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T Kanoh

Publications and source records attributed to T Kanoh.

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

[Multiple myeloma associated with phenytoin (diphenylhydantoin) therapy].

The occurrence of multiple myeloma is described in a patient receiving phenytoin (diphenylhydantoin) for 43 years. In this article, five cases of multiple myeloma and one of immunoblastic lymphadenopathy associated with diclonal gammopathy diagnosed after longterm phenytoin therapy are reviewed. These cases are characterized by lymphadenopathy, hepatosplenomegaly, and no or equivocal bone lesions, which are quite unusual in multiple myeloma. Because of the association of lymphomas with phenytoin, the role of the drug in the etiology of multiple myeloma or plasma cell dyscrasias is still in controversy, but highly suspected. It is suggested that a periodic examination of patients receiving phenytoin may be useful in an early detection of M-component. The possibility of reversing multiple myeloma by removal of phenytoin early in the course of the disease should be investigated.

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PubMed1996

[IgD (lambda) multiple myeloma associated with myelofibrosis: an isolated case of nuclear physicist].

A new case of IgD (lambda) multiple myeloma associated with myelofibrosis is described and four from the literature are reviewed. A 66-year-old nuclear physicist who had been diagnosed of having multiple myeloma in 1992 was admitted to the hospital in 1995 because of pancytopenia. A bone marrow biopsy specimen showed nests of myeloma cells with marked fibrotic background. The association of IgD (lambda) multiple myeloma with myelofibrosis was characterized by marked marrow fibrosis and myeloma cell proliferation, without typical features of extramedullary hematopoiesis. Some increase in the bone marrow fibrous tissue is not uncommon in hematologic disorders in which there is a rapid proliferation of marrow cells. What distinguishes these five patients is that their marrow fibrosis was an order of magnitude more extensive. These patients were generally severely anemic and commonly leukopenic and thrombocytopenic. Radiation has been reported as a causal factor in multiple myeloma. In the present case, radiation exposure during his study may have been related to the development of his disease. The correct diagnosis in the case of Dr. Torahiko Terada (1878-1935; physicist, essayist) who died of disseminated bone tumor seems to be multiple myeloma.

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PubMed1996

[Multiple myeloma presenting as parasellar syndrome and cranial nerve palsies].

Cranial and intracranial locations have been rarely reported in multiple myeloma. Their occurrence as a harbinger of multiple myeloma seems to have a particular significance. In this report, we discuss a case of multiple myeloma presenting as parasellar syndrome and cranial nerve palsies. A 75-year-old woman was admitted to the hospital in June, 1994, with a 3-month history of headache and a 3-week history of diplopia and photophobia. Physical examination revealed right third, fourth and sixth cranial nerve palsies. MRI scan demonstrated a homogeneous, voluminous mass, isointense in T1-weighted images with the cerebral parenchyma and hyperintense in T2-weighted images, occupying the sphenoid sinus and extending within the sella turcica and right cavernous sinus. Lying above the mass and apparently separated from it by a thin rim of hypointensity was a normal pituitary gland. X rays revealed destructive changes of the sella turcica. A minimal disturbance of endocrine function together with a radiologically abnormal pituitary fossa indicated that the primary lesion might lie outside the pituitary fossa. A diagnosis of IgG-kappa type multiple myeloma was made by pertinent laboratory studies. She received local radiation to the intracranial mass (50 Gy) and conventional chemotherapy. Sixteen months after the therapy she is in good health.

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PubMed1996

[Multiple myeloma with double gammopathy (IgA-kappa, IgA-lambda) : induction of complete remission from plateau phase with interferon-alpha 2a therapy].

