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Biomedical subjects

Y Harada

Publications and source records attributed to Y Harada.

At least 199 records · Page 11Linked to original sources
PubMed1998

[Clinical study of carcinoma in situ of the urinary bladder].

PURPOSE: To evaluate the natural history and the efficacy of treatments for carcinoma in situ (CIS) of the urinary bladder, we reviewed 70 patients with this disease. METHOD: The patients of CIS were divided into 3 groups based on tumor history: primary, secondary and concurrent CIS. We studied 70 patients with primary and secondary CIS treated at our hospital between 1957 and 1995, exclusive of concurrent one. They included 31 patients with primary CIS and 39 with secondary one, ranging in age from 39 to 82, with the average age of 63.1 years. Sixty-one patients were male and 9 were female. RESULTS: In 31 patients with primary CIS, 12 (32.8%) complained of gross hematuria, 10 (32.3%) urinary frequency and 9 (29.0%) pain on urination. The 5-year survival rates for primary and secondary CIS were 89.1% and 91.4%, and the 5-year bladder preservation rates were 54.5% and 57.6%, respectively. Three of 31 patients with primary CIS developed an invasive carcinoma, whereas 4 of 39 patients with secondary CIS did. There was no significant difference between each primary and secondary groups. In both primary and secondary CIS, the group of immediate total cystectomy was not significantly differ from the groups of the following total cystectomy and the bladder preservation in the effect of total cystectomy on the survival rate. A total of 51 cases of CIS was treated with intravesical therapy, 17 intravesical Bacillus Calmette-Guérin (BCG) therapy, 34 intravesical chemotherapy, respectively. Intravesical BCG therapy has shown the complete response rate of 78.6%, intravesical chemotherapy 42.1%. And the bladder preservation rate seemed to be better (but not significantly) in intravesical BCG group than in intravesical chemotherapy group or non-treatment group of intravesical therapy. CONCLUSION: For both primary and secondary CIS, the 5-year survival rate was about 90% and 5-year bladder preservation rate was over 50%. There was no significant difference between the primary and secondary group. The group of immediate total cystectomy was not significantly differ from the groups of the following total cystectomy and the bladder preservation in the effect of total cystectomy on the survival rate. About intravesical therapy, BCG was very effective in CR rate and the bladder preservation rate seemed to be better (but not significantly) in BCG group than in chemotherapy or non-treatment group.

Administration, Intravesical↗
PubMed1998

[Clinical efficacy of sulbactam/ampicillin in comparison with cefotiam in the treatment of elderly patients with pneumonia].

Clinical efficacy and safety of pareteral sulbactam/ampicillin (SBT/ABPC) was compared with cefotiam (CTM) in a randomized clinical trial of pneumonia in the elderly at 13 National Hospitals of Kyushu island. 37 patients received SBT/ABPC 3 g i.v., b.i.d., and 31 patients received CTM 1 g i.v., b.i.d. for 7 to 14 days. 1. 68 patients (37 for SBT/ABPC and 31 for CTM) were evaluated for safety. No statistical differences were noted in the patients' backgrounds of either group. 2. The clinical efficacy of SBT/ABPC was 96.3% (26/27 cases) while CTM was 75.2% (17/23 cases). This was found to be statistically significant (Fisher's exact test: p < 0.05). 3. 100% of evaluated cases (10 for SBT/ABPC and 4 for CTM) showed bacterial elimination. 4. No side effects were observed in the study. 5. Abnormal laboratory findings were noted in 10.8% (4/37 cases) for SBT/ABPC and 3.2% (1/31 cases) for CTM. The major adverse events were mild elevation of GOT, GPT and A1-P for SBT/ABPC, and mild platelets overproduction for CTM. No statistical differences were noted in both groups. These results are consistent with SBT/ABPC as a highly effective antibiotic in the treatment of elderly patients with pneumonia.

Aged↗
PubMed1998

[Leydig cell tumor of the testis: a case report].

A 63-year-old male visited our hospital with a complaint of painless swelling of the left scrotum. Left high orchiectomy was performed since ultrasonography suggested a testicular tumor. Histologically, this testicular mass was a Leydig cell tumor. We reviewed 47 cases of this tumor previously reported in Japan.

