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Biomedical subjects

E Tanaka

Publications and source records attributed to E Tanaka.

At least 667 records · Page 37Linked to original sources
PubMedDate not supplied

Type C chronic hepatitis associated with thrombocytopenia in two patients.

Portal hypertension in the presence of chronic hepatitis is generally thought to develop during the progression of the chronic hepatitis to cirrhosis. Before the establishment of assays for diagnosing hepatitis C virus infection, such a case of portal hypertension without liver cirrhosis could be misdiagnosed as idiopathic portal hypertension. It had not fully determined whether portal hypertension might precede the onset of cirrhosis in type C chronic hepatitis. This report presents two cases of women with chronic hepatitis C who developed severe thrombocytopenia; each showed splenomegaly and hypersplenism due to portal hypertension. Angiographic study and histological analysis were conducted to determine the cause of the portal hypertension. Histological evaluation showed an intrahepatic presinusoidal block pattern and fibrotic changes in the periportal area, but no evidence of liver cirrhosis or of other incidental complications such as idiopathic portal hypertension. Both of these patients exhibited normal platelet counts after splenectomy. Thus, type C chronic hepatitis can lead to portal hypertension, as demonstrated in these two patients.

Chronic Disease↗
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Epidemiology of genotypes of hepatitis C virus in Japanese patients with type C chronic liver diseases: a multi-institution analysis.

Sixteen medical institutions in Japan collaborated in this study of the epidemiology of hepatitis C virus (HCV) genotypes. A total of 4176 patients with type C chronic liver disease, from the four main islands of Japan, were evaluated. Of those evaluated, 2794 had chronic hepatitis, 727 had liver cirrhosis and 655 had hepatocellular carcinoma. The HCV genotype of the patients was determined by an enzyme-linked immunosorbent assay based on serological genotype 1- and 2-specific recombinant peptides (SG-1 and SG-2, respectively) of the NS4 region. The prevalence of SG-1 and SG-2 HCV was similar in the four main islands of Japan. SG-1 HCV predominated in each disease category (69-76%). The percentage of patients with SG-1 HCV increased by 7%, while that of patients with SG-2 HCV decreased by 7%, as liver disease progressed in severity from chronic hepatitis to carcinoma (P < 0.001). Patients with either SG-1 or SG-2 had a similar mean age and history of blood transfusion. In conclusion, SG-1 HCV was found to predominate in Japan, and the HCV genotype was found to be related to the stage of hepatitis C disease.

Adolescent↗
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Acute hepatitis C transmitted by needlestick accident despite short duration interferon treatment.

Hepatitis C virus (HCV) transmission by needlestick accidents involving hospital employees has become an important problem. The present report is of a case of acute hepatitis C that developed after a needlestick injury, despite short duration interferon treatment performed just after the accident in a trial effort to prevent HCV transmission. Nosocomial infection of HCV in medical employees is reviewed, and the current prospects for protecting them from HCV transmission after needlestick accident are discussed.

Accidents↗
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Changes in caffeine, lidocaine and trimethadione metabolism in carbon tetrachloride-intoxicated rats as assessed by a "cocktail" study.

We investigated the possibility of predicting liver damage from changes in the serum concentrations of caffeine (10 mg/kg), lidocaine (4 mg/kg) and trimethadione (4 mg/kg), which are metabolized catalysed by different cytochrome P450 (P450) and/or are dependent on blood flow, in rats with carbon tetrachloride (CCl4: 0.25 ml/kg)-induced liver injury using a strategy referred to as a "cocktail" study. These 3 probe drugs were simultaneously administered intravenously. The half-lives (t1/2) of caffeine, lidocaine and trimethadione were significantly longer in the CCl4-treated group than in oil-treated controls, but no significant differences were observed in mean apparent volumes of distribution (Vd). Serum total body clearance (CL) values of all three drugs were markedly reduced in CCl4-treated animals. In rats with liver damage, the production of 3 metabolites (theobromine, paraxanthine and theophylline) of caffeine in addition to the only metabolite (dimethadione) of trimethadione after intravenous administration of probe drugs were significantly reduced compared to those of controls. These findings suggest that each probe drug, metabolized by different or partially overlapping P450, is useful in evaluating drug-oxidizing capacity in liver disease.

Alanine Transaminase↗
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Age-related change in peripheral nerve conduction: compound muscle action potential duration and dispersion.

