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Biomedical subjects

K Ueda

Publications and source records attributed to K Ueda.

At least 415 records · Page 23Linked to original sources
PubMed1997

High-dose chemotherapy and autologous blood stem cell transplantation in children with metastatic neuroblastoma.

High-dose chemotherapy (HDC) followed by autologous blood stem cell transplantation (ABSCT) was performed to improve the prognosis of children with metastatic neuroblastoma over 1 year of age at diagnosis. Seven stage IV neuroblastoma patients with a median age of 3.9 years (range 1.6-11.4 years) received conventional chemotherapy before leukapheresis for ABSCT. The median duration of chemotherapy before harvest was 8 months (range 3-23 months). Peripheral blood stem cells (PBSC) were harvested from them after the use of cytotoxic drugs plus granulocyte colony-stimulating factor. The median number of granulocyte-macrophage colony forming units collected after harvest was 23.2 x 10(4)/kg (range 10.1-45.3 x 10(4)/kg). The patients were administered HDC consisting of carboplatin, etoposide, and melphalan followed by ABSCT. Hematopoietic reconstitution after ABSCT was favorable; recovery of granulocytes count > 0.5 x 10(9)/L occurred within 2 weeks and stable platelet engraftment occurred at a median duration of 23 days (range 7-33 days). The toxicity of ABSCT was well tolerable. Two of the four patients who received ABSCT at their first complete remission remained in remission 67 and 68 months after ABSCT. One with partial remission also showed a good response for 8 months. The other two at first relapse showed a transient regression of the tumor. The prognosis of seven patients who received ABSCT was significantly better than that of 13 patients who received conventional therapy alone. These findings suggest that HDC followed by ABSCT is safe and useful as consolidation therapy for the treatment of patients with metastatic neuroblastoma.

Adrenal Gland Neoplasms↗
PubMed1997

Anthracycline-induced cardiotoxicity in children with malignancies.

The anthracyclines (ATC) have been used in the treatment of many pediatric patients with malignancies. Their use, however, has been limited by a serious and potentially irreversible cardiotoxicity. The medical records of pediatric patients with malignancies who received ATC at the Department of Pediatrics, Kyushu University, from January 1985 to December 1994 were reviewed. Among the 120 children with malignancies who received ATC, six patients (5%) developed congestive heart failure, 33 (28%) had subclinical cardiac dysfunction, whereas 81 (66%) showed no evidence of cardiac dysfunction. The incidence of ATC cardiotoxicity increased at higher cumulative doses. The earliest cardiotoxicity, however, was observed in a patient who received 180 mg/m2 unassociated with other risk factors, showing the marked individual variations in its development. Children younger than 4 years had a higher incidence of cardiotoxicity compared with those older than 4 years (P < 0.01) and are therefore more vulnerable to ATC cardiotoxicity. Because serial myocardial biopsies and stress testing are not practical in younger children, and radionuclide angiogram is rather costly and not appropriate for frequent evaluation, non-invasive tests such as echocardiography and electrocardiography (ECG) still play the main role for serial cardiac monitoring in these age groups. Radionuclide angiogram should be added as the confirmatory test modality.

Antibiotics, Antineoplastic↗
PubMed1997

Effects of serum from pregnant versus non-pregnant women on natural killer cell activity.

PROBLEM: To test the effect of serum obtained from in vitro fertilization-embryo transfer (IVF-ET) patients on the healthy volunteers natural killer (NK) cell activity. METHOD OF STUDY: Retrospective non-randomized clinical study. Suppressive effect on NK cell activity was measured with serum obtained from 25 pregnant and 24 non-pregnant women during IVF-ET procedure. RESULTS: Suppressive serum effect of volunteers' NK cell activity was significantly higher in pregnant than in non-pregnant women (P < 0.01). CONCLUSIONS: The suppressive activity of serum from pregnant women on NK cell suppression activity was useful in predicting the establishment of a successful pregnancy.

Adult↗
PubMed1997

[Nasopharyngeal flora and carriage rates of Haemophilus influenzae type b of healthy infants].

