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Biomedical subjects

N Ando

Publications and source records attributed to N Ando.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Neoadjuvant chemotherapy and chemoradiotherapy in the treatment of esophageal cancer].

Adjuvant therapy following surgery has been mainstream in surgical adjuvant therapy for the patients with esophageal cancer in Japan. In western countries, neoadjuvant therapy has become popular in which surgery is performed depending on the effects of preoperative treatment. Neoadjuvant chemotherapy offers the advantage of downstaging the primary tumor and enhancing resectability and the potential advantage of assessing the response to preoperative chemotherapy directly in the primary tumor. Disadvantages include possible emergence of chemotherapy-resistant tumor cells, as well as the delay in achieving effective local tumor control and postoperative morbidity. In the phase II studies, most regimens have included CDDP/5-FU. Pathological CR rates have been less than 10% and median survival terms from eight to 28 months. The rationale for the concurrent use of chemotherapy and radiotherapy is to combine an agent that has an effect upon systemic micrometastases with a modality that enhances local tumor control. In addition, a number of chemotherapeutic agents have radiosensitizing effects. The majority of trials have employed CDDP/5-FU combined with RT for a total dose of 30 Gy. Pathological CR rates were from 20 to 40% and median survival terms from 12 to 29 months. Neither neoadjuvant chemotherapy nor chemoradiotherapy increased operative morbidity mortality, and there was a statistically significant increase in survival in complete responders. However, though the early and median survival was improved, the cure rate was not. Both therapies remain investigational.

Aged↗
PubMed1995

[Chemotherapy and multimodality therapy in the treatment of esophageal cancer].

Many single-agent phase II studies for patients with esophageal cancer had been performed, and at least five agents with modest activity have been indentified, BLM, MMC, CDDP, VDS and MTX, that revealed no CR. Even in the phase II study of 254-S, a new anticancer platinum complex, with a response rate of 43%, CR could not be recognized. Only two regimens of combination chemotherapy have been studied extensively, CDDP/BLM/VDS and CDDP/5-FU. The combination of CDDP/5-FU has gained popularity and JEOG phase II study revealed a response rate of 36%. As surgical adjuvant therapy, postoperative adjuvant therapy has been common in Japan. The 4th JEOG phase III clinical trial, comparing surgery alone and postoperative chemotherapy of CDDP/VDS, showed no additive effect to surgery by postoperative chemotherapy with such a regimen. In western countries, neoadjuvant chemotherapy is frequent and most of the regimens include CDDP/5-FU. Pathological CR rates were less than 10%, and median survival terms were from eight to 28 months. The rationale for the concurrent use of chemotherapy and radiotherapy is to combine an agent that has an effect upon systemic micrometastases with a modality that enhances local tumor control. In addition, a number of chemotherapeutic agents have radiosensitizing effects. In western countries, more than 35 trials studying over 1400 patients have been reported. The majority of trials have employed CDDP/5-FU combined with RT to a total dose of 30Gy. Pathological CR rates were from 20 to 40% and median survival terms were from 12 to 29 months. Both neoadjuvant chemotherapy and chemoradiotherapy did not change operative morbidity or mortality, and there was a statistically significant increase in survival in complete responders. However, early and median survival seems improved but cure rates are not. Both therapies require further investigation.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

[Rapid diagnosis of adenoviral conjunctivitis by enzyme-linked immunosorbent assay (Adenoclone)].

We evaluated an enzyme-linked immunosorbent assay test (Adenoclone) for the rapid diagnosis of adenovirus infection in 589 cases of acute follicular conjunctivitis. Of 255 cases of adenoviral conjunctivitis proven by positive virus isolation. Adenoclone was positive in 51.0% by visual determination and 40.4% by spectrophotometry. Twenty-seven of 130 cases giving visually positive results were interpreted to be negative by spectrophotometry. In 334 adenovirus-negative cases, Adenoclone was negative in 99.1% and 99.4 by visual and spectrophotometric determination, respectively. Adenoclone was less sensitive in cases of adenovirus 3, 4 or 37, infections than in those of adenovirus 8, and also showed lower sensitivity in cases presenting mild conjunctivitis. Adenoclone is a rapid and easy test with high specificity but low sensitivity, and thus the test seems to be helpful in diagnosing adenoviral conjunctivitis.

