Biomedical subjects

M Nasu

Publications and source records attributed to M Nasu.

At least 199 records · Page 11Linked to original sources

PubMed1996

Malignant schwannoma metastasizing to the dura mater--case report.

A 58-year-old female, with a previous history of radical resection of malignant schwannoma arising in the maxillary sinus, presented with a metastasis to the dura mater following lung metastases 15 years after the initial diagnosis. A large mass at the left temporal region was totally removed immediately after an intratumoral hemorrhage. She subsequently died of massive hemoptysis. Although the prognosis is poor for patients with malignant schwannoma, aggressive treatment including radical surgery combined with radiotherapy and chemotherapy is recommended.

Brain Neoplasms↗

PubMed1996

[A case of cardiac herniation following intrapericardial pneumonectomy after induction chemoradiotherapy].

A case of cardiac herniation following left intrapericardial pneumonectomy after induction chemoradiotherapy has been presented. Curative resection after induction chemoradiotherapy for central bronchogenic cancer may require intrapericardial pneumonectomy. Cardiac herniation through the pericardial defect is a fatal complication after a pneumonectomy unless pericardial repair should be done immediately. Closure of the pericardial defect with prosthetic patch, regardless of defect size, is always necessary for the prevention of the cardiac herniation following intrapericardial pneumonectomy after induction chemoradiotherapy.

Aged↗

PubMed1996

[Acute lymphoblastic leukemia with marked morphologic abnormalities after chemotherapy for gastric cancer].

A 76-year-old man was admitted to our hospital in February, 1994 because of fever and general fatigue. The patient had received radical gastrectomy for gastric cancer in August, 1987 and was subsequently treated with adjuvant chemotherapy using UFT for 25 months. On admission, the leukocyte count was 57,700/microliters with 74% blasts. Bone marrow aspiration revealed proliferation of blasts with marked giant cells and polynucleolar cells. The diagnosis of T-lineage of acute lymphoblastic leukemia (ALL) was then made by analysis of surface markers and T-cell receptor rearrangement. Although combination chemotherapy was initially effective, blasts rapidly reappeared in the peripheral blood, and the patient died of pneumonia in August, 1994. In the presented case, blasts showed marked morphologic abnormalities. It is well known that most cases of therapy-related leukemia deviate from the myeloid lineage, and rarely from the lymphoid lineage. In addition, morphologic abnormalities are rare in de novo ALL. Since such abnormalities were demonstrated in our patient, and UFT was administered for a long period, it is possible that this leukemia occurred as a second malignancy related to UFT treatment.

Aged↗

PubMed1996

[A case of contralateral pneumothorax after right pneumonectomy].

A 46-year old man, who had a history of right pneumonectomy for pulmonary tuberculosis 28 years ago, was referred to our hospital for surgical treatment of contralateral pneumothorax. The patient underwent multiple excisions of bullae and parietal pleurectomy through the median sternotomy in order to save pulmonary function. The postoperative course was satisfactory as he could maintain preoperative pulmonary function. He returned to his work soon. We consider that the median sternotomy would be the most useful approach to save pulmonary function of patients who plan to undergo surgical treatment of contralateral pneumothorax after pneumonectomy.

Humans↗

PubMed1996

[Thoracic duct cyst--a case report].

The patient was a 59-year-old man with a 5-month history of cough, difficulty breathing, and palpitations while working. Initial examination at the internal medicine department of our hospital in August 1992 revealed a mass in the left side of the neck, and he was admitted for further examination and treatment. Preoperative investigations revealed a cystic lesion extending from the left neck area to the mediastinum. The mass was resected on August 13, 1992. Based on the intraoperative findings and postoperative histological examination, a diagnosis of thoracic duct cyst was made. The postoperative course was good and the patient was discharged after two weeks. This is extremely rare case, and the Trap door surgical approach proved useful for resection.

Humans↗

PubMed1996

[Endobronchial actinomycosis].

