Biomedical subjects
Publications and source records attributed to M Mukai.
Serious complications such as angina pectoris and myocardial infarction in patients with anomalous origin of a coronary artery have been documented. However, this anomaly with dilated cardiomyopathy is very rare. We present the first case of anomalous origin of the left anterior descending coronary artery with dilated cardiomyopathy.
Ciliated cells were found in the gastric mucosa in close association with intestinal metaplasia, mainly in the pyloric mucosa, of Japanese patients. The occurrence of ciliated cells is believed to be an acquired phenomenon and is considered to be a type of metaplasia; the term "ciliated metaplasia" is used to describe this phenomenon. Ciliated cells are found in the basal part of the glands among normal-looking mucous cells, mucous neck cells and neuroendocrine cells, but never on the surface or in foveolar epithelium. In ciliated cell-containing glands, mitoses were noted in the neck region and the ultrastructural features of these cells were identical to those of undifferentiated neck cells. However, cell metaplasia from undifferentiated cells to metaplastic ciliated cells has never been demonstrated previously. The small mucus-granule-containing ciliated cells found in our present study may arise subsequent to division of undifferentiated neck cells into mucous cells with some daughter cells then exhibiting differentiation characteristics specific to ciliated cells. Thus they contain a mixture of both small mucus granules and numerous basal bodies and cilia, at the same time as a transitional form.
So-called minute pulmonary chemodectoma is a curious, small lung tumour found mainly in women. The nature and origin of the proliferating cells are still obscure. In the first report on the tumour, the component cells were described as resembling chemoreceptor cells and the tumour was named chemodectoma. However, electron microscopic studies of the tumour have revealed no evidence of neuronal characteristics and have shown a close resemblance to meningothelial cells. In this study, the electron microscopic findings were similar to those previously reported but in one of the two cases, tumour cells were filled with abundant cytofilaments, giving them an occasional dense, patch-like appearance. Immunostaining for myosin and vimentin was positive in all tumour cells, but epithelial membrane antigen staining was not seen. These findings indicate that the tumour might have its origin from muscle cells.
Tumor invasion-inhibiting factors were purified from bovine liver using an in vitro system for estimating the tumor invasion ability. The acid-ethanol extract of liver was subjected to ultrafiltration (Amicon PM10 membrane), and the fraction corresponding to the molecular weight range below 10,000 was further fractionated by ion-exchange (DEAE-Toyopearl), gel filtration (Bio-Gel P6), and reverse-phase (C18) chromatographies. Two types of active polypeptides with molecular weights of about 5,000 and 2,000 were purified and named IIF-1 and IIF-2, respectively. Both peptides inhibited tumor invasion with half-maximum concentrations of 2-6 ng/ml in vitro. The amino acid compositions of both peptides were determined.
In the gastric mucosa of Japanese patients, ciliated cells were found in association with intestinal metaplasia. The cells occurred frequently in the pyloric mucosa of nearly half of the cases examined but rarely in the cardiac mucosa of total 12 cases, but never adjacent to the chief cells of gastric glands. The ciliated cells were always found in the basal part of cardiac and pyloric glands, but never in the surface or in the foveolar epithelium. Furthermore, ciliated cells containing a few small mucus granules and simultaneously possessing numerous cilia and basal bodies were noted. Ciliated cells in the gastric mucosa have been found mainly in elderly Japanese patients, but were also observed exceptionally in one Chinese, two Swedes and one American. These ciliated cells are not present in the normal human gastric and intestinal mucosa, and therefore a new term, "ciliated metaplasia", is proposed for their occurrence.
