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Biomedical subjects

T Ueda

Publications and source records attributed to T Ueda.

At least 505 records · Page 28Linked to original sources

Paroxysmal urinary incontinence associated with multiple sclerosis.

We report a patient with multiple sclerosis who manifested urinary incontinence as a part of paroxysmal attacks which were characterized by sudden onset, short duration, and frequent repetition. This phenomenon has not been described previously. Urodynamic study during paroxysmal attacks revealed uninhibited detrusor contractions with coordinated relaxation of external urethral sphincter muscle. Neurological examination and magnetic resonance imaging suggested that paroxysmal urinary incontinence was induced by an ectopic excitation of the demyelinating lesion in the right rostral pons, the location of which was similar to the pontine micturition center reported in previous animal experiments. Treatment with carbamazepine, an antiepileptic drug, suppressed the attacks including the associated urinary incontinence.

Adult↗

Multiple primary malignant neoplasms associated with prostate cancer in 312 consecutive cases.

The relative risk for a second primary cancer after the diagnosis of prostate cancer and the prognostic impact of the association of multiple primary malignant neoplasms (MPMNs) in patients with prostate cancer were analyzed in a retrospective study. The development of MPMNs was examined in 312 consecutive patients who had been diagnosed with prostate cancer between 1966 and 1992. The population-based cancer incidence rates in Japan were utilized to calculate the expected number of MPMNs. Of the 312 patients, 60 fulfilled the diagnosis of MPMNs. In 13 men, prostate cancer and other malignancies were diagnosed simultaneously. In 35 of the 312 patients, prostate cancer was the second or third cancer diagnosis. In the remaining 287 patients, prostate cancer developed initially. Of the 287 patients, 12 developed a second primary malignancy compared with 17 expected (relative risk 0.71, 95% confidence interval 0.45-1.4). No single anatomic site showed a significantly increased risk above that expected either. The overall survival of patients with prostate cancer was not reduced by the association with MPMNs. This may be explained by the fact that the stage of the prostate cancer was lower in patients with MPMNs than in patients without MPMNs.

Adenocarcinoma↗

Studies on cardiac ingredients of plants. XIII: Chemical modification of gitoxin to cardiotonic compounds without vascular effect.

Nitrated gitoxins (4) and bufotoxin homologues with various lengths of alkyl chain at C-3 of the steroid nucleus (10) were prepared from gitoxin (1). The pharmacological activities of the resulting compounds (4 and 10) were evaluated by measurement of inhibitory effect on NA+, K(+)-adenosine triphosphatase (ATPase) prepared from dog kidney, positive inotropic effect (PIE) on isolated guinea-pig papillary muscle preparations, and the effect on smooth muscle using the mesenteric artery from spontaneously hypertensive rats. Most of the compounds showed a smaller contractile effect on the arterial muscle. Among these compounds, gitoxin 3"-nitrate (4g) exhibited the most desirable biological activities, such as PIE comparable to that of 1, 1.25 times wider concentration-dependent range than 1, and lack of contractile activity on vascular muscle.

Animals↗

Studies on chemical modification of monensin. VI. Preparation of C-7 modified monensins via protected 7-oxomonensin and evaluation of their ion transport activity.

7-Carboxymethylmonensin (3), 7-aminomonensin (4), and 7-oxomonensin (5) were synthesized via protected 7-oxomonensin (2), which is expected to be a useful intermediate for the preparation of various monensin derivatives. intermediate for the preparation of various monensin derivatives. Compounds 3-5 exhibited smaller ion transport activity than monensin (1).

Calcium↗

[Bioactive constituents of Chinese natural medicines. III. Absolute stereostructures of new dihydroflavonols, hovenitins I, II, and III, isolated from hoveniae semen seu fructus, the seed and fruit of Hovenia dulcis THUNB. (Rhamnaceae): inhibitory effect on alcohol-induced muscular relaxation and hepatoprotective activity].

The methanol-soluble fraction from a Chinese natural medicine Hoveniae Semen Seu Fructus, the seed and fruit of Hovenia dulcis THUNB. (Rhamnaceae) was found to show an inhibitory effect on the alcohol-induced muscular relaxation and a protective activity on the D-galactosamine/lipopolysaccharide or carbon tetrachloride-induced liver injury. Through bioassay-guided separation using a traction performance test, three new dihydrofravonols named hovenitins I, II, and III were isolated from Hoveniae Semen Seu Fructus together with four known flavonoids, (+)-ampelopsin, laricetrin, myricetin, and (+)-gallocatechin. The absolute stereostructures of hovenitins I, II, and III were determined on the basis of chemical and physicochemical evidence to be (2R, 3R)-5,7,4',5'-tetrahydroxy-3'-methoxydihydroflavonol, (2R,3S)-5,7,4',5'-tetrahydroxy-3'-methoxy-dihydroflavonol, and (2R, 3S)-5,7,3',4',5'-pentahydroxydihydro-flavonol, respectively. Hovenitin I and (+)-ampelopsin, both of which were principal ingredients of the active fractions from this natural medicine, were found to show an inhibitory activity on the ethanol-induced muscle relaxation in rats. In addition, hovenitin I showed a protective activity on the liver injury induced by D-galactosamine/lipopolysaccharide or carbon tetrachloride in mice.