A 63-year-old man was admitted to our hospital with obstructive pneumonia. The chest X-ray film and computed tomogram showed an infiltrative shadow in the right lower lung field. Examination with a fiberoptic bronchoscope showed a mass in the right basal bronchus. These findings suggested the diagnosis of lung cancer with obstructive pneumonia. Histopathological examination of a specimen obtained by transbronchial biopsy revealed sulfur granules with infiltration of neutrophils, which led to the diagnosis of endobronchial actinomycosis. After three months of treatment with penicillin, the mass disappeared. Comparison of bronchoscopic findings before and after penicillin treatment clearly showed the efficacy of therapy.

Actinomycosis↗

PubMed1996

Expression of vacuolating cytotoxin in clinical isolates of Helicobacter pylori.

Our objective was to determine whether the prevalence of vacuolating cytotoxin production differed among Helicobacter pylori isolates obtained from patients with chronic gastritis, gastric ulcer, or duodenal ulcer. We examined the vacuolating cytotoxin production of 114 clinical H. pylori isolates in rabbit gastic epithelial cells (RGECs). We also tested two positive control strains (NCTC 11637 and NCTC 11916). Seventy-four of the 114 H. pylori clinical isolates (64.9%) produced intracellular vacuolation in RGEC cells, but there was no significant difference in the prevalence of intracellular vacuolation among the isolates of patients with chronic gastritis, gastric ulcers, and duodenal ulcers. We found no strong correlation between vacuolating cytotoxin production and peptic ulceration.

Animals↗

PubMed1996

Sofalcone for treatment of Helicobacter pylori infection.

It is difficult to regard sofalcone as a single drug for the treatment of Helicobacter pylori infection. However, sofalcone exerts multiple effects against H. pylori: it has antibacterial activity, induces morphological changes, inhibits adhesion to gastric mucin and inhibits lipolytic activity. The safety profile of sofalcone even on long-term administration is well established. Therefore, it may be possible to establish a new triple therapy for H. pylori infection using sofalcone combined with antibacterial drugs and proton pump inhibitors.

Anti-Bacterial Agents↗

PubMed1996

Atopic dermatitis successfully treated by eradication of Helicobacter pylori.

A relationship between allergic diseases and Helicobacter pylori infection has recently been noted. We report a case of atopic dermatitis and H. pylori infection in a 14-year-old girl. She had had widespread diffuse skin erythema with erosions and pigmentation since the age of 3 years. Endoscopically, there was chronic antral gastritis with H. pylori infection and histological eosinophilic infiltration. A high titer of H. pylori-specific IgG was present in serum. She was treated with a proton pump inhibitor (lansoprazole 60 mg), an antibiotic (clarithromycin 800 mg), and plaunotol (a mucosal protective agent, 480 mg) for 2 weeks to eliminate the infection. After 10 days of treatment, erythema and itching were more widespread and vesicle formation was seen on the foot. Generalized skin lesions abated a few days later. After eradication of the bacterium by the treatment, eosinophils decreased from 38.8% to 19.0%, and the clinical signs of atopic dermatitis almost disappeared. Serum gastrin level and the pepsinogen I/II ratio were normalized and histological findings of gastric mucosa showed improvement. H. pylori-specific IgE antibody, analyzed by the Western blot method, gradually decreased with the eradication treatment.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1995

Emergent coronary angiographic findings of patients with ST depression in the inferior or lateral leads, or both, during anterior wall acute myocardial infarction.

In conclusion, the present study indicates that there are several distinctive differences in emergent coronary angiographic findings according to the presence or absence of ST depression in the inferior or lateral leads, or both, and location of the leads showing ST depression on admission electrocardiograms in patients with anterior AMI. The coronary angiographic features of patients with this ECG finding greatly support a poor prognosis. In patients with anterior AMI, analysis of ST depression on an admission electrocardiogram should be routinely performed because it is useful in predicting coronary anatomy, the extent of infarction, and its prognosis.

