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Biomedical subjects

K Hara

Publications and source records attributed to K Hara.

At least 829 records · Page 46Linked to original sources

[Neoplastic angioendotheliosis: a case of T cell lymphoma positive for S-100 protein].

A 63-year-old woman presented with painless, firm, subcutaneous nodules on her legs and trunk. The lesions were annular or serpiginous and their surface was livid-red to pale-red. Superficial lymph nodes were not palpable. Upper gastrointestinal series, barium enema, Ga scintigraphy, and CT findings were negative. Histological examination revealed deep dermal vessels occupied by neoplastic cells and fibrin thrombi. We diagnosed her as having neoplastic angioendotheliosis. Electron microscopically, tumor cells lacked Weibel-Palade bodies. Immunohistochemically, the tumor cells were positive for leukocyte common antigen, T11, MT-1, HLA-DR and S-100 protein. They were negative for Factor VIII-related antigen, epithelial membrane antigen, carcinoembryonic antigen, B-1, and B-2. Immunoelectron microscopic study showed that their nuclei, cytoplasma, and cell membranes were positive for S-100 protein. Based on these findings, we diagnosed her as having T cell lymphoma. The patient rejected chemotherapy and was discharged. Three months after discharge, right hemiplegia developed. Brain CT scan revealed enhanced masses in the left frontal, temporal, and occipital lobes. Craniotomy showed only gliosis and hemorrhage. She died of cerebral bleeding three months after craniotomy.

Biomarkers, Tumor↗

[Three cases of endobronchial hamartoma].

We reported three cases of endobronchial hamartoma. There were some difficulties in diagnosis of the disease by bronchoscopic examination, because the tumors were covered with normal bronchial epithelium. But X ray film and CT film contributed to the diagnosis when calcification of intra-bronchial tumor was observed. Three different modes of operation were performed as extirpation of tumor by wedge resection of upper lobe bronchus, sleeve resection of left S6 segmental bronchus, and right middle lobectomy.

Adult↗

[Four cases of myocardial sarcoidosis].

We reported 4 cases diagnosed as myocardial sarcoidosis. One of them was diagnosed by endomyocardial biopsy, however, the others were diagnosed by cardiological findings and biopsy of the scalene node, liver or skin. Analysis of ECG findings showed conduction disturbances in all cases and disorders of impulse formation in two. Thallium 201 myocardial perfusion scans (T1 scan) revealed inferior and anteroseptal wall defects in case 4 and entire heterogenous defect in case 2. And also in case 2, left ventricular perfusion defect detected in T1 scan before steroid therapy changed to entire heterogenous defect. Thus, T1 scan was thought to be useful for the evaluation of therapy and for follow up study of myocardial sarcoidosis. In the cardiac echogram, thickening of the wall was seen in cases 3 and 4, and dilated ventricle in another case. Steroid was given in all cases and a pacemaker was implanted in two cases. The therapy was effective in all cases and ECG abnormalities were improved. In one case (Case 3) treated by a pacemaker steroid administration was halted and subsequently developed heart failure, but the other (Case 1) continued treatment with steroid caused return to a natural beat. Thus steroid therapy with a pacemaker implantation was considered to be effective for severe myocardial sarcoidosis.

Adult↗

[The relationship between mitral regurgitation and asynergy of the left ventricle in old myocardial infarction].

To elucidate the mechanism of mitral regurgitation (MR) in patients with old myocardial infarction, two-dimensional (2D) and 2D Doppler echocardiographic examinations were performed in 92 patients. According to the sites of asynergy in the short-axis view of the left ventricle at the papillary muscle level, the patients were classified in three groups; i.e., anteroseptal (AS) group (49 cases), inferoposterior (IP) group (29 cases), and the AS + IP group (14 cases). The existence and severity of MR were evaluated by 2D Doppler echocardiography and the presence of mitral valve prolapse (MPV), by 2D echocardiography. The mitral valve ring diameter was also measured. The incidence of MR was significantly higher in the IP group (41%) and AS + IP group (43%) than in the AS group (20%) (p less than 0.05, respectively). In the IP group, 21 patients had left ventricular asynergy at the base of the posterior papillary muscle; eight did not. In the former 21 patients with asynergy, MR was detected in 12 (57%) and MVP in nine (43%), whereas neither MR nor MVP was detected in the eight patients without asynergy. The grade of MR assessed by 2-D Doppler echocardiography was significantly more severe in patients with MVP than in those without MVP (MR distance: 23 +/- 6 mm with MVP vs 11 +/- 1 mm without MVP; p less than 0.05, MR area; 312 +/- 217 mm2 with MVP vs 64 +/- 29 mm2 without MVP; p less than 0.05). MR appeared at the mitral orifice between its middle portion and the posteromedial commissure, which coincided with the site of MVP in the majority of cases. In the AS and AS + IP groups, however, such close relationships between MR and MVP were absent. In these groups, mitral valve ring diameters were significantly larger in patients with MR than in those without MR (AS group: 32 +/- 3 mm with MR vs 24 +/- 2 mm without MR; p less than 0.01, IP group: 26 +/- 2 mm with MR vs 25 +/- 2 mm without MR; NS, AS + IP group: 30 +/- 3 mm with MR vs 24 +/- 1 mm without MR; p less than 0.05). Mitral valve ring diameters in the IP group with MR (26 +/- 2 mm) were smaller than in those in the AS and AS + IP groups with MR, and did not differ from those in the IP group without MR (25 +/- 2 mm). In conclusion, posterior papillary muscle dysfunction was mainly responsible for MR in the inferoposterior infarction and the dilatation of the mitral valve ring in the infarction involving the anteroseptal wall.

