Biomedical subjects
Publications and source records attributed to M Sugitani.
We describe a unique case of a patient who presented with a linear, transverse filling defect in the common bile duct, detected by cholangiography, that was caused by the posterosuperior pancreaticoduodenal artery compressing the common bile duct associated with gallstones. We believe this case to be the first of its kind reported in the literature.
BACKGROUND: Probiotics are efficacious for treating and maintaining remission of ulcerative colitis. AIM: To conduct a randomized placebo-controlled trial of bifidobacteria-fermented milk supplementation as a dietary adjunct in treating active ulcerative colitis. METHODS: Twenty patients with mild to moderate, active, ulcerative colitis randomly received 100 mL/day of bifidobacteria-fermented milk or placebo for 12 weeks with conventional treatment. RESULTS: Clinical and endoscopic activity indices and histological scores were similar in the two groups before treatment. Although improvements were significant in both groups, the clinical activity index was significantly lower in the bifidobacteria-fermented milk than in the placebo group after treatment. The post-treatment endoscopic activity index and histological score were significantly reduced in the bifidobacteria-fermented milk, but not the placebo group. Increases in faecal butyrate, propionate and short-chain fatty acid concentrations were significant in the bifidobacteria-fermented milk, but not the placebo group. No adverse effects were observed in either group. CONCLUSION: Supplementation with this bifidobacteria-fermented milk product is safe and more effective than conventional treatment alone, suggesting possible beneficial effects in managing active ulcerative colitis. This is a pilot study and further larger studies are required to confirm the result these preliminary results.
We analyzed sequences of hypervariable region 1 (HVR1) of hepatitis C virus (HCV) in six chimpanzees, experimentally infected with a single HCV inoculum, to clarify the correlation between HVR1 mutation and antibodies to HVR1. Two chimpanzees had been immunized with synthetic HVR1 peptides before HCV inoculation. All six animals became infected with HCV but cleared the infection within the acute phase. The major HVR1 sequences in longitudinal sera were unchanged in animals both with and without anti-HVR1 antibodies. Additionally, sequences of HVR1 variants in each chimpanzee converged after 11 to 19 weeks. The data show that anti-HVR1 antibodies are unlikely to drive variation in HVR1.
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We report a patient with congenital dyserythropoietic anemia type 1 with characteristic anomalies and two novel clinicopathologic presentations: intrauterine onset of severe anemia resulting in cardiac failure and relatively mild dyserythropoietic features on bone marrow aspiration in contrast to severity of anemia. After repeated transfusions and a trial of erythropoietin administration, the patient died from respiratory infection at age 7 months. Autopsy revealed characteristic dyserythropoietic features of the bone marrow by light microscopy and electron microscopy, which confirmed a diagnosis of congenital dyserythropoietic anemia type 1.
Orotate phosphoribosyl transferase (OPRT) is an enzyme that converts the pyrimidine fluoride-class anticancer drug 5-fluorouracil (5-FU) into the active nucleotide form. As such, it can be considered a primary enzyme in the first stage inhibiting DNA and RNA expression. The present study measured OPRT activity both in gastric carcinoma tissue and in surrounding normal tissue, and investigated the correlation between these findings and clinicopathologic characteristics in the patients. The study subjects were 20 patients with gastric carcinoma who were treated by surgical resection in our department. The relationship between OPRT activity in gastric carcinoma and surrounding normal tissue and patient age, sex, tissue type, extent of tumor invasion, extent of metastasis to the lymph nodes, lymphatic invasion and the existence of venous invasion of the gastric wall were investigated. The mean OPRT activity for all patients was 0.039 +/- 0.042 nmol/min/mg-prot in normal tissue and 0.120 +/- 0.099 nmol/min/mg-prot in tumor tissue, and the mean ORPT activity was significantly higher in tumor tissue than in surrounding normal tissue (p < 0.01). The OPRT ratio for tumor tissue/normal tissue (T/N) was significantly decreased as the invasiveness of the tumor increased, and was also significantly lower in patients with lymph node metastasis (p < 0.05) than in patients without lymph node metastasis. A decrease of OPRT activity in tumor tissue is a possible reason for the equivocal results of 5-FU-based chemotherapy in advanced gastric carcinoma.
