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Biomedical subjects

T Oguni

Publications and source records attributed to T Oguni.

At least 19 recordsLinked to original sources
PubMed2000

A case of monoclonal gammopathy associated with acute myelomonocytic leukemia with eosinophilia suggested to be the result of lineage infidelity.

Acute myelomonocytic leukemia (AMMoL) accompanied by monoclonal gammopathy is a rare condition, and its pathogenesis and the cytogenetic mechanism of such leukemogenesis have not been determined in detail. A case of AMMoL with eosinophilia accompanied by immunoglobulin G kappa monoclonal gammopathy is described. Immunophenotypic studies of the peripheral blood and bone marrow mononuclear cells revealed no evidence of abnormally proliferating cells of B-lineage. DNA analyses of bone marrow mononuclear cells containing leukemic cells revealed rearrangement of the kappa-light chain (Igkappa) gene and c-myc and c-jun proto-oncogenes. The intensities of the rearranged bands for these genes on Southern blot analysis suggested the existence of a major population of leukemic cells with rearranged Igkappa gene and minor population(s) of leukemic cells with rearranged c-myc and/or c-jun proto-oncogene(s) in the patient's bone marrow and indicated the occurrence of genetic evolutionary changes in leukemic cells in this patient before starting chemotherapy. These results suggest that these leukemic cells are the most likely candidate for immunoglobulin G kappa monoclonal protein production, and structural abnormalities of c-myc and c-jun proto-oncogenes may have contributed to the evolution of leukemic cells in this patient.

Blotting, Southern↗
PubMed2000

Critical value for the index of body fat distribution based on waist and hip circumferences and stature in obese girls.

OBJECTIVE: To determine the critical value for the standard deviation score (SDS) of waist-hip ratio (WHR)/height (Ht), as an age-adjusted measure of body fat distribution, in relation to occurrence of biochemical complications in obese girls. DESIGN: Cross-sectional, clinical study. The (WHR/Ht)-SDS was calculated as described previously. Obese girls were classified into two groups according to the occurrence of abnormal values in either serum triglyceride, alanine aminotransferase or insulin level. The criteria for obesity were subjected to the receiver operating characteristic (ROC) analysis. SUBJECTS: One-hundred and twenty-four outpatient Japanese obese girls, ranging in age from 9 to 15 y. MEASUREMENTS: Height, body weight, waist girth and hip girth as anthropometric measures. Percentage overweight, waist girth, WHR and (WHR/Ht)-SDS as criteria for obesity. Clinical laboratory analysis for fasting blood samples of obese children. RESULTS: Fifty-nine girls were classified into the no complication group, and 65 girls into the complication group. Those with complications were older, more obese, and their waist girth and WHR were larger, than the girls without complications. The (WHR/Ht)-SDS was >2-fold higher and lipoprotein profile was more atherogenic in the complication group than in the no complication group. Among the four criteria of obesity, (WHR/Ht)-SDS gave the ROC curve skewed furthest into the top left corner of the diagram. Both sensitivity and specificity for (WHR/Ht)-SDS were >80% at the critical value of 2.00. The sensitivity for waist girth was as high as that for specificity for the rest of the criteria were <80%. CONCLUSION: Only (WHR/Ht)-SDS showed high enough sensitivity and specificity to predict metabolic derangement in the present obese girls. (WHR/Ht)-SDS can serve as the diagnostic criterion that classifies obesity in Japanese adolescent girls into two types.

Adipose Tissue↗
PubMed2000

Superselective embolisation for intractable idiopathic epistaxis.

37 patients with intractable idiopathic epistaxis were treated with superselective embolisation between 1995 and 1999. A total of 40 embolisations was performed, including three procedures for recurrence. The embolic material was gelatin sponge in 27 procedures, microcoils in 9 and both gelatin sponge and microcoils in 4. Immediate cessation of nasal bleeding was obtained in all patients after embolisation. Recurrent epistaxis occurred in 2 (5.4%) of the 37 patients within 7 days after initial embolisation, giving a short-term success rate of 94.6%. The long-term follow-up ranged from 1-51 months (mean 21.6 months). Late re-bleeding occurred in two patients, giving a long-term success rate of 94.6%. Two patients underwent re-embolisation; it was necessary to embolise the ipsilateral facial artery and/or the contralateral internal maxillary as well as the ipsilateral maxillary artery. Although the overall complication rate was 45.0%, no major complications occurred. Superselective embolisation with gelatin sponge is an effective and safe treatment technique for intractable idiopathic epistaxis.

