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Biomedical subjects

M Kitagawa

Publications and source records attributed to M Kitagawa.

At least 415 records · Page 23Linked to original sources

[Three cases of minocycline-induced pneumonitis].

All three patients complained of cough, fever and dyspnea. Their chest X-ray films revealed interstitial changes such as Kerley B lines. The results of lymphocyte stimulation tests were all negative for Minocycline (MINO), whereas the provocation tests were all positive in three cases. The onsets of symptoms appeared 7, 12 and 9 hours after administration of MINO respectively, which suggested type III allergy in terms of the latency period. In cases No. 1 and No. 3, lung tissue specimens obtained by transbronchial biopsy showed findings of mild acute eosinophilic pneumonia. The bronchoalveolar lavage fluid of case No. 3 showed eosinophilia. On diagnosing MINO-induced pneumonitis, the lymphocyte stimulation test is not always beneficial, whereas the provocation test is supposed to be a safe and sure method.

Adult↗

[A case of congenital bronchial atresia with obstructive pneumonia accompanied with partial anomalous pulmonary venous drainage].

A 25-year-old male was admitted with productive cough and an abnormal shadow on chest X-ray film which showed a cylindrical shadow near the left hilum and consolidation in the markedly hyperlucent left upper lung field. The cylindrical shadow appeared to be located in left S1+2 but bronchographic examination showed independence of the branches of B1+2. Furthermore, pulmonary venography by DSA showed that the left upper pulmonary vein entered the left brachiocephalic vein. The patient underwent left partial lobectomy under a diagnosis of congenital bronchial atresia with partial anomalous pulmonary venous drainage. Pathological examination of the resected lung revealed obstructive pneumonia in the over-inflated lung zone, probably induced through collateral airways.

Abnormalities, Multiple↗

Simian immunodeficiency virus infection of macaque bone marrow macrophages correlates with disease progression in vivo.

The pathogenesis of hematopoietic abnormalities associated with infection of susceptible hosts with either simian immunodeficiency virus (SIV) or human immunodeficiency virus (HIV) is not fully understood. To determine if bone marrow cells are infected with SIV and if the pattern of viral infection is correlated with the severity of disease and abnormalities in hematopoiesis, 23 SIV-infected rhesus monkeys were examined by immunohistochemistry and in situ hybridization. By immunohistochemistry, only four monkeys were positive for SIV core protein p27, while in situ hybridization revealed viral RNA in the bone marrow of 15 monkeys. Simian immunodeficiency virus RNA was consistently expressed in the bone marrow from monkeys with severe lymphoid depletion (11 of 11), but less so in monkeys with follicular hyperplasia (0 of 2) or mild lymphoid depletion (4 of 10). In animals with mild lymphoid depletion, bone marrow cells infected with SIV were mainly mononuclear cells that appeared to be of myelomonocytic lineage. In contrast, monkeys with severe lymphoid depletion had SIV RNA localized to larger mononuclear cells with abundant cytoplasm often located in small lucent areas of the stroma. These SIV RNA-positive mononuclear cells were positive for the macrophage determinant CD68 as demonstrated by immunohistochemistry. Furthermore the stage of simian acquired immune deficiency syndrome, as indicated by lymphoid morphology, and SIV localization in the bone marrow were correlated with the incidence of anemia, bone marrow hyperplasia, and abnormal distribution of macrophages in the bone marrow. These results indicate that, in common with other animal lentiviral infections, the macrophage is a major target of SIV infections in the bone marrow.

Animals↗

[Primary cardiac malignant mesenchymal tumor containing chondrosarcomatous component--a case report].

A case of 70 years old female bearing a primary cardiac tumor was presented. Mitral valve replacement and reconstruction of the interatrial septum were necessary because the tumor originated from the left atrial side of the interatrial septum and invaded the anterior mitral valve leaflet and around the annular area. Pathological examination of the resected specimens revealed mesenchymal tumor containing chondrosarcomatous component. The patient received radiation therapy (50 Gy) postoperatively and she resumed normal daily activity. Preoperative echocardiographic manifestations were of proved benefit in the diagnosis of malignant cardiac tumor and a proper therapeutic strategy could be chosen.

Aged↗

[Clinical analysis of renal cell carcinoma with intravenous tumor thrombus].

