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Biomedical subjects

T Wakayama

Publications and source records attributed to T Wakayama.

At least 91 records · Page 5Linked to original sources
PubMed1995

[Treatment with bolus methylprednisolone for pure red cell aplasia after ABO incompatible bone marrow transplantation in a patient with chronic myelocytic leukemia].

Pure red cell aplasia (PRCA) was found in a male patient with chronic myelocytic leukemia after major ABO incompatible bone marrow transplantation (BMT). He had blood group O, and received BMT from an HLA identical sibling (blood group A). Erythrocyte-depleted marrow was transplanted. Methotrexate for short time and cyclosporine (CyA) were used for graft versus host disease (GVHD) prophylaxis. Engraftment of neutrophils and platelets were observed on day 14 and 22, respectively. The Ph1 chromosome disappeared on day 133. However engraftment of erythrocytes was not observed on day + 280. Bone marrow puncture revealed depletion of erythrocyte precursors. Anti-A isoagglutinin was persisted. There was no evidence of acute or chronic GVHD. Administration of prednisolone, discontinuance of CyA and subcutaneous infusion of recombinant human erythropoietin failed to improve PRCA. Bolus methylprednisolone (m-PSL) therapy started on day 284 resulted in rapid increase in reticulocyte counts within 6 days, which was followed by normal hemoglobin concentrations. We conclude that bolus m-PSL may be one treatment for PRCA after BMT.

ABO Blood-Group System↗
PubMed1994

Risk factors influencing the short-term results of gastroduodenal perforation.

The purpose of this study was to evaluate the risk factors influencing the short-term results of gastroduodenal perforation to determine the optimal treatment for reducing mortality. A total of 136 patients were retrospectively reviewed and the prognostic factors were examined. Seven patients died within 30 days, with an overall mortality rate of 5.1%. Mortality was significantly worse in those aged 50 years or more, when the leukocyte count was less than 9,500/mm3, when treatment was delayed more than 12h after perforation, in cases of preoperative shock and renal failure, and when associated with liver cirrhosis or an immunocompromised state. Tolerance to the time delay was inversely proportional to age, while the deaths in patients aged 65 years or younger were related to serious concurrent diseases. Shock and renal failure occurred most often in elderly patients as a result of delayed surgery, and the leukocyte count was an age-dependent prognostic indicator. Thus, age, the time interval between perforation and treatment, serious concurrent disease, shock, and renal failure were presumed to be the most important prognostic factors. Although definitive operations were performed on low-risk patients with an acceptably low mortality, it remains to be determined whether simpler procedures should be adopted for high-risk patients.

Adolescent↗
PubMed1994

Development of early-stage embryos of the Japanese field vole, Microtus montebelli, in vivo and in vitro.

Although ovulation could be easily induced in the Japanese field vole by administering pregnant mares' serum gonadotrophin and hCG, the number of embryos obtained varied from 1 to 47 (mean, 9.6). One-cell embryos were small (57.8-63.3 microns in diameter; mean, 61.0 microns) compared with those in other mammals. Development of the preimplantation vole embryos in vivo was similar to that of mouse embryos. The first cleavage occurred between 24 and 26 h after mating. The second cleavage was between 46 and 52 h after mating, and subsequent cleavages occurred at about 12 h intervals. Blastocysts were clearly observed in the uterus 4 days after mating. Vole embryos could be cultured in vitro from the late two-cell to the blastocyst stage in M16 medium. However, development of one-cell and early two-cell embryos in vitro was limited, and few cleaved beyond the four-cell stage. Eliminating sodium pyruvate from M16 medium significantly improved the development of early two-cell embryos into blastocysts (P < 0.05). The Japanese field vole may be a useful experimental animal for reproductive biology, comparable with the mouse.

Animals↗
PubMed1994

[Complete remission induced by combined treatment with all-trans retinoic acid (ATRA) and granulocyte colony-stimulating factor (G-CSF) in a patient with relapsed acute promyelocytic leukemia].

In February, 1990, a 49-year-old man was admitted with petechia and gingival bleeding. The peripheral blood showed 5,200 leukocytes/microliters including 73% abnormal promyelocytes and 24,000/microliters platelets. Bone marrow puncture revealed that nucleated cell count was 331,250/microliters including 85.4% abnormal promyelocytes with 46XY, i(17q) chromosome. Coagulation tests revealed DIC. He was diagnosed as having acute promyelocytic leukemia, and he was treated with the BHAC-DMP protocol. He achieved complete remission, and received consolidation therapy and maintenance therapy. However, he relapsed in May, 1991 with 46XY, 16q-, i (17q) chromosome. He was treated with BHAC-MV protocol and again achieved complete remission. In June, 1992, he re-relapsed and 3.6% blasts and 10% abnormal promyelocytes was found in his bone marrow. He was treated for 14 days with 15 mg Aclarubicin without any change. Then he was treated with 60 mg All-trans retinoic acid (ATRA). After administration of ATRA, his peripheral blood leukocyte count increased temporarily but bone marrow suppression continued. Then he received continuous subcutaneous infusion of 24 micrograms/day granulocyte colony-stimulating factor (rhG-CSF). After treatment with ATRA and rhG-CSF, he entered a third complete remission.

Combined Modality Therapy↗
PubMed1993

Magnetic resonance cholangiography for evaluation of obstructive jaundice.

