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Biomedical subjects

M Baba

Publications and source records attributed to M Baba.

At least 253 records · Page 14Linked to original sources

Echocardiographic evaluation in long-term continuous ambulatory peritoneal dialysis compared with the hemodialysis patients.

In dialysis patients, the prevalence of severe left ventricular (LV) hypertrophy and systolic failure, important predictors of cardiovascular morbidity and mortality, has been reported to be very high. Therefore, we investigated cardiac function in 17 long-term CAPD patients (dialysis duration: 76.5 +/- 13.2 months; L-CAPD) by echocardiography and pulsed Doppler, and then compared with 16 short-term CAPD patients (dialysis duration: 28.9 +/- 11.9 months; S-CAPD), 21 long-term hemodialysis patients (dialysis duration: 165.1 +/- 52.7 months; L-HD), and 22 short-term hemodialysis patients (dialysis duration: 71.3 +/- 28.9 months; S-HD), except for the cases with diabetes mellitus, ischemic heart disease, cardiac surgery or overt congestive heart failure. We selected 13 normotensive patients with normal kidney function as normal control group matched for sex and age (Control). Concerning with L-CAPD, S-CAPD, L-HD, and S-HD, these four groups were matched for age and original diseases. We examined blood pressure (BP), cardiothoracic rate (CTR), antihypertensive (AHT) drugs and laboratory data. Wall thickness, left atrium, ventricular chamber size, ejection fraction (EF) and left ventricular mass (LV mass) [Devereux et al. 1986] were measured by echocardiograph. Peak early diastolic flow velocity (E), peak atrial filling velocity (A), A/E ratio and deceleration time of peak early diastolic flow velocity (DT) were calculated by analyzing transmitral flow, recorded by pulsed Doppler. BP control, CTR and EF were significantly worse in L-CAPD than in other patient groups. A/E as one of parameters for cardiac diastolic function was significantly higher in L-CAPD than in HD patients. LVMI (LV mass index: LV mass/body surface area) was significantly higher in L-CAPD than in other groups. LVMI in CAPD patients was shown to be significantly worse as time goes. Volume control by itself without AHT drugs could achieve good BP control in the long-term CAPD patients who were changed to maintenance hemodialysis because of peritoneal sclerosis. We concluded that LV hypertrophy and systolic dysfunction tend to progress in CAPD patients as time goes on. Also it is suggested that the cause of cardiac dysfunction in CAPD patients was mainly based on poor BP control probably due to overhydration, and therefore, appropriate volume control in CAPD patients is especially important.

Antihypertensive Agents↗

[Removal of the left atrial myxoma combined with coronary artery bypass grafting in an elderly patient].

The case of simultaneous coronary artery bypass grafting with resection of the leat atrial myxoma is rarely reported. We surgically treated a 81-year-old woman who had been diagnosed as left atrial myxoma and unstable angina. At surgery we performed coronary artery bypass grafting prior to resection left atrial myxoma, because we thought it is the most important to protect myocardium by antegrade cardioplegia in the consequence of CABG. Postoperative course was excellent and uneventful. The patient is doing well now.

Aged↗

[Neoadjuvant intraarterial chemotherapy for ten cases of inflammatory breast cancer by Seldinger's methods].

The conventional methods (CM) of intraarterial (IA) chemotherapy for inflammatory breast cancer were catheterizations from superior epigastric and brachial artery under general anesthesia. Since 1997, we selected the Seldinger's methods (SM) for ten cases of the disease to control local effects and simplify the technique. Complications of the SM were slight, and side effects were equal to those with CM. The postoperative pathological findings of the SM showed the direct effects of chemotherapy to tumor cells (degenerative and necrotic changes) as compared with the embolism-like effects of CM. But the overall histological effects of chemotherapy by SM were almost equal to those for CM. The strong points of the SM were as follows: 1) More selective IA chemotherapy is available, 2) one can find the passage of the aim vessels and no trouble related to catheter, 3) general anesthesia is not necessary, and the techniques are simple, 4) the wounds are not remarkable. The disadvantages are as follows: 1) Patients must rest the day of IA chemotherapy, 2) in 20% of the procedures, one can not search the vessels, and 3) in 4 cases complications of stiffness of Mj or Mn pectral muscles were found. In future, we expect more effective results by dose escalation or combination chemotherapy.

Adenocarcinoma↗

[Pulmonary pseudallescheriasis in a patient with diabetes mellitus and alcoholic liver cirrhosis].

