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Biomedical subjects

N Oka

Publications and source records attributed to N Oka.

At least 127 records · Page 7Linked to original sources
PubMed1991

[A case of adult T-cell leukemia (ATL) complicated with multiple nocardial abscesses].

A 45-year-old woman was admitted to our hospital with complaints of fever and lumbago. She was treated for adult T-cell leukemia and thrombocytopenia with 20 mg/day of prednisolone. CT scan showed multiple abscesses in right peri-kidney, right iliopsoas muscle, left subcutaneous region in the abdominal wall and the brain. Left subcutaneous abscess was drained. Gram-positive organisms consisting of filaments were found, and Nocardia farcinica was grown in cultures. After two months of chemotherapy (FMOX, MINO and AMK), all abscesses except one in the brain disappeared. Cerebral abscess was cured fifty days after the start of the treatment with oral administration of Sulfamethoxazole-trimethoprim (SMX/TMP). The mortality of Nocardial cerebral abscess is high. This patient is a very rare case in which multiple Nocardial abscesses including brain abscess was cured by chemotherapy.

Abscess↗
PubMed1991

Plasma free triiodothyronine response to thyrotropin-releasing hormone to predict the remission of Graves' disease treated with antithyroid drugs.

The responses of both plasma TSH and free T3 (FT3) to TRH were examined in 31 patients with Graves' disease who were euthyroid after treatment with antithyroid drugs, 6 patients with primary hypothyroidism, and 14 control subjects. TSH was measured 0, 15, 30, 60, 90, and 120 min and FT3 was measured 0, 30, 60, 90, 120, 150, and 180 min after TRH injection (500 microgram, iv). The increment in FT3 above the basal level (delta FT3) in normal controls ranged from 1.2-3.7 pmol/L, with a mean +/- SD of 2.2 +/- 0.8 pmol/L. The mean (+/- SD) delta FT3 in patients with primary hypothyroidism was 0.3 +/- 0.2 pmol/L. After the TRH test, antithyroid drugs were stopped in patients with Graves' disease. Nine of 31 Graves' patients relapsed within 6 months after the TRH test. The other 22 patients with Graves' disease were followed while in remission during the observation period of up to 48 months. The mean (+/- SD) delta FT3 were significantly lower in 9 Graves' patients who relapsed than in those who achieved remission (0.5 +/- 0.3 vs. 2.6 +/- 1.1 pmol/L; P less than 0.01). Eight of 9 Graves' patients who relapsed showed lower delta FT3 values than the lowest value (1.1 pmol/L) in 22 Graves' patients in remission. Although the mean increment of TSH above the basal level (delta TSH) was also significantly different between the Graves' patients who relapsed and those in remission (1.4 vs. 12.3 mU/L; P less than 0.01), there was considerable overlap between the 2 groups. These findings suggest that delta FT3 reflects the endocrinological recovery of the pituitary-thyroid axis and is a beneficial indicator for the termination of antithyroid drugs in Graves' disease.

Antithyroid Agents↗
PubMed1991

Effects of aging and sex on plasma insulin-like growth factor I (IGF-I) levels in normal adults.

Effects of aging and sex on total plasma IGF-I levels were studied in 207 normal adults (103 males and 104 females), aged 21 to 80 years. Plasma IGF-I concentrations were measured by specific radioimmunoassay after extraction with acid-ethanol. Plasma IGF-I levels ranged from 50.8 to 480.6 micrograms/l with a mean (+/- SD) value of 200.7 +/- 81.9 micrograms/l in these normal adults. The mean plasma IGF-I levels were higher in females than in males in the second decade (332.6 +/- 63.9 vs 252.4 +/- 45.2 micrograms/l, p less than 0.01), whereas there was no sex difference in plasma IGF-I levels in elderly subjects. In both sexes, plasma IGF-I levels declined with age. In females, the slope of the regression line was much steeper in the young group (aged 21 to 40 years) than in the middle-aged and elderly group (aged 41 to 80 years) (y = -11.3x + 641.7, r = -0.538, p less than 0.005 and y = -1.97x + 289.3, r = -0.308, p less than 0.01). In males, plasma IGF-I linearly declined with age and the slope of the regression line (y = -2.36x + 322.2, r = -0.480, p less than 0.005) was not considerably different from that of the middle-aged and elderly group in females.

