Biomedical subjects
H Sanada
Publications and source records attributed to H Sanada.
Dupuytren's contracture: morphological and biochemical changes in palmar aponeurosis.
The palmar aponeurosis removed from ten patients with Dupuytren's contracture was studied using morphological and biochemical approaches. The histological characteristic of Dupuytren's contracture is the presence of numerous nodules among the lamellar structures of the collagen fibres. In the nodules, there are many active fibroblasts which are surrounded by immature fibres and metachromatic substances demonstrated by toluidine blue staining. Ultrastructurally, the active fibroblasts have the characteristics of myofibroblasts, as previously reported by Dr. Gabbiani. We found that some fibroblasts have intracellular collagen fibrils in the cytoplasm. When assayed by Siegel and Martin's method, lysyl oxidase activity of the palmar aponeurosis was significantly higher in Dupuytren's contracture than in normal hands. Biochemical studies such as electrophoretic analysis of mucopolysaccharides, determination of uronic acid and collagen contents were undertaken to compare the aponeurosis of Dupuytren's contracture with normal cases. The uronic acid contents were higher in Dupuytren's contracture than in the controls. However, no difference between the two groups was found in the collagen contents and in the composition of the mucopolysaccharides. These characteristic features; existence of myofibroblasts and intracellular collagen fibrils and increase in the activity of lysyl oxidase probably play a significant role in the establishment of flexion contracture of the fingers in Dupuytren's contracture.
Treatment of relapsed acute myelocytic leukemia with a combination of aclarubicin and cytosine arabinoside.
Relapses in nine patients with acute myelocytic leukemia were treated with a combination of aclarubicin (ACR) and cytosine arabinoside (ara-C). ACR, 40 mg/m2/day, was administered daily by intravenous injection from day 1 to day 3 and ara-C, 60-80 mg/m2/day, divided into 2 doses, was given every 12 h by intravenous infusion from day 1 to day 7. Depending on the state of the bone marrow, ACR-ara-C regimen was modified in administration period and repeated after the resting periods of at least 7 days. Complete remission was obtained in 7 of 9 patients (77.8%). The time required for achieving the complete remission varied from 20 to 55 days with a median of 39 days. The duration of complete remission was from 8 to 52 weeks with a median of 22 weeks. Side effects on digestive system such as nausea, vomiting and anorexia, were seen in all patients, although they were managed by symptomatic treatment. The results indicate the effectiveness of this ACR-ara-C regimen in the clinical management of acute nonlymphocytic leukemia.
[Studies on leukemia in the old. 1. Clinical studies on hypoplastic leukemia in the old (author's transl)].
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[A case of acute myelogenous leukemia with auer body and Ph1 like chromosome (author's transl)].
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[Clinical management of acute lymphocytic leukemia in adults. 1. Treatment of acute lymphocytic leukemia with VP (vincristine, prednisolone)--DVMP (daunorubicin, vincristine 6-mercaptopurine, prednisolone) regimen].
Eighteen patients with acute lymphocytic leukemia (ALL) were treated with VP (vincristine, prednisolone) followed by DVMP (daunorubicin + vincristine + 6-mercaptopurine + prednisolone) regimen (VP-DVMP regimen). Patients were all previously untreated. Complete remission (CR) was obtained in 11 of 18 patients (61.1%,) by VP alone and 4 patients, by VP-DVMP. The time required for CR varied from 14 to 60 days with a median of 28 days. The duration of CR and survivals in responders were from 1.2 to 42.3 + months with a median of 24.0 months. The hematological toxicities in VP-DVMP regimen were lower than those in NVP (neocarzinostatin + vincristine + prednisolone) and NVMP (neocarzinostatin + vincristine + 6-mercaptopurine + prednisolone) regimens.
[Comparative evaluation of a combination of daunorubicin and cytosine arabinoside and that of aclarubicin and cytosine arabinoside in remission induction in acute non-lymphocytic leukemia].
