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Biomedical subjects

H Hashimoto

Publications and source records attributed to H Hashimoto.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Prognostic factors influencing survival after operations for gastric cancer in the elderly].

The prognostic factors influencing survival after operations for gastric cancer in the elderly were evaluated by Cox's proportional hazards model analysis. Data were obtained from 511 operations over a 10-year period, in patients with a mean age of 75.6 +/- 7.9 years. The significant prognostic factors of survival out of 47 examined risk factors were, in order of standardized coefficient values, (1) stage of cancer, (2) %IBW, (3) peritoneal dissemination (P-factor), (4) multiple non-gastric cancers, (5) postoperative hepatic injury and (6) postoperative cardiac complication. No other factors, including preoperative associated diseases and postoperative pulmonary complication (the major risk factor of operative death), were significant risk factors of survival. We conclude that by giving special postoperative attention to prevent hepatic injury and cardiac complication, the length of survival of elderly patients with gastric cancer will improve.

Aged↗
PubMed1994

[Postoperative delirium and abnormal behaviour related with preoperative quality of life in elderly patients].

Postoperative delirium and abnormal behavior were studied in 160 patients aged 60 and over with relation to their QOL assessed before surgical operation. QOL was assessed physically, psychologically, mentally and socially. Physical status was assessed with ability in daily life, seeing, hearing and severity of disease. Psychological condition (depression) was assessed by using GDS (Geriatric Depression Scale of Sheikh), Mentality (dementia) was assessed by using CDR (Clinical Dementia Rating) and HDS-R (Revised version of Hasegawa's dementia Scale). Sociality was assessed by social life and familial environment. Postoperatively 37.1% of males and 28.9% of females developed delirium and abnormal behaviour. Abnormal behaviour of demented patients was not defined as due to delirium or as dementia itself, so it was included in the classification "delirium and abnormal behaviour" because of the same aspect in terms of practical nursing care. The following factors were found to be statistically related to the occurrence of postoperative delirium and abnormal behaviour: disability in daily life, dementia, disturbance of hearing. Scores of HDS-R was closely related with the possibility of postoperative delirium and abnormal behaviour.

Activities of Daily Living↗
PubMed1994

[Studies on enhancement of drug absorption through the bladder mucosa].

We examined the effects of dimethyl sulfoxide (DMSO), hyaluronidase and saponin on drug absorption through the bladder mucosa. Female Wistar rats underwent intravesical instillation of each agent prior to the administration of lanthanum solution or anticancer drug; 4'-O-tetrahydropyranyldoxorubicin (THP). The absorption of lanthanum was recognized as dense grain in bladder tissue under electron microscope. The concentration of THP in bladder tissue and plasma was measured by high performance liquid chromatography. The ultrastructural change caused by instillation of DMSO, hyaluronidase and saponin was also investigated by transmission and scanning electron microscopy. The electron microscopic study of the bladder treated with DMSO revealed the exfoliation of superficial cells, and the electron-dense grains of lanthanum were observed in submucosal layer. The concentration of THP was twice as high as that of untreated animals in both bladder tissue and plasma. The treatment with hyaluronidase caused no severe histological change of bladder mucosa, and lanthanum was observed only in the cytoplasma of superficial cells. The increased concentration of THP was slightly exhibited in plasma but not in bladder tissue. The treatment with saponin caused vacuolization and swelling of superficial cells, and many grains of lanthanum were observed between superficial cells and intermediate cells. The concentration of THP in bladder tissue was significantly higher than that of untreated animals, but in plasma no difference was revealed. These findings indicate that each three agent caused an unique effect on drug absorption of bladder mucosa and such characteristic of each agent must be considered for clinical application. Saponin is thought to be useful on intravesical chemotherapy because of increased concentration of anticancer drug (THP) in bladder tissue without that in plasma.

