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Biomedical subjects

S Hosaka

Publications and source records attributed to S Hosaka.

At least 55 records · Page 3Linked to original sources
PubMed1996

[A case of rapidly grown pulmonary blastoma].

A 78-year-old woman who had been in a local hospital with a complaint of cough and chest pain was referred to our hospital because a mass 12 cm in size was found in her right lung by a chest X-ray and CT. Within 3 weeks, the tumor rapidly developed to 19 cm in size. Malignant schwannoma of the lung was suspected by a percutaneus lung biopsy and the right upper and middle lobectomy was performed. Histological analysis of the tumor showed a biphasic structure with epithelial and mesenchymal component which was diagnosed pulmonary blastoma. Pulmonary blastoma is very rare, but it may be of benefit for the thoracic surgeon to establish methods of diagnosis and treatment of this disease.

Aged↗
PubMed1996

[Truncal valvoplasty for post-operative truncal valve regurgitation of truncus arteriosus: a case report].

The surgical treatment for truncal valve regurgitation is still controversial in patients with truncus arteriosus. A two-year-old girl with complaints of low weight gain and tachypnea was referred for treatment of truncal valve regurgitation. She had undergone an emergency pulmonary artery banding for severe congestive heart failure due to truncus arteriosus-type I at six months of age. This anomaly had been corrected by Barbero-Marcial method at seven months of age. But the truncal valve regurgitation started appearing at sixteen months of age with the progression of the stenosis of the pulmonary artery orifice and the right ventricular outflow tract regurgitation. Echo cardiography and cineangiography revealed the truncal valve to be bicuspid, and the regurgitation severe, especially through the prolapsed left sided cusp. The truncal valve was repaired by commissural suspension method, and the right ventricular outflow tract reconstructed with patch angioplasty of the pulmonary artery orifice and Carpentier-Edwards pericardial Bioprosthesis (19 mm). The post-operative course was uneventful. One year after, truncal valve regurgitation is small by color Doppler study. We conclude that valvoplasty is to be considered as the first choice of treatment for truncal valve regurgitation.

Child, Preschool↗
PubMed1995

Growth-related gene product alpha. A chemotactic cytokine for neutrophils in rheumatoid arthritis.

Leukocyte recruitment is critical in the inflammation seen in rheumatoid arthritis (RA). To determine whether the chemokine growth-related gene product alpha (gro alpha) plays a role in this process, we examined synovial tissue (ST), synovial fluid (SF), and plasma samples from 102 patients with arthritis. RA SF contained more antigenic gro alpha (mean 5.3 +/- 1.9 ng/ml) than did SFs from either osteoarthritis (OA) or other forms of arthritis (mean 0.1 ng/ml) (p < 0.05). RA plasma contained more gro alpha (mean 4.3 +/- 1.8 ng/ml) than normal plasma (mean 0.1 ng/ml) (p < 0.05). RA ST fibroblasts (1.2 x 10(5)/cells/mI RPMI 1640/24 h) produced antigenic gro alpha (mean 0.2 +/- 0.1 ng/ml), and this production was increased significantly upon incubation with TNF-alpha (mean 1.3 +/- 0.3 ng/ml) or IL-1 beta (mean 2.3 +/- 0.6 ng/ml) (p < 0.05). Cells from RA SF also produced gro alpha: neutrophils (PMNs) (10(7) cells/mI/24 h) produced 3.7 +/- 0.7 ng/ml. RA SF mononuclear cells produced gro alpha, particularly upon incubation with LPS or PHA. Immunoreactive ST gro alpha was found in greater numbers of RA compared with either OA or normal lining cells, as well as in RA compared with OA subsynovial macrophages (p < 0.05). IL-8 accounted for a mean of 36% of the RA SF chemotactic activity for PMNs, while epithelial neutrophil-activating peptide-78 accounted for 34%, and gro alpha for 28%, of this activity. Combined neutralization of all three chemokines in RA SFs resulted in a mean decrease of 50% of the chemotactic activity for PMNs present in the RA SFs. These results indicate that gro alpha plays an important role in the ingress of PMNs into the RA joint.