Adenovirus Infections, Human↗
PubMed1995

[A study of heel-knee tapping test in cerebellar ataxia by a motion measurement system].

It is often difficult to estimate slight alterations in the severity of ataxia by bed-side neurological examinations. We analyzed the heel-knee tapping test, which has often been used as a standard bed-side examination to check incoordination in lower limbs, using a new motion measurement system "video/computer motion measurement system". We studied 9 normal controls and 21 patients with spinocerebellar degenerations (SCD). In patients with SCD, the up-and-down motion range of the heel was variable and the heel moved in the anterior-and-posterior direction, because of knee sways during the test. Following oral administration of TRH analogue, TA-0910, above-mentioned findings were clearly improved. Analysis of spatial and time elements of the knee joint demonstrated quantitative improvement. Therefore, an effect of TA-0910 on incoordination of the lower limbs could be proved objectively by a computer motion measurement system.

Adult↗
PubMed1994

Elastase gene expression in non-elastase-producing Pseudomonas aeruginosa strains using novel shuttle vector systems.

In order to determine whether non-elastase-producing strains of Pseudomonas aeruginosa such as N-10, PA103 and IFO3080 can express foreign elastase genes, we introduced elastase genes from P. aeruginosa IFO3455 (elastase-producing) as well as from PA103 and N-10 into non-elastase-producing P. aeruginosa strains. Results suggested that gene expression, secretion, and precursor processing systems of elastase were essentially normal in P. aeruginosa N-10 and IFO3080. Our studies using various elastase genes showed that both the elastase structural gene and 5'-upstream regions of P. aeruginosa PA103 were also normal. This was confirmed by the finding that P. aeruginosa N-10 and IFO3080 which carry the PA103 elastase gene produced elastase. Several deleted or chimeric genes were constructed using the 5'-upstream regions of elastase genes from P. aeruginosa N-10 or PA103 and studies of expression revealed that two individual DNA bases seem to be important in suppressing P. aeruginosa N-10 elastase gene expression. Possible reasons for the lack of elastase expression in these non-elastase-producing strains are discussed.

Base Sequence↗
PubMed1994

Localization and quantitation of blood-retinal barrier breakdown in experimental proliferative vitreoretinopathy.

OBJECTIVE: To determine the contribution of the breakdown of the blood-retinal barrier (BRB) as measured with magnetic resonance imaging in the development of retinal detachment in an experimental model of proliferative vitreoretinopathy. METHODS: Contrast-enhanced magnetic resonance imaging was used to evaluate BRB breakdown in an intravitreal cell-injection model of proliferative vitreoretinopathy. Intravitreal injection of 2.5 x 10(5) homologous dermal fibroblasts produced specific disruption of the inner, or vascular, BRB. RESULTS: Breakdown of the BRB was greatest in the first 3 days after injection, confirming previous work using fluorescein-based methods. Injection of 1 mg of intravitreal triamcinolone acetonide at the time of cell injection significantly reduced both BRB breakdown and the incidence of eventual traction retinal detachment. Eyes that did develop detachment had significantly greater leakage prior to its development than those that did not, regardless of steroid treatment. CONCLUSIONS: Quantitation and definitive localization of BRB leakage with magnetic resonance imaging provides a better understanding of the relationship between BRB compromise and the development of retinal detachment in this frequently used model.

Animals↗
PubMed1994

The effects of dopamine infusion on the postoperative energy expenditure, metabolism, and catecholamine levels of patients after esophagectomy.

Although dopamine is one of the most widely used vasoactive agents, its postoperative thermogenic and metabolic effects have not been studied. In this study, the effects of low-dose dopamine, given at 5 microgram/kg/min, on resting energy expenditure (REE), metabolism, and plasma catecholamine levels were examined in eight postsurgical patients. Dopamine infusion increased REE from 1,839 +/- 171 kcal/day to 2,071 +/- 170 kcal/day, and it decreased to 1,867 +/- 141 kcal/day after cessation of the infusion. Dopamine also increased the plasma levels of glucagon from 109.4 +/- 8.7 pg/ml to 132.5 +/- 8.0 pg/ml, and it decreased to 102.9 +/- 11.1 pg/ml after cessation of the infusion. The plasma levels of dopamine before, during, and after the infusion were 116.1 +/- 18.3, 161.1 +/- 25.6 and 121.4 +/- 17.2 ng/ml, respectively. Insulin and glucose were affected by dopamine, but changes in their plasma levels did not parallel the dopamine levels. Epinephrine and norepinephrine were increased by the infusion of dopamine and continued to increase even after its cessation. The results of this study revealed that low-dose dopamine increased REE in postsurgical patients and that this might be associated with the concomitant increase in plasma glucagon.

