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Biomedical subjects

S Inada

Publications and source records attributed to S Inada.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Pneumonia caused by varicella-zoster virus in a patient with rheumatoid arthritis].

A 56-year-old woman suffering from rheumatoid arthritis, was admitted to our hospital for evaluation of fever and dyspnea. A month before admission, she had been given a diagnosis of herpes zoster and was treated with an antiviral agent. However, a perineal eruption persisted. A chest X-ray film and a chest CT scan showed many diffuse nodular shadows in both lung fields. With conservative treatment, the shadows regressed along with the skin eruption and other symptoms. Pneumonia caused by varicella-zoster virus was diagnosed from the clinical course, chest roentgenographic and CT scan findings, and serological data. The risk of mortality in varicella-zoster pneumonia is high in adults, especially in immunosuppressed patients. Early diagnosis and effective treatment are, therefore, essential in the management of this disease. Though varicella-zoster pneumonia is rare, chest roentgenographic and CT scan findings are characteristic and suggestive. This case may serve as a reminder of the features of varicella-zoster pneumonia: many nodular shadows on the chest X-ray film and CT scan.

Aged↗
PubMed1996

[Two cases of interstitial pneumonia with anti-PL-12 (alanyl tRNA synthetase) antibodies].

We present two cases of interstitial pneumonia (IP) whose sera contain autoantibodies to PL-12 (alanyl tRNA synthetase). The first patient is a 47-year-old female who was diagnosed as IP and treated with corticosteroid at another hospital. She was admitted to Keio University Hospital due to worsening of dyspnea and polyarthritis. Laboratory studies revealed elevation of LDH and CRP, and her chest radiography showed interstitial fibrosis. Because of clinical deterioration, the dose of corticosteroid was increased (prednisolone 40 mg/day) and her symptom was stabilized. The second patient, a 55 year-old female, was admitted to Tokyo Metropolitan Ohtsuka Hospital because of dyspnea on exertion and polyarthritis. She did not show any symptom of myositis and was diagnosed as IP with arthritis on the basis of her clinical and chest radiography. She was treated with oral corticosteroid (prednisolone 30 mg/day), which resulted in improvement of her respiratory symptom and arthritis. Both patients were found to have autoantibodies to the PL-12. Autoantibodies to aminoacyl tRNA synthetases have been recognized as having a linkage with myositis mainly because of observations of the Jo-1 specificity. There was one report on a North American population that most but not all patients with anti-PL-12 antibodies had myositis. However, the clinical significance of anti-PL-12 has not been examined in Japanese patients. These patients suggested that anti-PL-12 antibodies have a stronger association with IP than myositis in Japanese patients.

Alanine-tRNA Ligase↗
PubMed1995

Occurrence of acute megakaryoblastic leukemia in a patient with idiopathic growth hormone deficiency.

We describe a case of a 15 year old boy who developed acute megakaryoblastic leukemia (AMKL) while receiving treatment with human growth hormone (hGH) for idiopathic growth hormone deficiency (GHD). He was diagnosed as having idiopathic GHD and given hGH from December 1991. The examination of his peripheral blood showed mild pancytopenia 2 months before the start of the hGH therapy. Since January 1992, paleness of the skin, general fatigue and fervescence progressed gradually. In February 1992, because of the occurrence of acute leukemia, administration of hGH was discontinued. Judging from the results of surface marker analysis of the blast cells, the patient was diagnosed as having AMKL. He was treated with chemotherapy for acute non-lymphoblastic leukemia from March 1992. A complete remission was obtained after 4 weeks of treatment. The chemotherapy was completed in July 1993. He remains in complete remission 26 months after diagnosis. This case suggests the importance of hematological examination and, when there is any abnormality which is not caused by GHD, such as pancytopenia, more detailed medical examinations (for example bone marrow examination) are necessary.

Child↗
PubMed1995

[A case of rheumatoid arthritis complicated with salazosulfapyridine-induced aplastic anemia].

