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Biomedical subjects

M Umeda

Publications and source records attributed to M Umeda.

At least 253 records · Page 14Linked to original sources
PubMed1994

[VCAP chemotherapy combined with interferon-alpha (HLBI) for elderly multiple myeloma].

VCAP chemotherapy combined with natural interferon-alpha (HBLI) was performed on elderly patients over 65 year with multiple myeloma (MM), and its clinical effects were compared with those of VCAP chemotherapy without HLBI on elderly MM and also with those of HLBI-VCAP and VCAP combination therapy on non-elderly MM. Sixteen elderly and 21 non-elderly patients received HLBI-VCAP combination therapy, whereas 12 elderly and 21 non-elderly patients were treated with VCAP chemotherapy alone. The remission rate (CR+PR) was 81% for the elderly HLBI-VCAP group, 58% for the elderly VCAP group, 90% for the non-elderly HLBI-VCAP group, and 76% for the non-elderly VCAP group. While the median survival time was 54 months for the elderly HLBI-VCAP group and 13.5 months for the elderly VCAP group, it was 70 months for non-elderly HLBI-VCAP group and 34.5 months for the non-elderly VCAP group. The survival time in the elderly HLBI-VCAP group was significantly longer than that in the elderly VCAP group. Therefore, improvement of survival in cases treated by interferon was much better in the elderly group than in the non-elderly group. These results indicate that HLBI-VCAP combination therapy is beneficial for the treatment of elderly MM.

Aged↗
PubMed1994

Combination chemotherapy with COP-BLAM III for intermediate and high-grade non-Hodgkin's lymphoma.

The clinical effects of COP-BLAM III combination chemotherapy and recombinant human granulocyte colony-stimulating factor (rhG-CSF) were examined in 60 patients with intermediate or high-grade non-Hodgkin's lymphoma (NHL). The patients consisted of 37 men and 23 women with a median age of 53 years. The modified COP-BLAM III regimen based on the method of Boyd et al. consisted of six cycles of 6 weeks duration each. The complete remission rate for all patients was 83.3% (50 of 60 patients). With the median observation duration of 47.5 months, the overall median survival time for all patients was 86 months or more. The disease-free survival rate for the 50 CR patients was 88.2% at 86 months. The incidence of infections was significantly reduced by the concomitant use of rhG-CSF. The most common adverse effect was neutropenia (< or = 1000/microliters). The percent diffusing capacity for carbon monoxide in the lung (%DLCO) was reduced in 12 of the 60 patients (20.0%). We conclude that COP-BLAM III is a useful regimen for intermediate and high-grade NHL. However, caution is required since some elderly patients had reduced pulmonary function.

Adolescent↗
PubMed1994

[Refractory immune thrombocytopenic purpura accompanied with avascular necrosis of femoral head receiving the combination of high dose immunoglobulin therapy followed by platelet transfusion could successfully be managed to undergo surgery].

A 31 year-old male with refractory immune thrombocytopenic purpura (ITP) was accompanied with avascular necrosis of the femoral head on both sides, refractory to the following conventional therapies: high dose immunoglobulin (IgG) therapy, splenectomy, vinblastin slow infusion; maintaining a platelet count less than 20 x 10(3)/microliters. He subsequently tried the combination of high dose IgG therapy with platelet transfusion from two single donors, which successfully increased the platelet count to more than 50 x 10(3)/microliters for as long as 9 days. Compared to this method, platelet transfusion alone without IgG infusion failed to maintain an increase in the platelet count. These results suggest that high dose IgG may affect transfused-platelet removal in ITP. Management by the combination method enabled him to undergo surgery twice and he was able to walk with a stick six months later.

Adult↗
PubMed1994

[Type III procollagen N-terminal peptide and type IV collagen-7S level in the serum and BALF of patients with non-Hodgkin's lymphoma before and after chemotherapy].

