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Biomedical subjects

T Kanoh

Publications and source records attributed to T Kanoh.

At least 73 records · Page 4Linked to original sources
PubMed1994

Recovery from rheumatoid cerebral vasculitis by low-dose methotrexate.

We report the successful management of cerebral vasculitis in a 46-year-old woman with longstanding rheumatoid arthritis with low-dose methotrexate. She suddenly developed dysarthria and left hemiparesis. Magnetic resonance imaging disclosed ischemia of the right pons, and angiography demonstrated cerebral vasculitis of vertebro-basilar arteries. The vasculitis was refractory with high-dose steroid therapy, which had only transient clinical benefit, and evolution to the pontine infarction followed. Her clinical status showed marked improvement in association with recovery of the vascular abnormalities after the initiation of the methotrexate therapy.

Arthritis, Rheumatoid↗
PubMed1994

[Aggressive transformation of an indolent myeloma with abdominal extramedullary plasmacytoma after 6-year period of observation].

62-year-old female, who had been under observation for an indolent myeloma for six years without therapy, was admitted because of left flank pain. Various imaging modalities disclosed left pleural effusion, and a huge abdominal tumor involving the left crus of the diaphragm, spleen, stomach, pancreatic tail, left adrenal gland, left kidney and left posterior abdominal wall. Morphological and immunological examinations revealed extensive proliferation of more anaplastic myeloma cells within the tumor and in the pleural effusion than those in bone marrow on admission or at the beginning of the period of observation. Chemotherapy reduced serum M-protein, but LDH, the volume of the pleural effusion, and the size of the tumor increased. She died of pancreatitis associated with massive bleeding from the gastric tumor. Renal function was well preserved until her terminal phase. The clinical course showed the progression of indolent myeloma into an aggressive one without chemotherapeutic intervention, implying a rare subtype in terms of the natural history of multiple myeloma.

Abdominal Neoplasms↗
PubMed1994

Renal transplantation in selective IgA deficiency.

We report a case of selective IgA deficiency in a girl who received a successful renal transplant from a donor with normal serum IgA level. Although the recipient serum was negative for anti-IgA antibody, the donor kidney was washed with a sufficient volume of perfusate and the amount of corticosteroid given to the patient immediately after the revascularization was increased to twice the normal dose. Serum complement level transiently decreased, but recovered during the first week after surgery. Although the patient suffered from acute pyelonephritis of the graft during the fourth month, there has been no evidence of infection thereafter.

Adolescent↗
PubMed1993

Coronary neovascularity: a possible sign of new and growing mural thrombus.

This is a case report of a coronary artery fistula through a mural thrombus on a left ventricular aneurysm into the left ventricle. Serial coronary arteriography disclosed a vessel exhibiting a "smokelike" appearance originating at the anterior descending artery. This abnormal finding faded away over a period of 10 years with a decrease in size of the mural thrombus. This finding strongly suggests that the abnormal vessel represents an acquired neovascularity related to a newly developed thrombus.

Coronary Angiography↗
PubMed1993

Urinary 1-hydroxypyrene as a marker of exposure to polycyclic aromatic hydrocarbons in environment.

The concentrations of pollutants, especially polycyclic aromatic hydrocarbons (PAHs), originating from automobile emissions are high in areas around urban arterial roads. To investigate the possibility of using urinary 1-hydroxypyrene (1-POH) a metabolite of pyrene, as a marker for estimating the amount of human exposure to PAHs, both an animal experiment and an ecological correlation study were conducted. Rats were exposed to one of two sources of PAH: diesel engine emissions containing particulate matter and NO2 at average concentrations of 4.20 mg/m3 and 2.90 ppm, respectively, or, for the control group, air having the respective average concentrations of 0.01 mg/m3 and 0.02 ppm. The concentration of pyrene was 36 ng/mg in the particulate matter in the diluted diesel engine exhaust and 9.0 ng/g in the feed to the rats. Urinary 1-POH levels in the rats of the exposure group increased remarkably over those of the control group, 2.4 times as much by the 2nd week of exposure and 5.6 times by the 4th and 8th weeks. The ecological correlation study was conducted in 1988 and 1989 in two area of Tokyo along arterial roads (Meguro and Itabashi Wards) and in one suburban area (Higashiyamato City) to measure urinary 1-POH levels in elementary school children who lived in those areas. Urinary samples were collected in October in 1988, as well as in January, May, and July in 1989. Throughout the period of investigation, the schoolchildren in the highly NOx-polluted Meguro and Itabashi Wards showed significantly higher urinary 1-POH levels than the children in the less-polluted Higashiyamato City by a factor of 1.1-1.6. These results suggest that the urinary 1-POH level could be used as a good marker for estimating the amount of exposure of residents to PAHs.

