Biomedical subjects

J Shimizu

Publications and source records attributed to J Shimizu.

At least 181 records · Page 10Linked to original sources

PubMed1993

[Evaluation of surgical treatment in patients over 80 years of age with lung cancer].

Seventeen lung cancer patients over 80 years of age were treated surgically at Kanazawa University Hospital from 1973 to 1991. The operative procedures were lobectomy (six patients), segmentectomy (seven patients), partial resection (three patients) and exploratory thoracotomy (one patient). Absolutely curative resection was done in two patients, relatively curative resection in two, relatively non-curative resection in ten, absolutely non-curative resection in two. The three-year survival rate after operation for all seventeen patients was 60.2%. Postoperative complication developed in eleven patients (64.7%). Patients who had lobectomy with mediastinal lymph node dissection had a high incidence of postoperative complications. In recent years, pulmonary resections have been performed in patients over 80 years of age who have been managed with pulmonary rehabilitation, resulting in better course. It is concluded that the limited resections produce good prognosis in patients over 80 years of age with lung cancer.

Adenocarcinoma↗

PubMed1993

[Results of surgical treatment of stage I lung cancer].

In this study, survival curves and background factors affecting prognosis of resected stage I lung cancer were reviewed. A total of 735 patients with primary lung cancer, including 288 cases (39.2%) of stage I lung cancer, were surgically treated at Kanazawa University Hospital from January 1973 through September 1989. The cumulative 5-year survival rate after operation for all cases of stage I lung cancer was 61.7%. The background factor which was most concerned with the survival rate was the T factor. The 5-year survival rates according to T factor were as follows: T1N0M0; 74.5%, T2N0M0; 53.8%. There was significant difference of survival rates between them (p < 0.05). Of these 288 cases, 128 cases with adenocarcinoma showed significant prolonged survival when compared to 120 cases with squamous cell carcinoma (p < 0.01). In female patients with stage I lung cancer the 5-year survival rate was significantly better than in male patients with stage I lung cancer (p < 0.01). When the survival rates were compared by ploidy pattern of the primary tumor, patients with diploid tumors showed significantly better survival than those with aneuploid tumors (p < 0.05). It is possible that adjuvant therapy is recommended to improve the survival rate of patients with stage I lung cancer, especially, those in the T2N0M0 classification.

Adenocarcinoma↗

PubMed1993

[Surgical treatment of thymoma--clinical evaluation].

Sixty-seven patients with thymoma were surgically treated during the past 19 years in our department. The 5-year, 10-year and 15-year survival rates of total cases with thymomas were 69.2%, 59.6% and 59.6%, respectively. Survival rates of thymoma with MG and without MG were not significantly different. According to clinical stages in Masaoka's classification, there were significant difference between Stage I and Stag III (p < 0.05), Stage I and Stage IV a (p < 0.01), and Stage I and Stage IV b (p < 0.01). We can conclude that complete resection of thymomas lead to better prognosis, and immunochemotherapy using cyclophosphamide, vincristine and OK-432 are effective.

Adult↗

PubMed1993

[The value of omental pedicle flap method for postoperative intractable infection in the field of thoracic surgery].

We present a series of 8 consecutive patients who underwent the omental pedicle flap method in the field of thoracic surgery. Four of them had empyema with bronchopleural fistula and four had mediastinal infection. A pedicle of omentum containing the right gastroepiploic artery was passed through a tunnel in the diaphragm into the empyema cavity or the mediastinal abscess cavity. All eight patients were cured successfully by single-stage procedures. We think this series demonstrates the value of omental pedicle flap method which lacks in symptoms due to defected organ and offers an excellent therapeutic effect with easy operative procedure. And, this method produce a quality of life. Further active application of this method can be expected in the management of chest problems.

Adolescent↗

PubMed1992

Role of a streptococcal antigen in the pathogenesis of acute poststreptococcal glomerulonephritis. Characterization of the antigen and a proposed mechanism for the disease.

