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Biomedical subjects

S Okada

Publications and source records attributed to S Okada.

At least 955 records · Page 53Linked to original sources
PubMed1991

[Peripheral neuropathy in two children with mitochondrial encephalomyopathy].

Peripheral neuropathy (PN) associated with mitochondrial encephalomyopathy (MEM) has been reported in adult patients, while children with both conditions are rare. Electrophysiological and pathological studies disclosed evidence of PN in a 3-year-old girl and an 8-year-old boy with MEM. In both patients, peripheral nerve conduction velocities were reduced, while amplitudes of evoked potentials were normal. No ragged red fibers were found in the biopsy muscle, while most of the muscle fibers showed poor activity with histochemical staining for cytochrome c oxidase (CCO). Biochemical studies revealed deficiency of CCO in both cases. In the latter patient, CCO activity was also absent in the intramuscular peripheral nerve using CCO staining, and histopathological studies of the sural nerve revealed a marked decrease in the number of large myelinated fibers and an unusual accumulation of the mitochondria in the Schwann cell cytoplasm. These results may support the hypothesis that a common pathogenesis exists in both peripheral nerve and muscle due to mitochondrial dysfunction.

Age Factors↗
PubMed1991

Effects of interleukin 3, interleukin 6, and granulocyte colony-stimulating factor on sorted murine splenic progenitor cells.

In order to examine the effect of recombinant growth factors on hemopoietic stem cells, these cells were enriched using wheat germ agglutinin (WGA) and monoclonal antibodies for lineage markers (Lin) such as B220, L3T4, Lyt-2, asialo GM1, Mac-1, and AL-21. Spleen colony-forming units (CFU-S) and in vitro colony-forming units were highly enriched in the fraction of WGA+Lin- spleen cells. To eliminate committed progenitor cells, spleen cells of 5-fluorouracil (5-FU)-treated mice were used. By this treatment, day-8 CFU-S disappeared but day-14 CFU-S were preserved. Day-14 CFU-S were also contained in the fraction of WGA+Lin- cells, which made up about 0.5% of total nucleated spleen cells. Moreover, this fraction contained primitive stem cells that could reconstitute the hemopoiesis of irradiated mice. Sorted WGA+Lin- spleen cells obtained from male 5-FU-treated mice were injected into lethally irradiated female mice. Southern hybridization using a mouse Y chromosome-specific probe showed that the bone marrow, spleen, and thymus of the recipients was reconstituted by male mouse-derived cells. When sorted WGA+Lin- spleen cells of the 5-FU-treated mice were cultured in vitro in the presence of recombinant interleukin 3 (IL-3), interleukin 6 (IL-6), and granulocyte colony-stimulating factor (G-CSF), colony formation was observed only in wells with IL-3, whereas unfractionated spleen cells formed colonies in the presence of IL-3, IL-6, or G-CSF. However, IL-6 but not G-CSF acted synergistically on enriched hemopoietic stem cells in the presence of IL-3. These data suggest that G-CSF or IL-6 did not affect primitive stem cells independently but showed the effect on these cells indirectly or synergistically with IL-3.

Animals↗
PubMed1991

In vivo and in vitro expression of myeloid antigens on B-lineage acute lymphoblastic leukemia cells.

The expression of myeloid antigens has been extensively examined using two-color analysis in 43 children with B-lineage acute lymphoblastic leukemia (ALL). On pre-culture cells, CD33 expression was frequently observed in CD19+, CD10- B-precursor ALL, and CD14 was expressed only on the cells from B-precursor ALL expressing CD19, CD10 and CD20, and B-ALL. After 2 or 3 days of culture without TPA, CD13 emerged on the cells from 21 of 29 patients irrespective of the presence or the absence of fetal calf serum in the culture. Of four patients with CD10+ B-precursor ALL, which showed no expression of CD13 after culture, two had T-cell associated antigens. Whereas the addition of TPA to the culture enhanced the expression of CD13 on the cells from acute non-lymphocytic leukemia (ANLL), TPA reduced the expression of this antigen on B-precursor cells. These findings suggest that the regulatory mechanism of CD13 expression may be different between B-precursor ALL and ANLL. Co-culture with cycloheximide mostly abrogated the induction of CD13, suggesting that CD13 expression was mainly dependent on de novo protein synthesis.

Adolescent↗
PubMed1991

Accelerated tumor growth and changes in images concomitant with vascularization in a patient with hepatocellular carcinoma.

