Biomedical subjects

Y Ebihara

Publications and source records attributed to Y Ebihara.

At least 127 records · Page 7Linked to original sources

PubMed1995

[Thoracotomy as treatment for pneumothorax associated with pneumocystic carinii pneumonia in a patient with hemophilia A and the acquired immunodeficiency syndrome].

Pneumocystis carinii pneumonia is the most common respiratory infection in patients with the acquired immunodeficiency syndrome, and inhalation of pentamidine aerosol is currently used for secondary prophylaxis. A 16-year-old patient with hemophilia A and the acquired immunodeficiency syndrome had a spontaneous pneumothorax during inhalation of pentamidine aerosol for secondary prophylaxis of Pneumocystis carinii pneumonia. Tube thoracostomy and pleurodesis were done without success. Thoracotomy was done 27 days after admission. The patient tolerated the procedure well, and the postoperative course was uneventful. Grocott staining of tissue from the bronchopleural fistula revealed Pneumocystis carinii, which suggests that the pentamidine aerosol failed to control and active Pneumocystis infection in peripheral lung zones.

AIDS-Related Opportunistic Infections↗

PubMed1994

Alpha-fetoprotein producing undifferentiated carcinoma of the bladder.

We report on a rare primary undifferentiated carcinoma of the bladder producing alpha-fetoprotein in a woman. Definitive features included an aggressive, invasive and rapidly growing tumor with a hepatoid carcinomatous lesion on histological examination. Histopathological findings suggested that the multipotent transitional cell induces production of alpha-fetoprotein. The association of an aggressive tumor with the ability to produce this antigen suggests a possible benefit in measuring serum alpha-fetoprotein levels and examining histological sections for its expression in primary undifferentiated carcinoma of the bladder. Further study may indicate radical cystectomy when the resected specimen produces alpha-fetoprotein, particularly if tumors appear to be aggressive and highly vascularized as in our case.

Aged↗

PubMed1994

An autopsy case of extraskeletal Ewing's sarcoma followed up for 24 years.

A long-term (24 years) follow-up case of extraskeletal Ewing's sarcoma is reported. The light microscopic examination showed features hardly indistinguishable from Ewing's sarcoma of the bone, that is, the tumor cells were diffusely arranged and uniform in size and shape, and possessed glycogen in the cytoplasm. Homer-Wright rosettes were found only in the autopsy material. An immunohistochemical study using a neural marker (neuron-specific enolase) demonstrated positive staining in most tumor cells. An ultrastructural study revealed intracytoplasmic glycogen particles and incomplete neural characters as follows: the cytoplasmic processes resembled neural processes without neurosecretory granules, microtubules or neurofilaments. These findings suggest that this case finally acquired an incomplete neural character with repeated recurrence. This tumor was diagnosed extraskeletal Ewing's sarcoma, but in future it may be categorized as primitive neuroectodermal tumor (PNET).

Adult↗

PubMed1994

[Changes in electrocardiographic findings with aging in a longitudinal study of 500 apparently healthy persons aged 60 years and older].

A number of studies have been published which have attempted to define the electrocardiographic (ECG) changes with aging, but most of them were obtained from cross-sectional studies. To distinguish ECG changes related to physiological aging from those associated with arteriosclerosis, we assessed the ECG changes of 500 apparently healthy subjects, aged 60 years and older in 1992, who had been followed at the Keio Health Consulting Center for over 15 years. All subjects had no overt cardiovascular diseases in 1992. We compared the ECG in 1992 with that taken over 15 years ago. Changes in ECG during that period were also reviewed. With aging, the mean axis deviated to the left, the mean QTc interval was shortened, and the mean PR interval was prolonged. ST segmental change, atrial overloading, bundle branch block developed newly in 16%, 8% and 7% of, respectively. There were no relationships among axis deviation, PR interval change, or QTc shortening and coronary risk factors. QTc prolongation and ST segmental change were strongly related to hypertension or impaired glucose tolerance. When ECG changes in those under 65 years old were compared with those over 80 years old, the incidence of ST segmental change in those over 80 years old was significant higher. This study was not a prospective study but suggested each type of ECG change related to aging was affected by physiological and/or pathological factors in a distinct way and had different phases of development and progression.

