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Biomedical subjects

H Ito

Publications and source records attributed to H Ito.

At least 649 records · Page 36Linked to original sources
PubMed1999

[Patient perceptions and satisfaction of psychiatric services at their discharge].

We conducted a multi-central survey on patient's perception and satisfaction of 31 psychiatric services at their discharge. The subjects were 364 patients who agreed to participate in the survey among 471 discharged patients between August 10th and September 10th, 1997. We excluded 48 patients emergently transferred to another hospitals, 47 patients with dementia or mental retardation, and 12 patients who refused to participate. Of the subjects, 326 patients (89.6%) responded. The rates of patients who rated the psychiatric care positively ranged between 79.4% (Amenity) and 93.6% (Overall satisfaction). Older patients tended to be more satisfied with psychiatric care than younger patients. Patients with schizophrenia and mood disorders rated the psychiatric care more positively, whereas patients with personality disorders rated negatively. Patients with neurosis rated the care positively in informed consent, but negatively in other items. Patients with the 60's score in Global Assessment of Functioning Scale rated higher in nurses and clerks than patients with other scores. Patients who have received their care in non-voluntary admission rated significantly lower in informed consent than other patients. There were no significant correlation of patient satisfaction with former admission and type of ward. Our results indicate that patient satisfaction survey could contribute to improve psychiatric care regarding patient characteristics in Japan.

Adult↗
PubMed1999

Radiotherapy for large hepatocellular carcinoma combined with transcatheter arterial embolization and percutaneous ethanol injection therapy.

This study was performed to determine the effect of radiotherapy (RT) combined with transcatheter arterial embolization (TAE) and percutaneous ethanol injection (PEI) on large HCC. Between 1988 and 1996, 102 patients with unresectable, biopsy proven HCC underwent uniform pretreatment assessment followed by TAE and PEI. Of the 102 patients, 68 (67%) had more than 2 lesions in the liver, and the largest tumor sizes in each patient ranged from 3 to 8 cm in diameter. Immediately after TAE and PEI, external beam RT (36 to 70 Gy) was administered to the largest tumors only in 44 patients. The cause-specific 5-year survival rate for all patients was 39.9%. The 3-year survival rate of the RT group was better than that of the no RT group (81.1% vs. 54.6%). The cumulative local control rates of the largest treated tumors were 53.2% in the RT group and 32.7% in the no RT, respectively (p=0.006). When the survival rate was compared between patients with and without local control in the RT group, that of patients with local control was significantly better than that with local recurrences (p=0.048). No deaths or major treatment related complications occurred. RT combined with TAE and PEI did not clearly show improvement of the survival, however, it effectively controlled large HCC, and demonstrated minimal toxicity. This treatment may represent therapeutic option for some patients with unresectable large HCC.

Aged↗
PubMed1999

Identification of a I-cM region of common deletion on 13q14 associated with human prostate cancer.

Frequent allelic losses on chromosome arm 13q are observed in carcinomas of the head and neck, breast, ovary, and pituitary gland. We analyzed 59 primary prostate tumors (stage B, 18 patients; C, 12 patients; D1, 4 patients; and endocrine therapy-resistant cancer death, 25 patients), as well as 18 metastatic tissues from 14 of the 25 cancer death patients for loss of heterozygosity (LOH) using 35 microsatellite markers on chromosome arm 13q. Of the 59 primary tumors, 31 (53%) showed LOH involving at least one locus. Detailed deletion mapping identified a distinct commonly deleted region in the I-cM interval flanked by D13S153 and D13S273 on 13q14 and this region overlapped a part of the RB1 gene. Paired DNAs were available from both primary and metastatic tumors in the 14 cases of cancer death; among those pairs, we detected LOH on 13q in seven (50%) primary tumors, and in all metastatic foci (P = 0.0029). Moreover, the regions lost in metastatic tissues were more extensive than those seen in the corresponding primary tumors. These results suggest that inactivation of a putative tumor suppressor gene(s) including the RB1 gene on 13q14 plays an important role in human prostate cancer.

Adrenal Gland Neoplasms↗
PubMed1999

[Penile carcinoma with humoral hypercalcemia of malignancy (HHM): a case report].

A 57-year-old male, with 1.5 cm tumor in his prepuce, was admitted to our institute in Feb. 1990. Circumcision and inguinal lymph node dissection was performed under the diagnosis of T1 disease of penile carcinoma. Pathological evaluation revealed well-differentiated squamous cell carcinoma (SCC). In April 1996, the patient revealed recurrence of the disease in the right inguinal lymph nodes and the lower abdomen, that was diagnosed to be poorly differentiated SCC. Laboratory findings showed elevation of serum calcium, parathyroid hormone-related protein (PTHrP) levels. Immunohistochemical staining confirmed production of PTHrP in the tumor tissue. This is the first case report of penile carcinoma that caused humoral hypercalcemia of malignancy in Japan.

