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Biomedical subjects

T Naruse

Publications and source records attributed to T Naruse.

At least 181 records · Page 10Linked to original sources
PubMed1993

Primary plasmacytoma of generalized lymph nodes: a long survivor.

Extramedullary plasmacytomas are occasionally seen in the course of multiple myeloma; however, primary plasmacytomas are unusual. Most of the primary plasmacytomas arise in the upper respiratory system, but a plasmacytoma of the lymph nodes is very rare. A case of a 56-year-old female with primary plasmacytoma in the lower mandibular, cervical, axillary, and para-aortic lymph nodes accompanied by IgA Kappa paraproteinemia is described. After ten courses of combination chemotherapy with cyclophosphamide and prednisolone, she obtained complete response. However, 6 years later, she had a relapse of plasmacytoma in the generalized lymph nodes. She received ten treatments of melphalan-prednisolone and again obtained complete response. She has remained well without chemotherapy or recurrent signs for 9 years. It is considered that conventional chemotherapy can be useful for primary plasmacytoma of generalized lymph nodes.

Female↗
PubMed1993

The trans-sphincteric and trans-sacral approaches for the surgical excision of rectal and presacral lesions.

In the decade from 1981 to 1990, 30 patients underwent a posterior transsacral approach at the Aichi Medical University Hospital for their benign or malignant rectal lesions. The operation was classified into two procedures, consisting of the transsphincteric approach and transsacral approach, in order to cope with the condition of the anal sphincter muscles; whether they were divided or not. Eleven rectal tumors were successfully excised through the opened-up rectum by using the transsphincteric approach, and excellent results were obtained without any postoperative complications. Using the transsacral approach, 2 presacral dermoid cysts and 11 rectal lesions were easily removed under direct vision. Their prognoses were excellent. The transsacral approach was also applied for the resection of recurrent rectal cancers after a radical, abdominoperineal resection in 6 patients suffering from intolerable local symptoms. All the patients were free from these uncomfortable local symptoms after the surgery. The posterior transsacral operation is thus considered to be of value not only for resecting benign rectal and presacral lesions, but also for resecting malignant rectal tumors in frail subjects who are unfit for radical operation and/or recurrent rectal cancer.

Adenoma, Villous↗
PubMed1993

Change of paraprotein from IgG lambda to lambda chain in myeloma.

We describe a unique case of IgG lambda myeloma in which a plasma cell leukemia developed and the paraprotein changed from IgG lambda to lambda chain, the latter inducing fatal renal failure. In addition, J-chain was detected in the cytoplasm of the plasma cell leukemia cells.

Female↗
PubMed1993

Fatal outcome of a patient with severe aplastic anemia after treatment with metenolone acetate.

A 75-year-old man suffering from severe aplastic anemia was treated first with cyclosporin A, then with steroid pulse therapy, and subsequently with metenolone acetate. Marked elevation of transaminases was detected following initiation of treatment with metenolone acetate. This was followed by hepatic failure and death. Histopathological findings in autopsy specimens were compatible with the diagnosis of drug-induced liver impairment, for which metenolone acetate was considered the most likely causative agent. Liver impairment as a side effect of the use of this drug has been thought to be mild, reversible and rather infrequent. However, as demonstrated in the case described here, it is apparent that extreme caution should be exercised when using this drug in debilitated patients.

Aged↗
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

Clonality in myelodysplastic syndromes: demonstration of pluripotent stem cell origin using X-linked restriction fragment length polymorphisms.

Restriction fragment length polymorphisms (RFLP) of the X-chromosome genes phosphoglycerate kinase (PGK) and hypoxanthine phorphoribosyltransferase (HPRT) were used to determine the clonal nature of myelodysplastic syndromes (MDS) in 22 patients. These included eight with refractory anaemia (RA), four with RA with ring sideroblasts (RARS), six with RA with an excess of blasts (RAEB), three with RAEB in transformation (RAEB-T), and one with chronic myelomonocytic leukaemia (CMML). Monoclonal X-inactivation patterns were observed in 19/22 patients. The remaining three cases, one each with RA, RARS and RAEB, were of polyclonal composition. Separated T-lymphocyte and granulocyte fraction analyses in six patients of the former cases revealed that T-lymphocyte as well as granulocyte fractions showed a monoclonal pattern of X-inactivation. These results support the view that the majority of MDS arise from a pluripotent stem cell capable of myeloid and lymphoid differentiation.

