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Biomedical subjects

Y Tada

Publications and source records attributed to Y Tada.

At least 127 records · Page 7Linked to original sources
PubMed1999

[An analysis of fever of unknown origin defined by newly proposed practical criteria. A prospective study of 56 cases].

The criteria proposed by Petersdorf has been in use internationally to define the fever of unknown origin (FUO) since 1961 and the research of FUO has progressed with this criteria. Mean-while, new diagnostic methods have been developed and illness behavior of febrile patients has changed considerablly. Accordingly, the definition by Petersdorf is becoming less matched to current clinical situation. Therefore, we have developed a new practical criteria of FUO; i.e., out-patients who are febrile more than 2 weeks, documented temperature higher than 37.5 degrees C at least on one occasion and undetermined diagnosis and in-patients who are febrile more than 1 week with documented temperature higher than 37.5 degrees C, and undetermined diagnosis. Between October 1, 1993, and October 31, 1996, we prospectively collected a series of febrile patients who fulfilled our new criteria. We identified 56 patients by our criteria (23 male and 33 female, age: 49.7 +/- 20.6. range 15 to 88). Of this 56 patients, 19 (32%) were found to have infections, 18 (31%) had collagen disorders, 5 (9%) had malignancy and 6 (10%) had died. Of 56 patients, 38 (68%) were in the newly added group. Of these 38 patients, 4 patients had subacute necrotizing lymphoadenitis, 4 cytomegalovirus infection, 3 polymyalgia rheumatica, 3 tuberculosis. Four patients (10%) died. With our criteria, febrile patients who previously had not been included were found to have as poor a prognosis as with the Petersdorf group.

Adolescent↗
PubMed1999

Labeled carcinoembryonic antigen antibodies excitable by infrared rays: a novel diagnostic method for micro cancers in the digestive tract.

OBJECT: An indocyanine green derivative (ICG-sulfo-OSu) was used as the labeling substance for monoclonal antibody, and a fluorescence imaging system appropriate for ICG-sulfo-OSu excitable by infrared rays (IR) was developed. The goal of this study was to demonstrate antibody labeling at the tissue level using this new imaging system. MATERIALS AND METHODS: ICG-sulfo-OSu labeled mouse anti-human carcinoembryonic antigen (CEA) monoclonal antibody, a newly developed imaging system, and an infrared ray microscope were employed in this experiment. Paraffin sections of human colon cancer previously proven to have cross-reactivity to anti-CEA antibody were examined. RESULTS: Positive staining was seen as a brownish discoloration of oxidized 3,3'-diaminobenzidine tetrahydrochloride (DAB) in sections that reacted with ICG-sulfo-OSu-labeled anti-CEA antibody, and the fluorescence was well-matched with the oxidized DAB-positive sites. CONCLUSION: Specific antibodies labeled with ICG-sulfo-OSu have significant affinity to cancer cells and seem to reflect sufficient amounts of fluorescence by IR to be useful in a system for the endoscopic detection of micro cancers using the immunohistochemical staining method.

Adenocarcinoma↗
PubMed1999

Polyangiitis overlap syndrome with eosinophilia associated with an elevated serum level of major basic protein.

Polyangiitis overlap syndrome is a new disease entity and the reported cases in the literature are still limited. We describe a female patient presenting with finger ulcers, skin eruptions, pleural effusion, interstitial pneumonia and eosinophilia. Skin biopsy showed systemic small-sized angiitis and thrombosis. She was diagnosed as having polyangiitis overlap syndrome and was successfully then treated with corticosteroid. It is also of interest that the disease activity was correlated with the number of eosinophils in peripheral blood. The measurement of the serum level of major basic protein released from eosinophils functioning as a coagulant indicated the possible association of eosinophilia with thrombosis and polyangiitis.

Aged↗
PubMed1999

Releasing severe adhesions around the eminence and the synovial portion of the TMJ: a clinical study of combined treatment using hydraulic lavage, arthroscopic surgery and rehabilitative therapy.

This paper evaluates the effects of treatment with a pumping technique and arthroscopic lysis and lavage, followed by rehabilitative training, on condylar head mobility of the temporomandibular joint (TMJ). We studied 32 TMJs in 19 patients suffering from chronic closed lock with severe adhesion. The results were compared between cases with adhesions concentrated in two areas: mostly in the posterior and/or the anterior synovial portion of the upper TMJ compartment (11 joints) and mostly around the eminence (21 joints). The results showed a statistically significant improvement in condylar head movement for both groups between the initial and final stages of treatment. However, the results also suggested that patients with adhesion concentrated around the eminence are less likely to recover condylar head mobility to the same extent as those in the other group.

