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Biomedical subjects

H Hara

Publications and source records attributed to H Hara.

At least 91 records · Page 5Linked to original sources
PubMed2001

Ultrasonographic features of parathyroid carcinoma.

Although several authors have reported single cases illustrative of some ultrasonographic characteristic of parathyroid carcinoma, the value of ultrasonography for diagnosing this entity remains to be determined. The purpose of our study was to investigate the ultrasonographic features of parathyroid carcinoma in a large number of cases. We assessed the shape, contour, echogenicity, and depth-width (DW) ratio of 16 parathyroid carcinomas and 61 parathyroid adenomas. Ultrasonography showed that parathyroid carcinomas tend to be large, inhomogeneous, hypoechoic masses with lobulated contours. In contrast, parathyroid adenomas were small, homogeneous, hypoechoic masses with smooth borders. The mean (range) DW ratios for parathyroid carcinomas were 1.21 (0.91-2.5) and 0.64 (0.33-1.47) for adenomas; the difference was statistically significant (p<0.0001). The DW ratio was > or =1 in 15 (94%) of the 16 cases of carcinoma, whereas only 3 (5%) of the 61 adenomas had a similar ratio. Ultrasonographic examination is useful not only for preoperative localization but also for differentiating parathyroid carcinoma from adenoma. Parathyroid tumors with irregular margins, inhomogeneous echogenicity, and a DW ratio > or =1 are likely to be malignant.

Adenoma↗
PubMed2001

Production of 8-OHdG and cytochrome c by cultured human mononuclear cells in patients with autoimmune thyroid disease.

Since oxidative stress is related to autoimmune thyroid disease, we studied the production of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and cytochrome c by culture of mononuclear cells from patients with Graves' disease and Hashimoto's thyroiditis. In patients with untreated Graves' disease, 8-OHdG and cytochrome c levels in culture supernatant of mononuclear cells were significantly higher than those of healthy control subjects, while the cytochrome c levels were significantly higher in patients with untreated Graves' disease and Hashimoto's thyroiditis than those of control subjects. Significant correlations between 8-OHdG and FT4, and cytochrome c were found. These results indicated that thyroid function has a potent influence on oxidative stress.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2001

Clinical usefulness of the atrial double potential at the intercaval region in the right atrium: a new index for inducibility of atrial fibrillation in electrophysiologic studies.

The second deflection of the atrial double potential (DP) recorded at the intercaval region is considered to reflect the far-field potential of the left atrium. The conduction via the upper interatrial connection was evaluated utilizing this DP and the relationship between atrial fibrillation (AF) and the conduction via the interatrial connection evaluated. In 30 consecutive patients with the DP at the intercaval region, prolongation in the left atrial activation time during the right atrial extra stimulation was measured at the intercaval region (deltaDP) and the coronary sinus (deltaCS). The difference between deltaDP and deltaCS (deltaDP-deltaCS) was used as an index of inhomogeneity in interatrial conduction. The patients were divided into AF (n=13) and non-AF (n=17) groups in accordance with the inducibility of AF in the electrophysiologic study. The max deltaDP and the max ACS were greater in the AF group than in the non-AF group, i.e., max deltaDP (43+/-19 vs 27+/-17 ms, P=0.021), max deltaCS (35+/-15 vs 21+/-14 ms, P=0.029). The max absolute value(deltaDP-deltaCS) was also greater in t

Action Potentials↗
PubMed2001

Change in levator veli palatini muscle activity of normal speakers in association with elevation of the velum using an experimental palatal lift prosthesis.

OBJECTIVE: The purpose of this study was to examine whether mechanical elevation of the velum can directly affect the levator veli palatini muscle (LVP) activity using normal speakers as subjects. DESIGN: Each subject was instructed to produce /mu/, /u/, /pu/, /su/, and /tsu/ in a speech task and to blow with maximum possible effort. Smoothed electromyographic activity of the LVP was recorded with an experimental palatal lift prosthesis (PLP) both in place and removed. PARTICIPANTS: Four normal speakers were used as subjects. RESULTS: LVP activity for all tasks was significantly smaller (p <.001; Student's t test) with the PLP in place than without the PLP for all subjects. An analysis of variance (p <.001) clarified that activity ranges of the LVP were significantly different between the removal and placement conditions for all the subjects. CONCLUSION: The result was similar to that previously obtained for patients with velopharyngeal incompetence wearing a PLP. It is possible that the decrease in the LVP activity in association with placement of a PLP is caused by the direct effect of mechanical elevation, which decreases the distance the velopharyngeal mechanisms must travel for complete closure of the velopharynx.

