[On the change of the muscle polarization by the increase of the given electric square potential within the threshold].
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Biomedical subjects
Publications and source records attributed to Y Mikami.
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During the last two decades new forms of insulin and a better understanding of the physiological insulin secretion profile have led to great changes in insulin therapy. New insulin regimens mimicking the normal insulin secretory pattern, called intensive insulin therapy, and new insulin-delivery systems have been introduced. Self-monitoring of blood glucose levels and the use of glycosylated hemoglobin determination for objective evaluation of long-term control have made the achievement of near normoglycemia a practical goal for most patients taking insulin. 1. New forms of insulin: Beef and pork insulin were replaced by monocomponent pork insulin and now monocomponent human insulin is most popularly used. 2. Intensive insulin therapy: Intensified conventional insulin therapy, that is a multiple injection regimen and a twice a-day insulin regimen using a mixture of intermediate- and short-acting insulins has been commonly accepted. New devices such as pen-type injectors and jet-injectors have also been introduced for simplifying the multiple injection regimen. Continuous subcutaneous insulin injection (CSII) has also been adopted by adolescents and young adults.
Sixty-three Paracoccidioides brasiliensis isolates obtained from three nine-banded armadillos (Dasypus novemcinctus), one Amazonian armadillo's and 19 clinical isolates were compared by random amplified polymorphic DNA analysis with the primer OPG-19. The isolates were divided into three major clusters, I, II and III. Coincidences between human and armadillo isolates were observed in clusters I and II. Cluster III consisted only of armadillos' isolates. The results suggested that (I) humans may acquire P. brasiliensis infection by contact with armadillo's environment, (II) there may be P. brasiliensis genotypes peculiar to the animal, and (III) individual armadillos may be infected with P. brasiliensis cells with different genotypes.
BACKGROUND: Abnormal fatty acid metabolism persists in hibernating myocardium, even after reperfusion. This study was designed to determine whether the K+ channel opener, nicorandil, improves fatty acid utilization after percutaneous transluminal coronary angioplasty (PTCA). METHODS: Patients undergoing elective PTCA were randomly assigned to treatment (group N, n = 26) or control groups (group C, n = 22). Group N received intracoronary and intravenous nicorandil during PTCA. Myocardial fatty acid use and perfusion were quantitatively evaluated by means of iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid single photon emission computed tomography (I-123 BMIPP SPECT) and thallium-201 (Tl-201) imaging before PTCA, 72 hours after PTCA, and 3 months after PTCA. Left ventricular function was also evaluated by means of contrast ventriculography before and 3 to 6 months after PTCA. RESULTS: The 1-123 BMIPP defect score in group N significantly decreased, from 28%+/-13% to 20%+/-20% after PTCA and to 18%+/-17% 3 months later. In contrast, the I-123 BMIPP defect score in group C increased from 28%+/-20% to 36%+/-15% (P<.05 versus group N) after PTCA, then returned to 28%+/-17% (P<.05 versus group N) 3 months after PTCA. Recovery of left ventricular function paralleled the recovery of I-123 BMIPP uptake. CONCLUSIONS: Nicorandil improves the recovery of myocardial fatty acid utilization and cardiac function after PTCA. K(ATP) channel activation may have a protective effect during coronary artery occlusion and improve subsequent recovery.
A case of florid endocervical glandular hyperplasia with pyloric gland metaplasia is described. MR images showed multiple and conjugated cysts in the uterine cervix, which suggested adenoma malignum. A postoperative examination revealed florid but definitely benign endocervical glandular hyperplasia. Hitherto described radiologic features considered suggestive of adenoma malignum are not necessarily specific and can be a diagnostic pitfall.