Arthritis, Rheumatoid↗
PubMed1995

In-vivo induction of monocyte chemotactic and activating factor in patients with chronic renal failure.

BACKGROUND: Monocyte chemotactic and activating factor (MCAF) is a novel inflammatory cytokine belonging to the chemokine superfamily and stimulates chemotaxis and activation of monocytes. Increased production of inflammatory cytokines has been shown in patients with end-stage renal disease (ESRD). This study was thus conducted to determine plasma MCAF in patients with ESRD. METHODS: Plasma levels of MCAF were determined by ELISA. Gene expression of MCAF in PBMC was assessed by RT-PCR followed by southern blot hybridization. RESULTS: Plasma MCAF in 72 patients with long-term haemodialysis (HD) (162.4 +/- 58.2 pg/ml) and eight uraemic patients not yet dialysed (167.6 +/- 57.7 pg/ml) was found to exceed significantly the level in 24 normal subjects (86.0 +/- 19.4 pg/ml). MCAF before HD session in long-term HD patients was the same whether HD was carried out with either cellulosic (CUP) or synthetic (PMMA) membrane dialysers. Intradialytic increase in plasma MCAF during a single HD session was observed in both patient groups dialysed with CUP or PMMA membranes. The results of RT-PCR analysis indicated that haemodialysis stimulates the gene expression of MCAF in PBMC in vivo. CONCLUSIONS: The present results indicate that increased levels of plasma MCAF may promote the activation of monocytes in patients with ESRD.

Adult↗
PubMed1995

Expression of basic fibroblast growth factor and angiogenin in arthritis.

Angiogenesis is an integral component of the vasculoproliferative phase of rheumatoid arthritis (RA). We examined the distribution of two angiogenic factors, basic fibroblast growth factor (bFGF) and angiogenin (ANG) in arthritic diseases. We used an enzyme-linked immunosorbent assay and immunohistochemical analysis to determine the levels of bFGF and ANG in synovial fluid (SF) and their distribution in synovial tissue (ST), respectively. Most SF contained little or no detectable bFGF ( < 5 pg/ml). ANG in RA SF was 248.7 +/- 17.4 ng/ml, which did not differ significantly from levels found in osteoarthritis (OA; 305.9 +/- 23.1 ng/ml). Synovial lining cells, macrophages, endothelial cells, and vascular smooth muscle cells were immunopositive for bFGF and ANG; however, their expression was not up-regulated in RA ST compared to ST from OA and normal subjects. Though bFGF and ANG are present in the joints of patients with arthritic diseases, they are not up-regulated in RA. These results suggest that not all angiogenic mediators are up-regulated in RA compared to normal subjects and subjects with other arthritic diseases. It may be that some of these mediators, like ANG, play a role in the physiology of normal synovium.

Angiogenesis Inducing Agents↗
PubMed1995

[Aortic valve replacement for rheumatoid aortic valve regurgitation].

Valve replacement for aortic regurgitation in patient with rheumatoid arthritis was rare in Japan. We report a successful case in which aortic regurgitation necessitated aortic valve replacement. A 62-year-old woman was admitted for shortness of breath, chest pain and progressive edema. She had been treated for rheumatoid arthritis for more than ten years using steroids. The aortic valve was successfully replaced by a prosthetic mechanical valve. The histopathological examination of the excised aortic valve demonstrated rheumatic nodules in the right- and non-coronary cusp. It was supported that these changes caused shrinkage of cusp and resulted in aortic regurgitation. This patient was discharged on the 20th postoperative day. There was no evidence of detachment of the prosthetic valve.

Anti-Bacterial Agents↗
PubMed1995

[Treatment of acute type A aortic dissection with onset of the right coronary insufficiency].

