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Biomedical subjects

M Hirokawa

Publications and source records attributed to M Hirokawa.

At least 181 records · Page 10Linked to original sources
PubMed1990

[MHC class I antigen expression by molar trophoblast].

It is an issue for debate why molar tissues are not rejected by an immunologically potent host, since all genes in complete moles and 2/3 genes in partial moles are considered to be paternally derived. Molar trophoblasts are in direct contact with host cells, and therefore HLA expression by these cells may hold the key to the elucidation of the immunological reaction between molar tissues and the host. It has been reported that villous trophoblasts are negative and extravillous trophoblasts are positive for HLA-A, B,C, but the expressed HLA-A,B,C molecule has been noted to lack their polymorphic determinants. We analyzed the reactivity of two monoclonal antibodies to a monomorphic determinant of HLA-A,B,C (W6/32 and Cappel anti-HLA-A,B,C) with molar trophoblasts, using three uteri containing complete moles and two containing partial moles. The reactivity was examined by an indirect immunoperoxidase method. The staining patterns were almost identical in complete moles and partial moles. Villous trophoblasts showed a negative reaction with both antibodies. On the other hand, extravillous trophoblasts exhibited intense staining for W6/32 and negative staining for Cappel anti-HLA-A,B,C, which may suggest that the expression of a constant region as well as a variant region of HLA-A,B,C molecule is incomplete.

Antibodies, Monoclonal↗
PubMed1990

[A case of massive hemoptysis occurring after lung injury due to a torn segment of pleural calcification].

A 64-year-old man was referred to our hospital because of little improvement of hemoptysis lasting three days after drug therapy. A chest roentgenogram and fiberoptic bronchoscopic examination performed on the second hospital day when the patient experienced a massive hemoptysis of about 2,000 ml revealed arterial bleeding from the left upper lobe. Even after extensive embolizations of the left upper bronchial, the first, second, third and 4th intercostal arteries, the patient's hemoptysis did not improve. On the 73rd hospital day the patient underwent left upper lobectomy. Macroscopic and microscopic examinations in the resected specimen revealed lung injury due to a torn segment of pleural calcification after tuberculous pleuritis, resulting in the massive hemoptysis. Although physicians encounter many patients complaining of hemoptysis and/or hemosputum, this case is considered to be very rare.

Calcinosis↗
PubMed1990

[A bulky mass non-Hodgkin's lymphoma with dysuria in the rectovesical space].

A case of non-Hodgkin's lymphoma is reported. A 71-year-old man presented with complaint of dysuria and urinary frequency. Rectal examination and CT scan revealed a bulky mass in the rectovesical space. Transperineal needle biopsy of the tumor revealed non-Hodgkin's lymphoma, large cell type, diffuse. The patient received combination chemotherapy of adriamycin, cyclophosphamide, vincristine, prednisolone and pepleomycin. After two days the tumor was marvelously reduced in size, and partial response (PR) by CT was achieved after two months. PR was sustained for two months with cyclophosphamide, vincristine and prednisolone. However, the tumor progressed gradually, and he died five months after the first treatment and two additional courses of chemotherapy. Autopsy showed a 1,700 g bulky mass in the rectovesical space. The mass was covered with peritoneum and had a fistula from rectum to central necrosis of the tumor. Nine cases of the non-Hodgkin's lymphoma with complaint of dysuria have been reported in Japan before our case, which seemed to arise from the submucosal tissue of anterior rectal wall, prostate or lymphatic tissue of rectovesical space.

Aged↗
PubMed1990

[A case of lung metastases of bladder cancer in which thoracotomy was performed following M-VAC therapy].

