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Biomedical subjects

K Nagao

Publications and source records attributed to K Nagao.

At least 145 records · Page 8Linked to original sources
PubMed1997

Carcinoma in basal cell adenoma of the parotid gland.

Malignant transformation of basal cell adenoma (BCA) of the parotid gland is rarely reported, and when occurred, may principally become manifest as a malignant basaloid tumor, i.e. basal cell adenocarcinoma or adenoid cystic carcinoma. We describe herein three cases of non-basaloid carcinoma arising in BCA. The incidence of this malignant tumor was 0.2% of all parotid gland tumors and 4.3% of BCAs in our series. One case was salivary duct carcinoma showing histologic evidence of transition between malignant and benign elements. The remaining two cases were well-encapsulated parotid gland tumors, which were composed of BCA and scattered foci of malignant transformation. Malignant components were adenocarcinoma, not otherwise specified (NOS), and sometimes intermixed with neoplastic myoepithelial cells included BCA cells. These two cases were regarded to be intracapsular carcinoma in BCA. BCA components showed solid, tubular and trabecular arrangements. The patients' prognosis was quite variable among these three cases; the first case died of disease after 27 months, whereas the latter two cases are alive and well for 4 and 10 years after surgery. Ki-67 labeling index indicated that cell proliferative activity was at least five times higher in carcinomas than BCAs. Non-basaloid carcinomas such as salivary duct carcinoma or adenocarcinoma, NOS, do develop in BCAs as in the case of a pleomorphic adenoma with malignant transformation, though the incidence may be extremely rare.

Adenoma↗
PubMed1997

Predictive value of serum medroxyprogesterone acetate concentration for response in advanced or recurrent breast cancer.

Medroxyprogesterone acetate (MPA) is one of the most commonly prescribed drugs for endocrine therapy of metastatic breast cancer. In this study, the serum MPA concentration was measured by high-performance liquid chromatography (HPLC) and evaluated for its usefulness in predicting the response in 79 cases of advanced or recurrent breast cancers. Overall, 29 patients (37%) achieved an objective response. The response rate correlated significantly with the oestrogen receptor (ER) status (P = 0.03), proliferative activity determined by DNA polymerase alpha (P = 0.04), the disease-free interval (DFI) (P = 0.05) and the serum MPA concentration (P < 0.001). Patients with ER-positive tumours, lower proliferative activity, a longer (DFI) or a higher serum MPA concentration responded more frequently. The mean serum MPA concentration in the responders with ER-positive tumours (P = 0.01) or tumours with a lower proliferative activity (P = 0.008) were significantly lower than in cases with ER-negative tumours or tumours with a higher proliferative activity, respectively. Cases with soft tissue metastases showed responses at significantly lower MPA concentrations (P = 0.003) than those with bone or visceral metastases. Furthermore, there was a dramatic decrease in the MPA concentration when a responder with a high concentration became unresponsive to the therapy. Thus, the serum MPA concentration is a determining factor for the response to treatment.

Adult↗
PubMed1997

Sexual function and clinical features of patients with Klinefelter's syndrome with the chief complaint of male infertility.

In this report, we present the overall sexual function and clinical features of patients with Klinefelter's syndrome with the chief complaint of male infertility. The study consisted of 40 patients with a control group of 55 infertile non-azoospermic males with a normal 46,XY karyotype who visited the Reproduction Center of Toho University Hospital during the 5.5-year period between January 1991 and June 1996 with the chief complaint of male infertility. Among the 40 patients with Klinefelter's syndrome, 38 cases were pure 47,XXY, one case was 47,XXY with a pericentric inversion of chromosome 9 and one case was a mosaic of 46,XY/47,XXY(2:28). Thirty-nine of these 40 patients were azoospermic and one (47,XXY) had severe oligoasthenozoospermia. The sexual function of the patients was evaluated according to their responses to a preliminary questionnaire devised by our department. There was no significant difference in the frequency of sexual function disturbances between the patients with Klinefelter's syndrome and the control group (67.5% vs. 60.0%; chi 2 analysis; p = 0.454). The mean frequency of sexual intercourse per month in the patients with Klinefelter's syndrome was significantly higher than in the control group (4.4 +/- 2.8 vs 3.3 +/- 1.6: Welch's t-test, p < 0.05). A possible explanation for this variation may lie in the fact that many of these patients were diagnosed with azoospermia poor to the administration of the questionnaire and may have wished to continue to have relations as a couple.