This is a case report of the successful treatment for acute type A aortic dissection with onset of the right coronary artery (RCA) obstruction due to compression of the dissected lumen. A 50-year-old man, who had been received medical therapy for hypertension for seven years, was admitted with profound cardiogenic shock. The ECG demonstrated complete A-V block and acute myocardial infarction (AMI) of right ventricle and inferior wall. Coronary catheter intervention was scheduled because intra-aortic balloon pumping was not effective, and arteriogram revealed aortic dissection, coronary insufficiency and aortic regurgitation (grade I). Soon after inflation of a perfusion catheter at the origin of RCA, elevation of arterial blood pressure and recovery to sinus rhythm were brought successfully by the coronary reperefusion. Replacement of the ascending aorta involving the intimal tear without surgical closure of RCA ostium, aortic valve resuspension and coronary artery bypass grafting with saphenous vein to RCA were performed 11 hours after the onset, and the postoperative course was uneventful. Although aortic dissection with onset of AMI was uncommon, it is suspected that the generalizing of catheter intervention for AMI increases awareness of such cases and it is emphasised that the application of perfusion catheter as an emergency procedure for the illness like this case is useful to preserve hemodinamic stability until the surgical treatment.

Aortic Dissection↗
PubMed1995

[A case of mitral regurgitation due to partial papillary muscle rupture whose etiology was unknown].

The etiology of the papillary muscle rupture includes myocardial infarction, trauma, hypertension, myxomatous degeneration, endocarditis etc. We report a case of partial papillary muscle rupture whose etiology was unknown, in a 77-year-old woman. The preoperative catheterization and coronary angiography showed severe mitral regurgitation and no significant coronary stenosis. And we recognized the mass waving into the left atrium in systole with the echocardiogram. At surgery, we repaired the mitral valve by resecting quadrangular areas of the posterior leaflet including the attachment of the torn papillary muscle. Additionally a number 28 Carpentier-Edwards mitral annuloplasty ring was sewn in place. In pathologic specimen, there were focal fibrosis, necrotic muscle, lymphocytes, and no vegetation.

Aged↗
PubMed1995

[Effects of preserving mitral apparatus on left ventricular systolic function and geometry in mitral valve replacement].

We investigated the left ventricular (LV) systolic function and geometry in mitral valve replacement (MVR) with and without preservation of mitral apparatus. Five patients had conventional MVR without mitral annulus papillary muscle continuity (group C) and five patients had MVR with preservation of the continuity (group P). LV cineangiograms were assessed before and one month after surgery. LV volume was calculated by the method of Kennedy. Long axis dimension is defined as the distance between the apex and the center of mitral orifice in right anterior oblique projection. Short axis dimension is defined as the cross-sectional dimension at the middle point of the long axis. Paired Student's t tests were employed to compare the preoperative and postoperative data. LV ejection fraction decreased significantly from 69.4 +/- 9.5 to 51.8 +/- 10.5% in group C (p < 0.05) and did not change significantly in group P (from 51.6 +/- 19.9 to 56.8 +/- 12.9%). Fractional shortening of the long axis increased significantly from 15.0 +/- 11.8 to 21.2 +/- 14.0% in group P (p < 0.02) and did not change significantly in group C (from 16.5 +/- 8.6 to 13.1 +/- 3.3%). Ratio of LV end-systolic long axis to short axis dimension increased significantly from 1.76 +/- 0.31 to 2.12 +/- 0.21 in group C (p < 0.05) and did not change significantly in group P (from 1.90 +/- 0.22 to 1.95 +/- 0.22). We conclude that the ratio of systolic long to short axis increases, i.e., systolic LV shape changes to become longer and slender, and ejection fraction decreases after surgery in MVR without preservation of mitral apparatus. Conversely, preserving the mitral apparatus in MVR results in no significant change in systolic LV function and geometry, because of preserving fractional shortening of long axis.

