Biomedical subjects
Publications and source records attributed to Y Kuroda.
We report the first case of surgically resected pure papillary hyperplasia of the pancreas. Interestingly, it was not associated with chronic pancreatitis or pancreatic cancer. Histologic and immunohistochemical features are described, with a review of the literature on papillary hyperplasia of the pancreas.
Sodium dichloroacetate (DCA) was administered orally at doses of 12.5 to 50 mg/kg body weight twice or three times per day to a patient with mitochondrial encephalomyopathy associated with congenital lactic acidemia. During therapy, the rates of decarboxylation of (1-14C) pyruvate and (3-14C) pyruvate, which represent the activity of the pyruvate dehydrogenase (PDH) complex and the function of the TCA cycle, respectively, were markedly increased in the platelets and increases in the lactate levels in the blood and urine during exercise were markedly reduced. These results suggest that oral administration of DCA causes significant increases in the activities of the PDH complex and TCA cycle not only in the platelets but also in various tissues of humans, which is important as a pathway for production of energy, resulting in decreases in the lactate and pyruvate levels in the blood and cerebrospinal fluid.
We have developed a radioimmunoassay (RIA) for nonenzymatically glycated serum proteins. The polyclonal antibodies prepared against reduced glycated human albumin were specific for the glucitollysine residues of serum proteins. Serum proteins from diabetic patients (n = 25) contained 5.3 +/- 2.8 nmoles of glucitollysine/mg protein, compared to 2.0 +/- 0.2 in controls (n = 20). The intra- and inter-assay variables were 3.2-6.2% and 4.4-8.6%, respectively. Results from this assay procedure correlated well with those from the boronate affinity chromatography procedure (r = 0.94; P less than 0.001). The data suggested that diabetic serum proteins contained at least 2.5 times as much immunochemically detectable glucitollysine residures as normal serum proteins after reduction of the proteins with sodium borohydride.
MRI was performed for 18 autistic patients, 11 patients with uncomplicated mental retardation (MR) and 18 controls. In autism and MR, and altered left/right relationship of the frontal lobe volume was observed. The altered asymmetry was more severe in autism than in MR. The brain stem was smaller in MR than in the controls, and the right operculum was smaller in MR than in autism. These findings are consistent with the hypothesis that some autisms may involve a type of early developmental abnormality. Furthermore, our results suggest that autism may involve a type of structural brain impairment different from MR.
Choledochoscopic lithotomy with the aid of electrohydraulic lithotripsy was performed in 40 patients, including 16 patients with choledocholithiasis, 15 with hepatolithiasis, and 9 with cholecystolithiasis. As a route for the choledochoscopy, a T-tube tract, external cholecystostomy, or jejunal limb of hepaticojejunostomy was used in nine patients, while percutaneous transhepatic biliary drainage followed by dilatation of the track was established in 31 patients. The largest cholesterol stone measured 55 mm by 33 mm and the largest bilirubinate stone measured 52 mm by 37 mm. The stones were disintegrated in all but one patient in whom choledochoscopic access to a gallstone was difficult due to deformity of the gallbladder. Complete removal of the stones was achieved in 38 of 39 patients. In a patient with hepatolithiasis, small stones located deep in inaccessible branches of the intrahepatic duct remained unremovable. There were no serious complication. Minor complications occurred, including bleeding from the bile duct mucosa in four patients and postprocedure chills and fever in three. Choledochoscopic lithotomy with electrohydraulic lithotripsy is efficient and useful to remove biliary calculi in patients who are poor surgical risks.
A 72-hr preservation of canine pancreas by a 2-layer (Euro-Collins'/Perfluorochemical) cold storage method was tested in the canine model of segmental pancreas autotransplantation. The functional recovery of the grafts by this method (group 1) was determined by daily fasting blood glucose concentration and intravenous glucose tolerance test at 2 weeks after autotransplantation and compared with simple cold storage with Euro-Collins' solution (group 2) and control (no preservation) (group 3). Maintenance of normoglycemia for at least 5 days after transplantation was considered a successful preservation. The functional success rates after 72-hr preservation were 100%, 0%, and 100% for groups 1, 2, and 3, respectively. The mean K values of group 1 after 72-hr preservation was 1.78 +/- 0.42 compared with 2.05 +/- 0.32 for group 3 at 2 weeks after transplantation. Biopsies of grafts of group 2 after 72-hr preservation showed remarkable autolytic changes in exocrine and endocrine tissues. In contrast, biopsies of grafts of group 1 after 72-hr preservation showed almost normal architecture in both tissues. In addition, biopsies of 72-hr preserved grafts of group 1 at 4 weeks after after autotransplantation showed almost normal pancreas architecture with minimal fibrotic changes in the exocrine tissue. This study demonstrated the possibility of 72-hr preservation of the pancreas for transplantation.
