Biomedical subjects
Publications and source records attributed to N Kodama.
Patients with small-cell lung cancer who survive more than 2 years have a significantly increased risk (relative risk of 3.6) of developing a second primary tumour. The cessation of cigarette smoking after successful therapy is associated with a significantly decreased risk of a second primary tumour.
Emphasis has recently been placed on the roles of chemotactic cytokines called chemokines to explain the accumulation of inflammatory cells in the lung that may precede or accompany pulmonary fibrosis in interstitial lung diseases. We hypothesized that RANTES, a member of the C-C chemokines, is one such chemokine. Bronchoalveolar lavage was done in 20 patients with sarcoidosis, 10 patients with interstitial pneumonia associated with collagen vascular disease (CVD-IP), 10 patients with idiopathic pulmonary fibrosis (IPF), and eight healthy volunteers (HV), all of whom were never-smokers. We semiquantitated the spontaneous RANTES mRNA expression by a competitive reverse transcription-polymerase chain reaction (RT-PCR) technique, and measured the levels of RANTES protein by enzyme-linked immunosorbent assay. In all disease groups the expression of RANTES mRNA by bronchoalveolar lavage fluid (BALF) cells and the levels of RANTES protein in BALF were significantly increased compared with those in HV. Patients with sarcoidosis and CVD-IP had a significant positive correlation between the expression of RANTES mRNA by BALF cells and BALF lymphocytosis. The amounts of RANTES mRNA expressed by peripheral blood mononuclear cells and the levels of RANTES protein in serum did not differ among all study groups. Our study demonstrates the adaptability of a semiquantitative RT-PCR method for determining cytokine mRNA expression in vivo. Our results suggest that RANTES may be one of the chemokines that are involved in the mechanism for the accumulation of inflammatory cells in the lung of some distinct interstitial lung diseases.
Catechol 2,3-dioxygenase (C23D; EC 1.13.1.2) was purified to homogeneity from a cell extract of Pseudomonas sp. AW-2 grown on aniline, and the purified C23D was characterized. The molecular mass estimated by gel filtration was 110 kDa. The enzyme dissociated into four identical subunits each with the molecular mass of 33 kDa. The enzyme had high activity for 3-methylcatechol as well as catechol, and differed from the enzyme from Pseudomonas putida mt-2, which carries the TOL plasmid, in optimal pH for catechol, extradiol cleavage activities for 3-methylcatechol and 4-methylcatechol, and immunochemical properties. The amino acid sequence deduced from a C23D gene, alnE, from Pseudomonas sp. AW-2 was 85.7% identical to that of 3-methylcatechol 2,3-dioxygenase from toluidine-assimilating Pseudomonas putida UCC22. AlnE was 44.1% identical to the C23D encoded by xylE in P. putida mt-2. Because XylE has low activity for 3-methylcatechol, these results suggest that the differences in substrate specificity for 3-methylcatechol among the C23Ds reflected their sequence similarity.
Meningeal enhancement (ME) using Gd-DTPA MRI was studied in 25 of 35 patients with meningiomas, and its clinical importance on associated MRI and histologic findings of ME was evaluated. ME extended 0.5-4.3 cm (mean: 1.5 cm) from the tumor attachment site, and was classified morphologically into two patterns: that extending with a gentle curve from the tumor attachment site to the dura, and that extending linearly. Tumor parenchyma was differentiated from ME based on time-dependent changes in signal intensity on Gd-DTPA MRI. Histologic examination was performed in tissue from regions of ME of 15 patients. Tissue corresponding to regions of ME consisted of two layers: an outer dura mater layer and an inner layer of hyperplasic loose fibrous tissue with dilated capillaries. Meningeal tumor cell clusters were observed in the fibrous tissue of 4 patients. These clusters were observed at a maximum distance of 1.4 cm from the tumor attachment site. It is thought that meningeal tumor cell clusters may represent a potential cause of local recurrence. Therefore, resection of the dura at least 2 cm from the tumor attachment site may be required to prevent local recurrence.
