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Biomedical subjects

K Sawada

Publications and source records attributed to K Sawada.

479 records · Page 27Linked to original sources
PubMedDate not supplied

Clinical efficacy and safety of sildenafil in elderly patients with erectile dysfunction.

Erectile dysfunction (ED) is a common medical disorder affecting elderly men. Sildenafil citrate has been shown to be an effective and well-tolerated oral agent for treating ED in the general population of adult men with ED of broad-spectrum etiology. Elderly men are more likely to have concomitant medical problems than the general population of men with ED. In this study, we examined the efficacy and safety of sildenafil administration in elderly patients with ED. Forty-four elderly men with ED (> or = 60 years old) of broad-spectrum etiology were treated with 25 mg or 50 mg doses of sildenafil citrate. Age ranged from 60 to 78 years (65 +/- 4.5; means +/- S.D.). Mean follow-up period was 12.3 +/- 6.5 months, with a range of 1 to 25 months. Primary efficacy assessments were performed using the International Index of Erectile Function 5 (IIEF5) before their first dose of sildenafil and after at least 4 weeks of therapy. Serum testosterone was measured before treatment. The mean IIEF5 among all patients increased from 8.5 +/- 3.9 to 20 +/- 4.2 after sildenafil use (P < 0.0001). In patients younger than 70 years, the IIEF5 score increased from 9.5 +/- 5.0 to 17 +/- 4.3 while in patients 70 years and older, the score increased from 8.2 +/- 3.6 to 21 +/- 3.9, a near normalization. The rate of improvement in younger men was higher than in older men. Serum testosterone before treatment was similar in the two groups. The most commonly experienced adverse events were flushing and dyspepsia, which occurred in 6.8% and 2.3%, respectively. No patients discontinued sildenafil treatment due to adverse events. In conclusion, oral sildenafil is efficacious and well tolerated by elderly men with ED, even among those older than 70 years.

Aged↗
PubMedDate not supplied

Squamous cell carcinoma of the tongue as a second malignancy in a patient previously treated for osteosarcoma.

A 15-year-old girl was diagnosed with osteosarcoma; limb salvage surgery was performed after preoperative chemotherapy. Postoperatively, adjuvant chemotherapy was given for 2 years. One year after completion of chemotherapy, the patient was readmitted for systemic recurrence. Amputation of the lower extremity and wedge resection of lung metastasis were performed followed by combination chemotherapy. Two years after cessation of chemotherapy, ulcer of the tongue was noted and cervical lymph nodes were detected by palpation. Biopsy of the lesion showed squamous cell carcinoma. The patient underwent a radical partial tongue resection and postoperative irradiation, followed by chemotherapy. Six years after treatment for the second malignancy, the patient remains well without evidence of disease. Squamous cell carcinoma of the tongue as a second malignancy after treatment of osteosarcoma is quite rare. Long-term follow-up, with particular attention to the head and neck, may be warranted in children treated for osteosarcoma.

Adolescent↗
PubMedDate not supplied

Morphologic abnormalities in the brain of chronically hemodialyzed patients without cerebrovascular disease.

In this study, the authors evaluated the cerebral atrophy in 56 chronic hemodialyzed patients, who did not have clinical episodes or radiologic findings of cerebrovascular diseases, and 42 controls. Using computed tomography (CT) images, brain atrophy index (BAI), the proportion of subarachnoidal plus ventricular space in the cranial cavity, and ventricular area index (VAI), percent area of ventricle in the brain, were calculated. CT of the brain demonstrated an age-dependent increase in BAI in both hemodialyzed patients and controls. BAI and VAI were greater in hemodialyzed patients than healthy controls and the difference was significant at ages under 60 years in BAI and at ages less than 50 years in VAI. The atrophy of the frontal parts of the brain in patients on hemodialysis for 10 years or more was significantly greater than in patients dialyzed for less than 10 years. There was a significant negative correlation between BAI or VAI and hematocrit. These findings indicate that renal failure or hemodialysis itself might cause cerebral atrophy, and that the cerebral atrophy is more prominent in patients on hemodialysis for a long duration and with low hematocrit.

Adult↗
PubMedDate not supplied

Sarcomatous hepatocellular carcinoma with malignant ascites. A report of two cases.

BACKGROUND: Although some cases of hepatocellular carcinoma (HCC) are known to possess a sarcomatous appearance, their cytologic characteristics in ascites have not been reported. CASES: Two Japanese males, aged 67 and 60 were admitted to the Gifu Municipal Hospital because of liver tumors. In the first case, although transcatheter arterial embolization (TAE) was performed, ascites with neoplastic cells continued to enlarge, and the patient died of liver failure. In the second case, although TAE, percutaneous ethanol injection therapy, chemotherapy and radiotherapy were performed, the patient died of tumor progression: expansion of the hepatic tumor, metastases to distal organs and increasing malignant ascites. Neoplastic cells in the ascites of both cases had nuclei that were shaped irregularly or were vesicular and contained conspicuous nucleoli. A number of multinucleated giant cells were also seen. Immunocytochemically, numerous neoplastic cells were positive for alpha-fetoprotein. These findings suggested sarcomatous HCC. Also, histologic findings of the liver tumors at autopsy showed the appearance of sarcomatous HCC. CONCLUSION: In both cases presented, HCC cells with sarcomatous change were observed in ascites. To our knowledge, this is the first report describing the cytologic diagnosis of sarcomatous HCC in ascites.

Aged↗
PubMedDate not supplied

Myasthenia gravis therapy: immunoadsorbent may eliminate need for plasma products.