BACKGROUND: We investigated the effect of age on nerve conduction parameters with special reference to the compound muscle action potential (CMAP) duration and duration ratio. METHOD: We examined 295 subjects (aged 15-85 years old) with no previous history or present signs of peripheral neuropathy. The subjects were divided into 3 groups: young (15-34 years old); intermediate (35-64 years old), and old (65-85 years old). RESULTS: CMAP amplitude was lower in the old group than in the young group; however, the CMAP ratio (proximal CMAP/distal CMAP) did not change with age. The CMAP duration and duration ratio did not differ among the 3 groups. The CMAP area was smaller in the old group, but the area ratio was almost constant among the 3 groups. CONCLUSION: We suggest that age-related changes in CMAP amplitude, duration or area may occur uniformly, at least in the forearm and the calf segment, in routine nerve conduction studies. The present findings also provide useful and reliable information, regardless of age, in diagnosing peripheral neuropathy.

Action Potentials↗
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Effects of the beige mutation on respiratory tract infection with Pseudomonas aeruginosa in mice.

The role of neutrophil proteinases in the pathogenesis of respiratory tract infections with Pseudomonas aeruginosa was evaluated by studying the course of murine respiratory tract infection with a clinical isolate of P. aeruginosa mucoid strain developed by the agarose beads method in C57BL/6J(bg/bg) mice (beige mice). Neutrophils of beige mice are known to have defects in elastase and cathepsin G, but to have normal ability to produce reactive oxygen species. Contrary to the reported high susceptibility of beige mice to bacterial infections, we found that intratracheal inoculation of approximately 10(5) colony-forming units (CFU) of P. aeruginosa enmeshed in agarose beads resulted in lower mortality (0/16 versus 16/16, p < .01), fewer CFU counts in the lungs on day 5 (p < .05), and fewer elastolytic lung tissue injuries in beige mice compared with C57BL/6(+/+) mice. In vitro bactericidal study, however, revealed that beige neutrophils killed fewer bacteria than those of C57BL/6(+/+) mice (p < .05). Neutrophil elastase activities in the supernatants of pulmonary lavaged fluids measured using methoxysuccinyl-alanyl-alanyl-prolyl-valine-4-methylcoumar-7-amide were lower (p < .05) in beige mice than those in the normal littermates, whereas neutrophil recruitment into the airways and production of superoxide anion measured as the superoxide dismutase inhibitable rate of cytochrome c reduction were not impaired. These results suggest that neutrophil proteinases play a key role in tissue injuries in the respiratory tract infection with P. aeruginosa.

Animals↗
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[Age-related changes in amplitude ratio, duration ratio and area ratio in nerve conduction studies].

We investigated the effect of aging on nerve conduction parameters in 184 subjects (aged 10-75 years) without any history or signs of peripheral neuropathy, in order to clarify the diagnostic parameters of demyelinating neuropathies in the aged. The CMAP amplitude ratio (proximal CMAP/distal CMAP), duration ratio and area ratio remained unchanged throughout the second to eighth decades. The lower limits of normal CMAP amplitude ratio (mean -3SD) were 0.79 (median nerve), 0.74 (ulnar nerve), 0.59 (peroneal nerve), and 0.48 (tibial nerve). The upper limits of normal CMAP duration ratio (mean 11+ 3SD) were 1.22 (median nerve), 1.19 (ulnar nerve), 1.35 (peroneal nerve), and 1.32 (tibial nerve). The lower limits of normal CMAP area ratio (mean -3SD) were 0.84 (median nerve), 0.78 (ulnar nerve), 0.61 (peroneal nerve), and 0.62 (tibial nerve). There were no age-related changes in amplitude ratio or duration ratio of SNAP, although the standard deviations increased with age. Since the amplitude ratio, duration ratio and area ratio are simple and age-independent, they can provide useful and reliable information for routine nerve conduction studies for aged patients with demyelinating neuropathies.

Action Potentials↗
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Ultrasonographic monitoring of high dose rate interstitial implant using template technique for oral tongue cancer.

192Ir high dose rate (HDR) fractionated interstitial brachytherapy was performed on two patients with tongue cancer with the aid of real-time intraoral ultrasonographic (US) guidance and the template technique. Blind-ended catheters with metallic rods (Obturator, Nucletron, the Netherlands) were inserted into the tongue from the submandibular region. This US monitoring allows for detection of the accurate location of both tumor and catheters in real-time motion. After implantation, we reconfirmed the position of the catheters by CT examination. Intraoral US monitoring was thus found to be a useful procedure for accurate implantation of brachytherapy for tongue cancer.

Brachytherapy↗
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Hepatectomy for metastases from breast cancer offers the survival benefit similar to that in hepatic metastases from colorectal cancer.

