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Biomedical subjects

S Hirohata

Publications and source records attributed to S Hirohata.

At least 127 records · Page 7Linked to original sources

Spontaneous epidural hematoma secondary to dural metastasis from an ovarian carcinoma--case report.

We report a case of spontaneous epidural hematoma secondary to dural metastasis of an undifferentiated ovarian carcinoma. The hemorrhage occurred 2 days after oophorectomy. The hematoma was evacuated, and histological examination of the galea and dura mater revealed metastatic ovarian carcinoma. The absence of other pathology in the vicinity of the hematoma indicates that the hemorrhage was caused by the dural metastasis. Although subdural hematoma secondary to dural metastasis has been reported, this is believed to be the first reported case of epidural hematoma attributable to dural metastasis.

Adult↗

T cell-dependent activation of B cell proliferation and differentiation by immobilized monoclonal antibodies to CD3.

The capacity of mAb directed at the CD3 molecular complex (64.1) to induce T cell-dependent B cell proliferation and differentiation was examined. Coculture of B cells with mitomycin C-treated T4 cells (T4 mito) stimulated by immobilized 64.1 resulted in marked B cell proliferation and Ig-secreting cells (ISC) generation in the absence of any additional stimulation. The magnitude of the B cell responses induced by immobilized 64.1-stimulated T4 mito was far greater than that induced by other stimuli, such as Staphylococcus aureus plus factors produced by mitogen-activated T cells, PWM, or soluble 64.1. The induction of maximal B cell responsiveness required direct contact between activated T cells and responding B cells. Of note, immobilized 64.1 also induced B cell proliferation and ISC generation in the presence of mitomycin C-treated T8 cells. By contrast, immobilized 64.1 stimulated T4 or T8 cells that had not been treated with mitomycin C induced very modest ISC generation and suppressed B cell responses supported by T4 mito even in the presence of exogenous IL-2 or factors produced by mitogen-activated T cells. The interactions between T and B cells in these cultures not only induced B cell responses, but also enhanced the production of IL-2 by activated T cells. Increased IL-2 production was facilitated when culture conditions afforded the opportunity for contact between B cells and activated T cells. These results indicate that the establishment of interactions between B cells and anti-CD3-stimulated T4 or T8 cells provides all of the signals necessary for proliferation and differentiation of B cells without other stimuli and also augments the production of lymphokines by the activated T cells. The data emphasize the role of Ag-nonspecific interactions between B cells and T cells in promoting polyclonal responses of both cell types.

Adult↗

Regulation of human B lymphocyte responsiveness.

Regulation of human B cell responses is a complex process involving the activities of a variety of cells and cytokines. There are important differences between the regulation of human and murine B lymphocytes, especially with regard to the action of IL2 and IL4. In man, IL2 appears to play a central role in regulating B cell activation, proliferation and differentiation, whereas IL4 plays a regulatory role by inhibiting initial B cell activation. Above and beyond providing regulatory cytokines, activated human T cells can also directly stimulate B cell differentiation by a process that requires cellular contact. A better understanding of the nature of signal transduction during interactions between B cells and activated T cells and provided by the various cytokines should provide additional insight into the regulation of B cell function in man.

Antibody Formation↗

A patient with systemic lupus erythematosus presenting both central nervous system lupus and steroid induced psychosis.

We describe a patient with systemic lupus erythematosus (SLE) who presented with both steroid induced psychosis and central nervous system (CNS) SLE at different times. The cerebrospinal fluid (CSF) immunoglobulin indices and electroencephalogram were found to be helpful and reliable for the correct diagnosis of both conditions. There have been no reports of patients with SLE who showed both steroid induced psychosis and CNS SLE, and our patient has provided substantial evidence that both conditions can occur in the same individual.

Adult↗

A serial study of changes in intrathecal immunoglobulin synthesis in a patient with central nervous system systemic lupus erythematosus.