Aged↗
PubMed1994

Expression of the chemokine superfamily in rheumatoid arthritis.

The infiltration of leucocytes into the joint of rheumatoid arthritis (RA) is believed to be mediated by chemotactic factors released by activated cells. In this study, examination was made of the gene expression and production of the chemokine superfamily in RA patients by reverse transcriptase-polymerase chain reaction (RT-PCR) and immunoprecipitation. Cultured synovial fibroblasts were found capable of expressing and producing IL-8, GRO, monocyte chemotactic and activating factor (MCAF), macrophage inflammatory protein-1 alpha (MIP-1 alpha), MIP-1 beta and RANTES in response to IL-1 alpha. The expression of IL-8, GRO, MCAF, MIP-1 alpha, and MIP-1 beta was clearly shown to increase in freshly isolated synovial fluid mononuclear cells (SFMC) of RA patients, in contrast to peripheral blood mononuclear cells (PBMC) of RA patients and normal subjects. The gene expression of RANTES appeared to be the same for RA SFMC, RA PBMC, and normal PBMC. Thus, the over-expression of various chemokines may promote the recruitment of inflammatory cells into rheumatoid inflamed joints.

Arthritis, Rheumatoid↗
PubMed1994

Cutaneous vasculitis in a patient with dermatomyositis without muscle involvement.

A 74-year-old female patient with cutaneous ulcerations and typical dermatomyositis (DM) skin rash had no muscle disease for a 1-year and 5 months period. Histological examination of the skin ulceration indicated vascular occlusion without cellular infiltration. Cutaneous ulceration is a very rare manifestation of adult-onset DM patients without inflammatory myopathy.

Aged↗
PubMed1994

[Intrabronchial neurilemmoma: a case report].

A 62-year-old woman who was pointed out abnormal shadow at left middle lung field in chest X-ray was followed up as a hamartoma from 1989. In this period, the tumor was growing up in chest X-ray and occupying the left segmental bronchus (B3) in bronchofiberscopic study. It was suspected neurilemmoma by the final biopsy examination. Left upper lobectomy was performed and pathohistological diagnosis was typical neurilemmoma that consist of Antoni type A and Antoni type B. Intrapulmonary or intrabronchial neurilemmoma is rare and only 20 cases have been reported in the Japanese literature.

Bronchial Neoplasms↗
PubMed1994

[Surgical treatment of distal aortic arch aneurysm combined with mitral regurgitation--a case using "elephant trunk" technique and concomitant mitral valvuloplasty].

We present a surgical case of a 63-year-old male with distal aortic arch aneurysm combined with mitral regurgitation. Through a median sternotomy, a mitral valvuloplasty was performed with McGoon's procedure and Carpentier's ring. Then with the aid of deep hypothermia and circulatory arrest, the aortic arch was opened. A long woven velour graft was anastomosed only proximally to the distal end of the aortic arch and was allowed to float down the descending aorta ("Elephant Trunk" technique). Anti-coagulant therapy was continued only for 4 weeks after the operation. Postoperative left ventriculogram showed no residual regurgitation. The aneurysm was confirmed fully thrombosed around the graft on computed tomogram. It is concluded that "Elephant Trunk" technique for distal arch aneurysm is useful when combined other cardiac surgery without anti-coagulant therapy, such as mitral valvuloplasty, is needed.

Aortic Aneurysm, Thoracic↗
PubMed1994

[Atheromatous embolization as a cause of postoperative renal dysfunction in infrarenal aortic reconstructive surgery].

