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Biomedical subjects

S Nakano

Publications and source records attributed to S Nakano.

At least 217 records · Page 12Linked to original sources

Quality of life following esophagectomy with three-field lymphadenectomy for carcinoma, focusing on its relationship to vocal cord palsy.

To clarify the quality of life of patients who underwent esophagectomy for carcinoma by right thoracotomy, laparotomy and cervical anastomosis, 116 patients who were cancer free at the time of mailing a questionnaire were analyzed. A significant decrease in vital capacity for 3 years postoperatively, as well as in the percentage of ideal body weight, between 3 and 5 years were observed in 57 patients with three-field lymphadenectomy. Patients' quality of life undergoing three-field dissection was worse than those with less radical lymphadenectomy (59 cases) in terms of the performance status and difficulty in talking at 60 months or more postoperatively. Around 20% of all patients reported severe hoarseness due to permanent recurrent nerve paralysis, resulting in poor quantity of food intake at 24 months or less postoperatively and restricted daily activity and difficulty in talking at 60 months or more after the operation. When a patient suffers from vocal cord insufficiency caused by permanent paralysis of the recurrent nerve, early treatment before discharge from the hospital should be performed to improve the quality of life of such a patient.

Aged↗

Determination of ciprofloxacin in plasma and urine by HPLC with ultraviolet detection.

A simple, sensitive isocratic method for the detection and quantification of ciprofloxacin in plasma and urine has been developed. The assay consisted of reversed-phase HPLC with ultraviolet detection. Plasma proteins were removed by a fast and efficient procedure. For the urine samples, the only required sample preparation was dilution. Separation was achieved on a C18 reversed-phase column. The quantification limit was 0.01 mg/L in plasma and 0.5 mg/L in urine. This method was sufficiently sensitive for pharmacokinetic studies.

Anti-Infective Agents↗

[Regional cerebral blood flow measurements by a noninvasive microsphere method using 123I-IMP: comparison with the modified fractional uptake method and the continuous arterial blood sampling method].

A noninvasive microsphere method using N-isopropyl-p-[123I]iodoamphetamine (123I-IMP), developed by Yonekura et al., was performed in 10 patients with neurological diseases to quantify regional cerebral blood flow (rCBF). Regional CBF values by this method were compared with rCBF values simultaneously estimated from both the modified fractional uptake (FU) method using cardiac output developed by Miyazaki et al. and the conventional method with continuous arterial blood sampling. In comparison, we designated the factor which converted raw SPECT voxel counts to rCBF values as a CBF factor. A highly significant correlation (r = 0.962, p < 0.001) was obtained in the CBF factors between the present method and the continuous arterial blood sampling method. The CBF factors by the present method were only 2.7% higher on the average than those by the continuous arterial blood sampling method. There were significant correlation (r = 0.811 and r = 0.798, p < 0.001) in the CBF factor between modified FU method (threshold for estimating total brain SPECT counts; 10% and 30% respectively) and the continuous arterial blood sampling method. However, the CBF factors of the modified FU method showed 31.4% and 62.3% higher on the average (threshold; 10% and 30% respectively) than those by the continuous arterial blood sampling method. In conclusion, this newly developed method for rCBF measurements was considered to be useful for routine clinical studies without any blood sampling.

Adult↗

[A study of colonic mucins in two kinds of experimental colitis model in rat].

We investigated the quantitative changes in colonic mucins of rats with colitis. Male Wistar rats were treated with dextran sodium sulfate (DSS) or N-ethylmaleimide (NEM) to induce colitis. Both DSS and NEM caused depletion of goblet cells, infiltration of inflammatory cells and erosion at the colonic mucosa around the anus. Though the goblet cells decreased, colonic mucins increased in the distal colon. These phenomena may explain the clinical features of human ulcerative colitis, namely the goblet cell depletion and the mucous stool. The increase of colonic mucins may be a compensatory function of the colon tissue in response to the localized decrease of mucin production.

Animals↗

[MRI phase contrast flow measurement of portal vein: influence and compensation of respiratory motion and propriety of phase correction using background].

