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Biomedical subjects

N Yamagata

Publications and source records attributed to N Yamagata.

At least 55 records · Page 3Linked to original sources

Serum levels of endogenous and exogenous granulocyte colony-stimulating factor after autologous blood stem cell transplantation.

Although the administration of recombinant human granulocyte colony-stimulating factor (rhG-CSF) enhances myeloid engraftment and reduces infectious morbidity after autologous and allogeneic bone marrow transplantations, the effect of rhG-CSF on neutrophil recovery in autologous blood stem cell transplantation (ABSCT) is controversial. We previously demonstrated that a low dose, delivered subcutaneously, of rhG-CSF (50 micrograms/m2) accelerates neutrophil recovery in ABSCT, but the optimal dosage of rhG-CSF is not known. To elucidate the effect of rhG-CSF on neutrophil recovery, we determined serum levels of endogenous and exogenously administered G-CSF in 24 patients receiving ABSCT. Of these, five received bolus subcutaneous injection of 50 micrograms/m2 rhG-CSF, 10 received 150 micrograms/m2, and nine received no rhG-CSF. Endogenous G-CSF levels rose immediately after ABSCT, and an inverse correlation was found between the serum level of G-CSF and the absolute neutrophil count (r = -0.73, p < 0.01). The pre-dose level in patients receiving rhG-CSF rose gradually, reaching a maximum between days 3 and 6. The level gradually decreased as the neutrophil count began to rise, even through administration of the same dose of rhG-CSF continued. Pharmacokinetic data showed that the half-life of elimination of G-CSF (t1/2) exceeded 15 hours during severe neutropenia but decreased during the recovery of neutrophils. These observations suggest that neutrophils provide a negative feedback mechanism for clearing G-CSF from the circulation. Pre-dose levels of G-CSF in patients receiving 50 micrograms/m2 rhG-CSF reached 10 ng/mL, equivalent to the concentrations used in clonogenic assay in vitro to stimulate myeloid progenitor cells.

Adolescent↗

IgE plasma cell leukemia successfully treated with combination VAD (vincristine, doxorubicin, dexamethasone) and MP (melphalan, prednisolone) followed by interferon-alpha.

A 69-year-old woman with IgE/kappa plasma cell leukemia (PCL) was treated with a sequential combination of VAD (vincristine, doxorubicin, dexamethasone) and MP (melphalan, prednisolone) followed by interferon-alpha (IFN alpha). A complete remission was achieved for 14 months. Maintenance therapy with IFN alpha has continued for an additional 10 months. IgE PCL is extremely rare. The biological characteristics of the myeloma cells, including surface marker, adhesion molecule, karyotype, DNA analysis, and the response to various cytokines, are presented.

Aged↗

Trichosporon cutaneum fungemia in patients with acute myeloblastic leukemia and measurement of serum D-arabinitol, Candida antigen (CAND-TEC), and beta-D-glucan.

Two patients with acute myeloblastic leukemia are described who developed fungemia due to Trichosporon cutaneum. Fungemia occurred at the leukocyte nadir following the administration of anti-cancer chemotherapy. One patient was cured but the other died. Both patients received prednisolone continuously and had central venous catheters in place for parenteral hyperalimentation. T. cutaneum isolates were resistant to 5-fluorocytosine and moderately susceptible to fluconazole. One case was complicated by endophthalmitis due to T. cutaneum; this is the second report of such a complication in the world. We investigated the serum levels of beta-D-glucan, D-arabinitol, and Candida antigen (CAND-TEC); beta-D-glucan was elevated in both cases, which suggests that simultaneous measurements of these laboratory values are useful for the diagnosis and possibly for the evaluation of therapy for this fungal infection.

Antigens, Fungal↗

Mouse anti-human interleukin-6 receptor monoclonal antibody inhibits proliferation of fresh human myeloma cells in vitro.

