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Uekusa S, Nemoto M, Hanai Y, Nakashin M, Miyagawa A, Yanagino S, Arita Y, Matsumoto T, Nishizawa K, Nagai H, Higai K, Matsuo K. Risk Factors for Lenvatinib-Induced High-Grade Hypothyroidism in Patients with Hepatocellular Carcinoma: A Retrospective Study. Pharmacology 2023; 108:460-468. [PMID: 37591220 DOI: 10.1159/000531881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/26/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Lenvatinib mesylate (LEN) is an orally administered tyrosine kinase inhibitor used for the treatment of various cancers, including hepatocellular carcinoma (HCC). HCC treatment with LEN is associated with a very high incidence of adverse events, especially hypothyroidism. This study investigated the incidence of hypothyroidism due to LEN and the relationships between hypothyroidism incidence and patient demographics by analyzing clinical laboratory data from HCC patients treated with LEN. METHODS This was a single-center, retrospective study of HCC patients who received LEN between April 19, 2018, and September 30, 2020. The observation period was from 1 week before the start of LEN administration to 1 month after the end of administration. RESULTS In total, 61 patients with HCC were enrolled. High-grade hypothyroidism (CTCAE Grade 2-3) was found in 36.1% (22/61 patients). In high-grade hypothyroidism, eosinophil (EOSINO) count was significantly low (p = 0.029). The cutoff value of EOSINO count was estimated to be approximately 150/µL. The adjusted odds ratios of high-grade hypothyroidism for current smoking and EOSINO count <150/µL were 0.237 (95% confidence interval: 0.063-0.893) and 4.219 (95% confidence interval: 1.119-15.92), respectively. CONCLUSION The results showed that noncurrent smoking and EOSINO count <150/µL are risk factors for LEN-induced high-grade hypothyroidism.
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Affiliation(s)
- Shusuke Uekusa
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Maho Nemoto
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Yuki Hanai
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Misaki Nakashin
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | | | | | | | | | | | - Hidenari Nagai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Koji Higai
- Laboratory of Medical Biochemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Kazuhiro Matsuo
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
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Abstract
During orthodontic tooth movement, the activation of the vascular system in the compressed periodontal ligament (PDL) is an indispensable process in tissue remodeling. We hypothesized that compressive force would induce angiogenesis of PDL through the production of vascular endothelial growth factor (VEGF). We examined the localization of VEGF in rat periodontal tissues during experimental tooth movement in vivo, and the effects of continuous compressive force on VEGF production and angiogenic activity in human PDL cells in vitro. PDL cells adjacent to hyalinized tissue and alveolar bone on the compressive side showed marked VEGF immunoreactivity. VEGF mRNA expression and production in PDL cells increased, and conditioned medium stimulated tube formation. These results indicate that continuous compressive force enhances VEGF production and angiogenic activity in PDL cells, which may contribute to periodontal remodeling, including angiogenesis, during orthodontic tooth movement.
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Affiliation(s)
- A Miyagawa
- Division of Oral Dysfunction Science, Department of Oral Health and Development Sciences, Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan
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Kanzaki H, Chiba M, Sato A, Miyagawa A, Arai K, Nukatsuka S, Mitani H. Cyclical tensile force on periodontal ligament cells inhibits osteoclastogenesis through OPG induction. J Dent Res 2006; 85:457-62. [PMID: 16632761 DOI: 10.1177/154405910608500512] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The periodontal ligament (PDL) maintains homeostasis of periodontal tissue under mechanical tensile-loading caused by mastication. Occlusal load inhibits atrophic alveolar bone resorption. Previously, we discovered that continuous compressive force on PDL cells induced osteoclastogenesis-supporting activity, with up-regulation of RANKL. We hypothesized that, unlike compression, cyclical tensile force up-regulates OPG expression in PDL cells via TGF-beta up-regulation, and does not induce osteoclastogenesis-supporting activity. PDL cells were mechanically stimulated by cyclical tensile force in vitro. The conditioned media of PDL cells that had been subjected to cyclical tensile force inhibited osteoclastogenesis. Cyclical tensile force up-regulated not only RANKL mRNA expression, but also OPG mRNA expression in PDL cells. Tensile force up-regulated TGF-beta expression in PDL cells as well. Administration of neutralizing antibodies to TGF-beta inhibited OPG up-regulation under cyclical tensile-force stimulation in a dose-dependent manner. Additionally, the osteoclastogenesis-inhibitory effect of the conditioned media of PDL cells under cyclical tensile force was partially rescued by the administration of TGF-beta neutralizing antibodies. In conclusion, tensile force inhibited the osteoclastogenesis-supporting activity of PDL cells by inducing the up-regulation of OPG via TGF-beta stimulation.
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Affiliation(s)
- H Kanzaki
- Division of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Tohoku University, Sendai, Japan.
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Imashuku S, Miyagawa A, Chiyonobu T, Ishida H, Yoshihara T, Teramura T, Kuriyama K, Imamura T, Hibi S, Morimoto A, Todo S. Epstein-Barr virus-associated T-lymphoproliferative disease with hemophagocytic syndrome, followed by fatal intestinal B lymphoma in a young adult female with WHIM syndrome. Warts, hypogammaglobulinemia, infections, and myelokathexis. Ann Hematol 2002; 81:470-3. [PMID: 12224006 DOI: 10.1007/s00277-002-0489-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2002] [Accepted: 05/22/2002] [Indexed: 10/27/2022]
Abstract
A rare association of Epstein-Barr virus-associated T- and B-lymphoproliferative disease (EBV(+) T- and EBV(+) B-LPD) in a patient with WHIM (warts, hypogammaglobulinemia, infections, and myelokathexis) syndrome is reported. A 26-year-old Japanese female, who had been treated for WHIM syndrome since early childhood, developed hemophagocytic syndrome associated with EBV(+) T-LPD at the lymph nodes and spleen. The disease rapidly resolved in response to prednisolone therapy. However, 6 weeks later, fatal EBV(+) B lymphoma unresponsive to chemotherapy occurred in the intestine and other organs. Caution must be exercised that the patient with WHIM syndrome may be at risk for EBV-LPD.
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Affiliation(s)
- S Imashuku
- Kyoto City Institute of Health and Environmental Sciences, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, Kyoto 604-8845, Japan.
