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Biomedical subjects

H Kudo

Publications and source records attributed to H Kudo.

At least 181 records · Page 10Linked to original sources

Massive congenital intracranial teratoma diagnosed in utero.

The authors describe a case of congenital intracranial teratoma. The patient was diagnosed to be hydrocephalic at 29 weeks' gestation, and to have a huge intraventricular mass lesion at 34 weeks' gestation. Subsequently, the patient underwent subtotal resection of the mass, resulting in a significant decrease in the remarkably elevated alpha-fetoprotein in serum and cerebrospinal fluid. Histological analysis revealed a malignant teratoma, also with alpha-fetoprotein-positive elements in the immunohistochemical study.

Brain Neoplasms↗

Ependymoma diagnosed in the first year of life in Japan in collaboration with the International Society for Pediatric Neurosurgery.

During 1987, 23 survey forms for ependymoma cases diagnosed in the 1st year of life were selected from 88 neurosurgical institutes in Japan in collaboration with the International Society for Pediatric Neurosurgery. There were no specific perinatal episodes. The most common clinical manifestations were symptoms of intracranial hypertension and hydrocephalus. Two of seven children with infratentorial ependymomas were alive, and all of the children with such supratentorial tumors were still alive. Of those with ependymoma, three of four in the total extirpation group, and three of seven in the subtotal or partial removal group were alive. The 1-year survival rate was 54% for ependymoma and 58.3% for ependymoblastoma. For 36% of the cases with ependymoma and 14.6% with ependymoblastoma, a 2-year survival rate was observed. Since the prognosis of these tumors is poor, they should be extirpated as often as possible. Collins' law held true in approximately half of the cases.

Brain Neoplasms↗

Immunohistochemical localization of vitamin B12 R-binder in salivary gland tumors. Implications for cell differentiation.

Vitamin B12 R-binder, a specific binding protein for vitamin B12, was studied immunohistochemically in normal and 106 neoplastic salivary gland tissues with a monoclonal antibody against vitamin B12 R-binder (R-binder). In normal salivary glands, R-binder localization was restricted to the ductal systems and to mucous acinar cells; serous acinar cells, myoepithelial cells and stromal connective tissues were consistently negative. Among salivary gland tumors, R-binder was present in 87% of pleomorphic adenomas, 100% of monomorphic adenomas, and 40% of adenoid cystic carcinomas; positivity was observed only on luminal surfaces of small ductular elements, indicating that the components closely related to ductal differentiation were rather small in population. R-binder could be detected both in lacunar and non-lacunar cells within chondroid areas of pleomorphic adenomas, suggesting the possibility that chondroid regions arise from metaplastic changes in ductal epithelial cells. In mucoepidermoid tumors, mucous cells and focal squamous cells exhibited cytoplasmic staining. The staining pattern for R-binder in epithelial components of adenolymphomas showed close similarities to those found in normal large excretory ducts. Two acinic cell tumors and one case each of myoepithelioma and malignant myoepithelioma exhibited negative reactivity for R-binder, showing that these neoplasms are solely composed of tumor cells without the characteristics of ductular differentiation. The immunohistochemical examination of salivary gland tumors, employing a monoclonal anti-R-binder antibody, may have some implications for cellular heterogeneity and differentiation in various tumors.

Antibodies, Monoclonal↗

Thymidine kinase and alpha-fetoprotein as biochemical markers of hepatocarcinogenesis induced by 3'-methyl-4-dimethylaminoazobenzene treatment in rats.