Air Pollutants↗
PubMed1993

Determination of polycyclic aromatic hydrocarbons in the lung.

Polycyclic aromatic hydrocarbons (PAHs) accumulated in human lung samples from men (n = 236) and women (n = 128) were determined by high-performance liquid chromatography (HPLC) to examine their association with lung cancer. The mean values for benzo[a]pyrene (BaP), benzo[k]fluoranthene (BkF), and benzo[g,h,i]perylene (BghiP) in lungs (ng/g dry lung) of Japanese autopsied patients were 0.54, 0.44, and 0.87, respectively. The modal values were 0.3, 0.3 and 0.5, respectively. Each of the PAH concentrations was highly correlated with the others (r > 0.83). PAH concentrations in the lungs showed age-related increases with low correlation-coefficient values. BaP, BkF and BghiP concentrations in lungs of various subgroups were in the following order: male > female; and lung cancer > all cancers > non-cancer among male not female group. Only BghiP concentration in the lungs of the male smoker group is significantly higher (P < 0.10) than that of the male non-smoker group. Even among non-smoker groups, PAH concentrations in the lungs of male group were significantly higher than those of female group. In the male population, excess exposure to PAHs together with fine carbon particles, such as tobacco smoke or diesel exhaust, correlated with increased prevalence of lung cancer.

Adult↗
PubMed1993

Electromagnetic wave emitting products and "Kikoh" potentiate human leukocyte functions.

Tourmaline (electric stone, a type of granite stone), common granite stone, ceramic disks, hot spring water and human palmar energy (called "Kikoh" in Japan and China), all which emit electromagnetic radiation in the far infrared region (wavelength 4-14 microns). These materials were thus examined for effects on human leukocyte activity and on lipid peroxidation of unsaturated fatty acids. It was revealed that these materials significantly increased intracellular calcium ion concentration, phagocytosis, and generation of reactive oxygen species in neutrophils, and the blastogenetic response of lymphocytes to mitogens. Chemotactic activity by neutrophils was also enhanced by exposure to tourmaline and the palm of "Kikohshi" i.e., a person who heals professionally by the laying on of hands. Despite the increase in reactive oxygen species generated by neutrophils, lipid peroxidation from unsaturated fatty acid was markedly inhibited by these four materials. The results suggest that materials emitting electromagnetic radiation in the far infrared range, which are widely used in Japan for cosmetic, therapeutic, and preservative purposes, appear capable of potentiating leukocyte functions without promoting oxidative injury.

Adolescent↗
PubMed1993

The adjuvant activity of pyrene in diesel exhaust on IgE antibody production in mice.