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Miyagawa A, Kobayashi M, Fujita Y, Hamdy O, Hirano K, Nakamura M, Miyake Y. Surface ultrastructure of collagen fibrils and their association with proteoglycans in human cornea and sclera by atomic force microscopy and energy-filtering transmission electron microscopy. Cornea 2001; 20:651-6. [PMID: 11473170 DOI: 10.1097/00003226-200108000-00019] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to investigate the possible association of proteoglycans with D-periodic collagen fibrils in the human cornea and sclera, using energy-filtering transmission electron microscopy (EF-TEM) and atomic force microscopy (AFM). METHODS Human cornea and sclera were digested with keratanase to eliminate keratan sulfate proteoglycans (KSPGs). For EF-TEM observation, surface proteoglycans were detected by cupromeronic blue (CB) staining. For AFM observation, cornea and sclera were treated with sodium hydroxide before and after keratanase digestion, and the surface topology of collagen fibrils was analyzed. RESULTS With CB staining, numerous CB-positive short filaments of surface proteoglycans (proteoglycan filaments) were observed in the interfibrillar spaces of cornea and sclera associated with collagen fibrils. AFM imaging showed that the depth and periodicity of D-periodic collagen fibrils in keratanase-treated corneal collagens were deeper and more regular than in untreated ones. Moreover, the depth and periodicity of keratanase-untreated corneal collagens were shallow and irregular in comparison with keratanase-untreated scleral collagens. On the other hand, there was no difference in depth or regularity between keratanase-treated and -untreated scleral collagen fibrils. Using AFM imaging, additional thin grooves sub-bands were detected on the surface of keratanase-treated corneal collagen fibrils. The grooves were not detected in keratanase-untreated collagen fibrils nor in scleral collagen fibrils with or without keratanase digestion. Comparing densitometry waves, the grooves of D-periodic corneal collagen sub-bands corresponded to a and c bands. CONCLUSION Using AFM and EF-TEM to study corneal and scleral collagen fibrils and their association with proteoglycans, we conclude that KSPG is found in ample amounts in the human cornea in comparison with sclera. Moreover, we topologically detected KSPG attached to a and c bands of collagen fibrils.
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Affiliation(s)
- A Miyagawa
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Hirano K, Murata K, Miyagawa A, Terasaki H, Saigusa J, Nagasaka T, Kobayashi M. Histopathologic findings of cornea verticillata in a woman heterozygous for Fabry's disease. Cornea 2001; 20:233-6. [PMID: 11248839 DOI: 10.1097/00003226-200103000-00028] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To report the histopathologic findings of the cornea verticillata observed in a woman who was heterozygous for Fabry's disease. METHOD A 67-year-old woman was found to have a whorl-like corneal opacity on her visit to the Department of Ophthalmology. Aichi Saiseikai Hospital. Her visit was because of a sudden loss of vision in her right eye owing to a central retinal artery occlusion in association with an ophthalmic artery occlusion. The patient died suddenly of an acute heart failure; with family consent, an autopsy was performed and the right eye was removed for histopathologic examination by light and electron microscopy. RESULTS Low levels of alpha-galactosidase in the leukocytes together with the corneal finding led to the diagnosis of heterozygous Fabry's disease. Light microscopy revealed a 0.3- to 0.5-microm thick layer between the epithelial and Bowman's layers. Oil red O positive deposits were accumulated in the subepithelial layer, and the density varied in different regions. Electron microscopy showed that subepithelial layer differed in thickness, and the basal lamina reduplicated regionally. We were not able to determine the structure that correlated with the "ridge" in the central part of the cornea. CONCLUSION The oil red O positive deposits and their variation in density in the subepithelial area of the cornea may have caused the characteristic whorl-like corneal opacity in this woman who was heterozygous for Fabry's disease.
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Affiliation(s)
- K Hirano
- Department of Ophthalmology, Nagoya University School of Medicine, Japan.
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Abstract
Fibrous tumor of the breast is a rare, benign stromal proliferation with atrophy of the epithelial component. Almost all patients who develop fibrous tumors are premenopausal. An unusual example of fibrous tumor of the breast is reported in a 62-year-old postmenopausal woman. The mass, first noted 1 year previously, progressively enlarged over the year. The patient noted a history of taking exogenous estrogens for 10 years. Intense estrogen administration during the year of enlargement may be associated with accelerated growth of the tumor. In addition, positive nuclear staining for estrogen receptor antibodies in stromal cells was demonstrated by immunohistochemical methods.
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Affiliation(s)
- A Miyagawa
- Department of Pathology, Tenri Hospital, 200, Mishima-cho, Tenri City, Nara, 632-8552, Japan.
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Abstract
PURPOSE To report a rare case of true exfoliation of the lens capsule following panuveitis, with slit-lamp photographs before and following the development of the true exfoliation. METHODS Case report. Review of the history and clinical features of a 70-year-old woman who developed true exfoliation during the treatment for panuveitis. RESULTS After 7 months of treatment for bilateral panuveitis with topical steroid and tropicamide, the patient developed a thin, transparent membrane arising on the lens surface in the right eye. A diagnosis of true exfoliation of the lens capsule was made. CONCLUSIONS True exfoliation of the lens capsule following uveitis may occur due to the weakening of the anterior capsule by metabolic disorder caused by uveitis and precipitated by repeated mydriasis.
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Affiliation(s)
- N Yamamoto
- Department of Ophthalmology, Gamagori City Hospital, 1-1 Mukaida, Hirata-cho, Gamagori-shi, Aichi-ken 443-0004, Japan
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Abstract
An 87-year-old woman died of rapidly progressive pneumonia due to Aeromonas hydrophila shortly after a near-drowning event. Autopsy showed necrotizing pneumonia and postmortem cultures of both blood and lung revealed the organism. Fulminant pneumonia should be considered in patients of a near-drowning event.
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Affiliation(s)
- M Miyake
- Department of Cardiology, Tenri Hospital
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Miyagawa A, Kobayashi M, Fujita Y, Nakamura M, Hirano K, Kobayashi K, Miyake Y. Surface topology of collagen fibrils associated with proteoglycans in mouse cornea and sclera. Jpn J Ophthalmol 2000; 44:591-5. [PMID: 11094171 DOI: 10.1016/s0021-5155(00)00272-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To clarify the histological basis for the optical difference in the cornea and sclera, we investigated the surface ultrastructure of D-periodic collagen fibrils. METHODS The fibril arrangement and topology of D-periodic collagen fibrils from corneas and scleras of mice were examined by transmission and scanning electron microscopy, as well as by atomic force microscopy (AFM). The banding patterns were estimated by densitometry and compared with the profile made by computer simulation from the protein sequence of amino acids. RESULTS Considerable association of proteoglycans/glycosaminoglycanson XI bands of corneal D-periodic collagen fibrils was seen with ruthenium red staining. Atomic force microscopy imaging showed that the depth of the groove in the D-periodicity of corneal collagen fibrils was shallow compared with that of the sclera. CONCLUSIONS Corneal collagen fibrils are associated with many extracellular matrix components on both elevated and depressed surfaces of D-periodic bands, which may serve to maintain interfibrillar spaces, resulting in corneal transparency.