We recently reported that the secretagogue, compound 48/80, activated Ca2(+)-permeable channels of mast cells possibly via a second messenger [Kuno, Okada, and Shibata. Am. J. Physiol. 256 (Cell Physiol. 25): C560-C568, 1989]. The effects of pretreatment with pertussis toxin (PT) on compound 48/80 (48/80)-induced activation of the Ca2(+)-permeable channel have now been investigated by measuring Ca2+ signals of cell suspensions using the Ca2+ indicator fura-2 and by recording Ba2+ currents through the channel using the patch-clamp technique. In the presence of extracellular Ca2+, the fluorescence change was biphasic, with an immediate rise and a delayed peak at room temperature. The delayed peak, mainly due to Ca2+ entry through plasma membranes, was greatly reduced by pretreatment with PT. The quenching of the fluorescence by 48/80-induced Mn2+ influx was also decreased by PT, whereas the Ca2+ transients due to Ca2+ release from the intracellular stores apparently did not change. In patch-clamp recordings from cell-attached patches with pipettes containing isotonic Ba2+, the 48/80-induced Ba2+ currents were either suppressed or delayed in the PT-treated cells, under conditions where degranulation was absent. These results suggest that PT-sensitive GTP-binding protein is involved in activating the Ca2(+)-permeable channel in mast cells during stimulus-secretion coupling.
A case of CJD with PLD in the first EEG is reported. The PLD became bilateral in the next EEG. The subsequent EEGs showed shifting asymmetries. In this case, PSD reappeared after 5 months' absence. The PLD occasionally appeared over the hemisphere ipsilateral to the side of the myoclonic jerks. The clinical significance of the PLD and reappearance of PD, and the diagnostic importance of PLD are discussed.
In 55 patients with primary Sjögren's syndrome (PSJS), we studied on peripheral HLA-DR positive T cells, suppressor inducer (CD4 + CD45R) cell and helper inducer (CD4 + CDw29) cells by 2-color analysis using flow cytometry system. As shown in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), progressive systemic sclerosis and myositis, the rate of pheripheral HLA-DR positive T cells in PSJS (5.9% +/- 3.9) was significantly higher than in normal (1.6% +/- 1.1). The rate of CD4 +/- CD45R + cells in PSJS (12.8% +/- 6.1) and SLE (12.8% +/- 8.2) were significantly lower than in normal (16.6% +/- 3.9). With respect to the disease pattern of PSJS, the increase of HLA-DR positive T cell and decrease of CD4 + CD45R cell were recognized in patients with leucopenia, high titer of anti-RNP antibody and/or abnormal findings of sialography, and the decrease of CD4 + CD45R + cell was not recognized in patients with kerato-conjunctivitis sicca alone. In either SLE or RA, there were no correlations between the rate of T cell subsets (HLA-DR positive T cells and CD4 + CD45R cells) and the degree of salivary gland damage. T cell subsets in PSJS were useful indicators of disease severity and it is also useful for classifying PSJS into several subtypes. To analyze T cell surface markers in PSJS is very important for investigation of functions of lymphocytes in this disease.
Hepatic arterial infusion chemotherapy was performed in 47 cases with colorectal liver metastasis. Methods of hepatic arterial cannulation were as follows: operative insertion of polyvinyl chloride catheter in 12 cases, angiographic insertion of polyethylene catheter via the left high brachial artery in 20 cases and operative implantation of reservoir in 15 cases. Mean durations of chemotherapy were 31 days, 25 days and 115 days, respectively. Chemotherapies were discontinued because of complications and catheter troubles in 7 cases (58%), 8 cases (40%) and 6 cases (40%), respectively. Regression of tumor size was observed only in the group with reservoir. Prolonged therapy is achievable by use of the reservoir. But catheter troubles, including obstruction, infection, extravasation and pseudoaneurysm, are still observed in the course of chemotherapy. Radionuclide study using 99m Tc macroaggregated albumin is useful to detect catheter troubles. We stressed that the proper management of reservoirs is important.
