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Biomedical subjects

K Tamura

Publications and source records attributed to K Tamura.

At least 559 records · Page 31Linked to original sources
PubMed1996

[Autoimmune hemolytic anemia with eosinophilia in elderly patient].

A 70-year-old woman was admitted to our hospital in November 1992 for evaluation of anemia. Physical examination revealed anemia, jaundice, swelling of axial and inguinal lymph nodes, and splenomegaly. Abnormal hematological findings were as follows: Hb of 3.9 g/dl, reticulocyte count of 58.2% (61.7 x 10(4)/microliters), hyperplasia of normal erythroblasts in bone marrow, and eosinophilia (21.0%, 2352/microliters) in peripheral blood. Routine laboratory examinations revealed polycolonal hypergammaglobulinemia 3.0 g/dl, a high level of serum LDH (797 IU/I) and a total bilirubin of 2.4 mg/dl (indirect, 1.6 mg/dl). The serum haptoglobin level was very low (< 5 mg/dl). Results of serological examinations were as follows: IgG of 3366 mg/dl, CH50 of 16.0 U/ml, positive Coombs test 2+, and positive tests for antinuclear antibody, rheumatoid factor, and cold agglutinin. CRP was negative. PHA-stimulated lymphocyte blast formation, NK activity, and ADCC activity were found to be suppressed, and the percentage of CD4-positive lymphocytes in peripheral blood was also low. An axillary lymph node biopsy revealed reactive lymphadenitis. No signs or history suggested allergy, collagen disease, or parasitic infection. Autoimmune hemolytic anemia (AIHA) complicated by immunologic abnormalities and eosinophilia was diagnosed. Oral prednisolone markedly reduced the hemolytic anemia, eosinophilia, lymph node swelling, and splenomegaly, but NK activity remained low.

Aged↗
PubMed1996

[Suspension of ventilation during extracorporeal membrane oxygenation with veno-venous by pass in dogs].

We studied whether extracorporeal membrane oxygenation with a veno-venous bypass would allow withdrawal of mechanical ventilation. Three mongrel dogs were anesthetized with intravenous pentobarbital. A Swan-Ganz catheter was placed via the left jugular vein into the main pulmonary artery, and an extra-long total volume catheter was placed in the right femoral artery. The animals were placed in the lateral position, and cannulas (15 Fr.) were placed in the inferior vena cava and the superior vena cava via the right jugular vein and the right femoral vein. These cannulas were connected to a pump and a membrane oxygenator. When the pump flow was almost the same as the previous cardiac output, the partial pressure of oxygen in the pulmonary artery, was high enough to allow ventilation to be suspended. All dogs survived. This suggests that extracorporeal membrane oxygenation with a veno-venous bypass can allow mechanical ventilation to be suspended during tracheocarinal operations such as tracheocarcinal resection.

Animals↗
PubMed1996

[Clinical classification of adult T-cell leukemia and its complications].

Since human lymphotropic virus, type 1(HTLV-1) associated adult T-cell leukemia (ATL) has various clinical appearances and courses, it is difficult for the clinician to differentiate acute disease which needs immediate treatment from chronic disease which can be observed with no specific treatment. The Lymphoma Study Group of Japan (1984-87) proposed four clinical subtypes: (1) smoldering type; more than 5% of abnormal T-lymphocytes with less than 4000/microliters of lymphocytes in peripheral blood and few abnormal blood chemistry profiles and ATL infiltration, (2) chronic type; absolute lymphocytosis with T-lymphocytosis of more than 4000/microliters, LDH < 2 times the normal upper limit and no hypercalcemia with possible lymph-node, liver, spleen, skin and lung involvement, (3) lymphoma type; no lymphocytosis with less than 1% of abnormal T-lymphocytes, and histologically-proven lymph-node enlargement, and (4) acute type; the patients not classified into any of the above 3 types. The median survival time (MST) was 6.2 months for acute type, 10.2 months for lymphoma type, and 24.3 months for chronic type; 62.8% of smoldering type was still alive up to 4 years. ATL has a poor prognosis because of life-threatening complications including infections and hypercalcemia. Among infectious complications, cytomegalovirus (CMV) is frequently encountered in autopsy patients. It is important to make an early diagnosis since an anti-CMV agent, ganciclovir is now available for clinical use. It takes 10-14 days to culture CMV in vitro, but now rapid diagnosis can be made by direct immunoperoxidase staining with human monoclonal antibodies against an immediate-early antigen. Another major complication is hypercalcemia. The patients' serum and tumor tissues are found to have parathyroid hormone related protein (PTHrP) associated with hypercalcemia. Serum PTHrP (1-34) is determined by radioimmunoassay and its values seem to be correlated with hypercalcemia and the disease activity. There are still many problems to solve for ATL, but recent advances have been made in clinical subtypes and the above 2 complications.

Adult↗
PubMed1996

[Two operated cases of synchronous double cancer of the lung and digestive tract in patients over 80 years old and genetical diagnosis].