Animals↗

Adult Still's disease with myocardial dysfunction induced by microangiopathy.

A 52-year-old man with inflammatory disease of unknown origin but no specific laboratory abnormalities was referred to our hospital. He has subsequently diagnosed as having adult Still's disease. During an episode of severe inflammation he suffered reversible myocardial damage as revealed by electrocardiography, echocardiography and 201Tl myocardial scintigraphy; this was ameliorated by treatment with steroids and immunosuppressive drugs. No significant stenosis of the coronary artery was observed on coronary angiography. Interstitial mononuclear infiltration was apparent in the right ventricle on endomyocardial biopsy. Myocardial injury with adult Still's disease, which may result in heart failure, has rarely been reported. We report a case of adult Still's disease with myocardial dysfunction that may have been caused by microangiopathy.

Heart↗

A case of arrhythmogenic right ventricular dysplasia with left and right ventricular hypofunction in an elderly subject--long-term follow-up.

A 72-year-old man was admitted with palpitations caused by sustained ventricular tachycardia. He had been followed for 27 years, with admissions on 7 occasions, on account of ventricular tachycardias, atrial fibrillation, and congestive heart failure. Electrophysiologic examination detected 2 points of origin of ventricular tachycardia in the right and left ventricles. During the examination a myocardial infarction led to death. At autopsy, most areas of the right ventricle and the left ventricular apex were found to have been replaced by fatty tissue, pointing to severe fatty infiltration into the myocardium. Thus, this patient represented a unique cause of arrhythmogenic right ventricular dysplasia (ARVD) with severe fatty degeneration causing progression of ARVD. It is important that a diagnosis of ARVD is made carefully and rigorously in elderly subjects.

Aged↗

Skeletal metastases from soft-tissue sarcomas. Incidence, patterns, and radiological features.

We reviewed 277 patients with soft-tissue sarcoma (STS) treated between 1975 and 1995 to study the incidence, distribution, time of appearance, and radiological findings of skeletal metastases. Of these, 28 (10.1%) had metastases within a mean period of 18.6 months after admission. The incidence of skeletal metastases differed among the histological subtypes of sarcoma; alveolar soft-part sarcoma, dedifferentiated liposarcoma, angiosarcoma, and rhabdomyosarcoma tended to show higher incidences. The regional bones close to the primary tumour were affected in 13 (46.4%) of the 28 patients, and the axial bones in 18 (64.3%). Radiologically, the metastatic bony lesions predominantly showed osteolytic changes, and there were pathological fractures in 21 of 44 lesions.

Adolescent↗

Influence of local recurrence on the prognosis of soft-tissue sarcomas.

We have investigated the significance of local recurrence on survival in 173 patients with localised soft-tissue sarcomas of the limbs and of the trunk. The overall survival rates at five and ten years were 75.2% and 68.0%, respectively. After definitive surgery at our hospitals, there was local recurrence in 25 patients (14.5%). After inadequate operations elsewhere, there was a higher incidence of late local recurrence (28.3%), in comparison with those with primary tumours treated by us (9.0%), or patients referred to us immediately after inadequate surgery elsewhere (10.2%). Because of small numbers these differences in the survival rates were not statistically significantly different. Univariate survival analysis showed that local recurrence after definitive surgery (p = 0.006) together with the histological grade (p = 0.0002), the size of the tumour (p = 0.002), its depth in relation to deep fascia (p = 0.003), and the surgical margin (p = 0.0001) were the significant prognostic factors. Local recurrence at the initial presentation did not affect survival. Multivariate analysis showed that local recurrence after definitive surgery also lost its apparent prognostic significance.

Adolescent↗

Recovery of iodine-123 metaiodobenzylguanidine uptake associated with left ventricular functional recovery in a patient with dilated cardiomyopathy. Endomyocardial histological findings before and after the improvement of uptake.

