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Biomedical subjects

K Ohara

Publications and source records attributed to K Ohara.

At least 127 records · Page 7Linked to original sources
PubMed1996

Acral lentiginous melanoma (including in situ melanoma) arising in association with naevocellular naevi.

Acral lentiginous melanoma (ALM) occurring on the sole of the foot is the most common type of malignant melanoma in Asians, African and North American Blacks, but is relatively infrequent in Caucasians. According to the literature ALM is thought less likely to arise in a precursor naevus of any type or be associated with dysplastic naevi elsewhere on the skin. We present five cases of ALM (two invasive and three in situ cases) arising in association with pre-existing naevi on the foot in Asians and Caucasians. All patients were female, aged 35-66 years (mean = 47.8). Clinically, all five tumours demonstrated various shades of tan, brown and black, admixed with hypopigmented areas. Histologically, these melanomas showed a lentiginous character of the radial growth phase component with rare foci of pagetoid intra-epidermal spread. Invasive determal components in the form of epithelial and spindle cells were evident in two cases, with a measured depth of 1.7 and 0.85 mm, respectively. Pre-existing naevi, either dermal or junctional, were identified in all tumours. Clinical follow-up in all patients showed no evidence of recurrence or metastasis over a period of 4 months-5 years. These cases appear at variance with the general belief that ALM and ALM in situ arise de novo and rarely arise in precursor naevi. To the best of our knowledge, this is the first documented series of ALM in situ arising in association with pre-existing naevi. We conclude that ALM can arise in association with acral naevi.

Adult↗
PubMed1996

A case of cutaneous malignant fibrous histiocytoma.

A 54-year-old Japanese man with cutaneous malignant fibrous histiocytoma on the back is reported. He not only had a past history of thyroid cancer 1 year prior to the onset of the skin tumor, but also had simultaneous bladder cancer. Despite the early, wide resection, the prognosis was rapid and progressive. Histologically, the primary lesion of the skin tumor was difficult to differentiate from dermatofibrosarcoma protuberans; however, the recurrent and the metastatic lesions changed in appearance.

Fatal Outcome↗
PubMed1996

Ectopic extramammary Paget's disease affecting the upper abdomen.

We present 57-year-old man in whom ectopic extrammary Paget's disease (EMPD) affected the upper abdomen. Although the clinical appearance was suggestive of Bowen's disease or superficial basal cell epithelioma (BCE), the biopsy specimen showed EMPD histologically. Only 12 cases of ectopic EMPD have been reported (including this case). In our 20 year experience of 129 EMPD, this is the first ectopic case. Thus, the frequency of ectopic EMPD is 0.78% (one of 129) in our study. The male/female ratio in the reported 12 cases is 2: 1, nearly the same as EMPD in general (2.1: 1, in our 129 cases). The mean age of the 12 patients is 65.8 years, which is not significantly different from ordinary EMPD (66.4 years, in our 129 cases). Comparing ectopic EMPD to ordinary EMPD, clinically and histologically, we could find no difference. As they appear to be the same disease, ectopic and ordinary EMPD may share similar origins and mechanisms of occurrence. We support the hypothesis that Paget's cells originate from the remaining pluripotential germinative cells which are able to differentiate into many kinds of secreting glands.

Abdomen↗
PubMed1996

[A case of report of surgical repair of ventricular septal perforation with left ventricular free wall rupture following acute myocardial infarction in an 86-year-old woman].

An 86-year-old woman had acute anterior myocardial infarction. A doppler echocardiogram taken on the second day of onset revealed ventricular septal perforation (VSP). Cardiac catheter examination was conducted under intraaortic balloon pumping. An emergency operation was performed on the third day after the onset because of the progression of cardiac failure and an increase of the left to right shunt ratio to 63%. A pericardiotomy revealed approximately 200 ml of blood in the pericardial cavity and a rupture in the left anterior ventricular free wall. The VSP was in the anterior septum and measured approximately 10 mm in diameter. Necrotic tissues surrounding the VSP were effectively resected using an ultrasonic aspiration instrument. The defect, measuring approximately 30 mm in diameter, was closed using a Teflon felt patch and a horse pericardial patch. The patient recovered with no complications and was discharged on the 31st postoperative day. She is presently in good conditions 2 years after the surgery. Our patient was the oldest among the reported cases of surgical repair of VSP in Japan, and our repair surgery was conducted the earliest after onset among the reported surgical cases for VSP in patients at 80 years of age or older.