Animals↗
PubMed1994

Nationwide investigation in Japan on the efficacy of arbekacin in methicillin-resistant Staphylococcus aureus infections.

A clinical investigation of methicillin-resistant Staphylococcus aureus (MRSA) infections to study the efficacy of arbekacin (ABK) was carried out by the MRSA Forum composed of 18 groups from 115 institutions in Japan. 348 patients (237 male, 111 female) were evaluated. All had infectious diseases clearly related to MRSA. 74 patients were treated with ABK alone and 274 with ABK in combination with other compounds. Most of them (94.6%/96.4%) had primary disease and suffered from pneumonia (38/175), sepsis (6/35) and other infections (30/64). Pure infection by MRSA was noted in 41/159 and polymicrobial infection with MRSA in 33/115. 53.6%/56.4% of MRSA was eradicated; bacteriological clinical efficacy was 75.6%/67.9% in pure infection and 63.6%/71.3% in polymicrobial infection. Clinical effect was obtained within three days in 70.3%/69.3% of total cases, 60.5%/72.0% in pneumonia and 90.0%/80.8% in the patients pretreated with other drugs, respectively. Efficacy ratio was shown to be 78.6%/71.4% in 30 min and 63.2%/66.4% in 60 min. Adverse effects were seen in 4.76%/5.70%, including renal function disorder (2/11), but no case was serious. Abnormal laboratory findings were noted in 15.4% of cases. ABK is effective against MRSA infection. Concurrent treatment with ABK and other drugs is effective in refractory infection.

Aged↗
PubMed1994

[Thoracic outlet syndrome due to first rib anomaly: a case report].

Compared to cervical rib, first rib anomaly is less familiar to us as a cause of thoracic outlet syndrome. We report a case of thoracic outlet syndrome due to first rib anomaly. A 50-year-old man was admitted to our hospital because of right arm pain when his arm was raised up. Chest X-ray showed an abnormal right first rib which made a J-shaped curve and was attached to the second rib. A palpable mass was noted in the supraclavicular region. Angiography revealed complete occlusion of the right subclavian artery in the Allen test position. During conservative therapy for two months, the symptom was gradually getting worse. We performed resection of the right first rib and anterior scalenotomy by the supraclavicular approach. The patient made a good recovery after the surgery. Postoperative angiogram showed no stenotic lesion of the right subclavian artery. If a patient has complaints suggesting compression of the subclavian neurovascular bundle, we should be careful not to overlook the first rib anomaly on chest X-ray.

Humans↗
PubMed1994

Modulation of tumor immunogenicity of rat glioma cells by s-Myc expression: eradication of rat gliomas in vivo.

The Myc family proteins represented by c-Myc are thought to play a crucial role in cellular proliferation, differentiation, transformation, and apoptosis. In this study, we demonstrated the novel role for a Myc family protein in elicitation of immunogenic phenotypes in tumor cells. Injection of rat 9L or C6 glioma cells, together with the s-myc gene linked to the cytomegalovirus promoter, completely prevented formation of both brain tumors and s.c. tumors derived from the parental glioma cells. However, introduction of the s-myc gene had no inhibitory effect on development of B104-derived neuroblastoma. In addition, unlike the s-myc gene, injection of the c-myc or wild type p53 (wt-p53) gene together with glioma cells did not modulate the tumor immunogenicity and resulted in formation of gliomas in the animals. These findings suggest that s-Myc expression may stimulate the presentation of a tumor antigen common to 9L and C6 cells to T lymphocytes and augment the activity of the host immune system, resulting in prevention of glioma formation in vivo. This success in tumor eradication indicates the possibility of application of the s-myc gene for gene therapy of human brain tumors.

Animals↗
PubMed1994

[Neuroleptanesthesia for a patient with mitochondrial encephalomyopathy].