The levels of OPRT, DPD, and TS were determined in colorectal cancer tissue specimens, and 5-FU sensitivity was measured by CD-DST. The correlation between enzyme activity and 5-FU sensitivity was then studied. Six patients with colorectal carcinoma who had undergone surgical resection in our institution between May and August 2000 were studied. The CD-DST method was used to measure the sensitivity to 5-FU under three sets of conditions: 0.2 microgram/ml x 5 days (A), 1.0 microgram/ml x 1 day (B), and 10.0 micrograms/ml x 3 h (C). The coefficients of correlation of tumor sensitivity to 5-FU and OPRT activity were A: 0.8246, B: 0.7670, and C: 0.7856, and to DPD activity were A: 0.2525, B: 0.3928, and C: 0.4337, while the coefficients of correlation to TS enzyme levels were A: -0.5240, B: -0.4770, and C: -0.6131. These findings demonstrate a high degree of correlation between OPRT activity at the tumor site and tumor sensitivity to 5-FU under a variety of conditions, suggesting that OPRT activity can be a useful indicator in predicting the anti-tumor effectiveness of 5-FU for a specific tumor.
Wistaria floribunda agglutinin and peanut agglutinin were found to bind histochemically to the anterior and posterior regions, respectively, of the vomeronasal nerve and glomerular layers in the rat accessory olfactory bulb. Furthermore, Ricinus communis agglutinin showed strong binding to the anterior region of the vomeronasal nerve and glomerular layers, whereas it bound weakly and/or moderately to the rostral two-thirds of the posterior glomerular layer but not at all to the caudal one-third. This suggests that the posterior region is further divided into two subregions. An electrophysiological mapping study in sagittal slice preparations demonstrated that stimulation given within the anterior vomeronasal nerve layer elicited field potentials within the anterior region of the external plexiform layer, whereas shocks to the rostral two-thirds and the caudal one-third of the posterior vomeronasal nerve layer provoked field responses within the rostral two-thirds and within the caudal one-third of the posterior external plexiform layer, respectively, indicating that the posterior external plexiform layer is also divided into two subregions. Real-time optical imaging showed similar results as above, except that neural activity also spread into mitral cell layers. Furthermore, the most anterior and posterior ends of the neural activity evoked in the rostral two-thirds of the posterior region immediately adjoined the posterior border of that evoked in the anterior region and the anterior border of that evoked in the caudal one-third of the posterior region, respectively. Moreover, the granule cell layer was also found to have similar boundaries. Thus, optical imaging studies demonstrated individual precise boundaries of these subdivisions, which were positioned right beneath those defined by Ricinus communis agglutinin histochemistry. The presence of functional segregation in each layer leads us to conclude that there are at least three different input-output pathways in the rat vomeronasal system.
AIMS/BACKGROUND: The present investigation compared the histological features of the liver of chronic hepatitis C patients who are or are not coinfected with hepatitis G virus (HGV) to determine the histological and clinical characteristics of HGV infection. SUBJECTS AND METHODS: This study included 194 patients with chronic hepatitis C who visited our institution between 1993 and 1995. Detection of serum HGV RNA was performed by nested reverse transcription-polymerase chain reaction. Scores were assigned to indicate the severity of each of the following features on the liver biopsy of a patient: inflammatory cell infiltration in the periportal, parenchymal, and portal area; fibrous stage; lymphoid aggregates in the portal area; portal sclerotic change; perivenular fibrosis; pericellular fibrosis; bile duct damage; bridging necrosis; and irregular regeneration of hepatocytes (IR). RESULTS: HGV RNA was detected in the sera of 18 (9.3%) of the 194 patients. The histological features of the HGV RNA-positive patients show significantly more severe bile duct damage, perivenular fibrosis, pericellular fibrosis and IR than the liver of the HGV RNA-negative patients. The biochemical results in the two groups did not significantly differ. CONCLUSION: Our data suggest that chronic HGV coinfection worsens the histological features of liver disease.