Adult↗
PubMed2000

[Antimicrobial susceptibility and serotypes of Streptococcus pneumoniae isolated from the patients with respiratory tract infections in Hokusetsu Area of Osaka].

One hundred and thirteen strains of Streptococcus pneumoniae (S. pneumoniae) were isolated from the clinical specimens of patients with respiratory tract infections between January and December 1998 in three hospitals in Hokusetsu area of Osaka. We investigated susceptibility of 113 strains of S. pneumoniae to benzylpenicillin (PCG) and other antimicrobial agents and their serotypes. 1) Of the 113 strains of S. pneumoniae isolated, 25.7% were susceptible (PSSP), 51.3% were intermediate (PISP) and 23% were resistant to benzylpenicillin (PRSP). 2) The MICs of cefaclor, cefditoren, cefpodoxime, cefdinir, erythromycin, clindamycin and minocycline were elevated, but the MIC values of cefditoren ranged from < or = 0.03 to 1.0 microgram/ml. The susceptibility of 113 strains to cefditoren was comparatively high. 3) The MIC values of imipenem, meropenem and vancomycin for 81 strains of PISP and PRSP ranged from < or = 0.015 to 1.0 microgram/ml, from < or = 0.015 to 2.0 micrograms/ml and from 0.13 to 0.5 microgram/ml, respectively. The susceptibility of these strains to three antimicrobial agents was superior to that to the other antimicrobial agents examined. 4) Of the 60 strains examined, 19, 6, and 23 serotypes were 30, 25 and 18.3%, respectively. The three serotypes were observed in PISP and PRSP with a high frequency. 5) Isolates of S. pneumoniae were 37.2% for children under 2 years of age and 30.9% for children from 2 to 6 years of age. Most of the strains isolated from these children were resistant.

Anti-Bacterial Agents↗
PubMed1999

Comparison of bioelectrical impedance analysis and dual energy X-ray absorptiometry for assessment of body composition in children.

BACKGROUND: There are a variety of methods for assessing body composition. Bioelectrical impedance analysis (BIA) is an easy and non-invasive technique, but has limitations in underweight and overweight subjects. Few reports have investigated the validity of BIA in children. In this report, the characteristics of BIA, especially in overweight and underweight children, are assessed and the results are compared with those of dual energy X-ray absorptiometry (DXA), as a reliable method for assessing body composition. METHODS: Determination of the fat-free mass (FFM), body fat content and percent body fat (%fat) was carried out using both BIA and DXA. The subjects (60 males and 44 females) were divided into five groups according to the percentage of ideal bodyweight (%IBW). Ten obese children, who were treated with exercise and a low-energy diet for 1 month, were also enrolled in this study. RESULTS: The %fat, FFM and body fat content showed a close correlation when measured by BIA and DXA with the correlation coefficients being 0.90, 0.95, and 0.95, respectively. In the underweight group, the %fat value determined by BIA tended to be greater than that determined by DXA, while in the overweight group, the BIA value was lower than the DXA value. The same trend was also seen in obese children before and after therapy with exercise and diet. CONCLUSION: Bioelectrical impedance analysis seems to be a reasonable method for daily clinical use, but attention should be paid to the interpretation of %fat values in underweight and overweight children.

Absorptiometry, Photon↗
PubMed1999

[A study of the degree of burden and subjective sense of well being in care-givers involved in home care].

We investigated the degree of burden on care-givers and their subjective sense of well being, and studied the factors affecting them. Twenty people who were responsible for at least a year for constant care of elderly or bed-ridden patients under visitation care and nursing supervision of this hospital were registered. Regarding the care-givers, we investigated age, sex, duration of care, the relations between the care-givers and the cared-for, assistant care-givers, profession and hobbies, if any, of the care-givers, the depression scores; the social support, the degree of burden imposed by care, and the subjective sense of well being. As for the cared-for, we investigated their age, disease and degree of ADL. The burden felt by the care-giver became greater if the care-giver was a woman (p < 0.05), if the relationship with the cared or the health status of the care-giver was poor (p < 0.05, respectively), and if the scores for functional and emotional support networks were poor (p < 0.005 and p < 0.05, respectively). As for the cared-for, the burden was greater if they were older (p < 0.05) and if it was difficult for them to leave bed (p < 0.05). The sense of subjective well being of the care-giver was greater if there was an assistant care-giver (p < 0.005); if the scores for the functional and the emotional support networks were higher (p < 0.05, respectively): and if understanding of information in terms of ADL was not adequate (p < 0.05). The present study suggested the importance of improving the emotional and functional support networks for the care-giver in helping them continue care by alleviating the burden and not suffering a loss in the subjective sense of well being.