This report describes a patient with mitochondrial encephalomyopathy who underwent an ophthalmic surgery under original neuroleptanesthesia. This 28-year-old female patient had been suffering from bilateral external ophthalmoplegia and blepharoptosis. Her preoperative neurological examination revealed a mitochondrial encephalomyopathy. Biopsy and blepharo-elevation for her left eyelid were scheduled. Anesthesia was induced with thiopental 5 mg.kg-1 and vecuronium 0.07 mg.kg-1, and maintained with total doses of 10 mg of droperidol, 400 micrograms of fentanyl and 4 mg of vecuronium. The patient recovered from anesthesia smoothly and her postoperative course was uneventful. Anesthetic management of patients with this disease and possible complications were discussed.

Adult↗
PubMed1994

[Vascular involvements in systemic lupus erythematosus].

It is an established fact that systemic vasculitis can occur during the course of SLE as well as other rheumatic diseases. The principal disorders of SLE are found to be associated with small arteries. However, clinical evidence of arterial disease in SLE patients varies considerably from patient to patient. Clinical manifestations of lupus vasculopathy including vasculitis and microangiopathy were described. Regarding systemic vascular lesions in SLE, the prognosis for the patients with thrombosis and vascular involvement of medium-sized arteries was the most grave. Treatments including steroids, immunosuppressants, plasmapheresis, anticoagulants, etc. are used according to causative factors which result in lupus vasculopathy.

Humans↗
PubMed1994

[A clinical study of total cystectomy for patients with bladder cancer].

We assessed the treatment outcome of total cystectomy for 67 patients with bladder cancer treated at Asahikawa Medical College Hospital between 1977 and 1991. The analyses of cause-specific 5-year survival rates by pathological stage (pT) and grade revealed a lower survival rate for higher stage, higher grade and non-transitional cell carcinomas. The condition of lymph node metastases (pN) was also correlated to the survival rate. Significant differences were observed between the survival rates of the patients with pT < or = 2 and pT > or = 3, and the patients with pNO and pN > or = 2. The cancer deaths were mainly caused by distant metastases. Preoperative irradiation showed prognostic advantage in the patients who had acquired down-staging by this treatment, and postoperative systemic chemotherapy also improved the prognosis in the patients with pT > or = 3.

Adult↗
PubMed1994

[A case of minocycline-induced pneumonitis with bronchial asthma].

We report a case of minocycline-induced pneumonitis. A 30-year-old woman was treated with minocycline for mycoplasma pneumonia of the right upper lobe. About 15 days after starting treatment, she developed a productive cough, stridor, and dyspnea. The chest X-ray film showed pulmonary infiltration in the left middle lung field. Based on the clinical history and the detection of eosinophilia in the bronchoalveolar fluid, drug-induced pneumonitis was suspected. Treatment with minocycline was discontinued and prednisolone (20 mg/day) was started, after which her symptoms subsided and there was marked regression of the pulmonary infiltrates on chest X-ray films. The lymphocyte stimulation test for minocycline was negative, but the diagnosis was confirmed by a positive oral provocation test.

Adult↗
PubMed1994

[Methylprednisolone pulse therapy for SLE patients with CNS disorder].

A clinical trial was conducted in 22 SLE patients with central nervous system (CNS) disorder in which the efficacy of pulse methylprednisolone suleptanate at the dose of 400 mg or 800 mg (as methylprednisolone) was assessed. The symptoms of CNS disorder disappeared within 40 days after pulse therapy in all of the 16 patients with organic brain syndrome (OBS). No improvement in the symptoms took place in any but one of the five patients who had cerebrovascular disorder. One SLE patient with depression showed improvement 55 days after pulse therapy. In the patients with OBS who had not received pulse therapy until 28 days or more after onset of CNS disorder, the symptoms disappeared in 20 days or more in both 400 mg and 800 mg dose groups. On the other hand, five of the six patients given the dose of 800 mg within 10 days of occurrence of the disease experienced a complete relief of the symptoms in 10 days after pulse therapy. However, at least 13 days were required for complete relief in all the four patients of the 400 mg group. The adverse reactions reported consisted of hyperlipemia, diabetes mellitus, and infections such as thrush or herpes zoster. The above results suggest that methylprednisolone pulse therapy is useful in the treatment of CNS disorder associated with SLE, particularly in patients with OBS who are given the dose of 800 mg early after onset of the disease.

