Search PubMed⌕ Search

Biomedical subjects

N Tajima

Publications and source records attributed to N Tajima.

At least 55 records · Page 3Linked to original sources
PubMed1999

[A case of systemic lupus erythematosus associated with thrombotic thrombocytopenic purpura manifestating homonymous hemianopsia].

We report on a 35-year-old Japanese woman with systemic lupus erythematosus (SLE) in whom homonymous hemianopsia developed. In August 1987, SLE was diagnosed. In November 1987, the patient was admitted to our hospital because of severe thrombotic thrombocytopenic purpura; however, clinical symptoms improved after treatment with vincristine. In 1992, severe lupus nephritis developed but improved after steroid therapy. In February 1994, diplopia developed owing to inflammatory invasion of the orbit by acute maxillary sinusitis. Humphrey Field Analyzer perimetry revealed a homonymous quadrantic hemianopic scotoma in the lower left side. Magnetic resonance imaging of the brain revealed a small infarct lesion in the posterior pole of the upper calcarine cortex. This lesion was thought to be responsible for homonymous hemianopsia. However, the lesion was not visualized with computed tomography. Our experience in the present case suggests that magnetic resonance imaging is more useful than computed tomography for identifying lesion causing visual field disorders in SLE.

Adult↗
PubMed1999

Effect of troglitazone on body fat distribution in type 2 diabetic patients.

OBJECTIVE: Troglitazone was recently reported to specifically promote the differentiation of pre-adipocytes into adipocytes in vitro in subcutaneous fat only, indicating a relation to insulin-resistance-improving action of troglitazone. To expand on this finding, we investigated at the clinical level how long-term administration of troglitazone influences the body fat distribution in type 2 diabetic patients. RESEARCH DESIGN AND METHODS: Troglitazone (400 mg/day) was administered for 6 months to 30 type 2 diabetic patients whose glycemic control was poor. A total of 18 patients received diet therapy alone (in the single-treatment group, BMI 26.0 +/- 4.6, HbA1c 8.2 +/- 1.7%), and 12 patients concomitantly received glibenclamide (1.25-7.5 mg/day) (in the concomitant sulfonylurea group, BMI 25.4 +/- 4.7, HbA1c 9.2 +/- 1.2%). BMI, HbA1c, serum lipid level, and body fat distribution, which were determined by computed tomography (CT) scan at the umbilical level, were measured and compared before and after troglitazone treatment. RESULTS: During the 6-month troglitazone treatment, HbA1c levels decreased and BMI increased in both groups. As for body fat distribution in the single-treatment group, visceral fat area (VFA) decreased (from 118.3 +/- 54.3 to 101.1 +/- 50.8 cm2; P < 0.001), and subcutaneous fat area (SFA) increased (from 189.7 +/- 93.3 to 221.6 +/- 101.6 cm2; P < 0.001), resulting in a decrease in visceral/subcutaneous (V/S) ratio (from 0.74 +/- 0.48 to 0.50 +/- 0.32; P < 0.001). In the concomitant sulfonylurea group, VFA was unchanged (from 108.1 +/- 53.5 to 112.5 +/- 59.9 cm2), while SFA increased (from 144.6 +/- 122.0 to 180.5 +/- 143.5 cm2; P < 0.01), thereby decreasing the V/S ratio (from 0.91 +/- 0.46 to 0.77 +/- 0.44; P < 0.01). The serum triglyceride level and the area under glucose curve during the 75-g oral glucose tolerance test decreased significantly in the single-treatment group. CONCLUSIONS: According to our data, troglitazone appears to promote fat accumulation in the subcutaneous adipose tissue rather than in the visceral adipose tissue in mildly obese Japanese people with type 2 diabetes. This shift of energy accumulation from the visceral to subcutaneous adipose tissue may greatly contribute to the troglitazone-mediated amelioration of insulin resistance.

Abdomen↗
PubMed1999

Segmental square spinal instrumentation for posterior lumbar spinal fixation.

The purpose of this study is to evaluate the clinical results of operations using a new spinal instrumentation for posterior fixation, called segmental square spinal (3-S) instrumentation. The 3-S instrument consists of two pairs of hooks to clasp the interarticular portion of the lamina bilaterally, two horizontal bars to connect the hooks on the right and left, and rods to connect the hooks side by side on the top and bottom. Twenty-seven patients who had degenerative lumbar disorders underwent operations with the 3-S instrument. Rigid fixation was obtained in all cases immediately after the operation. Bone union rates were 91% (21/23) with posterolateral fusion. The 3-S instrument seems to be suitable for spinal disorders in which anterior spinal fusion is not necessary, especially for degenerative spinal disorders.

