Biomedical subjects
Publications and source records attributed to S Maeda.
We reported 3 cases of patients developed moderate to severe anaphylactic reaction induced by tannalbin as anti-diarrhoeic. Specific IgE-mediated hypersensitivity to tannalbin was demonstrated by history, prick skin test, RAST and Immunoblotting. We also certified that tannalbin is composed by tannic acid and casein using HPLC and SDS-PAGE.
An interportal communicating branch was found at the hepatic bifurcation in two (2.4%) out of 83 hepatectomized cases of carcinoma of the biliary tract. The first case was a 54-year-old male with intrahepatic bile duct cancer, and the second was a 64-year-old female with gallbladder cancer. No other anatomical anomalies were found in the portal vein, hepatic artery, or biliary tract.
A successful surgical treatment of intracardiac rhabdomyoma in a 12-day-old female is reported. The neonate was first noted to have a cardiac murmur and she was diagnosed cardiac tumor by two dimensional echocardiography. It showed multiple cardiac tumors which occupied the right ventricular outflow tract and interventricular septum. Under the routine cardiopulmonary bypass the tumor of the right ventricular outflow tract was removed. Histological examination revealed a rhabdomyoma. Follow-up evaluation 7 years after operation showed normal growth and development of the patient. A repeated two dimensional echocardiogram revealed no sign of recurrence and the left ventricular cavity was not obstructed by the residual tumor in the interventricular septum. We reviewed 10 cases treated surgically in infancy including three neonate in Japan.
The primary antibody responses of spleen cell cultures were investigated for LEC rats, a mutant strain of LEA rats, which are known to develop spontaneous hepatic injuries. Compared to LEA rats, LEC rats were significantly low in responding not only to a T-dependent antigen, SRBC, but also to a B-cell stimulant, LPS. The antibody responses of LEC rats having fed a diet deprived of Cu metal (LEC/Cu-) showed values intermediate between LEA and LEC rats, thus suggesting a recovery from an immuno-deficient state as well as liver damage in LEC/Cu- rats. The addition of LEA bone marrow cells prior to culture to LEA or LEC spleen cells, strikingly enhanced the antibody response, whereas LEC bone marrow cells were totally ineffective, or sometimes depressed the response. These results have suggested a newer concept for a possible correlation between liver-dysfunction and bone marrow cell-functions in LEC rats, both encoded by autosomal genes.
Because of its anatomical location, mediastinal tumor is frequently accompanied by airway stenosis and signs indicating compression of the heart and large vessels. For this reason, a patient with this tumor often requires an urgent operation. We recently conducted such an operation on a girl 2 year and 7 month old in whom a giant tumor originating from the posterior mediastinum had caused dyspnea. In this case, anesthesia was induced with ketamine. Intubation was carried out while the girl was semiawake. No muscle relaxants were used, and spontaneous ventilation was partially preserved. During the operation, anesthesia was maintained with oxygen, nitrous-oxide and halothane, without using muscle relaxants. Although intratracheal bleeding, caused by manipulation of the tumor, aggravated the blood gas data, this could be coped with by elevating the oxygen concentration in the inspired gas. During the operation, respiratory control with 10cmH2O PEEP was carried out to cope with atelectasis from lung compression by the tumor. The postoperative course was excellent. From anesthetic management of this case we emphasize the following points: (1) preoperative assessment of the relationship between posture and dyspnea and assessment of the locational relationships of the tumor, heart, vessels and trachea, using CT, ultrasonography, bronchoscopy, etc; (2) utilizing a pulse oximeter, monitoring CO2 in expired gas and monitoring CVP during operation; (3) avoidance of the use of muscle relaxants before the improvement of the symptoms arising from tumor-caused compression; and (4) close respiratory care after operation.
Reoperation after cardiovascular surgical procedures are often accompanied by the possibility of injuring the heart the great vessels, and extracardiac grafts during resternotomy. To reduce the risk associated with resternotomy and to facilitate dissection of intrapericardial adhesion, we have used GORE-TEX SHEET as pericardial substitute since January, 1989. In case GORE-TEX SHEET are implanted in the mediastinum, prolongation of the foreign body reaction, mediastinitis, increasing postoperative hemorrhage should be in mind. In this study, the biocompatibility of GORE-TEX SHEET was examined clinically. The following postoperative indices such as duration of fever, change of the WBC counts, WBC fraction, CRP, mediastinal hemorrhage are evaluated. These results showed no statistical significance between GORE-TEX SHEET group and autologous pericardial group by the randomized study. We recommend use of GORE-TEX SHEET as a pericardial substitute in cases of major cardiovascular operation using median sternotomy.
