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Biomedical subjects

M Nagai

Publications and source records attributed to M Nagai.

At least 127 records · Page 7Linked to original sources
PubMed1999

Melanotic peritoneal sarcomatosis originating from clear cell sarcoma.

Peritoneal sarcomatosis was found in a 53-year-old male who had a history of resection of clear cell sarcoma (CCS) of the right wrist 7 years previously. Both the previous wrist tumor and the peritoneal disseminants consisted of small, spindle-shaped cells occasionally containing melanophages. Histologic features, histochemical demonstration of argentaffin granules, immunohistochemical reaction with HMB 45, and the demonstration of a chimeric transcript of EWS-ATF-1 established the diagnosis of CCS in the peritoneal tumors. As far as we are aware, this is the first case of a peritoneal sarcomatosis associated with CCS.

Antigens, Neoplasm↗
PubMed1999

The effect of combination therapy with interferon and cryofiltration on mesangial proliferative glomerulonephritis originating from mixed cryoglobulinemia in chronic hepatitis C virus infection.

Cryofiltration, which has developed from double filtration plasmapheresis (DFPP) with a cooling unit, is an on-line technique to remove cryoglobulin. We report on a patient who suffered from progressive edema and renal insufficiency caused by cryoglobulinemic membranoproliferative glomerulonephritis (MPGN), probably due to chronic hepatitis C virus (HCV) infection. To remove cryoglobulins and terminate the HCV infection, we utilized combination therapy with cryofiltration and interferon-alpha injection with corticosteroids. Interferon-alpha was capable of decreasing proteinuria but not diminishing cryoglobulin. Additional cryofiltration could remove cryoglobulin to an undetectable level. This combination therapy was partially successful to reduce proteinuria and prevent the progressive deterioration of renal function. The major adverse effects of this therapy were bleeding and myelosuppression. We conclude that this combination therapy may be effective and should be considered as treatment for cryoglobulinemic MPGN.

Aged↗
PubMed1999

Long-term follow-up results of adult patients with acute lymphocytic leukemia or lymphoblastic lymphoma treated with short-term, alternating non-cross-resistant chemotherapy: Japan Clinical Oncology Group Study 8702. Lymphoma Study Group.

BACKGROUND: Patients with acute lymphocytic leukemia (ALL) and those with lymphoblastic lymphoma (LBL) have overlapping clinical and immunophenotypic features and they have been treated with the same or very similar chemotherapy regimens. The goal of this multi-institutional phase II trial was to evaluate the therapeutic efficacy of a short-term, six-drug chemotherapy regimen for adult patients with untreated ALL or LBL. METHODS: Forty-six eligible patients, 41 with ALL and five with LBL, were treated with a short-term (planned total therapy duration; 36-38 weeks), simplified chemotherapy program; two courses of VEPA-L (vincristine, cyclophosphamide, prednisolone, doxorubicin, I-asparaginase plus intrathecal methotrexate and prednisolone) followed by four courses of M-VEPA (methotrexate plus VEPA), without the traditional maintenance therapy using daily 6-mercaptopurine and weekly methotrexate. RESULTS: Thirty-six (78%; 95% confidence interval 64-89%) of the 46 eligible patients achieved complete remission (CR). Among the 36 patients who achieved CR, four (11%) died of treatment complications, 26 (72%) relapsed and six (17%) remain alive in continuous CR. The median survival for all 46 eligible patients is 14 months and the median disease-free survival (DFS) for the 36 patients who achieved CR is 11 months. The estimate of the proportion of survival at 7 years of all 46 eligible patients is 15% at a median follow-up time of 96 months and that of DFS of the 36 patients achieving CR is 17% at a median follow-up time of 93 months. Subgroup analysis showed that an elevated serum C-reactive protein (CRP) level, age of 30 years or older, the presence of B-symptom and T-cell phenotype were likely to be associated with shortened survival. Although the observed CR rate (78%) is within the range of satisfaction, the long-term survival rate (15%) is inferior to those of published programs incorporating maintenance therapy. CONCLUSIONS: A fraction of adult patients with ALL or LBL are curable with a short-term, six-drug chemotherapy regimen. However, this simplified therapy of shorter duration cannot be recommended.

