Philadelphia chromosome-positive acute lymphoblastic leukemia after therapy for Langerhans cell histiocytosis.
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Child↗
Biomedical subjects
Y Sudo
Publications and source records attributed to Y Sudo.
Orally effective CVS-1123 prevents coronary artery thrombosis in the conscious dog.
BACKGROUND: We examined the oral efficacy of a direct thrombin inhibitor, CVS-1123 [(CH3CH2CH2)(2)-CH-CO-Asp (OCH3)-Pro-Arg-CHO; MW, 575]. The object was to determine whether thrombin inhibition could reduce the incidence of occlusive coronary artery thrombosis in response to arterial wall injury. METHODS AND RESULTS: Arterial wall injury was induced in conscious dogs by a 150-muA anodal current applied to the intimal surface of the circumflex coronary artery 30 minutes after oral CVS-1123 (20 mg/kg every 8 hours for three doses; n = 11) or placebo containing diluent (n = 10). Dogs were monitored for 8 hours and at 24 hours. The coronary artery remained patent for 24 hours in 8 of 11 CVS-1123-treated dogs. All dogs (n = 10) in the placebo group developed a sustained, occlusive arterial thrombus. Two hours after the initial oral dose, the plasma CVS-1123 concentration was 13 +/- 1 microgram/mL, reaching a maximum of 15 +/- 1 micrograms/mL after the second dose and 4.4 +/- 0.5 micrograms/mL at 24 hours. Ex vivo platelet aggregation to gamma-thrombin was inhibited and activated partial thromboplastin time was increased after treatment with CVS-1123 (P < .05). CONCLUSIONS: The direct thrombin inhibitor CVS-1123 is effective after oral administration in reducing the incidence of primary thrombus formation in an experimental model of arterial wall injury. Thrombin-specific inhibitors, such as CVS-1123, may be alternative antithrombotic agents in clinical settings in which heparin-associated thrombosis is a complicating factor or when long-term anticoagulation is required.
Administration, Oral↗
Mechanism of Phreatic Eruptions at Aso Volcano Inferred from Near-Field Broadband Seismic Observations
Broadband seismometers deployed at Aso volcano in Japan have detected a hydrothermal reservoir 1 to 1.5 kilometers beneath the crater that is continually resonating with periods as long as 15 seconds. When phreatic eruptions are observed, broadband seismograms elucidate a dynamic interplay between the reservoir and discharging flow along the conduit: gradual pressurization and long-period (approximately20 seconds) pulsations of the reservoir during the 100 to 200 seconds before the initiation of the discharge, followed by gradual deflation of the reservoir concurrent with the discharging flow. The hydrothermal reservoir, where water and heat from the deeper magma chamber probably interact, appears to help control the surface activity at Aso volcano.
Journal Article↗
Familial polycythemia vera in father and daughter.
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Adult↗
t(7;11) and trilineage myelodysplasia in acute myelomonocytic leukemia.
A 48-year-old Japanese man was admitted to our hospital because of general fatigue, nasal bleeding, and petechiae on his extremities. He was diagnosed with acute myelomonocytic leukemia with trilineage myelodysplasia (T-MDS). Chromosomal analysis of bone marrow cells revealed t(7;11)(p15;p15), which has been rarely reported but known to be characteristic of Japanese patients. Although t(7;11)(p15;p15) has been reported mainly in acute myelogenous leukemia (AML), it can be occasionally found in so-called stem cell diseases such as chronic myelogenous leukemia or chronic myeloproliferative disorders. Therefore, t(7;11)(p15;p15) might affect trilineage progenitors or stem cells as well as myeloid lineage cells, subsequently resulting in AML with T-MDS, as in our case reported here.
Antineoplastic Combined Chemotherapy Protocols↗
Decreased secretion of gonadotropins in a patient with Graves' disease.
