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Biomedical subjects

K Okada

Publications and source records attributed to K Okada.

At least 1,117 records · Page 62Linked to original sources
PubMed1990

[Clinical studies on mycosis especially deep-seated candidiasis in blood disorder patients].

Deep-seated mycosis is prominently increasing as a terminal infection in compromised hosts with malignant blood disorders or malignant tumors. Moreover, localized candidal abscess of visual organs has recently been reported in several laboratories. We investigated the occurrence of deep-seated mycosis in 105 autopsied cases with blood disorders in our clinic from 1980 to 1987. Forty-four of those cases had died of various infections, and 80% of them were fungal infections. More than half of the fungal infections were aspergillosis. Deep-seated candidiasis was recognized in 10 cases, 6 of which were systemic candidiasis, the average duration of neutropenia below 500/mm3 was 19.7 days that of lymphopenia was 36.5 days. Two cases were complicated with GI-tract ulcer, and involved with hepatic candidiasis. On the other hand, in the 4 cases of localized candidial abscess, the duration of neutropenia was 58.5 days and that of lymphopenia was 28.8 days. These four cases were complicated with GI-tract ulcer. Histologically, Candida spp. were recognized at the bottom of the ulcer and invasion by inflammatory cells or tumor cells was found in the portal vein. We surmised that GI-tract ulceration is a very important complication of hepatic candidiasis or liver abscess, and the occurrence of localized candidiasis seems to depend on the duration and severity of neutropenia.

Adult↗
PubMed1990

[An autopsied case of infective endocarditis with cardiac tamponade due to myocardial rupture].

Since it is very rare that cardiac tamponade due to myocardial rupture caused by infective endocarditis, occurs we are reporting this case. A 62 year old man, who had underlying diseases of pneumoconiosis and hypertensive heart disease, visited Chikuho Rosai Hospital complaining of chest oppression and general fatigue on Feb. 7, 1987. He was diagnosed as having ischemic heart disease by electrocardiogram. Two days later, he suddenly had chills and a fever, and the laboratory data showed leukocytosis and a positive C-reactive protein (CRP). The echo cardiogram showed mitral regurgitation (MR) and aortic regurgitation (AR), but neither vegetation nor pericardial effusion was observed. On Feb. 16, he was admitted with shock, and he died the next day. The blood cultures grew gram-positive cocci, respectively. From the clinical symptoms, chest roentgenogram and electrocardiogram, we suspected a cardiac tamponade. On autopsy findings, though coronary arteries were intact, the aortic valves had severe valvular adhesions, calcifications and hypertrophies. The rupture hole was observed in the left ventricles, which was just under the aortic valve through the pericardiac space. It seemed that he died of a cardiac tamponade due to the outflow of blood from this hole. On histopathologic findings of the cardiac wall, gram-positive cocci and many of neutrophils were observed.

Cardiac Tamponade↗
PubMed1990

IgA nephropathy in Japanese children and adults: a comparative study of clinicopathological features.

A comparative clinicopathological study was retrospectively performed in 61 children and 51 adults with IgA nephropathy. Hematuria and/or proteinuria as a chance finding was the most common initial clinical sign, being observed in 82.0% of the children and in 52.9% of the adults. At renal biopsy, hypertension and severe proteinuria were found in 9.8 and 33.3% of the adults and in 0 and 14.8% of the children (both p less than 0.05), respectively. Elevations of blood urea nitrogen and serum creatinine were found at this time of biopsy in 21.6 and 9.8% of the adults, but in none of the children (p less than 0.001 and p less than 0.05, respectively). Histologically, focal glomerulosclerosis and tubular atrophy were found in 52.9% of the adults and in 32.8% of the children (p less than 0.05). However, some features of the disease seen in both groups were similar, including the incidences of IgA nephropathy, sex ratio, the mode of onset, incidences of gross hematuria, and high IgA levels in the sera. Furthermore, the relationships between the severity of proteinuria and renal lesions were similar: mesangial proliferation, glomerulosclerosis, and tubular atrophy increased with the degree of the severity of proteinuria. These results suggest that IgA nephropathy is essentially identical in children and adults, although adult patients tend to be further advanced in their disease course at the time of diagnosis, and that focal glomerulosclerosis with tubular atrophy is correlated with deterioration of renal function.