We studied the significance of a streptococcal protein (preabsorbing Ag) (PA-Ag) in the pathogenesis of acute poststreptococcal glomerulonephritis (APSGN). This protein was isolated from nephritogenic streptococci. Purification of PA-Ag was achieved by chromatography, followed by Sephadex IEF. A single protein band at pH 4.7 was identified as PA-Ag. The m.w. was 43,000. Rabbit antisera against PA-Ag and sera of patients with APSGN showed identical precipitation lines by immunodiffusion. Antibodies to PA-Ag were found to be present in 30 of 31 patients with APSGN, in 1 of 36 patients with uncomplicated group A streptococcal upper respiratory tract infections, and in 1 of 36 normal adults. By using immunoelectrophoresis, it was found that PA-Ag activates the alternate pathway of C. Other water-soluble streptococcal fractions, used as controls, did not activate the C system. The demonstration that PA-Ag is present in the glomeruli in the early phase of APSGN and its ability to activate C3 and factor B suggest that PA-Ag may be involved in the pathogenesis of APSGN, via in situ C activation.

Acute Disease↗

PubMed1992

Tumor-bearing mice exhibit a progressive increase in tumor antigen-presenting cell function and a reciprocal decrease in tumor antigen-responsive CD4+ T cell activity.

Splenic CD4+ T cells from BALB/c mice bearing a syngeneic tumor (CSA1M) 2 to 3 wk after the inoculation with CSA1M cells produced IL-2 and macrophage-activating factor upon in vitro cultures. This lymphokine production was achieved without stimulation of these T cells with exogenous stimulating tumor Ag. However, elimination of APC from spleen cells resulted in almost complete abrogation of the capacity of CD4+ T cells to produce IL-2/macrophage-activating factor. The lymphokine production was regained when APC from CSA1M-bearing mice were added back to cultures. APC from normal or another syngeneic tumor (Meth A)-bearing mice failed to regain the lymphokine production. These observations demonstrated that the lymphokines were produced by CD4+ T cells from CSA1M-bearing hosts through their collaboration with APC binding CSA1M tumor Ag in the tumor-bearing state. The lymphokine-producing capacity of whole spleen cells from tumor-bearing mice reached the maximal level around 2 to 3 wk after tumor implantation but gradually decreased with the progress of tumor-bearing stages. Importantly, tumor-bearing stage-related changes were observed in a different fashion in the capacities of anti-CSA1M CD4+ T cells vs CSA1M tumor Ag-binding APC. The capacity of APC increased with the progress of tumor-bearing stages as demonstrated by the stimulation of CSA1M-immunized T cells with APC from different CSA1M-bearing stages. In contrast, the reactivity of anti-CSA1M T cells to APC from a given CSA1M-bearing stage decreased with the tumor-bearing stage. These results demonstrate a stage-related increase tumor Ag-binding APC function, as well as a reciprocal reduction in tumor Ag-responsive CD4+ T cell activity.

Animals↗

PubMed1992

Tumor-immunotherapy with the use of tumor-antigen-pulsed antigen-presenting cells.

Our previous study demonstrated that the administration of antigen-presenting cells (APC) pulsed with tumor cell membrane fraction to naive syngeneic mice results in effective induction of tumor-specific protective immunity in vivo. The present study examined whether tumor-antigen-pulsed APC can produce the inhibitory effect on the growth of tumor cells when administered to tumor-bearing hosts. Naive BALB/c mice were inoculated with viable tumor cells. Five days later, these mice started to receive the relevant tumor-antigen-pulsed APC at 3- to 4-day intervals. The administration of tumor-antigen-pulsed APC induced the rejection or growth inhibition of a growing tumor in approximately half of the recipient mice. Moreover, it was demonstrated that tumor-specific immunity was induced in such tumor-regressed mice. These results indicate that tumor-antigen-pulsed APC are effectively applicable to the tumor-specific immunotherapy.

Animals↗

PubMed1992

Excitatory amino acid receptors in brains of rats with methylazoxymethanol-induced microencephaly.

