Myocardial patchy staining of dystrophin in Becker's muscular dystrophy associated with cardiomyopathy.
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Adult↗
Biomedical subjects
S Arima
Publications and source records attributed to S Arima.
Marked alternans of the elevated ST segment during occlusion of the left anterior descending coronary artery in percutaneous transluminal coronary angioplasty: clinical background and electrocardiographic features.
To investigate the clinical background and the electrocardiographic features of marked alternans of the elevated ST segment during coronary angioplasty, we examined 12-lead electrocardiograms recorded continuously during occlusion of the left anterior descending coronary artery by balloon inflation in 41 patients. The incidence of marked ST alternans was 27% of 41 patients and 15% of 117 balloon occlusions. The incidence decreased progressively from the first to the third occlusion. The time course of ST alternans was determined. Compared with patients without ST alternans, patients with ST alternans had a shorter history of angina, less severe stenosis of the target lesion before coronary angioplasty, more leads showing ST elevation during occlusion, higher ST elevation during occlusion and lower incidence of previous myocardial infarction in the left anterior descending coronary arterial area. ST alternans recorded on the surface electrocardiogram may thus be considered a marker of acute severe and extensive myocardial ischemia.
Adult↗
Functions of ascending thin limb of Henle's loop with special emphasis on mechanism of NaCl transport.
Major controversy concerning the ascending thin limb of Henle's loop (ATL) centers on the urine concentration mechanism based on the countercurrent multiplier system in the inner medulla of the kidney. This renal tubular segment has specific transport properties which function to dilute the urine without any movement of water across the epithelium. This segment is fundamentally impermeable to water, moderately permeable to urea, and highly permeable to Na+ and Cl-. Whether NaCl is reabsorbed actively in the ATL has long been an important question. While mathematical modelling studies have failed to explain completely how the osmotic gradient in the inner medulla is generated without active NaCl transport in the ATL, the experimental data support the view that active NaCl reabsorption is absent. Recently, we succeeded in measuring the intracellular Na+ concentration by using the fluorescent Na+ indicator sodium-binding benzofuran isophthalate in the in vitro microperfused ATL. Our data suggest that the ATL maintains a low intracellular Na+ concentration by the ouabain-sensitive Na+/K+ ATPase in the basolateral membrane, and that the luminal membrane of the ATL has furosemide-insensitive Na+ permeability. Active Na+ reabsorption estimated in our study amounts to only a few per cents of the net Na+ reabsorption in the ATL. It is therefore suggested that the major role of Na+ extrusion in the ATL cells is to maintain a low cellular Na+ concentration against ambient hyperosmolarity, although small but substantial amount of Na+ is reabsorbed by the furosemide-insensitive Na+ permeability and ouabain-sensitive Na+/K+ ATPase.
Animals↗
Primary esophageal non-Hodgkin's lymphoma.
A 77-year-old woman with primary esophageal non-Hodgkin's lymphoma in clinical stage IEA (Ann Arbor Classification) developed pain and difficulty in swallowing. An upper gastrointestinal examination revealed a submucosal tumor from the upper to the middle portion of the esophagus. Histopathological examination at endoscopic biopsy with endoscopic partial incision showed non-Hodgkin's lymphoma (diffuse type--large cell). Immunohistological examination of tumor cells disclosed LCA (+), CD3(DAKO) (+), MT1 (+), UCHL1 (+), MB1 (+), MxPanB (-) and EMA (-) reactivity and showed T cell lymphoma. The clinical stage was determined to be IEA after further work-up. Improvement of swallowing difficulty and esophageal findings on upper gastrointestinal series were noted after modified CHOP therapy and radiotherapy (total 50 Gy).
Aged↗
[A study of inhibitory effect of chondroitin polysulfate on stone formation of calcium oxalate].