Adult↗
PubMed1990

Primitive reflexes and MRI findings, cerebral blood flow in normal elderly.

We studied the relation between primitive reflexes (glabellar, snout and palmomental) and MRI findings, cerebral blood flow and mental function in 68 normal aged volunteers. One or more of the three primitive reflexes was elicited in 50% of all subjects. The subjects who had the incidental cerebral lesions showed a significantly higher incidence of the primitive reflexes than those without them. However, there was no difference in mean regional cerebral blood flow (rCBF), brain atrophy and intellectual ability between the subjects with primitive reflexes and those without. The primitive reflexes appear in a significant proportion and these reflexes have a significant relationship with incidental cerebral lesions in normal elderly.

Aged↗
PubMed1990

Prevalence of Parkinson's disease in Izumo City, Japan.

The prevalence of Parkinson's disease was studied in Izumo City, the Shimane prefecture having the largest population of the elderly in the country. The adult population of Izumo City (56,869 people over 20 years of age) were screened by means of questionnaires sent by mail and by other methods. A total of 66 people, 18 males and 48 females, were found to have Parkinson's disease. The prevalence of this disease was 82.0/100,000 population, the highest reported in Japan to date. Of the patients affected, 17.1% showed apparent dementia. Those with dementia were older and were classified at a more advanced Yahr stage than were the nondemented cases. The prevalence of Parkinson's disease in the growing geriatric population has major medical and socioeconomic implications.

Adult↗
PubMed1990

Frontal white matter lesions and dementia in lacunar infarction.

We studied the associations of mental deterioration and blood pressure with severity and location of lesions in the cerebral white matter of 35 patients (27 men and eight women) aged 52-84 (mean 70.9) years with multiple lacunar infarcts; 21 had no dementia and 14 were demented. Using magnetic resonance imaging to evaluate lesion severity, we determined that demented patients had more severe lesions than nondemented patients; this difference was especially prominent for lesions in the frontal lobe (p less than 0.001). Score on the dementia rating scale of Hasegawa et al was negatively correlated with severity of the lesions in the frontal lobe. Blood pressure was positively correlated with the severity of white matter lesions. We show that severity of lesions in the white matter, especially in the frontal lobe, is correlated with mental deterioration of patients with multiple lacunar infarcts. Because uncontrolled hypertension is related to the severity of such lesions, careful selection of antihypertensive treatment is important in preventing both the cerebral lesions and the associated mental deterioration.

Aged↗
PubMed1990

Effect of inhibition of Na+/K(+)-adenosine triphosphatase on vascular action of vasopressin.

The present study was undertaken to examine the cellular interaction between a Na+/K(+)-ATPase inhibitor, ouabain, and arginine vasopressin (AVP) in rat vascular smooth muscle cells (VSMC) in culture. Preincubation with 10(-5) M ouabain for 60 min increased basal cytosolic free Ca2+ [( Ca2+]i) concentration and intracellular 45Ca2+ uptake. Ouabain, however, did not affect basal 45Ca2+ efflux or AVP-stimulated 45Ca2+ efflux. As assessed by cell shape change, preincubation with 10(-5) M ouabain for 60 min also enhanced the sustained cellular contractile effect of a submaximal (10(-8) M AVP, 21.5% vs. 30.5%, P less than 0.01) but not maximal dose of 10(-6) M AVP. Preincubation with 10(-5) M ouabain for 60 min did not change AVP-induced V1-specific surface receptor binding or AVP-induced inositol phosphate production but did however potentiate the mobilization of [Ca2+]i induced by a submaximal (10(-8) M AVP, 301 vs. 385 nM, P less than 0.01) but not a maximal dose of AVP. These effects of ouabain on the mobilization of [Ca2+]i were abolished by incubation in Ca2(+)-free buffer or 5 X 10(-5) M verapamil. Ouabain (10(-5) M) also enhanced the sustained cellular contractile effect of a direct protein kinase C activator, phorbol 12-myristate 13-acetate. The present results therefore indicate that the inhibition of Na+/K(+)-ATPase may enhance the vascular action of AVP, and perhaps other vasoconstrictors, by increasing the AVP-induced mobilization of [Ca2+]i and by potentiating the activity of protein kinase C stimulated by AVP through enhancing basal and AVP-stimulated cellular Ca2+ uptake.