Adult↗

PubMed1995

Expression of osteopontin in a macrophage cell line and in transgenic mice with pulmonary fibrosis resulting from the lung expression of a tumor necrosis factor-alpha transgene.

The expression level of osteopontin (OPN) mRNA was found to be increased in a macrophage cell line in the presence of recombinant tumor necrosis factor-alpha (TNF-alpha). OPN mRNA level was also explored in the lungs of transgenic mice which were expressing TNF-alpha in type II pneumocytes, a condition leading to pulmonary alveolitis and progressive fibrosis. OPN mRNA was significantly increased in the lungs of these transgenic mice. In situ hybridization showed that it was localized mostly in alveolar macrophages. Since OPN can be induced in macrophages by TNF-alpha stimulation and since on the other hand osteopontin appears to decrease the level of nitric oxide synthase, and thus the production of nitric oxide, osteopontin might also indirectly have an antifibrotic effect. The role played by osteopontin in fibrotic lesions resulting from the release of TNF-alpha deserves further study, since it may be involved in the balance of opposite effects eventually leading to local tissue damage ending in fibrosis.

Animals↗

PubMed1995

Flow capacity of internal mammary artery grafts: early restriction and later improvement assessed by Doppler guide wire. Comparison with saphenous vein grafts.

OBJECTIVES: The purpose of this study was to assess flow dynamics and flow capacities of internal mammary artery and saphenous vein grafts to the left anterior descending coronary artery. BACKGROUND: The postoperative flow capacity of internal mammary artery grafts to the left anterior descending coronary artery has been reported to be restricted compared with that of saphenous vein grafts in studies using radionuclide angiography. A recently developed Doppler guide wire has been used to analyze the flow dynamics of bypass grafts and to clarify the mechanism of this limited flow capacity. METHODS: Phasic flow velocity recordings were obtained in the midportion of the bypass graft and within the native left anterior descending artery, using a 0.018-in. (0.046-cm) 12-MHz Doppler guide wire, in 53 patients: 27 patients with an internal mammary artery graft (16 with a new graft assessed 1 month postoperatively and 11 with an old graft assessed at 1 year) and 26 patients with a saphenous vein graft (13 with a new graft assessed 1 month postoperatively and 13 with an old graft assessed at 1 year). All patients were studied at baseline rest and during hyperemia induced by intravenous infusion of dipyridamole, 0.56 mg/kg body weight, over 4 min. RESULTS: In the left anterior descending artery itself, systolic and diastolic peak velocities, the time average of the instantaneous spectral peak velocity (time-averaged peak velocity), vessel diameter and the calculated flow volume did not differ significantly among the four graft groups. The time-averaged peak velocity was significantly greater for new than for old arterial grafts or for new or old vein grafts (mean +/- SD 27 +/- 9 vs. 19 +/- 6, 11 +/- 5 and 12 +/- 6 cm/s, respectively, p < 0.01). However, because the diameter of new arterial grafts was significantly smaller than that of the other three grafts (2.4 +/- 0.1 vs. 2.9 +/- 0.2 [p < 0.05], 3.6 +/- 0.6 [p < 0.01] and 3.4 +/- 0.5 mm [p < 0.01], respectively), there was no difference in calculated flow volumes at rest (62 +/- 17 vs. 58 +/- 15, 61 +/- 18 and 58 +/- 19 ml/min, respectively, p = NS) between new arterial grafts and the other grafts. Although the maximal time-averaged peak velocity during hyperemia was significantly greater in new than in old arterial grafts or new or old vein grafts (47 +/- 17 vs. 40 +/- 7, 31 +/- 8 and 34 +/- 12 cm/s, respectively, p < 0.01), the flow reserve of new arterial grafts was significantly smaller than that of the other three groups (1.8 +/- 0.3 vs. 2.6 +/- 0.3, 2.8 +/- 0.5 and 3.0 +/- 0.6, respectively, p < 0.01) because the baseline time-averaged peak velocity of these new grafts was far greater than that of the other groups. CONCLUSIONS: Internal mammary artery graft flow early after operation is characterized by a higher rest velocity than that of vein graft flow. This high velocity maintains flow volume at baseline condition in compensation for the smaller diameter. Although flow reserve does not differ significantly between new and old vein grafts, that for internal mammary artery grafts is significantly reduced soon after bypass surgery. This restricted flow capacity improves late postoperatively because of an increase in diameter and a decrease in flow velocity from baseline levels.

