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Biomedical subjects

T Nakama

Publications and source records attributed to T Nakama.

At least 19 recordsLinked to original sources
PubMed1995

Relationships between eosinophil-associated parameters and disease severity in atopic dermatitis.

This study demonstrated not only the presence of house dust mite antigen (HDM)-specific IgE and IgG antibodies in the sera of 27 patients with atopic dermatitis (AD), but also considerably increased levels of serum eosinophil cationic protein (ECP) and uniformly nadir levels of plasma ECP, which provides evidence for ECP release from eosinophils in vitro. Besides blood eosinophilia, AD patients had an increased number of CD32+ eosinophils and EG2+ "activated" eosinophils; both of which, especially the latter, were significantly correlated with elevated levels of serum ECP. AD-source eosinophils had enhanced sensitivity for IgG-immune complexes corresponding to their increased expression of CD32, whereas neither HDM alone nor IgE/HDM-immune complex induced eosinophil activation. There were no gamma globulin-bearing cells in AD-source eosinophils, indicating that serum ECP levels may be dependent on EG2+ eosinophil numbers rather than the state of CD32-mediated eosinophil degranulation, as shown in vitro. Since HDM can cause an eczematous skin reaction accompanying the eosinophil accumulation and degranulation in sensitized AD, increased numbers of both CD32+ and EG2+ eosinophils according to the extent of AD severity indicates that these eosinophil in vivo generations and their subsequent functioning in the lesional skin may be regulated through HDM-initiated dermatitis events, and then, may form a vicious circle as the AD lesions spread.

Adult↗
PubMed1994

Eosinophilic cellulitis (Wells' syndrome) associated with ascariasis.

A case of eosinophilic cellulitis (Wells' syndrome) in association with ascariasis is described. The clinical and histopathologic features of the patient responded well to an oral anthelminthic drug. According to our search, this association has not previously been reported.

Adult↗
PubMed1994

A case report of serologically diagnosed pulmonary anisakiasis with pleural effusion and multiple lesions.

The second known human case of pulmonary anisakiasis is reported. A 22-years-old man living in Hyuga City, Miyazaki Prefecture, Japan, developed high fever, respiratory distress, and pleural effusion after consumption of raw fish. Although his total white blood cell count increased to approximately 10,000-20,000/mm3, eosinophilia was not observed. The total IgE level in his serum markedly increased up to 3,599 IU/ml. Since the patient was suspected to have a parasitic disease, immunoserologic tests were carried out. Screening tests using a multiple dot-enzyme-linked immunosorbent assay (ELISA) and an Ouchterlony double-diffusion test showed that his serum and pleural effusion had the strongest reactivity against crude antigen of Anisakis type I larvae, together with weak cross-reactivity against several other nematode antigens. Since extragastrointestinal anisakiasis was strongly suspected, this diagnosis was confirmed by a microplate-ELISA and Western blot analysis using a monoclonal antibody.

Adult↗
PubMed1992

Eosinophil phenotypes in bullous pemphigoid.

Eosinophil phenotypes were investigated in peripheral blood and skin lesions from eight patients with bullous pemphigoid (BP). By Nycodenz density gradients fractionation, blood eosinophils were divided into two phenotypes; normodense (greater than 1.080 g/ml) and hypodense (less than or equal to 1.080 g/ml). Increased numbers of hypodense eosinophils were observed in the blood from all patients with BP. Immunocytochemical observations, using an EG2 monoclonal antibody to react with the secretion form of eosinophil cationic protein (ECP), revealed that EG2 was expressed in 86 +/- 3% of hypodense phenotypes and 3 +/- 2% of normodense phenotypes. Ultrastructurally, hypodense eosinophils were characterized by numerous spheroidal granules, each with a lytic crystalloid core. These indicate that the hypodense phenotype represents a cell in an activated state. Only eosinophils with immunocytochemical and morphological characteristics similar to hypodense phenotypes infiltrated around the basement membrane zone in involved skin of BP. Furthermore, direct adherence of eosinophils associated with degranulation into basal keratinocytes was seen at the sites of blistering lesions. Bullous fluids contained higher concentrations of ECP than sera as determined by a radioimmunosorbent assay; thus hypodense (activated) eosinophils may directly damage the basal keratinocytes by releasing their granule proteins, subsequently leading to dermo-epidermal separation.

Aged↗
PubMed1991

Ultrasonographic findings and management of intrahepatic biliary tract abnormalities after portoenterostomy.

Ultrasonographic examinations was made in 24 children who had undergone a portenterostomy to correct extrahepatic biliary atresia. Abnormalities were observed in six patients. These were the result of ongoing inflammatory reactions because all had been suffering from cholangitis after surgery, and the size of the biliary tract structure changed in accordance with the occurrence and subsidence of the cholangitis. Ultrasonographic examination showed dilation of the intrahepatic bile duct in one patient and cystic lesions in five patients. Treatment included percutaneous transhepatic bile drainage for dilated bile ducts, alcohol injections for intrahepatic cysts, and reoperation for cysts in the porta hepatis. Treatment was not required for cysts in controllable cholangitis. The results of these approaches were excellent, indicating that they were of benefit in treatment intrahepatic abnormalities occurring after portoenterostomy.