Aged↗
PubMed1994

Vocal cord paralysis associated with difficult gastric tube insertion.

Many clinical reports have described vocal cord paralysis after general anaesthesia. In most cases, paralysis was attributed to tracheal tube insertion. In this report we describe one patient in whom gastric tube insertion was strongly suspected as the cause of paralysis. The patient was a 47-yr-old man who underwent left hepatic lobectomy. Just after the operation he complained of hoarseness and a diagnosis of complete right vocal cord paralysis was made, from which he recovered after eight weeks. In this patient, insertion of the gastric tube seemed to have injured the anterior ramus of the right recurrent laryngeal nerve directly. Although there have been several reports of vocal cord paralysis induced by gastric tubes, none has noted such an acute onset and direct nerve injury. Therefore we would like to report this rare case and elucidate the mechanism of vocal cord paralysis. Careful attention should be paid in inserting a gastric tube to patients under general anaesthesia and, sometimes, the use of the soft tube may be indicated.

Carcinoma, Hepatocellular↗
PubMed1994

Spinal cord injury hospitalisation in a rehabilitation hospital in Japan.

The Kanagawa Rehabilitation Hospital was established by Kanagawa Prefecture 20 years ago. The hospital has a 40 bed SCI unit and has been providing comprehensive medical and rehabilitation services for SCI patients of this prefecture. A letter of enquiry to 404 major surgical units within this prefecture revealed that 630 SCI patients had been under care in this prefecture during a period of 3 years. Of these, the Frankel grade A, B and C patients, were assumed to be rehabilitation candidates, totalling about 130 in this prefecture per year. The inpatient medical record revealed that we treated 770 SCI patients from 1986 to 1991. From this data, we estimated that the hospital accepted an average of 54.5 SCI patients per year for rehabilitation purposes. Other inpatients were rehospitalised for various complications. According to the study of 125 patients who were hospitalised for comprehensive rehabilitation, they waited an average of 139 days and stayed in the hospital for 288 days. The increasing number of chronic patients who required treatment of complications appeared to be delaying the early admission of rehabilitation patients. The medical treatment cost for those with spinal cord injuries was less than that for the average patient with other types of medical conditions.

Activities of Daily Living↗
PubMed1994

Input patterns and pathways from the six semicircular canals to motoneurons of neck muscles. I. The multifidus muscle group.

1. The pattern of connections between the six semicircular canals and neck motoneurons of the multifidus muscle group was investigated by recording intracellular potentials from motoneurons in the upper cervical cord of anesthetized cats. 2. Synaptic potentials were recorded in motoneurons of the rectus capitis posterior (RCP) muscle at C1, the obliquus capitis inferior (OCI) muscle at C1 and C2, and the cervical multifidus muscle (Multi) at C4 in response to electrical stimulation of individual ampullary nerves of the six semicircular canals. Excitatory or inhibitory postsynaptic potentials (EPSPs or IPSPs, respectively) were evoked by separate stimulation of individual ampullary nerves in all of the neck motoneurons. Virtually all of the neck motoneurons received convergent inputs from the six ampullary nerves. 3. Motoneurons that supplied a single muscle had a homogeneous pattern of input from the six semicircular canals. There were two patterns of input from the six semicircular canals to motoneurons of the multifidus muscle group. RCP and Multi motoneurons were excited by stimulation of the bilateral anterior canal nerves (ACNs) and the contralateral lateral canal nerve (LCN) and inhibited by stimulation of the bilateral posterior canal nerves (PCNs) and the ipsilateral LCN. This input pattern is similar to that previously observed in other dorsal extensor muscles, whereas the other input pattern observed in OCI motoneurons is entirely new. OCI motoneurons at C1 and C2 were excited by stimulation of the ipsilateral ACN, PCN, and the contralateral LCN and inhibited by stimulation of the contralateral ACN, PCN, and the ipsilateral LCN. 4. Most postsynaptic potentials (PSPs) were disynaptic, but there were trisynaptic inhibitory connections between the contralateral ACN and PCN and OCI motoneurons, and between the contralateral PCN and RCP motoneurons. 5. The pathways for mediating these inputs from different semicircular canals to neck motoneurons were determined by making lesions in the lower medulla. Transection of the ipsilateral medial longitudinal fascicle (MLF) abolished the following potentials: all disynaptic PSPs in RCP motoneurons except the disynaptic EPSPs from the ipsilateral ACN, and in OCI motoneurons, disynaptic PSPs from the bilateral LCNs, and disynaptic IPSPs from the contralateral PCN. Complete bilateral section of the MLF did not affect the disynaptic EPSPs from the ipsilateral ACN in RCP motoneurons, the disynaptic EPSPs from the ipsilateral ACN and PCN in OCI motoneurons, nor the trisynaptic IPSPs from the contralateral ACN and PCN in COI motoneurons and from the contralateral PCN in RCP motoneurons.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1994