It is known that a high incidence of hepatocellular carcinoma in rat liver can be induced by such azo dye carcinogens as 3'-methyl-4-dimethylaminoazobenzene (3'-MeDAB). Thymidine kinase (TK) catalyzes the formation of deoxythymidine monophosphate (dTMP) by the phosphorylation of thymidine via the salvage pathway. In the present study, we investigated serum alpha-fetoprotein (AFP) and TK levels, and tissue TK and its isozyme activities in the liver of rats treated with 3'-MeDAB. Serum TK activities rose abruptly directly after the onset of 3'-MeDAB treatment, peaking after 1 week and then gradually decreasing. At 3 weeks, though serum TK was decreasing, serum AFP and tissue TK began to increase, and oval cells appeared in the liver. At 5 weeks, though serum TK reached a nadir, serum AFP and tissue TK formed transient peaks, and oval cells occupied a major part of the hepatic lobules with hyperplastic nodules. Thereafter, serum TK continued to increase, and serum AFP and tissue TK, after transiently decreasing, re-increased; at 20 weeks, each value was at high level, and mixed type hepatocarcinoma was observed. The liver TK isozymes were separated into three types by DEAE-cellulose column chromatography. A 3'-MeDAB diet induced a remarkable increase in activity of cytosolic and fetal type isozyme in non-tumorous regions of livers at 5 weeks and tumorous regions at 20 weeks. These results indicate that early biochemical changes in 3'-MeDAB-induced hepatocarcinoma in rats may serve as a useful model and provide a valuable insight in hepatocarcinogensis.

Animals↗

Effects of percutaneous transhepatic biliary drainage on blood-bile permeability and selective IgA transport in patients with biliary obstructions.

Biliary obstruction induces a increase in the permeability between blood and bile, and a decrease in the rate of immunoglobulin A (IgA) transport into bile. We investigated the effects of percutaneous transhepatic biliary drainage (PTBD) on these derangements. PTBD reduced the extent of elevation of the bile-to-serum ratio of Immunoglobulin G (IgG; IgG-BS ratio) in patients with obstructive jaundice. Because IgG is known to be passively transported from serum to bile, the results indicate that PTBD restores the blood-bile barrier function. The IgA-BS ratio/IgG-BS ratio index (IgA/IgG index) and the IgM/IgG index, which indicated the function of selective transport of IgA and IgM into bile, initially decreased and then returned to the normal range 17 days after PTBD in patients who experienced a rapid resolution of hyperbilirubinemia. However these indices remained low in patients who did not experience this resolution. The serum secretory IgA levels in patients who did not experienced rapid resolution of hyperbilirubinemia markedly increased before PTBD. The serum secretory IgA levels in the patients who did and those who did not experience rapid resolution of hyperbilirubinemia, after initially increasing, decreased after PTBD. However the level returned to the control range only in patients who experienced a rapid resolution. These results indicate that the secretory IgA level is a sensitive indicator of hepatobiliary function, and measurement of the level of secretory IgA could predict the effect of PTBD.

Bile↗

Nucleotide sequence of rice dwarf virus genome segment 4.

The complete nucleotide sequence of rice dwarf virus (RDV) genome segment 4 was determined. Genome segment 4 was 2468 nucleotides long and had a long open reading frame initiating at nucleotides 64 to 66 and terminating at 2245 to 2247. The deduced polypeptide contained 727 amino acid residues with an Mr of 79.8K. Amino acid sequences similar to a 'zinc-finger' and purine NTP-binding motifs were present in the deduced polypeptide. Considerable amino acid sequence homology was detected between genome segment 4 of RDV and wound tumor virus (WTV). One of the sequences similar to the 'zinc-finger' motif was present in a conserved region of the polypeptide of both viruses. However, the sequence similar to the purine NTP-binding motif was not present in the polypeptide encoded by genome segment 4 of WTV.

Amino Acid Sequence↗

Isolation and characterization of cellulolytic anaerobic fungi and associated mycoplasmas from the rumen of a steer fed a roughage diet.

The isolation of 12 strains of cellulolytic fungi from the rumen of a roughage-fed steer is described. These represented three different genera, including one new genus and species (Orpinomyces bovis). The organisms were indistinguishable on the basis of fermentation products from cellulose, and their fermentation patterns were very similar to those of rumen fungi isolated in other countries. Mycoplasmas were found to be associated with 7 of the 12 isolates. The ecological role of the association of the mycoplasmas with rumen fungi is still unknown.

Anaerobiosis↗

Immunohistochemical distribution of CA19-9 in normal and tumor tissues of the kidney.

