Biomedical subjects

A Itoh

Publications and source records attributed to A Itoh.

At least 181 records · Page 10Linked to original sources

PubMed1993

Release of tumor necrosis factor-alpha from human alveolar macrophages is decreased in smokers.

It is known that smoking affects the development and maintenance of certain types of granulomatous lung diseases. To explore this mechanism(s), we measured tumor necrosis factor (TNF)-alpha concentrations in the culture supernatants of lipopolysaccharide (LPS)-stimulated alveolar macrophages (AMs) in 13 healthy nonsmokers, 13 healthy smokers, 13 nonsmoking sarcoid patients, and 16 smoking sarcoid patients. We found that the capacity of smokers' AMs to release TNF-alpha was significantly decreased both in the normal and sarcoid groups. We also confirmed the previous observation that there was an exaggerated TNF release in patients with pulmonary sarcoidosis. These results indicate a significant role of TNF-alpha in the pathogenetic mechanisms of pulmonary sarcoidosis and suggest the possible involvement of TNF in the mechanisms by which smoking modulates local immune phenomena.

Adult↗

PubMed1993

[Recurrence and survival rate of advanced gastric cancer after preoperative intraarterial EAP I injection therapy].

In our department, curative operations were performed for 32 patients with advanced gastric cancer from April 1989 to August 1990. Preoperative intra-arterial injection therapy with etoposide (100 mg), pirarubicin (20 mg) and cisplatin (20 mg) was given 18 patients. Recurrence and survival rate were investigated. The survival rate of patients with preoperative intra-arterial injection therapy 45 months after operation was 59.2%, while that of patients without preoperative intra-arterial injection therapy was 75.8%. There were no significant differences between these two groups. Three lymph node recurrences were seen in patients with preoperative intra-arterial injection therapy (recurrence rate, 16.7%). Four recurrences were observed in patients without preoperative injection therapy (peritoneal dissemination 2, liver 1, local 1; recurrence rate, 28.6%). We earlier reported that preoperative intra-arterial cisplatin (40 or 60 mg) injection therapy may reduce the incidence of lymph node recurrence and liver metastasis but may not be effective to prevent postoperative peritoneal recurrence, while no peritoneal dissemination was observed in patients with preoperative intra-arterial EAP I injection therapy. Thus, it was concluded that further study of combination and dose of anti-cancer drug may improve effectiveness of preoperative intra-arterial injection therapy for gastric cancer.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1993

Mucin-producing tumor of the pancreas: natural history and serial pancreatogram changes.

The clinical features and changes of the pancreatic duct system in nine patients with mucin-producing tumor of the pancreas were serially studied to clarify the natural history and evolution of pancreatograms. The observation periods ranged from 6 to 50 months (mean, 30 months), and all patients were examined by endoscopic retrograde pancreatography two or more times. Four of the nine cases exhibited obvious progression of pancreatic duct dilation in association with increased amounts of mucin in the dilated duct, whereas five did not show apparent progression of ductal changes. Changes in the pancreatograms of mucin-producing tumor occurred when mucin secretion by the tumor became prominent, and such cases frequently presented with abdominal pain and pancreatitis. In contrast, most of the branch duct type remained unchanged; all three cases of main duct type showed progression of pancreatograms. There was no apparent relationship between degree and progression of ductal changes and the tumor malignancy.

Aged↗

PubMed1993

[Intravascular ultrasound (IVUS) in the diagnosis of atherosclerosis].

Intravascular ultrasound (IVUS) is a newly developed diagnostic modality for atherosclerosis. Early in vitro studies showed that IVUS could identify normal vessel structures and atherosclerotic lesions, such as intimal thickening, lipid-rich plaque, fibrous plaque, and calcification. In clinical settings, IVUS offers precise quantitative measurement of vascular stenosis as well as providing new information regarding the transmural distribution and the qualitative assessment of vascular atherosclerotic lesions. IVUS is also useful for assessing the results and the mechanisms of catheter-based interventional therapeutic devices, such as balloon angioplasty, laser angioplasty, stent, and atherectomy. The development of three-dimensional reconstruction of ultrasound images would enhance the diagnostic quality and afford a reliable guidance for interventional therapeutic procedures.

Arteriosclerosis↗

PubMed1992

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. A possible role of the increased tyrosine phosphorylation of 41-kDa and 43-kDa protein in the signaling pathway of HGF is discussed.

