Systemic lupus erythematosus complicated with pulmonary thromboembolism originating from verrucae of Libman-Sacks endocarditis.
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Biomedical subjects
Publications and source records attributed to K Kikuchi.
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Two consecutive pregnancies at risk for Tay-Sachs disease with heat-labile beta-hexosaminidase B were monitored. Differential isozyme detection of beta-hexosaminidase in cell free amniotic fluid by DEAE cellulose column chromatography and cellulose acetate paper electrophoresis showed an affected fetus in the first pregnancy and an unaffected in the second. These results were confirmed in the aborted fetus and in a newborn baby, respectively.
The responsiveness of lymphocytes obtained from patients with brain tumors to in vitro stimulation with mitogenic lectins was examined. The previously reported finding of decreased responsiveness was confirmed. To investigate the factors responsible for the hyporesponsiveness, mitogen (phytohemagglutinin and pokeweed mitogen) induced lymphocyte activation was evaluated using lymphocytes from 22 patients with brain tumors and 22 normal individuals. Lymphocytes from 13 patients with brain tumors, showed depressed responsiveness when cultured in autologous serum; in eight this was marked and in five moderate. Normal, rather than autologous, serum corrected lymphocyte function from only one of the markedly hyporesponsive patients, suggesting the existence of an intrinsic lymphocyte abnormality in some patients with brain tumors. However, serum from the hyporesponsive patients depressed mitogen-induced activation of lymphocytes from both tumor patients and normals. The presence of suppressive serum factors could not be related to the nature of the tumor (benign versus malignant, site, cell type or degree of anaplasia). The present studies showed that significant depression of in vitro lymphocyte responsiveness occurred with exposure to two anti-convulsant agents (phenytoin and phenobarbital) and dexamethasone. Thus, impaired lymphocyte function in patients with brain tumors may have a complex explanation with drug (corticosteroids, anticonvulsants) induced suppression playing a significant role.
Seventeen placentas from normal Japanese women, obtained from 15 full term gestations and at 2 earlier gestational periods, were observed by electron microscopy for the presence of type C retrovirus-like particles. Immature free and budding particles were found in 16 placentas including those obtained pre-term. Free virus-like particles were seen in the intercellular spaces and within the lysosomes of syncytiotrophoblasts of the chorionic villi. Forms budding from syncytiotrophoblasts were found in 3 cases. Coincident data with the electron microscopic observations were obtained by immunohistological methods. Specific positive staining with antisera against heterogeneic whole murine leukaemia virus were seen within the cytoplasm of trophoblastic cells both in and along the basal lamina.
We successfully treated a critically ill infant with the classical type of maple syrup urine disease by multiple exchange transfusions via a peripheral artery and vein and with positive calorie supplementation in the early stage of therapy. Clinical improvement was definite after the plasma leucine level fell below 1 mmol/l. There was a close linear correlation between plasma concentrations of branched-chain amino acids and their corresponding branched-chain alpha-keto acids and branched-chain alpha-hydroxy acids. alpha-Hydroxy acids were more easily excreted in the urine than alpha-keto acids and amino acids. Our studies on urinary organic acids supported the existence of minor metabolic pathways of branched-chain alpha-keto acids, although they were not thought to be important in eliminating accumulated alpha-keto acids. Urinary excretion of succinic acid and alpha-ketoglutaric acid, which are components of the citric acid cycle, increased transiently during the patient's convalescence. The cerebrospinal fluid/plasma ratios for branched-chain amino acids, alpha-keto acids, and alpha-hydroxy acids were very high before the transfusions and decreased after improvement. The cerebrospinal fluid/plasma ratios for 5-carbon acids, alpha-ketoisovaleric acid and alpha-hydroxyisovaleric acid were much higher than for other branched-chain acids not only in the patient but also in normal controls. Cerebrospinal fluid levels of alpha-ketoisocaproic acid and alpha-hydroxyisovaleric acid were as high as 1 mmol/l in our patient.
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A new monoclonal antibody specific for human B cell differentiation antigen (HLB-1) is produced by a hybridoma established by fusion of splenocytes of mice immunized with the Epstein-Barr virus (EBV)-transformed peripheral B cell line, RPMI-8057. This monoclonal, antibody designated anti-HLB-1 monoclonal antibody (anti-HLB-1), reacted with surface immunoglobulin (sIg)-positive B cells of normal peripheral blood and lymphoid tissues and sIg-positive leukemic cells. The cells of T cell leukemia, non-T non-B acute lymphoblastic leukemia (ALL) and nonlymphoid leukemia were HLB-1 negative. These data were further confirmed by studying a panel of cultured human hematopoietic cell lines. Anti-HLB-1 reacted with B cell lines derived from pre-B, Burkitt's lymphoma, B cell type ALL and EBV-transformed peripheral B cells. Anti-HLB-1 was reactive with only one of three human myeloma cell lines, and with none of the T cell, myeloid and non-T non-B ALL cell lines. This newly defined HLB-1 antigen is different from other conventional human B cell markers such as sIg, Ia antigens, and receptors for the Fc portion of Ig and complement C3.