Adult↗
PubMed2001

[A case of stage IV gastric cancer with multiple liver metastases and carcinomatous ascites responding to TS-1 for six months before progression].

We report the case of a 72-year-old male with Stage IV gastric cancer accompanied by multiple liver metastases and carcinomatous ascites which responded to chemotherapy using TS-1. Treatment of the patient with daily oral administration of 120 mg TS-1 for 4 weeks resulted in complete regression of the liver metastases and ascites, as well as a 35% reduction in the size of the primary lesion. After 2 cycles, the primary tumor size was reduced to 55% and serum CA19-9 and CA125 levels were decreased to the normal ranges. This regimen was effective without any adverse effects, and improved the patient's QOL, for 6 months before progression of liver lesions. The patient received chemotherapy at our outpatient clinic for 10 months after the first treatment, after which he died of peritonitis carcinomatosa. The current case suggests that TS-1 may have a potent therapeutic efficacy in advanced gastric cancer patients.

Aged↗
PubMed2001

UVB-irradiated dendritic cells are impaired in their APC function and tolerize primed Th1 cells but not naive CD4+ T cells.

We have shown that low-dose UVB radiation converts Langerhans cells (LC) from immunogenic to tolerogenic APC. Therefore, we questioned whether low-dose UVB irradiation of bone marrow-derived dendritic cells (DC) alters their APC function, thereby inducing tolerance in T cells. To address this issue, cocultures of DC; and naive, allogeneic T cells; naïve, OVA-specific TCR-transgenic T cells from DO11.10 mice; or primed, antigen-specific T cells using the Th1 clone AE7 were analyzed. First, we found low-dose UVB-irradiated DC (UVB-DC) to dose-dependently (50-200 J/m2) inhibit T-cell proliferation of naive and primed T cells. In addition, supernatants harvested from cocultures of UVB-DC and naive T cells showed markedly reduced levels of IL-2 and IFN-gamma and to a lesser degree of IL-4 and IL-10, suggesting a preferential down-regulation of Th1 responses by UVB-DC. FACS analysis of UVB-DC revealed no changes in surface expression of MHC, costimulatory, and adhesion molecules. To test tolerance induction, allo- or antigen-specific T cells isolated from cocultures with unirradiated DC and UVB-DC were restimulated with unirradiated DC or IL-2. It is interesting that UVB-DC induced antigen-specific tolerance in the Th1 clone AE7. In contrast, UVB-DC induced a partial inhibition of allogeneic T-cell proliferation but no tolerance with similar unresponsiveness to restimulation with IL-2 and unirradiated DC irrespective of their haplotype. Similar observations were made when naive, TCR-transgenic T cells from DO11.10 mice were used. In conclusion, UVB-DC are impaired in their APC function and tolerize the primed antigen-specific Th1 clone AE7 but not naive allo- or OVA-specific T cells.

Animals↗
PubMed2001

[A case of metachronous multiple primary lung cancers coexistent with atypical adenomatous hyperplasia].

A seventy-year-old woman was admitted for an abnormal chest shadow on a routine radiograph. She had undergone left upper lobectomy with mediastinal lymph node resection (R2a) for lung cancer (stage I), eight years before. We diagnosed this cancer as well differentiated papillary adenocarcinoma, and it coexisted with a focus of atypical adenomatous hyperplasia (AAH) in the resected material. We had been following up this patient with chest radiography, CT scanning, and tumor marker tests, but eight years after her first operation, we found a small nodular lesion in the left upper field (S6). This nodule was not diagnosed with fiberoptic bronchoscopy. Because we could not exclude primary lung cancer or intrapulmonary metastasis (eight years ago), we performed partial lung resection on the left S6 nodule. Histopathologically, the diagnosis was well differentiated papillary adenocarcinoma of the lung, coexisting with a small hyperplastic focus in the resected material. It was very difficult to diagnose whether these two cancers were metachronous multiple primary lung cancers, or one primary and its intrapulmonary metastasis. In a retrospective study, an immunohistochemical examination employing Ki-67, PCNA, p 27 and p 53 was performed in order to differentiate between metachronous multiple primary lung cancer and intrapulmonary metastasis. But we found AAH in the same resected lung eight years ago, and suggested the possibility that another small, atypical focus had developed into a malignancy. We report a case of metachronous multiple primary lung cancers and review the relevant literature.

