[Clinical significance of bronchoalveolar lavage, Ga scintigraphy and serum angiotensin converting enzyme activity in granulomatous lung disease].
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Biomedical subjects
Publications and source records attributed to M Nishimura.
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The methods of combination treatment of inoperable lung cancer in our hospital were evaluated from the view-point of therapeutic ratio. In the case of combination of standard doses radiotherapy with usual doses of chemotherapy, there were some problematic side effects, though direct effect was remarkable. In the case of low doses radiotherapy combined with chemotherapy, a fairly good effect was obtained with lesser side effects, resulting in a better long term survival rate, that is a higher therapeutic ratio.
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A randomized controlled study was performed to evaluate the efficacy of intrapleural and systemic administration of OK-432, streptococcus preparation, in patients with cancerous pleurisy. A total of 53 patients were accessed to the study: 29 patients for the OK-432 group and 24 patients for the control group. Intrapleural instillation of 50 mg of adriamycin and a combination chemotherapy of MFC (mitomycin C 0.08 mg/kg, 5-FU 10 mg/kg, ara-C 0.8 mg/kg iv, weekly) were administered in both groups. In the OK-432 group intrapleural instillation of 2 units of OK-432 was administered daily until disappearance of pleural effusion; thereafter, 2 to 5 units of OK-432 were administered intradermally every other day. Patients with stage III in the OK-432 group survived significantly longer than those in the control group (P less than 0.05), but there was no significance between in patients with stage IV of both treatment groups. Also patients with PPD negative skin reaction at the time of beginning of treatment in the OK-432 group survived significantly longer than those in the control group (P less than 0.001), but there was no significance between both treatment groups in patients with PPD positive skin reaction at the time of beginning of treatment. Eighteen (62%) of 29 patients treated with OK-432 had a fever, but well tolerated.
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Ocular manifestations in two cases of congenital muscular dystrophy of Fukuyama type were reported. This disease is characterized by early onset of hypotonia, generalized muscle weakness and atrophy, mental retardation, and elevated serum creatine-phosphokinase activity. The symptoms include entropion of lower lids, pathological myopia with astigmatism, optic nerve pallor, and irregular grayish subretinal mottling. Case 1 showed additional features of posterior staphyloma, dragged papillomacular vessels, peripheral grayish-white discoloration of the retina, and rete mirabile as well as abnormal vascular anastomosis.
Histopathological examinations of stomachs of insulin-dependent (NOD) and noninsulin-dependent (KK-A gamma) mice were carried out. Spontaneous erosions in the fundic area were observed in 31% of NOD and 35% of KK-A gamma mice. The morphological features of the erosions were similar to those of erosions produced by stress. Although no erosions were detected in nondiabetic C3H/Slc mice raised and maintained in the same animal room, the presence of hyperglycemia and glycosuria in NOD and KK-A gamma mice did not appear to have a direct correlation with development of erosions. NOD and KK-A gamma mice may be useful animal models for human stress ulcers.
Clinical features of morning glory syndrome were studied in 8 eyes of 7 patients. The cases were divided into two groups according to the size of the elevated peripapillary white ring. The size of the ring was expressed as an average disk diameter of normal control eyes. In 2 eyes of Group I with the ring less than 2.0 disk diameters, white tissue on the disk was less pronounced than in Group II, and vascular pattern in the posterior retina was almost normal. The macular ring reflex was present. In 6 eyes of Group II with the ring exceeding 2.0 disk diameters, white tissue on the disk was more marked than in Group I, and retinal vessels were narrow and extended straight toward the midperiphery. the macula was not formed, but a yellowish retinal area was observed on the center or temporal part of the elevated peripapillary white ring. It was concluded that in morning glory syndrome the macula may often by involved when anomaly of the optic disk is remarkable.
We studied family members of 9 patients with falciform retinal fold, and found a number of cases showing features of familial exudative vitreoretinopathy (FEVR) in the fundi. Retinal fold was also seen in the eye of a cousin of the propositus. Three cases with falciform retinal fold were bilateral and 7 cases were unilateral. Retinal folds were located in the temporal half of the fundis in 11 of the 13 eyes with retinal fold. These 11 eyes showed avascularized zones of retinal vessels with scalloped edges in the periphery; in the 2 remaining eyes the retinal vessels were restricted within the fold. Thirty-one eyes of 18 cases, members of 7 pedigrees, showed features of FEVR. The observed avascularized zones with scalloped pattern of the vessels and vitreoretinal involvements were divided into 3 groups: 23 eyes of stage 1, 6 eyes of stage 2, and 2 eyes of stage 3, respectively. It was, therefore, concluded that falciform retinal fold being located temporally or bilaterally could be one of the signs of FEVR and that FEVR was a disease affecting regression of the hyaloid vascular system and development of the retinal vessels during fetal life. FEVR was classified into 4 groups: type 1, type 2, type 3 and type 4 of falciform retinal fold. The disease may be transmitted as autosomal dominant inheritance.
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We investigated chemical and physical modifications of the genetically determined ultrastructure of melanosomes. The flank skin of hairless mice was treated with ultraviolet energy (UV) shorter than 320 nm or with a combination of a photosensitizer and UV (PUVA treatment). All melanosomes in the induced melanocytes and those in resident melanocytes in the ear skin showed eumelanogenesis, although the degree of melanin deposition differed considerably according to the induction process. Eumelanogenesis was most advanced in the resident melanocytes while PUVA-induced melanocytes showed more immature premelanosomes. We then topically applied 4-tertiary butyl catechol on the skin. The depigmenting agent caused an appearance of pheomelanosomes. The alteration in melanogenesis was seen most distinctly in premelanosomes of the PUVA-induced cells. Altered ultrastructure was also observed in matured melanosomes; this change was most apparent in the resident melanocytes. These findings indicate that cells with eumelanogenesis may undergo pheomelanogenesis. The present study demonstrated effects of chemicals on genetically determined function of melanocytes by quantitative analysis of melanosome ultrastructure.