Humans↗
PubMed1998

Identification of cell types responsible for bone resorption in rheumatoid arthritis and juvenile rheumatoid arthritis.

Focal resorption of bone at the bone-pannus interface is common in rheumatoid arthritis (RA) and juvenile rheumatoid arthritis (JRA) and can result in significant morbidity. However, the specific cellular and hormonal mechanisms involved in this process are not well established. We examined tissue sections from areas of bone erosion in patients with RA and JRA. Multinucleated cells (MNCs) were present in resorption lacunae in areas of calcified cartilage and in subchondral bone immediately adjacent to calcified cartilage, as previously described. mRNA for the calcitonin receptor (CTR) was localized to these MNCs in bone resorption lacunae, a finding that definitively identifies these cells as osteoclasts. These MNCs were also positive for tartrate-resistant acid phosphatase (TRAP) mRNA and TRAP enzymatic activity. Occasional mononuclear cells on the bone surface were also CTR positive. Mononuclear cells and MNCs not on bone surfaces were CTR negative. The restriction of CTR-positive cells to the surface of mineralized tissues suggests that bone and/or calcified cartilage provide signals that are critical for the differentiation of hematopoietic osteoclast precursors to fully differentiated osteoclasts. Some MNCs and mononuclear cells off bone and within invading tissues were TRAP positive. These cells likely represent the precursors of the CTR-TRAP-positive cells on bone. Parathyroid hormone receptor mRNA was present in cells with the phenotypic appearance of osteoblasts, in close proximity to MNCs, and in occasional cells within pannus tissue, but not in the MNCs in bone resorption lacunae. These findings demonstrate that osteoclasts within the rheumatoid lesion do not express parathyroid hormone receptor. In conclusion, the resorbing cells in RA exhibit a definitive osteoclastic phenotype, suggesting that pharmacological agents that inhibit osteoclast recruitment or activity are rational targets for blocking focal bone erosion in patients with RA and JRA.

Acid Phosphatase↗
PubMed1998

[Two cases of complete atrioventricular canal defect whose pulmonary vascular resistance were over 10 wood unit.m2 before 6 months of age].

We report two cases with complete form of atrioventricular canal defect (CAVCD) accompanied by Down's syndrome whose pulmonary vascular resistance (Rp) were more than 10 Wood unit.m2 at the age of less than 6 months. One child was 3-month-old boy whose Rp was 12 Wood unit.m2. The open lung biopsy at 3 months old showed histopathological change of Heath-Edwards grade I. He underwent intracardiac repair at the age of 4 months. He is doing well at 30 months of postoperative period. Another child was 5-month-old girl whose Rp was 15.5 Wood unit.m2. Histopathological change of lung at 5 months old demonstrated Heath-Edwards grade III. She underwent intracardiac repair at the age of 7 months, 2 months after lung biopsy. However, she died of oversystemic pulmonary hypertension and low output syndrome 7 days after surgery. The postmortem examination revealed that pulmonary vascular obstructive disease progressed during 2 months interval between the lung biopsy and the operation. In conclusion, cardiac catheterization with estimation of Rp should be performed in the cases of CAVCD, especially in those with Down's syndrome, in early infancy. If Rp is more than 10 Wood unit.m2 and lung biopsy indicates the surgical indication, surgical intervention should be done as soon as possible since the pulmonary vascular obstructive disease may progress in a short period.

Endocardial Cushion Defects↗
PubMed1998

[Primary carcinoma in situ of the ureter: a case report].

A 55-year-old male visited our hospital with a complaint of gross hematuria and right lower abdominal pain. Cytological findings of voided urine suggested the presence of malignant cells. Cystoscopic examination revealed bloody urine discharge from the right ureteral orifice and no abnormality in the bladder wall. The retrograde pyelogram showed no tumor masses. However, malignant cells were detected cytologically in the right ureteral catheteral urine twice. Under the preoperative diagnosis of primary urothelial tumor of the right upper urinary tract, right total nephroureterectomy was performed. A histological study revealed transitional cell carcinoma in situ in the lower portion of the ureter. We reviewed 46 cases of primary carcinoma in situ of the upper urinary tract previously reported in Japan.