A 58-year-old man with idiopathic dilated cardiomyopathy was treated with incremental administration of a beta-blocker (metoprolol) and an angiotensin converting enzyme inhibitor (enarapril). The left ventricular end-diastolic dimension and ejection fraction improved in 8 months from 83.3 mm and 17.3% to 46 mm and 69%, respectively. The washout ratio and heart-to-mediastinum ratio depicted on the delayed image for iodine-123 metaiodobenzylguanidine 123I-MIBG) uptake improved from 61.7% and 1.34 to 23.1% and 1.85, respectively, in association with improvement of left ventricular indices. Successive endomyocardial biopsy specimens disclosed reduction of the degrees of vacuolation, staining irregularity, and deformity of myocyte cytoplasm and nucleus compared to the findings before therapy. In this patient with dilated cardiomyopathy 123I-MIBG scintigraphy was useful for the evaluation of the effects of therapy. We conclude that it may be informative in the estimation of the histopathological abnormalities of the myocardium.

3-Iodobenzylguanidine↗

Microcystic meningioma without enhancement on neuroimaging--case report.

A 63-year-old female presented with an unusual case of microcystic meningioma manifesting as a 4-year history of unsteady gait, dysarthria, and hearing loss. Computed tomography disclosed a large hypodense mass in the right cerebellopontine angle, clivus, and middle fossa, with slight contrast enhancement. T1-weighted magnetic resonance images demonstrated the lesion as a hypointense mass, which was little enhanced gadolinium-diethylenetriaminepenta-acetic acid. Right carotid angiography revealed blood supply from the external carotid artery, but no tumor staining. The extracerebral tumor was subtotally removed. The histological diagnosis was microcystic meningioma. Light microscopy revealed abundant microcystic throughout the tumor tissue, and electron microscopy disclosed that the microcysts were mostly located in the extracellular spaces and only a few in the cytoplasm. Microcystic meningioma without enhancement is rare and should be differentiated from low-grade astrocytoma, epidermoid, or other non-enhanced tumor.

Brain Neoplasms↗

The sex differences in cord-blood cholesterol and fatty-acid levels among Japanese fetuses.

We examined serum cholesterol and fatty-acid levels of cord blood and maternal blood samples collected from 193 Japanese fetuses and their mothers. Our study, which is the largest study of this kind ever conducted in Japan, is the first Japanese study reporting that total, high density lipoprotein (HDL) and non-HDL cholesterol levels in females were statistically significantly higher than those in males; the sex differences of total, HDL and non-HDL cholesterol levels were 8.5 mg/dl (P = 0.002), 4.5 mg/dl (P = 0.004) and 4.1 mg/dl (P = 0.045), respectively. The sex difference of total cholesterol was attributable to both HDL and non-HDL cholesterol. The sex of fetuses didn't show evident differences in cholesterol levels in maternal sera. Fatty-acid levels in cord blood were also higher in female fetuses than in male fetuses. However, none of the differences except for monoene fatty acids were statistically significant. Further investigations seem warranted to elucidate the mechanisms involved in our results.

Adult↗

Lectin-binding glycoconjugates in the subfornical organ of the rat.

In the rat subfornical organ (SFO), lectin-binding glycoconjugates were histochemically examined by 9 biotinylated lectins using a streptavidin-biotin peroxidase system. The strong or moderate binding of Canavalia ensiformis (Con A), Lens culinaris (LCA) and Phaseolus vulgaris erythroagglutinin (ePHA) indicated overall distributions of high mannose, intermediate, hybrid N-linked, and non-bisected, bi/triantennate N-linked complex oligosaccharides in the rat SFO. Nonsialylated terminal N-acetylglucosamines were detected throughout this organ, as revealed by its stainabilities with Triticum vulgaris (WGA) and Limax flavus (LFA). In this organ, Ricinus communis (RCA-1) specifically bound to vessel-associated structures, whereas Arachis hypogaea (PNA) reacted with selected neurons in the central and rostral regions of this organ. Dolichos biflorus (DBA) and Ulex europaeus (UEA-1) did not stain any histologic structures in the rat SFO. The results obtained in this study provide a basis for comprehensive analyses of glycoconjugates in the rat SFO.

Animals↗

Anti-Leukemia Chemotherapy of High-Risk Myelodysplastic Syndromes.

