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Biomedical subjects

K Miyagi

Publications and source records attributed to K Miyagi.

At least 91 records · Page 5Linked to original sources
PubMed1994

[Activated T cells in the peripheral blood of patients with subacute myelo-optico-neuropathy (SMON)].

It has been reported that some kinds of immunological abnormalities are more frequently seen in patients with subacute myelo-optico-neuropathy (SMON), as compared with normal subjects. In order to examine whether ageing and clioquinol intoxication in the past may be implicated in the immunological disorders of the patients, we investigated soluble interleukin-2 receptors (sIL-2R) and an appearance of HLA-DR positive T cells using two color flow cytometry analysis in the peripheral blood of 29 patients with SMON, who lived in Nagano Prefecture. The mean level of HLA-DR positive T cells in the total of SMON patients was significantly high as compared with that of normal subjects (p < 0.001). The mean levels of HLA-DR positive T cells were also significantly high in SMON patients in their fifties and younger, sixties, and seventies and older, respectively, as compared with those of normal subjects (p < 0.05, respectively). The mean level of sIL-2R in the total of SMON patients was significantly high as compared with that of normal subjects (p < 0.01). The mean levels of sIL-2R were also high in SMON patients in their fifties and younger, sixties, and seventies and older. An especially significant increase was seen in SMON patients in their sixties (p < 0.01). SMON patients with higher levels of HLA-DR positive T cells tended to have higher levels of sIL-2R, and statistical analysis showed a significant correlation between them (r = 0.696, p < 0.001). An increase in HLA-DR positive T cells and sIL-2R indicates an increase in activated T cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Increased levels of circulating intercellular adhesion molecule-1 in multiple sclerosis and human T-lymphotropic virus type I-associated myelopathy.

We evaluated the presence of soluble intercellular adhesion molecule-1 (sICAM-1) antigen in the sera of patients with multiple sclerosis and human T-lymphotropic virus type I (HTLV-I)-associated myelopathy (HAM) using an enzyme-linked immunosorbent assay. Patients with multiple sclerosis in the active phase had higher sICAM serum levels than did control subjects (p < 0.01). In addition, a significantly increased serum level of sICAM-1 was found in patients with HAM (p < 0.001). Furthermore, we found a positive correlation with HAM sICAM-1 and tumor necrosis factor-alpha levels in the sera of patients with multiple sclerosis in the active phase (r = 0.88, p < 0.01) and in those with HAM (r = 0.86, p < 0.01). These results suggest that serum sICAM-1 may be related to clinical activity in patients with multiple sclerosis and the detection of sICAM-1 could be useful as a marker of inflammatory disease.

Adult↗
PubMed1993

Limited value of anaerobic threshold for assessing functional capacity in patients with heart failure.

Exercise tolerance was assessed in 146 patients with cardiac dysfunction in terms of anaerobic threshold (ATge). Patients were divided into four classes according to the peak oxygen uptake: Class A (72 patients) exceeding 1000 ml/min; Class B (27 patients) 800-999 ml/min; Class C (37 patients) 500-799 ml/min; and Class D (10 patients) below 500 ml/min. An incidence of the ATge breakpoint was lower in patients of Class C (38%) than in those of either Class B (70%, p < 0.05) or Class A (87%, p < 0.05). The ATge could not be determined in any patients in Class D. The V-slope method improved the ability to determine ATge by 20%. In Classes C and D, ATge detection was precluded considerably by the fact that the initial workloads of exercise test involved oxygen uptake levels already close to or above the ATge. An oscillatory hyperventilation pattern was also significantly related to failure in defining ATge in Class C patients. Of the 51 patients whose ATge was undetermined, 9 had an atrial septal defect. In two of these, exercise-induced right-to-left shunting led to progressive arterial hypoxemia, and the consequent hyperventilation masked the appearance of ATge. Thus, ATge is virtually undetectable in patients with severe heart failure largely because of the early onset of anaerobic metabolism or abnormal ventilatory responses to exercise. Accordingly, the clinical application of ATge in the assessment of functional capacity would be limited to patients with mild to moderate heart failure.

