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Biomedical subjects

Y Tokuda

Publications and source records attributed to Y Tokuda.

At least 55 records · Page 3Linked to original sources
PubMed2000

Acute eosinophilic pneumonia following cigarette smoking.

Two cases of acute eosinophilic pneumonia following cigarette smoking are analyzed for characteristic features. The first patient noted dyspnea 14 days after initiation of smoking. The second patient noted dyspnea 12 days after beginning to smoke. Both cases had characteristic features including occurrence at an age younger than 30 years; less than 1 month duration of cigarette smoking before onset of disease; and no identifiable cause of acute eosinophilic pneumonia apart from smoking. We believe that acute eosinophilic pneumonia following cigarette smoking, which has characteristic features as described above, should be considered as a distinct subtype of AEP.

Acute Disease↗
PubMed2000

Primary intracerebral and aneurysmal subarachnoid hemorrhage in Izumo City, Japan. Part II: management and surgical outcome.

OBJECT: The purpose of this study was to assess the overall management and surgical outcome of primary intracerebral hemorrhage (ICH) and aneurysmal subarachnoid hemorrhage (SAH) among the 85,000 residents of Izumo City, Japan. METHODS: During 1991 through 1996, 267 patients with ICH and 123 with SAH were treated in Izumo. Of the 267 patients with ICH, 25 underwent hematoma removal by open craniotomy or suboccipital craniectomy and 34 underwent stereotactic evacuation of the hematoma, whereas aneurysm clipping was performed in 71 of the 123 patients with SAH; operability rates were thus 22% for ICH and 58% for SAH (p < 0.0001). The overall 30-day survival rates were 86% for ICH and 66% for SAH (p < 0.0001) and the 2-year survival rates were 73% and 62% (p = 0.0207), respectively. In patients who underwent surgery, 30-day and 2-year survival rates were 93% for ICH and 100% for SAH (p = 0.0262), and 75% for ICH and 97% for SAH (p = 0.0002), respectively. In patients with ICH, the most important predictors of 30-day case-fatality rates were the volume of the hematoma, the Glasgow Coma Scale (GCS) score, rebleeding, and midline shifting, whereas those for 2-year survival were the GCS score, age, rebleeding, and hematoma volume. In patients with SAH, the most important determinants of 30-day case-fatality rates were the GCS score and age, whereas only the GCS score had a significant impact on 2-year survival. CONCLUSIONS: The overall survival rates for patients with ICH or SAH in Izumo were more favorable than those in previously published epidemiological studies. However, despite improved surgical results, the overall management of ICH and SAH still produced an unsatisfactory outcome, mainly because of primary brain damage.

Adult↗
PubMed2000

[Long-term effect of polystan monocusp ventricular outflow patch after right ventricular outflow tract reconstruction].

Forty-eight patients who underwent right ventricular outflow tract reconstruction with Monocusp Ventricular Outflow Patch (MVOP) fifty-five times and survived surgery, were reviewed in this study. Mean age at surgery was 6.4 years-old and mean follow-up interval was 75.2 months. There was no late death, however reoperation was performed 7 times. Freedom from reoperation rate was 97.2% and 80.7% after 5 and 10 years after surgery, respectively. The main cause for reoperation were right ventricular outflow obstruction RVOTO (5 cases). All of the RVOTO occurred at the distal end of the anastomosis. However, there was no RVOTO in patients who underwent RVOTR with MVOP during the past ten years. So, we considered the cause of RVOTO a technical problem. Pulmonary regurgitation was one to two degree early after surgery, and had worsened by almost two or three degrees more than 5 years after surgery. Moreover, five of six patients who underwent cardiac catheterization more than 10 years after surgery had three degrees of pulmonary regurgitation as well as a large CTR. In conclusion, according to long-term results, especially more than 10 years post operatively, pulmonary regurgitation was the most important problem.

Adolescent↗
PubMed2000

Persistence of the benefits of a structured psychiatric intervention for breast cancer patients with lymph node metastases.

