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Biomedical subjects

M Tomonaga

Publications and source records attributed to M Tomonaga.

At least 253 records · Page 14Linked to original sources
PubMed1993

Intracranial cavernous angioma manifesting as subarachnoid hemorrhage--case report.

A 56-year-old male presented with a posterior fossa cavernous angioma manifesting as persistent headache with mild neck stiffness. Lumbar puncture revealed subarachnoid hemorrhage (SAH). Repeated four-vessel angiography failed to identify the source of the SAH. Magnetic resonance (MR) imaging demonstrated multiple small lesions in the posterior fossa and cerebral hemispheres, and the SAH. A mass arising from the biventral lobule of the right cerebellar hemisphere extended exophytically into the cisterna magna with intratumoral hemorrhage. These findings were compatible with the presumptive diagnosis of SAH from the mass at the right biventral lobule. The lesion was totally removed through a suboccipital craniectomy without sequelae. The histological diagnosis was cavernous angioma. Intracranial cavernous angioma presenting only as SAH has never been reported before. The use of MR imaging in establishing the diagnosis of vascular malformations is emphasized, particularly when neither computed tomography nor angiography can adequately visualize the origin of SAH.

Cerebellar Neoplasms↗
PubMed1993

A search for search asymmetry in chimpanzees (Pan troglodytes).

Two chimpanzees and two humans were trained on visual search tasks with several sets of geometric forms composed of 1 and 2 elements (graphemes). When the double-grapheme item was the target and single grapheme item was the distractor, both chimpanzees and humans searched the target quickly irrespective of the display size. On the other hand, when the single-grapheme item was the target and double-grapheme item was the distractor, they showed an increase in response times as a function of the display size on some sets of stimuli. These results were considered as evidence for search asymmetry by chimpanzees.

Adult↗
PubMed1993

Unusual morphological features of adult T-cell leukemia cells with aberrant immunophenotype.

We describe 4 cases of adult T-cell leukemia (ATL) with unusual morphology and aberrant immunophenotype. All patients were Japanese and born in the Nagasaki district, an area endemic for HTLV-I. Peripheral blood and/or bone marrow films revealed bizarre giant cells with and without large nucleoli; the cells were 5 to 6 times the diameter of erythrocytes, resembling Hodgkin's cells. Some peripheral blood cells were morphologically similar to prototypic ATL cells, while many other cells in the bone marrow showed unusual morphology. Furthermore, leukemic cells had aberrant immunophenotypes such as the CD8-positive type in patients 1 and 2, the CD4-.CD8- double-negative type in patient 3, and the CD5 antigen defect in patient 4. All patients had marked elevations of the serum calcium and LDH and organomegaly, while all had a short survival. Anti-HTLV-I antibodies and provirus DNA monoclonality were demonstrated in all patients. The results suggested that the unusual morphology and aberrant ATL cell immunophenotype may be indicative of a high grade malignant behaviour of ATL.

Aged↗
PubMed1993

Cytogenetic studies of non-lymphocytic neoplasias using hematopoietic growth factors: GM-CSF provides pronounced mitotic increase and improvement of the quality of banded chromosomes compared to G-CSF.

Thirty patients with a variety of non-lymphocytic neoplasias were studied cytogenetically using short-term liquid cultures of bone marrow or peripheral blood cells with or without either granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage CSF (GM-CSF). The final concentration of these growth factors was 10 ng/ml and the duration of culture was 48 h, since these provided optimal increases in mitotic index (MI). In GM-CSF-stimulated culture, 23 out of the 30 patients (77%) had a significantly (p < 0.05) higher MI than that in unstimulated culture, whereas only five (17%) did so in G-CSF-stimulated culture. The quality of banded chromosomes was considerably good in 17 out of the 30 patients (57%) with GM-CSF, whereas it was so only in two (7%) and three (10%) patients with no CSF and G-CSF, respectively. Of the 30 patients, 27 (90%) had the same chromosomal findings with G-CSF/GM-CSF as without CSF, but the remaining three (10%) showed a remarkable change after stimulation. Culture for 72 h with G-CSF or GM-CSF disclosed a minor abnormal clone which was undetected in 24 and 48 h cultures in a patient with myelofibrosis with myeloid metaplasia. Thus, compared with G-CSF, adding GM-CSF to cell culture may be useful for cytogenetic studies of non-lymphocytic neoplasias. The chromosomal findings may, however, be changed by these growth factors for some patients.