Neuro-psychiatric complications of primary Sjögren's syndrome (SjS) were studied on their frequency and characteristics of clinical signs in 150 patients of our clinic. Clinical symptoms and laboratory examinations were compared in the patients group complicated with neuro-psychiatric symptoms and the non-complicated group. Neuro-psychiatric symptoms (neuro SjS) were complicated with 63 patients (42.0%). Central nervous system (CNS) involvement were occurred in 47 patients (31.3%). In this group (CNS SjS), psychiatric complications were observed in 43 patients (28.7%), consisted with 29 cases of neurosis, 7 cases of depression, 6 cases of presenile dementia, and others. Nine patients (6.0%) in this group had neurologic involvement that were 3 cases of aseptic meningitis, 3 cases of neurogenic bladder, and each case of multiple infarction, multiple sclerosis, and others. These 9 patients showed more frequently positive results for rheumatoid factor, anti-SSA antibody, leucopenia, and lymphopenia, so this subgroup might be consisted of a small group which was resemble to systemic lupus erythematosus. Cranial nerve involvement, mainly injured in trigeminal nerve, and peripheral nerve involvement were complicated with 5 patients (3.3%) and 24 patients (16.0%), respectively. In neuro-psychiatric complicated group, mean age was older and dry mouth were more frequent (p less than 0.05) than non-complicated group. In psychiatric complicated group, mean age was older (p less than 0.01) and dry mouth were more frequent (p less than 0.05). In any groups of neuro-psychiatric complications, the frequency of any autoantibodies was not statistically different from non-complicated group. But, in the group of cranial nerve involvement, anti-RNP antibody was 60.0% positive (in non-complicated group, 17.2%: p less than 0.05). In CNS SjS group, magnetic resonance imaging (MRI) abnormalities were occurred in 8 of 13 patients. High intensity lesions in white matter on the T2-weighted examinations was characteristic, which showed lacnar infarctions or demyelinated lesions in MRI abnormalities. In CNS SjS, corticosteroid or immunosuppressant was not always necessary, because this complication was self-limited or enough controlled by minor-tranquilizer or anti-depressant. The character of onset in neuro SjS was chronic and neuro SjS was insidiously developing disease. And more studies including treatment on neuro SjS were needed.
Systemic arterial compliance, baroreflex sensitivity index and cardiac function were studied in elderly patients with isolated systolic hypertension (ISH, n = 12) comparing values with those of essential hypertensive patients (EHT, n = 12) and normotensive subjects (NT, n = 7) in the same age range. Systemic arterial compliance of the ISH group was markedly decreased. Baroreflex sensitivity indices of ISH and EHT were similarly decreased. Pre-ejection period index (PEPI) of ISH was normal, whereas PEPI of EHT was significantly longer than that of NT. These results demonstrate that of the haemodynamic characteristics of ISH, the predominant features are a decrease in compliance of large arteries with a disturbance of baroreflex sensitivity and normal cardiac function.
Tumors of the central nervous system in fish are rare, and only six cases of spontaneous olfactory neuroepithelioma have been reported. This is the seventh case, found in a medaka, Oryzias latipes. The tumor was noted near the right olfactory orifice and finally measured 1.5 mm in diameter. Histologically the tumor consisted of undifferentiated neuroblasts forming a few true rosettes. Mitosis was frequently observed. Tumor cells stained diffusely for neuron-specific enolase and sporadically for neurofilament proteins by immunohistochemical procedures. Additionally a few large tumor cells were positively stained for S-100 protein. Electron microscopy revealed that the tumor cells had extended cytoplasm in which parallel neurotubules and a few neuroendocrine granules were noted. In the perinuclear region, bundles of intermediate filaments and neuroendocrine granules were seen. Single cilia and a pair of centrioles were occasionally found, but no ciliated cells were found in this tumor. Some large tumor cells contained electron-dense intracytoplasmic inclusions which showed a crystalloid structure by high-magnification electron microscopy; however, this type of crystalloid has never been reported in neuronal tumors.
The combination therapy of local administration of OK-432 and radiation was performed for two patients with lower bile duct carcinoma. Initially, 10KE of OK-432 was given locally, and irradiation was performed according to the schedule of 180-200 rad/5 fractions/week and given 5,000-5,220 rad totally. One case received 5KE of OK-432 locally 17 days after first injection. Both cases showed complete response and survived 4 months and 59 months without any sign of recurrence, respectively.
