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Biomedical subjects

N Adachi

Publications and source records attributed to N Adachi.

At least 199 records · Page 11Linked to original sources

[A case of sarcoidosis beginning with extensive ground-glass pattern on chest X-ray, accompanied with high fever and eosinophilia].

A 62-year-old woman was admitted to our hospital with a chief complaint of dyspnea on effort. Her temperature was 38 approximately 39 degrees C. Eosinophilia was seen in peripheral blood and the chest roentgenogram showed bilateral extensive ground-glass pattern, accompanied by air bronchogram. The extensive shadow fitted the description of "unstable shadow." Transbronchial lung biopsy specimens demonstrated the formation of non-caseating epithelioid cell granulomas with severe alveolitis and exudative change in alveolar spaces. In bronchoalveolar lavage fluid (BALF), the total cell count was normal but the lymphocyte population was increased to 28%. Pathological findings were suggestive of either sarcoidosis or hypersensitivity pneumonitis. Prednisolone therapy was started. As a result, her symptoms rapidly disappeared and the chest roentgenogram showed remarkable improvement for a short period. However skin lesions on bilateral lower extremities appeared after approximately one month from discontinuation of prednisolone. Skin biopsy specimens showed non-caseating epithelioid cell granulomas leading to the final diagnosis of sarcoidosis. About one month after the appearance of the skin lesion, the chest roentgenogram findings deteriorated. At this time, the BALF eosinophil population surprisingly increased to 24.9%. Chest roentgenogram showed rapid improvement again by administration of prednisolone. This case was considered to be a unique case of sarcoidosis from the point of view of the chest roentgenogram pattern, eosinophilia, clinical course and presence of severe alveolitis with exudative change in alveolar spaces.

Alveolitis, Extrinsic Allergic↗

In vitro degradation of amyloid material by four proteases in tissue of a patient with familial amyloidotic polyneuropathy.

The effects of 4 proteolytic enzymes, alpha-chymotrypsin, bromeline, collagenase, and lysozyme on amyloid tissue sections from a patient with familial amyloidotic polyneuropathy (FAP) were evaluated. Degradation of amyloid fibrils was significant with alpha-chymotrypsin, moderate with bromeline and collagenase, and slight with lysozyme. All of these proteases except collagenase are used as oral mucolytics in humans. The possibility of their clinical usefulness in the treatment or prevention of the development of FAP is discussed.

Amyloid↗

Production of parathyroid hormone-related protein in adult T-cell leukemia cells.

Human parathyroid hormone-related protein (PTHrP) mRNA was detected in peripheral leukemic cells obtained from adult T-cell leukemia (ATL) patients as well as in cultured human T-cell leukemia virus type I (HTLV-I)-infected T-cell lines. In contrast, PTHrP mRNA was not detected in other types of leukemic cells. Using radioimmunoassay, immunoreactive PTHrP was also detected in the spent media of HTLV-I-infected T-cell lines. These results suggest that PTHrP plays an important role in developing the hypercalcemia frequently observed in ATL patients.

HTLV-I Infections↗

Bleeding manifestations in 24 patients with familial amyloidotic polyneuropathy.

Focal or generalized hemorrhage is a commonly encountered complication in patients with many kinds of amyloidosis. We studied 24 patients (18 males, 6 females) with familial amyloidotic polyneuropathy and found that five had experienced one or more bleeding episodes. In four of these five patients, bleeding occurred in the terminal stage. The incidence of hemorrhage in familial amyloidotic polyneuropathy is lower than that of other types of amyloidosis or that which has been reported in this disease. In our experience clotting abnormalities were rare; clotting factor deficiency appeared not to exist in familial amyloidotic polyneuropathy.

Amyloidosis↗

Provocation of a paradoxical growth hormone response to corticotropin-releasing hormone by pretreatment with metoclopramide in patients with acromegaly and normal subjects.

Two of 7 patients with acromegaly and one of 7 normal subjects exhibited a paradoxical rise in growth hormone (GH) to human corticotropin-releasing hormone (CRH) when pretreated with metoclopramide, although CRH alone did not induce an increase in GH. In one of these two patients with acromegaly, the GH increase to metoclopramide alone also reached the criteria of a paradoxical response. These two acromegalic patients showed a GH increase to metoclopramide pretreatment before and up to two months after surgery. In another acromegalic patient, whose GH level remained high 5 months after surgery, metoclopramide induced an increase in GH level, while in a patient who had an above-normal GH level 18 months after surgery, the resumption of physiological GH secretion after surgery was evidenced by a postoperative absence of a GH response to metoclopramide. It is suggested from these results that the GH response to metoclopramide and the metoclopramide-provoked GH response to CRH in patients with acromegaly result from the secretion of GH from nonadenomatous cells of the pituitary.

