Expression of heat shock protein in human gastric mucosa.
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Biomedical subjects
Publications and source records attributed to K Kashima.
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It has recently come to be thought that cases of juvenile polyposis have a natural tendency to develop adenoma and/or carcinoma. Here we present a case of juvenile polyposis coli with adenomatous change in a 21-year-old male, with a review of 34 cases of juvenile polyposis in the Japanese literature, and discuss the pathogenetic development of the polyps and their malignant potential. In this case, focal or entire adenomatous areas were found in large part of the polyps in the resected sigmoid colon and rectum, though these findings had not been recognized in 23 polypectomy specimens from the rectum 10 months prior to the operation. It was suggested that adenomatous change developed quickly in a very short time.
We measured the sequential changes in 2',5' oligoadenylate synthetase activity in 21 patients with acute viral hepatitis (5 with type A, 6 with type B, and 10 with type non-A, non-B hepatitis) by radioimmunoassay. Liver biopsies were performed during the acute phase in all patients. Among patients with acute hepatitis A and B, the 2',5' oligoadenylate synthetase levels were transiently elevated at the time of the peak alanine aminotransferase level in the patients in whom a liver biopsy showed acute hepatitis or non-specific reactive hepatitis. Of 10 patients with acute non-A, non-B hepatitis, 4 showed a similar 2',5' oligoadenylate synthetase activity pattern and liver histology to those observed in acute hepatitis A and B. In the remaining 6, the 2',5' oligoadenylate synthetase levels remained elevated for 3.5 to 6 months while the alanine aminotransferase was elevated. Liver biopsy in these patients showed chronic hepatitis. Persistent detection of raised 2',5' oligoadenylate synthetase activity levels during the acute stage of non-A, non-B hepatitis may thus be an indicator of progression of the disease.
We determined the effect on feeding of Lys-D-Pro-Thr (LDPT), an interleukin-1 beta 193-195 analogue which antagonizes the analgesic effects of interleukin-1 beta. Intracerebroventricular administration of 2 micrograms/rat LDPT increased food consumption at the 0-1 h time period, although food intake was reduced by LDPT at the 1-2 h time period. There was no effect on colonic temperature 1 h later. Subcutaneously injected LDPT (2 micrograms/rat) failed to increase food intake for 1 h. These data suggest that brain interleukin-1 beta may have a physiological role in feeding suppression.
Serial changes in the color tone of the mucosa after fluorescein administration in patients with peptic ulcers were evaluated using an electronic endoscope. In the healing and scar (S1) stage of a peptic ulcer, more intense fluorescence was observed in the lesion than in the surrounding normal mucosa shortly after intravenous injection of fluorescein. On processing of the electronic endoscopic fluorescent images using HSI transformation the difference between the lesion and normal areas could be clearly identified. This difference in the fluorescent image between the lesion and the surrounding normal mucosa may be associated with changes in the mucosal blood flow and cellular functions in the lesion. Fluorescent electronic endoscopy with fluorescein thus seems to be a useful technique for examination of the gastrointestinal mucosa.
We performed specular microscopy on the corneal endothelium of 22 long-term hard contact lens wearers (15-32 years duration) and 22 age- and sex-matched controls. We found polymegethism in users as shown by a significant difference in the coefficient of variation in cell area (p less than 0.01) and pleomorphism as shown by a significant decrease in the percent of 6-sided cells (hexagonality, p less than 0.01). There was no significant difference in cell density and mean cell area between the 2 groups. Contact lens wear was discontinued in five eyes of three patients after they were entered into the study and switched to eye-glasses. Specular micrographs were taken up to 60 months after discontinuation of use of the lenses. Comparison of the above parameters before and after discontinuation of the lenses did not show a significant change. However, there was a trend toward improvement in the coefficient of variation in the eyes that were followed the longest. This finding suggests that the morphological changes induced by long-term use of contact lenses may be slowly reversible after prolonged discontinuation of contact lens wear.
