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Biomedical subjects

H Naganuma

Publications and source records attributed to H Naganuma.

At least 73 records · Page 4Linked to original sources
PubMed1997

Isolated splenic metastases.

We analyzed the primary tumors, sonographic findings, clinical manifestations, and prognosis in five cases of isolated splenic metastases to determine in what situations these rare metastases should be suspected. The metastases were detected by ultrasonography in all five patients, and the primary tumors were colonic cancer in four patients and renal cancer in one patient. Splenectomy was performed and the postoperative course was uneventful in all patients. We conclude that preoperative and follow-up examinations must be performed with special attention given to the spleen in colonic or renal cancer patients.

Adult↗
PubMed1997

Temocaprilat, a novel angiotensin-converting enzyme inhibitor, is excreted in bile via an ATP-dependent active transporter (cMOAT) that is deficient in Eisai hyperbilirubinemic mutant rats (EHBR).

Temocapril x HCl (alpha-((2S,6R)-6-[(1S)-1-ethoxy-carbonyl-3-phenyl-propyl]amino-5-oxo-2- (2-thienyl)perhydro-1,4-thiazepin-4-yl)acetic acid hydrochloride) is a novel prodrug of an angiotensin-converting enzyme (ACE) inhibitor. Unlike many other ACE inhibitors, its pharmacologically active metabolite,temocaprilat, is excreted predominantly in bile. To investigate the mechanism for the biliary excretion of temocaprilat, we performed in vivo and in vitro experiments using mutant Eisai hyperbilirubinemic rats EHBR) whose canalicular multispecific organic anion transporter (cMOAT) is hereditarily defective. Biliary clearance of temocaprilat after i.v. administration of [14C]temocapril x HCl (1.0 mg/kg) in EHBR was significantly lower than that in Sprague-Dawley rats (5.00 ml/min/kg for Sprague-Dawley rats vs. 0.25 ml/min/kg for EHBR). The uptake of temocaprilat into canalicular membrane vesicles (CMVs) prepared from Sprague-Dawley rats was stimulated in the presence of ATP, whereas little stimulation was observed in CMVs from EHBR. The initial uptake rate of ATP-dependent transport of temocaprilat showed saturation kinetics; we obtained an apparent V(max) value of 1.14 nmol/min/mg protein and a K(m) value 92.5 microM. ATP-dependent transport of temocaprilat was competitively inhibited by 2,4-dinitrophenyl-S-glutathione, a typical substrate for cMOAT with an inhibition constant (K(i)) of 25.8 microM. The K(m) value for the uptake of 2,4-dinitrophenyl-S-glutathione into CMVs (K(m) = 29.6 microM) was consistent with this K(i) value. In addition, the ATP-dependent uptake of 2,4-dinitrophenyl-S-glutathione was inhibited by temocaprilat in a concentration-dependent manner. Active forms of some ACE inhibitors (benazepril, cilazapril, delapril, enalapril and imidapril) did not affect the transport of temocaprilat into CMVs even at concentrations as high as 200 microM. These data suggest that temocaprilat is effectively excreted in bile via cMOAT that is deficient in EHBR and that many of other ACE inhibitors have low affinity for cMOAT.

Adenosine Triphosphate↗
PubMed1997

Extrapleural solitary fibrous tumor: a report of seven cases.

Solitary fibrous tumors (SFTs) are rare, spindle-cell neoplasms generally associated with the serosal surface, especially the pleura. Histopathologic, immunohistochemical, ultrastructural, and flow cytometric analyses were performed on seven SFTs of extrapleural sites (two retroperitoneal, two soft tissue, one each peritoneal, nasal cavity, and orbit). Five patients were women, and two were men, aged from 21 to 68 years (average, 39 yr). All of the lesions presented as well-circumscribed masses. The lesions ranged in size from 2 to 20 cm in greatest diameter. Histologically, these lesions were entirely comparable to the pleural SFTs and lacked the characteristic features of other recognized neoplasms that occur in these regions. One tumor contained pleomorphic and round-cell sarcomatous foci. Immunohistochemically, all of the tumors were strongly positive for vimentin and CD34. Six of the seven tumors showed varying numbers of spindle cells positive for alpha smooth muscle actin, HHF35, neuron-specific enolase, Leu 7, or glial fibrillary acidic protein. Ultrastructural examinations of three tumors showed that they were composed of primitive mesenchymal or fibroblast-like cells. Six tumors examined were diploid by flow cytometric examination. Clinical follow-up in six patients ranged from 1 to 7.5 years (average, 2.6 yr) and showed that five patients remained well with no evidence of disease after excision and that the patient with the sarcomatous elements died of recurrence 2.5 years after surgical treatment. These findings suggest that SFTs represent ubiquitous neoplasms of fibroblasts or primitive mesenchymal cells with aggressive potential.