Chromosome Aberrations↗
PubMed1993

A randomized controlled study of granulocyte colony stimulating factor after intensive induction and consolidation therapy in patients with acute lymphoblastic leukemia. Japan Adult Leukemia Study Group.

To determine the efficacy and optimal daily dose of recombinant human granulocyte colony-stimulating factor (rG-CSF) after intensive chemotherapy, a prospective randomized study was conducted with daily intravenous administration of 2, 5 or 10 micrograms/kg G-CSF after induction therapy, and 0, 2, 5 or 10 micrograms/kg after consolidation therapy, until neutrophil counts recovered to more than 2000/mm3. The subjects were 41 adult patients with newly diagnosed acute lymphoblastic leukemia (ALL). After the induction therapy, neutrophil recovery to more than 1000/mm3 was significantly faster in the 5 (P = 0.047) and 10 micrograms/kg groups (P = 0.011) than in the 2 micrograms/kg group, but did not differ between the 2 former groups. The median days of neutrophil recovery to more than 1000/mm3 were 8.5, 9 and 12 days, respectively. After the consolidation therapy, neutrophil recovery to more than 1000/mm3 was significantly faster in the 2, 5 and 10 micrograms/kg groups than in the no rG-CSF group (P < 0.001, respectively), but did not differ among the 3 former groups. The median days of neutrophil recovery to more than 1000/mm3 were 12, 11, 10, and 23 days, respectively. Febrile neutropenia and incidence of documented infection tended to be less in the 5 and 10 micrograms/kg groups than in 0 and 2 micrograms/kg groups. A dose of 5 micrograms/kg rG-CSF given by a 30 min infusion daily seems to be an effective and optimal daily dose to accelerate neutrophil recovery after intensive remission induction and consolidation chemotherapy in adults with acute lymphoblastic leukemia (ALL).

Adolescent↗
PubMed1993

A clonal study of hematopoiesis using the M27 beta probe: aberrant band patterns caused by incomplete digestion of a methyl-sensitive enzyme in the the inactive X-chromosome.

The M27 beta probe has been used to determine the clonality of human tumors, based upon X-chromosome inactivation. However, it occasionally gives rise to aberrant results. In this study, the M27 beta probe was used for clonal analysis in Japanese women with clonal stem cell disorders and in those with normal hematopoiesis. Restriction digestion with PstI indicated heterozygosity for the DXS255 locus in 41 out of 50 individuals (82%). Further digestion with HpaII in heterozygous women led to four distinct band patterns: I, both fragments were partially digested; II, either one of the two fragments was completely digested; III, a three-band pattern; and IV, neither fragment was digested. Of 21 hematologically normal females, 17 (81%) and four (19%) had patterns I and III, respectively. In some subjects with pattern I, imbalanced HpaII digestion in the two alleles was seen. Fifteen (65%) of the 23 patients with clonal stem cell disorders had pattern II, while the remainder (35%) had pattern IV. The normal tissues of three acute myeloid leukemia patients with pattern IV all revealed pattern I. It is possible that the aberrant band patterns could be caused by incomplete HpaII digestion in inactive X-chromosomes. In this study, we propose a hypothesis whereby, in normal tissues, aberrant cells, the DXS255 locus of which is not digested with HpaII despite their inactive status, would be mixed with cells demonstrating the usual methylation pattern. In normal tissues, complex of proportion of aberrant cells and skewed Lyonization could produce a variety of band patterns. If a cell with the usual methylation pattern proliferated monoclonally, pattern II would be seen: whereas if an aberrant cell proliferated, pattern IV would be demonstrated.