Marked and persistent cytopenia was observed in two 3-year-old children with cancer, after lymphopheresis to collect peripheral blood stem cells (PBSC) for autotransplantation after high-dose chemotherapy. This finding suggests that PBSC are a major component of the hematopoietic cells in small children and, hence, that special care is necessary in the construction of a protocol for collection of stem cells from young children.
A 66-year-old woman was admitted to the Medical College Hospital of Oita on February 23, 1988, because of headache and fever. Chest X-P and chest CT findings showed a coin lesion in r-S4. Cryptococcus neoformans was isolated from the CSF. Abnormal lymphocytes with lobulated nuclei were found in 0-5% of peripheral leukocytes. The ATLA-antibody was positive and bone marrow smear showed normal myelogram. According to these data, we diagnosed the patient as smouldering adult T-cell leukemia accompanied with pulmonary cryptococcosis and cryptococcal meningitis. C. neoformans disappeared from the CSF and cryptococcal antigen was not detectable after Amphotericin B and Flucytosine treatment. On April 1, the patient complained of a dry cough, high fever and dyspnea. A chest X-ray showed bilateral patchy infiltrations. By the methenamine silver staining, cysts of Pneumocystis carinii were found in the specimens of transbronchial lung biopsy and bronchoalveolar lavage fluid. The abnormal shadow on chest X-ray disappeared after TMP-SMX and aerosolised pentamidine treatment.
Surveying the disease by sending questionnaires to all physicians of the Saga Medical Association, we tabulated 19 definite cases of HTLV-I-associated myelopathy (7 males and 12 females) as of January 31, 1988. The population at risk of HTLV-I carriers was estimated by applying sex- and age-specific anti-HTLV-I antibody-positive rates among blood donors at the Saga Red Cross Blood Center in the fiscal year of 1986 to the population of Saga Prefecture in 1982. The crude prevalence rates among HTLV-I carriers from 20 to 69 years of age per 100,000 were 65.7 for males and 86.9 for females, respectively. The summary prevalence rates with 95% confidence intervals were 46.5 (14.3-97.3) for males and 74.9 (35.3-129.2) for females. There was no remarkable difference in the age-specific prevalence rates in either sex. The crude and summary rates among females were higher than those among males, but the difference was not statistically significant.
We carried out the forced swimming test in mice to investigate the antidepressant potentials of GABA transaminase (GABA-T) inhibitors including aminooxyacetic acid, ethanolamine-O-sulfate, gamma-vinyl GABA (GVG) and valproic acid (VPA). In acute experiments only GVG reduced immobility. Following chronic oral administration via drinking water containing the drugs, immobility was significantly reduced at days 5 and 10 in all of the GABA-T inhibitors examined. The tolerance of the anti-immobility effect, however, occurred at day 20. Brain GABA contents showed moderate to marked increase during the session with the exception of VPA, which did not alter GABA contents. These results suggest that subchronic GABA-T inhibitors possess antidepressant properties, though the anti-immobility effect of GABA-T inhibitors did not directly correlate with the increase in brain GABA.
The in vivo dose-response potential of recombinant human granulocyte colony-stimulating factor (rG-CSF) in facilitating reconstitution of granulopoiesis was evaluated in an 11-year-old girl who received autotransplantation of peripheral blood stem cells (PBSC) after marrow-ablative therapy for relapsing acute lymphoblastic leukemia. The recovery of hematopoiesis was slow when a small number of progenitors were collected and reinfused into the patient, but administration of rG-CSF led to significant dose-dependent increase in peripheral blood granulocytes.
