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Biomedical subjects

M Sawamura

Publications and source records attributed to M Sawamura.

At least 91 records · Page 5Linked to original sources

Chronic idiopathic thrombocytopenic purpura complicated by chronic disseminated intravascular coagulation associated with abdominal aortic aneurysm.

A patient with chronic idiopathic thrombocytopenic purpura (ITP), chronic disseminated intravascular coagulation (DIC) and abdominal aortic aneurysm is described. He had severe thrombocytopenia and his platelet life span was shortened (29 h). Indium 111-labeled platelet scintigraphy demonstrated an increased accumulation of radioactivity over the aneurysm and the spleen. Following preoperative heparin therapy for DIC, the platelet count remained low (10 x 10(9)/l), while the DIC improved. Because of the elevated platelet-associated IgG, we considered that the patient had complicated chronic ITP. After intravenous immunoglobulin therapy, his platelet count increased. The aneurysm was successfully replaced with an artificial Y-graft vessel and a splenectomy was performed at the same time. The platelet count was maintained at about 60 x 10(9)/l after the operation and the patient is quite well now.

Aged↗

Spontaneous regression in B cell, diffuse large cell type non-Hodgkin's lymphoma.

A rare case of non-Hodgkin's lymphoma (NHL) that showed transient spontaneous regression (SR) is described. After 6 months of remission, recurrence was noted in the lymph nodes, pleura and the spleen. Although transient improvement was observed following combination chemotherapy, the pleural effusion became refractory to chemotherapy and the patient died 9 months after the relapse.

Antineoplastic Combined Chemotherapy Protocols↗

[Combination therapy with granulocyte colony-stimulating factor (G-CSF) and erythropoietin (EPO) induced prominent granulocyte increase in an elderly case of myelodysplastic syndrome (MDS)].

A 70-year-old man was admitted to our hospital with pancytopenia. He was diagnosed as having MDS (RA), and therapy with subcutaneous S-CSF (100 micrograms/day) was started. His leukocyte count increased from 800/microliters to 1,400/microliters in two weeks. The dose of G-CSF was raised to 200 micrograms/day in the third week, and leukocytes increased to 2,00/microliters. At the fifth week, intravenous EPO (6,000 U x 3 times/week) was added. His leukocyte count increased to 4,000/microliters. EPO therapy was raised to 12,000 U x 3 times/week at the eighth week, his leukocyte count remained at the same level. G-CSF and EPO was stopped at the eleventh week, and leukocytes decreased to the same level as before administration. Throughout the course, his platelet count and reticulocyte count did not change. G-CSF and EPO are known as the stimulators of granuriod and erythroid progenitor, respectively. However, in this case, combination therapy with G-CSF and EPO induced marked increase of granulocytes only. This was an interesting case in relation to the roles of these cytokines in the hematopoietic system.

Aged↗

[Effect of combination therapy with sulbactam/cefoperazone and amikacin in the treatment of infectious diseases accompanied by hematological disorders].

We studied the efficacy and safety of a combination therapy with sulbactam/cefoperazone (SBT/CPZ) and amikacin (AMK) on severe infections in the patients with hematological disorders. We administered SBT/CPZ and AMK to 65 patients and analyzed the result of 57 patients, except for 8 drop outs, for evaluation. The overall clinical efficacy of this combination therapy was 64.9% (excellent in 15 patients, good in 22 patients). Thirty seven patients had sepsis and suspected sepsis. The efficacy was 67.6% in these patients. The rate of improvement in the cases (18 patients) with neutrophil counts under 500/mm3 during the administration among 28 patients who had not responded to prior antibiotic treatment was 67.9%. Diarrhea was found in 1 patient as an apparent side effect likely related to this drug regimen. It appears that combination therapy of SBT/CPZ and AMK was a useful regimen in the treatment of infectious diseases complicated with hematological disorders.

Adolescent↗

[Mediastinal diffuse large-cell lymphoma with sclerosis diagnosed by needle biopsy].

A 28-year-old woman was admitted to our hospital with cough. CT scan indicated a huge mass in the anterior mediastinum. A transcutaneous needle biopsy showed tumor cell infiltration and compartmentalizing fibrosis. The tumor cells were positive for CD20 and CD45, and JH rearrangement was evident. The patient was diagnosed as mediastinal diffuse large-cell lymphoma with sclerosis. The tumor responded to combination chemotherapy. It should be emphasized that mediastinal diffuse large-cell lymphoma can be diagnosed using a small specimen obtained by transcutaneous needle biopsy.

