PubMed HealthSearch

Biomedical subjects

T Soma

Publications and source records attributed to T Soma.

At least 19 recordsLinked to original sources

Diverticular disease of the colon at a regional general hospital in Japan.

PURPOSE: X-ray film registry records were reviewed to better understand the changing nature of diverticular disease (DD) of the colon in Japan. RESULTS: Among 6,849 patients undergoing barium enema examination during a eight-year period from 1985 to 1992, this condition was found in 1,074 patients (15.7 percent), including 702 males (65.4 percent) and 372 females (34.6 percent). During this eight-year period there was an increase in frequency from 10.7 percent in 1985 to 17.8 percent in 1992. The proportion of patients with right-sided, bilateral, and left-sided DD was 69.2 percent, 17.5 percent, and 13.3 percent, respectively. The right-sided DD was more common in the younger age group and was predominant in male patients, whereas the left-sided DD increased with age, especially in female patients. Of the 1,074 patients, 11 (1.0 percent) underwent surgery in the same period. Regarding the right-sided DD, only 2 of 743 patients received surgery (0.3 percent). On the other hand, of the 143 patients with left-sided DD, 9 patients (6.3 percent) received some form of surgery. CONCLUSION: Right-sided diverticular disease of the colon is still common in Japan. It does not appear that this tendency will change in the future. Nearly all patients diagnosed as having diverticula had either no symptoms or only mild symptoms, and only about 1 percent required surgery. Right-sided diverticular disease of the colon seems to have had no serious clinical problems compared with left-sided DD.

Adolescent

Adjuvant-induced persistent photosensitivity models in guinea pigs. I. Induction of persistent photosensitivity.

Induction of persistent photosensitivity in guinea pigs was carried out in an attempt to induce a model suitable to clarify the mechanism of human persistent light reactors. Guinea pigs were treated with intradermal injection of adjuvant which consisted of desiccated Mycobacteria followed by topical application of hapten solution and irradiation with UVA. Unequivocal skin reactions were subsequently elicited with UVA exposure in the absence of hapten application. This enhanced UVA reactivity persisted and could be elicited for more than 2 years. In these guinea pigs, remarkably increased sensitivity to UVB was also observed. These animals appear quite similar to persistent light reactors among humans. Muramyl dipeptide used in place of Mycobacteria was also found to be effective in inducing photosensitivity to UVA. There were great differences of reactivity noted among different strains of guinea pig, suggesting that persistent photosensitivity is influenced by genetic background. Enhanced UV sensitivity was induced without hapten application, only with injections of adjuvant and UVA irradiation in the immunization procedure. These results suggest that this model will be useful to study chronic actinic dermatitis.

Acetylmuramyl-Alanyl-Isoglutamine

Adjuvant-induced persistent photosensitivity models in guinea pigs. II. Characterization of immunological mechanisms.

The immunological characteristics of our adjuvant-induced persistent photosensitivity (AIPP) guinea pig model were examined. The sensitivity to long-wavelength ultraviolet light (UVA) was transferred with peritoneal exudate cells. Proliferative response was observed in peritoneal exudate cells and lymph node cells concomitantly cultured in the presence of sera that had previously been irradiated with UVA. Cervical lymph nodes of AIPP animals were found to be hypertrophic, and the ratio of major histocompatibility complex (MHC) class II positive cells was increased as compared to that of intact guinea pigs. These results suggest that persistent photosensitivity elicited with UVA is based on cellular autoimmunity. Thus, the AIPP guinea pig model should be useful to study the mechanism of persistent photosensitivity disease in humans.

Adjuvants, Immunologic

Sealing of a fabric vascular prosthesis with autologous adipose tissue: a preliminary report of its clinical application.

A new method of sealing fabric vascular prostheses with autologous adipose tissue was clinically applied as an alternative to preclotting with fresh blood. Thirty-six patients with peripheral arterial occlusive disease were implanted with highly porous fabric prostheses. The prostheses were prepared by sealing the fabric pores with autologous adipose tissue that had been chopped up into small pieces and enmeshed in the fabric by forceful injection of the tissue suspension through a syringe. There was no complication related to the sealed graft such as graft bleeding after implantation. In-hospital mortality occurred in 4 patients: 1 case each of pneumonia, pulmonary infarction, sepsis, and acute myocardial infarction. During the period of 274 +/- 190 days, 3 prostheses were found to be occluded. All the other grafts were patent. The overall patency rate was 91.4%. Postoperative angiography revealed neither intimal thickening at the anastomotic sites nor irregularity of the prosthetic surface. The method proved safe and useful for implantation of smaller caliber artificial grafts.

