[A case of generalized melanosis due to wildly-metastatic malignant melanoma].
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Biomedical subjects
Publications and source records attributed to H Shishido.
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The electric surface charge of erythrocytes in patients with paroxysmal nocturnal hemoglobinuria (PNH) was analyzed by means of a fully automated cell electrophoretic instrument (Parmoquant-L). The electrophoretic mobility of PNH erythrocytes decreased significantly and showed a broader pattern. After a blood transfusion, erythrocytes of PNH patients showed a bimodal pattern because of the emergence of the higher mobility peak corresponding to normal erythrocytes. However, the next day after transfusion, this new peak disappeared. Furthermore, the next day after administration of Prednisolone, the main peak of the mobility pattern shifted to the higher side, and after treatment for 7 days, the pattern showed several peaks and tended to disperse. Reticulocytes had higher complement lysis sensitivity, lower cholinesterase activity and lower electric surface charge, and it was shown that PNH erythrocytes consisted of 2 populations. Studies on the electrophoretic mobility patterns of PNH erythrocytes under various conditions can be useful in understanding the properties of erythrocyte membrane surfaces.
Seventeen cases of spinal cord arteriovenous malformation (AVM) were evaluated by use of spinal dynamic computed tomography (CT). In the intravenous injection method, contrast medium was injected bolusly into the median cubital vein. In the intraarterial injection method, contrast medium was injected slowly into the feeding artery. In both methods, lesions were demonstrated in all cases. Three-dimensional localization of the lesions were more clearly demonstrated in the intraarterial injection method. Intravenous injection method was useful in the postoperative follow-up study due to its noninvasiveness.
Total three patients with arteriovenous malformation (AVM) in basal ganglia or thalamic region were treated by intraoperative liquid embolizations. These procedures were decided because of repeated hemorrhagic episodes. In the case with AVM in the head of the caudate nucleus which was fed by several anterior perforating arteries originated from anterior cerebral artery (A1 portion) and middle cerebral artery (M1 portion), frontotemporal craniotomy was performed. After the microsurgical dissection of these feeders, one of the feeders lenticulostriate artery, was cannulated with a small-caliber polyethylene catheter, 0.6 mm in outer diameter and 0.3 mm in inner diameter. A small amount of isobutyl 2-cyanoacrylate (IBCA) was injected through the catheter. Same procedure was carried out one month later. Postoperative angiograms revealed about 90% loss of AVM. In two cases with AVM which involved almost entire thalamus, subtemporal craniotomy was done. Feeding vessels which originated from posterior communicating artery and posterior cerebral artery (PCA) were carefully dissected under the operative microscope and one of them was prepared for cannulation with small catheter. When the small amount of IBCA was injected, proximal PCA and internal carotid artery were temporarily occluded. In both cases intraoperative embolization was carried out twice. Postoperative angiograms revealed that the size of AVM was decreased to 20% in one and 40% in the other. Although temporary postoperative deterioration of neurological deficits such as hemiparesis and visual disturbance was slightly noted in all cases, no hemorrhagic episode was experienced for 6 months, 1.5 and 2 years in each after embolization.
Two cases of stenosis of the internal carotid artery after blunt craniocervical trauma in children are described. Their neurological symptoms developed a few hours after the injury. A superficial temporal artery-middle cerebral artery anastomosis was performed in one, and the other was conservatively treated because of the spontaneous resolution of the stenosis. The pathophysiology and treatment of this clinical entity, especially in children, are discussed.
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Haemophilus influenzae is a common respiratory pathogen and recurrent infection due to H. influenzae is a phenomenon often present in patients with chronic respiratory tract infections. The effects of Neisseria perflava and B. catarrhalis culture filtrates on the growth and reversion of H. influenzae L-forms were determined using the L-forms of H. influenzae induced and subcultured in a medium containing 10% sucrose and these culture filtrates. When each culture filtrate of two strains of N. perflava was added, the viable count of revertants reached a peak of growth after 48 hr and exceeded 10(4) CFU/ml even 48 days after the subculture. Adding each culture filtrate of six strains of B. catarrhalis, the viable count of revertants from the L-forms of H. influenzae was much higher than that in the absence of any filtrate (negative control). The filtrate of a culture prepared from one of the six strains of B. catarrhalis was subjected to biochemical analysis. The molecular weight of the growth-enhancing factor(s) was determined to be approximately 1,000 to 5,000. Some peptide fractions showed growth-enhancing effects on the L-forms of H. influenzae. These findings suggest that culture filtrates may be important clues as to the correlation between recurrent infections due to H. influenzae and the growth of L-forms in the sputum of the patients with chronic respiratory tract infections, during or after the administration of beta-lactam antibiotics.