Carcinoma, Squamous Cell↗
PubMed1999

[Sertoli cell tumor of the testis: a case report].

A case of Sertoli cell tumor of the testicle is reported. A 33-year-old man visited the Chiba University Hospital with the chief complaint of a painless right testicular swelling on May 1990. The right testis was hard and swollen on palpation. Gynecomastia was not present. Serum levels of tumor markers and hormones including alphafetoprotein, human chorionic gonadotropin-beta, carcinoembryonic antigen, testosterone, prolactin, estradiol, luteinizing hormone, and follicle stimulating hormone were within normal limits. Ultrasonic examination showed a high echoic lesion in the right testis. Computerized tomography and magnetic resonance imaging showed no evidence of retroperitoneal lymph node enlargement. A high right orchiectomy was performed under a diagnosis of right testicular tumor. The right testis was elastic hard and measured 9 x 10 x 7 cm, weighing 450 g. The cut surface was light yellowish white and was completely displaced by the tumor. No normal tissue was seen. Histological examination showed a Sertoli cell tumor. No adjuvant therapy was performed. Neither recurrence nor evidence of metastasis has been detected for 8 years postoperatively.

Adult↗
PubMed1999

[Electroconductive lithotripsy: clinical results of the Sonolith sigma].

The electroconductive lithotripter (ECL) is a new concept for shockwave generation in which a highly conductive solution channels the discharge between the anode and cathode. Out of 152 patients treated, complete follow up data were available on 151 patients. The average number of shocks per treatment was 2,138. At 3 months the overall stone-free rate was 73.5%. Success rate, defined as stone-free or asymptomatic residual fragments measuring 4 mm or less, was 84.9% for renal and 94.9% for ureteral calculi. The overall success rate for all calculi was 89%.

Adult↗
PubMed1999

Effect of a polymorphism of endothelial nitric oxide synthase gene in Japanese patients with IgA nephropathy.

BACKGROUND: Nitric oxide (NO) is synthesized by endothelial cell NO synthase (ecNOS) on vascular endothelium, and it plays a key role in the regulation of blood flow and pressure. A polymorphism of the ecNOS gene was recently shown to be associated with the development of cardiovascular disease. PATIENTS AND METHODS: We investigated the ecNOS gene polymorphism in 68 Japanese patients with IgA nephropathy (IgAN) and 134 normal controls. RESULTS: The genotype distributions were not different between the normal controls and the IgAN patients (ecNOS4b/b: ecNOS4b/a: ecNOS4a/a = 106:27:1 and 50:18:0, respectively). There was no significant difference in the renal histopathological grading between the patients with ecNOS4b/a and ecNOS4b/b. However, among the subgroup of patients whose duration of illness was two or more years, the advanced histopathological grading was more frequent in the patients with the ecNOS4b/a genotype (than in those with the ecNOS4b/b (p = 0.04)). The incidence of hypertension was also higher in the patients with the ecNOS4b/a genotype (50% in ecNOS4b/a versus 12% in ecNOS4b/b, p = 0.04). CONCLUSION: These results suggest that the ecNOS4b/a genotype (or ecNOS4a allele) of the ecNOS gene polymorphism may be involved in the progression of IgAN.

Adult↗
PubMed1999

Selective stimulation of Hsp27 and alphaB-crystallin but not Hsp70 expression by p38 MAP kinase activation.

The levels of Hsp27 and alphaB-crystallin in C6 rat glioma cells, that had been heated at 43 degrees C for 30 min with a subsequent culture for 16 h at 37 degrees C, were markedly increased. The exposure of the cells to a low concentration (0.1-3 microg/ml) of anisomycin for a few hours after heat stress stimulated the accumulation of the small stress proteins Hsp27 and alphaB-crystallin, but not that of Hsp70. The levels of mRNAs for Hsp27 and alphaB-crystallin but not that for Hsp70 increased in cells that had been exposed to heat and subsequently for 2 h to 0.1-3 microg/ml anisomycin. The results of a reporter assay, using an alphaB-crystallin promotor fused to a luciferase reporter gene, suggested that the increase in level of alphaB-crystallin mRNA was due to the production of new mRNA. The activation of the binding of heat shock factors to heat shock elements induced in cells that had been heat stressed was barely affected by subsequent exposure to anisomycin at 0.3 microg/ml. The stimulatory effects of anisomycin were also observed in cells that had been exposed to NaAsO2 or CdCl2. The active form of p38 mitogen activated protein (MAP) kinase was increased in cell that had been subjected to heat shock and subsequent exposure to 0.3 microg/ml of anisomycin. The heat-induced accumulations of Hsp27 and alphaB-crystallin were also stimulated by cycloheximide, another stimulator of p38 MAP kinase. SB202190, a specific inhibitor of p38 MAP kinase, suppressed the stimulation by anisomycin of the heat stress-induced expressions of Hsp27 and alphaB-crystallin. These results suggest that the signal transduction pathway of the stress-induced expressions of Hsp27 and alphaB-crystallin in C6 glioma cells includes a process that is sensitive to p38 MAP kinase.