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Many reports have suggested that cardiac dysfunction with cardiomegaly is more often observed in patients with chronic hemodialysis. Moreover, cardiac dysfunction has been thought as one of the most important factors affecting the prognosis of these patients. In this study, in order to clarify the role of l-carnitine in the pathogenesis of cardiomegaly, 33 patients with chronic hemodialysis were studied using the multivariate analysis method. Among the factors which may affect cardiac function, the following 10 variables were examined. 1) age, 2) duration of dialysis, 3) plasma carnitine, 4) serum total cholesterol, 5) serum HDL-cholesterol, 6) triglyceride, 7) systolic blood pressure, 8) diastolic blood pressure, 9) left ventricular voltage on a electrocardiogram at rest and 10) hematocrit. The plasma carnitine levels in these patients were markedly reduced and inversely correlated with the cardiothoracic ratio (CTR) on the chest X-ray films (r = 0.38, p less than 0.05). In principal component analysis, the CTR was closely related to hematocrit and plasma carnitine levels. By multiregression analysis, both hypo-carnitinemia and anemia were independently shown to be important causes of cardiomegaly. Thus, it is suggested that the cardiomegaly in patients with chronic hemodialysis may be improved by supplemental therapy with l-carnitine, even in cases with severe anemia.
The present investigation was conducted to examine the effects upon normal lymphocyte activation of the addition of brain-tumor cyst fluid or cerebrospinal fluid (CSF) to an in vitro culture system. It was believed that factors present in these fluids may play a role in local and systemic immunosuppression in brain-tumor patients. The authors evaluated the effect of the cyst fluid, CSF, and serum from eight patients with brain tumors (one astrocytoma, five glioblastoma multiforme, one medulloblastoma, and one microglioma) on mitogen-stimulated lymphocyte function as measured by 3H-thymidine incorporation, cell size distribution, and cellular proliferation. Lymphocytes from normal volunteers were incubated for 90 hours in culture medium with 10% pooled human serum, mitogens (phytohemagglutinin, concanavalin A, and pokeweed mitogen), and a range of volumes of cyst fluid or CSF from the tumor patients. Significant suppression of mitogen-induced activation of the lymphocytes was demonstrated in the presence of cyst fluid from five out of six patients, but the mitogen response was only minimally affected by the addition of the CSF from these patients to the culture medium. The suppression of lymphocyte activation by cyst fluid was directly proportional in several cases to the concentration of the cyst fluid. The total protein, albumin, and immunoglobulin (Ig) concentrations in the cyst fluids were observed to roughly correspond to the serum levels and were much higher than in CSF. These studies suggest that brain-tumor cells locally produce lymphocyte-suppressive factors which may then be released into blood. Preliminary characterization of the suppressive factor(s) responsible for the inhibition of lymphocyte function indicates that they are non-dialyzable and do not appear to be an IgG.
This study was designed to evaluate the most effective administration method of NCS for advanced carcinoma of the stomach, mainly nonresectable and/or recurrent cases which were collected by our cooperative study group. Nine hundred seventy six cases were available for clinical evaluation. Rate of the efficacy of NCS alone and combined with 5-FU was higher (P less than 0.1) in the cases administrated intravenously by drip infusion than in those by one shot injection method, and adverse effects were fewer in the former than in the latter cases. The rate of efficacy of NCS was higher in cases treated with 4,000 mu/day alone intermittently 2-3 times for a week than in those with 2,000 mu/day alone every day. The rate of clinical effect was higher in the cases treated with 4,000 mu of NCS combined with 50 mg of 5-FU intermittently than in those with 2,000 mu of NCS combined with 250 mg of 5-FU every day, especially 20.6% of the former cases given more than 50,000 mu of NCS were interpreted as clinically effective by Karnofsky's criteria of I-A over.
