[Drug interaction].
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Adrenergic beta-Agonists↗
Biomedical subjects
Y Kamikawa
Publications and source records attributed to Y Kamikawa.
[Emergent operation after percutaneous transluminal coronary rotational atherectomy (ROTABLATOR)].
Emergent operations were performed in seven patients after percutaneous transluminal coronary rotational atherectomy (PTCRA). The causes of the emergent operations were coronary rupture in three patients, acute coronary occlusion in two patients, perforation of the ascending aorta in one patient and impossible weaning from IABP in one patient. IABP was used preoperatively in all patients. Coronary artery bypass grafting was performed in all patients. Ruptured sites of the coronary arteries were closed and perforated site of the ascending aorta was repaired. Two patients died due to cardiac failure but five patients were recovered. Coronary artery rupture was main complication after PTCRA. It is important to recognize the difference between the complication after PTCRA and that after conventional PTCA.
Adult↗
Suppressed apoptotic induction in esophageal squamous cell carcinomas expressing extensive p53 protein.
p53 protein accumulation, thought to be caused by p53 gene mutation, is closely related to poor prognosis of patients with certain types of carcinomas. The progression of esophageal squamous cell carcinoma (SCC) is also strongly suspected to depend on the p53 tumor suppressor gene. Formalin-fixed, paraffin-embedded sections were taken from 25 patients who underwent esophagectomy for SCC. Fourteen patients had no preoperative therapy (control group), while the other 11 patients received preoperative radiotherapy (radiation group). There was no difference in pathological TNM classification between the two groups. These sections were examined by immunostaining with monoclonal antibody PAb 1801 to determine the accumulation of p53 protein, and apoptotic frequency was determined by TdT mediated dUTP-biotin nick end-labeling (TUNEL). In the control group, well to moderately differentiated cases showed a significantly higher AI (apoptotic index which is the number of apoptotic cells among 1000 cancer cells. %0) (51.7+/-83.4) than poorly differentiated cases (AI=1.3+/-1.0) (P<0.05). Similar results were obtained in the radiation group. The former group included 4 cases of p53 grade 4 (p53 protein detected in over 70% of the tumor cells), and the latter included 2. Few apoptotic cells were observed in any of 6 tumor tissues. In each patient, tumor cells with accumulated p53 protein were very rare to be apoptotic. On the other hand, apoptosis was observed in tumor cells without p53 protein accumulation. Spontaneous apoptosis in esophageal SCC can be induced more easily in differentiated than in poorly differentiated cases. This tendency may be enhanced by preoperative radiotherapy. Extensive p53 protein may suppress apoptotic induction in esophageal squamous cell carcinomas.
Adult↗
Postoperative gastric motility, secretory function, and pre- and postoperative carbohydrate metabolic states in esophageal cancer patients.
This study was undertaken to assess postoperative gastric motility and gastric acid secretion, and pre- and postoperative carbohydrate metabolism in patients with esophageal cancer. The gastric motility was compared among 3 different reconstruction routes in 26 patients who were divided into 2 groups according to the duration of postoperative follow-up; group A, 3 months or less; and group B, 18 months or more. The routes used for subtotal resection of the stomach were the posterior mediastinal, retrosternal, and subcutaneous routes. All patients showed positive resting pressure in the esophagus, but peristaltic waves did not reach the gastric tube at dry swallowing in any patients and peristaltic waves appeared after eating pudding only in 1 patient in group B. The resting pressure and gastric emptying time were similar among reconstruction routes, but the incidence and amplitude of metoclopramide (MCP)-induced peristaltic waves were significantly higher in group B than in group A. Furthermore, 24-h intragastric pH monitoring of gastric secretion in a group of 9 patients revealed individual variation in gastric secretion. Some patients showed high acidity soon after operation, suggesting the need for prophylactic treatment for preventing gastric ulcer. Postoperatively, postprandial serum gastrin levels were significantly higher than preoperative levels. In the other group of 11 patients tested, preoperative and postoperative carbohydrate metabolism were not significantly different. Postoperatively, carbohydrate metabolism recovered to preoperative levels after a transient decrease. These results demonstrated that postoperative motility improved over time although no difference was found among the 3 reconstruction routes used.
