Spontaneous stent-edge spasm in a patient with myocardial infarction.
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Coronary Angiography↗
Biomedical subjects
H Kanaya
Publications and source records attributed to H Kanaya.
Combination chemotherapy using carboplatin (JM-8) and etoposide (JET therapy) for recurrent malignant gliomas: a phase II study.
BACKGROUND: To study efficacy and safety of chemotherapy using carboplatin (JM-8) and etoposide ("JET" therapy) for the treatment of recurrent malignant glioma, a phase II study was conducted. Tumour control, survival time, and toxicity/side effects were assessed in patients with recurrent malignant glioma which failed to respond to a postoperative combined auxiliary therapy comprising of IFN-beta, ACNU and radiation. METHODS: Twenty-eight patients, fourteen with anaplastic astrocytoma (AA) and fourteen with glioblastoma (GB) were included in this study. The JET regimen consists of the intravenous administration of carboplatin (300 mg/m(2)) on day 1 and etoposide (60 mg/m(2)) on day 1 to 5, repeated every 6 weeks. FINDINGS: Following the therapy, we observed partial response (PR) in five (36%) of 14 patients with AA and two (14%) of 14 with GB, and stabilization of the disease (SD) in six (43%) in each group. The mean survival/survival after recurrence was 51 months/25 months in the AA group, and 17/9 in the GB group. INTERPRETATIONS: These results compare favorably with the natural course of recurrent malignant glioma. JET shows signs of efficacy in patients with recurrent malignant glioma, and a randomized trial comparing it to standard therapy is warranted.
Adolescent↗
Right ventricular metastasis from a primary cervical carcinoma.
A 49-year-old female presented with a 1-month history of cough and low-grade fever. Echocardiography showed a large mass in the right ventricle and percutaneous right ventricular endomyocardial biopsy provided the histologic diagnosis. Despite radiotherapy and chemotherapy, the patient died. At autopsy, the metastatic deposit in the heart was larger than the primary cervical carcinoma.
Carcinoma, Squamous Cell↗
[Changes in serum malondialdehyde-modified low-density lipoprotein in patients with acute myocardial infarction and stable angina pectoris treated by coronary angioplasty].
OBJECTIVES: Serum malondialdehyde-modified low-density lipoprotein(MDA-LDL) was measured as a marker of oxidative stress, and the changes in serum MDA-LDL compared in patients with acute myocardial infarction and stable angina pectoris treated by percutaneous transluminal coronary angioplasty (PTCA). METHODS: Forty-one patients with acute myocardial infarction or stable angina pectoris were admitted to our hospitals between January 2000 and June 2000. Direct PTCA was performed in 17 patients(MI group) and elective PTCA in 24 patients(AP group). Coronary angiography was performed in nine control subjects(control group). Serum MDA-LDL was measured in the peripheral venous blood before and immediately after procedures in each group(normal range 20-80 U/l). RESULTS: There were no significant differences in patient characteristics, except age, between the MI group and AP group. Serum MDA-LDL was elevated above the normal range before the procedure in both groups(MI group 104.7 +/- 52.0 U/l, AP group 99.7 +/- 42.8 U/l), and significantly decreased immediately after the procedure(MI group 61.3 +/- 25.6 U/l, AP group 62.0 +/- 29.6 U/l), but there were no significant differences between the two groups. Serum MDA-LDL was elevated before the procedure (99.3 +/- 48.9 U/l) in the control group and significantly decreased immediately after the procedure(61.7 +/- 26.2 U/l). However, these values did not differ from the values before and immediately after the procedure in the MI group and the AP group. The percentage changes in serum MDA-LDL before and immediately after the procedure were -38 +/- 16% in the MI group, -37 +/- 17% in the AP group and -36 +/- 20% in the control group, and there were no significant differences between the three groups. CONCLUSIONS: No significant difference in the changes in serum MDA-LDL was observed between patients with acute myocardial infarction and stable angina pectoris treated by PTCA. However, anticoagulants may affect the MDA-LDL measurements directly, because similar changes in serum MDA-LDL were observed in control subjects after only coronary angiography.
