[Clinical experience of iotrolan].
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Adult↗
Biomedical subjects
H Handa
Publications and source records attributed to H Handa.
[Treatment of occlusive cerebrovascular disease with a selective thromboxane A2 synthetase inhibitor].
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Acrylates↗
Temporal changes of suppressor T lymphocytes and cytotoxic T lymphocytes in syngeneic murine malignant gliomas.
The temporal activities of suppressor T lymphocytes (Ts) and cytotoxic T lymphocytes (CTL) were investigated in a syngeneic murine malignant glioma (a methylcholanthrene-induced ependymoblastoma of C57BL/6 mouse origin, 203-glioma). After the s.c. tumor inoculation, it was suggested that both Ts and CTL were generated with target specificity against 203-glioma cells, because neither Ts nor CTL activity were seen against syngeneic EL 4 (benzpyrene-induced thymoma), allogeneic P815 (methylcholanthrene-induced mastocytoma of DBA/2 mouse origin) or YAC-1 (Moloney leukemia-induced T-cell lymphoma of A/Sn mouse origin), but only against 203-glioma. It was found that the generation of Ts preceded that of CTL and that the turnover was faster; furthermore, Ts were generated in the thymus and spleen, while CTL were distributed in regional lymph nodes and spleen. Surface marker analysis revealed that only Lyt-1-.2.3+ T-cells participated in suppressor responses in contrast to both Lyt-1-.2.3+ and Lyt-1+.2.3+ T-cells participating in cytotoxic responses. The effects of adult thymectomy (ATx) on the changes of the immunized T-cell subsets were also investigated. In mice thymectomized 3 weeks previously, the Ts activity was abrogated, whereas the CTL activity increased markedly and Lyt-1+.2.3+ T-cells were not detected. The results suggest that CTL or their precursors bearing Lyt-1+.2.3+ phenotype and Ts bearing Lyt-1-.2.3+ phenotype are short-lived lymphocytes. Accordingly, it is suggested that in tumor-bearing mice short-lived Ts are generated earliest with target specificity and, due to the reciprocal relationships between Ts and CTL activities, may have a modulating influence on CTL; furthermore, ATx may alter the patterns of generation of the precursor T-cells and Ts.
Animals↗
Sympathetic denervation and alpha adrenoceptors in dog cerebral arteries.
The magnitude of the noradrenaline-induced contractions of dog middle cerebral arteries was less than that seen in the vertebral, common carotid, femoral and renal arteries. Noradrenaline and clonidine produced a similar magnitude of maximum contractions in the middle cerebral arteries, whereas methoxamine produced no significant contractions in the same arteries. In the extracranial arteries, noradrenaline and methoxamine produced significantly larger contractions than clonidine. Binding studies revealed no specific 3H-prazosin binding sites in the cerebral arteries, though such binding sites were evident in the case of extracranial arteries. 3H-Yohimbine binding studies revealed the presence of two classes of binding sites with high and low affinities in both cerebral and extracranial arteries. After superior cervical ganglionectomy, noradrenaline- and clonidine-induced contractions of the denervated middle cerebral arteries were not altered, compared with the control arteries. A 3H-yohimbine binding study was also performed using the denervated cerebral arteries. This study revealed that there was a low affinity 3H-yohimbine binding site, whereas high affinity 3H-yohimbine binding site was not detectable. These results suggest the presence of two different binding sites with high and low affinity for alpha 2 adrenoceptors, which we are classifying into alpha 2H and alpha 2L subtypes. The high affinity sites, alpha 2H adrenoceptors, are presynaptically located while the low affinity sites, alpha 2L adrenoceptors, located postsynaptically. The noradrenaline-induced contractions are probably mediated by postsynaptic low affinity sites of alpha 2 adrenoceptors (alpha 2L adrenoceptors) in the cerebral arteries and mainly by alpha 1 adrenoceptors in the extracranial arteries.
Animals↗
Brainstem glioma: an analysis of 85 cases.