EG2 is a monoclonal antibody which recognize activated eosinophils, and the increased number of eosinophils stained by EG2 suggest activation of the disease. In bronchial epithelium of patient with asthma, not only EG2-positive eosinophils but CD25-positive T lymphocytes are increased, and support the theory that asthma is a nonsuppurative inflammatory disease of bronchial tree. Bronchial hyperresponsiveness of patient with asthma, which was assessed by a methacoline provocation test, was correlated significantly with the number of EG2 positive-eosinophils in bronchial epithelium. Moreover, most of eosinophils infiltrated to bronchial epithelium in patient with fatal asthma were EG2 positive. The severity of acute asthma attack however did not correlate with EG2-positive rate of eosinophils, but significantly correlated with releasability of granules from eosinophils in sputum of patients with asthma indicated by BMK-13 staining. There are many reports that EG2-positive eosinophils participate in the pathogenesis of other allergic diseases, several types of collagen disease and cancer therapy.
Active gamma subunit of skeletal muscle phosphorylase kinase has been obtained by expression of the rat soleus cDNA in a baculovirus system. The protein exhibited the expected pH 6.8/8.2 activity ratio of 0.6, and its activity was insensitive to Ca2+ addition, indicating that it was free gamma subunit and not a gamma subunit-calmodulin complex. It was stimulated approximately 2-fold by Ca(2+)-calmodulin addition, demonstrating that it had retained high-affinity calmodulin binding. By site-directed mutagenesis, we have examined the role of six of the amino acids that constitute the consensus ATP binding site of the protein kinase, which in the gamma subunit is represented by the sequence 26Gly.Arg.Gly.Val.Ser.Ser.Val.Val33. Changes were evaluated by the kinetic determination of the dissociation constants of gamma-ATP, gamma-ADP, gamma-AMP.PCP, and gamma-phosphorylase and the maximum catalytic activity. The mutants Ser26-gamma, Ser29-gamma, Phe30-gamma, and Gly31-gamma each exhibited an essentially identical dissociation constant for gamma subunit phosphorylase, indicating that these mutations had not caused a global alteration in the protein structure but were limited to changes in the nucleotide binding site domain. Substitution of either Val33 (by Gly) or Gly28 (by Ser), two of the most conserved residues in all protein kinases, resulted in enzyme with marginally detectable activity. In noted contrast, the Ser26 mutant, which substituted the first glycine of the consensus glycine trio motif, and which is also very highly conserved, retained at least 25% of the enzymatic activity. The Gly31 substitution, which restored a glycine to a position characteristic for most protein kinases, had little overall effect upon the maximum rate of catalysis. Restoration of Ser30 to the more typical phenylalanine, which is present in most protein kinases, had minimal effect on catalysis. These data provide the first direct evaluation of the roles that different residues play within this consensus glycine trio/valine motif of the protein kinases, which up to now have only been surmised to be of importance because of their conservation. Two unexpected findings are that for one residue that is very conserved (Gly26) there is some flexibility of substitution not apparent from the evolutionary conservation and that a second quite conserved residue in protein kinases (equivalent to Gly at position 31) does not produce a protein optimized for nucleotide binding.
A novel transthyretin (TTR) mutation associated with familial amyloidotic polyneuropathy was detected in a Japanese patient. Single-strand conformation polymorphism analysis and sequence analysis of polymerase chain reaction (PCR)-amplified exons of the patient's TTR gene revealed a point mutation resulting in a substitution of leucine for valine at position 30. As the mutation creates a Cfr13I site, it was confirmed by PCR and restriction analysis. Our finding indicates the importance of position 30 in TTR-derived amyloid fibril formation.