Adult↗
PubMed1997

[Replacement of the aortic root with woven and knitted Dacron composite graft].

Some of the patients with annuloaortic ectasia or Stanford type A require aortic root replacement. If conventional Bentall procedure is employed in such cases, aortic root will become a cylindrical shape totally lacking sinus of Valsalva because the procedure utilizes a straight tube. The sinuses of Valsalva support an important role in opening and closing the valvar leaflets, and opening of the coronary arteries, together with the interleaflet triangles and the sinutubular junction. In this study, we performed aortic root replacement with composite graft which consisted of two types of graft including 30 mm Knitted Dacron Graft (Gelsoft) with different dilation rates and 30 mm Woven Dacron Graft (Hemashield) as well as bioprosthesis (27 mm Carpentier-Edwards), in order to reconstruct sinus of Valsalva. Post-operative angiography revealed an excellent diastolic coronary flow, as evidenced by proximal Knitted graft of 37 mm in diameter, distal Woven graft of 30.3 mm in diameter and Doppler flow DSVR (Diastolic/Systolic Velocity Ration) of 2.2 measured at the left coronary orifice. Since it is difficult to obtain homograft at present, this procedure would be worth trying during aortic root replacement.

Aged↗
PubMed1997

[Mitral valve plasty and LV patch reconstruction for a left ventricular aneurysm with mitral regurgitation].

Three years after myocardial infarction, a 60-year-old man had congestive heart failure caused by left ventricular aneurysm with mitral regurgitation. He underwent the following concomitant operations: (1) patch reconstruction for a left ventricular aneurysm and (2) mitral plasty for a torn chordate and mitral regurgitation by using valvuloplasty, a shortening chordae and a prosthetic ring. A postoperative examination indicated that his cardiac function had markedly improved.

Heart Aneurysm↗
PubMed1996

A Case of Ductal Carcinoma In Situ (DCIS:noncomedo type)Detected by Ultrasonography: Demonstration of Occult Multiple Foci.

We report a case of ductal carcinoma in situ (DCIS) of the breast detected by ultrasonographic mass screening in a 51-year-old woman. In a mass screening program for breast cancer, physical examination with inspection and palpation, and ultrasonography (US) were performed. A hypoechoic mass with a slightly irregular margin was detected by US in the lateral upper quadrant of the right breast, at a distance 2 cm from the edge of the nipple. The mass was not detected by physical examinations or by mammography (MMG). The mass, which measured 0.8 x 0.5 cm and was examined by fine needle aspiration biopsy (FNAB) under US guidance, was cytologically diagnosed as class X. Modified radical mastectomy (Auchincloss method) was performed with the patient's consent. Pathological examination of the resected specimen revealed DCIS (noncomedo type) and occult multiple foci of malignancy which was considered tracking centripetally underneath the nipple. This case suggests that US and FNAB performed under US guidance are useful in the detection and diagnosis, respectively, of a breast mass. We should take multifocality into consideration, particularly with tendency tracking to the nipple, in the treatment of small breast cancers such as DCIS.

Journal Article↗
PubMed1996

Intestinal IgA deposition in Henoch-Schönlein purpura with severe gastro-intestinal manifestations.

UNLABELLED: In patients with Henoch-Schönlein purpura (HSP) presenting with severe gastro-intestinal (GI) symptoms, IgA deposition was studied in endoscopically obtained mucosal biopsies. A total number of 11 patients (male, 7; female, 4) were enrolled in this study; 7 patients underwent upper GI endoscopy and biopsy 1 underwent sigmoidoscopy and 3 underwent both. Upper GI endoscopy in each patient showed various mucosal changes including redness, petechiae, erosions, and ulcerations, most predominant in the second part of the duodenum. Sigmoidoscopy demonstrated no abnormality in two of four patients. Intestinal deposition of IgA was positive in 7 of 11 patients with HSP. Histological examination showed non-specific inflammation of varying degrees in each patient, but no small vessel vasculitis was observed. IgA deposits were seen in only 2 of 23 control subjects with various GI diseases. Positive rate of IgA deposition per patient was significantly higher in patients with HSP than in controls (P < 0.005). CONCLUSION: IgA deposition in the GI tract, as in the skin and kidneys, is characteristic of HSP. Intestinal IgA deposition complements the diagnostic criteria of HSP.