The present study investigates the nasopharyngeal flora and defines the carriage rates of Haemophilus influenzae type b of 144 healthy infants who visited the well-baby clinic. 224 nasopharyngeal swabs were obtained (44 swabs from 1-month-old infants, 96 swabs from 4 to 5-month-old infants and 84 swabs from 7 to 8-month-old infants), and 440 organisms were isolated. The most frequently isolated organism was Staphylococcus aureus (45.5%) followed by Corynebacterium (38.6%) from 1-month-old infants, Corynebacterium (55.2%) followed by S. aureus (32.3%) and Streptococcus pneumoniae (25.0%) from 4 to 5-month-old infants, Corynebacterium (59.5%) followed by S. pneumoniae (26.2%) from 7 to 8-month-old infants. Twenty-four strains of H. influenzae were isolated from 21 infants, being 1 strain from 1-month-old infant, 9 strains from 4 to 5-month-old infants, 14 strains from 7 to 8-month-old infants. Four type b strains were isolated from 3 infants, being 1 strain from 1-month-old infant, none from 4 to 5-month-old infant, 3 strains from 7 to 8-month-old infants. One of the three 7 to 8-month old infants also carried Hib when he was at the age of 1 month old. The nasopharyngeal carriage rates of H. influenzae of infants were 2.3% in 1-month-old infants, 9.4% in 4 to 5-month-old infants, 16.7% in 7 to 8-month-old infants and 10.7% in total. The carriage rates of Hib were 2.3% in 1-month-old infants, 0% in 4 to 5-month-old infant, 3.6% in 7 to 8-month-old infants and 1.8% in total.

Corynebacterium↗
PubMed1997

[Analysis of prognosis of bronchopulmonary infectious disease with lung cancer].

Bronchopulmonary infection affects the prognosis of lung cancer patients. Thus, we investigated the relationship between the prognosis of bronchopulmonary infectious diseases and their causative bacteria isolated by transtracheal aspiration (TTA) in lung cancer patients. In the present study, we determined which factor is more predisposing for the outcome of bronchopulmonary infections, the type of causative bacteria or the host nutritional status. A total of 107 lung cancer patients, which consisted of 105 males and 5 females (mean age 67.3 +/- 8.0), were included in this study. The study was conducted from 1981 to 1994. They were classified into the survival group and the deceased group. Causative agents of infection were compared between these 2 groups. S. pneumoniae, alpha-Streptococcus sp., M. catarrhalis, and Neisseria sp. were predominant in organisms isolated from TTA-specimens of lung cancer patients with bronchopulmonary infections, regardless of prognosis. Nutritional status, as determined by serum levels of cholinesterase, albumin, and cholesterol, was poor in the deceased group than in the survival group. These results indicate that the outcome of bronchopulmonary infections in lung cancer patients are affected mainly by the nutritional status of the host.

Aged↗
PubMed1997

[The evaluation of interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) level in peripheral blood of patients with chronic lower respiratory tract infection].

In the present study, we assessed the serum level of IL-6 and TNF-alpha by ELISA in patients with chronic lower respiratory tract infection. The serum levels of IL-6 and TNF-alpha of patients in acute exacerbation phase are higher than that of in stable phase. We also classified patients in acute exacerbation phase into two groups according to the microorganism of persistent infection. The serum level of IL-6 and TNF-alpha in the patients with persistent infection with Pseudomonas aeruginosa were higher than that with Haemophilus influenzae. Moreover, the serum level of IL-6 and TNF-alpha were found to be related with malnutrition which assessed by clinical indices such as the serum level of albumin and cholinesterase. The present result suggests that IL-6 and TNF-alpha may have relationship with not only inflammation in airway but also indices of nutrition in patients with chronic lower respiratory tract infection.

Acute-Phase Reaction↗
PubMed1997

[Prognostic analysis of sepsis in patients with lung cancer].