The purposes of this study were to (1) determine which condition, breath holding (BH) or quiet breathing (QB), is better for phase contrast (PC) measurement of the portal flow (PF); (2) assess the usefulness of respiratory compensation (RC), a technique that diminishes motion artifacts due to breathing, on PC flow measurement; and (3) evaluate the propriety of phase correction (PhC) using background for PC flow measurement. For purposes (1) and (2) respiratory simulation phantom (RSP) was measured, and PF measurements were performed in 6 healthy subjects (HS) and 53 patients. Thirty of the patients had liver cirrhosis (LC) and 23 did not. For purpose (3), flow measurements were carried out in the phantom and 6 HS. (1) In 6 HS, intra-subjective coefficients of variation (CV) were smaller under QB than under BH (p < 0.05). And PF in patients with LC was less than in those not under QB (p < 0.01). This difference was not statistically significant under BH. (2) In the RSP study PC flow measurement with high sort RC showed good reliability. (3) Intraobserver variation was smaller without PhC than with PhC (p < 0.05) in the HS study. It may be more useful to perform portal flow measurements under QB with RC and without PhC than with PhC or under BH.

Adult↗

Application of locoregional chemotherapy using lymph-directed substances in a canine transhiatal esophagectomy model.

We investigated whether lymph-directed substances injected into the mediastinal connective tissue of dogs reached the regional lymph nodes of the esophagus. In 46 dogs, 1.5 mL of cuttlefish particles or activated carbon particles containing 15 mg of bleomycin (CH-BLM) was injected at two sites: into the connective tissue between the trachea and the aorta via mediastinoscopy in 23 dogs (16 with cuttlefish particles and 7 with CH-BLM: mediastinal group), and into the crura of the diaphragm by means of laparotomy in 23 dogs (16 with cuttlefish particles and 7 with CH-BLM: crural group). Cuttlefish particles, distinguished by decolorization with melanin bleaching, showed selective affinity for lymphatics. When cuttlefish particles were injected into mediastinal connective tissue, the rate of staining (# of black-stain positive nodes/# of examined nodes) was higher in the crural group than in the mediastinal group. In the crural group, bleomycin activity in lymph nodes was higher in the regions from the neck to the abdominal para-aortic region than at the injection site, excluding the peri-gastric region. If the topography of lymphatics and lymph flow kinetics in man are similar to that of the dog, then the crura of the diaphragm appears to be a potentially effective site for applying loco-regional chemotherapy for carcinoma of the esophagus in patients undergoing transhiatal esophagectomy.

Animals↗

The relationship between primary splenic malignant lymphoma and chronic liver disease associated with hepatitis C virus infection.

BACKGROUND: An etiologically important role has been suggested for hepatitis C virus (HCV) infection in the development of B-cell non-Hodgkin's lymphoma (NHL). HCV has been recognized as the major cause of non-A, non-B chronic hepatitis throughout the world. Moreover, the occurrence of primary splenic malignant lymphoma (PSML) has been demonstrated in patients with chronic liver disease. METHODS: In this study, the authors describe three patients with PSML. The clinical, histologic, and immunohistochemical features of the lymphomas were studied. Clonal immunoglobulin heavy chain gene rearrangement was investigated by polymerase chain reaction. RESULTS: All three cases of PSML were detected by imaging studies performed in routine follow-up of cases of chronic liver disease associated with HCV infection. Macronodular lesions were found in the three spleens; two of them were of normal weight and another was moderately enlarged. The former two were the smallest PSMLs reported to date. The histology was B-cell NHL in all cases. All 3 patients were alive after splenectomy with an average follow-up of 51.7 months (range, 35-74 months). CONCLUSIONS: HCV infection may play an etiologic role in the development of splenic B-cell lymphoma. The long survival of the patients in this study may have been due to early splenectomy.

Aged↗

Erythrogenic toxin-induced arteritis in a rabbit ear model. Comparison with Arthus reaction angiitis.