Adult↗
PubMed1998

Primary leiomyoma of the ovary: a case report.

The imaging features of primary ovarian leiomyoma have seldom been described because of the very low prevalence of the tumor. Herein we present a case report on its magnetic resonance imaging features. Both T1- and T2-weighted images revealed a low-signal-intensity mass, which was well circumscribed and sharply demarcated from the uterus. Magnetic resonance imaging was useful in distinguishing it from a malignant ovarian tumor and uterine leiomyoma.

Diagnosis, Differential↗
PubMed1998

Region-specific expression of murine Hox genes implies the Hox code-mediated patterning of the digestive tract.

BACKGROUND: Hox genes encode transcription factors which are involved in the establishment of regional identities along the anteroposterior (AP) body axis. To elucidate the AP patterning of the digestive tract, we have systematically examined the expression patterns of Hox genes belonging to paralogue groups 6, 7, 8 and 9 by whole-mount in situ hybridization and by section in situ hybridization analyses. RESULTS: The expression patterns of these genes showed co-linearity along the wall of the digestive tract, thereby yielding the Hox code of the gut. The expression boundaries of the Hox genes at later stages (12.5 d.p.c.) corresponded to the morphological boundaries of individual gut subdomains. CONCLUSIONS: The visceral mesoderm-restricted expression suggested that the Hox code primarily functions in the mesenchymal specification which eventually leads to the regional differentiation of gut subdomains as the result of epithelial-mesenchymal interactions. Overlapping expression patterns were found among the paralogous Hox genes, indicating that the paralogues may have redundant functions in the specification of the gut.

Animals↗
PubMed1998

Optic nerve dysplasia associated with meningeal defect in Sprague-Dawley rats.

Unilateral and bilateral dysplasias of the optic nerve (ON) were observed in 20/114 male and 14/110 female Sprague-Dawley rats at 12 weeks of age. Grossly, the intracranial segment of the affected ON had nodular thickening, bifurcation, and curvature. Nodular thickenings were seen in 20 males and 11 females. One female had a bifurcated ON. Curvature was observed in the left ONs of two females. Of 34 ON dysplasias, 12 ONs tapered off into a thin filament at the portion anterior to the dysplastic lesions. The intraorbital segments of the ONs in 33 rats were also reduced in size and were hardly recognizable in the meningeal sheath in 10 rats. Both eyeballs appeared normal in all the animals examined. Histologically, nerve fibers in intracranial and intraorbital segments of the ONs that appeared as slender filaments were markedly reduced in number. Nerve fibers in nodular thickenings were intertwined in haphazard fashion, forming scrollworklike structures. The meningeal sheaths in intracranial segments of the ONs in 15 rats and in intraorbital segments in eight rats were partially missing. The naked portion of the ON protruded into the meningeal spaces or gaps. The data indicate that developmental failures in the ON may have been induced due to insufficient blood supply through the meningeal covering or herniation of growing nerve fibers into the defective meninges. However, etiology and pathogenesis of this condition remain unclear.

Animals↗
PubMed1998

Role of daunorubicin in the induction therapy for adult acute myeloid leukemia.

PURPOSE: To evaluate the relationship of total-dose of daunorubicin (DNR) to the induction therapy and treatment outcome, we have administered individualized doses of DNR during induction treatment to patients with acute myelogenous leukemia (AML). PATIENTS AND METHODS: Ninety-two previously untreated adult patients with AML who entered our hospital were analyzed for the dose of DNR required to achieve complete remission (CR), the CR rate, disease-free survival (DFS), and overall survival (OS). Induction therapy consisted of DNR 40 mg/m2 daily intravenously from day 1 until the marrow was hypoplastic, cytarabine (Ara-C), prednisolone (PRD), and/or 6-thioguanine (6-TG). RESULTS: Eighty-three of 92 patients with adult AML were assessable for this study. Sixty-three (76%) patients achieved CR. Fifty-two of 63 CR patients achieved the CR in the first course of induction therapy, and 11 patients required the second course of induction therapy. The 5-year and 10-year DFS rates were 31.2% and 5-year and 10-year OS rates were 45.1% and 42.3%, respectively. The median total dose of DNR in the induction therapy was 280 mg/m2 (120 to 480 mg/m2). DNR dose did not influence the response to therapy and was not influenced by the initial WBC count or French-American-British (FAB) system classification. CONCLUSION: These results indicated that when the dose was linked to observed tumor response, the optimal dose of DNR in the induction therapy was approximately 280 mg/m2 (40 mg/m2 for 7 days), which is greater than the conventional dose of 40 to 60 mg/m2 for 3 days.