We examined serial changes of tumor images in a patient with hepatocellular carcinoma. The hepatocellular carcinoma was initially detected as a homogeneous low-echo area with unclear margins, which was not enhanced by contrast media on computed tomograms, and did not reveal any vascular abnormalities on hepatic angiography. About 11 months later, the tumor growth accelerated, with a parallel increase in serum alpha-fetoprotein levels, and the ultrasonographic features of the tumor changed from a homogeneous low-echo area to a mixed low- and high-echo area with a peripheral low-echo zone. Hepatic angiography revealed a hypervascular tumor at this time. The present case indicates that tumor growth and imaging patterns of hepatocellular carcinoma are closely related to vascularization of the tumor.

Carcinoma, Hepatocellular↗
PubMed1991

[Changes in the megakaryocyte-platelet system in chronic neutrophilic leukemia].

Platelet functions and morphological changes of megakaryocytes were investigated in three cases with chronic neutrophilic leukemia (CNL). The bleeding time was prolonged, the ADP, collagen, epinephrine-induced aggregation of platelets decreased in one case. The adhesiveness, epinephrine-induced aggregation and adenine nucleotide content of platelets decreased in one other case. Megakaryocyte size in CNL was larger than in CML and this difference of the megakaryocyte sizes was related to DNA content distribution of the megakaryocytes. Atypical megakaryocytes were apparently found in one case. The present study suggests that CNL is a stem cell disorder.

Aged↗
PubMed1991

[Clinical study of miconazole on deep-seated fungal infections].

An investigation was made on the efficacy and the safety of miconazole (MCZ) in the treatment of deep seated mycosis. The drug was administered through intravenous drip infusion at dose levels of 800 to 2,000 mg/day to 21 cases of confirmed mycosis for which causative organisms was identified and to 32 cases to which other antibiotics considered to be appropriate had been administered at febrile stages but had failed to take effect, hence mycoses were strongly suspected. The overall clinical efficacy rate was 84.3% (43/51). Treatments were "remarkably effective" in 6 cases, "effective" in 37, "not effective" in 8 and "indeterminable" in 2. The efficacy rates were 100% (21/21) in the confirmed mycosis cases and 73.3% (22/30) in the suspected mycosis cases. The mycological efficacies in the cases for which causative strains were identified were: disappeared in 14 (66.7%), decreased in 4 (19%), unchanged in 2 (9.5%) and unknown in 1 (4.8%), thus the overall disappearance ratio was 70% (14/20). Chest X-ray showed the disappearance of shadow in 1 patient and improvements in 14 of 23 patients examined. Adverse reactions were observed in 5 of the 53 cases (9.4%). From these results, MCZ may be considered as a highly useful drug not only in the treatment of deep mycosis but also in cases for which mycosis is strongly suspected.

Adolescent↗
PubMed1991

[Blind ending bifid ureter with stone in the blind branch: report of a case].

Blind ending bifid ureter is a rare anomaly in the urinary tract. This anomaly may result from failure of a premature branch of the ureteral bud to join with the metanephric blastema. A 21-year-old man was admitted with macroscopic hematuria and colic pain in the left flank region. Urinalysis demonstrated hematopyuria and excretory urography suggested bifid ending accessory ureter with a stone on the left side. Surgical exploration showed that the accessory ureter was bifurcated from the left ureter at about 5 mm from the bladder wall and ran parallel with the left ureter. Although dense adhesions to the surrounding tissue existed, the accessory ureter was resected at the site of the junction. It measured 3 cm in length and 1 cm in greatest diameter. The stone found at the tip of the accessory ureter was composed of calcium oxalate (24%) and calcium phosphate (76%). Histological examination revealed that the ureter had all layers of normal ureteral structure and no renal tissue was identified in the specimen resected. During a follow-up period of 22 months after the operation, he was free of urinary tract infection and abdominal pain. Of 77 cases with blind ending bifid ureter reported in the Japanese literature, a ureteral stone was found in the blind branch in only 5 cases.

Adult↗
PubMed1991

[The anesthetic management of a patient with the malignant hyperthermia trait diagnosed preoperatively].

A patient for fixation of ankle arthrodesis diagnosed as having malignant hyperthermia trait preoperatively is reported. A 17 year old man was anesthetized with enflurane for orthopedic surgery of the knee joint. At that time malignant hyperthermia developed. He was critically ill, but resuscitated and recovered from acute renal failure on 7th day after operation. Ca2+ release test was performed. Ca2+ releasing speed was prominently accelerated in this patient. We could identify him as having malignant hyperthermia trait. Epidural anesthesia with procaine chloride was given cautiously. No drug which may induce malignant hyperthermia was used. Nevertheless, malignant hyperthermia occurred. This disease has various forms of presentation. The mechanism is equivocal, and in some cases, it is difficult to judge it immediately. This patient was managed without complication. We consider that tourniquet and stress provoked signs of malignant hyperthermia in this patient.

Adolescent↗
PubMed1991

[A case of invasive thymoma displaying endobronchial and endocaval polypoid growth].