Amino Acids↗

PubMed1992

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). Group 3 (27 patients) had total inflow exclusion during hepatic resection. There were no significant differences between the groups in blood loss or blood transfusion requirement. On the third day after operation, the serum glutamic-pyruvic transaminase level in group 3 was significantly higher than that in group 1 (P less than 0.01). Vascular inflow exclusion may not be essential for successful hepatic resection.

Adult↗

PubMed1992

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. These results demonstrate that the L-DOPA-induced DA release is exocytotic in nature and hence, derived from neurons in the striatum.

Animals↗

PubMed1992

Lack of linkage between atopy and locus 11q13.

Atopy as defined in terms of IgE responsiveness was reported to be controlled by a single gene in British families, and this concept was further supported by a significant linkage between atopy and restriction fragment length polymorphism (RFLP) detected by a DNA probe specific to chromosome 11q13. To confirm this observation in a Japanese population, segregation and linkage analyses were done in four large families. Although segregation patterns of atopy were in agreement with the pattern of autosomal dominant inheritance, there was no significant linkage between atopy and locus 11q13. Alterations in the definitions of atopy did not affect the results. These findings suggested the presence of heterogeneity in genetic elements of atopy, even though atopy may be determined mainly by a single dominant gene.

Adolescent↗

PubMed1992

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. We found that continuous LVAD assistance can give time for the impaired heart to recover while maintaining normal circulation. For patients with profound HF which is beyond the limit of intra-aortic balloon pumping's (IABP) capability, LVAD is a more powerful and effective means. Although the heart recovered, many patients later died of multiple organ failure (MOF) which was probably caused by prolonged ischemia before LVAD application. For completely successful recovery from profound HF, diagnosis and deciding to use LVAD should not be delayed. It should be applied before major organs including the heart itself suffer irreversible damage. We have established a systematic therapeutic concept of treating acute HF patients using assisted circulation including LVAD.

Acute Disease↗

PubMed1992

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. The factors influencing the prognosis of patients with CHF were the type of underlying heart disease, the left ventricular ejection fraction, the left ventricular end-diastolic dimension, and the central venous pressure. Survival rates differed significantly depending on the type of underlying heart disease. The cumulative 5-year survival rate was 35% for coronary artery disease, 40% for dilated cardiomyopathy, 53% for rheumatic valvular heart disease, and 80% for hypertensive heart disease.

Adult↗

PubMed1992

[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. The tumor in the right S1 was found to be protruding into the trachea through the right B1 and the main bronchus in a polypoid fashion. The pathological diagnosis of synovial sarcoma was made on the basis of the characteristic biphasic structure composed of spindle cells and epithelioid cells forming gland-like spaces. Three years and eight months after the pneumonectomy, a nodule in the tendon of the extensor hallucis longus muscle became palpable. It was also a synovial sarcoma pathologically. Synovial sarcoma is a soft tissue sarcoma which usually arises in the extremities. It is very rare for pulmonary metastasis of this tumor to be found while the primary tumor is undetectable.

Female↗

PubMed1992

[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. Pulse therapy with large dose of vitamin D3 for those who suffered from overt SHPT was an effective treatment modality at the initial stage, however, hypercalcemia which developed in the majority of the patients at the later stage of this treatment became an obstacle for the continuation of this treatment. Therefore, early detection of the hypersecretion state of parathyroid hormone (PTH) as well as earlier initiation of intensive therapy are important factors in preventing overt SHPT. Establishment of a suitable assay system for early detection of SHPT is an important task and the high sensitivity-PTH assay system may be the most desirable. Though diabetic patients were not likely to develop overt SHPT, this system could detect even the mild chronological increase of serum PTH level in diabetic patients. On the other hand, relatively earlier initiation of vitamin D3 therapy to the predialysis patients from the conservative treatment stage caused aggravation of deterioration of renal function. Therefore, we should be prudent to initiate vitamin D3 therapy on predialysis patients suffering from renal failure. Strict management of the patients by vitamin D3 as well as calcium supplement therapy along with evaluation of the serum PTH level is still an important measure to avoid overt SHPT.

Cholecalciferol↗

PubMed1992

Surgical excision of hemophilic pseudotumor of the ilium.