Adult↗
A case of traumatic neuroma of the gallbladder in the absence of previous surgery and cholelithiasis.
We experienced a patient with traumatic neuroma of the gallbladder with no history of gallbladder surgery or cholelithiasis. A 74-year-old man was referred to our department after a gallbladder tumor was incidentally discovered during a preoperative screening examination for prostate hypertrophy. Ultrasonography, MRI, CT and endoscopic retrograde cholangiography revealed a protuberant lesion of the gallbladder. Laparoscopic cholecystectomy was attempted but adhesion between the liver and duodenum forced us to convert to open laparotomy. Cholecystectomy and adjacent liver tissue resection was performed. Diagnosis was made by frozen histology during operation. It revealed no malignancy. Postoperative pathological examination revealed traumatic neuroma associated with inflammation. To our knowledge, this is the first reported case of gallbladder neuroma without a history of gallstones or surgery in the English and Japanese literature since 1980. This traumatic neuroma should be considered in a differential diagnosis in treating gallbladder neoplasm, even in the absence of an operative history or cholelithiasis.
Aged↗
Mucosal stripping in the treatment of a major leak from an oesophagojejunostomy.
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Aged↗
Endoscopic mucosal resection for superficial carcinoma and high-grade dysplasia of the esophagus.
Endoscopic mucosal resection (EMR) is a recently introduced therapeutic method based on the principles of the strip biopsy for resection of flat lesions of the gastrointestinal tract. Eleven asymptomatic patients (nine men, two women) with superficial carcinoma or high-grade dysplasia of the intrathoracic esophagus were treated by EMR during a 6-month period. The patients' mean age was 64 years (range, 49-78). The site of the lesions was the middle third of the esophagus in eight, upper third in two, and lower third in one patient. All patients in this series had a flat (II) type of superficial cancer. The procedure was carried out in all 11 patients without complication. Histopathological examination of the specimens revealed squamous cell carcinoma in nine patients. The remaining two patients were confirmed to have dysplasia only. Free margins measured greater than 5 mm in all cases. No recurrence was detected in a mean follow-up of 8 (5-10) months. For superficial flat lesions, EMR proved to be a safe and curative procedure that provided good quality of life following resection. However, larger trials are needed to confirm these results. Applying EMR to esophageal dysplasia could decrease the incidence of esophageal cancer.
Aged↗
Chopstick retention suture for the closure of abdominal wounds.
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Abdominal Muscles↗
[Preoperative intra tumor biological response modifier injection therapy for patients with stomach neoplasms].
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Antineoplastic Agents↗
Neurogenic control of airway smooth muscle function.
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Animals↗
Influence of epithelial removal on the antihistaminic activity of azelastine in the guinea-pig airway smooth muscles.
The influence of epithelial removal on the antihistaminic activity of azelastine in the guinea-pig isolated cervical trachea and main bronchus was examined. In both preparations with an intact epithelium, histamine produced a concentration-dependent contraction, but its potency (pD2) and contractility (Emax) were significantly higher in the main bronchus than in the cervical trachea. Epithelial removal from these preparations significantly increased the pD2 values in both tracheal and bronchial preparation, while the Emax value was significantly increased only in the cervical trachea. When these preparations were pretreated with azelastine (20 or 200 nM), concentration-response curves for histamine shifted downward, but were not influenced by the presence of an intact epithelium. Neither concentration of azelastine significantly modified the contractile responsiveness of tracheal and bronchial preparations to carbachol or neurokinin A. These results indicate that azelastine selectively antagonizes the histamine-induced contraction of the guinea-pig airway smooth muscles with or without an intact epithelium.
