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Biomedical subjects

K Nasu

Publications and source records attributed to K Nasu.

At least 109 records · Page 6Linked to original sources

Ureteral obstruction caused by endometriosis.

The diagnosis of ureteral obstruction caused by endometriosis can be difficult. We present a 51-year-old multiparous Japanese women who had undergone right salpingo-oophorectomy at the age of 19 years. She underwent total hysterectomy, left salpingo-oophorectomy, and adhesiotomy of the right ureter after the diagnosis of myoma uteri and endometriosis was made. Microscopic examination of the surrounding resected tissue confirmed the typical endometriotic origin. In addition to intravenous and retrograde pyelography, computerized tomography was useful to establish the diagnosis of ureteral obstruction caused by an extrinsic mass of endometriotic tissue.

Endometriosis↗

[Characterization of intraoperative rupture of epithelial ovarian cancer at early stage].

OBJECTIVE: To investigate whether intraoperative rupture of epithelial ovarian cancer. influences the prognosis. METHODS: Between 1984 and 1994, 46 patients with stage Ia and Ic epithelial ovarian cancer were treated at Oita Medical University Hospital. Of 46 patients, 20 had stage Ia tumors, 16 stage Ic secondary to capsular invasion-serosal disease or positive ascites or washings (stage Ic-ascites), and 10 stage Ic secondary to intraoperative rupture (Ic-rupture). Survival analysis was performed to compare the three groups of patients. RESULTS: The ages (mean +/- SD) of patients with stage Ia, Ic-ascites and Ic-rupture at the first diagnosis were 40.1 +/- 17.0, 47.6 +/- 13.4 and 52.8 +/- 15.7, respectively. The age of the stage Ia group tended to be lower than those of the Ic-ascites and Ic-rupture groups. At operation, ovarian tumors of all patients in the Ic-rupture group were firmly adhered to surrounding organs, had markedly thin weak cyst walls and were easily ruptured during operation. Fourteen of 20 patients in the Ia group (70%), 5 of 16 patients in the Ic-ascites group (31.3%) and 3 of 10 patients in the Ic-rupture group (30%) showed signs of mucinous cystadenocarcinoma. The incidence of mucinous cystadenocarcinoma in Ia group was significantly lower than in the Ic-ascites (p < 0.025, chi 2-test) and Ic-rupture (p < 0.05, chi 2-test) groups. The Kaplan-Meier survival plot for stage Ia, Ic-ascites and Ic-rupture patients revealed a probability of 5-year survival of 100%, 87.5% and 63.5%, respectively. The probability of 5-year survival in the Ic-rupture group tended to be lower than that in other groups. CONCLUSIONS: The results of our study suggest that intraoperative rupture of a malignant ovarian cystic tumor may worsen the prognosis of patients with the FIGO stage I epithelial ovarian cancer.

Adolescent↗

[Clinical features of epithelial ovarian cancer in young reproductive women].

A 10-year retrospective review of epithelial carcinoma of the ovary was performed about 95 patients which were diagnosed and treated at the Oita Medical University Hospital. The patients' ages at the first diagnosis ranged from 15 to 85 years with a mean of 51.6 years. Twenty-two of 95 patients (23.2%) were below the age of 40. Most patients analysed in this study complained of lower abdominal pain, lower abdominal mass, and/or lower abdominal fullness. Sixteen of 22 patients under the age of 40 (72.7%) and 27 of 73 patients over the age of 40 (37.0%) were diagnosed as having mucinous cystadenocarcinoma. The incidence of mucinous cystadenocarcinoma below the age of 40 was significantly higher than that over the age of 40 (p < 0.005, chi 2-test). Eleven patients below the age of 40 had FIGO stage Ia grade 1 disease and 2 of these patients were pregnant. The incidence of stage Ia disease under the age of 40 was significantly higher than that over the age of 40 (p < 0.005, chi 2-test). Both pregnant patients and 5 other patients with stage Ia disease were treated with only unilateral salpingo-oophorectomy. All patient with stage Ia disease had no evidence of recurrence within 5 years. This suggests that conservative surgery may be considered as the treatment for the FIGO stage Ia grade 1 ovarian cancer.

