[Study on pollinosis--survey of pollen in the air in Sagamihara city].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to K Furuya.
Explore the source record for details and available documents.
To clarify the pathogenesis of calcification in calcifying fibrous pseudotumor (CFT), the lesion arising in the chest wall of a 16-month-old boy was ultrastructurally investigated. Fibroblasts were surrounded by large amounts of collagen fibrils. The dystrophic and psammomatous calcifications were observed as electron-dense amorphous masses and laminated bodies, respectively, within the cytoplasm of fibroblasts and in the collagenous stroma. The degeneration of cytoplasm seemed to be an initial event of intracytoplasmic calcification. Extracellular calcified substances often abutted to fibroblasts. Fibroblasts may play an important role in both intracellular and extracellular calcifications of CFT.
Turco's one-stage posteromedial release with internal fixation has been performed in 51 children with a total of 73 congenital clubfeet since 1973. Thirty-one children (44 feet) followed for 4-12 years were evaluated using the McKay rating system. The occurrence of good and excellent results was 70%. The relationship between these results and angles measured from roentgenograms was analyzed using multiple regression. The results showed a closer relationship to the anteroposterior talocalcaneal angle, the tibiocalcaneal angle, and the MTR angle.
Eighteen children with 24 congenital clubfeet were examined for their foot-progression angle and radiographic angles before and after Turco's posteromedial release. The foot-progression angle was -12.9 degrees before surgery and 1.6 degrees after surgery. The ratio of correction of the foot-progression angle was 58%. Using multiple regression analysis, this ratio was mostly related to the ratio of correction of the anteroposterior talo-first metatarsal and lateral talocalcaneal angles. These results suggest that it is important in correction of toe-in gait of congenital clubfoot to correct adduction deformity of the forefoot and equinus deformity of the hindfoot.
Accurate preoperative diagnosis for gastrointestinal stromal tumor (GIST) was obtained using the endoscopic approach in about 50% of the cases. Preoperative assessment is quite important in reproductive women for the treatment of pelvic tumor. We report the first case of GIST of the rectum that was accurately diagnosed with preoperative needle biopsy from the vaginal wall. The case was a 38-year-old woman who presented with a history of genital bleeding. Internal examination revealed a round and elastic mass (7 x 7 cm) in the left pelvic cavity. The biopsy specimen from the left sidewall of the vagina using a manually manipulated biopsy needle showed strong reaction for CD34 and CD117 (c-KIT). The patient underwent low anterior resection of the rectum, tumor resection, and partial resection of the posterior vagina. Preoperative biopsy with vaginal approach might be helpful to make a diagnosis for pelvic tumor of unknown origin and unknown malignant potential.
We found Encephalitozoon-like organisms in an in vitro culture of a human liver lesion which was due to larval Echinococcus multilocularis. The organisms developed in the same fashion as an Encephalitozoon cuniculi. The spores that developed in parasitophorous vacuoles were 2.0-2.6 x 1.1-1.5 microns; each contained a single nucleus and 4-5 polar tubule coils, closely resembling E. cuniculi in its ultrastructure. Mature spores were collected from the supernatants by the use of Percoll centrifugation resulting in the banding of the spores on continuous gradients. We prepared three sorts of spores which were different in buoyant density in 0.15 M NaCl: 1.05-1.07 g/ml spores, 1.12 g/ml spores, and spores of over 1.14 g/ml. Polyclonal antibodies to a pool of each spore preparation were produced in a rabbit and applied to the detection of microsporidian antigen in situ. The histoimmunoperoxidase (HIP) procedure was used to detect the microsporidian antigen in echinococcal liver lesions from patients with alveolar hydatid disease (AHD). Ten echinococcal liver lesions from different AHD patients were examined and four were found to be positive in the HIP test. The Percoll-separated spores were also used as an antigen to detect for antibodies in the sera from the patients with AHD by Western blotting. Antibodies were detected in 62 (52%) of the 119 AHD patients and in only 8 (5%) of the 159 normal healthy individuals.
Microsporidian spores were developed from cells which were grown in vitro from a human liver lesion which was due to larval Echinococcus multilocularis. The microsporidian spores developed in the same fashion as an Encephalitozoon cuniculi. The Encephalitozoon-like spores were completely separated on Percoll gradients. The separated spores contained DNA capable of amplification by two different primer sets designed for the polymerase chain reaction (PCR) of E. multilocularis DNA. However, the cell DNA from which microsporidium developed was thoroughly insensitive to the PCR using the E. multilocularis primer sets. The results strongly suggested that Encephalitozoon should be taken into consideration, when DNA isolated from larval E. multilocularis is analyzed.