This in vitro study assessed the effectiveness of a new immunoadsorbent (Asahi IM-TR 350) in removing anti-acetylcholine receptor antibody from plasma with minimal loss of albumin. Plasma procured from a myasthenia gravis patient undergoing routine plasma exchange was perfused through the immunoadsorbent and recirculated in vitro to simulate a clinical treatment. To assess the temperature dependency of sorption, perfusion was performed at various temperatures. Plasma solute concentrations were taken before and after perfusion to calculate solute rejection coefficients. The immunoadsorbent has a high sorption capacity for anti-acetylcholine receptor antibody, while allowing a minimum loss of albumin. For patients with myasthenia gravis, this immunoadsorbent can provide an alternative to plasma exchange that does not require the use of plasma products.

Antibodies↗
PubMedDate not supplied

Evaluation of materials for use in extracorporeal circulation. In vitro serum-material interaction.

Polymeric membranes used in extracorporeal circulation procedures of varying hydroxyl (-OH) percent were evaluated with normal human serum to detect differences between chemical composition and serum-material interactions. The materials were evaluated as hollow fibers built into modules, including polypropylene (PP; 0%), polyvinyl alcohol (PVA; 23.7%), ethylene vinyl alcohol (EVAL; 29.7%), Cuprophan (CP; 31.5%), and Hemophan (HP; 30.9%). Data from serum perfusions expressed as percent changes to sham (circuit minus module) showed that solute % decreases were from 0% to 10% in all materials except for PVA (10-22%). Complement activation product % increases were higher with PVA (606-4309%) and CP (48-567%), and mononuclear cell transformation functions (MNCTFs) were more suppressed with PVA (100 to 98%) and CP (10-18%). Despite EVAL and HP having an -OH %, complement activation products were relatively low with EVAL (less than 212%), HP (less than 13%), and PP (less than 131%). MNCTFs were stimulatory with the co-polymer of vinyl alcohol and ethylene (EVAL), and very suppressed by serums from PVA contact. Ethylene vinyl alcohol and modified cellulose (HP) had reduced complement activation despite higher or comparable bulk -OH. Bulk -OH content alone cannot explain the differences observed.

Biocompatible Materials↗
PubMedDate not supplied

Do humoral factors removed by plasmapheresis suppress the cellular immune system in cryoglobulinemia?

The efficacy of plasmapheresis (PP) is believed to be primarily related to the removal of plasma humoral factors. Little is known, however, about the effect of solute removal on cellular systems. The effect of the presence of cryoprecipitable proteins (CPPT) on mononuclear blastogenesis (MNB) and polymorphonuclear cell phagocytosis (PMN-P) was studied. MNB stimulated by concanavalin A (Con A), phytohemagglutinin (PHA), and pokeweed mitogen (PWM) was significantly inhibited in cryoglobulinemic (CG) patients to 70, 75, and 60% that of normal controls, respectively. PMN-P were significantly suppressed to 30% that of normals. CPPT purified from cryoglobulinemic plasmas, type I and type III CG, exhibited higher suppressive effects (and in a concentration dependent manner) on normal MNB and PMN-P than albumin used as a control. The studies indicate that patients with CG have defective leukocyte function and that CPPT have suppressive effects on normal leukocyte function in vitro. Removal of plasma CPPT may improve the immunologic status of CG patients.

Cryoglobulinemia↗
PubMedDate not supplied

In vitro evaluation of a relationship between human serum- or plasma-material interaction and polymer bulk hydroxyl and surface oxygen content.

To evaluate serum- or plasma-material interactions and a relationship between such interactions and membrane properties such as bulk hydroxyl percentage and surface oxygen percent, medical polymeric membranes with extremely different hydroxyl percentage and surface oxygen percentage were evaluated with normal human serums or plasmas. Six types of mini-membrane modules (hydroxyl & surface oxygen %) were studied including cellulose triacetate (CA; 0 & 34.7%), Cuprophan (CP; 31.5 and 37.4%), ethylene vinyl alcohol (EVAL; 30.4 and 25.3%), polyacrylonitrile (PAN; 1.5 and 10.2%), polysulfone (PS-F; 0 and 14.2%), and a polymer alloy of polysulfone (PS-K; 0 and 16.2%). Post-perfusion values of biochemical solutes and complement components for PAN and both PS membranes were smaller than those for sham, CA, CP, and EVAL membrane module perfusions. C3a and C4a concentrations showed no significant differences among all membranes except PS-K. Mononuclear cell transformation functions to all mitogens for serums in contact with CA and CP membranes were suppressed versus sham and PAN and both PS membranes. Fibrinogen concentration changes for plasma in contact with EVAL, PAN, and PS-F membranes were significantly smaller than sham, and a significant prolongation of APTT was found for only EVAL versus sham, CA, and CP. Higher surface oxygen percentages (CA, CP > EVAL > PAN, both PS) but not hydroxyl content were associated with lower protein adsorption and higher suppressive transformation function results. These results suggest that surface oxygen percentage may be an important indicator of biocompatibility.

Carbohydrate Sequence↗
PubMedDate not supplied

Ki-1-positive large cell anaplastic lymphoma diagnosed by urinary cytology. A case report.

Cytomorphologic and immunocytochemical findings in urinary cytology in a case of Ki-1-positive large cell anaplastic lymphoma in the left cervical region in a 42-year-old man are reported. Smears stained with Papanicolaou or Wright-Giemsa stain showed a cytomorphologic spectrum that varied from immunoblastlike cells to large neoplastic cells with pleomorphic nuclei and vacuolated cytoplasm. Neoplastic cells with multilobulated, bizarre nuclei and mitosis were also observed. Immunocytochemistry on urinary sediments showed that the tumor cells were of a "null" phenotype and strongly expressed the Ki-1 antigen and "activation" markers of HLA-DR, Tac (CD25) and OKT9 (CD71). Histology and immunohistochemistry confirmed these findings.

Adult↗