Adolescent↗

[Dissection-like artifact on one-second scanning time CT].

Dissection-like artifact (DLA) is noted only on one-second scanning time CT image. It is usually observed in the ascending aorta, and less commonly in the superior vena cava and right pulmonary artery. We evaluated 136 cases of thoracic CT (including 20 cases of heart failure), and examined how often and where the artifact is noted and why it is produced. DLA was noted in the ascending aorta in 99 cases. Among the 99 cases, the same artifacts were also shown in the superior vena cava in 26 cases, and in the right pulmonary artery in 10 cases. DLA was never observed in other great vessels, such as the descending aorta and inferior vena cava. This artifact was not demonstrated in patients with heart failure. We presume that DLA is produced by pulsation of the ascending aorta and pulmonary artery. If the artifact is observed, the patient does not have severe cardiac impairment.

Adolescent↗

WT1 as a new prognostic factor and a new marker for the detection of minimal residual disease in acute leukemia.

The WT1 gene encoding a zinc finger polypeptide is a tumor suppressor gene that plays a key role in the carcinogenesis of Wilms' tumor. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to examine relative levels of WT1 gene expression (defined in K562 cells as 1.00) in 45 patients with acute myelogenous leukemia (AML), 22 with acute lymphocytic leukemia (ALL), 6 with acute mixed lineage leukemia (AMLL), 23 with chronic myelogenous leukemia (CML), and 24 with non-Hodgkin's lymphoma. Significant levels of WT1 gene were expressed in all leukemia patients and for CML the levels increased as the clinical phase progressed. In striking contrast with acute leukemia, the levels of WT1 gene expression for NHL were significantly lower or even undetectable. Clear correlation was observed between the relative levels of WT1 gene expression (< 0.6 v > or = 0.6) and the prognosis for acute leukemia (AML, ALL, and AMLL). Patients with less than 0.6 levels had significantly higher rates of complete remission (CR), disease-free survival, and overall survival than those with > or = 0.6 levels, whereas CR could not be induced in any of the 7 patients with acute leukemia having greater than 1.0 levels of WT1 gene expression. The quantitation of the WT1 gene expression made it possible to detect minimal residual disease (MRD) in acute leukemia regardless of the presence or absence of tumor-specific DNA markers. Continuous monitoring of the WT1 mRNA was performed for 9 patients with acute leukemia. In 4 patients, MRD was detected 2 to 8 months before clinical relapse became apparent. In 2 other patients, the WT1 mRNA gradually increased after discontinuation of chemotherapy. No MRD was detected in the remaining 3 patients with AML who received intensive induction and consolidation therapy. Simultaneous monitoring of MRD by RT-PCR using primers for specific DNA markers in 3 patients (2 AML-M3 with PML/RAR alpha, and 1 AML-M2 with AML1/ETO) among these 9 patients detected MRD comparable with that obtained from quantitation of WT1 gene expression. In a patient with acute promyelocytic leukemia, the limits of leukemic cell detection by RT-PCR using either WT1 or promyelocytic leukemia/retinoic acid receptor-alpha gene primers were 10(-3) to 10(-4) and 10(-4) for bone marrow, and 10(-5) and 10(-4) for peripheral blood, respectively. Therefore, we conclude that WT1 is a new prognostic factor and a new marker for the detection of MRD in acute leukemia.

Acute Disease↗

Differential expression of interleukin-2 receptors (alpha and beta chain) in mature lymphoid neoplasms.