We have developed a local type experimental model of angiitisin rabbits. Repeated intracutaneous injections of erythrogenic toxins types A and C (ETA, ETC) along the intermediate auricular artery of the rabbit ear produced subacute type arteritis, characteristic of lymphocyticinfiltration, simulating Kawasaki disease angiitis. Staphylococcal enterotoxin B (SEB) and toxic shock syndrome toxin 1 (TSST) also induced similar lesions, indicating superantigens as inflammogens in vivo. Conversely, the Arthus reaction included acute type angiitis when tested similarly in rabbits immunized to human serum albumin. The ear artery was infiltrated by heterophil leukocytes, often together with venules and capillaries affected, resembling periarteritis nodosa and leukoclastic vasculitis in human disease.

Animals↗

Nonneutralizing antibody to erythrogenic toxin A alpha(NY5ETA) in human sera.

A solid phase adsorption experiment was performed to detect anti-ETA alpha(NY5 strain ETA) nonneutralizing antibody. Toxin was applied to the Protein A-Sepharose column retaining IgG bound after pretreatment with test serum. Mitogenic activity recovered in the effluent and in the eluate containing the IgG was measured separately in rabbit lymphocyte culture. A significantly increased recovery in the eluate was found in combination with decreased recovery in the effluent of three sera from Kawasaki disease and one from Streptococcus pyogenes infection among 13 ELISA-positive, antimitogen assay (AMA)-negative sera tested. The nonneutralizing antibody may play an important role in the immune protection against ETA by binding to nonmitogenic epitope(s) on ETA and enabling to handle the toxin not as a superantigen but as a conventional peptide antigen.

Adult↗

Steroids decrease uptake of carboplatin in rat gliomas--uptake improved by intracarotid infusion of bradykinin analog, RMP-7.

This study sought to determine whether dexamethasone (DXN) treatment of rats with intracranial gliomas would 1) further impair delivery of carboplatin to brain tumors, and 2) whether intracarotid infusion of the bradykinin analog, RMP-7, would improve delivery during concurrent DXN treatment. In DXN pretreated animals, 3 mg/kg/day of DXN was administered intraperitoneally for 3 days prior to Ki determinations. Ki of [14C] carboplatin into DXN-treated tumors and brain surrounding tumor (BST) was significantly lower compared to non-DXN treated tumors and BST (3.30 +/- 0.91 vs. 4.47 +/- 1.80, p < 0.05, and 0.94 +/- 0.84 vs. 2.18 +/- 0.79, p < 0.05, respectively). Intracarotid infusion of RMP-7 significantly increased the Ki for carboplatin in DXN-treated tumors (6.35 +/- 3.10 vs. 3.30 +/- 0.91, p < 0.01), however, RMP-7 increased Ki to a greater extent in tumors not pretreated with DXN (12.07 +/- 3.60 vs. 4.47 +/- 1.80, p < 0.0001). Dexamethasone decreases transport of carboplatin into brain tumors. Intracarotid infusion of RMP-7 selectively increases carboplatin transport to tumors.

Animals↗

Recovery of portal blood flow after percutaneous transhepatic biliary drainage in patients with obstructive jaundice.

Using an ultrasonic Doppler system, we prospectively studied the changes in portal venous flow (PVF) following percutaneous transhepatic biliary drainage (PTBD) and evaluated the correlation between PVF and liver function in 10 patients with obstructive jaundice. The patients were divided into two groups according to their rate of decrease in serum bilirubin ("b"). Group A comprised 5 patients with a "b" of less than -0.1, while group B consisted of 5 patients who did not meet this criterion. The mean PVF increased following PTBD (P < 0.01). The increase in PVF was due to an increase in the maximum velocity of the portal vein (Vmax). The rate of increase in the Vmax in group A was significantly higher than that in group B on both the 7th and 14th postdrainage days (P < 0.05). The rate of increase in the Vmax correlated significantly with the rate of decrease in the serum bilirubin concentration (P < 0.01). Based on the above findings, we conclude that measuring the Vmax by Doppler ultrasonography is useful in evaluating the liver function in patients with obstructive jaundice.

Aged↗

Long-term survival in a young patient with anaplastic glioma.

