Biomedical subjects
Publications and source records attributed to N Oka.
A 50-year-old man was admitted to our hospital with a diagnosis of traumatic carotid cavernous fistula. The fistula was observed to disappear spontaneously just after orbital venography. This was confirmed by clinical examinations and subsequent carotid angiogram. The possible mechanisms responsible for the spontaneous occlusion of carotid cavernous fistula are discussed.
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T cells bearing IgG Fc receptors (Tr cells) were determined in 40 cases of brain tumor using the double rosette method, and compared with the changes of PHA reaction, immunoglobulin (IgG A M), performance status, and mass effect on CT in 20 pre-and post-operative and/or radio-clinico-immunotherapeutic patients. The proportion of control Tr cells was 8-19% in 20 healthy adults. Values of Tr cells over 20% were correlated with a poor grade of performance status, and large mass effects on CT. Post-therapeutic change in the value was well correlated with change in performance status, mass effects, and IgG. Our results suggest a correlation between the value of Tr cells and clinico-radiological findings. Immunological analysis of Tr cells serves as a parameter of tumor expansion or prognosis, and could be of significant importance clinically.
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A 44-year-old house-wife was admitted to the hematological clinic of our hospital on December 21, 1981 for the treatment of acute myeloid leukemia. Hematological examination showed severe anemia, leukocytosis and thrombocytopenia. She was soon started on DCMP therapy (Daunomycin, Cytosine arabinoside, 6-MP and prednisolone). After several repeats of remission and aggravation, she suffered from vertigo, nausea and vomiting in early August of 1982. The CT scan and angiography showed a mass lesion in the middle of the posterior cranial fossa. On August 26, surgical extirpation of the tumor locating in the vermis of the cerebellum was performed successfully. On gross examination the tumor revealed smooth yellowish-red surface, elastic in consistency and measured 40 X 40 X 30 mm in size. Histologically it comprised the leukemic cells. The pathology of the central nervous system due to leukemic cells was discussed in relation to the pertinent literature, including the CT findings and the indication of the surgical treatment.
A 64-year-old female visited Kawatetsu Chiba Hospital complaining of left retro-orbital pain. A month before, she had experienced ptosis and diplopia, that had been releaved two days later by corticosteroid. On admission, she had no neurological deficits except for minimal anisocoria, with the left pupil larger than the right. There was no cutaneous manifestation of von Recklinghausen's disease. Skull X-ray films showed depression of the floor of the sella turcica on the left side. CT scans demonstrated a parasellar enhancing mass with intrasellar extension. Left carotid angiogram showed intracavernous portion of the internal carotid artery displaced laterally, inferiorly, and anteriorly. With a tentative diagnosis of laterally extending pituitary adenoma, a transsphenoidal operation was carried out, which disclosed a solid tumor locating beside the medially-displaced pituitary gland. The histological diagnosis was typical neurinoma. Parasellar neurinoma is not so common. It is usually difficult to determine the origin of the parasellar neurinoma. Trigeminal neurinoma arising from the Gasserian ganglion is generally recognized to be the most frequent. However, the absence of the trigeminal nerve involvement, unusual CT findings, and angiographical changes in the present case were all different from those of the typical trigeminal neurinoma. We believe that the tumor of this case originated from the oculomotor nerve. Fifteen cases of neurinoma of the oculomotor, trochlear, and abducens nerve have been reported to date. Their clinical features were reviewed.
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Chromosomal abnormalities are found in a considerably high percentage of cases of male infertility, in particular azoospermia. We report a case of the XYY syndrome and review the literature. A 36-year-old man, a factory hand, presented with infertility. He was safely delivered at term as a fourth child when his father was 41 years old and his mother 38. He had no delinquent or criminal record. His height was 179 cm, weight 75 kg and distance of extended hands 184 cm. No gynecomastia was noticed. Both testes were 8ml in size and growth of pubic hair and penis were normal. Severe oligozoospermia was identified in semen analysis. Seminal vesiculography showed pathological dilatation of the seminal vas end. The testicular biopsy specimens revealed spermatogenic arrest for the most part. Chromosomal analysis showed 47, XYY karyotype; and, two Y-chromatin was revealed in cultured lymphocytes. Though plasma gonadotropin levels were high, testosterone, estradiol, prolactin, TSH, GH, T3 and T4 levels were within normal limits. Pituitary reserve function for secreting gonadotropins and Leydig cell reserve function to secrete testosterone have been found to be almost normal.
