Biomedical subjects

T Okamura

Publications and source records attributed to T Okamura.

At least 235 records · Page 13Linked to original sources

PubMed1997

Pure red cell aplasia with thymona: evidence of T-cell clonal disorder.

Pure red cell aplasia (PRCA) sometimes accompanies thymoma. Herein, we report a PRCA patient with thymoma with a clonal disorder of T cells. A 55-year-old man presented with anemia and anterior mediastinum tumor. The laboratory study revealed hemoglobin 8.2 g/dl; leukocytes 15.8 x 10(9)/L with 76.5% neutrophils, 20.0% lymphocytes, and reticulocytes 0.0%. Bone marrow aspirate smears and biopsy sections revealed normal myeloid and megakaryocyte differentiation and contained no erythroid precursors. We made the diagnosis of PRCA. The size of the lymphocytes was small without any granules in the cytoplasm. The surface marker of peripheral blood mononuclear cells demonstrated increased CD2+, CD3+, CD4-, and CD8+ populations. The mediastinal tumor was resected and a thymoma diagnosed. A monoclonal rearrangement of T-cell receptor (TCR)-beta-chain gene was found using Southern blot analysis of the mononuclear cells in both peripheral blood and thymoma. Treatment with prednisolone, thymectomy, and cyclophosphamide exerted no beneficial effect. After initiation of the Cyclosporin A therapy, the patient developed reticulocytosis. This PRCA case seems to present a neoplastic proliferation of CD8+ T cells in peripheral blood and thymus with a monoclonal rearrangement of the TCR-beta-chain gene.

Cell Differentiation↗

PubMed1997

Proliferative activity of esophageal carcinomas and their lymph node metastases: comparison using argyrophilic nucleolar organizer region staining.

BACKGROUND: Many reports have concluded that quantification of the argyrophilic nucleolar organizer regions (AgNORs) measures proliferative activity and is a prognostic indicator in malignant disease. This retrospective study set out to evaluate the relationship between the AgNORs of the primary tumors and those of lymph node metastases in esophageal carcinoma. METHODS: Using a one-step silver staining technique, AgNORs were counted in surgical specimens from 54 patients with squamous cell carcinomas. RESULTS: The AgNOR scores of the lymph nodes metastases were significantly lower than those of the primary tumor (P = 0.0001). In 53 of 54 cases (98%), the AgNOR scores in the nodal metastases were lower than those of the primary tumor. The survival of 22 patients with AgNOR scores > or =4.0 for the primary tumor was significantly less than that of 32 patients with AgNOR scores <4.0 for the primary tumor (P = 0.0014). CONCLUSIONS: The AgNOR score of the lymph node metastases had no prognostic significance. The AgNOR score of esophageal primary cancer reflects the prognosis of patients. Scores for lymph node metastases were lower and did not reflect prognosis. The lower score in the lymph node metastases may result from the antitumor activity of macrophages in the lymph nodes.

Aged↗

PubMed1997

Positron emission tomographic imaging of head and neck lesions.

Positron emission tomography (PET) produces images that reflect the rate and distribution of biochemical and physiological processes in tissue in vivo. This has been observed with many types of neoplasm not evident when using such anatomical imaging techniques as computed tomography or magnetic resonance imaging. We evaluated the feasibility of 2-18F-2-deoxy-D-glucose (FDG) PET studies in diagnosing and assessing the effects of treatment on lesions of the tongue, maxillary sinus and nasopharynx. FDG-PET imaging was performed 45 times in 17 patients with tumors before treatment. Ten patients with malignant lesions also underwent imaging after treatment. The differential absorption ratio (DAR) of the isotope was calculated at 55 min and the time activity curve (TAC) was obtained by dynamic emission scans for 0-55 min following injection of FDG. FDG-PET images, DAR and TAC were evaluated in all lesions. Findings showed that FDG-PET images could be used to diagnose malignant tumors and evaluate treatment when the DAR was > 4.0 and TAC was steep upward. Images suggestive of benign lesions had low DAR values (< 4.0) and mildly upward or flat TACs.