[Intraoperative fluorescein angiography with an ultrasensitive imaging tube].

Fluorescein angiographic examination may be prevented by vitreous hemorrhage or opacities in vitreoretinal diseases before vitrectomy. We performed intraoperative fluorescein angiography for such cases, using a conventional light source and an ultrasensitive video camera equipped with a silicone intensifier target tube to avoid retinal phototoxicity. Intraoperative fluorescein angiograms allowed evaluation of neovascular vessels, proliferative tissues, and avascular areas associated with diabetic retinopathy. Indentation of the pars plicata enabled us to also record fluorescein images of the area. This device may aid intraoperative assessment of vitreoretinal diseases including diabetic retinopathy.

Fluorescein Angiography↗
PubMed1994

Alcohol consumption and risk of esophageal cancer in Japan: a case-control study in seven hospitals.

In a multi-center case-control study, we evaluated the risk of esophageal cancer in the Japanese population. All patients and controls were inpatients in the surgical departments of seven hospitals nationwide. Patients eligible for the study were those newly diagnosed as having primary esophageal cancer. One control per case was selected from among patients admitted to the same hospital, and 141 male pairs were analyzed using logistic regression analysis. The results showed dose-response relation between the risk of esophageal cancer and both the quantity (g/week) and frequency (times/week) of alcohol drinking (P value for trend = 0.0001). Although a statistically significant risk increase was shown among moderate to heavy smokers (15 < or = cigarette/day < 25) (odds ratio, 4.35:95% confidence interval, 1.81-10.49), the dose-response for cigarette smoking was unclear (P value for trend = 0.07). No combined effect of alcohol drinking and cigarette smoking was found. A frequent intake of fruit was associated with a decreased risk (P value for trend = 0.02). After adjustment for alcohol consumption, cigarette smoking and fruit intake were found not to be associated with the risk, whereas a preference for high-temperature food and drink showed a statistically significant positive association (P value for trend = 0.02). Drinkers who consumed shochu most frequently showed a three-fold increased risk over that for beer consumers, although the association disappeared after adjusting for the amount of alcohol consumed. The present results confirm alcohol intake and a preference for high-temperature food to be associated with an increased risk of esophageal cancer and show the amount of alcohol consumed, rather than the type of alcoholic beverage, to be the main risk determinant.

Alcohol Drinking↗
PubMed1994

[Thoracoscopic surgery for benign esophageal disease].

Two patients with benign esophageal disease were successfully treated by thoracoscopic surgery. First case was a 66 year old male with esophageal diverticulum, who had complained of progressive dysphasia. The esophagogram showed a giant epiphrenic diverticulum which was 8 cm in diameter. Entire procedure was performed thoracoscopically under general anesthesia, while left side univentilation was applied. A flexible videoelectronic thoracoscope was introduced into thoracic cavity at the 5th intercostal space, and 4 additional trocars were inserted. The pleura over the diverticulum was divided, and the diverticulum was fully dissected and exposed. A multifire endoscopic stapler, an Endo GIA, was applied to resect the diverticulum. For security, uninterrupted suture of muscular layer of the esophagus over the stapled line was performed. Second case was a 60 year old male with esophagobronchial fistura, who had complained of choking during liquid intake for 20 years. The bronchogram showed a communication between a esophageal diverticulum and a right B6 bronchus. The operation was performed thoracoscopically. A thoracoscope was introduced as mentioned above, and the esophagus and the peripheral lung around the fistura was dissected and fully exposed. The diverticulum was divided at its base using an Endo GIA, and the fistura was resected with lung parenchyma using also an Endo GIA. The postoperative courses of the both patients were uneventful. The patients started diet on the 4th and the second postoperative day respectively, and the symptoms had disappeared after surgery.

