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Biomedical subjects

J Tanaka

Publications and source records attributed to J Tanaka.

At least 541 records · Page 30Linked to original sources

[Autonomic function and severity of hypertrophic cardiomyopathy by power spectrum analysis on heart rate variability].

To examine the relation of autonomic function and severity of hypertrophic cardiomyopathy (HCM) with and without ventricular tachycardia (VT) and poor blood pressure response on Treadmill exercise, 30 patients with HCM and 10 healthy controls were selected. Autonomic function was assessed by heart rate variability (HRV) on 24hr-Holter monitoring. The power spectrum analysis was classified into LF component, HF component and ratio of LF/HF. (1) Night time HF and LF decreased, and LF/HF increased in HCM compared with healthy controls. (2) HF decreased more in HCM with VT. (3) LF/HF also decreased in HCM with poor blood pressure response on exercise. These results suggest that autonomic function may be altered in HCM, and severity of HCM proved to be able to be assessed by power spectrum analysis of HRV.

Autonomic Nervous System↗

[A case of an cerebello-pontine angle pineoblastoma].

An extremely rare case of a left cerebello-pontine angle (CP angle) pineoblastoma has been reported. The patient was a 32-year-old male whose initial manifestations were those of increased intracranial pressure. CT scan showed a large enhancing mass located at the left CP angle, associated with a moderate occlusive hydrocephalus. Left suboccipital craniectomy was performed. The mass was an extramedullary tumor which had compressed the left cerebellar hemisphere, and was easily separable from the adjacent tissue. The tumor was totally resected, and the patient had a temporary release from the symptoms. Recurrence and spinal dissemination were found within the ensuing few months. The tumor had invaded deeply through the left CP angle into the cerebellar parenchyme, and showed no anatomical connection with the pineal body. The tumor dissemination was also observed widely in the spinal subarachnoid space. No abnormalities at the pineal region were able to be confirmed using CT and MRI studies. Irradiation to the whole brain, to the localized left CP angle and to the spinal cord with additional chemotherapy was given. The patient died half a year after the first operation. Autopsy was not performed. Histopathologically, the tumor was delineated into lobular structures by reticulin fibrils and vimentin-positive interstitial tissue. Tumor cells were small in size, and had irregularly shaped hyperchromatic nuclei with increased mitotic figures, and formed various types of rosettes; pineocytomatous, Flexner-Wintersteiner, Homer-Wright and perivascular. Fine argyrophilic cell processes with club-shaped expansions were demonstrated inside the pineocytomatous rosettes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Primary localized amiloidosis with recurrent relapse: a case report].

This is a case report of primary localized amyloidosis of the urinary bladder. The patient was a 73-year-old woman who had relapse of this disease three times. Primary localized amyloidosis of the urinary bladder is an especially rare disease and the prognosis is excellent in most cases. We performed transurethral resection of the bladder tumor (TUR-Bt) each time and we are following up this patient carefully. After the last TUR-Bt, she has had no recurrence for 7 months. Considering multifocal recurrence and excellent prognosis, we stress the importance of TUR-Bt for diagnosis and careful follow up.

Aged↗

[A case of microsurgically removed cavernous angioma in the midbrain].

The authors presented a case of microsurgically removed large cavernous angioma in the midbrain. A 46-year old woman was admitted to our service with bilateral nuclear oculomotor pareses and mild tetraparesis. MRI revealed a large round well-circumscribed high signal-intensity lesion on both T1 and T2 weighted image with low signal rim in the midbrain. This lesion was diagnosed preoperatively as a cavernous angioma. The operation was performed in three steps with intermittent hemorrhages by interhemispheric transcallosal-hippocampal commissure--velum interpositum-third ventricular approach and subsequent two infratentorial supracerebellar approaches and finally complete removal was performed. Histological examination of the surgical specimen revealed as a cavernous angioma having abnormal vessels with honeycomb appearance. The patient survived, although remains moderately disabled 6 months after the last operation.

Brain Neoplasms↗

[Effect of heart rate on cardiac hemodynamics in patients with aortic regurgitation].

We evaluated the effects of heart rate on cardiac hemodynamics in 10 patients with aortic regurgitation (AR, mean regurgitant fraction: 64.3%). Cardiac catheterization was performed in all patients, and the hemodynamic parameters were obtained by increasing heart rate (80.100.120.140) using right atrial pacing. Regurgitant fraction and total systemic resistance were improved up to 100/min, but aggravated on further increase in heart rate. Cardiac function curve was remarkably improved up to 100/min, but aggravated on further increase in heart rate. LV end-diastolic pressure-volume relation was moved toward the left lower direction up to 100/min, but toward the left upper direction on further increase in heart rate. Thus, it was concluded that in severe AR, cardiac function was improved up to 100/min, but aggravated on further increase in heart rate.

