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Biomedical subjects

Y Nishimura

Publications and source records attributed to Y Nishimura.

At least 181 records · Page 10Linked to original sources

Long-term administration of oral low-dose topoisomerase II inhibitors, MST-16 and VP-16, for refractory or relapsed non-Hodgkin's lymphoma.

It is known that the topoisomerase II inhibitors, MST-16 (sobuzoxane) and VP-16 (etoposide), are effective for the treatment of lymphoma. Five patients with refractory or relapsed non-Hodgkin's lymphoma (NHL) were treated with a combination of oral MST-16 and VP-16 over a long period. Two patients had severely refractory NHL. The remaining 3 patients could not be treated with intensive chemotherapy because of severe organ dysfunction or a poor hematopoietic reserve. All 5 are alive and well after MST-16 and VP-16 treatment. MST-16 and VP-16 are effective for NHL when intensive chemotherapy is ineffective or contraindicated.

Administration, Oral↗

Angiotensin II AT(1) blockade normalizes cerebrovascular autoregulation and reduces cerebral ischemia in spontaneously hypertensive rats.

BACKGROUND AND PURPOSE: Angiotensin II, through stimulation of AT(1) receptors, not only controls blood pressure but also modulates cerebrovascular flow. We sought to determine whether selective AT(1) antagonists could be therapeutically advantageous in brain ischemia during chronic hypertension. METHODS: We pretreated spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto controls with the AT(1) antagonist candesartan (CV-11974), 0.5 mg/kg per day, for 3 to 14 days, via subcutaneously implanted osmotic minipumps. We analyzed cerebral blood flow by laser-Doppler flowmetry, cerebral stroke in SHR after occlusion of the middle cerebral artery with reperfusion, and brain AT(1) receptors by quantitative autoradiography. RESULTS: Candesartan treatment normalized blood pressure and the shift toward higher blood pressures at both the upper and lower limits of cerebrovascular autoregulation in SHR. Candesartan pretreatment of SHR for 14 days partially prevented the decrease in blood flow in the marginal zone of ischemia and significantly reduced the volume of total and cortical infarcts after either 1 or 2 hours of middle cerebral artery occlusion with reperfusion, relative to untreated SHR, respectively. This treatment also significantly reduced brain edema after 2 hours of middle cerebral artery occlusion with reperfusion. In SHR, candesartan markedly decreased AT(1) binding in areas inside (nucleus of the solitary tract) and outside (area postrema) the blood-brain barrier and in the middle cerebral artery. CONCLUSIONS: Pretreatment with an AT(1) antagonist protected hypertensive rats from brain ischemia by normalizing the cerebral blood flow response, probably through AT(1) receptor blockade in cerebral vessels and in brain areas controlling cerebrovascular flow during stroke.

Angiotensin II↗

Subacute tuberculous pericarditis with fibroelastic constriction diagnosed upon pericardiectomy.

A patient with subacute pericarditis showed no evidence suggesting tuberculosis until pericardiectomy was performed because of hemodynamic deterioration. The excised pericardium had a rubbery fibroelastic consistency; histologically, there were granulomatous changes characteristic of tuberculosis. Although tuberculous pericarditis is a difficult diagnosis, this case illustrates the diagnostic and therapeutic importance of early pericardiectomy before myocardial inflammatory infiltration occurs together with end-stage pericardial fibrosis and calcification.

Diagnostic Techniques, Cardiovascular↗

Contrastive prevalence of feline retrovirus infections between northern and southern Vietnam.

The prevalence of infections with three feline retroviruses; feline leukemia virus (FeLV), feline immunodeficiency virus (FIV) and feline foamy virus (FeFV), was examined in domestic cats (Felis catus) and leopard cats (Felis bengalensis) in southern Vietnam in 1998. We then compared this data with our previous study in northern Vietnam in 1997. None of the cats had FeLV antigens in both the northern and southern areas. In contrast, there is a great distinction in the seropositivity of FIV. Twenty-two percent of domestic cats had FIV antibodies whereas no FIV positive cats were detected in northern area. FIV may have entered southern Vietnam recently and spread rapidly. FeFV infections were found in both areas, suggesting that FeFV might be present in the cat populations in Vietnam from the earliest time.