The present investigation attempted to determine the exact prevalence of hepatitis D virus (HDV) infection among inhabitants of Miyako Island (a remote island in the Okinawa Prefecture) and the molecular characteristics of the HDV genome that was isolated. Among the 4728 inhabitants, 375 (7.9%) were hepatitis B surface antigen (HBsAg) positive. Antibody to HDV (anti-HDV) was present in 32 (8. 5%) of these 375 subjects, and liver function tests were normal in most subjects. The presence of HDV RNA was analysed by nested polymerase chain reaction (PCR). Thirteen out of the 32 anti-HDV antibody-positive subjects were HDV RNA positive. Thus, 3.5% of HBsAg-positive subjects on Miyako Island were HDV RNA positive. Among the HDV RNA-positive subjects, liver function tests were within normal limits or were mildly abnormal. Nucleotide sequence analysis revealed that the HDV genomes on Miyako Island were similar to the Japanese and Taiwan isolates of HDV genotype II. Taiwan is geographically close to Miyako Island. Even though the races are different, a geographical factor was revealed to be significant with regard to HDV infection, which was spread in a closed environment.
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OBJECTIVE: To evaluate changes in serum immunoglobulin M (IgM) and G (IgG) hepatitis C virus (HCV) core antibodies after HCV infection in acute hepatitis C. METHODS: Serum HCV RNA and IgM and IgG HCV core antibodies were investigated using sera sequentially sampled from three chimpanzees experimentally infected with HCV. Serum IgG HCV core antibody titer was measured using a JCC.2 enzyme-linked immunosorbent assay (ELISA) kit (Chemo-Sera-Therapeutic Research Center, Kumamoto, Japan). IgM core antibody titer was measured using horseradish peroxidase-labeled monoclonal anti-human IgM as the secondary antibody for the JCC.2 ELISA kit. Serum HCV RNA was detected using the 5' noncoding region as the primer according to the reverse transcriptase (RT) nested polymerase chain reaction (PCR) and competitive RT-PCR method. RESULTS: IgM JCC.2 antibody was detected when alanine aminotransferase (ALT) peaked, showing the closest correlation with the changes in ALT. A period during which IgM JCC.2 antibody was positive but HCV RNA as determined by RT-nested PCR was negative was observed after the elevation of ALT level. CONCLUSION: These results indicate the usefulness of detection of serum IgM JCC.2 antibody in making a definitive diagnosis of acute hepatitis C and the follow-up observation of hepatitis C.
BACKGROUND: A patient with a sebaceous gland carcinoma without adequate treatment is reported. CASE: A 67-year-old man underwent an operation on his left upper eyelid after a diagnosis of chalazion in 1981. Two years after the initial operation, he noticed a tumor in the left upper eyelid. In 1987, he visited another hospital and was diagnosed with sebaceous gland carcinoma by a tissue biopsy. He left it untreated against medical advice. When he visited our hospital in 1996, the tumor was as large as 80 x 75 x 40 mm and the left upper and lower eyelids stuck together. After admission, he died of myocardial infarction 23 days after his visit to our hospital. Autopsy revealed that the tumor had extended into the orbital cavity, paranasal sinus, and base of the skull, with metastasis to the preauricular, submandibular, and cervical lymph nodes and both lungs. The pathology of the tumor was a moderately differentiated sebaceous gland carcinoma. CONCLUSION: This case showed the natural course of extension and metastasis of a sebaceous gland carcinoma.