Carcinoma in Situ↗
PubMed1998

Angiogenesis inhibitor TNP-470 inhibits growth and metastasis of a hormone-independent rat prostatic carcinoma cell line.

PURPOSE: Inhibitory effects of TNP-470, a synthetic analogue of the antibiotic fumagillin secreted by Aspergillus fumigatus, were studied with respect to growth and lung metastasis of the hormone-independent rat prostatic carcinoma cell line AT6.3. MATERIALS AND METHODS: Rat prostatic carcinoma AT6.3 cells were implanted in nude mice subcutaneously. Antimetastatic and growth-inhibitory effects of TNP-470 in vivo were examined 3 weeks after inoculation of AT6.3 cells. Direct growth-inhibitory effect was examined by MTT assay in vitro. RESULTS: TNP-470 inhibited the growth of AT6.3 cells in vitro. Subcutaneously injected TNP-470 markedly reduced numbers and individual size of lung metastases from AT6.3 cells inoculated percutaneously or intravenously into male BALB/c-nu/nu mice. CONCLUSION: This agent, which acts as an angiogenesis inhibitor, may prove to be clinically useful in preventing metastasis of hormone-independent prostatic cancer.

Animals↗
PubMed1998

[Diagnostic usefulness of the tuberculin reaction by PPD-B in Mycobacterium avium complex disease].

This study was carried out to clarify the diagnostic usefulness of the skin tests of purified protein derivatives from M. intracellulare (PPD-B) and M. tuberculosis (PPDs). Study subjects consisted of 41 patients with primary infection type of M. avium complex (MAC) disease, 36 patients with pulmonary tuberculosis (TB) and 29 patients with other bacterial respiratory infections including COPD (OB). The patients were sorted out to middle (50-69 y.o.) and old (70-89 y.o.) age groups of each disease. The size of skin redness elicited 48 hours after the PPD-B and PPDs intradermal injections were compared among them. The results were as follows. 1) Both PPD-B and PPDs skin reactions were larger in the middle age group than in the old one for each disease. 2) In PPDs skin tests, the reaction of TB group was the largest among the three diseases. In PPD-B skin tests, that of MAC was the largest. 3) In TB group, PPDs skin reaction was significantly larger than that of PPD-B, while in MAC and OB groups there was no significant difference between the skin reactions of PPDs and PPD-B. 4) Defining significant positive reaction to PPD-B as PPD-B skin reaction exceeding 10 mm and larger than that of PPDs skin reaction, the rate of significant positive reaction to PPD-B was significantly higher in MAC than TB in both age groups. These results showed that the simultaneous skin tests of PPD-B and PPDs were a useful aid in the diagnosis of MAC infection disease when mycobacterial infection diseases were clinically suspected by bacteriological or chest radiographic examinations.

Age Factors↗
PubMed1998

[One-stage repair of interrupted aortic arch with selective cerebral perfusion].

To minimize the neurological compromise after the circulatory arrest, the selective cerebral perfusion could be beneficial. We underwent one-stage repair of the interrupted aortic arch (IAA) with various intracardiac anomalies for the six patients, age ranging from 12 days to 4 months, by using the selective cerebral perfusion. Cardiopulmonary bypass was established by using two-way arterial cannulation supported by the two respective pump systems, one of which utilized the EPTFE graft anastmosed to either the bracheocephalic artery or the right subclavian artery and second of which enrouted through the arterial ductus to the descending aorta. The cerebral perfusion during the circulatory arrest for the aortic arch repair was maintained by the selective perfusion via EPTFE graft with 10 ml/kg/min blood flow. After the completion of the arch repair, the total system perfusion was restarted through the graft and the repair of the intracardiac anomalies was followed. Of six, no operative death or neurological complications related to the operation were found. The clinical neurological evaluation after operation also demonstrated the normal for the age. In conclusion, the selective cerebral perfusion by using the EPTFE graft during the circulatory arrest might decrease the risk of brain damage.