The phenomenon of persistent suppression of Candida albicans yeast cell growth after short drug exposures (postantifungal effect, PAFE) was determined by performing comparative studies using different concentrations of 5-fluorocytosine (5-FC), amphotericin B (AMPH) and miconazole (MCZ). An in vitro turbidometric method was used to measure cell growth and to quantitate the PAFE after removal of the drug by dilution following exposure to C. albicans yeast cells for 0.5 h, 1 h or 2 h. The PAFE was determined by the difference in time (h) required for growth of the control and test cultures to increase to the 0.5 absorbance level following removal of the antifungal agent. A PAFE was demonstrated with each agent and generally the length of the PAFE was dependent upon the concentration of the drug and the time of exposure. An exposure time of 0.5 h resulted in PAFEs ranging from 0.6 to 16.7 h with 5-FC, 0 to 16.5 h with AMPH and 0.1 to 14.1 h with MCZ. In most instances exposure of the cells to each drug for 1 or 2 h resulted in slightly longer PAFEs, respectively. Longer PAFEs were induced with lower concentrations of 5-FC as compared to AMPH and MCZ. The data from such PAFE assays may be useful for determining in vivo treatment regimens, since longer PAFEs may allow for intermittent dosing instead of continuous drug administration.
In vitro comparative evaluations were performed to study the efficacy of combinations of flucytosine and fluconazole in producing a postantifungal effect (PAFE) on Candida albicans. Initial studies were done to determine MIC, FIC (fractional inhibitory concentration) and optimal PAFE parameters. A turbidometric method was used to measure yeast cell growth following exposure to different concentrations of the two drugs for periods of 0.5, 1 or 2 h at temperatures of 30 degrees C and 37 degrees C. The PAFE was determined by the difference in time (h) required for growth of the control and test cultures to reach the 0.5 absorbance level following removal of the drug by dilution. Ten strains of C. albicans were then assayed (30 degrees C; 2 h exposure time) and a synergistic PAFE was evidenced with the two drugs at concentrations well below their individual MICs. PAFEs ranging from 3.8 to 10.5 h, which persisted for 1.2-2.5 h longer than those achieved with either agent separately, were evidenced when flucytosine and fluconazole were combined (flucytosine: fluconazole ratios of 1:16-1:32) at concentrations ranging from 0.024 to 0.098 micrograms ml-1 and 0.78 to 1.56 micrograms ml-1 respectively. The concentrations of each agent required to produce an optimal PAFE varied according to the C. albicans strain being assayed.
The in vitro combination effect of two azole antimycotics, miconazole and fluconazole, against Candida albicans was studied. When minimum (MIC) and sub-minimum (sub-MIC) inhibitory concentration and fractional inhibitory concentration (FIC) determinations were made, a synergistic interaction of the two agents at the concentration well below their individual MICs (at sub-MIC levels) was evidenced. The FIC index values ranged from 0.3 to 1.0 and the synergy was characterized by the potentiation of fluconazole activity with miconazole. The synergistic effect was also confirmed by a turbidometric method. On the other hand, such a synergistic effect against Candida krusei was not confirmed.
The in vitro antifungal activities of itraconazole and its active hydroxyl metabolite, hydroxy-itraconazole (R 63372), against Aspergillus fumigatus, Candida albicans and Cryptococcus neoformans were compared by visual assessment of growth as well as by colorimetric MTT [3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H tetrazolium bromide] assay using microtitre plates containing four different media. Minimum inhibitory concentration (MIC) end points determined by the colorimetric MTT assay correlated well with those obtained by visual assay. The two drugs showed different MIC values depending on the medium used. The activity of itraconazole was equal to or greater than the activity of hydroxy-itraconazole against most of the fungi tested. Both drugs showed lower MIC values against A. fumigatus and Cr. neoformans in brain heart infusion broth (BHI) medium than in yeast nitrogen base (YNBG) medium, Sabouraud glucose broth (SAB) or "synthetic amino acid medium, fungal" (SAAMF). However, the MIC end point of these drugs against C. albicans in BHI and SAB media was difficult to determine visually as well as by MTT assay. In C. albicans, the MTT assay method using SAAMF and YNBG media is recommended for the determination of MICs.
The in vitro activity of D0870, a new triazole, was compared with that of fluconazole, itraconazole, miconazole, amphotericin B and flucytosine against recent clinical isolates of Penicillium marneffei in Thailand. The minimum inhibitory concentrations (MIC) values were determined by a microbroth dilution method using morpholinopropanesulphonic acid (MOPS)-buffered RPMI-1640 and brain heart infusion (BHI) medium. Yeast nitrogen base (YNB) medium with glucose was also used for the assay of flucytosine. D0870 was less active against P. marneffei than itraconazole, but its activity was similar to that of miconazole, superior to that of amphotericin B and markedly superior to that of fluconazole and flucytosine. Much lower MIC values of D0870 were observed with BHI medium.