We evaluated the outcome of anti-leukemia chemotherapy on 42 patients with the high-risk myelodysplastic syndromes (MDS)-refractory anemia with excess of blasts (RAEB), 8 cases; RAEB in transformation (RAEB-T), 18 cases; chronic myelomonocytic leukemia (CMMOL), 6 cases; and leukemic transformation of MDS, 10 cases. The median age was 67 (range 20 to 84). As a remission-induction therapy, 35 patients received low-dose chemotherapy, such as low-dose cytarabine infusion, and seven patients received high-dose combination chemotherapy. The complete remission (CR) rates of the low-dose chemotherapy group and the high-dose combination chemotherapy group were 29% and 57%, respectively, and the overall CR rate was 33%. The median survival durations after induction chemotherapy of the CR group (14 cases), the partial remission (PR) group (11 cases), and non-remission (NR) group (17 cases) were 19 months, 8 months, and 3 months, respectively. As a post-remission consolidation chemotherapy, high-dose combination chemotherapy seemed to be superior to low-dose chemotherapy judging from the median CR duration (16 months versus 4 months), but a long-term disease-free survival is hardly expected, in contrast with results in cases of de novo acute myeloid leukemia.

Journal Article↗

[A case of primary squamous cell carcinoma of the ureter: biochemical modulation with cisplatin and 5-fluorouracil].

A case of primary squamous cell carcinoma of the ureter is reported. A 62-year-old male presented with gross hematuria and paralysis of the left leg. Abdominal computed tomographic (CT) scan and ultrasonography revealed left hydronephrosis, a massive tumor (8 x 7 cm) in the left distal ureter which invaded the pelvic bone (T4), and left obturator lymph node metastasis (N2). Pathologic examination of the biopsy specimen revealed poorly differentiated squamous cell carcinoma. Cisplatin (100 mg/m2, day 1) and 5-fluorouracil (960 mg/m2/day, days 2-6) were administered systemically in accordance with biochemical modulation regimen for head and neck squamous cell carcinoma, and a minor response was obtained (tumor regression rate 38%, serum SCC antigen regression rate 64%). Thereafter, resection of residual tumor was performed, resulting in noncurative operation because of direct invasion to the pelvic bone. Four months after tumorectomy, liver metastasis appeared, and the patient died of disease 14 months after the initial visit. Combination therapy with cisplatin and 5-fluorouracil is widely used for head and neck squamous cell carcinoma, and the response rate has been reported to be 46-94%. This regimen may also be effective against urological squamous cell carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗

Molecular analysis of the fusion of EWS to an orphan nuclear receptor gene in extraskeletal myxoid chondrosarcoma.

The pathogenesis of myxoid chondrosarcoma (CS) is poorly understood. A recurrent translocation, t(9;22) (q22;q12), has been recognized in CS, specifically in extraskeletal myxoid CS. Recently, this translocation has been shown to represent a rearrangement of the EWS gene at 22q12 with a novel gene at 9q22 designated CHN (or TEC). Sequence analysis suggests that CHN encodes a novel orphan nuclear receptor with a zinc finger DNA-binding domain. The structure of this gene fusion has been characterized in only a limited number of extraskeletal myxoid CSs and its presence in other types of CS has not been extensively examined. We studied 46 cases of CS (8 extraskeletal myxoid, 4 skeletal myxoid, 4 mesenchymal, and 30 other) for the EWS/CHN gene fusion by reverse transcriptase polymerase chain reaction, Southern blotting, and long-range DNA polymerase chain reaction. The EWS/CHN gene fusion was present in 6 of 8 extraskeletal myxoid CSs and was not detected in any of the remaining cases, including the 4 skeletal myxoid CSs. The negative findings in the latter cases suggest that skeletal myxoid CS is pathogenetically distinct from its extraskeletal counterpart. Notably, 2 cases of extraskeletal myxoid CS showed neither an EWS/CHN fusion transcript nor EWS/CHN genomic fusion nor EWS or CHN genomic rearrangement, suggesting genetic heterogeneity within extraskeletal myxoid CS. Finally, we also provide evidence for alternative splicing of the 3' end of the fusion transcript. Extraskeletal myxoid CS thus represents yet another sarcoma type containing a gene fusion involving EWS.

Adult↗

[Spontaneous urinary extravasation from the renal pelvis associated with ureteral fibroepithelial polyp: report of a case].

A 26-year-old woman presented with a colicky right flank pain. Retrograde pyelogram showed extravasation of the contrast medium from the right renal pelvis and a filling defect in the right ureter 4.5 cm proximal to the ureteral orifice. Urinary cytology was negative for malignancy. A partial ureterectomy with a vesicoureteroneostomy was performed. Gross inspection of the resected distal ureter revealed a 3-mm polyp with a grayish-white smooth surface as well as a ureteral stenosis of 2 cm in length just distal to the polyp. Pathological diagnosis was a fibroepithelial polyp. In our case, urinary extravasation probably resulted from an impacted polyp in the stenotic ureter.

Adult↗