We reviewed treatment and prognosis in 7 operative and 7 non-operative cases of renal cell carcinoma with venous tumor thrombosis formation, 14 cases in total. Treatment after around 1983 involved the use of biological response modifier (BRM), chiefly interferon (IFN), and operation by thoracoabdominal approach. Before that, chemotherapy, radiotherapy and operation by peritoneal approach were used, with many cases judged inoperable. Even in non-operative cases, life-prolongation was frequently achieved by embolization of the renal artery and administration of various BRMs. On the other hand, in cases judged operable which were always treated by resection, early postoperative death sometimes occurred. These facts brought home to us the difficulty of choosing appropriate treatment. Though it is hard to determine the relative merits of various treatments from the present data, since the series is small and contains cases from 1963 onwards, the clinical and pathological pictures should be carefully evaluated for each case, and the most suitable course of treatment should be selected individually. We describe a non-operative case in which a combined use of embolization, IFN-gamma and tumor necrosis factor (TNF) elicited a lasting partial response, and an operative case in which postoperative complications such as pulmonary infarction and renal failure occurred after operation under extracorporeal circulation and patient died at 2 months after operation.

Aged↗

Usefulness of a new tumor marker, Span-1, for the diagnosis of pancreatic cancer.

Levels of serum Span-1, a new tumor marker for pancreatic cancer, were assayed in 64 patients with pancreatic cancer, 90 with nonpancreatic cancer, and 254 with nonmalignancies, involving 55 healthy controls. Furthermore, Span-1 was compared with other tumor markers (CA19-9, carcinoembryonic antigen [CEA], and DU-PAN-2). Frequency of elevated Span-1 levels was 81.3% in pancreatic cancer. False-positive elevations of serum Span-1 levels were rather common in liver cirrhosis (53.8%) and chronic hepatitis (26.3%). The sensitivity, specificity, and efficiency of this assay for pancreatic cancer, was 81.3%, 75.6%, and 76.5% against all subjects without pancreatic cancer, respectively. In comparison with other markers, sensitivity of Span-1 tended to be highest with similar specificity to those of CA19-9 and CEA. The Span-1 assay has a high sensitivity and specificity for pancreatic cancer. It is almost equivalent to CA19-9 assay. However, this assay is not specific for chronic liver diseases.

Adult↗

Prevention of experimental acute pancreatitis by intraduodenal trypsin inhibitor in rat.

To confirm that trypsin activity is a most important initiating factor in closed duodenal loop pancreatitis in rats, we observed the course of acute pancreatitis when trypsinogen activation was inhibited by intraduodenal infusion of a potent synthetic trypsin inhibitor (TI, nafamostat mesilate) but the other conditions were left unchanged. Intraduodenal and intrapancreatic trypsinogen activation was inhibited for 16 hr after the intraduodenal infusion of the inhibitor, although elevation of serum amylase and immunoreactive trypsin and pancreatic trypsinogen remained similar both in the TI and control groups. The mortality decreased from 44% (control) to 4% (TI) at 48 hr after establishing the model. Active trypsin in duodenal reflux is an initiating factor for further development of acute pancreatitis in the closed loop model, and inhibition of the initial activation of trypsinogen has a favorable effect on acute pancreatitis even if other deleterious factors remain unchanged.

Acute Disease↗

Reappraisal of bronchial arterial infusion therapy for advanced lung cancer.

As preoperative adjuvant therapy for advanced lung cancer, bronchial arterial infusion (BAI) of a chemotherapeutic agent was administered to patients with stage IIIa and IIIb hilar lung cancer. The infusion modality was changed for each term, from a single drug infusion, to a two drug infusion and then a three drug infusion, and the combination of infused drugs was selected in accordance with cell types. A significant radiographic shrinkage was observed after BAI therapy by the single, two and three drug infusions, being noted as 40.7 per cent, 61.8 per cent and 83.9 per cent, respectively. The effect on squamous cell carcinoma was more prominent than on other cell types. Upon microscopic examination of the resected specimens, significant histo-pathological effects were observed in 57.7 per cent of the patients who received single or two drug infusions, while the rate increased to as high as 92.2 per cent in the patients who received the three drug infusion. The histological effects of BAI therapy were also most marked in squamous cell carcinoma. It is of special interest that 5 of the 10 patients who received the three drug infusion of Carboquone (CQ) + Mitomycin C (MMC) + Nimustine-HCL (ACNU) for squamous cell carcinoma, showed complete disappearance of viable cancer cells at the tumor site; something which was never observed after the single and two drug infusions. It was therefore concluded that BAI therapy for advanced lung cancer should be reappraised through the modification of infusion methods.

Adenocarcinoma↗

A quantitative study of iliac bone histopathology on 62 cases with itai-itai disease.

