[An operative case of the migration of a needle into the thoracic aorta].
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Biomedical subjects
Publications and source records attributed to H Ishihara.
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The anesthetic management of a patient with Ehlers-Danlos syndrome (EDS) type IV, who suffered a ruptured uterus following delivery at 37 weeks of gestation was described. During laparotomy, massive blood loss occurred and blood was replaced through the catheter introducer sheath in the internal jugular vein. The woman with EDS type IV carries a risk of excessive bleeding during labour.
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A successful surgery of abdominal aortic aneurysm due to bacterial infection is described. The patient, 71-year-old man, had been suffering from high fever of unknown origin which had narrow escape with the several kinds of antibiotics about a month and more. During the antibiotic therapy in another hospital, he was diagnosed as an abdominal aortic aneurysm by whole body computed tomography. Immediately after the arrival to our hospital, digital subtraction angiography was done, and it showed a saccular aneurysm in the infrarenal abdominal aorta. Surgical removal of this aneurysm without opening of the aneurysmal wall was performed and the kitted dacron graft was used for aorto-biiliac anastomosis. The diagnosis of aneurysm due to bacterial infection was confirmed by bacteriological and pathological examinations. The patient in now surviving 17 months after operation. Abdominal aortic aneurysm due to bacterial infection is a serious disorder that generally carries grave prognosis. Complete removal of infected lesion without contamination and long-term follow-up with antibiotic chemotherapy are essential for this disease.
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The axonal transport of substance P-hydrolyzing peptidase was studied both 2 and 10 days after the ligation of rat sciatic nerves. A peptidase(s) hydrolyzing substance P at the bonds of Phe7-Phe8 and Phe8-Gly9 was found to have accumulated to about 2 times the normal amount in the proximal segment 10 days after ligation. This enzyme activity was inhibited by ethylenediamine tetraacetate or dithiothreitol. These results suggest that this is a metalloendopeptidase which is slowly transported to inactivate neuropeptides in the nerve terminals.
Three monoclonal antibodies against human liver ferritin were selected to study antigenic determinants (epitopes) of human isoferritins. These monoclonal antibodies were found to form immunoprecipitin lines with ferritin in double diffusion tests (Ouchterlony), indicating multiple epitopes on a single ferritin molecule. The antibodies revealed high species specificity as well. Monoclonal antibodies MA301 and MA311 appeared to recognize different epitopes, since they did not inhibit each other in competitive enzyme-linked immunosorbent assay (ELISA). However, MA309 recognized both epitopes for MA301 and MA311 with similar competitive inhibition. These epitopes were not detectable when ferritin was treated with 8M urea (pH 2.5) and were detectable upon reconstruction by dialysis against 2 M urea (pH 7.2), suggesting that these monoclonals recognize epitopes in the tertiary structure of the ferritin molecule. As a matter of fact, these monoclonals react preferentially with intact ferritin molecule and only negligibly with subunits. Isoelectric focusing patterns of human ferritins demonstrated that liver, spleen, placenta, and hepatoma cells (Li-7) transplanted in nude mice contained basic isoferritins, whereas HeLa cells (carcinoma), Wa cells (EB virus-transformed B cells), and Raji cells (Burkitt's lymphoma) contained acidic isoferritins. Human heart ferritin displayed a somewhat intermediate pattern between liver and HeLa ferritins. In spite of the heterogeneous population of human isoferritins, the dissociation constants (Kd) of the three monoclonal antibodies to liver, HeLa, and heart isoferritins were quite similar.
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Yoshida sarcoma cells were incubated with each of 4 different saturated and 17 different unsaturated fatty acid methyl and ethyl esters in order to modify the fatty acid composition of the cell membrane, and a possible correlation between the lipid fluidity of the cell membrane and the metastatic efficiency was studied. Almost all the unsaturated fatty acids used were incorporated into the tumor cell membrane, resulting in an increase of fluidity. In contrast, the incorporation of saturated fatty acids brought no change in fluidity. Exogenous treatment of the cells with palmitoleic acid (16:1, cis) induced a remarkable increase of membrane lipid fluidity resulting in easier passage of modified cells through capillary vessels, which was detected in an in vitro perfusion test of the lung. Intravenous injection of the modified cells resulted in fewer metastatic foci in the lung as compared with that of unmodified cells. A similar effect on lung metastasis was also observed in exogenous modification of the cells by linoleic acid (18:2, cis) or linolenic acid (18:3, n-3). On the other hand, although exogenous eicosapentaenoic acid (20:5, n-3) and docosahexaenoic acid (22:6, n-3) treatments induced a slight increase in the lipid fluidity of the cells, intravenous injection of the cells produced a significant increase in their metastatic potential in the lung. Interestingly, the treatment with 20:5 and 22:6 produced increased stickiness of the cells to a glass surface and reduced cellular passage through the vessels as detected by the lung perfusion test. Thus, the present results suggested that selective modification of membrane fatty acid may be a useful method for artificial regulation of the ability of circulating tumor cells to pass through vessels.
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