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Biomedical subjects

Y Kato

Publications and source records attributed to Y Kato.

At least 397 records · Page 22Linked to original sources

Intraoperative pancreatoscopy for pancreatic duct stone debris distal to the common channel in choledochal cyst.

BACKGROUND/PURPOSE: Pancreatic duct stone debris is a recognised problem in patients with choledochal cyst (CC). The authors present the use of intraoperative pancreatoscopy (IP) in diagnosis and treatment of pancreatic duct stone debris distal to the common channel (distal PDSD). METHODS: Sixty-seven patients with CC treated over the past 12 years were reviewed retrospectively. Distal PDSD was detected in 8 of these 67 cases (11.9%) using cholangiography. IP of the common channel or pancreatic duct at the time of surgery for CC was performed using a pediatric cystoscope in 7 of these 8 cases. RESULTS: All 8 patients had a long common channel. All presented with acute pancreatitis. In 7 of these 8 patients, IP was efficient in detecting and for removing distal PDSD by irrigation. In the remaining case associated with annular pancreas, distal PDSD was identified in the proximal pancreatic duct and was removed directly after incision of the pancreatic duct. Postoperative pancreatitis occurred in only 1 case. All patients are well after a mean follow-up period of 7.3 years. CONCLUSION: Distal PDSD should not be ignored. IP allows direct examination of the pancreatic duct system and facilitates complete removal of distal PDSD, which may be the cause of relapsing pancreatitis or pancreatolithiasis after radical surgery for CC.

Acute Disease↗

[Clinical effects of adjuvant therapy using Z-100 (Ancer 20 injection) for oral cancer--prevention of stomatitis and hematopoietic impairment].

A combination of radiotherapy and chemotherapy is a usual treatment method for malignant head and neck tumors, however chemoradiotherapy is associated with hematopoietic impairment and serious stomatitis in patients. The clinical effects and evaluation of hematopoietic activity (e.g., leukocyte count) and the degree of stomatitis under adjuvant therapy using Z-100 (Ancer 20 injection) for oral cancer were investigated for preoperative cancer therapy. In order to evaluate the clinical effects of Ancer 20 injection with regard to hematopoietic activity and the degree of stomatitis, a clinical study was performed for 18 patients with oral cancer in our department. The 18 patients, who had oral squamous cell carcinomas (5 of the tongue, 4 of the mandibular gingiva, 3 of the maxillary gingiva, 1 of the floor of the mouth, 3 of the buccal mucosa, and 2 others), were treated with this combination of adjuvant therapy with Ancer 20 injection, from March, 1991 to March, 1997. They were injected with Ancer 20 (twice a week, 40 micrograms) during the cancer treatment period. We investigated hematopoietic activity, (e.g., leukocyte and platelet counts) and the degree of stomatitis periodically, before and after the combined radiotherapy and chemotherapy treatment period. It was found that in the patients who were treated with Ancer 20 injection, the decrease in leukocyte and platelet counts was prevented and the condition of stomatitis was improved. These results suggest that Ancer 20 injection may generally improve various dysfunctions due to hematopoietic impairment by radiotherapy combined with chemotherapy, and improve immunological factors. We conclude that Ancer 20 injection is a useful adjuvant treatment for oral cancer.

Antineoplastic Agents↗

[A case of prostate cancer treated with combined androgen-blockade].

A 62-year-old man was admitted to our hospital because of urinary retention. A digital rectal examination revealed an enlarged, elastic, and hard prostate with an irregular surface. Prostatic biopsy was done and the pathological diagnosis was moderately differentiated adenocarcinoma. He was diagnosed as stage D2 by bone scan and MRI. We gave him 250 mg of fosfestrol intravenously for 13 days. Afterward, he underwent orchiectomy castrate and was given flutamide for two years. His condition has improved and he has experienced no relapse.

Adenocarcinoma↗

Clinical significance of serum soluble intercellular adhesion molecule 1 in gastric cancer.