The iliac hemophilic pseudotumor is a rare complication of hemophilia occurring in 1-2% of patients with Factor VIII or Factor IX deficiency. It is frequently disabling and life threatening. This report presents a comparative study of postoperative results of two cases of hemophilic pseudotumor of ilium. One patient undergoing partial resection showed a favorable postoperative course, whereas the patient with complete resection of the pseudotumor died of postoperative bleeding and sepsis. Studies on the postoperative results of these two cases indicate that careful preoperative consideration of tumor size and degree of infiltration is of the utmost importance in operative management. Early excision of tumors eliminates the possibility of endogenous infection. Even partial resection of huge tumors, leaving the lateral wall intact for compression, can promote recovery of functions.

Angiography↗

PubMed1992

[Surgical treatment of double aortic arch: report of a case associated with frequent respiratory infections].

A seven-month-old baby with double aortic arch was reported. He was admitted to our hospital with complaint of frequent respiratory infections shortly after birth. On examination, bronchofiberscopy revealed compression of the trachea and left main bronchus from behind and angiography showed complete vascular ring, namely double aortic arch with no other cardiac anomaly. Soon after the operation, stridor disappeared at rest, but mild stridor persisted on exertion. Three months later, he was re-admitted to our hospital because of pneumonia. Therefore, close observation is required for the patients with double aortic arch, even if the operation is effective.

Aorta, Thoracic↗

PubMed1992

[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. EPOCH was administered intravenously once a week with the dosage of 3,000-9,000 IU for 8 weeks. All patients showed prominent improvement of anemia. Though no patient show serious adverse effect, two patients showed controllable hypertension accompanying with the increase of hematocrit. Meanwhile, the speed of the deterioration of residual renal function obtained from the regression line by reciprocal of the serum creatinine was not aggravated by the correction of anemia. Pharmacokinetic study revealed that the halflife of EPOCH was extended compared to normal but the degree of extension was same as that of in dialyzed patients. The plasma concentration-time curves showed the pattern of monoexponential disappearance and the area under the curve (AUC 0 to 48 hr.) showed dose-response increase. However, both parameters mentioned above as well as systemic clearance rate did not show any change between those of on day 0 and on day 56. These results no long-term accumulation of EPOCH, though the level of intrinsic erythropoietin was decreased after EPOCH treatment. Thus, the beneficial effect of EPOCH on the correction of anemia was revealed even in the predialysis patients without affecting on residual renal function.

Adult↗

PubMed1992

[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. Macrophage-CSF mRNA was detected in all subjects examined and interleukin 3 mRNA in none. Granulocyte-macrophage CSF (GM-CSF) mRNA was detected in 15 of 20 patients with pulmonary sarcoidosis, whereas it was detected in none of the farmer's lung disease patients and normal controls. The sarcoid patients whose BAL cells expressed GM-CSF mRNA had more active disease than those patients whose BAL cells did not, as judged from clinical and laboratory findings. These results indicate that GM-CSF produced by the inflammatory cells plays a substantial role in the formation or maintenance of the sarcoid lesion.

Adult↗

PubMed1992

[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). The detectability of coronary artery by DIP-Tl was almost same with Ex-Tl (sensitivity 85% vs. 86%, specificity 80% vs. 95%). In the case of normal controls, the mean washout rate of group 2b was 44.4%, which was less than other two groups (50.6% for group 1, 48.8% for group 2a). And the mean myocardial/background (M/B) ratio of group 2b was 4.3 less than other two groups (4.7 for group 1, 4.9 for group 2a). In the case of the patients of angina pectoris, washout rate, M/B ratio, initial % uptake and delayed % uptake in the ischemic region were almost same among the 3 groups. This study demonstrates that DIP-Tl is as effective as Ex-Tl, and the ischemic level in the ischemic region is almost same among the 3 groups. But the thallium accumulation in the background of the group 2b is slightly higher than other two groups in the normal controls, so it is suggested that the image after only dipyridamole infusion becomes slightly unclear.

Coronary Disease↗

PubMed1991

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. To investigate cell kinetics and the ploidy pattern of these lesions, Feulgen DNA-cytofluorometry analysis was performed. The result of this analysis suggested that AH developed into extremely well-differentiated HCC composed of mononuclear diploid cells at first and then was further transformed into clear cell type HCC composed of mononuclear tetraploid cells. The development of human HCC, at least in cirrhotic liver, may therefore be a multi-step process.

Aged↗