The hens' egg-sized tumor connecting from anterior mediastinum to the hilus by chest radiography and chest CT was noted in a 63 year old female who complained of facial swelling and cough. The defect of the thumb tip-sized shadow was noted in the superior vena cava by superior vena cavography, and polyp covered with white coating obstructing the right apical bronchus was noted by fibrotic bronchoscopy, and malignant finding was obtained by biopsy of this polyp. After midsternotomy, a mass invaded to the superior vena cava and the right upper lobe was resected, and then superior vena cava was reconstructed by using supported polytetrafluoroethylene. The resected specimen revealed that the tumor extended not only to the pulmonary parenchyma with polypoid growth into the lumina of bronchi but also to the superior vena cava with polypoid growth. The patient was discharged at the postoperative radiotherapy with 40 Gy, and he is still alive free from the disease 3 years and 11 months after operation.

Bronchial Neoplasms↗
PubMed1991

GM1-gangliosidosis (genetic beta-galactosidase deficiency): identification of four mutations in different clinical phenotypes among Japanese patients.

GM1-gangliosidosis is a genetic neurological disorder caused by mutations in the lysosomal acid beta-galactosidase gene. While its phenotypic expression is complex, it is usually classified as being of infantile, juvenile, or adult form, on the basis of age at onset, the rate of symptomatic progression, and severity of central nervous system involvement. We have analyzed the acid beta-galactosidase gene in 12 Japanese patients from nine families. The aim was to identify mutations in individual patients and then to examine possible correlation between the mutations and the clinical phenotypes. Northern blotting studies with a full-length human beta-galactosidase cDNA showed that the mRNA ranged from undetectable to substantially decreased in the infantile patients but was normal in quantity and size in all juvenile and adult patients. Four distinct missense mutations have been identified, each limited to the respective clinical forms within our small-size samples. In the infantile patient with decreased but detectable mRNA, a point mutation was found resulting in Arg49----Cys. In the infantile patient with nearly undetectable mRNA, mutation Arg457----Ter was identified. The mutation Arg201----Cys was found in all four of the juvenile patients, while all six adult patients were homozygous for the point mutation Ile51----Thr. The mutations found in the juvenile and adult patients alter restriction sites in the normal gene and thus are amendable to quick screening. The prediction that these mutations are responsible for the clinical disease was confirmed by no expression of the catalytic activity of the mutant proteins in the COS-I cell expression system.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Acute megakaryoblastic leukemia developing 11 years after diagnosis of essential thrombocythemia].

A 57-year-old man was diagnosed to have essential thrombocythemia (ET) in July 1977. He was doing well with continual medication of carboquone but was hospitalized because of slight unconsciousness and gait disturbance in May, 1988. His laboratory data were as follows: WBC count 81,600/microliters with 55% of blasts with cytoplasmic blebs, Hb 10.2 g/dl, and platelet count 2.6 x 10(4)/microliters. Bone marrow aspiration revealed hypercellular marrow with 72.8% blasts. Chromosomal analysis showed tetraploidy with 7p+ and 19p+. Cytochemistry of blasts showed the positivity for platelet peroxidase and CDw 41. The diagnosis of acute megakaryoblastic leukemia was made. Meningeal leukemia was also suspected by the cerebrospinal fluid data, and cytarabine was intrathecally injected. Then the percent of blasts of peripheral blood gradually decreased and the data of cerebrospinal fluid improved. However, several days later the patient became comatose probably due to cerebral bleeding, and died. In this case, two possibilities were considered (1) that a blastic transformation to acute leukemia from ET, and (2) that a secondary leukemia developed as a result of the chemotherapy, independently of ET. Since there was no evidence of myelodysplastic syndrome, it was concluded that this case represented a blastic transformation of ET.

Blast Crisis↗
PubMed1991

[Prognosis of life in polymyositis/dermatomyositis].

Although substantial patients are dead in the course of PM/DM, little papers have precisely investigated the cause of death and factors which may relate to death in PM/DM. The purpose of the present study is to evaluate the prognosis for life, causes of death and risk factors for life in PM/DM. Clinical records of 76 adult PM/DM patients were retrospectively reviewed. Seven patients died of associated malignancy. Five-year survival rate was 69.7% in PM/DM patients without malignancy. During the last 24 years, there was no significant change in survival rate. Among causes of death in 19 cases without malignancy, 7 cases died of respiratory failure and 7 patients died of cardiac involvement. There seems to be two types of pulmonary involvement causing respiratory failure; i.e. acute interstitial pneumonitis and chronic interstitial pneumonitis. In the former cases, the courses were very rapid, and patients died during 4 months after appearance of the first symptom. Risk factors were chosen by comparing clinical manifestation in dead patients with those in control subject. Control subjects were selected from non-dead patients by matching with sex, age, and duration after start of the first therapy. Acute onset disease, fever, arthritis, hypergammaglobulinemia, elevated ESR (greater than or equal to 30 mm/hr), lung fibrosis, and heart involvement are risk factors for life.

