[Detection of hilar and mediastinal lymphnode metastasis in lung cancer (author's transl)].
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Biomedical subjects
Publications and source records attributed to M Sako.
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The adrenal medullae of rats were studied electron microscopically from day 13.5 of gestation. Synapses with thickening of pre-and post-synaptic membranes were first evidenced on the medullary cells of 15.5-day-old fetuses. They increased gradually in number with advancing age. In the medullary cells, a few membrane-limited granules were recognized on day 13.5 of gestation, and thereafter they increased in number. The appearance of the granules was not uniform; some of the granular contents consisted of fine or coarse particles and others contained homogeneous material of varying electron-densities. The population of these granules in the cytoplasm was different from cell to cell. Thus, the discrimination of cell types (NA-and A-cells) was not possible in the prenatal period. Granular discharge of the cells was totally absent in the normal untreated fetuses. However upon the intraperitoneal administration of insulin to the fetus on day 16.5, 18.5, or 21.5 of gestation, discharge by reverse pinocytosis was first evidenced in the medullary cells of the 21.5-day-old fetus.
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The adrenal glands of decapitated and encephalectomized fetal rats were investigated electron microscopically and compared to those of normal intact fetal rats. Although the adrenal cortices did not show three zones (zona glomerulosa, fasciculata, and reticularis) on the 16.5th day of gestation when the decapitation or encephalectomy was carried out in utero, the zonation was recognized in fetuses operated on the 21.5th day of gestation. The same was true for normal control fetuses. However, cytoplasmic characteristics suggesting steroidogenesis in the cortical cells were reduced to various degrees in the encephalectomized or decapitated fetuses, especially in the latter ones. The change in cytoplasmic appearance was more conspicuous in the inner portion of the cortex. This result suggests that for the maintenance of normal adrenocortical function the hypothalamus may be indispensable even during the prenatal life of rats.
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To prevent embolization of necrotic renal vein tumor after transcatheter embolization of a left renal cell carcinoma, we placed a suprarenal Bird's nest inferior vena cava filter. The patient tolerated the procedure well and had extensive tumor infarction including the tumor thrombus on 6-month follow-up computed tomography.
Successful treatment was achieved for a patient with superior mesenteric artery thromboembolism concomitant with bilateral renal artery thromboembolism. Thrombi of the three vessels were lysed simultaneously with a three-catheter technique using short-term, high-dose urokinase followed by overnight infusion with low-dose urokinase.
A new embolic material has been devised to improve the therapeutic effect of ferromagnetic embolization upon tumors. Iron sponge microspheres (diameter 10-30 mu) were suspended in viscous, aqueous polysaccharide solution, dextran 40, and sodium carboxymethyl cellulose (Ferro-polysaccharide, FPS). Transcatheter embolization with FPS was performed under external magnetic control (2,800 gauss) in dog kidneys and VX2 carcinomas of rabbits, causing widespread, intraparenchymal vascular occlusion of target vessels. Neither recanalization nor collateral circulation was found to the infarcted areas, and the embolized tumors had extensive necrosis with resultant tumor regression. No significant untoward reaction or other undesirable embolization was noted serologically or histologically, even after intravenous administration of FPS. Clinical application to two patients, one with a hepatoma and the other with a renal cell carcinoma, resulted in excellent tumor infarction with no significant side effects.
PURPOSE: Although immune dysfunction is suspected in patients with hemophagocytic lymphohistiocytosis (HLH), the difference between immune dysfunction in patients with familial erythrophagocytic lymphohistiocytosis (FEL) and familial inheritance-unproved lymphohistiocytosis (FIU) remains unknown. The aim of this study was to determine useful markers to distinguish patients with FEL from those with FIU. PATIENTS AND METHODS: Clinical features and laboratory findings, especially natural killer (NK) cell activity and the relative frequencies of peripheral blood mononuclear cell (PBMC) subsets, and serum levels of interferon-gamma and soluble interleukin-2 receptor were compared in 9 patients with FEL and 14 age-matched patients with FIU. Twenty-seven healthy infants served as controls. The treatment and outcome were also compared for patients with FEL and FIU. RESULTS: Comparison between patients with FEL and FIU revealed significantly lower NK activity in those with FEL (p = 0.03) but failed to show any significant differences in PBMC subsets, except that the percentage of CD3+ T cells was higher in patients with FEL (p = 0.02). CD4- and CD8-dominant phenotypes were characteristic findings in both groups of patients, although increased CD19+ B cells were restricted to patients with FIU. NK activity was deficient (< 5%) in four of the seven patients with FEL tested but in only one of eight patients with FIU. By comparison to values for age-matched controls, the percentages of CD3+, CD3+DR+ and CD45RO+ PBMCs in patients with FEL were significantly high (p < 0.05) and those of CD19+ and CD45RA+ subsets were lower than normal. Among patients with FIU, PBMC subsets included significantly reduced CD3+, CD4+, CD45RA+, and CD4+CD45RA+. In this small series, the outcome of patients with FEL and FIU treated with chemotherapy was not significantly different at the time of evaluation. CONCLUSIONS: These results indicate considerable immune heterogeneity among patients with HLH younger than 2 years. Although NK activity was useful but not diagnostic, determination of PBMC subsets and patterns of cytokine expression was not helpful in distinguishing patients with FEL from those with FIU, suggesting that the immune responses characteristic of these diseases may reflect different triggering factors, including viruses. The impact of this immune heterogeneity on patients' outcome remains to be determined.