Multiple myeloma is manifested by a malignant proliferation of plasma cells producing a specific monoclonal immunoglobulin, referred to as an M component. The presence of two M components in the serum or urine (double gammopathy) in multiple myeloma constitutes an uncommon event. The author observed an unusual case of multiple myeloma with double gammopathy (IgA-kappa, IgA-lambda). By double immunofluorescence staining, 80% of kappa-positive myeloma cells were found to be lambda-positive. These results indicated that cells of common clonal origin produced monoclonal IgA of both kappa and lambda type. On the other hand, the two M components fell in a parallel fashion with a conventional chemotherapy. This concordant pattern which represents a common cell line producing both M components exactly coincided with the results of double immunofluorescence study. Generally speaking, interferons prolong the plateau phase but bring about no further reduction in the tumor load. In this case, however, a complete remission was induced with interferon-alpha 2a alone after a plateau phase achieved with a conventional chemotherapy. This fact indicates the effectiveness of interferon-alpha 2a in treating a part of patients with refractory multiple myeloma.

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PubMed1996

[Pleural amyloidosis].

Pleural involvement in primary (AL) amyloidosis was reported. Pulmonary involvement in patients with primary amyloidosis is not so uncommon, but the pleura is regarded as an unusual site for amyloid deposition. A woman, born in 1942, was referred for evaluation of a four-month history of edema of eye lids and lower legs in 1987. Nephrotic syndrome with Bence Jones (lambda-type) proteinuria was demonstrated. She was diagnosed of having renal amyloidosis. In 1990, X-ray films incidentally demonstrated a small amount of right pleural effusion. A needle biopsy of the pleura was performed. Congo red stain demonstrated amyloid deposition in the pleura. The following clinical features indicating systemic amyloidosis occurred in succession: orthostatic hypotension, diarrhea or constipation, carpal tunnel syndrome, and weight loss. In 1993, sudden death due to cardiac arrest occurred. The patient survived 6 years after the diagnosis of renal amyloidosis. A combined use of melphalan, prednisolone, colchicine, and dimethyl sulfoxide (DMSO) might have contributed to the long survival of the patient. At postmortem examination, systemic deposition of type AL amyloid was confirmed. In patients with pleural effusion and multiorgan involvement or monoclonal gammopathy, a closed pleural biopsy should be performed, especially if the effusion is transudative.

Amyloidosis↗
PubMed1996

[Multiple myeloma complicated by necrotizing fasciitis].

Necrotizing fasciitis is a rare but often fatal soft-tissue infection primarily involving the superficial fascia and fat tissue resulting in extensive undermining of surrounding tissues. Skin is initially spared, but as necrotizing fasciitis spreads, all the soft-tissue components, including the skin, become involved. The progression of necrotizing fasciitis is often fulminant, and the prognosis depends to a large extent on the rapidity of correct diagnosis and surgical treatment (debridement). Most of the patients affected with necrotizing fasciitis have some risk factors: chronic general or local diseases, leukopenia, immunodeficiency diseases, malignancies, and an age of 50 years or more. The author reported the occurrence of necrotizing fasciitis in a 69-year-old man with multiple myeloma during the granulocytopenic phase after chemotherapy. The successful treatment of necrotizing fasciitis in the present case relied not only on surgical debridement, but also on G-CSF administration.

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PubMed1996

[An unusual case of multiple myeloma diagnosed by a noticeable decrease in the serum M-component level].

The author has recently observed an unusual case of multiple myeloma, which was diagnosed by a noticeable decrease in the serum monoclonal IgG (kappa) level in close association with Bence Jones escape. [Case Report] In June 1986, a 61-year-old woman was noticed to have monoclonal gammopathy of undetermined significance (MGUS) at a local hospital. Bence Jones escape was found in association with a decrease in the serum M-component level in April 1991, when a diagnosis of indolent multiple myeloma was made. In April 1993, the daily amount of Bence Jones proteins excreted in the urine was 1 g. Examination of bone marrow aspirate demonstrated immature plasma cells in clusters. The patient was diagnosed of having overt multiple myeloma. The double immunofluorescence studies on the bone marrow plasma cells were performed. Only 40 percent of cells producing kappa light chains were found to be positive for gamma heavy chains, while all of gamma heavy chain-positive cells contained kappa light chains. kappa light chain-positive cells were stained neither with anti-alpha, nor with anti-mu. From the above-mentioned data, the proportion was about two cells producing IgG (kappa) to three cells producing kappa light chain alone. Thus, myeloma cells contained two morphologically identical but immunologically diverse subpopulations. Conceivably, the subclone producing kappa light chain alone could be derived from the original clone producing monoclonal IgG (kappa). Bence Jones escape of this type has not hitherto been described.

