insulin-like growth factor-I.
In a case of acromegalic gigantism with hyperprolactinemia is reported, the basal serum growth hormone (GH) levels ranged from 1.2 to 1.9 ng/ml. Serum GH response to either insulin-induced hypoglycemia or GH-releasing hormone was blunted. Frequent blood sampling showed non-pulsatile GH secretion. Serum prolactin and insulin-like growth factor-I (IGF-I) levels were elevated. After unsuccessful surgery, bromocriptine treatment normalized serum prolactin without affecting serum GH and IGF-I levels. Combined administration of octreotide with bromocriptine reduced serum GH and IGF-I levels. In this case, non-pulsatile GH secretion and enhanced tissue sensitivity to GH may induce hypersecretion of IGF-I and cause clinical acromegalic gigantism.
Acromegaly↗
A new nitric oxide (NO) releaser: spontaneous NO release from FK409.
The remarkable vasorelaxant and anti-platelet effects of FK409 have been reported to be due to nitric oxide (NO) release. The purpose of the present study is to investigate the spontaneous NO-releasing pathway of FK409 in aqueous solutions. 1H-NMR spectra of FK409 suggested that the compound underwent a time-dependent elimination of the hydrogen atom at alpha-position of the nitro moiety (at the 5-position) in weakly alkaline solutions. In addition, the degradation of FK409 monitored by HPLC showed a pH-dependency accelerating with an increase of pH. These results revealed that the first step in the degradation of FK409 might be the hydroxyl ion-dependent subtraction of the hydrogen atom at the 5-position. On the other hand, NO release from FK409 also exhibited a pH-dependency, and the velocity of NO liberation was markedly enhanced above pH 6. Furthermore, a linear relationship between the rate of FK409 degradation and that of NO formation was observed, indicating that the rate-limiting step for NO formation is the same as that for degradation. Thus, the rate-limiting process of NO formation from FK409 is due to the deprotonation reaction of the hydrogen atom at the 5-position by hydroxyl ions. The deprotonation process appears to be an essential step for both FK409 degradation and NO release. On the basis of the results, a possible kinetic scheme for NO release from FK409 is proposed.
Buffers↗
Proteoglycan degradation in hemarthrosis. Intraarticular, autologous blood injection in rat knees.
We determined the degradation of articular cartilage proteoglycans in a single episode of experimental hemarthrosis in rat knees. The right knee joints of rats were injected once with autologous whole blood. Both knee joints were examined histologically. Biochemical studies of cartilage proteoglycans extracted from the knees were also conducted. Histological examination revealed an accumulation of mononuclear cells in intraarticular fibrin clots and subsynovial layers 8 hours after the injection of blood. Accordingly, initiation of proteoglycan degradation occurred 8 hours after injection of blood, lasting from 1 day of limited degradation to 3 days; recovery then occurred within 7 days. The proteoglycan degradation could be inhibited by 1 mM phenylmethylsulfonyl fluoride, a general serine proteinase inhibitor, 0.1 M 6-aminohexanoic acid, a specific inhibitor of plasminogen activators, 10 mM EDTA, and 10(-6) to 10(-8) M dexamethasone, indicating that the accumulation of mononuclear cells in intraarticular fibrin clots and subsynovial layers may play an important role in cartilage damage.
Aminocaproic Acid↗
Streptococcal pneumoniae polysaccharide increases IgA-class antibody activity under the immunological memory of a protein antigen: two signals on experimental IgA nephropathy.
