End-stage renal disease in a patient with Werner's syndrome.
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Diabetes Complications↗
Biomedical subjects
T Goya
Publications and source records attributed to T Goya.
Vascular access infection associated with methicillin-resistant Staphylococcus aureus nasal carriage in a hemodialysis patient.
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Aged↗
Blood monitoring of bezafibrate in a chronic hemodialysis patient.
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Bezafibrate↗
Magnetic resonance imaging and angiographic appearance of meningioma of the fourth ventricle--two case reports.
A 47-year-old female presented with a transitional type meningioma entirely confined to the fourth ventricle. The tumor was totally resected. A 67-year-old female had undergone resection of an intraventricular transitional type meningioma of the fourth ventricle 9 years previously. She presented with a new meningioma of an obviously different origin at the posterior rim of the foramen magnum. The new meningioma was totally resected and the histological diagnosis was atypical meningioma. The magnetic resonance (MR) imaging characteristics of these two intraventricular meningiomas of the fourth ventricle were isointense and slightly hypointense to gray matter on the T1-weighted images, and hyperintense to gray matter on the T2-weighted images, with intense and homogeneous enhancement with gadolinium. Angiography showed the two intraventricular meningiomas fed by branches of the posterior inferior cerebellar arteries or superior cerebellar arteries. The second meningioma with dural attachment was fed by the right occipital artery. Intraventricular meningiomas of the fourth ventricle are not supplied by meningeal branches from vertebral and external cerebral arteries. MR imaging is the most useful tool in preoperative diagnosis, but cerebral angiography should also be performed to confirm the feeding vessels and the correct diagnosis.
Aged↗
Establishment and characterization of a new human glioblastoma cell line (MGM-1) with highly motile phenotype.
A new cell line MGM-1 was established from a primary tumor of the left temporal lobe with histological diagnosis of glioblastoma multiforme, removed from a 64-year-old Japanese male. The patient died of recurrence and unusual extracranial metastases of the tumor 7 months after the surgery. The cultured MGM-1 cells are spindle or polygonal in shape. After serial passages, glial fibrillary acidic protein became negative immunocytochemically in vitro. The modal chromosome number was 61-64. Doubling time and soft agar colony forming efficiency were 42.9h and 0.4%, respectively (at 25th passage). MGM-1 is a highly motile cell line in vitro and its serum-free conditioned medium is chemotactic and chemokinetic for other glioma cells. Secretion of gelatinases (probably MMP-2/72-kDa type i.v. collagenase) and MMP-9/92-kDa type i.v. collagenase) and urokinase-type plasminogen activator were also investigated. MGM-1 would therefore be useful for studying the mechanisms regulating glioma-cell motility and invasion. The MGM-1 cell line has been propagated continuously by serial passages (more than 100 passages) during the past 4 years.
Brain Neoplasms↗
Systemic lupus erythematosus in a patient with remitting minimal change nephrotic syndrome.
Minimal change nephrotic syndrome (MCNS) developed in a 17-year-old female and spontaneously remitted. One month later the nephrotic syndrome relapsed. Prednisolone therapy, 60 mg/day, was started and resulted in a full remission within a week and the prednisolone dose was subsequently tapered. Seven months later, when 10 mg/day of prednisolone was being administered, she developed erythematous rash with photosensitivity and polyarthralgia without exacerbation of the nephrotic syndrome, and fulfilled four of the American College of Rheumatology criteria for classification of systemic lupus erythematosus (SLE). Avoidance of direct sunlight ameliorated the erythematous rash and the polyarthralgia disappeared even though the prednisolone dose was decreased further. This is the first reported case of SLE developed in a patient with remitting MCNS.
Adolescent↗
Evaluation of the effects of steroids on experimental septic lung injury.