Animals↗
PubMed1990

Leuprorelin acetate depot: results of a multicentre Japanese trial. TAP-144-SR Study Group.

The clinical efficacy and safety of 3.75 or 7.5 mg leuprorelin acetate depot given subcutaneously once every 4 weeks was evaluated in a collaborative study of 81 patients with untreated prostatic cancer. Efficacy of treatment was assessed using criteria based on a meeting of the Prostatic Cancer Study Group funded by the Japanese Ministry of Health and Welfare and using National Prostatic Cancer Project criteria. Japanese criteria enabled evaluation of individual parameters, unlike the National Prostatic Cancer Project system which classified a patient as unevaluable if one evaluation parameter was unavailable. Leuprorelin acetate depot suppressed serum luteinizing hormone, follicle stimulating hormone and testosterone concentrations. Objective response rates of the prostate, bone metastases, serum prostatic acid phosphatase and soft tissue metastases, and subjective dysuria and pain responses were comparable to those found with conventional hormone therapy. Leuprorelin acetate depot was well tolerated, with no significant differences in response to the two doses.

Adult↗
PubMed1990

An early phase II study of CPT-11: a new derivative of camptothecin, for the treatment of leukemia and lymphoma.

An early phase II study of a new camptothecin analog and an inhibitor of topoisomerase I, CPT-11, was conducted in 62 patients with refractory leukemia and lymphoma by four different treatment schedules in a multiinstitutional cooperative study. CPT-11 therapy resulted in four complete remissions (CRs) and three partial remissions (PRs) in 29 assessable non-Hodgkin's lymphoma (NHL) patients, one PR in three Hodgkin's disease (HD), one CR and one PR in 11 acute lymphoblastic leukemia (ALL), and one PR in 15 acute myelogenous leukemia (AML) patients. Single infusion of 200 mg/m2 every 3 to 4 weeks produced no response in both leukemia and lymphoma patients. Sixty-minute infusions of 40 mg/m2/d for 5 days every 3 to 4 weeks or for 3 days weekly produced four CRs (17%) and four PRs (17%) in 24 patients with malignant lymphoma. Sixty-minute infusions of 20 mg/m2 twice a day for 7 days every 3 to 4 weeks resulted in one CR and two PRs in 12 patients with acute leukemia. No response was seen in an acute leukemia patient by another treatment schedule. CPT-11 was effective in two (15%) of 13 primarily refractory leukemia and lymphoma cases, in two of four relapsed cases, and in seven (17%) of 41 relapsed and refractory cases. Major side effects were leukopenia (91%) and gastrointestinal (GI) (76%). CPT-11 was shown to be effective against refractory leukemia and lymphoma, and thus deserves further clinical study; the novel antitumor activity mode of this drug predicts no cross-resistance to presently available antitumor drugs.

Adolescent↗
PubMed1990

Prompt inhibition of arginine vasopressin-induced cellular adenosine 3',5'-monophosphate production by extracellular sodium depletion in rat renal inner medullary collecting duct cells in culture.