Animals↗
PubMed1999

[Measurement of left ventricular filling by automated contour tracking method in echocardiography: comparison with radionuclide ventriculography].

Recent development of an automated contour tracking (ACT) method using the energy minimization principle provides automated edge detection and tracking of the endocardial boundary of the left ventricle, without tracing a region of interest. This study determined whether left ventricular filling indexes obtained from the ACT method provide a reliable estimate of left ventricular diastolic filling. Fourteen patients were examined by the ACT method and equilibrium radionuclide ventriculography. The volume-time wave form for ACT measurements was obtained from the 4-chamber views. Peak filling rate and time to peak filling rate measured by the ACT method were compared with those determined by radionuclide ventriculography. Peak filling rate and time to peak filling rate by the ACT method were closely correlated with those determined by radionuclide ventriculography (peak filling rate: r = 0.88, y = 0.71x + 0.36, SEE = 0.54 ml/end-diastolic volume/sec, time to peak filling rate: r = 0.89, y = 0.72x + 30.0, SEE = 0.02 msec, respectively) The ACT method is useful for the assessment of left ventricular diastolic filling.

Aged↗
PubMed1999

[Intra-arterial chemotherapy for invasive bladder cancer].

Between July 1993 and May 1999, 36 patients with invasive bladder cancer were treated with intra-arterial chemotherapy using cisplatin and pirarubicin, and their treatment outcome was evaluated. Clinical CR was obtained in 18 patients, PR in 13, and NC in 5, for an overall response rate of 86%. The median follow-up for evaluating patients was 24 months (2-70 months). The bladder was preserved in 13 of 18 patients showing CR and in 4 of 13 patients showing PR. The 5-year cause-specific survival rate for the 36 patients was 56%. The grade factor did not effect the survival rate significantly. Compared with stage T2, stage T3 yielded a significantly poor prognosis, especially with grade 3. Intra-arterial chemotherapy was confirmed useful as a regional treatment, but not sufficient as a systemic treatment. Thus the selection of patients for this therapy was considered to require exact staging and assessment of the effectiveness.

Adult↗
PubMed1999

[Chiari malformation (type I) associated with bilateral abducens nerve palsy: case report].

There are still many questions concerning the pathology and therapeutic strategy for Chiari malformation. We recently encountered a case of Chiari malformation associated with only bilateral abducens nerve palsy which was successfully treated by foramen magnum decompression. The pathology and mechanisms of Chiari malformation (type I) were evaluated in this case. The patient was a 12-year-old girl who had visited our institute 1 month previously complaining of diplopia. She had no particular past or family history and her general appearance was also normal. Bilateral abducens nerve palsy was the only neurological deficit. Her cerebrospinal pressure was 9 cm H2O. Neuroradiological findings revealed basilar impression, C4-6 syringomyelia and Chiari malformation (type I), but no hydrocephalus or meningocele. Foramen magnum decompression with lateral extension, upper cervical laminectomy and open duraplasty were performed. The position of both eyes recovered fully shortly after surgery, and diplopia occurred only when the patient looked sideways. Eye movements also returned completely to normal 3 months after surgery. MRI showed no syringomyelia 4 months after surgery, the upward shift of the pendulous portion of the cerebellar tonsil, and the expansion of the subarachnoidal space of the pons-oblongata junction. In conclusion, it was thought that the mechanism of bilateral abducens nerve palsy in this case was due to the strangulation and the downward traction of the pons-oblongata junction. The nerve was relieved from this traction by foramen magnum decompression.

Abducens Nerve Diseases↗
PubMed1999

4-methylcatechol increases brain-derived neurotrophic factor content and mRNA expression in cultured brain cells and in rat brain in vivo.

