Sequence of a new HLA-A allele (A*0218) encoding a serological variant, HLA-A2K, observed in Japanese.
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Alleles↗
Biomedical subjects
M Hashimoto
Publications and source records attributed to M Hashimoto.
A new HLA-DQB1*0306 allele sharing motifs from DQB1*03032 and DQB1*04 sequences.
We have discovered a new HLA-DQB1 allele in a Japanese family, MAT. In the family the new allele segregates in three generations and demonstrates the positive association with DRB1*0901. We observed a novel RFLP pattern in the course of examining the modified PCR-RFLP method for HLA-DQB1 genotyping. The PCR-SSOP analysis also showed a new hybridized pattern. Sequence analysis of the allele indicates that it was generated by a gene conversion-like event between the HLADQB1*03032 and one of DQB1*04 contemporary alleles. This new allelic product did not react with all of allosera and monoclonal antibodies against DQ1, DQ2, DQ3, DQ4 and DQ7. The HLA molecule encoded by the allele is not defined by serology. This new allele was officially recognized and named DQB1*0306 by the WHO Nomenclature Committee in November 1995.
Alleles↗
Case report: gastrointestinal bleeding from a hepatocellular carcinoma invading the transverse colon.
A 72-year-old woman with cirrhosis of the liver was treated repeatedly by transcatheter arterial embolization for multifocal hepatocellular carcinomas. She developed gastrointestinal bleeding secondary to direct invasion of the wall of the transverse colon. The diagnosis was made pre-operatively by colonoscopy and the patient was treated successfully. This rare complication of hepatocellular carcinoma was due to the protrusive type of growth exhibited by this tumour and may have been affected by the transcatheter arterial embolization.
Aged↗
Antineutrophil cytoplasmic antibodies (ANCA)-associated crescentic glomerulonephritis and propylthiouracil therapy.
Cutaneous vasculitis is an uncommon complication of propylthiouracil therapy. Although its pathogenesis remains to be established, detection of antineutrophil cytoplasmic antibodies (ANCA) in association with this type of vasculitis has recently been described. We report here 2 patients who developed ANCA-associated crescentic glomerulonephritis without evidence of cutaneous vasculitis during propylthiouracil treatment of hyperthyroidism. Improvement of the renal function and the disappearance of ANCA were correlately found after discontinuation of propylthiouracil and by corticosteroid therapy in both patients.
Adult↗
AILD-like dysplasia transformed in AILD-type T cell lymphoma in an HTLV-1 carrier: usefulness of interferon-alpha.
A 61-year-old Japanese woman who was an HTLV-1 carrier had angioimmunoblastic lymphadenopathy with dysproteinemia (AILD)-like dysplasia that transformed into AILD-type lymphoma after 3 years. Complete remission was achieved with interferon-alpha (IFN-alpha) treatment following a previous combination of anticancer drugs. IFN-alpha was also effective for maintenance therapy after this complete, albeit transient, remission. From clinical and pathological studies on AILD patients, it appears that AILD may in some cases be the consequence of an immune dysfunction caused by HTLV-1 infection and that AILD-type lymphoma is a malignant disorder of peripheral T cell clones different from those T cells incorporating the HTLV-1 virus.
Antineoplastic Combined Chemotherapy Protocols↗
Extraforaminal stenosis in the lumbosacral spine. Efficacy of MR imaging in the coronal plane.
PURPOSE: To review experience with MR images of extraforaminal (EF) stenosis in the lumbosacral spine. MATERIAL: MR images from 9 patients with 10 EF stenoses were reviewed. The diagnosis was confirmed in 6 patients at surgery, and in 4 on the basis of findings of nerve root injection combined with nerve block. RESULTS AND CONCLUSION: All patients had congenital lumbosacral anomalies with various degrees of fixation between the last formed level and the pelvis. In all cases, affected roots were compressed between the transverse process of the last lumbar segment and the sacral ala. MR using coronal plane imaging demonstrated the root impingement directly in the far lateral zone in all patients. However, sagittal and axial images were unable to define the EF stenoses in all patients. The results of this study show that a transitional vertebra is a cause of EF stenosis and that MR images using coronal plane are useful in the assessment of EF stenosis.
Female↗
Synthesis and characterization of a carbene-generating biotinylated lactosylceramide analog as a novel chromogenic photoprobe for GM3 synthase.