A case of lung metastases of bladder cancer in which thoracotomy was performed following M-VAC is presented. A fifty-nine-year-old man underwent radical cystectomy and ileal conduit diversion for bladder cancer. Pathological diagnosis was TCC greater than AC much greater than SCC. After nine months, he was admitted because of lung metastases. Three courses of M-VAC therapy brought partial remission. A thoracotomy was performed on residual lung metastasis. Pathological diagnosis was AC much greater than TCC greater than SCC. Because M-VAC therapy has limited antitumor activity against mixed histological bladder cancer, we recommend not only M-VAC therapy but also surgical resection for the metastatic tumor the primary site of which has nontransitional components.

Adenocarcinoma↗
PubMed1990

[Cytomorphological reappraisal of choriocarcinoma cells--a proposal of a four cell pattern].

It is generally accepted that choriocarcinoma is composed of two cell types: syncytiotrophoblast (ST)-like cells and cytotrophoblast (CT)-like cells. In normal and molar pregnancy, there is another population of trophoblast in the cell column, the decidua and so forth. They are designated intermediate trophoblast (IT) and multinuclear IT. It remains to be clarified whether IT-like cells and multinuclear IT-like cells are observed in choriocarcinoma. In the present study, choriocarcinoma cells were reappraised cytomorphologically in three cases of uterine choriocarcinoma and additional three cases of metastatic choriocarcinoma. The results were as follows: 1. Choriocarcinoma cells could be classified into four cell types: ST-like cells, CT-like cells, IT-like cells and multinuclear IT-like cells. 2. IT-like cells predominated in metastatic lesions as compared with primary lesions. It seemed that choriocarcinoma shows both differentiations which take place in villous and extravillous trophoblasts of normal and molar pregnancy. IT-like cells were found to infiltrate into vessel walls, which, together with the predominance of IT-like cells in metastatic lesions, suggests that IT-like cells contribute greatly to the hematogenous metastasis in choriocarcinoma. The presence of ST-like cells, CT-like cells and multinuclear IT-like cells in metastatic lesions may indicate a germinative nature of IT-like cells.

Cell Nucleus↗
PubMed1989

Evidence for the in vivo production of interleukin-3 in lethally irradiated mice transplanted with syngeneic murine splenocytes.

We wish to demonstrate new evidence for the in vivo production of interleukin-3 (IL-3). Syngeneic murine splenocytes were transplanted into lethally irradiated mice. The spleen cells in these transplant mice spontaneously produced IL-3 in cultures, and IL-3-like activity was detected in the serum. Chronological changes of the Thy-1 antigen expression on the bone marrow cells, and the number of myeloid progenitors in the bone marrow from post-transplant mice correlated with the amount of IL-3 produced in vivo. These results suggest that IL-3 may be produced by activated T cells during the syngeneic mixed lymphocyte reaction induced in vivo.

Animals↗
PubMed1989

Carbamazepine-induced granulomatous necrotizing angiitis with acute renal failure.

A 42-year-old male treated with carbamazepine developed a skin eruption in the trunk, followed by acute renal failure. Laboratory data revealed leukocytosis (15,700/mm3) with eosinophilia (37%). A renal biopsy disclosed granulomatous necrotizing angiitis that differed from classic periateritis nodosa and hypersensitivity angiitis. All drugs were discontinued immediately, and there was a gradual improvement of the renal function. A carefully performed provocation test using carbamazepine was positive. We made a diagnosis of carbamazepine-induced granulomatous necrotizing angiitis. Only 6 cases of drug-induced granulomatous angiitis have been reported prior to the present case. Drug-induced granulomatous angiitis is often fatal. The present report suggests the importance of making a diagnosis quickly, and providing adequate treatment in order to prevent a fatal course.

Acute Kidney Injury↗
PubMed1989

Clinical observations on fertile males with varicocele.

During the clinical observation of 32 fertile cases with varicocele interesting findings were made. Normal semen, a sperm density above 40 million/ml and a motile sperm rate of over 60% were observed in 46.9% of the cases. Furthermore, a sperm density of more than 40 million/ml was found in 75% and a motile sperm rate of more than 50% was detected in 81.3%, indicating normal or adequate spermogram data. A difference in right-left testicular size was recognized in 35.5% (11 cases). Only 2 of the cases had oligospermia and 9 cases had normospermia. Two cases had low testosterone values and low motile sperm rates were also detected. Secondary infertility occurred in 33.3%. In 25% of the cases, scrotal scintigraphy revealed an accumulation of high radioactivity indicating venous blood pooling over the affected site in the early phase of dynamic images. In the other cases, different venous flow characteristics were detected visually.