Acromegaly↗

[Clinical study of the delivery of very low birth weight infants in Iwate Prefecture].

Over the past 4 years, 119 very low birth weight infants (VLBWI, less than 1,500g) were delivered at Iwate Medical University. We analysed clinical background of mothers and prognosis of neonates. The objective of this study was to upgrade our perinatal care tailored to regional demand. The following results were obtained. 1. Maternal transport was necessary in 90.7% of the mothers. Preterm Premature Rupture of the Membranes (PPROM) was present in 38.8% of them. 2. The percentage of mothers with a cervical dilatation of more than 4cm was significantly higher in mothers without PPROM than in those with PPROM. 3. Delivery occurred within 24 hours in 86.8% of mothers without PPROM who had a cervical dilatation of more than 4cm. 4. The percentage of cesarean sections was 16.5%. 5. Death in the neonatal period occurred in 10.8% of VLBWI, 20% of extremely low birth weight infants (ELBWI, less than 1,000g), and 42.8% of infants weighing less than 750g. 6. There was no significant difference in the incidence of intraventricular hemorrhage (IVH) between infants with cephalic presentation and infants with breech presentation, or between infants delivered vaginally and infants delivered by cesarean section. The incidence of IVH was significantly higher in infants weighing less than 1,000g than in those weighing 1,000g or more. 7. The neonatal death nate and the incidence of IVH were significantly higher in infants weighing less than 750g than in those weighing 1,000g or more. 8. The incidences of pneumonia and sepsis were significantly higher in infants with PPROM than those without PPROM.(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death↗

[Subrenal capsule assay (SRCA) using human lung cancer].

SRCA was performed using surgically removed fresh tissues in 26 cases of lung cancer. The histological examination of day 6 xenograft showed that only a few xenografts contained tumor cells because of the host cell infiltration and stroma. For the assay considered as evaluable, we defined that control mice needed to show delta tumor size larger than -0.5 OMU and histological presence of tumor cell more than 50% in the day 6 xenograft. The evaluable assay rate (EAR) was no more than 25% (4/16). By the pretreatment with X-ray irradiation of 3 Gy, host cell infiltration was significantly suppressed. With this procedure however, only 40% (4/10) of EAR was gained. The reason for this low EAR was due to the difficulty to obtain the specimens enriched with tumor cells because of stroma and necrotic tissue. Then we used specimen obtained from the human lung cancer line xenografted in nude mice, which resulted in a high EAR of 84% (16/19). We concluded that SRCA for fresh surgical materials was still difficult. However SRCA for lung cancer line was feasible, especially for in vivo preclinical chemosensitivity test for new agents and decision for new drug combination. SRCA as a disease oriented chemosensitivity test is expected to develop in the future.

Animals↗

Studies of protease and protease inhibitors in familial amyloidotic polyneuropathy.

Serum levels of 6 protease inhibitors, alpha 1-antitrypsin, Cl inactivator, alpha 2-macroglobulin, antithrombin-3, alpha 1-antichymotrypsin and inter-alpha-trypsin inhibitor were measured in patients with familial amyloidotic polyneuropathy (FAP) and a control group without neurologic disease. No significant differences were observed between the 2 groups. The proteolytic effect of brinase, an enzyme from Aspergillus oryzae, on amyloid tissue sections from patients with FAP was also evaluated. Amyloid fibrils were degraded by brinase, while the tissue structure remained fairly intact.

Amyloid↗

Analysis of cell proteins in lymphoblasts of acute lymphocytic leukemia by two-dimensional gel electrophoresis.

