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Biomedical subjects

H Baba

Publications and source records attributed to H Baba.

At least 379 records · Page 21Linked to original sources

[A case of leiomyoblastoma of the jejunum].

Reported is a submucosal tumor of the jejunum that had developed in a 46-year-old man who manifested general fatigue and anemia. The tumor measured 3.0 x 3.0 cm and was composed of polygonal and/or round cells with a clear zone surrounding the nucleus. Five mitotic figures per 50-power fields were present. The light microscopic appearance was consistent with those of a Leiomyoblastoma. Follow-up evaluations approximately 2 years after the resection showed no evidence of metastasis or recurrence.

Humans↗

[A case of primary hypothalamic malignant lymphoma with diabetes insipidus].

A case of primary malignant lymphoma involving the hypothalamus is reported. A 31-year-old man was admitted with progressive disorientation. A computed tomography (CT) scan demonstrated a normodense, homogenously enhanced, and nodular shaped mass lesion involving the suprasellar region and extending to the third ventricle. In view of marked cerebral edema, dexamethasone was intravenously administered, at a dose of 4 mg/4 hr, and gradually tapered off. CT scans obtained 10 days after the admission revealed dramatic regression of the lesion, which corresponded with the clinical remission. However, on the 4th day after the discontinuance of corticosteroid, a CT scan demonstrated the recurrence of the mass lesion. Because of the rapid deterioration of consciousness and the progressive enlargement of the mass and dilatation of the ventricles, partial removal of tumor and ventricular drainage were carried out on the 24th day after admission. Dexamethasone was intravenously administered again at a dose of 4 mg/4 hr. A CT scan obtained five days after the operation showed complete disappearance of the lesion, and the patient had became almost alert. CT scans obtained on the 18th day and the 35th day after the operation showed complete disappearance of the mass. However, Magnetic Resonance Imaging revealed a localized area of abnormal signal intensity in the hypothalamus. Diabetes insipidus was continuously observed from the time of admission. A concomitant change of beta-2-microglobulin (beta-2-MG) and immunoglobulin (IgA, IgG, IgM) concentrations in serum and cerebrospinal fluid (CSF) with clinical profiles and CT findings were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Eighteen-year survival of unresected leiomyoblastoma of the stomach with liver and lymph node metastases.

A case of gastric leiomyoblastoma with liver and lymph node metastases occurring in a 31-year-old man, who has been alive with the tumor but without symptoms for more than 18 years after only an exploratory laparotomy without resection, is reported. On laparotomy, the liver metastasis and paragastric and para-aortic lymphadenopathies made it impossible to resect the stomach with the tumor. A diagnosis of malignant leiomyoblastoma was confirmed by incision of the liver and paragastric lymph nodes. Postoperative chemotherapy with mitomycin C and cyclophosphamide was performed for 6 months. As demonstrated by roentgenography, echography and computed tomography, the size of the tumor has remained almost identical for an 18-year period. Histologically, the low mitotic rate of the tumor in this case is considered primarily responsible for the long survival of the patient. A review of the records has revealed that our patient is the longest survivor to have unresectable gastric leiomyoblastoma with liver and lymph nodes metastases.

Adult↗

Thoracoabdominal approach for cure of patients with an adenocarcinoma in the upper third of the stomach.

In 134 patients with an adenocarcinoma in the upper third of the stomach and involving the lower esophagus, the authors retrospectively assessed the significance of a thoracoabdominal approach (TAA). Nineteen (48.7%) of 39 with TAA had major postoperative complications, while 25 (26.3%) of 95 with the abdominal approach (AA) had similar complications (P less than 0.02). The most frequent complication was anastomotic leakage. In the case of TAA, seven (18.0%) experienced this, and nine (9.5%) did so after AA. However, deaths resulting from complications were few for both TAA (five, or 12.8% and AA nine, or 9.5%). There was one (2.6%) patient with histologically positive cancer cells at the proximal stump of the resected specimen in patients with TAA, while there were seven (7.7%) such patients with AA. In the histologically curative cases without palliative factors, patients with TAA had a significantly better prognosis than did those with AA (P less than 0.05). In the histologically noncurative cases and in cases with palliative factors, the prognosis was poor for both TAA and AA patients. These results suggest that the surgeon should perform the TAA in order to obtain tumor-free margins at the proximal stump and a better prognosis in patients without palliative factors, while the surgeon need not consider doing the TAA in patients with palliative factors.