Aged↗
PubMed1999

[A decrease in urinary proteins in an elderly patient with refractory minimal change nephrotic syndrome administration of an angiotensin converting enzyme inhibitor in combination with steroids].

A 72-year-old woman had been treated for hypertension and hyperthyroidism by a local doctor. In May 1998, she came to this institution with a chief complaint of leg edema. Based on the clinical findings, she was diagnosed as having nephrotic syndrome with massive proteinurea, hypoproteinemia and hyperlipidemia. Renal biopsy findings showed minimal change nephrotic syndrome (MCNS). No substantial improvement was obtained by steroid therapy. We therefore additionally administered angiotensin-converting enzyme inhibitor (enalapril maleate). The urinary protein concentration significantly decreased. On decreasing the dose of steroids, the urinary protein concentration increased. Cyclophosphamide helped us to decrease the steroid dosage. This treatment resulted in type II incomplete remission. The final diagnosis was refractory MCNS. During steroid therapy, she developed hyperglycemia. She had no histology of diabetes mellitus. There is therefore a possibility that steroids can induce hyperglycemia even in patients without a history of diabetes mellitus. These results suggest that careful monitoring of plasma glucose is necessary during steroid therapy and that the administration of an angiotensin-converting enzyme inhibitor is effective in elderly patients with refractory primary nephrotic syndrome.

Aged↗
PubMed1999

[A study of depressive state and background factors in community-dwelling older persons].

In order to maintain and improve the mental health of elderly people living in the community, a cross-sectional survey was conducted to elucidate their depressive state and its background factors. Subjects were elderly persons living in the community who were able to fill in the questionnaire themselves. The study used the self-recording questionnaire sheets used in the Kahoku Longitudinal Aging Study by Matsubayashi et al and the Zung Self-rating Depression Scale (SDS). Out of 2,379 elderly persons who were able to fill in the questionnaire by themselves in the community, 2,361 (99.2%) returned the questionnaire sheets. After removing inadequate responses, analysis was possible for 1,181 (49.6%) (542 males (average age 72.3 +/- 5.5) and 639 females (average age 73.0 +/- 6.3). Degree of depressive state as evaluated by SDS was normal for 731 persons (61.9%); mild, 240 (20.3%); moderate, 181 (15.3%); and severe, 29 (2.5%). The average age became higher as the SDS became high, of being indicating the seriousness of the depressive state (p = 0.0155), with the ratio women significantly higher (p = 0.0077). Among those with severe SDS, the ratio of single persons was high (p < 0.001) as well as those who were non-drinkers (p = 0.0015), without regular habit of walking (p < 0.001), or without work (p < 0.001). The ratio of those receiving medication regularly was also significantly high (p = 0.0022). As for the relation of SDS with various of the scores, the higher the SDS score became, the scores for ADL, information-related function, functional and emotional support network, family relationship, friendship, economic condition became significantly lower (p < 0.001, respectively). In logistic regression analysis using the background factors for SDS as explanatory variables, factors such as being women (odds ratio, 1.73; 95% confidence interval, 1.10-2.72). ADL (0.80; 0.69-0.93), emotional support network (0.88; 0.81-0.96), friendship (0.98; 0.96-0.99) were significant independent contributing factors. As for the relation between SDS and subjective senses, the more serious the SDS score became, the scores for feelings of healthiness and satisfaction became significantly smaller (both p < 0.001). For prevention and amelioration of the depressive state of elderly persons living in the community, attempts should be made to improve the background factors which were clarified by the present study by efficiently utilizing health, medical and welfare services and following the future course with a positive attitude.

Activities of Daily Living↗
PubMed1999

[A case of pituitary apoplexy approving as severe headache and nausea].

The causes of pituitary apoplexy are unclear. We report a case of pituitary apoplexy presenting with headache and nausea. On June 17th, 1997 a 74-year-old woman had complained of retro-orbital headache, fever and vomiting. A cold was diagnosed for which she recurred medication. In addition to the previous symptoms she was getting to lose appetite. She was admitted to our hospital for further examination and treatment on June 21. On admission neurological examination showed left pupil mydriasis, the left eye had no light reflex and the right eye had only a slight response to the light. She could hardly move both eyeballs up. Laboratory data showed a normal white blood cell count and the CRP was 16.2 mg/dl. Lumbar puncture showed 97 mg/dl total protein and 82 cells per microliter, most of which were lymphocytes. We diagnosed viral infection based on the evidence of clinical symptoms and lumbar puncture data. The patient was treated with gamma-globulin and improved. From the 16th day of sickness we recognized symptoms of oculomotor paralysis and the syndrome of inappropriate antidiuretic hormone. On the 23rd day of sickness we strongly suspected pituitary apoplexy based on transaxial MR images. After absorption of intra-tumor hemorrhage, the oculomotor symptoms recurred. We finally reached a diagnosis of pituitary apoplexy based on pathological material, MR images, symptoms and laboratory data. We must think of pituitary apoplexy when we see an aged out-patient with severe headache, nausea, vomiting and oculomotor paralysis. It was difficult to diagnose this disease in the early time course of the disease.