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Affiliation(s)
- A Miyagawa
- Department of Ophthalmology, Nagoya University School of Medicine, Nagoya, Japan
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Miyagawa A, Yasuoka T, Sakabe H, Matsuda H, Nakajima S, Aoyama H, Kushima R, Fujiyama Y, Bamba T. [A case of ulcerative colitis with ileus due to extensive stricture of the colon]. Nihon Shokakibyo Gakkai Zasshi 2000; 97:1267-71. [PMID: 11075591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Affiliation(s)
- A Miyagawa
- Department of Internal Medicine, Social Insurance Shiga Hospital
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Hamanishi T, Gohma I, Oida K, Kori Y, Taguchi Y, Inoue T, Kato T, Maniwa K, Miyagawa A, Kobashi Y, Noma S. [Occurrence of BOOP outside radiation field after tangential radiation therapy for breast carcinoma]. Nihon Kokyuki Gakkai Zasshi 2000; 38:551-6. [PMID: 11019571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
We report three cases of bronchiolitis obliterans organizing pneumonia (BOOP) that occurred outside the radiation field after radiation therapy using tangential fields for breast carcinoma. All patients complained of a cough between 14 and 20 weeks after completion of radiation therapy. Fever also developed in two of the three. Chest radiography and computed tomography demonstrated peripheral alveolar opacities outside the radiation field on the same side as the radiation therapy. Laboratory data showed an increased level of C-reactive protein and an increased erythrocyte sedimentation rate. Bronchoalveolar lavage showed an elevated total cell count with a very high percentage of lymphocytes. Transbronchial lung biopsy revealed a histologic pattern consistent with BOOP. Treatment with corticosteroids resulted in rapid clinical improvement and complete resolution of the radiographic abnormalities. This pulmonary disorder appears to be induced by radiation, especially when a tangential field is employed for breast carcinoma, though the etiology has not been fully investigated. It is important to be aware of this type of pulmonary complication in patients given radiotherapy for breast carcinoma.
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Affiliation(s)
- T Hamanishi
- Department of Respiratory Medicine, Tenri Hospital, Nara, Japan
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Miyagawa A, Sakabe H, Amakata Y, Inoue T, Andoh A, Hodohara K, Fujiyama Y, Bamba T. [Effective pentostatin-based treatment of adult T cell leukemia in a patient with severe arthritis]. Rinsho Ketsueki 1998; 39:487-92. [PMID: 9750455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We report a 48-year-old woman with adult T-cell leukemia who had refractory arthralgia, intense headaches, and fever. Leukemic cell infiltration of the cerebrospinal fluid was detected but no other acute signs were observed. Abnormal lymphocytes with lobulated nuclei were found in the synovial fluid, and a histologic examination revealed proliferation into the synovium. Because combination chemotherapy did not elicit a favorable response, the patient was treated with a pentostatin bolus injection. The articular symptoms disappeared and complete remission was obtained. Six months later, she experienced arthralgia again together with a gradual increase of abnormal lymphocytes in peripheral blood. Sixteen months later, the patient was given pentostatin and achieved a complete remission again. She is still free from relapse without further therapy after 36 months, and her articular symptoms have not returned either. There were no adverse effects due to pentostatin. The patient's serum IL-6 level was elevated, suggesting that IL-6 may play a role in arthropathy.
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Affiliation(s)
- A Miyagawa
- Department of Internal Medicine, Social Insurance Shiga Hospital
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Andoh A, Fujiyama Y, Kitamura S, Ihara T, Ueda K, Miyagawa A, Hodohara K, Inoue H, Bamba T. Acute lupus peritonitis successfully treated with steroid pulse therapy. J Gastroenterol 1997; 32:654-7. [PMID: 9349992 DOI: 10.1007/bf02934116] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A 21-year-old man with systemic lupus erythematosus (SLE) who developed acute lupus peritonitis is described. Acute lupus peritonitis appeared during generalized lupus flare, with nausea, vomiting, frequent diarrhea, and abdominal tenderness with rebound and guarding. The patient was afebrile and had decreased bowel sounds. Abdominal ultrasonography and computed tomography revealed marked thickening of the gastric, duodenal, and jejunal walls, massive intraluminal fluid collection, and increasing ascites. Gastrointestinal endoscopy showed edematous mucosa with multiple erosions of the stomach and duodenum. The ascitic fluid was remarkable for low complement levels and elevated anti-DNA antibody. These manifestations of acute lupus peritonitis resolved after steroid pulse therapy with methylprednisolone. We should consider acute lupus peritonitis in a patient with SLE when abdominal symptoms are severe. Experience with our patient indicates that steroid pulse therapy is effective for this rare but severe manifestation of SLE.
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Affiliation(s)
- A Andoh
- Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan
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Yasunaga M, Fujiyama Y, Miyagawa A, Inoue T, Andoh A, Hodohara K, Bamba T, Inoue T, Yawata Y, Harano K. Thalassemia incidentally found by marked erythrocytosis due to an ochre mutation at codon 35 in a Japanese man. Intern Med 1995; 34:1198-200. [PMID: 8929650 DOI: 10.2169/internalmedicine.34.1198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
We present a patient with beta-thalassemia minor diagnosed on the basis of the incidental findings of marked hypochromic and microcytic erythrocytosis. Hemoglobin analysis revealed increased hemoglobin (Hb) A2 levels and decreased beta/alpha synthesis ratio in both the propositus and his mother. Further molecular studies identified a single base substitution of TCA to TAA within codon 35 in heterozygous state, which creates a premature terminator resulting in a defect of effective beta globin synthesis. This is the first report of beta-thalassemia due to a nonsense mutation at codon 35 of beta-thalassemia gene in the Japanese population.
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Affiliation(s)
- M Yasunaga
- Second Department of Internal Medicine, Shiga University of Medical Science
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Yasunaga M, Hodohara K, Bamba F, Kitamura K, Fukuda M, Boku T, Miyagawa A, Inoue T, Kitoh K, Andoh A. [A case of acute myelogenous leukemia accompanied with myelofibrosis and megakaryocyte-like giant bizarre blasts]. Rinsho Byori 1995; 43:1078-82. [PMID: 8531394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A 45-year-old man was admitted with high fever and leukocytosis in August 1993. The diagnosis of acute myelogenous leukemia (AML; M2) was made on the basis of morphological, cytochemical and immunological characteristics of the blasts in the bone marrow. The induction therapy with BHAC, daunorubicin, 6-MP was unsuccessful in achieving remission; the bone marrow biopsy specimen revealed the proliferation of the remaining leukemic cells and massive fibrosis accompanied with unusual megakaryocyte-like giant bizarre cells. These megakaryocyte-like giant cells were positive for myeloperoxidase and CD34, but not GPIIIa and factor VIII, indicating that those were derived from myelogenous stem cells. Following the low-dose Ara-C therapy, improvement of fibrosis and disappearance of these giant cells were observed in the bone marrow. After the reinduction therapy with high-dose Ara-C and MIT against markedly increased blasts, the patient died of systemic fungal infection. The presence of myelofibrosis and giant atypical blasts might allow resistance to therapy and poor prognosis.