Female↗
PubMed1996

Adjuvant activity of diesel exhaust particulates (DEP) in production of anti-IgE and anti-IgG1 antibodies to mite allergen in mice.

The present study indicates that diesel exhaust particulates (DEP) and pyrene contained in DEP have an adjuvant activity on IgE and IgG1 antibody productions in mice immunized intranasally with a mite allergen. The effect of pyrene on IgE and IgG1 antibody productions in mice was investigated to clarify the relation between mite allergy and adjuvancy of the chemical compounds in DEP. Der f II, one of the major allergens of house dust mite (Dermatophagoides farinae), was used as a mite allergen. Mice were grouped, and immunized with 5 micrograms of Der f II alone, 5 micrograms of Der f II plus 200 micrograms of pyrene and 5 micrograms of Der f II plus 100 micrograms of DEP intranasally seven times at two week intervals. The separate groups of mice were also immunized with 10 micrograms of Der f II plus the same dose of adjuvants in the same way. The IgE antibody responses to Der f II in mice immunized with Der f II plus pyrene or Der f II plus DEP were markedly enhanced compared with those immunized Der f II alone. The anti-Der f II IgE antibody production increased with increasing the dose of Der f II from 5 micrograms to 10 micrograms in mice immunized with Der f II plus the same dose of adjuvants. The IgG1 antibody responses to Der f II in mice immunized with 10 micrograms of Der f II plus 200 micrograms of pyrene or 10 micrograms of Der f II plus 100 micrograms of DEP were extremely higher than those immunized with 10 micrograms of Der f II alone. In addition, when the peritoneal macrophages obtained from normal mice were incubated with pyrene or DEP in vitro, an enhanced interleukin-1 alpha production of the macrophages was observed. When the spleen lymphocytes obtained from the mice immunized with 10 micrograms of Der f II plus 100 micrograms of DEP or 10 micrograms Der f II plus 200 micrograms of pyrene were stimulated with 10 micrograms of Der f II in vitro, an enhanced IL-4 production of the lymphocytes was also observed compared with those immunized with Der f II alone. These results suggest that the adjuvancy of DEP and pyrene on the production of IgE and IgG1 antibodies to Der f II may be one of the factors responsible for an incidence of asthma caused by house dust mite.

Adjuvants, Immunologic↗
PubMed1996

Adjuvant activities of pyrene, anthracene, fluoranthene and benzo(a)pyrene in production of anti-IgE antibody to Japanese cedar pollen allergen in mice.

We have previously demonstrated that pyrene in diesel-exhaust particles (DEP) has an adjuvant activity on immunoglobulin E (IgE) antibody production in mice immunized with Japanese cedar pollen allergen (JCPA) or ovalbumin (OA) intraperitoneally. The present study is concerned with the adjuvant activity in IgE antibody production against JCPA of pyrene or DEP inoculated intranasally in mice. We show that anthracene, fluoranthene and benzo(a)pyrene in DEP have the ability to enhance anti-JCPA IgE antibody production in mice by intranasal immunization. Mice were grouped, immunized with 10 micrograms of JCPA plus 400 micrograms of pyrene, 10 micrograms of JCPA plus 100 micrograms of DEP, 10 micrograms of JCPA plus 2 mg of aluminum hydroxide and 10 micrograms of JCPA alone intranasally 7 times at 2 week intervals. Mice were also grouped, and immunized with JCPA (10 micrograms) plus 40 micrograms of anthracene, JCPA (10 micrograms) plus 400 micrograms of fluoranthene, JCPA (10 micrograms) plus 40 micrograms of benzo(a)pyrene, and JCPA (10 micrograms) plus 400 micrograms of pyrene and JCPA (10 micrograms) alone. We found that the IgE antibody responses to JCPA in mice immunized with JCPA plus pyrene, JCPA plus DEP or JCPA plus the three chemical organic compounds mentioned above were significantly enhanced compared with those immunized with JCPA alone. In addition, when the intraperitoneal macrophages obtained from the normal mice (unimmunized mice) were incubated with pyrene, anthracene, fluoranthene or benzo(a)pyrene in vitro, an enhanced chemiluminescence (CI) response and interleukin-1 alpha (IL-1 alpha) production of the macrophages was observed in each instance. These results suggest that in the production of IgE antibody to JCPA the adjuvancy of polycyclic aromatic hydrocarbons (PAHs) in DEP may be important in an attack of Japanese cedar pollinosis.

