Biomedical subjects
Publications and source records attributed to Y Hashimoto.
A 40-yr-old woman with alveolar soft-part sarcoma and multiple hypervascular cardiac tumors involving both left and right ventricles is reported. Papillary muscle dysfunction and mitral valve prolapse with mitral regurgitation were caused by the largest tumor in the left ventricle.
When normal polymorphonuclear leukocytes (PMN) were incubated with sera from patients with active systemic lupus erythematosus (SLE), a significantly increased cytotoxicity against human cultured vascular endothelial cells (EC), compared with normal control sera, was demonstrated by the standard 51Cr release method. The degree of this cytotoxicity was correlated with the immune complex level in each serum. The cytotoxicity did not correlate with the presence of anti-EC antibody. An absorption study with C1q-Sepharose 4B further suggested that the immune complexes are the factor which induce cytotoxicity. A gel fractionation study, however, indicated the heterogenity of the cytotoxic activity, and suggested the possible contribution of other substances including anti-EC, at least in some of the patients. This type of cytotoxicity may initiate the inflammatory process including vascular damage of the disease.
The comparative localisation of renin in the genital organs, especially in the coagulating glands of male mice of the strains C57BL/6 and Balb/c, was investigated using immunocytochemical, immunoelectron microscopical and Northern blot techniques. Dot-like reactions for renin, of varying diameters, were detected immunocytochemically in the epithelial cells of coagulating glands of C57BL/6 mice, but not in those of Balb/c mice. In both strains, many electron dense granules differing in content and morphology were observed in the epithelial cells of the coagulating glands. Crystalline materials were sometimes contained in these granules. Colloidal gold particles indicating the presence of renin were detected in the electron dense granules of C57BL/6 mice, in which they showed a heterogeneous distribution and were especially located on the crystalline structure. No positive reaction was detected in these crystalline structures in Balb/c mice. Renin mRNA was detected in the coagulating glands of both C57BL/6 and Balb/c mice by Northern blot analysis. However, the expression in C57BL/6 coagulating glands was stronger than that in Balb/c. These findings suggest that renin is synthesised and released in the coagulating glands.
We investigated the effects of epithelium removal and cooling (32 degrees C, 27 degrees C, 22 degrees C) on isolated tracheal smooth muscle contraction induced by bethanechol (BCh), acetylcholine (ACh), histamine (Hist), and KCl in guinea pigs. The pD2 values (-logED50) increased in the epithelium damaged group compared with the intact group when ACh was administered at 37 degrees C, 32 degrees C, 27 degrees C and 22 degrees C, with histamine at all four temperature conditions, and with KCl at 37 degrees C, 32 degrees C and 27 degrees C. In both groups, the pD2 values for BCh, ACh, and KCl tended to decrease as temperature was lowered, and significant decrease in pD2 was observed at 27 degrees C. In contrast, the pD2 value for histamine tended to increase as temperature was lowered in every group. Concerning these agents, we conclude that epithelium removal and cooling exert neither significant nor consistent effect on tracheal epithelial function.
N-(2)-Carboxyphenyl-4-chloroanthranilic acid disodium [Lobenzarit disodium (CCA)] is widely used for the treatment of patients with RA in Japan; however, the pharmacological mechanism of the compound is still unclear. In this report, the effect of CCA on the proliferation and DNA synthesis of endothelial cells was examined. CCA inhibited DNA synthesis in endothelial cells at a rather lower concentration than that in fibroblasts and HeLa cells. The DNA polymerase alpha activity was inhibited by CCA at a lower concentration than E. coli DNA polymerase I and avian myeloblastosis virus reverse transcriptase. Thus, CCA is a potent inhibitor of DNA polymerase alpha and this inhibitory effect could cause the inhibition of endothelial cell proliferation, which may be related to the therapeutic and pharmacological mechanisms of CCA.