A comparative trial of a combination of daunorubicin and cytosine arabinoside (Regimen A) and a combination of aclarubicin and cytosine arabinoside (Regimen B) was performed. Sixteen patients with acute non-lymphocytic leukemia, previously untreated, were entered into this study. Five of 8 patients (62.5%) obtained a complete remission (CR) in Regimen A and B, respectively. The days required for achieving a CR varied from 37 to 46 days in Regimen A and from 22 to 56 days in Regimen B. The total doses of daunorubicin and cytosine arabinoside were from 100 to 240 mg and from 640 to 1,120 mg in Regimen A, respectively. Those of aclarubicin were from 180 to 300 mg and from 660 to 1,000 mg in cytosine arabinoside in Regimen B. In a comparative study on hematological changes, toxic effects on peripheral white blood cell, platelet and nucleated cell counts in bone marrow tended to appear later in Regimen B compared to those in Regimen A. Side effects on digestive system such as nausea and vomiting and vascular pain were more frequently recognized in patients treated with Regimen B, although they were managed by symptomatic treatment. The results indicated the usefullness of aclarubicin in combination chemotherapy for the treatment of acute non-lymphocytic leukemia.
A case of angio-immunoblastic lymphadenopathy with dysproteinemia related to allopurinol.
A 63-year-old man developed generalized lymphadenopathy with skin rashes, fever, hepatomegaly and polyclonal hypergammaglobulinemia, twice, in February 1972 and in June 1979, after taking allopurinol for gout. Cervical lymph node biopsy, performed each time, showed the presence of immunoblasts and plasma cells, effaced nodal structure with involvement of the pericapsular tissue, rich vascularity and numerous mitoses, indicative of angio-immunoblastic lymphadenopathy with dysproteinemia (Frizzera, Moran and Rappaport). The existence of hypersensitivity to drugs, in particular, allopurinol in certain patients was emphasized, and induction of immunoblastic lymphadenopathy with various other therapeutic agents was briefly discussed.
A 14q+ chromosome in adult T-cell leukemia.
Chromosome studies were conducted on two patients with adult T-cell leukemia. In both patients, a marker chromosome 14q+ and a structural change involving chromosome 1 with trisomy of the q arm were found in peripheral blood leukocytes. The 14q+ marker chromosome had resulted from translocation from #5p in one patient and #5q in the other patient. The present and previous studies suggest that the donor chromosomes involved in the 14q+ translocation are variable. This indicates that the 14q+ marker chromosome rather than the donor chromosome is intimately related with adult T-cell leukemia.
A case of hand mirror cell variant of acute lymphoblastic leukemia.
A 30 year old female patient diagnosed as acute lymphoblastic leukemia (ALL) with hand mirror like configuration of lymphoblastic-lymphocytic cells is reported. Although the leukemia was resistant to conventional chemotherapeutic regimens, the patient always looked well and survived for more than 20 months. Surface marker analysis showed that the cell was non-T, non-B, and not reactive to antiserum against common ALL antigen. A cytogenetic study of all the analyzable metaphases of the direct bone marrow preparation had a normal female karyotype. The clinical and hematological course is described. The immunological significance and the influence of hand mirror cell on chemosensitivity and prognosis are discussed.
Treatment of refractory acute leukemia with aclacinomycin-A.
Twelve patients with refractory acute leukemia (7 patients with acute myelocytic leukemia and 5 patients with acute lymphocytic leukemia) were treated with a new anthracycline antibiotic, aclacinomycin-A (ACM). ACM was administrated by intravenous drip infusion at a dose of 20 mg/day for 7 or 14 days and this was repeated after at least 7 days. Four of 12 patients (33.3%) achieved a complete remission; 3 of 7 acute myelocytic leukemia (42.8%) and 1 of 5 acute lymphocytic leukemia (20.0%). The days required for achieving the complete remission ranged from 23 to 78 days (median: 61) and the total doses of ACM used from 180 to 500 mg (median: 310), and the durations of complete remission from 11 to 28+ weeks (median: 21+). The untoward effects on digestive organs, such as nausea, vomiting and anorexia, and hematological toxicities were frequently seen; however, they were controlled by supportive treatment. Alopecia was not observed. Arrythmia was recognized in one patient at the initiation of ACM infusion with complete remission without withdrawal of ACM. These results suggest that ACM is a potentially effective anthracycline antibiotic in the clinical management of acute leukemia.