Adolescent↗
PubMed1998

Puberty, IDDM, and death in Japan. Diabetes Epidemiology Research International Study Group.

OBJECTIVE: To investigate the impact of age at onset on the prognosis of childhood IDDM in Japan. RESEARCH DESIGN AND METHODS: The study population consisted of 987 prepubertal-onset and 345 pubertal-onset IDDM cases who were registered by two nationwide surveys and who were diagnosed between 1965 and 1979. The living status was identified as of 1 January 1990 with the ascertainment rate of 96.5%. Prognosis was evaluated by cause- and age-specific mortality rates and life-table analyses; in addition, an attained-age-matched case-control study was analyzed by conditional logistic regression. RESULTS: The adjusted mortality rates per 100,000 person-years for the pubertal-onset cases were significantly higher than those of the prepubertal-onset cases (835 [95% CI 573-1,168] vs. 391 [283-526]). Life-table analyses revealed that the survival rate of the pubertal-onset cases was lower than that of the prepubertal-onset cases for each observation period. Life-table analyses after the age of 15 years indicated that the prognosis of pubertal cases was almost the same as that of the prepubertal cases despite having a shorter duration of diabetes. The attained-age-matched case-control study indicated that the pubertal onset was a potent determinant of death. CONCLUSIONS: The prognosis of pubertal-onset IDDM was considerably poorer than that of prepubertal-onset IDDM.

Accidents↗
PubMed1998

[EPOCH therapy for relapsed/refractory lymphoid malignancies].

Patients with refractory or relapsed non-Hodgkin's lymphoma (NHL), acute T-cell leukemia (ATL), ATL lymphoma and acute lymphocytic leukemia (ALL) received EPOCH therapy. All were previously treated with doxorubicin (DOX), vincristine (VCR) and other drugs. The EPOCH treatment schedule is consisted with DOX (10 mg/M2/day, 5 days c.i.v.), VCR (0.4 mg/M2/day, 4 days c.i.v.), etoposide (50 mg/M2/day, 4 days c.i.v.), cyclophosphamide (750 mg/M2/day, day 6 i.v.) and prednisolone (60 mg/M2/day, 5 days p.o.). Twenty-one patients (ALL:10, NHL:8, ATLL:2, ATL:1) were assessable for response and toxicity. Two patients with ALL and NHL, respectively, achieved a complete remission and 3 patients obtained partial remission (NHL:2, ATLL:1). The hematological toxicity (grade > 1) included neutoropenia, anemia and thrombocytopenia, which were observed in 83.3%, 76.7% and 76.7% respectively, of total 30 EPOCH courses. The major non-hematological toxicities were nausea/vomiting, constipation and infection, but most of the toxicity were tolerable with sufficient clinical supportive care. These results indicate that continuous infusion of DOX, VCR and ETP might be effective in patients who were treated with, and presumed to be resistant to the same drugs administrated by bolus infusion.

Adolescent↗
PubMed1998

[Primary cardiac non-Hodgkin's lymphoma].

A 69-year-old man who initially presented with lumbago developed heart failure during an MRI scan on the day of admission. A chest X-ray showed cardiomegaly and bilateral pleural effusion. Echocardiogram and computed tomography (CT) scan of the chest revealed a large tumor mass encompassing the heart with much pericardial effusion was demonstrated. The cytology of the effusion obtained by pericardiocentesis was consistent with non-Hodgkin's lymphoma, diffuse large B cell type. As CT scans of the abdomen and pelvis were negative, he was considered to have primary cardiac lymphoma. Although he responded remarkably to therapy with vincristine, cyclophosphamide and prednisolone and, he developed acute respiratory failure on the seventh month after admission. Although incidence of primary cardiac lymphoma is very low, it is necessary to investigate the mechanism of this disease in order to establish appropriate diagnostic and therapeutic approaches.