Sixty-two autopsy cases with "itai-itai" or "ouch-ouch" (in English) disease and 50 control subjects were examined by static quantitative bone histopathology. Decalcified sections after cyanuric chloride treatment (Yoshiki's method) were used. The small observer variances of the decalcified sections guaranteed the accuracy and precision of this method. In the static measurement analyses, significant increases in formation parameters and decreases in structural parameters were observed (P less than 0.05-0.000001), suggesting the presence of a marked osteoid accumulation accompanied by a bone mass reduction. Discriminant analysis clearly separated the patients from the control subjects. Two-thirds of the patients showed an increase in resorption surface prior to osteoid deposition and a decrease in osteoblast surface. Double tetracycline labeling in 4 patients showed an impaired osteoid maturation and mineralization. An impaired osteoblastic function was suggested by the results of the static and dynamic histomorphometry. The bone cadmium contents were measured in 46 patients by an atomic absorption spectrophotometer and found to be increased significantly (P less than 0.01). In Aluminon (an ammonium salt of aurine tricarboxytic acid) staining, a clear, reddish line was located in an osteoid-bone interface, suggesting a reaction of Aluminon with tissue aluminium and/or cadmium. These results suggested that an impairment of osteoblastic function and mineralization occurred in itai-itai disease and that cadmium is a possible etiological factor.

Aged↗

Prospective trial for early detection of pancreatic cancer by elevated serum immunoreactive elastase.

Early detection of pancreatic cancer was prospectively evaluated by measuring serum immunoreactive elastase (IRE) in 722 patients in two hospitals during the past 18 months. Patients included in the study were over 40 years of age and had symptoms suggestive of pancreatic disease such as upper abdominal pain, discomfort or mass, jaundice, weight loss, or diabetes. Among the 722 patients, 171 exhibited elevation of serum IRE. Pancreatic diseases were subsequently found in 42% of the 171 patients. Pancreatic cancer was found in 22 patients, among which 17 had elevated serum IRE. Among the 17 pancreatic cancer patients with elevated IRE, 10 underwent radical resection of the cancer but in none of the five patients with normal serum IRE could radical resection be carried out. Three of the 10 patients had a small cancer less than 2 cm in diameter and two of them survived for more than three years. Patients over 40 or 45 years of age complaining of upper abdominal pain of recent onset that cannot be explained by diseases other than that of the pancreas would be candidates for measurement of serum elastase, and this is an effective way to detect pancreatic cancer at an early stages.

Adult↗

In vivo dynamics of pulmonary lymphoid cell subpopulations generated against pulmonary metastasis: evaluation by bronchoalveolar lavage fluid.

The dynamics of lymphoid cell subpopulations in bronchoalveolar lavage fluid (BALF) and the systemic lymphoid organs of mice after intravenous injection of B16 melanoma cells were examined with a fluorescence-activated cell sorter. The lymphoid cell subpopulations of BALF and mediastinal lymph nodes showed significant changes in numbers and proportions, while those of other lymphoid organs including inguinal lymph nodes, thymus and spleen, showed little change. In week 1, the cells with a Thy-1.2+, Lyt-1+, L3T4-, Lyt-2- phenotype and asialo-Gm1+ cells in BALF significantly increased and L3T4+ cells slightly increased in number. By week 3, the numbers of Lyt-2+ cells in BALF markedly increased in number (by about 90 times) compared with controls. The number of Thy-1.2+ cells in mediastinal lymph nodes also increased significantly by week 3. Mice that had been pretreated with an immunosuppressive dose of cyclophosphamide were also inoculated intravenously with B16 melanoma cells. In these mice, a significantly increased number of pleural tumors developed and the number of Thy-1.2+ cells in BALF was markedly reduced from week 1 to 3. The results indicate that L3T4 and Lyt-2 double negative T-cells and natural killer (NK) cells may be generated and/or mobilized to the lung in an early phase of experimental metastasis of B16 melanoma cells and that at a later stage, when multiple metastases develop, T-cells with a Lyt-2+ phenotype markedly increase, probably as an expression of a host reaction against proliferating metastatic tumor cells.

Animals↗

Plasma osmolality and exocrine pancreatic secretion.