We designed the following experiment in order to clarify the factors that induce a hyper-immune state of IgA. Six-week-old Balb/c mice were immunized with bovine gammaglobulin (BGG) at 0 and 2 weeks, followed by the administration of phosphorylcholine-BGG (PC-BGG) at 3 and 5 weeks to obtain an immunological memory. At 6 weeks, we divided the mice into three groups: one was a saline group used as a control, another was a PC-BGG group used to investigate T-cell dependent antigen, and the last was a streptococcal pneumoniae polysaccharide (R36A) group used to investigate T-cell independent antigen. We compared the antibody activity in response to BGG, and glomerular immune deposition among the groups. In the control group, antibody activities did not change, and all stainings on glomerular immune deposits were negative. In the PC-BGG group, IgG-class antibody activity was significantly suppressed (p < 0.05), but IgA- and IgM-class antibodies were not affected. The intensity of glomerular deposition of IgM was level one positivity (TFS: 116.7 +/- 20.2 (mean +/- SD)). In the R36A group, polysaccharide produced significant increases (almost four times) in IgA-class and IgM-class antibody activity under the condition of immunological memory (IgA: p < 0.05, IgM: p < 0.005). The intensity of IgA was between weak and level one positivity (TFS: 60.8 +/- 6.3), but the intensity of IgM was weak positive (TFS: 36.7 +/- 10.4). This became a predominant glomerular deposition of IgA in the R36A group.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
IgA nephropathy associated with hyper IgAnemia, psoriasis or pustulosis and ossification.
This is a report on two cases of IgA nephropathy associated with psoriasis vulgaris, having hyper IgAnemia (above 500 mg/dl) and ossification. Case 1 is a 47-year-old woman with a 7-year history of psoriasis vulgaris, and case 2 is a 57-year-old man with a 17-year history of this disease. IgA was 526 and 1,356 mg/dl, respectively. HLA analysis showed A2, A26 (10), Bw62 (15), Bw46, Cw3, DRw12 (5), and DRw8 in the former, and A2, A11, B13, Bw46, Cw11, DR4, and DRw8 in the latter. Renal biopsy specimens disclosed mild mesangial proliferative glomerulonephritis and moderate mesangial proliferative glomerulonephritis with predominant IgA deposition in mesangial area, respectively. A bone-scintigraphy revealed a high uptake of radioisotopes in the left shoulder, the vertebra, the sacroiliac joint, both sides of the knees and ankles, and the sterno-cost-clavicular area. An X-ray study showed ossification of the posterior longitudinal ligament (OPLL) in the former, and ankylosing spinal hyperostosis (ASH) in the latter. A review of the literature discloses three other case reports of hyper IgAnemia, IgA nephropathy, psoriasis or pustulosis, and ossification. The alertness of dermatologists, orthopedic surgeons, rheumatologists, and general practitioners will be required to attain to a more frequent diagnosis of the above combination.
Female↗
[Continuous measurement of myocardial oxygen saturation using near-infrared spectroscopy during warm blood cardioplegia].
Continuous infusion of warm blood cardioplegic solution is often interrupted during coronary artery bypass grafting to obtain a bloodless operating field. We measured myocardial oxygen saturation continuously using near-infrared spectroscopy to determine myocardial oxygen metabolism during intermittent warm blood cardioplegia (IWBC). In 7 adult mongrel dogs undergoing cardiopulmonary bypass IWBC was administered using the Buckberg-Shiley system. Cardiac arrest was induced by a warm blood cardioplegic infusion of 100 ml/min for 5 minutes followed by a maintenance infusion of 40 ml/min for 5 minutes. The infusion of warm blood cardioplegia was then stopped for 15 minutes. Measurement of myocardial oxygen saturation was performed continuously throughout cardiopulmonary bypass. IWBC produced an increase in myocardial oxygen saturation for the first 5 minutes and a slight decrease for the second 5 minutes. After the termination of IWBC, myocardial oxygen saturation showed a marked reduction for 3 minutes and plateaued after 5 minutes. Measurement of myocardial oxygen saturation revealed myocardial oxygen metabolism during IWBC. This procedure may be a useful way to monitor myocardial oxygen metabolism during open heart surgery.
Animals↗
[Surgical treatment of coronary artery fistulas].