A CASE REPORT: A newly developed treatment method of local administration of OK-432 bronchoscopically combined with irradiation was applied to a patient with carcinoma of the Trachea complaining dyspnea and dysphagia. The tumor showed extra-wall growth. Dyspnea was improved in a week and the tumor disappeared after the treatment. A patient became to take food orally and could discharge in well condition.
Intestinal metaplasia of the gastric mucosa occurs commonly in aged Japanese patients and has been discussed in relation to the high incidence of gastric cancer in Japanese. Ciliated cells in the gastric mucosa have frequently been found in association with intestinal metaplasia in the pyloric gland and rarely in the cardiac gland in many Japanese patients, and exceptionally in one Chinese and in one Swedish patient. Electron microscopic examination of 12 Japanese patients has revealed that these structures are not metaplastic stereocilia, but true cilia. Ciliated cells have been found in the basal part of the gastric glands and never in the surface epithelium. The fine structure of the gastric cilia was almost the same as that of normal respiratory cilia. However, in the gastric cilia, most dynein arms were inconspicuous even after tannic acid fixation, indicating that ciliary beating of the gastric cilia is problematic. Abnormal cilia and basal bodies also were found. Ciliated cells have always occurred in association with intestinal metaplasia, therefore this phenomenon might be a type of metaplasia and is named "ciliated metaplasia" of the gastric mucosa.
The many different theories on the histogenesis of alveolar soft part sarcoma (ASPS) have caused great confusion. Owing to the recent rapid advance in immunohistochemical studies, two major hypotheses have been proposed. One group of researchers supports the idea that ASPS shows myogenic differentiation, while the other group opposes the idea. This confrontation is essentially one between a group that believes in the immunohistochemically demonstrated presence of desmin in ASPS and a group that denies it. In the present study we detected desmin in 6 of 10 formalin-fixed paraffin sections (although there were differences due to the use of five commercially available types of anti-desmin antibodies). When acetone-fixed paraffin sections and periodate-lysin-paraformaldehyde (PLP)-fixed frozen sections were used in one and three cases, respectively, they were found to be desmin positive, regardless of the type of antibody. The consistent positivity for all anti-desmin antibodies in the cases treated with acetone or PLP is very suggestive of a myogenous origin of ASPS. It is important to take into consideration the fact that formalin-fixed paraffin sections are not very suitable for immunohistochemical study of desmin.
Unusual electron-dense paracrystalline inclusions were found in metaplastic ciliated cells in the stomachs of three Japanese male patients with gastric carcinoma. These patients had not been given antitumour drugs before surgery and ethrane (enflurane) was used as the anaesthetic. Ciliated cells in the gastric mucosa are found not infrequently in the pyloric glands in association with intestinal metaplasia in elderly Japanese patients. Paracrystalline inclusions were found only in the ciliated cells and never in any other types of gastric mucosal cell. These inclusions were located in the apical portion of the ciliated cells in intimate association with the basal bodies. They consisted of twisted strings about 27 nm wide with a regularly repeated spacing of about 30 nm. On highly magnified electron micrographs, granules about 4 nm in diameter were detected. These paracrystalline inclusions have never been reported previously, although their location in ciliated cells and their morphological characteristics suggest an intimate relationship with the ciliogenesis of metaplastic ciliated cells in the human stomach.
Mucus-negative vacuolated cells, often with apical cilia, were found in the metaplastic pyloric gland of the human stomach. These vacuoles were not stained by various mucus stains, but contained neutral fat. Electron microscopic observation revealed that the ciliated cells had prominent autophagosomes in the supranuclear region and sometimes had large vacuoles. These vacuoles were limited by a unit membrane and had electron-lucent contents consisting of small amounts of lipid droplets and lamellar bodies. The non-mucus vacuolated cells might correspond to the mature ciliated cells in which cystic degeneration of the autophagosomes occurred after digestion by lysosomal enzymes.