To confirm the influence of plasma osmolality on exocrine pancreatic secretion, hypertonic saline (4% saline) was given intravenously to dogs with gastric and pancreatic fistulae. Intravenous administration of hypertonic saline caused a reduction of pancreatic juice flow and bicarbonate output, but did not alter protein output stimulated by secretin and cerulein. The changes of pancreatic juice flow(X) exhibited negative correlations with the changes in plasma osmolality(Y) (Y = -2.2X + 6.4, r = -0.74, p less than 0.01). Plasma osmolality and plasma vasopressin level were measured simultaneously. Plasma osmolality was elevated from 292 to 315 mOsm/kg with concurrent increase of plasma vasopressin level from 2.4 to 19.6 pg/mL. On the other hand, exogenous administration of vasopressin inhibited pancreatic juice flow and bicarbonate output dose-dependently. In conclusion, elevation of plasma osmolality decreased exocrine pancreatic secretion stimulated by secretin and cerulein, and vasopressin may play an important role in its mechanism.

Animals↗

4, 6-0-benzylidene-D-glucopyranose (BG) in the treatment of solid malignant tumours, an extended phase I study.

4, 6-0-Benzylidene-D-glucopyranose (BG), a derivative of benzaldehyde (BA), whose anti-tumour action has often been reported, showed responses in 10 out of 24 patients (41.7%). These patients consisted of 11 cases of primary lung cancer, 4 of metastatic lung cancer, 5 of gastric cancer, and one each of cancer of the sigmoid colon, liver, pancreas and prostate. There were two complete responses (one each of ipsilateral lung metastasis from breast cancer and metastatic liver lesions due to gastric cancer). The mean total dose of BG was 392.6 g, given by intravenous infusion of 1.2 g BG in 100 ml saline twice daily. The treatment was discontinued when no response was observed after two months. Careful monitoring showed no toxic action of BG at these large doses. Complete necrotic liquefaction of tumour, without any damage to surrounding tissue, was seen in 2 of 3 cases in which histological examination was feasible. It is apparent that BG, like BA, is not a cytotoxic agent in the ordinary sense, but its mechanism of action is still unknown.

Adult↗

Thrombotic thrombocytopenic purpura as a complicating factor in a case of polymyositis and Sjögren's syndrome.

A 62-year-old woman was admitted for evaluation of muscular weakness, skin pigmentation, dry mouth, and interstitial pneumonia. During the course of her stay, adult respiratory distress syndrome, hemolytic anemia, renal failure, neurologic dysfunction, and thrombocytopenia appeared. A clinical diagnosis of thrombotic thrombocytopenic purpura (TTP) accompanied by polymyositis and Sjögren's syndrome was made. She died two weeks after the beginning of plasmapheresis, and an autopsy was performed. Immunohistochemistry disclosed deposits of IgM, fibrinogen, and C1q in glomeruli and arterioles and deposits of C3 in small arteries. von Willebrand's factor antigen, which promotes the adhesion of platelets to the subendothelium, was positive in onion-peeled arteries of the kidney and the spleen. These results suggest that immune complexes may have triggered a sequence of events from vascular endothelial injury to TTP.

Female↗

Amylase release from streptolysin O-permeabilized pancreatic acini.

Intracellular mediators of exocytosis were investigated using isolated mouse pancreatic acini permeabilized with the bacterial toxin streptolysin O (SLO). Permeabilization was demonstrated by fluorescent staining with ethidium bromide and fluorescein diacetate and release of cytoplasmic lactate dehydrogenase. When SLO-permeabilized acini were incubated at 37 degrees C in Ca2(+)-EGTA buffers containing MgATP, amylase secretion was Ca2+ dependent with an EC50 of 0.40 microM Ca2+ and a maximally effective Ca2+ concentration of 1 microM. Maximal amylase secretion was 330% of that in Ca2(+)-free buffer (basal). The nonhydrolyzable GTP analogue guanosine 5'-O-(3-thiotriphosphate) (GTP gamma S; 30 microM) increased the maximal secretion to 451% of basal in the presence of 1 microM Ca2+ and decreased the EC50 to 0.14 microM Ca2+. Removal of ATP plus addition of antimycin A and 2-deoxy-D-glucose inhibited Ca2(+)-dependent, GTP gamma S-enhanced amylase secretion by 56%. The phorbol ester 12-O-tetradecanoylphorbol 13-acetate (TPA; 1 microM) also enhanced maximal secretion to 450% of basal and decreased the EC50 to 0.18 microM Ca2+. Enhancement of amylase secretion by submaximal concentrations of GTP gamma S or TPA was inhibited by the protein kinase C inhibitor staurosporine. These results suggest that Ca2+ stimulation of amylase secretion is potentiated by activation of protein kinase C. However, the enhancement of secretion by GTP gamma S and TPA was additive at their maximally effective concentrations, suggesting that another G protein(s) maybe involved in the terminal steps of exocytosis.

Alkaloids↗