We investigated the immunohistochemical localization of parathyroid hormone-related protein (PTHrP), a major factor responsible for the humoral hypercalcemia of malignancy, in uterine cervical lesions. Formalin-fixed paraffin-embedded specimens from 16 cases of normal and reactive conditions, 45 cases of cervical intra-epithelial neoplasm (CIN) and 63 cases of invasive cancer were studied immunohistochemically by the avidine-biotin-peroxidase method, using an anti-PTHrP monoclonal antibody (MAb), 4B3. In normal and reactive conditions, PTHrP was positive in parabasal cells, squamous metaplasia, and hyperplastic reserve cells. In neoplastic conditions, 96% (43/45) of invasive squamous-cell carcinomas were positive for PTHrP, regardless of the patients' serum calcium levels. Two cases with hypercalcemia were strongly positive for PTHrP and showed prominent stromal interaction of the scirrhous type. In CIN, including koilocytic atypia, 76% (32/42) of cases were positive for PTHrP. In contrast, 91% (10/11) of adenocarcinomas were negative for PTHrP. In conclusion, we found, first, that in non-neoplastic conditions, the presence of PTHrP was correlated with the transformation of progenitor cells into squamous epithelia and with the maturation of keratinocytes and, second, that in squamous-cell carcinoma, the degree of keratinization and stromal interaction was higher in direct proportion to the apparent incidence of detectable PTHrP.
We characterized the mutation associated with familial amyloidotic polyneuropathy in a Japanese patient. Sequence analysis of polymerase chain reaction-amplified exons of the transthyretin gene revealed a novel point mutation resulting in a substitution of arginine for glycine at position 47. The mutation was confirmed using allele-specific olgonucleotide hybridization procedures. This most likely represents a de novo mutation since neither parent carries the mutant allele.
The expression and localization of parathyroid hormone-related protein (PTHrP), a major factor responsible for humoral hypercalcemia of malignancy (HHM), was investigated in 14 cases of surgically resected normal parathyroid glands. For light microscopic immunohistochemistry, formalin-fixed and paraffin-embedded specimens were stained with avidin-biotin-peroxidase complex (ABC) using the anti-PTHrP monoclonal antibody (MoAb), 4B3. Four percent paraformaldehyde (PFA)-fixed and OCT compound-embedded specimens were used for pre-embedded immunoelectron microscopy. For in situ hybridization, 4% PFA-fixed, frozen sections were studied using a bromodeoxyuridine (BrdU)-labeled PTHrP cDNA probe. Immunohistochemically, 12 of the 14 cases were positive for PTHrP, which was observed mainly in the oxyphil and transitional oxyphil cells. The chief and clear cells, on the other hand, were faintly positive. Electron microscopically, secretory granules positive for PTHrP were observed in cells containing abundant mitochondria. Consistent with the PTHrP immunoreactivity, transcripts of PTHrP were observed also in the oxyphilic cells by in situ hybridization. Thus the production and secretion of PTHrP was shown by the oxyphil cell lineage in the normal parathyroid glands.
A case of obstructive colitis associated with rectal carcinoma in a 56 year old Japanese man is reported herein. He presented to Shinkokura Hospital with severe abdominal pain following a one month history of anal bleeding and mild abdominal pain. On palpation, muscle guarding was observed in the left lower quadrant and the white blood cell count was 14,200/mm3. An exploratory laparotomy was performed under the provisional diagnosis of acute abdomen, which revealed localized peritonitis 8 cm oral to an area of rectal carcinoma. An anterior resection of the lesion was therefore performed together with a descendo-proctostomy. The histopathologic diagnosis revealed adenocarcinoma and obstructive colitis involving the entire thickness of the sigmoid colon and resultant fibrino-purulent peritonitis. His post-operative course was uneventful and he was continuing to do well on the 30th postoperative day, at the time of writing. The clinical significance of this combination of obstructive colitis with rectal carcinoma is briefly discussed following the presentation of this case.