We used methylazoxymethanol-acetate (MAM), a potent alkylating agent, to produce microencephaly in offspring by injecting it into pregnant rats on day 15 of gestation. Binding activities of central excitatory amino acid receptors were examined in Triton-treated membranes prepared from brains of adult offspring with MAM-induced microencephaly (MAM rats). MAM rats exhibited approximately 40-50% reductions of the wet weights of the cerebral cortex, hippocampus and striatum compared to those in controls. In the cortex and hippocampus of MAM-rats, total bindings of [3H]glutamate (Glu) (which is sensitive to N-methyl-D-aspartate (NMDA) receptor), and strychnine-insensitive [3H]glycine (Gly) and (+)-5-[3H]methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imi ne (MK-801; a noncompetitive antagonist of NMDA receptor), were reduced to approximately 40% of those in controls. Similarly, in both regions of MAM rats, total bindings of [3H]kainate and DL-alpha-amino-3-[3H]hydroxy-5-methylisoxazole-4-propionic acid (an agonist of quisqualate receptors), were reduced to approximately 35-50% of those in controls. However, total bindings of these radioligands in the striatum of MAM rats were more than 65% of those in controls, despite the significant loss of striatum mass. However, specific bindings of radioligands in the striatum of MAM rats were elevated by more than 60% of those in controls, and Scatchard analysis revealed that elevations of [3H]Glu, [3H]Gly and [3H]MK-801 bindings were due to a significant increase in the densities of binding sites, with their affinities remaining unaltered. Spatial recognition ability examined by an 8-armed radial maze task was markedly impaired compared to those in controls. These results suggest that the proliferation of neurons bearing excitatory amino acid receptors (EAA) in the striatum is less affected by MAM treatment on day 15 of gestation than that in the cortex and hippocampus in spite of drastic weight loss in these brain regions. The significant reduction of EAA receptors in the cortex and hippocampus may be involved in the impairment of spatial memory observed in MAM-treated rats.

Animals↗

PubMed1992

Tumor-specific T cell lines: capacity to proliferate and produce interleukin 2 in response to various forms of tumor antigens.

Anti-tumor proliferative T cell lines were established from cultures of lymph node cells from BALB/c mice immunized to syngeneic CSA1M fibrosarcoma with the CSA1M tumor cell membrane. The cultures were maintained throughout in the absence of exogenous interleukin 2 (IL2). Cell surface phenotypes of all T cell lines established were Thy-1+, Ig-, L3T4+ and Lyt-2-. Their proliferation was induced in a tumor antigen dose-dependent fashion and a tumor antigen-specific way. Such proliferative responses were inhibited by the addition to cultures of anti-class II H-2d (anti-I-Ad) or anti-L3T4 but not of anti-class I H-2d or anti-Lyt-2 monoclonal antibody. None of the T cell lines exhibited any cytotoxic T lymphocyte activity but they all produced IL2 upon stimulation with CSA1M tumor antigens, indicating that they represent helper-type T cell (Th) lines. The activation of these tumor-specific Th lines was induced with either CSA1M tumor cells themselves, or their membrane or detergent-solubilized fraction depending on the presence of antigen-presenting cells (APC). Most importantly, activation was also inducible by membranous tumor antigen-pulsed APC, which were capable of producing potent anti-tumor protective immunity when administered in vivo into syngeneic BALB/c mice. These results indicate that the tumor-specific Th lines established here can be activated with various forms of tumor antigens for their expression of helper function. Since Th lines of this type have not been described previously, our Th lines provide an intriguing tool for investigating the cellular and molecular mechanisms by which tumor-specific Th recognize tumor antigens.

Animals↗

PubMed1992

Primary extramedullary plasmacytoma of the lung.

A case with primary plasmacytoma of the lung is described. The patient, a 55-year-old Japanese female, who simultaneously had a pulmonary plasmacytoma and bladder carcinoma. The bladder tumor was treated with transurethral resection. Pathologically, the bladder tumor was a non-invasive, papillary transitional cell carcinoma, grade II. The lung tumor was located in the right upper lobe and upper lobectomy was performed. The tumor measured 2.8 x 2.7 x 2.0 cm and had a white-yellowish cut surface. Histologic, electron microscopic and immunohistochemical examinations of the lung tumor revealed monoclonal proliferation of plasma cells (IgA, lambda light chain). There was no evidence of multiple myeloma.