Aged↗

PubMed1994

[A case of large cell carcinoma of the lung producing granulocyte colony-stimulating factor].

A 48-year-old female was admitted complaining of cough and right chest pain. A chest X-ray showed a tumorous mass in the right lower lung field and hilar and mediastinal lymphadenopathy. The patient underwent transbronchial lung biopsy, and was diagnosed as having a malignant tumor. Because a metastatic lesion was detected in the left lung filed, we opted for chemotherapy. The white blood cell count rose to 103,700/mm3 and 190,000/mm3 in the fifth and sixth month after hospitalization, respectively. The serum granulocyte colony-stimulating factor (G-CSF) level by enzyme immunoassay exceeded 1000 pg/ml. The histological diagnosis of large cell carcinoma was made from the specimen obtained by percutaneous needle biopsy of the lung. The carcinoma cells in this specimen, showed positive staining with anti-G-CSF monoclonal antibody.

Carcinoma, Non-Small-Cell Lung↗

PubMed1994

Genesis of squamous cell lung carcinoma. Sequential changes of proliferation, DNA ploidy, and p53 expression.

Squamous cell lung carcinomas (SCCs) represent a highly malignant group of tumors, and effective treatment is greatly dependent upon early diagnosis. However, objective diagnosis of atypia is difficult and useful markers need to be defined. In this study, genomic instability, cell proliferation, and cellular accumulation of mutant p53, as reflected by DNA aneuploidy, proliferating cell nuclear antigen, and p53 immunoreactivity, respectively, were evaluated in bronchial squamous metaplasia without atypia (n = 4), bronchial squamous metaplasia with low-grade atypia (n = 12), bronchial squamous metaplasia with high-grade atypia (n = 15), early-stage SCC (n = 15), and advanced-stage SCC (n = 33). Our results suggest that hyperproliferation is an early event followed by DNA aneuploidy, which in turn precedes p53 immunoreactivity in the genesis of SCC. We conclude that routine assessment of proliferating cell nuclear antigen, DNA ploidy, and p53 may be valuable for the early diagnosis of SCC.

Aneuploidy↗

PubMed1994

[DNA ploidy and proliferating cell nuclear antigen positivity rate as predictive indication of effectiveness of preoperative radiation].

We compared histological effects following radiotherapy in relation to the DNA ploidy pattern and the proliferating cell nuclear antigen (PCNA) positivity rate in 37 patients with rectal cancer who underwent preoperative radiation therapy. Twelve of 23 cases in which the PCNA positivity rate before irradiation was more than 25% showed the effectiveness of radiotherapy (52.2%), against 2 of 6 cases with a rate of less than 25%. Cases in which the rate was more than 25% tended to show more effectiveness. Seventeen of 23 cases in which the PCNA positivity rate was more than 25% showed a decrease in PCNA positivity rate (73.9%). The rate in 6 cases showed no change, and no cases had an increase. In particular, in 12 cases in which the PCNA positivity rate was more than 55%, half showed effectiveness, and the PCNA rate decreased 20% on average. The PCNA positivity rate tended to decrease as a result of irradiation, and especially in diploid cases there were significant differences in the rate before and after irradiation. We suggest that cases in which the PCNA positivity rate is more than 55% with diploid DNA pattern would show most effect. The effects of irradiation could be predicted with biopsy materials and by measuring the DNA ploidy pattern and the PCNA positivity rate.

Adenocarcinoma↗

PubMed1994

[A case of peritoneal metastasis of breast cancer successfully treated by multidisciplinary therapy with hyperthermia therapy].