Aged↗
PubMed1996

[Multicystic encephalopathy with frontal lobe-originated gelastic seizure, ipsilateral oculogyric crisis, and horizontal epileptic nystagmus: an autopsy case].

Attacks of gelastic (laughing) seizure are usually reported as complex partial seizures of temporal lobe epilepsy and seizures associated with hypothalamic hamartomas, but are rarely reported as complex partial seizures of frontal lobe origin. We recently encountered a 29-year-old woman who had gelastic seizure attacks from age 17. She had shown severe mental retardation with cerebral palsy at 7 months, and entered precocious puberty at age 7. Attacks of gelastic seizure with ipsilateral adversive seizures, ipsilateral oculogyric crisis, and horizontal epileptic nystagmus were observed until her death at age 29. Each gelastic seizure lasted 1 to 10 minutes. Her laughing was very strong and loud. Interictal spikes were observed over the right fronto-parietal lobe, but no ictal spike was detected. The neuropathological examinations of her brain revealed no hypothalamic lesions such as hamartomas, gliosis, and distinct neuronal loss. Her brain was severely affected with multicystic encephalopathy, and the bilateral temporal lobe tissues were almost replaced by the cystic changes. The right frontal lobe and occipital lobe were not cystic. From the clinicopathological examinations, the focus of her gelastic seizure was considered to be of the right frontal origin. The hippocampus and parahippocampal gyrus are major components of the limbic system, which is involved in affective emotions. Although the right hippocampus and parahippocampal gyrus were completely lost, and those of the left hemisphere were almost completely lost, by the multicystic replacements in this case, the gelastic seizure attacks were evoked from right frontal origin. The frontal lobe may play an important role in motor expressions of laughing. The motor expressions of the loud and strong laughing may be one of the characteristic features of frontal lobe-originated gelastic seizure of this case.

Adult↗
PubMed1995

Transcriptional inhibition of insulin by FK506 and possible involvement of FK506 binding protein-12 in pancreatic beta-cell.

FK506 (tacrolimus) is a strong immunosuppressant: it has been approved as a drug for liver transplantation in Japan, the United States, and the United Kingdom. One of its main adverse effects is hyperglycemia. Thus, in this study, we investigated the mechanism and the reversibility of the hyperglycemia caused by FK506. FK506 did not affect the glucose uptake by insulin into rat strio-muscle cell line, but suppressed insulin production in rat insulinoma cells. Two-week oral administration of FK506 at 10 mg/kg/day suppressed insulin production time-dependently at the transcriptional step in pancreatic beta-cells, while glucagon content in pancreatic alpha-cells was not affected. When FK506 administration was stopped in these rats, insulin mRNA transcription and insulin production returned to normal. This recovery indicates that the adverse effect of FK506 on the pancreas is reversible. A high content of FK506 binding protein-12 (FKBP-12) in the pancreatic beta-cells was confirmed by immunostaining with anti-human FKBP-12 mAb, but the content was less in the pancreatic alpha-cells and almost negligible in the acinar cells. In contrast, a high content of calcineurin in the pancreatic alpha-cells was confirmed by using anti-calcineurin polyclonal antibody, but this content was less in the pancreatic beta-cells and not found in the acinar cells. Thus, as in the case with NF-AT in T cells, these findings point to the reduction of unidentified nuclear factors for insulin mRNA transcription caused by the binding of FK506 to FKBP-12 and a subsequent inhibition of calcineurin in the beta-cells.

Animals↗
PubMed1995

Coexistence of Pick bodies and atypical Lewy bodies in the locus ceruleus neurons of Pick's disease.

