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Biomedical subjects

M Ikegami

Publications and source records attributed to M Ikegami.

At least 343 records · Page 19Linked to original sources

Anaplastic carcinoma of the esophagus.

The present report includes the histological, electron microscopical and immunohistochemical findings observed in two cases of anaplastic carcinoma of the esophagus. Anaplastic carcinoma of the esophagus revealed histological features similar to oat-cell carcinoma and carcinoid. Positive argyrophil reaction, neurosecretory granules, and hormonal activity suggest that both cases come under the category of neuroendocrine cell tumors. Anaplastic carcinoma of the esophagus may be considered as a pluripotential tumor. The biological behavior of this tumor is quite different from that of carcinoid and is a highly malignant tumor.

Aged↗

A histopathological study of diffuse hyperplasia of gastric argyrophil cells.

The present study includes a histopathological and immunohistochemical study of 4 cases of diffuse hyperplasia of gastric argyrophil cells. The mode of proliferation of these cells and the production of hormone by these cells have been documented. The distribution of microacinar nests composed of argyrophil cells was thought to be related to chronic gastritis in which there are atrophy of mucosa and intestinal metaplasia. In the case in which these nests were found only in the corpus ventriculi, there was intestinal metaplasia throughout the stomach. On the other hand, in the case in which these nests appeared only in the pyloric area, atrophy of the mucosa with mild intestinal metaplasia was observed only in the pyloric area. The microacinar nests composed of argyrophil cells were distributed in the deep mucosa at the basal portion of the glands in the area with intestinal metaplasia. Serial sections revealed a sprout composed of argyrophil cells budding from the gland with intestinal metaplastic changes. The sprout buds out from the growth zone of glands with intestinal metaplasia and then becomes isolated and gives rise to reactive hyperplasia. The peptide hormone contained in these cells differs according to the mucosal environments. Cells containing gastrin were observed in the pyloric area, but not in the corpus ventriculi where there was marked intestinal metaplasia. The cells in this area were assumed to contain other hormones.

Adenocarcinoma↗

Left ventricular performance and regional blood flows before and after ductus arteriosus occlusion in premature lambs treated with surfactant.

The hemodynamic consequences of patent ductus arteriosus (PDA) were studied during the first few hours of life (1.9 +/- 0.7 hours) in 13 mechanically ventilated, surfactant-treated, preterm lambs (gestational age of 120-124 days). Cardiovascular pressures, left ventricular (LV) performance and regional blood flows were measured using cine left ventriculography and radionuclide-labeled microspheres before and after occlusion of the PDA with a catheter balloon. Before occlusion, the left-to-right shunt was 44 +/- 13%; after occlusion the shunt was negligible (2%). Heart rate (164 +/- 17 beats/min), LV end-diastolic pressure (5 +/- 3 mm Hg), ejection fraction (74 +/- 8%) and cardiac output (241 +/- 13 ml . min-1 . kg-1) were normal and did not change after ductus occlusion. However, "effective" systemic blood flow increased significantly after occlusion (130 +/- 53 vs 228 +/- 93 ml . min-1 . kg-1, p less than 0.001), as did blood flow to organs such as the brain, myocardium and gastrointestinal tract. The reduction of systemic blood flow in the presence of a left-to-right PDA shunt may be responsible for many early pathologic manifestations of the PDA "syndrome" of prematurity even in the absence of overt LV dysfunction.

Animals↗

Surfactant pool sizes and severity of respiratory distress syndrome in prematurely delivered lambs.

To quantify the relationship between surfactant pool size and severity of respiratory disease, 21 lambs were delivered at 134 to 136 days gestational age and ventilated by varying only peak inspiratory pressure to maintain tidal volume at 6.2 +/- 0.3 ml/kg (mean +/- SE) and thus to control PCO2. Compliance measurements were used to quantify the severity of lung disease. After alveolar wash, surfactant phosphatidylcholine, saturated phosphatidylcholine, and minimal surface tensions were estimated. Compliance correlated linearly with saturated phosphatidylcholine pool size (r = 0.755, p less than 0.001). The mean minimal surface tension of the alveolar washes was 17.4 +/- 1.7 dynes/cm, and alveolar washes from lambs with more compliant lungs had lower minimal surface tensions than did washes from lambs with poorly compliant lungs (p less than 0.001). Lung tissue of all lambs contained similar amounts of saturated and total phosphatidylcholine, and in vitro rates of incorporation of labeled choline and palmitate into phosphatidylcholine in lung slices were similar, independent of severity of lung disease. The pool size of surfactant within the alveoli is an important determinant of lung disease in premature lambs; however, surface tension, tissue maturity, and other factors may contribute to the severity of the disease.

