[Evaluation of secondary hyperparathyroidism in the patients undergoing hemodialysis--focused on parathyroid hormone assay system].

We evaluated the degree of secondary hyperparathyroidism (SHPT) in the patients undergoing long-term hemodialysis treatment. Most patients showed improvement of SHPT by administration of the active vitamin D3 analogue. However, some patients developed overt SHPT even under intensive treatment.

Vascular inflow exclusion and hepatic resection.

Seventy-nine patients undergoing hepatic resection without manipulation of the vena cava were divided into three groups. Group 1 consisted of 32 patients in whom hepatic hilar vascular exclusion was not performed. Group 2 (20 patients) had vascular inflow exclusion performed at the operative site only (right or left unilateral exclusion).

Hepatocyte growth factor rapidly induces the tyrosine phosphorylation of 41-kDa and 43-kDa proteins in mouse keratinocytes.

We have examined the hepatocyte growth factor (HGF)-mediated changes in protein-tyrosine phosphorylation in mouse keratinocytes (PAM-212) and canine kidney epithelial cells (MDCK). In PAM-212 cells HGF and epidermal growth factor, both of which stimulated the DNA synthesis, rapidly induced the tyrosine phosphorylation of two 41-kDa and two 43-kDa proteins: increased tyrosine phosphorylation of those proteins has been commonly observed when quiescent fibroblasts are stimulated with a variety of mitogenic agents. In contrast, HGF did not stimulate the DNA synthesis but induced cell dissociation in MDCK cells; under this condition, increased tyrosine phosphorylation of the 41-kDa and 43-kDa protein was not observed.

[Pharmacokinetics and clinical effect of recombinant human erythropoietin on the anemia of predialysis patients].

The marvelous effect of recombinant human erythropoietin (EPOCH) on the anemia of the patients suffering from chronic renal failure had been already reported even in the predialysis patients. However, the influence on residual renal function as well as pharmacokinetics of EPOCH in predialysis patients was not clarified yet. Therefore, we made a clinical study of EPOCH in 10 predialysis patients to investigate the clinical effect as well as pharmacokinetics.

[Expression of granulocyte-macrophage colony-stimulating factor mRNA by inflammatory cells in the sarcoid lung and its clinical significance].

T lymphocytes and alveolar macrophages accumulating in the lower respiratory tract of patients with pulmonary sarcoidosis are known to be activated to produce several cytokines, presumably leading to granuloma formation within the lung. I hypothesized that these cells produce colony-stimulating factors (CSF), which have been shown to affect the proliferation and function of monocyte/macrophage-lineage cells. To test this hypothesis, I tried to detect mRNA encoding CSFs in cells obtained by bronchoalveolar lavage using a reverse transcription-polymerase chain reaction.

Prognosis of patients with congestive heart failure: its determinants in various heart diseases in Japan.

We investigated the prognosis of patients with congestive heart failure (CHF) and the factors which influence the prognosis of Japanese patients with this condition. From among the patients admitted to our hospital from January 1, 1978 to December 31, 1985, the 298 patients who were diagnosed having CHF were investigated. Patients with CHF had a rather poor prognosis, with the 1-year, 3-year, and 5-year cumulative survival rates being 76%, 60%, and 49%, respectively.

[Thallium-201 scintigraphy after dipyridamole infusion in patients with ischemic heart disease--comparison with maximal exercise].

Myocardial images after dipyridamole infusion (DIP-Tl) were compared with maximal thallium-201 images (Ex-Tl) to determine the utility for detecting coronary artery disease and the ischemic level in ischemic regions. Ex-Tl was performed in 36 patients of angina pectoris (Group 1), and DIP-Tl was performed in 22 patients of angina pectoris (Group 2), who were divided into two groups (Group 2a: 15 patients with low level exercise, Group 2b: 7 patients without low level exercise). Each group had normal controls (41, 27 and 31 people).

Treatment of acute profound heart failure by ventricular assist device.