Adult↗
PubMed1993

Importance of abnormal lung perfusion in excessive exercise ventilation in chronic heart failure.

Whether excessive ventilatory response to exercise is related to the maldistribution of pulmonary blood flow was examined in 23 patients with chronic heart failure and nine age-matched normal subjects. With the use of technetium 99m macroaggregated albumin, the resting distribution of pulmonary blood flow was assessed by the scintigraphic counts ratio of upper to lower lung fields. The ventilatory response to exercise was assessed by the slope of the relationship between minute ventilation and carbon dioxide production during exercise. Eight patients (group A) had slope less than 33, the upper limit of the normal range, and 15 patients had slope of 33 or greater (group B). In group B pulmonary blood flow was distributed more to the upper lung, which made the counts ratio (60%) higher than in normal subjects (34%) or in patients in group A (38%). There was no significant difference in pulmonary flow distribution between normal subjects and patients in group A. In group B tidal volume did not increase during exercise as much as it did in normal subjects and in patients in group A; therefore, the respiratory pattern was rapid and shallow. Although the ratio of physiologic dead space to tidal volume fell by 20% during exercise in normal subjects and by 23% in patients in group A, it failed to decrease in patients in group B (-1%), which indicates a relative increase in dead space respiration during exercise. These data indicate that decreased lung compliance and regional ventilation-perfusion mismatch caused by pulmonary vascular and parenchymal abnormalities would play an important role in the excessive exercise ventilation in chronic heart failure.

Exercise Test↗
PubMed1993

Cytotoxicity of T cells for cerebral endothelium in multiple sclerosis.

We investigated the cytotoxic effect of peripheral blood T cells on cerebral endothelium in patients with MS. We examined in vitro the damage to 51Cr-labelled dissociated human brain endothelial cells produced by mitogen-stimulated T cell lines from patients with MS and controls. Endothelial targets were lysed by T-lymphocytes from patients with acute relapsing MS during an exacerbation at every target-effector cell ratio tested compared with controls (P < 0.001). The percentage of endothelial targets lysed was not significantly increased by incubation with T cells from patients with acute relapsing MS in remission and chronic progressive MS, compared with that of normal subjects. Relapsing MS patients during an exacerbation had significantly higher interleukin-1 (IL-1)-alpha concentrations in cultures of targets with effector cells than normal subjects (P < 0.02). Experiments of major histocompatibility complex (MHC)-restricted cytotoxicity in MS demonstrated incomplete blocking of specific lysis by either anti-MHC class I or class II monoclonal antibody (mAb). These results indicate that cytotoxicity of T cells for cerebral endothelial cells may play a role in the initiation of immune response in acute relapsing MS during an exacerbation which appears to cause an increase in blood-brain barrier (BBB) permeability.

Adolescent↗
PubMed1993

Development of an enzyme-labeled oligonucleotide probe for the cholera toxin gene.

An alkaline phosphatase-conjugated 30-mer oligonucleotide probe was developed to detect the cholera toxin gene (ctx) in Vibrio cholerae O1. For rapid identification, V. cholerae O1 was grown on selective agar (thiosulfate-citrate-bile salts agar) or in alkaline peptone water and organisms were transferred directly to nylon membranes. Lysis of cells, denaturation of DNA, neutralization, and hybridization were carried out on the membrane. These procedures required only 3 h for completion. The results of the hybridization test with 88 clinical and 20 environmental isolates agreed almost exactly with the results of the immunological tests (anti-cholera toxin antibody-sensitized latex agglutination tests). The specificity of the probe was also tested with strains of enterotoxigenic Escherichia coli, V. cholerae non-O1, and Vibrio mimicus.