Adjuvants, Immunologic↗
PubMed1995

[Multiple myeloma: etiology, epidemiology, tumor biology and pathophysiology].

Normal plasma cells in the bone marrow are terminal cells secreting immunoglobulins, which die after a short life of one day. This failure presents a great contrast to myeloma cells, which proliferate and occupy the bone marrow and other tissues. Human myeloma cells originate from precursors that find the bone marrow an optimal microenvironment to differentiate into plasma cells. A bewildering array of biological abnormalities of myeloma cells are related to complicated clinicopathological aspects of multiple myeloma. These include molecular, cytogenetic and oncogenic changes, kinetic abnormalities, changes in homing receptors of myeloma cells, multi-drug resistance, abnormal cytokine levels, cytokine receptor dysfunction and abnormal enzyme activities.

Animals↗
PubMed1995

[Multiple myeloma: a proper selection of the treatment regimen for an individual patient].

The importance of distinguishing accurately between patients with asymptomatic or stable monoclonal gammopathies and those with overt multiple myeloma cannot be overemphasized. Most patients with asymptomatic monoclonal gammopathy will remain stable without treatment, but in some overt multiple myeloma may develop after several to many years of observation. Multiple myeloma is a malignant disease of the bone marrow plasma cells. Most patients die of progressive disease despite chemotherapy. Thus, accurate differentiation between asymptomatic monoclonal gammopathy and multiple myeloma is essential. Given a diagnosis of overt myeloma, how does the physician decide which treatment regimen to use for an individual patient? Based on the risk assessment, age considerations and risk benefit consideration for the patient, the most proper selection of treatment regimen should be done. Until we can identify a group of patients who will survive longer, intensive therapy, including stem cell transfusion, should be done with caution.

Diagnosis, Differential↗
PubMed1995

[Heavy chain disease].

Heavy chain diseases (HCDs) are monoclonal, lymphoproliferative disorders characterized by the production of incomplete heavy chains, devoid of light chains. Since the first report of gamma-HCD in 1964, alpha-HCD and mu-HCD have also been described. The clinical features of gamma-HCD may vary considerably. In contrast, alpha-HCD primarily involves the secretory IgA system and mainly the digestive tract. Its clinical pattern is strikingly uniform. alpha-HCD is the most common of the HCDs, while mu-HCD is relatively rare. The demonstration of Bence Jones proteins in the urine in association with lymphoproliferative disorders and vacuolated plasma cells in the bone marrow deserves further investigation for mu-HCD. Recently, two disease entities related to molecular abnormalities of heavy chains have been reported; heavy-chain-associated amyloidosis and heavy chain deposition disease.

Adolescent↗
PubMed1994

Prevention of restenosis after percutaneous transluminal coronary angioplasty by reducing lipoprotein (a) levels with low-density lipoprotein apheresis. Low-Density Lipoprotein Apheresis Angioplasty Restenosis Trial (L-ART) Group.

This study was designed to test the hypothesis that high plasma lipoprotein (a) (Lp[a]) levels are associated with an increase incidence of restenosis after angioplasty. Elective transluminal coronary angioplasty was performed in 66 patients (58 men and 8 women) aged 57 +/- 9 years (mean +/- SD). Two days before and 5 days after angioplasty, all patients underwent low-density lipoprotein (LDL) apheresis with a dextran sulfate cellulose column as an Lp(a) absorbent; 39 patients also received 10 mg of pravastatin and 1,500 mg of niacin daily. Restenosis was defined as a recurrent luminal stenosis of > or = 50% in a previously dilated segment. Median Lp(a) levels were reduced from 23.3 mg/dl before apheresis to 10.9 mg/dl after apheresis (p < 0.0001). Angiography performed 2 to 9 months after angioplasty revealed restenosis in at least 1 site in 38% of the 137 control patients and in 32% of the 66 patients who underwent apheresis. Restenosis also occurred in 37% of the patients who underwent apheresis alone and in 28% of the patients who also received pravastatin and niacin in combination with LDL apheresis. The restenosis rate was 21% in the 42 patients whose Lp(a) levels were significantly reduced > or = 50%, and in 50% of the 24 patients whose Lp(a) levels were significantly reduced < 50% (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