Synchronous double cancer of the lung and gastrointestinal organ was successfully resected by an one-step approach in two aged patients over 80 years. An 81-year-old man was clinically diagnosed as having a right lung cancer (S3) along with a sigmoid colon cancer. The pathological cell types of these cancers were squamous cell carcinoma and adenocarcinoma respectively. Right upper lobectomy and sigmoidectomy were performed at the same time because he had no risks for the operation. An-80-year-old woman was diagnosed as having a left lung cancer (S8-9) along with a stomach cancer. The cell types of these cancers were both highly differentiated adenocarcinoma. Left lower lobectomy and subtotal gastrectomy were performed at the same time, too. We limited lymph nodes dissection to shorten the operation time and no postoperative complications occurred in both patients. It is suggested that simultaneous operation for double cancer in aged patients can be safely performed in selected cases. In the latter patient, pathological cell type of the lung cancer was similar to that of stomach cancer. So we applied polymerase chain reaction (PCR) for making a diagnosis of double cancer postoperatively, and it was proved that the lung and gastric cancers were different from each other in genetical natures. Application of the genetical technique to clinical field which greatly contribute to making a diagnosis of double cancer is expected.

Adenocarcinoma↗
PubMed1996

Evaluation of mRNAs encoding muscarinic receptor subtypes in human detrusor muscle.

PURPOSE: The present study evaluated the muscarinic receptor subtypes corresponding to m1 to m5 genes in human detrusor muscle. MATERIALS AND METHODS: The mRNAs encoding m2 and m3 subtypes were assessed by reverse transcription (RT)-polymerase chain reaction (PCR). The amounts of cDNA synthesized from m2 and m3 mRNAs were measured by using subcloned plasmid DNAs. The distribution of m2 and m3 mRNAs in detrusor was estimated by comparing the amount of m2 cDNA with that of m3 cDNA. RESULTS: The m2 mRNA:m3 mRNA ratio was 1.06:1.00 in human detrusor. In the cryostat sections of human detrusor, the presence of both m2 and m3 mRNAs was confirmed by in situ hybridization. However, the RT-PCR products derived from m1, m4 and m5 subtype mRNAs were not detected. CONCLUSION: These results suggest that human detrusor muscle coexpresses muscarinic m2 and m3 receptors and that the populations of the 2 subtypes are not significantly different.

Base Sequence↗
PubMed1996

[Nodular and cavitary pneumocystosis in a patient with hemophilia A and the acquired immunodeficiency syndrome].

A 25-year-old man with hemophilia A who had received concentrated plasma and plasma factor VIII products since childhood presented with a productive cough and a fever. The CD4/CD8 ratio of peripheral lymphocyte subsets was very low and the serum was positive for anti-HIV antibodies. The chest roentgenogram showed bilateral multiple nodules with cavity formation. The patient underwent transbronchial lung biopsy, and the specimen obtained had Pneumocystic carinii organisms. The patient was treated with sulfamethoxazole and trimethoprim compounds, and with inhaled pentamizine. His condition improved. Patients with pulmonary pneumocystosis usually present with interstitial infiltrates spreading from the hilium to the periphery of the lungs, and nodular and cavitary lesions are unusual pulmonary radiographic findings in this condition.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Pathology of infective endocarditis].

Clinico-pathological studies were made of 40 patients with infective endocarditis : 34 (22 men, 12 women ; ages, 5-71 years, mean, 40.4 years) had native valve endocarditis (NVE) and 6 (3 men, 3 women ; ages, 26-48 years, mean, 38.3 years) had prosthetic valve endocarditis (PVE). The aortic valve was involved most frequently (AV : 16, MV : 6, AV+MV : 8, TV : 3, MV+TV : 1). Thirteen patients had preexsisting heart disease (rheumatic in 4, floppy in 6, other in 3). Six of 21 "normal" valves showed myxomatous changes with connective tissue degradation, findings compatible with the histological diagnosis of floppy valve. The infecting organisms were identified by blood cultures in 26 patients. Bacteria and/or fungi were found histologically in 23 valves, even in those in which cultures of excised tissues were negative. In 2 cases, fungi were identified in the sewing ring of the prosthetic valves. This study demonstrates that : 1) floppy valve is a most important underlying heart disease in NVE ; 2) the infecting organisms are frequently identified histologically, even when cultures of excised tissues are negative ; and 3) fungi are important causes of both NVE and PVE, especially in patients given intensive antibiotic therapy.

Adolescent↗
PubMed1996

[Constrictive pericarditis with dissecting aortic aneurysm (DeBakey type II)].

We experienced a case of constrictive pericarditis with dissecting aortic aneurysm (DeBakey type II). The patient complained of orthopnea and leg edema. The cause of constrictive pericarditis was pericardial effusion due to dissecting aortic aneurysm. Ascending aortic replacement with graft and decortication of thickened pericardium were performed. We confirmed the decrease of CVP and PAP intraoperatively. Postoperative course was uneventful.

Aged↗
PubMed1996

[Mononeuritis multiplex associated with measles virus infection].

