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Biomedical subjects

T Kanoh

Publications and source records attributed to T Kanoh.

At least 19 recordsLinked to original sources
PubMed1992

IgM-producing renal plasmacytoma.

A seventy-six-year-old woman with plasmacytoma presenting as a renal mass died three months after diagnosis. Bone surveys disclosed no lytic lesions. Gallium-67 scan showed an avid uptake of the radionuclide in the renal mass. Histologic and immunofluorescence studies of resected specimens demonstrated that the renal parenchyma was destroyed by sheets of immature plasma cells producing IgM-lambda and by massive deposits of amorphous, eosinophilic substance stained with anti-mu and anti-lambda antisera. The literature is reviewed. We believe this case is the first one of well-documented IgM-producing renal plasmacytoma.

Aged↗
PubMed1992

[Vacuolar inclusions with multivesicular structure in leukemic multiple myeloma].

A case of leukemic multiple myeloma with IgG-lambda type, which plasma cells in the peripheral blood and the bone marrow had large vacuolar inclusions is reported. A 67-year-old male was admitted because of bone pain. A diagnosis of leukemic multiple myeloma of IgG-lambda type was established, based on Bence Jones proteinuria (1.5 g/day), marked plasmacytosis in peripheral blood (63%) and bone marrow (90%), serum M-component (IgG-lambda type, 6.0 g/dl) and multiple osteolytic lesions. Most plasma cells in the bone marrow as well as in the blood had vacuolar inclusions in the cytoplasm which were 1-8 microns across and were negative with PAS and myeloperoxidase staining. Acid phosphatase reaction was distributed densely around vacuolar inclusions and sparsely within them in the form of fine granules. Ultrastructurally, most of the vacuolar inclusions were electron-lucent cytoplasmic spaces, encircled in a distinct limiting membrane, in which inner microvesicles were distributed diffusely. A few vacuoles showed fibrillary structures. These findings suggested that the lysosomal system might play a major role in the vacuolation of these plasma cells.

Aged↗
PubMed1992

[Effect of chemotherapy on the prognosis of ovarian cancer].

Through the collaboration of 22 institutions nationwide, a total of 1,185 cases of ovarian cancer treated between January, 1980 and December, 1987, were investigated as to their prognosis from the aspect of the chemotherapeutic effect. (1) An excellent effect of the remission-induction chemotherapy was observed in a group receiving combination therapy with CDDP as the main ingredient. In particular a significant effect was seen in stages III and IV. In addition, the effect on the remaining tumors by diameter also showed a significant difference in cases of tumors of not less than 2 cm in diameter. (2) As to the effect on histological types, a comparison in stage III showed a favourable effect on endometroid, serous and mucinous adenocarcinomas, while no effect was observed in clear cell adenocarcinoma. (3) The effect of the remission induction chemotherapy did not always give rise to an improvement in the long-term prognosis of ovarian cancer, and the establishment of a therapeutic method aimed at the prevention of recurrence was desired. (4) To improve the long-term prognosis, intermittent (or cyclic) chemotherapy with CDDP as the main ingredient was found to be very effective, but maintenance chemotherapy with orally administered of 5-Fluorouracil or Tegaful was not effective. (5) The effect of the conventional immunotherapy was not observed at all.

Adenocarcinoma↗
PubMed1992

[A long-term result of coronary artery bypass on left coronary ostial stenosis secondary to Takayasu's disease: a case report].

A 37-year-old woman was admitted to our hospital for post operative coronary angiography. At the age of 17, she was diagnosed as having Takayasu's disease and at that time prednisolone was administered. At the age of 22, she was operated on to receive a coronary artery bypass graft (CABG) because of a 95% isolated stenosis in the left coronary ostium. Pathological specimen obtained from the ascending aorta demonstrated a proliferative stage of Takayasu's aortitis. After the CABG, she married and delivered two children, with the inflammation being kept under control by prednisolone. Coronary angiography performed 13 years after the operation proved the saphenous vein graft to the left anterior descending artery to be still patent. To our knowledge, this case has the longest history of a patent CABG used in an operation to correct the ostial stenosis secondary to Takayasu's disease. According to the previous reports we collected, the long-term patency rate of CABG is 78%, whereas that of ostial endarterectomy is unknown. Whether CABG or endarterectomy is better as an operating method for ostial stenosis due to aortitis is still a controversial point. We hope that reports of further examples will be available in order to help make the final decision.

Adult↗
PubMed1992

[Primary macroglobulinemia with hypercalcemia, renal failure and systemic amyloidosis].