To evaluate the clinical usefulness of steroids for septic lung injury, we investigated the effects of methylprednisolone (MP) on this disorder using an experimental rat model of cecal ligation and puncture (CLP). While 92% of the rats that underwent CLP (CLP rats) died within 30 h, those given high-dose MP (30 mg/kg) just after the operation (CLP + MP rats) survived for a significantly longer period (p < 0.01). Concentrations of endotoxin (ET) in arterial blood were significantly higher in the CLP + MP rats than in the CLP rats, while those in the bronchoalveolar lavage fluid (BALF) were significantly lower. Alveolar macrophages (AM) obtained from the CLP rats (CLP-AM) generated more O2-than did AM from sham-operated rats (sham-AM) following stimulation. However, the administration of MP did not reduce the upregulated generation of O2-by CLP-AM. While CLP-AM produced less leukotriene (LT)B4 than did sham-AM following stimulation with A23187, the administration of MP further reduced LTB4 production. When AM were cultured with [3H]arachidonic acid (3H-AA), the uptake of the isotope and the 3H release were significantly less in CLP-AM than in sham-AM. The administration of MP did not cause recoveries in the uptake and release of 3H-AA by CLP-AM. Although the survival time of CLP rats was significantly prolonged and the translocation of ET into BALF was reduced by steroid administration, the steroid effects were not explained by those on altered AM function. The upregulated generation of O2- and reduced LTB4 production from CLP-AM were not reversed by the treatment of this drug.
Animals↗
Prediction of hemorrhagic complications after thrombolytic therapy for middle cerebral artery occlusion: value of pre- and post-therapeutic computed tomographic findings and angiographic occlusive site.
OBJECTIVE: To evaluate the usefulness of pre- and post-therapeutic computed tomographic (CT) findings in predicting hemorrhagic complications, we retrospectively examined 35 patients treated with intra-arterial thrombolytic therapy for middle cerebral artery (MCA) occlusion. METHODS: The presence or absence of early CT findings (loss of the insular ribbon, obscuration of the lentiform nucleus, and cortical effacement) and the presence and location of extravasation of contrast medium were evaluated on pre- and post-therapeutic CT scans, respectively. According to the angiographic occlusive site, the patients were classified into the following three groups: Group 1 (n = 13), MCA trunk occlusion involved lenticulostriate arteries; Group 2 (n = 11), occlusion of the MCA trunk without involvement of the lenticulostriate arteries; Group 3 (n = 11), occlusion of a branch of the MCA. Hemorrhagic complications (hemorrhagic transformation and/or massive brain swelling) were evaluated by reviewing CT scans obtained 3 to 14 days after thrombolytic therapy. RESULTS: No patient without extravasation (n = 17) showed hemorrhagic complications, and extravasation is the most useful finding in predicting hemorrhagic complications. There was significant correlation between extravasation and hemorrhagic complications (P < 0.01). In Groups 1 and 2, there was also significant correlation between early CT findings and hemorrhagic complications (P < 0.01), indicating that early CT findings are also useful in predicting hemorrhagic complications. In Group 1, 10 of 13 (76.9%) patients had both early CT findings and extravasation, and 6 of these 10 patients had hemorrhagic complications with clinical deterioration, suggesting the difficulty of thrombolytic therapy in this group. On the contrary, in Group 2, 8 of 11 (72.7%) patients had neither early CT findings nor extravasation and none of these 8 patients had hemorrhagic complications. In Group 3, however, early CT findings and extravasation had no correlation. Because the affected area was small in this group, it was difficult to evaluate cortical effacement. Although negative early CT findings did not always mean absence of extravasation and hemorrhagic complications in this group, the patients with hemorrhagic complications did not clinically deteriorate because of the small affected area. CONCLUSION: Hemorrhagic complications could be predicted by evaluation of angiographic occlusive site and pre- and post-therapeutic CT findings.
Aged↗
Use of serial semithin frozen sections to evaluate the co-localization of estrogen receptors and progesterone receptors in cells of breast cancer tissues.
