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Biomedical subjects

S Ohtake

Publications and source records attributed to S Ohtake.

At least 109 records · Page 6Linked to original sources
PubMed1995

[Secondary myeloid/natural killer cell acute leukemia appeared in multiple myeloma treated with melphalan].

A 67-year-old woman was treated with MP-P therapy and combination chemotherapy for multiple myeloma IgG-lambda type. After the therapy for about three years, pancytopenia developed. Bone marrow aspiration study revealed a few of myeloma cell and many atypical cells showing promyelocytic feature. Chromosomal abnormality was 46, X, -X, +8, -13, +mar. CD33 and CD56 were positive, but CD16 and HLA-DR were negative. We diagnosed as multiple myeloma complicated with secondary myeloid/natural killer (NK) cell acute leukemia. After she had been treated with low dose etoposide for leukemia, she obtained complete remission. But since myeloma progressed and the amount of M protein was increased, she was treated with dexamethasone and low dose etoposide, resulting in a decrease in the amount of M protein. After that, because of leukemic cell re-proliferation, she was treated with etoposide. However, she died of sepsis due to severe myelosuppression. This case was interesting one in coexist of multiple myeloma and secondary myeloid/NK cell acute leukemia, and those affecting her clinical course each other.

Aged↗
PubMed1995

[Serum cardiac troponin-T in coronary artery bypass graft and mitral valve replacement].

Serum cardiac troponin-T was measured to evaluate perioperative myocardial injury in heart surgery. Twelve patients of coronary artery bypass graft (CABG) and nine of mitral valve replacement (MVR) were selected and the measurements were performed at 3 points-before, as well as after the surgery and on the first postoperative day. Elevated serum levels of troponin-T were observed in postoperative measurement in both groups (CABG 2.98 +/- 1.44, MVR 2.57 +/- 0.52 ng.ml-1), where all the preoperative values were less than 0.1 ng.ml-1. On the first postoperative day, CABG group showed a higher serum level of troponin-T than MVR group (6.05 +/- 4.16 vs. 2.57 +/- 2.12 ng.ml-1, P < 0.05 respectively). Taking another myocardial marker, such as CK-MB or myosin light chain I, into consideration, these data indicate that myocardial injury occurs during heart surgery and the grade of injury is severer in CABG than in MVR.

Aged↗
PubMed1994

Plasma and leukemic cell pharmacokinetics of high-dose N4-behenoyl-1-beta-D-arabinofuranosylcytosine in acute leukemia patients.

The pharmacokinetics of N4-behenoyl-1-beta-D-arabinofuranosylcytosine (BHAC), a lipophilic antitumor analog of 1-beta-D-arabinofuranosylcytosine (ara-C), was investigated, by assay of plasma and leukemic cells of ten acute leukemic patients receiving 60-minute intravenous (IV) infusion of 700 mg/m2 BHAC, for BHAC and 1-beta-D-arabinofuranosylcytosine 5'-triphosphate (ara-CTP) by high-performance liquid chromatography, ara-C by radioimmunoassay, and 1-beta-D-arabinofuranosyluracil (ara-U) by gas chromatography-mass fragmentography. The plasma concentration of BHAC reached a maximum (173.4 +/- 75.3 micrograms/mL) at the end of the infusion and then declined in a biphasic pattern with an initial-phase half-life (t1/2 alpha) of 1.00 +/- .36 hours and a second-phase half-life (t1/2 beta) of 4.28 +/- 2.35 hours. That of ara-C similarly reached a maximum (102.2 +/- 39.9 mg/mL) at the end of the infusion and then declined with t1/2 alpha of 1.37 +/- 1.11 hours and t1/2 beta of 11.2 +/- 4.31 hours. Intracellular ara-CTP concentration increased in a linear-accumulation manner for the first 4 hours after the infusion, reached a maximum of .081 +/- .112 micrograms/10(7) cells at approximately 7 hours, and then declined very slowly in accordance with a one-compartment model with t1/2 of 13.56 +/- 9.62 hours.

Antineoplastic Agents↗
PubMed1994

Primary T cell non-Hodgkin's lymphoma of the central nervous system. Case report and review of the literature.