Coronary artery fistula is one of the most common coronary malformations and is being diagnosed with increasing frequency with widespread use of selective coronary arteriography. Twenty-one patients with coronary artery fistulas underwent surgical treatment at our institute between 1973 and 1994. The left coronary artery was most commonly involved, and the fistula communicated primarily with the pulmonary artery. Associated cardiovascular disease include: mitral stenosis (1), mitral insufficiency (1), partial anomalous pulmonary venous return (1), ventricular tachycardia (1), atrial septal defect (1), aortitis syndrome (1), and coronary arteriosclerotic narrowing (1). In five patients, the coronary artery fistulas were selectively ligated without CPB. In sixteen patients, in addition to selective ligation, the fistula ostia were closed from inside using CPB. There were no operative or late deaths in the patients who underwent operations. Thus, the risks of surgical correction appear to be considerably less than the potential development of serious and possibly fatal complications, even in asymptomatic patients.
Adult↗
Selective inhibition of human TNF-alpha action by flecainide acetate, an antiarrhythmic drug.
It is now generally accepted that human tumor necrosis factor-alpha (hTNF-alpha) affects not only tumor cells but also normal cells, providing critical tissue damage. hTNF-alpha also enhanced the response of polymorphonuclear neutrophils (PMN) by its priming action and resulted in the increased generation of active oxygen which in turn may be responsible for the tissue injury. Seeking a conventional drug to attenuate the cytolytic activity of tumor necrosis factor (TNF-alpha) and thereby prevent excessive tissue injury, we focused on the cytolytic action of hTNF-alpha against L929 cells, which are sensitive to TNF-alpha, and found that flecainide acetate [N-(2-piperidylmethyl) 1,5-bis-(2,2,2-trifluoroethoxy) benzamide acetate] inhibited specifically the cytolytic action of hTNF-alpha against L929 cells. Flecainide acetate also specifically inhibited the priming action of hTNF-alpha which enhance the formylmethionyl-leucyl-phenylalanine (FMLP)-induced receptor-mediated superoxide (O.2-) generation of human peripheral polymorphonuclear neutrophils (hPMN). The ID50 values for hTNF-alpha induced cytotoxicity in L929 cells and hTNF-alpha primed FMLP-induced O.2- generation of hPMN were 30 and 50-60 microM, respectively. However, the drug does not inhibit the FMLP- or phorbol myristate acetate (PMA)-induced O.2- generation of nonprimed hPMN and has a weak cytotoxic effect on L929 cells. From these results, it is concluded that flecainide acetate suppressed specifically the action of hTNF-alpha.
Animals↗
[Preventive chemotherapy for residual liver after resection of hepatic metastasis from colorectal cancer].
We compared 12 cases treated with intra-arterial chemotherapy (group A), with 15 cases only undergoing the usual hepatectomy (June 1991-February 1995). Six cases in group A were H1, 4 were H2, and 2 were H3; 12 cases in group B were H1, and 3 were H2. In both groups, primary lesions were removed. All cases received high-dose intermittent 5-FU infusion (WHF) at 1,000 mg/m2 via a reservoir for 5 hours a week at the outpatient clinic. Cumulative survival rates for 1 and 3 years are 100% and 68.6%, respectively, in group A, and 58.7% and 25.2% in group B, which indicates the treatment outcome in group A was significantly better. Recurrence in residual liver was not found in group A except for one case whose tumor was unremoved, but it was found in 8 cases (53.3%) in group B up to this writing. CEA value after resection in group A was within the normal range except for one case with a local recurrence. It seems that intra-arterial 5-FU infusion chemotherapy for residual liver after resection of hepatic metastasis from colorectal cancer has a preventive effect on residual liver, and the improvement of the cumulative survival rate can be expected.
Aged↗
[Preoperative neoadjuvant chemotherapy with a combination of 5-fluorouracil, adriamycin and cisplatin (FAP) for advanced esophageal cancer invading trachea or main bronchus].