Blotting, Southern↗
PubMed1993

fgr proto-oncogene is expressed during terminal granulocytic differentiation of human promyelocytic HL60 cells.

In order to elucidate the function of the c-fgr protein tyrosine kinase, we have investigated the expression of c-fgr in the human promyelocytic cell line, HL60, during myeloid differentiation induced by dimethylsulfoxide (DMSO). The expression of c-fgr was preceded by growth arrest of DMSO-treated cells, as determined by [3H]-thymidine incorporation and colony-forming ability, and it became detectable when cells committed for terminal differentiation. The maximum expression was detected in the terminal stage of differentiation. The profile of tyrosine phosphorylation in cellular proteins was distinct among cells at various stages of the differentiation program. The 116 kd tyrosine-phosphorylated protein detected in exponentially proliferating HL60 cells diminished during the course of the growth arrest and a distinct profile of tyrosine phosphorylation (including 177 and 165 kd proteins) appeared in cells undergoing terminal granulocytic differentiation. These findings implicate the involvement of p55c-fgr in the process of terminal granulocytic differentiation. However, the tyrosine kinase activity of p55c-fgr expressed in differentiating HL60 cells was markedly inhibited by the tyrosine phosphatase inhibitor, sodium orthovanadate, suggesting the presence of a mechanism involving tyrosine phosphorylation that negatively regulates the kinase activity of p55c-fgr.

Cell Transformation, Neoplastic↗
PubMed1993

[Isolated trochlear nerve palsy caused by mixed dural-pial arteriovenous malformation of the anterior cranial fossa: a case report].

A 62-year-old male was admitted to our hospital in May, 1985, with double vision, which had persisted for 1 month. The neurological examination revealed left trochlear nerve palsy. A cerebral angiogram showed an arteriovenous malformation at the anterior cranial fossa. The malformation was mainly fed by the left anterior ethmoidal artery which branched off from the orbital branch of the left middle meningeal artery. There was a marked enlargement of anastomosis between the orbital branch of the middle meningeal artery and the recurrent meningeal branch of the lacrimal artery. Bilateral distal branches of the internal maxillary arteries, bilateral anterior falx arteries and the left fronto-orbital artery were also involved in supplying the AVM. The dilated fronto-orbital vein was the main drainer which emptied into the pterygoid plexus via the uncal vein and the sphenoparietal vein. In June 1985, the nidus involving the dura at the region of the cribriform plate and olfactory bulb was totally removed through a left frontal craniotomy. Postoperatively, the isolated left trochlear nerve palsy improved completely within a few days. This is the first reported case of isolated trochlear nerve palsy caused by a mixed dural-pial arteriovenous malformation of the anterior cranial fossa. We concluded that the etiology of isolated trochlear nerve palsy consisted of nerve compression due to the dilated orbital branch of the middle meningeal artery within the superior orbital fissure.

Carotid Arteries↗
PubMed1992

Frequency of eosinophilia in adult T-cell leukemia/lymphoma.

Cases of adult T-cell leukemia/lymphoma (ATLL) display several peculiar clinical features, including skin rash, hypercalcemia, and an increase in the absolute neutrophil count. The patients rarely have pronounced eosinophilia. In this study, the eosinophilia observed in lymphoproliferative disorders of 62 patients with ATLL, 27 with T-cell lymphoma (TL), and 19 with B-cell lymphoma (BL) was investigated. The incidence of eosinophilia (greater than or equal to 570/microliters) was higher in patients with ATLL than in patients with TL or BL. Thirteen patients with ATLL (21.0%), 3 with TL (11.1%), and 2 with BL (10.5%) had eosinophilia. Of these patients, three with ATLL and one with TL who had a pathologic diagnosis of immunoblastic lymphadenopathy (IBL) showed pronounced eosinophilia up to 10,934/microliters. Because the number of eosinophils in the peripheral blood of these patients correlated both with the number of ATLL cells and the degree of lymphadenopathy and because this fluctuated with chemotherapy, it seems likely that the secretion of some lymphokines by the lymphoma cells is responsible for the eosinophilia.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Dementia in cerebral amyloid angiopathy: a clinicopathological study.