Combination chemotherapy regimens using multiple agents have been reported to produce long term survival in patients with non-Hodgkin's lymphoma (NHL). However, the adverse effects of those regimens, particularly pulmonary complications, have resulted in fatalities. We measured P-III-P and type IV collagen-7S level in the serum and BALF of 23 previously untreated NHL patients who underwent COP-BLAM III chemotherapy in which a high dose of bleomycin (BLM) was used, and studied the relationship between those parameters and the pulmonary functions in those patients. The parameters and pulmonary function were measured before the first course and after the completion of the fourth course of chemotherapy. As for pulmonary function, chemotherapy produced an increment of %DLCO value but no change in PaO2, %VC, and %FEV1.0. While serum P-III-P levels remained unchanged, P-III-P levels in BALF slightly decreased after the chemotherapy. Type IV collagen-7S levels both in serum and BALF showed no change after the chemotherapy. Serum P-III-P levels after the chemotherapy were significantly correlated with both total cell counts and lymphocyte counts in the BALF. But there was no correlation between serum P-III-P levels and %DLCO. Mild and early-Stage fibrosis was observed in the lungs of the patients who were treated with COP-BLAM III. Pulmonary adverse effects are not likely to be associated with the total administered dose of BLM, but are associated with individual susceptibility to BLM toxicity. Our results suggest that the chemotherapy should be discontinued or the dose of BLM should be reduced if the P-III-P level in BALF increases.

Adolescent↗
PubMed1994

[Clinical usefulness of 123I-MIBG myocardial SPECT in patients with adriamycin-induced cardiomyopathy].

In 29 patients who had been administrated adriamycin (ADR) for the treatment of hematopoietic malignancies, myocardial SPECT was performed 20 minutes and 4 hours after an intravenous dose of 123I-metaiodobenzylguanidine (MIBG). Findings of the myocardial SPECT were compared with the total dose of ADR, ejection fraction (EF) and left ventricular wall motion, as assessed by ultrasound echocardiography. The mean total dose of ADR was 329.3 mg/m2 (range, 150-550 mg/m2). 1) Although the cardiac function was normal, the washout rate (WR) of MIBG was high in 75% of the patients whose MIBG myocardial SPECT showed abnormality on ADR, suggesting the presence of adrenergic nerve disorder. 2) The total dose of ADR was significantly correlated with WR of MIBG (p < 0.001). Consequently, WR of MIBG may be an index which reflects adrenergic nerve disorder in the myocardium earlier than EF. 3) It was suggested that adrenergic nerve disorder was involved in pathogenesis of myocardial complications associated with ADR administration. In summary, MIBG myocardial SPECT could be a useful test for determining a dosage regimen of ADR therapy of individual patients.

3-Iodobenzylguanidine↗
PubMed1994

[Idiopathic myelofibrosis transformed to acute myelomonocytic leukemia associated with non-Hodgkin's lymphoma].

We report a rare case of idiopathic myelofibrosis transformed to acute myelomonocytic leukemia associated with non-Hodgkin's lymphoma. A 64-year-old woman was admitted to our department because of anemia and leukocytosis. On admission, anemia and hepatosplenomegaly were noted. The hemoglobin content was 6.8 g/dl, and WBC count was 26,200/microliters with an increased number of immature neutrophils. Bone marrow biopsy revealed an increased amount of reticulin fiber. Because she had no disease which causes secondary myelofibrosis, idiopathic myelofibrosis was diagnosed, and she was treated with prednisolone, anabolic steroid and blood transfusion. Fifteen months after the diagnosis of myelofibrosis, blast increased in her peripheral blood and her spleen and liver enlarged remarkably. A tumor of right parotid region was recognized at the same time. The pathological diagnosis of biopsied tumor was non-Hodgkin's lymphoma. The cytochemical study of blasts in her peripheral blood showed that she had acute myelomonocytic leukemia. In spite of intensive chemotherapy, she died from heart failure, respiratory failure and renal insufficiency.

