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Biomedical subjects

T Ueda

Publications and source records attributed to T Ueda.

At least 325 records · Page 18Linked to original sources
PubMed1997

A case of arrhythmogenic right ventricular dysplasia with left and right ventricular hypofunction in an elderly subject--long-term follow-up.

A 72-year-old man was admitted with palpitations caused by sustained ventricular tachycardia. He had been followed for 27 years, with admissions on 7 occasions, on account of ventricular tachycardias, atrial fibrillation, and congestive heart failure. Electrophysiologic examination detected 2 points of origin of ventricular tachycardia in the right and left ventricles. During the examination a myocardial infarction led to death. At autopsy, most areas of the right ventricle and the left ventricular apex were found to have been replaced by fatty tissue, pointing to severe fatty infiltration into the myocardium. Thus, this patient represented a unique cause of arrhythmogenic right ventricular dysplasia (ARVD) with severe fatty degeneration causing progression of ARVD. It is important that a diagnosis of ARVD is made carefully and rigorously in elderly subjects.

Aged↗
PubMed1997

Skeletal metastases from soft-tissue sarcomas. Incidence, patterns, and radiological features.

We reviewed 277 patients with soft-tissue sarcoma (STS) treated between 1975 and 1995 to study the incidence, distribution, time of appearance, and radiological findings of skeletal metastases. Of these, 28 (10.1%) had metastases within a mean period of 18.6 months after admission. The incidence of skeletal metastases differed among the histological subtypes of sarcoma; alveolar soft-part sarcoma, dedifferentiated liposarcoma, angiosarcoma, and rhabdomyosarcoma tended to show higher incidences. The regional bones close to the primary tumour were affected in 13 (46.4%) of the 28 patients, and the axial bones in 18 (64.3%). Radiologically, the metastatic bony lesions predominantly showed osteolytic changes, and there were pathological fractures in 21 of 44 lesions.

Adolescent↗
PubMed1997

Influence of local recurrence on the prognosis of soft-tissue sarcomas.

We have investigated the significance of local recurrence on survival in 173 patients with localised soft-tissue sarcomas of the limbs and of the trunk. The overall survival rates at five and ten years were 75.2% and 68.0%, respectively. After definitive surgery at our hospitals, there was local recurrence in 25 patients (14.5%). After inadequate operations elsewhere, there was a higher incidence of late local recurrence (28.3%), in comparison with those with primary tumours treated by us (9.0%), or patients referred to us immediately after inadequate surgery elsewhere (10.2%). Because of small numbers these differences in the survival rates were not statistically significantly different. Univariate survival analysis showed that local recurrence after definitive surgery (p = 0.006) together with the histological grade (p = 0.0002), the size of the tumour (p = 0.002), its depth in relation to deep fascia (p = 0.003), and the surgical margin (p = 0.0001) were the significant prognostic factors. Local recurrence at the initial presentation did not affect survival. Multivariate analysis showed that local recurrence after definitive surgery also lost its apparent prognostic significance.

Adolescent↗
PubMed1997

Recovery of iodine-123 metaiodobenzylguanidine uptake associated with left ventricular functional recovery in a patient with dilated cardiomyopathy. Endomyocardial histological findings before and after the improvement of uptake.

A 58-year-old man with idiopathic dilated cardiomyopathy was treated with incremental administration of a beta-blocker (metoprolol) and an angiotensin converting enzyme inhibitor (enarapril). The left ventricular end-diastolic dimension and ejection fraction improved in 8 months from 83.3 mm and 17.3% to 46 mm and 69%, respectively. The washout ratio and heart-to-mediastinum ratio depicted on the delayed image for iodine-123 metaiodobenzylguanidine 123I-MIBG) uptake improved from 61.7% and 1.34 to 23.1% and 1.85, respectively, in association with improvement of left ventricular indices. Successive endomyocardial biopsy specimens disclosed reduction of the degrees of vacuolation, staining irregularity, and deformity of myocyte cytoplasm and nucleus compared to the findings before therapy. In this patient with dilated cardiomyopathy 123I-MIBG scintigraphy was useful for the evaluation of the effects of therapy. We conclude that it may be informative in the estimation of the histopathological abnormalities of the myocardium.

3-Iodobenzylguanidine↗
PubMed1997

Microcystic meningioma without enhancement on neuroimaging--case report.