Adult↗
PubMed1999

[Non-steroidal antiinflammatory drug--management of gastrointestinal complications and inhibition of COX-2].

Non-steroidal antiinflammatory drugs (NSAID) are widely used for the treatment of rheumatoid arthritis and other collagen vascular diseases, and now more than 30 drugs are available. However, caution should be paid in using NSAIDs because of their serious side effects, especially gastrointestinal toxicity. Misoprostol has been shown to prevent NSAID-induced gastrointestinal damage, and proton-pump inhibitor omeprazole and misoprostol have been shown to be effective in the treatment of ulcers and erosions induced by NSAIDs. After the discovery of cyclooxygenase-2 (COX-2), investigators have raised a hypothesis that specific inhibitor of COX-2 should have anti-inflammatory activity with least gastrointestinal toxicity. According to this, efforts have been paid to produce COX-2 selective inhibitors. Although several COX-2 inhibitors have been reported to show reduced toxicity, further investigations are needed to establish their usefulness.

Animals↗
PubMed1999

[Myocardial distribution of iodine-123-iodophenyl-9-methyl-pentadecanoic acid (9MPA) in patients with acute myocardial infarction: comparison with regional wall motion obtained from technetium-99m-sestamibi gated SPECT].

123I-iodophenyl-9-methyl-pentadecanoic acid (9MPA) is a modified long-chain (15 carbons) fatty acid with a methyl branch on its 9 carbon location. Myocardial SPECT images (two sets, 10 min each) were obtained starting 10 min (early phase) and 50 min (delay phase) after the injection of 160 MBq 123I-9MPA at rest in 10 patients with acute myocardial infarction. The segmental myocardial uptake (% uptake) and clearance (% washout) from early to delay image were calculated by the SPECT data. ECG-gated myocardial SPECT with 99mTc-sestamibi was also performed and segmental left ventricular (LV) wall motion was evaluated using QGS (quantitative gated SPECT) program. The % uptake of LV segments with hypokinetic or akinetic wall motion were significantly lower than those with normokinesis (p < 0.01) for both early and delay phases. The % washout of hypokinetic segments were significantly lower than those of normokinetic regions (p < 0.01), while the % washout of akinetic segments were significantly higher than those of severely hypokinetic segments (p < 0.05). Thus, 123I-9MPA myocardial distribution and clearance thought to be associated with left ventricular regional wall motion.

Fatty Acids↗
PubMed1999

[Clinical characteristics of thrombotic diseases of arteries and veins].

Thrombotic occlusion of the arteries and veins are categorized as acute and chronic presentations. Acute arterial occlusion results in severe ischemia because of poor or no development of the collateral arteries. They should be treated promptly by thrombectomy or thrombolysis. On the other hand, chronic arterial occlusion is preferably treated by bypass surgeries. Although the vascular surgeries in the chronic arterial occlusion have undergone remarkable development in the recent years, the treatment of acute occlusion still lags behind poor with prognosis. The treatment of acute venous occlusion is aimed to prevent postphlebitic syndrome except for the ischemic type such as venous gangrene. The purpose of the treatment of chronic venous occlusion is to assist the pump function of the calf muscles to avoid venous stasis. Pulmonary embolism is the most severe complication and its treatment remains controversial.

Arterial Occlusive Diseases↗
PubMed1999

[Recent advances in vascular surgery].

In the recent years, the vascular reconstructions are being performed regularly in patients with chronic arterial occlusion, while no remarkable advances are observed in cases with acute arterial deterioration. The poor results of the vascular surgeries for the acute arterial occlusion are mainly due to myonephropathic metabolic syndrome (MNMS). The thrombectomy which is performed by Fogarty's balloon catheter is the simplest technique and found to be useful in patients suffering from thromboembolism. But it should be applied carefully to avoid vascular injury. The surgical techniques have been remarkably improved especially in the area of tibial bypass surgery and endovascular surgery. The former has been achieved by tourniquet occlusion technique and the later by angioplasty with a metal stent.

Arterial Occlusive Diseases↗
PubMed1999

[Simulation study on parent artery occlusion therapy for basilar head giant aneurysms: hemodynamic efficacy of additional bypass on enhancing aneurysmal thrombosis].