Sepsis is one of the most serious infections occurring in patients with lung cancer. Thus, we determined what is most predisposing factor in prognosis of sepsis in lung cancer patients; the type of causative bacteria, neutropenia or host nutritional status. A total of 27 lung cancer patients with sepsis, which consisted of 23 males and 4 females (mean age 70.7 +/- 6.6), were included in this study. The study was conducted from 1991 to 1995. All subjects were classified into the survival group and the dead group. Staphylococcus aureus or Esherichia coli most frequently isolated from the blood of the patients in the survival group, while either E. coli alone or multiple organisms were predominant in the dead group. Neutropenia did not affect the outcome of sepsis in lung cancer patients. In contrast nutritional status, as determined by serum albumin levels, was closely related to the mortality in septic lung cancer patients. These results predict that the prognosis of sepsis is dependent on nutritional status of lung cancer patients.

Aged↗
PubMed1997

[A case of multiple muscular abscesses of the lower limbs by Staphylococcus aureus after chemotherapy for lung cancer].

A 67-year-old male was admitted to our hospital because of lung cancer and interstitial pneumonia. Cisplatin, vindesie and mitomycin C were administered for treatment of lung cancer. The leucocyte-counts declined to 1700/microliter on the eighth day after the chemotherapy. Though granulocyte colony-stimulating factor was administered, pain in the right thigh and high grade fever developed. Because Staphylococcus aureus was isolated from the blood specimen, piperacillin was administered. But the high grade fever continued and the pain was expanded to the right hip, left hip, thigh and leg. Because a computed tomograph of the lower limbs showed low density areas in bilateral gluteus maximus muscle right adductor magnus muscle, left biceps femoris muscle and left soleus muscle and the culture of an aspirate from abscess of right leg detected S. aureus, multiple muscular abscesses of the lower limbs was confirmed. We changed the antibiotics from PIPC to imipenem/cilastatin and minocycline on nineteenth day after the chemotherapy. His symptoms improved after the change of antibacterial agents. But he died of acute exacerbation of interstitial pneumonia, after about two months of the chemotherapy. Muscular abscesses of the limbs are very rare in Japan. Only four cases with muscular abscess of the limbs were reported in Japan, since 1988. This case suggests that a muscular abscess must be considered in the differential diagnosis of fever in patients with neutropenia.

Abscess↗
PubMed1997

Is family history an independent risk factor for stroke?

OBJECTIVE: To estimate the influence of family history on the occurrence of stroke. METHODS: A case-control study was carried out from August 1992 to January 1994. The study population comprised 502 patients with a first stroke, aged between 20 and 70 years, who were treated at 48 affiliated hospitals. The same number of age and sex matched controls were selected from outpatients. Diagnoses were based on CT findings and clinical signs. There were 155 case-control pairs for subarachnoid haemorrhage, 158 for intracerebral haematoma, and 159 for cerebral infarction. Information about the patients and their families was obtained from a questionnaire which included the family histories of each subtype of stroke and other potential risk factors for stroke. The data were analysed focusing on the role of the family histories in the occurrence of stroke. RESULTS: In univariate analysis, the family histories of subarachnoid haemorrhage and intracerebral haematoma were positively associated with each of the subtypes of stroke (odds ratios 11.24 for subarachnoid haemorrhage, 2.39 for intracerebral haematoma), whereas family history of cerebral infarction was not a significant risk factor for its occurrence (odds ratio 1.41). Family history of intracerebral haematoma was correlated with a personal history of hypertension and habitual alcohol consumption. After adjustment for potential risk factors (hypertension, diabetes, hyperlipidaemia, obesity, alcohol consumption, and regular smoking), family history of subarachnoid haemorrhage still remained the most powerful risk factor for subarachnoid haemorrhage, whereas family history of intracerebral haematoma no longer showed a significant association with haematoma. CONCLUSION: Genetic factors play a major part in the pathogenesis of subarachnoid haemorrhage, and family history of subarachnoid haemorrhage is the strongest independent risk factor for the disease. On the other hand, family history of intracerebral haematoma was not an independent risk factor for haematoma, but it might be a good predictor, which indirectly influences the pathogenesis of intracerebral haematoma via certain hereditary components such as hypertension, and even lifestyle factors such as alcohol consumption. In cerebral infarction, genetic factors play a minor part in its pathogenesis.

Adult↗
PubMed1997

Aberrant gastric venous drainage in a focal spared area of segment IV in fatty liver: demonstration with color Doppler sonography.

