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Biomedical subjects

M Hara

Publications and source records attributed to M Hara.

At least 379 records · Page 21Linked to original sources
PubMed1998

Urinary excretion of podocytes reflects disease activity in children with glomerulonephritis.

The significance of the presence of podocytes in the urine was studied in various renal diseases in children. The podocytes were detected by immunofluorescence using monoclonal antibodies against the podocalyxin that is present on the surface of podocytes which serves as a glycocalyx. They were scored according to the numbers per partitioned area on cytospun urine sediments. Urine podocytes were absent in normal control, nonglomerular diseases such as urinary tract infection and nonglomerular hematuria, and glomerular, non-inflammatory diseases such as minimal change nephrotic syndrome and membranous nephropathy. Conversely, the excretion of podocytes in the urine were detected in various glomerular, inflammatory diseases. A significantly higher level of the podocyte score was found in the acute state of glomerular diseases which was defined as within 6 months after disease onset. Positive correlations were obtained between the presence of urinary podocytes and the histological features of active extracapillary changes and mesangial proliferation. Urinary podocytes were examined monthly for 12 months in 7 cases with IgA nephropathy and 2 cases with Henoch-Schönlein purpura nephritis, and a consistently higher urinary podocyte score was observed in the patients with histological progression. The scoring of urinary podocytes was found to be useful clinically, as a diagnostic tool for glomerular or nonglomerular diseases, inflammatory or noninflammatory diseases, a marker for the estimation of the severity of active glomerular injury and also as a predictor of disease progression.

Adolescent↗
PubMed1998

Glomerular injuries--excretion of glomerular epithelial cells-- induced by chemotherapy (antineoplastic drugs) independent of tubular damage.

For the purpose of studying glomerular injuries induced by antineoplastic drugs, the excretion of glomerular epithelial cells (GEC) was evaluated. In 13 children who received antineoplastic drugs, the excretion of GEC in urine samples was examined with an immunofluorescent study using a monoclonal antibody directed against podocalyxin, which was expressed on glomerular epithelial cells. GEC were detected in 20 of 25 chemotherapy courses. The excretion of GEC persisted until the next chemotherapy course in some cases. After an initiation of chemotherapy an increased urinary albumin-creatinine ratio (more than 2-fold) was found in 6 patients. A significant increase of N-acetylglucosaminidase was observed in 2 patients. Proteinuria and hematuria were not observed in all patients. These results indicate that glomerular injuries are frequently induced by chemotherapy independent of the tubular damage. Repeated glomerular injuries may result in late renal dysfunction.

Acetylglucosaminidase↗
PubMed1998

Role of circadian rhythmicity in the heart rate variability preceding non-sustained ventricular tachycardia.

The difference in sympathovagal activity preceding non-sustained ventricular tachycardia (NSVT) was examined between patients with and without a circadian rhythm. Thirty-three patients' Holter monitoring data (41 NSVT episodes) were analyzed regarding the frequency domain measures (low-frequency component [LF: 0.04-0.15 Hz], high-frequency component [HF: 0.15-0.4 Hz], and the ratio of LF to HF [LF/HF]) for each 15-min average from 120 min before each episode of NSVT. The presence of a circadian rhythm was accepted when the rhythm adaptation was significant by cosinor analysis and the acrophase was located at night (22.00-06.00h) in HF (HF-positive group, n=17), and during the daytime (10.00-20.00h) in LF/HF (LF/HF-positive group, n=12). The negative groups were identified by the absence of a circadian rhythm (HF-negative group, n=16; LF/HF-negative group, n=21). The serial changes in the HF power before NSVT were significantly different between the HF-positive and -negative groups (p<0.05). The HF increased from 75-60 min before NSVT in the HF-positive group, whereas the HF decreased from 60-45 min in the HF-negative group. The serial changes in the LF/HF ratio were not significantly different between the LF/HF-positive and -negative groups. Thus, the circadian rhythmicity of vagal activity seems to have an important role in the genesis of NSVT.

Aged↗
PubMed1998

Spontaneous larval Gnathostoma nipponicum infection in frogs.

From June 1993 to September 1997, a survey was carried out for the prevalence of larval Gnathostoma nipponicum infection in several kinds of frogs, toads, and their tadpoles collected from an endemic area of this nematode in Aomori Prefecture. Two frog species, one of 436 (0.2%) Rana nigromaculata and 51 of 147 (34.7%) R. catesbeiana were infected, and a total of 446 advanced third-stage larvae (AdL3) of G. nipponicum were recovered. These results confirmed that two frog species which can serve as the second intermediate and/or paratenic hosts in the life cycle of G. nipponicum exist in nature. This report is the first record of spontaneous infection of frogs with AdL3 of G. nipponicum.