Animals↗

Quantification of viral ribonucleic acid in plasma of cats naturally infected with feline immunodeficiency virus.

OBJECTIVE: To assess plasma viral RNA concentration in cats naturally infected with feline immunodeficiency virus (FIV). ANIMALS: 28 FIV-infected cats. PROCEDURE: Cats were categorized into 1 of the 3 following stages on the basis of clinical signs: asymptomatic (nonclinical) carrier (AC; n = 11), acquired immunodeficiency syndrome-related complex (ARC; 9), or acquired immunodeficiency syndrome (AIDS; 8). Concentration of viral RNA in plasma (copies per ml) was determined by use of a quantitative competitive polymerase chain reaction (QC-PCR) assay. Total lymphocyte count, CD4+ cell and CD8+ cell counts, and the CD4+ cell count-to-CD8+ cell count ratio were determined by use of flow cytometry. RESULTS: Plasma viral RNA concentration was significantly higher in cats in the AIDS stage, compared with cats in AC and ARC stages. Most (5/7) cats in the AIDS stage had low total lymphocyte, CD4+ cell, and CD8+ cell counts. CONCLUSIONS AND CLINICAL RELEVANCE: Concentration of plasma viral RNA is a good indicator of disease progression in FIV-infected cats, particularly as cats progress from the ARC to the AIDS stage. Determination of CD4+ and CD8+ cell counts can be used as supportive indicators of disease progression.

Animals↗

Assessment of magnesium status in patients with bronchial asthma.

To elucidate the contribution of magnesium to bronchial hyperreactivity in patients with stable bronchial asthma, magnesium concentrations in serum (S-Mg), erythrocytes (R-Mg), and lymphocytes (L-Mg) were measured in 25 patients with bronchial asthma (BA group) and 9 age-matched healthy subjects (control group). A parenteral magnesium loading test, a continuous low-dose magnesium infusion of 0.2 mEq/kg over 4 hr, was performed in 10 of 25 asthmatic patients and in the control group. R-Mg was significantly lower in the BA group than in the control group (4.96 +/- 0.47, 6.13 +/- 0.62 mEq/L, p < 0.001, respectively), although S-Mg (2.4 +/- 0.1, 2.4 +/- 0.2 mg/dL) and L-Mg (1.28 +/- 0.26, 1.15 +/- 0.13 microg/mg/protein) were not significantly different between the two groups. Magnesium deficiency in total body stores was revealed in 40% of patients (4/10 patients) and 11% of control subjects (1/9 subjects) by parenteral magnesium loading test. The ratio of magnesium retention to urinary excretion through the parenteral magnesium loading test showed a significant inverse correlation with R-Mg (r = -0.78, p < 0.01). Bronchial reactivity to inhaled methacholine had a significant inverse correlation with R-Mg (r = -0.42, p < 0.05). We conclude that 40% of asthmatic patients demonstrated magnesium deficiency, and that the low magnesium concentration in erythrocytes reflects decreased magnesium stores in patients with bronchial asthma.

Adolescent↗

Facial nerve repair accomplished by the interposition of a collagen nerve guide.

OBJECT: Facial nerve paralysis due to a surgical procedure or trauma is a frequently observed complication. The authors evaluated facial nerve repair achieved by the interposition of a collagen nerve guide. METHODS: Ten cats were divided into three groups. Group 1 consisted of six animals in which a 5-mm facial nerve segment on one side was resected and replaced by a collagen tube that was sutured to bridge both nerve stumps. On the opposite side a 5-mm segment of facial nerve was resected, reversed 180 degrees, and sutured to the stumps as an autograft nerve. Group 2 consisted of two cats in which the collagen nerve guide was interposed on one side and the nerve on the other side was left intact. Group 3 consisted of two cats in which a reversed autograft nerve was placed on one side and the nerve on the other side was left intact. Histological, electrophysiological, and horseradish peroxidase labeling examinations were performed starting 3 weeks after surgery. Light and electron microscopic examinations of collagen tube-implanted specimens revealed a well-vascularized regenerated nerve. The electrophysiological study confirmed the recovery of electrical activity in regenerated axons. Horseradish peroxidase labeling also confirmed restoration of the whole facial nerve tract. CONCLUSIONS: The collagen nerve guide shows great promise as a nerve conduit.

