Biomedical subjects
Publications and source records attributed to K Ueda.
A case is presented of a nose bitten off by a dog and successfully replanted by artery-to-artery and artery-to-vein anastomosis. In the absence of vein-to-vein anastomosis, the clinical course suggested that artery-to-vein anastomosis was useful for venous drainage, although the extent to which this contributed to the survival is not known.
The relationship between salivary methotrexate (MTX) concentration and severity of oral mucositis after administration of MTX was investigated in six children with acute lymphoblastic leukemia. They received two administrations of MTX at 500 mg/m2 with one third given bolusly and the remainder by 24-hour continuous infusion. No significant difference among patients or administration session was observed in serum MTX concentration. Detectable concentrations of salivary MTX (greater than 0.01 microM) were observed during nine of the ten infusions. A concentration of 0.1 microM or more, apparently lasting at least 12 hours, was observed during one infusion and followed by severe mucositis. During two of the ten infusions for different patients, concentrations of 0.04 to 0.07 microM and 0.02 to 0.04 microM, apparently lasting at least 12 and 18 hours, respectively, were observed, followed by moderate mucositis. During the other seven infusions, either much shorter or no increase in salivary MTX concentration was observed, with only mild or no subsequent mucositis. Analysis by Kendall's rank method showed a statistical correlation between concentration at 6 hours of infusion and severity of oral mucositis. The findings suggest that the early secretion of MTX into saliva has a significant role in the development of oral mucositis in leukemic children.
1. To elucidate the neural mechanisms that mediate visual responses of optic tectum (OT) to medullary and spinal motor systems, we analyzed medullary reticular neurons in paralyzed Japanese toads (Bufo japonicus). We examined their responses to electrical stimulation of OT, and stained some neurons intracellularly. Responses to stimulation of the glossopharyngeal nerve (IX) were also analyzed. 2. Extracellular single unit recording revealed excitatory responses of medullary neurons to OT and IX stimulation. Among 92 units encountered, 79 responded to OT stimuli, 10 to IX stimuli, and 3 to both. Some units responded to successive stimuli of short intervals with relatively stable lags. 3. Intracellular recording and staining experiments revealed morphologies of reticular neurons that received excitatory inputs from OT. Thirteen units were identified after complete reconstruction of somata and dendrites. Neurons in the nucleus reticularis medius received excitatory inputs from bilateral OT. They had wide dendrites in ventral, ventrolateral and lateral funiculi, and single axons descending in the ipsilateral ventral funiculus as far caudally as the cervical spinal cord. Some collaterals of these axons projected directly to the hypoglossal and spinal motor nuclei. Some neurons in other medullary nuclei (nuc. reticularis superior, pretrigeminal nucleus, nuc. reticularis inferior, and nuc. tractus spinalis nervi trigemini) also responded to the OT stimulation. 4. Activities in bilateral OT converge onto medullary reticular neurons, which may directly control medullary and spinal motor systems.
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Correlation between T cell phenotypes, especially activated T cells expressing early (EA1) and late (HLA-DR) activation antigens and clinical features were investigated in 22 patients with systemic lupus erythematosus (SLE) of childhood onset. Percentages of T cells expressing EA1 and HLA-DR in 22 patients with SLE were significantly higher than those in controls. Comparison of T cell phenotypes between patients with active and inactive SLE showed that eight patients with active disease had significantly increased percentages of HLA-DR positive T cells than 14 with inactive disease (P less than 0.01). Serial examinations showed that the percentages of HLA-DR positive T cells were decreased after therapy in seven with active non-renal or active non-renal and renal diseases but not in one with only active renal disease. A possible significance of T cells expressing EA1 and HLA-DR in the management of patients with SLE is discussed.
A 15-year-old girl with systemic lupus erythematosus (SLE) in remission for 3 years showed abdominal pain and bloody stools. No evidence for exacerbation of SLE was obtained. An air-contrast barium enema examination and colonoscopy revealed findings typical of Crohn disease. Despite the rarity of the combination, patients with SLE showing gastrointestinal manifestations might need evaluation for Crohn disease.
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Recurrent parotid gland enlargement is a common disorder in children, while that of auto-immune aetiology is rare. Three children with recurrent parotid swelling had autoantibodies including antinuclear antibody, anti-SS-A (Sjögren syndrome-A), SS-B (Sjögren syndrome-B) antibodies and rheumatoid factor, abnormal sialograms and lymphocytic infiltration of salivary glands, which were consistent with Sjögren syndrome. Initially, all three lacked symptoms of keratoconjunctivitis sicca. During follow up, two patients developed xerostomia and were diagnosed as having primary Sjögren syndrome. Recurrent parotid enlargement appears to be important as an initial manifestation of Sjögren syndrome in children.