Absorption↗

PubMed1997

Pericentric inversion of chromosome 16 and eosinophilia in chronic myelomonocytic leukemia.

We report a case of myelodysplastic syndrome with bone marrow eosinophilia and the chromosomal abnormality, inv(16)(p13q22). Hematologic findings including monocytosis and trilineage myelodysplasia were consistent with chronic myelomonocytic leukemia, and numerous abnormal eosinophils were present in the bone marrow. Chromosomal analysis of all metaphase cells from peripheral blood and bone marrow revealed in(16)(p13q22), which is well known characteristic of acute myelomonocytic leukemia with eosinophilia (M4Eo). Both monocytes and eosinophils in this case may be derived from common leukemic progenitors affected by inv(16)(p13q22).

Aged↗

PubMed1997

Increased incidence of cytomegalovirus (CMV) infection and CMV-associated disease after allogeneic bone marrow transplantation from unrelated donors. The Fukuoka Bone Marrow Transplantation Group.

Cytomegalovirus (CMV) infection and CMV-associated disease were monitored using the CMV antigenemia assay in 72 patients who received allogeneic bone marrow transplantation (BMT), and their incidences were compared between related and unrelated donor transplant patients. The incidence of CMV infection after BMT was significantly higher in patients who received transplants from HLA-matched unrelated donors than from HLA-matched sibling donors (87% vs 53%, P < 0.05). CMV-associated disease developed in 73% of unrelated and in 14% of sibling donor transplant patients (P < 0.01). The peak levels of CMV antigenemia were significantly higher in unrelated donors than in sibling donor transplant patients (16 vs 1 CMV antigen-positive cells per 50000 WBCs, P < 0.01). The median number of CMV antigen-positive cells on first detection was also significantly higher in unrelated donor transplant patients (15 vs 1, P < 0.01). The detection of CMV antigen-positive cells preceded the development of CMV-associated disease in 18% of unrelated donor transplant patients, suggesting a lower predictive value of CMV antigenemia for subsequent CMV-associated disease in unrelated donor BMT. Careful monitoring and further studies are needed for the early diagnosis and prevention of CMV-associated disease in unrelated donor BMT.

Adolescent↗

PubMed1997

Changes in hemostatic parameters in hepatic veno-occlusive disease following bone marrow transplantation.

Hepatic veno-occlusive disease (VOD) is a major complication after bone marrow transplantation (BMT). Its prediction, diagnosis and treatment remain unclear. Examination was made of changes in hemostatic parameters in patients with or without VOD after BMT. Twenty-seven children were studied following BMT. Eight of them developed VOD. Tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), thrombomodulin (TM), von Willebrand factor (vWF), factor VII, fibrinogen (FBG), FDP, D-dimer (D-D), plasminogen (PLG), thrombin-antithrombin III (TAT), alpha 2-plasmin inhibitor/plasmin complex (PIC), antithrombin III (AT-III), protein C, N-terminal propeptide for type III procollagen (P-III-P), were measured weekly from pre-BMT to day 28 after BMT. In VOD patients, t-PA and PAI-1 significantly increased (P < 0.05) and FBG significantly fell during the post-transplant period (P < 0.05). Significantly low AT-III and PLG were also noted before VOD (P < 0.05). There were no changes in other hemostatic parameters. t-PA, PAI-1 and FBG would thus appear useful markers for the diagnosis of VOD, and AT-III and PLG, predictive markers for VOD. The coagulation-fibrinolysis system following endothelial cell damage may contribute to the onset of VOD.

Adolescent↗

PubMed1997

Autologous peripheral blood stem cell transplantation for acute myelogenous leukemia.