In this communication, it is shown that pyrene has an adjuvant activity on IgE antibody production when mice are immunized by an intraperitoneal injection of ovalbumin (OA) or Japanese cedar pollen allergen (JCPA) with pyrene. The effects of pyrene on IgE antibody production in mice were investigated to clarify the relation between pollen allergy and the adjuvanticity of the chemical compounds contained in diesel-exhaust particulates (DEP). In the first experiment, three groups of mice were immunized intraperitoneally six times at 2-week intervals with 1 microgram of OA alone, 1 microgram of OA plus 1 mg of pyrene, and 1 microgram of OA plus 1 mg of DEP, respectively. The IgE antibody responses to OA in mice immunized with OA plus pyrene or OA plus DEP were extremely enhanced as compared with those in mice immunized with OA alone, and the highest responses were observed in mice immunized with OA plus DEP. In the second experiment, mice were immunized with 10 micrograms of JCPA alone or 10 micrograms of JCPA plus 5 mg of pyrene in the same way. The IgE antibody responses to JCPA in mice immunized with JCPA plus pyrene were higher than those in mice immunized with JCPA alone. The intraperitoneal macrophages of the mice also clearly stimulated in vitro by pyrene on chemiluminescence assay. These results suggest that pyrene contained in DEP acts as an adjuvant in IgE antibody production when mice are immunized with antigens.

Adjuvants, Immunologic↗
PubMed1993

[Postoperative pain relief by continuous epidural infusion: a comparison of three solutions].

The effect of three solutions on postoperative pain relief by continuous epidural infusion was studied. Seventy-five patients after upper or lower abdominal surgeries were assigned to one of three groups and the postoperative pain relief was evaluated for 48 hours. Group I: bolus injection of buprenorphine (Bn) 0.1 mg + saline (S) 8 ml and continuous infusion (2 ml.h-1) of Bn 0.8 mg + S 92 ml; Group II: bolus injection of Bn 0.1 mg + 0.5% bupivacaine (Bc) 4 ml + S 4 ml and continuous infusion of Bn 0.8 mg + S 92 ml; Group III: bolus injection of Bn 0.1 mg + 0.5% Bc 4 ml + S 4 ml and continuous infusion of Bn 0.8 mg + 0.5% Bc 40 ml + S 60 ml. The combination of buprenorphine with low-dose bupivacaine (Group III) offered the most effective postoperative analgesia in three groups without increasing the frequency of adverse effects induced by epidural administration of local anesthetics. However, even in Group III, the percentage of patients complaining of pain at bed rest was still high during early postoperative period (56% at 6 hours postoperatively). The results suggest that further consideration is necessary on agents selection and dosage adjustment for the postoperative epidural analgesia.

Aged↗
PubMed1993

[Bullous amyloidosis].

Although bullous amyloid lesions are very rare, the cutaneous lesions of this type can be a crucial manifestation of plasma cell dyscrasia. [Case Report] A 66-year-old man with a six-year history of multiple myeloma (IgG-lambda, lambda-type Bence Jones proteins) was admitted to the hospital because of hemorrhagic bullous lesions of the skin, chronic diarrhea and general malaise. A diagnosis of myeloma-associated amyloidosis with renal failure was made. One month later, he died as a consequence of progressive renal failure and systemic amyloidosis. A postmortem examination revealed myelomatous infiltrations (bone marrow and kidneys) and widespread amyloid deposits (skin, heart, lungs, kidneys, liver and intestine). The histologic examination of a bullous lesion showed amyloid deposits with formation of an intradermal blister.

Aged↗
PubMed1993

[Renal plasmacytoma].

Extramedullary plasmacytoma arising in the kidney is uncommon. So far only 11 cases have been reported. Recently, we noted the 12th case, the third case seen at the Kyoto University Hospital. The literature is reviewed. A 43-year-old man was hospitalized because of paraplegia due to spinal cord compression by the solitary plasmacytoma arising in the cervical spine, producing an IgG-lambda paraprotein. The tumor excision was followed by radiotherapy and standard chemotherapy. Two years later, new lesions on the thoracic spine, the left clavicle, and the occipital bone successively developed with Bence Jones proteinuria (lambda), but without IgG-lambda paraproteinemia. Ga-67 scanning was performed to detect extramedullary tumors. The marked accumulation of the radionuclide revealed intraabdominal tumors. A CT scan of the abdomen revealed a large soft-tissue mass (73 x 50 mm) emanating from the right kidney and several enlarged lymph nodes. Ultrasound of the right kidney revealed a solid mass with hydronephrotic change. RI-renogram showed delayed excretion from the right kidney. Clusters of myeloma cells were repeatedly observed in the urinary sediment. Thus, a diagnosis of plasmacytoma of the kidney was made. Treatment with radiotherapy alone was sufficient.