Adolescent↗
PubMed1999

A patient with genetic deletion of glutathione-S-transferase T1 and M1 who developed non-small-cell lung cancer and myelodysplastic syndromes.

Glutathione S-transferase (GST) M1 polymorphism is a marker for susceptibility to smoking-related neoplasms, such as lung and bladder cancer. Recently, a genetic deletion of GSTT1, an isoenzyme of GST, has been reported to be associated with myelodysplastic syndromes (MDS). A 59-year-old man with a long-term smoking habit was treated successfully for non-small-cell lung cancer. Four years after the surgical removal of his lung cancer, he developed MDS and died. Using a polymerase chain reaction-based genotyping method, he was found to have a deletion of both the GSTM1 and GSTT1 genes. Screening for the deletion of the GSTM1 and GSTT1 genes may be useful for assessing individual genetic susceptibility to smoking-related lung cancer and MDS.

Asian People↗
PubMed1999

Lung cancer in patients under 50 years old.

A long-term retrospective study was carried out on 790 cases of lung cancer to determine if the clinicopathologic characteristics and survival rates of lung cancer patients under the age of 50 differ from those of patients 50 years of age or older at diagnosis by analyzing data on patients registered at Tochigi Cancer Center Hospital. Of the 790 patients, 77 (9.7%) were under the age of 50 at diagnosis. The percentage of women in the younger patient group was significantly higher than that in the older patient group (39.0% vs. 27.5%; P = 0.034). Tumor histology revealed a significant preponderance of adenocarcinomas (60 patients, 77.9%) and a paucity of squamous cell carcinomas (8 patients, 10.4%) in the younger age group (P<0.001). The preponderance of adenocarcinoma was significant in both males and females (male: P = 0.004, female: P = 0.004). Smoking rates and rate of detection by cancer screening did not differ between the two age groups. Because of the paucity of smokers among the younger female patients, causes of lung cancer other than smoking should be sought in younger patients. No difference was found in the stage of the disease at presentation, treatment methods and survival rates between the two age groups. It is suggested that the prognosis for patients with lung cancer under the age of 50 is not significantly worse than for those aged 50 years or older, as has been shown by several investigators.

Adult↗
PubMed1999

Specific skin manifestations in CD56 positive acute myeloid leukemia.

We found 16 CD56+ cases (29.6%) among 54 acute myeloid leukemia (AML) patients; they showed significantly frequent cutaneous involvement compared to CD56- cases (43.8% vs. 15.8%, p<0.05). Four of the CD56+ AML cases with specific skin manifestations were reviewed histologically. In all cases, cutaneous leukemic cells were seen in the dermis and subcutaneous tissue with accentuation around the adnexa/nerve, but sparing the epidermis. In addition, angiocentric/ angiodestructive and prominent cohesive tumor cell growth were seen in two cases, respectively. These findings suggest that the expression of CD56 may often be associated with the cutaneous involvement in AML, and that the above histological findings should remind us of the possibility of specific skin manifestations in CD56+ AML.

Acute Disease↗
PubMed1999

Degradation of composite materials composed of tricalcium phosphate and a new type of block polyester containing a poly(L-lactic acid) segment.

Degradation of a new type of poly(L-lactic acid)/poly(ethylene; hexamethylene/ sebacate) block polyester and its composite containing 10 and 30 wt% tricalcium phosphate (TCP) were studied in vitro. Film specimens of thickness 100 and 250 microm for each of the three materials were immersed in phosphate buffered saline (pH 7.4) at 37 degrees C for up to 24 weeks. At appropriate intervals, water absorption, dry and wet tensile strength, molecular weight, and thermal properties of the specimens were measured by weighing, tensile strength testing, size exclusion chromatography, and differential scanning calorimetry, respectively. The decrease in tensile strength was greater in the unblended and thicker polymer film than in the other five films. The retention of tensile strength after 24 weeks increased with increasing TCP content. This trend was also noticed in the retention of molecular weight. The tensile strength of the materials having molecular weights below 5 x 10(4)-6 x 10(4) Mw or 2 x 10(4)-3 x 10(4) Mn dropped substantially and the materials became fragile. Blending of TCP to the PLLA block polyester retarded degradation, suggesting that TCP neutralized the carboxyl end groups formed by hydrolysis of ester bonds.