Aorta, Thoracic↗
PubMed1998

[A surgical case of cervical canal stenosis caused by atlas hypoplasia in an elderly patient].

We report an 81-year-old man with hypoplastic atlas resulting in a severe stiff feeling in the bilateral shoulders, spastic tetraparesis, and hypesthesia below the C2 segment level of the spinal cord. These symptoms are compatible with compression of the high cervical cord. Neuroimaging studies revealed a narrowing of the spinal cord by compression of the hypoplastic atlas. Laminoplasty of the atlas was performed under general anesthesia, and the patient's symptoms were resolved. Operated cases of older patient's with atlas hypoplasia have been rarely reported. Laminoplasty of the atlas is a safe and useful procedure for high cervical compression due to hypoplastic atlas.

Aged↗
PubMed1998

[A case of severe cytomegalovirus infection after the repair of coarctation of aorta].

We report a 2-month-old boy without any immuno-compromised diseases, who suffered from the severe cytomegalovirus (CMV) infection after the subclavian flap aortoplasty and pulmonary artery banding for coarctation complex. He underwent the operation at 2 months old and received 2 units of irradiated packed red blood cells before and after the surgery. His postoperative course was uneventful but the interstitial pneumonitis, until he developed watery diarrhea 10 days after the surgery following hepatitis with the marked hepatomegaly 3 weeks after. Since CMV infection was confirmed as the cause of the pneumonitis, enterocolitis and hepatitis, he was initially treated by gamma-globulin with the high CMV titer at a dose of 200 mg/kg/day for 2 days and ganciclovir at a dose of 10 mg/kg/day for 14 days. Because of the persistent CMV infection, he needed two more treatments of ganciclovir at the same dosage and gamma-globulin once a week for 2 months. He finally recovered from severe CMV infection 5 months after the above treatments. In conclusion, the severe CMV infection can occur by blood transfusion even in the surgical case with normal immune system. If one finds pneumonitis, hepatitis or enterocolitis after any type of surgery with history of blood transfusion, CMV infection should be suspected as the cause of these diseases.

Antiviral Agents↗
PubMed1998

[A case report of dumbbell neurogenic tumor of the superior mediastinum].

A 15-year-old female was admitted because of the superior mediastinum mass on chest X-rays and sensory loss of ulnar side of the left arm. Computed tomographic scanning and magnetic resonance imaging revealed that the tumor was dumbbell-shaped and invaded the vertebral canal through the intervertebral foramen between C 7 and Th 1. At first laminectomy of vertebrae (C 6-Th 1) was made in a prone position and intra-spinal portion of the tumor was resected. Then the patient was placed in a supine position and the chest was opened by left hemicollar incision and sternotomy to the 2nd intercostal space. The tumor was divided into two parts at the level of 1st rib and completely removed. The pathological diagnosis was schwannoma. This procedure is safe and useful for dumbbell type tumor located in superior mediastinum, especially in case of large tumor from neck to the thoracic cavity.

Adolescent↗
PubMed1998

[Cases of multiple ventricular septal defects].

We had 4 cases with multiple ventricular septal defects (VSDs) in complexed congenital heart disease. One of four had two separate VSDs detected by two dimensional echocardiography before operation. Second of four had additional infundibular muscular VSD which was detected by echocardiography in the intensive care unit (ICU) after patch closure of a perimembranous VSD. The third case had two additional VSDs of inlet muscular and subaortic septum detected by transesophageal and direct echocardiography during reoperation, beside a subpulmonary VSD which was originally diagnosed before Jatene operation for double outlet right ventricle. The fourth case had multiple trabecular muscular VSDs diagnosed by postoperative angiography soon after Rastelli operation. Since these additional multiple VSDs compromise the postoperative hemodynamics if those are unrecognized, it is indispensable to detect all VSDs before operation, using transthoracic and transesophageal echocardiography.

Echocardiography↗
PubMed1997

[Effects of establishing a special smoking area in the office of an electronic factory].