A 53-year-old female with peritoneal metastasis of breast cancer was treated with hyperthermia with chemotherapy. One course consisted of THP 60 mg and FT 400 mg/iv (day 1), CPM 100 mg and MPA 800 mg/daily/po) with RF heating of hyperthermia monthly. After completion of 10 courses of this regimen, ascites completely disappeared and peritoneal metastases were not found observed in any peritoneal cavity with abdominal CT and ultrasound. Peritoneal metastasis of breast cancer was one of the worst reactions with any therapy. The patient has been living for about four years without any signs of recurrence, with the tumor markers within the normal range after surgery. Thermochemotherapy seems a very promising treatment modality for peritoneal metastasis of breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗

PubMed1994

[An autopsy case of lymphoepithelioma-like carcinoma of the mediastinum].

A case of lymphoepithelioma-like carcinoma of the mediastinum is reported. A 67-year-old male was admitted to Tokyo Medical College Hospital, in February of 1992, for evaluation of an abnormal mediastinal shadow on chest X-ray. The mediastinal tumor was biopsied using mediastinoscopy. Histological diagnosis was undifferentiated carcinoma and radiation therapy was performed. Six months after treatment, he complained of dyspnea. Combination chemotherapy was performed. Although the tumor size decreased, he died of pneumonia. Histological findings at autopsy included nesting of large carcinoma cells with vacuolar nuclei and large nucleoli, interstitial lymphocytic infiltration similar to that of lymphoepithelioma of the epipharynx, and lymphoepithelioma-like carcinoma in the thymus. The epipharynx and thymus were, however, intact at autopsy. We found no other origins of this tumor, including the trachea and lung. This case was therefore diagnosed as lymphoepithelioma-like carcinoma of the mediastinum.

Aged↗

PubMed1994

[A case of inflammatory breast cancer successfully treated with 5'-DFUR and MPA].

A 67-year-old female with extensive inflammatory breast cancer was treated with oral chemoendocrine therapy using 5'-deoxy-5-fluorouridine (5'-DFUR) 1,200 mg and medroxyprogesterone acetate (MPA) 1,200 mg before intra-arterial infusion chemotherapy, which made the extensive inflammatory skin lesion improve remarkably. Sequential intra-arterial infusion made the skin lesion completely disappear. But the main tumor remained, so extended mastectomy was performed. These findings suggested that this therapy was effective for the prevention of extension of the skin lesion on the inflammatory breast cancer, and also served as induction therapy for this modality.

Administration, Oral↗

PubMed1994

A case of cerebellar neuroectomesenchymoma in an infant.

This case report concerns a congenital cerebellar tumor in an infant. The tumor consisted of small, immature lymphocyte-like cells, medium-sized, rhabdoid cell-like cells, and large, polymorphic gemistocytic astrocyte-like cells, which were admixed in motley form on a background of neuronal matrix and dural and collagen fibrous tissues. Immunohistochemical studies revealed that the cytoplasm of rhabdoid cells had conspicuous structures, resembling weakly eosinophilic homogeneously amorphous inclusion bodies, and that the strongly eosinophilic cytoplasm, seen abundantly in the gemistocytic astrocyte-like cells, was a mixture of components that were positive for glial fibrillary acidic protein (GFAP) and vimentin and of components positive for myoglobin. Because of the simultaneous expression of both, neuroectodermal and mesenchymal characteristics the reported tumor was not a mixed tumor of independent neuroectodermal and mesenchymal tumor components, but a very rare neuroectomesenchymoma derived from immature cells with pluripotential differentiating capabilities.

Biomarkers, Tumor↗

PubMed1994

[A case of pulmonary fibrosis associated with CMV inclusion body].