The safety and efficacy of myeloablative therapy followed by autologous peripheral blood stem cell transplantation (ABSCT) for acute myelogenous leukemia (AML) were evaluated in 60 patients. Peripheral blood stem cells (PBSC) were collected during recovery after consolidation chemotherapy. High-dose chemotherapy consisting of busulfan (16 mg/kg), etoposide (40 mg/kg), and cytosine arabinoside (3 g/m2 x 4) (BEA regimen) was used for pretransplant conditioning in 13 patients. For the remaining 47 patients, granulocyte colony-stimulating factor (G-CSF) was administered concurrently with the BEA regimen during conditioning. Unpurged, cryopreserved PBSC containing a median number of 5.4 x 10(8) MNC/kg or 12 x 10(4) CFU-GM/kg were reinfused at transplantation. The median number of days to granulocytes exceeding 500/microl and last platelet transfusion were 15 (8-44) and 24 (0->180), respectively. The 3-year probabilities of disease-free survival (DFS) and relapse were 78.6 and 21.4% for patients transplanted in first remission, 29.6 and 64.4% for those in second or third remission, and 11.1 and 77.8% for those in relapse, respectively. There were no transplant-related deaths within 100 days of transplantation. Age, disease status at transplantation, and number of induction chemotherapies to first complete remission were risk factors affecting the outcome of ABSCT. These results of ABSCT for AML in first remission warrant a prospective study of ABSCT as post-remission therapy.

Acute Disease↗

PubMed1997

Angina pectoris occurring during granulocyte colony-stimulating factor-combined preparatory regimen for autologous peripheral blood stem cell transplantation in a patient with acute myelogenous leukaemia.

We describe a patient with acute myelogenous leukaemia who developed angina pectoris during pretransplant conditioning for autologous peripheral blood stem cell transplantation (PBSCT); the conditioning regimen consisted of cytotoxic drugs in combination with granulocyte colony-stimulating factor (G-CSF). Neutrophilia and hypercoagulability were observed at the time of angina pectoris. Recurrence of angina pectoris was not seen after nitrate and aspirin therapy. Exercise stress testing performed after PBSCT suggested the presence of myocardial ischaemia. Therefore cases at risk of vascular events should be carefully managed with prophylactic treatment during G-CSF administration.

Angina Pectoris↗

PubMed1997

Hepatitis GB virus C genome in the serum of aplastic anaemia patients receiving frequent blood transfusions.

GB virus C (GBV-C) RNA was detected in five of 18 patients with aplastic anaemia who had received blood transfusions, whereas it was not detected in eight patients who had not received any transfusions. Antibody against hepatitis C virus (anti-HCV) was detected in nine patients in the transfusion group, compared with one of eight who had not received any transfusions. Therefore, the route of transmission of both GBV-C and HCV in these patients appeared to have been multiple blood transfusion. Since all of the GBV-C RNA-positive patients harboured anti-HCV, GBV-C seems to frequently superinfect with HCV. Neither GBV-C nor HCV is likely to have been a causative agent of the anaemia in the cases examined.

Adolescent↗

PubMed1997

Decreased expression of the p16/MTS1 gene without mutation is frequent in human urinary bladder carcinomas.

The p16 (CDKN2,MTS1) gene is located at 9p21 and its product, p16, inhibits the cyclin D/CDK4 complex. Loss of heterozygosity on chromosome 9p is very common in human bladder carcinomas and has been found in all stages of lesions, suggesting that it occurs early in bladder tumor progression. Several studies have revealed frequent homozygous deletion of the p16 gene in cell lines, and that such deletions are also common in some types of cancers. In addition, point mutations in the p16 gene have been identified in several types of neoplasia. In the present examination of urinary bladder tumors, no p16 gene mutations were detected, but nine cases out of 23 (39%) showed decreased mRNA expression, revealed by the reverse transcriptase polymerase chain reaction. There were no histological differences apparent between those cases with normal and those with decreased p16 expression. These results indicate that while p16 gene mutations may be rare, changes in the level of the p16 transcripts could play a role in human bladder carcinoma development.

Carrier Proteins↗

PubMed1997

Hypoxia-induced inhibition of the response to nitroxidergic nerve stimulation in canine cerebral arteries.