In a mass screening programme, 54 children with haematuria and proteinuria were detected and evaluated by clinical findings and renal histology. IgA glomerulonephritis (GN) occurred in 29 patients, diffuse mesangial proliferative GN (DPGN) in 16, membranous GN (MGN) in 4, membranoproliferative GN (MPGN) in 3, and focal segmental glomerular sclerosis (FSGS) was seen in 2. Of the 35 children with proteinuria less than or equal to 1 g/m2 per day, 21 with IgA GN and 14 with DPGN had only mild to moderate glomerular changes. None of these children had developed renal impairment after a mean period of 6.5 years (range 5-10 years). On the other hand, 8 children with IgA GN, 2 with DPGN, 4 with MGN, 3 with MPGN, and 2 with FSGS had proteinuria that exceeded 1 g/m2 per day. The biopsy specimens from these children showed moderate to severe glomerular changes, and 7 of these children had hypertension or renal impairment during the period of evaluation. This study suggests that a poor outcome correlates with the level of proteinuria and the severity of renal pathology in children with haematuria and proteinuria.
Infants and toddlers often start crying at venopuncture and the stress of crying has been known to increase the levels of plasma renin activity (PRA) and plasma aldosterone concentration (PAC), but no precise information is available. We measured the levels of PRA and PAC in blood samples taken from 30 infants and toddlers within 1 min after the onset of crying, as induced by venopuncture, and 3 and 5 min after continuation of crying (PRA1.0, PRA3.0, PRA5.0, and PAC1.0, PAC3.0, PAC5.0). The age of these subjects ranged from 1 to 30 months (median 16 months). PRA1.0, PRA3.0 and PRA5.0 were 4.0 +/- 1.8 ng/ml per hour, 5.5 +/- 2.7 ng/ml per hour, and 7.8 +/- 4.2 ng/ml per hour, respectively. PAC1.0, PAC3.0 and PAC5.0 were 210 +/- 110 pg/ml, 231 +/- 118 pg/ml and 269 +/- 145 pg/ml, respectively. Both PRA and PAC increased with elapsing time. The increase in PRA was marked after a short episode of crying, but that in PAC was of a mild degree.
The highest activity of poly(ADP-ribose) synthetase was found in the testis among several rat tissues tested. Subcellular fractionation of the testis demonstrated that the synthetase was localized primarily in the nucleus and partially in the microsomal-ribosomal fraction. This result was confirmed by immunocytochemical staining with the enzyme-specific antibody. The synthetase was localized in the nuclei of interstitial cells, Sertoli cells, spermatogonia, and spermatocytes. In addition, round spermatids showed a granular staining in the cytoplasm, which was comparable in intensity with that in the nucleus. The cytoplasmic synthetase had a molecular weight of 115,000 and synthesized oligomers of ADP-ribose on itself (automodification). The synthetase activity in the isolated cytoplasmic fraction was stimulated about threefold by the addition of DNA and depressed by treatment with DNase I, suggesting the presence of endogenous activator DNA. A candidate DNA for such an activator was isolated from the microsomal-ribosomal fraction, and identified tentatively as mitochondrial DNA on the basis of its size and restriction fragment patterns.
The genome of the hepatitis B virus contains a sequence (X gene) whose role is unclear. The almost complete region of the hepatitis B virus X gene was expressed in Escherichia coli, with the resulting protein being approximately 17 kilodaltons in molecular weight. Sera from 139 subjects were analyzed by Western blot analysis. Of the hepatitis B surface antigen-positive patients, anti-X was not found in 4 patients with acute hepatitis and in 12 healthy carriers, but was present in 41% (21/51) of the patients with chronic hepatitis, 63% (15/24) of those with liver cirrhosis, and 46% (12/26) of those with hepatocellular carcinoma. The expression of the X product in the liver tissues (43 hepatitis B surface antigen-positive patients) was investigated using an indirect immunohistochemical method. The X protein was observed in 64% (21/33) of the patients with chronic hepatitis and 50% (5/10) of those with liver cirrhosis, and was found when the serum was negative for anti-X. Hepatitis B core antigen was frequently expressed together with the X protein in the liver. The conclusions reached were that the frequency of anti-X increases with the length of chronic hepatitis B virus infection, that anti-X may suppress the expression of the X protein in the liver, and that the X protein may be related to hepatitis B virus replication.
A human hepatoblastoma cell line (HB 611) that continuously synthesizes hepatitis B viral (HBV) DNA was grown in the presence of various inhibitors of DNA synthesis, and the DNA from the cells was analyzed by the Southern blotting method to examine selective inhibition of the viral DNA synthesis. Among those that showed selective inhibition, and interferons alpha and beta, acyclovir, and dideoxy cytidine were effective. This system should be useful for screening new antiviral agents against HBV.