A 64 year-old woman with rheumatoid arthritis was admitted to our hospital because of general fatigue. She noticed polyarthralgia 8 months prior to the admission and diagnosis of rheumatoid arthritis was made. Administration of salazosulfapyridine (1.0 g/day) was started 6 months before the admission. Complete remission of rheumatoid arthritis was obtained in 2 months and blood cell counts showed normal values at that time. The results of laboratory tests included hemoglobin; 8.6 g/dl, white blood cell count; 1,900/mm3 with a differential of 19% neutrophils, 77% lymphocytes, and 4% monocytes; platelets were 21,000/mm3. A bone marrow aspiration and biopsy were performed. There were reduced numbers of myelocytes, erythroblasts, and megakaryocytes indicating aplastic anemia. Salazosulfapyridine was discontinued. Prednisolone, anabolic steroid and granulocyte-colony stimulating factor (G-CSF) were administrated. In spite of these therapy, recovery of peripheral blood cell counts have not been observed and supporting therapy including red cell and platelets transfusion have been continued. To our knowledge, this is the first case report which describes occurrence of aplastic anemia in patients with rheumatoid arthritis treated by salazosulfapyridine.

Anemia, Aplastic↗
PubMed1995

Concentric fibrosis and cellular infiltration around bile ducts induced by graft-versus-host reaction in mice: a role of CD8+ cells.

We report in this paper on obvious fibrotic lesions in the liver of mice undergoing specified graft-versus-host reaction (GVHR). B6 CD8+ splenocytes were transferred into (bm 12 x bm 1)F1 mice to induce GVHR. Recipient mice had been thymectomized and administrated with anti-CD8 monoclonal antibody (mAb) to deplete CD8+ cells from the hosts. Two weeks after the mAb administration, recipient mice were injected with B6 CD8+ cells and sacrificed further two or four weeks later for analyzing hepatic lesions histopathologically. Light microscopic analyses revealed the presence of concentric fibrosis around both small and large duct levels and the infiltration of mononuclear cells into portal areas. Focal necrosis of hepatocytes was also detected electron-microscopically. These findings suggest that CD8+ T lymphocytes might play an important role in the induction of fibrotic lesions in the liver.

Animals↗
PubMed1995

[A case of mixed connective tissue disease associated with gastric cancer and cancer of the uterine cervix].

We report here a very rare case of MCTD complicating double cancer. A 43-year-old woman with suspected MCTD was admitted because of high fever and lymphadenopathy. The laboratory findings indicated high titers of speckled ANA, anti-RNP, DNA and Scl-70, but anti-Sm. SS-A and SS-B was not detected. Chest CT and Spirogram revealed lung fibrosis, restrictive ventilatory impairment, and decreased diffusion capacity. Biopsy specimen by gastric fiberscope s screening indicated II c advanced type of poorly differentiated adenocarcinoma. After subtotal gastrectomy, she had high fever, pleuritis, leukopenia, butterfly erythema and hypoxemia, which were improved by 30 mg/day of oral prednisolone. One year after from the last operation, she had contact bleeding, and squamous cell carcinoma of the uterine cervix was diagnosed. She had Raynaud's phenomenon 6 months after from hysterectomy.

Adenocarcinoma↗
PubMed1995

[A case of remarkable response of colon cancer with multiple liver and bone metastasis treated with tegafur and cisplatin].

A 47-year-old man with ascending colon cancer with multiple liver metastases and bone metastasis (VII thoracic vertebra) showed a remarkable response to the combination therapy of tegafur and cisplatin. Tegafur (1,200 mg/day) was administered through continuous intravenous infusion mixed with IVH, and cisplatin was given every two weeks at a dose of 100 mg. The total dose of tegafur was 39.6g and that of cisplatin was 300mg. After therapy, primary and metastatic lesions were remarkably reduced according to various imaging techniques, and the serum CEA level of 34ng/ml at diagnosis decreased 3.7 ng/ml. Various tumor-related symptoms were improved. Drug toxicity caused slight nausea and leucopenia. Right hemicolectomy with R2 lymph node dissection was performed after chemotherapy. Histologically, primary lesion and regional lymph nodes showed diffuse fibrosis and necrosis, and only a few cancer cells remained some vessels. These results suggested that the combination chemotherapy of tegafur and cisplatin is useful for the treatment of colon cancer.

