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Biomedical subjects

T Kamimura

Publications and source records attributed to T Kamimura.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Malignant lymphoma with c-myc gene rearrangement in a patient receiving long-term treatment for multiple myeloma].

We encountered a 65-year-old woman with diffuse large B-cell lymphoma showing t(8;14)(q24;q32) and c-myc gene rearrangement that developed following 12 years of melphalan-based chemotherapy for multiple myeloma. Short-term remission was obtained by CHOP chemotherapy. However, shortly thereafter the patient died of an aggressive progression of lymphoma. It was suspected that the lymphoma was a secondary malignancy related to the treatment with cytotoxic agents and radiation for prolonged multiple myeloma. The chromosomal abnormality t(8;14)(q24;q32) is rare in secondary malignancies. Overexpression of c-myc by gene rearrangement may be associated with clinical courses manifested by the rapid progression of lymphoma.

Aged↗
PubMed1998

Interferon-alpha treatment of acute lymphoblastic leukemia relapse after unrelated bone marrow transplantation.

A 32-year-old Japanese male in his second remission of acute lymphoblastic leukemia (ALL) received a matched unrelated donor bone marrow transplant (BMT) from the Japan Marrow Donor Program. On day +83, a bone marrow examination revealed 5.2% leukemic cells. Despite the cessation of cyclosporine, leukemic cells in the bone marrow increased to 18.4% on day +91. Treatment was started with interferon (IFN)-alpha-2b 3 x 10(6) U/body s.c. daily on day +92 and leukemic cells in the bone marrow disappeared completely. The toxicity of IFN-alpha treatment included leukoencephalopathy consisting of somnolence, disorientation, short-term memory loss, lack of coordination and ataxia, myelotoxicity requiring multiple platelet transfusions and exacerbation of graft-versus-host disease (GVHD) of oral cavity, skin and lung. Because of progressive GVHD, IFN-alpha was discontinued on day +124. On day +132, a bone marrow aspirate showed 6.4% leukemic cells. The patient died of progressive ALL on day +178. IFN-alpha may be useful for the treatment of leukemic relapse following BMT, although its toxicity is marked.

Adult↗
PubMed1998

Longterm outcomes and quality of life after Z-shaped anastomosis for Hirschsprung's disease.

BACKGROUND: Z-shaped anastomosis is one of the modifications of Duhamel's procedure that was designed to eliminate the blind rectal pouch and to achieve complete resection of the colorectal septum. It has been the most widely performed operation in Japan for many years. The longterm postoperative function of evacuation and quality of life of the patients are considered important to evaluate this procedure. METHODS: At Kyushu University Hospital, from 1963 to 1997, 127 patients with Hirschsprung's disease underwent Z-shaped anastomosis. As a result, 122 out of 127 patients (96%) survived. The present status and symptoms, and anorectal functions, including a manometric study and barium enema, were evaluated during the clinical followup. RESULTS: A total of 99 of the 122 surviving patients (81%) were available for this study, and the mean postoperative period was 16 years. Evacuation scores in all patients were as follows; excellent, 62.2%; good, 28.6%; fair, 8.2%; and poor, 1.0%. The percentage of the patients who showed severe symptoms was 4.1% for diarrhea, 3.1% for constipation, 5.1% for incontinence, and 7.1% for soiling. The evacuation score improved chronologically and tended to reach a plateau at 10 to 15 years after operation, at which time 73% of the patients showed excellent outcomes and 95% were satisfactory (good or excellent). The appearance of a sense of defecation and an increase in the pressure difference between the anal canal and the rectum substantially contributed to the improvement in the defecation score. The appearance of the rectosphincteric reflex, including the atypical one, was seen in 40.5% of patients, but the appearance of a reflex did not seem to be related to the clinical status of defecation. Twenty-two of 30 patients older than 20 years were married, and 8 patients had children. CONCLUSIONS: The evacuation scores of in-patients undergoing Z-shaped anastomosis improved with age and were satisfactory (good or excellent) in most patients at least 10 years after operation. Most of the patients adapted to a normal social life.

Adolescent↗
PubMed1998

Effect of thrombopoietin on proliferation of blasts from CD7-positive acute myelogenous leukaemia.

