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Biomedical subjects

T Kitahara

Publications and source records attributed to T Kitahara.

At least 127 records · Page 7Linked to original sources
PubMed1994

[Recent advances in radiotherapy for breast cancer].

Radiotherapy for breast cancer has been performed as adjuvant lymph node irradiation after radical operation, irradiation for chest wall relapse, and palliative treatment for bone, lung and brain metastases. However, attention has been paid to irradiation of the breast as a conservative treatment. The role of radiotherapy in breast conservative treatment is to reduce local relapse after shrinkage of operation, and to enhance the cosmetic outcome. The indications of this treatment, technique of irradiation, effects and side effects of irradiation, and risk of radiation-induced cancer were discussed. In Japan, we have experience with this treatment. Breast conservation treatment and modified mastectomy showed the same results in local control and survival. Sometimes the cure and most cases of relief of complaints are attained for recurrent or advanced breast cancer by radiotherapy. High dose rate brachytherapy by 192-Ir showed high local control of uncontrollable tumor by external irradiation. And hyperthermia combined with radiotherapy is also effective for superficial (less than 3 cm in depth) tumor. Even in patients with lung and or brain metastases, radiotherapy sometimes showed complete remission for years. The standard method of radiotherapy for bone and brain metastases is 30 Gy/2 wks, and the symptom relief rate is over 80%. Oncologists should be made aware of the high complaint relief rate by radiotherapy.

Brachytherapy↗
PubMed1993

[A clinical and pathological study of non-Hodgkin's lymphoma of the nasal cavity and paranasal sinuses].

We studied 30 patients with early stage malignant lymphomas involving the nasal cavity and/or paranasal sinus who were treated between 1972 to 1991 in Hokkaido University Hospital. The mean age of the patients was 60.6 yr, and the male-to-female ratio was 2.6. The predominant histologic type was diffuse large cell type (n = 23). Treatment policy differed depending on time: radiotherapy (RT) alone between 1972 and 1980 (n = 15), RT followed by modified CVP or CHOP between 1981 and 1988 (n = 10) and BACOP followed by RT between 1989 and 1991 (n = 5). Overall five-year survival was 53%. Better survival was observed in patients with B-cell type (72%), smaller mass (tumor limited to the unilateral nasal cavity or paranasal sinus) (76%), and patients who were treated with combination chemotherapy (BACOP) followed by RT (100%). Eleven patients experienced recurrence. Four of nine local recurrences were in patients with T-cell lymphoma. CNS relapse was observed in three patients with T-cell lymphoma. We conclude that T-cell lymphoma arising at the nasal cavity and/or paranasal sinus needs careful follow-up for its high frequency of local and CNS relapse. More intensive treatment such as prophylactic whole brain RT, intrathecal administration of MTX or third generation chemotherapy (e.g. MACOP-B) might improve survival in these patients.

Adolescent↗
PubMed1993

Diazepam therapy of verbal auditory agnosia.

A 7-year-old girl suffered from a gradual loss of her ability to understand speech. But she had normal hearing and understood various environmental sounds. Brain computerized axial tomography showed normal, but electroencephalogram revealed spike and wave activity from temporal leads, especially on the left side. She was diagnosed as having verbal auditory agnosia. The treatment consisted of diazepam therapy. One year after the onset, her impaired auditory comprehension dramatically improved with the use of diazepam. The dichotic listening test revealed a left ear advantage for both environmental sounds and spoken words. The results seemed to suggest that in this patient the right hemisphere might be functioning as a speech center instead of the left one.

Agnosia↗
PubMed1993

Spurious macrocytosis associated with non-Hodgkin's lymphoma: report of two cases.

We report two rare cases of spurious macrocytosis (SM) associated with non-Hodgkin's lymphoma caused by cold agglutinin. SM was reversed, accompanied by the regression of lymphoma in case 1 but not in case 2, where the lymphoma was refractory to the chemotherapy. It is strongly suggested that lymphoma cells were related to the production of cold agglutinin and the cause of SM.

Adult↗
PubMed1993

Correlation between intravascular pressure and risk of hemorrhage due to arteriovenous malformations.

The correlation between intraoperative pressure levels measured in the feeding arteries and in the draining veins, and the risk of hemorrhage from arteriovenous malformations (AVMs) is discussed. Feeding artery pressure (FAP) was significantly higher in AVMs with hemorrhage (57 +/- 11 mmHg) than in AVMs without hemorrhage (38 +/- 4), and draining vein pressure (DVP) in the former (24 +/- 5) was significantly higher than that in the latter (13 +/- 5). FAP and DVP were inversely related to the number of draining veins and size of the AVMs. The present study suggests that a high FAP and a high DVP may contribute to the development of hemorrhage from AVMs, and supports previous reports that small AVMs and AVMs with only one draining vein are susceptible to hemorrhage.