The aim of this study was to investigate the persistence of clinical effectiveness of a 5 week structured group intervention program for Japanese breast cancer patients. A total of 47 patients with breast cancer completed the full program. The results of the Profile of Mood States (POMS) scores were compared before, immediately after, and 6 months after the intervention program. As analysed by POMS scores, the clinical effectiveness of a structured group intervention program persisted for 6 months for patients without nodal metastases. In contrast, the intervention program did not show a lasting effect for patients with nodal metastases. This study demonstrated the short-term effectiveness of structured interventions among Japanese cancer patients, but persistence of the effects of intervention was found only among patients without nodal metastases. For patients with nodal metastases, additional intervention would be needed.

Adult↗
PubMed2000

Effects of a structured psychiatric intervention on immune function of cancer patients.

The aim of the present study was to examine the influence of mood state and coping styles on the immune function in Japanese breast cancer patients who participated in a structured group intervention program. The program consisted of five-weekly 90-minute sessions, including psycho-education, psychological support, problem-solving technique and relaxation/imagery. Out of 77 breast cancer patients who participated in this program, 34 were eligible for measurement of immune functions because they received adjuvant chemotherapy. Comparison of the pre- and post-intervention scores of the Profile of Mood States (POMS) revealed significant decreases in Depression (p < 0.05), Lack-of-Vigor (p < 0.01), Tension-Anxiety (p < 0.01), Confusion (p < 0.05) and Total Mood Disturbances (p < 0.01), as expected. Concerning coping styles, there were tendencies to decrease the score of active-cognitive coping (p = 0.09), although the differences were not statistically significant. In contrast, the pre- and post-intervention values of immune parameters such as CD3, CD4, CD8, CD4/8 and natural-killer cell activity showed no significant differences. In this report, we discuss several possibilities underlying these findings. Further studies with a larger number of subjects and controls are needed to reach conculusions.

Adaptation, Psychological↗
PubMed1999

Sequence and expression of a cDNA encoding the red seabream androgen receptor.

The cDNA of the androgen receptor (AR) has been isolated from the ovary of red seabream, Pagrus major, and sequenced. The amino acid sequence of red seabream AR (rsAR) shows about 45% identity with those of Xenopus, rat, mouse, and human ARS. It is shown that rsAR has the ability to trans-activate the responsive gene depending on the presence of androgen.

Amino Acid Sequence↗
PubMed1999

Sequence and expression of a cDNA encoding the red sea bream androgen receptor.

The cDNA of the androgen receptor (AR) has been isolated from the ovary of red sea bream, Pagrus major, and sequenced. The amino acid sequence of red sea bream AR (rsAR) shows about 45% identity with that of Xenopus, rat, mouse, and human AR. It is shown that rsAR has the ability to trans-activate the responsive gene depending on the presence of androgen.

Amino Acid Sequence↗
PubMed1999

Anesthetic dose and analgesic effects of sub-Tenon's anesthesia in cataract surgery.

PURPOSE: To compare the analgesic effects of different doses of sub-Tenon's anesthesia in cataract surgery by assessing patient response to visceral stimulus. SETTING: Inouye Eye Hospital, Tokyo, Japan. METHODS: A prospective study was done of 1019 eyes of 1019 patients having phacoemulsification and posterior chamber intraocular lens implantation. They received a 1.0 mL (391 eyes), 2.0 mL (366 eyes), or 3.0 mL (262 eyes) anesthetic infiltration into the sub-Tenon's space. Pain scores were recorded when the anterior chamber was irrigated with an acetylcholine chloride solution to attain miosis after lens implantation. RESULTS: The distribution of pain scores was significantly different among the 3 groups (P < .0001, Kruskal-Wallis test). Multiple comparison revealed that the 3.0 mL anesthetic infiltration offered significantly higher analgesic effects than the 2 lower doses. The 3.0 mL sub-Tenon's anesthesia effectively blocked the visceral stimulus. CONCLUSION: For cataract surgery, 3 mL is the optimal dose of anesthetic solution in sub-Tenon's anesthesia.

Aged↗
PubMed1999

Comparison of sub-Tenon's anaesthesia by different delivery techniques in cataract surgery.