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A 32-year-old woman developed myalgia, fever, consciousness disturbance, mental disorder, pyramidal tract signs and meningeal irritation signs at about 2 months after a normal labor. Laboratory examination showed hypopituitarism (decreased ACTH, TSH), renal dysfunction and hypercalcemia. A variety of antibiotics, acyclovir and gamma-globulin failed to improve her symptoms. A diagnosis of Chlamydia trachomatis infection was considered from the elevated antibody titers. In this case, minocycline was very effective. Rarely Chlamydia trachomatis infection involved general organs, including the central nervous system. It was interesting that she had endocrine disorders. We must take a look for Chlamydia trachomatis infection because this infection infrequently involves general organs, including the central nervous system and minocycline is very effective for this infection.
Omeprazole, a proton pump inhibitor was used for premedication for general anesthesia, and its effects on gastric secretion and serum gastrin level were investigated in 60 patients. The patients were divided into the following 4 groups and each group received one of the following medications; (I) a tablet of omeprazole 20 mg before sleep at the night before the surgery, (II) a tablet 2 hours before the induction of anesthesia, (III) one on the night before and another tablet 2 hours before the induction, or (0) no tablet. In the patients who received any dose of the drug, the volume of gastric juice at the beginning of the surgery was significantly less than that in those who received no drug (P less than 0.05). Gastric pH showed a tendency to increase depending on the dose of omeprazole (0 less than I less than II less than III), but it was not significant. No significant change in serum gastrin level was observed in this study. A 20 mg omeprazole tablet may not be adequate as the premedication for general anesthesia.
Effect of pirenzepine, famotidine or a combination of both agents on gastric secretion during anesthesia and surgery was evaluated in 42 surgical patients ranged in age from 17 y to 70 y. They underwent orthopedic, ophthalmic, ENT, plastic, oral or non-abdominal surgery under either neuroleptanesthesia or enflurane anesthesia. They received either pirenzepine 10 mg, famotidine 20 mg or the combination of both agents intravenously just before the induction of anesthesia. Volume and acidity of gastric juice were measured during 3 hours after the administration of these agents. A continued decrease in volume and acidity of gastric juice was observed 3 hrs after the administration of the agents both in the pirenzepine group and in the famotidine group. Efficacy of the combination of pirenzepine and famotidine on gastric secretion tended to be more prominent than that of either pirenzepine or famotidine alone.
The effect of ranitidine, administrated 2 or 4 hours prior to induction of anesthesia, on volume and pH of gastric juice was investigated in patients undergoing elective surgery. Three-hundred mg of ranitidine was administrated orally in 54 patients 2 hours prior to anesthesia and in 50 patients 4 hours prior to anesthesia. The volume and pH of gastric juice were measured immediately after induction of anesthesia. In more than 90% of patients of both groups, volume of gastric juice was smaller than 25 ml and its pH was more than 2.5. Ranitidine 450 mg was administrated orally in 7 patients, and its plasma concentration was measured 2, 4 and 6 hours after administration. In one patient, volume of gastric juice was larger than 25 ml and its pH was less than 2.5. Ranitidine concentration in this patient was below the effective level 2 hours after administration and it was above the level after 4 hours. We concluded that oral administration of ranitidine 300 mg, 4 hours preoperatively, could be more effective to prevent aspiration pneumonitis than when it is given 2 hours preoperatively.
The induction and intubation with high concentrations of sevoflurane (4% or 6.4%) were investigated in 180 children with ages ranging from 1 to 6yr 12m. Average induction time (duration between the start of induction and loss of consciousness) with 4% sevoflurane was 56 sec and that with 6.4% was 47 sec. Eight patients out of 90, to whom 4% sevoflurane was applied, could not be intubated due to closure of vocal cord, cough or closure of mouth. The most serious side effect was convulsion during induction, of which incidence was 6% of all patients, and occurred more frequently with 6.4% sevoflurane. The convulsion spread from hand on one side to all over the body, and disappeared spontaneously within 30 sec. There was no significant side effect in cardiovascular system, such as hypotension, arrhythmia or bradycardia. In conclusion, smooth intubation was possible without use of muscle relaxants with high concentrations of sevoflurane. This can be one of the choices for induction of children, though there is a possibility of occurrence of convulsion.