A new biotinylated lactose derivative bearing a nitro-substituted chromogenic diazirine was synthesized. The biotinyl group within the structure enabled the performance of a convenient assay of GM3 synthase based on avidin-biotin technology, and the Km values of this biotinylated photoprobe were determined as 40 and 47 microM using bovine brain and rat liver Golgi as enzyme sources, respectively. Furthermore, the sialylation of lactosylceramide, a natural acceptor substrate for GM3 synthase, was competitively inhibited by this synthetic analog. The reagent could be a useful chromogenic photoprobe for GM3 synthase.
Animals↗
A case of Schmidt syndrome accompanied by a pituitary adenoma.
Schmidt syndrome consists of adrenal insufficiency and Hashimoto's thyroiditis, which are probably caused by an autoimmune process. We encountered a patient who manifested severe generalized fatigue due to Schmidt syndrome recurrently. The endocrinological examination tests on the patient showed that the increase in thyroid stimulating hormone (TSH) and ACTH concentrations were not remarkable, despite hypo-function of the peripheral glands. Subsequent cranial magnetic resonance imaging (MRI) exhibited the existence of a pituitary tumor. The pathological findings on the resected tumor and endocrinological stimulation tests proved that the tumor was a FSH-producing adenoma. Although involvement of the pituitary region in Schmidt syndrome on rare occasions presents as hypophysitis, no pituitary adenoma has previously been reported in association with this syndrome. We present a patient with Schmidt syndrome and an accompanying FSH-producing pituitary adenoma. The coexistence of these disorders suggests that the functioning pituitary tumor might be considered as a pituitary lesion in Schmidt syndrome.
Adenoma↗
Manifestation of subclinical diabetes insipidus due to pituitary tumor during pregnancy.
We describe a case of diabetes insipidus (DI) due to a pituitary tumor in a 33-year-old pregnant woman who developed a sudden onset of polyuria (over 8 l/day) and polydipsia at 30 weeks of gestation. Her plasma concentration of vasopressin (AVP) was low compared with high serum osmolality (298 mOsm/kg), and her urine output was well controlled by treatment with desmopressin acetate (DDAVP). Cranial magnetic resonance imaging (MRI) demonstrated a 1.8 x 1.2-cm pituitary tumor, but she did not have any disturbance in the release of anterior pituitary hormones. The serum concentration of cystine aminopeptidase (CAP) was within the normal range for a woman at 34 weeks of gestation. After an uncomplicated delivery of a healthy girl, her polyuria gradually resolved. The size of the pituitary tumor gradually decreased in parallel to a reduction in her urine output, but a silent hemorrhage was detected in her pituitary gland 4 weeks after the delivery. Although pregnancy is sometimes associated with central DI, the occurrence of DI due to pituitary tumor under pregnancy is rare. The basal AVP recovered to within the normal range, but the low response of AVP secretion to high osmolality persisted. In this case, pregnancy may affect the manifestation of subclinical DI. This case may therefore enhance our understanding of the mechanisms of DI during pregnancy.
Adenoma↗
Effect of chronic high protein intake on magnesium, calcium, and phosphorus balance in growing cats.
The effects of high protein feeding on food and water intake, and the retention and urinary excretion of macrominerals (magnesium (Mg), phosphorus (P), and calcium (Ca)) were examined in growing cats. Seven female cats aged 4 months were fed diets containing 55% crude protein (n = 4) or 29% crude protein (n = 3) for 12 months on an ad libitum basis. Mineral balances were determined at 0.5, 2, 6, 10, and 12 months of feeding. The higher protein intake stimulated daily water intake and urine excretion throughout the study, although daily food intake was not affected by dietary protein levels. The urinary Mg concentration was decreased by the high protein intake, resulting from both increased urine volume and reduced excretion of urinary Mg. In contrast, the concentration and daily excretion of urinary P were increased by the high protein intake. The protein-induced increase in urinary P would not necessarily imply the increased excretion of PO4(3-), the anion responsible for struvite crystallization, because the dissociation of phosphate depends on urinary pH. Urinary Ca excretion was not affected by the dietary protein levels, but the high protein intake caused less retention of P and Ca as a result of enhanced urinary P excretion and lowered Ca absorption. The possibility of high protein feeding for the prevention of struvite crystallization in growing cats is discussed.
Animals↗
The CT findings of pulmonary sarcoidosis.