Adult↗

PubMed1995

Effects of Helicobacter pylori infection on gastric mucosal defense factors in Japanese monkeys.

The pathogenic role played by Helicobacter pylori in gastric mucosal defense was investigated in Japanese monkeys infected with H. pylori. Serum gastrin levels and ammonia concentrations in gastric juice were compared in H. pylori-infected (n = 6) and control (n = 7) groups. The gastritis score, the intracellular content of periodic acid-Schiff (PAS)-positive substance and hexosamine, and the bromodeoxyuridine (BrdU) labeling index in the gastric mucosa were compared in the two groups in the antrum and the corpus. The ammonia concentration in the gastric juice was significantly higher in the infected group (P < 0.01). The gastritis scores were significantly higher in the antrum and corpus in the infected group (P < 0.01, and P < 0.05, respectively). The content of PAS-positive substance and hexosamine was significantly decreased in the antrum of the infected group compared with that in the controls (P < 0.01, and P < 0.05, respectively), but there was no significant difference between the two groups in the corpus. The BrdU labeling indices were significantly higher in the antrum and corpus of the infected group (P < 0.01, and P < 0.01, respectively). Colonization by H. pylori injures the gastric mucosa by depressing the gastric mucosal defense factors, and, consequently, the cell kinetics are accelerated.

Ammonia↗

PubMed1995

Effects of ethanol on the pancreas of disulfiram-treated rats.

To study the effects of ethanol on disulfiram-treated rats, we administered ethanol orally at a does of 2000 mg/kg, twice daily for 5 days. The administration of ethanol or disulfiram alone produced no recognizable changes in pancreatic acinar cells. Ethanol administration, in disulfiram-treated rats resulted in a decrease in the content of zymogen granules in acinar cells, and the appearance of intraplasmic vacuolization. Electron microscopically, these vacuoles appeared on the basal side of nuclei. In addition, similar vacuoles appeared in liver cells, and these vacuolizations seemed to show lipid inclusions. However, ethanol administration to disulfiram-treated rats did not cause inflammatory changes or edema in the pancreas. A comparison of blood ethanol levels in rats receiving ethanol alone and disulfiram plus ethanol showed no significant difference, but acetaldehyde levels in rats receiving ethanol plus disulfiram rats were significantly higher than those in rats receiving ethanol alone. These findings suggested that acetaldehyde caused a decrease of zymogen granules and the presence of lipid inclusions in pancreatic acinar cells.

Acetaldehyde↗

PubMed1995

Postoperative flow characteristics of left internal thoracic artery grafts.

Twenty patients whose left internal thoracic artery (LITA) was anastomosed to the left anterior descending artery (LAD) underwent postoperative coronary angiography and Doppler ultrasound velocimetry. During angiography, the diameter of the LITA conduit was measured at three points: proximal, mid, and distal. The degree of left anterior descending artery stenosis proximal to the anastomotic site was evaluated by densitometry. The LITA flow velocity pattern was obtained at the three points to calculate the total, systolic, and diastolic flow volume. There were significant differences in the total LITA flow among the three points (proximal, 36.0 +/- 17.2 mL/min; mid, 29.9 +/- 15.2 mL/min; distal, 27.2 +/- 14.0 mL/min; p < 0.001 between the proximal and the mid or distal portions). The degree of left anterior descending artery stenosis affected the distal LITA flow and diameter (r = 0.823 and 0.811, respectively). There were significant differences in the systolic LITA flow among the three points (proximal, 13.2 +/- 6.5 mL/min; mid, 8.1 +/- 4.7 mL/min; distal, 5.6 +/- 3.4 mL/min; p < 0.001 between the proximal and the mid or distal portions). However, there was no statistically significant difference in the diastolic LITA flow among the three points (proximal, 22.9 +/- 11.0 mL/min; mid, 21.7 +/- 10.8 mL/min; distal, 21.6 +/- 10.8 mL/min). We conclude that a lower degree of LAD stenosis significantly reduces the LITA flow, inducing the string phenomenon. Additionally, during the diastolic phase, the LITA graft transports the blood primarily to the coronary artery but not to the side branches. Therefore, the steal phenomenon might not apply in the setting of an LITA graft.

