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Biomedical subjects

K Ota

Publications and source records attributed to K Ota.

At least 973 records · Page 54Linked to original sources
PubMedDate not supplied

Isolated factor VII deficiency diagnosed after a life-threatening brain haemorrhage.

A 65-year-old man was admitted to another hospital with a life-threatening brain haemorrhage, and laboratory examinations on admission revealed prolonged prothrombin time with normal activated partial thromboplastin time. To establish the cause of his abnormal coagulation, he was referred to our clinic. Neither the patient nor his family had any previous history of bleeding symptoms. His liver function was within normal limits but coagulation tests showed increased plasma activities of factors II, VIII, IX, X, with reduced activities of factors V and VII. The activity of factor VII was less than 2% but no inhibitor of factor VII was detected in the plasma. We concluded that the patient had a rare congenital isolated factor VII deficiency although he had not shown earlier bleeding problems, presumably because of compensation for the factor VII deficiency by enhanced activities of components of the extrinsic coagulation pathway, factors II, VIII, IX and X.

Aged↗
PubMedDate not supplied

The CAG regimen (low-dose cytarabine, aclarubicin hydrochloride and granulocyte colony-stimulating factor) for the treatment of elderly acute myelomonocytic leukaemia: a case study.

Elderly patients with acute myelomonocytic leukaemia (AMMoL) frequently have a poor quality of life after induction of remission using high-intensity treatment; we seek a more appropriate regimen for such patients. An 86-year-old man was hospitalized with a diagnosis of AMMoL (FAB classification M4), of abnormal karyotype, and complications of diabetes mellitus and complete right bundle branch block. He was treated with CAG therapy (cytarabine 10 mg/m2 subcutaneously every 12 h for 14 consecutive days; aclarubicin hydrochloride 10 mg/m2 per day, bolus intravenously for 4 consecutive days; granulocyte colony-stimulating factor 100 microg/day, subcutaneous injection for 14 consecutive days) every 3 months. White blood cell counts were at their lowest (around 600 - 800/microl) 12 days after the end of therapy, but returned to about 2000 - 2300/microl 30 days after stopping therapy. No symptoms of drug-related toxicity, except slight nausea, were found. Complete remission with a good quality of life was induced and lasted over 2 years suggesting that CAG therapy might prove effective in elderly patients with AMMoL.

Aclarubicin↗
PubMedDate not supplied

Treatment of acute myeloblastic leukaemia in a patient with Bombay blood type: a case report.

A 62-year-old female was admitted to our hospital with suspected acute leukaemia and after investigation we diagnosed acute myeloblastic leukaemia (AML-M1). The patient's blood type was found to be the very rare Bombay type and surveillance of her relatives showed the same blood type in her male cousin on her mother's side. Alongside chemotherapy the patient received 4000 ml of frozen Bombay-type red cells, 1400 ml of concentrated red cells in manitol adenine phosphate solutions and 360 units of type O concentrated platelets without marked effects. The anti-H antibody was initially at 128 dilution but for unknown reasons increased to 2048 dilution after remission of AML-M1. About 3 months after hospitalization the patient died of Cryptococcus neoformans pneumonia despite strict precautions against infection. Although AML-M1 is a common adult leukaemia and is chemosensitive to anti-leukaemic drugs, neither AML-M1 in a patient with Bombay-type red cells nor its treatment with chemotherapy and transfusion with type Oh frozen red cells have previously been reported.

Antineoplastic Agents↗
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A therapeutic strategy for isolated plasmacytoma of bone.

Two cases of solitary plasmacytoma of bone (SPB) were diagnosed. The first case was a 41-year-old woman, complaining of fatigue from her lumbar region to her legs. The second case was a 56-year-old man complaining of poor gait and severe lumbago with numbness in the toes of both feet. Magnetic resonance imaging showed the osteolytic lesion in the 12th thoracic bone in the first patient and around the 2nd, 3rd and 4th lumbar bones in the second patient. In both patients serum analysis revealed the monoclonal component of immunoglobulin G (IgG) protein with kappa-light chain, and considering this and other findings SPB was diagnosed. Both patients were first treated with irradiation around the involved bone and then with a course of chemotherapy. In the first patient the tumour region of the bone was surgically removed and replaced with a ceramic spacer. The symptoms of both patients were ameliorated, and the patients remained in good condition for around 3 years without conversion to multiple myeloma. In view of the overall effectiveness of treatments for SPB, our therapeutic strategy deserves careful evaluation.

Adult↗
PubMedDate not supplied

Purpura due to aspirin-induced platelet dysfunction aggravated by drinking alcohol.