BACKGROUND/AIMS: There have been no reports comparing surgical results of hepatectomy for metastases between breast cancer origin and colorectal cancer origin. The aim of the present study was to compare the both and to clarify the survival benefit brought by hepatectomy for metastases from breast cancer. METHODOLOGY: Between 1990 and 1999, 6 patients with hepatic metastases from breast cancer and 94 patients with those from colorectal cancer underwent hepatectomy with curative intent. All patients in the breast-cancer-origin group received adjuvant chemotherapy following hepatectomy, however, fewer patients (55% of the 94 patients) did in the colorectal-cancer-origin group (P = 0.034). RESULTS: Morbidity and mortality rates after hepatectomy in patients with hepatic metastases from breast cancer were 0% and 0%, respectively, and those in patients with metastases from colorectal cancer were 12% and 1%, respectively. Postoperative survival curves in the both groups were similar. Three- and five-year survival rates in the breast-cancer-origin group were 60% and 40%, respectively, and those in the colorectal-cancer-origin group were 54% and 42%, respectively. CONCLUSIONS: When appropriate adjuvant chemotherapy is performed, hepatectomy for metastases from breast cancer offers the survival benefit similar to that in hepatic metastases from colorectal cancer.

Adult↗
PubMedDate not supplied

Radiation and low dose adriamycin for the treatment of carcinoma of the hypopharynx.

PURPOSE: To evaluate the utility of adriamycin in radiation therapy for hypopharyngeal cancer. PATIENTS AND METHODS: Forty-five patients with hypopharyngeal carcinoma without distant metastasis were treated. Adriamycin was administered i.v. and weekly (15 mg i.v./once a week, median 64 mg) concurrently with radiation therapy to 38 patients, 76% (34 out of 45) of whom were in an advanced stage (III or IV). RESULTS: Overall survival, cause specific survival and local control rates at 5 years were respectively, 49%, 66% and 69% and better than results obtained in the 1970's. Radiation therapy achieved an 84% (38 out of 45) response rate at 40 Gy. Treatment without voice function loss was attained for 16 patients, consisting of 15 local CR (all T1 and 12 out of 26 T2 tumors) by radical radiation therapy and one posterior wall resection for a T2 tumor. Overall and cause specific survival rates were 57% and 91% at 5 years. Twenty patients who underwent further surgery showed 69% overall and 74% cause specific survival rates. The remaining nine patients, who lost local control, died within 16 months. In 18 patients with T2 cancer originating from the pyriform sinus, 69% local control was obtained for patients using adriamycin compared with 20% for patients without adriamycin (p = 0.17). No severe side effect from the addition of adriamycin has been found so far. CONCLUSIONS: Radiation therapy using low dose adriamycin with or without follow-up surgery is safe and has potential to be a good option.

Adult↗
PubMedDate not supplied

Changes in performance status of elderly patients after radiotherapy.

BACKGROUND: To examine the feasibility of external radiation therapy for patients 80 years old and older. METHODS: We analyzed changes in the performance status (PS) of 1353 patients by external radiotherapy at Osaka Teishin Hospital. In addition, factors influencing PS change and interruption of treatment were assessed in patients undergoing radical and palliative radiotherapy. RESULTS: Among elderly patients aged 80 years or more (n=67), two patients showed deterioration in PS (3%), whereas 128 (10%) did so among those 79 years old or younger. The rate of treatment completion was 90% (60/67) for patients aged 80 years and over compared with 89% (1146/1286) for younger patients. Changes in PS were more frequent for palliative treatment (improvement 83/683, 12%; deterioration 77/683, 11%) than for radical treatment (improvement 12/305, 4%; deterioration 21/305, 7%) because patients with better performance status and early disease stages underwent radical treatment. For radical radiotherapy, patients with advanced disease (stages III and IV) showed more changes (improvement 4/108, 4%; deterioration 17/108, 16%) than those with early ones (stages I and II)(improvement 7/132, 5%; deterioration 3/132, 2%) (p<0.01). Better treatment results showed a higher treatment completion rate (CR 99%, PR 86%) than poor treatment results (NC 75%, PD 50%)(p<0.01). For palliative therapy, better performance status (PS 0-2) showed a better correlation with completion of treatment (403/451 or 89%) than did poor performance status (PS 3-4)(174/ 232, 75%)(p<0.01). CONCLUSIONS: Age is not a limiting factor for external radiation therapy. Poor performance status is a significant predisposing factor for interruption of palliative radiotherapy.

Adolescent↗
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Effect of radiotherapy on serum level of interleukin 6 in patients with cervical carcinoma.

To determine the inflammatory state of cervical cancer after radiotherapy, we examined serum interleukin 6 levels (sIL-6) and C-reactive protein (CRP) before and after radiation therapy in sixteen patients with cervical cancer. External radiation therapy did not cause changes in sIL-6 and CRP during the examined periods. On the other hand, brachytherapy caused transient elevation of sIL-6 on the day after treatment by 6.39 +/- 1.89 pg/ml to 13.41 +/- 2.34 pg/ml (p < 0.05) while CRP did not show any significant change. Therefore, brachytherapy would induce a small inflammatory reaction. However, we confirmed that radiotherapy is a less invasive treatment than surgery from the point of view of cytokine related inflammation.