Adenocarcinoma↗
PubMed2001

[Results of questionnaire on open disclosure to patients with malignant lung tumors comparison of responses before and after chemotherapy].

To investigate patient attitudes towards open disclosure of malignant disease, we conducted a questionnaire survey of 17 patients with malignant lung tumors, to whom the nature of their disease was revealed. The questionnaire used a 100 mm analog scale. Ten of the patients were treated by chemotherapy and their questionnaire results before and after treatment were compared. It was found that they were mostly satisfied about being truthfully informed and that, indeed, they were anxious to know their true diagnoses. They were also keen to have their true prognosis revealed, but not as much as the diagnosis. They also wished to be informed about treatment and its effects. These attitudes showed no marked changes resulting from the administration of chemotherapy, and we therefore concluded that chemotherapy itself had no influence on patients' feelings about disclosure. The questionnaire was well accepted and was useful in judging attitudes to open disclosure.

Female↗
PubMed2001

High-dose vitamin C therapy for inclusion body myositis.

OBJECTIVES: The efficiency of high-dose vitamin C therapy for inclusion body myositis (IBM) was assessed. SUBJECTS & METHODS: The subjects were five patients with IBM confirmed pathologically. After the intravenous administration of 40 mg/kg vitamin C five times/week for four weeks, muscle weakness was found to improve in three cases. The average muscle score improved from 8.1 to 8.8, from 7.0 to 8.1 and from 6.2 to 6.8. Magnetic resonance imaging (MRI) demonstrated a reduction in the size of T2 high lesions and gadolinium enhancement in the thigh muscles in one case. Based on our findings, high-dose vitamin C therapy is considered to be effective in some cases of IBM.

Aged↗
PubMed2001

[Ganglioneuroma detected in a patient over age 60].

We report a case of ganglioneuroma in a 67-year-old woman who presented with an abnormal shadow at a medical examination. She was admitted and chest radiography disclosed a mass in the upper right mediastinum. We suspected a mediastinal tumor after chest CT, chest MRI and bronchofiberscopic examination, and so surgical treatment was performed. The histopathological diagnosis was ganglioneuroma. Ganglioneuroma is thought of as a children's disease and adult onset is rare. We reasoned that ganglioneuroma should be included among the mediastinal tumors in patients over 60.

Aged↗
PubMed2001

[An ultrasound biomicroscopic study of eyes after non-penetrating trabeculectomy].

PURPOSES: We studied the control of intraocular pressure(IOP) by various types of blebs after non-penetrating trabeculectomy(NPT) and the difference between bleb formation after penetrating trabeculectomy(PT) and that after NPT. METHODS: The filtering blebs of 45 yeys from 40 patients after NPT were studied using ultrasound biomicroscopy. They were grouped into four types, and the space under the scleral flap was classified into three types. The filtering blebs and the space under the scleral flap were correlated with IOP level. RESULTS: Overall, 40% of the blebs were L(low-reflective) type, 16% H(high-reflective) type, 16% E (encapsulated) type, and 29% F(flattened) type, but in good IOP control cases 59% of the blebs were L type, 14% H type, 14% E type, and 14% F type. L type blebs were found in 94% of eyes with good IOP control. CONCLUSION: Though filtering blebs of the L type could produce sufficient IOP reduction, blebs after NPT showed a greater tendency to become flattened than after PT. Additional systematic therapy must be designed to maintain the L type of filtering blebs after NPT.

Glaucoma↗
PubMed2001

[A case of Coxiella burnetii pneumonia in an adult].

A 49-year-old man visited our hospital complaining of a continuous high-grade fever and cough which had appeared during his stay in Indonesia. He was admitted on the same day because his laboratory data showed marked inflammatory changes and his chest radiograph revealed an infiltrative shadow in the right upper lung field. Initial treatment with beta-lactams was not effective and both his symptoms and his chest radiograph worsened. However, treatment with erythromycin clearly had an effect. Then, we carried out several tests for detection of atypical pathogens including Mycoplasma and Chlamydia. Finally, the case was diagnosed as one of Coxiella burnetii pneumonia because the DNA of C. burnetii was detected from his sera and seroconversion of C. burnetii--specific antibody was observed among paired serum samples. C. burnetii is one of the most commonly recognized pathogens among community-acquired pneumonias in Western countries, but in Japan, reports of community-acquired C. burnetii pneumonia have been rare. This difference may be due to the features of Q fever, in which there are large differences in frequency and form from country to country and among areas of the same country. Surveillance of C. burnetii pneumonia in Japan and different area will be required.