Female↗

PubMed1992

Seven patients with plasma cell granuloma (inflammatory pseudotumor) of the lung, including two with intrabronchial growth: an immunohistochemical and electron microscopic study.

Seven patients (mean age, 50.7 +/- 20.4 years; range 21-77) with plasma cell granuloma (PCG) of the lung are reported. Cough and sputum were the most common presenting symptoms, followed by fever. Elevated erythrocyte sedimentation rate and serum C-reactive protein levels were found in all patients tested. Radiologically, five cases presented as solitary, well-circumscribed masses and two as ill-defined, pneumonia-like densities. One showed focal calcification. No predilection of occurrence was observed in either lobe of the lung. Histologically, the lesions consisted of a proliferation of mature plasma cells and reticulo-endothelial cells supported by a stroma of granulation tissue, with varying degrees of myxoid change or collagenization. Angioinvasion within the lesion was observed in 4 of the 7 cases. Immunohistochemical staining revealed the IgG-predominant polyclonal nature of the plasma cells, indicating a reactive inflammatory process rather than a neoplastic one. Electron microscopy confirmed the benign nature of the plasma cells with fibroblast and myofibroblast proliferation admixed with that of other inflammatory cells.

Adult↗

PubMed1992

Second surgical intervention for recurrent and second primary bronchogenic carcinomas.

Second operations were performed in 1961-1990 on 23 patients with non-small cell bronchogenic carcinoma, constituting 2.5% of 906 who had undergone pulmonary resection for such tumor and 3.6% of the 641 with apparently curative surgery. The second operation was performed for recurrent tumor in 15 cases and for second primary tumor in eight. Five-year survival after the first operation was 30% in the former group and 88% in the latter (significant difference). Among the total 23 patients, this survival rate was 51%. The study indicates that an aggressive attitude to second surgical intervention is warranted. For early detection of second lesions, follow-up at maximally 6-month intervals should be continued for more than 5 years after the first operation.

Adenocarcinoma↗

PubMed1992

[Two cases of familial pulmonary arteriovenous fistula].

Two cases of familial pulmonary arteriovenous fistula are reported. Case 1: A 54-year-old woman was admitted with exertional dyspnea. An abnormal shadow on chest X-ray had been noted since the age of 37 years. Pulmonary angiography demonstrated bilateral pulmonary arteriovenous fistulas. Case 2: A 25-year-old man, the son of Case 1, was admitted for operation for the same disease. The mother and son both suffered from repeated epistaxis due to Rendu-Osler-Weber disease. In order to reserve pulmonary function, fistulectomy was performed in both cases, and their subsequent clinical courses were good.

Adult↗

PubMed1992

[A case of fibromuscular dysplasia presenting with Wallenberg syndrome, and developing a giant aneurysm of the internal carotid artery in the cavernous sinus].

A 25-year-old man developed Wallenberg syndrome (WS). At that time his carotid angiography was normal. When he was 28 years old, he suffered from retinal artery embolism in the left eye. At the age of 30 years, he had an acute onset of abducens nerve palsy in his right eye. The carotid angiography showed a giant aneurysm at the cavernous sinus portion in the right internal carotid artery. At his age of 38, the right oculomotor, trochlear and trigeminal nerves were involved. A vertebral angiography revealed a bead-like formation, and a diagnosis of fibromuscular dysplasia (FMD) was made. An intensive angiographic examination revealed many stenotic or dilated lesions in the carotid, vertebral, coronary, renal, and hepatic arteries. A sural nerve biopsy specimen revealed that the sural vein was involved. In Japan only one case of FMD presenting with WS is known. FMD should be under consideration as an underlying disease, when WS occurred in younger patients with few risk factors. In this patient an angiography revealed no abnormality in the cavernous sinus portion of the internal carotid artery, when he suffered from WS. However, eight years later he was proved to have a giant aneurysm in the cavernous sinus portion. In conclusion, we support the hypothesis that aneurysm may originate from angiographically normal arterial wall in FMD.

