Biomedical subjects
Publications and source records attributed to T Nagae.
Eighteen dammarane-type triterpenes were obtained from the whole plant of Cleome africana by means of cytotoxic bioassay-directed fractionation. Twelve of them were novel compounds whose structures were elucidated by various spectroscopic methods.
Beclomethasone dipropionate was administered via a cecostomy to four patients with active ulcerative colitis that was refractory to conventional glucocorticosteroid therapy. From a tube cecostomy, beclomethasone dipropionate solution was administered continuously throughout the day. Clinical manifestations, laboratory examinations, and endoscopic and/or radiographic findings markedly improved within 1-2 wk. A serial decrease in the index of disease activity was observed from the time administration began (mean score, 226.0) to 2 wk later (137.4 points). An excellent clinical response was recognized without any significant side effects, and the urgent need for total colectomy was avoided in all four patients.
A 19-year-old female was referred to our hospital for azotemia and anemia. She had been taking a health food for atopic dermatitis for about three years. Urinalysis showed proteinuria, glycosuria and microscopic hematuria. Generalized aminoaciduria was observed. Moreover, severe anemia, azotemia, hypokalemia and hypophosphatemia were also observed. Renal biopsy specimen disclosed hypocellular interstitial fibrosis and degeneration of the proximal tubular epithelial cells. No remarkable changes were observed in the glomeruli. Aristolochic acid was detected in the health food. From these findings, she was diagnosed as having Chinese herbs nephropathy (CHN). Although consumption of the food intake was stopped, her renal function deteriorated rapidly. Previously, we reported that certain kinds of Chinese herbal drugs contain aristolochic acid and that the drugs should be prohibited if aristolochic acid is identified. However, we experienced a patient of CHN arising from traditional remedy, which was not proved to be safe. It should be awared that health foods may contain aristolochic acid.
Explore the source record for details and available documents.
Polytetrafluoroethylene (PTFE) prostheses were modified to produce two types of composite porosity PTFE grafts: type I--inner 60 microns/outer 20 microns and type II--inner 20 microns/outer 60 microns. These composite porosity PTFE designs were investigated for bleed through, graft healing and patency and compared with high porosity PTFE (60 microns) and standard PTFE (20 microns) grafts. The grafts were implanted into the carotid and femoral arteries of dogs and retrieved after 4, 12 and 18 weeks. Both composite porosity grafts showed significantly less bleed through than standard and high porosity grafts after reperfusion. In composite grafts, the 60-microns layer allowed fibrovascular tissue and histiocyte ingrowth from perigraft tissue, but the 20-microns layer did not. Neointima formation occurred earlier and endothelialization was more extensive in high porosity grafts, but seroma formation occurred in 25% of cases. In type I composite porosity grafts, smooth muscle cells of neointima migrated into the pores of the graft, providing a firmly anchored intima. Type II composite porosity grafts allowed better ingrowth of fibrovascular tissue at the outer layer from the perigraft tissue; however, endothelialization was not completed. Composite porosity grafts should be considered for evaluation in specific clinical situations.