PURPOSE: To compare the analgesic effects of three different delivery techniques of sub-Tenon's anaesthesia in cataract surgery by assessing patients' response to the visceral stimulus. METHODS: A prospective, randomised study was conducted on 345 eyes of 345 patients undergoing phacoemulsification and posterior chamber intraocular lens implantation. They received anaesthetic infiltration into the sub-Tenon's space through a conjunctival incision (115 eyes), infiltration into the posterior sub-Tenon's space (retrobulbar space) through a conjunctival incision (114 eyes), or injection into the intra-Tenon's space (subconjunctival space) without making a conjunctival incision (116 eyes). Pain scores were recorded when the anterior chamber was irrigated with an acetylcholine chloride solution to achieve miosis after lens implantation. RESULTS: There were no significant differences in pain scores among the three groups (chi-squared test of homogeneity, p = 0.814). Approximately 10-20% of patients reported slight to severe pain at the time of acetylcholine administration. CONCLUSIONS: The three anaesthetic delivery methods of sub-Tenon's anaesthesia possess similar and reasonable analgesic effects in cataract surgery, but may not block visceral stimuli completely.

Acetylcholine↗
PubMed1999

Dose escalation and pharmacokinetic study of a humanized anti-HER2 monoclonal antibody in patients with HER2/neu-overexpressing metastatic breast cancer.

We conducted a phase I pharmacokinetic dose escalation study of a recombinant humanized anti-p185HER2 monoclonal antibody (MKC-454) in 18 patients with metastatic breast cancer refractory to chemotherapy. Three or six patients at each dose level received 1, 2, 4 and 8 mg kg(-1) of MKC-454 as 90-min intravenous infusions. The first dose was followed in 3 weeks by nine weekly doses. Target trough serum concentration has been set at 10 microg ml(-1) based on in vitro observations. The mean value of minimum trough serum concentrations at each dose level were 3.58 +/- 0.63, 6.53 +/- 5.26, 40.2 +/- 7.12 and 87.9 +/- 23.5 microg ml(-1) respectively. At 2 mg kg(-1), although minimum trough serum concentrations were lower than the target trough concentration with a wide range of variation, trough concentrations increased and exceeded the target concentration, as administrations were repeated weekly. Finally 2 mg kg(-1) was considered to be sufficient to achieve the target trough concentration by the weekly dosing regimen. One patient receiving 1 mg kg(-1) had grade 3 fever, one at the 1 mg kg(-1) level had severe fatigue defined as grade 3, and one at 8 mg kg(-1) had severe bone pain of grade 3. No antibodies against MKC-454 were detected in any patients. Objective tumour responses were observed in two patients; one receiving 4 mg kg(-1) had a partial response in lung metastases and the other receiving 8 mg kg(-1) had a complete response in soft tissue metastases. These results indicate that MKC-454 is well tolerated and effective in patients with refractory metastatic breast cancers overexpressing the HER2 proto-oncogene. Further evaluation of this agent with 2-4 mg kg(-1) weekly intravenous infusion is warranted.

Antibodies, Monoclonal↗
PubMed1999

Proliferation and differentiation of rat dorsal prostatic epithelial cells in collagen gel matrix culture, focusing upon effects of adipocytes.

BACKGROUND: Prostatic epithelial cells organize functional acinus structures under epithelial extracellular matrix and epithelial-stromal cell interactions. Recently, the adipose tissue, which surrounds and even exists within the prostate, has been suggested to affect the differentiation and proliferation of some cell types. Therefore, tissue fragments, which consist mainly of epithelial and fibromuscular stromal cells, were cultured in three-dimensional collagen gel matrix culture with adipocytes. METHODS: Tissue fragments of rat dorsal prostate, including both epithelial and fibromuscular stromal components, were cultured in collagen gel with or without adipocytes. Epithelial cell differentiation was evaluated with the reconstruction of acinus-like structures and with immunohistochemistry of rat dorsal prostate-specific proteins, dorsal protein-1 and probasin. The proliferation was examined by uridine uptake. RESULTS: Under coculture of the fragments and adipocytes, epithelial cells reconstructed more differentiated acinus-like structures surrounded by fibromuscular stromal cells than tissue fragment culture without adipocytes. Dorsal protein-1 and probasin expressions of epithelial cells in this coculture system were the same as in rat prostate in vivo. In the coculture, epithelial cells had a higher proliferation activity. CONCLUSION: These results indicate that adipocytes promote proliferation and differentiation of prostatic epithelial cells. Our new culture model with adipocytes suggests the importance of cell-cell interactions, including those of epithelial cells and adipocytes.