Sixteen patients with acute profound heart failure (HF) have been treated with the left ventricular assist device (LVAD), nine of them were successfully weaned from LVAD, and three of them were discharged and survived longer. Decompression of the left ventricle (LV) at the beginning will prevent overextension of impaired myocardium and accelerate scar formation. Gradual increase of LV work will promote the compensation ability of the residual myocardium.

L-dopa administration enhances exocytotic dopamine release in vivo in the rat striatum.

Peripheral administration of L-3,4-dihydroxyphenylalanine (L-DOPA) methylester increased extracellular levels of DOPA and dopamine (DA) in the rat striatum monitored by in vivo brain microdialysis. The increase in DA levels persisted after inhibition of DA reuptake by nomifensine. Administration of blockers of voltage-dependent Na+ (tetrodotoxin) or Ca2+ (NKY-722) channels through the dialysis membrane completely eliminated the increase in DA levels.

[A case report of multiple pulmonary tumors as a sole manifestation of synovial sarcoma].

A 47-year-old woman was admitted to our hospital for cough and dyspnea. Roentgenologic studies and bronchoscopy revealed multiple lung tumors one of which obstructed the right main bronchus. Right pneumonectomy was performed for the pending obstruction of the trachea.

[Clinical study of drug accumulation in gastric cancer after preoperative intra-arterial EAP II injection therapy].

Preoperative intra-arterial injection therapy using etoposide, epirubicin and carboplatin (EAP II) was done for patients with resectable advanced gastric cancer. Twenty-six patients (14 males and 12 females) were treated. The concentrations of adriamycin (ADM) and platinum (Pt) were measured in cancer tissue, normal mucosa and regional lymph-nodes which were obtained operatively and in sera just before operation.

A case report of hepatocellular carcinoma within adenomatous hyperplasia: is adenomatous hyperplasia a precancerous lesion or not?

It is controversial whether adenomatous hyperplasia (AH) of the liver progresses to hepatocellular carcinoma. We experienced two hepatic lesions in a patient (73-yr-old male) with cirrhotic liver. One was diagnosed as HCC and the other was AH including a small HCC histologically.

Enhanced expression of CD2 antigen on lung T cells.

CD2 molecules not only function in the adhesion of T cells to other cell types but also in the activation of T cells via an alternative pathway. To investigate the possible roles of CD2 molecules in the activation and accumulation of lung T cells, using monoclonal antibodies and a flow cytometer we evaluated CD2 antigen expression on lung and blood lymphocytes in 10 normal subjects, 30 patients with pulmonary sarcoidosis, 7 patients with interstitial pneumonia associated with collagen vascular disease, 5 patients with farmer's lung disease, and 8 patients with Crohn's disease. The mean fluorescence intensity (MFI) of CD2 on lung T cells obtained by bronchoalveolar lavage (BAL) was significantly higher than that on blood T cells in all study groups except the control group.

[Clinical effect of miconazole gel against upper digestive tract mycosis].

A total of 43 patients, comprising 41 patients with oral candidiasis and 2 with esophageal candidiasis, were treated with miconazole (MCZ) gel to assess its efficacy and safety in treating upper digestive tract mycosis. The efficacy of the drug was evaluable in 33 of them, consisting of 32 patients with oral candidiasis and 1 with esophageal candidiasis. The clinical efficacy rate of the drug against oral candidiasis was 87.

Recurrent epicardial fibrosarcoma which arose 12 years after the first resection.

Primary malignant tumours of the heart are very rare, with an incidence of only 0.0017%-0.03% in consecutive autopsy series.

YS-822A, a new polyene macrolide antibiotic. II. Planar structure of YS-822A.

The planar structure of a new polyene macrolide antibiotic, YS-822A, which was isolated from the culture filtrate of a mutant strain H-8 of Streptoverticillium eurocidicum var. asterocidicus S-822, was established as I on the basis of spectroscopic evidences and by comparison spectroscopic data with nystatin A1 (II) and amphotericin A (III), representative polyene macrolide antibiotics. Molecular formula of YS-822A was established as C37H59NO14 (MW 741) by elemental analysis, NMR, and FAB mass spectra.