The study analyses 85 cases of brainstem glioma in the past 35 years, 69 of which include patients under 16 years of age. The incidence of brainstem glioma was 2.4% of all intracranial tumours, and 9.4% of intracranial tumours in children. There were two peaks in age distribution, in the first and in the fourth decades. In children, the tumours were located mainly in the pons, so VIth and VIIth cranial nerve palsies, and pyramidal and cerebellar signs were frequently seen. In adult cases, the tumours ranged in location from the midbrain to the medulla, so neurological symptoms caused by lesions of the whole brainstem axis were seen. The left side was dominant in both age groups. The choice of treatment was steroid administration and radiation. Chemotherapy was not effective. Even after these treatments, the median survival period from onset was no longer than 10.5 months. We conclude that the treatment of brainstem gliomas in children should be distinguished from adult cases, which in the latter may be considered to be merely one of the gliomas which may occur at any other sites. Since brainstem gliomas in children may be congenital, we must redirect our treatment of these lesions to treatment of congenital tumours.
Adolescent↗
Induction of human glioma-specific cytotoxic T-lymphocyte lines by autologous tumor stimulation and interleukin 2.
Two human glioma-specific cytotoxic T-lymphocyte (G-S-CTL) lines were established by autologous tumor stimulation (ATS) with the aid of lectin free interleukin 2 (IL 2). Coculture of patient's peripheral blood lymphocytes and autologous irradiated glioma cells and subsequent addition of partially purified IL 2 enhanced the tumoricidal activity of the lymphocytes. These CTL lines possessed cross-cytotoxic activity against autologous allogeneic glioma cells and exhibited low cytotoxic activity against non-glial tumor cells. They did not lyse autologous lymphoblasts. This phenomenon suggested the existence of a common glioma-specific antigen recognized by the CTL lines. T-cell subset depletion test revealed that the major surface phenotype of G-S-CTL line, responsible for cytotoxic activity was OKT 3 positive, OKT 4 negative and OKT 8 positive. G-S-CTL lines were composed of a low proportion of OKT 8 positive subpopulation after primary ATS and successive propagation with IL 2. The proportion of OKT 8 positive subpopulation was increased by secondary ATS, which enhanced the cytotoxic activity to glioma cells more effectively.
Adult↗
Long-term follow-up of large or invasive pituitary adenomas.
A long-term follow-up study of pituitary adenomas showed that 60 out of 83 patients with mild or moderate suprasellar extension, but only three out of 19 patients with huge or invasive adenomas, were alive at a mean post-operative period of 12.8 and 12 years, respectively. Cerebral ischemic attacks and complications of radiotherapy affected their fate and quality of survival. Patients in the post-computed tomography scan era had a good prognosis, and this may be due partly to the brevity of the postoperative period.
Adenoma↗
Suprasellar germinoma with shunt metastasis: report of a case with an immunohistochemical characterization of the lymphocyte subpopulations.
A case of suprasellar germinoma metastatic to the peritoneum 3 years after the placement of a ventriculoperitoneal shunt is presented. The excised metastatic germinoma was analyzed immunohistochemically with monoclonal antibodies against human lymphocyte subpopulations. Approximately 80% of the lymphocytes expressed pan-T, or Leu-1, surface antigens, and 20% were B1+, or B cells. Approximately 30% of T cells were Leu-2+, or cytotoxic and suppressor cells; 70% were Leu-3+, or helper cells. The large number of T cells is consistent with their role in cell-mediated immunity; their subpopulation ratio approximated that of the circulation. The literature pertinent to germinoma shunt metastasis is also reviewed.
Adolescent↗
Ruptured cerebral aneurysms in patients with systemic lupus erythematosus.
Two cases of ruptured aneurysms in the cerebral arteries in patients with established systemic lupus erythematosus are presented. A 32-year-old woman with a 3-year history of systemic lupus erythematosus was found to have a ruptured cerebral aneurysm at the top of the basilar artery. Another 38-year-old woman with a 4-year history of lupus erythematosus had a ruptured aneurysm in the anterior communicating artery. Both were treated surgically. Cerebral aneurysms associated with systemic lupus erythematosus are reviewed in the literature and the pathogenesis of these aneurysms is discussed.