We studied the correlation between serum soluble intercellular molecule 1 (sICAM-1) and clinicopathological features in patients with gastric cancer. The impact of sICAM-1 on prognosis was also evaluated. The sera from 224 patients with gastric cancer, 44 healthy individuals, and 35 patients with benign gastrointestinal diseases (4 patients with submucosal stomach tumors, 6 patients with gastric ulcers, 1 patient with Crohn disease, 2 patients with ulcerative colitis, 7 patients with gall stones, 5 patients with chronic pancreatitis, and 10 patients with liver cirrhosis) were measured for sICAM-1 titer using a sandwich enzyme immunoassay method. There was no correlation between the serum titer of sICAM-1 and the age or gender of healthy controls. Among patients with benign gastrointestinal diseases, the patients with liver cirrhosis had a significantly higher mean serum sICAM-1 titer than that of healthy controls (P < 0.0001). The mean serum sICAM-1 titer of all patients with gastric cancer was not significantly different from that of healthy controls. However, among the patients with stage IV and recurrent disease, the serum sICAM-1 titer of those with hematogenous metastasis was significantly higher than that of patients without hematogenous metastasis (P = 0.001). The patients with a high serum sICAM-1 titer of more than 304 ng/ml (mean of healthy controls plus SD) showed a significantly worse prognosis than patients with a low serum sICAM-1 titer (P = 0.010). Nevertheless, serum sICAM-1 titer was not an independent predictor of prognosis by multivariate analysis. In conclusion, serum sICAM-1 cannot be used as a tumor marker for early diagnosis. However, sICAM-1 in sera may still be worthwhile to measure for monitoring hematogenous metastasis.

Adult↗

[Vesicovaginal fistula due to a vaginal foreign body: a case report].

An 18-year-old female consulted a clinic complaining of pollakisuria and urinary incontinence. She was referred to our department for operation under the diagnosis of vesicovaginal fistula due to a vaginal foreign body confirmed by intravenous pyelography and cystoscopic examination. About 7 months earlier, she inserted a hair spray can into the vagina but could not remove its cap. The vaginal foreign body was transvaginally removed. After 2 months, transabdominal repair of the vesicovaginal fistula was performed. After operation, dysuria and urinary incontinence were not observed. Few cases of vesicovaginal fistula due to a foreign body in the vagina have been reported, and there have been only 6 reported cases in Japan including ours.

Adolescent↗

[Statistics of the operations at the Department of Urology, Tone Chuo Hospital during a six-year period (June 1993-May 1999)].

A clinical statistic survey was made on the operations performed at the Department of Urology, Tone Chuo Hospital between June 1993 and May 1999. The total number of operations was 1296, consisting of 97 (7.5%) operations of the kidney, 67 (5.2%) operations of the ureter, 190 (14.7%) operations of the bladder, 454 (35.0%) operations of the prostate, 63 (4.9%) operations of the urethra, 92 (7.1%) operations of the penis, 149 (11.5%) operations of the scrotum and 184 (14.2%) other operations. With the aging society, the number of operations for those over 60 years old has exceeded 60%.

Adolescent↗

[The effect of combination chemotherapy to adapted to chronotherapy with 5-fluorouracil, leucovorin, mitomycin C and cisplatin in patients with gastric or colorectal cancer].

We performed combination chemotherapy adapted to chronotherapy with 5-fluorouracil, leucovorin, mitomycin C and cisplatin in 11 patients with gastric cancer and 7 with colorectal cancer. Treatment consisted of a 5-day course of continuous arterial or intravenous infusion of 5-FU (500 mg/body/day), arterial or intravenous infusion of leucovorin (20 mg/body/day) at 6:00 p.m. on days 1-5, arterial or intravenous infusion of mitomycin C (2 mg/body) at 9:00 a. m. on day 5, and arterial or intravenous infusion of cisplatin (20-80 mg/body) at 6:00 p.m. on day 5. The effective rate against gastric cancer was 73%; however, the effective rate against colorectal cancer was 29%. During and after this therapy, there was only a little appetite loss, nausea and stomatitis.

Aged↗

[An autopsy case of thymic carcinoma producing various tumor markers and the examination of 222 autopsy cases of thymic malignant tumor in Japan].

The autopsy of a 76-year-old Japanese female patient, which revealed thymic carcinoma with various tumor markers such as NSE, CYFRA, and CA-125, is presented. The patient died from hepatic failure because the liver was overtaken by the tumors. At autopsy, the thymic carcinoma was found to have metastased only in the liver. From microscopical analyses and electron microscopical findings, we diagnosed poorly differenciated squamous cell carcinoma of thymic origin. In the histochemical analyses, the tumor cells were positively stained in CA 125, CA 19-9, EMA, NSE, AE 1, AE 3, CEA, S-100, glimerius and Bcl-2. These date suggest that the tumor cells produced various tumor markers. In 222 autopsy cases of thymic malignant tumor observed in Japan over a period of 4 years, the dominant pathohistological image was squamous cell carcinoma. It is interesting that the greatest number of combined malignant tumors with thymic malignancies were thyroid papillary carcinomas.

Aged↗

[Burkitt's lymphoma occurring as a primary lymphomatous effusion].