Anti-Bacterial Agents↗
PubMed2001

[Clinicopathological study of early peripheral adenocarcinoma of the lung].

Fifty surgically resected small peripheral adenocarcinomas measuring 20 mm or less in greatest diameter were reviewed according to Noguchi classification (1995). Type A (localized bronchioloalveolar carcinoma: LBAC) and type B (LBAC with foci of structural collapse of alveoli) showed no lymph node metastasis and in these two types, 5-year survival was 100%. Histologic types A and B in Noguchi classification are thought to be early peripheral adenocarcinoma. By further evaluation of preoperative imaging diagnosis, operative procedure and pathological study patients with early peripheral adenocarcinoma would be able to become candidates for limited surgery (segmentectomy or partial resection).

Adenocarcinoma↗
PubMed2001

Optic cup enlargement followed by reduced optic nerve head circulation after optic nerve stimulation.

PURPOSE: To investigate changes in optic nerve head (ONH) circulation, visual evoked potentials (VEPs), and ONH cupping after stimulation of the optic nerve. METHODS: Electrodes were fixed above the optic chiasma in rabbits under general anesthesia. Screw-type electrodes for VEP recording were fixed on the dura. ONH circulation, intraocular pressure (IOP), and blood pressure (BP) were measured after the passage of a current of 0.1 mA for 0.1 second (weak stimulation), 1 mA for 1 second (moderate), 5 mA for 10 seconds (strong), or 25 mA for 10 seconds (severe). Normalized blur (NB), indicative of tissue blood flow and velocity, was measured in the ONH after each stimulation, by using a laser speckle circulation analyzer. Changes in VEP and ocular fundus were also recorded. The ratio of cup area (CA) to disc area (DA) was measured before and 4 weeks after stimulation. After all experiments, the ONH was histologically examined. RESULTS: Weak stimulation increased NB in ONH for 10 minutes, whereas strong or severe stimulation significantly decreased NB for a longer time, in a dose-dependent manner. BP showed no significant change, except with severe stimulation. IOP was not significantly changed. VEP amplitude was reduced 30 minutes after strong stimulation. The CA-to-DA ratio was significantly increased 4 weeks after strong stimulation. In some rabbits, disc hemorrhage occurred, followed by enlargement of disc cupping, with slight gliosis. CONCLUSIONS: Electrical stimulation of the optic nerve changed ONH circulation and VEPs and increased disc cupping. This technique warrants further investigation as an experimental model for normal-tension glaucoma.

Animals↗
PubMed2001

[Persistent hyperplastic primary vitreous--a case report of adult onset acute angle-closure glaucoma].

BACKGROUND: We report a patient with persistent hyperplastic primary vitreous(PHPV) who presented with acute angle-closure glaucoma in his adult life. CASE: A 30-year-old man had an attack of acute angle-closure glaucoma associated with retrolenticular fibrous tissue, atrophic retina, and elongated cilliary process in his right eye. RESULT: Ultrasound biomicroscopy(UBM) study showed iris bowing, shallow anterior chamber, and elongated cilliary body which were being pulled by the retrolenticular mass. The posterior chamber was normal. CONCLUSION: Although the mechanisms of secondary angle-closure glaucoma in PHPV are complicated, we suspected pupillary block resulting from constriction by the retrolenticular mass in this case.

Acute Disease↗
PubMed2001

[A case of multiple emphysematous bullae treated with living-donor lung transplantation from identical twin brothers].

A 30-year-old man with multiple emphysematous bullae and bronchiectasis was admitted to Toyama Medical and Pharmaceutical University Hospital because of exertional dyspnea and fever. His chest radiograph and CT scan revealed multiple large bullae in the right lung and infiltrative shadows in the left middle lung field. Pseudomonas aeruginosa was isolated from his sputum culture. Although standard therapies including various antibiotics were administered, his respiratory condition was exacerbated, accompanied with the enlargement of bullae in the right lung and the consequent shift of the mediastinum to the left. The patient and his family proposed lung transplantation, and we concluded that lung transplantation would be an appropriate treatment for his disease. We transported the patient to Osaka University Hospital. Living-donor lung transplantation from the patient's identical twin brothers was successfully performed.

Adult↗