PURPOSE: To clarify the correlation between aberrant gastric venous drainage and a focal spared area at the posterior edge of segment IV in fatty liver by using color Doppler ultrasound (US). MATERIALS AND METHODS: Seventeen patients with fatty liver were examined with gray-scale, color Doppler, and power Doppler US. In one patient with a focal spared area, arteriography and computed tomography (CT) were performed during injection of contrast medium into the right gastric artery. RESULTS: Focal spared areas of fatty liver at segment IV were shown in five of 17 patients. In all five patients with a focal spared area, aberrant gastric venous drainage was observed with color Doppler US. Power Doppler US depicted aberrant gastric venous drainage more clearly than color Doppler US. On the other hand, no definite aberrant gastric venous drainage was seen in the 12 patients who had no focal spared area. In one patient who underwent selective arteriography of the right gastric artery and CT arteriography, aberrant gastric venous drainage into segment IV was directly demonstrated. CONCLUSION: Focal spared areas at segment IV in fatty liver correlate strongly with aberrant gastric venous drainage. Noninvasive imaging methods such as color and power Doppler US are useful for depicting these aberrant drainage veins.

Adult↗
PubMed1997

Posterior aspect of hepatic segment IV: patterns of portal venule branching at helical CT during arterial portography.

PURPOSE: To determine the anatomy of the portal venous system in the posterior aspect of segment IV of the liver by using helical computed tomography (CT) during arterial portography (CTAP). MATERIALS AND METHODS: One hundred consecutive patients underwent CTAP. Helical CT during hepatic arteriography was performed in 20 patients. In seven patients with hepatocellular carcinoma in the posterior aspect of segment IV, the feeding arteries were also analyzed. RESULTS: A venule from the intrahepatic portal vein to segment IV was seen in all patients. Other findings included a tiny venule from the distal part of the main left portal vein (n = 36), from the proximal left main portal vein (n = 20), and from the right portal vein (n = 18). Aberrant right gastric venous drainage and/or parabiliary venous drainage directly into the posterior aspect was present in 14 patients. In two patients, a tiny accompanying artery was seen on images from CT during hepatic arteriography. In seven patients with hepatocellular carcinoma, the main feeding artery branched from the right (n = 2) or left (n = 5) hepatic artery. CONCLUSION: CTAP adequately demonstrates the tiny portal venous and arterial branches from the main right or left portal vein that distribute to the posterior aspect of segment IV. Knowledge of this vascular anatomy is clinically important.

Adult↗
PubMed1997

Life expectancy and social adaptation in individuals with Down syndrome with and without surgery for congenital heart disease.

Life expectancy and social adaptation in 373 children with Down syndrome with and without congenital heart disease (CHD) were assessed retrospectively. Survival at age 24 years was 92.2% for patients without CHD (n=200), and 74.6% for those with CHD (n=173). Survival for those who underwent operation for cardiovascular lesions (n=95) was 87.8%, and for those not operated on despite hemodynamically significant cardiovascular lesions (n=39), it was 41.4%. Cardiac functional capacity was better in the children without congenital heart disease and in the group operated on, where most patients also attained good social adaptation. We conclude that children with Down syndrome with congenital heart disease should undergo early cardiac evaluation and surgery if indicated.

Down Syndrome↗
PubMed1997

Effects of various doses of intracoronary verapamil on coronary resistance vessels in humans.

To investigate the vasodilatory effect of various doses of intracoronary verapamil on coronary resistance vessels, we studied 13 patients with normal angiograms. A coronary Doppler guide wire was inserted into the left anterior descending coronary artery, and coronary blood flow velocity (CBFV) was measured. Verapamil was injected into the left coronary artery at doses of 0.1 mg, 0.5 mg, 1.0 mg, and 2.0 mg at 10-min intervals. Nitroglycerin was also injected into the same artery to avoid changes in cross-sectional area. As a measure of coronary vascular resistance, coronary vascular resistance index (CVRI) was calculated as the quotient of mean aortic pressure/CBFV. An injection of verapamil produced a dose-dependent increase in CBFV: 79 +/- 38% with 0.1 mg, 131 +/- 56% with 0.5 mg, 143 +/- 46% with 1.0 mg, and 128 +/- 47% with 2.0 mg of verapamil. The percent peak decreases in CVRI were dose dependent: -42 +/- 13% with 0.1 mg, -50 +/- 17% with 0.5 mg, -62 +/- 14% with 1.0 mg, and -60 +/- 9% with 2.0 mg of verapamil. Thus, intracoronary verapamil produces a dose-dependent dilation of coronary resistance vessels, and the optimal effect is produced with an injection of verapamil at a dose of 1.0 mg into the left coronary artery. At this dose, verapamil did not affect atrioventricular conduction.