The immunohistochemical distribution of CA19-9 in normal and tumor tissue of the kidney was investigated. CA19-9 was detected in the cytoplasm and apical surface of renal proximal tubules, distal tubules and uroepithelium of the renal pelvis. Eight of 28 renal cell carcinomas (29%) expressed CA19-9. CA19-9 was also detected in 2 cases of transitional cell carcinoma and 1 of 4 cases of Wilm's tumor, but not in angiomyolipoma. As the measurement of CA19-9 is widely used to detect gastrointestinal carcinoma, the expression of CA19-9 in normal and neoplastic kidney tissue might have some clinical significance.

Antigens, Tumor-Associated, Carbohydrate↗

Feasible cone beam scanning methods for exact reconstruction in three-dimensional tomography.

Feasible cone beam scanning methods that permit exact reconstruction in three-dimensional tomography are proposed, and their performances are investigated using the theory developed by Kirillov [Sov. Math. Dokl. 2, 268 (1961)], Tuy [SIAM J. Appl. Math. 43, 546 (1983)], and Smith [IEEE Trans. Med. Imaging MI-4, 14 (1985)]. The proposed methods move an apex of a cone on two circles that are perpendicular to each other (orthogonal scan) or on a few twists of a helical curve (helical scan). The obtainable information, the feasibility of reconstruction, and the redundancy of measurement by some typical cone beam scanning methods are analyzed using the relationship between the cone beam projections and the three-dimensional Radon transform. Consequently it is found that the proposed methods can obtain the complete information about the three-dimensional Fourier transform of an object with less redundant measurement. Moreover, based on the analysis, a practically implementable reconstruction algorithm suitable for the proposed methods is derived. Experiments performed with both numerical and real x-ray projections demonstrate the validity of the proposed scanning methods and the reconstruction algorithm. Especially when a large cone angle is used, the proposed methods greatly improve the spatial resolution and the quantitative accuracy of reconstruction as compared with the method of circular apex motion.

Algorithms↗

Multicentric glioblastoma multiforme occurring in the supra- and the infratentorial regions--case report.

A 74-year-old male was admitted because of severe headache, vertigo, and vomiting. A computed tomographic scan showed heterogeneously enhanced tumors in the supra- and the infratentorial regions, apparently attached to the cerebellar tentorium. He died 2 months after the onset despite external decompression and a ventriculo-peritoneal shunt. The autopsy showed both tumors were intra-axial and not attached to the dura mater including the cerebellar tentorium. The histological diagnosis of either tumor was glioblastoma multiforme. This case could be classified as multicentric gliomas. In the 23 reported cases, including our case, most died soon after the onset of symptoms. Some, however, with low grade tumors had a comparatively long life span after the onset. It is, therefore, important to investigate the histology of these tumors for correct prognosis.

Aged↗

Quantitative analysis of glutathione in human brain tumors.

Reduced glutathione (gamma-glutamylcysteinylglycine, GSH) plays an important role in the protection of cells against damage from free radicals and other electrophils and also influences cellular radiosensitivity, cellular response to hyperthermia, and cytotoxicity to some kinds of chemotherapeutic agents. The concentrations of GSH in 40 primary and metastatic brain tumors were quantitatively analyzed, and GSH was localized in these tumors by a novel o-phthalaldehyde histofluorescence method. The level of GSH was 195.2 +/- 57.1 micrograms/gm (mean +/- standard deviation) in glioblastomas multiforme, 444.1 +/- 105.1 micrograms/gm in normal brain tissues, and 614.4 +/- 237.4 micrograms/gm in meningiomas. The differences in GSH levels between glioblastomas and normal brain tissues and between glioblastomas and meningiomas were statistically significant (p less than 0.01). The mean GSH level in astrocytoma grades II and III was 321.9 +/- 11.8 micrograms/gm. The difference in the GSH level between glioblastomas and astrocytomas was statistically significant (p less than 0.05). Radiosensitive tumors, such as multiple myeloma, germinoma, and small-cell carcinoma, showed low GSH levels. These data suggest the possibility that the GSH may be a predictor for the efficacy of radiation therapy. The cytochemical study showed GSH localized in the cytoplasm; although it stained well in meningioma tissue, GSH was not well stained in sections of multiple myeloma. The endothelial proliferation did not stain well in glioblastoma, which seems to imply that this area is vulnerable to attack by free radicals from irradiation and/or chemotherapy.