Adult↗
PubMed1997

Characteristics and pathogenicity of non-melibiose-fermenting strains of Yersinia pseudotuberculosis O3.

The biological properties of non-melibiose-fermenting (NMF) strains of Yersinia pseudotuberculosis O3 were investigated. These strains were clearly distinguished from representative melibiose-fermenting (MF) strains of Y. pseudotuberculosis O3 by their pathogenicity in mice, sensitivity to some phages, production of catalase, restriction endonuclease analysis of virulence plasmid DNA with BamHI, detection of specific yersinia outer-membrane proteins with SDS-PAGE, antigenicity of the outer-membrane proteins and neutrophil resistance to phagocytosis. The pathogenicity of NMF strains was clearly less than that of MF strains. In addition, the resistance of NMF strains to phagocytosis and catalase activity was evidently weaker than that of MF strains. These results suggested that the difference of pathogenicity was due to the ability of catalase production. Although the relationship between the above characteristics and melibiose-fermentation was not analysed, the pathogenicity of Y. pseudotuberculosis O3 strains can probably be predicted by testing melibiose-fermentation and catalase production.

Animals↗
PubMed1997

Chromosomal translocations in human soft tissue sarcomas by interphase fluorescence in situ hybridization.

In soft tissue sarcomas, clonal rearrangement of chromosomes has been shown by cytogenetic analysis to be unique and specific for tumor types. The development of fluorescence in situ hybridization (FISH) has allowed detection of chromosomal rearrangements in the interphase nuclei isolated from paraffin-embedded tissues. Three kinds of translocations in the interphase nuclei that were isolated from 47 cases of soft tissue sarcomas were examined by FISH with chromosome-specific DNA probes of centromeric and total probes. Of 47 soft tissue sarcomas 42 (89.4%) revealed tumor-specific translocations by retrospective cytogenetic analysis. Translocation t(X;18) was detected in 25/28 synovial sarcomas; translocation t(11;22) in 5/6 Ewing's sarcomas and primitive neuroectodermal tumors (PNET); and translocation t(12;16) was found in 12/13 liposarcomas, including 10 myxoid and two round cell types as clonal chromosomal aberrations specific for both subtypes. Based on the cytogenetic analysis, Ewing's sarcoma is related closely with PNET as shown by MIC2-protein reactivity. Other cytogenetic findings of translocation t(12;16) indicate that round cell liposarcomas share chromosomal changes with myxoid liposarcomas, and further suggest that both tumor subtypes of liposarcoma may possess common precursor cells. FISH is a useful aid in determining the tumor type of soft tissue sarcomas with regard to histogenetic origin.

Adolescent↗
PubMed1997

Studies on the site of renal tubular defect in Bartter's syndrome.

Renal tubular function was studied in an 8-month-old male infant with Bartter's syndrome, which is characterized by hypokalemic metabolic alkalosis, normotensive hyperreninemic hyperaldosteronism, and reduced pressor response to angiotensin II. Chloride transport along the diluting segment (CH2O/CH2O + CCl) was impaired. Furthermore, furosemide did not elicit normal natriuresis, which suggested impaired chloride reabsorptive capacity at the furosemide-sensitive ascending limb of Henle's loop. Loss of antidiuretic hormone-mediated urinary concentration was in support of this. These findings pointed to the thick ascending limb of Henle's loop as the site of the primary defect in this child.