Adipose Tissue

[Usefulness of allopurinol for prevention of myocardial reperfusion injury in open heart surgery].

Xanthine oxidase has been demonstrated to be an important factor in postischemic reperfusion injury. Allopurinol is the inhibitor of xanthine oxidase. In this study, we evaluated usefulness of allopurinol for prevention of myocardial reperfusion injury in open heart surgery. Twenty adult patients were divided into two groups; Ap-group (n = 10) were administered allopurinol for seven days just before operation and control-group (n = 10) were administered nothing. The dose of allopurinol was ranged 100-300 mg/day. The dose was determined according to renal function of patients. Coronary sinus blood hypoxanthine, xanthine, uric acid, lactate, pyruvate, CK, and CK-MB levels were measured at before CPB, 5 and 15 min. after aortic declamping, 5 min. after CPB. Hypoxanthine and xanthine levels in Ap-group were significantly higher than those in control-group at 5 and 15 min. after aortic declamping, 5 min. after CPB. Uric acid levels in Ap-group were significantly lower than those in control-group at 5 and 15 min. after aortic declamping, 5 min. after CPB. Lactate, pyruvate, CK, and CK-MB levels were not different between Ap-group and control group. We considered that allopurinol suppressed the reaction rate of xanthine oxidase. Therefore, the levels of intermediates, hypoxanthine and xanthine, were high and, the level of final product, uric acid was low in Ap-group. However, allopurinol had no efficacy for the level of lactate, pyruvate, CK, and CK-MB, in this study.

Aged

[A case of aortic and mitral regurgitation with two aneurysms in the mitral valve].

A 59-year-old male was found to have two aneurysms in the mitral valve, mitral regurgitation, and aortic regurgitation by the echocardiographic examination. The patient had a previous history of infectious endocarditis by streptococcus at the age of 24. Under the diagnosis of mitral aneurysms developed after infectious endocarditis, surgery was undertaken. A 5 x 8 mm sized perforation in the right coronary cusp and two aneurysms in the anterior mitral leaflet, 22 mm and 17 mm in size, were found intraoperatively. Both the mitral and aortic valves were replaced. Patients with a history of infectious endocarditis have to be followed up for a long period of time. Transesophageal echocardiogram is useful in those patients. Considering high prevalence of aortic valvular diseases in those with a mitral aneurysm after infectious endocarditis, aortic valves should be carefully evaluated.

Aneurysm, Infected

[Surgical treatment of active infective endocarditis].

From January, 1978, through December, 1990, surgical treatment for active infective endocarditis was performed in 11 patients. There were 8 men and 3 women who ranged in age from 19 to 54 years with a mean age of 38.8 years. Two patients had ventricular septal defects and 1 patient had rheumatic valve disease. In all patients, the infecting organism was isolated from blood, including streptococcus in 7, staphylococcus in 2, and gram-negative rods in 2. The indication for operation at the active phase was uncontrolled infection in 7 and progressive heart failure in 4. The operation was performed at 7 to 150 days with a mean of 53 days after diagnosis. Operative findings showed vegetations in all cases and perforations of the valve in 6. There were no operative deaths. Perioperative complications developed in 5, whose indication for operation was uncontrolled infection. Complications consisted of 1 prosthetic valve endocarditis, 1 pulmonary suppuration, 1 ruptured mycotic aneurysm of the hepatic artery, 1 ruptured mycotic aneurysm of the popliteal artery, and 1 pyogenic spondylitis. All were successfully treated surgically or with antibiotic therapy. There were no complications in patients whose indication for operation was progressive heart failure. We conclude that the risk of embolism is high in patients undergoing surgery at the active phase of infective endocarditis because of uncontrolled infection; thus, such patients should be carefully monitored for emboli.

Adult

[Comparison of surgical therapy and combined irradiation in rectal cancer--second report. Effect of irradiation and ACNU on the tumor].

As part of a joint study on preoperative radiotherapy for developing an optimal mode of rectal cancer therapy, ACNU sensitization was studied in a total of 120 cases, with the cooperation of 48 facilities participating nationwide. The following results were obtained. Improvement in depth of invasion was more distinct in the combination preoperative therapy-ACNU group than in the preoperative radiotherapy group, with no other significant differences between the two. This finding suggests that dose and administration method could be improved. White blood cells and platelets were reduced in some cases of the ACNU combination group, but these reductions were not serious enough to impede surgical procedures. In addition, no significant difference in complications was noted between the two.