Brain Neoplasms↗

Down's syndrome in middle age. Topographical distribution and immunoreactivity of brain lesions in an autopsied patient.

A 45-year-old patient with Down's syndrome was autopsied. The brain, weighing 800 g, was small in size, and serial sections revealed generalized gyral atrophy and ventricular dilatation. In the gray matter, there was diffuse neuronal degeneration characterized by numerous neurofibrillary tangles (NFTs), senile plaques and frequent amyloid angiopathy. Histochemical and electron microscopical analyses of these lesions showed no qualitative difference from those in Alzheimer's disease. A topographical study of NFTs showed that they were numerous in the limbic system and cerebral neocortex. Various numbers of NFTs were seen in the olfactory bulb, thalamus, medial geniculate body, innominate substance, putamen, caudate, pallidum, central gray, reticular formation, certain midline nuclei of the brainstem, substantia nigra, red nucleus and dorsal vagal nucleus. This distribution pattern was not different qualitatively from that in Alzheimer's disease, and such a similarity was especially evident in the olfactory bulb, where many tufted and mitral cells as well as anterior olfactory nucleus cells showed NFTs. These common features of brain pathology in Down's syndrome and Alzheimer's disease may be due to a specific gene defect in both diseases.

Aging↗

[Hospital and district differences in susceptibilities to antibiotics of main clinical isolates].

A nationwide survey of susceptibilities of Staphylococcus aureus, Escherichia coli, Klebsiella sp. and Proteus mirabilis initiated in 1980 was continued in 1986. This report documents differences in susceptibilities of clinical isolates of the above microorganisms to ampicillin (ABPC), cefazolin (CEZ), cefmetazole (CMZ) and gentamicin (GM) among general hospitals throughout Japan. Clinical isolates of each species of microorganisms which were collected in 24 hospitals made up each study group and were collected at the Kosei General Hospital, Tokyo, from April 1980 to March 1986. We compared the variability in the resistant rates (MIC greater than or equal to 25 micrograms/ml) and MICs of each antibiotic for 50% and 80% of the isolates among the hospitals. MICs were determined by the serial 2 fold agar plate dilution method, standardized by the Japan Society of Chemotherapy, with an inoculum of approximately 10(6) CFU/ml or 10(8) CFU/ml. Susceptibility patterns of S. aureus to ABPC, CEZ and GM, of E. coli to ABPC, of Klebsiella sp. to CEZ and GM and of P. mirabilis to ABPC, CEZ and GM varied from hospital to hospital. On the other hand, the differences in the susceptibility patterns among the 6 districts of Japan were not obvious, because the differences were affected by different susceptibility patterns of each hospital located in each district.

Ampicillin↗

Comparative studies of DU-PAN-2, carcinoembryonic antigen, and CA19-9 in the serum and bile of patients with pancreatic and biliary tract diseases: evaluation of the influence of obstructive jaundice.

The levels of DU-PAN-2 antigen, carcinoembryonic antigen, and CA19-9 in serum and bile of patients with pancreatic and biliary tract diseases were measured. The sensitivities (true positive) of DU-PAN-2 in serum to pancreatic carcinoma (64%) and to biliary tract carcinoma (62%) were similar to those of CA19-9 in serum (69% and 72%, respectively). Nine of 18 (50%) patients with CA19-9-negative pancreatic carcinoma tested positive for DU-PAN-2. The sensitivities of CEA to pancreatic carcinoma (56%) and to biliary tract carcinoma (52%) were lowest. The measurement of these antigens in bile seemed to be of little diagnostic value in differentiating between malignant and benign diseases. False positives of these three assays occurred frequently in patients with benign pancreatic or biliary tract disease coupled with obstructive jaundice. After percutaneous transhepatic biliary drainage, serum DU-PAN-2 and CA19-9 levels returned to normal ranges in patients with benign diseases, but not in patients with carcinoma of the pancreas or of the biliary tract. Serum CA19-9 and DU-PAN-2 antigens are useful tumor markers for pancreatic and biliary tract carcinomas. Longitudinal assays of these antigens may be useful for the differential diagnosis of patients with obstructive jaundice.