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Affiliation(s)
- M Yasunaga
- 2nd Department of Internal Medicine, Shiga University of Medical Science, Otsu
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Mizutani A, Taniguchi K, Miyagawa A, Ikebe H, Yoshitake S, Honda N. [The analgesic effect of iontophoresis with magnesium sulfate]. Masui 1995; 44:1076-9. [PMID: 7474304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The analgesic effect of iontophoresis with magnesium sulfate was studied in fourteen healthy adult volunteers. Magnesium sulfate 0.5 mg.5 ml-1 was locally administered by the iontophoresis with 1.0 mA electric current for 10 min. The pain recognition time was measured by the pain thermometer before and after 5, 15, 30, 60 and 120 min of iontophoresis. The pain recognition time was significantly extended and lasted for 60 min. These results support the view that the iontophoresis with magnesium sulfate has analgesic effect and produces a good pain relief clinically.
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Affiliation(s)
- A Mizutani
- Department of Anesthesiology, Oita Medical University
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Ikebe H, Miyagawa A, Mizutani A, Miyamoto M, Taniguchi K, Honda N. [The effect of iontophoresis with several Ca channel blockers for PHN patients]. Masui 1995; 44:428-33. [PMID: 7745800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We performed iontophoresis with Ca channel blockers for healthy adult volunteers. In this clinical study, we used iontophoresis with Ca channel blockers. Ten out patients with PHN treated at our pain clinic were treated with iontophoresis. They were randomly assigned to one of the following four treatments: (1) 5 ml of 4% lidocaine HCl, (2) 2 mg of nicardipine HCl + 5 ml of distilled water, (3) 2 mg of verapamil HCl + 5 ml of distilled water, and (4) 2 mg of diltiazem HCl + 5 ml distilled water. Iontophoresis was performed using the above four drugs on the positive pole. Using a VAS, each patient was evaluated concerning the analgesic effect. The pain before treatment (10 points) was used as the base line. Compared with the scores before treatment, VAS scores decreased significantly after iontophoresis in all four groups. In the lidocaine group, a significant decrease in VAS scores occurred immediately after iontophoresis and lasted up to 24 hours, reaching the nadir at 2 hours. In the nicardipine group, the decrease occurred immediately after iontophoresis and lasted up to one day, reaching the nadir at four hours. In the verapamil group, the decrease started 1 hour after iontophoresis and lasted up to 48 hours, reaching the nadir at 8 hours. In diltiazem group, the decrease started 1 hour after iontophoresis and lasted up to 48 hours, reaching the nadir at 4 hours. Iontophoresis with Ca channel blockers produced a prolonged analgesic effect in PHN patients. Previously we had observed the same effect in adult volunteers. Therefore, we believe that this therapy will be clinically useful.
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Affiliation(s)
- H Ikebe
- Department of Anesthesiology, Oita Medical University
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Yasunaga M, Hodohara K, Uda K, Miyagawa A, Kitoh K, Andoh A, Okabe H, Ochi Y, Fujiyama Y, Bamba T. Small intestinal perforation due to cytomegalovirus infection in patients with non-Hodgkin's lymphoma. Acta Haematol 1995; 93:98-100. [PMID: 7639056 DOI: 10.1159/000204119] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We describe two patients with non-Hodgkin's lymphoma (NHL) who suffered cytomegalovirus (CMV)-related small intestinal perforations during the course of chemotherapy. Surgical specimens from both patients revealed histologic evidence of occlusive vasculitis and tissue destruction caused by CMV-affected cells in the submucosa and muscular walls, that may have played an important role in the pathogenesis of these perforations. Although such intestinal perforations are rare complications in NHL patients, CMV infection should be recognized as a primary etiological factor in acute abdominal crises when treating NHL patients with pharmaceutical agents including steroids. Emergency surgery and the anti-CMV agent, ganciclovir, would improve the prognoses of such patients.
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Affiliation(s)
- M Yasunaga
- Second Department of Internal Medicine, Shiga University of Medical Science, Japan
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Abstract
The possible co-existence of pituitary adenylate cyclase-activating polypeptide (PACAP)-38 and nitric oxide synthase (NOS) in the rat hypothalamus was examined by a combination of PACAP-immunocytochemistry and NADPH-diaphorase histochemistry. Virtually all PACAP-38-immunoreactive neurones in the paraventricular and supraoptic nuclei exhibited NADPH-diaphorase activity. Since NADPH-diaphorase activity was identical to NOS-immunoreactivity in the magnocellular neurosecretory neurones, this finding indicates that the PACAP neurones synthesize NO.
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Affiliation(s)
- H Okamura
- Department of Anatomy, Kyoto Prefectural University of Medicine, Japan
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21
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Miyagawa A, Okamura H, Ibata Y. Coexistence of oxytocin and NADPH-diaphorase in magnocellular neurons of the paraventricular and the supraoptic nuclei of the rat hypothalamus. Neurosci Lett 1994; 171:13-6. [PMID: 8084473 DOI: 10.1016/0304-3940(94)90592-4] [Citation(s) in RCA: 101] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Nitric oxide (NO), which was firstly identified as an endothelium-derived relaxing factor, has recently been demonstrated to be a neurotransmitter in the central and peripheral nervous systems. In the hypothalamus, abundant nitric oxide synthase (NOS) immunoreactivity and its histochemical marker, NADPH-diaphorase activity, have been demonstrated in the hypothalamo-neurohypophyseal system. In the present study, we examined whether NOS is coexpressed with posterior pituitary hormones in the rat hypothalamus by combination of oxytocin and vasopressin immunofluorescence and NADPH-diaphorase histochemistry. Most oxytocin-immunoreactive neurons in the paraventricular and supraoptic nuclei expressed NADPH-diaphorase activity, but virtually no vasopressin-immunoreactive neurons contained NADPH-diaphorase activity. This suggests that oxytocin neurons are the main source of NO production in the hypothalamic-pituitary system.
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Affiliation(s)
- A Miyagawa
- Department of Anatomy, Kyoto Prefectural University of Medicine, Japan
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22
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Uchiumi R, Hidaka T, Miyagawa A, Sugino K, Taniguchi K, Honda N. [Clinical evaluation of diazepam suppository for premedication in children]. Masui 1994; 43:102-5. [PMID: 8309040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Anesthesiologists need a safe and effective premedication before general anesthesia and want to help decrease anxiety and minimize psychologic trauma to children. Therefore, we evaluated diazepam suppository (0.5 mg.kg-1 body weight) administered to 21 children before minor surgery under general anesthesia. We evaluated the sedative effect of the diazepam suppository (tablet) on the arrival at the operating room, during anesthesia induction and in the recovery room. On the arrival at operating room, 86% of children were sedated, and 65% of children could be induced smoothly under mask. There was no delayed emergence. Plasma diazepam level at induction was 376.5 +/- 28.4 ng.ml-1, which is the level needed for sedation. We conclude that diazepam suppository is a useful drug for premedication in children.