Adipocytes↗
PubMed1999

A dose-finding study of lenograstim (glycosylated rHuG-CSF) for peripheral blood stem cell mobilization during postoperative adjuvant chemotherapy in patients with breast cancer. Lenograstim/Breast Cancer Study Group.

BACKGROUND: The optimum dose of granulocyte colony-stimulating factor (G-CSF) for peripheral blood stem cell (PBSC) mobilization after disease-oriented, conventional-dose chemotherapy remains unknown. METHODS: A multicenter dose-finding study of glycosylated G-CSF (lenograstim) for the mobilization of PBSCs following adjuvant CAF chemotherapy (cyclophosphamide, doxorubicin and 5-fluorouracil) was performed in 38 patients with postoperative breast cancer. Each 10, ten and eight patients were sequentially allocated to one of the three dose groups (2, 5 and 10 micrograms/kg, respectively) of lenograstim. Lenograstim was administered subcutaneously (s.c.) daily from day 8 to the day of the last apheresis and CD34+ cells and colony-forming units-granulocyte macrophage (CFU-GMs) in peripheral blood were measured serially. Additionally, 10 patients who received adjuvant CAF chemotherapy alone also participated in the study, as a control. RESULTS: Lenograstim was well tolerated up to 10 micrograms/kg, except for one patient given 10 micrograms/kg who developed transient grade 3 hepatic enzyme elevation. The peak levels of CD34+ cells and CFU-GMs in peripheral blood showed dose-response relationships. The median peak CD34+ cells for the 0, 2, 5 and 10 micrograms/kg dose groups were 5.4, 34.3, 55.0 and 127.6 cells/microliter, respectively, and those of CFU-GMs for the 0, 2, 5 and 10 micrograms/kg dose groups were 0.01, 0.33, 1.32 and 3.30 CFU-GMs/microliter, respectively. CONCLUSIONS: Considering the previous reports suggesting that a pre-apheresis number of 40-50 CD34+ cells/microliter in peripheral blood is highly predictive for achievement of more than 2.5 x 10(6) CD34+ cells/kg in a standard apheresis procedure of 10 litres, the optimum dose of lenograstim for PBSC mobilization following CAF chemotherapy in patients with postoperative breast cancer is 5 micrograms/kg/day s.c.

Adjuvants, Immunologic↗
PubMed1999

Granular-lattice (Avellino) corneal dystrophy.

Granular-lattice (Avellino) corneal dystrophy has rarely been reported in the literature. It consists of a combination of granular and lattice dystrophy. We describe the histopathologic examination of the corneal button of one Japanese patient who had undergone unilateral keratoplasty because of severely decreased vision caused by what had been diagnosed clinically as granular dystrophy. However, on pathologic examination, lesions characteristic of both granular dystrophy and lattice dystrophy were found. We also describe 2 Japanese patients who had a clinical appearance characteristic of both granular and lattice dystrophy. Granular-lattice corneal dystrophy was found in a wider geographic distribution than previously proposed and should not be named after the geographic area.

Adult↗
PubMed1999

Combined cardiac surgery and total thyroidectomy: a case report.

A 65-year-old woman with aortic stenosis, ischemic heart disease, and Graves' disease had complained of effort angina. She then suffered from liver dysfunction due to treatment with antithyroid drugs. One year after the start of radioiodine administration, she demonstrated unstable angina with palpitation and sweating. Laboratory studies revealed a recurrent hyperthyroid state, and a second coronary angiogram revealed progressive ischemic heart disease. Combined coronary artery bypass grafting, aortic valve replacement, and total thyroidectomy were performed. The postoperative course was uneventful without any problems associated with hyperthyroidism or hypothyroidism. Combined cardiac surgery and total thyroidectomy can be performed safely if the perioperative levels of thyroid hormone are maintained at euthyroid or hypothyroid levels.

Aged↗