Adenocarcinoma↗

[New quantitative parameters for CT evaluation of orbitopathy in dysthyroid ophthalmopathy].

The new index (c/o ratio) is defined as the content of the orbit divided by the capacity of the bony orbit on the mid-orbital axial CT slice showing the medial and the lateral rectus muscles and optic nerve. Other quantitative parameters such as for exophthalmos and the capacity of bony orbit were also obtained on CT films. These parameters were measured in 474 eyes of patients with dysthyroid ophthalmopathy. The capacity of bony orbit showed large variations among all patients. The average for males was 17.8cm3 and that for females was 16.1cm3. Exophthalmos measurement on CT is more reliable than that by the Hertel exophthalmometer. The new index (c/o ratio) is a very reliable parameter for evaluating orbitopathy in dysthyroid ophthalmopathy. A large c/o ratio (greater than 1.6) was of clinical significance, because approximately 70% of the enlargement of the extraocular muscle observed in older patients (greater than 40 yrs old) was associated with a large c/o ratio (greater than 1.6).

Adolescent↗

[Reversibility of glaucomatous defects of the central visual field].

We analyzed more than 4 consecutive measurements of the central area of the visual field in 1,004 eyes of 533 subjects with various types of glaucoma as diagnosed by the Octopus 201 and its examination program No. 31. We used a non-repeated analysis of variance to determine the statistical relationship between the mean sensitivity measurements for individual quadrants of the central visual field. We made the series of measurements used in this statistical analysis during repeated examinations that took place over a follow-up period of 1 year. Out of 1,004 eyes, 53 eyes (5.3%) were shown to have an improved mean sensitivity of the central 30 degrees of the visual field. We adopted the degree of sensitivity improvement [(final mean sensitivity - initial mean sensitivity)/follow-up period] as the indicator of the degree of reversibility in the central visual field to determine which factors might influence changes in the visual field. In patients under 50 years of age, who were at an early stage of the disease, as opposed to those over 50 years of age, who were at an intermediate or advanced stage of this disease or who had undergone reduction of intraocular pressure, a relatively high degree of sensitivity improvement was more frequently observed. In the cases with primary open angle glaucoma which includes low tension glaucoma, we think treatment for abnormality in the aqueous humor dynamics is very important. We concluded, that the reversibility of the central visual field defect in glaucomatous eyes is possible, though it can only be clearly detected by careful follow-up examinations employing computerized perimetry.

Female↗

Premotor cortical kindling interferes with subsequent hippocampal kindling.

Interaction between the neocortical motor system and the limbic system was investigated in terms of the transfer of kindling. Premotor cortical kindling induced limbic seizures accompanied by dissociated hippocampal afterdischarges (AD) which outlasted the premotor AD. Subsequent kindling of the hippocampus was markedly retarded despite prolonged hippocampal AD. These results suggest that premotor cortical kindling induces a neuronal mechanism which prevents limbic access to the motor system.

Animals↗

DNA ploidy is closely linked to tumor invasion, lymph node metastasis, and prognosis in clinical gastric cancer.

DNA ploidy microspectrophotometrically determined in 254 patients with gastric carcinoma was investigated from the standpoint of tumor invasion, lymph node metastasis, and prognosis. DNA distribution patterns were grouped into low and high ploidies. The 24.0% frequency in the high ploidy group, at the mucosal stage, increased in proportion to invasion into the deeper layers. There was a high incidence of lymph node metastasis in the high ploidy group, compared with the low ploidy group, in case of invasion beyond the mucosa. Widespread nodal involvement was frequent in the high ploidy group. The 5-year survival rate was 73.7% in patients of high ploidy, with a statistical difference compared to the 90.6% in those of low ploidy (P less than 0.01). In the multivariate analysis of 226 patients undergoing curative surgery, the DNA ploidy proved to be a major independent prognostic factor. These findings indicate a close correlation among DNA ploidy, tumor invasion and nodal involvement, and the significant clinical value of DNA analysis for predicting the prognosis in patients with gastric carcinoma.

Aged↗

Endoscopic intratumoral injection of OK-432 and Langerhans' cells in patients with gastric carcinoma.