Aged↗

Sultamicillin experiences in the field of internal medicine.

Sultamicillin is a substance in which sulbactam, a beta-lactamase inhibitor, is covalently linked through an ester group to ampicillin. This paper describes the results of a clinical trial with sultamicillin in the infectious diseases encountered in internal medicine. In an open segment of the trial, 426 adult patients were treated orally with sultamicillin. The efficacy rates achieved were 86.1% (136/158) in acute respiratory infections, 67.5% (137/203) in chronic respiratory infections, 92.9% (39/42) in acute urinary tract infections, 76.9% (10/13) in chronic urinary tract infections, and 70.0% (7/10) in other types of infections. The bacteriological efficacy of sultamicillin was 83.8% (62/74) for Gram-positive and 74.0% (159/215) for Gram-negative bacteria. Efficacy was similar, 81% (17/21), for those strains that were high producers of beta-lactamase. Adverse reactions were observed in 10.1% of the patients in the open phase of the trial. In the double-blind segment, sultamicillin was compared with bacampicillin in respiratory infections, including pneumonia, lung abscesses, and chronic respiratory tract infections. One tablet of either drug was given orally three times a day for 14 d. Evaluation of clinical effectiveness by the trial committee revealed efficacy rates of 82.8% (96/116) for sultamicillin and 69.8% (81/116) for bacampicillin, indicating a significant superiority for sultamicillin. All of this difference resulted from the superior efficacy of sultamicillin (89.2%) over that of bacampicillin (63.2%) in patients with chronic respiratory infections. Efficacy in pneumonia was the same for both agents. Adverse reactions to sultamicillin and bacampicillin were observed in 16.3% (21/129) and 6.3% (8/127) of the cases, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Effect of lobenzarit disodium (CCA) on B cell differentiation to antibody secreting cells].

We investigated the effect of the immunomodulator CCA on B cells, using the system of Staphylococcus aureus Cowan 1-stimulated B cells developing into antibody secreting cells in the presence of T cell factors. Results were expressed as the number of plaque-forming cells (PFC), as measured by reverse hemolytic plaque assay. Serially diluted CCA was added to the culture system to evaluate its effect (500-0.005 micrograms/ml). Different results were obtained by adding CCA at a high dose or a low dose. High-dose CCA showed an inhibitory effect on PFC (p less than 0.01). On the other hand, low-dose CCA showed an inhibitory effect on high PFC responses of B cells and a stimulatory effect on low responses. Our data suggest that CCA has a direct effect on B cells and that low-dose CCA has immunomodulatory action on normal variations in immune responses.

Antibody-Producing Cells↗

[Evaluation of time-resolved fluorometric immunoassay of CA 50].

Serum CA 50 was determined by a time resolved fluorometric immunoassay (TR-FIA) with CANAG CA-50 DELFIA kit. Evaluation of the assay system gave satisfactory results in its sensitivity, accuracy, reproducibility, dynamic range and easy handling. No prozone phenomenon was observed up to 347,000 U/ml. From a histogram of 134 normal sera, the cut off point was determined at 34 U/ml. CA 50 in 202 patients' sera was determined with this assay. Nineteen of 20 patients pancreatic cancer, 6 of 21 gastric cancer, 14 of 25 hepatoma gave positive values. In comparison with CA 19-9, higher values and higher rates of positive CA 50 were observed in benign and malignant liver diseases, suggesting its non-cancerous origin in the liver. A high correlation was observed between the level of CA 50 and CA 19-9 of 157 patients' sera. Serum CA 50 was completely correlated with CA 19-9 in the clinical course of patients with pancreatic cancer, but not in patients with hepatoma. Thus we conclude that the CANAG CA-50 DELFIA System is useful for the diagnosis and monitoring cancer patients but must be used with care because of its elevation in benign liver diseases.