This report deals with an unusual case of primary macroglobulinemia with hypercalcemia, chronic renal failure and systemic amyloidosis. In May 1990, a 63-year-old male was transferred to our hospital because of hypercalcemia (13.5 mg/dl) and renal failure. Clinical examinations showed anemia, macroglossia, lymph node swellings and hepatomegaly. Laboratory findings included Bence-Jones (kappa type) proteinuria (0.8 g/day), a monoclonal gammopathy of the IgM-kappa type (2.8 g/dl), a proliferation of lymphoid cells in the peripheral blood (5%) and the bone marrow (59.6%), and lymphomatous involvement of an inguinal lymph node. Serum creatinine concentration was 8.5 mg/dl. The serum levels of parathormone and vitamin D3 metabolites were normal. The roentgenogram of bones showed a compression fracture of the lumbar spine and systemic osteoporosis. The treatment included eel calcitonin, prednisolone and the CHOP regimen, followed by hemodialysis and plasmapheresis. The serum level of IgM increased to 4.6 g/dl. The patient died three months later and postmortem examination demonstrated marked systemic amyloidosis.

Amyloidosis↗
PubMed1992

[Multiple myeloma with a mass formation in a pacemaker pocket].

A 74-year-old female was diagnosed as having multiple myeloma in August 1989 and was treated with combined vincristine, melphalan and prednisolone. Subsequently, she was followed followed up in the outpatient clinic using interferon-alpha. On August 6, 1990, she had a transvenous demand pacemaker inserted because of severe atrioventricular block. The pulse generator was placed in a subcutaneous pocket in the left pectoral area. On February 3, 1991, she developed a mass overlying the pulse generator. This tumor was diagnosed as plasmacytoma by histological examinations. A myelogram showed 5.1% plasma cells with 5.5 x 10(4) nucleated cells/microliter. The amounts of serum protein and IgA M protein were 6.8 g/dl and 1.8 g/dl, respectively. The tumor responded to combined chemotherapy, but reenlarged to the initial size 3-4 weeks later. On August 6, 1991, this tumor, including the pulse generator was removed. By October 1991, the patient had systemic subcutaneous tumors and a right maxillary tumor suggesting the aggressive phase. On December 19, 1991, she died due to cardiac failure. In this paper the discussion focussed on the etiopathogenesis of plasmacytoma arising in the region of pulse generator pockets.

Aged↗
PubMed1992

[A group study on prognosis of ovarian cancer in Japan].

An assessment has been made, with the cooperation of 22 institutes, of 1,185 cases of ovarian cancer as subjects who were treated in the period from January, 1980, to December, 1987. As a result, (1) As for distribution by clinical staging at the initial examination, the cases in Stage III were the most numerous, followed by those in Stage I, and if classified according to the histological type, serous cystadenocarcinoma was the most frequently observed in Stage III, and undifferentiated and unclassified carcinomata were observed in Stages III and IV. (2) In the examination of prognostic factors, it was confirmed that the clinical stage, histological type and diameter of the remaining tumor after the initial operation were important factors. (3) A significant difference was observed between the grade of histomorphological differentiation and prognosis, the difference was chiefly due to the deviated distribution of clinical staging in each group of differentiation. (4) A favorable trend was observed in the prognosis by patient's age toward the younger layer. (5) When the starting time of the therapy is considered, a trend toward improvement has been seen year by year, and it is considered that the beneficial effect of chemotherapy with CDDP contributes to this.

Adult↗
PubMed1992

[An unusual case of localized form of primary macroglobulinemia developing from a nodular primary pulmonary amyloidosis].

The authors reported here a case of primary pulmonary amyloidosis, which developed into a localized form of primary macroglobulinemia (PMG) 10 years later. A nodular shadow was pointed out on routine chest x-ray films of a 61-year-old Japanese male in 1977. In 1981, a diagnosis of nodular primary pulmonary amyloidosis was made by percutaneous lung biopsy. At that time, he suffered from signs and symptoms of chronic cold agglutinin disease (CCAD). Cold agglutinins were IgM-kappa antibodies. In 1986, serum immunoelectrophoresis demonstrated the presence of a small amount of monoclonal IgM-kappa. In 1987, the patient was readmitted because of pleural effusions. In the pleural effusion, the IgM level was 3,341 mg/dl and the titer of cold agglutinin was 32,000. Cytological examinations of pleural effusion showed the proliferation of lymphocytes, lymphoid cells and plasma cells. These cells showed the monoclonality of IgM-kappa by the peroxidase-antiperoxidase method. At post-mortem examination in March 1988, PA and PMG were found, but both lesions were localized only in the thoracic cavity. It is suggested that primary amyloidosis (PA) as well as CCAD and monoclonal gammopathy of undetermined significance may be one of the pre-neoplastic conditions of PMG.