A 63-year-old female presented with an unusual case of microcystic meningioma manifesting as a 4-year history of unsteady gait, dysarthria, and hearing loss. Computed tomography disclosed a large hypodense mass in the right cerebellopontine angle, clivus, and middle fossa, with slight contrast enhancement. T1-weighted magnetic resonance images demonstrated the lesion as a hypointense mass, which was little enhanced gadolinium-diethylenetriaminepenta-acetic acid. Right carotid angiography revealed blood supply from the external carotid artery, but no tumor staining. The extracerebral tumor was subtotally removed. The histological diagnosis was microcystic meningioma. Light microscopy revealed abundant microcystic throughout the tumor tissue, and electron microscopy disclosed that the microcysts were mostly located in the extracellular spaces and only a few in the cytoplasm. Microcystic meningioma without enhancement is rare and should be differentiated from low-grade astrocytoma, epidermoid, or other non-enhanced tumor.

Brain Neoplasms↗
PubMed1997

The sex differences in cord-blood cholesterol and fatty-acid levels among Japanese fetuses.

We examined serum cholesterol and fatty-acid levels of cord blood and maternal blood samples collected from 193 Japanese fetuses and their mothers. Our study, which is the largest study of this kind ever conducted in Japan, is the first Japanese study reporting that total, high density lipoprotein (HDL) and non-HDL cholesterol levels in females were statistically significantly higher than those in males; the sex differences of total, HDL and non-HDL cholesterol levels were 8.5 mg/dl (P = 0.002), 4.5 mg/dl (P = 0.004) and 4.1 mg/dl (P = 0.045), respectively. The sex difference of total cholesterol was attributable to both HDL and non-HDL cholesterol. The sex of fetuses didn't show evident differences in cholesterol levels in maternal sera. Fatty-acid levels in cord blood were also higher in female fetuses than in male fetuses. However, none of the differences except for monoene fatty acids were statistically significant. Further investigations seem warranted to elucidate the mechanisms involved in our results.

Adult↗
PubMed1997

Lectin-binding glycoconjugates in the subfornical organ of the rat.

In the rat subfornical organ (SFO), lectin-binding glycoconjugates were histochemically examined by 9 biotinylated lectins using a streptavidin-biotin peroxidase system. The strong or moderate binding of Canavalia ensiformis (Con A), Lens culinaris (LCA) and Phaseolus vulgaris erythroagglutinin (ePHA) indicated overall distributions of high mannose, intermediate, hybrid N-linked, and non-bisected, bi/triantennate N-linked complex oligosaccharides in the rat SFO. Nonsialylated terminal N-acetylglucosamines were detected throughout this organ, as revealed by its stainabilities with Triticum vulgaris (WGA) and Limax flavus (LFA). In this organ, Ricinus communis (RCA-1) specifically bound to vessel-associated structures, whereas Arachis hypogaea (PNA) reacted with selected neurons in the central and rostral regions of this organ. Dolichos biflorus (DBA) and Ulex europaeus (UEA-1) did not stain any histologic structures in the rat SFO. The results obtained in this study provide a basis for comprehensive analyses of glycoconjugates in the rat SFO.

Animals↗
PubMed1997

Anti-Leukemia Chemotherapy of High-Risk Myelodysplastic Syndromes.

We evaluated the outcome of anti-leukemia chemotherapy on 42 patients with the high-risk myelodysplastic syndromes (MDS)-refractory anemia with excess of blasts (RAEB), 8 cases; RAEB in transformation (RAEB-T), 18 cases; chronic myelomonocytic leukemia (CMMOL), 6 cases; and leukemic transformation of MDS, 10 cases. The median age was 67 (range 20 to 84). As a remission-induction therapy, 35 patients received low-dose chemotherapy, such as low-dose cytarabine infusion, and seven patients received high-dose combination chemotherapy. The complete remission (CR) rates of the low-dose chemotherapy group and the high-dose combination chemotherapy group were 29% and 57%, respectively, and the overall CR rate was 33%. The median survival durations after induction chemotherapy of the CR group (14 cases), the partial remission (PR) group (11 cases), and non-remission (NR) group (17 cases) were 19 months, 8 months, and 3 months, respectively. As a post-remission consolidation chemotherapy, high-dose combination chemotherapy seemed to be superior to low-dose chemotherapy judging from the median CR duration (16 months versus 4 months), but a long-term disease-free survival is hardly expected, in contrast with results in cases of de novo acute myeloid leukemia.

Journal Article↗
PubMed1997

[A case of primary squamous cell carcinoma of the ureter: biochemical modulation with cisplatin and 5-fluorouracil].