Dementia is in addition to cerebral haemorrhage major symptom of cerebral amyloid angiopathy (CAa). In order to explore the pathological basis for dementia in CAa-related conditions, we made a clinicopathological analysis of CAa, with special attention to dementia. Among 150 patients (mean age 78.6 years) with autopsy-proven intracranial haemorrhage in Tokyo Metropolitan Geriatric Medical Center, CAa with cerebral haemorrhage accounted for 8.0% (12 cases), associated with hypertension and metastatic brain tumour. Among 38 patients with lobar haemorrhage, CAa represented the second most common cause (21.1%) of intracranial haemorrhage after hypertension. A total of 20 patients with CAa (mean age 82.5 years) were studies clinically and pathologically. Hypertension was present in 50%. Thirteen had a history of stroke and others had either ill-defined or no strokes. The average number of strokes 2.9. Fifteen patients (75%) had dementia. Based on the clinicopathological grounds for dementia, CAa-related conditions could be divided into three subtypes: "haemorrhagic", "dementia-haemorrhagic" and "dementia" type. Haemorrhagic type (30%, 6 cases) showed multiple recurrent lobar haemorrhages caused by CAa. Hypertension was present in only 1 patient. The incidence of senile plaques and neurofibrillary tangles was generally correlated with age. Only 1 patient had dementia. The dementia-haemorrhagic type (40%, 8 patients) had recurrent strokes with cerebral haemorrhage after preceding dementia. There were two different neuropathological subsets: CAa with atypical senile dementia of Alzheimer type (SDAT) and CAa with diffuse leucoencephalopathy. Patients with CAa with atypical SDAT had multiple cerebral haemorrhages caused by CAa combined with atypical Alzheimer-type pathology. Patients with CAa with diffuse leucoencephalopathy had cerebral haemorrhages in combination with diffuse white matter damage like Binswanger's subcortical vascular encephalopathy (BSVE). The incidence of senile changes correlated with age. Patients with the dementia type (30%, 6 patients) showed progressive dementia with or without haemorrhage. All had hypertension. They had a combined condition of Alzheimer-type pathology with conspicuous CAa with BSVE. Dementia in CAa-related conditions may be responsible for multiple factors including not Alzheimer-type degeneration, but also diffuse leucoencephalopathy like Binswanger's disease. We also found an asymptomatic type, an ischaemic type, a vasculitis type and an hereditary type in this condition.

Aged↗
PubMed1992

Electronmicroscopic observation of amyloid deposits in the vascular walls of the choroid plexus in systemic amyloidosis.

This report concerns an ultrastructural study of the vessels of the choroid plexus in 3 cases of systemic amyloidosis, sections of formalin-fixed brains being used. Small-sized arteries and arterioles were mainly affected by deposition of amyloid fibrils. In the arterioles, the amyloid fibrils were often so densely accumulated that they separated individual smooth muscle cells of the media and reached the subendothelial region. The basal surface of the endothelium of such vessels showed frequent invaginations filled with amyloid tufts; some of the tufts displaced the thin cytoplasm of the endothelial cells toward the lumen. Occasionally, tufts of amyloid fibrils were found to be exposed to and to float in the vascular lumen. These observations were made only in severely amyloid-laden vessels. Among the several possibilities regarding the tuft-endothelial relationship, the transendothelial transport of amyloid tufts is most likely, but the possibility of intraendothelial processing of amyloid precursor proteins and their secretion to form fibrils extracellularly cannot be excluded.

Adult↗
PubMed1992

Chromosome 11 rearrangement at band 11q21 in a patient with essential thrombocythemia.