The extent of co-expression of estrogen receptors (ER) and progesterone receptors (PgR) in breast cancer cells was examined immunocytochemically. Eight surgical cases of infiltrating ductal carcinoma designated as ER-positive and PgR-positive (ER+/PgR+) by enzyme immunoassay (EIA) were used. They were fixed with 4% formaldehyde and cut into serial frozen semithin sections. Using sections stained with either anti-ER or anti-PgR antibody, we ascertained the co-localization of ER and PgR in a single cell and estimated the ratio of the number of cells co-expressing ER and PgR. Twenty-six to 95% of the cells were immunopositive for both ER and PgR, 2-25% of them, varying in cases, were positive for ER but not for PgR, and <3% of the cells were positive for PgR but not for ER. The remaining 5-60% cells were positive for neither ER nor PgR. A significant percentage of breast cancer cells in tissues designated as ER+/PgR+ by EIA showed the phenotype of ER-positive but PgR-negative. The co-expression ratio of ER and PgR in biochemically detected ER+/PgR+ breast cancer may reflect a particular clinical parameter, such as the heterogeneous responsiveness of ER+/PgR+ breast cancers to hormonal treatment. Immunostaining of serial semithin frozen sections for two or more different antigens is a useful method to assess the correlation of localization of antigens.
Animals↗
The effects of electrolyte, lactate, high-concentrated glucose, and dialysate on peritoneal mesothelial cells.
In order to investigate which component of dialysate is responsible for mesothelial cell damage, we studied the chronic cytotoxicity to mesothelial cells by using four types of solution. Four different types of solution (Ringer's solution, lactate, high-concentrate glucose, and 4.25% Dianeal) were prepared and injected into the abdominal cavity of five ddY-mice, 5 mL every day for one month. The monolayer of the mesothelial cells was carefully removed from the liver surface by the imprint technique. Then, the mesothelial cell damage was evaluated by using trypan blue staining and comparing the results. Trypan blue-stained cells in 100 mm2 were observed in 7.0% of the control, 15.4% of the Ringer's solution, 18.7% of the lactate, 23.2% of the high-concentrate glucose, and 22.4% of the 4.25% Dianeal group, respectively. The damaged cells were significantly (p < 0.05) greater in the 4.25% Dianeal group than in the control group, and those in the high-concentrate glucose group also appeared to be greater in number compared to the control group It is concluded from these results that damage to the mesothelial cells is induced by chronic exposure to high-glucose dialysate, and its pathogenesis is deeply related to high concentration of glucose.
Animals↗
Repeating hemorrhage with a long duration after radiotherapy for glioma: radiological and histological observations.
A case of radiation necrosis which was observed 6 years after radiotherapy for a glioma in the right parietal lobe is reported. This patient developed hemiparesis, and radiological examinations showed similar findings consisted with recurrent glioma. Histological examination disclosed the lesion to be radiation necrosis. Repeated episodes of hemorrhage and cystic formation in the right hemisphere appeared during 8 to 10 years after radiotherapy, and removal of the mass lesion conducted four times. Histological examinations of each specimen showed the increasing proliferation of neo-vessels accompanied by hemorrhage and cystic formation.
Adult↗
Quantification of the Na+/K(+)-pump in solubilized tissue by the ouabain binding method coupled with high-performance gel chromatography.