Various interpretations have been attempted, but no definitive theory has yet been established as to the etiology of the low-birth-weight infant. We carried out the present study in an attempt to explore the relationship between platelet functions and fetal growth during normal pregnancy. For this purpose, we made a retrospective study of 130 pregnant women aged 23-35 with no clinical abnormalities throughout pregnancy or at delivery. Blood samples were taken at 29-30 weeks of gestation (referred to as the 2nd trimester) and 37-38 weeks of gestation (referred to as the 3rd trimester). The cases studied were divided into two groups: i) those with a birth weight of under 2,500g (n = 32), and ii) those with a birth weight of over 2,500g (n = 98). In these two groups, we studied the platelet functions in maternal blood in the 2nd and 3rd trimesters. The following results were obtained: 1) In the 2nd to 3rd trimester, the platelet count showed no significant variation with the birth weight. 2) In the 2nd to 3rd trimester, the platelet aggregation was found to be moderately depressed in cases with a birth weight of under 2,500g, while it was found to be moderately activated in cases with a birth weight of over 2,500g. 3) In the 2nd to 3rd trimester, platelet factor 4 was significantly lower (p < 0.005) in cases with a birth weight of under 2,500g, while it was moderately higher in cases with a birth weight of over 2,500g.(ABSTRACT TRUNCATED AT 250 WORDS)
Exocytosis of cortical granules (CGs) and the concomitant electron density changes of the zona pellucida (ZP) in the absence of sperm penetration were investigated in mouse oocytes processed with tannic acid containing fixation at various stages during and after maturation. After fusion of the CG membrane with the plasma membrane, the CG contents became very electron-dense, due to tannic acid. CG material is seen to be made up of coarse granular structures which gradually change to fine amorphous structures, which accumulate within the developing perivitelline space (PVS). When the coarse CG material attaches to the ZP, small domains exhibiting higher electron density appeared, and the number of these domains gradually increased. Release of CG was observed from metaphase I through metaphase II. In metaphase I to immediately after ovulation, the higher electron density of ZP and CG release was restricted to the cortical area overlying the meiotic spindle. Finally, the CG-free domain formed itself overlying the meiotic spindle as a result of CG release. However, in oviductal ova, CG release additionally occurred in the hemisphere opposite the spindle. At this stage the entire PVS was well developed and contained numerous fine electron-dense materials. Moreover, the inner half of the ZP increased in electron density as well. This change in electron density of the ZP might be associated with released CG material. These results suggest that the "partial cortical reaction" may play an important role in conditioning the ZP prior to ZP reaction.
The serum levels of C-reactive protein (CRP) produced as an inflammatory response in dogs with various disorders and surgical traumas were measured by enzyme-linked immunoabsorbent assay and slide reversed passive latex agglutination test (RPLA). The CRP levels were greatly increased 1-2 days after surgery in most of the dogs (n = 29) subjected to surgery. These levels had markedly decreased by the time the sutures were removed. In dogs with various disorders (n = 58), the serum CRP levels at first diagnosis were high in infectious diseases. In dogs from which paired serum samples were examined, the serum CRP usually showed a decrease with improvement in the condition (n = 11) or a terminal increase (n = 4) but, conversely, some showed an increase with improvement in the condition (n = 3).
OBJECTIVE: High porosity (HP) (90 micron internodal distance) PTFE grafts were implanted into the carotid and femoral arteries of dogs to investigate early thrombogenicity, patency, and endothelialization. EXPERIMENTAL DESIGN: Standard PTFE (STD) grafts (30 micron internodal distance) were used as controls. 12 HP and 12 STD grafts were implanted into 6 dogs. Indium-111 labeled platelets were infused intravenously after graft implantation. A graft platelet accumulation index (GPAI) was calculated as the ratio of radioactive emission from the PTFE grafts excised at 48 hours to the emission from a native arterial segment. Another 12 HP and 12 STD grafts were implanted into femoral and carotid arteries to assess patency and endothelialization at 4 and 18 weeks. RESULTS: There was no significant difference in the GPAI of the HP and STD grafts at either the carotid (HP = 31.5 +/- 9.7, STD = 30.6 +/- 11.8; p > 0.05) or femoral (HP = 34.0 +/- 5.0, STD = 31.5 +/- 7.9; p > 0.05) positions. Combined data (carotid and femoral HP vs. carotid and femoral STD) also did not demonstrate a difference in GPAI (HP = 32.8 +/- 7.5, STD = 31.1 +/- 9.6; p > 0.05). Patency rates were the same at 4 weeks (75%), but greater in the HP grafts at 18 weeks (HP = 75%, STD = 37%; p > 0.05). No difference was noted in the percentage of graft endothelialization at 4 weeks (HP = 5.2 +/- 5.8, STD = 5.0 +/- 4.0; p > 0.05), however, at 18 weeks the HP graft had significantly more endothelial coverage compared to STD grafts (HP = 75.2 +/- 13.9, STD = 22.6 +/- 9.5; p < 0.01). CONCLUSIONS: Given that HP PTFE is no more thrombogenic than STD PTFE, and that it provides superior endothelialization, HP grafts should continue to be developed and studied for potential clinical use.