Chondroitin polysulfate (CPS) have inhibitory activity on stone formation of calcium oxalate. This study compared the inhibitory effect of three CPS (CPS S-I, CPS S-II, CPS S-III) with sodium pentosan polysulfate (SPP) and chondroitin sulfate (CS). Crystal growth inhibition was measured in a seeded crystal growth system with 14C-oxalate, and CPS S-I and CPS S-II were the most active substances inhibiting crystal growth. Since CPS S-II and CPS S-III had remarkable hemorrhagic adverse effect, these two substances were excluded from the following study. The study of administration of the rest of the substances (CPS S-I, SPP, CS) to rats revealed that CPS S-I highly inhibited formation of stone in kidney. About 65 percent of CPS S-I administered subcutaneously was excreted in 24 hours urine. Therefore it may be of value to study clinical usefulness of CPS S-I for treatment of patient with urolithiasis.
Animals↗
[Multicenter cooperative study of pre- and post-operative adjuvant chemotherapy in the treatment of colorectal cancer. North Kyushu Co-operative Study Group for Cancer Chemotherapy].
The usefulness of pre- and post-operative adjuvant chemotherapy in colorectal cancer patients was studied by the North Kyushu Co-operative Study Group for Cancer Chemotherapy (21 participating institutions). Comparisons were made among group I given a tegafur suppository preoperatively+tegafur oral preparation postoperatively, group II given a tegafur suppository preoperatively+UFT oral preparation postoperatively and group III given a tegafur oral preparation postoperatively. No differences were seen in the incidence of postoperative complications depending on whether or not tegafur suppositories were administered preoperatively. There were also no differences in the symptom or incidence of side effects due to postoperative administration of tegafur or UFT. In a study of 5-FU concentration in the lymph nodes due to preoperative tegafur administration and recurrences, the concentration of 5-FU was significantly higher in the lymph nodes of cases without recurrences than in those with recurrences, and it was suggested that a relation exists between the concentration of agent and recurrences. The concentration of 5-FU in the lymph nodes of Dukes B patients was significantly higher in cases without recurrences than in those with recurrences. The non-recurrence rate (healthy rate) was better in the group given UFT postoperatively than in that administered tegafur postoperatively although the difference was not significant.
Administration, Oral↗
An index of disease activity in patients with ulcerative colitis.
Quantification of disease severity was studied in 72 patients with ulcerative colitis, who had undergone total 85 clinical courses. We performed a multiple stepwise regression analysis, according to Truelove and Witts' classification, with disease severity as a dependent variable, and with 18 clinical, laboratory, and endoscopic parameters as independent variables. Results showed that disease severity in patients with ulcerative colitis is significantly influenced by five factors, namely, bloody stool, bowel movements, erythrocyte sedimentation rate (ESR), hemoglobin (Hb), and serum albumin. The activity index (AI) developed for ulcerative colitis is expressed as follows: AI = 60 x blood stool + 13 x bowel movements + 0.5 x ESR - 4 x HB - 15 x albumin + 200. Index values below 150, values between 150 and 220, and values above 220 nearly corresponded to mild, moderate, and severe disease, respectively, in Truelove and Witts' classification. We believe that the activity index is useful in evaluation of the effect of medical treatment in patients with ulcerative colitis. Its most important value will be in therapeutic trials.
Adolescent↗
[Diagnosis and care for emergency patients].
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Cardiopulmonary Resuscitation↗
Atherogenic risk factors in cerebrotendinous xanthomatosis.