A 62-year-old man with diabetes mellitus and alcoholic liver cirrhosis was admitted to the hospital because of hemoptysis. Chest X-ray films and computed tomograms showed a dense infiltrative lesion and a healed tuberculous cavity with a possible fungus ball in the upper lobe of the right lung. Bronchoscopy revealed that the hemoptysis originated from the right upper-lobe bronchus. The bleeding stopped after thrombin was applied into the bronchus. Filamentous fungi were seen in lavage fluid from the right upper-lobe bronchus. The fungi were identified as Pseudallescheria boydii, and pulmonary pseudallescheriasis was diagnosed. the patient was treated successfully with miconazole (400 mg/day) for 2 months. Pseudallescheriasis should be taken into account in the differential diagnosis of aspergilloma-like lesions.

Antifungal Agents↗

[A case of a chronic traumatic thoracic aneurysm with compression of left main bronchus at the isthmus].

We report a case of traumatic thoracic aortic aneurysm found by occurrence of pulmonary atelectasis in the chronic phase. The patient, an 18-year-old female, was hospitalized with multiple trauma caused by a traffic accident. At the time of hospitalization, no thoracic trauma was found but a fracture of the pelvis and one leg was recognized. 45 days after the initial trauma, a pulmonary atelectasis on the left lung was found on a chest X-ray film. By chest CT and angiography, the pulmonary atelectasis was proved to be caused by compression of the left main bronchus by a traumatic aneurysm of the thoracic aorta. 55 days after the initial trauma, resection of the aneurysm and graft replacement was performed. Postoperative course was satisfactory. In conclusion, possibility of an injury to the thoracic aorta should be considered on the treatment for the patient with multiple trauma in the chronic phase as well as in the acute phase.

Adolescent↗

[Food and food additives hypersensitivity in adult asthmatics. I. Skin scratch test with food allergens and food challenge in adult asthmatics].

OBJECTS: The aim of this study was to investigate in adult asthmatics, which kinds of food allergen can cause a positive reaction by skin scratch test and cause symptoms when administered as a food challenge. SUBJECTS AND METHOD: Three thousand one hundred and two adult asthmatic patients were submitted to skin scratch tests with housedust mite. Japanese cedar extracts and 33 types of food. Sixty one adult asthmatic patients with a history of immediate, adverse reactions after food ingestion underwent open food challenge. RESULT: Six hundred and twenty five of 3102 subjects (20.1%) had a positive test to one or more food allergens. The commonest food allergens were shrimp (27.7%), crab (27.7%), yeast (23.8%) and buckwheat (15.8%). The positive tests of shrimp, egg and cow's milk were highest in patients under 20 years and decreased with age, however the test rates of crab and soybean were not influenced by age. Positive food challenge responses occurred in 30/60 subjects (50%). The foods, which most of ten provoked a reaction, were buckwheat, shrimp, crab and bread. CONCLUSION: Skin scratch test results in adult asthmatics were different from those in atopic children where the commonest foods with positive tests were egg, cow's milk and soybean. Except for patients with a previous life-threatening reaction. Food allergy should be diagnosed by food challenge where a patient's history of adverse reaction to food, positive skin test and RAST strongly support specific food reactivity.

Adult↗

[A case of spontaneous hemopneumothorax occurred after thoracic drainage].

A 21-year-old man; complaining of left chest pain and dyspnea, was admitted to our hospital with a diagnosis of spontaneous pneumothorax. Though chest X-ray on admission did not show hemothorax, chest drainage revealed intrapleural bleeding. As chest X-ray on the following day showed evident fluid level, emergency operation was carried out with a diagnosis of spontaneous hemopneumothorax. Bleeding point was a ruptured vessel between parietal pleura and bulla in apex of lung. The bulla was resected following hemostasis. After improvement of complicating postoperative re-expansive pulmonary edema, the patient was discharged on the 18th postoperative day. On treatment of spontaneous hemopneumothorax, existence of such a case as ours should be taken into account.

Adult↗

Application of locoregional chemotherapy using lymph-directed substances in a canine transhiatal esophagectomy model.

We investigated whether lymph-directed substances injected into the mediastinal connective tissue of dogs reached the regional lymph nodes of the esophagus. In 46 dogs, 1.5 mL of cuttlefish particles or activated carbon particles containing 15 mg of bleomycin (CH-BLM) was injected at two sites: into the connective tissue between the trachea and the aorta via mediastinoscopy in 23 dogs (16 with cuttlefish particles and 7 with CH-BLM: mediastinal group), and into the crura of the diaphragm by means of laparotomy in 23 dogs (16 with cuttlefish particles and 7 with CH-BLM: crural group). Cuttlefish particles, distinguished by decolorization with melanin bleaching, showed selective affinity for lymphatics. When cuttlefish particles were injected into mediastinal connective tissue, the rate of staining (# of black-stain positive nodes/# of examined nodes) was higher in the crural group than in the mediastinal group. In the crural group, bleomycin activity in lymph nodes was higher in the regions from the neck to the abdominal para-aortic region than at the injection site, excluding the peri-gastric region. If the topography of lymphatics and lymph flow kinetics in man are similar to that of the dog, then the crura of the diaphragm appears to be a potentially effective site for applying loco-regional chemotherapy for carcinoma of the esophagus in patients undergoing transhiatal esophagectomy.