Antigens, Tumor-Associated, Carbohydrate↗

[Two cases of tuberculous peritonitis and clinical significance of serum CA-125].

We had recently experienced two cases of tuberculous peritonitis. One was suspected of ovarian cancer but finally diagnosed as tuberculosis by the exploratory laparotomy. The other was found out casually at the operation of benign ovarian tumor. Both cases accompanied with pulmonary tuberculosis. Tuberculous peritonitis should be considered in the differential diagnosis in patients with abdominal disorders. Remarkable elevation of serum CA-125 related to ovarian cancer was found in both cases. It was suggested that level of serum CA-125 might be useful for diagnosis and monitoring of the disease.

Adult↗

[Amelioration of cisplatin-induced vomiting and anorexia by methylprednisolone].

Amelioration of cisplatin (CDDP)-induced vomiting and anorexia by methylprednisolone (MP) was studied using conscious dogs. The incidence of vomiting was 88.9% and the mean number of emetic episodes was 8.22 +/- 1.25/dog during 5 hours after i.v. administration of 1.5 mg/kg CDDP in 9 dogs. In control dogs, food intake on the day after administration of CDDP was markedly reduced to 60 +/- 22.4 g/day from 461 +/- 23 g. Continuous high-dose infusion of MP (10 mg/kg, 10 min before the start of CDDP infusion and 50 mg/kg/h for 5 h) markedly reduced the incidence (33%) and mean number of vomiting episodes (2.00 +/- 1.51/dog) and also mitigated the reduction of food intake (350 +/- 30.6 g/day). However, continuous low-dose infusion of MP (5 mg/kg, 10 min before CDDP infusion and 16.6 mg/kg/h for 5 h) showed a little effect on CDDP-induced vomiting. Plasma MP levels after the high-dose and the low-dose regimens were 6.20 +/- 0.628 micrograms/ml and 4.66 +/- 1.72 micrograms/ml, respectively, 30 min after CDDP infusion. In both cases, MP levels gradually increased and reached to those more than twice 5 hours after CDDP infusion. Bolus administrations of MP (30 mg/kg, each time) 2 hr and 30 min before CDDP infusion also significantly reduced the mean number of emetic episodes (3.22 +/- 1.33/dog) and mitigated the reduction of food intake (325 +/- 37.3 g/day). No significant changes in catecholamines, prostaglandins, vasopressin, plasma renin activity, Na+, K+, Mg++ and osmolality in peripheral blood were noted after administration of CDDP and/or MP. The results suggest that administration of MP was effective against CDDP-induced vomiting and anorexia in dogs.

Animals↗

[Clinical studies on eleven patients with nasal and paranasal lymphoma, with special reference to staging evaluation].

Adequacy of applying Ann Arbor classification and TNM classification to evaluate extent of disease in extranodal lymphoma was assessed in patients with nasal and paranasal lymphoma. Ann Arbor classification proposed to evaluate extent of Hodgkin's disease was not considered to be good at assessing extranodal local lesions. TNM classification was superior to Ann Arbor classification in terms of the correspondence with survival. Patients with nasal and paranasal lymphoma of T3 and T4 stage (TNM classification) were prone to develop bone marrow and CNS spread.

Adult↗

[Effect of LDL-apheresis on a case of Cerebrotendinous Xanthomatosis].

Cerebrotendinous Xanthomatosis (CTX) is a rare familial disease characterized by tendon-xanthomas, cataracts, progressive cerebellar ataxia, dementia and an elevation of serum cholestanol with normal levels of cholesterol. Although the pathogenesis of CTX is not fully understood, increment of cholestanol is suggested one of the major metabolic derangements of the disease. Recently, the LDL-apheresis has been developed as a new therapeutical equipment in the field of hyperlipidemia and been widely used to reduce the levels of LDL-cholesterol by selective LDL adsorption. From the point of view that cholestanol is involved mainly in LDL-cholesterol (1.019 less than d less than 1.063), we used this LDL-apheresis in the aim of reducing the cholestanol in 58 years old woman with typical sign and symptoms of CTX. The levels of serum cholestanol and cholesterol before the treatment with LDL-apheresis, were 10.7 micrograms/ml and 175 mg/dl respectively. Also the ratio of cholestanol/cholesterol indicated 0.63. By the first procedure of apheresis, the level of cholestanol was markedly decreased to 5.2 micrograms/ml (50%). Several LDL-apheresis treatments were carried out once a month. During 5 months treatments, neurological deterioration was arrested, dementia which included disorientation and recent-memory loss, cleaned a little. Although the xanthomas did not decrease in size, this patients was better oriented to person, place, time and was able to speak rationally, 2nd her cerebellar dysfunction revealed improvement. From our new experiments-we believe that the LDL-apheresis offers the strong hope of preventing the progress on cerebrotendinous xanthomatosis.