A 56-year-old female with Graves' disease who presented with decreased secretion of gonadotropins is described. She was admitted to hospital because of her being in a state of confusion. One month before admission she had been diagnosed as having Graves' disease and was treated with methimazole since then. Plasma LH and FSH levels were undetectable, and their responses to LH-RH were extremely decreased in spite of undetectable levels of plasma estradiol and estriol. One year after treatment, both basal and stimulated values of LH and FSH reverted to normal as did those of TSH. Reversible suppression of gonadotropins as described herein has never been reported in cases of Graves' disease.
Antithyroid Agents↗
Effects of obesity on pregnant women: maternal hemodynamic change.
The purpose of this study is to clarify the effects of obesity on hemodynamic change in pregnant women. From 1322 primiparous women and 1027 multiparous women who delivered singleton babies with no life-threatening anomalies, 110 primiparous obese women, 1050 primiparous normal-weight women, 139 multiparous obese women, and 816 multiparous normal-weight women were selected according to body mass index at the first visit prior to the 10th gestational week. Women exhibiting chronic hypertension, over diabetes mellitus, and extreme skinniness were excluded. All of the women had been under the same management at Osaka City University Hospital. Their medical records were analyzed retrospectively. The study determined the arterial blood pressure of obese women to be significantly higher than that of normal-weight women throughout pregnancy in both primipara and multipara. The incidence of pregnancy-induced hypertension in obese women was significantly higher in primipara (22.7% versus 8.2%) and multipara (15.8% versus 5.0%). The incidence of intrapartum hypertension was also higher in the obese group. Hematocrit count at 3 gestational months (37.7 +/- 3.1 in primipara, and 37.6 +/- 2.7 in multipara) and 8 gestational months (34.4 +/- 2.7 in primipara, and 33.7 +/- 2.7 in multipara) were significantly higher than those in normal-weight women. Exercise tests using impedance cardiographs showed poor cardiac function in 5 of 17 obese women. These findings led us to conclude that obesity during pregnancy is clearly accompanied by hypertension, hemoconcentration, and poor cardiac function.
Adult↗
Antithrombotic effect of GYKI-14766 in a canine model of arterial and venous rethrombosis: a comparison with heparin.
We compared the antithrombotic effects of the thrombin inhibitor, D-methyl-phenylalanyl-prolyl-arginal (GYKI-14766) with those of heparin in a canine model of arterial and venous rethrombosis. Thrombogenesis was induced by electrolytic injury to the endothelial surface of the carotid artery and jugular vein. Either heparin (300 U/kg, n = 7), GYKI-14766 (0.5 mg/kg/h, n = 7), or saline (n = 10) was administered intravenously (i.v.) immediately after the local administration of anisoylated plasminogen streptokinase activator complex (APSAC 0.1 U/kg). Supplemental doses of heparin (100 U/kg) were administered at 1-h intervals. Infusion of GYKI-14766 was maintained for 5 h throughout the experiment. Ex vivo platelet aggregation in response to ADP or arachidonic acid (AA) was not changed in any of the experimental groups. Both GYKI-14766 and heparin increased the activated partial thromboplastin time (aPTT) over their respective baseline values. Heparin, but not GYKI-14766, increased the bleeding time. After successful thrombolysis, arterial and venous rethrombosis occurred in all saline-treated dogs. GYKI-14766 prevented cyclic flow variations and reocclusion in the artery and the vein (p < 0.01). Heparin had only minimal effects on the artery and no effect on the vein. Arterial thrombus weights were reduced by GYKI-14766 [saline control = 24 +/- 4 mg, GYKI-14766 = 9 +/- 3 mg, (p < 0.05); heparin = 14 +/- 2 mg, p = NS]. The venous thrombus weights were reduced slightly by GYKI-14766 and were unchanged by heparin (saline = 25 +/- 5 mg, GYKI-14766 = 13 +/- 4 mg, heparin = 26 +/- 3 mg). The data suggest that GYKI-14766 is effective in preventing occlusive rethrombosis in both the arterial and venous circulation after thrombolysis without augmenting bleeding time. GYKI-14766 may represent an alternative to heparin as an adjunctive agent during thrombolytic therapy.