Alkaline Phosphatase↗
PubMed1993

Increased levels of intercellular adhesion molecule-1 (ICAM-1) and tumor necrosis factor receptor in the cerebrospinal fluid of patients with multiple sclerosis.

We investigated the presence of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble tumor necrosis factor receptor (sTNF-R) antigens in the CSF of patients with multiple sclerosis (MS) using a double-determinant ELISA. Patients with acute relapsing MS during an exacerbation (p < 0.001) and those with chronic progressive MS (p < 0.001) had significantly increased CSF levels of sICAM-1 compared with subjects with other neurologic diseases. CSF levels of sTNF-R were also significantly increased in patients with acute relapsing MS during an exacerbation (p < 0.001) and chronic progressive MS (p < 0.001) compared with subjects with other neurologic diseases. CSF levels of sICAM-1 and sTNF-R were positively correlated in patients with acute relapsing MS during an exacerbation (r = 0.81, p < 0.01) and chronic progressive MS (r = 0.86, p < 0.001). These results suggest that active immune reactions involving ICAM-1 and TNF-R production are present within the CNS and that both sICAM-1 and sTNF-R are important immunologic markers of the clinical activity of MS.

Adolescent↗
PubMed1993

Human recombinant interleukin-1 beta-mediated growth inhibition of cultured malignant glioma cells.

The effect of human recombinant interleukin-1 beta (hrIL-1 beta) on tumor growth was studied in eight glioma cell lines. hrIL-1 beta inhibited growth in all cell lines, but to varying extents. Two cell lines were suppressed by 0.5 ng/ml hrIL-1 beta, and three cell lines required 20 ng/ml. hrIL-1 beta also induced morphological changes and increased F-actin contents. hrIL-1 beta-treated cells demonstrated multipolar shapes and numerous processes with a greater number of cell-cell contacts 24 hours after treatment. Fluorescence microscopy revealed that these processes contained a large amount of polymerized F-actin. These results suggest that hrIL-1 beta-mediated growth inhibition may be related to the differentiation of glioma cells.

Brain Neoplasms↗
PubMed1993

Adhesion of cerebral endothelial cells to lymphocytes from patients with multiple sclerosis.

To investigate the factors regulating the entry of lymphocytes into the brain, we assessed the adhesion in vitro of 51Cr labelled lymphocytes from peripheral blood of patients with multiple sclerosis (MS) to human cerebral endothelial cells, and evaluated the effect on the adhesion of endothelium activated by interferon-gamma (IFN-gamma), lipopolysaccharides (LPS), interleukin-1 (IL-1) and tumor necrosis factor (TNF). Patients with acute relapsing MS during an exacerbation showed significant increase in MNC adherence to cerebral endothelial cells as compared with controls (p < 0.001). MNC adherence to cerebral endothelial cells activated by IFN-gamma or LPS, was significantly increased as compared to the controls (p < 0.01). MNC adherence to endothelial cells was not blocked by antibodies against the intercellular adhesion molecule-1 (ICAM-1), but was blocked by lymphocyte function-associated antigen-1 (LFA-1). The increased adherence observed in patients with acute relapsing MS during an exacerbation would modulate the migration of lymphocytes across the blood-brain barrier (BBB).

Adolescent↗
PubMed1993

[Angiographic evaluation of reconstructed spinal arteries in thoracic aortic aneurysm surgery].