Animals↗
Comparison of the effect of zopiclone and brotizolam on sleep EEG by quantitative evaluation in healthy young women.
We studied the effect of brotizolam (BRO) (0.25 mg) and zopiclone (ZPC) (7.5 mg) on the sleep electroencephalograms (EEG) of seven healthy young women (ages 20-21 years). In addition to conventional sleep scoring, we performed spectral analysis of EEG wave forms using the Fast Fourier Transformation (FFT) method. Four weeks following two consecutive polysomnographic recordings with placebo administration (for baseline data), polysomnography with BRO or ZPC administration was performed on the subjects who were then crossed over to polysomnography with ZPC or BRO, respectively, 1 week later. Total rapid eye movement (REM) time was decreased on the ZPC and BRO nights and REM latency was prolonged on the ZPC night compared with baseline (BL) night. Other parameters, however, were not significantly different between the drug nights and the BL night. There were also no differences in standard scoring results between both drug nights. FFT analysis revealed significant differences in total power density percentage and mean power density percentage in both nonrapid eye movement (NREM) and REM sleep between ZPC and BRO nights and between both drug nights compared to the BL night. Total power density and mean power density per epoch showed significant decreases in the theta band (6.0-8.0 Hz) and sigma band (12.0-14.0 Hz) on the ZPC night versus the BRO night or BL night during specific NREM periods. The results of this study corroborate previous reports that suggest computer-aided quantitative electroencephalography aids in differentiating specific effects of hypnotics and other central-nervous-system-acting agents on the sleep EEG.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Agreement of visual scoring of sleep stages among many laboratories in Japan: effect of a supplementary definition of slow wave on scoring of slow wave sleep.
The purpose of this study was to elucidate the agreement of visual scoring of all-night polysomnographic recordings among many scores from different laboratories. Ten scorers including the author from different laboratories in Japan scored the same paper recordings of two young male subjects. We calculated the agreement rate for each stage using an epoch by epoch analysis. In both records, the agreement rates for stages 2 and R were high; on the contrary, those for stages 3 and 4 were low. After adding a supplementary definition of high voltage slow wave in deep sleep, we scored the first NREM period of another subject. The mean agreement rate for stage 3 among 10 scorers was significantly higher than those of the two former subjects. However, the agreement for stage 4 did not change so much. This result demonstrates that there is much interrater (laboratory) variability of visual scoring, especially in slow wave sleep. When the result of automatic scoring is compared to that of the visual scoring to evaluate the reliability of automatic scoring, these findings must be considered.
Adult↗
Inhibitory effect of CP-96,345, a non-peptide neurokinin-1-receptor antagonist, on neurogenic responses of guinea-pig isolated airway smooth muscle.
The actions of CP-96,345, a non-peptide neurokinin-1 receptor antagonist, on the responses evoked by electrical-field stimulation or by acetylcholine and substance P in guinea-pig tracheal and bronchial muscle strips were examined. Electrical-field stimulation evoked a biphasic response, consisting of a cholinergically-mediated fast contraction followed by non-adrenergically-mediated relaxation in tracheal muscle and by a non-cholinergically-mediated slow contraction in bronchial muscle. CP-96,345 (1-10 microM) caused a concentration-dependent and non-selective inhibition in the amplitude of these neurogenic responses, where non-cholinergic contractions were more profoundly inhibited. Submaximal contractions of tracheal and bronchial muscles evoked by exogenous substance P (0.1-3 microM) were partly inhibited by CP-96,345 (1-10 microM), but acetylcholine-induced contractions were hardly inhibited. The results indicate that in guinea-pig isolated airway smooth muscle CP-96,345 can non-selectively inhibit neurogenic responses probably via neurokinin-1 receptor-dependent and independent mechanisms.
Acetylcholine↗
SR 48968, a novel non-peptide tachykinin NK-2-receptor antagonist, selectively inhibits the non-cholinergically mediated neurogenic contraction of guinea-pig isolated bronchial muscle.