Animals↗

[Pulmonary function at the early stage after bone marrow transplantation].

Twenty-one patients, aged 16-41 years, were prospectively followed for pulmonary function prior to and up to nine months after bone marrow transplantation (BMT). All patients had normal radiographs and no clinical signs of pulmonary disease. The FEV1.0%, V25, and of V50/V25 were within the normal ranges for all patients. Percent vital capacity (%VC) and percent diffusing capacity of lung for CO (% DLco) dropped progressively in most of the patients up to 9 months following BMT. Pulmonary function decreased earlier in patients with GVHD as well as patients who received total body irradiation either at a high dose rate (10 cGy/min) or a high lung dose (12 Gy). These asymptomatic declines in pulmonary function were measured by frequent tests of lung function.

Adolescent↗

[Spontaneous resolution of idiopathic spinal subdural hematoma: case report].

A 32-year-old female presented with about a week's history of dull pain in the head and neck pain. On the day of admission, she experienced a sudden onset of severe pain, extending from the occipital to the lower back region and hypesthesia and paresthesia of the right C8-Th3 dermatome. On admission, she was alert but there was a band of hypesthesia and paresthesia at the level of C8-Th3. Cervical X-ray, computed tomography scan (CT) and magnetic resonance images (MRI) of the head revealed no definite abnormalities. The peripheral blood picture was normal, and the bleeding and clotting times were in the normal range. The cerebrospinal fluid (CSF) was bloody and the CSF pressure was 220 mm H2O. An emergent 4-vessel intracranial angiography disclosed no abnormal findings. MRI and myelography revealed an intradural extramedullary lesion extending from the Th2 to the Th5 levels, ventral to the spinal cord. A T1-weighted MR image showed iso-low intensity and a T2-weighted MR image showed low intensity at these lesions. Spinal angiography revealed no abnormal vessels. In one month, spinal compression cleared gradually without surgery and her clinical symptoms disappeared about 40 days after admission. Spontaneous spinal subdural hematoma is uncommon and only 28 cases have been reported. 15 cases have been treated with surgical procedure, but spinal compression cleared spontaneously in this case. This spontaneous recovery is such a rare event that only 3 such cases have been reported in the literature. However, with the prevailing MRI, this disease will be detected more frequently in the future.

Adult↗

[Surgical treatment of carcinoma of the cardia with special references to mediastinal extension and lymph node metastasis].

We retrospectively analyzed the clinicopathological findings in 141 patients with advanced cardiac cancer. According to histological type, 117 patients had an adenocarcinoma and 24 patients a squamous cell carcinoma. Curative resection was performed in 114 patients, whereas the remaining 27 patients underwent palliative resection. Preoperative endoscopic ultrasonography and abdominal ultrasound were useful for the diagnosis of esophageal invasion and lymph node metastases. Particularly, the classification of paraaortic lymph node metastasis by ultrasound was important in deciding on the surgical method. Mediastinal lymph node metastases were found histologically in 19 of 68 patients. The survival of patients with mediastinal lymph node metastasis was poor. However, among them, a favorable outcome was expected for patients with few involved nodes and if only perigastric node involvement in abdominal nodes was found. Paraaortic lymph node metastasis was found histologically in 15 of 48 patients (27.9%). Two of 35-year survivors had 5 or fewer lymph node metastases, and showed only perigastric and paraaortic node involvement. It is equally important that tumor extension and lymph node metastases in the mediastinum and abdomen should be determined in the surgical treatment of advanced carcinoma of the cardia.

Adenocarcinoma↗

[Communications between hospital laboratory personnel and physicians].

The availability of internet facilities have been spreading rapidly and widely over the past several years. We publish a laboratory data handbook every year and distribute this to physicians in our hospital. Recently we have moved the information to our web site of the Internet. Using the web site, physicians can refer to the information on a 24-hour basis. This information includes: reference ranges; correlation of data obtained by previous and new methods; procedures for ordering each type of laboratory test. Furthermore, anyone can send questions and opinions by E-mail through the web page. The graphs which show the average values of patient results for each day can be obtained by using our database. These graphs are useful for long-range quality management of precision. Another important application is displaying histograms showing the distribution of test results between patients with a specific disease and healthy subjects. The application is expected to facilitate progress in laboratory medicine.

Clinical Laboratory Information Systems↗

Allosteric inhibitors against HIV-1 reverse transcriptase: design and synthesis of MKC-442 analogues having an omega-functionalized acyclic structure.