Bartter Syndrome↗
PubMed1997

Skin infiltration in acute promyelocytic leukemia.

Acute promyelocytic leukemia (APL) is a type of acute leukemia showing unique clinical, morphological and cytogenetic features. A skin infiltration by APL cells is an extremely rare occasion, but there have been several case reports of leukemia cutis in APL, in which all-trans retinoic acid (ATRA) may have induced the skin infiltration. However, no immunohistochemical analyses of the APL cells in the skin have been done to date. A 30-year-old woman with APL developed multiple reddish purple nodules on the extremities in her second complete remission. Histological findings revealed a dense infiltration of medium to large atypical cells, which were positive for myeloperoxidase, throughout the dermis. Despite the conventional chemotherapy and ATRA therapy she died from disseminated intravascular coagulation during her third relapse. Leukemic cells in the peripheral blood before the treatment with ATRA revealed CD3-/CD4-/CD5-/CD7-/CD8-/CD10-/CD13++/CD14-/CD19 -/ CD20-/CD33++/CD38++/CD41-/Ia-, but they expressed CD3-/CD4-/CD5-/CD7++/ CD8-/CD10-/CD13++/CD14-/CD19-/CD20-/CD33++ /CD38++/CD41+/Ia+ after the treatment. We suggest that the alternation of the surface molecules on the tumor cells is closely associated with the skin infiltration of APL cells.

ADP-ribosyl Cyclase↗
PubMed1997

Is diabetic neuropathy responsible for diabetic impotence?

It is well known that diabetes mellitus is accompanied by complications of sexual dysfunction and it is believed that diabetic neuropathy may cause impotence. In our study, we found that not all the patients who visited our center with the chief complaint of diabetic impotence were suffering from organic impotence, and diabetes mellitus per se served as a means of psychological stress in a substantial number of cases. Probably because no method has been available to provide precise information on the state of the penile-controlling nerves, we found that a larger number of patients than expected were suffering from a vascular disorder.

Algorithms↗
PubMed1997

Relationship between preinfarction angina and time interval to reperfusion with thrombolytic therapy in acute myocardial infarction.

This study was conducted in an attempt to clarify whether preinfarction angina has an ischemic preconditioning effect. The subjects of this study were Killip class I patients who had suffered a first acute myocardial infarction (MI) as a result of total occlusion of the proximal left anterior descending coronary artery without development of collateral vessels and multivessel coronary artery disease. All subjects achieved successful reperfusion [thrombolysis in myocardial infarction (TIMI) flow grade 3] through intracoronary thrombolysis with single-chain urokinase-type plasminogen activator (SCU-PA). Subsequently, they received the same drug therapy and remained free of reocclusion. The patients were divided into those who experienced a new onset of prodromal angina within 24 h before the onset of acute MI [PA(+) group] and those who had a sudden onset of acute MI without the preceding angina [PA(-) group]. They were further divided according to the time interval from the onset of acute MI to reperfusion (within 1 h, 1-2 h, 2-3 h, 3-4 h, and 4-7 h). In addition, the left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), and the amount of creatine kinase (CK) released (sigma CK) were compared in these 2 groups at reperfusion time. The results of this study showed that sigma CK was significantly lower in the PA(+) group than in the PA(-) group (1,850 mIU vs 3,583 mIU) when reperfusion was induced within 1 h after the onset of acute MI. When reperfusion was induced 1-2 h after the onset of acute MI, sigma CK tended to be lower in the PA(+) group than in the PA(-) group (3,677 mIU vs 5,261 mIU). Once the time to reperfusion exceeded 2 h, there was no significant difference in sigma CK between these 2 groups. On the other hand, there were no significant differences in LVEF and LVEDVI between these 2 groups at any reperfusion time. In conclusion, preinfarction angina had a preconditioning effect (reduction in sigma CK), but this effect was lost once the time interval from the onset of acute MI to reperfusion exceeded 2 h.