We report a case of dural arteriovenous fistula (dAVF) of the transverse and sigmoid sinus which developed over five years. The patient was a 64-year-old man, who had a history of congestive heart failure and transient ischemic attack (TIA). No abnormal lesions were detected in the cerebral angiograms five years prior to the time the etiology of his TIA was investigated. He suddenly suffered from left hemiparesis and the CT scan showed right parietal subcortical hemorrhage. Right carotid angiogram demonstrated dAVF of the transverse and sigmoid sinus supplied by the right occipital and ascending pharyngeal arteries. We thought the reason for the subcortical hemorrhage in this patient was due to the disturbance of venous return in the right cerebral hemisphere. We underwent direct embolization of the right transverse sinus by interlocking detachable coils. Postoperative cerebral angiograms demonstrated the disappearance of dAVF and he was discharged. Whether dAVF is a congenital anomaly or not, has been controversial. Since the dAVF in this case had newly developed over five years, it is suggested that dAVF is an acquired lesion.
We report a case of motor neuron disease in which fasciculations and cramps progressed generally before the development of muscle wasting. After involvement of the upper and lower motor neurons became clinically manifest, widespread fasciculations and cramps persisted and accompanied pseudotetany. The present case suggests that spinal cord pathology of motor neuron disease can cause the abnormal excitability of the motor neurons, resulting in the development of generalized fasciculations and cramps.
Mouse thymocytes are known to undergo apoptosis by ligating some unique anti-Thy-1 monoclonal antibodies (mAbs), G7 and KT16. However, the precise mechanisms of Thy-1-mediated apoptosis are as yet unclear. We investigated Thy-1-mediated apoptosis using our previously generated anti-Thy-1 mAb, MCS-34, which was similar to G7 because both antibodies recognized both Thy-1.1 and Thy-1.2 and bound Thy-1A epitope. Unlike G7, MCS-34 alone could not induce apoptosis in thymocytes; however, it could induce apoptosis when it was cross-linked with second antibodies. Thus, MCS-34 could not aggregate by itself, but G7 could. In the course of investigating the apoptosis-related molecules that were involved in the thymocyte apoptosis induced by cross-linking of MCS-34 or by G7 ligation, we found that CPP 32-like proteases were activated during the apoptosis. Furthermore, the expression of bcl-2 and bcl-XL proteins was decreased in these apoptosis processes. Whereas the ligation of MCS-34 alone could not generate apoptosis signals that led to the activation of CPP32-like proteases and the decrease in bcl-2 and bcl-XL expression, the aggregation of Thy-1 glycoprotein might be crucial to signal thymocyte apoptosis. These results indicate that MCS-34 is a useful anti-Thy-1 mAb for analyzing the Thy-1-mediated signals since MCS-34 can control the level of apoptosis by using second antibodies.
Gram+ aniline-assimilating Rhodococcus erythropolis AN-13 (AN-13) produces catechol 1,2-dioxygenase (C12O) showing high enzymatic activities for 3- and 4-methylcatechols [Aoki et al. (1984) Agric. Biol. Chem. 48, 2087-2095]. A 3.0 kb Sau3AI fragment carrying a gene encoding C12O(catA) was cloned by selection of transformants showing C12O activity from a gene library of AN-13. Furthermore, we specified a 1.6 kb SalI fragment containing catA from the Sau3AI fragment by subcloning. Sequence analysis revealed that the 1.6 kb SalI fragment carried a 855 bp open reading frame (ORF) encoding the entire AN-13 catA, preceded by a potential ribosome binding site (RBS). From comparison of the deduced amino acid (aa) sequence of C12O from AN-13 with other C12O reported previously, it was found that the AN-13 enzyme shares 56.0% aa sequence identity with C12o from Arthrobacter sp. mA3 (mA3) [Eck and Belter (1991) Gene 123, 87-92] compared with less than 36.4% aa sequence identities with others. In conclusion, we classified all C12O including the AN-13 enzyme into three subfamilies on the basis of similarity of aa sequences, numbers of aa residues, and substrate specificity.