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PubMed1994

Effectiveness of LDL-apheresis in preventing restenosis after percutaneous transluminal coronary angioplasty (PTCA): LDL-apheresis angioplasty restenosis trial (L-ART).

To investigate the efficacy of reducing plasma lipoprotein(a) (Lp(a)) as well as low density lipoprotein cholesterol (LDL-C) levels on the prevention of restenosis after PTCA, LDL-apheresis was attempted on a total of 54 patients at six institutions. LDL-apheresis using a dextran sulfate cellulose column has been proven to be an effective method for reducing both plasma Lp(a) and LDL-C levels. As a subgroup (apheresis-drug combined group), 29 of the 54 patients were given Pravastatin (HMG CoA reductase inhibitor) and Niceritrol (Nicotinic Acid) in addition to LDL-apheresis to maintain low plasma levels of both Lp(a) and LDL-C through the follow-up period of 5 months after PTCA. Patients whose plasma Lp(a) levels were reduced by more than 50% showed a lower restenosis rate than those whose plasma Lp(a) levels were reduced by less than 50% (21.2% vs. 52.4%, P = 0.0179), especially in patients with high plasma Lp(a) levels above 30 mg/dl where a much lower restenosis rate (15.0%) was observed. Furthermore, in the apheresis-drug combined group, the restenosis rate was 11.8% regardless of baseline plasma Lp(a) levels, including even those below 30 mg/dl. In conclusion, in patients with high plasma Lp(a) levels, a greater than 50% reduction in Lp(a) levels by LDL-apheresis is effective in preventing restenosis after PTCA. If the plasma Lp(a) reduction rate is greater than 50%, LDL-apheresis combined with lipid-lowering drugs such as niceritrol and pravastatin seems to be more effective, even in patients with low plasma Lp(a) levels.

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PubMed1994

BE-23372M, a novel and specific inhibitor for epidermal growth factor receptor kinase.

The fungal metabolite BE-23372M is a structurally novel protein kinase inhibitor. Its IC50 for epidermal growth factor (EGF) receptor kinase was 0.03 microM. IC50 values of BE-23372M for other protein tyrosine kinases, erbB-2, p43v-abl, insulin receptor kinase, and p60c-src were 0.42, 1.0, 3.3, and 4.5 microM, respectively, and the IC50 for protein kinase C, a serine/threonine kinase, was 4.1 microM. Cdc2 kinase, casein kinases I and II and cAMP-dependent protein kinase were not inhibited by 20 microM BE-23372M. A kinetic study showed that BE-23372M was competitive with respect to the substrate peptide and to ATP. Autophosphorylation of solubilized EGF receptor kinase was clearly inhibited by 0.1 microM BE-23372M. Autophosphorylation of EGF receptor in A431 cells was also inhibited. These results show that BE-23372M is a potent and specific EGF receptor kinase inhibitor. It should be a valuable tool for EGF receptor kinase research.

Amino Acid Sequence↗
PubMed1994

Ten-year survival and prognostic factors in multiple myeloma. Japan Myeloma Study Group.

Among 1119 Japanese patients with symptomatic multiple myeloma diagnosed between 1965 and 1981, 38 (3.4%) survived more than 10 years. Younger age, low tumour mass (absence of severe anaemia, hypercalcaemia, renal failure, and multiple bone lesions), low plasma cell percentage in bone marrow, mature and intermediate myeloma according to Greipp's criteria, and a positive response to subsequent treatment, were related to long-term survival according to univariate analysis. Multivariate logistic regression analysis indicated younger age and low tumour mass as pretreatment characteristics to be related to long-term survival. Prognostic factors proposed applicable to myeloma were also related to 10-year survival.

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