[Genetic factors and smoking habits].

To investigate whether genetic factors are involved in the maintenance of smoking habits, we examined restriction fragment length polymorphisms of cytochrome P-450 gene (P450 IIB1), one of the metabolizing enzymes of nicotine. The presence or the absence of polymorphic bands detected after digestion with Bam HI or Msp I was not related to smoking habits, the subjective degree of fondness for smoking and the subjective strength of addiction to smoking. Thus, we found no evidence for the involvement of this gene or adjacent gene(s) in the determination of smoking habits.

Treatment of vestibular disorders.

At our department, we generally perform inner ear anesthesia with lidocaine and intratympanic dexamethasone injection for treatment of patients with Menière's disease or labyrinthine vertigo due to circulatory disturbances of the inner ear, having failed other conservative treatments. These treatments were performed in 322 patients who consulted us during the past 7 years, including 136 patients with Menière's disease and 186 patients with labyrinthine vertigo. The criteria for evaluation of the therapeutic effect included the AAOO (1972), the AAO-HNS (1985) and Sakata's (1987) method.

[A successfully operated case of tetralogy of Fallot with marked left ventricular dysfunction in adult].

Adults, especially high-aged patients with tetralogy of Fallot (TOF) are said to have a higher operative risk than younger ones because of fragility of their myocardium, bleeding from rich collateral circulation to lungs, and other complications such as brain abscess and endocarditis. It is often difficult to determine the surgical risk for total correction in cases of high-aged patients who have such complications. We report a successfully operated high-aged case of TOF with marked left ventricular dysfunction.

Expression of granulocyte-macrophage colony-stimulating factor mRNA by inflammatory cells in the sarcoid lung.

T lymphocytes and alveolar macrophages accumulating in the lower respiratory tract of patients with pulmonary sarcoidosis are known to be activated to produce several cytokines, presumably leading to granuloma formation within the lung. We hypothesized that these cells produce colony-stimulating factors (CSFs), which have been shown to affect the proliferation and function of monocyte-/macrophage-lineage cells. To test this hypothesis, we tried to detect mRNA encoding CSFs in cells obtained by bronchoalveolar lavage using a reverse transcription-polymerase chain reaction.

[Clinical study of drug accumulation in gastric cancer after preoperative intra-arterial EA'P injection therapy].

In order to deliver a high concentration of anti-cancer drugs in tumor tissue, preoperative intra-arterial injection therapy using Etoposide (VP-16), Pirarubicin (THP-ADM) and Cisplatin (CDDP), was used for 22 patients with resectable advanced gastric cancer. The concentration of VP-16, Adriamycin (ADM) and platinum (Pt) were measured in cancer tissue, normal mucosa and lymphnodes without metastasis at the greater curvature, which were gathered operatively and in serum just before operation. Student's t test was performed with their data.

YS-822A, a new polyene macrolide antibiotic. I. Production, isolation, characterization and biological properties.

A new polyene macrolide antibiotic, YS-822A was isolated from the culture filtrate of a mutant strain H-8 of Streptoverticillium eurocidicum var. asterocidicus S-822. Whereas the original S-822 strain produced not only YS-822 substances but also teleocidin as by-product which is well-known as a strong carcinogenic promoter, the mutagenized H-8 strain produced the antibiotic with only a trace amount of teleocidin.

Study of 16,16-dimethyl prostaglandin E2 for prevention of stress ulcer after hepatectomy of experimental cirrhotic liver and its influence on hepatic regeneration.

The influence of 16,16-dimethyl prostaglandin E2 (16,16-dm PGE2; an agent used for the prevention of stress ulcer after hepatectomy of the cirrhotic liver) on liver regeneration after hepatectomy was studied in rats. The following results were obtained. Ulceration after the stress of 6 h of water immersion was markedly suppressed in rats treated with 30 r/kg of 16,16-dmPGE2 as compared with the untreated controls.