Blood Pressure↗
PubMed1993

Coexpression of keratins characteristic of skin and hair differentiation in nail cells.

To further investigate the differentiation of nail, this study examined the composition and expression patterns of nail keratin by using monoclonal antibodies specific for keratins characteristic of skin or hair differentiation. Immunoblotting studies revealed that bovine hoof plate contains skin and hair differentiation-specific keratins, whereas immunofluorescence staining also showed that both keratins were present in the suprabasal cells in the bovine nail matrix. Skin differentiation-specific keratins were found to be expressed in the apical and dorsal nail matrices, whereas the hair differentiation-specific keratins were expressed mainly in the ventral nail matrix and partially in the apical and dorsal nail matrices. Moreover, the localization of the two types of keratins partially overlapped. Double-label immunofluorescence showed that unusual keratinocytes that co-express skin and hair differentiation-specific keratins exist in the nail matrix. These results indicate that the nail matrix consists of both skin-type and hair-type differentiating cells and, additionally, intermediate keratinocytes that may be progressing the pathways of both skin and hair differentiation.

Animals↗
PubMed1993

Subcortical cerebral hemorrhage with reference to vascular malformations and hypertension as causes of hemorrhage.

The authors have reviewed 80 cases of subcortical cerebral hemorrhage, in all of which intraoperative examinations during craniotomy or autopsies were performed. Cases involving trauma and aneurysm were excluded from the study. The diagnosis of subcortical hemorrhage was made by plain computed tomography in all cases. The most common cause of hemorrhage was vascular malformation (68%; 56 cases), in 20 (36%) of which angiographically occult vascular malformations were noted. Hypertension was present in 23 (29%) of 80 cases but was the cause of hemorrhage in only 9 cases (11%). Hypertension was present in 6 (30%) of 20 angiographically occult vascular malformations, all of which were in patients under 65 years. In 12 (75%) of 16 cases of angiographically occult vascular malformations, prolonged high-dose delayed-contrast computed tomography and magnetic resonance imaging were able to provide definite diagnostic information. We recommend that patients with subcortical cerebral hemorrhage, especially those under age 65, with or without hypertension, be carefully examined by prolonged high-dose delayed contrast computed tomography and magnetic resonance imaging for the presence of angiographically occult vascular malformations causing hemorrhage.

Adolescent↗
PubMed1993

Neurotropic pyrimidine heterocyclic compounds. I. The newly synthesized pyrimidine compounds promote neurite outgrowth of GOTO and neuro 2a neuroblastoma cell lines, and potentiate nerve growth factor (NGF)-induced neurite sprouting of PC 12 cells.

From the study using cultured human and mouse neuroblastoma cells, we found that a new type of synthetic bicyclic pyrimidine compounds possessing piperazine moiety strongly promoted neurite outgrowth in neuroblastoma cell lines human GOTO and mouse neuro 2a. The most effective compounds of these 2-piperazinopyrimidine derivatives possessing nerve growth factor (NGF)-like activity were 2-piperazino-6-oxo-5,6-dihydro(7H)pyrrolo[2,3-d]pyrimidine and 2-piperadino-6-methyl-5-oxo-5,6-dihydro(7H)pyrrolo[3,4-d]pyrimidin e. The piperazinopyrimidine compounds were also shown to potentiate NGF-induced neurite sprouting of rat pheochromocytoma PC12 cells. The compounds were more effective in cell cultures than isopropylaminopyrimidine (isaxonine) which had been previously developed and then withdrawn. We discussed the merit of the method of the screening of neurotropic compounds by neurite sprouting activity in cultured neuroblastoma cells.

Animals↗
PubMed1993

[The etiology of sudden cardiopulmonary arrest in subarachnoid hemorrhage].

Sudden death due to subarachnoid hemorrhage (SAH) is not uncommon. However, the mechanism remains unclear. In this paper, sixty-eight consecutive patients with sudden death in SAH (DOA group) were studied to clarify the etiology of sudden cardiopulmonary arrest (CPA) in SAH. SAH was confirmed by CT scan and/or by autopsy. These patients accounted for 10% of the total intrinsic DOA patients in that period. Clinical symptoms, CT scan and autopsy findings concerning the DOA group were carefully evaluated and compared to those of patients with SAH of WFNS Grade V (V group). The DOA group accounted for 10% of all SAH patients. Average time interval from the onset of SAH to the recognition of CPA was 21.2 minutes. In 30% of cases, the time interval was within 15 minutes. Pulmonary edema was recognized as being significantly higher in the DOA group than in the V group (P < 0.01). In CT finding, the number of patients who were classified into S type (mainly subarachnoid clot only) was significantly higher in the DOA group than in the V group (P < 0.01). The CT Score and MAX. CT NO. in the DOA group were significantly lower than in the V group (P < 0.01 and P < 0.0001, respectively), suggesting that the intensity of subarachnoid hemorrhage was not severe in the DOA group. Postmortem histological examination of the myocardium was carried out on 6 cases of the DOA group. A contraction band necrosis in the myocardium which did not correspond to the coronary perfusion area was found in all 6 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Clinical study in patients with perimesencephalic subarachnoid hemorrhage of unknown etiology].