Adult↗
PubMed1993

[Studies of prognostic factor and chemotherapeutic effect of epithelial ovarian cancer using Cox's proportional hazard model].

To make clear the prognostic factor and chemotherapeutic effect of epithelial ovarian cancer, a multiple-center study involving 22 hospitals in Japan was conducted using Cox's proportional hazard model. A total of 1,181 cases were reviewed. Clinical stage, histologic type, and residual tumor diameter were significant prognostic factors, but the degree of tissue differentiation was not. The effect of remission induction chemotherapy was assessed with or without CDDP, and a distinct prognostic difference was noted. Among the patients receiving CDDP + ADM + other chemotherapeutic agents (PA group), CDDP + other chemotherapeutic agents (PO group) and CDDP only (P group), the prognosis of the PO group was better than for the P group. The long-term prognosis improving effect of chemotherapy was assessed. Neither maintenance chemotherapy based on oral administration of pyrimidine fluoride nor immunotherapy had any long-term prognosis improving effect, while intermittent chemotherapy based on CDDP resulted in improved prognosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Age-dependent basal level and induction capacity of copper-zinc and manganese superoxide dismutase and other scavenging enzyme activities in leukocytes from young and elderly adults.

Several enzymes, including superoxide dismutase (SOD), catalase, glutathione peroxidase, and D-glucose-6-phosphate dehydrogenase are capable of scavenging reactive oxygen species in in vivo. We assessed both basal levels and the capacity of these enzyme activities to be induced in human leukocytes in response to a variety of agents. Basal activity of copper-zinc SOD, and manganese SOD showed little variation with age. In contrast, the basal activity of the three H2O2 scavenging enzymes, catalase, glutathione peroxidase, and D-glucose-6-phosphate dehydrogenase, was significantly higher in younger adults than in elderly individuals. Both manganese SOD and copper, zinc SOD activities were significantly induced by paraquat, interleukin-1, tumor necrosis factor, adriamycin, and bleomycin in lymphocytes and neutrophils from asymptomatic non-aged adults, whereas neither activity was induced in aged individuals. In contrast, glutathione peroxidase activity was significantly induced in both groups of subjects, whereas catalase and D-glucose-6-phosphate dehydrogenase were only slightly induced in either. Enzyme induction with paraquat, adriamycin, or bleomycin was inhibitable by neutralizing antibody to interleukin-1 and tumor necrosis factor, suggesting that the inductions observed with these three drugs are due to the distal mediators, interleukin-1 or tumor necrosis factor released from the cells. Finally, as observed in the regulation of genes in eukaryotes (Storz et al: Bacterial defenses against oxidative stress. Trends Genetics 1990, 6:363-368, ref. 1) O2- and H2O2 seem to differ in the rate of change with age in both basal levels and inducibility under oxygen stress.

Adolescent↗
PubMed1993

[Continuous intra-hepatic-arterial infusion of low dose 5-fluorouracil for colorectal cancer patients with unresectable liver metastases].

Five cases of colorectal cancer with unresectable liver metastases treated from April 1992 to April 1993 in Osaka National Hospital were summarized in this paper. A silicone catheter was placed in the hepatic artery through the gastroduodenal artery by operative procedure and connected to a subcutaneously implanted reservoir. 5-FU was administered ambulatorily using Baxter Infusor (multi day type) according to a regimen of 5-day continuous infusion and subsequent 2-day rest. The patients were 4 men and 1 woman, and from 51 to 65 years old (average: 62.4 y.o.). According to criteria for antitumor effectiveness by CT scan, one patient was judged CR, two were PR, and one was PD. One case could not be estimated because of catheter obstruction. The total efficacy rate was 75%. The serum CEA level was reduced in 3 patients. As for complication, obstruction of catheter, damage to reservoir and segmental necrosis of liver were observed in 3 patients. In conclusion, our ambulatory therapy for colorectal cancer patients with liver metastases was considered to have a high potential of not only effectiveness for cancer lesion but also the improvement of patients' quality of life.