Interleukin-6 (IL-6) is a major growth factor in multiple myeloma. We investigated the effect of mouse anti-human IL-6 receptor monoclonal antibody (anti-IL-6R mAb) on the in vitro proliferation of freshly isolated myeloma cells from 21 patients to evaluate the therapeutic potential. The addition of anti-IL-6R mAb inhibited more than 30% of the spontaneous proliferation of myeloma cells in 9 of 21 cases in a dose- (0.1 to 20 micrograms/ml) and time-dependent manner. The inhibitory effects of anti-IL-6R mAb did not differ significantly from that of anti-IL-6 mAb, and were correlated with the extent of the response of myeloma cells to IL-6. Flow cytometric analysis showed that all myeloma cells expressed IL-6R, whose intensity was not correlated with either the extent of response of myeloma cells to IL-6 or the inhibitory effects of anti-IL-6R mAb on proliferation of myeloma cells. Although our study showed heterogeneity in the proliferative responses of myeloma cells to IL-6 and anti-IL-6R mAb, these observations suggest the possibility of using anti-IL-6R mAbs for treating some patients with multiple myeloma whose growth depends on IL-6.

Animals↗

Kinetics of serum cytokines in adults undergoing peripheral blood progenitor cell transplantation.

We investigated the serum cytokine levels (G-CSF, GM-CSF, IL-1 beta, IL-3 and IL-6) using an ELISA in 14 patients with haematological malignancies undergoing peripheral blood progenitor cell transplantation (PBPCT). Serum G-CSF levels in all patients rose immediately after PBPCT, then gradually decreased as the neutrophil counts began to rise. No detectable serum levels of GM-CSF or IL-1 beta were observed, but serum levels of IL-3 rose transiently immediately following PBPCT. Serum levels of IL-6 rose transiently during a fever in four patients. These observations suggest that G-CSF and IL-3 may contribute to the early haemopoietic reconstitution in PBPCT.

Adolescent↗

Effect of granulocyte colony-stimulating factor on hematopoietic recovery after peripheral blood progenitor cell transplantation.

To examine the effect of granulocyte colony-stimulating factor (G-CSF) on hematopoietic recovery after high-dose chemotherapy and peripheral blood progenitor cell transplantation (PBPCT), 20 patients with hematologic malignancies were divided into two groups. One group was given G-CSF at a daily dose of 50 micrograms/m2 subcutaneously, the other received no G-CSF. Neutrophil recovery was accelerated in the G-CSF treated patients and exceeded 0.5 x 10(9)/l at a median of 10 days post-PBPCT compared with 14 days in the control group (p < 0.01). This reduction led to a decrease in antibiotic use and a trend toward fewer febrile days in the G-CSF treated group.

Adolescent↗

Reconstitution of lymphocyte subsets after peripheral blood stem cell transplantation: two-color flow cytometric analysis.

The reconstitution of lymphocyte subsets after high-dose chemotherapy followed by peripheral blood stem cell transplantation (PBSCT) was studied using two-color flow cytometry in 14 patients with acute leukemia (four AML and two ALL) and malignant lymphoma (six NHL and two HD). The CD3+HLA-DR+ lymphocytes (activated T cells) and CD8+ lymphocytes increased markedly by 4 weeks after PBSCT. Most of the increased CD8+ lymphocytes were CD11b-, S6F1+ cells and CD8+CD11b+ cells remained low throughout the follow-up period. The CD4+ lymphocytes remained below the normal range up to 34 weeks after PBSCT. The ratio of CD4+ to CD8+ lymphocytes (CD4/CD8 ratio) transiently increased and then decreased below 1.0 at 2 weeks after PBSCT. The CD19+ lymphocytes and the CD3-CD16+CD56+ lymphocytes returned to normal levels in the early period. The CD4+CD45RA+ lymphocytes (suppressor-inducer) decreased to below the normal range, while the CD4+CD45RO+ lymphocytes (helper-inducer) increased more rapidly than the CD4+CD45RA+ lymphocytes. This study shows that an immunosuppressed state exists after PBSCT as is seen after bone marrow transplantation (BMT) and that B cell reconstitution is more rapid in PBSCT than in BMT.

Acute Disease↗

Acute myelomonocytic leukemia after treatment with chronic oral etoposide: are MLL and LTG9 genes targets for etoposide?