In a study of coronary artery disease in patients with cerebrotendinous xanthomatosis (CTX), we documented the presence or absence of atherogenic risk factors and performed detailed analyses of serum lipid and lipoprotein profiles. Four of the seven patients examined had coronary arterial narrowing and/or obstruction, but multiple atherogenic risk factors were not found in any of these patients. Total cholesterol (T.ch) levels and low density lipoprotein-cholesterol (LDL-ch) levels were lower, and high density lipoprotein2-cholesterol (HDL2-ch) levels were higher in CTX patients than in controls. Triglyceride and very low density lipoprotein (VLDL) levels were significantly lower in the former. Indices correlating with the risk of atherosclerosis, such as the atherogenic index, and the ratios of apolipoprotein B/apolipoprotein AI, HDL2-ch/LDL-ch, HDL2-ch/HDL3-ch, indicated that CTX serum was, in fact, 'anti-atherogenic'. However, coronary artery disease is frequently seen in patients with CTX. This discrepancy suggests the existence of a unique mechanism by which atherosclerosis is induced in patients with CTX. We discuss a mechanism of disturbed lipoprotein metabolism which might be responsible for the deposition of sterols in the tissues of patients with CTX.
Adult↗
Significance of mononuclear phagocytes in IgA nephropathy.
To clarify the significance of mononuclear phagocytes in IgA nephropathy, renal biopsied materials from 45 patients with the disease were examined by the indirect immunoperoxidase method using anti-human monoclonal antibodies and by ultrastructural peroxidase (PO) cytochemistry. The monoclonal antibodies were FMC32, S-100 (alpha), My4, and LeuM5 for detection of mononuclear phagocytes and HLA-DR for Ia antigens. Mesangial hypercellularity in IgA nephropathy was divided into three grades. The number of monocyte/macrophages per glomerulus differed significantly among the grade of mesangial hypercellularity. In the capillary lumen, monocytes were more numerous in the group with slight mesangial hypercellularity. By contrast, macrophages were often found in the Bowman's space and mesangial area of the glomeruli in the advanced group. In the renal interstitium, the number of monocyte/macrophages per 100 interstitial cells differed significantly among the degree of interstitial damage, and they were observed mainly around sclerotic glomeruli. Ultrastructural PO cytochemistry revealed infiltration of monocytes, exudate macrophages, and/or PO-negative macrophages. Clinicopathological study showed a relationship between the number of monocyte/macrophages per glomerulus and the number of glomerular crescents and the degree of proteinuria. The constancy of the percentage of exudate macrophages and polymorphonuclear leukocytes were observed irrespective of the grade of mesangial hypercellularity. On the other hand, the increasing percentage of PO-negative macrophages and decreasing percentage of monocytes were observed over the grade. These results suggest that mononuclear phagocytes might play an important role in the pathogenesis of mesangial hypercellularity, and irreversible glomerular damage and interstitial tissue injury in IgA nephropathy.
Adolescent↗
[Immunohistochemical examination of carcinomas in the pancreatoduodenal region and its non-malignant counterparts using monoclonal antibodies against Lewis blood group-related antigens and sialyl Tn antigen].
Forty cases of carcinomas in the pancreatoduodenal region (carcinoma of the ampulla of Vater: 11 cases, carcinoma of the pancreas head (CPH): 12 cases, carcinoma of the inferior common bile duct (CIBD): 17 cases) and its non-malignant counterparts were examined immunohistochemically, using monoclonal antibodies against four Lewis (Le) blood group-related antigens and sialyl Tn antigen. TKH-2 (anti-sialyl Tn) reactivity, which is almost negative in non-malignant counterparts except for goblet cells in the duodenum, is highly positive in carcinomas, therefore, sialyl Tn antigen can be an excellent tumor marker in this region. Lex and sialyl Lex-i antigens have been regarded as pancreatic cancer-associated antigens, however, this study suggests that Lex and sialyl Lex-i are more useful markers for CIBD than CPH. Above findings imply that altered regulation of glycosyltransferase activity is associated in malignant state of the pancreas and inferior common bile duct.
Antibodies, Monoclonal↗
[The treatment of hypertensive patients with renal insufficiency--a comparison of the blood pressure management in patients with diabetic nephropathy and patients with hypertensive nephropathy].