Adult↗
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Renal cortical retention of contrast medium after angiography as assessed by delayed CT: a multivariate analysis.

Renal cortical retention (RCR) of contrast medium discovered by delayed X-ray examination is sometimes reported in patients with problems in the urinary system. However, we frequently found RCR even in patients with normal renal function. Therefore, we examined the incidence and factors involved in RCR by delayed computed tomography (CT) 12-24 hours after angiography in 168 patients. RCR was found in 80 of 168 cases (48%). Ioxaglate (60%) and iohexol (60%) showed higher incidences of RCR than diatrizoate (37%) and iopamidol (37%). Multivariate logistic regression analysis was performed to determine the predisposing factors of RCR. Dose of administered contrast medium by body weight (p = 0.004), age (p = 0.009), sex (p = 0.013), type of contrast medium (p = 0.003), serum albumin (p = 0.011), and serum creatinine (p = 0.002) were identified as significant and independent predisposing factors of RCR. We suggest that RCR is not a rare phenomenon if delayed CT is carried out.

Adolescent↗
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Lack of effect of hepatocyte growth factor on bone marrow suppression induced by total body irradiation in the rat.

We examined the role of hepatocyte growth factor (HGF) on the bone marrow suppression by irradiation, by analyzing peripheral blood counts 2 weeks after 7 Gy of total body irradiation in rats. The rats underwent two weeks of continuous intraperitoneal human recombinant HGF injection (50 mg/day) from one day before irradiation using an Alzet osmotic pump. Red blood cell, white blood cell, and platelet counts did not increase with response to administration of HGF. Thus HGF does not show protection against myelosuppression caused by total body irradiation.

Animals↗
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Heparin induces rapid and remarkable elevation of hepatocyte growth factor/scatter factor during trans arterial embolization of renal cell carcinoma.

BACKGROUND: Our aim was to determined the change of serum hepatocyte growth factorl scatter factor (HGF) before and after transarterial embolization (TAE) for renal cell carcinoma (RCC). MATERIALS AND METHODS: We examined serum HGF levels in two patients. RESULTS: Serum HGF levels rapidly increased to six-fold higher levels immediately after heparin-injection even before embolization. Serum HGF then decreased to below 1.0 ng/ml at 6 hours after the procedure. The second peak (a two-fold increase) appeared 1-3 days after TACE. The first increase may have been due to the injection of heparin which releases HGF from the cell-surface and extracellular matrix. HGF is a pleiotropic cytokine which has a potential to enhance cell motility and angiogenesis related to tumor progression and the first larger elevation of serum HGF is enough to make a physiological effects. CONCLUSION: Therefore, we should remind the physiological influence of heparin injection not only to prevent of clotting.

Aged↗
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Comparison of the long-term results of brachytherapy for T1-2N0 oral tongue cancer treated with Ir-192 and Ra-226.

BACKGROUND: The authors report the compatibility of iridium-192 (Ir-192) to Radium-226 (Ra-226) based on the clinical results of three-decades. METHODS: From 1967 through 1985, 119 patients with early oral tongue cancer (T1-2N0) were treated with conventional Ra-226 needles and 135 patients with Ir-192 hair pins. RESULTS: Local control rates at 10 years for T1 and T2 tongue cancer were 79% and 61% for patients treated with Ra-226, 83% and 68% with Ir-192. The 10-year cause-specific survival rates for the T1 and T2 patients with Ra-226 were 76% and 63%, and those with Ir-192 were 77% and 68%, respectively. CONCLUSIONS: Ir-192 showed good possibilities as a substitute for Ra-226 in brachytherapy for early oral tongue cancer.

Adult↗
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Age as a prognostic factor for late local recurrence of early tongue cancer treated with brachytherapy.

BACKGROUND: We aimed to examine predisposing factors on late local recurrence of early oral tongue cancer (T1-2N0). METHODS: We analysed 152 patients with no evidence of disease 2 years after interstitial radiation therapy without external radiation. RESULTS: Multivariate analysis showed age to be the only significant prognostic factor for late local control (p = 0.03). We then examined the influence of age by comparing the results between 36 older patients (age more than, or equal to, 65) and 116 other control patients (age less than 65). Aged patients showed poor local control rates of 62% at 10 years after treatment, whereas the corresponding figures for control patients were 90% (p = 0.003). The cause specific survival rate at 10 years was also lower in elderly patients (75%) than in control patients (93%, p = 0.02). CONCLUSIONS: Age is a predisposing factor for late local recurrence in patients free from disease 2 years after treatment.

Adult↗