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Biomedical subjects

Y Inoue

Publications and source records attributed to Y Inoue.

At least 685 records · Page 38Linked to original sources
PubMed1998

[Evaluation of transcatheter hepatic segmental or subsegmental infusion of SMANCS for treatment of hepatocellular carcinoma].

A total of seventeen patients with hepatocellular carcinoma (HCC), nineteen HCCs, who underwent as an initial treatment transcatheter hepatic segmental or subsegmental arterial administration of SMANCS alone for hepatocellular carcinoma (HCC), were studied to evaluate the efficacy and complication of that treatment. The initial treatments provided CR in eight patients (47%), and repeat administrations of SMANCS achieved CR in an additional four patients (24%). The initial treatment provided a dense deposit of Lipiodol in the twelve tumors (63%), in five of which Lipiodol was thereafter washed out in some portions of the tumor. Complete necrosis was obtained in nine (75%) of fourteen hypervascular tumors, and in two (40%) of five intermediately vascular or hypovascular tumors. Segmental or subsegmental administration of SMANCS was well tolerated with self-controlled abdominal pain or fever well responding to medication. Ascites was seen in three cases, and atrophy of the segment infused occurred in five patients. Cholinesterase significantly reduced at one week and one month, then recovered to baseline two to three months after initial treatment. The cumulative survival rates were 77% at 1 year, 66% at 2 years, and 53% at 5 years in the whole patients. The survival rate was 100% at 5 years in the Child A group. In the patients who obtained CR using SMANCS alone, the survival rates were 89% at 1 year, 74% at 2 years and 56% at 5 years. Although this method may transiently deteriorate hepatic function, segmental or subsegmental administration of SMANCS may be an excellent therapeutic method for treatment of HCC and promising for use in properly selected patients.

Adult↗
PubMed1998

[Acute transverse myelitis presenting with syrinx formation associated with anti-sulfated glucuronyl lactosaminyl paragloboside antibody and anticardiolipin antibody].

A 37-year-old woman was admitted because of rapidly progressive unsteady gait, back pain and ascending dysesthesia below the lower chest level. On admission, she showed ataxic gait, positive Romberg's sign, severely impaired deep sensation of lower extremities, and vesico-rectal disturbance. Deep tendon reflexes in both lower extremities were brisk, while normal in the upper extremities. Babinski's sign was positive on both sides. On laboratory data, antinuclear antibody, immune complex and the low titer of IgG anticardiolipin antibody as well as IgM anti-sulfated glucuronyl lactosaminyl paragloboside (SGLPG) antibody were positive in her serum. Cerebrospinal fluid showed pleocytosis and increased protein level, but no oligoclonal IgG bands. The posterior tibial nerve SEP showed no P39 peak with normal latency of N20. Spinal MRI revealed mild cord swelling and syrinx formation at T7 to T9 level. Steroid therapy including pulse therapy with methylprednisolone was effective. The present case was diagnosed as acute transverse myelitis (ATM) similar to lupoid sclerosis, and to the best of knowledge, the first case of ATM with anti-SGLPG antibody. It is speculated that the autoimmune mechanism with anti-SGLPG antibody and anticardiolipin antibody by reacting with the endothelial cells in the central nervous system might contribute to causing ATM in our case.

Acute Disease↗
PubMed1998

Extrinsic innervation modulates canine jejunal transport of glutamine, alanine, leucine, and glucose.

BACKGROUND: We previously showed a decrease in ileal glutamine transport in vitro and net absorption in vivo after extrinsic denervation of the canine jejunoileum. The aim was to determine whether extrinsic innervation modulates in vivo net absorption and in vitro transport of glutamine and other nutrients in canine jejunum. METHODS: In vivo net jejunal uptakes of glutamine, alanine, leucine, and glucose were measured in five dogs before and 2 and 8 weeks after a model neurally isolating in situ the jejunoileum (extrinsic denervation, intestinal transection). To assess mechanisms, carrier-mediated uptakes were quantitated in jejunal brush border membrane vesicles from six dogs before and at 2 and 8 weeks after neural isolation of the jejunoileum and compared with six control dogs with fully intact extrinsic innervation. RESULTS: In vivo net absorption of glutamine decreased at 2 weeks (p < 0.05) and returned to normal values at 8 weeks; net absorptions of leucine, alanine, and glucose were decreased at both 2 and 8 weeks. In vitro brush border membrane vesicles transport of glutamine, leucine, and alanine followed the patterns of in vivo absorption, but glucose transport did not differ at any time point. Decreased glutamine uptake at 2 weeks resulted from a decrease in Vmax rather than a change in K(m) in sodium-dependent carrier-mediated transport. CONCLUSIONS: Extrinsic denervation down-regulated carrier-mediated transport of amino acids but not glucose. Decreased in vitro glutamine transport was mediated in part by a decrease in number rather than affinity of sodium-dependent transporters.