Adult↗
PubMed1997

Comparison between dietary soybean protein and casein of the inhibiting effect on atherogenesis in the thoracic aorta of hypercholesterolemic (ExHC) rats treated with experimental hypervitamin D.

Atherosclerotic lesions of the thoracic aorta were induced in exogenously hypercholesterolemic (ExHC) rats by treating initially with hypervitamin D2 and subsequently feeding on hypercholesterolemic diets for 180 days. Dietary soybean protein, in comparison with casein, substantially decreased the degree of atherosclerotic lesions, which was evaluated by intimal thickening, although with a similar topographical distribution. The casein-fed rats tended to maintain a high concentration of serum cholesterol, particularly in triacylglycerol-rich lipoproteins. The concentrations of apo A-I and TBARS in the serum was comparable between the dietary protein groups. The data suggest that dietary soybean protein, compared to casein, produced lipoproteins which were less atherosclerotic by partitioning cholesterol in the triacylglycerol-poor lipoproteins.

Animals↗
PubMed1997

[Coronary artery bypass grafting without cardiopulmonary bypass].

From October 1995 until April 1996. CABG (coronary artery bypass grafting) was performed under the beating heart without CPB (cardiopulmonary bypass) in nine cases. They consisted of 7 males and 2 females ranging in age from 31 to 79 years old (mean 64.7 years). Single bypass grafting was performed in 6 cases, and double bypass grafting was done in 3 cases, involving 2 re-do cases. With regard to the major associated diseases, two patients had required chronic hemodialysis three time a week, four patients were administered with insulin for diabetes mellitus. There were other three patients with renal dysfunction not requiring hemodialysis, two patients had pulmonary problems, and one patient had Parkinson's disease. Further more two patients were older than 75th years in age. Graft anastomosis to the coronary artery was performed with 7-0 polypropylene. In one case, left thoracotomy was done to approach the heart for the anastomosis to intermediate artery, and in the other eight cases, median sternotomy was done. The grafts used in the nine cases were 4 right internal thoracic arteries, 6 left internal thoracic arteries, one gastroepiploic artery and one saphenous vein, 12 grafts in total. Subtotal gastrectomy for gastric cancer and cholecystectomy for cholecystitis was done in one patient for each. Heterologous blood transfusion was required two cases (22.2%). The postoperative course was very good in all cases. Eleven grafts in postoperative angiographed 8 cases were all patent, although presenting the string sign in one case, and angina pectoris disappeared in all cases. CABG under the beating heart without CPB was considered to be useful for the patients with considerable other diseases from the point of view of safety and ease of postoperative managements. We think that this procedure should be considered particularly for patients on chronic hemodialysis who required CABG.

Adult↗
PubMed1997

[Clinical investigation for recurrence and progression in Ta grades 1 and 2 bladder cancer].

We treated 107 new patients with stage Ta, grades 1 and 2 transitional cell bladder carcinoma by transurethral resection during the past 23 years. The clinicopathological factors evaluated were grade, size, number and form of tumor. Fifty-five patients (51%) had recurrent tumors after initial resection and progression (muscle invasion or metastasis) occurred in four patients (3.7%). The 5-year and 10-year recurrence free rates were 47.3 and 29.8%, respectively. Seven patients (6.5%) had grade 3 tumor (grade-up) at recurrence. An increase in T category to T1 (stage-up) occurred in 13 patients (12%), only one of whom later developed an invasive tumor (pT4). The size of tumor significantly affected the rate of recurrence (p < 0.01). Sessile tumor were at a significantly greater risk for progression (p < 0.05). Stage-up did not have a significant effect on progression, but grade-up was significantly risky for progression (p < 0.01). Initial grade 2 tumors were highly related to grade-up (p < 0.05).

Adult↗
PubMed1997

Appropriate hematocrit levels of erythropoietin supplementary therapy in end-stage renal failure complicated by coronary artery disease.