Animals↗
PubMed1998

Primary cardiac leiomyosarcoma growing rapidly and causing right ventricular outflow obstruction.

Leiomyosarcomas are extremely rare primary cardiac tumors. We report a rapidly growing primary leiomyosarcoma of the right ventricle, which obstructed the right ventricular outflow tract within one month after symptom onset in a 68-year-old man. Two-dimensional echocardiography was useful in diagnosing the extent and progression of the tumor. The tumor was surgically resected on an emergency basis, and the right ventricle and pulmonary artery were successfully reconstructed. Recurrence of the tumor on the right ventricle was observed, and the patient was overcome by sudden dyspnea and died three months after surgery.

Aged↗
PubMed1998

Autopsy findings in a long-term survivor with glioblastoma multiforme--case report.

Autopsy detected no tumor tissues in a patient who died 6.5 years after the diagnosis of glioblastoma multiforme. A 54-year-old male developed left hemiparesis one month prior to admission. Computed tomography demonstrated a cystic lesion in the right frontal region with irregular ring-like enhancement. The tumor was extensively removed together with the surrounding tissue followed by irradiation (whole brain 32.4 Gy, local 28.8 Gy), and intravenous administration of interferon-beta. Histological examination confirmed the diagnosis of glioblastoma multiforme. He died of accidental head trauma 6.5 years after surgery. Autopsy of the brain detected no evidence of glioblastoma multiforme. The only findings were cerebral edema and hematoma caused by head trauma, as well as histological changes due to radiation damage. This case apparently confirms the histological disappearance of tumor tissue in a long-term survivor with glioblastoma multiforme.

Brain Neoplasms↗
PubMed1998

Angiodysplasia of the stomach confirmed by endoscopy and selective angiography--report of a case.

Gastric angiodysplasia that caused continuous gastrointestinal bleeding is reported in a 75-year-old woman who had been treated with repeated blood transfusions because of severe anemia. Endoscopic examination was performed and revealed a bright-red lesion on the anterior wall of the upper gastric body. Injection therapy was performed at first, but the follow-up endoscopy showed a recurrent red lesion in same place. Selective angiography revealed a dense stain suggestive of a hypervascular lesion, measuring about 1 cm in diameter. Partial gastrectomy including resection of the lesion was performed. During a follow-up period of more than 12 months, there was no sign of recurrence of bleeding.

Aged↗
PubMed1998

A case of giant leiomyosarcoma of the rectum.

A 63 year-old-man was admitted to our hospital with the chief complaint of dyschezia. Digital examination revealed a large solid mass on the posterior wall of the rectum. Endoscopically, the tumor was covered by an intact mucosal layer. Under the diagnosis of rectal leiomyosarcoma, abdominoperineal resection of the rectum was performed. The tumor was 10 x 9 x 8 cm in size, and its cross section showed a gray-white tumor with central necrosis. Microscopically, the large tumor of the rectum was mainly located in the proper muscle layer and adventitia, and showed cellular proliferation of spindle-shaped and mild pleomorphic stromal cells, arranged in interlacing fashion, and focal necrosis. The histologic findings support the diagnosis of leiomyosarcoma. Leiomyosarcoma of the rectum is a relatively uncommon disease. We report our case with reference to the literature.

Humans↗
PubMed1998

Treatment of bile leaks from cystohepatic and common hepatic duct after laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is widely accepted by patients and physicians despite the lack of controlled trials comparing this technology with conventional cholecystectomy. The cystohepatic ducts represent accessory bile ducts of variable size which frequently travel within the gallbladder fossa or in the posterior wall of the gallbladder. These ducts can be injured during laparoscopic cholecystectomy and can result in bile collection if transected. Recently, we have experienced two cases of injury to the bile duct during operation. One case was a transection of the accessory bile duct, the other one was an injury to the common hepatic duct. We present herein the clinical course of the two cases, in which biliary leakage, following laparoscopic cholecystectomy, was successfully managed by the end to end anastomosis of the bile duct.

Adult↗
PubMed1998

Three cases of the giant gastric leiomyosarcomas.

We report three cases of giant gastric leiomyosarcoma. Diagnosis was made prior to surgery using various diagnostic modalities. The patients were two women (77 and 77 years old) and one man (40 years old) whose chief complaints were abdominal pain, anorexia, and tarry stool. All patients presented with a large palpable mass in their upper abdomen at the time of admission. Based on characteristic findings from a gastric barium study, computed tomography (CT), and angiography, the patients were diagnosed as having gastric leiomyosarcomas displaying extramural growth. In the first case, a patient received a total gastrectomy, while local resection was performed in the second case because of pedunculated extragastric development. In the third case, total gastrectomy was combined with splenectomy and resection of the pancreatic tail. Twenty-two months after the original operation, the first case had multiple liver metastases. We present the three cases here, and review the literature.