A patient with secondary acute myelomonocytic leukemia after treatment with chronic oral etoposide (VP-16) for lung cancer is reported. The leukemic cells showed a t(9;11)(p22;q23) translocation. Southern blot analysis revealed the rearrangement of the MLL (ALL-1/HRX) gene at 11q23. Reverse transcriptase-polymerase chain reaction (RT-PCR) revealed a chimeric mRNA between the MLL gene at 11q23 and LTG9 (MLLT3/AF-9) gene at 9p22. The patient was successfully treated with a VP-16 based regimen. This case is instructive in the understanding of the leukemogenesis of VP-16-related leukemias.

Administration, Oral↗

[Neoplastic angioendotheliosis presenting Tolosa-Hunt syndrome, intraspinal invasion and intraorbital tumor].

A 76-year-old woman with painful erythema on legs and right oculomotor disturbance was diagnosed as neoplastic angioendotheliosis (NAE, B cell type) by skin biopsy. Remission was obtained by 2 courses of VEPA regimen. But 3 months later, she relapsed with right oculomotor, optic, trochlear and trigeminal nerve disturbance which suggested that she had Tolosa-Hunt syndrome. Cerebrospinal fluid (CSF) revealed infiltration of lymphoma cells. She developed intraorbital tumor and died of respiratory failure due to tumor emboli. Autopsy revealed infiltration of tumor cells in the small vessels of systemic organs. This rare case presented intracerebrospinal and intraorbital tumor growth in addition to intravascular infiltration of tumor cells.

Aged↗

[Successful treatment of acute myelogenous leukemia in an elderly patient with cytarabine ocfosfate].

A 77-year-old female with left hemiplegia caused by cerebral infarction and with mild senile dementia was admitted for further examination of hematological abnormalities. She was diagnosed as acute myelogenous leukemia (AML-M5a) according to French-American-British classification. Since intensive combination chemotherapy seemed difficult, she was treated with oral administration of cytarabine ocfosfate (200 mg/day, for 14 days), a cytidine deaminase-resistant derivative of Ara-C, resulting in complete remission. Major side effects were nausea, vomiting and appetite loss, but their incidences were reduced tolerably when cytarabine ocfosfate was given just before sleeping. Cytarabine ocfosfate might be useful to treat AML in elderly patients having certain complications such as cerebrovascular disease.

Administration, Oral↗

Extrathymic development of V alpha 14-positive T cells.

It is known that rearrangement of the T cell antigen receptor (TCR) gene occurs in the thymus during T cell development and consequently results both in the deletion of DNA between the variable (V) and diversity/joining segments and in the formation of a circular DNA with recombination signal sequences. Here, we provide evidence that V alpha 14+ TCR gene rearrangements take place in extrathymic sites, such as bone marrow, liver, and intestine, but not in spleen, because we were able to detect frequent productive and nonproductive V alpha 14+ coding and signal sequences as a result of TCR rearrangements in extrathymic sites. Similar findings were also detected in athymic mice. Quantitative analysis shows that the relative amounts of V alpha 14 gene-mediated signal sequences in extrathymic tissues are higher than those in thymus. On the contrary, TCR rearrangements of V alpha 1.1 T cells, which are known to develop in the thymus, were mainly detected in the thymus, Peyer's patch, and spleen, but not in other extrathymic tissues, showing patterns distinct from V alpha 14 TCR rearrangements. These findings are evidence of extrathymic development of V alpha 14+ T cells. Differential characteristic TCR rearrangement patterns also indicate that distinct TCR repertoires are generated in different lymphoid tissues.

Animals↗

[Transthoracic Doppler color imaging of the blood flows in the left coronary septal branches].