Animals↗

Cardiovascular effects of surfactant suspensions given by tracheal instillation to premature lambs.

After delivery by cesarean section at 133-136 days gestational age, 18 lambs were supported with infant ventilators. Peak inspiratory pressure was the only ventilator setting that was changed in an attempt to normalize PCO2. The lambs were retrospectively divided into two groups based on their respiratory status before treatment. Ten lambs with PCO2 values of 38 +/- 2 mmHg (mean +/- S.E.) at 5 h of age were treated with a 15-ml suspension containing 50 mg natural sheep surfactant lipid/kg body weight. After surfactant instillation, pH fell, PCO2 increased and compliance/kg decreased transiently. Surfactant treatment did not reduce the respiratory support that these lambs required. Eight lambs with PCO2 values of 68 +/- 3 mmHg at 3 +/- 0.8 h of age responded to surfactant instillation with a decrease in PCO2 and an increase in PO2 and pH. In both groups of lambs heart rates, mean aortic pressures, and mean pulmonary artery pressures changed little after surfactant instillation. Cardiac outputs and regional blood flows measured before and after surfactant treatment were unchanged. Instillation of surfactant suspensions to premature lambs did not adversely affect cardiovascular status; however, some lambs did have a transient deterioration of lung function after surfactant instillation.

Animals↗

Saturated phosphatidylcholine secretion and the effect of natural surfactant on premature and term lambs ventilated for 2 days.

Lambs prematurely delivered by cesarean section and term lambs were supported on ventilators and studied over a period of 2 days. Sequential measurements of ventilatory requirements, lung compliance, and arterial pH, pO2, and pCO2 values documented the course of the lung disease. In five premature lambs the pCO2 increased to 77 +/- 5 mm Hg (mean +/- SE) by 40.5 +/- 3.1 hr of age, at which time treatment with 50 mg natural sheep surfactant lipid/kg body weight by tracheal instillation resulted in improvements in pH, pO2, and pCO2 measurements. Radiolabeled palmitic acid was injected systemically after birth to detect the appearance of endogenously synthesized and secreted saturated phosphatidylcholine in sequential airway samples. Radiolabeled saturated phosphatidylcholine specific activity increased in a relatively linear fashion for about 30 hr in lambs treated with natural surfactant, in untreated premature lambs, and in term lambs. The study demonstrates that surfactant therapy can improve the ventilatory status of premature lambs despite many hours of ventilation for pulmonary immaturity. The overall kinetics of secretion of saturated phosphatidylcholine is similar in lambs with and without pulmonary immaturity.

Animals↗

[Clinical and pathological studies of multiple primary carcinoma of the colon and rectum].

During a 5-year period from 1976-1981, we clinicopathologically studied 21 patients with 45 lesions of multiple primary colorectal carcinomas and compared our findings with those made in 288 single carcinomas of the large intestine. The frequency of multiple primary colorectal carcinoma was 6.8%. The pathological findings suggested an interrelationship between colorectal adenoma and carcinoma. Patients with multiple carcinomas of the large bowel had coexisting adenomas more than patients with single carcinoma. We suggest that it is necessary to do a thorough preoperative examination of cancer of the large intestine to detect double cancers or other adenomatous polypoid lesions with synchronous association.

Adenoma↗

Surfactant phosphatidylcholine source, fluxes, and turnover times in 3-day-old, 10-day-old, and adult rabbits.

We have measured turnover times for alveolar surfactant phosphatidylcholine in rabbits at 3 and 10 days of age and in adult rabbits. To generate accurate estimates of the turnover time of surfactant phosphatidylcholine from lamellar bodies into the alveolar space, large numbers of rabbits at each age were injected with radiolabeled choline, palmitic acid, and phosphate. Phosphatidylcholine was isolated from lamellar body and surfactant fractions from each rabbit. Curves of specific activity versus time were analyzed using the Zilversmit equations for a two compartment precursor-product model. The curves for each labeled precursor at each age were consistent with the lamellar bodies being the sole precursors of surfactant phosphatidylcholine. The same equations were used to calculate turnover times for surfactant phosphatidylcholine; these were 8-10 h in 3- and 10-day-old rabbits but only 3 h in adult rabbits. From estimates of surfactant phosphatidylcholine pool sizes and turnover times, the flux of surfactant phosphatidylcholine was estimated to be 3.4 mumol/h in adult and 0.48 mumol/h in 3-day-old rabbits; however, the flux expressed/kg of body weight is 2.4 times larger in 3-day-old than in adult rabbits. Finally, the conservation of the radiolabeled precursors in phosphatidylcholine implies reutilization of phosphatidylcholine after synthesis and secretion.