Alanine↗
PubMed1998

[A case of poorly differentiated adenocarcinoma of prostate with neuroendocrine differentiation].

A 59-year-old man was diagnosed with clinical stage D1 poorly differentiated prostatic adenocarcinoma (PAC). The patient was treated with total androgen blockade therapy. The tumor recurred 18 months later. Digital rectal examination revealed a large, stony-hard prostate. The serum PSA level was within normal limits. Pathological examination of the prostate revealed conventional adenocarcinoma with large numbers of neuroendocrine (NE) cells. The patient died 3 months after the diagnosis of PAC with NE differentiation, 22 months after the initial diagnosis of prostate cancer.

Adenocarcinoma↗
PubMed1998

[Cerebral kinetics of brain perfusion agents].

Radiotracers called chemical microsphere are widely accepted as brain perfusion agents. Following the intravenous administration, these drugs are transported via the artery to the brain, cross the intact blood-brain barrier, and enter the brain tissue. Once the tracer flows into the brain, the efflux of the tracer is prevented by some trapping mechanism, resulting in prolonged retention. Because the distribution of the accumulated tracer remains approximately consistent with regional cerebral blood flow for a relatively long period, high-quality SPECT images reflecting the distribution pattern of cerebral blood flow can be acquired. However, unlike true microsphere, cerebral kinetics of the brain perfusion agents is complicated, and various causes may produce discrepancy between the distributions of the tracer and blood flow. In this review, cerebral kinetics of the brain perfusion agents used commonly is discussed. The knowledge of the mechanism of brain accumulation appears to be essential to appropriately determine the tracer of choice and interpret the obtained images.

Amphetamines↗
PubMed1998

[Combination chemotherapy (CVP) in a patient with refractory idiopathic thrombocytopenic purpura (ITP)].

A 54-year-old woman, who had been given a diagnosis of idiopathic thrombocytopenic purpura (ITP) refractory to steroid therapy, was admitted to our hospital because of severe bleeding tendency. Splenectomy, high dose vitamin-C and interferon-alpha were not effective, although high-dose gamma-globulin had some effect. Since high-dose glucocorticoid was effective temporarily, we decided to perform chemotherapy. Seven courses of CVP chemotherapies (CVP; CPM 500 mg, VCR 2 mg, PSL 50 mg) prevented severe bleeding and did not have serious toxicity. Chemotherapy can be indicated for refractory ITP reactive to immunosuppressive therapy such as high-dose glucocorticoid.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

A case report of Candida parapsilosis endocarditis.

A 57-year-old male was treated for fungal endocarditis caused by Candida parapsilosis which precipitated severe cardiac valve vegetation and insufficiency. His condition resulted from a three-month installation of a central venous catheter for hyperalimentation and chemotherapy following total gastrectomy for gastric cancer. Aortic valve replacement combined with fluconazole administration resulted in satisfactory recovery with no adverse events during an 18-month follow up period.

Antifungal Agents↗
PubMed1998

[Midbrain ptosis with diurnal fluctuation like myasthenia].

A 51-year-old man was admitted because of bilateral fatigable blepharoptosis with diurnal fluctuation. He had a tendency to take much instant foods before onset. On admission, he showed symmetrical bilateral ptosis, supranuclear upward gaze palsy and vertical diplopia. Ptosis mildly improved on lateral or upward gaze. Bell's phenomenon and pupillary response were intact. Intravenous edrophonium infusion test and serum antiacetylcholine receptor antibody were negative. Cranial MRI and CT demonstrated the lesion in the periaqueductal gray (PAG) region from superior colliculus to upper pontine level, which was remarkably enhanced by Gd-DTPA infusion. He was diagnosed as midbrain ptosis, probably due to atypical Wernicke's encephalopathy. It was conceivable that the PAG lesion might be contributory to fatigable blepharoptosis (pseudomyasthenia) and supranuclear upward gaze palsy in the present case, because the PAG controls levator palpebrae neurons of central caudal nucleus in oculomotor nucleus complex and receives afferents from the limbic system., reticular formation and posterior commissure.

Blepharoptosis↗
PubMed1998

[All-trans retinoic acid was effective for marked skin infiltration in a relapsed acute myelogenous leukemia (AML-M2) patient with t(12; 17)].