Membrane-bound Na+/K(+)-ATPase purified from dog kidney outer medulla was solubilized with octaethylene glycol n-dodecyl ether (C12E8) and incubated with [3H]ouabain in the presence of NaCl. ATP and MgCl2 for 10 min at 0 degrees C. The resulting enzyme was separated, by high-performance gel chromatography executed at 0.2 degrees C. Mainly into its (alpha beta)2-diprotomer and alpha beta-protomer, which both bound stoichiometrically to [3H]ouabain. The amounts of ouabain that bound to the tissue itself and its microsomes could be estimated in the same way, as [3H]ouabain was found to bind only to the diprotomer and protomer they possessed. The amounts of ouabain that bound to them in the solubilized state were at least 5-times higher than those that did so when they were non-solubilized, suggesting that the surfactant rendered the enzyme accessible to ouabain. When the solubilized tissue (138 mg ml-1 wet tissue) was reacted with ouabain in the presence of 0.1 M NaCl and 4.8 mM MgCl2 for 10 min at 0 degrees C, maximal ouabain binding was attained in the presence of 18.3 microM [3H]ouabain, 1.2 mM ATP and 3 to 5 mg ml-1 C12E8, which was common to the outer medulla and human colon cancer cells. The present method enabled the pump number in protein and tissue samples in the range 7.2 x 10(-9) (purified pump) to 1.5 x 10(-12) (cancer tissue) mol/mg protein to be estimated within 2 h.
Animals↗
Superficial repositioning of the artery for chronic hemodialysis: indications and prognosis.
Superficial repositioning of the artery (SRA) is a modality of the blood access operation for chronic hemodialysis that has been previously used in cases of cardiac failure. We performed 42 SRAs from 1986 to 1993; thereafter, we retrospectively investigated the operative indications, postoperative complications, and long-term results. Superficial repositioning of the artery was indicated for the lack of an appropriate vein (17 cases; 40%), frequent and early access failure due to arteriovenous fistula or polytetrafluoroethylene grafts (six cases; 14%), venous hypertension (five cases; 12%), and cardiac failure (two cases; 5%). The patency rates of the SRAs were 87% at 3 years and 58% at 4.5 years. There was some difficulty in finding the returning veins in five of 28 functioning SRAs (18%). The SRA is thus considered to be a secondary-selected blood access operation; however, it also may be used as an efficient blood access for an extended period of time without any serious complications.
Adult↗
Acute thrombolytic therapy and subsequent angioplasty for atherosclerotic stenosis of the basilar artery--case report.
A 50-year-old male presented with severe atherosclerotic stenosis of the basilar artery at its origin with very poor blood flow distally, manifesting as sudden onset of deterioration of consciousness to semicomatose with decerebrate posture. He regained consciousness dramatically after acute thrombolysis, although right hemiparesis persisted due to left pontine infarction. Follow-up angiography after 3 months of antiplatelet and anticoagulation therapy demonstrated severe residual stenosis of the basilar artery. Percutaneous transluminal angioplasty (PTA) resulted in wide patency of the basilar artery stenosis with excellent blood flow distally. Combination of acute thrombolytic therapy and subsequent PTA is an effective treatment for severe basilar artery occlusive disease.
Angioplasty, Balloon↗
CT-defined large subcortical infarcts: correlation of location with site of cerebrovascular occlusive disease.
PURPOSE: To correlate the location of large subcortical infarcts with the site of cerebrovascular occlusive disease. METHODS: We examined CT and angiographic findings of 38 patients with major arterial occlusive disease and newly developed large subcortical infarcts of 2.0 cm or more, which were classified into three types: striatocapsular infarcts in the basal ganglia, terminal supply area infarcts in the corona radiata, and terminal supply area infarcts in the centrum semiovale. RESULTS: Two or three of the types of infarct were sometimes combined; the combination of the striatocapsular and corona radiata infarcts was the most frequent (14 [36.8%] of 38). Thirty-four (89.5%) had atherosclerotic major arterial occlusive diseases; 22 (57.9%) had occlusive diseases of the internal carotid artery, and 12 (31.6%) had diseases of the middle cerebral artery. The other 4 (10.5%) had embolic transient middle cerebral artery occlusion. Middle cerebral artery occlusive diseases frequently produced striatocapsular (13 [81.3%] of 16) and corona radiata (13 [81.3%] of 16) infarcts but never induced the centrum semiovale lesions. On the other hand, in patients with internal carotid artery occlusive disease, the centrum semiovale (16 [72.7%] of 22) was more susceptible to ischemia than the striatocapsular region (11 [50%] of 22) or the corona radiata (9 [40.9%] of 22). CONCLUSIONS: Middle cerebral artery occlusive diseases frequently produced striatocapsular and/or corona radiata infarcts but never induced the centrum semiovale lesions, which were usually associated with internal carotid artery occlusive diseases.