Based on X-ray crystallographic analysis of MKC-442/human immunodeficiency virus type 1 reverse transcriptase (HIV-1 RT) complex, analogues in which the N1-substituent is replaced with omega-functionalized alkyl groups were designed to improve the affinity for the enzyme. Synthesis of these compounds was carried out starting from MKC-442 by a sequence of reactions (N3-protection, removal of N1-ethoxymethyl group, alkylation, and N3-deprotection). The compounds were evaluated for anti-HIV activity. Structure-activity relationships are discussed in terms of the possible interaction with the enzyme.

Allosteric Site↗

Two distinct pathways for targeting proteins from the cytoplasm to the vacuole/lysosome.

Stress conditions lead to a variety of physiological responses at the cellular level. Autophagy is an essential process used by animal, plant, and fungal cells that allows for both recycling of macromolecular constituents under conditions of nutrient limitation and remodeling the intracellular structure for cell differentiation. To elucidate the molecular basis of autophagic protein transport to the vacuole/lysosome, we have undertaken a morphological and biochemical analysis of this pathway in yeast. Using the vacuolar hydrolase aminopeptidase I (API) as a marker, we provide evidence that the autophagic pathway overlaps with the biosynthetic pathway, cytoplasm to vacuole targeting (Cvt), used for API import. Before targeting, the precursor form of API is localized mostly in restricted regions of the cytosol as a complex with spherical particles (termed Cvt complex). During vegetative growth, the Cvt complex is selectively wrapped by a membrane sac forming a double membrane-bound structure of approximately 150 nm diam, which then fuses with the vacuolar membrane. This process is topologically the same as macroautophagy induced under starvation conditions in yeast (Baba, M., K. Takeshige, N. Baba, and Y. Ohsumi. 1994. J. Cell Biol. 124:903-913). However, in contrast with autophagy, API import proceeds constitutively in growing conditions. This is the first demonstration of the use of an autophagy-like mechanism for biosynthetic delivery of a vacuolar hydrolase. Another important finding is that when cells are subjected to starvation conditions, the Cvt complex is now taken up by an autophagosome that is much larger and contains other cytosolic components; depending on environmental conditions, the cell uses an alternate pathway to sequester the Cvt complex and selectively deliver API to the vacuole. Together these results indicate that two related but distinct autophagy-like processes are involved in both biogenesis of vacuolar resident proteins and sequestration of substrates to be degraded.

Aminopeptidases↗

Identification and molecular characterization of fractalkine receptor CX3CR1, which mediates both leukocyte migration and adhesion.

Leukocyte trafficking at the endothelium requires both cellular adhesion molecules and chemotactic factors. Fractalkine, a novel transmembrane molecule with a CX3C-motif chemokine domain atop a mucin stalk, induces both adhesion and migration of leukocytes. Here we identify a seven-transmembrane high-affinity receptor for fractalkine and show that it mediates both the adhesive and migratory functions of fractalkine. The receptor, now termed CX3CR1, requires pertussis toxin-sensitive G protein signaling to induce migration but not to support adhesion, which also occurs without other adhesion molecules but requires the architecture of a chemokine domain atop the mucin stalk. Natural killer cells predominantly express CX3CR1 and respond to fractalkine in both migration and adhesion. Thus, fractalkine and CX3CR1 represent new types of leukocyte trafficking regulators, performing both adhesive and chemotactic functions.

Antigens, CD↗

Ornithine decarboxylase inhibitor lessens the rat gastric carcinogenesis enhancement caused by tyrosine methyl ester.

The effects of combined administration of a catecholamine precursor, tyrosine methyl ester (TME), and an ornithine decarboxylase (ODC) inhibitor, 1,3-diaminopropane (DAP), on the incidence of gastric cancers induced by N-methyl-N'-nitro-N-nitrosoguanidine (MNNG), the norepinephrine (NE) concentration and ODC activity of the gastric wall, and the labeling index of the gastric mucosa were investigated in inbred Wistar rats. Rats received s.c. injections of TME, 512 mg/kg body weight, every other day and drinking water with or without 2.5 g/l of DAP after 25 weeks of oral administration of MNNG. At week 52, administration of TME resulted in significant increases in the incidence of gastric cancers, in the NE concentration and the ODC activity of the antral portion of the gastric wall, and in the labeling index of antral epithelial cells. Administration of both TME and DAP significantly reduced the enhancements by TME of gastric carcinogenesis, NE concentration and ODC activity of the antral wall, and the labeling index of the antral mucosa. Our results suggest that ODC inhibition lessens enhancement by TME of gastric carcinogenesis and that the enhancement by TME of gastric carcinogenesis is mediated in part by polyamine biosynthesis.

Animals↗