Absorption↗
PubMed1999

Inhibition of lysoPAF acetyltransferase activity by components of licorice root.

Licorice root traditionally used as an anti-inflammatory drug exhibited an inhibitory effect on lysoPAF (platelet-activating factor) acetyltransferase in vitro: the ether soluble fraction of the crude drug produced a 27.3% inhibition at a concentration 10 microg/ml. From this fraction, licoricidin (1), 1-methoxyphaseollin (2), 6,8-diprenylgenistein (3) and 1-methoxyphaseollidin (4) were isolated as active components, whose IC50 values were 7.7, 57, 19 and 48 microM, respectively. Licoricidin (1) seems to be one of the most potent compounds of plant origin isolated so far.

Acetyltransferases↗
PubMed1999

Atypical Wegener's granulomatosis with positive cytoplasmic antineutrophil cytoplasmic antibodies, ophthalmologic manifestations, and slowly progressive renal failure without respiratory tract involvement.

A 68-year-old woman had microscopic hematuria and proteinuria since the age of 50. She also had hearing impairment, arthralgia, retinal embolism, peripheral arterial occlusion of the right foot and chronic renal failure during the course. At the age of 68, she had progressive renal failure and nephrotic syndrome with high titers of serum cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCA). No evidence of respiratory tract involvement was found. Methylprednisolone pulse therapy and low dose cyclophosphamide therapy ameliorated the renal failure and reduced the serum c-ANCA level. She, however, died on July 19, 1998 due to pulmonary fungal and pneumocystis carinii infection.

Aged↗
PubMed1999

Adrenocorticotropic hormone-independent bilateral adrenocortical macronodular hyperplasia treated with mitotane.

We report a case of adrenocorticotropic hormone (ACTH)-independent bilateral macronodular adrenocortical hyperplasia (AIMAH), which was successfully treated with mitotane. A 71-year-old man visited our hospital because of central obesity and enlarged bilateral adrenal glands. The endocrinological studies showed elevated plasma cortisol and undetectable levels of ACTH, a lack of suppression with high-dose dexamethasone and a hyper-response to exogenous ACTH. These clinical features were compatible with the diagnosis of AIMAH. In this patient, extra-adrenal multiple tumors were also detected. After treatment with mitotane, the plasma level of cortisol was decreased while that of ACTH was increased and the signs of Cushing's syndrome were resolved.

Adrenal Cortex↗
PubMed1999

cAMP enhances insulin secretion by an action on the ATP-sensitive K+ channel-independent pathway of glucose signaling in rat pancreatic islets.

Cyclic AMP potentiates glucose-stimulated insulin release by actions predominantly at a site, or sites, distal to the elevation of the cytosolic free Ca2+ concentration ([Ca2+]i). Glucose also acts at a site, or sites, distal to the elevation of [Ca2+]i via the ATP-sensitive K+ channel (K+ATP channel)-independent signaling pathway. Accordingly, using rat pancreatic islets, we studied the location of the action of cAMP and its interaction with the glucose pathway. Forskolin, an activator of adenylyl cyclase, raised intracellular cAMP levels and enhanced KCl-induced (Ca2+ -stimulated) insulin release in the presence, but not in the absence, of glucose. Thus, cAMP has no direct effect on Ca2+ -stimulated insulin release. The interaction between cAMP and glucose occurs at a step distal to the elevation of [Ca2+]i because forskolin enhancement of KCl-induced insulin release, in the presence of glucose, was demonstrated in the islets treated with diazoxide, a K+ATP channel opener. The enhancement of insulin release was not associated with any increase in [Ca2+]i. Furthermore, the interaction between cAMP and glucose was unequivocally observed even under stringent Ca2+ -free conditions, indicating the Ca2+ -independent action of cAMP. This action of cAMP is physiologically relevant, because not only forskolin but also glucagon-like peptide 1, glucose-dependent insulinotropic polypeptide, and pituitary adenylyl cyclase activating polypeptide exerted similar actions. In conclusion, the cAMP/protein kinase A pathway has no direct effect on Ca2+ -stimulated insulin exocytosis. Rather, it strongly potentiates insulin release by increasing the effectiveness of the K+ATP channel-independent action of glucose.