We investigated the effect of thrombopoietin (TPO) on the growth of leukaemic blasts from 30 acute myelogenous leukaemia (AML) patients according to the surface expression of CD7 and CD34: 10 patients were CD7 positive (CD7+), nine were CD7 negative/CD34+ (CD7-/CD34+) and the remaining 11 were CD7-/CD34-. Significant growth response of leukaemic blasts to TPO was observed in 10/10 CD7+, 5/9 CD7-/CD34+ and 2/11 CD7-/CD34- AML cases using 3H-thymidine incorporation. Synergistic stimulatory effects of TPO with stem cell factor (SCF), interleukin-3 (IL-3), granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor were observed in both TPO-responding cases (9/17) and TPO-non-responding cases (8/13). In a leukaemic blast colony assay. significant growth response to TPO was observed in 5/6 CD7+ and 4/17 CD7-AML cases examined. However, the effect of TPO on the growth of CD7+ leukaemic blasts was not so potent as that of IL-3 and SCF, both of which support the proliferation of primitive haemopoietic progenitors. Expression of c-mpl (TPO receptor) was significantly higher in CD7+ AML cases than in CD7- cases, suggesting a relationship between expression of c-mpl and proliferative response to TPO. These data indicate that CD7+ leukaemic blasts express functional TPO receptors and proliferate in response to TPO. These observations also imply that CD7 expression on AML blasts may indicate involvement of leukaemic progenitors at an early stage of multipotent haemopoietic stem cells.

Adolescent↗
PubMed1998

Acute acalculous cholecystitis in systemic lupus erythematosus: a case report and review of the literature.

A 27-year-old woman with systemic lupus erythematosus (SLE) was found to have acute acalculous cholecystitis. At the time of admission, the patient was not under corticosteroid or immunosuppressive therapy. Computed tomography (CT) and ultrasonography revealed findings in the gall bladder consistent with acute acalculous cholecystitis. Her abdominal pain completely disappeared following corticosteroid therapy, with dramatic improvement in the images of CT and ultrasonography. Six similar cases of SLE complicated with acute acalculous cholecystitis have been reported in the literature and they were all treated surgically by cholecystectomy or cholecystostomy. This is the first case report in which acute acalculous cholecystitis accompanying SLE was treated successfully by corticosteroid without surgical intervention.

Acute Disease↗
PubMed1998

[Clinical features of transurethral anterior sphincterotomy and urological management of patients with cervical spinal cord injury].

BACKGROUND: The ideal urological management for the patients with cervical spinal cord injury (CSCI) is to obtain catheter free urination and to prevent urinary tract complications. We have evaluated cases that had undergone transurethral anterior sphincterotomy from the view-point of the operative indications and the efficacy. METHODS: We carried out sphincterotomy 166 times on 133 male patients with CSCI in our Center. Before the operations were performed, all patients suffered from urinary incontinence, and they were unable to catheterize themselves for low level activity of daily life. Before and after the operation, their detrusor functions with sphincter reactions were assessed by urodynamic study. In principle we have followed up these cases by cystogram combined with cystometry, cystogram and excretory-pyelography or abdominal ultrasonography. RESULTS: In post-operative evaluations, more than 80% of cases attained hypotonic detrusor contractions and residual urine was significantly decreased. In long term follow-up, 96% of patients had obtained catheter free urination and about 85% of patients had no urinary tract complications, such as bladder deformity, vesicoureteral reflux, or hydronephrosis, with the exception of common unavoidable urinary infections. About 20% of cases had to be re-operated upon, and some cases showed hypertonic detrusor contractions or detrusor-sphincter-dyssynnergia during follow-up. CONCLUSION: The operative indications of sphincterotomy should be decided when the CSCI patients is unable to perform self-catheterization, and when due to the dysfunction of the urethral sphincter, these patients suffered from voiding difficulties or autonomic dysreflexia, or when the urinary tract complications might occur. In the majority of cases the aims of the sphincterotomy were achieved but some cases underwent another operation or had recurrent dysfunction of the urethral sphincter, indicating the need for careful follow-up.

Follow-Up Studies↗
PubMed1997

Novel naphthalene derivatives as inhibitors of human immunoglobulin E antibody production.