A 73-year-old man was admitted with severe abdominal fullness. Physical examination suggested much ascites. Laboratory data revealed that BUN was 39 mg/dl, Cr was 2.2 mg/dl, UA was 19.7 mg/dl, and LDH was 1,569 U/l. In ascites, there were many cells with large nuclei and many vacuoles. Immunocytological characterization indicated that most of these cells were B lineage. And diagnosis of malignant lymphoma, the patient was treated with VEPA therapy. However, he soon died with acute renal failure. We examined the possibility of gene rearrangements between the c-myc and immunoglobulin genes and found that c-myc gene was rearranged at the first intron, and joined with immunoglobulin JH locus as head to head. These results suggested that the patient carried Burkitt's lymphoma of the American type.
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The perioperative courses of 10 patients with obstructive sleep apnea syndrome who underwent uvulopalatopharyngoplasty were reported. No hypnotic was administered at night before operation. Premedication consisted of atropine 0.5 mg, meperidine 35 mg, given i.m. 1 hr prior to surgery. No patients developed respiratory depression after premedication. General anesthesia was induced with iv thiopental, and succinylcholine was given to facilitate tracheal intubation. Airway management was technically difficult in all patients. Anesthesia was maintained with N2O-O2-enflurane under controlled ventilation. At the end of the surgery the insertion of a nasopharyngeal airway was performed for the prevention of airway obstruction. In 8 patients it was possible to remove the airway in the next morning. Dexamethasone was administered 3 times to reduce pharyngeal edema during perioperative period. Trachea was extubated when the patient was fully awake and alert. Perioperatively the following points are important in the management of uvulopalatopharyngoplasty. 1. Assessment of airway and the method of airway control. 2. Reduction of pharyngeal edema. 3. Using caution against the postoperative hemorrhage. 4. Avoidance of sedation. 5. Close observation extending into the postoperative period.
The correct endotracheal tube size was assessed in 600 anesthetized infants and children. The correct tube size was determined by the airway pressure at which a gas leak around the endotracheal tube occurred, when the lungs were inflated with slowly increasing positive pressure. Endotracheal tube size correlated most with body length where the correlation coefficient was 0.973 (P less than 0.01), followed by body weight, tracheal size in X-ray photograph and age. But, there were four correct tube sizes for patients with the same body length.
The purpose of this study was to elucidate the effect of Peptide YY (PYY) on gastric acid output in association with gastric mucosal blood flow (GMBF), acetylcholine (ACh) release in the gastric wall and gastric vascular perfusion pressure in rats. Baclofen stimulated the gastric acid output and GMBF in a dose-dependent manner. Both atropine sulfate and truncal vagotomy completely abolished the effect of baclofen. PYY caused inhibition of baclofen-stimulated gastric acid output and reduction in baclofen-stimulated GMBF in a dose-dependent manner, however PYY didn't cause inhibition of pentagastrin- and histamine-induced acid output completely. But PYY had no effect on bethanechol-induced acid output. PYY inhibited the [3H] ACh release from cholinergic nerve endings of gastric body evoked by electrical transmural stimulation. PYY had little effect on gastric vascular perfusion pressure in the basal state, and basal gastric acid output. In the present study, it was concluded that the mechanism of the inhibitory effect of PYY on gastric acid output seems to involve reduced ACh release from cholinergic nerves.
Co-existence of three M-components in the serum or urine is rare. A case of non-Hodgkin's lymphoma was associated with three M-components. A 64-year-old woman was referred to our hospital because of M-proteinemia in June, 1989. On admission, serum electrophoresis on cellulose acetate membrane disclosed a triple M-peak. Immunoelectrophoresis showed M-bows for anti-IgG, anti-IgA, anti-IgM and anti-kappa simultaneously. In the urine, kappa type only Bence Jones protein was found. Scanning computed tomography revealed bulky masses in the lower abdomen, and the tumor masses were removed and diagnosed as non-Hodgkin's lymphoma. Immunohistochemical staining with antibodies to each immunoglobulins revealed the cells producing single M-component of each isotype of immunoglobulins. Although surgical removal of tumor caused a marked decrease in M-component especially IgA kappa, consistent presence of plasmacytoid lymphocyte was observed in peripheral blood. Combination therapy with melphalan and procarbazine resulted in disappearance of IgG kappa and IgA kappa from the serum. In January 1990, she achieved partial remission and was discharged. The patient has remained in remission for 16 months.