Adult↗

[Clinical features and status in multiple myeloma].

Quantitation of peripheral circulating myeloma cell precursors, problems on serum beta 2-microglobulin value which is a prognostic factor in myeloma, and prognostic factors associated with long-term survival in our Japanese myeloma patients are described. Peripheral blood mononuclear cells were cultured in vitro in the presence of various recombinant cytokines and differentiated to plasma cells to quantify peripheral circulating myeloma cell precursors. It has speculated that the variation in the number of myeloma cell precursors in peripheral blood could be used as a parameter of the efficacy of chemotherapy in patients with myeloma. Serum beta 2-microglobulin value increased with age and under alpha-interferon therapy in myeloma, even if M protein decreased, suggesting that its value should be carefully monitored when evaluating the response to alpha-interferon and other chemotherapeutic agents. Of 1,119 Japanese patients with symptomatic myeloma who were newly diagnosed at 16 institutions of the Japan Myeloma Study Group between 1965 and 1981, 38 (3.4%) patients survived for more than 10 years. In comparison with 121 patients who died within 10 years in our institution, younger age, low and intermediate tumor mass, lower plasmacytosis, higher percentages of granulocytes and erythroblasts in bone marrow, and subtype classified as mature or intermediate were strongly correlated with long-term survival.

Adult↗

Liver mevalonate 5-pyrophosphate decarboxylase is responsible for reduced serum cholesterol in stroke-prone spontaneously hypertensive rat.

Spontaneously hypertensive rat (stroke-prone) (SHRSP) has an interestingly low serum cholesterol level due to a reduced biosynthesis of cholesterol in the liver (Iritani, N., Fukuda, E., Nara, Y., and Yamori, Y. (1977) Atherosclerosis 28, 217-222). In this study, we examined the mechanism underlying the reduction of hepatic cholesterol biosynthesis in the rat. Our initial findings in SHRSP, as compared with normotensive Wistar Kyoto rat (WKY), showed that 1) the incorporation of [14C]acetate into cholesterol in the liver slices was markedly less, 2) 3-hydroxyl-3-methylglutaryl (HMG) CoA reductase activity was not reduced, and 3) the incorporation of [3H]mevalonic acid into both cholesterol and squalene was significantly less. The above initial findings suggested that the reduction in the hepatic cholesterol biosynthesis took place in one or more enzymatic processes starting with mevalonic acid and continuing to squalene. When the incorporation of [3H]mevalonic acid into phosphomevalonate derivatives was studied using an ion exchange column, only the radioactivity incorporated into isopentenyl-pyrophosphate (isopentenyl-PP) was less in SHRSP. Furthermore, the specific activity of diphosphomevalonate (mevalonate-PP) decarboxylase in the liver-soluble fractions was reduced 50% in SHRSP as compared with WKY. Kinetic studies using liver crude extracts indicated a lower Vmax value in SHRSP (SHRSP, 0.47; WKY, 2.05 nmol/min/mg), and an unchanged Km value (SHRSP, 18.2; WKY, 19.6 microM). The activity of mevalonate-PP decarboxylase was also found to be reduced in other tissues, including the brain, testis, small intestine, and cultured vascular smooth muscle cells. From the above observations, we concluded that the lower activity of mevalonate-PP decarboxylase was responsible for the reduced cholesterol biosynthesis in the liver of SHRSP.

Acetates↗

Polymerase chain reaction-based DNA fingerprinting in the spontaneously hypertensive rat: potential source of cDNA library probes.

1. Using the Polymerase Chain Reaction with a primer homologous to a repetitive unit found at irregular distances in the rat genome, we were able to synthesize DNA fragments spanning such units and visualize them as a ladder of discrete bands following electrophoresis. 2. Differences between fingerprint patterns generated using SHR, WKY and SD DNA, in the form of band deletions or duplications, were readily detected. 3. Unlike traditional fingerprinting, PCR fingerprints allow the ready extraction and characterization of polymorphic bands. Such bands could then be used as probes with which to screen a cDNA library that might, in turn, identify expressed genes involved in the development of hypertension.

Animals↗