Conventional irradiation and systemic chemotherapy is scarcely effective for advanced esophageal cancer invading trachea or main bronchus. Therefore, to reduce the area of invasion and suppress distant metastasis, we have preoperatively treated 4 patients suffering from advanced esophageal cancer invading the trachea or main bronchus by neoadjuvant chemotherapy (FAP) as follows: 2 times every 4 weeks, CDDP 100 mg and ADR 50 mg on day 1 and continuous infusion of 5-FU 1,000 mg/day for 7 days. The response rate (PR) was 75% (3/4). In 2 of 4 patients (50%), no cancer cells except broad fibrosis were detected histologically in the region of the trachea or main bronchus suspected to be invaded. There was no severe complication. This FAP regimen is suspected to be useful chemotherapy for advanced esophageal cancer.
Aged↗
[Clinical and neuroradiological studies of eclampsia--cerebral vasospasm and relation to the brain edema].
Clinical and neuroradiological studies involving cerebral angiography were conducted in four patients with eclampsia. In three cases (case 1, 2 and 4), neurological focal signs, abnormal low density areas on cranial CT and T2 high intensity areas on cranial MRI disappeared within a month. But in one case (case 3), cerebral infarction occurred and right hemiparesis and aphasia persisted. Cerebral angiography in the acute phase demonstrated vasospasm in all cases and arterial occlusion in the middle cerebral artery due to vasospasm in case 3. Angiography demonstrated several types of spasms, including diffuse, peripheral and multi local. Furthermore, in some cases, diffuse vasospasms were recognized at the siphon and extracranial portions of the internal carotid artery. In one case (Case 4), segmental vasospasms were detected in the bilateral vertebral arteries. Three to four weeks later, follow-up cerebral angiography was performed in three cases. Cerebral vasospasms had partially or completely recovered. Subarachnoid hemorrhage (SAH) was excluded by lumbar puncture and neuroradiological findings in all cases. We concluded that eclampsia itself causes cerebral vasospasm and that the mechanism of vasospasm is different from that of SAH, since cerebral vasospasm occurred in the extracranial cerebral arteries. We suspected that cerebral vasospasm in eclampsia causes cerebral ischemia, which leads to cytotoxic edema and dysfunction of the blood-brain barrier (BBB) and cerebral autoregulation. With this background, brain edema, especially vasogenic edema, may easily occur and clinical symptoms of eclampsia may appear when the blood pressure rapidly increases.
Adolescent↗
[Microbiological assay method for T-3761 concentration in body fluids].
A microbiological assay method for measurement of T-3761 and its stability in body fluids were investigated. The paper disc method proved suitable for this assay using Escherichia coli Kp as a test organism and commercially available heart infusion agar as a test medium. When using the paper disc method, lower detection limit of T-3761 was approximately 0.05 microgram/ml and 0.1 microgram/ml for 1/15M phosphate buffer (pH 7.0) and human serum, respectively. T-3761 in human serum and urine was stable under freezing -20 degrees C for at least 28 days.
Agar↗
[Mechanism of renal excretion of T-3761, a novel fluoroquinolone agent, in rabbits].
The mechanism of the renal excretion of T-3761, a novel oral fluoroquinolone agent, was studied by renal clearance, stop-flow techniques and analyzing the pharmacokinetics with and without probenecid in rabbits, and which were compared with those of ofloxacin (OFLX). In rabbits probenecid treatment induced increases in the elimination half-life (2.1 times higher) and area under the serum concentration-time curve (3.1 times), and decreases in elimination rate constant (0.44 times) and total body clearance (0.35 times), while volume of distribution showed no significant change. In the stop-flow pattern, a specific peak of T-3761 was observed. On the other hand, a peak of OFLX was observed at the peak of PAH and a small trough at the trough of sodium. And the renal clearance of T-3761 and OFLX were about 4.9 and 3.3 times higher than the corresponding Clcr, respectively. These results suggested that T-3761 was excreted into urine by both glomerular filtration and renal tubular secretion, and was scarcely reabsorbed at distal tubule. The short elimination half-life of T-3761 might be explained by its great ratio of tubular excretion.