We investigated the expression of interleukin-2 receptors (IL-2R) in 60 adult patients with mature lymphoid neoplasms by flow cytometric analysis, using two monoclonal antibodies, anti-Tac for IL-2R alpha-chain (IL-2R alpha) and Mik-beta 1 for IL-2R beta-chain (IL-2R beta). Among B-cell malignancies, IL-2R alpha was found in 13/25 (52%) cases of chronic lymphocytic leukemia (CLL) and its variants, 3/14 (21%) of a heterogeneous group of non-Hodgkin's lymphoma (NHL) and none of the plasma cell diseases. IL-2R beta was not observed in any of B-cell neoplasms. IL-2R alpha was more frequently expressed in CD11b(+) B-cell neoplasms than in CD11b(-) (P < 0.05). In T-cell disorders, all three cases of adult T-cell leukemia/lymphoma expressed IL-2R alpha but not IL-2R beta. IL-2R beta was detected in 3/8 cases of CLL and 2/3 of NHL and none of these cases expressed IL-2R alpha. CD8(+) malignant T-cells commonly displayed IL-2R beta. These data indicate that the IL-2R alpha and IL-2R beta in mature lymphoid neoplasms was expressed independently each other and was associated with the particular phenotypical characteristics of neoplastic cells, respectively.

Adult↗

[An epidemiological study on osteoporosis using ultrasound bone densitometry].

Ultrasonic bone density measurements were performed in a population to study the relationship of bone density to age, body size, fracture, hip and back pain, and their diagnostic value for osteoporosis. In additions other factors related with osteoporosis diagnosed using ultrasonic measurements values were examined. The study subjects were thirty-eight men and sixty-three women who participated in community health examinations in 1993 in Akabane, Aichi prefecture. Indices evaluated for ultrasonic bone density measurement were speed of sound (SOS), broadband ultrasound attenuation (BUA) and stiffness index (SI). 1) In men, means for SOS and SI values declined with age from the forties to the seventies, but BUA was not related to age. In premenopausal women, SOS, BUA and SI were not related to age, but an age related decline was observed in postmenopausal women. 2) BUA was positively related to body weight in men and women, while the relationship with SOS and SI was not as strong. 3) Two postmenopausal women experienced fractures due to osteoporosis, and their SI values were less than 59%. About fifty percent of the subjects had hip and back pain but no clear association of SI to prevalence rate was observed. 4) Osteoporosis was diagnosed using SI values. Cases of osteoporosis were relatively older, had more years since menopause, were lower in height, body weight and thickness of skinfolds, but had higher serum total cholesterol levels others. 5) Further prospective epidemiological studies should be performed to evaluate the validity of this diagnostic criterion using SI values, and to clarify the relationship of lifestyles to ultrasonic bone density measurement and osteoporosis.

Adult↗

[A patient with adult T cell leukemia in smoldering stage expressing an aberrant phenotype of CD3- and CD4+].

This report is of a patient with adult T cell leukemia (ATL) in the smoldering stage showing expression an aberrant phenotype of CD3-, CD4+ and CD8-. A 71-year-old woman was admitted to our hospital in December 1992, because of skin eruption and persistent low grade fever. Laboratory examination showed a leukocyte count of 7,000/microliter with 29% abnormal lymphocytes. The diagnosis of ATL was made by the detection of serum anti-HTLV-I antibody and the monoclonal integration of HTLV-I proviral DNA in abnormal lymphocytes. ATL cells at diagnosis were CD3+, CD4+ and CD8+. However, one month later ATL cells lacked CD3 and CD8. Three color analysis showed that most of the CD25+ cells were CD3- and CD4+.

Aged↗

[A comparison between a food frequency and amount questionnaire and 7-day diet record with weighing].

A nutritional evaluation questionnaire to assess usual dietary intake was developed with the aim of achieving an accuracy level of a seven consecutive day diet record with weighing (DRW). With this questionnaire (FAQ), weekly frequencies and amounts for eleven food groups and three dishes per meal were assessed. The FAQ was conducted twice with 19 female students with a week interval (FAQ-1 and FAQ-2) in October or November of 1992. Concurrent with FAQ-2 each subjects' weekly diet was analyzed using the DRW for seven consecutive days. 1) The Spearman's correlation coefficient between the weekly frequencies obtained from FAQ-2 and those from DRW was more than 0.40 in thirty-seven of forty-one food items. 2) Nutrient intakes evaluated by DRW was highly correlated with food intake for several foods. Nutrient intake was estimated using multiple regression equations with food intake obtained from FAQ-2. 3) Compared to DRW derived values, mean values of most nutrient intakes estimated from FAQ-2 showed deviations within ten percent. Correlation coefficients between the nutrient intake estimated from FAQ-2 and those for DRW were high for calcium, vitamin C, retinol, sugar and vitamin B2, but rather low for total energy, protein and fat. 4) These results show that for some nutrient intakes, FAQ reflected those obtained from DRW for these subjects. The use of FAQ in population-based epidemiological studies should be the subject of future evaluation.