We analyzed the CT findings in 35 patients with pulmonary sarcoidosis. Twenty-seven patients had biopsy-proven sarcoidosis; in eight patients the diagnosis was made clinically. In all the 35 patients, 10-mm collimation scans were available. In seven patients, high-resolution CT was also obtained. Twenty-eight patients had lymphadenopathy associated with pulmonary infiltration, two patients had pulmonary infiltration without lymphadenpathy, five patients had lymphadenopathy alone. The most frequent parenchymal features on CT were small nodules (100%) and irregularly thickened bronchovascular bundle (90%). Other frequent CT findings were pleural or subpleural thickening (83%), septal lines (73%) and ground-glass attenuation (63%). In all cases, small nodules were associated with other lesions. The authors conclude that in patients with sarcoidosis, CT is a valuable technique to visualize the findings in the pulmonary parenchyma characteristic enough to allow confident diagnosis. While high-resolution CT is superior in the assessment of linear opacities and cysts, conventional CT is superior in demonstrating small nodular opacities. We believe that both should be combined in the examination of patients with sarcoidosis.
Adult↗
Current issues with regard to single dose toxicity studies.
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Animals↗
Radiofrequency catheter ablation for a patient with Wolf-Parkinson-White syndrome associated with sustained atrial tachycardia.
Successful catheter ablation for a patient with both Wolff-Parkinson-White syndrome and sustained atrial tachycardia has not been reported. We describe a patient with Wolff-Parkinson-White syndrome associated with sustained atrial tachycardia, in whom an atrioventricular accessory pathway and an intra-atrial reentrant circuit were successfully ablated in a single session. Radiofrequency catheter ablation for the left-sided atrioventricular accessory pathway was performed via the trans-septal approach. Catheter ablation for the atrial tachycardia was achieved in the right atrium where the earliest and fractionated atrial activation was obtained. Catheter ablation for multiple lesions during a single session is feasible.
Catheter Ablation↗
Response of conductance and resistance vessels of the coronary artery to intracoronary isosorbide dinitrate in patients with variant angina.
To elucidate the response of conductance and resistance vessels of the coronary artery after intracoronary isosorbide dinitrate (ISDN), we evaluated 11 patients with variant angina and 13 controls with a Doppler guidewire. Epicardial arterial diameter increased significantly after ISDN in patients with variant angina while it did not change significantly in the controls. Coronary diastolic flow velocity increased significantly in controls (p < 0.05), but was unchanged in patients with vasospastic angina. Coronary flow volume increased from 23.8 +/- 18.6 to 46.5 +/- 28.4 ml/min in patients with vasospastic angina as well as in the controls from 32.2 +/- 24.2 to 54.7 +/- 44.4 ml/min. Coronary resistance did not differ between the two groups before or after the injection of ISDN. Conductance vessels were dilated to a greater extent in the patients with variant angina. However, the response of resistance vessels did not differ significantly between the two groups.
Aged↗
Massage therapy is associated with enhancement of the immune system's cytotoxic capacity.
Twenty-nine gay men (20 HIV+, 9 HIV-) received daily massages for one month. A subset of 11 of the HIV+ subjects served as a within subject control group (one month with and without massages). Major immune findings for the effects of the month of massage included a significant increase in Natural Killer Cell number, Natural Killer Cell Cytotoxicity, soluble CD8, and the cytotoxic subset of CD8 cells. There were no changes in HIV disease progression markers (CD4, CD4/CD8 ratio, Beta-2 microglobulin, neopterin). Major neuroendocrine findings, measured via 24 hour urines included a significant decrease in cortisol, and nonsignificant trends toward decrease of catecholamines. There were also significant decreases in anxiety and increases in relaxation which were significantly correlated with increases in NK cell number. Thus, there appears to be an increase in cytotoxic capacity associated with massage. Implications for HIV+ men as those with other illnesses, particularly cancer, are discussed.
Adult↗
[Use of a micturition-monitoring device in elderly inpatients].
More than 100,000 people suffer from functional urinary incontinence in Japan. To improve the quality of life of these people, we tested a device for monitoring micturition by means of a thin-layer membrane sensor in a diaper. The device was tested in elderly inpatients, and associated changes in the wordload of the nursing staff were also recorded. The device was beneficial because the precise micturition time was easily obtained and thus the daily pattern of micturition became obvious. With the use of this device, the time during which the patients wore wet diapers was shorter than with the conventional system of scheduled changes. However, the increase in the frequency of diaper changed doubled the workload of the nursing staff. In conclusion, improving the quality of life with regard to urinary incontinence entails an increase in the workload of the nursing staff; efficient distribution of that work may require some staff members to devote all their time to changing diapers.
Aged↗
[A clinical study of squamous cell carcinoma of the tongue base].