In isolated canine middle cerebral arteries contracted with prostaglandin F2 alpha, transmural electrical stimulation (TES), nicotine, and substance P produced relaxations. Transmural electrical stimulation- and nicotine-induced endothelium-independent responses are mediated by nitric oxide (NO) liberated from perivascular nerve, whereas substance P-induced relaxations are mediated by endothelium-derived NO. These responses were attenuated by replacement of 95% O2 and 5% CO2 gas (about 550 mm Hg of partial O2 pressure) with 95% N2 and 5% CO2 gas (about 40 mm Hg); inhibition of the response to TES was stabilized 30 minutes later. Reoxygenation partially reversed the response. Relaxations caused by exogenous NO were not influenced by hypoxia. Inhibition by hypoxia of the response to TES was not affected by superoxide dismutase. However, the inhibitory effect was prevented by amiloride and dimethyl-amiloride, Na(+)-H+ exchange inhibitors, or acidosis caused by the addition of HCl. The inhibition by hypoxia was reversed by amiloride. It is concluded that depression by hypoxia of the response mediated by endogenous NO is associated with impaired membrane function caused by restoration of normal intracellular pH by Na(+)-H+ exchanger.

Acidosis↗

PubMed1997

Radioimmunodetection with 111In-labeled monoclonal antibody Nd2 in patients with pancreatic cancer.

This report summarizes results from an initial clinical evaluation of radioimmunodetection (RAID) in patients with pancreatic cancer using murine monoclonal antibody Nd2, directed against mucins from pancreatic cancer. Nd2 (2 mg) was labeled with 111In (2 mCi) and injected into 19 patients suspected of having pancreatic cancer. Planar scintigrams were taken 3 days post-infusion. As for final diagnoses after surgery, 14 cases were pancreatic cancer, and one case each was chronic pancreatitis, neurilemmoma, islet cell carcinoma, cholangioma, and apparent absence of suspected recurrent lesion of pancreatic cancer. Of 14 patients with pancreatic cancer, RAID was positive in 10 cases (71.4%). Cases other than pancreatic cancer were all negative, so the specificity was 100%. These results demonstrate that RAID using 111In-Nd2 can be useful in differentiating exocrine pancreatic cancer from benign conditions and other types of carcinomas in the pancreatoduodenal regions.

Adenocarcinoma↗

PubMed1997

Urethral recurrence of an urachal carcinoma: a case report.

A 68-year-old man presented with microscopic hematuria. Cystoscopy revealed a papillary and pedunculated tumor in the bladder dome which, on punch biopsy, proved to be adenocarcinoma. Partial cystectomy and urachal remnant resection were performed. Histopathologically, the tumor was diagnosed as an urachal tumor. Four months after surgery, multiple posterior urethral tumors were found; punch biopsy revealed adenocarcinoma, which was quite similar to the previous tumor. Based on the histopathological examination of the transurethrally resected tissue, the urethral tumor was diagnosed as a recurrence of the urachal carcinoma. No evidence of either tumor recurrence or metastasis was found within the 15 months following the second surgery.

Adenocarcinoma↗

PubMed1997

A chance SPECT study of ictal aphasia during simple partial seizures.

We report obtaining an ictal single photon emission computed tomographic (SPECT) scan in a right-handed 51-year-old man who had an astrocytoma in the left cerebral hemisphere and simple partial seizures characterized by aphasia. An epileptic seizure producing loss of speech and right-sided facial twitching occurred by chance during a SPECT scan. During the attack, he was unable to speak, but auditory comprehension and writing were intact. Ictal SPECT showed an area of increased perfusion in the left frontal cortex, with the area of highest perfusion involving the left frontal operculum to the inferior part of the left precentral gyrus. Interictal SPECT showed hypoperfusion in the same area. These SPECT findings suggest that the frontal operculum of the dominant hemisphere is one of the regions that can give rise to epileptic aphasia.

Astrocytoma↗

PubMed1997

Nitric oxide-mediated neurogenic vasodilatation in isolated monkey lingual arteries.