Animals↗

[Comparison of combined operation and nasal CPAP treatments for sleep disorders].

UNLABELLED: Uvulopalatopharyngoplasty (UPPP) and nasal CPAP are used for the treatment of obstructive sleep apnea syndrome (OSAS) in different institutions. Although OSAS results from an abnormality in the soft-palate, almost no reports have been made on the selection of UPPP or nasal CPAP procedures according to the type of abnormality. The most probable reason for this is that a comparison of treatment methods in individuals cases is difficult. We performed CPAP titration before and after operations, and compared the treatment methods, and evaluated the medical therapy. METHOD: A sleep polygraph was performed on the first night, and cases diagnosed as OSAS received CPAP titration on the second night. The blocked region was identified by endoscopic examination. The results of the operation were evaluated after 1-2 months, and apnea hypopnea index (AHI) improvements of less than 50% received a second CPAP titration. RESULTS: The operation results were poor for cases where endoscopic examination showed full-circumference palatal type, and good for soft palate and tonsillar type abnormalities. When endoscopic examinations were performed in conjunction with nasal CPAP, the treatment was observed to act on the soft palate and expand the air way in all cases. Nasal CPAP was effective in cases with full-circumference palatal abnormalities because in these cases, the pressure was caused by inflamma. Combined medical treatments were effective in cases where CPAP alone was ineffective because the pressure was too high.

Adult↗

[Electromyographic study of the striated urethral sphincter by using the bulbocavernosus reflex: study on change of sacral reflex activity caused by bladder filling].

PURPOSE: The change of sacral reflex activity of the striated urethral sphincter in the urine storage phase is investigated using evoked potential reaction of the bulbocavernosus reflex (BCR). METHODS: Eleven normal male subjects and 13 male patients with neurogenic bladder due to suprasacral (C3-C7) spinal cord injury (SCI patients) were investigated. Within the SCI patients, five were complete SCI and 8 were incomplete SCI. BCR was elicited by electrical stimulation of dorsal nerve of the penis, and the evoked potential of the BCR was recorded with a concentric needle electrode from the periurethral striated muscle. BCR was performed both at empty and at filled bladder respectively, and changes of the amplitudes (AMP) were examined. Moreover, the changes of AMP affected by bladder filling were compared between the normal subjects and the SCI patients. RESULTS: In both the normal subjects and the SCI patients, AMP increased at the filled bladder as compared with that of the empty bladder. In addition, the change of AMP was statistically bigger in the SCI patients (a ratio of amplitude at filled bladder/amplitude at empty bladder: 4.73 +/- 3.90) than in the normal subjects (the ratio: 1.32 +/- 0.44). CONCLUSION: Sacral reflex activity was accelerated by bladder filling in both the normal subjects and SCI patients. And the acceleration in the SCI patients was more remarkable than that in the normal subjects. In addition to the conventional evaluation of the integrity of sacral reflex arc by BCR examination, the observation of changes of BCR affected by bladder filling may provide the information for the continuity of sacral segment and supraspinal micturition center.

Adult↗

[Hydronephrosis as a complication of the appendiceal abscess: report of a case].

We report a case of appendiceal abscess complicated with right hydronephrosis in a 67-year-old woman. She visited our department complaining of right flank pain. Intravenous pyelography (IVP) showed hydronephrosis and hydroureter on right and a narrow ureter at the pelvic brim. A pelvic computed tomographic scan revealed a low density area measuring 44 x 37 mm in size, anterior to the right ureter, which was thought to be a pelvic tumor. Further examination did not reveal the origin of the tumor. An exploratory laparotomy was performed. The tumor developed from the cecum and adhered to the right ureter. The appendix was not found. The tumor was resected with the cecum while the ureter was preserved. Histological investigations revealed an appendiceal abscess. The postoperative course was uneventful. IVP after the operation showed the hydronephrosis to have resolved.

Abscess↗

[Pulmonary adenocarcinoma with central ossification].