Adult↗
PubMed1991

[Treatment of newly diagnosed stage D2 prostatic carcinoma with hormonal therapy alone, or chemotherapy agents in combination with hormones].

From June 1984 to March 1988, patients with newly diagnosed stage D2 prostate cancer were treated with protocol 1. This comprised oral hormonal agents either diethylstilbestrol diphosphate (Honvan: 300 mg/day) or estramustine phosphate (Estracyt: 560 mg/day), or chlormadinone acetate (Prostal: 100 mg/day), plus intravenous cyclophosphamide (CPM, 0.5-1 g/m2) every 3-4 weeks. From May 1988, protocol 2 was used in a randomized study of castration alone versus castration plus intravenous methotrexate (MTX, 20 mg/m2) every 2 weeks. Forty-nine of 53 patients who underwent the two protocols were evaluable for the response. The response rates according to the NPCP criteria were 92% (11/12) for Honvan, 100% (9/9) for Estracyt, 78% (7/9) for Prostal and castration plus MTX, and 80% (8/10) for castration alone. There were no significant differences among these treatments. The median response duration and survival time (months) were 16 and 44, respectively, for Honvan, 19 and 37 for Estracyt, 12 and 43 for Prostal, 11 and 15 for castration plus MTX, and 13 and 13 for castration alone. The short survival times of the castration alone and castration plus MTX groups were due to a short follow-up period. There were no statistical differences among the oral hormonal agent plus CPM groups. However, the 2-year survival rate (Kaplan-Meier method) was higher in the CPM and MTX groups than in the castration alone group. Survival was longer in the good performance status (P.S.) group than the poor P.S. group (p less than 0.05 by Wilcoxon test) and in the responders than the non-responders (p less than 0.01). Side effects were not excessive in the chemotherapy groups and patient compliance was good.

Administration, Oral↗
PubMed1991

[Combination chemotherapy with methotrexate, vincristine, cisplatinum, cyclophosphamide, adriamycin, and bleomycin (MVP-CAB) for metastatic urothelial cancer].

We studied 31 patients with bidimensionally measurable metastases of urothelial cancer who were treated with a planned regimen (20 mg/m2 methotrexate, 0.6 mg/m2 vincristine, 500 mg/m2 cyclophosphamide, 20 mg/m2 adriamycin, and 30 mg bleomycin on day 1, and 50 mg/m2 cisplatinum on day 2) in cycles given every 3 weeks. CR was achieved in 4 patients (13%) and PR in 17 patients (55%). The response rates according to the disease characteristics were 71% for TCC, 33% for SCC, 67% for renal pelvis tumors, 67% for bladder tumors, 73% for lung metastases, 67% for liver metastases, and 67% for lymph node metastases. The median response duration and the number of cycles of therapy were 32 months/3 cycles for patients with a CR and 6 months/6 cycles for those with a PR. The median duration of survival was 32 months (range: 3-46) in CR, 11 months (range: 1-37) in PR, and 6 months (range: 2-10) in non responders (NC + PD). A significant prolongation of survival was noted in patients with either CR (p less than 0.01) or PR (p less than 0.05). Then main toxic effects were pulmonary fibrosis and myelosuppression. Two patients aged 73 and 81 died of pulmonary fibrosis. However, it was possible to prevent pulmonary fibrosis by not administering bleomycin to patients over 70 years of age, or to patients with pulmonary dysfunction. WBC count nadirs of less than 2,000/m3 were noted in 22 patients (71%). Platelet count nadirs of greater than 5 x 10(4)/mm3 were noted in 7 patients (23%). However, there were no deaths due to myelosuppression.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

[Effects of volatile anesthetics on crossbridge mechanism of skeletal muscle--effects on the crossbridge in contraction].