The present study was undertaken to determine whether the absence of extracellular Na+ affects cellular action of arginine vasopressin (AVP) in rat renal inner medullary collecting duct cells in culture. AVP increased cellular cAMP production in a dose-dependent manner. Na+ depletion promptly diminished the cellular cAMP response to AVP (1 nM AVP; 405.9 +/- 26.1 vs. 189.8 +/- 12.1 fmol/micrograms protein, P less than 0.01). The dose-response relation shifted to the right. The inhibition of the ability of AVP to produce cAMP was observed with an extracellular Na+ concentration less than 60 mM. Similar results were obtained with 2 x 10(-8) M forskolin, a diterpene activator of adenylate cyclase. Such inhibition was easily released, since only 10-min reexposure of the Na(+)-depleted cells to the control medium totally recovered the cAMP response to AVP. Extracellular Na+ depletion promptly decreased the cellular Na+ concentration from 15.8 +/- 1.0 to 5.4 +/- 0.6 mM (P less than 0.01), measured using the fluorescence dye sodium-binding benzofuran isophthalate. If the Na(+)-depleted cells were again incubated with the control medium, intracellular Na+ rapidly recovered to the precontrol level. Such a change was closely related to the change in cellular pH, which decreased from 7.19 +/- 0.02 to 6.97 +/- 0.02, measured using the fluorescence dye 2',7'-bis-(2-carboxymethyl)-5 (and -6)carboxyfluorescein,acetamethylester. However, Na+ depletion did not affect the cellular free calcium concentration or cellular protein and ATP contents. These results indicate that Na+ depletion promptly attenuated the ability of AVP to produce cAMP mediated through either the decrease in intracellular Na+ or cellular pH in renal inner medullary collecting duct cells.

Animals↗
PubMed1990

Twenty cases of equine osteoarthrosis detected at autopsy.

A pathological study was performed on osteoarthrosis detected at autopsy in 20 horses whose ages ranged from 21 days to 17 years old. They were asymptomatic on the joints except in 3 animals, and autopsied after death or sacrificed due to accidental fracture or other diseases. Lesions of osteoarthrosis were recognized in all horses, which tended to increase in incidence and severity according to age. Lesions were concentrated at hinged joints such as the elbow, fetlock, and hock. Synovial fossae and ulcerative lesions were observed on each opposite articular cartilage, forming the so-called mirror image. Linear erosions regarded as a secondary one were frequently observed on the cartilages. Histologically, the lesions were classified into 4 phases, 1) edematous degeneration, 2) crevice formation, focal necrosis, erosion of cartilage, 3) ulcerative changes, 4) regenerative changes of cartilage in foals and proliferation of fibrous or adipose tissue on the denuded subchondral bone in aged horses. By toluidine blue stain, decreased acid mucopolysaccharide was suggested in cartilaginous matrix around the lesions. From the results, it was concluded that the disease was a disorder of articular cartilage accompanied with hypoplasia of articular subchondral bone.

Age Factors↗
PubMed1990

Prompt recovery of plasma arginine vasopressin in diabetic coma after intravenous infusion of a small dose of insulin and a large amount of fluid.

We studied the changes in plasma arginine vasopressin in 5 patients with diabetic ketoacidosis and one patient with non-ketotic hyperosmolar coma who had marked hyperglycemia (36.6 +/- 4.6 mmol/l, mean +/- SEM) and dehydration. Plasma osmolality (Posm) was 342.2 +/- 11.4 mOsm/kg H2O, and hematocrit, serum protein, and blood urea nitrogen were also elevated at hospitalization. Circulating blood volume was decreased by approximately 21% as compared with that on day 7. Plasma AVP level was increased to 8.5 +/- 1.6 pmol/l at hospitalization. When hyperglycemia was improved by iv infusion of a small dose of insulin plus fluid administration, plasma AVP level promptly decreased to 2.4 +/- 0.4 pmol/l within six hours. When plasma AVP level had normalized, Posm was still as high as 305 mOsm/kg H2O, but the loss of circulating blood volume was only 4.2% of the control state. Plasma AVP level was positively correlated with change in hematocrit (plasma AVP = 3.58 + 0.45.hematocrit, r = 0.468, p less than 0.01), serum protein (r = 0.487, p less than 0.01), Posm (r = 0.388, p less than 0.01), and blood glucose (r = 0.582, p less than 0.01). Plasma AVP level was negatively correlated with the change in circulating blood volume (plasma AVP = 3.6 - 0.14.change in circulating blood volume, r = -0.469, p less than 0.01). These results indicate that both non-osmotic and osmotic stimuli are involved in the mechanism for AVP release in patients with diabetic coma, and that the non-osmotic control of AVP may contribute to circulating homeostasis, protecting against severe blood volume depletion in diabetic patients suffering from hyperglycemia and dehydration.