The present study was designed to evaluate the efficacy of chemotherapy by NCS for advanced and/or recurrent carcinoma of the pancreas, mainly nonresectable cases in which exploratory laparotomy or construction of biliary fistula were performed. Three hundred fifty seven cases were available for the study. Of the 357 cases, 116 were treated with NCS alone 5-FU. In the former, the efficacy rate was higher in cases with 2,000 mu/body of NCS every day than in those with 4,000 mu/body of NCS intermittently 2-3 times for a week. 19.6% of the cases treated with more than 40,000 mu of NCS alone in total were interpreted as effective clinically by Karnofsky's criteria of I-A over. In the latter, the efficacy rate was higher in cases with 2,000 mu/body of NCS combined with 250 mg of 5-FU every day than in those with 4,000 mu of NCS combined with 500 mg of 5-FU intermittently, 22.5% of the cases given more than 40,000 mu of NCS in total were interpreted as effective clinically by Karnofsky's criteria of I-A over. The major adverse effects of NCS such as anorexia, vomiting and nausea were observed in 20% of total cases respectively, leucopenia in 10% and fever in 15% of them.
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Rat thymus and T-cell antigens were defined by using two distinct monoclonal antibodies (R-1-3B3 and R-1-12C5). R-1-3B3 antibody, when tested for its reactivity with rat lymphoid cells by immunofluorescence, labelled virtually all thymus and T cells but not B cells and bone marrow cells. The antigen defined by this R-1-3B3 antibody occurred more abundantly on medullary thymocytes and peripheral T cells than on cortical thymocytes. Immunochemical data showed that R-1-3B3 antibody recognized a single glycoprotein with a molecular weight of 67,000, which were able to interact with Lens culinaris haemagglutinin. R-1-12C5 antibody, on the other hand, reacted with all of thymus and T cells as well as with a subpopulation (approximately 20%) of bone marrow cells. In contrast to the antigen defined by R-1-3B3, that detected by R-1-12C5 antibody existed largely on cortical thymocytes and to a much lesser extent on medullary thymocytes and peripheral T cells. R-1-12C5 antibody detected a single glycoprotein with a 95,000 molecular weight, which could also interact with Lens culinaris haemagglutinin. Based on these data described above and since both antigens defined by R-1-3B3 and R-1-12C5 antibodies were absent from rat brain tissue, we concluded that they were distinct from brain-associated thymic antigens in rats including Thy-1 and W3/13 antigen systems.
A randomized study of 5-FU + adriamycin (the control group) vs 5-FU + adriamycin + levamisole (LMS group) was conducted by an envelope method in 167 patients with advanced gastrointestinal cancer for clinical evaluation of LMS against advanced gastrointestinal cancer. There was a significant increase in survival with the LMS group (p less than 0.05). Median survivals were 3.7 months for the control group and 6.1 months for the LMS group of all patients with gastrointestinal cancer and patients with gastric cancer, respectively. There were no differences in response rate and duration of response between both groups, but the number of PD (progressive disease) cases was significantly smaller in the LMS group than in the control group (p = 0.001). Adverse reactions occurred more frequently in the LMS group, but there was no significant difference in incidence between both groups.
Human thymus and T cell antigens were identified by using four distinct monoclonal antibodies (MoAb), designated 2D5, 5B3, 7A5 and 9D4. 2D5 antibody reacted with most human thymocytes and a few peripheral lymphocytes as well as with a subpopulation (20%) of bone marrow cells, and precipitated a 45K molecular weight (mol. wt.) component from 125I-labelled thymus cell lysate. 7A5 antibody also reacted with the majority (80%) of thymocytes but neither with peripheral lymphocytes nor with bone marrow cells. The antigen detected by 7A5 was a glycoprotein consisting of 48K and 12K mol. wt. components, which were non-covalently associated with each other. 5B3 reacted with virtually all of human thymus and T cells but not with the majority of B cells and bone marrow cells. This reagent precipitated a 72K mol. wt. glycoprotein from thymus and T cells. An additional 65K mol. wt. glycoprotein was precipitated by 5B3 together with the 72K mol. wt. component, but with poor reproducibility. 9D4 antibody, on the other hand, reacted with a 200K mol. wt. component from thymus and T cells as well as 220K and 210K components from the non-T cell fraction of tonsil lymphocytes. Whereas antigens detected by 2D5 and 7A5 appeared to be highly expressed on cortical thymocytes, the antigen defined by 5B3 occurred much more abundantly on medullary thymocytes and peripheral T cells than on cortical thymocytes. Based on the data described above, it is suggested that 7A5, 5B3 and 9D4 MoAb recognize human homologues of mouse TL, Ly-1 and Ly-5 antigens, respectively, whereas 2D5 antibody seems to resemble OKT10, as described by others.