We have recognized a characteristic distribution of cisternal blood in 10 (43%) of 23 patients with subarachnoid hemorrhage (SAH) of unknown etiology. On the initial CT examination undertaken within 48 hours of the onset, blood from 10 patients was found to be more densely distributed in the cisterns around the brainstem. In this study, clinical characteristics and CT findings in those 10 cases were carefully evaluated and the CT findings were compared to those of 416 patients with aneurysmal SAH (anterior circulation aneurysm 368 cases, posterior circulation aneurysm 48 cases). There were seven men and three women, with an age ranging from 39 to 64 years (average age, 50.6 years). The follow-up period ranged from 4 to 45 months (average follow-up period, 23 months). Neurological grade (WFNS) on admission was I in 9 cases and III in one case. None of the patients suffered symptomatic vasospasm, hydrocephalus or rebleeding. All the patients had favourable outcome and were categorized as good recovery according to the Glasgow Outcome Scale. In comparison with the cases of aneurysmal SAH, especially in comparison with 48 cases with SAH caused by posterior circulation aneurysm, 43 cases could be easily distinguished on CT. The other 5 cases showed almost the same pattern of SAH on CT, but 4 cases could be differentiated by either the extension of SAH to the interhemispheric fissure or the presence of intraventricular hemorrhage. Only one case could not be differentiated on CT. Thus SAH located only around the brainstem differs from aneurysmal SAH in its clinical course, and in distribution and severity of bleeding on CT. This could be recognized as a new clinical entity and could be called benign SAH.

Adult↗
PubMed1992

Characterization of a unique nonsecretory ribonuclease from urine of pregnant women.

We have reported previously [Sakakibara, et al. (1991) Chem. Pharm. Bull. 39, 146-149] that a protein purified from a partially purified pharmaceutical preparation of human chorionic gonadotropin (a urinary protein preparation from pregnant women) is a unique nonsecretory ribonuclease (RNase)-like protein on the basis of its amino terminal sequence homology. We purified the protein further from the same materials by gel filtration and reversed-phase column chromatographies with RNase activity as an index. The purified protein was designated RNase UpI-2. The catalytic activity and its sensitivity to inhibition by divalent cations suggest that the protein is related to nonsecretory RNase. The estimated molecular weight of RNase UpI-2 (38 kDa) by sodium dodecyl sulfate-polyacrylamide gel electrophoresis was significantly higher than that of urinary nonsecretory RNases (13 to 19 kDa) reported so far. After trifluoromethanesulfonic acid treatment, the molecular weight of RNase UpI-2 was reduced and approached that of nonsecretory RNase, which indicated that the protein contains a significant amount of carbohydrate (approximately 50%). RNase UpI-2 was immunoreactive with antibodies to a nonsecretory RNase, RNAase 1 [Yasuda et al. (1988) Biochim. Biophys. Acta 965, 185-194]. By immunoblot analysis of the protein freshly prepared from various urine samples, it was shown that a considerable amount of RNase UpI-2 is present in urine of pregnant women, but only a trace of RNase UpI-2, if any, was detected in urine of nonpregnant women and men. These results suggest the possibility that RNase UpI-2 may have been formed via a specific protein modification in pregnant women.

Amino Acid Sequence↗
PubMed1992

Choroid plexus arteriovenous malformations.

Among 24 arteriovenous malformations (AVMs) involving the choroid plexus, 11 were plexal type AVMs predominantly located in the choroid plexus of the lateral ventricle, and 13 were parenchymal type AVMs mainly situated in the paraventricular cerebral parenchyma. 83% of all AVMs involved both the choroid plexus and the paraventricular cerebral parenchyma. Most cases presented with intracranial hemorrhage, particularly intraventricular hemorrhage. The most serious surgical problem was a small residual nidus unrecognized at the initial operation causing postoperative hemorrhage. Five parenchymal type AVMs presented residual niduses in the choroid plexus, causing death in two cases. Two plexal type AVMs resulted in residual AVMs supplied by the cisternal segment of the anterior choroidal artery, situated in the medial temporal lobe. To prevent postoperative hemorrhage from a small residual nidus, immediate postoperative angiography while the patient is still under general anesthesia should be performed to identify any residual nidus.

Adolescent↗
PubMed1992

An analysis of the venous drainage system as a factor in hemorrhage from arteriovenous malformations.