Practical use of brain-derived neurotrophic factor (BDNF) as therapy is limited by two serious problems, i.e., its inability to cross the blood-brain barrier and its instability in the bloodstream. In the present study, we investigated the effects of 4-methylcatechol (4-MC), which stimulates nerve growth factor synthesis and protects against peripheral neuropathies in rats, on BDNF content and mRNA expression in cultured brain cells and in vivo in the rat brain. 4-MC elevated BDNF content in culture media of both rat astrocytes and neurons with different dose-response relations. The increase in BDNF mRNA level was correlated with the increase in BDNF content, demonstrating that 4-MC can stimulate BDNF synthesis of both neurons and astrocytes. Then we examined the in vivo effects of 4-MC. First, we found that ventricularly administered 4-MC facilitated an increase in the BDNF content in the cerebral cortex and hippocampus in association with its diffusion into the brain parenchyma. Second, i.p. administration of 4-MC enhanced BDNF mRNA expression in the infant rat brain, in which the blood-brain has not yet fully been established. These results demonstrate that 4-MC, once delivered into the brain, can stimulate BDNF synthesis.

Animals↗
PubMed1999

[Body surface ultrasonography-guided bronchofiberscopy].

Transbronchial lung biopsies and cytologic studies under ultrasonographic guidance from the body surface were conducted in 39 patients whose lesions were adjacent to the thoracic wall. In 26 patients, biopsy, curettage, or brushing forceps were visualized in the mass or infiltrative lesion by thoracic echogram. Positive findings were obtained in 23 patients, for a conclusive diagnostic rate of 88.5%. Of the 13 patients in whom forceps could not be visualized by echogram, 10 had positive findings, for a diagnostic rate of 76.9%. For visualization by thoracic echogram, abnormal lung lesions must be in direct contact with the thoracic wall. Occasionally, diagnostic procedures may be impeded by anatomical structures such as shoulder joints or scapula. Despite these disadvantages, the ultrasonography-guided bronchofiberscope is quite useful because it facilitates real-time confirmation of the positioning of the forceps relative to the lesions. It is also useful in cases when the peripheral lesions are too small or vague to be demonstrated by fluoroscopy alone, because the echo probe can be the target of the forceps instead of the missing shadows. The diagnostic rate should be higher when the forceps are visualized in the lesions ultrasonographically.

Adult↗
PubMed1999

Application of low-intensity ultraviolet irradiation to the treatment for pharmacological vasoconstriction via a percutaneous transluminal approach.

We applied low-power ultraviolet (UV) laser irradiation via a thin flexible optical fiber to an in vivo model of vasospasm using an intravascular transluminal approach. The surgically exposed left femoral arteries of a rabbit were constricted by norepinephrine. A quartz fiber of 400 microm in diameter was introduced into the artery via the right common carotid artery through a 2.5F catheter. The femoral artery lumen was then irradiated with a helium-cadmium laser (wavelength 325 nm, output power 8 mW) through the fiber for 30 s. The UV irradiation increased the mean luminal diameter by 85% in comparison to the precontracted state, while the increase was only 45% in a sham operation. A histopathologic examination revealed no thermal damage and an intact internal elastic lamina. These results suggest that intravascular transluminal irradiation with a low-power UV laser may thus have potentially clinical applications to reverse acute arterial vasospasm.

Angiography↗
PubMed1999

[Radiotherapy for cervical cancer: a multi-institutional comparison].

Radiotherapy has long been recognized as a successful treatment modality for all stages of carcinoma of the uterine cervix. In Japan, however, radiotherapists mainly have had to treat patients with far advanced cancer. Recently, however, the incidence of patients with early-stage cervical cancer who undergo surgery has increased, whereas that of patients with advanced disease has decreased significantly. As a result, the number of cervical cancer patients who visit radiotherapy departments has decreased significantly. Radiotherapy is useful for early cervical cancer, and radiotherapists need to make every effort to treat patients with early-stage cancer. Radiotherapy alone for cervical cancer consists mainly of external irradiation and intracavitary brachytherapy. Two modalities are used for brachytherapy, low dose rate and high dose rate. The latter modality, which was developed about three decades ago, spread rapidly and was improved in Japan and Europe. In 1983, the standard method of treating cervical cancer with Co-60 RALS was proposed by Arai et al. in Japan. Most institutes accepted this method with some modifications and have reported treatment results based on it. Currently, several modalities of radiotherapy are available for cervical cancer. JASTRO organized a study group to reconsider the treatment proposed by Arai et al. and reviewed the outcomes from nine institutions in Japan. Chemotherapy combined with radiotherapy previously was considered ineffective for cervical cancer. However, this February NCI suggested concomitant chemoradiotherapy was effective for improving the survival rates of most cervical cancer patients. This suggestion is introduced.

Antineoplastic Combined Chemotherapy Protocols↗