Aging↗

Increased shunt through the patent ductus arteriosus after surfactant replacement therapy.

Instillation of surfactant into the trachea of preterm infants with respiratory distress syndrome is associated with a 90% incidence of patent ductus arteriosus. We studied the effects of surfactant therapy on the ductus arteriosus in 12 preterm lambs. Flow across the ductus arteriosus and systemic blood flow were calculated from radioactive microsphere injections. All developed respiratory failure (pH less than 7.1, Paco2 greater than 60) by 30 minutes after birth. Between 30 and 60 minutes after birth, six lambs were treated with tracheal instillation of 50 mg/kg surfactant lipid. By two hours after birth, treated lambs differed significantly from controls in pH (7.27 +0.02 vs 6.97 +0.08) and Paco2 (43.3 +4.1 vs 85 + 15). There were no differences in Pao2 or PGE2 concentrations or ductus arteriosus resistance, but there was a significantly larger shunt through the ductus arteriosus in treated lambs. This increased shunt resulted from the significant drop in pulmonary vascular resistance and not from a change in patency of the ductus arteriosus. Surfactant replacement may require interventions directed specifically at the patent ductus arteriosus in sick preterm infants.

Animals↗

Premature lambs rescued from respiratory failure with natural surfactant: clinical and biophysical correlates.

Thirty-four Western mixed breed lambs were delivered prematurely at 120 days gestational age (term = 150 days). Four lambs were sacrificed at birth, and four lambs were sacrificed with the onset of respiratory failure (PCO2 greater than 80 torr) at about 30 min of age. The remaining lambs were treated by tracheal instillation with 50 mg of natural sheep surfactant lipid/kg body weight. These lambs were sacrificed 10 min, 40 min, 1.5 h and 3 h after surfactant treatment. Frequent blood gas and compliance measurements documented the clinical responses of the lambs. Lungs from treated lambs showed large increase relative to untreated lungs in air volumes as assessed by pressure-volume curves and by histology. However, the pressure-volume and histologic measurements did not distinguish between the posttreatment groups of lambs. Minimum surface tensions of alveolar washes fell from greater than 30 dynes/cm to 6.3 dynes/cm 10 min after treatment and again rose to 21.6 dynes/cm within 3 h. Minimum surface tensions correlated well with the PO2 values but not with the PCO2 values measured before sacrifice. The combination of dilated distal airways and atelectasis resulted from increasing surface tensions with time and mechanical ventilation and may explain the clinical deterioration without much change in the volume of gas within the airways.

Animals↗

Metabolism of exogenously administered natural surfactant in the newborn lamb.

[3H]-Palmitate labeled natural lamb surfactant and free [14C]-choline were mixed with the lung fluid of 11 term lambs at cesarean section, before the first breath. After receiving the isotope, the lambs were delivered, allowed to breathe spontaneously, and were subsequently sacrificed from 5 min to 96 h of age. Alveolar washes, lung homogenates, microsomal and lamellar body fractions of lungs, and pulmonary alveolar macrophages were examined for the presence of labeled phosphatidylcholine. Analysis of the labeled natural surfactant kinetic data revealed an apparent t 1/2 of phosphatidylcholine in the whole lung of 6.0 days. This half-life can be interpreted only as a rough estimate. Appearance of considerable [3H] labeled phosphatidylcholine in the lung homogenates demonstrated uptake of phosphatidylcholine from alveoli into lung tissue. The surfactant-associated label in homogenates was localized preferentially to lamellar body fractions. Some of the administered [14C]-choline appeared in phosphatidylcholine. Almost all of this labeled phosphatidylcholine was associated with the homogenate. Extremely small % of administered [3H] and [14C] were found in pulmonary alveolar macrophages.

Animals↗

Changes in the amount of lung and airway phosphatidylcholine in 0.5-12.5-day-old rabbits.

Newborn rabbits delivered spontaneously at term and cared for by the mothers were studied from 0.5 to 12.5 days of age. Curves are constructed to describe the changes in weight, lung and alveolar wash phosphatidylcholine and saturated phosphatidylcholine, and lung protein. The curves are complex and non-linear. However. expressing the increases in lung and alveolar wash phosphatidylcholine and saturated phosphatidylcholine pool sizes relative to animals weight results in a decreasing linear relationship from 0.5 to 12.5 days of age. By 12.5 days the ratios of lung phosphatidylcholine and saturated phosphatidylcholine to weight approximate the ratios measured for adult rabbits. The ratios of saturated to total phosphatidylcholine in the alveolar washes and lungs remained invarient throughout the study period.

Age Factors↗