We report a rare case of prominent purpura induced by aspirin and enhanced by alcohol. A 44-year-old woman presented with a history of generalized purpura. She drank alcohol once or twice a week and regularly took an analgesic preparation, containing aspirin and acetaminophen, for alleviation of headaches. When purpura was evident the patient's liver function was within normal limits and her coagulation time was normal but her bleeding time was prolonged. Red blood cell, white blood cell and platelet counts were normal but a poor response to platelet agonists demonstrated platelet dysfunction. After stopping the analgesic and abstaining from alcohol for 5 days, platelet aggregation, in response to the agonists, returned to normal and purpura disappeared. When the patient took further doses of the analgesic preparation for 3 days for headache relief, but did not drink alcohol, platelet aggregation was again abnormal but purpura was only slight.

Adult↗
PubMedDate not supplied

Autologous peripheral stem-cell transplantation after intensive chemotherapy in a case of CD30 (Ki-1)-positive anaplastic large-cell lymphoma.

Simultaneous treatment with peripheral blood stem-cell (PBSC) transplantation and intensive chemotherapy was evaluated in a case of non-Hodgkin's lymphoma (NHL) with poor prognosis. A 59-year-old male diagnosed with a high-grade, anaplastic large-cell (Ki-1) NHL, involving fractures in the left hip, underwent computed tomography and gallium scintigram surveillance. The patient received chemotherapy with epirubicin hydrochloride, cyclophosphamide, vincristine and prednisolone, and the fractured hip bone was repaired following the first course of chemotherapy. After the second and third courses of chemotherapy, PBSCs were harvested and cryopreserved. The patient then received a further course of chemotherapy and PBSC transplantation was conducted using infused cells consisting of 9.63 x 10(6)/kg CD34 cells and 2.24 x 10(5)/kg granulocyte macrophage colony-forming units. Recovery of platelet and white blood cell counts occurred 10 and 8 days, respectively, after PBSC infusion and the patient remains well.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Hand-Schüller-Christian disease with occult diabetes insipidus, cardiac failure and renal dysfunction.

A 60-year-old man was diagnosed as Hand-Schüller-Christian disease due to the triad of exophthalmus, decalcification of the bone, and diabetes insipidus. He had xanthogranuloma on the face and a nuchal region, and unusual complications of ADH-resistant diabetes insipidus due to renal dysfunction, and chronic cardiac failure. Urine osmolality was hypotonic, but urine volume was within the normal limit, despite the presence of central diabetes insipidus. Hypophyseal, adrenal and thyroid function were not remarkable. The skin biopsy showed the infiltration of eosinophilic granuloma cells. Treatment with vincristine was effective to regress the xanthogranuloma. Diabetes insipidus was not treated because of the absence of polyuria and polydipsia.

Acute Kidney Injury↗
PubMedDate not supplied

Effect of low protein diet on cardiac function and ultrastructure of spontaneously hypertensive rats loaded with sodium chloride.

The effects of low protein diet on cardiac metabolic and structural changes subsequent to an extremely high pressure load were investigated. Spontaneously hypertensive rats(SHR) were divided into four groups, and fed the following diets for four weeks: 1) Group A: regular diet (23% protein) and water, 2) Group B: regular diet and 1% saline, 3) Group C: low protein diet (10% protein) and water, and 4) Group D: low protein diet and 1% saline. Two weeks after the start of feeding, there was no significant difference in the left ventricular ultrastructures between the corresponding regular and low protein diet groups. Four weeks after, degenerative findings such as streaming of Z lines, dilatations of smooth endoplasmic reticulum, and disarrangements of myofilaments appeared Group D, while in Group B electron microscopic findings indicated hypertrophy. Incorporation of [14C] leucine into the myocardial myosin B in Group D was significantly low, with a resulting fall of the LVdP/dtmax per integrated isometric pressure (IIP) and a rise of the left ventricular end-diastolic pressure (LVEDP), as compared to that in Group C at four weeks after the start of feeding. These observations suggest that, in the heart with an extremely high pressure load, low protein diet hinders the development of hypertrophy to the load with resulting heart failure.

Animals↗
PubMedDate not supplied

Experimental studies on improved polyester-polyurethane vascular grafts for hemodialysis.

A new poly(ether-urethane) graft (PEUG) was developed. Although this graft had several advantages, it became clear that it also had disadvantages, such as the formation of pseudoaneurysms by repeated puncture. To overcome these problems, the PEUG was modified to add mechanical strength by incorporating knitted polyester fibers. Physical strength tests were done, and it was concluded that the graft was more durable than either PEUG or expanded polytetrafluorethylene. Additional experiments showed that gelatin coated PEUG implanted in dogs facilitated endothelialization of the internal surface and improved its patency, although these observations were too short to draw any definitive conclusions.