Parent artery occlusion therapy has been used as an alternative for directly untreatable basilar head giant aneurysms. However, some aneurysms still require additional technique to further induce intraaneurysmal stagnation and thrombosis. Using a hydraulic model, half-life of the dye in the model aneurysm was measured as an index of the intraaneurysmal stagnation. The ratio of diameters (D1, D2) of the two posterior communicating arteries (PCom) is defined as diameter ratio (DR) (D1/D2, D1 < D2). Occlusion therapy was simulated in 4 different sites. The most distal site was at the distal BA (Type A) and the most proximal site at the bilateral VA (Type D). The additional technique investigated was bypass placement to the P2 segment of the posterior cerebral artery (PCA) on the smaller PCom side. The half-life was 2.5 +/- 0.2 (mean +/- 2SD) sec before occlusion. Occlusion therapy significantly increased the half-life depending on the occlusion site and DR values with the maximum values of infinite in Type A and 25 sec in Type D. Placement of the bypass decreased the tangential flow volume to the aneurysmal neck, and increased the time markedly in Types A and B, considerably in Type C and slightly in Type D. Parent artery occlusion therapy has been considered less beneficial for patients with a diameter ratio of less than 0.70 since aneurysmal stagnation depends on the diameter ratio. Bypass placement additional to the occlusion therapy is very useful in enhancing the aneurysmal stagnation, which would make those patients indicated for the therapy.

Basilar Artery↗
PubMed1999

Nondissection method in distal arterial bypass surgery.

One of the most conspicuous advances in vascular surgery during the past two decades has been the improvement of the patency of distal bypasses. The nondissection method, in particular, has made a great contribution to better the tibioperoneal bypass patency. This review describes the operative procedure and background of the method, in which only the vascular sheath of the recipient artery is exposed and circumferential dissection of the artery avoided. The limb is exsanguinated with an Esmarch's bandage, and haemostasis is maintained with a pneumatic tourniquet. Vascular clamps are not applied to the artery at the distal anastomotic site. In a series of 42 tibial bypasses, a primary revised patency of 84% has been achieved after five years with this method.

Anastomosis, Surgical↗
PubMed1999

[A case of recurrent breast cancer successfully treated with docetaxel].

A 53-year-old female underwent mastectomy for left breast cancer in April, 1993. She was given oral tamoxifen but this had to be discontinued due to its side effects. In March, 1998, she developed bone and lung metastases, in spite of treatment with combination chemotherapy (CEF). We thus treated here with docetaxel 90 mg three times and 40 mg six times. After the chemotherapy, she achieved complete remissions of the lung metastases and a decrease in serum CEA, CA 15-3, NCC-ST439, and BCA225. Adverse reactions to docetaxel were grade 2 alopecia, grade 4 neutropenia, dysgeusia, and fluid retention. All were tolerable. This new agent may play an important future role in chemotherapy for recurrent breast cancer.

Antineoplastic Agents, Phytogenic↗
PubMed1999

[A clinical study for improving the survival rate of pN2 lung cancer through our case of 53 patients].

BACKGROUND: In management of non-small cell lung cancer, the evaluation and treatment of N2 disease has a lot of controversy. MATERIALS AND METHODS: Between 1983 and 1998, 53 patients of pN2 non-small cell lung cancer were operated by standard lymph node dissection method (R2) using CUSA system. We studied the sensitivity of the diagnosis of preoperative N factor, survival rate, and analysed the relationship between the postoperative mediastinal lymph node metastasis and the site of recurrence. RESULTS: Three-year and five-year survival rates for 53 cases were 46.8% and 33.4% respectivery. Preoperative sensitivity of CT scan for N factors were only 45% in squamous cell carcinoma and 24.2% in adenocarcinoma. Even with intraoperative findings, the sensitivity was not better. In a follow up survey, ipsilateral mediastinal lymph node recurrence was not detected, contralateral mediastinal lymph node recurrences were rare and the distant metastases were common cause of death. CONCLUSION: It is more important to accomplish the standard lymph node dissection completely in all cN cases than to evaluate the preoperative node stage aggressively using invasive methods.

Adenocarcinoma↗
PubMed1999

[Surgical treatment of 2 cases of irradiation induced constrictive pericarditis].