Female↗
PubMed1994

[Lennert's lymphoma associated with the syndrome of inappropriate secretion of antidiuretic hormone and autoimmune hemolytic anemia].

We report a case of Lennert's lymphoma complicated by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and autoimmune hemolytic anemia (AIHA). A 76-year-old female patient was admitted to our hospital because of cervical lymph node swelling. A diagnosis of Lennert's lymphoma was made by histological examination of the biopsied lymph node. She was also diagnosed as SIADH and AIHA. After the patient was treated with COP-BLAM therapy, lymph-adenopathy, SIADH and AIHA improved. However, lymph node swelling and hyponatremia became exacerbated again after the third course of COP-BLAM therapy. Then she was treated with IMV-triple P therapy. Eventually, she died of aspergillus pneumonia. The etiology of her SIADH was suggested to be an abnormal feedback mechanism of ADH secretion due to the infiltration of lymphoma cells into the diencephalic-hypophysial system.

Aged↗
PubMed1994

[Relationship between prognosis of multiple myeloma and response to VCAP therapy].

We investigated the relationship between response in M-protein to VCAP therapy and survival duration in 50 multiple myeloma (MM) patients who survived for at least 6 months. The relationship between improvement of hemoglobin level as a response of VCAP therapy and survival duration was also assessed. The survival time in patients whose M-protein was reduced by 50% or more within 6 months after therapy was shorter than that in patients in whom the reduction of > or = 50% or more was obtained in more than 6 months. Patients with a hemoglobin level of 10 g/dl or higher before therapy survived significantly longer than those with a hemoglobin level of less than 10 g/dl. Among the patients with a hemoglobin level of less than 10 g/dl, patients in whom the hemoglobin level improved to 10 g/dl or higher survived for significantly longer duration than patients without improvement (p < 0.01). Patients in whom the hemoglobin level improved after more than 6 months survived form significantly longer duration than patients in whom hemoglobin level improved within 6 months. Therefore, it was considered that it was difficult to predict prognosis from the rate of decrease in M-protein in the early stage of treatment.

Aged↗
PubMed1994

[Infection-induced transient increase in the platelet count, and a transient remission of thrombocytopenia with high-dose intravenous gammaglobulin therapy during intercurrent pneumonia in chronic idiopathic thrombocytopenic purpura].

A patient with chronic idiopathic thrombocytopenic purpura (ITP), who had a transient increase in platelet count during infectious episodes, and had a transient remission of thrombocytopenia with administration of high-dose intravenous gammaglobulin during intercurrent pneumonia was described. A 64-year-old Japanese woman with a 12-year history of chronic ITP was refractory to steroids and azathioprine, and the platelet count was constantly less than 10 x 10(9)/l. During both acute upper respiratory infections and chronic cystitis due to E. coli, the platelet count transiently increased to more than 40 x 10(9)/l. High-dose intravenous gammaglobulin therapy successfully induced a remarkable increase in the platelet count, which persisted for 3 months, when gammaglobulin was administered during the intercurrent pneumonia. The bleeding tendency disappeared and transient remission of ITP was obtained. In contrast, the clinical efficacy of high-dose intravenous gammaglobulin proved to be only transient and slight, when administered before the onset of pneumonia or after recovery from pneumonia. These phenomena may suggest that high-dose gammaglobulin may enhance some positive mechanisms related to platelet increment in infectious diseases accompanied with chronic ITP.

Female↗
PubMed1993

A large cell-adhesive scatter factor secreted by human gastric carcinoma cells.