Animals↗
PubMedDate not supplied

Prolongation of cardiac xenograft function after reduction of natural antibodies using double filtration plasmapheresis.

A double filtration plasmapheresis (DFPP) technique was applied to selectively remove the natural antibodies in discordant xenotransplantation. A swine heart was heterotopically transplanted in a canine neck after two DFPP procedures during which 200 to 500 ml of plasma were replaced with the same amount of Hartman's solution containing 7% human albumin. Mean removal rate of IgC and IgM by DFPP ranged from 74.2 +/- 0.5 to 95.9 +/- 2.8%. The anti-swine lymphocytotoxic reaction of canine serum was decreased after DFPP but still remained in low titers. Mean graft survival time in the group treated by DFPP in which 1000 ml of plasma was totally replaced was prolonged to 107 +/- 47 min, while it was 9 +/- 5 min in the group without any treatment (p less than 0.01). Deposits of canine IgM and C3 on the vascular endothelium of the graft were observed on immunofluorescence, while there were no deposits of IgG. In conclusion, DFPP effectively removed the natural antibodies, resulting in prolongation of xenograft survival time. Immunofluorescence study suggested that natural IgM antibodies played an important role in this xeno-hyperacute rejection.

Animals↗
PubMedDate not supplied

Immunoadsorption of anti-A or anti-B antibody for successful kidney transplantation between ABO incompatible pairs and its limitation. Japanese Biosynsorb Research Group.

Kidney transplantation between ABO incompatible pairs, contraindicated because of a high incidence of hyperacute rejection episodes, has become feasible after provisional removal of anti-A or anti-B antibody from recipient canidates. Initially, a total of 54 patients were scheduled to be transplanted with ABO incompatible kidneys after removal of anti-A or anti-B antibody by immunoadsorption, using A or B antigen expressing trisaccharide immobilized on silica beads. Levels of anti-A and/or anti-B antibody (-ies) were negative (below less than X8 dilution) after three to four immunoadsorption treatments, and, thereafter, kidneys were successfully transplanted in 47 patients (incompatibility in A:21, B:25, AB:1). However, in four patients, anaphylactoid reaction occurred immediately after initiation of immunoadsorption, and double filtration plasmapheresis (DFPP) took place. Kidney transplantation was cancelled in three patients because of rebound to high level of anti-A or anti-B antibody, or appearance of T cell antibody after immunoadsorption.

ABO Blood-Group System↗
PubMedDate not supplied

Non-heparin hemodialysis with oral administration of newly developed antiplatelet agent.

Non-heparin hemodialysis (HD) was successfully done in anuric dogs with the oral administration of a newly developed antiplatelet agent, 4-cyano-5,5-bis(4-methoxyphenyl)-4-pentenoic acid, (E5510, Eisai Pharmaceutical Co., Japan). In the current study, the antithrombotic effect of E5510 during HD was investigated. Eleven mongrel dogs with bilateral ureteral ligation were given 0.1 mg/kg of E5510 orally 1 hr before undergoing 4 hr HD using hollow fiber dialyzers, (PMMA 5, regenerated cellulose 6) without heparin and under general anesthesia. Blood samples were taken before the administration of E5510 and before and 1, 2, 3, and 4 hr after starting HD; blood counts, hematocrits, blood chemistries, and plasma thromboxane levels (TxB2) were examined. Platelet aggregation, activated clotting times (ACT), and activated partial thrombin times (APTT) were also measured, and sequential plasma E5510 concentrations were determined. In 10 of 11 anuric dogs, non-heparin HD was successfully done with minimal clotting in the dialyzer and drip chambers. The maximum aggregation rate was depressed to less than 20% of the initial value throughout HD. Plasma TxB2 concentration was depressed, and ACT and APTT were mildly, but not significantly prolonged. Neither hemorrhagic complications nor other side effects of E5510 were observed.

Administration, Oral↗
PubMedDate not supplied

Difference in beta 2-microglobulin removal between cellulosic and synthetic polymer membrane dialyzers.

Several kinds of dialyzers, with highly permeable membranes (HPM), have been designed to specifically remove beta 2-microglobulin (BMG). To clarify their solute transport characteristics, nine types of HPM dialyzers were evaluated during in vivo and in vitro studies using human plasma and aqueous solutions. No BMG membrane adsorption and/or plugging was seen with cellulosic membrane dialyzers during in vitro experiments using human plasma. On the other hand, all synthetic polymer membrane dialyzers had adsorptive properties, and in a dialyzer with a polymethylmethacrylate membrane, a large amount of BMG was removed by adsorption alone. Dialyzers with cellulose triacetate and polyacrylonitril membranes showed higher values of BMG diffusive dialysance (greater than 20 ml/min) and sieving coefficient (greater than 0.9). From in vitro experiments using an aqueous solution containing several solutes with relatively small or middle molecular weights, all HPM dialyzers had a higher overall mass transfer coefficient than any conventional membrane dialyzer.