The suppressive effect of enflurane on the maximal activated force in skinned muscle fiber at high Ca2+ concentration was determined in our previous report. This result suggests that the acto-myosin system might be inhibited in the presence of enflurane. Therefore, the present study was performed to identify the sites and to clarify the mechanism of the above mentioned action. For this purpose, the stiffness during Ca2+ contraction was measured using mechanically-skinned frog muscle fiber. The force oscillation was given by high frequently sinusoidal length perturbation. The maximum shortening speed, which is considered to be a parameter of crossbridge kinetics, was also measured using the slack method on frog and rat muscle fibers. The results of this study are summarized as follows: 1. The total force was decreased when enflurane or halothane was present, while the stiffness, which is a parameter of the number of attachments (crossbridges), was decreased only by enflurane. Furthermore, the stiffness over force ratio, which is a parameter of the individual force generated by each crossbridge, was increased when enflurane or halothane was present. These results initially seem contradictory. However, the contradiction seems far smaller in light of our assumption that the amplitude of reduction of the force generated by each crossbridge was much higher in the presence of halothane than in the presence of enflurane. 2. The maximum shortening speed was also decreased when enflurane or halothane was present. Therefore, it was suggested that enflurane and halothane have a potentiality to decrease the rate of crossbridge cycling.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[A case report; ganglion cyst of a cervical facet joint].

Ganglion or synovial cyst typically occurs in peripheral joints and tendon sheaths such as elbow joint or wrist joint, but rarely in the spinal facet joint. From reported cases the most common site involved seems to be the lumbar facet joint. Only three cases of cervical ganglion or synovial cyst have so far been found in the literature. A case of cervical ganglion cyst was reported. The patient was a 2-year-old boy who was found to have a tumor in the midline of the nape. He had no history of trauma. Neurological and physical examination revealed no abnormalities. On CT scan a round low dense lesion with clear margin was found in the nape. Enhanced CT scan showed ring-like enhancement. Magnetic resonance (MR) imaging showed a well defined lesion of high intensity on T1- and T2-weighted images. At operation, the lesion was found to form a cyst containing old hematoma, and the cyst wall seemed to be fixed to the cervical spinal facet joint. The tumor was histologically diagnosed as ganglion cyst.

Cervical Vertebrae↗
PubMed1991

Malignant mixed tumor (malignant ameloblastoma and fibrosarcoma) of the maxilla.

We present a rare case of carcinosarcoma (malignant ameloblastoma and fibrosarcoma) of the left maxilla that developed in a 63-year-old Japanese man. The tumor recurred repeatedly despite multiple surgical removals, radiotherapy, and chemotherapy and led to progressive cachexia; the patient died after 3.8 years of hospitalization. Histopathologic examination revealed that the recurrent tumor was carcinosarcoma, which had progressed from malignant ameloblastoma with fibroma. An autopsy confirmed the diagnosis of malignant mixed tumor with lung metastasis of malignant ameloblastoma and fibrosarcoma.

Ameloblastoma↗
PubMed1991

[A case of human tail].

A human tail is a rare anatomical curiosity. A case of a human tail associated with lipomyelomeningocele is reported. The made subject was born, by breech delivery, at the 39th-week with a 3,008 g body weight. He was admitted to our hospital because of the presence of a human tail and subcutaneous mass in the midline lumbosacral region. The tail was about 7.5 cm in length and 2 cm in diameter. It was elastic and covered by normal skin. No systemic anomaly was found. Spina bifida below L5 was revealed, and no bony shadow was found on the plain X-ray film. CT scan showed a low density area in the spinal canal between L3 and lower sacral region that extended into the tail through the spina bifida. MRI also revealed intraspinal long T2 mass which was attached to the spinal cord and extended into the tail. Myelogram indicated intradural extramedullary mass below the L3 level. Surgical treatment was performed on the 3rd month of life with a diagnosis of a human tail with lipomyelomeningocele. At surgery, the tail was found to consist mainly of lipomatous tissue which extended subcutaneously and entered the spinal canal through the spina bifida. The tail and subcutaneous lipomatous tissue were totally excised. The capsule of subcutaneous lipomatous tissue was followed circumferentially down into the spinal canal, and found to be transformed to arachnoid membrane. Intradural lipomatous tissue was excised piece by piece, leaving only a small remnant attached to the conus medullaris to preserve sacral nerve root function.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1991

[Effects of enflurane on the elastic properties of frog skinned skeletal muscle fiber under relaxed and rigor conditions].

We studied the effects of enflurane on the elastic property of the mechanical skinned fiber prepared from M. Semitendinosus of bullfrog. Longitudinal and lateral elastic properties of the skinned fibers were measured under relaxed and rigor conditions to clarify the effects of enflurane on actomyosin complex. Under the rigor condition, enflurane did not change the lateral elasticity of the fibers, but enflurane decreased the longitudinal elasticity. On the other hand, under the relaxed condition, enflurane did not change the elasticity. The results suggest that enflurane probably decreases the force of binding of cross-bridges to actin, which is one of the factors to reduce the maximal force.