A case of essential thrombocythemia with a partial deletion of the long arm of chromosome 11, del(11)(q21) as a sole chromosomal anomaly is reported. Rearrangement of chromosome 11 at band 11q21 has been reported in six patients with chronic myeloproliferative disorders: four with post-polycythemic myelofibrosis, one with myelofibrosis with myeloid metaplasia, and one with Ph+ chronic myeloid leukemia in blastic phase. Except for the last patient, all patients had been treated with 32P and/or an alkylating agent prior to cytogenetic examination. This is the first report of the 11q21 abnormality in essential thrombocythemia seen at diagnosis.

Adult↗
PubMed1992

Perception of complex geometric figures in chimpanzees (Pan troglodytes) and humans (Homo sapiens): analyses of visual similarity on the basis of choice reaction time.

In a conditional-discrimination task (matching-to-sample), we assessed similarities among figures consisting of 2 elemental figures through the choice reaction time, nonmetric multidimensional scaling, and hierarchical cluster analysis data from chimpanzees (Pan troglodytes) and humans (Homo sapiens). Humans also rated similarities among figures. The results of the 3 experiments clearly indicated that the reaction time data obtained from chimpanzees' performances were useful measures of the similarities among figures. The results suggested that chimpanzees and humans perceived the complex figures similarly. The outer-contour elements were perceived most dominantly by both species, and the straight-line elements were perceived least dominantly. Both species showed the same perceptual hierarchy or dominance among perceptual categories, as determined by the similarity of simple elements, on the basis of transformational invariances.

Adult↗
PubMed1992

Remission with morphological myelodysplasia in de novo acute myeloid leukaemia: implications for early relapse.

Myelodysplastic features of remission bone marrow were investigated in 46 adults with de novo acute myeloid leukaemia (AML) according to the FAB morphological criteria for myelodysplastic syndromes (MDS). Compared with a group of 18 patients with the common type of acute lymphoblastic leukaemia in remission, micromegakaryocytes (30.4% v. 5.6%, P less than 0.05), multi-separated nuclear megakaryocytes (45.7% v. 0%, P less than 0.01), degranulated neutrophils (39.1% v. 5.6%, P less than 0.05), and neutrophils with hyposegmented nuclei (34.8% v. 0%, P less than 0.01) were significantly more common in the AML patients. In contrast, dyserythropoietic changes had a similar incidence in both groups. When compared with the clinical features at initial diagnosis in AML cases, the dysmegakaryocytic changes in remission marrow were found to be significantly more frequent in patients with monocytic involvement (mainly M4) or trilineage myelodysplasia (T-MDS AML). Disease-free survival was significantly shorter in patients with micromegakaryocytes (P less than 0.05) or neutrophils with hypogsegmented nuclei (P less than 0.05) than in those without these features. Overall survival was also significantly shorter in patients with micromegakaryocytes (P less than 0.05). These findings may help in developing new strategies for the post-remission therapy of AML, and also suggest that myelodysplastic changes in the remission marrow of de novo AML patients may be related to haematopoietic recovery by a preleukaemic clone which eventually leads to early leukaemic relapse. Dysplastic marrow, however, was not necessarily associated with peripheral pancytopenia in the present series, warranting basic research on such putative clonal remissions.

Acute Disease↗
PubMed1992

[Infectious complications in patients with adult T-cell leukemia].

Between January, 1982, and January, 1992, a total of 112 patients with adult T-cell leukemia (ATL) and 109 patients with non-Hodgkin's lymphoma (NHL) were admitted to our hospital. They were studied for their infectious complications. Infectious complications were seen in 90 patients (80.4%) with ATL, and 51 patients (46.8%) with NHL (p < 0.001). Documented infections were seen in 70 patients (62.5%) with ATL, and 30 patients (27.5%) with NHL (p < 0.001). Pneumonia (p < 0.005), skin infections (p < 0.05), Pneumocystis carinii pneumonia (p < 0.05), fungal infections (p < 0.05), cytomegalovirus infections (p < 0.05) and herpes simplex virus infections (p < 0.01) were identified infections at high risk for patients with ATL. Tuberculosis, listeriosis and salmonella infections were seen only in patients with ATL.

Adolescent↗