Animals↗
Expression of adhesion molecules on myeloma cells.
We investigated the expression of adhesion molecules including LFA-1 alpha (CD11a), Mac-1 (CD11b), LFA-1 beta (CD18), VLA-beta 1 (CD29), H-CAM (CD44), VLA-4 (CD49d), VLA-5 (CD49e), ICAM-1 (CD54), N-CAM (CD56), LFA-3 (CD58), VNR-beta (CD61), and LECAM-1 (CD62L) on fresh myeloma cells and human myeloma cell lines. By two-color flow cytometric analysis with anti-CD38 antibody, we demonstrated that myeloma cells were located in the strongly CD38-positive (CD38++) fractions. Fresh myeloma cells were obtained from 28 patients with multiple myeloma (MM) and 3 patients with plasma cell leukemia (PCL). All myeloma cells expressed VLA-4 on their surface. Most of the myeloma cells also expressed VLA-5, ICAM-1, and LFA-3, H-CAM was strongly expressed in 3 cases of PCL and 2 cases of aggressive myeloma, and moderately expressed in other MMs. N-CAM was expressed in 68% of MMs, but none of the 3 PCLs. LFA-1 was expressed in two cases of aggressive myeloma, but not expressed in other non-aggressive myelomas. Most of the myeloma cells did not express Mac-1, VNR-beta, or LECAM-1. These results suggest that VLA-4, VLA-5, ICAM-1, LFA-3, and H-CAM are involved in cellular interaction and migration in MM, and that the expression of N-CAM and LFA-1 varies with disease activity in MM.
ADP-ribosyl Cyclase↗
Lowering glucose depletes a thapsigargin-sensitive calcium pool and inhibits transcription of the S14 gene.
S14 is a nuclear protein that is rapidly and synergistically induced by glucose and thyroid hormone, and the level of it's messenger RNA correlates with hepatocyte and adipocyte lipogenesis. We previously reported that the calcium ionophore A23187 markedly inhibits the carbohydrate response of the S14 gene without inhibiting glucose metabolism. Because the calcium ionophore not only increased intracellular cytosolic free calcium but also depletes intracellular calcium stores, we examined which of these two possibilities accounts for the regulation of S14 gene transcription. We found that increasing cytosolic calcium with arginine vasopressin is insufficient to inhibit S14 gene transcription. Furthermore, reduction of intracellular calcium by addition of EGTA to medium containing A23187 leads to further inhibition of S14 transcription. Measurement of intracellular free calcium in indo-1-loaded hepatocytes showed no significant changes induced by high glucose. These results suggested that depletion of an intracellular pool of calcium by A23187 causes the inhibition of S14 transcription. Addition of thapsigargin, which depletes intracellular calcium pools by inhibition of endoplasmic reticulum Ca2+-ATPase, led to significant inhibition of glucose-regulated S14 transcription. Lastly, continuous incubation in 5.5 mM glucose depletes the thapsigargin-sensitive calcium pool. These studies imply that the ability of glucose to induce S14 transcription is related to a thapsigargin-sensitive calcium pool, and depletion of this pool by lowering glucose inhibits S14 transcription.
Adipocytes↗
[Comparison between retrograde cerebral perfusion and selective cerebral perfusion by intraoperative electroencepharogram].
We used retrograde cerebral perfusion (RCP) to protect the brain in patients undergoing aortic arch replacement from May 1991 to July 1992. Subsequently, we have been using selective cerebral perfusion (SCP). In this study, a group of six patients undergoing RPC were compared with 5 patients undergoing SCP with regard to the intraoperative electroencepharogram (EEG) and post operative clinical course. There were no deaths in either group, but transient palsy of the right arm developed in one patient in the RCP group. The amplitude of intraoperative EEG was examined at four points: before cardiopulmonary bypass, during RCP or SCP, at 30 degrees C and at 35 degrees C during rewarming. The EEG amplitude at these four points was expressed as a ratio to the value before cardiopulmonary bypass. The ratios at these four points were 1, 0, 0.08, and 0.19 in the RCP group and 1, 0, 0.70, and 0.90 in the SCP group, respectively. In the SCP group, EEG recovered rapidly, whereas in the RCP group EEG did not recover until the completion of cardiopulmonary bypass in all but one patient. These results indicated that RCP does not provide reliable protection of the brain.