We have examined the actions of SR 48968 ((S)-N-methyl-N-[4-(4-acetylamino-4-phenyl piperidino)-2-(3,4-dichlorophenyl)butyl]benzamide), a novel non-peptide tachykinin NK-2-receptor antagonist, on the response evoked by electrical field stimulation or by acetylcholine and neurokinin A on guinea-pig isolated airway smooth muscle. Electrical field stimulation (1-32 Hz, 0.3 ms, 30 V for 20 s) evoked a biphasic response in a frequency-dependent manner, consisting of a cholinergically-mediated fast contraction followed by a non-adrenergically-mediated relaxation in tracheal muscle and by a non-cholinergically-mediated slow contraction in bronchial muscle. SR 48968 (0.01-1 microM) caused a concentration-dependent inhibition of non-cholinergically mediated contraction of bronchial muscle, without significant influence on cholinergically and non-adrenergically-mediated responses. Submaximal contractions of tracheal and bronchial muscles evoked by exogenous neurokinin A (10-300 nM) were markedly inhibited by SR 48968 (0.1-1 microM), but those by exogenous acetylcholine (1-3 microM) were slightly inhibited by the antagonist. The results indicate that in guinea-pig isolated bronchial muscle, SR 48968 selectively inhibited non-cholinergically mediated neurogenic contraction via antagonism of NK-2 receptors.
Acetylcholine↗
[A case report of tracheal inflammatory pseudotumor].
The tracheal tumor is uncommon, and tracheal inflammatory pseudotumor seems to be rare with only four cases reported in the Japanese literature. We here in report a case of tracheal inflammatory pseudotumor in a 61-year-old Japanese man presenting with dyspnea and wheezing 2 weeks after a sub total gastrectomy Billroth I for gastric cancer in april 1991. At bronchofiberscopic examination a rounded tracheal mass 40 mm distal to the vocal cord was found. High vascular on the surface and obstruction of about 90% of the tracheal lumen was noticed. Surgery was attempted immediately and 25 mm of the trachea was excised. The histopathological findings revealed an inflammatory pseudotumor. We concluded that the tumor was caused by injury during tracheal intubation.
Granuloma, Plasma Cell↗
Acute superior mesenteric artery syndrome following left hemicolectomy: a case report.
Acute superior mesenteric artery syndrome (SMAS) following a major surgical procedure is extremely rare, and represents an iatrogenic cause of postoperative upper gastrointestinal obstruction. In this report, the first documented case of acute SMAS following a left hemicolectomy is presented in an obese patient. Upper gastrointestinal roentgenographic series and conservative management remain to be the first line diagnostic and therapeutic modalities and were successful in our patient. Up to date no patient with SMAS reported to be obese but apparently obesity per se, can not be considered as an insurance. A postoperative acute SMAS is impossible to predict depending on the previous history, predisposing factors and the physique of the patient. Therefore, the surgeon should be aware of the SMAS and it is his task to secure all the precautions in order to preclude excessive traction on the mesenteric vasculature and vascular compression of the duodenum during surgery. In cases in which SMAS is suspected during extended colonic resections with lymph node dissection, duodenal mobilization seems to be selectively justifiable.
Acute Disease↗
Primary malignant lymphoma of the breast mimicking breast carcinoma: a case report.
A case of primary malignant lymphoma of the breast in a 52 year old woman is described herein. She presented with a painless tumor of the right breast, which was elastic-hard and measured 2 X 1 cm, although there was no lymphadenopathy noted in the axilla or any other regions. Both the biopsy carried out prior to surgery and frozen sections revealed evidence of malignancy, however, histologically, it was difficult to differentiate between malignant lymphoma and carcinoma until staining with the monoclonal antibody MB1 was performed. This allowed a diagnosis of B cell malignant lymphoma of the diffuse large-cell type to be made. The patient remains alive and well 24 months after her mastectomy.
Breast↗