OBJECTIVE: To investigate an appropriate hematocrit (Hct) for managing renal anemia complicated by angina pectoris at rest. DESIGN: Nonrandomized, retrospective and prospective observational study. SETTING: Sapporo Medical University Hospital, Sapporo, Japan. PATIENTS: Thirty-two anemic patients (aged 62 +/- 10 years, range 40 to 78) with rest angina in end-stage renal failure. INTERVENTIONS: Serial changes of exercise tolerance (estimated metabolic equivalents [METs] on stress electrocardiography produced by improvement of patients' Hct, using recombinant human erythropoietin (rHuEPO). Adverse effects, such as deteriorating systemic hypertension, were investigated with regard to the severity of coronary arteriographic findings (Leaman's score) and cardiac events within a six-month period. MAIN RESULTS: Higher Hct was clearly correlated with better estimated METs: when Hct was less than 20%, MET was 1.4 +/- 0.5; with 20% < or = Hct < 25% 2.1 +/- 1.4; with 25% < or = Hct < 30% 3.1 +/- 1.6; and with 30% < or = Hct < 35% 4.9 +/- 1.1. Patients with cardiac events (elective balloon angioplasty [n = 5], bypass surgery [n = 1], myocardial infarction [n = 2] and hospital death from congestive heart failure [n = 3]) had advanced coronary lesions compared with patients without coronary events (Leaman's score 15.9 +/- 9.3 versus 7.3 +/- 4.4, respectively, P < 0.01) and lower exercise capacity at 25% < or = Ht < 30% (estimated METs 2.4 +/- 1.2 versus 3.9 +/- 1.9, respectively, P < 0.05). Moreover, there was an inverse linear correlation between estimated METs and Leaman's score only when Hct was over 25%. In prospectively examined subjects (n = 16), Hct 35% or greater without systemic hypertension was obtained in only seven (44%), and no additional effect on exercise tolerance was expected when Hct was 35% or greater. CONCLUSIONS: Managing renal anemia with 30% < or = Hct < 35% with rHuEPO is considered an appropriate therapy in patients with end-stage renal failure complicated by rest angina.

Adult↗
PubMed1997

[Inflammatory bronchial polyps with a foreign body-like substance].

A 68-year-old male complaining of hemosputum was admitted to our hospital. Fiberoptic bronchoscopic examinations revealed bronchial polyps and a flat foreign body-like substance in the left main bronchus. A closer inspection of a biopsied bronchial inflammatory polyp showed inflammatory edema with hypervascularization in the submucosal space and inflammatory cell infiltration. Following complete removal of this foreign body-like substance, the polyps disappeared within six weeks. It is therefore feasible to assume that the polyps appeared as a reaction to this extrinsic substance. The origin of the foreign matter is not obvious because the patient had no history of aspiration and because the histological examination did not confirm that it was a foreign body. The substance could have been formed out of the organization and calcification of some secretes in the bronchus.

Aged↗
PubMed1997

[Regulation of male sexual function].

MECHANISM OF ERECTION: Commands transmitted from the brain to the spinal cord during audiovisual sexual stimulation and sexual fantasy cause excitation of the central erection-related nerves of the spinal cord, which transmit the commands to the corpora cavernosa. As a result, the following sequence of phenomena takes place: 1) The cavernosal and helical arterioles dilate and the volume of blood in the lacunar spaces increases. 2) The cavernosal smooth muscle relaxes and the vascular lacunae expand. 3) Extension of the lacunar spaces causes compression of the veins below the albuginea corpora cavernosa of the penis. MECHANISM OF EJACULATION: The mechanism of ejaculation can be divided broadly into two stages. In the first stage, seminal emission to the posterior urethra and closure of the internal urethral opening are occurred by stimulation of the hypogastric nerve. The second stage of ejaculation, which is projectile ejaculation of the semen from the posterior urethra, occur as the result of a spinal reflex via the pudendal nerve. For this sequence of events to occur, simultaneous stimulation from the hypogastric nerve is required.

Ejaculation↗