Age Factors↗
Generation of tumor-specific T-lymphocytes by cross-priming with human dendritic cells ingesting apoptotic tumor cells.
It has been suggested that dendritic cells (DCs) are capable of ingesting apoptotic tumor cells (ATCs) and presenting tumor-associated antigens to immune cells. We evaluated the potential of human DCs, which have ingested ATCs, to serve as a source of antigenic epitopes for presentation to T cells specific for PCI-13, a squamous cell carcinoma of the head and neck cell line. Immature DCs (DCimm) generated in the presence of interleukin 4 and granulocyte machrophage colony-stimulating factor from peripheral blood monocytes of HLA-A2+ healthy donors were incubated in the presence of ATCs. Uptake of ATCs by DCs was monitored by flow cytometry and confocal microscopy after 2-18 h of coincubation. When DCs were matured (DCmat) in the presence of proinflammatory cytokines, their capacity to uptake ATCs was reduced. Responses of PCI-13-specific CD8+ T cells to unmodified PCI-13 cells and to DCimm or DCmat +/- ATCs or +/- tumor lysates were tested in gamma-IFN enzyme-linked immunospot and cytotoxicity assays. Unmodified tumor cells were found to be the best stimulators of antitumor activity of the established T-cell line, and ATCs alone were minimally stimulatory. However, DCs that ingested ATCs were able to present tumor antigens to CTLs, and DCimm and DCmat were almost equally stimulatory. When DCs plus various tumor-derived preparations were used as antigen-presenting cells with autologous HLA-A2+ T cells obtained from normal donors, DCs that had ingested ATCs were more effective in generating CD8+ CTLs than tumor cells alone or DCs pulsed with tumor lysates. The results indicate that human DCs fed with ATCs and then matured effectively generated T cell-mediated antitumor responses in vitro.
Antigens, CD↗
A modified JAM assay detects apoptosis induced in activated lymphocytes by FasL+ human adherent tumor cells.
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Apoptosis↗
Acute inferior myocardial infarction and coronary spasm in a patient with an anomalous origin of the right coronary artery from the left sinus of valsalva.
A 56-year-old Japanese woman with an acute inferior myocardial infarction was admitted to hospital. Emergency coronary angiography revealed an anomalous origin of the right coronary artery from the left sinus of Valsalva, but there was no stenosis or thrombus in either the right or left coronary artery. Coronary spasm was provoked at the site of the proximal portion of the anomalous coronary artery, which was located between the aorta and pulmonary trunk. This was thought to be the cause of the myocardial infarction.
Acetylcholine↗
Urinary output changes in racemic ethylamphetamine and optical activity discrimination in rat urine by HPLC analysis.