Aortic Valve Insufficiency↗

Sarcoidosis of the ring finger: a case report.

Sarcoidosis is a systemic granulomatous disease of unknown etiology. The author reports on the isolated involvement of the soft tissues of a finger in a 44-year-old housewife, without bony alterations or synovialitis of the tendons or joints.

Adult↗

Glial fibrillary acidic protein stimulates proliferation and immunoglobulin synthesis of lymphocytes from Alzheimer's disease patients.

The level of anti-GFAP (glial fibrillary acidic protein) IgG antibody titer was assayed in sera of patients with Alzheimer's disease, multi-infarct dementia, and the age-matched control subjects. Significantly higher level of anti-CFAP titer was found in sera of Alzheimer's disease patients. The in vitro lymphocyte response was studied by stimulation with GFAP and interleukin 2 (IL-2). The lymphocytes of Alzheimer's disease patients showed higher proliferative response than those of the control by GFAP and IL-2 stimulation. The IgG secretion by lymphocytes from Alzheimer's disease patients was also stimulated by GFAP as well as by GFAP plus IL-2. The results demonstrate that the lymphocytes of Alzheimer's disease patients are more responsive to GFAP than those of the control subjects.

Aged↗

More than ten years' follow-up of the Hancock porcine bioprosthesis in Japan.

From February 1975 through October 1981, 256 Hancock porcine bioprostheses (Johnson & Johnson Cardiovascular, King of Prussia, Pa.) (60 aortic, 169 mitral, and 27 pulmonary/tricuspid position) were implanted in 220 patients (104 male and 116 female, aged 9 to 67 years; mean 43.3) at Kyushu University Hospital in Japan. The procedures include 41 aortic valve replacements, 121 mitral valve replacements, 4 pulmonary valve replacements, 6 tricuspid valve replacements, and 48 combined valve replacements (31 aortic plus mitral, 13 mitral plus tricuspid, and 4 aortic plus mitral plus tricuspid). Hospital mortality was 6.4%. Follow-up was 98% during 8 to 14 (mean 10.5) years. Cumulative follow-up was 1836 patient-years and 2078 valve-years. At 10 years the overall actuarial survival rate, including hospital morality, was 70% +/- 3%, and freedom from valve-related mortality with sudden death was 87% +/- 3%. More than half of the current survivors required no anticoagulant therapy. Freedom from thromboembolism or anticoagulant-related hemorrhage (or both) and prosthetic valve endocarditis was common. Freedom from structural valve failure and reoperation declined more than 9 years after replacement of left-sided heart valves but not after replacement of right-sided heart valves. Sixty-seven patients underwent 68 repeat operations, and there were four deaths (5.9%). The rate of freedom from overall valve-related complications at 10 years was 62% +/- 8% for aortic valve replacement, 53% +/- 5% for mitral valve replacement, 80% +/- 13% for pulmonary/tricuspid valve replacement, and 42% +/- 9% for combined valve replacement. There was a significant difference between pulmonary/tricuspid valve replacement and combined valve replacement (p less than 0.05). The Hancock bioprosthesis is suitable for the replacement of valves in the right side of the heart but not for combined valve replacement.

Actuarial Analysis↗

Etoposide with lonidamine or pentoxifylline as modulators of alkylating agent activity in vivo.

In an effort to improve the additive anti-tumor efficacy of commonly used alkylating agents, the topoisomerase-II inhibitor etoposide was used in combination with either the mitochondrial poison and energy-depleting agent lonidamine or the hemorheologic agent and tumor-blood-flow-increasing agent pentoxifylline. In the FSaIIC murine fibrosarcoma system, these modulators were evaluated for modulation of whole-tumor cell killing vs. bone-marrow CFU-GM toxicity with the alkylating drugs CDDP, CTX, L-PAM or BCNU. Etoposide alone was essentially additive with the alkylating drugs for both tumor-cell and bone-marrow killing, except for BCNU, where a substantial increase in tumor-cell killing occurred (0.5 to 2.0 logs over the dose range of BCNU tested) without a significant increase in bone-marrow toxicity. Etoposide plus lonidamine was significantly more active than etoposide alone only with CTX and BCNU in tumor-cell vs. bone-marrow killing. Etoposide plus pentoxifylline was also most active with these two alkylating agents, where increases in tumor-cell killing of 0.5 to 1.0 log were observed. Hoechst-33342-defined tumor-cell sub-population studies revealed that etoposide significantly improved the killing of dim (putative hypoxic) cells by CDDP, but neither lonidamine nor pentoxifylline significantly improved killing of bright or dim cells together. With CTX, etoposide plus lonidamine or pentoxifylline substantially improved killing of dim cells over etoposide alone (each by about 0.8 logs). These data indicate that a therapeutic advantage may be achievable by combining etoposide with lonidamine or pentoxifylline for use with alkylating drugs.