Adult↗
PubMed1998

A case of leiomyosarcoma of the small bowel mesenterium.

Leiomyosarcoma of the small bowel mesenterium is a rare entity. Approximately 21 cases originating from the small bowel mesenterium have been described in the Japanese literature. Differentiation from its benign counterpart, leiomyoma, and other connective tissue tumors is often difficult, but it is important because each respective tumor type has an entirely different prognosis. The case of a 65 year-old-man in whom an 9 x 6 x 5 cm leiomyosarcoma of the mesenterium was excised surgically is presented.

Aged↗
PubMed1998

Jejunal varices as a cause of massive gastrointestinal bleeding--a case report.

This report describes a 49-year-old woman with recurrent massive gastrointenstinal bleeding from jejunal varices without portal hypertension. Preoperative diagnosis was obtained by abdominal computed tomography, superior mesenteric arterial angiography and percutaneous transhepatic portography. Percutaneous transhepatic portographic findings revealed no step-up of oxygen concentration and normal pressure in the portal vein, only dilation of superior mesenteric vein. Jejunal resection and anastomosis resulted in complete resolution of the bleeding, and the patient has experienced no recurrent bleeding over a 4 year follow-up period. A review of the literature shows that this syndrome is nearly always characterized by portal hypertension, generally due to liver cirrhosis. Accurate preoperative diagnosis is often difficult. We report a very rare case of jejunal varices without portal hypertension.

Female↗
PubMed1998

Pseudomyxoma peritonei. A report of three cases and a review of published reports.

Pseudomyxoma peritonei is a disease characterized by the progressive accumulation of mucinous ascites within the abdomen and pelvis. Metastatic disease outside the peritoneal cavity is unusual. Gastrointestinal function is lost from external compression of stomach, small bowel, and large bowel. We present three cases of pseudomyxoma peritonei which were treated by different therapeutic methods. Case 1 was a 61-year-old man who underwent treatment by appendectomy with administration of Cisplatin and Doxorubicin hydrochloride into the intraperitoneal cavity. Case 2 was a 64-year-old woman who underwent bilateral oophorectomy with administration of Cisplatin and ADM into the intraperitoneal cavity. About 4 years after the first operation, she died of peritonitis due to small and large bowel perforations underlying recurrent tumors. Case 3 was a 79-year-old woman who underwent surgery to evacuate about 4000 ml of mucinous ascites, and received intraperitoneal administration of 5-Fluorouracil (500 mg/day) for 5 days without severe complications.

Combined Modality Therapy↗
PubMed1998

A case of gastric cancer with nephrotic syndrome.

A 77-year-old woman complaining of anorexia and nausea was referred to the hospital with a diagnosis of advanced gastric cancer. The patient also had congestive heart failure with atrial fibrillation and severe hypoproteinemia. Proteinuria, hypoproteinemia and other laboratory data suggested that she had nephrotic syndrome. Total protein level was 4.6 g/dl and albumin level was 1.6 g/dl. In order to avoid postoperative complications such as wound dehiscence, anastomotic leakage and so on, careful pre- and post-operative management of nephrotic syndrome is necessary. Administration of albumin and fresh frozen plasma regimen was continued after the operation. Urinary protein level started to decrease after subtotal gastrectomy. Histological examination revealed moderately differentiated tubular adenocarcinoma with nodal metastases. Her post-operative course was uneventful. Although the signs and symptoms of nephrotic syndrome did not improve immediately, twelve months after operation she has become well and has no symptoms of ascites and hypoproteinemia.

Aged↗
PubMed1998

Nonfunctioning islet cell carcinoma--a twenty-one years survival case after distal pancreatectomy.

A case of nonfunctioning islet cell carcinoma was reported. A 40-year-old woman was admitted with epigastralgia. Abdominal angiography and other diagnostic modalities suggested pancreatic malignancy. After distal pancreatectomy, histopathological study revealed her pancreatic tumor to be a nonfunctioning islet cell carcinoma. Fourteen years later, postoperative computed tomographic examination (CT) detected the recurrence of para-aortic lymph node metastases. Five years later, distal gastrectomy was performed to control bleeding from a gastric ulcer. Twenty-one years after the original operation, she died because of underlying metastatic carcinoma. In this case, slow growth and a low grade malignancy were characteristic. Operative removal of the tumor would be the treatment of choice even if metastatic lesions existed.

Adenoma, Islet Cell↗