Antigens, Neoplasm↗

[Causes of death in patients with rheumatoid arthritis--analysis of 117 cases for 13 years].

One hundred seventeen deaths of RA patients (30 males and 87 females) at National Sagamihara Hospital for 13 years (1975-1988) were analysed. The average duration of disease were 10.5 years in male patients and 17.7 years in female. The average life span of the patients with RA, revealing 65.8 years in male and 63.7 years in female, were much shorter than of general population. The causes of all deaths were investigated by ourselves and/or autopsy. The autopsy was performed in 56.6%. The most common causes of death in RA patients were infectious diseases (20.5%), respiratory diseases (16%, mainly interstitial pneumonia and chronic obstructive lung diseases), and gastrointestinal diseases (14.7% chiefly perforation or bleeding of peptic ulcer). The distribution of causes of death in RA patients was quite different from in general population. The gastrointestinal disease decreased from 20% in the early half (1975-1981) to 12.6% in the latter half (1982-1987). It seems likely that H2-receptor antagonist played a major role for preventing the death by perforation or bleeding of ulcer, because the drug has been used since 1982 in Japan. Renal insufficiency including amyloidosis increased markedly in the latter half (14.9%) compared with in the early half (6.7%). Frequency of infectious diseases, respiratory diseases, and basilar impression remain unchanged in all course. Although our study are case-analysis in only one institute and further study will be necessary, the accumulation of the data investigated by rheumatologist will be helpful to grasp correct cause of death in patients with RA.

Adult↗

Total elbow arthroplasty with a non-constrained surface-replacement prosthesis in patients who have rheumatoid arthritis. A long-term follow-up study.

Thirty-seven elbows in thirty-six patients who had rheumatoid arthritis had a total elbow arthroplasty with insertion of a non-constrained surface-replacement prosthesis. The patients were followed for an average of nine years and six months, the longest follow-up being seventeen years. A good result was seen in twenty-nine elbows; a fair result, in one; and a poor result, in seven. The reasons for the poor results were gross posterior displacement of the humeral component in five elbows, persistent subluxation with pain in one, and recurrent ankylosis in one. Of the five elbows that had gross posterior displacement, four had a revision operation with a new humeral component, and a satisfactory result was eventually achieved. Radiographic examination revealed various degrees of proximal subsidence of the humeral component in 70 per cent of the elbows. However, in most of the elbows the subsidence was not progressive and was compatible with a good clinical result. In contrast, the rate of loosening of the ulnar component was low; loosening was seen in only 5 per cent of the elbows. Seventeen elbows were followed for ten years or more, and comparison of the clinical results in the intermediate period with those at the most recent review revealed that the results improved with time. Because of the number of elbows in which subsidence of the humeral component developed, we now use a humeral component with an intramedullary stem, and were no longer recommend the use of our Type-1 and Type-2 prostheses.

Adult↗

[Primary myelofibrosis with extramedullary haematopoiesis of the skin transformed into acute megakaryoblastic leukemia].

A 70-year-old man, who had been diagnosed as primary myelofibrosis in 1987 at Tokyo Women's Medical School, was admitted to our hospital because of left hip-joint pain in May 1988. Physical examinations revealed marked hepatosplenomegaly and multiple reddish papules on the skin. The peripheral blood showed marked leukoerythroblastosis and severe anemia with poikilocytosis. Bone marrow aspirations were dry tap. Needle biopsy of iliac crest showed a diffuse fibrosis. Biopsy of the papules showed an extramedullary haematopoiesis. He was treated with low dose Ara-C for seven days. Although hepatosplenomegaly and skin papules were reduced, he died of pneumonia a month later. At autopsy, leukemic cells massively infiltrated into the multiple organs, including bone marrow. The cells were identified with megakaryoblast, as those were positive for factor VIII related antigen. As far as we know, this is the third case of primary myelofibrosis transformed into acute megakaryoblastic leukemia.

Aged↗