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Biomedical subjects

T Maeba

Publications and source records attributed to T Maeba.

At least 37 records · Page 2Linked to original sources

[Chemotherapy for two patients with non-Hodgkin's lymphoma in hemodialysis].

There are few reports on chemotherapy of non-Hodgkin's lymphoma (NHL) in patients with chronic renal failure. Two long-term hemodialysis patients were treated for NHL with modified CHOP therapy. The plasma pharmacokinetics of adriamycin (ADR) and etoposide (VP-16) were investigated in these patients. In the first case, NHL was diagnosed in a 37-year-old male (diffuse pleomorphic, T cell type, stage I E). After 4 courses of chemotherapy, he achieved complete remission. The second case, was a 56-year-old male who was admitted to our hospital with melena and abdominal pain. A diagnosis of NHL (diffuse mixed, B cell type, stage III E) was made. Complete remission was achieved with 2 courses of chemotherapy. Levels of hematological and neurological toxicity were moderately severe but tolerable. Pharmacokinetics of ADR and VP-16 in these patients were similar to those in patients with normal renal function. These results suggested that ADR and VP-16 were effective drugs for hemodialysis patients with NHL.

Adult

Surgical treatment of an enormous aneurysmal portahepatic venous fistula: report of a case.

We report herein the case of a 20-year-old woman in whom an enormous aneurysmal portahepatic venous fistula was found. The portal aneurysm developed in the anterior inferior segment of the right hepatic lobe, and communicated with the right portal vein and the right hepatic vein. Due to the enormous size of the shunt, and because the patient's venous blood ammonia level increased by about twofold after eating, a right lobectomy of the liver was performed. A review of the available literature and a discussion of the most appropriate treatment follows the presentation of this case.

Adolescent

Prediction of the early prognosis of the hepatectomized patient with hepatocellular carcinoma with a neural network.

The early prognosis of the hepatectomized patients with hepatocellular carcinoma was determined preoperatively with a perceptron-type neural network. The neural network was trained with the preoperative data of 54 example cases with the early prognosis, successful or died of hepatic dysfunction, as teaching signals. After learning these examples, the neural network came to give a precise prediction to the example data except for one case. With the learned neural network, the outcomes of the hepatectomy of 11 patients (10 successful; 1 died) were predicted prospectively with 100% precision. The usefulness of the neural network for the prediction was determined.

Adult

Comparison of warm and cold ischemia of the canine small intestine.

Warm and cold ischemia-reperfusion injuries to canine small intestine was compared. In the warm ischemic model, the superior mesenteric artery of mongrel dogs was clamped for 2 h and then released (group A). As a cold ischemia model, canine small intestines were harvested with cold lactated Ringer solution, preserved for 24 h in cold LR solution and then autotransplanted (group B). After ischemia and during reperfusion, activities of maltase (MAL), myeloperoxides (MPO), xanthine dehydrogenase (XD) and xanthine oxidase (XO) were measured as well as hypoxanthine (HX) concentration. MAL activities were not changed during warm or cold ischemia, whereas it was remarkably decreased after revascularization in both the groups. Neutrophil infiltration after reperfusion was shown by the increase of MPO activities to 8 and 1.5 U/mg protein in groups A and B respectively from a normal value of 0.35 U/mg protein. During warm ischemia, %XO (XO/XD + XO) was increased from 18.4 to 84.9% for 2 h. In contrast, %XO was not changed for 24 h of cold ischemia. Tissue accumulation of HX was increased 2.8 times from a normal value of 1.06, 2 h after warm ischemia, but there was almost neither accumulation of HX nor the conversion of XD to XO in 24 h cold ischemia. It was observed that warm and cold ischemia caused similar injury after reperfusion in spite of the striking difference in the conversion of XD to XO and accumulation of HX. Thus, it is suggested that the XO system is not always necessary for ischemia-reperfusion injury.

Animals

The effect of FK506 on warm ischemia and reperfusion injury in the rat liver.

The protective effect of FK506 on hepatocytes against ischemia and reperfusion injury was examined by evaluating the following: the high energy phosphorus metabolism obtained using 31P magnetic resonance spectroscopy (31P-MRS) and the tissue blood flow of the liver in ischemia and the reperfusion process, mitochondrial glutamic oxaloacetic transaminase (m-GOT) and glutamic pyruvic transaminase (GPT), the survival rates of the animals, a histological study and immunohistological staining for intercellular adhesion molecule-1 (ICAM-1) in the liver after ischemia. The rats were treated with FK506 1 mg/kg/day i.m. for 4 days before testing. Ischemia was induced by clamping the hepatoduodenal ligament for 30 min. In 31P-MRS, the recovery of the hepatic energy status after ischemia, evaluated by beta-ATP/inorganic phosphate (Pi), was significantly better in the FK506 group. It also coincided with the recovery of tissue blood flow monitored with a laser Doppler flowmeter. In the histological examination, the congestion observed in the periportal region of the control group was mild, while there was less induction of ICAM-1 in the endothelial cells of the portal veins and hepatic veins in the FK506 group. From these findings, we concluded that FK506 had a protective effect on hepatocytes against warm ischemia and reperfusion injury, and the mechanism for this could partially be attributed to improved tissue blood flow after ischemia by the modulation of immunological events.

Alanine Transaminase

D-lactate metabolism in patients with chronic renal failure undergoing CAPD.

To clarify the D-lactate metabolism in patients with chronic renal failure undergoing CAPD, plasma levels, loaded doses and urinary excretion of D-lactate were measured. In addition, D-2-hydroxy acid dehydrogenase activities in resected and autopsied specimens were measured. The daily loaded dose of D-lactate by CAPD was 88.9 +/- 1.29 mmol and urinary excretion was negligible. There was no tendency for the plasma D-lactate to accumulate. The enzyme activity was detected in the liver, kidney and pancreas tissues both in the resected and autopsied specimens. The above findings indicate that the loaded D-lactate is catabolized in patients with chronic renal failure undergoing CAPD, and D-2-hydroxy acid dehydrogenase is responsible for the metabolism of D-lactate in humans.

Adolescent

[Thrombotic thrombocytopenic purpura associated with myasthenia gravis].

A case of thrombotic thrombocytopenic purpura (TTP) associated with myasthenia gravis (MG) is reported. A 56-year-old woman was admitted to our hospital on April 27, 1988, because of easy fatigue and double vision. She was diagnosed as having myasthenia gravis from her neurological and laboratory findings. On the 14th hospital day, she developed fever, jaundice, hematuria, purpura and consciousness disturbance. Hematological examination revealed marked anemia, thrombocytopenia, fragmented red blood cells, elevated bilirubin and LDH level. Coagulation studies were almost normal. She was diagnosed as having TTP and treated with corticosteroid, antiplatelet agents and plasma exchange. Clinical condition and laboratory findings improved by the 23rd hospital day. It has been reported that TTP is associated with various autoimmune disease such as systemic lupus erythematosus, rheumatoid arthritis, Sjögren's syndrome or idiopathic thrombocytopenic purpura. However TTP associated with MG appears the first report. This case may suggest that one of pathogenesis of TTP is autoimmune mechanism.

Autoimmunity