The authors studied the venous drainage system and its impairment in relation to risk of hemorrhage in 108 cases of supratentorial arteriovenous malformation (AVM). The proportion of AVM's undergoing hemorrhage (hemorrhagic rate) was calculated in relation to: 1) the number of draining veins (one, two, or three or more); 2) the presence or absence of impairment in venous drainage (severe stenosis or occlusion in draining veins); and 3) the location of draining veins (deep venous drainage alone, superficial venous drainage alone, or a combination of the two). Statistical analysis demonstrated that AVM's with the following characteristics had a high risk of hemorrhage: 1) one draining vein (hemorrhagic rate 89% in 54 patients); 2) severely impaired venous drainage (hemorrhagic rate 94% in 18 patients); and 3) deep venous drainage alone (hemorrhagic rate 94% in 32 patients). The present study suggests that the venous drainage system of AVM's is significantly associated with the risk of hemorrhage of these lesions. Therefore, careful preoperative angiographic evaluation of the venous drainage system is mandatory for decision making in the management of patients with AVM's.

Cerebral Hemorrhage↗
PubMed1992

[Fundus hemorrhage in patients with intracranial hemorrhage caused by cerebrovascular disease--its clinical significance].

To clarify the significance of fundus hemorrhage in the acute stage of intracranial hemorrhage due to cerebrovascular disease (HCVD), the incidence of such hemorrhage (retinal, preretinal, and subhyaloid hemorrhage) was examined and its correlations with the severity of the disturbance of consciousness and the prognosis were investigated. Two hundred sixteen HCVD patients with intracranial hemorrhage were the subjects of this study, including 87 cases of subarachnoid hemorrhage (SAH), 60 cases of hypertensive intracerebral hemorrhage (HICH), 54 cases of arteriovenous malformation (AVM), and 15 cases of Moyamoya disease. Fundus hemorrhage was recognized in 41 cases of SAH (47%), 5 cases of HICH (8%), 3 cases of AVM (6%), and 2 cases of Moyamoya disease (13%). The incidence of fundus hemorrhage was significantly higher in SAH than in the other type of HCVD associated with intracranial hemorrhage. Among patients with severe disturbance of consciousness (JCS 100-300), fundus hemorrhage was recognized in 69% with SAH, 13% with HICH, 17% with AVM, and none with Moyamoya disease. Therefore, patients with both fundus hemorrhage and severe disturbance of consciousness in the acute stage are most likely to have SAH, but HICH and AVM should be also taken into consideration. In patients with slight disturbance of consciousness (JCS 0-30), fundus hemorrhage was only noted in SAH (27%) and not in other types of HCVD associated with intracranial hemorrhage. Thus, SAH is highly likely to be the primary HCVD associated with intracranial hemorrhage, if we recognize fundus hemorrhage in patients with slight disturbance of consciousness in the acute stage.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Hemorrhage↗
PubMed1991

The extraction and characterization of human nail keratin.

We investigated nail keratins obtained by sequential extraction with increasing reducing agent concentrations (50 mM and 200 mM 2-mercaptoethanol) and examined each of the extracted keratins by gel electrophoresis followed by immunoblotting. It was found that nail contained epidermal and hair keratins. With 50 mM 2-mercaptoethanol, only epidermal type of keratins including skin differentiation specific-keratin could be extracted, whereas hair type of keratins required 200 mM 2-mercaptoethanol for extraction from nail. These results may indicate that nail has unique properties with respect to it's keratin compositions. The difference in durabilities of epidermal and hair keratins in nail against 2-mercaptoethanol suggests that two different types of the keratin filaments which are composed of epidermal or hair keratin polypeptides may have differing structural features, despite of co-existence in nail.

Electrophoresis, Gel, Two-Dimensional↗
PubMed1991

Immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma in a child.

We report the case of a 14-year-old Japanese boy with peripheral T-cell malignant lymphoma, showing progression from immunoblastic lymphadenopathy (IBL) to overt malignant lymphoma. He suffered recurrent fever, generalized lymphadenopathy, hepatosplenomegaly and maculopapular exanthema. Leukocytosis with eosinophilia and polyclonal hypergammaglobulinemia were observed during the aggressive course of the disease. In the early phase, human immunoglobulin and steroids improved the symptoms but did not induce complete remission, and the patient died one year after the onset of the illness. Four biopsies of lymph nodes revealed progression from IBL to CD4 positive T-cell lymphoma through IBL-like T-cell lymphoma. Though IBL-like T-cell lymphoma is defined as IBL with neoplastic features and overt T-cell malignant lymphoma progressed from IBL-like T-cell lymphoma is excluded from the definition, it may be preferable that such malignant lymphoma as our case should also be included in IBL-like T-cell lymphoma.

Adolescent↗