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Affiliation(s)
- R Uchiumi
- Department of Anesthesiology, Oita Medical University
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23
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Yoshitake S, Matsumoto K, Miyagawa A, Mori M, Kitano T, Oda S, Taniguchi K, Honda N. [Anesthetic consideration of a patient with congenital insensitivity to pain with anhidrosis]. Masui 1993; 42:1233-1236. [PMID: 8366567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Congenital insensitivity to pain with anhidrosis is a rare disorder but several clinical anesthetic experiences have been reported in Japan. We anesthetized a patient with this disorder for orthopedic operation with a low concentration of sevoflurane under monitoring of body temperature and we measured the concentrations of plasma ADH, cortisol and catecholamines levels before, during and after the operation. There were no problems during anesthesia and the patient awoke rapidly. ADH, cortisol and epinephrine concentrations showed slight elevations during and after the operation. The management of intraoperative body temperature and the necessary level of anesthesia were also discussed.
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Affiliation(s)
- S Yoshitake
- Department of Anesthesiology, Oita Medical University
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24
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Mizutani A, Taniguchi K, Miyagawa A, Ikebe H, Yoshitake S, Honda N. [Reversal by the calcium ion of the pain threshold elevated by calcium channel blockers]. Masui 1993; 42:698-702. [PMID: 8515546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
We investigated calcium ion effects on pain thresholds by iontophoresis in healthy adult volunteers. The pain thresholds were measured by the pain thermometer to evaluate the effect of iontophoresis. At first, one of calcium channel blockers (nicardipine, verapamil or diltiazem) was administered by iontophoresis with 1.0 mA for 10 minutes. Then, next to calcium channel blockers, calcium chloride or saline was locally administered after the elevation of pain threshold had been recognized and the pain threshold had been measured again. Calcium ion decreased the elevation of pain threshold significantly, but saline had no effect. These results suggest that not only sodium channel but also calcium channel influences pain mechanism during iontophoresis.
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Affiliation(s)
- A Mizutani
- Department of Anesthesiology, Medical College of Oita
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25
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Natsume H, Imamizu M, Sugibayashi K, Shibata T, Miyagawa A, Morimoto Y. Selective accumulation and tumoricidal effect of cisplatin suspended in viscous ethyl oleate on hepatic cancers in animals after intraarterial infusion. J Drug Target 1993; 1:207-15. [PMID: 8069562 DOI: 10.3109/10611869308996078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The selective accumulation and tumoricidal effects of cisplatin after intra-arterial infusion suspended in viscous ethyl oleate (VEO) on hepatic cancers of AH 272 tumor-bearing rats and VX-2 tumor-bearing rabbits were compared with those of cisplatin suspensions in ethyl oleate (EO) and Lipiodol Ultra Fluide (LP). The viscosities of VEO, EO and LP were 120, 4, and 21 centipoise (cp) respectively. Complete in vitro release of cisplatin from EO and LP occurred within 24 h, whereas only about 25% of cisplatin was released from VEO over the same period. When EO or VEO containing 3H-oleic acid were infused into the hepatic artery of rat liver inoculated with AH 272 tumor cells, radioactivity in the tumor site was higher than that in normal liver. In the case of cisplatin, concentration ratios after the infusion of EO and VEO were almost the same as those of oily carriers. Similar results were obtained in rabbit liver inoculated with VX-2 tumor cells. Cisplatin concentration in the tumor site seven days after intra-arterial infusion of VEO suspension was 5- and 1.7-fold higher, respectively, than that after EO and LP suspensions. The tumoricidal effect of cisplatin in VEO suspension on AH 272 tumor-bearing rats was higher than that after cisplatin solution and EO and LP suspensions, while VX-2 tumor growth was inhibited by the infusion of all cisplatin-containing oily carriers. VEO suspension thus appears very promising in intra-arterial infusion therapy.
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Affiliation(s)
- H Natsume
- Department of Pharmaceutics, Faculty of Pharmaceutical Sciences, Josai University, Saitama, Japan
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26
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Natsume H, Imamizu M, Sugibayashi K, Shibata T, Miyagawa A, Morimoto Y. Oily drug carriers in cancer chemotherapy. II. Preparation of viscous ethyl oleate for intraarterial infusion therapy and its disposition in rats and hamsters. Chem Pharm Bull (Tokyo) 1992; 40:1545-52. [PMID: 1394675 DOI: 10.1248/cpb.40.1545] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Viscous ethyl oleate (VEO) was prepared as an oil drug carrier by the addition of aluminum stearate or ethyl cellulose. Since the rate of shear of VEO containing aluminum stearate was greatly and nonlinearly changed against the shearing stress compared to that containing ethyl cellulose, the latter was used for subsequent microvascular and organ distribution experiments in rats and hamsters. For infusion into the carotid artery in hamsters, neat ethyl oleate (EO, 4cP) or VEOs of various apparent viscosities (40, 80, 120 cP-VEOs) embolized the vascular system in the cheek pouch, although arrival time to the site where the embolization was observed and the embolization period differed depending on the type of oily drug carrier. For infusion into the hepatic artery in rats, however, only 120 cP-VEO embolized the vascular system in the liver. After infusion of the oily drug carrier containing 3H-oleic acid into the artery of hamster cheek pouch and rat liver, 30-50% of the radioactivity was gradually eliminated within 48 h, whereas about 80% of the dose was rapidly eliminated after infusion to rat stomach and kidney. In addition, the amount of 120 cP-VEO remaining in each organ 48 h after infusion was higher than those of EO and 40 and 80 cP-VEOs. Histological observation after infusion in rat liver revealed that 120 cP-VEO slowly migrated from the artery or arteriole to the sinusoidal capillary region. These results suggest that 120 cP-VEO can be used as a drug carrier because of its function of vascular embolization and high retention in a targeted tissue.
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Affiliation(s)
- H Natsume
- Faculty of Pharmaceutical Sciences, Josai University, Saitama, Japan
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27
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Miyagawa A, Taniguchi K, Sendaya K, Mizutani A, Yoshitake S, Ikebe H, Honda N. [Influence of calcium channel blockers and beta-blockers on pain relief with iontophoresis]. Masui 1992; 41:805-10. [PMID: 1608158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
We studied usefulness of iontophoresis on pain relief using several Ca channel blockers, propranolol and guanethidine. Subjects were 18 healthy adult volunteers. We used 4% lidocaine with/without several drugs (2 mg of nicardipine, verapamil, diltiazem, propranolol and 10mg of guanethidine), and evaluated the pain relief effect with Nakahama's algesimeter. In all groups except for propranolol group, the pain recognition time was elongated significantly in comparison with control. In making comparison between each Ca channel blocker, we did not observe any significant differences, but, in propranolol group, elongation of pain threshold time was observed in some subjects. During these processes, systemic blood pressure and heart rate showed no remarkable changes. Our results suggest that it is possible to achieve more prolonged analgesic effect by the Ca channel blockers.