Blood Flow Velocity↗
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Effect of treatment schedule on antitumor activity of glycolate-0,0'-diammineplatinum(II), a new platinum derivative: comparison with cis-diamminedichloroplatinum(II).

The effect of treatment schedule on the antitumor activity of a new platinum derivative, glycolate-0,0'-diammineplatinum (II) (254S) compared with cis- diamminedichloroplatinum (II) (CDDP) was investigated using ascites L1210 leukemia and solid Lewis lung carcinoma. The drugs were given i.p. by three treatments: as a single injection, as three injections at 4 day intervals and as 9 daily continuous injections. 254S produced a marked increase of lifespan in mice by all three treatment schedules (about 100% ILS), although the consecutive treatment of 254S needed more total doses against L1210 leukemia. The antitumor activity of 254S was, however, inferior to that of CDDP. Moreover, 254S did not show certain dependence on treatment schedule, while CDDP was rather dependent on treatment schedule. The single injection (day 1) of CDDP exhibited the most potent antitumor activity. On the other hand, although the single injection of CDDP showed more host toxicity than the other treatment schedules and the consecutive treatment needed more total doses, neither drug showed any definite schedule dependency against Lewis lung carcinoma. Moreover, the tumor growth inhibitory activity of 254S was almost the same as or slightly superior to that of CDDP. Both drugs produced about 70% (days 14-17) and 50% (day 20) tumor weight inhibitions against early and advanced Lewis lung carcinoma, respectively.

Animals↗
PubMedDate not supplied

Comparative clinical trial of regional anticoagulation for hemodialysis.

The regional anticoagulating effects of FUT-175 (protease inhibitor), and regional or low dose heparinization (RH or LH) were examined comparatively by randomized controlled protocol on 157 hemodialysis (HD) patients with hemorrhagic complications. Increases in bleeding because of HD were milder in FUT as compared with RH and LH, and the bleeding time after needle removal was significantly shorter in FUT than that in heparin. During HD, the prolongation of celite activated coagulation time (CCT) of the intracorporeal blood was significantly milder in FUT than in heparin and that of blood passing through the dialyzer was increased in FUT compared with LH. FUT showed no prolongation of CCT after HD. These results indicate that FUT is a more useful and safer anticoagulant for HD patients with hemorrhagic complications than any regional anticoagulating method using heparin (RH or LH).

Anticoagulants↗
PubMedDate not supplied

Forty-eight hour liver preservation using an artificial blood substitute.

Forty-eight hour hypothermic continuous perfusion preservation was attempted using a perfusion technique with an artificial blood substitute, a pyridoxylated hemoglobin-polyoxyethylene conjugated solution (stabilized hemoglobin, PHP). After preservation each of the 10 canine livers was orthotopically transplanted. Postoperative graft function was estimated by parameters such as activated clotting time (ACT), bile excretion, consciousness level, survival period, histologic findings, and adenosine triphosphoric acid (ATP) content of the perfused liver. Four of ten livers displayed good function, with bile excreted immediately after revascularization, and animal survival for over 24 hr. Cellular structure of the liver was well maintained, although atrophy of the hepatocytes and swelling of the mitochondria were seen. PHP solution is therefore considered suitable as a perfusate for long-term liver preservation.

Animals↗
PubMedDate not supplied

Superiority of selective bolus infusion and simultaneous rapid removal of anticancer agents by charcoal hemoperfusion in cancer treatment.

This report presents the clinical effectiveness of multidisciplinary therapy consisting of intraarterial selective chemotherapy, combined with radiofrequency regional hyperthermia (RFRH) in advanced cancer patients. Patients were categorized into the following therapeutic groups: Group I: RFRH without intraarterial chemotherapy. Group II: Intraarterial infusion of a standard dose of Mitomycin C (MMC) and 5Fu. Group III: RFRH combined with intraarterial chemotherapy as in Group II. Group IV: RFRH combined with a large intraarterial infusion of MMC or Adriamycin (ADM) during charcoal hemoperfusion. Clinical effectiveness in terms of more than 50% tumor size reduction was achieved in 9% in Group I, 0% in Group II, 25% in Group III and 55% in Group IV, respectively. In Group IV, several side effects were observed but were not serious, despite the lethal dose of drug administered. These results suggest that RFRH combined with selective infusion chemotherapy, especially when large doses are administered during charcoal hemoperfusion, is a valuable treatment for advanced cancer patients.

Adolescent↗