A 72-years-old man underwent radiation therapy (62 Gy) for esophageal carcinoma. Twelve months later, symptoms of heart failure such as syncope, cough and hepatomegaly manifested. On catheter study, a dip and plateau pattern of right ventricular pressure curve was evident. Pericardiectomy without extracorporeal circulation was performed. Operative findings and pathological results were compatible with radiation-induced constrictive pericarditis. He recovered from the heart failure, and has been doing well 3 months after the surgery. A 54-years-old man underwent thymectomy for malignant thymoma. He underwent a radiation therapy (52 Gy) postoperatively. After 12 months from the irradiation, syncope and dyspnea manifested. On catheter study, a dip and plateau pattern of right ventricular pressure curve was observed. Pericardiectomy with extracorporeal circulation was performed. He recovered from the heart failure after pericardiectomy, however he died of radiation-induced pneumonitis 6 months later.

Aged↗
PubMed1999

Primary aortoduodenal fistula treated successfully with surgery in a patient with Takayasu's arteritis.

Takayasu's arteritis was originally described as a systemic inflammatory arterial disease presenting with occlusive changes. However, it has also been known to cause aneurysm formation. In this report, a patient with Takayasu's arteritis was found to have an aortoduodenal fistula. An emergency operation was carried out with resection of the saccular aneurysm and the fistula. The aorta was reconstructed with a prosthetic graft and the duodenum repaired. A pedicled omental flap was placed between the aorta and the duodenum. The postoperative recovery was uneventful, there was no evidence of persistent bleeding, and the patient was well at the 3-year follow-up. This is the first case in the English language literature of a primary aortoduodenal fistula treated successfully with surgery in a patient with Takayasu's arteritis.

Adult↗
PubMed1998

Synthesis and antiallergic activity of dimethyl-2-(phenylcarbamoyl)ethylsulfonium p-toluenesulfonate derivatives.

The derivatives of dimethyl-2-(phenylcarbamoyl)ethylsulfonium p-toluenesulfonates were synthesized and evaluated for antiallergic activity. The 2,3-dihydroxyethoxy group was introduced to the phenyl ring from the standpoint of lipophilicity and electronic effects of substituent. The IgE-induced rat passive cutaneous anaphylaxis (PCA) was inhibited by oral administration of several substituted 2-[(4-propoxyphenyl)carbamoyl]ethyldimethylsulfonium p-toluenesulfonate derivatives. Among them (+/-)-2-[N-[4-(3-ethoxy-2-hydroxypropoxy)phenyl]carbamoyl]ethyldimeth ylsulfonium p-toluenesulfonate (1a, IPD-1151T) was found to possess considerable activity in the PCA test, and it was launched as Suplatast tosilate in Japan.

Animals↗
PubMed1998

A missense mutation of the gene for Na+,K(+)-ATPase alpha-subunit causes abnormal feeding behavior in Caenorhabditis elegans.

The Na+,K(+)-ATPase activity of membranes from a behavioral mutant of C. elegans was found to be about one-third that of the wild-type. The levels of mRNA and polypeptide of Na+,K(+)-ATPase alpha-subunit in the mutant were as high as those in the wild-type, but the level of the phosphorylated intermediate of the Na+,K(+)-ATPase in the mutant worm was 80% lower than that in the wild-type. A single predicted amino acid replacement (Leu to Phe) was found in a highly conserved region in the alpha-subunit that is involved in the formation of phosphorylated intermediate. The abnormal feeding behavior of the mutant worm may be attributed to this missense mutation.

Amino Acid Sequence↗
PubMed1998

Prognostic and Therapeutic Implications of the MIB-1 Labeling Index in Breast Cancer.

BACKGROUND: Assessment of tumor proliferative activity is considered to be the most powerful prognostic factor aside from axillary lymph node status. The purpose of this study is to assess the clinical value of measurement of proliferative activity using the MIB-1 labeling index in patients with breast cancer. METHODS: Surgical specimens from 36 patients with benign breast disorders and146 patients with breast cancer were investigated. The MIB-1 labeling index wasdetermined on the specimens stained by immunohistochemical methods as much as possible. Clinical factors associated with the MIB-1 labeling index were reviewed. RESULTS: The MIB-1 labeling index for non-proliferative disorders, proliferative disorders, and breast cancer was 3.4 +/-1.9%, 8.9 +/-6.2% and 20+/-12%, respectively. The MIB-1 labeling index and tumor size, lymph node metastasis status, and clinical stage according to the TNM classification correlated significantly. Survival rate was inversely correlated with the MIB-1 labeling index. No patientwith an MIB-1 labeling index of less than 10% had lymph node metastases, and all are alive without recurrence. Patients with an MIB-1 labeling index of over 30% had an extremely poor prognosis. CONCLUSION: The MIB-1 labeling index is very useful for predicting both either extremely good or extremely poor prognosis, and axillary lymph node metastasis

Journal Article↗