The p53 expression in various skin tumors was immunohistologically evaluated using two mouse monoclonal anti-p53 antibodies, PAb421 and PAb1801. The p53 expression was not detected in the normal epidermal cells. Nuclear staining suggested that the p53 expression was observed in 10 of 26 squamous cell carcinomas (SCCs) from 24 patients, in one undifferentiated carcinoma, one proliferating trichilemmal cyst, one malignant proliferating trichilemmal tumor and in one metastatic carcinoma of breast cancer. None off four cases of Bowen's disease (SCC in situ) showed nuclear staining. In the SCCs, five of 20 primary lesions, three of four recurrent lesions and both of two metastatic lesions had positive nuclei. There was one case of SCC in which a primary lesion was negative but a recurrent lesion was positive. Thus, p53 expression was more frequently observed in SCCs at more clinically advanced stages. This may suggest that p53 has some relevance to progression of SCC. Nuclear staining was not detected in any of the following cases: two cases of seborrheic keratosis, one eccrine poroma, one keratoacanthoma, 11 basal cell epitheliomas, two mammary Paget's disease, three genital Paget's disease, one sebaceous carcinoma, four malignant melanomas, six lymphomas, two leukemia cutis and two angiosarcomas.
Congenital bicuspid aortic valve is a risk factor of aortic dissection, but the case is rare in Japan. Several reports described ascending aortic aneurysm after aortic valve replacement. In these reports, most of aneurysms were false aneurysm, but the cases of ascending aortic dissection were rare. In this case, dissecting aneurysm of the ascending aorta occurred 4 years after aortic valve replacement, which was performed with mechanical prosthesis because of infective endocarditis, and it was repaired successfully by the modified Cabrol's method. This case was congenital bicuspid aortic valve, and had already been complicated with moderate aortic dilatation in the ascending aorta. In patients of congenital bicuspid aortic valve with aortic dilatation, consideration of complete replacement of the ascending aorta with aortic valve replacement is important.
There are many factors influencing the growth of the fetus. Since these factors have complex interrelations, they are difficult to clarify. The authors studied the effects of blood coagulation and fibrinolysis on the growth of the fetus during pregnancy, especially from the 2nd trimester into the 3rd trimester. The subjects were 86 normal pregnant women, and the subjects of study were blood coagulation, fibrinolysis activity of the mother, and estimated fetal birth weight after the 28th (2nd trimester) and 36th weeks of gestation (3rd trimester) in each case. 1. Changes in blood coagulation activity and fibrinolysis varied from the 2nd trimester into the 3rd trimester. The percentage of cases showing lowered platelets was 68.6% of the total, and the percentages of cases with reduced platelet ADP, epinephrine, and collagen aggregation were 60.5%, 55.8%, and 51.2%, respectively. The percentages of cases showing shortened prothrombin time and activated partial thromboplastin time were 58.1% and 51.2% of the total, respectively. The percentage of cases with reduced fibrinogen was 24.4% of the total. The percentages of cases with reduced antithrombin III, plasminogen, and alpha 2-plasmin inhibitor activity were 66.3%, 55.8%, and 75.6% of the total, respectively. 2. The birth weight of babies in a group with shortened prothrombin time was 2,935.1 +/- 395.2g(n = 50, mean +/- SD), while that in a group with prolonged prothrombin time was 3,106.2 +/- 357.9g(n = 36). The estimated fetal birth weight gain from the 2nd trimester to the 3rd trimester was 1,431.6 +/- 296.5g in the former group and 1,644.5 +/- 390.5g in the latter group. The differences were significant (p less than 0.05, p less than 0.01). The birth weight of babies in a group with lowered antithrombin III activity was 2,960.1 +/- 341.3g(n = 57), and that in an acceleration group was 3,157.8 +/- 370.0g(n = 29). The estimated fetal weight gain from the 2nd trimester to the 3rd trimester was 1,477.7 +/- 281.9g in the former group and 1,637.1 +/- 390.6g in the latter group. The differences were significant (p less than 0.02, p less than 0.05). 3. The estimated fetal weight gain from the 2nd trimester to the 3rd trimester in the group showing prolongated prothrombin time and activated partial thromboplastin time in this period was significantly larger than in the group showing shortened prothrombin time and activated partial thromboplastin time (p less than 0.001). These results suggested that the changes in blood coagulation and fibrinolysis activity of mothers from the 2nd trimester to the 3rd trimester affected the growth of the fetus.