A 64-year-old man who had taken acute myelogenous leukemia (AML-M2) in 1989 have relapsed with t(12; 17) (p13; q11.2-21) chromosomal abnormality and presenting marked infiltration to the skin in 1994. Blasts were seen on his peripheral blood smear (15%) and bone marrow examination showed increased leukemic cells (56%), with maturation. Leukemic cells expressed CD13 and CD33 antigen but not HLA-DR. Although leukemic cells had not promyelocytic feature morphologically, detection of PML/RAR alpha infusion signal of peripheral leukemic cells were positive for 8% (1% for control) by fluorescence in situ hybridization method. Because he did not response to standard combination chemotherapy and because we considered the possibility that t(12; 17) (p13; q11.2-21) observed in this case are t(15; 17) variant, we tried all trans retinoic acid (ATRA) to him. Interestingly, ATRA was very effective for skin lesion but hematologically it had no effect at all, and he died because of bacterial pneumonia.

Antineoplastic Agents↗
PubMed1998

Nuclear matrix protein, tumor necrosis factor-alpha, and nitrite/nitrate levels in patients with multiple organ dysfunction syndrome.

Nuclear matrix protein (NMP), an indicator of apoptosis, was analyzed in patients with multiple organ dysfunction syndrome (MODS). Blood levels of tumor necrosis factor-alpha (TNF-alpha) and nitrite/nitrate (NOx) were also measured in these patients to determine the involvement of these factors in the production of NMP. Forty-six patients with MODS were studied, 21 (45.7%) of whom died. NMP and TNF-alpha were measured by enzyme-linked immunosorbent assay (ELISA). NOx was measured by the Griess's method. Marshall's multiple organ dysfunction score (MOD score) was used as an indicator of organ failure. The severity of organ failure was assessed by use of the acute physiology and chronic health evaluation II score (APACHE II score). The number of organs that failed was found to be significantly correlated with the NMP level. The NMP level was also correlated significantly with MOD score and APACHE II score, as well as with TNF-alpha and NOx levels. NMP and NOx levels in the group that died significantly exceeded those in the surviving group. Results suggest that apoptosis can occur in the presence of MODS, and that its extent increases as the number of failing organs increases. The results also suggest that TNF-alpha and NO are involved in the induction of apoptosis.

Adolescent↗
PubMed1998

[Use of a scanning laser tomograph to evaluate the optic disc of the normal eyes].

We evaluated the optic disc in 77 eyes of 77 normal volunteers using a scanning laser tomograph (Heidelberg Retina Tomograph: HRT, version 1.11). Particular attention was paid to age, refractive error, and disc size. The topographic parameters included: cup area, C/D area ratio, rim area, cup volume, rim volume, mean cup depth, maximum cup depth, cup shape measure, height variation contour, mean RNFL thickness, and RNFL cross section area. There was a significant decline in mean RNFL thickness and RNFL cross section area with increase in age (p < 0.05). The mean and maximum cup depths were significantly deeper in myopic eyes (p < 0.05). Large discs had large values of cup area, C/D area ratio, rim area, cup volume, mean cup depth, cup shape measure (p < 0.01), and maximum cup depth (p < 0.05). Large discs had small values of mean RNFL thickness and RNFL cross section area. Rim volume was independent of age, refractive error, or disc area.

Adult↗
PubMed1998

Neutrophil chemotaxis induced by corneal epithelial cells after herpes simplex virus type 1 infection.

PURPOSE: Neutrophil invasion is a primary event in the development of herpetic keratitis. It has been reported that HSV-1 infection of keratocytes induces the synthesis of IL-8, a potent neutrophil chemoattractant, while corneal epithelium does not. Nevertheless, little is known about the correlation between neutrophil migration and the production of chemotactic factors by HSV-1-infected corneal cells, especially in epithelial cells which form an initial barrier of the ocular surface. We examined whether human corneal epithelial cells as well as keratocytes could induce neutrophil chemotaxis in response to HSV-1 infection. METHODS: Human corneal epithelial cells immortalized with SV40 (HCE) and human keratocytes were infected with HSV-1. The culture fluids collected at 4, 12, 24 h after infection were assayed for human neutrophil chemotaxis using a modified Boyden chamber method. IL-8 levels in these supernatants were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: The chemotactic activity induced by HCE and keratocytes after MP strain of HSV-1 infection peaked as early as 4 h postinfection, then declined. Chemotactic activity induced by HSV-1-infected HCE and IL-8 levels on these supernatants paralleled with the infectious virus titer. It was inhibited by monoclonal anti-IL-8 antibody. UV-inactivation of MP strain abrogated neither the induction of chemotactic activity nor IL-8 secretion of infected HCE. CONCLUSIONS: At the early phase of HSV-1 infection, corneal epithelial cells play an important role in inducing neutrophil chemotaxis, which was mediated by IL-8.