Animals↗
PubMed1990

Premature onset of fast axonal transport in bromophenylacetylurea neuropathy: an electrophoretic analysis of proteins exported into motor nerve.

To test whether abnormal processing of proteins for fast axonal transport is involved in the neuropathy induced by BPAU (p-bromophenylacetylurea) we examined transport onset. [35S]Methionine was injected into the lumbar ventral horn of rats 2 weeks after BPAU, 400 mg/kg (i.p.) or vehicle. At intervals of 30-90 min consecutive 3-mm segments of the L4 and L5 ventral roots were digested for polyacrylamide gel electrophoresis and fluorography. Fast transported proteins were identified by comparison with samples from mid-thigh sciatic nerve ligated for 16 h after radiolabeling. A prominent 26 kDa band represented the earliest exported protein. It was usually absent at 30 min, but it entered the roots by 45 min. This band was consistently displaced further in BPAU nerve (n = 11) than in controls (n = 11). The mean difference was 5 +/- 0.6 mm (P less than 0.001). However, there was no difference in the apparent velocity of transport. These results imply premature onset of transport in BPAU neuropathy.

Animals↗
PubMed1990

Distribution of factor XIIIa-containing cells and collagenous components in radicular cysts: histochemic and immunohistochemic studies.

The distribution of subunit A of Factor XIII (FXIIIa) and of collagenous components was investigated by the avidin-biotin-peroxidase complex (ABC) method for FXIIIa and by the Sirius red F3BA method, respectively, in 43 cases of radicular cysts. Besides the covering epithelial layer, the radicular cyst wall was composed of the following three layers: an inner granulomatous layer, an outer fibrous connective tissue layer, and an intermediate layer. In each layer, a positive reaction for FXIIIa was observed in certain connective tissue cells. These FXIIIa-containing cells were few in number in the inner layer where collagenous components were also sparse. In the slightly to moderately fibrous intermediate layer, these cells markedly increased in number and were dendritic or stellate in shape. In the outer densely fibrous connective tissue layer, they decreased slightly in number and were slender and spindle-shaped. The results obtained in the present study indicate the close relationship between the distribution of FXIIIa-containing cells and of collagenous components. Such a relationship suggests that these cells play an important role in the process of fibrosis occurring in the radicular cyst wall.

Collagen↗
PubMed1990

[A case report of spotted fever group rickettsiosis first encountered in Shimane Prefecture, Japan].

Rickettsial infections of a spotted fever group have recently been experience in Japan. Although there have been 50 cases reported by this time, they were exclusively distributed in the areas along the Pacific coast. We report in this paper the first case of spotted fever group rickettsiosis in Shimane prefecture, an area faced to the Japan Sea. A 57 year-old man with high fever, general fatigue and rash was admitted to the hospital of Shimane Medical University at the end of September 1987, who had been treated with cefaclor for a few days without effect before his visit to the University Hospital. Physical examination revealed erythematous eruption, eschar on the left side of the abdomen, and generalized lymphadenopathy. Hepatosplenomegaly was not detected. Laboratory studies showed normal leukocyte counts with relative lymphopenia, high ESR and increased CRP. Transaminase levels were slightly elevated. Paul-Bunnel and Weil-Felix tests resulted in negative. Specific immunofluorescence tests demonstrated that IgG and IgM antibodies of acute-phase serum to Rickettsia japonica, a spotted fever group rickettsia isolated from patients in Japan, were not detected, while both IgG and IgM antibody titers of convalescent-phase serum increased to 1:320. Convalescent-phase serum reacted at significantly lower titers with R.typhi as well as other pathogenic spotted fever group rickettsiae. The patient was treated with ofloxacin for six days and then with combination of ofloxacin and minocycline. It should be noted that clinical symptoms such as high fever and general fatigue disappeared during a single therapy with ofloxacin.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Bacterial↗
PubMed1990

Surgical approach to arteriovenous malformation of the medial temporal lobe--report of three cases.