Characterization of optical activity and simultaneous analysis of racemic ethylamphetamine (EAMP) and its metabolites, as well as the urinary excretion of the optical isomers, were examined in rats by high-performance liquid chromatography (HPLC). Analysis of the optical isomers of EAMP, amphetamine (AMP), para-hydroxy-ethylamphetamine (p-OH-EAMP), and para-hydroxy-amphetamine (p-OH-AMP) was performed within 90 min. The limit of detection was 30 ng for EAMP and AMP, and 60 ng for p-OH-EAMP and p-OH-AMP per 20 microliters injection. After oral administration of racemic EAMP, rat urine specimens were collected at four intervals, 0-4, 4-12, 12-20 and 20-24 h. After administration of 30 mg/kg EAMP, not only each isomer of EAMP, i.e. AMP, p-OH-EAMP and p-OH-AMP, but also an unidentified substance (UI) were detected. The UI was presumed to be 3-hydroxy-4-methoxy-N-EAMP or 3-methoxy-4-hydroxy-N-EAMP by gas chromatographic mass spectrometry (GC-MS) analysis. The d-isomer of EAMP was generally excreted more abundantly than the l-isomer (p < 0.01-0.05). The d-isomer of AMP and p-OH-EAMP was excreted in the first 4 h in a somewhat smaller amount than the l-isomer but thereafter in a greater amount than the l-isomer. The d-isomer of p-OH-AMP was generally excreted in a smaller amount than the l-isomer (p < 0.1-0.05). The total percentages of the dose excreted up to 24 h were 2.65% of the dose of EAMP administered [d: 2.04% and l: 0.61%], AMP 3.15% [d: 1.68% and l: 1.47%], p-OH-EAMP 63.06% [d: 32.68% and l: 30.38%], and p-OH-AMP 2.57% [d: 1.05% and l: 1.52%]. The optical purity ratio (l/d) of EAMP up to 24 h was 0.31, significantly lower than that (1.03) of the original racemic EAMP (p < 0.01). The changes in the excretion of EAMP and AMP indicated a stereoselective disposition, but those of p-OH-EAMP and p-OH-AMP were unremarkable: the d- and the l-isomer of p-OH-EAMP and p-OH-AMP did not differ significantly. The entire amount excreted up to 24 h was about 71.43% of the dose administered; the d-isomer 37.45% and the l-isomer 33.98%. The l/d was 0.91, which was clearly less than that of the original racemic EAMP (p < 0.01). These results suggested stereoselective disposition of EAMP in the rat, and the methods are potentially applicable to identification of the optical activity of EAMP and thereby of methamphetamine abusers.
Amphetamine↗
Evaluation of five polymorphic microsatellite markers for typing DNA from decomposed human tissues--correlation between the size of the alleles and that of the template DNA.
For PCR-based genotyping using polymorphic microsatellite markers, DNA from decomposed postmortem human tissues was fractionated into six groups according to molecular size. The minimum required amounts of this degraded DNA, for detecting alleles at five microsatellite loci (ACTBP2, CMAG, HUMTH01, CYP19, and LPL) and one minisatellite locus (MCT118) were investigated respectively. The allele patterns were detected by electrophoresis of the PCR products on a 6%-denaturing polyacrylamide gel following silver staining. The detection of alleles for the loci with large allele size required more template DNA with higher molecular size than for that with small allele size. Amounts from 0.3 ng to 5 ng were needed for allele detection on genomic DNA from fresh blood. When the decomposed DNA mixture was used as the template, approximately ten times the amount of genomic DNA was required to detect alleles at the three loci of LPL, CYP19 and HUMTH01, while 24 to 67 times was required for the loci, CMAG, ACTBP2 and MCT118. It was demonstrated that a minimum molecular, size and amount of template DNA was needed for amplifying alleles of the six loci, and degraded DNA less than minimum size in the samples would prevent the detection of the loci which have large allele size.
Alleles↗
Segmental pericholangial fibrosis: a peculiar benign fibrosing disease at the hepatic hilum.
The authors report on a 9-year-old child who underwent surgery to remove a tumor of the hepatic hilum with preoperative radiographic studies suggestive of malignancy, but whose surgical specimens showed a peculiar fibrosing disease. The lesion was localized to the bifurcation of the hepatic duct, where the bile duct wall and the surrounding tissue was markedly fibrotic. No malignant cells or epithelial destruction were seen. The patient's postoperative course was uneventful, and he is without any sign of recurrence 2 years after surgery. Because the histological features of this case do not correspond to any established disease, including primary sclerosing cholangitis, the authors believe it represents a new entity, segmental pericholangial fibrosis. Local resection resulted in a good outcome. A review of the literature disclosed a few similar cases with a benign clinical course.
Bile Duct Neoplasms↗
[Cerebral infarction and asymptomatic arteriosclerosis obliterans in the elderly].