Aged↗
PubMed1991

Why are natural plant medicinal products effective in some patients and not in others with the same disease?

We had previously found that the clinical efficacy of natural medicinal products was significantly enhanced by pretreatments of the natural compounds with far infrared radiation heating and brewing that effected degradation of high molecular polymers to yield free forms of low molecular monomers with anti-oxidant activity. The gastric samples from the patients were incubated with untreated or treated natural products, and the resulting materials assayed in vitro for the capacity to scavenge reactive oxygen species (ROS). The gastric fluid of patients who had responded to the untreated natural products showed a significantly greater scavenging ability than did the patients who had not responded to these agents. Similarly, the gastric fluid of patients who responded only to the treated, commercial products also showed a slightly greater scavenging ability than did those who failed to respond to any agent, treated or untreated. Acid and pepsin contents were demonstrated in largest amounts in the gastric juice from the patients who had responded well to the untreated natural medicines. Furthermore, the materials incubated with gastric fluid from the responding patients produced an increase in the free forms of alpha-tocopherol, beta-carotene, and flavoprotein as compared with the fluids of nonresponding patients. These findings suggest that one of the factors determining the clinical response to natural herbal medicinal products is the ability of the patient's digestive system to degrade the product to liberate bioactive low molecular compounds from repeating polymers.

Adult↗
PubMed1991

Amylase-producing multiple myeloma.

We managed a case of amylase-producing multiple myeloma with extensive extramedullary spread. We reviewed five cases of amylase-producing multiple myeloma, including this case. This type of multiple myeloma has shown unique clinicopathologic features. (1) A distinct elevation of the serum amylase activity was demonstrated in all five patients. The amylase isozyme was of the S type without exception. (2) Extensive extramedullary spread with extramedullary tumors and/or myelomatous pleural effusions or ascites was seen in all five patients during the course of illness. (3) In three of four cases in which it was mentioned, extensive destruction of multiple bones was demonstrated roentgenographically. (4) In four patients, excepting one with a solitary bone lesion, the survival from the initial therapy was shorter than 1 year. (5) Myeloma cell lines were established in three cases. A common feature of these three cell lines was a translocation of chromosome 1, which supplied the amylase gene. This finding may be pathogenetically related to this entity.

Aged↗
PubMed1991

[Studies on 13 cases of double gammopathy].

By a combined use of immunoelectrophoresis and immunofixation, we detected 13 cases of double gammopathy among 269 cases of monoclonal gammopathy investigated between 1986 and 1990. The incidence of double gammopathy (4.8%) was greater than that in previous studies. Double gammopathy was classified into 5 groups: (1) identical pairs of both heavy (H)- and light (L)-chains (1 case); (2) identical H-chains and different L-chains (2 cases); (3) different H-chains and identical L-chains (3 cases); (4) different pairs of both H- and L-chains (5 cases); and (5) monoclonal immunoglobulin and Bence Jones protein of different type (2 cases). An additional M-component was detected during the course of illness in 2 of the 13 cases. As to H-chain combinations, a pair of IgG and IgA (46%) was most frequently encountered. Seven patients had myeloma, three benign double gammopathy and two macroglobulinemia. One case of benign double gammopathy developed IgA (lambda) myeloma three years after the diagnosis. Serum and urine immunofixation is a useful method to detect a trace amount of M-component and to follow up the clinical course of monoclonal gammopathy.

Adult↗
PubMed1991

[Progression from Crow-Fukase syndrome with double gammopathy (IgM-kappa, IgG-lambda) to primary macroglobulinemia].

This report deals with a case of double gammopathy (IgM-kappa, IgG-lambda) with Crow-Fukase syndrome, which developed into primary macroglobulinemia four years after the diagnosis. In May 1980, a 74-year-old woman was admitted to the hospital because of a rapid progression of peripheral neuropathy. The patient was diagnosed as having Crow-Fukase syndrome from the following data: albumin-cytologic dissociation of cerebrospinal fluid, peripheral edema, diffuse hyperpigmentation of the skin, diabetic glucose intolerance, serum double gammopathy (IgM-kappa, IgG-lambda) and hepatomegaly. The administration of prednisolone yielded the improvement of neuropathy. In December 1984, serum IgM level was increased from 104 mg/dl to 3,025 mg/dl. Plasma cells in the bone marrow increased in the percentage from 5.6% to 18.4%, and then Bence Jones protein (kappa type) was excreted in the urine. No antibody activity to myelin antigens was detected in the serum. The patient died of cerebral infarction in 1985. At postmortem examination, lymphomatous involvement was found in the jejunum. At the immunohistological examination of the tumor specimens, the morphology and the distribution of IgM- and IgG-positive cells corresponded to that of kappa- and lambda-positive cells, respectively. A small number of cells containing both kappa and lambda light chains were also demonstrated. It seems likely that IgM (kappa)- and IgG (lambda)-positive cells were derived from the common precursor cells.