Adult↗
Mitogenic activity of the adenovirus type 12 E1A gene induced by hormones in rat cells.
Several lines of rat 3Y1 cells in which expression of the adenovirus type 12 E1A gene can be regulated by dexamethasone were established by introduction of recombinant vector DNA containing the adenovirus type 12 E1A gene placed downstream of the hormone-inducible promoter of mouse mammary tumor virus. These cell lines (gMA cells) produced low basal levels of the E1A transcripts and proteins in normal medium and much higher levels upon addition of dexamethasone to the medium. When dexamethasone was added to density-arrested cells, DNA synthesis was induced in 10 to 40% of the cells, the percentage depending on the cell line. DNA synthesis was increased to up to 60% of the cell population by further addition of epidermal growth factor. Indirect immunofluorescence detection of E1A proteins in gMA cells treated with dexamethasone indicated that the intensity of fluorescence in cells varied and that the proportion of cells synthesizing DNA was correlated with the proportion that exhibited strong fluorescence. These results indicate that the E1A gene has a function to trigger the synthesis of cellular DNA.
Adenovirus Early Proteins↗
Thalamic tumours invading the brain stem produce crossed cerebellar diaschisis demonstrated by PET.
Two cases of thalamic tumour, spreading through the midbrain into the pons ventrolaterally, showed suppression of cerebellar blood flow on the opposite side to the tumour, and also showed reduction of blood flow in the pons on the side of the tumour in positron emission tomographic studies. The pathophysiological mechanism of crossed cerebellar diaschisis may be due to functional suppression of the pontine nuclei by destruction of descending fibres from the cerebral cortex.
Adult↗
Immunohistochemical analysis of infiltrating lymphocytes in central nervous system tumors.
To investigate cell-mediated immune responses to central nervous system tumors, we immunohistochemically analyzed 32 operative specimens, including 19 primary tumors, 5 recurrent tumors, and 8 metastases, for the presence of infiltrating T lymphocytes. In 1 patient, an additional sample of normal brain was studied. Using monoclonal antibodies against T lymphocyte surface markers with a peroxidase technique on frozen sections, we determined that a mild lymphocytic response was present in 3 of 7 primary glial tumors, 1 of 4 recurrent glial tumors, and in 3 of 9 primary meningiomas. The predominant subset was Leu 2, or suppressor/cytotoxic. In contrast, 5 of 7 intracranial metastatic tumors and 1 extracranial metastasis showed marked infiltration with an overall Leu 3, or helper/inducer, predominance. The remainder of the specimens, including 1 recurrent meningioma, 3 neurinomas, and the normal brain sample, were free of infiltrates. Permanent sections revealed an overall pattern of lymphocytic infiltration similar to that of frozen sections. Although additional studies such as electron microscopy are required to establish definitively the lymphocytic nature of the infiltrates, these results support the concept of the ability of the body to mount a cell-mediated response against central nervous system tumors and imply a differential response to primary and secondary tumors.
Adolescent↗
Glandular kallikrein, renin and tonin in tissues of diabetic and hypertensive rats.
The submaxillary gland and kidney of diabetic and hypertensive rats were compared for their content of glandular kallikrein and the activities of tonin and renin. The submaxillary glands and the kidneys of both diabetic Wistar strain and hypertensive rats contained significantly less glandular kallikrein than non-diabetic Wistar strain and hypertensive rats (reduction fron 40 to 76%). The renin activity of the kidney showed only a slight change in spite of diabetes, whereas the activity of the submaxillary gland decreased in parallel with the reduction of the kallikrein content when diabetes was induced. On the other hand, the tonin of the submaxillary gland, which has a potent hypertensive activity like renin, was not affected by induction of diabetes. However, the tonin activity in hypertensive rats was significantly higher (p less than 0.001) than that in the normotensive rats (His-Leu, 168.7 +/- 10.1 vs. 131.5 +/- 17.3 nmol/min X mg protein).
Animals↗
[Criteria for evaluating treatment regimens in patients with brain tumors].