Adolescent↗
PubMed1994

[Double blind trial of pulse methylprednisolone versus conventional oral prednisolone in lupus nephritis].

A double blinded clinical trial was conducted in which the efficacy and safety of pulse methylprednisolone (400 mg/day) was compared with oral prednisolone (50 mg/day), a control drug for a period of 3 months. One-hundred and two (102) patients were enrolled in the study, of which 91 patients were determined as eligible for analysis of efficacy. Patients on pulse methylprednisolone had more favorable response to therapy with regard to laboratory value changes from baseline such as CH50 and anti-DNA antibody titers. In terms of anti-DNA antibodies, a significant difference was detected at one week after treatment. With regard to time course changes in laboratory values, CH50 at one and two weeks after treatment showed a significantly higher elevation in the pulse methylprednisolone group than in the control group. There was no significant difference noted in incidence of adverse reactions between both treatment groups. No serious adverse reaction was encountered in the pulse methylprednisolone group. The physician's assessment of final global improvement significantly favored the pulse methylprednisolone-treated group. The above results suggest that the pulse therapy with methylprednisolone leads to more rapid onset of drug effect than the conventional oral prednisolone in the treatment of lupus nephritis.

Administration, Oral↗
PubMed1994

Prostaglandin H2 as an endothelium-derived contracting factor modulates endothelin-1-induced contraction.

OBJECTIVE: To investigate the possible involvement of prostaglandin H2, an endothelium-derived contracting factor in the rat aorta, in the development of the contraction induced by endothelin-1. METHODS: The aortic rings from spontaneously hypertensive rats (SHR) were prepared, and the changes of isometric tension of these rings developed by endothelin-1 were recorded with or without the treatment of several inhibitors or an antagonist. The concentrations of prostaglandins and thromboxane B2 in the bath solution with the rings contracted by endothelin-1 were measured by radioimmunoassay. The effects of a thromboxane A2/prostaglandin H2 receptor antagonist (ONO-3708) on endothelin-1-induced contraction were compared in SHR and Wistar-Kyoto (WKY) rats. RESULTS: Indomethacin (10(-5) mol/l) and ONO-3708 (10(-6) mol/l) significantly diminished endothelin-1 (3 x 10(-8) mol/l)-induced contractions in the aortic rings from SHR with but not without endothelium. The thromboxane A2 synthetase inhibitors OKY-046 (10(-5) mol/l) and RS-5186 (10(-5) mol/l) did not attenuate the contractions either with or without endothelium. Endothelin-1 significantly increased the release of 6-keto-prostaglandin F1 alpha, which is the metabolite of prostaglandin I2 and its precursor prostaglandin H2, from rings with endothelium of SHR, but the concentration of thromboxane B2 from aortic rings was unchanged. In the rings without endothelium the endothelin-1-induced release of 6-keto-prostaglandin F1 alpha was also observed. The half-maximal effective concentration of endothelin-1 for rings from SHR was shifted to the right by ONO-3708, but that of WKY rats was not changed, and significantly greater amounts of 6-keto-prostaglandin F1 alpha were released in the rings from SHR than in those from WKY rats by endothelin-1. CONCLUSIONS: Endothelin-1 induced the release of prostaglandin H2 from endothelial cells in the rat aorta, the effect being greater in the hypertensive state. The released prostaglandin H2, an endothelium-derived contracting factor, modulated the vasoconstriction that is induced by endothelin-1, another endothelium-derived contracting factor, in addition to the direct vasoconstrictive action of endothelin-1 on vascular smooth muscle.