A 42-year-old man developed primary non-Hodgkin's lymphoma of the central nervous system (CNS). Immunohistochemical examination suggested that tumor cells were derived from T cells. Primary T cell non-Hodgkin's lymphoma of the CNS is a rare tumor, with only 12 well-documented cases in the literature. The clinical features of these 12 cases were similar to those of other CNS lymphomas, and the effect of treatment and prognosis were usually worse than those of extranodal lymphoma. Our patient, who was treated with partial tumor resection and whole-brain irradiation with a boost to the primary site and 5 courses of CHOP therapy (cyclophosphamide, doxorubicin, vincristine, prednisolone), is still alive and in remission 38 months after diagnosis.

Adult↗
PubMed1993

Hemolytic uremic syndrome developing during remission of acute myelomonocytic leukemia.

A 47-year-old woman was diagnosed with acute myelomonocytic leukemia (AMMoL) and was treated with combination chemotherapy. After one cycle of remission induction therapy, she entered into complete remission and then received three cycles of consolidation therapy. A month after the last consolidation therapy, she was diagnosed with having the complication of chemotherapy-related HUS (C-HUS). The C-HUS improved after initiation of plasma exchange and antiplatelet therapy. In the present case, it seems that the antileukemic agents might play an important role in the development of C-HUS.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Prevention of doxorubicin-induced cardiotoxicity by recombinant interleukin-1 in hamsters. Doxorubicin cardiotoxicity and interleukin-1.

The major factor contributing to doxorubicin (DXR)-induced cardiotoxicity is the insufficiency of antioxidant defense mechanisms. As a model of acute cardiotoxicity with DXR, ten-week-old golden hamsters were given DXR (5 mg/kg) intravenously, and the toxicity was investigated by monitoring ECG changes. Complete A-V block and cardiac arrest on the ECG were observed in DXR-treated hamsters. DXR-induced edema and fragmentation of myofibrils were observed by electron-micrograph. Pretreatment with interleukin-1 beta (10 or 1 microgram/body) 12 or 24 hrs before prevented these changes, but pretreatment with tumor necrosis factor alpha had no effect.

Animals↗
PubMed1993

Cerebral metabolism and circulatory arrest: effects of duration and strategies for protection.

Hypothermic total circulatory arrest (CA) is commonly used to facilitate repair of complex congenital heart defects. However, the "safe" period of CA remains to be defined. Extended periods of hypothermic total circulatory arrest may impair cerebral metabolism and cause ischemic brain injury. This study defines the relationship between increasing durations of CA at 18 degrees C and cerebral metabolism, and examines the protective value of topical cooling of the head or continuous "trickle" flow (5 to 10 mL.kg-1.min-1). Thirty-three 1-week-old piglets were randomized to six experimental groups: control; 15, 30, or 60 minutes of CA; 60 minutes of CA with topical cooling of the head; and 60 minutes of trickle flow. Animals were placed on cardiopulmonary bypass (CPB) at 100 mL.kg-1.min-1 and cooled to 18 degrees C. After the experimental period of CA or trickle flow (or 60 minutes of CPB at normal flow for the control group), animals were rewarmed to 37 degrees C and weaned from CPB. Data were obtained before and immediately after CPB at 37 degrees C, and before and immediately after the experimental period at 18 degrees C. Parameters measured included cerebral blood flow by xenon 133 clearance, arterial and sagittal sinus blood gases, and cerebral metabolism. Hypothermic total circulatory arrest caused an impairment of cerebral metabolism that was directly proportional to CA duration (r2 = 0.73; p = 0.0001), and recovery of metabolic function after 60 minutes of CA improved more than 50% if the head was packed in ice.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

Mixed type of total anomalous pulmonary venous connection with hemi-pulmonary vein atresia.

This reports a successfully corrected case of an 8-day-old baby who had a rare mixed type of total anomalous pulmonary venous connection in which the left pulmonary vein connected to the portal vein and the right one was atretic as demonstrated by pulmonary artery wedge angiography. The left common pulmonary vein and right pulmonary veins were anastomosed to the left atrium, separately. The patient tolerated the operation and has been well. Early total repair after accurate diagnosis was successful for this rare combination of anomalous pulmonary venous connection.

Anastomosis, Surgical↗
PubMed1993

Malignant lymphoma with myxoid change and sarcomatous features.