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Brain↗
Transsphenoidal extracapsular approach to pituitary tumors.
Two years' experience with an extracapsular transsphenoidal approach to pituitary adenomas is presented. Some pituitary tumors contain an inordinate amount of connective tissue that often makes transsphenoidal resection difficult. By opening the tumor capsule and adjacent arachnoid membrane, such tumors with suprasellar extension can be safely removed. In some cases of functioning adenoma, resection of the diaphragma sellae and adjacent arachnoid membrane results in hormonal control. Among 62 cases of transsphenoidal surgery for pituitary adenomas, eight cases required this procedure. The surgical procedure is described and the cases are summarized. The indication and limitations of this procedure are discussed.
Adenoma↗
Effects of ACNU and radiotherapy on malignant glioma.
A randomized clinical study of irradiation and irradiation combined with ACNU in the treatment of malignant gliomas was performed in order to determine if there was an enhancing therapeutic effect of ACNU given in addition to radiotherapy. An effect was defined as a reduction in tumor size, changes in neurological signs and performance status within 1 month after the completion of radiotherapy, or statistically improved survival times. Seventy-seven patients from 14 neurosurgical clinics were included in this validated study group. Radiotherapy with a total dose of 5000 to 6000 rads, given in 25 to 30 subdoses, was applied to the whole brain and to a generous field surrounding the tumor. Patients who were assigned to receive chemotherapy were given ACNU intravenously once or twice during radiotherapy at a dose of 100 mg/sq m of body surface area. The response rate (more than 50% reduction of the tumor size) was 13.5% in the group treated by radiotherapy alone and 47.5% in the group with radiotherapy and ACNU. The hematological toxicity was more severe in the group treated with radiotherapy and ACNU. Other toxicity was mild and acceptable. The survival rates of patients with astrocytoma grade III and glioblastoma multiforme at 36 months after the surgery were 48.9% and 0% for radiotherapy alone and 59.0% and 16.3% for radiotherapy plus ACNU, respectively. The differences between the survival curves were not significant at the p = 0.05 level. This study has demonstrated that, although the use of ACNU during radiotherapy suppressed malignant gliomas more than radiotherapy alone, the survival time was not extended significantly. It is necessary to continue to search for an effective chemotherapeutic regimen to prolong survival of patients with malignant gliomas.
Adolescent↗
Intracranial and intraspinal dissemination from a growth hormone-secreting pituitary tumor. Case report.
A 48-year-old woman developed multiple intracranial and intraspinal metastases from an invasive growth hormone-secreting pituitary adenoma after surgery and radiation therapy. This is the first reported case to show that the cells in the metastatic tumors and in the cerebrospinal fluid contained growth hormone.
Adenoma↗
Intracranial and orbital cavernous angiomas. A review of 30 cases.
The authors review 30 documented cases of intracranial and orbital cavernous angiomas treated at their institution between 1965 and 1984. The diagnosis was based on computerized tomography (CT) or surgery; three patients were treated in the pre-CT era (1965 to 1976) and 27 since the advent of CT. The number of cases diagnosed preoperatively markedly increased after the introduction of CT, and 22 cases were verified histopathologically at surgery. Six cases were in children (aged 2 months to 17 years) and 24 in adults (aged 19 to 73 years). There was no significant sex difference (male:female ratio was 14:16). Nineteen lesions were intraparenchymal, five were intraventricular, three were in the middle fossa, two were intraorbital, and one originated from the tentorium. Symptoms varied according to the site of the lesion; hemorrhage occurred in 11 cases. Calcifications were seen on CT scans in all cases, but on plain skull films in only two. Angiography revealed hypovascular masses in all cases excluding those with lesions in the middle fossa; in two cases, tumor stain could be detected only with prolonged-injection angiography. Radionuclide brain scanning showed a dense hot area in eight of 19 patients. Recent experience has shown that magnetic resonance imaging clarified anatomic relationships that were obscure on CT. The overall outcome was favorable except for one patient who died in the postoperative period. The clinical results in this series are summarized and some diagnostic and therapeutic problems are discussed.
Adolescent↗