Aged↗
PubMed1998

[Prognostic significance of CD7 expression in adult acute myeloid leukemia].

To evaluate the prognostic significance of CD7 expression in de novo acute myeloid leukemia (AML), we studied 63 patients with AML who had been admitted to our hospital between September 1989 and January 1996. Even of the patients were later eliminated from the study (9 due to insufficient surface marker analyses, and 2 due to early death). The remaining 52 patients (median age: 42.5 years) were evaluated for morphologic subtype, immunophenotypic classification, complete remission (CR), disease-free survival (DFS) and overall survival (OS). All 52 patients were grouped by the French-American-British classification system: 10 as M1, 16 as M2, 11 as M3, 8 as M4, 5 as M5, and 2 as M6. Ten of the patients expressed CD7 on their leukemia cells (positive rate > or = 25) and were classified as CD7(+)AML, with morphological subtypes as follows: 3 as M1, 6 as M2, and 1 as M3. Thirty-three of the 42 patients with CD7 + AML (78.6%) and 6 of the 10 patients with CD7 + AML (40%) achieved CR. DFS and OS rates for the patients with CD7(+)AML were 22.1% and 35.4%, respectively; those for the CD7(+)AML patients were 53.3% and 44.4%, respectively. No significant differences in gender hematological findings, clinical manifestations such as hepatosplenomegaly, lymphadenopathy, or incidence of central nervous system involvement, CR rate, and DFS distinguished patients with CD7(+)AML from those with CD7(+)AML. These suggest that CD7 expression is unlikely to be a prognostic factor in AML.

Adolescent↗
PubMed1998

Comparative study of MR myelography and conventional myelography in the diagnosis of lumbar spinal diseases.

The purpose of this study was to investigate the usefulness of magnetic resonance (MR) myelography by comparing it with conventional myelography. MR myelography was performed on 40 patients (24 men and 16 women; mean age, 44 years) with lumbar spinal diseases. MR myelography was imaged three-dimensionally by fast spin-echo technique with fat suppression and maximum intensity projection. We assessed both the ability to provide the images of nerve root sheaths and the similarity of the findings to conventional myelography. Satisfactory images of nerve root sheaths in the lumbar region were provided almost equally by MR and conventional myelography. The images obtained by MR myelography were similar in quality to those obtained by conventional myelography. When combined with some other conventional MR imaging techniques, this diagnostic technique of imaging lumbar spinal diseases is further enhanced.

Adolescent↗
PubMed1997

Geographic variation in mortality among individuals with youth-onset diabetes mellitus across the world. DERI Mortality Study Group. Diabetes Epidemiology Research International.

The aim of this study was to evaluate the geographic variation in mortality among individuals with youth-onset insulin-dependent diabetes mellitus (IDDM) across the world. The study was based on the currently available IDDM incidence and mortality data. Mortality data for diabetes in the 0-24 year age group were obtained from the World Health Organization (WHO) statistics. The mortality rates were adjusted for the frequency of occurrence of IDDM and dividing the mortality rates by the IDDM incidence rates which were obtained from the WHO DiaMond project. There was a more than 10-fold geographic variation in mortality between the developed countries and Eastern European populations. The areas with the highest mortality rates were located in Japan, Eastern Europe and Russia. The areas having the best outcome associated with IDDM were Northern Europe, Central Europe, and Canada. An ecological study demonstrated a relationship between the incidence-adjusted mortality (estimated case-fatality) with IDDM incidence itself (Spearman's correlation coefficient = 0.45) as well as infant mortality and life expectancy at birth. These data demonstrated the possibility of an enormous geographic variation in mortality of youth-onset diabetic patients even in developed countries. It is important to note that these excess deaths are potentially preventable. The ecological study also suggested that the mortality differences may be in part related to overall and diabetes related care.

Adolescent↗
PubMed1997

Arteriovenous malformation of the gallbladder.

Review of the literature shows no reports of vascular malformation of the gallbladder. Herein we report an unusual case of arteriovenous malformation of the gallbladder in a patient with hepatocellular carcinoma. The gallbladder lesion was found incidentally during abdominal angiography for the carcinoma. The angiographic features were specific, comprising dilated and tortuous feeding cystic arteries, a racemose vascular network, and early-filling cystic veins.