The growth-enhancing effects of culture filtrates of respiratory pathogenic bacteria, including Haemophilus influenzae, as well as normal floral bacteria other than Neisseria perflava and Branhamella catarrhalis on L-forms of H. influenzae were examined in vitro, using five species of major respiratory pathogenic bacteria and seven species of normal floral bacteria commonly isolated from the sputum of patients with chronic respiratory tract infections. The growth-enhancing factor(s) was present in the filtrates prepared from the culture of respiratory pathogenic Streptococcus pneumoniae and Staphylococcus aureus, the effects of which were as potent as those of a culture filtrate of B. catarrhalis used as the positive control. The culture filtrates of respiratory pathogenic Pseudomonas aeruginosa and Klebsiella pneumoniae had weak growth-enhancing effects on H. influenzae L-forms. The culture filtrates of 21 strains of normal floral bacteria isolated from the sputum including alpha-hemolytic Streptococci, non-hemolytic Streptococci, Micrococcus roseus, coagulase-negative Staphylococci, and Neisseria spp. had growth-enhancing effects on the L-forms of H. influenzae. These data elucidate the significance of L-forms of H. influenzae in recurrent infections due to H. influenzae in patients with chronic respiratory tract infections.
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Forty-six elderly patients (mean age 60 years) suffering from diabetes mellitus (DM), or essential or arteriosclerotic hypertension (HT) were divided into 4 groups. Group 1 served as a control, group 2 was administered 1500 mg niceritrol, group 3 was administered 162 mg acetylsalicylic acid (ASA), and group 4 was administered both 1500 mg niceritrol and 162 mg ASA/day for 8 weeks. Niceritrol lowered serum levels of beta-lipoprotein and total cholesterol and increased HDL cholesterol, usually in 8 weeks. ASA did not affect the lipid-lowering effects of niceritrol. Platelet aggregation induced by epinephrine (1 microgram/ml), collagen (1 microgram/ml), and ADP (2 microM) was depressed in groups 2, 3 and 4. Degrees of depression were higher in groups administered ASA (groups 3 and 4) than in the group administered niceritrol alone (group 2). Plasma fibrinogen levels were lowered in groups administered niceritrol (groups 2 and 4) in 8 weeks. Apparent whole blood viscosity measured at shear rates of 37.6/s and 376/s was improved only in group 4 in 8 weeks, while hematocrit did not change during the study. Because flushing, the most frequent side effect of niceritrol, can be easily controlled by a low dose of ASA, and because the combination of the 2 drugs has some beneficial effects on blood rheology, this combination is considered worthwhile for treatment and prevention of atherosclerosis.
Normal human peripheral blood T cells and T-cell subsets defined by monoclonal antibodies of the OKT series were pretreated with pokeweed mitogen (PWM). Their effects on the haematopoietic precursors, erythroid (BFU-E, CFU-E), granulocyte-macrophage (CFU-GM) and megakaryocyte (CFU-M) colony forming cells were evaluated by coculture. While unstimulated T cells and T-cell subsets enhanced growth of autologous blood BFU-E, PWM-stimulated T and OKT4+ cells suppressed it, also inhibiting proliferation of both autologous and allogeneic bone marrow BFU-E, CFU-E, CFU-GM and CFU-M. PWM-stimulated OKT8+ cells had little effect on the growth of any of the precursors at the cell concentration at which growth was completely inhibited by PWM-stimulated OKT4+ cells. Irradiation of T or OKT4+ cells with 3000 rad before PWM stimulation completely abrogated the inhibition. These observations might be related to the mechanism of pancytopenia in some cases of immune-mediated aplastic anaemia.
To explore the possibility that an eosinophil colony stimulating factor (EO-CSF) is elaborated independently of neutrophil CSF (N-CSF), we compared the effect on the production of EO-CSF and N-CSF of adding a specific antigen, an aspergillus extract, to peripheral blood leucocytes of an eosinophilic patient with allergic bronchopulmonary aspergillosis. Conditioned media prepared from the patient's mononuclear (MN) and T cells were assayed for EO-CSF and N-CSF activities by agar culture technique, using normal human nonphagocytic MN bone marrow cells as target cells. The addition of the specific antigen to the cultures of the patient's MN or T cells significantly stimulated the production of EO-CSF, but not that of N-CSF, while the patient's non-T cells and normal MN or T cells were not stimulated by the antigen challenge to produce either CSF. These results suggest that EO-CSF is a factor distinct from N-CSF, that its production is dependent on the presence of sensitized T cells with antigen-specific stimulation, and that it might be one of the causes of blood eosinophilia in this patient.
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