Encephalitozoon-like spores were separated from a human echinococcal liver lesion, which was caused by Echinococcus multilocularis. They were found to fall into the species Encephalitozoon cuniculi, which was shown to have En. cuniculi-specific DNA by way of polymerase chain reaction (PCR). We also used PCR to genetically discriminate between the En. cuniculi spores and the Ec. multilocularis larvae. Two primer sets, known to be specific for Echinococcus, were examined. These primers were expected to work normally when the two quite different DNA preparations were tested as templates, i.e. only Echinococcus DNA could give a positive signal in the PCR tests. However, it was found that the two Echinococcus-specific primer sets could amplify not only Ec. multilocularis DNA, but also En. cuniculi spore DNA. We then tried to determine the order of nucleotides in the Echinococcus-specific primers-amplified En. cuniculi PCR products and compared the determined sequences with those of Ec. multilocularis. The results clearly indicated that sequencing made little difference between En. cuniculi and Ec. multilocularis.
Extracellularly applied ATP, UTP and UDP induce a transient increase in the intracellular Ca2+ concentration of mammary cells via a P2U receptor. The P2U receptor in the mammary tumor cell line MMT060562 was cloned and expressed in the human leukemia cell line K-562. The deduced amino acid sequence of the mammary tumor cell P2U receptor was 98% homologous with that of mouse NG108-15 cells. It was a member of the superfamily of GTP-binding-protein-coupled receptors. ATP and UTP induced the increase in the intracellular concentrations of Ca2+ and inositol-1,4,5-trisphosphate in both mammary tumor cells and P2U-receptor-expressed K562 cells. Dose-response curves on the production of inositol-1,4,5-trisphosphate and Ca2+ by ATP and UTP were consistently similar. Injection of GTP enhanced the ATP-induced outward current and injection of GTP gamma S induced a repetitive outward current. Both pertussis and cholera toxins did not affect ATP-induced calcium increase. It was suggested that the P2U receptor coupled with pertussis- and cholera-toxin-insensitive GTP-binding proteins and activated phosphoinositide turnover.
An 8-year-old girl with chronic idiopathic intestinal pseudo-obstruction (CIIP), who is the first case of CIIP in Japan, has been receiving total parenteral nutrition (TPN) for more than 6 years. During this time, she experienced deficiencies of copper, zinc, vitamin A, vitamin B12, folic acid, and biotin, and an excess of vitamin A; she exhibited a series of signs and symptoms due to these deficiencies and vitamin A overdosage. Nevertheless, careful monitoring of serum levels of trace elements and vitamins and appropriate therapy have almost solved these problems. She has achieved normal physical and mental development and goes to school, while receiving home parenteral nutrition with an ambulatory infusion system.
The effect of tibial and femoral attachment site on the length change and force of an anterior cruciate ligament graft during unloaded flexion in eight cadaver specimens was examined. Two tibial sites (anteromedial and central portion of the anterior cruciate ligament attachment) and three femoral sites (anterior and central portions of the anterior cruciate ligament attachment, and over-the-top) were evaluated. Graft length changes between all combinations of attachment sites were measured from full extension to 150 degrees of passive flexion at 15 degrees intervals using the displacement of a 2-mm inextensible cord. The anterior cruciate ligament was then reconstructed using a Kennedy Ligament Augmentation Device, and graft forces at the same angles of passive flexion were measured with a buckle transducer. Graft length change and force were more affected by the femoral attachment site than the tibial site. There was a close correlation between length change and force measurements in flexion, but not near extension. The pattern of force and length change versus flexion angle for a given combination of attachment sites sometimes varied over the knees tested. Our results suggest that intraoperative isometry measurements are worthwhile for indicating an overloaded graft in flexion; however, length changes near extension may not adequately reflect graft force, creating the possibility that a graft may be more highly loaded than realized.
To investigate the effects of postoperative immobilization and limited motion on reconstructed anterior cruciate ligaments, 28 rabbits received an anterior cruciate ligament reconstruction using autogenous Achilles tendon and were then divided into three groups: fully immobilized, 4 weeks immobilized, and limited motion. Two rabbits from each group were evaluated macroscopically, histologically and microangiographically at 4-week intervals until 12 weeks postoperatively. An additional six rabbits in the 4 weeks immobilized and limited motion groups were studied biomechanically at 12 weeks postoperatively. Macroscopically, both immobilized groups showed more proliferation of the infrapatellar fat pad, which was adherent to the reconstructed anterior cruciate ligament. Histology revealed more rapid regeneration of reconstructed anterior cruciate ligaments in the limited motion group, with no findings of necrosis in the mid-substance. Microangiography indicated faster normalization of vascularity in the limited motion group. The biomechanical study showed no significant difference in laxity between the 4 weeks immobilized and limited motion groups. The graft stiffness and maximum load to failure were greater for the limited motion group, although the increase was not statistically significant. The histologic and microangiographic results from the limited number of animals in this study support limited postoperative motion in the anterior cruciate ligament reconstructed knee. However, there were no differences in terms of the biomechanical parameters at 12 weeks postoperatively between the immobilized and limited motion treatment modes.