Child↗
PubMed1996

Castleman disease in the anterior neck: the role of Ga-67 scintigraphy.

A case of Castleman disease in the anterior cervical region is presented. Ga-67 scintigraphy revealed moderate uptake in the thyroid region. Thyroid scintigraphy demonstrated the presence of an extrinsic thyroid tumor. Contrast-enhanced CT showed dense homogeneous enhancement within, the tumor. Radionuclide tracer accumulation on gallium scintigraphy as well as dense contrast enhancement on CT scan may be characteristic of Castleman disease. Castleman disease should be considered in the differential diagnosis when increased tracer activity is noted in an anterior cervical extrathyroid tumor on Ga-67 scintigraphy.

Adult↗
PubMed1996

Malignant fibrous histiocytoma of the esophagus.

A 78-year-old man presented with an esophageal polyp that was confirmed by immunohistochemistry and electron microscopy to be malignant fibrous histiocytoma. The tumor was comprised of a proliferation of spindle-shaped cells admixed with bizarre giant cells. These tumor cells were immunoreactive for smooth muscle actin, vimentin, alpha-1-anti-chymotrypsin and CD68. Electron microscopic examination revealed the myofibroblastic and histiocytic features of the tumor cells. No elements of epithelial or myogenic differentiation were found in the tumor. Malignant fibrous histiocytoma of the esophagus is extremely rare, with 10 cases being documented so far in the literature. The differential diagnosis of pleomorphic tumors of the esophagus is discussed.

Aged↗
PubMed1996

Modulation of transforming growth factor-beta secretion from malignant glioma cells by interleukin-1 beta.

Malignant glioma cells secrete transforming growth factor-beta (TGF-beta) which has potent immunosuppressive properties. We investigated the effect of interleukin-1 beta (IL-1 beta) on TGF-beta secretion from malignant glioma cells in vitro. T98G glioblastoma cells were treated with various doses of IL-1 beta and the TGF-beta activity in the supernatant was determined using a specific bioassay. Six other human malignant glioma cell lines were also treated with 1000 U/ml of IL-1 beta, and the TGF-beta activity in the supernatants was determined. The effect of IL-1 beta on the growth of tumor cells was also assessed by a bioassay using crystal violet which reflects the actual cell number in the plate wells. IL-1 beta treatment resulted in inhibition of TGF-beta secretion in two malignant glioma cell lines. TGF-beta secretion from T98G cells was suppressed by IL-1 beta in a dose-related manner. However, IL-1 beta treatment resulted in an obvious increase (> 20%) of TGF-beta secretion in two tumor lines, and a slight increase (< 20%) in three tumor lines. IL-1 beta did not affect the growth of four malignant glioma cell lines, and only slightly affected the growth of the other three cell lines. IL-1 beta modulates TGF-beta secretion from malignant glioma cells, but not in a consistent way.

Cell Division↗
PubMed1996

Transforming growth factor-beta inhibits interferon-gamma secretion by lymphokine-activated killer cells stimulated with tumor cells.

The effect of transforming growth factor-beta (TGF-beta) secreted by glioblastoma (T98G) cells on the secretion of interferon-gamma (IFN-gamma) by lymphokine-activated killer (LAK) cells stimulated with tumor cells was investigated in cocultures of LAK and Daudi cells supplemented with T98G culture supernatant, T98G culture supernatant preincubated with anti-TGF-beta 1 and anti-TGF-beta 2 neutralizing antibodies, anti-TGF-beta 1 and anti-TGF-beta 2 antibodies, or natural human TGF-beta 1 or recombinant human TGF-beta 2. LAK cells were incubated with anti-TGF-beta 1 and anti-TGF-beta 2 antibodies, and with T98G cells of which the supernatant contained both active and latent forms of TGF-beta 1 and TGF-beta 2, with or without neutralizing antibodies. Addition of the supernatant from T98G cells to LAK/Daudi culture caused inhibition of IFN-gamma secretion by LAK cells. The inhibition was abolished by pretreatment of the supernatants with anti-TGF-beta antibodies. Addition of TGF-beta 1 and TGF-beta 2 to the LAK/Daudi culture inhibited IFN-gamma secretion by LAK cells in a dose-dependent manner. Addition of anti-TGF-beta antibodies to the LAK culture resulted in increased IFN-gamma secretion. T98G cells failed to stimulate LAK cells to secrete more IFN-gamma. Addition of anti-TGF-beta antibodies to the LAK-T98G culture resulted in increased IFN-gamma secretion by LAK cells. These results suggest that most malignant glioma cells which secrete high levels of TGF-beta can inhibit IFN-gamma secretion by LAK cells even after tumor cell stimulation.