Effect of cholinergic stimulation on the release of digestive enzymes from isolated rat pancreatic acini prepared by collagenase digestion was investigated. The release of enzymes (amylase, chymotrypsinogen, lipase) increased linearly with the time of incubation in the absence of secretagogues. Carbachol, a muscarinic agonist, induced a remarkable increase in the release of these enzymes. This carbachol-stimulated amylase release showed a biphasic curve, and its maximal response was observed at 10(-5) M. The release patterns of chymotrypsinogen and lipase were similar to that of amylase. This carbachol-stimulated amylase release was inhibited by atropine in a dose-dependent manner, with an ED50 value of 1.17 X 10(-8) M. Other cholinergic agonists such as methacholine also stimulated the release of these enzymes, and these increases in the release were inhibited by atropine. Scatchard analysis for [3H]quinuclidinyl benzilate ([3H]QNB) binding to isolated pancreatic acini revealed that the binding site of [3H]QNB was a single component with a Kd value of 0.09 nM and a Bmax value of 89.3 fmol/mg protein, respectively. The effect of other cholinergic antagonists, pirenzepine and AF-DX 116 (11-[[2-[(diethylamino) methyl]1-piperidinyl]acetyl]-5,11-dihydro- 6H-pyrido[2,3-b][1,4]-benzodiazepine-6-one), on pancreatic acini was also investigated. Based on these results, it has been concluded that isolated rat pancreatic acini have muscarinic receptors and are useful for analyzing the mechanism of pancreatic enzyme secretion.
A female patient in whom acute nonlymphocytic leukemia (ANLL, FAB-M6) developed during treatment of hepatocellular carcinoma (HCC) is described. Two years after partial hepatectomy and subsequent chemotherapy, leukemia developed following a 2 month preleukemic stage. Chromosomal analysis revealed an abnormal karyotype, 46,XX,-5, + der(5)t(3;5)(q25;q31). The balanced translocation t(3;5) has been observed in all types of ANLL and MDS except for ANLL M3 subtype. We summarize patients with ANLL M6 and t(3;5).
Intra-arterial chemotherapy from bilateral superficial temporal arteries and radiotherapy were carried out preoperatively on two patients with oral cancer on the midline. Total doses of preoperative chemo- and radio-therapies were 160 mg/m2 of carboplatin, 50 mg of peplomycin and 20 Gy of 60Co-irradiation, respectively. Therapeutic effect of preoperative chemo- and radio-therapies was evaluated on the resected materials from histological point of view. In case 1, the effect was judged as Grade II A in Oboshi's classification, which indicated a mild destruction of architecture of tumor tissue and a few viable tumor cells, but an extreme reduction of the primary lesion was observed on clinical appearance. In case 2, the therapeutic effect was regarded as Grade II B, which indicated a severe destruction of architecture of tumor tissue and few viable tumor cells. Concerning toxicity, mucositis and slight thrombocytopenia (96,000/mm3) in case 1, and mucositis and leukopenia (2,300/mm3) in case 2 appeared. However, they soon recovered after termination of the preoperative therapies. From the above results, it was considered that a combination of bilateral intra-arterial chemotherapy and radiotherapy was quite effective as a preoperative treatment for oral cancers on the midline at the same doses of anti-neoplastic agents and irradiation as for the other unilateral oral cancers.
We have evaluated the problem of autoantibodies such as antinuclear antibodies (ANA), smooth muscle antibody (SMA) and antibodies to thyroid microsomal (TMA) and to thyroglobulin (TGA) related to interferon therapy in 27 patients with chronic hepatitis B. Anti-interferon antibody was also studied by Western blot method. Eight patients had ANA and 2 had SMA during interferon therapy. However, 6 of the 8 patients were ANA positive and one of the 2 was SMA positive prior to interferon treatment. No patients developed TMA, TGA or anti-interferon antibody. Eight (29.6%) of the 27 patients had clearance of both DNA polymerase and HBeAg and persistent normalization in alanine aminotransferase levels with interferon therapy. Seven of the 8 responders developed none of the autoantibodies related to interferon therapy. These results suggest that the presence of ANA or SMA during treatment may affect the therapeutic response to interferon.