We observed abundant Pick argentophilic inclusion bodies (PBs) as well as some atypical Lewy bodies (LBs) in the locus ceruleus (LC) from a patient with Pick's disease. In addition, there were a few neurons which contained both PBs and LBs. PBs in the LC frequently appeared multiple and had lobulated or irregular shapes, though their ultrastructural elements were the same as those of the PBs appearing in the cerebral cortex, and consisted of randomly arranged smooth-surfaced straight tubules of 15 nm in diameter, mixed with a small number of long-period constricted fibrils. The ultrastructure of the LB coexisting with PB was identical with that previously reported; a dense core was surrounded by concentric layers of radially oriented 10-nm filaments and was clearly distinguishable from the PB. Immunohistochemical examination with various antibodies related to neurofibrillar pathology demonstrated that anti-tau antibodies reacted positively with both PB and the rim portion of LB in the present case; an unusual finding for LB. The anti-neurofilament 200-kDa protein stained only LBs, even when PBs and LBs coexisted in the same neuron. These findings show that two kinds of neuronal fibrillar inclusions, whose underlying cytoskeletal abnormalities are thought to be different, can coexist in the same neuron. In addition, the formation of multiple, lobulated PBs may suggest some particularity of cytoskeletal composition of the LC neurons.

Aged↗
PubMed1995

The gene encoding the 5-HT1A receptor is intact in mood disorders.

We studied the 5-HT1A receptor gene in 50 mood disorders and 50 normal volunteers. The 5-HT1A receptor gene was amplified by polymerase chain reaction and sequenced by the dideoxy method. The sequence of the 5-HT1A receptor encodes a protein of 422 amino acids, that is, one amino acid longer than the reported sequence (Kobilka et al. 1987). The DNA sequence at positions 454 to 459 is CGC GCC GCT, not CCG CGT, and the amino acids sequence at these positions is changing from proline arginine to arginine alanine alanine. These differences, however, were observed in both mood disorders and controls. One silent polymorphism, CTG to GTA at position 294, was found. These results suggest that the 5-HT1A receptor gene is intact in mood disorders.

Adult↗
PubMed1995

Membranous outgrowth suggesting lens epithelial cell proliferation in pseudophakic eyes.

PURPOSE: We sought to determine the incidence and structure of membranous outgrowth, which extends from the anterior capsular opening onto the intraocular lens surface in pseudophakic eyes. METHODS: Thirty-four eyes of 31 patients with age-related cataract were prospectively studied. No patient had any abnormality other than cataract. Each patient underwent continuous circular capsulorhexis, phacoemulsification, and implantation within the capsule of a three-piece posterior chamber lens. A slit lamp and specular microscope were used to observe and photograph the intraocular lens surface and anterior capsular opening every day for the first postoperative week, and at days 14, 21, and 28. We counted the number of eyes with the membranous outgrowth and graded the outgrowth according to its shape and length at each postoperative period. RESULTS: In total, 27 of 34 (79%) eyes had the membranous outgrowth from the anterior capsular opening onto the intraocular lens surface. The membrane was first observed on day 3. Three of 34 eyes had the dendritic or fan-shaped structure, which extended less than 0.5 mm from the capsular edge. The membranes were most frequently found on day 7. Twenty-five of 34 eyes had the outgrowth in various grades. After four weeks, no membranes were observed. CONCLUSIONS: The time course and structure of the membranous outgrowth we observed were comparable to those of the outgrowth of lens epithelial cells under tissue culture conditions. The membranous outgrowth may be the result of a transient but active proliferation of human lens epithelial cells onto the intraocular lens surface.

Aged↗
PubMed1995

Branch retinal vein occlusion in a child with ocular sarcoidosis.

PURPOSE/METHODS: A 13-year-old girl had unilateral iridocyclitis and periphlebitis. The periphlebitis exacerbated, and macular edema as well as branch retinal vein occlusion developed. The patient was treated with systemic corticosteroids. RESULTS/CONCLUSIONS: The lesions responded well to systemic corticosteroids. Histologic diagnosis of sarcoidosis was obtained by transbronchial lung biopsy. Ocular lesions in this child were similar to those seen in adult sarcoidosis. Branch retinal vein occlusion may occur as a rare vascular complication of sarcoidosis.