Bile Ducts, Intrahepatic↗
PubMed1991

Primary anastomosis for acute ascending aortic dissection.

Intimal tear resection and primary anastomosis of the aorta were used for the treatment of eight patients with DeBakey I and II type acute aortic dissection. Five patients were of DeBakey I type, and three patients were of the II type. Moderate or severe aortic regurgitation (AR) was observed in six of eight patients. The site of the intimal tear was diagnosed by intraoperative echocardiography, and the adventitia corresponding to the intimal tear was transversely opened under total cardiopulmonary bypass. While resuspension of the aortic valve was performed on only one of six patients, AR disappeared in four, postoperatively. Two of eight patients died early postoperatively. The cause of death was postoperative cardiac tamponade in one patient and cerebral herniation in the remaining one. The other six patients have been observed for a mean period of 27 months. There is no late death, and they show no dilatation of the aortic root and deterioration of AR. We believe that this operative method is a simple and safe emergency procedure for DeBakey I and II type acute aortic dissection.

Acute Disease↗
PubMed1991

[Surgical treatment of acute ascending dissection--a simplified operative method].

Primary anastomosis for acute ascending aortic dissection was performed in 8 patients. Primary anastomosis included resection of the intimal tear where applicable, a circumferential suture line in the ascending aorta at the site of the tear, and wrapping of the anastomosis of the ascending aorta with Dacron vascular prosthesis. The aortic valve was resuspended in 1 of 6 patients associated with aortic regurgitation. In 4 patients, aortic regurgitation disappeared postoperatively. Two patients show minor non-progressive valve regurgitation. Two of 8 patients died early postoperatively. There was no late death and dilatation of the aortic root in the follow-up period of mean 27 months. On the basis of these results, we believe that primary anastomosis is a simpler and safer operative method for acute dissection of the ascending aorta.

Acute Disease↗
PubMed1989

[Surgery for aortic aneurysms with coronary disease].

Between 1981 and 1988, 52 patients with dissecting aneurysms were operated and four of them (7.7%) had right coronary dissections that were repaired by Bentall's method with or without right coronary bypass grafting (CABG). Three (8.5%) of 35 patients with thoracic aneurysms had coronary disease. Among them, two had one vessel disease (1VD) and one had 2VD; two underwent temporary axillofemoral bypass grafting (AFBG) without CABG and one underwent extracorporeal circulation with CABG. Eight (5.6%) of 142 patients with abdominal aneurysms had coronary disease. They consisted of three patients with 1VD, two with 2VD and three with 3VD; their ejection fraction rates were 0.46 to 0.75. Three of them underwent temporary AFBG and one first underwent CABG but later underwent abdominal aortic graft replacement. In conclusion, patients with good coronary distal run-off and a low ejection fraction rate (under 0.5) should initially undergo CABG, but for those with poor run-off, temporary AFBG is better to prevent cardiac afterload.

Aged↗
PubMed1988

A monoclonal antibody against dentin phosphophoryn recognizes a bone protein(s) appearing at the beginning of ossification.

Decalcified and nondecalcified sections of fetal bovine tibia were stained immunohistochemically with a monoclonal antibody against dentin phosphophoryn. In the epiphyseal portion of the long bone, osteoblasts, osteocytes and the bone matrix were stained, but chondrocytes and the cartilage matrix were not. Similar staining was observed in the epiphyseal and diaphyseal portions of bones. These findings suggest that a protein(s) with the same epitope as phosphophoryn may be synthesized and secreted by osteoblasts at the beginning of ossification and may be involved in mineralization of bone tissue. On Western blots of proteins extracted from fetal bovine bone, the antibody reacted with two bands of molecular weights of about 71,000 and 63,000. These proteins and antibody(s) to the proteins may be useful for detection of the phenotype of osteogenesis.

Animals↗
PubMed1987

[Intraoperative autotransfusion in aortic aneurysm operations combined with temporary external shunt].

Intraoperative autotransfusion was done in nine patients who underwent major vascular surgery for thoracic aortic aneurysms including one total abdominal aneurysm using temporal external shunt. After general heparinization (1mg/kg), shed blood was collected by Sorenson Autotransfusion System with local heparinization. After confirming ACT longer than 300-400 second, 425-3700 ml, averaged 1804 ml, of shed blood was reinfused to the patients by gravity flow. The reinfusion rate of shed blood was 43.1 +/- 15.8%. There were no deaths and no complications referable to autotransfusion. Although mild hemolysis was observed immediately after surgery, plasma free hemoglobin level returned to normal in the first operative day and no renal failure occurred. The volume of bleeding after surgery was not differed from that of control. Microembolism was not evident clinically. We concluded that intraoperative autotransfusion is safe and useful procedure in major vascular surgery if proper anticoagulation is done.