It is well known that hypertension (HT) is frequently accompanied with diabetic nephropathy (DN) and that HT contributes to progression of DN. Thus, proper anti-hypertensive therapy is required in hypertensive patients with DN. However, there is so far no consensus of optimal blood pressure (BP) level to maintain the renal function in these patients. In order to evaluate the optimal BP level in the patients with renal insufficiency, we investigated the relation between BP and renal function in 15 DN patients with HT (aged 56.9 +/- 11.7 years at the first medical examination; 6 male and 9 female, total 117 patient-years) and 20 patients with hypertensive nephropathy (aged 44.3 +/- 13.0 years at the first medical examination; 17 male and 3 female, total 207.5 patient-years) as the control, who receive antihypertensive therapy for more than 4 years as outpatients at the second department of internal medicine of Tohoku University Hospital between 1974 and 1990. During this period 7 patients with DN came to receive hemodialysis therapy 2 to 6 (average 3.8 +/- 1.3) years after the first medical examination. As a result, in patients with hypertensive nephropathy, there was a tendency to show that the lower the mean BP was, the better the renal function. On the contrary, in DN patients there was an optimal mean BP (MBP) range; i.e, when MBP was controlled in this range, the deterioration rate of renal function was delayed, while deviation of MBP from this range made the renal function worse (p less than 0.01). However, this range varied with the serum creatinine (SCr) concentration level.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Non-invasive evaluation of coronary reperfusion using myoglobin: significance of quantitative and semi-quantitative latex agglutination methods].
We assessed the usefulness of myoglobin measured by latex agglutination methods as a parameter for successful reperfusion of the infarct-related artery. Plasma myoglobin levels were measured for 25 patients with acute myocardial infarction in whom thrombolysis and/or percutaneous transluminal coronary angioplasty (PTCA) were performed within 8 hours after the onset of symptoms. Blood samples were obtained before and 56 +/- 26 min (mean +/- SD) after commencing treatment. Plasma myoglobin levels were measured by quantitative and semi-quantitative latex agglutination methods, which required a procedure time of about 10 min. Coronary reperfusion was achieved by thrombolysis or PTCA in 22 cases (Group 1) but was not achieved by thrombolysis in 7 cases (Group 2). Before treatment (4.2 +/- 1.2 hours after the onset of symptoms), plasma myoglobin levels measured quantitatively and semi-quantitatively were 434 +/- 330 ng/ml and 4.6 +/- 4.2 fold, respectively. After treatment, the increased rate of myoglobin was significantly higher in Group 1 (8.4 +/- 7.5 and 9.2 +/- 7.1) than in Group 2 (1.8 +/- 0.5 and 1.7 +/- 0.5). Plasma myoglobin levels measured by quantitative and semi-quantitative latex agglutination methods showed a close correlation (r = 0.91, p < 0.01). In conclusion, measurement of plasma myoglobin levels by latex agglutination methods is a rapid and reliable way to confirm successful coronary reperfusion.
Aged↗
[Multihospital co-operative study of post-operative adjuvant chemotherapy in the treatment of gastric cancer-(Part 3). Comparisons between tegafur and UFT. North Kyushu Co-operative Study Group for Cancer Chemotherapy].
The North Kyushu Co-operative Study Group for Cancer Chemotherapy (21 participating facilities) carried out a comparative study of post-operative adjuvant chemotherapy in the treatment of 243 patients after surgery of gastric cancer in stages II, III and IV over 27 months period starting from October 1983. The patients were divided randomly into group A (treated with 20 mg of MMC on the day of the surgery and 10 mg of MMC on the following day, and with a daily dose 600 mg of orally administered tegafur starting from two weeks after the surgery. In addition to the above treatments, patients with Stage IV were treated with 10 mg of MMC every three months starting from four weeks after the surgery) and group B (treated with MMC in a similar manner to group A, and with 600m g of UFT instead of the tegafur). Thirty-three patients (13.6%) were excluded or dropped out, and the remaining 210 cases were analyzed. No severe side effects appeared in either of the groups, and a long-term administration was safe. The five-year survival rate among the radical surgery patient was significantly higher in the UFT group compared with the tegafur group (p less than 0.05). Significantly higher survival rate in the UFT group was observed (p less than 0.05) for the cases of poorly-differentiated adenocarcinoma. From the above results it appears that an addition of UFT to the treatment with MMC is useful in post-operative adjuvant chemotherapy for gastric cancer.