We examined the associations between cerebral infarction (CI), asymptomatic arteriosclerosis obliterans (ASO), and known risk factors for these diseases. The subjects were 67 elderly patients (11 men and 56 women, mean +/- SD age of 79.6 +/- 8.5 years). in 44 patients CI was diagnosed by CT scan; 23 were classified as having cortical infarction and 21 as having lacunar infarction. In 41 patients asymptomatic ASO was diagnosed by an ankle-pressure index (API) of less than 0.9. To identify risk factors for these diseases, we examined the association among these diseases and hypertension (blood pressure > or = 140/90 mmHg), hypercholesterolemia (total cholesterol concentration > or = 220 mg/dl), hypertriglyceridemia (triglyceride concentration > or = 150 mg/dl), low HDL-cholesterolemia (HDL-C concentration < 40 mg/dl), high LDL-cholesterolemia (LDL-C concentration > or = 150 mg/dl), and glucose intolerance (fasting blood sugar concentration > or = 110 mg/dl). The incidence of asymptomatic ASO in the subjects with CI was significantly higher than that in the subjects without CI (chi 2 test; p < 0.05, odds ratio 6.4), including cortical infarction (p < 0.05, odds ratio 8.9) and lacunar infarction (p < 0.05, odds ratio 3.8). Patients with lacunar infarction were more likely to have hypertension than were controls (p < 0.05). Cortical infarction was not associated with these risk factors. Both low HDL-C and high LDL-G were more common in patients with asymptomatic ASO than patients without asymptomatic ASO (p < 0.05). These results indicate that CI and asymptomatic ASO are strongly associated in the elderly, especially in subjects with cortical infarction, and that aging itself contributes to cortical infarction.
Aged↗
Clinical features of prognosis of Japanese patients with anomalous origin of the coronary artery.
Anomalous origin of the coronary artery can lead to angina pectoris, acute myocardial infarction or even sudden death in the absence of atherosclerosis. However, in Japan, this anomaly is usually treated medically rather than surgically. To clarify the clinical features of anomalous origin of the coronary artery in Japanese and the prognosis of such patients who are treated medically, we reviewed 56 patients with anomalous origin of the coronary arteries. The mean age of these patients was 55.9 +/- 11.5 years. Anomalous origin of the right coronary artery from the left sinus of Valsalva was seen most frequently (78.6%). In contrast, we found no cases of anomalous origin of the left coronary artery from the right sinus of Valsalva traversing between the aorta and the pulmonary trunk. A history of syncope (14.3%) and aorta regurgitation (21.4%) was frequent and serious complications during exercise stress testing occurred in 5 patients. These patients were treated medically, such as by limiting exercise or by the oral administration of medicine. During the follow up period (mean 5.6 +/- 4.2 years), death directly related to anomalous origin of the coronary artery was not found despite the lack of surgical treatment. Our results suggest that the prognosis of these middle-aged-to-elderly patients without atherosclerosis is relatively good, despite the lack of surgical treatment.
Adult↗
Hyperthyroidism complicated with sick sinus syndrome.
A 50-year-old woman was transported to a hospital complaining of marked general malaise and epigastralgia with diarrhea and vomiting. Her electrocardiogram showed sinus arrest with a duration of nearly 8 sec. Atrial pacing with an external pacemaker improved her symptoms promptly. Following transfer to our hospital 3 days later, bradyarrhythmia was not detected despite the removal of the external pacemaker. Transient atrial fibrillation was found in our hospital, and she was diagnosed as hyperthyroidism based on findings of finger tremor, exophthalmos, diffuse goiter and an abnormally high level of thyroid hormone. On cardiac catheterization, left ventriculography showed anterior wall hypokinesis and mild mitral regurgitation. Coronary arteriography showed the absence of organic stenosis. Right ventricular endomyocardial biopsy showed myocardial hypertrophy and partial disarray, but no findings of myocarditis. Electrophysiological study showed the normal upper range of AH-time (120 msec) and HV-time (50 msec), and prolongation of corrected sinus recovery time (CSRT, 955 msec). After a euthyroid state was successively induced for about 10 days by methylmercaptoimidazole therapy, AH-time, HV-time and CSRT were shortened to 85, 35 and 290 msec respectively. Her complaints and sick sinus syndrome disappeared after the treatment of hyperthyroidism without a pacemaker.