Adult↗
PubMed1989

Improved technique of tubeless cutaneous ureterostomy and results of permanent urinary diversion.

An improved technique of tubeless cutaneous ureterostomy through a single stoma was devised by modifing the traditional cutaneous ureterostomy. Using this method, urinary diversions were performed on 12 cases with malignancies: 6 had radical cystectomy and the other 6 had pelvic exenteration. Normal bilateral ureters were observed in 11 cases in preoperative intravenous pyelography. Stomal stenosis was found in 1 case (8.3%) requiring operative stomal revision. Generally satisfactory results were obtained. This method could lower the incidence of complications. A long-term follow-up is needed, but 2 cases who have survived for more than 4 years since the operation have shown excellent results. It was thought that it would be difficult to perform tubeless cutaneous ureterostomy on normal-sized ureters, but our clinical results indicate that this method may be able to provide permanent urinary diversion.

Adult↗
PubMed1989

Serum tumor necrosis factor-alpha levels in allogeneic bone marrow transplant recipients with acute leukemia.

We determined the serum levels of tumor necrosis factor-alpha (TNF) in allogeneic bone marrow transplant recipients in order to evaluate the relationship between TNF and graft-versus-host disease (GVHD). Eight patients with acute leukemia receiving an HLA-identical marrow graft were studied. Samples from healthy subjects and pretransplant recipients were all negative for TNF. Six of eight patients had detectable levels of TNF in serum after transplantation. All three patients with acute GVHD, and three of five patients without acute GVHD had elevated TNF levels in serum. Among the patients with increased TNF levels, documented infection was demonstrated in only one patient, with a clinical diagnosis of B19 parvovirus infection. Serum TNF levels were elevated when the WBC counts were more than 2,000/microliters. However, serum concentrations of TNF significantly correlated with body temperature. Although we could not conclude definitely that serum TNF levels correlated with severity of GVHD, it was suggested that TNF may be produced as a result of latent infections or immunological reaction against non-HLA allogeneic antigens.

Acute Disease↗
PubMed1989

Lymphokine activity production in graft-versus-host reactions across minor histocompatibility antigen barriers.

Activated T cells responding to murine minor histocompatibility antigens (HA) were characterized according to the patterns of lymphokine activity production. Although B10.D2/nSN and BALB/c are mutually non-reactive in mixed lymphocyte reaction (MLR), graft-versus-host reaction (GVHR) can be induced by the injection of a large amount of B10.D2/nSN lymphoid cells into irradiated BALB/c recipient mice. Spleen cells from such GVHR mice spontaneously produced interleukin 3 (IL-3)-dependent cell-stimulating activity in cultures, but did not produce interleukin 2 (IL-2). Normal B10.D2/nSN spleen cells also produced IL-3-like activity, but not IL-2 in MLR supernatants, in response to irradiated BALB/c splenocytes. In addition, B-cell stimulatory factor-1 (BSF-1)/interleukin 4 (IL-4) and colony-stimulating factor (CSF) activity were detected in MLR supernatants. The properties of the produced lymphokine activities were similar to those produced in syngeneic transplant mice and syngeneic MLR, but a difference in the time course of lymphokine production existed between GVHR and syngeneic transplant mice. These results indicate that T cells may be activated in vivo in allogeneic transplantation when the donor and the recipient are matched for major HA, and are non-reactive in MLR. Also, the character of lymphokine-producing T cells activated by minor HA may not be qualitatively different from those responding to irradiated syngeneic cells.