In isolated monkey lingual arteries denuded of the endothelium and contracted with prostaglandin F2alpha, transmural electrical stimulation produced a contraction that was reduced by prazosin and reversed to a relaxation by additional treatment with alpha,beta-methylene ATP. The relaxation thus induced was abolished by tetrodotoxin and N(G)-nitro-L-arginine (L-NNA), a nitric oxide (NO) synthase inhibitor, and L- but not D-arginine restored the response in the L-NNA-treated arteries. Under treatment with prazosin and alpha,beta-methylene ATP, the arterial strips responded to nicotine with a relaxation that was not influenced by atropine and timolol but was abolished by hexamethonium, oxyhemoglobin, and methylene blue. The nicotine-induced relaxation was abolished by L-NNA but not by N(G)-nitro-D-arginine and was reversed by L-arginine. Relaxations to exogenously applied NO (acidified NaNO2 solution) were not influenced by L-NNA but were abolished by oxyhemoglobin and methylene blue. The response was not affected in the strips made unresponsive to vasoactive intestinal polypeptide and calcitonin gene-related peptide by desensitization. Histochemical study demonstrated the presence of perivascular neurons containing neuronal NO synthase. It is concluded that monkey lingual arteries are innervated by vasoconstrictor nerves liberating norepinephrine and possibly ATP and also by nonadrenergic noncholinergic vasodilator nerves liberating NO as a neurotransmitter to activate soluble guanylate cyclase. Vasoactive intestinal polypeptide and calcitonin gene-related peptide do not appear to be involved in the neurogenic vasodilatation.

Adenosine Triphosphate↗

PubMed1997

Pelvic nerve stimulation-induced pressor responses in corpus cavernosum of anesthetized dogs.

To analyze the mechanism of penile erection and pathogenesis of impotence, pressures in the corpus cavernosum in anesthetized dogs were measured. Pelvic nerve stimulation produced pressor responses in a frequency-dependent manner. Intravenous injections of NG-nitro-L-arginine, a nitric oxide (NO) synthase inhibitor, dose dependently attenuated the response, and the inhibition was reversed by intravenous injection of L-arginine but not of D-arginine. The response was also inhibited by NG-nitro-L-arginine injected into the corpus cavernosum, the potency being approximately 10 times of that applied intravenously. The intracavernous injection of L-arginine restored the response. NG, NG-dimethylarginine, an endogenous NO synthase inhibitor, dose dependently attenuated the stimulation-induced response, which was restored by an intracavernous injection of L-arginine. An intravenous injection of hexamethonium abolished the pressor response to nerve stimulation, whereas phentolamine and atropine did not significantly alter the response. These findings suggest that an increase in intracavernous pressure caused by pelvic nerve stimulation in anesthetized dogs is mediated by NO liberated from postganglionic neurons that originate in the ganglion located in the vicinity of corpus cavernosum.

Animals↗

PubMed1997

beta1-Adrenoceptor-mediated relaxation by norepinephrine in dog hepatic arteries.

Dog hepatic arterial strips treated with prazosin responded to norepinephrine with concentration-related, endothelium-independent relaxations, the maximal response being 81.7% of the papaverine-induced maximal relaxation that was markedly greater than that in renal arteries. The norepinephrine-induced relaxation in hepatic arteries was significantly attenuated by metoprolol but not influenced by butoxamine. Relaxant responses to norepinephrine of dog hepatic arteries appear to be mediated by the beta1-adrenoceptor subtype, like those of coronary arteries. Evidence for functioning of the beta1-subtype in hepatic arteries would contribute to the analysis of neural and hormonal regulation of blood flow in the liver.

Adrenergic alpha-Antagonists↗

PubMed1997

Inhibition by adrenomedullin of the adrenergic neurogenic response in canine mesenteric arteries.

Adrenomedullin (AM) inhibited the pressor action caused by transmural electrical stimulation in perfused isolated canine mesenteric arteries. The inhibitory potency of AM was greater than that of calcitonin gene-related peptide (CGRP) or proadrenomedullin NH2-terminal 20 peptide (PAMP). [8-37]CGRP did not affect the inhibitory action of AM, but suppressed the CGRP-induced inhibition. It may be concluded that AM has an ability to inhibit adrenergic neuronal transmission without the mediation of CGRP1 receptors in the peripheral vasculature, and this inhibition partly participates in the potent hypotensive action of AM.

Adrenomedullin↗