Influences of atheromatous changes in the aortic wall at the site of proximal clamping were studied retrospectively on postoperative renal function in an infrarenal aortic reconstruction. Atheromatous lesion was evaluated on CT scan as low density layer in the aortic wall observed in cases with the thickened wall exceeding 3mm, and they were classified into atheromatous group (group II) consisted of 21 patients. In these patients, the postoperative serum creatinine showed significant elevation from preoperative value of 0.89 +/- 0.32 mg/dl to 1.67 +/- 0.90 mg/dl on 1st postoperative day (p < 0.01), 1.25 +/- 0.99 mg/dl on 7th day (p < 0.05) and 1.24 +/- 0.89 mg/dl on discharge (p < 0.05). Correlation between the severity of the postoperative renal dysfunction and the degree of the atheromatous changes evaluated by preoperative CT scan was also defined and 2 patients with severe changes died of acute renal failure. On the contrary, 39 patients without thickened wall (group I) showed no significant elevation of serum creatinine after operation. These results strongly suggest that atheromatous embolization to the kidney plays an important role to cause postoperative renal impairment following infrarenal aortic reconstructive surgery for the patients with atheromatous changes in the aorta near the site of proximal clamping.

Acute Kidney Injury↗
PubMed1994

[Three cases of Castleman's disease mimicking the features of collagen disease].

We report three cases of Castleman's disease mimicking the features of collagen disease. Case 1: A 39-year-old woman presented with intermittent arthralgia and fever. Laboratory findings were positive results for antinuclear antibody (80x speckled type), the LE test, anti-SSA antibody, anti-RNP antibody, and Coombs test. The patient was suspected to have systemic lupus erythematosus (SLE) or Sjögren syndrome, but a lymph node biopsy revealed the plasma cell type of Castleman's disease. Steroid treatment led to resolution of her symptoms. Case 2: A 60-year-old man with mixed type Castleman's disease had proteinuria with renal dysfunction, autoimmune thrombocytopenia, antinuclear antibody, anti-RNP antibody, anti-DNA antibody and anti-cardiolipin antibody. The patient was suspected to have SLE but cervical lymph node biopsy revealed the mixed type of Castleman's disease. Symptoms were not controlled with steroid therapy. He developed renal failure that required for hemodialysis and died of gastrointestinal bleeding due to severe thrombocytopenia. Case 3: A 46-year-old woman had Raynaud's phenomenon, sclerodactylia, and nail fold bleeding. Laboratory tests were revealed positive for antinuclear antibody, anti-ENA antibody, and LE cell preparation. Radiographic study showed multiple masses in the retroperitoneal spaces, which necessitated laparotomy. Firstly, the patient was suspected to have systemic sclerosis or mixed connective tissue disease (MCTD). A biopsy revealed the hyaline-vascular type of Castleman's disease. The serum level of IL-6 by ELISA was high in all of three cases. In case 1, symptoms improved and the IL-6 level normalized after steroid treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Expression of monocyte chemotactic and activating factor in rheumatoid arthritis. Regulation of its production in synovial cells by interleukin-1 and tumor necrosis factor.

OBJECTIVE: To investigate whether monocyte chemotactic and activating factor (MCAF) contributes to the accumulation of macrophages in the joints of patients with rheumatoid arthritis (RA). METHODS: MCAF was measured by radioimmunoassay. MCAF gene expression was determined by Northern blotting and reverse-transcriptase polymerase chain reaction. Recombinant human MCAF was injected into rabbit joints to evaluate the effect of MCAF on infiltration of macrophages. RESULTS: High levels of MCAF were detected in synovial fluid from patients with RA. Cells freshly isolated from synovial fluid expressed MCAF messenger RNA (mRNA). Fibroblast-like synoviocytes were found to express MCAF mRNA and to secrete MCAF in response to interleukin-1 (IL-1) and tumor necrosis factor in vitro. IL-1 also promoted MCAF gene expression in rabbit synovial tissue in vivo. MCAF caused marked infiltration of macrophages in rabbit synovial tissue. CONCLUSION: Our findings suggest that MCAF may contribute to the accumulation of macrophages in inflamed rheumatoid joints.

Arthritis, Rheumatoid↗