Adenosine Triphosphate↗
PubMed1999

Detection of human T-lymphotropic virus type I p40tax protein in cerebrospinal fluid cells from patients with human T-lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis.

We investigated the role of viral transcripts of human T-lymphotropic virus type I (HTLV-I) in the cerebrospinal fluid (CSF) cells and peripheral blood mononuclear cells (PBMCs) of patients with human T-lymphotropic virus type I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP). To detect the HTLV-I p40tax protein, we developed a new sensitive method of immunohistochemistry combined with tyramide signal amplification and quantitative analysis. Seven patients with HAM/TSP were examined. As controls, four patients with other neurological diseases were examined; two of these patients were infected with HTLV-I and the other two were not. Both the CSF cells and PBMCs were reacted with a monoclonal antibody, Lt-4, for p40tax protein, followed by secondary antibody labeled with horseradish peroxidase. This was visualized by fluorescein directly labeled with tyramide and the number of positive cells was quantified with a Laser Scanning Cytometer. In the samples from patients with HAM/TSP, the HTLV-I p40tax protein was successfully detected by tyramide signal amplification, but not without it. In HAM/TSP patients, 0.04-1.16% of the CSF cells and 0.02-0.54% of PBMCs were positive for the HTLV-I p40tax protein, respectively. The expression of the HTLV-I p40tax protein in the CSF cells was more frequent than that in PBMCs in both HAM/TSP patients and HTLV-I carriers, and was also more frequent in the patients with HAM/TSP of shorter duration of illness. This technique could be a powerful tool to investigate the pathogenic mechanism of diseases associated with HTLV-I.

Adult↗
PubMed1999

[Medulloblastoma originating in the pons].

Medulloblastoma usually originates in the cerebellum. We report here a case of medulloblastoma originating in the pons. Pontine medulloblastoma is extremely rare, with only one report in the literature. An 11-year-old girl was admitted to our hospital with vertigo. Magnetic resonance imaging (MRI) revealed a tumor originating in the pons. On the 4th day after admission, the tumor bled. Because the patient's life was in danger from brain herniation, hematoma removal and tumor resection were carried out. The diagnosis was medulloblastoma. After surgery, the patient received radiation therapy and chemotherapy. Unlike tumors originating in the cerebellum, this tumor did not seem to be effectively reduced by these therapies. Radiation therapy and chemotherapy may not be effective for medulloblastoma originating in the pons. We considered it necessary to make a histological diagnosis even though the tumor originated in the pons and resection was difficult technically.

Brain Neoplasms↗
PubMed1999

Combined spectral karyotyping and DAPI banding analysis of chromosome abnormalities in myelodysplastic syndrome.