Aged↗
PubMed1998

Bilateral fistulas from the internal mammary arteries and the bronchial arteries to the pulmonary arteries--a case report.

A 78-year-old man was admitted to hospital with heart failure and chronic bronchitis. A computed tomographic scan of the chest incidentally demonstrated bilateral abnormal vessels near the left atrium. Selective angiography showed that both internal mammary arteries and bronchial arteries communicated with the pulmonary arteries bilaterally. The patient refused surgery and was discharged on medical therapy. This is the first reported case of bilateral fistulas between the internal mammary arteries and bronchial arteries and the pulmonary arteries.

Aged↗
PubMed1998

[Effect of warm bathing on blood pressure in bedridden patients].

The effects of warm bathing on short-term and circadian rhythms for blood pressure (BP), pulse rate (PR), and endocrine function were studied in 10 bed-ridden patients (5 men and 5 women; age 78.9 +/- 10.5 years old) hospitalized in Nomura Municipal Hospital. The results indicated a transient elevation of BP with bathing and its rapid fall after bathing. Compared with the days when patients did not take bath, systolic BP was significantly lower for 12 to 16 hours (p < 0.005) after bathing and diastolic BP was also significantly lower during 8 to 12 hours (p < 0.01), 12 to 16 hours (p < 0.001) and 20 to 24 hours (p < 0.001). The PR was significantly higher from 0 to 4 hours after bathing (p < 0.01), but became significantly lower during 8 to 12 hours (p < 0.001) and 12 to 16 hours (p < 0.001). Plasma renin activity increased significantly after bathing (p < 0.05). Thus, the effects of bathing in lowering BP of bedridden patients in stable condition may continue for several hours after bathing.

Aged↗
PubMed1997

[A case of hemophagocytic syndrome with severe liver injury manifestating adult Still's disease].

In April 1988, a 23 year-old woman developed high fever, arthralgia, eruptions and splenomegaly. She was treated with non Steroid anti-inflammatory drugs, and the symptoms disappeared. In June 1991, she was diagnosed as adult Still's disease and treated with prednisolone. In July 1994, she was treated with pulse therapy methylprednisolone due to high fever, eruptions, arthralgia and the high levels of ferritin. However, due to the marked increase of serum transaminase and bilirubin levels, she was referred to University hospital. She developed hepatic failure after admission Bone-marrow puncture revealed hemophagocytosis. She died ten days after admission. She was diagnosed as hemophagocytic syndrome combined with acute hepatic failure.

Adult↗
PubMed1996

Embolization for ruptured superior mesenteric artery aneurysms.

Superior mesenteric artery (SMA) aneurysms are very uncommon. They are difficult to detect until they rupture and cause hypovolaemic shock. We performed embolization in four cases of aneurysm of branches of the superior mesenteric artery, succeeding in three cases without the need for surgical treatment. In the first case, the aneurysm was excised because of migration of a microcoil into the left hepatic artery. It was not retrieved because sufficient blood flow to the liver was shown on angiography after migration and no ischaemic change of liver was detected on laparotomy. In the second case, the aneurysm arose from the anterior pancreaticoduodenal artery. In the third case, the patient had two SMA aneurysms; one had been resected at surgery, another was revealed on follow-up angiography and embolized with microcoils. The fourth patient had a jejunal artery aneurysm with extravasation; haemostasis was achieved by packing it. In all four cases, no major complications were observed in the clinical course after embolization. Microcoils were considered to be the desirable embolic material, in order to prevent post-therapeutic ischaemic change. Embolization should be the treatment of choice for SMA aneurysms, because it is less invasive and takes less time than surgical treatment.

Adult↗
PubMed1996

[Usefulness of MRA in an infant with cerebral infarction due to streptococcal meningitis].