PURPOSE: To compare the response rates, toxicities and survival durations of elderly patients (70 years of age or more) with those of younger patients (less than 70 years of age) with non-small-cell lung cancer (NSCLC) treated with cisplatin-based chemotherapy. PATIENTS AND METHODS: We analyzed retrospectively the data of 203 assessable patients entered on a prospective randomized trial of cisplatin-based combination chemotherapy. Chemotherapy consisted of three dosage regimens: (1) vindesine and cisplatin (VP); (2) mitomycin, vindesine and cisplatin (MVP); or (3) etoposide and cisplatin alternating with vindesine and mitomycin (EP/VM). RESULTS: A greater proportion of elderly patients had localized disease and more squamous cell carcinoma than non-elderly patients. The overall response rates were 44% in the elderly group and 28% in the non-elderly group. In the EP/VM arm, the response rate was significantly better in the elderly group than in the non-elderly group. The frequency of grade 4 leukocytopenia in the MVP and EP/VM arms in the elderly group was significantly greater than in the non-elderly group (P < 0.05). No differences were found in nonhematological toxicities between the two groups. There was no difference in overall survival between the groups. CONCLUSION: Elderly patients treated with mitomycin-containing regimens have higher hematologic toxicities than younger patients. The results of this study are consistent with the previously reported pharmacologic data on mitomycin suggesting altered pharmacokinetics in elderly patients. The improved response rate in the elderly patients was probably because more elderly patients had earlier disease, squamous cell carcinoma and better performance status. Cisplatin-based chemotherapy was tolerable for most elderly NSCLC patients with good performance status.
Four transpositional mutants of aniline-assimilating Pseudomonas sp. AW-2 produced 2-hydroxymuconic 6-semialdehyde (HMS) from aniline and accumulated it in a cultural medium. Among the four mutants, strain Y-2 produced the greatest amount of HMS (0.77 mg/ml) from 1 mg/ml of aniline hydrochloride in a 15-h growing culture. The conversion rate of aniline to HMS was 70% on a molar basis. Resting cells of strain Y-2 produced 0.65 mg/ml of HMS during 4h of incubation in a reaction mixture containing 1 mg/ml of aniline hydrochloride (conversion rate, 60%). Transposon Tn5-Mob was found to be inserted into the gene of HMS dehydrogenase in strain Y-2 by sequence analysis.
We have evaluated the feasibility, toxicity, and tumour response of concurrent whole-brain radiotherapy (WBRT) and chemotherapy with cisplatin, vindesine and mitomycin in the treatment of 33 patients with brain metastasis from non-small-cell lung cancer (NSCLC). The imaging response demonstrated that 25 patients (75.8%) responded to brain lesions, including five complete responders, and the response rate to primary lesion was 18%. The treatment improved at least one grade of performance status in 30% and of neurological functions in 55% of the patients. The major toxicity was leucopenia (> or = grade 3, 84.4%). Median survival was 9.7 months and the 1-year survival rate was 40%. Concurrent WBRT and chemotherapy can be safely administered to patients with brain metastasis from NSCLC, with a remarkable response rate, improvement of neurological functions and encouraging survival duration.
Sixty-three patients with extensive-stage small-cell lung cancer were randomized to receive either cyclophosphamide, vincristine, doxorubicin and etoposide (CODE) alone or CODE plus recombinant human granulocyte colony-stimulating factor (rhG-CSF). rhG-CSF administration in support of CODE chemotherapy resulted in increased mean total received dose intensity for all drugs (P = 0.03) with a significant improvement in survival (P = 0.004).
OBJECTIVE: The facial colliculus is a reliable landmark for a surgical approach via the fourth ventricle. Our aim is to elucidate the most suitable electrophysiological methods for identification of the facial colliculus. We evaluated the usefulness of facial electromyography and antidromic evoked potentials of the facial nerve. The effect of stimulation on cardiorespiratory function is also studied. METHODS: We localized the facial colliculus by facial electromyography and antidromic facial evoked potentials in adult dogs. To determine the most effective stimulus pattern, intensity was varied, and both monopolar and bipolar electrical stimulation were tried. To confirm the cardiorespiratory effect of the stimulation, systemic blood pressure, heart rate, respiratory rate, and thoracic excursion were measured. After administration of atropine sulfate, changes in vital signs were recorded. RESULTS: A stable facial electromyographic wave form was produced by 0.1-mA monopolar stimulation of a small portion of the fourth ventricular floor (4 mm2). Using 0.1-mA bipolar stimulation, the same wave form was obtained. As saline was gradually added around the electrodes, the amplitude of the response gradually decreased; however, the response with monopolar stimulation was more stable than that with bipolar stimulation. Stimulation of the facial colliculus with greater than 2 mA caused transient hypotension and bradycardia; respiratory arrest occurred with 3 mA stimulation. Administration of atropine sulfate (0.01 mg/kg) decreased these responses. Antidromic facial evoked potentials were recorded only at "hot points" that existed within 2 mm of the facial colliculus. CONCLUSION: Our study resulted in three findings. First, the most suitable electrophysiological stimulation of the fourth ventricular floor for identification of the facial colliculus was 0.1-mA monopolar stimulation. Second, significant alteration in cardiorespiratory function appeared with greater than 1-mA stimulation. Third, a recording of an antidromic facial evoked potential can identify the facial colliculus more safely than direct stimulation of the facial colliculus. Both orthodromic and antidromic methods were useful for identification of the facial colliculus in brain stem surgery.