Alkylating Agents↗

Clinico-pathological features of liver metastases from colorectal cancer in relation to prognosis.

Twenty-nine patients undergoing hepatic resection for colorectal metastases from 1980 to 1986 were studied. The overall cumulative survival rates were 82%, 63% and 32% at 1, 2 and 3 years, respectively. The possible prognostic factors, i.e., Dukes' staging of the primary lesion, the number of metastatic nodes, synchronous versus metachronous appearance of metastases, and curative versus non-curative resection were estimated. Evaluation of those categories did not provide any significant information for prognosis after hepatic resection for liver metastases. The growth patterns of the tumor boundary were classified into three types as sinusoidal, expansive, and mixed. There was no significant difference in the survival rates among these groups. The significant factor affecting prognosis was only whether the secondary tumors were encapsulated or not. Patients with encapsulated tumor of the interval longer than 2 years between colon resection and hepatic resection had a significantly better survival rate.

Adult↗

Modulation of alkylating agents by etanidazole and Fluosol-DA/carbogen in the FSaIIC fibrosarcoma and EMT6 mammary carcinoma.

Tumor cell survival assay in the FSaIIC murine fibrosarcoma demonstrated that when the modulator Fluosol-DA (0.3 ml; 12 ml/kg i.v.) was administered just prior to an alkylating agent plus carbogen breathing for 6 h or the modulator etanidazole (1 g/kg i.p.) was administered just prior to an alkylating agent, the combination treatment produced significantly more tumor cell killing across the dosage range of each alkylating agent tested compared with the alkylating agent alone. Each alkylating agent produced a dose-dependent log-linear tumor cell survival curve. There was an increase in tumor cell killing of 5-10-fold when either Fluosol-DA/carbogen or etanidazole was added to treatment with the alkylating agent. For cis-diamminedichloroplatinum(II) (CDDP) and N,N',N''-triethylenethiophosphoramide, the modulators used in combination increased tumor cell killing by only 2-3-fold over that obtained with a single modulator, but for the other alkylating agents, tumor cell killing was increased by 10-50-fold when the combination of modulators was used. Bone marrow granulocyte-macrophage colony-forming unit survival assays showed that the combination of modulators with the alkylating agents resulted in only small increases in bone marrow toxicity of the alkylating agents except for N,N',N''-triethylenethiophosphoramide and L-phenylalanine mustard (L-PAM), for which the toxicity to the bone marrow granulocyte-macrophage colony-forming unit was increased by 5-10-fold compared with the alkylating agents alone. The Hoechst 33342 dye diffusion defined tumor cell subpopulation assay, also in the FSaIIC tumor, demonstrated that the combination of modulators increased the toxicity of CDDP, cyclophosphamide, L-PAM, and 1,3-bis(2-chloroethyl)-1-nitrosourea by 9-55-fold compared with the alkylating agent alone in both the bright (euxoic-enriched) and dim (hypoxic-enriched) cells. For each alkylating agent except 1,3-bis(2-chloroethyl)-1-nitrosourea, the increase in tumor cell killing was greater in the dim cells than in the bright cells. Finally, tumor growth delay studies in both the FSaIIC tumor and the EMT-6 murine mammary adenocarcinoma confirmed that the combination of modulators significantly increased the tumor growth delay caused by CDDP, carboplatin, cyclophosphamide, N,N'N"-triethylenethiophosphoramide, L-PAM, and 1,3-bis(2-chloroethyl)-1-nitrosourea. The greatest increases (4-5-fold) were observed for carboplatin and L-PAM in the FSaIIC tumor and CDDP and cyclophosphamide in the EMT-6 tumor. These results suggest that Fluosol-DA/carbogen together with etanidazole may be an effective modulator combination of alkylating agents in the clinic.