Animals↗
PubMed1989

[Recovery of marrow myeloid progenitors (CFU-GM) after bone marrow transplantation, especially associated with chronic graft-versus-host disease (GVHD)].

Six patients underwent allogeneic bone marrow transplantation (BMT) for treatment of acute non-lymphocytic leukemia. Hemopoietic reconstitution after BMT was monitored by peripheral blood counts, counts of bone marrow cellularity, bone marrow pictures, and clonal assays for myeloid progenitors (CFU-GM). Although bone marrow samples were markedly hypocellular on day 7 posttransplant, myeloid and erythroid elements were seen in 5 of 6 patients. Peripheral blood recovery of these 5 patients was achieved by third weeks posttransplant. The values of (CFU-GM) per 1 X 10(5) marrow mononuclear cells reached normal values on day 7 in two patients and significantly increased by day 28 in a patient. After day 84 the values of (CFU-GM) were remained almost normal and they had no relation to the occurrence of chronic graft-versus-host disease (GVHD). But in patients with chronic GVHD, marrow (CFU-GM) values were significantly increased on day 7 and day 14. These results suggest that marrow (CFU-GM) values by day 28 may predict the occurrence of chronic GVHD.

Bone Marrow Transplantation↗
PubMed1988

Ampullary carcinoma in Gardner's syndrome: case report.

A case of ampullary carcinoma associated with Gardner's syndrome is reported. Such an association is well described in the textbook, but its true incidence is very low. A review of the literature disclosed only 19 cases of Gardner's syndrome or familial polyposis coli in association with ampullary carcinoma, three of them in Japan. Whether or not ampullary carcinomas develop de novo or arise from adenoma still remains controversial. In order to ascertain the facts about their origin, more cases need to be collected and the early detection of ampullary lesions may be necessary.

Adenomatous Polyposis Coli↗
PubMed1988

Angiocentric and angiodestructive infiltration of adult T-cell leukemia/lymphoma (ATLL) in the skin. Report of two cases.

This report describes the clinical and pathological features of cutaneous lesions observed in a 73-year-old woman with terminal adult T-cell leukemia/lymphoma (ATLL) and a 42-year-old man who had chronic ATLL with persistent nasal stuffiness and rhinorrhea of 2 years' duration. Histology of the skin lesions from these two cases showed large blood vessel (arterial and venous) involvement at the level of the dermosubcutaneous junction, in which angiocentric and angiodestructive infiltration of the tumor cells was prominent and reminiscent of lymphomatoid granulomatosis (LYG) and/or polymorphic reticulosis. ATLL commonly involves the skin. Moreover, it may originate in the skin. The majority of researchers have observed perivascular and periadnexal infiltration, frequent epidermal exocytosis with Pautrier's microabscesses, and the occasional presence of leukemic cells within the vascular lumen; however, vascular involvement like that seen in our cases has not been described before. Our cases suggest that a variety of T-cell malignancies may be angiocentric and angiodestructive in nature, and that so-called LYG and LYG-like malignant lymphomas are not a single disease, but may constitute a heterogeneous group of T-cell malignancies including ATLL.

Aged↗
PubMed1988

Arteriovenous malformations of the kidneys: ablation with alcohol.

Ablation of renal arteriovenous malformations with absolute alcohol was performed in seven patients with massive hematuria. In three patients, total occlusion of the malformations was accomplished by ablation of two arterial branches. In the remaining four patients, the malformations were partially occluded by ablation of one or two arterial branches. In addition to ablation with alcohol, two of the four patients underwent subselective embolization with Gelfoam (absorbable gelatin sponge) under epinephrine pharmacoangiography, which resulted in the disappearance of the remaining malformations. None of the patients had serious complications from ablation with alcohol, although dyspnea and headache occurred in one patient with marked arteriovenous shunting. During long-term follow-ups, hematuria disappeared in six patients. In the remaining patient hematuria recurred but did not require treatment. These data suggest that alcohol ablation is useful and safe in the treatment of renal arteriovenous malformations.

Adult↗