Biomedical subjects

T Iwasaka

Publications and source records attributed to T Iwasaka.

312 records · Page 18Linked to original sources

PubMedDate not supplied

Metastatic tumor extending through the inferior vena cava into the right atrium: a case report of carcinoma of the uterine cervix with para-aortic lymph node metastases.

Carcinoma of the uterine cervix with cardiac metastasis is not uncommon in autopsy cases. However, an intraatrial tumor extending through the inferior vena cava (IVC) from the site of para-aortic lymph node metastasis has never been reported. A 57-year-old Japanese woman was admitted to an emergency care unit complaining of mild chest pain and shortness of breath. She had progressive multiple lymphatic metastases of stage IIIB squamous cell carcinoma of the uterine cervix that had initially been treated with concurrent chemoradiation. Echocardiogram showed pedunculated tumor in the right atrium (RA), and computed tomography demonstrated multiple pulmonary tumor embolism. Surgical specimen from the RA showed squamous cell carcinoma resembling the primary cervical tumor, and the peduncle appeared to originate from within the IVC. Postoperative ultrasonography showed severe stenosis of the abdominal IVC due to the invasive growth of para-aortic lymph node metastases. The stalk of the tumor originated from this lesion. We present an extremely unusual case of intraatrial metastatic tumor originating from the para-aortic lymph nodes of cervical cancer.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Prognostic impact of plasma brain natriuretic peptide for cardiac events in elderly patients with congestive heart failure.

BACKGROUND: Plasma brain natriuretic peptide (BNP) has been reported to be useful in determining the prognosis of patients with ischemic heart disease and cardiomyopathy. However, aging increases the level of plasma BNP; therefore, the prognostic impact of plasma BNP in elderly patients with congestive heart failure has not been fully established. OBJECTIVE: We sought to determine whether plasma BNP could predict recurrent cardiac events in elderly patients with congestive heart failure. METHODS: Forty-eight consecutive elderly patients (>65 years old) were enrolled in the present study. All patients were admitted with their first episode of congestive heart failure. Clinical characteristics, plasma BNP, left ventricular ejection fraction, and left ventricular mass index were compared between patients with and those without recurrent cardiac events. RESULTS: During the follow-up period, twelve cardiac events were observed. The New York Heart Association functional class was signi- ficantly higher in patients with cardiac events than in those without (p < 0.05). The plasma BNP level in pa- tients with cardiac events was significantly higher than in those without (521.0 +/- 156.0 vs. 126.8 +/- 20.1 pg/ml, p<0.001), despite more frequent treatment with angiotensin-converting enzyme inhibitors (75 vs. 28%, p<0.05). The left ventricular ejection fraction was significantly lower and the left ventricular mass index higher in patients with cardiac events as compared with those without (38.1 +/- 5.0 vs. 49.2 +/- 2.4%, p < 0.05; 193.8 +/- 14.3 vs. 132.6 +/- 7.8 g/m(2), p < 0.001, respectively). The plasma BNP was selected as an independent factor associated with cardiac events besides New York Heart Association functional class, left ventricular ejection fraction, and left ventricular mass index using multivariate Cox proportional-hazards regression analysis (hazard ratio = 2.656, p<0.05). The cardiac event rate was significantly higher in patients with a plasma BNP concentration >132 pg/ml using Kaplan-Meier analysis (p < 0.001). Moreover, the plasma BNP level correlated inversely with the length of time from hospital discharge to a cardiac event (r = -0.575, p<0.05). CONCLUSION: Measuring the plasma BNP level before hospital discharge in elderly patients with congestive heart failure was more useful than other conventional examinations for predicting the recurrence of cardiac events.

Aged↗

PubMedDate not supplied

Clinical significance of the urinary oxygen tension in patients with ischemic heart disease.

The clinical significance of the urinary oxygen tension (PuO2) was evaluated in 60 patients with ischemic heart disease. The PuO2 had fair relations to cardiac index and serum creatinine level (r = 0.73 and r = 0.73, respectively). Although the PuO2 had a fair relation to serum creatinine in patients with a low cardiac index, there was no relation to the cardiac index. In patients with increases in PuO2 from day 1 to day 2, the cardiac index increased, and the serum creatinine level decreased on the 2nd day, whereas a sustained decrease in cardiac index and an increase in serum creatinine were observed in patients with a decrease in PuO2 from day 1 to day 2. Thus, PuO2 can be used as an indicator of the renal function in patients with ischemic heart disease.

Aged↗

PubMedDate not supplied

Anticellular activities of human fibroblast interferon beta and human recombinant interferon gamma. Cytologic changes in a cervical cancer cell line.

The cellular changes in a human cervical squamous-cell-cancer cell line (SKG-IIIb) were investigated after treatment with human recombinant interferon gamma and human fibroblast interferon beta. Cytoplasmic changes characterized by elongation, vacuolization and blurring of cytoplasmic borders appeared relatively early in both treatment groups. After two days of treatment with interferon gamma, the cells began to aggregate and to form pearl-like structures in the center of these aggregates; frequently seen were isolated cells with an eosinophilic cytoplasm and a pyknotic nucleus, similar to keratinizing cells. After six days of treatment with interferon beta, on the other hand, more than 20% of the cells began to show nuclear changes, including remarkable pleomorphism, multilobulation and multinucleation. The differences in biologic activities between the two interferons are discussed on the basis of these observations.

Cell Line↗

PubMedDate not supplied

The cellular changes in primary and recurrent infection with herpes simplex virus type 2 in an in vitro model.

The cellular changes of primary and recurrent herpes simplex virus (HSV) infection were investigated in in vitro models. In the primary infection model, nuclear changes were characterized by clumping and margination of the nuclear chromatin, a homogeneous ground-glass nuclear appearance, multinucleation and the appearance of two different types of intranuclear inclusions. One of the two types of inclusions appeared as early as six hours postinfection, reached a maximum at nine hours postinfection and gradually decreased thereafter. This early inclusion, relatively small in size as compared to the other type of inclusion, gave a basophilic staining when the Papanicolaou staining method was used. The other type of inclusion was the typical Cowdry type A inclusion, which appeared as early as 12 hours postinfection. Both types of inclusions contained clear perinuclear halo. In the recurrent infection model, the appearance of all the nuclear changes was delayed, the appearance of early inclusions was infrequent, and the Cowdry type A inclusions were observed more frequently than in the primary infection model. These results may indicate that the early inclusion is a sign of rapid virus replication while the Cowdry type A inclusion is one form of the remains of an HSV infection.

Animals↗

PubMedDate not supplied

Cytology of microinvasive squamous-cell carcinoma of the uterine cervix.

The cervical cytology in 53 cases with histologically confirmed microinvasive squamous-cell carcinoma of the uterine cervix was studied. The smears were originally correctly diagnosed as showing microinvasion in 42% of the cases and were underinterpreted in 45%. On review, four of the underdiagnosed smears did show features of microinvasion. The depth of invasion did not have much influence on the cellular features. The patients underdiagnosed by cytology showed a tendency to have a smaller surface lesion and to have a history of a prior cervical manipulation within four weeks of the cytologic examination. The mean age of the overdiagnosed cases was distinctly higher than that of other cases. The colposcopic diagnosis correlated well with the cytologic diagnosis; both diagnostic modalities were considered to reflect well the change within the surface epithelium but to be less sensitive in recognizing the subtle changes of early invasion.

Carcinoma, Squamous Cell↗