Adult↗
PubMed1991

[Treatment of endoscopic laser therapy for obstruction due to granulation at the anastomosis site after right sleeve lobectomy].

A case treated with endoscopic laser therapy for obstruction due to granulation at the anastomosis site after sleeve lobectomy was reported. A 57-year-old male was admitted to our hospital with complaint of dyspnea four months after right sleeve upper lobectomy for long cancer. Chest roentgenogram showed complete atelectasis of the right lung and bronchoscopy revealed obstruction at the anastomotic site. The biopsy of the site showed granulation tissue. Pulmonary angiography immediately after bronchography yielded 3 to 4 mm obstruction in length and no particular vascular communication between the obstruction site and pulmonary vessel. Nd-YAG Laser irradiation of 774 Joules gave complete reopening. Good patency has been maintained one month since the laser therapy. It is important to recognized bronchus peripheral to the obstructive site and to identify the correlation between the anastomotic site and vascular system preoperatively. Pulmonary angiography combined with bronchography examination could be very useful to obtain these information.

Anastomosis, Surgical↗
PubMed1991

[Malignant histiocytosis with complex chromosomal abnormality: successful treatment with CHOP-E chemotherapy].

A 43 year-old man admitted to our hospital because of fever and splenomegaly. Laboratory findings were as follows: Hb 9.5 g/dl, Plts 4.9 X 10(4)/microliter, LDH 2,348 IU/l. Bone marrow findings showed tumor cell 47% with or without phagocytosis. The tumor cells were stained positive lysozyme and alpha 1 antitrypsin. Cytogenetic study was 47, XY, -7, -8, +9, -11, -12, -19, -21, 3q+, 6p+, +6 markers. This case was diagnosed as malignant histiocytosis. Complete remission was achieved with CHOP-E chemotherapy. Remission has been maintained with repeated this therapy. Etoposide deserves a good evaluation in the treatment of malignant histiocytosis. Some cases of malignant histiocytosis with a t(2; 5) (p23; q35) translocation were often reported in Europe and America, while there was no specific chromosomal abnormalities with malignant histiocytosis in Japan.

Adult↗
PubMed1991

[A case of pulmonary nocardiosis with squamous cell carcinoma].

A 61-year-old man was admitted to our hospital with cough, bloody sputum, and chest pain. Bronchoscopy showed a tumor in the truncus intermedius which biopsy and brushing cytology revealed to be squamous cell carcinoma. Also, bronchial washings grew only N. asteroides. Treatment with minocycline and trimethoprimsulfamethoxazole (TMP/SMX) over one month resulted in some improvement in pulmonary symptoms and resolution of the infiltrates in the right lower field. Then, right pneumonectomy was performed. N. asteroides was isolated from the resected tumor. Aggressive bacteriological examinations should be utilized when the possibility of pulmonary nocardiosis is considered.

Carcinoma, Squamous Cell↗
PubMed1991

[Studies on retroperitoneal lymph node dissection concerning postoperative ejaculatory function in patients with testicular cancer].

This study was done to explore the appropriate procedure of retroperitoneal lymph node dissection (RLND) to preserve ejaculatory function. The relation between postoperative ejaculatory function and area dissected at RLND was investigated in 47 patients with testicular cancer. The patients were divided into 5 groups according to the retroperitoneal area dissected. Group 1 (38 patients) underwent bilateral RLND, group 2 (3 patients) and 3 (2 patients) right unilateral RLND, and group 4 (2 patients) and 5 (2 patients) left unilateral RLND. The vertical limits of the dissected area were similar in all groups, namely renal pedicle and bifurcation of common iliac artery. The lateral limits were bilateral ureters in group 1, right border of aorta and right ureter in group 2, left border of aorta and left ureter in group 4, and vena cava and left ureter in group 5. Group 3 was similar to group 2, but the paraaortic region at the root of inferior mesenteric artery was also dissected. All patients in group 1 had dry ejaculation. Thirty patients in this group were examined for seminal emission and none of them could demonstrate seminal emission. Normal antegrade ejaculation was seen in group 2 and 4 patients, but retrograde ejaculation was recognized in group 3. Inability of seminal emission ws confirmed in group 5 patients. When consideration is given to the function of retroperitoneal sympathetic nerves, our results suggest that unilateral RLND without impairing superior hypogastric plexus should be adopted to preserve ejaculatory function.

Adolescent↗