Revascularization of the spinal arteries with thoracic aortic aneurysm were performed on nineteen patients using partial extracorporeal bypass. They were 16 men and 3 women. Age range were from 33 to 70 years (mean 49.9 +/- 10.3 years). There were eleven patients of dissecting aneurysm (DeBakey type IIIb in eight patients, type I in two patients and type IIIa in one patient), and eight patients of non-dissecting thoracoabdominal aneurysm (including two patients with ruptured aneurysm). The number of revascularized spinal arteries were 60 pairs (average 3.2 pairs per each patient). The revascularized spinal arteries were localized between levels T4 and L5.36 pairs of the 60 existed between levels T8 and L2 from where the artery of Adamkiewicz arises. Seven patients (eleven spinal arteries) underwent selective angiography of the revascularized spinal arteries postoperatively, and the anterior spinal artery and the artery of Adamkiewicz was identified in three patients. Two patients died within one month, one from MOF and the another from intestinal perforation respectively (operative mortality 11.1%). One patient, with ruptured thoracoabdominal aortic aneurysm showed paraparesis postoperatively, but no paraplegia was found in any patients. We recommend that not only the artery of Adamkiewicz but also the spinal arteries at the midthoracic area from T4 to T8 should be revascularized, to prevent postoperative paraplegia. Replacing of extended thoracic aneurysm, our method (using partial extracorporeal circulation and segmental aortic clamping) was thought to prevent spinal cord ischemia.

Adult↗
PubMed1993

[Effect of intracerebral injections of tumor necrosis factor and interleukin-1].

In order to examine the effect of cytokines on the central nervous system, we injected tumor necrosis factor (TNF) alpha or interleukin-1 (IL-1) alpha into the brains of mice. Although mice injected with saline alone exhibited no inflammatory responses, histopathological studies of mice injected with TNF alpha or IL-1 alpha revealed mild mononuclear cell infiltration around the blood vessels, edema and mild hemorrhage several millimeters distant from the needle track. These findings are similar in pattern to those observed in the early stage of experimental allergic encephalomyelitis (EAE). Increased vascular permeability induced by injections of TNF or IL-1 may play a role in the pathogenesis of these inflammatory responses. The direct cytokine injection model offers a new way of examining the mechanisms of early inflammation in the central nervous system.

Animals↗
PubMed1993

[Surgical treatment of aortic arch aneurysm with coronary artery disease].

A 69-year-old man with aortic arch aneurysm was admitted for abnormal shadow of chest X-ray. Computed tomography (CT) and aortography revealed aneurysm of aortic arch. His coronary angiogram showed 60% stenosis at LMT (seg 5), 90% stenosis at LAD (seg 7) and 75% stenosis at LCX (seg 11). The graft replacement for arch aneurysm and CABG were performed simultaneously. Postoperative course was good. Postoperative angiogram demonstrated successful reconstruction of the aortic arch and patent three bypass grafts. This patient has been worked healthy 14 months postoperatively.

Aged↗
PubMed1993

[Intraosseous meningioma associated with lung cancer: a case of multiple neoplasms].

Intraosseous tumor was found in a 63 year old male patient with lung cancer during metastatic work-up study. Plain skull X-ray film showed a large osteolytic lesion in the left temporo-parietal bone. Bone and Ga scintigrams revealed an increased activity in this lesion. CT scan demonstrated an isodense lentiform configuration, which was homogeneously enhanced with contrast medium. It was iso-intense in T1, and high-intense in T2 and proton weighted MR images. The tumor was removed en bloc with surrounding normal bone. The attached dura was markedly thickened, but there was no tumor infiltration. Histological diagnosis was transitional meningioma with psammoma body. Postoperatively he was transferred back to Okinawa Hospital and right lower lobectomy was performed for the lung tumor. Histological diagnosis was well-differentiated adenocarcinoma. We examined immunohistochemically p53 protein expression, but p53 immunoactivity was observed in neither tumor. Multiple neoplasms associated with brain tumor are relatively rare, but the incidence will increase in the future as the diagnostic work-up develops. Pathological diagnosis will give us the decisive opportunity for proper treatment. It is to be stressed that, in multiple neoplasms, care should be taken to avoid misdiagnosis of metastasis.

Adenocarcinoma↗
PubMed1993

[Allergic granulomatosis and angiitis associated with intestinal perforation and eye movement disorder].