We report a case of adult T-cell leukemia presenting with sensorimotor polyneuropathy with persistent severe pain. The patient died without treatment after 4 months. Autopsy showed infiltration of peripheral nerves by leukemia with no involvement of the CNS. This case closely resembles Marek's disease of fowls, a virus-induced T-cell lymphoma associated with neurolymphomatosis.
Novel alkyl-1,4-butanediamine Pt(II) complexes having a seven-membered ring structure were synthesized and characterized by fast atom bombardment mass and infrared spectra and elemental analysis. Their antitumor activities in vivo toward lymphoid leukemia L1210 and Lewis lung carcinoma LL were studied in the case where the leaving group was either dichloride or cyclobutane-1,1-dicarboxylate. 1,4-Butanediamine Pt(II) complexes (seven-membered ring) showed higher antitumor activities than those of ethylenediamine Pt(II) (five-membered ring) and 1,3-propanediamine Pt(II) (six-membered ring) complexes toward L1210 for both leaving groups. Alkyl-1,4-butanediamine Pt(II) complexes showed high antitumor activities toward L1210, except for 1,1-dimethyl-1,4-butanediamine Pt(II) complexes. In particular, 2,2-dimethyl-1,4-butanediamine and 2,3-dimethyl-1,4-butanediamine Pt(II) complexes exhibited excellent antitumor activities with T/C% values higher than 300. None of the dichloro Pt(II) complexes showed antitumor activities toward LL, but the cyclobutane-1,1-dicarboxylato Pt(II) complexes, which were moderately active toward L1210 with T/C% values around 200, also showed high antitumor activities toward LL with T/C% values of more than 200. Alkyl-1,4-butanediamine Pt(II) complexes with a seven-membered ring structure were found to be stable and to have antitumor activities in vivo.
We present a case of OPCA with severe respiratory failure due to vocal cord dyskinesia. This vocal cord dyskinesia was found by fiberoptic bronchoscopy and confirmed by laryngeal electromyogram. Tracheal fenestration and drug therapy of haloperidol were successful for clinical improvement. To our knowledge, this is the first report of vocal cord dyskinesia in OPCA. We emphasized that OPCA could complicate vocal cord dyskinesia, causing severe respiratory failure.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A comparative multicenter study was carried out on postoperative adjuvant chemotherapy on 243 gastrectomy patients from October 1983 to December 1985. The medications were assigned at random to 2 groups of patients by the envelope method: group A (administered 20 mg of MMC on the day of surgery and 10 mg of MMC on the day after surgery, and started on tegafur at a dose of 600 mg/day 2 weeks after surgery); group B (similarly treated with MMC and started on UFT at a dose of 600 mg/day 2 weeks after surgery). Further, patients presenting in stage IV were administered MMC intravenously every 3 months, starting 4 weeks after surgery. The final drug effect evaluations were made in 210 patients excluding 33 dropouts (13.6%). The incidence of side effects was somewhat higher in group B than in group A, but their frequency was low and no serious symptoms were observed. For patients with poorly differentiated adenocarcinoma and were carried out curative operation, the 3-year survival rate was significantly higher in group B than in group A.
Bronchial artery infusion (BAI) has been looked to as an important adjunct for controlling lung cancer. However, there are some anatomic facts to meet in performing angiography: multiplicity of the bronchial artery with wide variation of ramification pattern. To deal with these problems, since 1984, we have been working with DSA apparatus (Siemens: ANGIOTRON) for intervention in 162 cases of lung cancer. Because of higher contrast resolution, subtracted dynamic image and realtime replay on CRT, DSA allows (1) bronchial artery mapping on aortography, (2) prompt verification of the areas to be or not to be infused by anticancer drugs, and (3) tumor stain not only in the primary lesion but also metastasized lymph nodes or mediastinal invasion. DSA aortography evaluated the right-sided bronchial artery more frequently (90.1%) than the left-sided (46.3%). Tumor location made feeding vessels more remarkable on DSA: 96.0% in the right and 68.9% in the left. The overall accuracy of BAI basically depends on the result of DSA measuring 91.9% (149 of 162 cases). The effect of BAI combined with radiation therapy, for each histologic category, preliminarily estimated in two groups: one with two drugs and another with CDDP. Small cell carcinoma with "two drugs" and squamous cell carcinoma with CDDP seem to show statistical predominance in the period of 50% tumor size reduction.