Allergic diathesis in patients with IgA nephropathy.
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Biomedical subjects
Publications and source records attributed to H Kojima.
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Among thyroplasties, type I is the most frequently used for medialization of the vocal cord. Follow-up study on patients indicated that reversion of voice can occur after operation. Revision was done in five cases with improvement of voice. On the basis of this experience, modifications were made in the technique of thyroplasty type I. They include 1) cutting the calcified cartilage with minimal intervention in the soft tissue, 2) fixation of the window with a silicone plug to enhance medialization, and 3) overmedialization of the vocal cord and definition of criteria for it that can be used during surgery.
Effects of N-(2,6-dimethylphenyl)-2-(2-oxo-1-pyrrolidinyl) acetamide (DM-9384) on learning and memory were studied using four different experimental rat models. In electroconvulsive shock- or scopolamine-induced amnesia in the step-through passive avoidance task, DM-9384 improved both types of amnesia when administered before the training trial. Aniracetam also showed similar but somewhat weaker effects. Furthermore, in the scopolamine amnesia model, an improvement was confirmed with arecoline. The dose-response curves for these compounds were bell-shaped. In the shuttle box active avoidance task, DM-9384 administered daily 1 hr before each training session facilitated the acquisition process of the avoidance response. In addition, the experiment of light-dark discrimination task with positive reinforcement showed that this compound administered daily after each session slightly accelerated the acquisition process of the correct response. These results suggest an ability of DM-9384 to enhance cognitive functions.
Using intact and transected hippocampal slices, we investigated the relationship between CA3 and CA1 subfields in the generation of stimulus train-induced bursting. In intact slices, spontaneous bursts in CA3 always preceded those in CA1, whereas after-discharge bursts in CA3 followed those in CA1 when it was possible to distinguish differences in the burst onset. After transection between CA3 and CA1, neither spontaneous nor triggered bursts could be induced or maintained in isolated CA1, where only small after-discharge bursts with higher bursting frequency were observed. Some of the mechanisms underlying the generation of these stimulus train-induced bursts are discussed.
In this paper, we summarize the results of a multicentric controlled study of induction treatment with intravesical BCG in patients with superficial bladder cancer (Ta, T1) or CIS. The BCG Tokyo 172 strain (Japan BCG K.K.) was given for 8 weeks, as a rule, in a dose of either 80 mg or 120 mg in 40 ml of saline instilled into the bladder. Sixty-six (90.5%) of the 73 patients registered in the study were evaluable for response. High response rates were obtained in the patients with Ta or T1 tumors, irrespective of the treatment dose; 65.4% CR, 27.3% PR and 7.3% NC for all. The number of CIS patients is too small to draw any conclusions, but 54.5% CR, 36.4% PR and 9.1% NC were obtained. Several factors were evaluated in relation to the tumor ablative effects. The CR rate was significantly higher for tumors less than 1 cm in size compared with tumors 1-3 or larger in size, although the response rates, including CR and PR, were very similar irrespective of the size. Other factors did not contribute to provoke a significant difference. Japanese elder people show a high positive rate of PPD reaction. Thus, in our study, 78% of the patients showed positive PPD reaction. In this situation, no significant relation between PPD reaction and BCG efficacy was obtained. In addition, OKT8, OKT7, OKT4, OKT4/OKT8 ratio, Leu7, ADCC activity and NK activity did not show any correlation with tumor ablative effect of BCG.(ABSTRACT TRUNCATED AT 250 WORDS)
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An endoscopic biopsy was performed on specimens taken from 374 patients with a large bowel cancer, who had received a colo-rectal resection between 1980 and 1984. An average of three to four biopsy specimens was taken from each patient. The pathological diagnosis of these specimens revealed a carcinoma with an identifiable pathological classification in 280 patients (74.9%), a carcinoma without an identifiable classification in 54 (14.4%), a suspect cancer in 7 (1.9%), and no sign of a cancer in 33 (8.8%). The diagnosis of the 33 cases in which no cancer was detected were adenoma in 11 patients, inflammation in 8, necrosis in 1, and no clear pathological determination in 11. The correspondence rates between a biopsy specimen and a tissue specimen diagnoses were 57.9% in a well differentiated adenocarcinoma; 77.4% in a moderately differentiated adenocarcinoma; 85.5% in a poorly differentiated adenocarcinoma; and 100% in a mucoid carcinoma.