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Affiliation(s)
- A Miyagawa
- Department of Anesthesiology, Medical College of Oita
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28
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Okumura Y, Fuse K, Miyagawa A, Shimizu N, Kosuga K, Inoue H, Bamba T, Hosoda S, Kushima R, Hattori T. [A case report: inflammatory fibroid polyp of the jejunum]. Nihon Shokakibyo Gakkai Zasshi 1991; 88:2162-5. [PMID: 1795429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Y Okumura
- Department of Internal Medicine, Hikone Municipal Hospital
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29
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Kinoshita R, Ishida K, Sendaya K, Miyagawa A, Oda S, Taniguchi K, Honda N. [Clinical evaluation of isosorbide dinitrate (ISDN) spray: a study on the plasma concentrations of ISDN and on its hemodynamic effects using three administration routes]. Masui 1990; 39:1660-3. [PMID: 2098594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The effects of ISDN spray has been evaluated using oral, nasal or tracheal routes in patients under enflurane anesthesia. These 30 patients were in ASA I or II physical status without cardiovascular, kidney or liver diseases. Under enflurane anesthesia, hemodynamic parameters (blood pressure and heart rate), blood gas and plasma concentration of ISDN were measured at several points before and after drug administration. The plasma concentration reached a maximum point (C max) 4 min after drug administration in the oral group (O-group) and nasal group (N-group), and the values obtained were 48.4 +/- 5.4 ng.ml-1 and 87.4 +/- 13.8 ng.ml-1 respectively. The C max of the N-group was significantly higher than that of O-group (P less than 0.05). In the O- and N-groups, systolic blood pressure decreased 10% and 17%, after 4 min (P less than 0.05) and recovered 20 after min. Diastolic blood pressure decreased in both groups after 4 min (P less than 0.05). Heart rate significantly increased in the N-group (P less than 0.05), and continued to change up to 60 min after drug administration. In both groups, PaO2/FIO2 decreased 14% and 9% after 10 min (P less than 0.01). In the tracheal group, plasma concentration did not increase and these hemodynamic changes were not observed. These results suggest that nasal route of ISDN spray is the best route of administration.
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Affiliation(s)
- R Kinoshita
- Department of Anesthesiology, Medical College of Oita
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30
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Imaizumi S, Mazgalev T, Dreifus LS, Michelson EL, Miyagawa A, Bharati S, Lev M. Morphological and electrophysiological correlates of atrioventricular nodal response to increased vagal activity. Circulation 1990; 82:951-64. [PMID: 2394013 DOI: 10.1161/01.cir.82.3.951] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The mechanisms responsible for slowing cardiac impulse conduction through the atrioventricular (AV) node are not well understood but include anatomical architecture, presence of cells with diverse electrophysiological characteristics, and modulation by autonomic nervous system. The present study was designed to determine the site of vagally induced slowing of conduction through the AV node. We attempted to correlate the electrophysiological response of AV nodal cells to postganglionic vagal stimulation applied in different regions of the node with the morphological findings and patterns of acetylcholinesterase-positive staining of nodal tissue. This multifaceted approach revealed that vagal stimulation produced localized hyperpolarization of the cells from the N region of the AV node, which correlated with the strong acetylcholinesterase positive staining of the central nodal area. In contrast, the density of the acetylcholinesterase staining decreased toward both the AN and His bundle regions, whereas vagal stimulation had a negligible effect on the cells from these regions. These results suggest that vagal-induced depression of AV nodal conduction is produced by release of acetylcholine predominantly around the midnodal region and the depressive action of acetylcholine is concentrated on the cells occupying the same region (i.e., the N cells). Thus, there appears to be a close juxtaposition of nerve elements and effector cells in the midnodal region of the AV node. This unique combination of available neuromediator and responding cells with hyperpolarization and depressed action potential determines the midnodal region as the focus of vagal effect on AV nodal conduction.
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Affiliation(s)
- S Imaizumi
- Department of Medicine, Lankenau Hospital, Philadelphia, PA 19151
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31
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Abstract
Adenosine exerts pronounced depressant effects on cardiac pacemakers. Previous studies in vitro have indicated that different pacemakers exhibit variable sensitivity to adenosine: ventricular greater than junctional greater than sinus node pacemakers. This study tested the hypothesis that ventricular pacemakers are more sensitive to adenosine than sinus node pacemakers in vivo in an experimental canine model and determined the mechanism involved in this phenomenon using specific pharmacological interventions. For this purpose, dogs with chronic atrioventricular block, stable ventricular escape rhythm, and bilateral stellectomy and cervical vagotomy were studied. Dose-response curves for negative chronotropic action of adenosine in the sinus node and ventricular pacemakers were obtained in group 1 under base-line conditions, during isoproterenol infusion, and after subsequent administration of propranolol; in group 2 before and after administration of quinidine; in group 3 before and after administration of aminophylline; and in group 4 before and after administration of 1,3-dipropyl-8-phenylxanthine amine congener (XAC). Adenosine exerted a dose-dependent negative chronotropic effect on sinus node and ventricular pacemakers. At all doses tested, this action was more pronounced in the ventricle. Isoproterenol accentuated the action of adenosine in the sinus node (by 60-138%; P less than 0.05) but suppressed it in the ventricle (-37 to 53%; P less than 0.05). These effects of isoproterenol were attenuated by propranolol. Quinidine suppressed the action of adenosine in the sinus node (-38 to -52%; P less than 0.05) but not in the ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Pelleg
- Lankenau Medical Research Center, Hahnemann University, Philadelphia, Pennsylvania 19102-1192
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32
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Shiraki M, Miyagawa A, Akiguchi I, Ito H, Ohkawa S, Sugiura M. Evidence of hypovitaminosis D in patients with mitral ring calcification. Jpn Heart J 1988; 29:801-8. [PMID: 3241333 DOI: 10.1536/ihj.29.801] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
In order to evaluate the role of calcium regulating hormones in the pathogenesis of mitral ring calcification, we have studied the serum levels of PTH and vitamin D metabolites in aged females both with and without mitral ring calcification (MRC). In the patients with MRC (n = 17), significantly lower levels of serum total protein (6.6 +/- 0.2 in the MRC group vs 7.1 +/- 0.1 g/dl in the control group, mean +/- SEM), BUN (15.7 +/- 0.9 vs 18.3 +/- 0.9 mg/dl), creatinine (0.7 +/- 0.02 vs 0.9 +/- 0.02 mg/dl) and calcium (8.4 +/- 0.1 vs 9.2 +/- 0.1 mg/ml) were observed as compared with those in the controls (n = 32). Significantly higher PTH levels (0.57 +/- 0.07 vs 0.38 +/- 0.04 ng/ml) were found in the MRC group. Levels of all three vitamin D metabolites in the MRC group were significantly lower than those in the control group (25-OHD; 11.2 +/- 1.4 vs 19.6 +/- 1.2 ng/ml, 24,25(OH)2D; 0.7 +/- 0.1 vs 1.3 +/- 0.1 ng/ml and 1,25(OH)2D; 12.5 +/- 2.4 vs 43.0 +/- 3.5 pg/ml). The correlation coefficient between PTH and 1,25(OH) 2D was -0.382(n = 49, p less than 0.01). Thus, the significantly higher PTH levels in the MRC group might result in hypovitaminosis D. In conclusion, evidence of hypovitaminosis D in the patients with mitral ring calcification was demonstrated.