The two-dimensional gel electrophoresis (2-DE) method developed by O'Farrell was used to analyze the differences of major proteins between lymphoblasts from children with acute lymphocytic leukemia (ALL) at diagnosis (lymphoblasts, n = 6), normal lymphocytes (n = 6) and lymphocytes from children with ALL in complete remission (lymphocytes in CR, n = 12). Among all the spots, those which were deeply stained and large were termed 'major spots'. Their number was 118. Two spots (No. B1 and B2) were characteristic of lymphoblasts, three spots (No. N1-N3) were characteristic of normal lymphocytes. In lymphocytes in CR, the latter spots were not always detected, and furthermore, the former spots were detected in several gels. These findings may relate to the insufficient recovery of functions of lymphocytes in CR. Several spots (No. 6, 55 and 57) in lymphoblasts were remarkably larger than those in normal lymphocytes. Spot No. 67, an actin spot, in lymphoblasts was smaller than that in normal lymphocytes. Spots No. 6, 55 and 57 in lymphocytes in CR were relatively small in size.

Adolescent↗

Pituitary-adrenocortical response to metoclopramide in patients with acromegaly and prolactinoma: a clinical evaluation of catecholamine-mediated adrenocorticotropin secretion.

We have demonstrated that metoclopramide stimulates cortisol secretion at least in part by a stress-mediated effect in normal men. To examine further the effect of the drug on the hypothalamo-pituitary adrenal system, we studied the cortisol response to 20 mg metoclopramide in patients with acromegaly, prolactinomas, and functional hyperprolactinemia and compared the results with the responses to insulin-induced hypoglycemia. In some patients, the effects of metoclopramide on CRH-induced ACTH and cortisol increase were studied to determine whether a change in dopaminergic (catecholaminergic) activity altered CRH stimulation of pituitary-adrenal function. No cortisol response to 20 mg metoclopramide occurred in 13 tests on 8 of 9 patients with prolactinoma or acromegaly with hyperprolactinemia, whereas both acromegalic patients without hyperprolactinemia had a response. All of the patients had a normal cortisol response to insulin-induced hypoglycemia. Pretreatment with metoclopramide enhanced the CRH-induced cortisol increase from 30-120 min after CRH in normal men, but only at 15 and 30 min in 5 agromegalic patients. The results suggest that metoclopramide acts in the hypothalamus to release ACTH through a dopamine antagonist-mediated (catecholaminergic) mechanism, and that metoclopramide may act additively with CRH to stimulate ACTH secretion in normal men. The absence of a metoclopramide-induced cortisol response in patients with acromegaly or prolactinomas and the absence of a normal cortisol response to metoclopramide-CRH in acromegalic patients could be due to endogenous catecholamine deficiency in these patients.

Acromegaly↗

Detection of gastrin-releasing peptide mRNA in small cell lung carcinomas and medullary thyroid carcinomas using synthetic oligodeoxyribonucleotide probes.

Human gastrin-releasing peptide (GRP) mRNA was detected in the tumor tissues of medullary thyroid carcinomas and small cell lung carcinomas using synthetic oligodeoxyribonucleotides as hybridization probes. The amount of GRP mRNA was estimated by radiodensitometric hybridization assay. A good correlation was found between the amount of GRP mRNA and the concentration of immunoreactive GRP in the tumor tissues.

Carcinoma↗

[Autologous bone marrow transplantation in osteosarcoma].

Four patients with osteosarcoma were treated with intensive chemotherapy and autologous bone marrow transplantation (ABMT). The patients received high-dose methotrexate (9-12 mg/m2) with citrovorum factor rescue, high-dose melphalan (60 mg/m2 X 3), actinomycin D (0.5 mg/m2 X 3), adriamycin (30 mg/m2 X 2) and high-dose cyclophosphamide (60 mg/kg X 2) during 4 weeks. Bone marrow was aspirated and cryopreserved before treatment and reinfused 48 hours after the completion of chemotherapy. Two of four patients had advanced osteosarcoma with multiple pulmonary metastasis, one of whom had responded well and achieved partial response while the other had shown no response, and both patients died of disease progression 4 and 11 months after ABMT, respectively. The other two patients who received this regimen at an earlier disease stage for prevention of pulmonary metastasis, are alive and well without any evidence of metastasis 31 and 18 months after ABMT, respectively. This regimen was tolerated well in all patients except for mild nausea and vomiting. No infectious episodes were observed during the period of aplasia which continued for 19 to 38 days after marrow infusion. These results suggest that this supralethal combination chemotherapy is safe and tolerable when used with ABMT and effective for patients with osteosarcoma, especially when applied in the non-metastatic phase.

Antineoplastic Combined Chemotherapy Protocols↗