A 50-year-old man with systemic lupus erythematosus developed organic brain syndrome. He responded to corticosteroid therapy and recovered completely from acalculia, apraxia and memory disturbance. Throughout his course, the cerebrospinal fluid (CSF) IgM, IgA and IgG indices were decreased in relation to the progression of normal alpha activity in the electroencephalogram. CSF Ig indices may be useful for monitoring central nervous system lupus disease activity.

Humans↗

Association of cerebrospinal fluid IgM index with central nervous system involvement in Behçet's disease.

Immunoglobulin (IgM, IgA, and IgG) and albumin values were determined in 12 patients who had signs and symptoms of central nervous system involvement attributable to Behçet's disease. Only the cerebrospinal fluid IgM index, which was significantly elevated in patients with active neuro-Behçet's syndrome, was found to decrease when the neurologic manifestations of the disease had disappeared. This indicates that determination of this index may be of help in the evaluation of central nervous system disease activity in neuro-Behçet's syndrome.

Adolescent↗

Increased intrathecal immunoglobulin synthesis of both kappa and lambda types in patients with systemic lupus erythematosus and central nervous system involvement.

The concentration of immunoglobulins in paired serum and cerebrospinal fluid (CSF) specimens from 15 patients with systemic lupus erythematosus (SLE) and central nervous system (CNS) involvement (CNS-SLE) were determined based on their light chain properties. Eight patients with SLE without CNS involvement and 20 patients with noninflammatory neurological diseases were also studied for comparison. We found that both of the CSF Ig-k (immunoglobulin kappa) and Ig-1 (immunoglobulin lambda) indices were significantly elevated, indicating the increased intrathecal immunoglobulin synthesis of both kappa and lambda types in patients with CNS-SLE. Moreover, the CSF Ig-k and Ig-1 indices correlated well with each other, and both indices were found to decrease remarkably when the CNS manifestations subsided after successful treatment. In 4 of 15 patients, intrathecal synthesis of free light chains in addition to Ig bound light chains seemed to be increased. These observations provide substantial evidence for polyclonal B lymphocyte activation within the CNS.

Adolescent↗

Adult Still's disease complicated with adult respiratory distress.

A 65-year-old woman with adult Still's disease developed adult respiratory distress syndrome (ARDS), a fatal pulmonary complication. Intravenous administration of cyclophosphamide, 500 mg/d for three days, was much more effective than high doses of corticosteroids in the patient. Interestingly, hypersensitivity to flavoxate hydrochloride seemed to be a precipitating factor, but not a cause, for both a series of characteristic manifestations of adult Still's disease and development of ARDS in our patient. The association of ARDS with adult Still's disease has not yet been reported. Physicians should be aware of this fatal complication in adult Still's disease, especially in the presence of drug hypersensitivities.

Aged↗

A sensitive and simple method for determination of IgM in cerebrospinal fluid by a solid-phase enzyme-immunoassay. Comparison of two different methods.

A sensitive and simple solid-phase enzyme-immunoassay for quantitative determination of IgM in cerebrospinal fluid has been developed. This method is based on a sandwich technique and is much more sensitive than the competition enzyme-immunoassay which we described previously. The IgM values obtained by this sandwich technique were well correlated with those by the competition technique. This new method is considered to be more suitable for the estimation of IgM in cerebrospinal fluid because of its simplicity and good sensitivity.

Enzyme-Linked Immunosorbent Assay↗

Cerebrospinal fluid IgM, IgA, and IgG indexes in systemic lupus erythematosus. Their use as estimates of central nervous system disease activity.