A 71-year-old woman admitted to our hospital with complaints of progressive dyspnea on exertion and weight loss. Roentgenological examination demonstrated peripheral pulmonary fibrosis and a mediastinal tumor suggesting thymoma. The pathological findings of transbronchial lung biopsy (TBLB) confirmed pulmonary fibrosis. Moreover, cytomegalic inclusion bodies in TBLB and a high titer of serum CMV IgG antibody suggested pulmonary CMV infection. It is considered that pulmonary fibrosis and CMV infection were coexistent in this patient.

Aged↗

PubMed1994

Expression of gamma-glutamyl transpeptidase mRNA after depletion of glutathione in rat liver.

Gamma-glutamyl transpeptidase (gamma-GT) is the enzyme in the gamma-glutamyl cycle which mediates the first step of glutathione degradation. Recently, it has been reported that diethyl maleate, a glutathione-depleting agent, enhanced hepatic gamma-GT activity. In this study, we examined how gamma-GT mRNA was expressed after the depletion of glutathione by using the RT-PCR method and in situ hybridization technique with digoxigenin-labeled oligonucleotide probe. We could detect hepatic gamma-GT mRNA in the epithelial cell of bile duct and the cytoplasm of hepatocytes in the periportal area, even in control rats. Furthermore, we found that the expression of gamma-GT mRNA was expanded to hepatocytes of a whole lobule 12 hr after depletion of glutathione by diethyl maleate, followed by the return to the pretreatment condition under which gamma-GT mRNA appears to be controlled in correlation with hepatic glutathione levels. These results suggest that the depletion of glutathione may induce hepatic gamma-GT activity through an increased synthesis of its mRNA.

Animals↗

PubMed1993

Tracheobronchial AL amyloidosis: histologic, immunohistochemical, ultrastructural, and immunoelectron microscopic observations.

We have studied three cases of localized amyloidosis in the lower respiratory tract. Amyloid was nodularly or diffusely deposited in the lamina propria of the tracheobronchial mucosa. Its nature was confirmed by Congo red staining with green birefringence on polarized microscopy. "Tracheobronchopathia osteoplastica" also was demonstrated. Plasma cells and lymphocytes were scant in the amyloid mass. Few fibroblasts and even fewer macrophages were seen. The number of plasma cells was not increased in the bone marrow in any of our cases. Amyloid fibrils were demonstrated by electron microscopic examination. The amyloid P component was detected by immunohistochemical methods. The precursor protein of amyloidosis was shown to be amyloid L protein by the postembedding protein-A gold technique with anti-light chain antisera. The role of the plasma cells in amyloid formation, however, could not be ascertained. Based on these observations, amyloid fibril formation in tracheobronchial amyloidosis appears to be related to light chains secreted by local plasma cells, combined with amyloid P, calcium, and other factors.

Adult↗

PubMed1993

Inhibition of glycolysis or increased perfusate H+ buffering capacity, but not their combination, attenuates myocardial stunning.

OBJECTIVE: Both inhibition of glycolysis and enhancement of the H+ buffering capacity of the perfusate during ischaemia reduce myocardial reperfusion injury. The aim of the study was to investigate whether these manoeuvres, performed separately or together, could reduce myocardial stunning after brief global ischaemia. METHODS: The hearts of male Sprague-Dawley rats were preperfused for 10 min with oxygenated or hypoxic buffer (pH 7.4) containing 100 mM sucrose, 100 mM HEPES, or 5 mM 2-deoxyglucose plus 100 mM sucrose, followed by 15 min of total ischaemia and 30 min of reperfusion. In some hearts, 5 mM 2-deoxyglucose was combined with 100 mM HEPES during the 10 min preperfusion period. RESULTS: Brief hypoxic preperfusion, 2-deoxyglucose, or HEPES reduced myocardial stunning as well as improving the metabolic recovery and reducing Ca2+ overload after reperfusion. These changes were associated with a smaller increase in intracellular Na+ and a smaller decrease of coronary effluent pH at the end of ischaemia. In contrast, the combination of HEPES with hypoxic preperfusion or 2-deoxyglucose depressed functional recovery and increased the intracellular Na+ level at the end of ischaemia as well as increasing Ca2+ overload after reperfusion. This happened even though the decrease in coronary effluent pH was attenuated to the same extent as before. CONCLUSIONS: Both inhibition of glycolysis and enhancement of the perfusate H+ buffering capacity before ischaemia attenuated myocardial stunning, but the protective effect of each manoeuvre was lost when they were combined.