Adult↗
[A case report of mediastinitis due to methicillin resistant Staphylococcus aureus after total aortic arch replacement].
A 78-year-old man underwent total aortic arch replacement for ruptured aortic arch aneurysm. Two weeks after the surgery, high fever and leucocytosis developed. He was placed on a regimen of antibiotics. However, mediastinitis eventually ensued five weeks later with the pus draining from the sternotomy wound. The culture revealed a Methicillin resistant staphylococcus aureus. The infected tissue was debrided from the mediastinal cavity 40 days postoperatively. The cavity was kept open and was intermittently irrigated with 2% Providone-iodine for three days. Subsequently, an omental graft was placed. The infection successfully subsided gradually and the patient has been well for a year and a half after the initial surgery. The procedure is considered to be extremely effective for the management of a drastic infection involving thoracic aortic prosthesis.
Aged↗
[Emergency surgical salvage for a type A early thrombosed aortic dissection complicated cardiac tamponade in a 80-year-old-patient].
A 80-year-old woman underwent emergency operation for a type A early thrombosed aortic dissection associated with cardiac tamponade. Her preoperative chest CT (not enhanced) showed high density area in the false lumen that indicated early thrombosis and the projection of true lumen at antero-left-lateral portion of ascending aorta that means "ulcer-like projection" called on aortogram. After the relief of the cardiac tamponade by pericardiocenthesis, we emergently performed the graft replacement of the ascending aorta under the extracorporeal circulation combined with selective cerebral perfusion. Her postoperative course was uneventful and satisfactory.
Acute Disease↗
[Usefulness of the preoperative MRI for diagnosis and operative method in a case of cor triatriatum].
A case was 6-year-old female diagnosed as the cor triatriatum. The magnetic resonance imaging synchronized at R wave on the electrocardiogram was performed in order to see the abnormal septum in the left atrium. In the horizontal view, the abnormal septum that divides the left atrium into the accessory left atrial chamber and the true left atrium, was well visualized. This septum lied on the vertical portion. Operation was carried out with the approach through the accessory chamber and the fibromuscular membrane were excised. Preoperative imaging of the MRI was useful and helpful for us to reach to a decision of the surgical approach in this patient.
Cardiac Surgical Procedures↗
[Three cases of secondary acute myeloid leukemia after long-term treatment with oral etoposide].
Three cases of secondary acute myeloid leukemia (AML) that developed after long term treatment with oral etoposide were reported. Case 1 was a 72-year-old male in whom small cell lung cancer was diagnosed in January 1987. He developed AML (M4) in February 1993 after long-term treatment with oral etoposide (total dose 14,650 mg) t(9; 11) (p21; q23) with rearrangement of MLL genes was recognized. Case 2 was a 68-year-old female non-Hodgkin's lymphoma (NHL) was diagnosed in February 1989. AML (M4Eo) with inv(16) (p13q22) developed in March 1994 after long-term treatment with oral etoposide (total dose 5,100 mg). Case 3 was a 39-year-old male in whom NHL was diagnosed in January 1991. He developed AML(M2) with t(11; 19) (q23; p13) in May 1994 after long-term treatment with oral etoposide (total dose 20,450 mg). These three cases suggest that long-term treatment with oral etoposide may be associated with a risk of developing a secondary AML in patient with malignancies.
Administration, Oral↗
[Rupture of the aortic arch due to bacterial aortitis--a case report of a patient undergoing successful surgical therapy].