In this study we examined the role of the complement system in acute glomerulonephritis (AGN). Breakdown products of complements (iC3b, C4d and Bb) and Terminal complement complex (TCC, SC5b-9 complex) in plasma samples were measured by ELISA. The microassay plates were coated with monoclonal antibodies which bind specifically to human iC3b, C4d, Bb and SC5b-9 complex. This assay accurately quantitates small amounts of in vivo complement activation. The plasma samples were drawn from patients with AGN and other glomerulonephritis. There were some patients with various glomerulonephritis whose plasma iC3b, C4d and Bb concentrations were higher than those in normal human. However specificity was not found. The ratios iC3b/C3 and C4d/C4 were increased in the early stages of AGN, but plasma Bb concentrations revealed no significant changes. Plasma SC5b-9 complex concentrations were increased in the early stages of AGN. C3c, C3d, C4d and SC5b-9 were found to be localised in the glomeruli of those AGN patients. It is suggestive that in these cases of AGN (especially case 2) complement activation is predominantly mediated through the classical pathway and TCC is formed by this activation. This complement activation in the blood and the renal tissue is presumed to be involved in the initiation and progression of AGN.
Pathologic examination at autopsy of a 74-year-old man with central diabetes insipidus revealed that he had a chronic lymphocytic inflammation limited to the infundibulum, stalk, and posterior lobe of the pituitary gland. No meningitis, sarcoidosis, or granulomas were detected, though there was evidence of chronic pancreatitis. In addition, neuronal loss with gliosis was observed bilaterally in the supraoptic and paraventricular nuclei. The unusual localized inflammatory brain lesion was considered to be responsible for the diabetes insipidus.
A 32-year-old man with an 18-year history of protein losing enteropathy (PLE) was admitted to hospital for abdominal distention. On physical examination, he had massive pleural effusion, ascites and edema of the right leg, but no superficial lymphadenopathy or organomegaly. Laboratory studies revealed mild microcytic anemia and hypoproteinemia. alpha 1-antitrypsin clearance was elevated (316 ml/day). Examination of ascites disclosed numerous lymphoblastoid cells of B cell phenotype with mu chain and lambda light chain of immunoglobulin (Ig) in the cytoplasm. Southern blot analysis showed monoclonal rearrangement of mu chain and lambda chain genes. No evidence of lymphomatous involvement of lymph nodes and non-lymphoid organs was found by CT scan, ultrasound echography and gallium scan of the chest and abdomen. Bone marrow biopsy was negative. Thus, a diagnosis of non-Hodgkin lymphoma (NHL) stage IVB limited in the pleural and peritoneal cavities was made. He was treated with the combination chemotherapy of BACOD with high dose ara-C or methotrexate followed by 4 doses of autologous LAK cell infusion resulting in no significant response. The massive pleural effusion, ascites and edema of the leg have not been improved. We consider this to be a rare case of NHL associated with PLE which is extremely resistant to chemotherapy or LAK therapy.