Aged↗
PubMed1993

[Rapid development of primary amyloidosis after two years' follow-up of monoclonal gammopathy of undetermined significance (MGUS)].

Recently, we have encountered an unusual case of "monoclonal gammopathy of undetermined significance (MGUS)" in which some clinical features indicative of primary and amyloidosis (PA) were observed two years after the diagnosis of MGUS. The patient, born in 1925, was diagnosed of having MGUS (IgG-lambda type M-component level; 1 g/dl) in June 1990. The following clinical features occurred in close succession within five months after a stable course of two years: general malaise, abdominal, distension, pretibial edema and facial puffiness, ecchymoses on the chest wall, and dyspnea on effort. The biopsy specimens from the skin and gastric mucosa revealed amyloid deposition. The M-component levels in the serum and urine as well as the number of bone marrow plasma cells remained unchanged. The various kinds of laboratory examinations indicated that systemic amyloidosis rapidly developed within five months. It seems quite likely that the heart, liver, and spleen may be affected with amyloidosis. It is noteworthy that PA can occur without an increase in the serum M-component level at any time after the diagnosis of MGUS. An early diagnosis of PA as well as multiple myeloma should be kept in mind in the follow-up study of patients with MGUS.

Aged↗
PubMed1993

[Multiple myeloma presenting with amyloid arthropathy].

Amyloid arthropathy rarely occurs in patients with multiple myeloma (MM) or primary amyloidosis (PA). Amyloid infiltration in and about the joints may be so extensive as to simulate the findings of rheumatoid arthritis. Some cases have been reported in which the articular manifestations were present for many months prior to the diagnosis of amyloid arthropathy. The delay of the diagnosis can result in the development of a fatal complication of MM or PA, which is not always unavoidable. We have encountered an unusual case of MM which the articular manifestations were present prior to the diagnosis of MM. A 59-year-old woman had a four-month history of hypesthesia in the median-nerve distribution of both hands and polyarthralgia. Far advanced renal insufficiency was evident, but its etiology was not determined. The patient was maintained on hemodialysis. The shoulders, wrists, hips and finger joints were symmetrically involved with articular swelling. All of these joints showed the avid uptake of Tc-99m (V) DMSA. The serum and urine immunoelectrophoresis demonstrated the presence of IgG-lambda type M-component and lambda type Bence Jones proteins, respectively. The bone marrow findings and bone roentgenograms supported the diagnosis of MM. Biopsy specimens from the synovial membrane revealed amyloid deposition. Her condition was much improved with melphalan and prednisolone.

Amyloidosis↗
PubMed1993

[Usefulness of contact thermography for the evaluation of chemotherapeutic effectiveness in breast cancer].

We examined temperature differences between a cancerous breast and its counterpart normal one by contact thermography before and after preoperative chemotherapy, and evaluated the relationship between the changes in the thermograms and response to chemotherapy in six patients with breast cancer. We used the following definitions: 1) delta Tmean: temperature differences between a mean temperature of a cancerous breast and that of the contralateral healthy breast; 2) delta Tmax: temperature differences between a cancer-related hyperthermic area in a breast and the mirror area of contralateral breast; 3) and the thermal patterns in thermogram were estimated by the criteria of Tada et al. In responders the thermograms after chemotherapy indicated an improvement in the hyperthermic vascular pattern (HVP) or hyperthermic area and a decrease of delta Tmean and delta Tmax. In contrast, little or no changes were observed in the thermograms of non-responders. Degrees of changes in thermograms reflected the effectiveness of chemotherapy. Our study showed that chemotherapeutic effectiveness may be better evaluated by combining contact thermography with the present method measuring tumor sizes than by only the present one.

Adult↗