A 39-year-old man was admitted with massive ascites. Specimens of ascitic fluid contained numerous cells with a FAB-L3 appearance, and small noncleaved cell lymphoma morphology. These cells expressed CD10, CD19, CD20, CD38, CD45, HLA-DR, and IgM antigens, and were positive for IgM and c-myc protein in cytoplasmic immunostaining tests. Clonal rearrangements of IgH and c-myc genes were detected by Southern blot analysis. No mass lesions were found by physical examination, and systemic computed photography did not reveal enlargement of lymph nodes, spleen, or liver. Bone marrow aspiration showed no infiltration of malignant cells. Ga scintigraphy indicated hot lesions only in the abdomen. These findings suggested that Burkitt's lymphoma had developed in the peritoneal cavity as a primary lymphomatous effusion. Chemotherapy with methotrexate, cyclophosphamide, vincristine, doxorubicin, etoposide, and dexamethasone was effective, and the patient has been free from the disease for 1 year since completion of consolidation treatment with autologous peripheral blood stem cell transplantation.

Adult↗

Usefulness of a toothbrush as a source of evidential DNA for typing.

We investigated the usefulness of a toothbrush as a source of DNA for an unidentified cadaver. Ten toothbrushes were obtained from ten individuals along with their peripheral blood. We recovered from 10 to 430 ng of DNA from all but one of the toothbrushes. All ten toothbrushes, including the one containing no detectable DNA by fluorometry, were typed correctly at all of the loci tested, including nine STRs. Three toothbrushes obtained in two actual deaths also identified two victims and one suspect. Therefore, toothbrushes seem to be useful as a source of evidential DNA for personal identification.

Cadaver↗

Hydroxyprolylserine derivatives JBP923 and JBP485 exhibit the antihepatitis activities after gastrointestinal absorption in rats.

It has been a desire to develop orally effective therapeutic agents that restore the liver function in chronic injury. Here we demonstrated that trans-4-L-hydroxyprolyl-L-serine (JBP923) and cyclo-trans-4-L-hydroxyprolyl-L-serine (JBP485), which was previously isolated from hydrolysate of human placenta, exhibit potent antihepatitis activity after their oral administration. The increase in bilirubin concentration and activities of liver cytosolic enzymes in serum caused by alpha-naphthylisothiocyanate intoxication in rats were significantly countered both after i.v. and oral administration of these dipeptides, whereas glycyrrhizin, which has been used in the treatment of chronic hepatitis, is active only after its i.v. administration. Antihepatitis activity of dipeptides results, at least partially, from their direct effect on hepatocytes because glutamic-oxaloacetic transaminase and lactate dehydrogenase activities in the medium of hepatotoxin-exposed primary cultured hepatocytes were reduced by these compounds. When comparing the plasma concentration-time profile of JBP923 after its i.v., oral, and portal vein injection, it is suggested that JBP923 is almost completely absorbed from gastrointestinal lumen, and hepatic first-pass removal is minor. JBP923 inhibited the proton-dependent transport of glycylsarcosine in brush-border membrane vesicles, suggesting that peptide transport system(s) may recognize JBP923. Thus, these dipeptides are potent antihepatitis reagents that are still active after oral administration and may be useful for clinical applications.

1-Naphthylisothiocyanate↗

[Localized amyloidosis of the ureter and bladder treated effectively by occlusive dressing technique therapy using dimethyl sulfoxide: a case report].

We report here the first case of localized amyloidosis of the ureter and bladder to be treated effectively by occlusive dressing technique therapy using dimethyl sulfoxide. The patient was a 48-year-old woman whose chief complaint was macrohematuria and right back pain. Ultrasound sonography demonstrated right hydronephrosis and an intravesical mass in the region of the right ureteral orifice. Retrograde pyelography revealed severe stricture of the right lower ureter. Cystoscopy demonstrated a yellow submucosal tumor around the right ureteral orifice. We suspected urinary tract amyloidosis, and transurethral biopsy and resection of the intravesical mass were performed under right ureteral stenting. Histopathological diagnosis was amyloidosis. There was no evidence of systemic amyloidosis. To treat residual amyloidosis of the ureter and bladder, we performed occlusive dressing technique therapy using dimethyl sulfoxide every day. After 6 months of therapy, the right hydronephrosis disappeared, and there was no evidence of a recurrence of amyloidosis. We concluded that this therapy was very effective and safe for urinary tract amyloidosis.

Administration, Cutaneous↗

Both cMOAT/MRP2 and another unknown transporter(s) are responsible for the biliary excretion of glucuronide conjugate of the nonpeptide angiotensin II antagonist, telmisaltan.