Spectral karyotyping (SKY) is a new molecular cytogenetic technique that allows simultaneous visualization of each chromosome in a different color. We have used SKY for comprehensive analysis of 20 myelodysplastic syndromes (MDSs) (13 primary MDSs, 3 therapy-related MDSs, and 4 acute leukemias developed from MDS, including 1 cell line established from a secondary leukemia), previously analyzed by G-banding. To locate the chromosomal breakpoints, DAPI-counterstained band images from all metaphases were transformed to G-band-like patterns. By using SKY, it was possible to identify the origin and organization of all clonal marker chromosomes (mar), as well as the origin of all abnormalities defined as additional material of unknown origin (add) or homogeneously staining regions (hsr) by G-banding. In total, SKY identified the chromosomal basis of 38 mar, add, and hsr, corrected 8 abnormalities misidentified by G-banding, and revealed 6 cryptic translocations in 5 cases. Total or partial chromosomal loss (mainly of -5/5q- and -7/7q-) is the most frequent cytogenetic abnormality in MDS. In 3 of 11 cases with -5/5q- and in 4 of 8 with -7/7q-, lost material was detected by SKY in unbalanced translocations. A total of 60 chromosomal losses were identified by G-banding in 16 cases with multiple chromosome abnormalities involving at least 3 chromosomes. For 26 of these losses (43%), SKY analysis suggested that the losses were not complete, but had been translocated to a variety of partner chromosomes. Moreover, SKY analysis revealed that a ring chromosome in a case of acute leukemia developed from MDS contained three to six segments that originated from chromosome 21 material. Fluorescence in situ hybridization showed the amplification of the AML1 gene on regions derived from chromosome 21, providing the first evidence of amplification involving this gene in MDS. Genes Chromosomes Cancer 26:336-345, 1999.

Adult↗
PubMed1999

[Distributions of the numbers of monitoring stations in the surveillance of infectious diseases in Japan].

To describe the characteristics of monitoring stations for the infectious disease surveillance system in Japan, we compared the distributions of the number of monitoring stations in terms of population, region, size of medical institution, and medical specialty. The distributions of annual number of reported cases in terms of the type of diseases, the size of medical institution, and medical specialty were also compared. We conducted a nationwide survey of the pediatrics stations (16 diseases), ophthalmology stations (3 diseases) and the stations of sexually transmitted diseases (STD) (5 diseases) in Japan. In the survey, we collected the data of monitoring stations and the annual reported cases of diseases. We also collected the data on the population, served by the health center where the monitoring stations existed, from the census. First, we compared the difference between the present number of monitoring stations and the current standard established by the Ministry of Health and Welfare (MHW). Second, we compared the distribution of all medical institutions in Japan and the monitoring stations in terms of the size of the medical institution. Third, we compared the average number of annual reported cases of diseases in terms of the size of medical institution and the medical specialty. In most health centers, the number of monitoring stations achieved the current standard of MHW, while a few health centers had no monitoring station, although they had a large population. Most prefectures also achieved the current standard of MHW, but some prefectures were well below the standard. Among pediatric stations, the sampling proportion of large hospitals was higher than other categories. Among the ophthalmology stations, the sampling proportion of hospitals was higher than other categories. Among the STD stations, the sampling proportion of clinics of obstetrics and gynecology was lower than other categories. Except for some diseases, it made little difference in the average number of annual reported cases of diseases in terms of the type of medical institution. Among STD, there was a great difference in the average number of annual reported cases of diseases in terms of medical specialty.

Child↗
PubMed1999

[Determination of the numbers of monitoring medical institutions necessary for estimating incidence rates in the surveillance of infectious diseases in Japan].

Our purpose was to determine the number of monitoring stations (medical institutions) necessary for estimating incidence rates in the surveillance system of infectious diseases in Japan. Infectious diseases were selected by the type of monitoring stations: 15 diseases in pediatrics stations, influenza in influenza stations, 3 diseases in ophthalmology stations and 5 diseases in the stations of sexually transmitted diseases (STD). For each type of monitoring station, 5 cases of the number of monitoring stations in each health center, including the number determined from presently established standards and the actual number in 1997, were given. It was assumed that monitoring stations were randomly selected among medical institutions in health centers. For each infectious disease, each case and each type of monitoring station, standard error rates of estimated numbers of incidence cases in the whole country were calculated in 1993-1997 using the data of the surveillance of infectious diseases. Among 5 cases of monitoring stations, the case satisfied the condition that those standard error rates were lower than the critical values, was selected. The critical values were 5% in pediatrics and influenza stations, and 10% in ophthalmology and STD stations. The numbers of monitoring stations in the selected cases were 3,000 in pediatrics stations, 5,000 in influenza stations (including all pediatrics stations), 605 in ophthalmology stations and 900 in STD stations.

Child↗