A 26-year-old man with anaplastic glioma in the left frontoparietal lobe survived for 9 years and 9 months after combined therapy, including subtotal resection, postoperative irradiation, and chemotherapy. The tumor recurred and he received immunotherapy using lymphokine-activated killer (LAK) cells. At the last LAK cell infusion, infection of the Ommaya reservoir occurred, but subsided after antibiotics were administered. Follow-up neuroimaging showed no recurrence of the tumor. Review of the surgical specimens found that the original diagnosis of glioblastoma was inconclusive, although the tumor is considered to be a type of anaplastic glioma.

Adult↗

Polypoid adenomyoma of the gallbladder.

We describe a distinctive polypoid lesion of the gallbladder (16 mm in diameter) at the fundus, associated with a granulomatous mass in the liver adjacent to the gallbladder fossa, in a 64-year-old Japanese woman. Preoperatively, the lesion was diagnosed as advanced gallbladder cancer infiltrating the liver, and hepatopancreato-duodenectomy was performed. In the resected specimen, the polyp was round and pedunculate in shape, and, microscopically, it consisted of a mixture of small glandular and surrounding muscular elements, but atypia was not noted. The constituent elements were identical with those of adenomyoma, but the polypoid appearance was unusual. The hepatic lesion proved to be a foreign body granuloma containing multiple barium fragments and giant cells. A deep gastric ulcer, which penetrated into the gallbladder fossa, was also noted, near the granuloma. The histologic features indicate that the polypoid appearance of the tumor was due to a secondary modification of pre-existing adenomyoma by hepatic granuloma. To our knowledge, this is the second reported case of an adenomyomatous lesion of the gallbladder with a polypoid appearance.

Adenomyoma↗

p35nck5a and cyclin-dependent kinase 5 colocalize in Lewy bodies of brains with Parkinson's disease.

We examined the immunohistochemical localization of p35nck5a, the regulatory subunit of cyclin-dependent kinase 5 (cdk5), in brains obtained postmortem from patients with Parkinson's disease (PD) and controls. We found p35nck5a immunoreactivity in Lewy bodies (LB) in the substantia nigra, locus ceruleus, and neocortex of brains from patients with PD. In addition, p35nck5a was colocalized with cdk5 immunoreactivity in LB. Cdk5 is the kinase most likely to be responsible for the phosphorylation of neurofilament proteins of LB, which is a crucial step for the formation of the insoluble LB fibrils. Since p35nck5a regulates the catalytic activity of cdk5 by forming a heterodimer with cdk5, the present results strongly support the hypothesis that a cdk5-p35nck5a complex is involved in the formation of LB fibrils.

Aged↗

Aortic arch operation using selective cerebral perfusion for nondissecting thoracic aneurysm.

BACKGROUND: Risks of increasing mortality and disability in aortic arch operations using the selective cerebral perfusion method for nondissecting aneurysm have not yet been determined. A multicenter, retrospective study was employed. METHODS: The subjects were 143 patients who were admitted to one of the nine cardiovascular centers between January 1988 and December 1993, including 15 with ruptured aneurysm. A graft replacement of the transverse aortic arch or distal arch was performed in 80 patients, extensive aortic reconstruction comprising simultaneous replacement of the ascending or descending thoracic aorta (or both) in 46, and patch repair of involved arch in 17. The mean postoperative follow-up period was 19 months. RESULTS: Hospital mortality was 36/143 patients (25.2%). Univariate analysis revealed that age of 70 years or more, ruptured aneurysm, and renal dysfunction affected hospital mortality. Neurologic deficits were noted in 15 patients (10.5%). Reoperation was performed in 13 patients for residual distal aneurysm or false aneurysm. Late death occurred in 10 patients and were due to vascular complications in 6. Multivariate analysis confirmed that aneurysmal rupture and renal dysfunction were independent predictors for vascular death including hospital mortality. CONCLUSIONS: The present study confirmed that age, aneurysmal rupture, and renal dysfunction were significant predictors for mortality and disability in the aortic arch operation using selective cerebral perfusion for nondissecting thoracic aneurysm.

Aged↗