Adenocarcinoma↗
[The effect of blood pressure control on the progression of chronic glomerulonephritis associated with hypertension].
It is well known that hypertension (HT) frequently develops in patients with chronic glomerulonephritis (CGN) and that HT contributes to progression of CGN. So, proper antihypertensive therapy is required in hypertensive patients with CGN. However, there is so far no consensus of optimal blood pressure (BP) level to maintain the renal function in these patients. In order to evaluate the BP control level in the patients with renal insufficiency, we investigated the transition of BP and renal function in 22 CGN patients with HT (average age 36.5 +/- 9.9 years at the first medical examination, 15 male, 7 female, total 179.5 patient-years), who receive antihypertensive therapy for more than 5 years as outpatients at the second department of internal medicine of Tohoku University Hospital between 1975 and 1990. Renal biopsy had been performed in all these patients for CGN diagnosis. During this period 7 patients came to receive hemodialysis therapy from 5 to 10 (average 7.6 +/- 2.1) years after the first medical examination. In one of these 7 patients, the rate of decline in renal function accelerated after child-birth, and one after two years interruption of treatment. The other 13 patients are currently receiving drug treatments at our hospital. As a result, in CGN patients there was an optimal mean BP (MBP) control range, that is, when MBP was controlled in this range, the rate of decline in renal function became slow, but when MBP deviated from this range it became fast (p less than 0.01). Moreover, this range changed according to the serum creatinine (SCr) concentration level.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Drug concentration in cancerous large bowel tissue and thymidylate synthase inhibition rate after administration of tegafur and UFT].
Tegafur and UFT are most widely used for the treatment of cancers of the gastrointestinal tract. FdUMP, a metabolite of 5-fluorouracil(5-FU), is known to have an inhibitory activity of thymidylate synthase (TS). We administered 600 mg/day of tegafur or UFT to 37 patients with cancer of the large bowel beginning 1 week prior to surgery and then measured the concentrations of tegafur and 5-FU, and TS inhibition rate in the excised tissue. Our results showed that the concentrations of 5-FU in tumor were 0.077 +/- 0.026 microgram/g in tegafur group and 0.208 +/- 0.143 microgram/g in UFT group, with the UFT showing significantly higher levels (p less than 0.05). On the other hand, TS inhibition rates in tumor tissue were 45.5 +/- 13.3% in tegafur group and 56.1 +/- 13.0% in UFT group, with a significantly higher level existing in the latter group (p less than 0.05). Furthermore, the same high 5-FU concentration and TS inhibition rates were observed in the lymph nodes affected by metastasis. No difference between the tegafur and UFT groups was noted in normal tissue or normal lymph nodes, and compared to tegafur, UFT showed an effective action on cancerous large bowel tissue.
Antineoplastic Agents↗
[A case of ulcerative colitis with toxic megacolon, successfully treated with colonoscopic decompression].
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Adult↗
Renal disease in an adult with type 1 glycogen storage disease.
The renal disease in an adult woman with Type 1 glycogen storage disease (GSD) is reported. Since she was 15 years old, several episodes of gouty arthritis had developed. At the age of 18, proteinuria was pointed out. Hepatomegaly, renomegaly out of proportion to the impairment of renal function, hyperuricemia, hyperlipidemia, fasting hypoglycemia and lactic acidemia were observed. The diagnosis of GSD was established on the basis of a glucose tolerance test, glucagon test and liver biopsy. The findings of renal biopsies performed at the ages of 24 and 27 years old suggested that glomerular damage might have preceded the tubulo-interstitial lesion.
Adult↗