We describe a 19-year-old patient who developed mononeuritis multiplex associated with measles virus infection. On April 30th, 1995, he suffered from fever and skin eruption, which disappeared ten days later. Thirteen days later, he noticed weakness of the fingers of both hands and forearms, and pain on both elbow joints. He was admitted to our hospital on June 12th, 1995. Neurologic examination revealed weakness and sensory disturbance, confined to the distal aspects of the right radial nerve and left median nerve. The electrodiagnostic findings confirmed those of axonal neuropathy in the right radial and left median nerves. Routine laboratory studies were normal. The cerebrospinal fluid test and EEG were normal. The IgG and IgM antibody titers against measles virus continued to be elevated in serum over four months after the onset, while they were not elevated in the cerebrospinal fluid. The corticosteroid therapy was mildly effective. Although the pathogenesis of this case is unclear, we speculate that the mononeuritis multiplex was caused by vasculitis related to the persistent measles virus infection in both elbow areas.

Adult↗
PubMed1996

[Risk of second primary cancer in two-year survivors of small cell lung cancer].

A total of 498 patients with small cell lung cancer received chemotherapy with or without chest irradiation at Osaka Prefectural Habikino Hospital from October 1977 through December 1991. Sixty-one who survived for more than two years were evaluated to determine the incidence and anatomic patterns of redevelopment of small cell lung cancer and development of second primary cancers. The numbers of expected cancers were estimated by cumulating person years of observation from 2 years after the start of treatment for small cell lung cancer to the date of death. Second primary cancers were observed in seven patients (four cases of non-small cell lung cancer, two of gastric cancer, and one of prostate cancer). The risk of a second primary cancer was 3.2 times greater than in the general population (95% Cl: 1.3-6.6). the relations between occurrence of a second primary cancer and family history of cancer, smoking history, smoking cessation after treatment of small cell lung cancer, and thoracic irradiation were studied. Occurrence of a second primary cancer correlated with family history (relative risk 7.5, 95% Cl: 1.5-22) and smoking cessation (relative risk 3.2, 95% Cl: 1.2-6.9). Long-term survivors were more likely to have a second primary cancer than a relapse of small cell lung cancer. Therefore, long-term survivors should be closely monitored for second primary cancers. Meta-analyses of studies done at several institutions may provide more detailed information on the occurrence of second primary cancers after small cell lung cancer.

Adenocarcinoma↗
PubMed1996

[A case report of germinoma with syncytiotrophoblastic giant cells (STGC) in the basal ganglia].

We report a case of germinoma with syncytiotrophoblastic giant cells (STGC) in the basal ganglia which was encountered at the Department of Neurosurgery, Hiratsuka City Hospital, Kanagawa, Japan. A 9-year-old boy was admitted to our hospital on September 13th, 1993 because of left hemiparesis and precocious puberty. Endocrinological examination revealed a high serum level of human chorionic gonadotropin (HCG) (290 mIU/ml) and beta-subunit human chorionic gonadotropin (HCG-beta) (1.3 ng/ml). Plain CT scan showed an irregularly-defined mass lesion in the right basal ganglia, which had several low density spots and was inhomogeneously enhanced on contrast CT scan. The tumor developed from the right putamen to the thalamus and showed a tendency towards involvement of the hypothalamic region on MR imaging. We performed a right front-temporal craniotomy on 29th September, 1993, and a piece of the tumor was removed. It was histologically diagnosed to be germinoma with STGC. We treated the patient with carboplatin and etoposide (CBDCA 200 mg/m2day1, VP-16 60 mg/m2day1-5) chemotherapy and radiotherapy (local 30 Gy) after surgery. Postoperative course was good without recurrent signs. He is now in good health and going to elementary school without neurological deficit. There are very few reports of germinoma with STGC arising in the basal ganglia. We provide a new treatment of germinoma with STGC, chemotherapy and radiotherapy after surgery.

Basal Ganglia Diseases↗
PubMed1996

[Application for therapeutic use of deuterium oxide (D2O) against human pancreatic cancer].

This study was designed to assess the possibility of D2O as a therapeutic agent against human pancreatic cancer. We examined the effect of D2O on growth and invasion of human pancreatic cancer cells (Panc-1, MIA PaCa-2, BxPC-3) by using MTT assay and nude mice, on which human pancreas cancer cells were transplanted. In vitro growth of the three lines was significantly inhibited by D2O in a dose dependent manner, especially at more than a 10% concentration. Growth of Panc-1, which was transplanted in nude mice, was also inhibited by continuous oral intake of 30% D2O. Furthermore, the effect of D2O on cancer invasiveness was assessed by Matrigel invasion chamber assay. BxPC-3, which is the most adherent of the three lines, significantly reduced its invasiveness in more than 30% D2O media. In addition, the present study also demonstrated the inhibition of cancer cell locomotion by D2O in phagocytokinetic analysis. In conclusion, D2O may be applied for the therapeutic use against pancreatic cancer.

Animals↗