Adult↗

Clinical aspects of B-cell malignancy involving the BCL1/PRAD1 locus.

BCL1/PRAD1 is the gene locus involved in the t(11;14)(q13;q32) translocation, which often occurs in a proposed subtype of non-Hodgkin's lymphoma of B-cell phenotype (B-NHL), named mantle cell lymphoma (MCL). When 67 Japanese patients with B-NHL were examined using two separate probes composed of the BCL1 MTC probe and the PRADI cDNA probe, rearrangement of BCL1/PRAD1 or overexpression of PRAD1 was detected in 11 patients. Among 13 patients with MCL, 8 had the abnormalities (61%) and the MTC probe detected the BCL1 rearrangement in 5 (38%). Five of the 6 MCL patients studied (83%) showed PRAD1 overexpression. These frequencies were compatible with those reported for Western patients. Although the remaining three with BCL1/PRAD1 abnormalities were diagnosed as having other histologies, 11 patients had advanced diseases, with dissemination to the extranodal sites. Except for one with diffuse large cell lymphoma, they had a slowly progressive disease, and none of the patients displayed clinical or pathological transformation. The tumor cells usually expressed CD5 and lacked CD10. The cells were completely uniform in the expression of IgM and/or IgD, and in the absence of C mu gene deletion. It thus appears that B-malignancies involving the BCL1/PRAD1 locus constitute a refined disease entity.

Adult↗

Disseminated Trichosporon infection. A case report and immunohistochemical study.

An autopsy case of disseminated Trichosporon beigelii infection in a patient with acute promyelocytic leukemia is presented. We diagnosed the T beigelii infection with immunoperoxidase method using our rabbit antiserum to T beigelii. The diagnosis of T beigelii infection is difficult, because of its close resemblance to Candida species in both clinical features and histopathologic findings. We could consistently identify T beigelii in tissue sections with the present immunohistologic method. We conclude that the immunoperoxidase method using antiserum to T beigelii is very useful to diagnose T beigelii infection.

Cadaver↗

Multilineage response in aplastic anemia patients following long-term administration of filgrastim (recombinant human granulocyte colony stimulating factor).

The present multicenter study was undertaken to confirm whether filgrastim/recombinant human granulocyte colony stimulating factor (rhG-CSF) could mobilize residual multipotential stem cells by its G0-shortening effect in patients with aplastic anemia (AA) and induce a multilineage response. Twenty-seven patients with acquired severe or moderate AA received long-term administration (2 to 12+ months) of rhG-CSF in doses from 100 to 400 micrograms/body/day by s.c. injection or 250 to 1,500 micrograms/body/day by i.v. infusion. Twenty-six out of the 27 evaluable patients showed a substantial increase in neutrophils associated with a recovery of myeloid precursors in bone marrow within one month of therapy. Interestingly, 10 out of the 27 patients showed a dramatic improvement in severe anemia after two to ten months of therapy. Moreover, severe thrombocytopenia improved after two to four months of therapy in three out of these ten patients accompanied by a significant increase in megakaryocytes in bone marrow. Clonal cultures of bone marrow cells revealed a recovery in myeloid as well as erythroid precursors in most of these ten patients. In two patients who showed a trilineage response, mixed and megakaryocyte colony formations also recovered. These results suggest that long-term administration of rhG-CSF mobilizes myeloid, erythroid, megakaryocyte and multipotential progenitor cells and induces a multilineage response in some patients with AA.

Adolescent↗

Liver scintigraphy in a patient with Gaucher disease.