We used computerized tomography to evaluate the position of the tibial tubercle and to determine if the tibial tubercle is positioned more laterally in female patients with patellofemoral pain. We also wanted to determine the relationship of the tibial tubercle to tibial external rotation and patellar tilt. Sixty female patients and 19 healthy female controls were evaluated. To evaluate the position of the tibial tubercle, the tibial tubercle rotation angle (the angle formed by the line between the posteriormost edges of the medial and lateral femoral condyle and the line between the central point of the intercondylar space and the central point of the patellar tendon at the level of the tibial tubercle) was measured by superimposing the images from the level of the distal femoral condyle and the tibial tubercle. The relationship between the tibial tubercle rotation angle and patellar tilt was then assessed by dividing the patients into 3 subgroups according to the patellar tilt. The tibial tubercle rotation angle was significantly different between the patellofemoral pain patients and the controls. There were also significant differences between the patients with moderate patellar tilt (10 degrees to 20 degrees) and the controls, and between the patients with high patellar tilt (> 20 degrees) and the controls.
To clarify the natural course of synovitis after anterior cruciate ligament injury, we took synovial tissues at various periods after injury and analyzed them immunohistologically. Twelve patients with isolated anterior cruciate ligament injuries participated in the study. Inflammation intensity was graded semiquantitatively based on the following parameters: synovial lining cell depth, synovial hyperplasia, vascular hyperplasia, lymphocyte infiltration, and the expression of cell adhesion molecules. The expression of fibrogenic cytokines and the degree of fibrosis were also investigated to elucidate the mechanisms of arthrofibrosis. The results demonstrated that synovitis in the infrapatellar fat pad subsides within 3 months after injury with the progression of fibrosis. Fibrogenic cytokines, platelet-derived growth factor and transforming growth factor-beta, were detected at fibrotic sites, suggesting their involvement in arthrofibrosis. An increased incidence of arthrofibrosis recently has been recognized to occur when anterior cruciate ligament reconstruction is performed within several weeks after injury. We speculate that when anterior cruciate ligament reconstruction is performed during the stage of acute synovitis, the operation may further promote the synovitis, accelerating the arthrofibrotic reaction. Waiting to perform the anterior cruciate ligament reconstruction until the synovitis resolves may possibly decrease the motion problems seen postoperatively.
We performed quantitative analysis of synovial fibrosis in the infrapatellar fat pad in 26 patients who underwent arthroscopically assisted anterior cruciate ligament reconstructions. Twelve patients underwent reconstruction with patellar tendon autografts, and 14 had reconstructions with semitendinosus and gracilis tendon autografts. Synovial samples were obtained at the time of reconstruction from 10 patients and at second-look arthroscopy from all 26 patients. Sections from quick-frozen samples were stained with either hematoxylin and eosin or Fast green and Sirius red. We used sodium hydroxide in absolute methanol to elute the Fast green and Sirius red stains, and the total collagen content of each section was estimated by measuring the optical density of the eluted solution. The volume of each section was determined on a computer using an imaging program, and collagen content per unit of tissue was calculated. Median collagen content was 15.3 micrograms/mm3 for the preoperative samples, 25.1 micrograms/mm3 for the group with patellar tendon autografts, and 27.1 micrograms/mm3 for the group with hamstring tendons autografts. Analysis of preoperative and postoperative paired samples revealed a significant increase in synovial collagen after anterior cruciate ligament reconstruction. We observed increased fibrosis in patients who had pain on exertion or stiffness in squatting after the reconstructive surgery.
Between 1986 and 1989, 40 patients with acute lateral ligament injury of the ankle joint were treated by immobilizing their affected feet in a plaster cast with a heel for 4 weeks, followed by a brace for the next 2 months. The average follow-up time was 29 months. Ninety-eight percent of the patients were rated as having satisfactory functional results. Stress radiographs at the latest follow-up showed good stability even in ankles that were severely unstable at injury. Posttreatment stress radiographs taken periodically showed that stability was maintained 6 months after treatment.
A 40-year-old woman was presented with a fever, which proved to be due to mediastinal tuberculous lymphadenitis. Up to 1988, 149 cases of tuberculous mediastinal lymphadenitis have been reported in the literature in Japan. This case was very rare because a chest plain film revealed neither mediastinal widening nor lung parenchymal involvement. On the other hand, a CT scan of the chest was very useful because it showed unsuspected mediastinal lymph nodes enlargement. The diagnosis of tuberculous mediastinal lymphadenitis was made by the findings of a supraclavocular lymph node biopsy, which showed granulomas, compatible with tuberculosis. A good response from the patient to antituberculous therapy confirmed this diagnosis.
The authors report a malignant peripheral nerve sheath tumor (MPNST) that developed in the body of the pancreas of a 76-year-old woman. The well-demarcated tumor, 4.5 x 3.5 cm in size, was composed of spindle-shaped cells arranged in a storiform pattern or sweeping fascicles. Ultrastructurally, the tumor cells had elongated cytoplasmic processes with numerous pinocytotic vesicles, and were covered with discontinuous basal lamina-like substances. Immunohistochemically, tumor cells were diffusely positive for epithelial membrane antigen, vimentin, and CD34, but negative for S-100 protein and Leu 7. It was therefore concluded that the tumor was a MPNST with perineurial cell differentiation. Primary MPNST of the pancreas is extremely rare and the immunohistochemical and ultrastructural studies are necessary for its diagnosis.