Purpose of this study was to survey subjective health problems occurring among Japanese nursing students. Data collected with the self-administered Cornell Medical Index Health Questionnaire Japanese version (JCMI) from 102 Japanese first year nursing students were analyzed. The total CMI score (section A-R) ranged from 2-108 with an average of 23.1 (SD = 15.9). The mean CMI for physical (section A-L) and psychological health complains (section M-R) were 15.7 (SD = 11.8) and 7.3 (SD = 6.1), respectively. Two-way analysis of variances with multiple comparison of means revealed significant relationships between age and psychological health complaints and both physical and overall health complaints. The older nursing students reported more physical and overall health complaints than the youngest. The nursing students who reported more complaints about psychological health also reported significantly more physical and overall health complaints. A comparison of Fukamachi's and Brodman's criteria for classification of neurotic traits is discussed. Findings from this study support the hypothesis that psychological health is somewhat reacted to physical health.
We reviewed the clinical findings, the surgical problems and results in fifteen operated cases of skull base meningioma encasing the main cerebral arteries. The fifteen cases of meningiomas are summarized as follows; The patients' age ranged from 18 to 76 years old with an average age of 48 years old. Thirteen were in female and two in males. Of 15 cases, four cases were sphenoid ridge meningiomas (all clinoidal types), three cases were planum sphenoidale, two cases were tuberculum sellae, olfactory groove and cerebellar tentorium, one case was a cerebello-pontine angle and foramen magnum meningioma. Twelve cases (80%) had a large tumor of 50mm in maximum diameter. Major advances in imaging modalities, especially magnetic resonance imaging (MRI), have enabled precise preoperative information about vascular encasement and location of the encased vessels within the tumor. Preoperative tumor embolization was performed in 2 patients, STA-MCA anastomosis was performed in one patient with severe stenosis of the internal carotid artery encased in the tumor. In 5 cases with the presence of interfacing arachnoid membranes between the tumor and cerebral vessels, the tumor was totally removed. In the 10 patients without interfacing arachnoid membranes, total removal was achieved in 4 of the 10 patients by the sacrifice of the encased artery and in one patient injuring the arterial wall consequently. In the remaining 5 patients, the tumor could not be removed totally. One patient showed a recurrence on follow-up ranging from 0.5 to 13 years. In conclusion, greater difficulty with dissection of such tumors was encountered in patients who did not have an arachnoid plane between the encased artery and the tumor. In those cases, to avoid the devastating sequelae injuring the encased cerebral vessels and its surrounding perforators, we considered that total removal should not be carried out.
Explore the source record for details and available documents.
BACKGROUND: Direct surgical intervention to treat ruptured cerebral aneurysms in patients with moyamoya disease has rarely been attempted and few of these patients have demonstrated full recovery following treatment. METHODS: To clarify the particular operative problems encountered in performing aneurysmal surgery in patients with moyamoya disease, we present two cases and review 10 cases in the literature. RESULTS: The first patient had a newly formed internal carotid artery aneurysm, which enlarged within a period of approximately 2 years. The second patient had multiple basilar artery aneurysms. Both patients had their aneurysms successfully clipped and were discharged without any neurologic deficits. CONCLUSIONS: Aneurysmal surgery in moyamoya disease presents three problems unlike those encountered in uncomplicated aneurysmal surgery: (1) the ordinary approach is prohibited by the presence of moyamoya vessels, (2) careful consideration is required to preserve collateral circulation, and (3) acute surgery is necessary to prevent cerebral vasospasm due to massive subarachnoid hemorrhage.
Explore the source record for details and available documents.