This study characterized blood flow signals derived from the left coronary septal branches by transthoracic Doppler color flow imaging. In the anterior ventricular septum, the signal was detected in 7 of 13 patients with aortic stenosis, 8 of 34 with hypertrophic cardiomyopathy, and 5 of 144 patients with other diseased states. The peak diastolic flow velocity assessed by a pulsed Doppler technique ranged 21-115 cm/s (mean 57). Systolic signal was depicted in 13 of the 20 with the diastolic signal, indicating retrograde flow direction in all of them. The peak negative systolic component ranged 11-80 cm/s (mean 40). Peak diastolic flow velocity of the left anterior descending artery was higher in patients with the septal branch flow signal than in those without the signal (53 +/- 24 vs 31 +/- 11 cm/s). Patients with the signal showed larger transvalvular pressure gradient in aortic stenosis, and greater septal thickness in hypertrophic cardiomyopathy than in those without the signal. In conclusion, transthoracic visualization of the septal branch flow signal by Doppler color flow mapping is attributable to increased coronary blood flow at rest which is probably due to excessive load and/or septal hypertrophy. Augmented systolic retrograde flow may play additional role in the diastolic high velocity flow in the septal perforator.

Adolescent↗

Suppression of pulmonary granulomatous inflammation by immunomodulating agents.

We demonstrated previously that macrophages and macrophage-derived cytokines including lymphocyte-activating factors (LAFs) play a critical role in lung granuloma formation in mice and that granulomas sizes correlated with LAF activity in the lesions. In the present study, we examined the effects of D-penicillamine (D-Pc), 2-acetylthiomethyl-3-(4-methyl-benzoyl)propionic acid (KE-298) and dexamethasone (Dex) on dextran bead-induced lung granulomas in mice. KE-298 is a newly synthesized compound containing sulfur (S) similar to D-Pc. Large granulomas developed, which reached peak intensity within 3 days and declined in size thereafter. Aqueous lung extracts of the mice contained high levels of LAF that were correlated with granuloma sizes. The lesions and local LAF activity were inhibited by administration of these agents. The most potent inhibitor was Dex. The suppressive effect of KE-298 was similar to that of D-Pc. These results suggest that suppression of granulomas may be attributed to inhibition of LAF activity/synthesis by these agents.

Animals↗

Augmentation of pulmonary foreign body granulomatous inflammation in mice by lipopolysaccharide: involvement of macrophage activation and tumor necrosis factor-alpha.

We examined the effect of lipopolysaccharide (LPS) on dextran bead-induced lung granulomas using LPS responder (C3H/HeN) and nonresponder (C3H/HeJ) mice. LPS augmented granuloma sizes, TNF-alpha and N-acetyl-beta-D-glucosaminidase levels of lung extracts in C3H/HeN, but not in C3H/HeJ mice. Granuloma macrophages of C3H/HeN mice produced higher levels of superoxide anion and TNF-alpha than those of C3H/HeJ mice. Taken together with our previous report that macrophages and macrophage-derived cytokines are essential for the development of lesions, the present results suggest that activation of macrophages plays an important role in the development and augmentation of pulmonary granulomas.

Acetylglucosaminidase↗

Inflammatory cytokines and enzymes in synovial fluid of patients with rheumatoid arthritis and other arthritides.

Cytokines and lysosomal enzymes, which are produced by inflammatory cells, play a role in inflammation. We have found that synovial fluid (SF) in rheumatoid and septic arthritis contained a large number of white blood cells (WBCs) and high levels of cytokines and enzymes, while in contrast the SF of osteoarthritis and traumatic arthritis did not contain significant amounts. Measurements of WBCs, cytokines and enzymes in SF are useful for evaluating clinical disease activity. Assays for WBCs and enzymes are simple and rapid when compared to those for cytokines.

Adult↗

Ultrahigh-resolution scanning electron microscopy of biological materials.

The age of ultrahigh-resolution scanning electron microscopy (SEM) began in 1985, when the UHS-T1, with a resolution of 0.5 nm, was developed. Commercial instruments of the same or similar types followed rapidly. As instrumental resolution progressed, conventional specimen preparation methods became inadequate, and a number of new techniques were devised. In this paper, detailed procedures for these preparation methods such as the CC plate method and heavy metal impregnation are described, together with precautions recommended for achieving ultrahigh-resolution. Some applications of the method to biological specimens are also reported. Morphological identification of immunoglobulins prepared from human blood was attempted, and although the identification was not completely successful this technique may yet come to be of use in the clinical examination of allergic or infectious diseases. SEM images of complement, Clq, proteoglycan and the helical structure of double stranded DNA are shown, as also is the visualization of immunolabelled cell-surface receptors.

Carbon↗