Adult↗

PubMed1995

Myxoma of the mitral valve detected by echocardiography and magnetic resonance imaging.

Myxomas of the mitral valve diagnosed during life are exceedingly rare. We employed transthoracic and transoesophageal echocardiography and magnetic resonance imaging enhanced by gadolinium-diethylene-triamine-pentaacetic acid in a patient with palpitations. After these examinations clearly demonstrated a myxoma on the atrial side of the posterior mitral valve leaflet, urgent surgery was performed. When a small tumour of the mitral valve exists, these examinations are useful not only for detecting and characterizing the tumour, but also for deciding the optimal surgical management.

Adult↗

PubMed1995

Inferior ST segment depression as a useful marker for identifying proximal left anterior descending artery occlusion during acute anterior myocardial infarction.

To determine whether or not ST segment deviation on admission electrocardiograms can identify patients with anterior acute myocardial infarction due to proximal left anterior descending artery occlusion, the magnitude and location of ST segment elevation or depression were compared between patients with proximal left anterior descending artery occlusion (group A, n = 47) and those with distal left anterior descending artery occlusion (group B, n = 59). ST segment depression in each of the inferior leads was significantly greater in group A than in group B. The incidence of ST segment depression > or = 1 mm in each of the inferior leads (II; 81% vs 27%, III; 85% vs 54%, aVF; 87% vs 47%, P < 0.01) was significantly higher in group A than in group B. In addition, the incidence of ST segment depression > or = 1 mm in all of the inferior leads was significantly greater in group A than in group B (77% vs 22%, P < 0.01). In group A, maximal ST segment elevation was more frequent in lead V2 alone (43% vs 14%, P < 0.01). Group A had greater ST segment elevation in lead aVL than group B, and the incidence of ST segment elevation > or = 1 mm in lead aVL was significantly higher in group A than in group B (66% vs 47%, P < 0.05). ST segment depression > or = 1 mm in all of the inferior leads was most valuable for identifying group A patients (77% sensitivity and 78% specificity). In contrast, the maximal ST segment elevation in lead V2 alone or ST segment elevation > or = 1 mm in lead aVL had a low diagnostic value (43% sensitivity and 86% specificity, 66% sensitivity and 53% specificity, respectively). In conclusion, this study indicates that analysis of ST segment deviation in the inferior leads is useful for identifying patients with acute anterior myocardial infarction due to proximal left anterior descending occlusion.

Adult↗

PubMed1995

Acute myeloblastic leukaemia without Philadelphia chromosome developing after interferon therapy for chronic myelocytic leukaemia with Philadelphia chromosome.

We report a patient who developed Philadelphia chromosome negative acute myeloblastic leukaemia with trisomy 8 and trisomy 11 after receiving treatment with alkylating agents and interferon for chronic myelocytic leukaemia positive for Philadelphia chromosome. Leukaemic cells were positive for myeloperoxidase and expressed CD13, CD33 and DR; some expressed CD2, CD4 and CD34. The fluorescence in situ hybridization method revealed that bcr-abl fusion genes were absent from > 90% of the bone marrow cells. The major bcr rearrangement was not detected by Southern blot analysis. We conclude that the leukaemic cells negative for Philadelphia chromosome may have developed as a result of treatment with alkylating agents and interferon in the present case.

Aged↗