Between 1979 and 1992, 27 previously untreated patients with squamous cell carcinoma involving the base of the tongue underwent treatment with curative intent. Seven patients were in Stage I, II (26%) and 20 patients were in stage III, IV (74%). Seventeen patients (63%) presented clinically with neck metastasis. The patients were followed for a minimum of two years or until death or recurrence. Primary tumors treated with surgery or radiotherapy showed control rates of 80% (12 of 15 tumors) and 88% (7 of 8 tumors), respectively. The overall survival was 59 percent at 5 years. For the patients with exophitic primaries, local control with radiotherapy produced excellent results, whereas for advanced or deeply invasive tumors, surgery enhanced local control. Radiation therapy successfully controlled early neck disease (N0, N1). Patients with advanced neck disease (N2, N3) had poor regional control with radiotherapy, necessitating subsequent neck dissection. Forty-three percent of the N2b or N3 patients were found to have contralateral occult metastasis. Results obtained in the present study show that patients with T3, T4 or N2, N3 should undergo surgery. Prospective trials are necessary to compare surgery versus definitive radiotherapy with respect to patient survival and quality of life.
Adult↗
[Treatment of bilateral neck metastases in laryngeal cancer].
Laryngeal cancer is one of the most curable malignancies. One of the reasons is that most of them are in the early stage. However, the prognosis of advanced bilateral neck metastases is still poor. Based on loco-regional failure and cause of death, the effective procedure of neck dissection and the efficacy of postoperative irradiation were investigated retrospectively. A total of 1022 patients with laryngeal squamous cell carcinoma were registered in our hospital between 1979 and 1991, 58 of them (5.7%) had bilateral neck metastases. Clinical N2c cases accounted for 52% (32/58). In the other patients, the metastatic nodes were revealed by elective neck dissection for a clinically negative neck. The T stages of the 58 cases were as follows; T2 in 14 cases, T3 in 22 and T4 in 22. Forty-nine of the patients treated curatively by bilateral neck dissection were analyzed, 48 with total laryngectomy and 1 with partial laryngectomy. The remaining 9 patients were excluded because of radical irradiation in 3, distant metastases found the diagnosis in 3, unresectable recurrent neck metastases treated in other hospitals in 2 and no treatment because of severe myocardial infarction in 1. Cumulative crude and cause-specific 5-year survival rates for the 49 patients were 32.2% and 52.2%, respectively. Nineteen patients died of their disease; 10 of them of an uncontrolled neck lesion. From a comparison of the surgery alone group (28 cases) with a surgery plus irradiation group (21 cases) which consisted of preoperative irradiation in 2 and postoperative in 19, addition of irradiation may be effective for loco-regional control. Eight patients died of an uncontrolled neck lesion in the surgery alone group, while there were only 2 deaths in the postoperative irradiation group. Nevertheless there were no significant differences in survival: the cumulative crude and cause-specific 5-year survival rates in the surgery alone group were 34.4% and 56.2%, respectively, while those in the surgery plus irradiation group were 28.6% and 46.3%, respectively. It is obvious that the procedure of neck dissection influenced the loco-regional control. Excluding the recurrence-free patients who died of intercurrent diseases within 2 years, recurrence in the ipsilateral neck was found in 1 of 12 patients with radical neck dissection (RND), in 1 of 3 with modified radical neck dissection (MRND), in 2 of 15 with lateral neck dissection (lateral ND) and in 9 of 11 with regional neck dissection (regional ND). Recurrence is the contralateral neck were found in none of 2 with RND, of 3 with MRND and of 20 with lateral ND, but in 6 of 16 with regional ND. These results suggest that regional ND was insufficient to accomplish loco-regional control in those patients and that lateral ND or MRND or RND may be required bilaterally. Since 1986, all patients except 1 were treated by more extensive maneuvers than lateral ND bilaterally, so that loco-regional recurrence was found in only 1 case, in spite of the fact that the surgery alone group accounted for 73% (19/26). Cumulative crude and cause-specific 5-year survival rates for the patients prior to 1985 (23 cases) were 26.1% and 32.6%, respectively, while those for the patients since 1986 (26 cases) were 38.5% and 76.9%, respectively. There was no significant difference (p = 0.73) in cumulative crude 5-year survival rates between the 2 groups, but the difference in their cause-specific 5-year survival rates was statistically highly significant (p = 0.0032). It was concluded that lateral ND, MRND or RND should be required bilaterally for the patients with bilateral neck metastases and that addition of irradiation is not always indispensable for patients treated by curative neck dissection, such as lateral ND, MRND or RND.
Aged↗