We report three cases of arteriovenous malformation (AVM) of the medial temporal lobe and the surgical approaches used. The AVM was fed by the anterior choroidal artery (AChA) in two cases (Cases 1 and 2) and by the posterior cerebral artery in one (Case 3). The trans-Sylvian approach was first used for cerebrospinal fluid aspiration to retract the brain in all cases, and for confirming the feeding arteries to prevent premature bleeding from the AVM in Cases 1 and 2. In Case 1, a corticotomy was then made in the fusiform gyrus via the subtemporal approach to avoid the development of speech disturbance and visual field defects, while in Cases 2 and 3, a cortical incision was made in the middle temporal gyrus because visual field defects were preoperatively present. Cases 1 and 2 achieved good recoveries, but Case 3 suffered postoperative speech disturbance and died of rebleeding from a recurrent AVM fed by the AChA 22 months after the operation. This AVM was not demonstrated on the postoperative angiograms. We emphasize the usefulness of the combination of trans-Sylvian and subtemporal approaches for this lesion, because the feeding arteries are easily identified and retraction of the temporal lobe is alleviated. A corticotomy in the fusiform gyrus is also recommended to avoid the development of not only visual field defects but also aphasia.

Adolescent↗
PubMed1990

[Intraoperative intraperitoneal administration of CDDP against gastric cancer with peritoneal dissemination].

This study was undertaken in order to evaluate the effect of intraoperative intraperitoneal (i.p.) administration of CDDP on patients who underwent gastrectomy for gastric cancer with peritoneal dissemination, compared with MMC or OK-432 i.p. administration group and untreated group. The median survival time was 11 months in CDDP i.p. group (35 patients), 8 months in MMC or OK-432 Ip group (33 patients) and 7 months in untreated group (25 patients). 1- and 2-year survival rates were 30.4% and 12.1% for MMC or OK-432 i.p. group, and 28% and 8% for untreated group, while in CDDP i.p. group, the rates were higher at 46.4% and 14.7%, respectively (CDDP i.p. group vs. untreated group, p less than 0.05). In vitro chemosensitivity test by succinate dehydrogenase inhibition (SDI) test supported the clinical results. CDDP had higher sensitivities than MMC and ADM on poorly differentiated cases as well as peritoneal dissemination cases. Our results suggest that intraoperative i.p. administration of CDDP was useful for the treatment of gastric cancer with peritoneal dissemination.

Adult↗
PubMed1990

[The alternation of CD8+ cells and its subpopulations by serial monitoring of peripheral blood lymphocytes of renal allograft recipients].

To catch and treat the initial alternation of a rejection and infection, we have introduced the serial analysis of lymphocyte surface antigens of peripheral blood lymphocytes by flow cytometry for 9 cases of renal allo-graft recipients since September 30 in 1988. In three recipients without rejection and infection, we found that T8+(CD8+), T8+Mo1+(CD11b+), T8+Mo1-(CD11b-), and T8+IL-2R+(CD25+) subsets were variable for first 20 days and then they were stable. However, another activated CD8+ T-cell subset such as T8+I2+(HLA-DR+) subset gradually increased after first 20 days, so that we investigated the different processes between these two activated subsets. On primary rejection of 5 cases, T8+I2+ and T8+IL-2R+ subsets showed peak formations within 2 days before the rejection. Two of these 5 cases resisted to a primary rejection therapy and showed rebounding arise of these subsets. We could easily convert to OKT-3 rescue therapy and treat them successfully. In order to catch the initial alternation of the primary rejection and treat the rebounding reaction successfully, we should monitor the T8+I2+ and T8+IL-2R+ subsets daily for first 2 weeks and after then 3 times a week.

Adult↗
PubMed1990

[Acoustic neurinoma in a child].

A case is reported of acoustic neurinoma unrelated to Von Recklinghausens' disease in a child. A 14-year-old boy had suddenly become aware of impaired hearing associated with tinnitus, in August, 1988. He was admitted to our department in October, 1988. On admission, he had no neurological deficits except for right tinnitus. Acoustic tumor was found on air CT and MRI. Total removal of the tumor was achieved through a suboccipital craniotomy. The tumor had originated in the superior vestibular nerve. The size of the tumor was about 1 X 2 cm. The histological diagnosis was neurinoma. The facial and cochlear nerves were anatomically preserved. Twenty-two reported cases of acoustic neurinoma in children less than 15 years of age were reviewed. Based on these reports, it was concluded that acoustic neurinoma may grow rapidly in children, and they should be diagnosed and treated at an early stage.

Adolescent↗