Adenocarcinoma↗
PubMed1995

[A case of Sjögren's syndrome and systemic lupus erythematosus complicated with necrotizing angiitis of the gallbladder].

A 71 year-old man with Sjogren's syndrome and systemic lupus erythematosus was admitted to our hospital because of abdominal pain and fever. Laboratory investigation showed an ESR of 76 mm/hr, elevation of CRP and marked leukocytosis. Abdominal ultrasound and CT scan showed enlargement of the gallbladder and intravesicular sludge without stones. With a clinical diagnosis of acute cholecystitis and pan-peritonitis, the surgical procedures including cholecystectomy were performed. Histological examination of the gallbladder showed a presence of necrotizing angiitis of small arteries. The postoperative course was uneventful with daily administration of 10 mg of prednisolone.

Acute Disease↗
PubMed1994

Peaks of brainstem auditory evoked potentials in dogs.

The effects of electrode configuration and click polarity on brainstem auditory evoked potentials (BAEP) in dogs were investigated to clarify the inconsistent nomenclature for each peak. Four positive peaks (waves 1, 2, 3 and 4) before a deep negative trough and a fifth positive peak (wave 5) following the trough were the basic components of BAEP in dogs, which were easily identified regardless of recording conditions such as electrode configuration and click polarity. Additional peaks tended to be present when a noncephalic reference electrode and/or single-polarity (rarefaction or condensation) click stimuli were used. The Roman nomenclature for the individual positive peaks of BAEP in dogs is confused owing to variations in the observed waveforms among researchers, but click polarity and/or reference electrode position can explain all the previously reported variations in BAEP waveforms in dogs. When the criteria concerning 'wave V' in the guidelines of BAEP in human beings are applied to avoid further confusion of Roman nomenclature in dogs, it is recommended that the basic five positive peaks (waves 1, 2, 3, 4 and 5 as identified easily with Ai-Vertex configuration and alternating clicks) are designated as waves I, II, III, V and VI, respectively. Wave IV (wave 3b) occurs occasionally before wave V in dogs.

Animals↗
PubMed1994

Induction of autoimmune disease by graft-versus-host reaction across MHC class II difference: modification of the lesions in IL-6 transgenic mice.

We examined the effect of IL-6 on the development of autoimmune diseases (primary biliary cirrhosis, Sjögren's syndrome) employing murine graft-versus-host reaction (GVHR) model with MHC class II disparity. For this purpose, we used IL-6 transgenic (B6.6) mice in which a high level of IL-6 was detected. C57Bl/6 (B6) spleen T cells were injected into B6.6 mated with B6.C-H-2bm12 (bm12) mutant mice ((bm12 x B6.6)F1) and GVHR with MHC class II disparity was induced. The transgenic hybrid mice with GVHR showed a larger spleen index and contained a higher serum level of IL-6 than those without GVHR. Autoimmune-like lesions in transgenic recipients became weakened compared with those in non-transgenic (bm12 x B6)F1 recipients. In contrast, levels of antimitochondrial antibodies in (bm12 x B6.6)F1 GVHR group were significantly higher than that of (bm12 x B6)F1 GVHR group. These results indicate that IL-6 excessively produced in vivo might regulate the progression of autoimmune diseases.

Animals↗
PubMed1993

Elevation of cytokines during open heart surgery with cardiopulmonary bypass: participation of interleukin 8 and 6 in reperfusion injury.