Atrial Fibrillation↗
[Persistent carotid-superior cerebellar artery anastomosis presenting with cerebellar ischemic attack: a case of persistent trigeminal artery variant].
A rare case of persistent primitive trigeminal artery variant (PTAV) with cerebellar ischemia is reported. A 23-year-old male complained of sudden dizziness and nausea after playing valley ball. CT scan and MRI on admission revealed no abnormal findings. Left carotid angiography demonstrated a PTAV anastomoting precavernous portion of left internal carotid artery to the left superior cerebellar artery. The 37 cases reported in literature were reviewed to characterise PTAV. Ninety-seven% of the cases arising from precavernous portion of internal carotid artery, and terminated in anterior inferior cerebellar artery in 73%, posterior inferior cerebellar artery in 13.5% and superior cerebellar artery in 13.5%. Approximately 22.2% of patients with PTAV have cerebral aneurysms. The hypotension or mechanical compression of PTAV on playing valley ball with poor vascular supply to the part of cerebellum possibly caused cerebellar ischemia in this case.
Adult↗
Time course study of the extracellular matrix in puromycin-aminonucleoside-induced glomerulosclerosis.
The purpose of this study was to investigate the mechanism of glomerulosclerosis, which is an important histopathological feature of various renal diseases. Puromycin aminonucleoside (PAN) was administered to rats to produce glomerular lesions, and the kidneys were examined by repeated renal biopsy with light microscopy and immunohistochemical detection of glomerular extracellular matrix (ECM) components (laminin, fibronectin, type I, III, and IV collagen). Immunohistochemical studies utilizing the streptavidin-biotin method showed marked accumulation of laminin and type IV collagen in the adhesions between the glomerular epithelium and Bowman's capsule, as well as in the mesangial matrix. Fibronectin was detected in the normal mesangium and the basement membrane of Bowman's capsule, while adhesions and the matrix accumulations were also positive. The sclerotic lesions of the glomeruli were also stained for type I and III collagen, which exist in normal interstitial tissue, but never in healthy glomeruli. Type I collagen appeared in the lesions after type III collagen. All of the ECM components examined in this study were present in advanced glomerulosclerosis and showed distinctive patterns of progression. These finding suggest that abnormal accumulation and production of ECM components in the glomeruli may have a role in the development of glomerulosclerosis.
Animals↗
[Clinical study of cerebellar hemorrhage].
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Age Factors↗
[Classification of CT images in intracerebral hemorrhage].
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Cerebral Hemorrhage↗
[Prediction of outcome in putaminal hemorrhage].
We obtained information on patients with putaminal hemorrhage (3,638 medically treated cases and 3,372 surgically treated cases). With these data, we have developed easily applicable and clinically useful prediction models for both mortality and activities of daily living (ADL) at three months after admission. We derived these models by Hayashi's discriminant technique for categorical data. Before their derivation, variables generally available on the initial day of hospitalization and possibly related to outcome were examined individually with tests of homogeneity. Neurological grading (NG), age, deformity of cisterns around midbrain, midline shift, hematoma volume, and motor paralysis were identified as candidate predictors of both mortality and ADL. CT classification was also added to the predictors of ADL. Initially, all these factors were included in tentative models, and then those which were found not to contribute substantially to the prediction were deleted. Ultimately, we proposed two models, one for mortality and the other for ADL. The mortality model used NG, hematoma volume, and deformity of cisterns around midbrain as predictors, and the ADL model used age, NG, CT classification, hematoma volume, and motor paralysis. Average correct classification rates were 87% (medical) and 69% (surgical) for mortality, and 64% (medical) and 60% (surgical) for ADL. With these models, we evaluated indications of both kinds of treatment by comparing each predicted ADL of the medically treated cases with that of the surgically treated cases.
Activities of Daily Living↗