Measurements of concentrations of suspended particles and a questionnaire survey at the office of an electronic factory were conducted before and after the establishing of a special smoking area. Compared with the previous conditions where smoking had been allowed during a specified time, the suspended particle concentration has decreased to less than one fifth of the previous condition. Both smokers and non-smokers are satisfied with the establishment of the smoking area. All were convinced that the separation of the smoking permissible area and non-smoking area was more effective than the time restriction on smoking.

Adult↗
PubMed1997

Breast-Coserving Surgery for Primary Breast Cancer: Immediate Volume Replacement Using Lateral Tissue Flap.

We have developed a breast-conserving surgery consisting of quadrantectomy and regional lymph node dissection and immediate volume replacement using lateral tissue flap (LTF). The quadrantectomy was employed on the basis of segmental anatomy of the duct-lobular system in which breast carcinoma originates. Lateral skin incision was performed from the apex of mid-axillary line to the inframammary fold, without removing the skin overlying the tumor, In the early period of breast reconstruction embraced latissmus dorsi flap (LDF) for 10 patients(reconstruction was not performed on 35 patients), but in the late period we employed LTF for 56 patients. Four of the 101 patients developed ipsilateral breast cancer during a mean follow-up period of 48 months, but none died of breast cancer, Among the 56 patients with LTF replacement no patient developed ipsilateral breast cancer. Fairly good cosmetic outcome was obtained in the patients who underwent the immediate volume replacement. Breast-conserving surgeries are reviewed, and the surgical procedure using LTF for immediate volume replacement is described.

Journal Article↗
PubMed1997

PACAP stimulates pancreatic exocrine secretion via the vagal cholinergic nerves in sheep.

The present study evaluates the possible role of the vagus nerves in mediating the stimulatory effect of PACAP-27, PACAP-38 and VIP on the exocrine pancreas, especially on enzyme secretion which is atropine sensitive in sheep. The animals were equipped with two cannulae into the common bile duct, a duodenal cannula, and a ruminal cannula under anesthesia. The bilateral cervical vagus nerves were coiled with a cooling device. In conscious animals, the peptides were infused intravenously for 10 min at 10 pmol kg(-1)min(-1) in phase II of the duodenal migrating motor complexes and the same peptide infusion was repeated in the reversible cooling blockade of the vagus nerves. Increment in fluid secretion was not significantly altered by the vagal blockade in all the peptide infusions, while increment in bicarbonate ion by only PACAP-27 was inhibited by the vagal blockade. Increments in protein and amylase output decreased significantly to 32.0+/-5.0 and 23.2+/-2.6% in PACAP27, and to 26.1+/-7.7 and 20.8+/-6.4% in PACAP-38 in the vagal blockade, but the increments by VIP did not decrease. These results demonstrate that circulating PACAP stimulates pancreatic enzyme secretion via the vagal cholinergic preganglionic neurons in sheep, suggesting the central action of PACAP.

Amylases↗
PubMed1997

Characterization and In Vitro Cytotoxic Effect of Adriamycin-conjugated Monoclonal Antibody Prepared Against Breast Cancer Cell Line.

We have produced an adriamycin-conjugated monoclonal antibody, AM1, covalently linked by acid-labile cis-aconitic spacer. The immunoconjugate, cis-aconitic adriamycin(cAA)-AM1, was confirmed to retain the binding activity against human breast cancer cell lines by flow cytometry. The immunoconjugate was shown to be internalized into antigen-positive cancer cells by flow cytometry analysis and high performance liquid chromatography. Antitumor effects of cAA-AM1 were assessed on human breast cancer and colon cancer cell lines, with inhibition of (3) H-leucine uptakes to the cells. cAA-AM1 demonstrated a selective cytotoxicity to ZR-75-1 which was reactive with AM1, whereas it showed no antitumor effect on SW1116 cells which did not react with AM1. Free adriamycin demonstrated a non-selective cytotoxicity against both cell lines. AM1 alone and cAA-control IgM did not show any antitumor effect on ZR-75-1. These results suggest that cAA-AM1 retains binding activity and specificity against breast cancer cells in vitro.

Journal Article↗