Myocardial ischaemia is one of the major causes of low output syndrome during open heart surgery. Injury associated with ischaemia and reperfusion has been considered to result, in part, from the action of neutrophils, the interaction of neutrophils with vascular endothelial cells, and the effects of cytokines which are mediators that induce and modify reactions between these substances. We investigated cell injury in relation to the concentrations of interleukins 6 and 8 (IL-6 and IL-8), which have recently received attention as neutrophil activators. Neutrophil counts, granulocyte elastase (GEL), IL-6, IL-8, tumour necrosis factor-alpha (TNF-alpha), CK, and CK-MB concentrations were determined serially in 11 patients undergoing open heart surgery with cardiopulmonary bypass (CPB). Neutrophil counts (mean +/- SD 2717 +/- 2421 microliters-1 preoperatively) peaked 60 min after declamping the aorta at 7432 +/- 4357 microliters-1 (P < 0.01) and remained elevated 7136 +/- 5194 microliters-1 at 180 min (P < 0.01). Plasma GEL level (168 +/- 71 micrograms.L-1 preoperatively) peaked at 1134 +/- 453 micrograms.L-1 120 min after declamping of the aorta (P < 0.01) and remained elevated, 1062 +/- 467 micrograms.L-1, after 180 min (P < 0.01). Serum IL-6 level (118 +/- 59 pg.ml-1 preoperatively) peaked at 436 +/- 143 pg.ml-1 60 min after declamping of the aorta (P < 0.01) and remained elevated, 332 +/- 109 pg.ml-1, after 180 min. Serum IL-8 level (37 +/- 44 pg.ml-1 preoperatively) peaked at 169 +/- 86 pg.ml-1 at 60 min after declamping of the aorta (P < 0.001) and remained elevated at 113 +/- 78 pg.ml-1 180 min after declamping of the aorta.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Power spectral analysis and digital filtration of brain stem auditory evoked potentials in dogs.

Power spectral analysis and digital filtering of brain stem auditory evoked potentials (BAEP) were performed in dogs. The BAEP were recorded in 7 dogs, using alternating clicks at frequency of 20 Hz. The clicks were delivered monaurally at intensity of 90-dB normal hearing level. Power spectral analysis indicated that the frequency compositions of the averaged responses were divisible into 4 frequency bands: A (30 to 390 Hz), B (390 to 680 Hz), C (680 to 910 Hz) and D (910 to 1960 Hz). The frequency limits of digital high-pass (HP) and low-pass (LP) filters, at which neither peak-to-peak nor absolute amplitudes were reduced, were 1,170 and 1,270 Hz for P1, 290 and 1,170 Hz for P2, 290 and 980 Hz for P3, 290 and 980 Hz for P4, and 200 and 880 Hz for P5, respectively. The dual structure of BAEP was confirmed in dogs. Below 200 Hz for the HP filter, peak-to-peak and absolute amplitudes of all waves were not significantly reduced. Therefore, this frequency may be a boundary frequency between low- and high-frequency components of BAEP in dogs. The main source for the high-frequency components that constituted each positive peak and the following trough was derived from frequency bands C and D. The frequency limits of 200 Hz for a digital HP filter and of 1,270 Hz for a digital LP filter, at which amplitudes of all waves were not reduced, support the analog filter settings recommended for dogs (ie, < or = 53 and 3,000 Hz for analog HP and LP filters, respectively).

Animals↗
PubMed1992

Primary hepatocellular carcinoma with severe hypoglycemia: involvement of insulin-like growth factors.

We report a case of severe hypoglycemia and hepatic masses suspected to be an insulin-like growth factor-II (IGF-II)-producing hepatocellular carcinoma. A 62-year-old man presented with mental disorder in the night and early morning associated with extremely low blood sugar levels (less than 21 mg/dl). Computerized axial tomography and ultrasonography revealed a massive tumor in the right lobe of the liver with multiple secondary nodules, and a tumor thrombus in the portal vein. At autopsy 107 days after admission, the liver weighed 3070 g, histologically showing an Edmondson type II tumor with liver cirrhosis. IGF-II in plasma (899 ng/ml) and tumor tissue (2.4 micrograms/g) was higher than that in normal plasma (374-804 ng/ml) and non-tumor liver tissue (0.2 micrograms/ml), while IGF-I (14 ng/ml) was significantly reduced. IGF-II, probably produced by the liver tumor, appeared to be involved in the mechanism of hypoglycemia.