Aged↗
PubMed1993

Synaptic organization of the vestibulo-collic pathways from six semicircular canals to motoneurons of different neck muscles.

The pattern of inputs from six semicircular canals to neck motoneurons was investigated by stimulating six ampullary nerves electrically and recording intracellular potentials from motoneurons of the rectus capitis dorsalis (RD), the complexus (COMP) and the obliquus capitis caudalis (OCA) muscles at the upper cervical cord of the cat. RD and COMP motoneurons received disynaptic excitation from bilateral anterior and contralateral horizontal ampullary nerves and disynaptic inhibition from bilateral posterior and ipsilateral horizontal ampullary nerves. OCA motoneurons received excitation from ipsilateral vertical and contralateral horizontal ampullary nerves and inhibition from contralateral vertical and ipsilateral horizontal ampullary nerves. Ipsilateral disynaptic inhibitory postsynaptic potentials and contralateral disynaptic excitatory postsynaptic potentials to these motoneurons were mediated by the medial longitudinal fasciculus (MLF) and the other postsynaptic potentials by the extra-MLF pathways. The results indicated that motoneurons of a neck muscle have its own characteristic pattern of inputs from six semicircular canals.

Animals↗
PubMed1993

Increased chemiluminescence and ulcer development in the low blood flow state of the gastric tube for esophageal replacement.

Peptic ulcers in the gastric tube for esophageal replacement develop in spite of reduction of acid secretion after truncal vagotomy and often result in serious conditions such as bleeding and perforation. Thirteen cases of gastric tube ulcers were detected endoscopically from 1985 to 1990 in our hospital. Most of these ulcers developed within 20 cm of the anastomosis (esophagogastrostomy), which was an especially hypoxic and ischemic area. Ischemic change due to decreased blood supply is suggested as a causative factor in ulcer development. Recent studies indicate that chemiluminescence (ChL) activity may increase even in the low-flow hypoxic condition. Therefore, we investigated the ChL of regional blood in the hypoxic gastric tube in dogs. The ChL activity of the blood sample collected from the ischemic region in the gastric tube significantly increased after construction of the gastric tube, compared with systemic blood from the femoral vein, and the number of leukocytes decreased in the ischemic region. We believe that oxygen radicals derived from neutrophils adhering to the vascular endothelium may play an important role in the damage to endothelial cells of the gastric tube and suggest the possibility of their causative effects in the process of ulcer formations.

Anastomosis, Surgical↗
PubMed1993

[Inhibitory effects of oral glucocorticoid therapy on T-lymphocyte infiltration in the bronchial mucosa of asthmatic subjects].

Although one of the mechanisms of glucocorticoid action in asthma is thought to be suppression of bronchial inflammation, there is little evidence to support this view. In the present study we have attempted to clarify the effect of oral glucocorticoid therapy on lymphocyte infiltration in the bronchial mucosa. Bronchial biopsies were obtained from 9 patients with asthma who had been taking oral prednisolone for at least the previous 18 days. They were stained immunohistochemically with a panel of monoclonal antibodies against: T cell subsets (CD3, CD4, CD8, CD57), and interleukin-2 receptor (CD25). The numbers of positive staining cells were counted for each antibody and compared with those in 11 patients with asthma who were symptomatic but had not been receiving glucocorticoid therapy for at least the previous one month. There was a significant decrease in the numbers of CD3- CD4-, CD8- and CD57-positive cells in glucocorticoid treated asthmatics compared with those of symptomatic asthmatics. Moreover, when one patient who showed glucocorticoid resistance was excluded from the analysis, there was a significant inverse correlation between the dose of prednisolone expressed as the total dose for the previous 2 weeks and the numbers of CD3- and CD4-positive cells. The number of CD25-positive cells (interleukin-2 receptor-bearing cells, presumed activated T-lymphocytes) also showed a tendency to decrease but the difference was not statistically significant. These results suggest that oral glucocorticoids exert an inhibitory effect on T-lymphocyte infiltration in the bronchial mucosa, which could be a mechanism of their beneficial action in asthma.

Administration, Oral↗