We report a case of unusual B-cell malignant lymphoma of the kidney and mediastinum. Renal biopsy showed prominent myxoid changes and sarcomatous features, leading to considerable difficulty in histologic diagnosis on routinely stained histologic sections. However, immunohistochemical staining for lymphocyte markers led to the final histologic diagnosis of B-cell malignant lymphoma. Although myxoid change is not generally found in malignant lymphoma, malignant lymphoma should not be excluded from consideration when one encounters a small round cell sarcoma with myxoid stroma, especially in extranodal soft tissue tumors.

Adolescent↗
PubMed1993

[Anatomic correction without extracardiac conduit for Taussig-Bing malformation (REV procedure)].

A 2-year-old boy with Taussig-Bing malformation with mild pulmonary stenosis underwent anatomical repair without extracardiac conduit (REV procedure). He had pulmonary arterial banding at 4 months of age, and REV procedure was performed at 2 years and 4 months of age. Under cardiopulmonary bypass, enlargement of ventricular septal defect were performed with an internal conduit. Pulmonary arterial trunk was divided and the proximal end was closed. Direct anastomosis of the posterior wall of the distal pulmonary arterial trunk to the right ventriculotomy was carried out without transection of aorta or translocation of pulmonary artery. Right ventricular outflow tract (RVOT) was reconstructed with a patch bearing a monocusp. The postoperative course was very smooth and postoperative cardiac catheterization revealed no stenosis in both left and right ventricular outlfow tract and good cardiac performance.

Aorta↗
PubMed1993

[Plasma exchange failures in two patients with thrombotic thrombocytopenic purpura].

We treated two patients with thrombotic thrombocytopenic purpura (TTP) with multiple plasma exchanges for a short period. Following 6 plasma exchanges during 11 days in patient 1 and the 8 exchanges during 13 days in patient 2, consciousness disturbance and thrombocytopenia improved with a decrease in serum lactate dehydrogenase (LDH) levels in both patients. However, thrombocytopenia rapidly progressed with a rise of serum LDH levels after a few days from cessation of the treatment. They received a few rounds of plasma exchange without beneficial effects and eventually died of massive hemorrhage. The clinical course of these patients indicates that some patients with TTP are refractory to repeated plasma exchanges for a short period. It seems important to determine the target point in blood chemistry values such as the LDH level for plasma exchange at which the treatment could be discontinued without causing relapse of TTP.

Aged↗
PubMed1992

Effect of recombinant human granulocyte colony-stimulating factor (G-CSF) in the treatment of Pseudomonas aeruginosa bacteremia complicating hematologic malignancy--a preliminary study.

The efficacy of recombinant human granulocyte colony-stimulating factor (G-CSF) in the treatment of Pseudomonas aeruginosa bacteremia in cancer patients receiving intensive chemotherapy was studied retrospectively. In 14 of the 24 episodes of P. aeruginosa bacteremia, which occurred in 23 severely neutropenic patients with hematologic malignancies during a three-year period, G-CSF was given subcutaneously or intravenously at daily doses of 75 micrograms/body to 200 micrograms/m2 of body surface. Overall, survival at one week after onset was observed in 13 patients (54%). Treatment with G-CSF, however, had no statistically significant association with one-week survival, although a favorable outcome was well correlated with an increase in the neutrophil count during therapy. On the other hand, septic shock and appropriate antibiotic therapy were the major prognostic factors. The frequency of shock was reduced by appropriate therapy, but not by G-CSF treatment. These preliminary findings thus suggested that G-CSF should not be effective in the treatment of neutropenic cancer patients with P. aeruginosa bacteremia. No adverse effects of G-CSF were observed.

Adolescent↗
PubMed1992

Argyrophilic proteins of the nucleolar organizer region in acute leukemias and its relation to the S-phase fraction of leukemic cells.

Nucleolar organizer regions (NORs) are loops of DNA which transcribes to ribosomal RNA. The NOR-related protein becomes visible in nucleus by a silver-staining technique under a light microscope, and it has been named argyrophilic protein of NOR (Ag-NOR). In various malignancies, the correlation between the proliferation potential of tumor cells or histological grade and the number of Ag-NORs has been reported. In this study, we investigated the Ag-NOR of acute leukemic cells and its relation to the in vivo proportion of bone marrow leukemic cells in DNA synthetic phase. The number of Ag-NORs in bone marrow leukemic cells was more than that in peripheral blood (means values 2.78 and 2.48, respectively, p less than 0.01). This result shows that the number of Ag-NORs reflects the vigorous proliferative potential of bone marrow leukemic cells. However, no significant correlation was obtained between the number of Ag-NORs and the bromodeoxyuridine-labeling indices (r = 0.2064). These results suggest that Ag-NOR might be one of the markers for cellular proliferation in leukemia, while DNA synthesis of leukemic cells do not seem to be directly related to Ag-NOR. In order to clarify the role of Ag-NOR in leukemia, further studies are needed.