A case of familial essential myoclonus was reported with electrophysiological studies. A 58-year-old female presented with involuntary movement (myoclonic jerk) since age 6 years. At the age over 50, she developed difficulty in writing and fine finger movements. Two years ago, the diagnosis of hyperthyroidism was made, but she did not take any anti-thyroid medication. She was admitted to our hospital for further evaluation of myoclonus. On family history, her grandson (4-years-old) had myoclonus. On general physical examination, she showed a diffuse goiter. On neurological examination, she showed spontaneous myoclonus in the face, neck, trunk and the proximal limb muscles, especially in the left upper and right lower extremities. The myoclonus was exacerbated with auditory stimulation and emotional tension, but there was no temporal relationship between each stimulus and myoclonus. There was no myoclonus during sleep. Finger-to-nose test showed coarse intention myoclonus. Laboratory examinations including lysosomal enzyme assay revealed no abnormalities except for the decrease in total cholesterol (118 mg/dl) and the increase in serum lactate (19.7 mg/dl). The serum concentration of thyroxin was 18.4 micrograms/dl, that of triiodothyronine 3.0 ng/ml, and that of thyroid stimulating hormone (TSH) 0.027 microIU/ml. Anti-thyroglobulin antibody and anti-microsomal antibody were positive (X100, X6400). Neurological laboratory tests were normal including cerebrospinal fluid, peripheral nerve conduction study, electromyogram (EMG), muscle biopsy, cranial computed tomography and magnetic resonance imaging, and positron emission tomography. Electron transport system of the biopsied muscle was normal. So, we made a diagnosis of familial essential myoclonus and hyperthyroidism. In the electrophysiological studies, the electroencephalogram (EEG) was within normal limits.(ABSTRACT TRUNCATED AT 250 WORDS)
Endoscopic manometry using microtransducer was applied to evaluate the motor activity of the sphincter of Oddi (SO) and common bile duct (CBD) in patients with biliary tract stones and in controls. CBD pressure, SO pressure and the incidence of irregular phasic wave pattern (IRPWP) were relatively higher in patients with biliary tract stones than those in controls. There was no significant difference in CBD and SO pressure between patients with dilated CBD and patients with non-dilated CBD, however the incidence of IRPWP was significant higher in patients with dilated CBD than that in patients with non-dilated CBD. SO pressure and the incidence of IRPWP were significant higher in patients with papillitis than those in patients without it. Patients with valvular orifice of the papilla of Vater showed high incidence of IRPWP, and in such cases it was suggested that SO had different motor functions for CBD and pancreatic duct because these ducts were seen opening onto the papilla separately according to the findings of pancreatocholangiogram. We concluded that endoscopic manometry of CBD and the SO was useful to evaluate the motor activity of SO and provided a basis for the assessment of the motor function mechanism of SO. Our results indicated the motor activity of SO had close relationship with biliary tract stones, CBD dilatation and endoscopic findings of the papilla of Vater.