Light microscopy of the mandibular joint tissues from fetal mice show a distribution of fibrillar structures in the articular fibrous capsule covering the condylar head. Further SEM and TEM studies were conducted on autoclaved xiphoid and mandibular condylar processes of the fetuses for observation of the elastic system fibers in these cartilaginous tissues. SEM showed that non-collaginous fibers branched and united to form a complicated network in the cartilage. A fine structure study on diameter distribution of the fibers indicated elastogenesis in the differentiating cell layer and fiber maturation in the articular surfaces and calcification layer, thus suggesting a sequential development, growth, and degeneration of the cellular and fibrillar components in the cartilage, as well as bidirectional cell differentiation in the growing mandibular joint. A further TEM study on these autoclaved connective tissues showed the elastic system fibers in the network to be composed of fine microfibrils and amorphous elastin. The elastic fibers in the condylar cartilage were a loose network having many tortuous main and oblique elastic fibers, and coiling oxytalan fibers.
A 59-year-old woman was admitted to the hospital with a complaint of right visual disturbance. At admission, she had proteinuria and microscopic hematuria. The pulmonary X-ray showed bilateral hilar lymphadenopathy (BHL) but tuberculin test were negative. Also, bronchoalveolar lavage (BAL) and renal biopsy were performed. Bronchoalveolar lavage fluid (BALF) contained a high percentage of OKT 4 positive cells. In renal biopsy, light microscopic study showed thickening glomerular basement membrane (GBM) with tubulo-interstitial legion. Immuno-fluorescent study revealed granular deposits of IgG along glomerular capillary wall. Electron microscopic study showed subepithelial electron dense deposits of GBM, which are characteristic for membranous nephropathy (MN). It is well known that both sarcoidosis and MN are associated with immunological abnormality. This case might be significant for the study of pathogenesis of sarcoidosis.
Incubation of normal human serum with hemodialysis membranes in vitro resulted in conversion of C3 which was detected by crossed immunoelectrophoresis. In addition, formation of C3d was also observed, as was detected by double-decker rocket immunoelectrophoresis. Furthermore, breakdown products of complement (iC3b, C4d & Bb) in plasma samples were measured by ELISA. The microassay plates were coated with monoclonal antibodies which bind specifically to human iC3b, C4d and Bb, respectively, while the plasma samples were drawn from five polycystic kidney patients during initial hemodialysis. As a result, the iC3b and Bb levels in plasma were seen to increase during hemodialysis but the C4d levels revealed no significant changes. It was also observed that the Bb levels in patients undergoing hemodialysis were significantly higher than those in various renal and collagen diseases. Terminal complement complex (TCC) was not present in detectable amounts in normal human serum when measured by ELISA. However, incubation of normal human serum with hemodialysis membranes in vitro resulted in detection of TCC. TCC was present in the same plasma samples drawned from the five polycystic kidney patients during initial hemodialysis. It is suggestive that activation of complement by hemodialysis membrane is predominantly mediated through the alternative pathway and products such as TCC and anaphylatoxin are formed by this activation.
C-T scan findings in glioma and brain tissue after irradiation were histopathologically analyzed with the post-mortem examination of 4 patients. High density of contrast enhancement observed in gliomas mainly corresponded to proliferation of irregular blood vessels and hypodensity reflected less cellular area or necrotic foci in the tumor tissue. A mottled lesion with high density margin in C-T of radionecrosis of the brain tissue observed in a non-glioma patient was formed by coagulation necrosis showing marked proliferation of telangiectatic blood vessels in periphery of lesion and acellular area in the center. It is occasionally impossible to differentiate the findings between delayed radionecrosis of brain and recurrence of glioma using the C-T criteria alone.
A case of a simultaneous adenocarcinoma and a primary malignant lymphoma of the stomach is presented. A sixty-one-year-old male was referred to us with epigastralgia. Gastroscopy and a biopsy revealed a *** c-like lesion in the stomach and, on histological examination, was determined as being an adenocarcinoma. A proximal gastrectomy and an R2-resection of lymph nodes then was performed. A pathological examination of the resected stomach disclosed a malignant lymphoma neighboring the adenocarcinoma. The presence of a simultaneous carcinoma and a malignant lymphoma of the stomach is quite rare, with only twenty-eight documented patients reported in the Japanese literature. This entity is discussed.