A series of naphthalene derivatives with a variety of substituents at the 2-position was prepared in order to evaluate their suppressive effect on immunoglobulin E (IgE) antibody production by human peripheral blood mononuclear cells provoked with anti-CD40 antibody (alpha-CD40), interleukin-4 (IL-4), and interleukin-10 (IL-10). Compounds having a 1,4-phenylene spacer moiety tethered between the 2-naphthyl nucleus and anthranilic acid suppressed IgE antibody production in vitro in preference to that of IgG antibody without affecting cell viability. Deletion of the anthranilic acid moiety diminished the inhibitory activities. Changing the 2-naphthyl to a 1-naphthyl or phenyl nucleus led to no change in the potency, indicating that the aromatic group at this position is indispensable for the inhibitory activities. On the other hand, changing the 1,4-phenylene spacer to a 1,3-phenylene one resulted in reduced potency. Similarly, inhibitory activities were lost when the CO2H moiety at the 2-position was moved to the 3- or 4-position on the terminal benzene. These observations suggest that the conformation around the anthranilic acid moiety affects the inhibitory activities toward IgE biosynthesis. 2-(4-(2-Naphthyloxy)benzamido)benzoic acid (29) seemed to be a more potent inhibitor of IgE production than of IgG production. Insertion of a methylene between the inter-phenylene and the amide moiety resulted in 2-((4-(2-naphthyloxy)phenyl)acetamido)benzoic acid (31), which provided a stronger inhibition of both IgE and IgG production, although the selectivity toward IgE was lower than that of 29. Introduction of a benzyl group at the 6-position on the naphthalene ring considerably increased the inhibitory activity toward IgE production with an IC50 of 8.3 nM (36). The potency of 31 and 36 was retained when hydrocortisone or lipopolysaccharide was used instead of alpha-CD40 and IL-10 as costimulatory factors with IL-4, implying that these compounds may interfere with signal transduction between IL-4/IL-4 receptor cognition and genetic transcription that induce class-switching of immunoglobulin in B cells. These novel naphthalene derivatives are thus excellent candidates for further investigation with a view toward a therapeutic remedy against IgE-mediated allergic diseases.

Antibody Formation↗
PubMed1997

Abnormalities in visceral evoked potentials from the anal canal in children with chronic constipation.

The integrity of the sensory nervous system in the anal canals of chronically constipated children was investigated using evoked potential techniques examining cerebral and spinal evoked potentials from the lower extremities and anal canal. Stimulation of the posterior tibial nerve produced no significant difference in the parameters of spinal and cerebral evoked potentials between 18 controls and 12 chronically constipated children. However, stimulation of the anal canal resulted in evoked potentials related to the age and/or consciousness level of the control children. Reproducible cerebral responses were obtained only from nine of these control children, all aged over 4 years, who were examined while awake without sedatives. A typical response was characterized by a polyphasic wave occurring with an onset latency of 79.4 +/- 27.7 ms (mean +/- SD). In the 12 chronically constipated children, the 5 sedated patients examined while asleep did not show any reproducible potential, as in the controls. However, in the remaining 7 children examined while awake, the occurrence of the anal canal evoked potential was significantly reduced, and only two exhibited a cerebral response. These findings suggest that rectal mucosal perception of the intraluminal stimuli might be disturbed in some children with chronic constipation.

Adolescent↗
PubMed1997

Functional innervation of the aganglionic segment in Hirschsprung's disease--a comparison of the short- and long-segment type.

The authors examined the neuro-effector transmission in the aganglionic segment from 13 patients with Hirschsprung's disease, 10 patients had short-segment type and three patients had long-segment type. Circular muscle strips were prepared and the responses to transmural electrical field stimulation were examined using the isometric tension recording technique. In the ganglionic preparations from the short- and long-segment cases, the stimulation evoked a biphasic response consisting of a relaxation and an atropine-sensitive contraction. The relaxation was partly inhibited by N-omega-nitro-L-arginine (NNLA, a nitric oxide [NO] synthase inhibitor), and the effect of NNLA was abolished completely in the presence of L-arginine, which suggested the presence of NO-mediated inhibitory innervation. In the aganglionic preparations from the short-segment-type cases, stimulation evoked only an atropine-sensitive contraction, while in the aganglionic preparations from the long-segment-type cases, a weak inhibitory response persisted after the contractile response was abolished by atropine. This NO-mediated inhibitory response was frequently detected as the examined region approached the ganglionic segment. These results suggest that the aganglionic segment in the long-segment-type cases might therefore receive NO-mediated inhibitory input from the proximal ganglionic segment.

Colon, Sigmoid↗
PubMed1997

External anal sphincter dysfunction and postoperative bowel habits of patients with Hirschsprung's disease.

An electromyogram (EMG) of the external and sphincter (EAS) was obtained both before and after surgery in five patients with Hirschsprung's disease and eight normal control patients. The EMG, evoked by the transrectal stimulation of the pudendal nerve, was recorded at both the sacral and anal regions to investigate the deep and superficial EAS, respectively. In eight control patients, the EMG at the sacral region consisted of a polyphasic wave with apparently two or three major peaks, and the simple monophasic wave with one or two peaks was found at the anal region. Its peak corresponded to the early peaks in the sacral region. The mean onset latency of the EMG in the sacral region was 2.8 ms. Four patients with Hirschsprung's disease also exhibited responses that were similar to the controls, and their postoperative bowel habits were satisfactory. However, the remaining one patient, who still required a daily enema after surgery, exhibited an apparently different response, which was monophasic at both the sacral and anal regions with a long onset latency of 5.0 ms before and after surgery. It is postulated that some cases with Hirschsprung's disease might be associated with an EAS dysfunction before surgery, which possibly led to the development of postoperative bowel dysmotility.