Adult↗
PubMed1997

Influence of highly purified eicosapentaenoic acid ethyl ester on insulin resistance in the Otsuka Long-Evans Tokushima Fatty rat, a model of spontaneous non-insulin-dependent diabetes mellitus.

We investigated the effect of long-term administration of highly purified eicosapentaenoic acid ethyl ester (EPA-E), an n-3 polyunsaturated fatty acid derived from fish oil, in comparison to the effects of lard, olive oil, safflower oil, or distilled water as the control on the development of insulin resistance in Otsuka Long-Evans Tokushima Fatty (OLETF) rats, a model of spontaneous non-insulin-dependent diabetes mellitus (NIDDM) with obesity. After 17 or 18 weeks of treatment, the glucose infusion rate (GIR) in the euglycemic insulin-glucose clamp test only showed a significant increase in EPA-E-treated rats compared with control rats given distilled water alone as the vehicle. The GIR in EPA-E-treated animals was approximately three times greater than in the controls. This is the first report to display the influence of various fatty acids on the development of insulin resistance in OLETF rats. We demonstrated that EPA-E prevents the onset of insulin resistance, whereas olive oil and safflower oil have no effect and lard exacerbates insulin resistance. Fatty acid analysis of phospholipids in skeletal muscle showed a significant increase of the C18:2, C20:5, and C22:5 components in EPA-E-treated rats and, conversely, a significant decrease in C20:4. In addition, EPA-E-treated rats showed a significant increase in GLUT4 mRNA in skeletal muscle when compared with control rats. Our results indicate that the beneficial effect of EPA-E on insulin resistance in OLETF rats is likely to be dependent on modification of the phospholipid components of the skeletal muscle membrane. These findings suggest that dietary fatty acids may play a key role in the development of insulin resistance in patients with NIDDM.

Animals↗
PubMed1997

Radioiodinated alpha-p-iodophenyl-N-tert-butylnitrone as a radical detecting agent in vivo.

For in vivo detection of unstable radical species, a novel radioiodinated radical trapping agent, alpha-p-iodophenyl-N-tert-butylnitrone (IPBN), was designed based on the plausible characteristics of alpha-p-hydroxy-m-iodophenyl-N-tert-butylnitrone (HIPBN). Both compounds are iodinated analogs of alpha-phenyl-N-tert-butylnitrone (PBN), but the latter showed low stability in vivo. The present compound IPBN was easily prepared and labeled with radioiodine. It showed very stable characteristics in vitro as well as in vivo, but was easily metabolized and retained at sites of superoxide production.

Animals↗
PubMed1997

Inhibitory effects of insulin on intracellular calcium and aggregatory response of platelets are impaired in hypertensive subjects with insulin resistance.

To determine the effects of insulin on intracellular calcium and platelet aggregatory responses in hypertensive subjects with insulin resistance, we measured insulin sensitivity in terms of glucose disposal rate (GDR) by the hyperinsulinemic euglycemic clamp technique (GC) in 14 non-diabetic untreated hypertensive subjects, and determined basal ([Ca2+]i) and thrombin-stimulated (T-[Ca2+]i) platelet-free calcium concentrations and thrombin-stimulated platelet aggregatory response (AG) before (PRE[Ca2+]i, T-PRE[Ca2+]i, and PRE AG, respectively) and during (POST[Ca2+]i, T-POST[Ca2+]i, and POST AG, respectively) GC. As a control for GC, vehicle (normal saline) was infused on another day. No significant difference was observed between PRE[Ca2+]i and POST[Ca2+]i, T-PRE[Ca2+]i and T-POST[Ca2+]i, or PRE AG and POST AG, GDR inversely correlated with delta[Ca2+]i (POST [Ca2+]i-PRE[Ca2+]i, r = -0.75, p < 0.02), delta T-[Ca2+]i, (T-POST[Ca2+]i-T-PRE[Ca2+]i, r = -0.63, p < 0.02) and delta AG (POST AG-PRE AG, r = -0.67, p < 0.01). No significant changes were observed in these variables during vehicle infusion. [Ca2+]i, T-[Ca2+]i, and AG decreased during GC as compared with baseline in hypertensive subjects with normal insulin sensitivity, but were unchanged in those with insulin resistance, suggesting that the vasodilatory and anti-platelet aggregatory effects of insulin are impaired in patients with insulin-resistant hypertension.

Adult↗