Adult↗

PubMed1992

[A case of acid maltase deficiency (juvenile type)--immunohistochemical and biochemical study].

A 22-year-old housewife was referred to us for review of progressive proximal muscle weakness which started at 15 years of age. A biopsy of left rectus femoris muscle showed acid phosphatase positive vacuoles partly filled with PAS-positive material. Acid maltase activity of the cultured fibroblasts was pathologically low at 0.4 nmol/mg protein considering 161.0 +/- 32.4 nmol/mg protein as a normal range. A diagnosis was made of acid maltase deficiency (juvenile type). Western blot using anti-acid maltase polyclonal antibody revealed 115 and 70 kDa bands in control muscles, where as only the 115 kDa band, a presumable precursor of the enzyme, was visualized in the patient. By immunohistochemistry using the same antibody the epitope was localized to the acid phosphatase positive vacuoles and immunoelectron microscopy demonstrated the acid maltase immunoreactivity within lysosomes. We concluded that the protein precursor unable to proceed into mature enzyme can access to lysosomes from endoplasmic reticulum through Golgi complex in the present case.

Adult↗

PubMed1992

[The efficacy of transarterial immuno-embolization therapy in patients with hepatocellular carcinoma].

The efficacy of transarterial immuno-embolization therapy (TIE) was investigated in 7 patients with multiple hepatocellular carcinoma (HCC). We administered OK-432 (10 KE), fibrinogen (30 mg/ml) and thrombin (1 U/ml) as a new treatment for HCC with intrahepatic metastasis. In all patients with a high level of AFP, the AFP level decreased promptly less than the pretreatment level after TIE therapy. High fever in all cases, epigastralgia in 6 cases and appetite loss in 3 cases were observed after TIE therapy. Our results indicate that this therapy may be a safe and effective method in HCC patients with intrahepatic metastasis.

Administration, Oral↗

PubMed1992

[Wallenberg's syndrome due to vertebral artery dissection following minimal neck injury--report of two cases].

We described two cases of the lateral medullary syndrome (Wallenberg's syndrome) due to vertebral artery dissection following minimal neck injuries. The first case was a 45-year-old man, who hit his head and often rotated his head because of posterior neck discomfort. Two years after the injury, he suffered from sudden sharp neck pain, nausea, and vertigo, which was followed by left hand numbness and difficulty in walking due to the right lateral medullary syndrome. Angiography showed right vertebral artery dissection at the fourth segment. The second case, a 48-year-old man, suffered from neck pain immediately after he hyperextended his neck for painting a wall. Within several hours, he experienced left hand numbness and difficulty in walking due to the lateral medullary syndrome. Angiography showed a saccular aneurysm and dissection of the right vertebral artery at the fourth segment. In both cases, minor traumas were thought to be the causes of vertebral artery dissection. We surveyed previously reported 84 cases (men: 50, women: 34) of the vertebral artery dissection due to minor traumas. Seventy per cent of patients were in their third or fourth decade of life. The main causes of trauma preceding the dissection were neck manipulation especially chiropractics (52%). The third segment was most vulnerable. Delay in onset following neck trauma could be more than a week, but in most cases the delay was less than 24 hours. Cervical rotation and extension were thought to precipitate dissection.

Aortic Dissection↗

PubMed1992

[Combined resection of the aorta in a T4 lung cancer under nonheparinized temporary bypass using Anthron tube].

A 63-year-old male had squamous cell carcinoma in the left upper lobe. CT scan suggested the invasion of the tumor into the vertebral body and the descending aorta. Left pneumonectomy and combined aortic resection under the temporary bypass using Anthron tube was performed. The bypass using Anthron tube provides us no systemic heparinization and the procedure is easy. So the danger of massive bleeding during and after the operation can be decreased and the operative time can also be shortened. This procedure may be a great help for carrying out the operation with combined aortic resection more safely and speedily.

Aorta↗