Brain Neoplasms↗
PubMed1996

Basophilic deposits on the cupula: preliminary findings describing the problems involved in studies regarding the incidence of basophilic deposits on the cupula.

In this study, the possibility of whether basophilic deposits adhered to the cupulas in the semicircular canals was investigated histologically. Results indicated that basophilic deposits were present in all three cupulas of the semicircular canals. The overall incidence of basophilic deposits in the superior, lateral and posterior semicircular canal cupulas was 26%, 41% and 37%, respectively. The incidence of basophilic deposits bound to the cupulas increased with age. The possible origin of these basophilic deposits on the cupulas and the increased incidence of basophilic deposits with increasing age are discussed.

Adult↗
PubMed1996

Influence of vestibular organ stimulation on stomach movement and respiration.

Some previous investigators have reported controversial results in the stomach movement in response to labyrinthine stimulation (1). The purpose of the present study was to investigate the influence of vestibular stimulation on the stomach movement and respiration in anesthetized cats, and to investigate the differences between increased and decreased responses of the stomach movement. This study used an electrophysiological technique: a bipolar stainless-steel stimulating electrode with a tip diameter of 20 microns introduced chronically into the anterior and/or lateral semicircular canal (2). The intragastric pressure was recorded by using a balloon-transducer system. Respiration was recorded by measurement of the thorax. When the peripheral labyrinth was stimulated, we found conflicting results in that the pressure in the stomach increased several times and sometimes decreased. Respiration usually became irregular or intensified. It seems that forced respiration may be involved in vestibular vomiting but we were unable to induce vomiting.

Animals↗
PubMed1996

Vestibular training for acute unilateral vestibular disturbances: its efficacy in comparison with antivertigo drug.

We carried out a clinical trial on the treatment of acute unilateral vestibular disturbances (AUVD) without typical Meniere's disease and benign paroxysmal positional vertigo. Two therapy groups were selected: vestibular training (VT) with drug therapy and drug administration alone. After the experimental period of 8 weeks, all patients were classified into two groups depending on the methods of treatment, and the clinical courses of the patients were compared statistically. It was confirmed statistically by global judgments of symptoms and signs that improvement rates were higher in the group treated by VT with medication than the improvement rate in the group with medication alone. It is concluded that VT is effective for early relief from vestibular ataxia.

Adult↗
PubMed1996

Optokinetic after-nystagmus in the human: a comparative study between normals and patients with peripheral vestibular and central disorders.

The purpose of this study was to classify various patterns of optokinetic after-nystagmus (OKAN) appearing in normal subjects, and to investigate the difference of OKAN between 147 normal subjects and 55 patients suffering from central nervous system (CNS) or peripheral vestibular disorders, in which 18 CNS disorders and 37 peripheral vestibular diseases were included. Data was divided into three categories by duration of the 1st phase of OKAN, i.e. hypo-response below 10 sec, middle response between 10 and 60 sec and hyper-response above 60 sec. The patterns of OKAN were then classified into six types with nine subtypes according to the following classification. All combinations of duration times of the 1st phase of OKAN toward both directions were then classified into six types, i.e. type 1, bilateral middle responses; type 2, bilateral hyper-responses; type 3, bilateral hypo-responses; type 4, unilateral hypo-response with contralateral middle response; type 5, unilateral hypo-response with contralateral hyper-response; and type 6, unilateral middle response with contralateral hyper-response. Moreover, subtypes "a" and "b" indicated symmetric and asymmetric in both types 1 and 2. Namely, if a relative value of the difference between bilateral responses against the sum of those was less than 20%, it was called "symmetric", otherwise, "asymmetric". Type 3 was divided into two subtypes: no response (3a) and hypo-response (3b). Results were summarized as follows. All combinations of horizontal OKAN toward both sides appeared in the 147 normal subjects. The incidence of each type, i.e. 1a, 1b, 2a, 2b, 3a plus 3b, 4, 5 and 6, was 10.9, 15.0, 2.7%, 1.4%, 25.2%, 31.3%, 4.1% and 9.5%, respectively. The incidence of type 3, type 3a in particular, was higher in patients than in the normals (p < 0.001). Also, the incidence of type 4 in normals was significantly higher than that of the patients (p < 0.01). Caloric tests revealed unilateral and bilateral canal pareses (CP) in 44 of 52 patients. The incidence of type 3 in the group of patients with CNS disorders was higher than those with peripheral vestibular disorders (p < 0.01). The 2nd phase of OKAN appeared in only nine of the 147 normals and in nine of the 55 patients. However, the 3rd phase of OKAN was observed in only one patient, the duration of which was 80 sec. The appearance rate of the 2nd phase of OKAN in patients was significantly higher than in the normal subjects (p < 0.05).