Adolescent↗
PubMed1992

Determination of optimal perfusion flow rate for deep hypothermic cardiopulmonary bypass in the adult based on distributions of blood flow and oxygen consumption.

To determine the optimal perfusion flow in deep hypothermic cardiopulmonary bypass at 20 degrees C in human beings, we studied the relationship of perfusion flow to the whole body and to regional oxygen consumption. In adult patients (n = 11, average age 54 years) with valvular or coronary heart disease, the distributions of perfusion flow rate and oxygen consumption were analyzed by dividing into the superior and inferior vena caval areas. Measurements (n = 39) were made at various perfusion flow rates (perfusion flow rate in the superior vena caval area plus that in the inferior vena caval area equals whole-body perfusion flow rate: 0.4 to 2.2 L/min/m2) in a setting of average hemoglobin levels of 8.1 gm/dl. Between whole-body perfusion flow rate and oxygen consumption (total oxygen consumption equals superior plus inferior vena caval oxygen consumption), there was a hyperbolic correlation (r = 0.73; p less than 0.001; asymptote = 29.0 ml/min/m2). A positive linear correlation was found between whole-body perfusion flow rate and inferior vena caval oxygen consumption (r = 0.75; p less than 0.001), whereas no significant relation was seen between whole-body perfusion flow rate and superior vena caval oxygen consumption. For distributional changes in inferior vena caval perfusion flow rate/whole body perfusion flow rate and inferior vena caval oxygen consumption/whole body oxygen consumption, the broken-line regression analysis showed respective critical points where both parameters started to drop when whole-body perfusion flow rate was gradually reduced: 1.2 L/min/m2 for inferior vena caval perfusion flow rate/whole-body perfusion flow rate and 0.8 L/min/m2 for inferior vena caval oxygen consumption/whole-body oxygen consumption. The results indicate that (1) the oxygen consumption to the superior vena caval area was maintained independent of the perfusion in a relatively wide range in contrast to that for the inferior vena caval area and (2) when the redistribution of oxygen consumption is considered as undesirable under low-flow perfusion, the optimal perfusion flow for 20 degrees C deep hypothermic cardiopulmonary bypass appeared to be 0.8 L/min/m2.

Adult↗
PubMed1991

Living-related lobar lung transplantation in beagle puppies.

Unilateral lung transplantation has provided effective short-term therapy in adults with end-stage lung disease. Rejection continues to be the most common cause of transplant failure. Living-related lung transplantation may decrease the recipient immune response. The purpose of this study is to test the technical and physiological feasibility of living-related lobar lung transplantation from adult beagles into beagle puppies in a chronic model. Twenty purebred adult beagle donors underwent left thoracotomy with harvest of the left lower lobe using cold perfusion of the pulmonary artery and cold immersion. Twenty recipient purebred beagle puppies from the same colony underwent left thoracotomy, left pneumonectomy, and implantation of the donor adult lobe. Anastomoses were performed in sequence: pulmonary vein to left atrium, bronchus, pulmonary artery. Postoperative immunosuppression was with Cyclosporine. Respiratory function of the implanted lobe was evaluated by pulmonary angiography and during balloon occlusion of the right pulmonary artery with arterial blood gases 1 month after transplantation. Ten recipient puppies died of rejection (4), infection (3), or bronchial dehiscence (3) prior to angiography. Seventeen pulmonary angiograms in 10 surviving animals showed normal left pulmonary arterial blood flow (2), diminished left pulmonary arterial flow (5), and occluded left pulmonary artery (3). In two recipients balloon occlusion of the right pulmonary artery was performed and respiratory function was maintained solely by the transplanted lobe for 2 days in one recipient and for 30 minutes at 1 month and 2 months postimplant in a second recipient. Living-related lung transplantation of adult beagle lobes into pneumonectomized beagle puppies is technically feasible. High mortality rates in a chronic model are related to infection and rejection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