Human gastric carcinoma cell line STKM-1 secretes a large protein that induces scattering of a rat liver epithelial cell line (BRL) into disconnected individual cells in monolayer culture. This cell-scattering factor was purified from serum-free conditioned medium of STKM-1 cells and found to be composed of three disulfide-linked subunits of 140, 150, and 160 kDa. The 140-kDa peptide contains an amino acid sequence homologous to that of the laminin B2t chain. The native protein has an apparent molecular mass of > 1000 kDa and a pI of 5.0. In addition to the cell-scattering activity, the purified protein stimulates attachment of BRL cells to substrate and their migration. Similar effects have been observed toward various cell lines, including nontumorigenic epithelial, endothelial, and fibroblastic cell lines and human cancer cell lines. Similar cell-scattering activity was secreted by human squamous carcinoma and gastric carcinoma cell lines and nontumorigenic epithelial and endothelial cell lines. These results indicate that the protein, named "ladsin," is probably an extracellular matrix protein that regulates cell-cell and cell-substrate interactions and cell migration.

Animals↗
PubMed1993

Molecular structure of ras-related small GTP-binding protein genes of rice plants and GTPase activities of gene products in Escherichia coli.

We isolated two rice cDNA clones (ric1 and ric2) encoding proteins homologous to the ras-related small GTP-binding protein. The amino acid sequences of ric1 and ric2 are conserved in four regions involved in GTP binding and hydrolysis which are characteristic in the ras and ras-related small GTP-binding protein genes. In addition, two consecutive cysteine residues near the carboxyl-terminal end required for membrane anchoring are also present in ric1 and ric2. The ric1 and ric2 proteins synthesized in Escherichia coli possessed GTPase activity (i.e. hydrolysis of GTP to GDP).

Amino Acid Sequence↗
PubMed1993

Purification and characterization of a two-chain form of tissue inhibitor of metalloproteinases (TIMP) type 2 and a low molecular weight TIMP-like protein.

Multiple forms of metalloproteinase inhibitors were found in the serum-free conditioned medium of the EJ-1 human bladder carcinoma cell line by reverse zymography assay with gelatinase A as the indicator enzyme. Two novel forms of inhibitor with apparent molecular masses of 18 and 22 kDa on nonreducing SDS-polyacrylamide gel electrophoresis (PAGE), together with tissue inhibitor of metalloproteinases (TIMP) and TIMP-2, were purified from the conditioned medium by a series of chromatographic steps. Structural analysis showed that the 18-kDa inhibitor is a two-chain form of TIMP-2 (tc-TIMP-2) produced by proteolytic processing, and the 22-kDa inhibitor may be a partially glycosylated form of TIMP. The purified tc-TIMP-2 was separated into a 17-kDa peptide and a small peptide of about 2.5 kDa by reducing SDS-PAGE and into four isoforms with pI 7.6, 7.3, 7.2, and 6.8 by isoelectric focusing. tc-TIMP-2 has essentially the same inhibitory activity as TIMP-2 toward gelatinase A, collagenase, stromelysin, and matrilysin. Unlike TIMP-2, however, tc-TIMP-2 does not bind to the latent precursor fo gelatinase A. Similar two-chain forms of TIMP-2 were produced by its partial digestion with trypsin or less effectively with plasmin. These results suggest that proteolytic processing of TIMP-2 plays a role in the regulation of gelatinase A activity in the extracellular matrix.

Amino Acid Sequence↗
PubMed1993

A metalloproteinase inhibitor domain in Alzheimer amyloid protein precursor.

Extracellular deposition of amyloid beta-protein (beta-AP), or A4 protein (M(r) 4,000), is associated with Alzheimer's disease and with Down's syndrome (trisomy for chromosome 21). The large membrane-bound precursor protein (APP) of beta-AP is normally cleaved within the beta-AP region by a putative proteinase (APP secretase) to release its extracellular portion; beta-AP is produced by an alternative proteolytic processing. Here we demonstrate that APP contains a proteinase inhibitor domain for the matrix metalloproteinase gelatinase A, which is located in the C-terminal glycosylated region of the secretory forms of APP. In addition, we show that the gelatinase has an APP secretase-like activity, which hydrolyses the Lys16-Leu17 bond in the beta-AP sequence. Our results indicate that the proteinase inhibitor domain of APP and gelatinase A may be involved in the formation of beta-AP.

Amino Acid Sequence↗