Adult↗
PubMed1986

Hepatolithiasis in East Asia. Retrospective study.

Hepatolithiasis is a major disease in Asia but differences in operative incidence between countries have not been examined. A retrospective study was conducted in Taiwan, Hong Kong, and Singapore, and the results were compared with those in Japan with the aim of defining factors involved in the etiology of the condition. In order to ensure uniformity of the data collected, the same form was used throughout the study and was completed by the same personnel after reviewing the patient's record and radiographs in each case. The years 1976-1980 were chosen for the study, since the newer methods of diagnosis such as ultrasound, endoscopic retrograde cholangiography, and percutaneous transhepatic cholangiography became available during that period. The most significant finding was the difference in the relative prevalence of hepatolithiasis as a proportion of all gallstone cases in Taiwan, Hong Kong, and Singapore, where the majority of the population consisted of patients of Chinese descent. The highest prevalence, 53.5%, was found in Taiwan, while in Hong Kong it was 3.1% and in Singapore 1.7%. Environmental rather than ethnic factors are implicated in the cause of hepatolithiasis.

Adult↗
PubMed1986

A case of blue rubber bleb nevus syndrome with familial onset.

We experienced a case of blue rubber bleb nevus syndrome with familial onset. The patient was a 32-year-old male with a gallstone and many bluish rubber bleb-like hemangiomas on the skin. He suffered from repeated rectal bleeding and underwent a sigmoidectomy at age 17. Gastrointestinal hemangiomas were recognized in the esophagus, stomach, ileum and colon. An angiogram revealed multiple small poolings in the liver, suggesting the presence of hemangiomas. During the cholecystectomy, surgeons noted the presence of hemangiomas on the surface of the liver, serosa of the small intestine and retroperitoneum. Out of 73 blood relatives, 24 also had bluish skin hemangiomas, suggesting them to be inherited by an autosomal dominant trait. More than sixty cases of this syndrome had been reported in the world, eight of which had family histories of skin lesions. However, in only three cases, including our own, was the presence of skin and gastrointestinal hemangiomas recognized. Because the clinical indications for diagnosis of blue rubber bleb nevus syndrome consist of minimal to massive bleeding from the gastrointestinal tract, the possibility that this syndrome is present should be considered when diagnosing a bleeding patient with multiple bluish rubber bleb-like skin lesions, in addition to taking a detailed family history.

Adult↗
PubMed1984

A rare case of early carcinoma of the gallbladder.

A 38-year-old woman was diagnosed preoperatively to have a benign polyp of the gallbladder with a delineated polypoid mass, as demonstrated with drip infusion cholangiography and ultrasonography. Cholecystectomy was performed. Postoperatively, however, this tumor proved to be an early stage carcinoma of the gallbladder. In the neck of the gallbladder, there was a protruded polypoid elastic tumor of 1.1 X 0.9 cm in width and 2.5 cm in height. The tumor was supported by a stem of 0.1 cm in diameter and 0.2 cm in height. Histopathological examination revealed a well differentiated papillotubular adenocarcinoma, which exhibited no invasion of the stem itself or its basal region. This is a rare case of early carcinoma of the gallbladder (Stage I) which grew only towards the lumen of the gallbladder cavity, and did not invade the wall. Postoperatively, cholecystectomy alone was thought to be sufficient for cure.

Adenocarcinoma↗
PubMed1984

Clinical features and classification of hepatolithiasis.

A newer classification of hepatolithiasis based on the prevailing pathology was applied to 59 cases of hepatolithiasis. The results indicated once again the preponderance of stones and strictures in the left lateral segmental ducts. In addition, involvement of peripheral segmental ducts is most commonly found in the anterior inferior area of the right hepatic lobe and in the left lateral inferior area duct of the left lateral hepatic segment. Such incidence of segmental or area involvement is expected to rise because of improved techniques for imaging the hepatobiliary tree. The disease classification presently used offers several advantages. It is solely based on an exact description of the prevailing pathology and therefore is devoid of subjective bias such as that involved in designating without much factual basis whether disease is primary or secondary or is congenital or acquired. The coding used offers easier compilation of data, which can be stored in a computer for later retrieval and computation.

Adult↗
PubMed1983

Sialomucin in Paget cells of extramammary Paget's disease.

The cytoplasmic sialomucin in Paget cells of extramammary Paget's disease was examined by means of a battery of histochemical techniques. The staining methods used involved an electrolyte--Alcian Blue (pH 5.8), periodic acid--Schiff and azure A at selected pH levels. Methylation, saponification, borohydride reduction, acid hydrolysis, and digestion with diastase, neuraminidase (Vibrio cholerae) or chondroitinase ABC, were also employed. The cytoplasmic mucin was found to exhibit positive reaction for the above staining which were variously altered by the chemical modification procedures and diminished in intensity or abolished by digestion with neuraminidase. These results suggest that the cytoplasmic mucin is sialomucin without side-chain substituent in extramammary Paget's disease located in axillary or genital area, and with a substituent at C7 in the disease located in perianal area.

Histocytochemistry↗