The rabbit A-V node was dissected into pieces (0.2 x 0.2 x 0.2 mm) smaller than its space constant of 692 +/- 96 micrometers (n = 5). These small specimens showed spontaneous action potentials whose configurations were similar to those of large specimens before dissection. The membrane time constant was 21.5 +/- 1.5 ms (n = 5). Voltage clamp experiments were performed on the above specimens using the two-microelectrode technique. On depolarization from the holding potential of -40 mV to various potential levels a transient inward current and delayed outward current were recorded. On repolarization an outward current tail was observed. The transient inward current was blocked by application of D 600 (2 x 10(-7) g/ml) but was insensitive to TTX (1 x 10(-7) g/ml). The inward current was decreased by superfusion with Na- or Ca-free Tyrode solution. Thus, this current was classified as the slow inward current (is). When the K concentration in the Tyrode solution was varied, the reversal potential of the outward current tail changed as expected for a K electrode, indicating that the outward current was carried by K ions. On hyperpolarization slow activation of inward current was recorded. The reversal potential of this current was between -20 and -30 mV, which was analogous to hyperpolarization activated current, ih, in the S-A node. A contribution of sodium current (iNa) to the action potential was obviously demonstrated from an inhibitory effect of TTX on the upstroke of the anodal break excitation. The ionic selectivity of each current system is compared with analogous current systems in other cardiac tissues and a possible mechanism for the slow conduction in the A-V node is discussed.
Under normal (95% + 5% CO2) and hypoxic (95% N2 + 5% CO2) perfusions, electrophysiologic effects of disopyramide phosphate (5 microgram/ml) on canine Purkinje fibers were studied using microelectrode techniques. In the presence of normal oxygenation, disopyramide decreased the action potential amplitude and maximal rate of phase 0 depolarization, and lowered the level of plateau. The action potential duration at 80% of repolarization was prolonged in fibers initially having shorter durations, whereas it was shortened in fibers with longer durations, making the repolarization process more uniform. Addition of disopyramide under hypoxia similarly decreased the amplitude and upstroke velocity of action potential, and tended to reverse hypoxia-induced shortening of the refractory period. The maximal diastolic potential was altered by neither hypoxia nor disopyramide alone, but was significantly decreased by the combination of these two factors. Disopyramide prolonged the effective refractory period more than the action potential duration. From these results, antiarrhythmic effects of disopyramide under hypoxia appear to depend on (1) depressed conduction and resultant conversion of unidirectional block to bidirectional block abolishing reentry, and (2) decreased vulnerability due to decreased inhomogeneity of repolarization. Usefulness of this experimental model in studying electrophysiologic action of antiarrhythmic agents in ischemic hearts is also suggested.
Alterations in the somatostatin (SRIF)-, insulin- and glucagon-containing cells were examined in two strains of spontaneously diabetic mice, KK and newly inbred non-obese diabetic (NOD) mice, using radioimmunoassay and immunohistochemical methods. The total pancreatic content and concentration of SRIF was decreased in male KK mice compared to their male controls aged 12-18 weeks. These results were consistent with the immunohistochemical findings. Pancreatic glucagon concentration and number of glucagon-containing cells were also decreased in KK mice, but pancreatic insulin concentrations were increased in KK mice. On the other hand, NOD mice aged 12-38 weeks within 15 days after onset of diabetes had increased concentrations of pancreatic SRIF. The pancreatic islets in NOD mice were decreased both in number and in size and were characterized by lymphocyte infiltration. SRIF-containing cells occupied the major part of the endocrine cells of the islets. Insulin-containing cells significantly decreased in number, but the number of glucagon-containing cells was fairly well preserved. These results and previous work concerning obob and dbdb mice indicate a parallel relationship between pancreatic SRIF and glucagon. The pancreatic glucagon thus as well as the pancreatic insulin may be an important determinant of pancreatic SRIF concentration in these diabetic animals.
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1. The dependences of the reduction of ferricytochrome c-555 in the reaction center-cytochrome c complex on the redox potential and pH were investigated using N,N,N',N'-tetramethyl-p-phenylenediamine (TMPD), ferrocyanide, and reduced 2,5-dimethyl-p-quinone as electron donors. 2. In the reduction of cytochrome c-555 by TMPD, the unprotonated form was the exclusive electron donor to the cytochrome with a second-order rate constant of 1.0 X 10(5) M-1.s-1. 3. Ferrocyanide reduced cytochrome c-555 slowly with a rate constant of 7.8 X 10(3) M-1.s-1 at infinite salt concentration. The value of -5.2 X 10(-4) elementary charge/A2 was estimated as the surface charge density in the vicinity of cytochrome c-555 by analyzing the salt effect on the cytochrome reduction using the Gouy-Chapman theory. 4. The characteristics of the dependences of the reduction of cytochrome c-555 by reduced 2,5-dimethyl-p-quinone on the redox potential and pH were well explained by the redox potential and pH dependences of the formation of the semiquinone. In the neutral-to-alkaline pH range the anionic semiquinone was the main electron-donating species with a second-order rate constant of 6.0 X 10(7) m-1.s-1.