As neoadjuvant chemotherapy for advanced bladder cancer, the intra-arterial administration of methotrexate (MTX), Adriamycin (ADM), and cisplatin (CDDP; IA-MAC) was evaluated. A total of 48 patients with bladder cancer (greater than or equal to T2 or CIS) were selected and received 30.1 mg MTX, 34.5 mg ADM, and 89.1 mg CDDP as an average course. The mean tumor-regression rate after 2 or 3 weeks was 52.3%, and patients with grade 3 transitional-cell carcinoma showed the best results, achieving a 69.6% regression rate. In 30 cases (63%), downstaging was observed. Among the 46 patients who underwent subsequent surgical therapy, the bladder could be preserved in 26 cases by transurethral resection or segmental resection. According to the criteria of the Japanese Association of Cancer Therapy, a histological effect of GIII or better was obtained in 15 cases (29%). The histological effect correlated well with the tumor-regression rate. As compared with intravenous therapy with MTX, vinblastine, ADM, and CDDP (M-VAC), IA-MAC treatment was well tolerated due to its lower degree of bone marrow suppression, and it resulted in a longer disease-free interval and better survival. In addition, the period prior to surgical therapy was shortened in this study. These results suggest that IA-MAC chemotherapy can be useful as an arm of multidisciplinary treatment of advanced bladder tumors.
A ring-shaped electrode was developed and used in 20 patients to record evoked electromyographic responses directly from the extraocular muscles during skull base surgery. Intra-operative monitoring with this electrode helps the surgeon to localize the nerves that innervate the extraocular muscles precisely and to refrain from disturbing important neural structures during operations. Such monitoring also provides some insight into the pathophysiology of the dysfunction of these nerves resulting from skull base lesions.
Monoclonal anti-proliferating cell nuclear antigen (PCNA PC10), which is directed against a 36 kDa auxiliary protein for DNA polymerase delta specific for the S-phase of cell cycle, was used to measure tumour cell proliferation in 4 lactating breasts and 98 benign and malignant breast tumours. The percentage of PCNA-positive cells determined by point counting was significantly lower in the lactating breast [mean 3.6%, standard deviation (SD) 0.67, n = 5] than in fibroadenoma and mastopathy (mean 23.7, SD 5.0, n = 2). Primary breast carcinoma showed a PCNA index ranging from 2% to 36% (mean 12.3, SD 9.3, n = 50), whereas in recurrent carcinoma the index was mean 28.5, SD 4.0. A high index was correlated with c-erbB-2 and epidermal growth factor (EGF) receptor membrane reactivity, worsening histological grade, poor survival and disease-free survival. The expression of c-erbB-2 and EGF receptor was associated with poor survival and disease-free survival in primary breast cancer patients.
We report that the penetrating type of early gastric cancer (PEN) is a specific type of early gastric cancer and that the poorly differentiated PEN type could be considered an initial lesion of linitis plastica-type cancer. We performed an immunohistochemical study to clarify the role of growth factors (epidermal growth factor [EGF] and transforming growth factor-beta [TGF-beta]) in the PEN type of early gastric cancer. The results indicated that the PEN type of early gastric cancer has a high growth capacity. Moreover, it was suggested that EGF was involved in its specific infiltrative growth and that both EGF and TGF-beta were involved in its specific scirrhous growth. From these findings, it was assumed that the immunohistochemical staining of EGF and TGF-beta in endoscopic biopsy specimens was useful for the diagnosis of the PEN type of gastric cancer and also for the diagnosis of the initial lesion of linitis plastica-type gastric cancer.
Acute cytogenetic effects of benzene in LE rat bone marrow cells in vivo were studied. Chromosome aberrations (CA) induced by benzene consisted mainly of gaps and breaks. Cells with exchanges were rarely observed. The incidence of benzene-induced CA was at its maximum level 12 h after the p.o. or i.p. administration of benzene, dependent on the dose of benzene administered, and higher in male rats than in female rats. However, the sex difference was not observed in the repeated inhalation experiment. Chromosome damage was higher with the p.o. than the i.p. administration. LE rats were more sensitive than Wistar and SD rats to the clastogenic action of benzene. Phenobarbital and Sudan III are well known as inducers of drug-metabolizing enzymes. The peak percentage of benzene-induced CA in the rats pretreated with phenobarbital was observed 6 h after the benzene injection, and it occurred at a higher level than in the rats given only benzene. On the other hand, Sudan III pretreatment suppressed benzene-induced CA at all periods after the benzene injection. SKF-525A (a cytochrome P-450 inhibitor) and cyclohexene oxide (an epoxide hydrase inhibitor) pretreatment also suppressed benzene-induced CA.