Canalicular multispecific organic anion transporter (cMOAT/MRP2) is known to play a major role in the transport of anionic xenobiotics including many types of glucuronide and glutathione conjugates across the bile canalicular membrane. In the present study, the biliary excretion of telmisartan (BIBR 277) and its glucuronide was examined in Sprague-Dawley rats (SDRs) and also in mutant strain Eisai-hyperbilirubinemic rats (EHBR), which have a hereditary defect in cMOAT/MRP2. Only a minimal difference was observed in the time profile of the plasma concentration of total radioactivity after administration of an i.v. bolus of BIBR 277. About 45% of the administered dose was excreted into bile up to 240 min in both strains, most of the radioactivity in the bile being BIBR 277 glucuronide. No significant difference was observed in the biliary excretion of BIBR 277 and its glucuronide between SDRs and EHBR although the plasma disappearance of BIBR 277 glucuronide was delayed in EHBR. To explain these data, the extent of glucuronidation of BIBR 277 by liver microsomes was examined in both strains. The V(max) value for the formation of BIBR 277 glucuronide was 2 to 3 times higher in EHBR than in SDRs, whereas both strains had similar K(m) values. After an i.v. bolus administration of BIBR 277 glucuronide, its plasma disappearance was delayed in EHBR, the biliary clearance in EHBR being about half that in SDRs. These results suggest that BIBR 277 glucuronide is transported by both cMOAT/MRP2 and another transporter that is also expressed in EHBR, and that the BIBR 277 glucuronidation is enhanced in EHBR, resulting in comparable excretion of glucuronide in both strains.

Angiotensin-Converting Enzyme Inhibitors↗

Selective inhibition of human cytochrome P450 3A4 by N-[2(R)-hydroxy-1(S)-indanyl]-5-[2(S)-(1, 1-dimethylethylaminocarbonyl)-4-[(furo[2, 3-b]pyridin-5-yl)methyl]piperazin-1-yl]-4(S)-hydroxy-2(R)-phenylmethy lpentanamide and P-glycoprotein by valspodar in gene transfectant systems.

Our previous report showed that L754.394 and valspodar (PSC833) are potent inhibitors of midazolam hydroxylation in human jejunum microsomes and vectorial transport of vinblastine in Caco-2 cells, respectively. In the present study, to directly examine the interactions of these compounds as well as other substrates with CYP3A4 and P-glycoprotein (P-gp), we performed in vitro inhibition studies using recombinant CYP3A4-expressed microsomes and an MDR1-transfected cell line, LLC-MDR1, respectively. In CYP3A4-expressed microsomes, both L754.394 and ketoconazole, at a concentration less than 0.5 microM, are the most potent inhibitors of the formation of 1'-hydroxymidazolam, a major metabolite of midazolam formed by CYP3A4. The greatest inhibitory effect on the transcellular transport of digoxin in LLC-MDR1 cells was observed in the presence of valspodar (<0.1 microM), followed by verapamil. From a comparison of the IC(50) values, it was shown that L754.394 and valspodar exhibited the highest selectivity for CYP3A4 and P-gp, respectively. To demonstrate such specificity, both midazolam hydroxylation and digoxin transport were observed in CYP3A4 transfected Caco-2 cells, which coexpress both P-gp and CYP3A4, in the presence or absence of L754.394 (0.5 microM) and valspodar (1.0 microM). L754.394 almost completely inhibited midazolam hydroxylation, but not digoxin transport, whereas almost complete inhibition of digoxin transport was observed in the presence of valspodar, but inhibition of the hydroxylation was minimal. Thus, the present study has demonstrated that L754.394 has a specific inhibitory effect on CYP3A4, whereas valspodar is specific for P-gp.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Effects of specific warm-up at various intensities on energy metabolism during subsequent exercise.

BACKGROUND: To investigate the effects of specific warm-up at various intensities on energy metabolism during subsequent intense exercise. METHODS EXPERIMENTAL DESIGN: specific warm-up was consisted of 3 sets of wrist flexions for 5 min, with each set followed by a 3-min rest. The intensity of specific warm-up was set at 20%, 30% or 40% of maximal voluntary contraction (MVC). The subjects then performed a set of wrist flexions at 60% MVC for 4 min as the criterion exercise. For the control experiment, criterion exercise was done without specific warm-up. PARTICIPANTS: Five healthy volunteers. MEASUREMENTS: using phosphorus-31 magnetic resonance spectroscopy, spectra were obtained from the wrist flexor muscles to determine the ratio of inorganic phosphate to phosphocreatine (Pi/PCr) and intracellular pH. RESULTS: The Pi/PCr during the criterion exercise after specific warm-up at any intensity was not significantly different from that without specific warm-up. The intracellular pH during the criterion exercise after specific warm-up at 30% or 40% MVC was significantly higher than that without specific warm-up. CONCLUSIONS: These results indicate that mild warm-up exercise could inhibit the development of intracellular acidosis during subsequent intense exercise.

Adult↗