Anal Canal↗
PubMed1997

Surgical strategy for the treatment of pyriform sinus fistula.

Pyriform sinus fistula recurs when a complete excision of the fistula has not been made. As a supportive technique for this radical operation, the authors performed an intraoperative endoscopic examination of the pyriform sinus for the cannulation or dye injection of the tract in four cases. In three cases, the sinuses were relatively long and ran outside the thyroid cartilage. The cannulation of the tract with a guide wire, in these cases, was useful for identifying the thin membranous tract. In one of these three cases sinus fistula recurred, but a complete excision of the tract was then performed by introducing a 10F Nelaton catheter over a guide wire, which allowed for easy handling of the remnant tract. In the remaining case, cannulation proved not to be useful because the tract was short and ran inside the thyroid cartilage. A short tract embedded within the inferior constrictor muscle could only be found through careful observation after repeated dye injections. The proper selection of the optimum supportive techniques as described above, are considered to be essential for performing a complete excision.

Catheterization↗
PubMed1997

Total colonic aganglionosis with or without small bowel involvement: a changing profile.

BACKGROUND/PURPOSE: To identify recent trends in the diagnosis and treatment of total colonic aganglionosis with or without small bowel involvement (TCSA), the authors analyzed the findings in 107 patients who had TCSA seen between 1988 and 1992 at 147 medical institutions throughout Japan and compared the results with those of a previous survey conducted between 1978 and 1982. RESULTS: The estimated incidence of total colonic aganglionosis was 1 in 58,084 live births, the male to female ratio was 1.5:1, and the incidence of associated anomalies was 15%. These findings were all very similar to those of the previous survey. Ten years ago, 83.6% of all patients underwent Martin's procedure. In the recent survey, this rate had fallen to 52.1%, and a right colon patch method has also been developed as a new procedure. A marked decrease in the overall mortality rate from 40.9% to 21.5% was observed. However, a high mortality rate persists in those cases with small bowel involvement (33.3%); most such cases are complicated with enterocolitis. CONCLUSIONS: Although the general features of TCSA were similar to those in the previous survey, a substantial improvement in the treatment results for TCSA has occurred. However, further efforts are still required both to prevent and more effectively to treat enterocolitis, especially in cases involving any aganglionosis extending into small bowel.

Enterocolitis↗
PubMed1997

Evoked potential abnormalities in postoperative patients with biliary atresia.

The somatosensory evoked potentials from the lower extremities were measured postoperatively in 15 patients with biliary atresia to investigate whether they were free of neurologic dysfunction. Because long-standing cholestasis causes progressive neuropathy due to malabsorption of vitamin E, the serum vitamin E, D, and A levels were also examined to evaluate the fat-soluble vitamin status. The cerebral evoked potentials to posterior tibial nerve stimulation were recorded in all 15 patients as well as in 45 controls, but spinal evoked potentials examined at the level of the cauda equina could not be recorded in five patients more than 8 years of age with long-standing icterus. The remaining 10 patients exhibited spinal evoked potentials as observed in the controls, but the mean neural conduction velocity at the cauda equina was significantly lower than that of the 45 controls (42.0 +/- 5.1 m/s vs 52.3 +/- 6.8 m/s, P = .0002). The serum vitamin E, D, and A levels were within the normal range in 13, 9, and 1 of 15 patients, respectively. These results suggest that the patients with long-term follow-up are still at risk of developing neural disturbances even with normal serum vitamin E status.

Adolescent↗
PubMed1997

Studies on 3'-quaternary ammonium cephalosporins--III. Synthesis and antibacterial activity of 3'-(3-aminopyrazolium) cephalosporins.

The synthesis and in vitro antibacterial activity of 7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-methoxyiminoacetamido]cephalos porins bearing N-mono or dialkyl and carbamoyl aminopyrazolium, and five- or six-membered rings fused to the 3-aminopyrazolium methyl groups at the 3-position, are described. Aminopyrazolium methyl cephalosporins (23e, f, i), with fused saturated and unsaturated rings were especially effective against Staphylococcus strains compared to 3-amino-2-methylpyrazolium methyl cephalosporin (1). Among the cephalosporins prepared in this work, 7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-methoxyiminoacetamido]-3-(4,5, 6, 7-tetrahydro-1-pyrazolo[1,5-a]pyrimidinio)methyl-3-cephem-4-carbox ylate (23f) showed a good balance of antibacterial activity against both Gram-positive bacteria including Staphylococcus aureus and Gram-negative bacteria including P. aeruginosa. An imidazopyrazolium group at the 3-position in, for example, cephalosporin (23i) was particularly effective for improving antibacterial activity against MRSA.

Cephalosporins↗