Adult↗
PubMed1997

Five cases of measles secondary vaccine failure with confirmed seroconversion after live measles vaccination.

We report 5 patients with secondary vaccine failure (SVF) who were infected with natural measles 2, 5, 5, 7 and 12 years, respectively, after vaccination with further attenuated live measles vaccine during infancy. Their seroconversion had been confirmed after vaccination. Three of the 5 patients had mild (modified) measles, while the remaining 2 patients had typical measles. The hemagglutination inhibition antibody titers to measles virus in paired acute and convalescent sera showed a secondary response pattern in 4/5 patients, and a primary response pattern was present in the remaining patient. Measles IgM antibodies were present in all patients during the convalescent stage. The patient with the primary response pattern may have had a decrease in the B cell memory during the 5-year period between vaccination and infection. This may be the first SVF case report that confirms the existence of completely waning immunity in recipients of the further attenuated live measles vaccines.

Adolescent↗
PubMed1997

[Benefit of monitoring the level of blood flecainide acetate in an elderly patient with ventricular premature contractions].

A 67-year-old woman without organic heart, disease had symptomatic ventricular premature contractions. Because class Ia, Ib and IV antiarrhythmic drugs did not prevent the premature contractions, the patient was treated with flecainide acetate at a dose of 50 mg t.i.d. Adverse reactions were noted. After measurement of the blood drug level, the dose was reduced to 50 mg b.i.d. The adverse reactions disappeared, and the arrhythmia was controlled. Flecainide acetate has a relatively long blood elimination half-life and a narrow safety margin. When some antiarrhythmic drugs are used in elderly patients, blood drug level monitoring is useful in preventing adverse reactions and in designing appropriate therapy.

Aged↗
PubMed1997

[Effect of body mass index on morbidity and mortality in a general Japanese population--the Hisayama study].

In order to investigate the effect of body mass index (BMI, kg/m2) on life expectancy, 2053 Hisayama residents, aged 40 years or older were studied for 13 years from 1974. During the follow-up period, 419 subjects died; of these, 39 deaths due to accident or suicide were excluded from further analysis. On initial examination, male subjects with BMI > or = 27 had significantly higher age-adjusted prevalence rates of hypertension, glucose intolerance, hypercholesterolemia, electrocardiogram abnormalities and proteinuria, as compared with those with 23-25 BMI. In contrast, the frequency of male smokers was inversely associated with BMI levels. Female prevalence rates of glucose intolerance, hypercholesterolemia and proteinuria were significantly higher in 25-27 BMI than in 23-25. Body Mass Index showed a U-shaped relationship with all cause mortality rates with the lowest rate in 23-27 BMI for men and in 23-25 BMI for women. These associations remained substantially unchanged, even after controlling for age, systolic blood pressure, glucose intolerance, serum cholesterol, proteinuria, electrocardiogram abnormalities, alcohol consumption, and smoking habits. When analyzing the BMI mortality relationship by cause of death, age- and sex-adjusted mortality rates from myocardial infarction and stroke significantly increased in subjects with BMI > or = 27 compared with those with 23-25 BMI. In contrast, there was a decreasing risk of death from malignant neoplasms with rising BMI levels, but the relationship was not significant. Mortality from pneumonia and other causes showed a U-shaped relationship with significantly higher rates seen in BMI < 19 than in 23-25 BMI. These data indicate that BMI has a U-shaped relationship with total mortality in the general Japanese population, which results from various associations between BMI and cause-specific mortality rates.

Adult↗