Animals↗
[Important prognostic factors in surgically treated gastric cancer patients].
In order to clarify important factors in prognosis of patients with gastric cancer, 3,515 surgically treated cases were investigated. The survival rate varied widely depending on the curativity which strongly correlated with the stage of the disease. For example, such cases with peritoneal dissemination and hepatic metastasis have a poor prognosis. According to our multivariate investigation by Cox's proportional hazard model (SAS, PHREG procedure) based on resectable cases of gastric cancer, the most significant prognostic factor was lymph node metastasis with a ratio of risk 4.58, followed by the macroscopic-type cancer, ratio of risk 3.61, and depth of invasion, with the ratio of risk 2.22. It should be noted that such factors as macroscopic type of cancer turned out to be an important prognostic factor aside from those related with the stage of cancer, such as lymph node metastasis and depth of invasion. Type 4 gastric cancer had a markedly poor prognosis. Among all surgically treated patients, the histologic type was insignificant as a prognostic factor, however, when limited to mucosal cancer, the undifferentiated type had a higher lymph node metastasis rate than the differentiated type. This result suggests that the histologic type of cancer should be carefully considered in case of endoscopic treatment of gastric cancer.
Analysis of Variance↗
Two cases of early gallbladder cancer incidentally discovered by laparoscopic cholecystectomy.
In case 1, a 68-year-old woman with asymptomatic gallstones underwent laparoscopic cholecystectomy after radical mastectomy for breast cancer. Histological examination revealed gallbladder carcinoma with involvement confined to the mucosa and positive margin at the cystic duct. We resected the remnant cystic duct with open laparotomy. In case 2, a 63-year-old woman with a diagnosis of early rectal cancer underwent laparoscopic cholecystectomy for silent gallstones following transanal resection of the rectal tumor. Pathologic analysis illustrated a gallbladder carcinoma with wide mucosal spread and minimal invasion into the subserosal layer. No additional treatment was warranted. As laparoscopic cholecystectomy has become widely used, an increase in the number of resected cases of early gallbladder cancer can be expected, especially among asymptomatic gallstone patients. Additional treatment should be determined through meticulous microscopic investigation of the specimen, with special attention to the depth of invasion and the range of mucosal spread.
Adenocarcinoma↗
An improved simple colorimetric method for quantitation of non-transferrin-bound iron in serum.
A simple method for direct quantitation of non-transferrin-bound iron (NTBI) in serum is introduced. NTBI was separated from serum by adding excess nitrilotriacetic acid disodium salt (NTA) to serum to form an Fe-NTA complex and then ultrafiltrated using a micro-filter. The NTBI in the ultrafiltrate was quantitated using a bathophenanthroline-based method. The optimal detection condition and several potential confounding factors were investigated. The actual measurements to samples in vivo and in vitro showed that this method is very practical.
Animals↗
Correlation of alpha-1-antitrypsin (PI) polymorphism between blood and semen.
The correlation between isoprotein types of alpha-1-antitrypsin (PI) in blood and semen samples from the same individual was determined in 48 Japanese men by the combined technique of isoelectric focusing with immobilized pH gradients and immunoblotting. Five common PI types (M1, M1M2, M1M3, M2 and M2M3) were detected in the blood plasma samples. However, PI-specific bands in semen migrated more cathodally than those in plasma into a pI region of approximately 5.05, and about 17% of the semen samples could not be phenotyped: the rest were easily phenotyped and their PI types were found to correlate with the type found in the corresponding blood samples. PI typing could therefore provide an additional discriminant characteristic for the forensic examination of individualization from semen samples.
Forensic Medicine↗