Adult↗
PubMed1990

[Histological effects of endocrine therapy on prostatic cancer].

Histological effects of endocrine therapy were evaluated in one hundred and four prostatic cancer patients by new criteria presented by the committee of "General Rule for Clinical and Pathological Studies on Prostatic Cancer". Route and time of biopsy, clinical stage and histological grade were related to histological effects. Biopsy specimens taken within three months from the start of the therapy tended to score rather low marks and this tendency is especially apparent with low grade cancers. Histological effects evaluated by the present method correlated well with prognosis in localized stages (stage B, C and D1). In metastatic cases, however, local effects were not related to the prognosis.

Aged↗
PubMed1990

[Clinico-pathological investigation on frequency and prognosis in patients with incidental prostatic carcinoma: preliminary report].

To investigate the relationship between some clinico-pathological features of incidental prostatic carcinoma and its prognosis, totally 96 consecutive cases with simple prostatectomy from 1968 to 1973 under the diagnosis of prostatic hypertrophy were examined by the 3 mm step-section technique. Twenty-one cases (21.9%) of incidental carcinoma were detected histologically. The age of the patients with or without prostatic carcinoma ranged from 59 to 81 years old, 72.0 years old on the average, and from 54 to 87 years old, 69.9 years old on the average, respectively. The weight of the specimen varied from 7 to 84 grams, 32.4 g on the average, for the patients with carcinoma, and 10 to 64 grams, 29.7 g on the average, for the patients without carcinoma. Fifteen of 21 cases showed well differentiated carcinoma. None of the Japanese histological differentiation, Gleason's classification and volume of carcinoma presumably affected the survival of the patients.

Aged↗
PubMed1990

Mechanism of formation of subepithelial electron-dense deposits in active in situ immune complex glomerulonephritis.

The influences of the epitope density on cationic antigens on the fate of immune reactants and the formation of subepithelial electron dense deposits (EDD) were studied in a model of active in situ immune complex glomerulonephritis (ICGN), using a hapten-carrier system. Three weeks after immunization with trinitrophenol conjugated bovine serum albumin (TNP17.3-BSA), the left kidneys of rats were perfused with 500 micrograms of TNP6.2-cationized human immunoglobulin G (C-HIgG) or TNP31.3-C-HIgG. The renal tissues were then examined at intervals by light, immunofluorescence, and electron microscopies. The perfused kidneys of rats given high-valency antigens (TNP31.3) showed marked subepithelial EDDs with foot process retraction associated with proteinuria. In contrast, those of rats given low-valency antigens (TNP6.2) showed only small subepithelial EDDs beneath the slit membrane, which consisted of apparently normal epithelial cells, and did not develop proteinuria. Kinetic studies on immunofluorescence showed that glomerular depositions of immune reactants (TNP-carrier conjugate, rat IgG, and C3) were present longer in rats treated with high-valency antigens than in those treated with low-valency antigens. We conclude that the epitope density on cationic antigens strongly influences the retention of immune reactants and the formation of subepithelial EDDs, as well as development of glomerular injury.

Animals↗