Cell Line↗
PubMed1998

[Utilization of a direct sandwich ELISA kit for rapid diagnosis of adenovirus hemorrhagic cystitis in a patient with adult T-cell leukemia].

We report on a case of adenovirus hemorrhagi cystitis that developed in a 49-year-old woman during intensive chemotherapy for adult T-cell leukemia. Although rapid etiologic diagnosis is essential for the effective management of viral hemorrhagic cystitis, the isolation of adenovirus from urine is often too time-cousuming. We detected the adenovirus antigen in the patient's urine using an Adenoclone direct sandwich ELISA kit (Cambridge Bio Science), which is commonly employed for the diagnosis of adenovirus conjunctivitis. Treatment consisted of intravenous vidarabine and bladder irrigation, which resulted in prompt clinical improvement. The Adenoclone kit was useful for the rapid etiologic diagnosis of adenovirus hemmorrhagic cystitis.

Adenoviridae Infections↗
PubMed1998

Severe corneal dystrophy phenotype caused by homozygous R124H keratoepithelin mutations.

PURPOSE: To determine the mutational status of the beta ig-h3 gene in five patients from four Japanese families affected with an unusual, severe form of corneal dystrophy. In these five cases, the corneas were remarkable for confluent round opacities in the superficial stromal layer. The beta ig-h3 gene coding for keratoepithelin was recently identified as the gene responsible for 5q-linked autosomal dominant corneal dystrophies. METHODS: Genomic DNA was isolated from leukocytes of five patients with the severe form of corneal dystrophy. To screen for point mutations, exons of the beta ig-h3 gene were amplified by polymerase chain reaction and were analyzed with the single-strand conformational polymorphism technique. Subsequently, the mutations were identified by a direct sequencing method and restriction enzyme digestion analysis. RESULTS: All five patients with the severe form of corneal dystrophy had homozygous R124H keratoepithelin mutations. Histopathologic examinations of the corneas obtained from two patients with the severe form showed granular, rod-shaped deposits. CONCLUSIONS: The severe phenotype was a pathologic variant of granular corneal dystrophy (GCD). All five patients had homozygous R124H keratoepithelin mutations. The R124H keratoepithelin mutation is the same mutation recently reported to be responsible for Avellino corneal dystrophy. The homozygous R124H keratoepithelin mutations are the cause of the severe variant of GCD characterized by juvenile-onset and confluent superficial opacity.

Adult↗
PubMed1998

A new preshaped catheter for right ventriculography with minimal artificial tricuspid regurgitation.

A new type of preshaped angiographic catheter for right ventriculography to be inserted from the femoral vein has been developed. Right ventriculography using this catheter was conducted in about five hundred clinical cases. The result has revealed that this catheter is very useful in clinical settings without causing catheter-induced tricuspid regurgitation (TR) allowing easier and safer right ventriculography as compared with conventional catheters.

Cardiac Catheterization↗
PubMed1998

[Psychopathological study on schizophrenic autism through the paintings of a case of simple schizophrenia].

Autism is the symptom which has the most specific features of schizophrenia. However, the content of pathological experience of the patients has not yet been clarified as it was never told by themselves. In the present study, a case of simple schizophrenia with a major symptom of autism is reported. Schizophrenic autism was studied psychopathologically by drawing tests. The analysis of drawings was summarized by the following characteristics. 1. The objects were drawn so as to be small at the center. The composition was further characterized by the overwhelmingly predominant empty space of its circumference, which we termed "reversed zoom lens effect". This seemed to show that the objects were isolated and removed from the patient. 2. The entire image of the theme was not drawn. 3. Lack of vitality was observed in all the drawings. On the basis of the above characteristics of these drawings and the clinical findings, the following were suggested as the pathology of the patient's experience: 1. The "reversed zoom lens composition" seen in the drawings suggested that the psychological distance between objects and the patient might be expanded. 2. The patient was alienated from the objective world to which he had once been accustomed as the object lacked vitality and familiarity. 3. The pathology of schizophrenic autism observed in the patient could be expressed as "alienation from objective experience." 4. It was considered that although akin to depersonalization, "alienation from objective experience" was the pathology characteristic of schizophrenia.

Adult↗