OBJECTIVES: Magnetic resonance (MR) cholangiography is a newly developed adjunctive tool for noninvasive evaluation of patients with obstructive jaundice. We discuss whether MR cholangiography can provide useful information about the biliary tract, compared with other diagnostic modalities. METHODS: MR cholangiographies of 20 patients with obstructive jaundice were reviewed to evaluate the site of obstruction, the cause of obstruction, and the degree of stricture. RESULTS: The precise location of an obstructing lesion and complete display of the dilated biliary tree just proximal to the obstruction were provided in all 20 patients by MR cholangiography the same as in direct cholangiography. MR cholangiography could completely distinguish common duct stones from malignancies, whereas accurate differentiation among the malignancies was impossible. In six patients, MR cholangiography was not able to help in differentiating between high-grade stenosis and complete occlusion. CONCLUSION: Although precise cholangiographic estimation of the morphology and extent of the malignant disease by MR cholangiography was inferior to direct cholangiography, MR cholangiography is easily performed for a short duration and is a noninvasive diagnostic modality for assessing the outline of the anatomy of the dilated biliary tree. Therefore, we recommend promptly performing MR cholangiography if obstructive jaundice is suspected on clinical grounds.

Aged↗
PubMed1993

[Diagnosis of cholelithiasis].

Evaluation of the patient with suspected cholelithiasis has been changed dramatically recently, to make accurate prediction of composition of the gallstone. That is mainly because of improvement and development of all kinds of diagnostic imaging modalities and development of several nonsurgical options. If we do the initial evaluation of the patient, it is natural to choose the ultrasonography first, because of its easiness and noninvasiveness. But it is important to choose the most appropriate modality following ultrasonography, in order to complete the integrated imaging diagnosis. Here we describe the gross feature of the each modality, and how we choose it in order to make accurate diagnosis and to arrive at a treatment plan best suited for each patient.

Bile Duct Diseases↗
PubMed1992

[Effect of subcutaneous administration of interleukin-1 beta on blood platelet count and serum GM-CSF in patients with myelodysplastic syndrome and aplastic anemia].

Subcutaneous administration of recombinant human Interleukin-1 beta (IL-1 beta) in a dose of 1-3 x 10(4) U/day for 14 to 72 days resulted in an increase in circulating granulocytes and bone marrow monocytes in all the 4 patients examined. Circulating platelet count was also increased in two of four patients with myelodysplastic syndrome (MDS) and aplastic anemia (AA). Bone marrow examination revealed an increase in megakaryocyte count in these patients, whereas the percentage of blast was not changed. An increase in blood platelet count was accompanied by an increase in serum GM-CSF in a patient with AA, whereas serum IL-6 level was not changed throughout the treatment with IL-1 beta. These findings suggest that IL-1 beta may be useful for the treatment of a proportion of patients with MDS and AA who are associated with thrombocytopenia.

Aged↗
PubMed1992

[Salvage therapy for recurrent or refractory non-Hodgkin's lymphoma with etoposide, methotrexate, vindesine and prednisolone (EMVP)].

Seventeen patients with recurrent or refractory non-Hodgkin's lymphoma were treated with EMVP (Etoposide 75 mg/m2 i.v. d 1-5, Methotrexate 100mg/m2 i.v. d 1, Vindesine 3 mg/body i.v. d 1, Prednisolone 60 mg/m2 p.o. d 1-5), repeating every 3 weeks. Six complete responses (35%) and five partial responses (30%) were obtained with an overall response rate of 65%. The median duration of response was 26 months (range 8-49+months) for complete response (CR) and 4 months (range 2-6 months) for partial response (PR). The median duration of survival was 31 months for CR, 11 months for PR and 10 months for all patients, respectively. The major toxic effect was myelosuppression. Leukopenia less than 1,000/mm3 and thrombocytopenia less than 25,000/mm3 occurred in 5 and 3 patients, respectively. The other toxicities were alopecia, nausea and mucositis. However, these toxicities were well tolerated and clinically manageable. These results suggested that EMVP therapy was an effective regimen for patients with recurrent or refractory lymphoma.

Adult↗
PubMed1989

Prevention of the spread of experimental acute pancreatitis by intraductal administration of a synthetic protease inhibitor in dogs.

The effect of a synthetic protease inhibitor, gabexate mesilate (GM), which was administered directly into the pancreatic duct, on acute pancreatitis induced by sodium taurocholate in dogs was investigated. Intraductal administration of GM significantly inhibited intrapancreatic trypsin activity at 24 h, compared with the control. The survival rate 10 days after initiation of pancreatitis for the group in which GM was administered intraductally was 100%, whereas that for the control group was 25%. Serial blood biochemical analysis and histopathological findings suggested that the progress of pancreatitis was favorably influenced by intraductal administration of GM.

Amylases↗
PubMed1985

[A case of adenolipoma of the breast].

A 40-year-old woman was found to have a well-circumscribed mass in the upper outer quadrant of the right breast at a routine physical examination. Mammographically, the tumor was a radiolucent mass, measuring 4.6 X 3.2 X 4 cm, surrounded by a capsule. The tumor consisted of fat and numerous strings with the appearance of ordinary glandular tissue. There was no area of microcalcification. Grossly, the tumor mass was encapsulated by fine connective tissue. On the cut surface, the tumor consisted of fatty tissue containing islands of grayish-white breast tissue. Histologically, the fatty tissue presented (a feature) of mature lipoma. Embedded in the fat were areas of breast tissue simulating fibrocystic disease. In limited areas, the fat cells had direct contact with the ducts without intervening fibrous tissue.

Adult↗