Liver scintigraphy including SPECT was performed in a patient with Gaucher disease and compared with other methods. Multiple photon-deficient areas in the liver and spleen were recognized, and in evaluating the reticuloendothelial system of the liver, liver SPECT image was superior to US, CT and MR images.

Adult↗

Interleukin-2 receptor alpha chain on acute myelocytic leukemia cells is involved in cell-to-cell interactions.

Leukemic cells from 21 to 197 adult patients with de novo acute myelocytic leukemia (AML) were positive for IL-2R alpha chain (IL-2R alpha), whereas IL-2R beta chain (IL-2R beta), which is responsible for IL-2 signal transduction, was not found on leukemic cells from any of these cases tested. The expression of IL-2R alpha was closely associated with that of adhesion molecules CD4, CD11b and CD22, and endopeptidase CD10. None of the IL-2R alpha (+) AML cells responded to recombinant human IL-2. These data suggest that IL-2R alpha on AML cells may not be involved in cellular proliferation as one of growth factor receptors but may have a role in the control of cell-to-cell interactions.

Adult↗

[Prediction of performance status after pneumonectomy].

To predict performance status (P.S.) following pneumonectomy, patients with lung carcinoma underwent pre-surgical pulmonary function tests with spirometry and unilateral pulmonary artery occlusion test (UPAO test). Between 1980 and 1991, twenty-nine patients who had survived more than six months after surgery were selected for the study. These patients were divided into two groups according to P.S. measured at six months after surgery: 16 patients with P.S. 0 to 1 were in Group A, and 13 patients with P.S. 2 to 3 were in Group B. The results of the following tests obtained prior to surgery were compared for the two groups to predict post-surgical P.S.; vital capacity (VC), VC/m2, forced expiratory volume in 1 second (FEV1.0), FEV1.0/m2, predicted VC/m2 and predicted FEV1.0/m2 calculated with residual pulmonary segments, mean pulmonary arterial pressure (PPA) before UPAO and 15 minutes after UPAO, total pulmonary vascular resistance (TPVR) before and during UPAO, and rate of changes in PPA and TPVR. Results obtained were as follows: Group B demonstrated significantly higher TPVR (p < 0.05) before the UPAO, PPA (p < 0.05) and TPVR (p < 0.002) during UPAO, and rate of change in TPVR (p < 0.02) than those in Group A. There were no significant differences between the two groups for other test results. From these results, lowering of post-surgical P.S. might be predicted when the TPVR during UPAO was 350 dyne.sec.cm-5/m2 or more.

Blood Pressure↗

A granulocytic population with rearranged immunogenotype in chronic myelocytic leukemia blast crisis and Philadelphia-chromosome-positive acute leukemia with cross-lineage nature.

Two patients with chronic myelocytic leukemia (CML) mixed crisis and one with Philadelphia-chromosome-positive (Ph1 +) acute lymphoblastic leukemia (ALL) with cross-lineage nature had a considerable number of granulocytes with monoclonally rearranged immunogenotype. The gene configurations of immunoglobulin heavy chain (IgH), T-cell receptor beta chain (TCR beta), and gamma chain (TCR gamma) in the granulocytic cells were identical to those in the blasts, indicating that both the blasts and the granulocytes were derived from common leukemic progenitors with the IgH gene rearrangements. In a colony assay of cells from in the Ph1 + ALL patient, the leukemic cells showed the potential to differentiate into granulocytes in the presence of either granulocyte-macrophage colony-stimulating factor (GM-CSF) or granulocyte-CSF (G-CSF). Interleukin 7 (IL-7) exerted synergistic effects on colony and cluster formation in cultures with these cytokines. Further, IL-3, GM-CSF, and G-CSF receptor gene expression was found in the leukemic cells. Our findings indicate that the Ph1 + common progenitors in these three patients preserved the potential for granulocytic differentiation even after the occurrence of the Ig (and TCR) gene rearrangements as the first genomic event in lymphocyte differentiation. The phenomenon of cross-lineage in leukemic cells, at least in Ph1 + leukemia, can be considered to demonstrate the potential of leukemic progenitors to differentiate in multiple directions.

Base Sequence↗