A case of primary squamous cell carcinoma of the ureter is reported. A 62-year-old male presented with gross hematuria and paralysis of the left leg. Abdominal computed tomographic (CT) scan and ultrasonography revealed left hydronephrosis, a massive tumor (8 x 7 cm) in the left distal ureter which invaded the pelvic bone (T4), and left obturator lymph node metastasis (N2). Pathologic examination of the biopsy specimen revealed poorly differentiated squamous cell carcinoma. Cisplatin (100 mg/m2, day 1) and 5-fluorouracil (960 mg/m2/day, days 2-6) were administered systemically in accordance with biochemical modulation regimen for head and neck squamous cell carcinoma, and a minor response was obtained (tumor regression rate 38%, serum SCC antigen regression rate 64%). Thereafter, resection of residual tumor was performed, resulting in noncurative operation because of direct invasion to the pelvic bone. Four months after tumorectomy, liver metastasis appeared, and the patient died of disease 14 months after the initial visit. Combination therapy with cisplatin and 5-fluorouracil is widely used for head and neck squamous cell carcinoma, and the response rate has been reported to be 46-94%. This regimen may also be effective against urological squamous cell carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Molecular analysis of the fusion of EWS to an orphan nuclear receptor gene in extraskeletal myxoid chondrosarcoma.

The pathogenesis of myxoid chondrosarcoma (CS) is poorly understood. A recurrent translocation, t(9;22) (q22;q12), has been recognized in CS, specifically in extraskeletal myxoid CS. Recently, this translocation has been shown to represent a rearrangement of the EWS gene at 22q12 with a novel gene at 9q22 designated CHN (or TEC). Sequence analysis suggests that CHN encodes a novel orphan nuclear receptor with a zinc finger DNA-binding domain. The structure of this gene fusion has been characterized in only a limited number of extraskeletal myxoid CSs and its presence in other types of CS has not been extensively examined. We studied 46 cases of CS (8 extraskeletal myxoid, 4 skeletal myxoid, 4 mesenchymal, and 30 other) for the EWS/CHN gene fusion by reverse transcriptase polymerase chain reaction, Southern blotting, and long-range DNA polymerase chain reaction. The EWS/CHN gene fusion was present in 6 of 8 extraskeletal myxoid CSs and was not detected in any of the remaining cases, including the 4 skeletal myxoid CSs. The negative findings in the latter cases suggest that skeletal myxoid CS is pathogenetically distinct from its extraskeletal counterpart. Notably, 2 cases of extraskeletal myxoid CS showed neither an EWS/CHN fusion transcript nor EWS/CHN genomic fusion nor EWS or CHN genomic rearrangement, suggesting genetic heterogeneity within extraskeletal myxoid CS. Finally, we also provide evidence for alternative splicing of the 3' end of the fusion transcript. Extraskeletal myxoid CS thus represents yet another sarcoma type containing a gene fusion involving EWS.

Adult↗
PubMed1997

[Spontaneous urinary extravasation from the renal pelvis associated with ureteral fibroepithelial polyp: report of a case].

A 26-year-old woman presented with a colicky right flank pain. Retrograde pyelogram showed extravasation of the contrast medium from the right renal pelvis and a filling defect in the right ureter 4.5 cm proximal to the ureteral orifice. Urinary cytology was negative for malignancy. A partial ureterectomy with a vesicoureteroneostomy was performed. Gross inspection of the resected distal ureter revealed a 3-mm polyp with a grayish-white smooth surface as well as a ureteral stenosis of 2 cm in length just distal to the polyp. Pathological diagnosis was a fibroepithelial polyp. In our case, urinary extravasation probably resulted from an impacted polyp in the stenotic ureter.

Adult↗
PubMed1997

[Surgical correction of an incomplete endocardial cushion defect in a 66-year-old male with the remarkable pulmonary hypertension].

A surgical case of a 66-year-old male with an endocardial cushion defect (ECD) is reported. He had preoperative pulmonary hypertension (80/25 mmHg, Pp/Ps 0.61), hypoxia (63.7 mmHg) and decreased creatinin clearance (45.7 ml/min). Respiratory condition was New York Heart Association's (NYHA's) grade III. Angiocardiography showed a typical gooseneck deformity associated with mitral and tricuspid valve regurgitations with the cleft (Seller's grade II and III). As surgical correction, direct suture of the cleft in an anterior leaflet with mitral annuloplasty, patch closure of the ostium primum defect with Xenomedical patch and tricuspid annuloplasty were performed. Postoperative data were restored to NYHA grade I. decreased pulmonary artery pressure (43/21 mmHg) and resistances (Pp/Ps 0.36). The only three surgical treatments of an incomplete ECD were reviewed in over 65-year-old patients in Japan included one perioperative death. Although we suggest it should be actively taken surgical repair even in elderly patients with pulmonary hypertension.