Paired serum and cerebrospinal fluid (CSF) specimens from 13 patients with systemic lupus erythematosus (SLE) and central nervous system involvement (CNS-SLE) were studied for CSF IgM, IgA, and IgG indexes (indicators of intrathecal immunoglobulin synthesis) and CSF-serum albumin quotient (Q albumin) (an indicator of blood-brain-barrier function). We also studied 20 patients with noninflammatory neurologic diseases and seven patients with SLE without CNS involvement for comparison. In addition to an increase in the CSF IgG index, IgM and IgA indexes also were elevated in patients with CNS-SLE. All three indexes decreased significantly when CNS manifestations subsided by successful treatment. The Q albumin was normal in most patients. The elevation of CSF immunoglobulin indexes may be a result of polyclonal B-lymphocyte activation within the CNS, rather than the leak of immunoglobulins from the systemic circulation into the CNS. Since these indexes reflect CNS disease activity in SLE, they may be a successful tool for the management of SLE.

Adolescent↗

Situs ambiguous with polysplenia complicated by renal adenocarcinoma.

Two men developed renal adenocarcinoma in association with situs ambiguous off with polysplenia (SAP) (also known as the polysplenia syndrome). Features of their diseases included (1) no normal spleen--just splenuli, (2) interruption of the inferior vena cava with azygos or hemiazygos continuation, (3) bilateral hyparterial bronchi, (4) cardiac malformations, (5) renal adenocarcinomas originating from the kidneys, ipsilateral to the anomalous spleens. The association of renal adenocarcinomas and SAP has not been previously reported, to our knowledge. We suggest that renal adenocarcinoma and SAP may share a common pathogenetic link.

Abnormalities, Multiple↗

Quantitative determination of immunoglobulins in the cerebrospinal fluid based on their light chain properties using a solid-phase enzyme immunoassay.

A method for quantitative determination of immunoglobulins in the cerebrospinal fluid (CSF) on the basis of their light chain properties is described. The method is a solid-phase enzyme immunoassay, based upon competitive binding of immunoglobulins in unknown and labeled immunoglobulin for antibody adsorbed to the wells of a microplate. The values for immunoglobulins kappa (Ig-k), lambda (Ig-l) and k/l ratio obtained from 38 subjects without neurological disorders were 8.6 +/- 4.0 micrograms/ml, 7.0 +/- 2.6 micrograms/ml and 1.21 +/- 0.21, respectively (mean +/- SD). Our method is considered to be less influenced by the molecular size and weight of immunoglobulins than radial immunodiffusion, and thus may provide more precise values of Ig-k and Ig-l.

Adolescent↗

Quantitation of IgG, IgA and IgM in the cerebrospinal fluid by a solid-phase enzyme-immunoassay. Establishment of normal control values.

A sensitive, specific and simple solid-phase enzyme-immunoassay for quantitative determination of IgG, IgA and IgM in the cerebrospinal fluid (CSF) has been developed. Using this technique, we have established the control values for CSF immunoglobulins from 30 neurologically normal subjects. The value of IgG determined by our method was closely correlated with that found by single radial immunodiffusion although the latter was found 1.5 times higher. The values of IgG and IgA showed significant positive correlations with CSF total protein values, while the value of IgM did not. This finding suggested that the concentration of CSF IgM might be less affected by transudation from the serum than those of IgG and IgA in neurologically normal subjects. Our method needs no complicated technique nor special apparatus other than microplate photometer, and offers more facility and convenience for routine laboratory use.

Adolescent↗

Kinetics of heterologous anti-rat tubular antigen antibody in rat kidneys.

The distribution of rabbit antirat tubular antigen antibody (ATAb) in rat kidneys was examined by immunofluorescence at various times after the intravenous injections of various doses. The results were also compared with those of the experiments in rats made already nephrotic by aminonucleoside of Puromycin. Our results that ATAb could be demonstrated not only in the glomerular capillary wall but in the brush border of the proximal tubule might suggest the possibility that the tubule could also be damaged by immunological mechanism, although no histological support could be obtained. In the patients of the chronic glomerulonephritis (membranous glomerulonephritis), some of which are considered to be caused by tubular antigen and anti-tubular antigen antibody complexes, more attention should be attracted not only to the pathological changes in glomerulus but to those in proximal tubule.

Animals↗