A perforation in the small intestine and one and a half syndrome were observed in 45-year-old male with allergic granulomatosis and angiitis (AGA). The patient was first admitted to our hospital in 1988 with complaints of bronchial asthma and an abnormal density on his chest X ray. The diagnosis of PIE syndrome was made based on marked peripheral blood eosinophilia. He was successfully treated with prednisolone and had been well on the maintenance therapy of small doses of it. In May 1990, peripheral neuropathy occurred in his bilateral lower legs and it was followed by nausea and vomiting. The laboratory findings on admission showed leukocytosis (19,300/mm3) with 43% eosinophilia and elevated blood level of IgE (3000 IU/ml). On the tenth day of admission, ileus symptom and subsequently a perforation of the small intestine were observed. The mesenterial specimens obtained during the emergency operation showed the findings compatible with AGA. Remission of AGA was induced by the treatment with 60 mg prednisolone and 100 mg cyclophosphamide per day following methylprednisolone pulse therapy. He was well on maintenance prednisolone until June 1991, when he suddenly developed one and a half syndrome. Although cranial CT scan and MRI showed no abnormal findings, cyclophosphamide therapy was resumed and prednisolone was increased because microangiopathy due to AGA was thought to be the cause of this central nervous system symptom. The one and a half syndrome improved with this therapy. This case suggests that the long term treatment with prednisolone and cyclophosphamide would be indicated in the severe AGA with close monitoring of the symptoms and peripheral blood eosinophilia.

Churg-Strauss Syndrome↗
PubMed1993

[Unusual CT and MRI appearance of the epidermoid tumor--a case report].

We reported a case of epidermoid tumor with unusual findings on CT and MRI. A 41-year old woman was admitted because of headache. On admission she had no neurological deficits. CT revealed a lobular homogenous high-dense mass with a sharp margin in the mid-portion of the posterior fossa. The mass was shown as a low signal intensity on both T1- and T2-weighted MRI. An encapsulated mass containing "motor oil" like viscid fluid was removed by surgical operation. Histological examination revealed epidermoid cyst. CT-dense epidermoid tumor was discussed with referring to the literature.

Adult↗
PubMed1993

[Extravascular lung water in patients after cardiac surgery].

Extravascular lung water (EVLW) measured by a double indicator dilution method using thermal-dye indicator was evaluated in 204 patients after cardiac surgery during last 7 years. The measurement of EVLW was done at 2, 4, 8, 24 and 48 hours after extracorporeal circulation (ECC), EVLW showed no significant change except transient decrease at 4 hours after ECC, average of that was 7.62 +/- 3.58 ml/kg, EVLW of group I (MVR) and group III (AVR + MVR) were significantly higher than those of group II (AVR), group IV (noncyanotic congenital heart disease) and group V (A-C bypass). EVLW of 7 patients with postoperative pulmonary edema was 14.47 +/- 4.44 ml/kg, and that was significantly higher than those of others (7.54 +/- 3.06 ml/kg). EVLW of the patients using bubble oxygenator (8.60 +/- 3.90 ml/kg) was significantly higher than those of membrane oxygenator (7.15 +/- 3.40 ml/kg). Postoperative EVLW correlated with mean pulmonary artery pressure (mPAP), mean left atrial pressure (LAP) and microvascular hydrostatic pressure (PMV), and showed inverse correlation with cardiac index (CI). But there was no correlation of EVLW with duration of ECC. In the preoperative parameter, EVLW correlated with age, mPAP, mean pulmonary wedge pressure (mPAWP), PMV, serum BUN and serum creatinine, and showed inverse correlation with CI, %VC, FEV%, PSP test and creatinine clearance. We concluded that the patients with mitral valve disease who have high mPAP and LAP, respiratory and renal dysfunction and old aged preoperatively showed upward trend of EVLW. In perioperative management, care must be taken in such patients and membrane oxygenator was thought useful for prevention of pulmonary edema.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