Adolescent↗
PubMed1995

[Depression in the elderly].

Depression in the elderly is characterized by agitated depression, chronic course, high risk of suicide, and masked depression-like states in which somatic symptoms are predominant. In the treatment of the elderly with depression, nontricyclic antidepressants are beneficial because of their few side effects. In addition to pharmacotherapy, psychotherapy is indispensable. Psychotherapy should be given frequently even though the time of each interview may be limited. The therapeutic efforts should be directed to coordinate the relationships among family members and advise the patients to take some role in their society, because distorted relationships among family members and the loss of roles are closely related to the development of depression.

Aged↗
PubMed1995

The looping behavior of fish in microgravity.

Fish subjected to microgravity during space flight were monitored for their swimming behavior, particularly the looping response. Experiments were performed on normal fish, unilaterally labyrinthectomized fish, and bilaterally labyrinthectomized fish. Observation were compared against the behavior of other species which had been evaluated in microgravity during parabolic flight.

Animals↗
PubMed1995

[A case report of corrected TGA with ventricular septal defect, tricuspid valve regurgitation and atrioventricular block].

A 61-year-old woman was admitted for heart failure. She was diagnosed as corrected TGA with tricuspid regurgitation, perimembronous ventricular septal defect and atrioventricular block by echocardiography and cardiac catheterization. We chose tricuspid valve replacement with preservation of valve leaflet and subvalvular apparatus, direct closure of ventricular septal defect and implantation of permanent pacemaker (myocardial lead). Although IABP was needed for 24 hours, after that postoperative course was uneventful. It is preferable that tricuspid valve replacement with preservation of valve leaflet and subvalvular apparatus is applied to similar adult cases from standpoint of morphological structure.

Cardiac Pacing, Artificial↗
PubMed1995

Basal cell carcinoma of the vulva with lymph node and skin metastasis--report of a case and review of 20 Japanese cases.

A 79-year-old Japanese woman who had basal cell carcinoma presenting as a large ulcer on her vulva with lymph node and skin metastasis is described. Histological examination revealed that tumor nests with peripheral palisading invaded deeply into the subcutaneous tissue and were accompanied by marked mucinous changes and fibrous reaction. Vascular invasion was also observed. There were inguinal lymph node metastases and two papular skin metastases on her right thigh. The primary tumor and the metastases were excised. The defect was repaired by bilateral gracilis musculo cutaneous flaps and a skin graft. We surveyed the literature and found 20 cases of metastasizing basal cell carcinoma in Japan.

Aged↗
PubMed1995

[Whole abdominal irradiation for peritoneal dissemination of alimentary tract cancers].

Between January 1986 and August 1991, 19 patients with alimentary tract cancers complicated by peritoneal dissemination received whole abdominal irradiation combined with intraperitoneal chemotherapy postoperatively. Using a moving-strip technique of irradiation, 12.0 Gy was delivered in three fractions to the entire abdominal contents with partial liver and kidney shielding. The primary tumor sites were the stomach in 12 patients, the colorectum in five, and the gall bladder in two. Nine patients with gross residual disease also received a limited field boost of 30.6 Gy in 17 fractions after completion of treatment to the whole abdomen. None of the patients failed to complete the planned dose despite acute gastrointestinal toxicity (nausea and vomiting, 84%, diarrhea and cramping, 78%) and acute hematologic toxicity (leukocytopenia, 84%, thrombocytopenia, 68%). Our follow-up study revealed that the actuarial one-year survival rate was 28.4% and the median survival time was 9.0 months. Survival rates at one-year for patients with colorectal and gastric cancer were 75.0% and 16.7%, respectively. Patients with gastric cancer (n = 12) had a poorer outcome than those with colorectal cancer (n = 5) in the present study. One reason for this difference may have been the presence of cancerous pleuritis, which was frequently observed in patients with gastric cancer. Therefore, more intensive treatment to prevent cancerous pleuritis seems to be necessary to improve the efficacy of whole abdominal irradiation.

Abdomen↗