We developed a polymerase chain reaction assay for the direct detection of hepatitis B virus in paraffin-embedded liver tissue and applied this assay to determine whether hepatitis B virus DNA exists in livers with chronic hepatitis non-A, non-B. Fifty five liver biopsy samples were studied: 11 from patients with HBeAg-positive chronic hepatitis (paraffin-embedded) and 44 from patients with chronic hepatitis non-A, non-B (21 paraffin-embedded; 25 fresh frozen). Thirty three (75%) of the non-A, non-B cases were positive for hepatitis C virus antibodies. Approximately 1 to 10 ng of DNA was extracted from the paraffin-embedded tissue and amplified using oligonucleotide (23-mer) primers specific for the S gene (positions 261 to 692). The beta-globin gene was used as an internal control for sensitivity because this is a single copy gene and allows for relative quantification. In each of the chronic hepatitis B livers, the expected 432-base-pair amplification product for hepatitis B virus DNA and beta-globin gene product were both detected. On the other hand, in the 21 paraffin-embedded chronic hepatitis non-A, non-B livers, no hepatitis B virus DNA was detected, although beta-globin gene was observed in all. Furthermore, in all 25 frozen non-A, non-B livers, beta-globin gene was observed, but no hepatitis B virus band was seen. The limit of detection of hepatitis B virus DNA by this method was estimated to be one genomic copy of hepatitis B virus DNA per cell.(ABSTRACT TRUNCATED AT 250 WORDS)
A 53-year-old Japanese woman suffered hypophosphatemic osteomalacia secondary to bone tumor. Her clinical symptoms did not improve for a long time following the oral administration of Alfacalcidol (vitamin D3). A bone survey using radiographs revealed a small tumor located in the proximal head of the left fibula. Hypophosphatemia and low levels of 1-alpha,25-dihydroxycholecalciferol (1-alpha,25(OH)2D3) returned towards normal levels soon after an en-bloc tumor resection, and bone pain and muscle weakness gradually disappeared. The histology, especially of the trabecular bone of the left fibula, showed typical features of osteomalacia with demineralization. The tumor comprised numerous small blood vessels, spindle shaped or oval neoplastic cells, a few multinucleated giant cells, osteoid tissue with or without calcification, chondroid tissue and hemangioma. The spindle shaped or oval cells contained a round nucleus with no mitotic figures. These clinical and histological findings coincide well with a diagnosis of benign ossifying mesenchymal tumor of the bone with vitamin D resistant hypophosphatemic osteomalacia.
A patient with B-cell lymphoma with a chromosome rearrangement of t(14;19)(q32.3;q13.1) is reported. This patient had leukemic features and an aggressive clinical course. The histopathologic diagnosis was malignant lymphoma, small noncleaved cell. Chromosome analysis of the cells from a cervical lymph node and peripheral blood showed a reciprocal translocation between chromosome 14 with a break at band q32.3 and chromosome 19 with a break at band q13.1, to which the bcl-3 gene has been mapped. Monoclonal rearrangement of the JH gene was detected by Southern blot analysis. However, we could not detect rearrangement of the bcl-3 gene. This case also had a t(2;8)(q13;q24.1), but the c-myc gene remained in its germline. This is the first case with the reciprocal t(14;19) and 8q24 chromosomal breakpoint in a B-cell lymphoid malignancy.
In our chromosome study of 97 patients with myelodysplastic syndrome (MDS), six showed an unbalanced translocation between chromosomes 1 and 7 [-7, +der(1)t(1;7)(p11;p11)]. All of them had morphologic myelodysplasia in trilineage of bone marrow cells, and cytopenia was the major finding in the peripheral blood. All six patients had symptoms of infection at the time of diagnosis, and five showed immunologic abnormalities (polyclonal hypergammaglobulinemia in four and increased marrow plasma cells in three). None of the patients survived more than 11 months after the diagnosis; the median survival time was 4 months. Both of the two patients whose karyotypes were reexamined in the course of their disease showed karyotypic evolution accompanying the coincidental leukemic transformation. Six patients with MDS who had the same chromosome abnormality [t(1;7)] are described and their characteristic clinical features are presented.
Urinary bile acids from 20 patients treated with chenodeoxycholate, 18 treated with ursodeoxycholate, 15 treated with rifampicin and 8 patients with advanced cirrhosis were analyzed by gas-liquid chromatography and gas-liquid chromatography-mass spectrometry. Occurrence rates and amounts of three so-called unusual trihydroxy bile acids, hyocholate, ursocholate and omega-muricholate, were increased in patients treated with chenodeoxycholate, ursodeoxycholate or rifampicin and decreased in cirrhotic patients as compared with those in untreated healthy adults. These data suggest that chenodeoxycholate and ursodeoxycholate are hydroxylated to produce unusual trihydroxy bile acids in bile acid-loaded humans and that this metabolism may be related to the induction of hepatic microsomal enzymes by rifampicin. In contrast, the hydroxylation of chenodeoxycholate and ursodeoxycholate may be impaired by severe hepatic damage. Because the urine is a secretory pathway for internal bile acids, the occurrence of unusual trihydroxy bile acids in the urine may be used as an indicator of hepatic ability to metabolize "hydrophobic" dihydroxy bile acids to their secretory forms.
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