A 59-year-old man came to our hospital because of hoarseness and chest pain. On initial examination, a chest roentgenogram showed no abnormality. Three weeks later, while the patient was waiting to undergo a computed tomographic (CT) scan, shock suddenly developed. A chest roentgenogram revealed an extremely wide mediastinal shadow. A CT scan revealed rupture of the aortic arch near the base of the left subclavian artery, although there was no aneurysm. An emergency operation was performed. The ruptured aortic arch was replaced with an artificial graft during cardiopulmonary bypass with selective cerebral perfusion. A diagnosis of infectious aortitis was not made until a pathologist discovered colonies of gram-positive cocci in the resected specimen of the aortic arch. Postoperatively, antibiotics were administered for only four days. The patient is well about two years after the operation. Infectious aortitis had a very low prevalence and rarely involves the thoracic aorta. However, we should be aware of that it may cause aortic rupture even in the absence of aneurysmal dilatation.
Aorta, Thoracic↗
Monoclonal antibody [7E3 F(ab')2] prevents arterial but not venous rethrombosis.
The role of the platelet glycoprotein IIb/IIIa (GPIIb/IIIa) receptor and the efficacy of GPIIb/IIIa receptor antagonists on reocclusion after arterial versus venous thrombolysis is unknown. We used a canine model of simultaneous carotid artery and jugular vein thrombosis to evaluate the effect of the murine monoclonal antibody 7E3 [7E3 F(ab')2] on intravascular thrombotic reocclusion after thrombolysis in both vessels. The left carotid artery and right jugular vein were instrumented with flow probes, a critical stenosis, and an electrode through which an anodal current was applied to induce formation of an occlusive thrombus. After persistent occlusion of both vessels, 7E3 (0.8 mg/kg, n = 7) or saline (n = 10) was administered intravenously (i.v.) immediately after the local administration of anisolylated plasminogen streptokinase activator complex (APSAC, 0.1 U/kg). Ex vivo platelet aggregation in response to ADP or arachidonic acid was inhibited completely, and bleeding time was increased threefold by 7E3. The administration of 7E3 did not affect the activated partial thromboplastin time as compared with control values. The time to reperfusion of either vessel was not altered significantly in the presence of 7E3. Arterial or venous thrombolysis after APSAC was achieved in 10 of 10 and 8 of 10 control animals, respectively, but rethrombosis occurred in both the carotid artery and jugular vein in each of the saline-treated animals. Treatment with 7E3 prevented cyclic flow variations and reocclusion in the carotid artery (p < 0.05) in all treated animals (n = 7). In contrast, 7E3 did not suppress cyclic flow variations in the jugular vein, and rethrombosis occurred in five of six vessels despite the presence of platelet inhibition as assessed ex vivo. Residual arterial thrombus weights were reduced by pretreatment with 7E3 (saline = 24 +/- 4 mg, 7E3 = 11 +/- 3 mg; p < 0.05), whereas residual venous thrombus weights were not affected (saline 25 +/- 5 mg and 7E3 26 +/- 11 mg). The results indicate that inhibition of the platelet GPIIb/IIIa receptor does not prevent jugular vein rethrombosis despite its ability to prevent rethrombosis in the carotid artery. Different thrombotic mechanisms are involved in forming arterial and venous thrombi. Interventions that modulate arterial thrombotic events need not affect occlusive thrombotic activity in the venous circulation.
Animals↗
Insulin autoimmune syndrome after the third therapy with methimazole.
In 1986, a 26-year-old female had been diagnosed as having Graves' disease and had been treated with methimazole for four months. After the treatment with propylthiouracil for another four months, she had been treated with methimazole once again. She was in complete remission for two years. She again experienced symptoms of hyperthyroidism, and treatment with methimazole was started again. On the thirteenth day after treatment, she experienced hypoglycemic attacks with skin eruption. The plasma glucose was 57 mg/dl, 125I-Insulin binding 69%, free IRI 196 microU/ml. The patient had the HLA-DRB1*0406.
Adult↗