We described a 4-month-old boy with cerebral infarction due to streptococcal meningitis. He complained of cough and high fever for 2 days. On the next day he admitted to our hospital because of bad humor, drowsiness, and vomiting associated with high fever, respiratory failure and loss of consciousness. On admission, he had opisthotonic posturing, anisocoria and elevated deep tendon reflexes with left side dominance. The cerebrospinal fluid showed increased cells (564/mm3), protein (295 mg/dl), and decreased sugar (1 mg/dl). Streptococcus pneumoniae was detected in the cerebrospinal fluid. Despite intensive treatment by antibiotics, glycerol, and dexamethasone, general condition was worsened, MRI showed a high intense area along the territory of bilateral anterior cerebral arteries and left middle cerebral artery 3-D time-of-flight MRA revealed a decreased signal of these arteries, confirming cerebral infarction. Recanalization of the arteries were observed 17 days after the first MRA examination. Since complication of cerebral infarction influences the prognosis of meningitis, repetitive MRA is very beneficial in patients with bacterial meningitis in order to evaluate the vascular lesion.

Cerebral Infarction↗
PubMed1995

Clinical and laboratory characteristics in the families with diabetes and a mitochondrial tRNA(LEU(UUR)) gene mutation.

We identified three families having a mutation in the mitochondrial tRNA(LEU(UUR)) gene at bp 3243 in 300 patients with non-insulin dependent diabetes mellitus (NIDDM), who had first degree relatives of patients with NIDDM. We found six individuals with diabetes, one with impaired glucose tolerance (IGT), and five with normal glucose tolerance (NGT) among three families. Insulin secretory response to oral glucose load was impaired in six diabetics, but was normal in IGT and NGT, and the proportion of mutant DNA in the blood did not always associate with the severity of glucose intolerance. Furthermore, both gender and obesity may influence the clinical expression of diabetes in three pairs with an age-matched brother-sister relationship with similar high mutation rate in blood samples. Thus, although patients with mitochondrial gene mutation had a high frequency of diabetes, the proportion of mutant DNA evaluated by blood samples may not necessarily indicate glucose intolerance in the members with the mutation. Unidentified factors including gender, aging, and obesity may alter the clinical manifestation of diabetes.

Adolescent↗
PubMed1994

[Percutaneous transluminal angioplasty of the ilio-femoro-popliteal arteries: initial and long-term results].

The initial and long-term results of percutaneous transluminal angioplasty (PTA) were assessed in 254 atherosclerotic lesions of the ilio-femoro-popliteal arteries in 130 patients. There were 122 men and 8 women, aged 36-85 years (average, 68 years). Follow-up periods ranged from 1 to 131 months, with a mean of 42 months. PTA was performed in 6 patients in Fontaine's stage I, 112 patients in stage II, and 12 patients in stage III-IV. We reported initial success rates of 92%, 58%, 83% and 74% for iliac stenosis, occlusion, femoro-popliteal stenosis and occlusion, respectively. Overall, the initial success rate was 82% (203/247). The 5-year patency rates according to Kaplan-Meier analysis were 70%, 69% and 63% for iliac stenosis, occlusion and femoro-popliteal stenosis, respectively. In femoro-popliteal occlusion, the 1-year patency rate was 42%, which was significantly worse than that for stenosis (P < 0.01). The longest patency periods obtained were 131 months in the iliac artery, and 106 months in the femoro-popliteal artery. The recurrence rate within 6 months was significantly higher in patients with diabetes. The recurrence rate between 6 and 12 months was significantly higher in patients with poor run-off, and those of advanced age.

Adult↗
PubMed1994

[Percutaneous transluminal angioplasty of the subclavian arteries].

We studied the complications and long-term results of percutaneous transluminal angioplasty (PTA) of subclavian artery stenosis in 11 patients. In all patients but one, the systolic blood pressure before PTA in the arm on the involved side was at least 30 mmHg lower than that in the opposite arm. PTA of 11 left subclavian arteries and one right subclavian artery was attempted. Five of the patients suffered from symptoms of vertebrobasilar insufficiency as well as ischemia of the upper limb, two had only cerebral symptoms, two had only ischemia of the upper limb, and another had no symptoms related subclavian arterial lesion. Standard techniques for PTA were employed, using the femoral route eight times and the axillary route four times. Angioplasty was successful in 11 lesions (92%). In the successfully treated patients, the blood pressure in the ipsilateral arm was significantly increased after PTA. No complications occurred during or after the procedure. The patients were followed for 2-74 months (mean 25.7 months). During this time, no recurrence of the stenosis was observed, although the symptoms of vertebrobasilar insufficiency did not always improve. These results suggest that PTA is useful for treating subclavian artery stenosis.

Adult↗