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Affiliation(s)
- M Shiraki
- Section of Laboratory Medicine, Tokyo Metropolitan Geriatric Hospital, Japan
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33
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Matsumura S, Sato S, Fujiwara H, Takamatsu H, Kajiwara T, Yamashiro K, Miyagawa A. [Cerebral aspergillosis as a cerebral vascular accident]. No To Shinkei 1988; 40:225-32. [PMID: 3395519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cerebral aspergillosis is one of the most common mycotic infections in the central nervous system causing different clinical features such as brain abscess, granuloma, meningitis, and encephalitis. Cerebral aspergillosis, however, may lead to a cerebral vascular accident such as intracranial hemorrhage or cerebral infarction. In this report, we present two patients with cerebral aspergillosis accompanied by intracranial hemorrhage. A total of 124 reported cases of cerebral aspergillosis are reviewed to ascertain the pathogenesis of the associated vascular lesion. The first patient was a 9-year-old girl, who developed drowsiness with a headache during the medical treatment for acute myelocytic leukemia. CT disclosed subarachnoid and intraventricular hemorrhage. The autopsy revealed that the aspergillus arteritis was the cause of repeated hemorrhage. The second patient was a 15-year-old boy with allergic purpura and renal failure, who suddenly developed a stupor with convulsive seizure. CT disclosed an intracerebral hemorrhage in the right parieto-occipital area. The patient gradually deteriorated and died in spite of the surgical removal of the hematoma. The autopsy revealed that the hemorrhage was caused by the aspergillus arteritis. Cerebral aspergillosis has two routes of infection to the central nervous system: hematogenous dissemination from the distant site (usually the lung) and direct extension from the contiguous site (usually the paranasal sinuses or orbit). The primary mechanism of neuropathology is different between these two types. Primary cerebral arteritis is most often seen in patients with the former type, whereas primary basal meningitis occurs in the latter. The incidence of clinico-pathological features is different between hematogenous dissemination type and direct extension type.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- S Matsumura
- Neurosurgery Service, National Sapporo Hospital, Sapporo, Japan
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34
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Abstract
It was reported that unsaturated long chain fatty acids, such as arachidonic acid, oleic acid and docosahexaenoic acid inhibit the binding between progesterone and estrogen receptors and steroid hormones. Most of the long chain fatty acids are contained in phospholipids within the cells. The effect of phospholipids on the binding between R5020 and progesterone receptors was studied. Phosphatidyl ethanolamine and sphingomyelin had no effect on binding, but phosphatidyl inositol and phosphatidyl serine inhibited the binding 53% and 34% respectively. The effect of phosphatidyl inositol on the binding between R5020 and progesterone receptors was dose dependent. Scatchard analysis revealed that the addition of phospholipid markedly decreased the number of binding sites from 1398 fmol/mgp to 258 fmol/mgp, but the dissociation constant was little affected.
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Affiliation(s)
- N Mitsuhashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan
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35
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Abstract
Unsaturated long chain fatty acids are known to inhibit the binding between estrogen and estrogen receptor, or progesterone and progesterone receptor in rat uterus. The effects of long chain fatty acids on the binding between androgen receptor of castrated rat prostate and 3H-R1881 were studied. The binding was not affected by saturated fatty acids such as palmitic acid (16:0) or stearic acid (18:0). But unsaturated fatty acids such as oleic acid (18:1), arachidonic acid (20:4) and docosahexaenoic acid (22:6) inhibited the binding between androgen receptor and 3H-R1881. The inhibitory effect of arachidonic acid was dose dependent. Scatchard analysis showed that the addition of arachidonic acid markedly decrease the number of binding sites of androgen receptor. But the dissociation constant was not affected. The inhibitory effect of arachidonic was not a competitive one.
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Affiliation(s)
- N Mitsuhashi
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, Japan
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36
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Ezaki H, Ohkawa S, Miyagawa A, Ueda K, Sugiura M. A histopathologic study of the conduction system in an elderly patient with partial atrial standstill. Jpn Heart J 1987; 28:933-40. [PMID: 3444042 DOI: 10.1536/ihj.28.933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Electrophysiologic and histopathologic studies were performed on an 83-year-old man with partial atrial standstill. In the electrophysiologic study, no atrial electrical activity was recorded in the right atrium, but f waves were seen in the coronary sinus electrogram. Although the high right atrium and the atrial septum could not be activated by electrical stimuli of up to 10 V, the low atrium could be stimulated. The pathologic examination showed that there was extensive fatty infiltration into the sinus node and fibrosis in the atrial muscle. In the low right atrium, the musculature was partially preserved.
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Affiliation(s)
- H Ezaki
- Division of Cardiology, Tokyo Metropolitan Geriatric Hospital, Japan
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37
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Ohkawa S, Sugiura M, Sakai M, Miyagawa A, Imai T, Watanabe C, Matsushita S, Ueda K, Kuramoto K. [Mitral regurgitation due to ruptured chordae tendineae in the aged: a clinicopathologic study]. J Cardiol 1987; 17:507-19. [PMID: 3453847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We observed 13 cases of mitral regurgitation (MR) due to ruptured chordae tendineae (RCT) among 4,000 consecutive autopsies of patients over 60 years of age (0.33%). There were four men and nine women whose average age was 79.8 yrs. Five cases had a single RCT (Group I) and eight had multiple RCT (from two to eight chordae) (Group II). The sites of RCT were in the posterior mitral leaflet (PML) in nine, the anterior leaflet in one, and both in three. All in Group I showed RCT in the PML; the posterior scallop in two and the middle scallop in three. The average heart weight was 340 g in Group I and 431 g in Group II. Sclerosis of the coronary arteries, the circumference of the mitral valve ring, and thickness of the leaflets did not differ significantly. Estimated volume of the left atrium was significantly greater in Group II than in Group I (185 ml vs 57 ml, p less than 0.05). Jet lesions were observed in 10 of the 13 cases. The etiologies of RCT were previous endocarditis in two, mitral valve prolapse in three, and spontaneous rupture in eight. Congestive heart failure was observed in three (60%) in Group I and eight (100%) in Group II (p less than 0.01). Cardiothoracic ratio more than 60% was observed in three (60%) of Group I and six (75%) of Group II. Atrial fibrillation was demonstrated in one in Group I (20%) and six (75%) in Group II (p less than 0.05), and cardiac death in one (20%) in Group I and six (75%) in Group II (p less than 0.05). Phonocardiograms showed pansystolic murmur in all cases, third heart sound in nine (69%), and fourth heart sound in four (57%). Echocardiographically, RCT was diagnosed in six of nine cases (67%). In conclusion, patients with RCT involving more than two chordae tendineae can show more severe clinical course than cases with a single RCT.