Regulation of tryptophan-niacin metabolism in diabetic rats.
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Effect of pituitary hormones on alpha-amino-beta-carboxymuconate-epsilon-semialdehyde decarboxylase in rat.
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Regulation of tryptophan-niacin metabolism by hormones.
The regulation of tryptophan-niacin metabolism by pituitary and adrenocortical hormones was investigated. Hypophysectomized rats fed on a niacin-free purified diet were injected with bovine somatotropin, predonine acetate or both. The urinary excretion of N-methylnicotinamide (MNA) and N-methyl-2-pyridone-5-carboxamide (2-Py) after oral administration of tryptophan was then compared before and after the hormone treatment. The amount of urinary MNA was found to be increased after the injection of somatotropin, but decreased after the predonine injection. On the other hand, no change in urinary MNA was observed in the rats administered with both hormones. The amount of 2-Py appeared to be reduced by the predonine treatment, but was not affected by somatotropin injection. The activity of liver alpha-amino-beta-carboxymuconate-epsilon-semialdehyde decarboxylase (picolinic carboxylase) was shown to be directly proportional to the ratio (oral tryptophan)/(urinary MNA). Moreover, the enzyme activity appeared to be inversely proportional to the concentration of niacin in liver. In addition, the amount of urinary MNA was suggested to be affected by the change of body weight gain. The administration of both pituitary hormone and insulin failed to normalize the reduced urinary MNA excretion in diabetic rats, suggesting that any change in pituitary hormone was not responsible for the abnormal tryptophan-niacin metabolism in diabetes.
[Studies of the real state of antibiotic consumption at an university hospital. Study in the pediatric department (author's transl)].
Antibiotic use at the Department of Pediatrics, Teikyo University Hospital was studied from 1974 to 1978, during which period a marked change was observed in the antibiotic consumption of Japan on the whole. From the view point of net weight of antibiotics consumed, beta-lactam antibiotics have been increasing up to more than 90% of antibiotic consumption and then follow macrolides and aminoglycoside substances. Chloramphenicol which was once the top antibiotic prescribed, and tetracyclines which have not been our choice, both have become very minor antibiotics in our present prescription. More than 90% of oral antibiotics were prescribed for outpatients and more than 90% of injectable antibiotics were administered to outpatients. Concerning oral penicillins, major three were ACPC, ABPC and AMPC for these years and as to oral CEPs most of them was CEX. ABPC and the fixed combination of ABPC and penicillinase resistant penicillin, were the top choice among injectable penicillins and CEZ was the top among CEPs. Concerning aminoglycoside antibiotic SM and KM were preferred as antituberculosis drug, and GM and DKB as antipseudomonas drug which took the main role in place with CBPC and SBPC since 1976. The type of oral drug preferred by pediatricians for prescription was also investigated and dry syrup type was found to be the most important one for pediatrics use. In spite of a steady increase of our outpatients for these five years, there was observed a remarkable decrease in number of antibiotic prescriptions, namely from 8,223 in 1974 to 4,613 in 1978. The reason is esteemed due to our policy to restrict possibly the needless use of oral antibiotics.
A defect of purine nucleotide cycle in the skeletal muscle of hereditary dystrophic mice.
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Experimental studies of the elastic fiber of the capsular ligament: influence of ageing and sex hormones on the hip joint capsule of rats.
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[A case of B-cell acute lymphocytic leukemia (author's transl)].
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