A 70-year-old woman was admitted in April 1997 because a coin lesion in the left middle lung field was observed on chest roentgenograms. The lesion had slightly increased in size since 1994, when it was first pointed out. Chest computed tomography elucidated a high density area with irregular borders in the center of the shadow in S 3 a. Transbronchial biopsy revealed adenocarcinoma, and a left upper lobectomy was performed. The resected specimen demonstrated a tumor with central ossification and pleural indentation. Histologic examination determined that the the tumor was a papillary adenocarcinoma with central ossification containing marrow tissue. Primary lung cancer with central ossification is very rare, and only 6 cases have been reported to date, including this case.

Adenocarcinoma, Papillary↗

[A case of HTLV-I associated myelopathy with abnormal patchy MRI lesions in the spinal cord].

We report a case of HTLV-I associated myelopathy (HAM) with a spinal cord MRI showing abnormal multifocal and patchy lesions. A 50-year-old woman suffering from progressive paraparesis was admitted to our hospital. HTLV-I antibodies in the serum and CSF were positive, and a diagnosis of HAM was made. Her T2 weighted spinal cord MRI showed scattered areas of high signal intensity from the cervical to the thoracic cord. The lesions were enhanced with gadolinium-DTPA on T1 weighted imaging. Atrophy of the thoracic cord has been reported in many patients with HAM. In rare cases, T2 weighed thoracic cord MRI showed diffuse high signal intensity. The pattern of high signal intensity in our case, however, was multifocal and patchy, thus differing from the findings of previous reports. And we believe this is the first such report. This case suggests that the MRI of HAM patient may show multifocal and scattered lesions in the spinal cord.

Biomarkers↗

[Ovalbumin sensitization affects nonadrenergic noncholinergic relaxation response on guinea-pig tracheal smooth muscle].

We investigated the effects of anaphylactic challenge on nonadrenergic noncholinergic (NANC) relaxation response to electrical field stimulation (EFS) or to aminophylline in sensitized guinea pig tracheal smooth muscles. An anaphylactic challenge with ovalbumin (OA) reduced the relaxation response to EFS (20 V. 5 Hz. 300 pulse. duration 1 msec.), but the relaxation response to aminophylline was not affected by OA exposure. NG-monomethyl L-arginine, a nitric oxide (NO) synthesis inhibitor, reduced the relaxation response to EFS in the OA sensitized guinea pig. While the relaxation response to EFS on the sensitized guinea pig tracheal smooth muscle was significantly attenuated compared with that on the non-sensitized guinea-pig, there was no significant difference between the tracheal strip of OA challenge group and that of control group in sensitized guinea-pig under the existence of NO synthesis inhibitor. These results suggest that the attenuation of NANC relaxation response associated with sensitization plays an important role in airway hyperreactivity and is responsible for the decrease in NO amount.

Animals↗

[Cost analysis on stomach cancer treatment in Japanese hospitals].

BACKGROUND: In an effort to further the discussion of DRG/PPS, we performed a coat analysis on stomach cancer cases in Japanese hospitals. We analyzed individual in-patient data (both clinical and financial) to research the amount of variation in treatment and costs. METHODS: The data was taken from two hospitals. In order to compare the daily cost/revenue of each episode of operation/hospitalization, we analyzed the data that was stored for reimbursement purposes by using patient ID numbers. We also simulated the cost/revenue in cases where the length of stay could be shortened with clinical pathways created by Japanese hospitals. RESULTS: (1) There is a common pattern for the operation/hospitalization of stomach cancer cases if the patient's condition, like severity, is well controlled. However, there is still a noticeable difference in the length of stay for patients both before and after the operation. (2) Hospitals are currently losing money by having extended patients' lengths of stay. Simulation results indicate that hospitals can reduce losses, even become profitable, by shortening the patient's length of stay. CONCLUSIONS: The potentiality of implementing a standard treatment process and/or a fixed payment system, like DRG/PPS, is high, because there is a common a pattern among the treatment process. More research must be completed in this area, specifically on the significant variations in lengths of stay and the methodology for standardization of treatment. Furthermore, clinical outcomes research must also be done.

Costs and Cost Analysis↗