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Affiliation(s)
- S Ohkawa
- Division of Cardiology, Tokyo Metropolitan Geriatric Hospital
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38
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Ubayama Y, Gotoh M, Yamawaki S, Isu K, Miyagawa A, Yamashiro K, Ishikawa E, Shimoda T. [A case report of malignant schwannoma originating from the bone]. Gan No Rinsho 1987; 33:988-92. [PMID: 3613120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
While malignant schwannoma is encountered frequently as soft tissue sarcomas, it rarely is found to originate in the bone. We have had a case of malignant schwannoma originating from the tibia of a 47-year-old man. He died from uremia, that resulted from lung, spinal vertebral body, and lymph nodes metastases, despite surgical treatment and chemotherapy. In cases of rare bone tumors, the clinical diagnosis of tumoral manifestations originating in the bone is more important than the histopathological diagnosis.
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Yamaguchi H, Isu K, Ubayama Y, Yamawaki S, Gotoh M, Miyagawa A, Minami A, Matsuno T, Sasaki T, Nojima T. Clear cell chondrosarcoma. A report of two cases and review of literature. Acta Pathol Jpn 1986; 36:1577-85. [PMID: 3541492 DOI: 10.1111/j.1440-1827.1986.tb02829.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Two cases of clear cell chondrosarcoma located in the distal femur and proximal humerus are reported. Both patients were men aged 35 and 51 years. Their initial symptom was a pathologic fracture. Roentgenographically, one patient showed a purely lytic lesion and another lytic with centrally radiodensity. Microscopic examination revealed that the tumor cells have a centrally placed vesicular nucleus surrounded by a clear cytoplasm, with distinct boundaries. Their cytoplasm stained with S-100 protein by the peroxidase-antiperoxidase method. We found 36 reported cases (including the two reported here), and delineated the clinico-pathologic characteristics of the disease.
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Matsui R, Sugiura M, Ohkawa S, Miyagawa A, Imai T, Ohgawara S, Matsushita S, Ueda K, Shimada H. [Clinicopathological study of cardiac amyloidosis in the aged]. Nihon Ronen Igakkai Zasshi 1985; 22:437-49. [PMID: 4079104 DOI: 10.3143/geriatrics.22.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Takahashi T, Ohkawa S, Sugiura M, Miyagawa A, Sakai M, Kamata C, Matsushita S, Ueda K, Kuramoto K, Takenaka K. [A clinicopathologic study of valvular aortic stenosis in the aged]. J Cardiogr 1984; 14:493-505. [PMID: 6536681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
To evaluate the usefulness of phonocardiography (PCG), carotid pulse recording (CAG) and echocardiography (UCG) used in diagnosing valvular aortic stenosis (AS) in the aged, we performed a clinicopathologic study of 23 autopsied patients with pathological evidence of aortic stenosis (AS). There were eight men and 15 women, whose ages averaged 82 years. PCG and CAG were available in 15 patients, and UCG was available in 13 patients. We classified the subjects into three groups; Group A with calcified AS, Group B with bicuspid AS and Group C with rheumatic AS. The following results were obtained. There were 12 patients in Group A, four in Group B and seven in Group C. Patients in Group A were older than those in Group B or C (A; 84-year-old, B; 80-year-old, C; 79-year-old on the average). The mean heart weight of Group A was less than that of Group B or C (A; 345 g, B; 453 g, C; 486 g). Congestive heart failure was more frequent in Groups B and C than in Group A. The fourth heart sound was recorded on the PCG in nine of 11 patients without atrial fibrillation, but there was no difference in incidence among the three groups. An ejection systolic murmur was recorded in all cases and a diastolic murmur of aortic regurgitation in 10. No patients had shudder formation on the CAG. The T-time tended to be prolonged in AS, especially in Groups B and C. The peak of the systolic murmur tended to be late in systole in Groups B and C. A1-peak/LVET was significantly increased in Groups B and C (A; 0.38, B; 0.51, C; 0.47). The decreased amplitude of aortic valvular opening (AVO) and the dense diastolic echo of the aortic valve were observed in all AS cases. The AVO of Group A was significantly less in amplitude than that of Group C (A; 3.6, C; 6.4). Thus, we could differentiate Group A from Groups B and C by various non-invasive techniques. These findings may be attributed to the different anatomic features of the aortic valves among these three groups.
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Shimoda T, Yamashita H, Furusato M, Kirino Y, Ishikawa E, Miyagawa A, Ubayama Y. A light and electron microscopic study with comments on their relation to malignant fibrous histiocytoma and angiosarcoma. Acta Pathol Jpn 1980; 30:779-97. [PMID: 6255738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Analysis of 365 cases of malignant soft tissue tumors revealed 83 cases of liposarcoma. The ages of the patients were distributed between 18 and 86 years with a mean average of 54.3 years. Approximately 50% of the cases were located in the lower extremity. Histologically, they consisted of 5 types; well differentiated (17 cases), myxoid (49 cases), round cell (3 cases), pleomorphic (11 cases), and mixed (3 cases). The appearance of lipoblasts of either the signet-ring type or mulberry (multivacuolated) type with displaced nuclei was the common characteristic feature for all types. Electron microscopically, lipid droplets were found inside of endoplasmic reticulum in lipoblasts, and abundant glycogen granules were seen in the cells containing only few lipid droplets. The lipoblasts were usually located close to the vascular wall in the interstitium, and findings suggesting an intimate relation between pericytes and lipoblasts were encountered. Although the differential diagnosis of malignant fibrous histiocytoma and liposarcoma was made possible by the appearance of lipoblasts in the latter, storiform pattern and histiocyte-like cells sometimes appeared in poorly differentiated liposarcoma. This tendency was also found in angiosarcoma. A close follow-up of recurrent cases revealed that there are actually cases of liposarcoma with malignant fibrous histiocytoma-like pattern and angiosarcoma with malignant fibrous histiocytoma-like pattern. It was considered that malignant fibrous histiocytoma-like figures can appear in various poorly differentiated sarcomas.
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Abstract
A direct spectrophotometric suspension method for the estimation of immobilized ligands on a gel matrix was developed. The method uses 0.05% agarose solution to prepare a practically stable suspension of various agarose beads. The quantity of agarose beads in the suspension was estimated turbidometrically from the attenuance at 650 nm. The determination of immobilized ligands on agarose beads was performed colorimetrically at the wavelength of the absorption maximum against a control suspension of a similar amount of underivatized agarose beads. This method is more sensitive and simpler than previously known methods. The method is applicable to the estimation of absorption spectra and the measurement of the time course of reactions on agarose beads.
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Naito H, Miyagawa A, Fujita M, Takahashi T, Sasaki M. [P.B.C. (primary biliary cirrhosis)--an autopsy case]. Hokkaido Igaku Zasshi 1975; 50:522-5. [PMID: 1240850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Watanabe J, Furukawa T, Ooka K, Miyagawa A, Okitsu J. [Clinical use of indomethacin on lower 3rd molar extractions]. Shikwa Gakuho 1968; 68:849-51. [PMID: 4881556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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