Animals↗

PubMed1993

Attenuation of myocardial stunning by an increase in the H+ buffering capacity of the perfusate and that by hypoxic preperfusion are affected differently by the free [Ca2+] of the perfusate.

OBJECTIVES: Protons produced during ischemia may increase intracellular Na+ (Na+i) through Na+/H+ exchange, and may lead to Ca2+ overload through Na+/Ca2+ exchange to cause myocardial stunning. This study investigated whether an increase in the H+ buffering capacity of the perfusate or a reduction of H+ production by a brief hypoxic preperfusion before ischemia would reduce myocardial stunning. We also investigated whether the protective effect of these maneuvers depends on the free [Ca2+] of the perfusate. METHODS: Isolated rat hearts were preperfused with oxygenated or hypoxic buffer (pH 7.4) containing 100 mM of either sucrose or HEPES for 10 min, followed by 15 min of total ischemia and 30 min of reperfusion. To investigate the dependence of the effects of HEPES or a brief hypoxic preperfusion, the free Ca2+ concentration in the buffer was changed from 1.25 mM to 2.5 mM in some hearts. RESULTS: Oxygenated preperfusion with buffer containing HEPES and 1.25 or 2.5 mM Ca2+ improved the metabolic and functional recovery with a decrease in the accumulation of Na+i during ischemia and in 45Ca2+ uptake during reperfusion. A brief hypoxic preperfusion with 1.25 mM Ca2+ provided a similar protective effect whereas no protective effect was observed when the [Ca2+] was raised to 2.5 mM. CONCLUSIONS: An increase in the H+ buffering capacity or a brief hypoxic preperfusion reduced myocardial stunning with improved metabolic recovery, and reduced Ca2+ uptake. However, the effects of these interventions were affected differently by the free [Ca2+] of the perfusate, which suggests that they work, at least in part, through some different mechanism(s).

Animals↗

PubMed1993

Mesothelial splenic cyst.

A 29-year-old female was admitted because of thrombocytopenia and an abdominal mass which was palpated 5 finger breadths below the left costal margin. A computed tomographic scan of the abdomen revealed splenomegaly with a large calcified cystic lesion. The spleen was removed and the pathological examination disclosed that the cyst was monolocular and the wall was of mesothelial origin.

Adult↗

PubMed1993

[The changes in physico-chemical parameters obtained from apparently healthy aged people followed over ten years].

The author assessed the physiological aging parameters of 38 apparently healthy subjects who were over 80 years old 1989, who were not on medication, and who had consulted with the Keio Health Counseling Center over 10 years. All subjects had no history of overt vascular disease and/or malignancy in 1989. In 17 of 38 subjects, physical, hematological and blood chemical parameters when they were in their 70s were analyzed. Many parameters were unchanged and remained within normal limits for ordinary adults. Cataract, atherosclerotic change of optic fundi and diagonal ear lobe creases were seen in all subjects during the study period. Concerning standard deviations, those of forced expiratory volume in one second/predicted vital capacity and pure tone average (acoustic ability) decreased with age, unlike those of other parameters. Furthermore, multiple regression analysis, revealed that serum albumin decreased but pure tone average, Scheie's atherosclerotic score, senile cataract, HDL-cholesterol blood urea nitrogen and forced expiratory volume in one second/predicted vital capacity increased with age. This study was not cohort study with selected subjects but shows very slight change of almost any parameter irrespective of age and abnormality can suggest the existence of disease.

Aged↗