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A case report of heterotopic pancreas in intra- and extrahepatic biliary tracts in a 36-year-old female who suffered from intra- and extrahepatic choledochal cysts with an anomalous pancreatobiliary duct system. Histologic examination of the resected specimen showed pancreatic tissues located along the wall of the biliary tract with choledochal cysts. The pancreatic tissue consisted of acinar cells and duct elements without Langerhans' islets; the acinar cells were positive immunohistochemically for alpha-amylase and negative for endocrine hormones. Ultrastructural study revealed zymogen granules in the acinar cells. In the present case the heterotopic exocrine pancreatic tissue seems to be etiologically related to choledochal cysts as well as to the anomalous arrangement of the pancreatobiliary duct.
To investigate the action of GABAergic agents on oscillatory signal propagation induced by electrical stimulation of the vomeronasal nerve layer, optical and electrophysiological recordings were carried out in slice preparations of the guinea-pig accessory olfactory bulb. In response to electrical stimuli, characteristic optical signals appeared in each layer: in the vomeronasal nerve layer, a transient presynaptic response; in the glomerular layer, pre- and postsynaptic responses; in the external plexiform, mitral cell and granule cell layers, a damped oscillatory response. Application of the GABAergic agonists, that is, GABA, muscimol (a GABAA receptor agonist) and baclofen (a GABAB receptor agonist), suggested that the GABAB action existed mainly in the glomeruli, whereas the GABAA action was present in both the glomeruli and the external plexiform layer. Bicuculline (a GABAA receptor antagonist) produced long-lasting but nonoscillating excitation in the external plexiform and mitral cell layers, indicating that the GABAA action contributes to the formation of oscillatory responses. When double-pulse stimulation was applied to the vomeronasal nerve layer, the test responses in the glomerular layer and external plexiform and mitral cell layers were depressed, but those in the vomeronasal nerve layer were not. Application of 2-hydroxysaclofen (a GABAB receptor antagonist) mostly blocked paired-pulse depression occurring in the glomerular layer and restored the reduced transmission to mitral cells, but had only a small effect on the depressed oscillatory response in the external plexiform and mitral cell layers. These observations suggest that GABAB action in the glomerular layer might, at least, regulate information flow from vomeronasal afferents to apical dendrites of mitral cells, like a gate inhibition. However, actions other than GABAB could also be involved in the depression of the oscillation in the external plexiform and mitral cell layers.
Nitric oxide (NO) has divergent actions under physiological and pathological conditions. NO is rapidly decomposed to nitrite (NO2-) and nitrate (NO3-). Since these metabolites are stable, they are good indices of NO production under various conditions. In the present study, we measured NO2- and NO3- concentrations in the urine collected from 62 hospital controls and 504 healthy subjects by means of a new HPLC system combined with Griess reaction. NOx was the sum of NO2- and NO3-. There was no considerable inter-day variation in urinary NO metabolite levels, and there was close correlation between NO2-, NO3- and NOx values in spot urine obtained in the early morning and those in 24-h stored urine in hospital controls. Urinary NO metabolite levels, which were corrected by creatinine (Cr) excretion and expressed on a logarithmic scale, showed normal distribution and were independent of sex and age in healthy subjects. The normal ranges of urinary NO2-, NO3- and NOx levels were estimated as 17-72 micromol/g Cr, 1,023-2,818 pmol/g Cr, and 1,071-2,951 micromol/g Cr, respectively. We also found that urinary NO metabolite levels were lower than normal range in patients with various diseases.
Three cases of calcifying epithelioma observed in the anterior auricular region are reported. The ages were 9 to 15 years, and all were females. The size of the tumors ranged from 20 x 20 mm to 22 x 34 mm. One case showed elevated (4.1 ng/ml) SCC antigen preoperatively, however, the value was reduced within the normal range (1.3 ng/ml) after removal of the tumor. One case showed a fistula with brownish and serous discharge on the epithelial surface of the tumor. In the same case, mitotic change of basophilic cells in the tumor was observed, however, distinctly malignant changes such as cell invasion into the surrounding tissue were not observed. Although the head and neck region are the most common areas where calcifying epithelioma occur otolaryngologists do not have sufficient understanding of this disease. Therefore, epidemiology, clinical findings, clinical examination, pathology, therapy and prognosis of calcifying epithelioma were discussed.