Alkylating Agents↗

[67Ga citrate imaging in AIDS-related Pneumocystis carinii pneumonia in Japan].

Six AIDS patients with Pneumocystis carinii pneumonia (PCP) underwent 67Ga scan as part of their evaluation. Only one patient of them showed the characteristic 67Ga distribution pattern for PCP, that is, diffuse, increased, bilateral lung activity greater than liver activity. Two patients who were receiving therapy for PCP and one patient with recurrent PCP showed focal or uneven 67Ga lung uptake. In the four patients, the scan showed more extensive lesion than the chest radiograph. The other two patients who died 2 months later of cellular immunodeficiency showed no or very slight lung uptake of 67Ga. In summary, 67Ga scanning is useful diagnostic procedure in evaluation of PCP in patients with AIDS.

Acquired Immunodeficiency Syndrome↗

Fluosol-DA/carbogen with lonidamine or pentoxifylline as modulators of alkylating agents in the FSaIIC fibrosarcoma.

In an effort to increase the efficacy of several antineoplastic alkylating agents (CDDP, L-PAM, CTX, or BCNU), we examined the effect of the modulator Fluosol-DA/carbogen in combination with a second modulator, either lonidamine or pentoxifylline, on the survival of FSaIIC tumor cells and of bone marrow CFU-GM from tumor-bearing C3H mice. Fluosol-DA/carbogen increased the tumor-cell killing activity of each alkylating agent by about 10 times. In contrast, lonidamine alone did not significantly increase the cytocidal activity of any of the alkylating agents tested. However, in combination with Fluosol-DA/carbogen, the use of lonidamine produced about a 100-fold increase in the tumor cell kill achieved with CDDP as compared with CDDP alone. No increase in tumor cell kill over that produced with the single modulator Fluosol-DA/carbogen was seen following the addition of lonidamine to the combination treatment with L-PAM, CTX, or BCNU. Unfortunately, although neither lonidamine nor Fluosol-DA/carbogen alone significantly increased alkylator toxicity to bone marrow CFU-GM, the combination of modulators increased the toxicity of each alkylating agent to bone marrow by about 10 times. Pentoxifylline caused an increase in alkylator activity against the FSaIIC fibrosarcoma only when used with BCNU; this effect was further augmented by the addition of Fluosol-DA/carbogen. The combination of modulators pentoxifylline plus Fluosol-DA/carbogen was more effective than Fluosol-DA/carbogen alone only when the former was used with BCNU, whereas only minimal increases in tumor-cell killing activity were obtained with this modulator combination and CDDP, L-PAM, or CTX. Pentoxifylline increased the bone marrow CFU-GM toxicity of L-PAM by about 10 times. The bone marrow CFU-GM toxicity was further increased by Fluosol-DA/carbogen, as was the toxicity of each of the other alkylating agents. Lonidamine plus Fluosol-DA/carbogen may be useful in increasing the therapeutic efficacy of CDDP, and the combination of pentoxifylline plus Fluosol-DA/carbogen might improve the antitumor activity of BCNU.

Alkylating Agents↗

Clinical trial with a protease inhibitor gabexate mesilate in acute pancreatitis.

To evaluate whether early administration of protease inhibitors could improve mortality and morbidity in acute pancreatitis (AP), we made a retrospective analysis of 23 patients with severe AP and 88 with mild to moderate AP who were treated in our institute and four affiliated medical centers during the 10-y period from 1980 to 1990. Intravenous infusion of a protease inhibitor, Gabexate Mesilate (FOY), was started within 24 h from onset of AP (early administration) in 17 patients with severe AP and 51 with mild to moderate AP. The remaining patients were put on FOY later than 24 h from onset of AP (late administration). Comparison of the mortality and morbidity between the two groups, early vs late administration of FOY, led to the following conclusions: (1) Early administration of FOY significantly improved mortality (29.4 vs 83.3%) in severe AP, although the improvement in mortality was not directly proportional to the shortening of the time lag between the onset of AP and the start of FOY, and (2) earlier administration of FOY brought about significantly earlier recovery of abdominal pain, hyperamylasemia, and leucocytosis in mild to moderate AP.

Acute Disease↗

An arterialised venous flap using the long saphenous vein.

Free arterialised venous flaps and an arterialised osteocutaneous venous flap, fed by an arterialised long saphenous vein, were used successfully in three cases. This flap has a larger skin territory than those previously reported and the incorporation of bone into such a flap has not been reported before.

Aged↗