Aged↗
PubMed1991

Ring neutrophils in plasma cell dyscrasia.

Sporadic reports in the medical literature concern the significant incidence of neutrophils with ring-shaped nuclei in myeloproliferative disorders. We report our first encounter with ring neutrophils in patients with lymphoproliferative disorders. A significant incidence of ring neutrophils was observed in all of 20 patients with multiple myeloma and in nine of 10 patients with monoclonal gammopathy of undetermined significance. The mean percent of ring neutrophils was 9.5% (range, 1.0% to 28.0%) in patients with multiple myeloma, which was significantly greater than in those with monoclonal gammopathy of undetermined significance or in healthy controls. In multiple myeloma, the incidence of ring neutrophils in the pretreatment phase was greater than that in the remission phase. A great deal of overlap was noted between multiple myeloma in the remission phase and monoclonal gammopathy of undetermined significance. The incidence of ring neutrophils seemed to vary according to disease stage. Ring neutrophils may reflect abnormal granulopoiesis in plasma cell dyscrasias.

Bone Marrow↗
PubMed1991

[An operative case of solitary interruption of the aortic arch in adult].

A 43-year-old lady was hospitalized due to easy fatiguability in the legs during exercise, and for evaluation of an abnormal shadow in the chest X-ray, and hypertension. Her blood pressure was 200/80 mmHg in the right arm, 140/70 mmHg in the left, and 110/70 mmHg in both lower extremities. Systolic vascular bruit radiating to her neck and back was audible in the Erb's area. DSA and aortogram disclosed extremely dilated vessels around the origin of the left common carotid artery. The left subclavian artery was opacified retrogradely as a subclavian blood steal via the left vertebral artery, and mild stenosis was seen at its origin. There was no evidence of associated congenital anomaly such as VSD, PDA, or ASD. The final diagnosis, solitary interruption of the aortic arch (S-IAA, type B), was made by MRI. The patient had an extra-anatomical bypass operation by using Cooley woven dacron graft from the ascending to the abdominal aorta. The result was good. S-IAA is a very rare congenital anomaly. As far as we know, only 21 patients with S-IAA including this case have been reported. A physician should be aware that a patient with S-IAA tends to have a difference of blood pressure not only between the upper and lower extremities but also between both arms, and pressure in the right arm is usually higher than that in the left. These are good signs to suspect S-IAA. And they also can be helpful to differentiate S-IAA from coarctation of the aorta.

Angiography, Digital Subtraction↗
PubMed1990

Induction of superoxide dismutase in leukocytes by paraquat: correlation with age and possible predictor of longevity.

Reactive oxygen species (ROS) are thought to play a role in the aging process as well as in a number of human diseases states. Superoxide dismutase (SOD), an enzyme that scavenges the superoxide anion (O2-) is constitutively expressed in leukocytes and other tissues. When assayed in peripheral blood leukocytes (PBL), constitutive SOD activity shows little variation among individuals of different ages. We have found that significant induction of SOD activity occurs in PBL incubated in vitro with paraquat, an agent known to cause intracellular O2- production. This induction was found to be highly age dependent; lymphocytes from 36 healthy subjects aged 20 to 40 years showed an increase of 85% +/- 10%, versus an increase of only 8% +/- 1% for lymphocytes from 30 healthy subjects aged 65 to 79 years (P less than 10(-4)). Forty subjects, aged 67 to 73 years, who were healthy at the time of assay of leukocyte SOD induction were followed up 5 years later. Nineteen of these subjects had died; all 19 had shown SOD induction of less than 10% (range, 0% to 7%; mean, 2.4%). In contrast, of the 21 survivors (range, 2.5% to 50%; mean, 21%), 12 had shown SOD induction greater than 10%, and 7 had shown SOD induction greater than or equal to 35% (P less than 10(-3)). Thirteen of the 19 deaths were attributable to malignancy or cerebrocardiovascular disease. Preservation of leukocyte SOD inducibility appears to correlate with longevity in elderly individuals and may be of value in predicting resistance to malignancy or fetal cardiovascular events.

Adult↗