Achilles Tendon↗

[Evaluation of the response of advanced diffuse large cell lymphomas (LSG classification) to weekly CHOP therapy].

"Weekly CHOP" therapy characterized by reduced dosages of cyclophosphamide, doxorubicin and vincristine, was evaluated in 33 patients with advanced diffuse large cell lymphomas (LSG classification). There were 19 complete responders (59%) and 8 partial responders (25%) with a response rate of 84%. A prolonged disease-free survival rate (survival plateau) of 60% was considered comparable to the results of second-generation chemotherapies. The response was poor in patients with high grade malignancy (large cell, immunoblastic category in Working Formulation for Clinical Usage) as well as in patients with bone marrow invasion.

Antineoplastic Combined Chemotherapy Protocols↗

[Clinical analyses on 10 patients with follicular lymphoma].

Clinicopathologic analyses were done on 10 patients with follicular lymphoma including 8 patients with low grade malignancy. The complete response rate to chemo- and combined modality therapy was 80% with no deaths occurring in patients in complete remission with median follow-up of 73 months. The 5-years' survival for these 10 patients was 86%. There were two patients with second primary neoplasm, one with gastric cancer detected one year after initiation of chemotherapy, the other with leiomyosarcoma detected 3 years after cessation of chemotherapy. Histologic transformation from follicular medium sized cell to diffuse large cell was noted in one patient.

Adult↗

[A case of antigranulocyte antibody positive Felty's syndrome and its efficacy of plasmapheresis].

The patient is a 44-year-old female case of RA having a history of 10 years after onset, being admitted due to fever accompanied by granulocytopenia. By laboratory findings, WBC was 1,900/mm3, CRP 5+, RA 2+, RAHA 80 times, LE cells positive, antinuclear antibody strongly positive, granulocyte-specific antinuclear antibodies positive, and granulocyte specific cytotoxicity test strongly positive. Examination of bone marrow smears revealed, the cell numbers tended to decrease in the neutrophil maturity phase. The case was diagnosed as Felty's syndrome because of the obvious splenomegaly and leukopenia. Administration of 30 mg/day of prednisolone was not sufficient in effect, and plasmapheresis was conducted concomitantly. As a result, the granulocyte count increased and the granulocyte cytotoxicity titer was lowered. It is hence suggested that the antigranulocyte antibodies are responsible for the mechanism of granulocytopenia in this case, and the possibility of promotion of destruction in the periphery was inferred, and it is accordingly considered useful to combine administration of small dose of adrenocortical steroid preparation with plasmapheresis for the treatment of this disease.

Adult↗

[Clinicopathologic analyses of eleven patients with Hodgkin's disease].

Clinicopathologic analyses were performed on 11 patients with histopathologic diagnosis of Hodgkin's disease which was confirmed immunohistochemically with the use of anti-Leu M 1 which is known to be specific to Reed-Sternberg cells. Patients with clinical stage II developed infradiaphragmatic involvement after Mantle field irradiation and should have been treated with extended field irradiation or combined modality therapy because of the possibility of PSIII1. Maintenance VENP therapy seemed to sustain remission but may have caused opportunistic infections. There were no rearrangements in either immunoglobulin or T cell receptor genes studied in two patients.

Adolescent↗

[Screening of drugs and chemicals by wide-bore capillary gas chromatography with flame ionization and nitrogen phosphorus detectors].

A method is presented for forensic toxicological screening of drugs and chemicals in blood and urine by wide-bore capillary gas chromatography with flame ionization detectors (FID) and nitrogen phosphorus detectors (NPD). The presence of drugs and chemicals in blood and urine specimens was confirmed by comparing these gas chromatograms with those of typical drug-free specimens. Peak components of drug-free specimens were piperidone, p-cresol, myristic acid, palmitic acid, stearic acid, oleic acid, linoleic acid, n-butylphthalate, bis (2-ethylhexyl) phthalate, squalene, cholesterol and two alcohols (unidentified) on FID chromatograms and were piperidone, indole, nicotine, cotinine, hydroxycotinine, caffeine and several unknown urine constituents on NPD chromatograms. In practical cases, the presence of drugs and chemicals in postmortem specimens was easily ascertained by the present method.

Adult↗