Ependymoma is a glioma with differentiation toward ependymal cells that usually arises in the central nervous system. Ovarian ependymoma is extremely rare, and the treatment strategies for this disease have not been established. This is the first report of a patient with advanced ovarian ependymoma who received fertility-sparing surgery and is now alive without disease. A 23-year-old Japanese woman, gravida 0, presented with a chief complaint of lower abdominal distension and weight loss. She underwent left salpingo-oophorectomy for suspected ovarian cancer. Microscopic examination revealed a highly cellular tumor composed of small cells with hyperchromatic, round-to-oval nuclei and scanty cytoplasm. Perivascular pseudorosettes, ependymal rosettes, and extensive necrosis were observed. After thorough pathologic examination, she was diagnosed as having stage IIIC ovarian ependymoma. Postoperatively, she received adjuvant chemotherapy and underwent secondary cytoreductive surgery that preserved the uterus and right ovary. Her menstrual cycle has resumed, and she is alive without evidence of disease 16 months after the start of treatment. Although rare, primary ovarian ependymoma must be kept in mind in the differential diagnosis of ovarian tumors, especially in young women. Administration of etoposide-based chemotherapy along with cytoreductive surgery is a potential standard treatment for advanced ovarian ependymoma.
We report a case of adenomyoma of endocervical type arising in a 44-year-old female. Grossly, a well-circumscribed tumor protruding from the right side of the uterine cervix was seen which was assumed to be an ovarian tumor by imaging studies carried out preoperatively. The tumor was composed of a mixture of proliferating glands of endocervical type and fascicles of smooth muscle cells. There was no distinct nuclear anaplasia in the proliferating glands, there were no architectural abnormalities, and there was no evidence of destructive stromal invasion such as desmoplasia. Minimal deviation adenocarcinoma, which shows a gastric phenotype with immunoreactivity for M-GGMC-1 and predominantly PAS-positive neutral mucin, was a serious diagnostic possibility, but the lesion was well-circumscribed, cytologic and architectural abnormalities were absent, and staining for M-GGMC-1 was negative, which suggested a diagnosis of endocervical adenomyoma. An increased Ki-67 labeling index by up to 20%, the presence of predominantly PAS-positive neutral mucin, and membranous immunoreactivity for CEA in limited areas were diagnostic pitfalls, which could lead to an erroneous diagnosis of minimal deviation adenocarcinoma of the uterine cervix. Therefore, the results of these ancillary techniques should be interpreted with caution and combined with gross and light microscopic features.
BACKGROUND: Intraductal papillary-mucinous carcinoma of the pancreas is a new diagnostic term proposed by the 1996 World Health Organization classification of the exocrine pancreas. So far, there have been only a few reports concerning its cytologic findings, especially in noninvasive cases. CASES: The clinical and cytohistologic findings in two cases of noninvasive intraductal papillary-mucinous carcinoma of the pancreas were reviewed. Cytologic specimens were obtained from pure pancreatic juice in the dilated main pancreatic duct during the operation (case 1) and during endoscopic retrograde pancreatography (ERP) (case 2). Both cases showed three-dimensionally or individually scattered tumor cells with an increased nuclear/cytoplasmic ratio and prominent nucleoli. CONCLUSION: Our cases suggest that pancreatic juice cytology during ERP or surgery is useful in diagnosing pancreatic cancers and that it may detect noninvasive intraductal papillary-mucinous carcinoma of the pancreas.
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The effects of a bacterial vaccine, heat-killed Clostridium butyricum MII 588 cells, on the metastasis of B16-F10 melanoma in BDF1 mice was investigated. The vaccine stimulated natural killer (NK) cell cytotoxic activity against YAC-1 target cells, which peaked at 72 hr after the pretreatment, whereas maximum macrophage cytotoxic activity was obtained on days 9 to 11. These stimulated cytotoxic activities were also observed in B16-F10 tumor-bearing BDF1 mice. The important role of stimulated NK cells and/or macrophage in the antimetastatic effect was confirmed using Anti-asialo GM1 antibody, whole body x-ray irradiation and carrageenan treatment. In addition, the vaccine could induce a high titer of interferon-gamma (IFN-gamma), an important lymphokine which may account for a significant portion of its antimetastatic activity.
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