Adult↗
PubMed1993

Chronic idiopathic thrombocytopenic purpura complicated by chronic disseminated intravascular coagulation associated with abdominal aortic aneurysm.

A patient with chronic idiopathic thrombocytopenic purpura (ITP), chronic disseminated intravascular coagulation (DIC) and abdominal aortic aneurysm is described. He had severe thrombocytopenia and his platelet life span was shortened (29 h). Indium 111-labeled platelet scintigraphy demonstrated an increased accumulation of radioactivity over the aneurysm and the spleen. Following preoperative heparin therapy for DIC, the platelet count remained low (10 x 10(9)/l), while the DIC improved. Because of the elevated platelet-associated IgG, we considered that the patient had complicated chronic ITP. After intravenous immunoglobulin therapy, his platelet count increased. The aneurysm was successfully replaced with an artificial Y-graft vessel and a splenectomy was performed at the same time. The platelet count was maintained at about 60 x 10(9)/l after the operation and the patient is quite well now.

Aged↗
PubMed1993

Spontaneous regression in B cell, diffuse large cell type non-Hodgkin's lymphoma.

A rare case of non-Hodgkin's lymphoma (NHL) that showed transient spontaneous regression (SR) is described. After 6 months of remission, recurrence was noted in the lymph nodes, pleura and the spleen. Although transient improvement was observed following combination chemotherapy, the pleural effusion became refractory to chemotherapy and the patient died 9 months after the relapse.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

A fatal case of acute boric acid poisoning.

A 77 year-old male mistakenly ingested an estimated 30 g of boric acid as a single oral dose to stop hiccups. On admission, he had vomiting, diarrhea, and hiccups. Laboratory data was diagnostic of acute renal failure. Hemodialysis and charcoal hemoperfusion were performed in series. The serum concentration of boric acid was reduced by the therapy, but the patient died due to cardiac insufficiency. Acute boric acid poisoning resulting from a single oral dose in adults has rarely been reported. Our case is the fourth fatal case in adults since the 1920s following a single, acute ingestion of boric acid.

Acute Kidney Injury↗
PubMed1993

[Combination therapy with granulocyte colony-stimulating factor (G-CSF) and erythropoietin (EPO) induced prominent granulocyte increase in an elderly case of myelodysplastic syndrome (MDS)].

A 70-year-old man was admitted to our hospital with pancytopenia. He was diagnosed as having MDS (RA), and therapy with subcutaneous S-CSF (100 micrograms/day) was started. His leukocyte count increased from 800/microliters to 1,400/microliters in two weeks. The dose of G-CSF was raised to 200 micrograms/day in the third week, and leukocytes increased to 2,00/microliters. At the fifth week, intravenous EPO (6,000 U x 3 times/week) was added. His leukocyte count increased to 4,000/microliters. EPO therapy was raised to 12,000 U x 3 times/week at the eighth week, his leukocyte count remained at the same level. G-CSF and EPO was stopped at the eleventh week, and leukocytes decreased to the same level as before administration. Throughout the course, his platelet count and reticulocyte count did not change. G-CSF and EPO are known as the stimulators of granuriod and erythroid progenitor, respectively. However, in this case, combination therapy with G-CSF and EPO induced marked increase of granulocytes only. This was an interesting case in relation to the roles of these cytokines in the hematopoietic system.

Aged↗
PubMed1993

Evaluation of intraplatelet and urinary 5-hydroxytryptamine (5-HT), and urinary 5-hydroxyindoleacetic acid (5-HIAA) levels in patients with toxemia of pregnancy.