Cisplatin (100 mg) was given by intraperitoneal infusion to 23 patients with peritoneal carcinomatosis. Eighteen patients had gastric cancer, and five had colorectal cancer. The effects of this therapy were as follows. 1) In gastric cancer patients, the mean survival period was 11.0 months. The cumulative survival rate was superior at the level of statistical significance in comparison with controls. 2) The side effects of this agent given intraperitoneally were mild. In particular, nausea was slightly less than with intravesicular or intraarterial infusion.
In rare occasions, patients with aortitis syndrome have cerebral aneurysms and only seven cases have been reported so far. A case of aortitis syndrome complicated with basilar bifurcation aneurysm is reported. A 58-year-old woman, who had been hypertensive for 20 years and was diagnosed as pulseless disease 10 years ago, suddenly had severe headache and became unconscious on Feb. 17, 1983. Spinal tap performed 3 days after the onset demonstrated bloody cerebrospinal fluid. She was referred to our clinic 8 days following the ictus of subarachnoid hemorrhage. On admission, she was drowsy and had headache, neck stiffness, disorientation and left hemiparesis. Pulsation of the left common carotid and left radial artery was unpalpable. Angiography through the intraaortic catheter revealed occlusion of the left common and left subclavian arteries at their origin, confirming aortitis syndrome. Through the patent right vertebral artery, basilar artery was visualized and an aneurysm at the basilar bifurcation was noted. Seven cases reported in the literature were reviewed.
3-Hydroxyamino-1-methyl-5H-pyrido[4,3-b]indole (N-OH-Trp-P-2) is a direct-acting mutagenic compound derived by metabolic activation from 3-amino-1-methyl-5H-pyrido[4,3-b]indole (Trp-P-2), a strongly mutagenic carcinogen. The action of N-OH-Trp-P-2 on DNA in vitro was investigated. N-OH-Trp-P-2 inactivated Bacillus subtilis transforming DNA and produced single-strand cuts in a supercoiled circular DNA (phi X174RFI) under neutral conditions. When mouse FM3A cells in culture were treated with a noncytotoxic dose of N-OH-Trp-P-2 and then the cellular DNA was examined by the alkaline elution technique, chain cleavages of the DNA were observed. Cysteamine inhibited the spontaneous degradation of N-OH-Trp-P-2 and enhanced the covalent binding of [3H]N-OH-Trp-P-2 to DNA. This finding offered an explanation for the previously observed enhancement of Trp-P-2 mutagenicity by cysteamine. In contrast cysteamine inhibited the N-OH-Trp-P-2-mediated inactivation of B. subtilis DNA as well as the strand cleavage in phi X174RFI DNA. The cleavage in phi X174RFI DNA was also inhibited by catalase. These observations indicate that the mutagenicity and DNA-cleaving activity of N-OH-Trp-P-2 are distinct from each other, that the inactivation of transforming DNA was caused mainly by strand cleavage, and that the DNA cleavage was probably caused by active oxygen radicals produced in the oxidative degradation of N-OH-Trp-P-2.
A phase II study of a new anthracycline, (2''R)-4'-0-tetrahydropyranyladriamycin (THP) was performed on 37 patients with gastrointestinal cancer in 6 co-operative study institutions. Twenty-five patients out of 37 were evaluable for response according to the Koyama-Saito's criteria. THP was administered weekly at doses of 10 to 30 mg/body or every 3 to 4 weeks at doses of 40 to 60 mg/body intravenously. Of the 14 patients with gastric cancer, we obtained one complete response and 3 partial responses (response rate 28.6%), and of the 6 patients with rectal cancer, we obtained one partial response (16.7%). Leukopenia of less than 3 X 10(3)/mm3 and erythrocytopenia of less than 300 X 10(4)/mm3 were seen in 48% and 26% of cases. Neither cardiotoxicity nor hair loss were seen. These results suggest that THP is useful in the treatment of patients with gastrointestinal cancer.
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