OK-432, a compound composed of penicillin-G-treated, attenuated Streptococcus pyogenes of human origin, was administered by intratumoral injection (IT) to 15 of 49 patients with Stage III gastric carcinoma, at the time of preoperative endoscopic examination. The 5-year survival rate of patients given IT was 73.3%, whereas the rate was only 36.5% in those not given IT (P less than 0.05). A study of recurrent cases revealed a significantly low incidence of peritoneal recurrence in the group on OK-432 IT (P less than 0.01). In previous work, the authors noted a favorable prognosis of patients with Stage III gastric carcinoma and with a marked infiltration of Langerhans' cells (LC) in the tumor tissues. All of the 49 in the current study were thus examined immunohistochemically, using anti-S-100 protein antibody, the objective being to clarify the relationship between OK-432 IT and the density of LC. The density of LC among those given IT was significantly increased as compared with those not given IT (P less than 0.05). The results of this study suggest that OK-432 IT may lead to augmentation of the density of LC in tumor tissues and hence prevent peritoneal recurrences in patients with Stage III gastric carcinoma.

Adenocarcinoma↗

A treatable multifocal motor neuropathy with antibodies to GM1 ganglioside.

We report 2 patients with a treatable, immune-mediated motor polyneuropathy associated with antibodies to defined neural antigens. In these patients asymmetrical weakness developed in one arm and progressed over 2 to 3 years to involve the other arm, legs, and trunk. Both patients were initially diagnosed as having lower motor neuron forms of amyotrophic lateral sclerosis. However, repeated electrophysiological testing eventually showed multifocal conduction blocks in motor but not sensory fibers compatible with patchy selective demyelination. Serum testing by thin-layer chromatography and enzyme-linked immunosorbent assay revealed that both patients had high titers of antibody directed against GM1 and other gangliosides. Initial therapeutic trials of prednisone (100 mg daily for 4 to 6 months) and plasmapheresis were unsuccessful. Treatment with cyclophosphamide, however, was followed by marked improvement in strength in both patients.

Adult↗

Results of resection of gastric cancer extending to adjacent organs.

We report the late results of resection in 281 patients with gastric carcinoma extending to adjacent organs. In 92 without incurable factors (peritoneal dissemination, liver metastasis and widespread nodal involvement) the 5-year survival rate was 36.7 per cent in those treated by gastrectomy and complete removal of the invaded organ. This value is significantly higher than the 17.4 per cent recorded in those undergoing gastrectomy alone or with incomplete removal of the invaded organs (P less than 0.05). In 189 patients with incurable factors, the 5-year survival rates were 5.4 and 2.8 per cent respectively in cases of complete and incomplete excisions. This tendency was similar in patients with a single invaded organ and also in those with plural organ involvement. In potentially curable patients treated by complete excision, the probability of long-term survival was statistically better than that following incomplete excision only when the pancreas was involved (P less than 0.05). We recommend complete excision of invaded organs, irrespective of the number or site of organs involved, provided that there is no evidence of incurable factors.

Colonic Neoplasms↗

Cervical laminoplasty to enlarge the spinal canal in multilevel ossification of the posterior longitudinal ligament with myelopathy.

We studied 23 patients with severe myeloradiculopathy involving multiple (more than three) levels of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, who were treated with laminoplasty to enlarge the spinal canal. The resected spinous processes were used as bone grafts to support the opened laminae. These patients were analyzed pre- and postoperatively with a neurological evaluation according to the Japanese Orthopedic Association (JOA) score system for cervical myelopathy. Follow-up was from 2.0 to 5.3 years with an average of 31.5 months. The results were compared with those in 31 patients with the same degree (multilevel) of OPLL who had been operated upon previously by laminectomy (14 cases) or anterior resection (17 cases). Postoperative neurological recovery by improvement ratio of the JOA score was observed in 81.2% of those who had undergone expansive laminoplasty, in 72.4% of those with laminectomy, and in 63.6% of those with anterior decompression. We concluded that expansive laminoplasty is a safer procedure with fewer complications. Stability is achieved by fixing the expanded laminae permanently with a bone graft. The neurological recovery following our technique of laminoplasty and fusion appears to be superior to that with laminectomy or anterior decompression.

Adult↗

Suppressive effect of camostat mesilate (FOY 305) on acute experimental allergic encephalomyelitis (EAE).

Camostat mesilate (FOY305), a synthetic serine protease inhibitor and has been developed as a drug for pancreatitis, is effective in suppressing acute experimental allergic encephalomyelitis in Lewis rats. Loss of weight, clinical score and yield of myelin protein from brain stem were improved by daily injection of FOY305 compared with saline from day 6 after inoculation with homogenate of guinea pig spinal cord. A significant decrease of yield of myelin has been shown here for the first time in acute EAE in Lewis rat. This is in accord with myelin breakdown demonstrated morphologically. Our study also demonstrates a significant improvement of yield of myelin protein by FOY305. Our results suggest the possibility of a clinical application of this protease inhibitor for human demyelinating diseases such as multiple sclerosis.