Adenocarcinoma

Monocytoid B-cell lymphoma arising in extranodal organs.

Six cases of monocytoid B-cell lymphoma (MBCL) developing in extranodal sites (thyroid, three; stomach, two; rectum, one) are described. Patients were all women aged 46 to 65 years (median, 53 years). Three patients with thyroid lymphoma presented with an increasing goiter, two with positive serum antithyroid antibodies, and one patient had chronic lymphocytic thyroiditis (CLTH). The histologic type of surgically resected specimens was a diffuse proliferation of atypical lymphoid cells with monocytoid appearance, i.e., abundant pale cytoplasm with distinct cell border and small reniform nucleus. These cells were CD20+, 22+, 24-, 9- showing their B-cell origin. The monoclonal nature of the proliferating cells was confirmed by restricted expression of immunoglobulin (Ig) light chain and/or gene rearrangement study in three cases. Two cases of thyroid lymphoma in which the monoclonality could not be confirmed had histologic appearances characteristic of malignant lymphoma. All three patients with gastric or rectal lymphoma had reactive lymphoid hyperplasia (RLH) near the tumors. These findings showed presence of MBCL in the extranodal sites with invariable coexistence with lymphoid follicles formed by CLTH in thyroid or RLH in stomach and rectum.

Aged

The clinical effect of bifemelane hydrochloride on dementia in aged patients.

The effect of bifemelane hydrochloride on dementia in the elderly was studied in thirty-one patients having cerebrovascular disorders. Alzheimer's disease, Parkinsonism and related diseases. The drug (150 mg) was administered orally three times daily for 10 weeks. The final global improvement rating was 77.4% for all patients. The rates of improvement for Alzheimer's disease were higher than those for cerebrovascular disorders, suggesting that this drug affects Alzheimer's disease through a cholinergic potentiating action. Psychotic, neurological and subjective symptoms, and the activity of daily life, were rated before, during and after treatment. All mean rates of improvement were based on observations made in the 4th week after the start of treatment. Improvement rates for global symptoms were more than 80% for emotional incontinence and prejudice or querulous attitudes toward the nurses, and in headache, tinnitus and dizziness among the subjective symptoms. The improvement in intellectual function was evaluated by the dementia rating scale for the elderly (DRSE), and a significant increase was found in DRSE after treatment with this drug. Side effects attributable to the drug were noted in one patient developing urticaria. It is thus suggested that bifemelane hydrochloride is useful in the treatment of different symptoms of dementia.

Aged

Malignant lymphoma of the rectum.

Eleven patients with primary lymphoma of the rectum were reviewed on a mainly histological basis, especially in association with reactive lymphoid hyperplasia (RLH). They included three males and eight females with an age range of 21-71 (median 59) years. Common symptoms were anal bleeding, melena, difficulty with defecation and constipation. A physical examination echogram and computed tomographic scans showed the tumor to be restricted to the rectum. The tumors were classified microscopically as six intermediate lymphocytic lymphomas (ILL) and five others. Histologic findings compatible with RLH were found in all five ILL cases and three of the others. Immunohistochemistry on paraffin-embedded sections revealed eight cases to be of B-cell type and one with a pleomorphic histology, to be of T-cell type; one case did not react with any of the antibodies tested, but were regarded as being of B-cell type purely on morphological grounds. A gene rearrangement study carried out in one ILL case showed a monoclonal rearrangement of the Jh chain. The findings showed rectal lymphoma to be characterized by a high frequency of ILL cases and an association with RLH. These are also common findings among patients with thyroid, salivary and gastric lymphoma, suggesting a common etiologic role in these diseases of long-standing inflammation.

Adult

Alteration of opioid receptors in seizure-susceptible El mouse brain.

The distribution density of opioid receptors in the brain of El mice (seizure-susceptible strain) was examined to determine the relation between seizures and the opioid system. Saturation curves and Scatchard plots of [3H]2-D-alanine-5-D-leucine enkephalin binding revealed that the opioid delta receptor density in adult El mice during interictal periods was significantly increased in the cerebral cortex, hippocampus, and septal area. It was further shown that the concentration of such receptors in 25-day-old El mice that had no seizures was also significantly increased in the hippocampus and septal area, with no changes in apparent affinities, as compared with in the corresponding regions in ddY mice (seizure-nonsusceptible strain; the mother strain of El). Such up-regulation of opioid receptors in the El mouse brain could result from deficits in endogenous opioid peptides, which could be associated with the pathogenesis of seizure diathesis in the El mouse.

Animals