Toxemia of pregnancy is considered to represent a disorder of activated blood coagulation. To identify possible indicators for evaluating the clinical course of toxemia, we measured the intraplatelet and urinary levels of 5-HT and its urinary metabolite, 5-HIAA in 25 patients with toxemia vs. 29 non-toxemic pregnant women. 5-HT and 5-HIAA were assayed by high performance liquid chromatography (HPLC). During the 24-34 weeks of gestation, the toxemic patients and the non-toxemic women each had low intraplatelet levels of 5-HT which didn't differ significantly. A significant (p < 0.05) decrease in intraplatelet 5-HT was observed in the toxemic patients vs. the non-toxemic women after the 35th week of gestation until delivery. The untake of exogenous 5-HT by platelets was increased in the toxemic patients, and their urinary (5-HT+5-HIAA) value increased significantly (p < 0.05) as compared with the non-toxemic women after the 35th week of gestation until delivery. A decrease in the intraplatelet level of 5-HT and an increase in the urinary level of (5-HT+5-HIAA) were observed in the toxemic patients, findings that paralleled the progression of this disorder. Serial measurements of intraplatelet and urinary levels of 5-HT and urinary levels of 5-HIAA in the toxemic patients revealed a significant correlation between disease activity and those levels. These observations support the concept that the measurement of intraplatelet and urinary levels of 5-HT and of urinary levels of 5-HIAA may be useful in following the clinical course of the toxemic patients.

Adult↗
PubMed1993

[Efficacy of the treatment of gastric cancer as neo-adjuvant chemotherapy of 48 hour continuous intravenous infusion of 5-fluorouracil (5-FU) with leucovorin (LV)].

A 51-year-old female with inoperable gastric cancer and with infiltration of pancreatic tail diagnosed by abdominal CT was treated with leucovorin (LV) and 5-fluorouracil (5-FU). The regimen was: LV 30 mg/body/24 hr prior to 5-FU 1,000 mg/m2/day for 48 hrs. This treatment was repeated 6 times. After treatment, the size of tumor decreased so that the patient was able to be operated (Total gastrectomy with partial distal pancreatico-splenectomy). During the treatment, patient showed no side effect except for slight nausea. This neo-adjuvant chemotherapy might be a recommendable treatment of advanced gastric cancer.

Adenocarcinoma↗
PubMed1993

[Hemolytic uremic syndrome (HUS): pathophysiology--with reference to the differentiation between HUS and thrombotic thrombocytopenic purpura].

HUS and TTP have the same fundamental pathologic lesion, thrombotic microangiopathy, induced by many possible causes, all of which initially induce endothelial cell damage. This damage triggers a cascade of biochemical events that ultimately leads to the formation of thrombi in the microcirculation. HUS and TTP share hematologic and vascular abnormalities and are sometimes similar in their clinical manifestations, some authors believe they should be considered a single condition and be termed HUS/TTP. On the contrary, others consider that HUS could be defined as a disorder marked by microvascular lesions limited to the kidney, whereas TTP has generalized lesions. The causative factor(s) resulting in either HUS or TTP have not been completely elucidated, and further studies are required for precise differentiation between HUS and TTP.

Autoantibodies↗
PubMed1993

[Mediastinal diffuse large-cell lymphoma with sclerosis diagnosed by needle biopsy].

A 28-year-old woman was admitted to our hospital with cough. CT scan indicated a huge mass in the anterior mediastinum. A transcutaneous needle biopsy showed tumor cell infiltration and compartmentalizing fibrosis. The tumor cells were positive for CD20 and CD45, and JH rearrangement was evident. The patient was diagnosed as mediastinal diffuse large-cell lymphoma with sclerosis. The tumor responded to combination chemotherapy. It should be emphasized that mediastinal diffuse large-cell lymphoma can be diagnosed using a small specimen obtained by transcutaneous needle biopsy.

Adult↗