6-Ketoprostaglandin F1 alpha↗
PubMed1994

[Drug resistance of methicillin-resistant Staphylococcus aureus (MRSA) in Japan until 1993].

Isolation frequency of MRSA in Japan increased up to 60% until 1993. The therapy of infectious diseases usually begins empirically, then doctors would verify or change their regimen according to laboratory data. But the hospital-infected MRSA strains are now highly resistant to beta-lactams, and strains resistant to other antibiotics such as, macrolides, quinolones and minocycline are also increasing. MRSA strains in infected focus are often mixtures of strains expressing different patterns of multiple resistance, and often exist with other pathogens such as Pseudomonas aeruginosa. Relying upon laboratory data alone, often results in emergence of new resistant bacteria or replacement of pathogens, hence ineffectiveness of chemotherapy. Now only arbekacin and vancomycin are the antibiotics to which resistant strains are less than 3%. Other antibiotics should be used after considering the resistance pattern of isolates from the patient and in the hospital. Most of the MRSA-infected patients are compromised hosts, and the in vivo efficacy does not always reflect the in vitro results. Even arbekacin and vancomycin are sometimes recommended to be used in combination therapies with other drugs.

Aminoglycosides↗
PubMed1994

[Nationwide investigation in Japan of the status of MRSA infections and usefulness of arbekacin].

A clinical investigation on MRSA infections, and the determination of the efficacy and usefulness of arbekacin (ABK) were performed an "MRSA Forum" composed of 18 groups including 115 institutions in Japan. Patients with infectious diseases clearly related with MRSA, a total of 348 (males: 237, females: 111), were evaluated, 74/274 patients were treated with ABK alone/combination with ABK. Most of them (94.6%/96.4%) had underlying diseases and they had pneumonia (38/175), sepsis (6/35) or other infections (30/64). Infections by MRSA alone were noted in 41/159 and polymicrobial infections including with MRSA were in 33/115. 53.6%/56.4% of MRSA were eradicated and bacteriological clinical efficacies were 75.6%/67.9% in single infections and 63.6%/71.3% in polymicrobial infections. The clinical efficacies were obtained in 70.3%/69.3% of total and in 60.5%/72.0% of pneumonia and in 90.0%/80.8% of the patients pretreated with other drugs within 3 days previously. Efficacy rates were 78.6%/71.4% in 30 minute's div and 63.2%/66.4% in 60 minute's div. Adverse effects were found in 4.76%/5.70% including renal function disorder (2/11) but no case was serious. Abnormal laboratory test results were noted in 15.4%. ABK is effective against MRSA infections.

Adolescent↗
PubMed1994

[Questionnaires regarding MRSA in Japan].

UNLABELLED: Changes in properties of MRSA and the status of MRSA infections in the last two years were investigated by an MRSA Forum composed of 18 groups including 115 medical institutions in Japan. And an opinion poll regarding MRSA was taken by professional doctors (41) and general clinical doctors (323). Points of discussion: 1. Did properties of MRSA change? 2. Did the pattern of MRSA infections change? 3. Did the understanding of MRSA change? 4. What is the relationship between MRSA and the 3rd cephems? 5. How is MRSA related to polymicrobial infections? 6. Is ABK useful against MRSA infections? 7. What will be future trend in characteristics of MRSA and MRSA infections? CONCLUSIONS: 1. MRSA has become more resistant to methicillin however it seemed to have become less toxic. 2. Severe MRSA infections are decreasing and colonizations are increasing. 3. There were some differences in attitude against MRSA between professional doctors and general clinical doctors. 4. The 3rd cephem should be used reasonably. 5. MRSA infections should be treated with polymicrobial infections in consideration. 6. MRSA did not gain resistance against ABK and ABK is useful against MRSA infections. 7. Problems of MRSA will cool down but they should always be kept in our mind.

Aminoglycosides↗