Aged↗
PubMed1997

Intracellular pharmacodynamics of ara-C and flowcytometric analysis of cell cycle progression in leukemia chemotherapy.

To establish the most effective and reasonable mode of combining and administrering ara-C with other antileukemic agents in chemotherapy for acute leukemia, the action mechanisms of ara-C was investigated in terms of intracellular pharmacodynamics and the biochemical action mechanism of ara-C was investigated in leukemic cell. Rensonable methods of administering the agent was considered as follows. 1. A low level of ara-C in the incubation medium induced a higher concentration of ara-CTP in leukemic cells. Therefore, maintenance of even a low plasma ara-C level after ara-C therapy could enhance the antileukemic effect of the agent. 2. Ara-C activation was increased in the presence of 6MP by suppressing elevation of deaminase activity in the cell suspection medium. Therefore, administration of 6MP prior to ara-C therapy could enhance the antileukemic effect of the agent. 3. Ten micrograms/ml of ara-C, corresponding to intermediate dose ara-C therapy, induced rapid endonuclease activation, DNA ladder fragmentation and subsequent apoptosis in large numbers of leukemic cells, suggesting that intermediate dose ara-C therapy is effective in reducing residual leukemic cells after therapy. 4. Blood transfusion for patients with high grade anemia prior to bebenoyl ara-C therapy prolonged higher and longer plasma drug maintenance. 5. Flowcytometry of cell cycle progression of L1210 cells treated by ara-C and daunorubicin revealed that a combination of ara-C first and daunorubicin second was superior to the reverse sequential combination. These improvements in the mode of administering ara-C could provide better results following chemotherapy for leukemia.

Animals↗
PubMed1997

[Improvement of bleeding tendency and normalized platelet count increment following splenectomy in a patient with refractory anemia].

A 72-year-old woman with refractory anemia had severe bleeding tendency. Since 1994, platelet transfusions (10 units three times per week) were unable to maintaining her platelet count over 10 x 10(3)/ microliter. Her hemoglobin was decreased to 3.9 g/dl as a result of bleeding from early gastric cancer. At one-hour after posttransfusion corrected platelet count increment (1-hour CCI) was slightly low, as 14 x 10(3)/microliter/m2. A 24-hour posttransfusion CCI (24-hour CCI) and the (24-hour CCI)/(1-hour CCI) ratio were markedly low, as 0.5/microliter/m2 and 0.36, respectively. Anti-HLA antibody was not detected. The ineffectiveness of platelet transfusion was suspected to be highly associated with splenomegaly. Her spleen had been gradually increased in size since the first clinical examination. She underwent both subtotal gastrectomy and splenectomy, while receiving 40 units of platelet transfusion. After splenectomy, the 1-hour CCI and the (1-hour CCI)/(24-hour CCI) ratio markedly improved (76 x 10(3)/microliter/m2 and 0.79, respectively). Cutaneous bleeding halted and there have been no further episodes, despite less frequent platelet transfusions. This is the first report in which bleeding tendency and CCI were improved by splenectomy in a case of myelodysplastic syndrome.

Aged↗
PubMed1997

[Coronary artery bypass grafting in patients aged 80 years or older].

Coronary artery bypass grafting (CABG) in elderly patients was increasing in recent years. Between January 1989, and December 1996, 11 patients aged 80 years or older (mean 81) underwent CABG in our hospital. Nine patients (82%) were in New York Heart Association class III or IV. Emergency surgery was required in 4 patients (36%). Incidence of emergency surgery is higher than younger patients (p < 0.005), emergency surgery required 7.7% (46/592) in younger patients. The operative mortality was 27% for these 80 years or older. It was one in elective cases and two of four (50%) in emergency cases. One operative death in elective cases was concomitant operation with arch aneurysm. More patients of CABG operations in octogenarians required emergency surgery, and emergency surgery is high operative mortality. Thus CABG in octogenarians should be performed earlier, not be denied because of age alone.

Age Factors↗