Carcinoma, Hepatocellular↗
PubMed1992

Effects of analog filtering on brain stem auditory-evoked potentials in dogs.

Effects of analog filter frequency on brain stem auditory-evoked potentials (BAEP) were investigated in 7 non-sedated dogs. The BAEP were recorded successively at various low-pass (LP) and high-pass (HP) filter frequency settings. The analog filters had a rolloff of 6 dB/octave. Decrease of LP filter frequency from 30 kHz to 100 Hz caused prolongation of the peak latency and reduction of the peak-to-peak (from a positive peak to the following trough) and absolute (from a positive peak to the baseline) amplitudes for all peaks, except the peak latency for P5 and the absolute amplitude for P4. Changes in these variables were statistically significant (P less than 0.05) at different cutoff frequencies specific for the individual peaks. The interpeak latency between P1 and P4, and P4/P1 peak-to-peak amplitude ratio were not changed significantly. At the lowest LP filter frequency of 100 Hz, positive peaks (fast waves) seemed to be superimposed on a slow positive wave (slow wave). In contrast, increase of HP filter frequency from 0.53 to 160 Hz did not result in significant changes for any peaks, except for reduction in the absolute amplitude of P4. The various effects of LP filter frequency and negligible effects of HP filter frequency on individual peaks may be attributable to their frequency composition and/or elimination of the slow wave at higher HP filter frequency settings. On the basis of our results, LP filter setting of 3 kHz and HP filter setting of less than or equal to 53 Hz are recommended for recording of BAEP in dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Prognosis of the patients with high grade bladder carcinoma].

The pathological features and clinical outcome of grade 3 transitional cell carcinoma of the bladder, excluding CIS, encountered between 1972 and 1988 were studied to clarify the clinical characteristics of the disease. The subjects of this study were 108 patients consisting of 76 males and 32 females aged 33-87 years, with a mean age of 66 years. The survival rate according to each factor was calculated by Kaplan-Meier method, and the survival curves were compared by generalized Wilcoxon test. Grade 3 bladder cancer was often papillary, sessile and about 3 cm in diameter and showed a tendency of multiple occurrence. Histopathologically, it was often in high stages of pT2 or above and frequently with vascular invasion. Total cystectomy is not considered to be an absolute necessity for pT1, G3 bladder cancer patient, because, in our experience, it did not improve the prognosis. However, bladder-preserving operation requires strict postoperative follow-ups. After this operation, the 5-year survival rate was higher in the no-recurrence group than in the recurrence group, and the out come tended to be better in the group that had undergone intravesical instillation chemotherapy for prevention of recurrence than in the group without this therapy. Ample intravesical instillation chemotherapy after bladder-preserving operation seems to improve the postoperative course of bladder cancer patients. Total cystectomy may be unavoidable in patients with pT2 or above, and no effect of postoperative adjuvant chemotherapy was noted in our series. The establishment of multidisciplinary approaches is considered to be needed for improvement of the prognosis of high stage bladder cancer.

Adult↗
PubMed1991

Percutaneous embolization of ruptured splanchnic artery pseudoaneurysms.

The usefulness of emergent embolotherapy was evaluated in 17 patients with life-threatening hemorrhage from 18 ruptured splanchnic artery pseudoaneurysms. Complete hemostasis was obtained in 16 out of 17 patients by embolotherapy. Of the 12 initial embolization procedures with permanent embolic materials including stainless steel coils, microcoils, and Ivalon, complete cessation of bleeding was obtained in 11. On the other hand, 6 out of 9 initial embolization procedures with Gelfoam particles failed to halt bleeding, and additional embolization with permanent embolic materials was required. Emergent embolization with permanent embolic materials using superselective catheterization should be considered the initial treatment of choice for ruptured splanchnic artery pseudoaneurysms.

Adult↗