To improve distribution of drug by intraarterial infusion a new catheter system with sideholes, tip of which was able to be occluded by an embolus, was developed. Inner diameter of the catheter was 0.038 inch. Tip of the catheter was so smoothly tapered to 0.025 inch in inner diameter that it could be occluded by an embolus of 0.038 inch in diameter. After occlusion of the tip, drug flowed out rectangly to catheter axis from only sideholes, resulting that drug flowed out was mixtured by blood stream to make a uniform distribution of it.
We reported a case of interstitial pneumonia immediately after hepatic arterial infusion of Lipiodol anticancer drug emulsion for hepatocellular carcinoma. The reason was considered that Lipiodol-anticancer drug emulsion ran through an A-V shunt to alveolar septum resulting in alveolitis.
In order to clarify the cause of arterial changes after intra-arterial infusion of anti-cancer drugs (AI-AD) experiments were made on the arteries of rabbits. Histopathologic sections, 7 days after AI-AD revealed endothelial damage characterized by pyknosis, hyalinization with edematous change of the intimal layer. Proliferation of the endothelial cells was also observed. The cause of narrowing or occlusion of the arteries was considered to occur with thrombus formation surrounded by the proliferated endothelial cells and this suggested that thrombolytic agents would be effective to prevent these arterial changes.
Hepatic arterial embolization was performed on VX2 liver tumor of rabbit with subsequent induction heating to the tumor. Prior to the heating, iron particle suspension was injected into tumor tissue as a target of induction heating (500 KHZ, 9 KW). The temperatures of the tumor and liver parenchyma were measured with fluoroptic thermometer. Elevation of the tumor temperature during initial heating for 6 minutes were well correlated to the dose of iron particles injected; 1.4 degrees C with 1 g, 3.0 degrees C with 2 g, and 4.9 degrees C with 3 g. The temperature of liver parenchyma were below 39 degrees C even with 3 g injection.
Uncontrollable change of diabetes mellitus (DM) has occurred in one of our patients who had received hepatic arterial embolization (HAE) for hepatocellular carcinoma (HCC). This prompted us to examine the influence of HAE to the diabetic patients with HCC. Thirty-four patients accompanying DM who had received HAE were examined fasted blood glucose (FBG) and the liver function before and after the procedure. HAE was performed using Gelatin Sponge and Lipiodol containing anticancer agents, either alone or combined. Of 34 patients 6 showed increase of FBG level of more than two times after HAE. The FBG level had a tendency to elevate as the grade of DM advanced. The tendency was also recognized on pre-HAE oral glucose tolerance test. However, FBG elevation had no relation to the changes of liver function (GPT, Choline Esterase), the difference of embolic materials and pre-HAE status of DM control. From the results, one must be aware that HAE or Lipiodol infusion to diabetic patients with HCC sometimes may cause uncontrollable change of DM, especially in case of advanced DM patients. Consequently, careful follow-up of HCC as DM is advisable for improvement of the patients' prognosis.
Experience with surgery for ruptured aneurysm of sinus of Valsalva into right atrium (Konno's type IV) in two cases was reported. The first case is a 39-year-old male developing into congestive heart failure for 5 days after the onset that was suspected of "rupture's attack". In the second case of 33-year-old male the course was slow progressing and the onset could not be identified. Mitral valve prolapse was suspected previously because of his syncope attack and infectious endocarditis. Closure of the ruptured noncoronary sinus of Valsalva with mattress suture was undertaken on both cases through the right atrium. Cardiac murmur was disappeared postoperatively on the both cases, and MR was denied in the later case. Postoperative courses were uneventful.