Adult↗
Ofloxacin concentrations in serum, saliva and pleural effusion of patients with pulmonary tuberculosis and lung cancer.
The ofloxacin (OFLX) concentration in serum, saliva and pleural effusion was measured in 12 patients with pleural effusion after oral administration at a dose of 200 mg three times a day (600 mg daily). Three patients had non-small cell lung cancer and the others had pulmonary tuberculosis. The mean OFLX levels in the serum, saliva and pleural effusion at 2 hours after the first administration on day 3 was 3.15 +/- 1.52, 3.36 +/- 2.23 and 2.86 +/- 1.77 micrograms/ml respectively. There was a strong correlation among these concentrations. The OFLX concentration of pleural effusion was predictable from that of saliva. A 3-day oral administration is sufficient to achieve the OFLX level of pleural effusion similar to that of the serum. It is possible that OFLX is effective for pleuritis caused not only by common infectious pathogens but also by Mycobacterium tuberculosis.
Administration, Oral↗
Malignant germ cell tumor of the mediastinum: a multimodality therapeutic approach.
Twenty-five patients with a malignant germ cell tumor of the mediastinum were treated at the National Cancer Center Hospital, Tokyo. Three patients had pure seminomas while 22 had a nonseminomatous histology. The treatment modalities consisted of surgery alone in 7 patients, surgery with chemotherapy and/or radiation in 14, and chemotherapy and/or radiation without surgery in 4. Cisplatin-based chemotherapy was administered in nine patients, one of whom successfully underwent high-dose chemotherapy with autologous bone marrow transplantation after resection of the tumor. A complete response was achieved in only five patients. The overall survival rate at 5 years was 33.5% and the median survival time was 51 weeks. Eight patients (32%), all of whom underwent surgery either with or without chemotherapy and/or radiation, were free of disease with a mean follow-up period of 439 weeks (72-1,120 weeks). The median survival times for 14 patients undergoing combined modality treatment, 7 patients undergoing surgery alone, and 4 patients undergoing chemotherapy and/or radiation were 83, 16, and 18 weeks, respectively.
Adolescent↗
Extended resection of the left atrium, great vessels, or both for lung cancer.
One hundred one patients with locally advanced lung cancer underwent combined resection of the lung and the left atrium with or without the great vessels. A single additional organ was resected in 92 patients, two organs in 8 patients, and three organs in 1 patient. The left atrium was resected in 44 patients, the superior vena cava in 32, the adventitia of the aorta in 21, the aorta in 7, and the pulmonary artery in 7. The most important factors affecting survival defined by multivariate analysis were postoperative pneumonia, complete resection, postoperative bleeding, and lymph node metastasis (p < 0.05). Thirteen patients survived 3 years or more and 10 of the 13 survived 5 years or more. The 5-year survival rate for all patients, including 8 with operative death, was 13%, and the median survival time was 9.2 months. The 5-year survival and median survival time were 19% and 13.8 months after complete resection and 0% and 6.5 months after incomplete resection (p < 0.01). The 5-year survival and median survival time for patients with pathologic stage IIIA, IIIB, and IV were 16.8% and 16.8 months; 18.3% and 9.8 months; and 0% and 5.4 months, respectively. There was a significant difference between stages IIIA plus IIIB and stage IV (p < 0.05). The 5-year survival after left atrium resection was 22%. Extended resection was worthwhile for the patients undergoing complete resection and without postoperative complications.
Adenocarcinoma↗