Using an isolated canine heart-lung autoperfusion model, the effect of prostacyclin analog (OP-41483) on pulmonary oxygen toxicity was investigated. Twenty-four mongrel dogs were divided into four groups. Groups 1 and 2 inspired oxygen at concentrations (FiO2) of 0.95 and 0.6, respectively, while groups 3 and 4 received OP-41483 (0.1 micrograms/kg/min) in addition to FiO2 of 0.95 and 0.6. Autoperfusion was performed for five hours, and during the experiments the systolic blood pressure was maintained at 100 mmHg and the cardiac output at 40 ml/kg/min. After five hours of perfusion, PaO2 decreased significantly (P less than 0.01) from 410 +/- 49 mmHg to 237 +/- 38 mmHg in group 1, and also decreased significantly (P less than 0.01) from 368 +/- 44 mmHg to 243 +/- 26 mmHg in group 2. However, no significant changes in PaO2 were observed in groups 3 and 4. The pathological examinations clearly revealed perivascular edema and vascular dilation in groups 1 and 2, whereas no abnormal pathological findings were seen in groups 3 and 4. The above results indicate that OP-41483, when administered at the low dose of 0.1 micrograms/kg/min, induces no circulatory changes and exerts an effective action with respect to the prevention of pulmonary edema.
The frequencies of spontaneous and mitomycin C (MMC)-induced sister chromatid exchange (SCE) were examined in 35 patients with cancer of the cervix uteri (stage 0, eight cases; stage I, nine cases; stage II, nine cases, and stage III, nine cases) before they had undergone cancer treatment, as well as in seven patients with uterine myoma and 18 healthy women as controls. The frequency of SCE was analyzed in reference to the stage of cancer in the cancer group and in reference to chromosome group in the cancer and normal groups. The frequencies of spontaneous and MMC-induced SCE in the cancer group were 10.0 +/- 1.8 and 20.7 +/- 2.6, respectively, and both were significantly higher than in the myoma (8.1 +/- 0.8 and 17.6 +/- 1.8) and normal (7.6 +/- 0.8 and 17.6 +/- 2.3) groups. Furthermore, the frequency of SCE in the cancer group increased with cancer stage. All chromosome groups contributed equally to the increase in SCE in the cancer group. These results indicate that an increase in the frequency of SCE in patients with cervical cancer is related to the presence of cancer, but is not related to a predisposition to cancer.
Major categorical diagnosis by International Classification of Diseases and type-specific diagnosis for cardiovascular diseases in death certificates were compared to the diagnosis made at autopsy in 864 consecutive autopsy cases aged 20 or over, among the Japanese residents in Hisayama town. Cerebral stroke was correctly diagnosed in 84%, malignant neoplasms in 78% and cardiac disease in 66%. Cerebral stroke and cardiac disease tended to be overdiagnosed, while malignant neoplasms were underdiagnosed. The validation of certified diagnosis was less reliable in the aged population, and in type-specific diagnosis of cardiovascular diseases. Cerebral hemorrhage with false negative or false positive diagnoses was usually classified into type unspecified stroke or different categories of cerebral stroke, while those misdiagnosed as cases of cerebral infarction frequently had no significant lesions in the autopsied brain. Finally, the relationship between the validation of diagnosis on the death certificates and the secular trend in cardiovascular disease in the Japanese vital statistics was discussed.
Combined chemotherapeutic regimens of (1) cyclophosphamide (40 mg/kg x two days), (2) cisplatinum (20 mg/m2 x five days) plus VM-26 (100 mg/m2), and (3) Adriamycin (60 mg/m2) plus DTIC (250 mg/m2 x five days) were prescribed for 42 Japanese children greater than 1 year of age with stage III or IV neuroblastoma. The protocol was separated into three forms (A, B, and C) from the combination pattern of three such high-dose courses. The cumulative survival rates for those with stages III and IV 48 months after initiation of therapy were 76.2% and 20.1%, respectively, and the overall rate was 36.7%. The tumor disappeared during the course of treatment in 25 of 42 children (59.5%). The 48-month survival rate was superior in patients greater than 5 years of age than younger patients (P less than .01). Even in patients with a tumor originating in the suprarenal region, the 48-month survival rate was 30.5%. Among 12 patients in whom the N-myc oncogene was measured, one of five with one to ten copies of amplification died, whereas all seven with greater than ten copies died or had a recurrence. Thus, the present chemotherapeutic regimens, in particular alternate administration of each high-dose course, considerably improved the survival of patients with stage III neuroblastoma. More aggressive protocols are needed for those with stage IV neuroblastoma who are greater than 1 year of age, particularly in those with an amplified N-myc oncogene.
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