Adult↗
PubMed1996

Initial symptoms and retrospective evaluation of prognosis in Menière's disease.

Clinical studies on an initial symptom and a long-term course of vertigo and hearing impairment and retrospective evaluation of the prognosis were performed in Menière's disease. One hundred and fifty-one patients (67 males and 84 females) with Meniere's disease were treated in the Neuro-otological clinic, Kitasato University Hospital from 1990 to 1995. Ages ranged from 17 to 77 years (mean 47.3 years) at the onset of the disease when the first vertigo attack occurred. There were 106 (70.1%) in their 30s, 40s and 50s, and 28 (18.5%) aged 60 years or over. Seventy-eight patients visited the clinic within one year of the onset of the disease, but the mean interval was 4 years and 5 months (the longest was 25 years). The mean duration time for the follow-up studies from the time of their first visit to the hospital was 2 years and 5 months. The bilateral ears were invaded in 19 patients (12.6%) and the mean length of their time course was 9 years and 10 months which is longer than the length in unilateral cases. Several important key points for diagnosis of Menière's disease were investigated in 28 of the 151 cases who had been followed up successfully over a relatively long time course (the mean follow-up time was 7 years and 3 months). Fluctuated or stational cochlear signs, such as tinnitus, hearing impairment and/or fullness in the ear, had started prior to the onset of the first vertigo attack in 17 (61%) of 28 cases. Vertigo without cochlear sign appearing at the onset and cochlear signs were combined later in six (21%) of the 28 cases. Only five (18%) of the 28 cases had vertigo combined with a cochlear sign simultaneously at the onset of the disease. The affected ear was on the left in 15 cases and on the right in seven of 22 unilateral cases. In six bilateral cases the left ear was the first to be invaded in four out of six cases. The interval between the first and second attacks was over 1 year in six of the 28 cases and over 6 months in 10 of the 28 cases. Nine out of the 28 patients had recurrence of vertigo attacks during the first month and five of the nine had a cluster of attacks in the first month. Our study of 28 patients over a long time course revealed eight patients (28.6%) free from the disease. These patients had no recurrence of vertigo for more than 2 years after their last attack, and sixteen (57.1%) of the 28 patients had no recurrence of vertigo for more than 1 year. However, a long period of relief time of more than 2 years in 11 of the 28 patients and a period of more than 1 year was noticed in 16 of the 28 patients. Hearing levels at the middle and low frequencies in the first hearing test were compared with the last test. The mean of hearing levels changed from 38.1 to 36.2 dB after 2 years and 1 month in six cases with the right ear affected and from 34.1 to 45.3 dB after 5 years and 3 months in 15 cases with the left ear affected, but in seven cases with bilateral diseased ears the hearing in both ears became worse, from 25.5 to 57.1 dB in the right ear and from 30.5 to 53.6 dB in the left ear during a period of more than 10 years. These clinical findings should be utilized for diagnosis at the onset of Menière's disease to determine the interval for observation in order to evaluate the efficacy of treatment.

Adolescent↗
PubMed1996

Effectiveness of fibronectin in myringoplasty using temporal fascia.

A study of myringoplasty with temporal fascia homograft employing fibronectin was conducted in 14 ears in which the same myringoplasty procedure without fibronectin (1-5 times) had failed to afford closure of tympanic membrane perforation. Closure was obtained in eight ears. These results suggest that fibronectin is effective in myringoplasty using treated temporal fascia homograft.

Adult↗