Animals↗

Lymphadenectomy for cure in patients with early gastric cancer and lymph node metastasis.

The anatomic distribution, size, and histologic mode of involvement of 98 metastatic lymph nodes in 49 of 370 patients were examined to determine to what extent lymphadenectomy should be performed in addition to gastrectomy in patients with early gastric cancer. Nodal involvement in the marginal sinus (30 nodes) and partial medullary sinus (37 nodes) were commonly seen, and the lymph nodes of those types were enlarged compared with 1,086 patients with no metastatic lymph nodes (control group). Lymph nodes of the wide medullary sinus (11 nodes), small nodule (3 nodes), and massive involvement types (17 nodes) did not enlarge compared with those of the other types and those of the control group. Most of the metastatic sites (76.6 percent) were in the perigastric lymph nodes along the lesser and greater curvatures, about a fifth were in the extraperigastric nodes along the left gastric, common hepatic, celiac, and splenic arteries, and the least were in the extraperigastric nodes (3.1 percent) along the hepatoduodenal ligament. Since the rate of macroscopic diagnosis during operation was so poor, regardless of the histologic modes of nodal involvement, and also in cases of metastatic lymph nodes less than 15 mm in widest diameter, for curative operation of patients with early gastric cancer, perigastric and extraperigastric lymph nodes along the main arteries near the stomach should be completely dissected, in addition to resection of the stomach.

Adenocarcinoma↗

IgM binding to sialosyllactosaminylparagloboside in a patient with polyradiculoneuropathy due to Mycoplasma pneumoniae infection.

IgM in serum without paraprotein in a patient with polyradiculoneuropathy due to a Mycoplasma pneumoniae infection reacted specifically with a ganglioside, sialosyllactosaminylparagroboside (SLPG), in a human peripheral nerve on a thin-layer chromatogram plate by an immunostaining technique. This finding suggests the possibility that anti-SLPG antibody in the patient's serum may play a role in the pathogenesis of neuropathy.

Female↗

Ultrastructural visualization of selective peanut agglutinin binding sites in rat osteoclasts.

We investigated the distribution of concanavalin A (ConA)-reactive alpha-D-mannosyl and alpha-D-glucosyl groups and peanut agglutinin (PNA)-reactive beta-D-galactose-(1----3)-N-acetyl-D-galactosamine residues on the surface of osteoclasts with pre-embedment ultrastructural lectin cytochemistry after aldehyde fixation of the metaphyses of the rat tibiae. By routine morphology, the plasma membrane of the ruffled border of the osteoclast was distinguished from the rest of the cell membrane, with the exception of the membrane of coated pits, by its characteristic thick coat at its cytoplasmic surface. Cytochemistry, using ConA in combination with horseradish peroxidase (ConA-HRP) and PNA conjugated to HRP, showed that binding of ConA was distributed over the entire cell surface of osteoclasts. In contrast, intense binding of PNA was limited to the membranes of the ruffled border and coated pits, whereas the remainder of the cell membrane stained weakly or not at all. These results demonstrate that preferential PNA binding sites of the cell surface correspond to coated membranes associated with osteoclastic endocytosis.

Animals↗

Partial purification and properties of neutral PTHase from the cytosolic fraction of rat renal cortex.

A possible new enzyme, a cytosolic neutral PTH-degrading enzyme previously described by us, was purified by ammonium sulfate fractionation, Sephadex G-200 column chromatography and DEAE cellulose column chromatography from the 100,000 x g supernatant of rat kidney. Three active peaks (designated P-I, P-II and P-III) were obtained through a DEAE cellulose chromatographic column. These three activity peaks were interchangeable on rechromatography. Further characterization of the major P-II fraction was attempted. When PTH was used as the substrate, this enzyme preparation (P-II) was inhibited by Ca2+, ATP and glutathione (GSH), but not by trypsin inhibitor, PMSF, E-64, leupeptin, chymostatin or pepstatin. This enzyme preparation could hardly hydrolyze several synthetic analogs containing MCA but not Leu-MCA and Z-Phe-Arg-MCA. When Z-Phe-Arg-MCA was used as the substrate, this enzyme preparation was activated by ATP and GSH, while no activation was induced when PTH was used. These results indicate that the neutral PTH-degrading enzyme seems to represent a new PTHase capable of specifically splitting PTH at certain locations.

Animals↗