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Biomedical subjects

S Nagai

Publications and source records attributed to S Nagai.

At least 127 records · Page 7Linked to original sources
PubMed1998

[Limited operation for stage I lung cancer: a retrospective study].

Although lobectomy is standard therapy for Stage I non-small cell lung cancer, it often cannot be performed in poor-risk patients. In this report, we describe the results of a retrospective study to assess the usefulness of limited operation for stage I lung cancer. Over a 21-year period, 1,286 lung cancers were resected at our center. Among the 497 patients with stage I lung cancer, 36 sublobar resections were performed. There was only one surgery-related death, and the 5-year survival rate was 46% for all patients. At 5 years, survival was 69.2% for patients with squamous cell carcinoma and 33.7% for patients with adenocarcinoma. Survival rates were higher in patients who underwent mediastinoscopy than those who did not, and depended on histological findings and accurate pathological staging.

Adenocarcinoma↗
PubMed1998

[A case report of extralobar pulmonary sequestration associated with mediastinal bronchogenic cyst].

A 48-year-old woman was admitted to our hospital because of abnormal shadow on the chest X-ray. Chest contrast CT scan showed roundly mass in the posterior mediastinum which were combined with and without contrast elements, and chest MRI (T2 weighted) showed high signal intensity. These features suggested mediastinal cyst or extralobar sequestration. The operation was performed through left 6th intercostal thoracotomy. Two different lesions connected to the mediastinum were confirmed, a cystic tumor and small accessory lung. The former was diagnosed as bronchogenic cyst and the latter as extralobar pulmonary sequestration.

Bronchogenic Cyst↗
PubMed1998

Lipocortin I gene expression is higher in blood monocytes than in BAL fluid macrophages in patients with pulmonary sarcoidosis.

BACKGROUND AND AIM OF WORK: Lipocortin I, induced by corticosteroids in vivo is considered to be related to cell activation and differentiation in mononuclear phagocytes, key cells in the process of epithelioid cell granuloma formation in sarcoidosis. Therefore, we focused on the expression of lipocortin I gene in mononuclear phagocytes in patients with sarcoidosis. METHOD: The amounts of transcripts of lipocortin I gene obtained from both BAL fluid macrophages and blood monocytes were measured by RT-PCR and HPLC, and then standardized as the ratio of lipocortin I/beta-actin for comparison. RESULTS: 1. Smoking did not affect the expression of lipocortin I gene in BAL fluid macrophages and monocytes. 2. There were no differences in the amounts of expression in BAL fluid macrophages between patient groups (nonsmokers and smokers), or between patients and healthy subjects. 3. The gene expression in BAL fluid macrophages was higher than that in monocytes in patients with IPF (macrophages 1.23 +/- 0.48, vs monocytes 0.50 +/- 0.38, p < 0.05) and healthy subjects (nonsmokers: 1.66 +/- 1.17, vs 0.34 +/- 0.26, p < 0.05, smoker: 1.98 +/- 0.96, vs 0.34 +/- 0.48, p < 0.05, but sarcoidosis patients showed a higher expression of lipocortin I gene even in monocytes (2.62 +/- 1.87, vs 2.66 +/- 2.21). CONCLUSION: The increase in lipocortin I gene expression in monocytes was a disease-related finding in sarcoidosis.

Annexin A1↗
PubMed1998

[A pulmonary tumorlet with caseous granuloma associated with atypical mycobacterium].

We encountered a case of pulmonary tumorlet with caseous granuloma associated with atypical mycobacterium. A 73-year-old woman was admitted to the hospital because a chest x-ray film showed enlargement of an abnormal shadow in the middle lobe of the right lung. Primary lung cancer was suspected and right middle lobectomy was performed. Acid-fast bacilli (Gaffky 1) were found in a caseous lesion and examination of intraoperatively obtained frozen specimens showed caseous granulomas. The bacilli were later identified as Mycobacterium avium complex. The permanent specimen showed a minute lesion consisting of small clusters of epithelial cells resembling carcinoid tumor in contact with granulomatous tissue. Histopathological examination revealed argyrophilia on Grimelius stain and immunoreactivity to chromogranin-A in the clusters of epithelial cells. Although these results are consistent with small cell carcinoma or peripheral carcinoid tumor, pulmonary tumorlet was diagnosed because of the lesion's small and minimal cytologic atypia, and because of chronic pulmonary damage around the lesion. Pulmonary tumorlets are minute, usually microscopic, tumor-like lesions mostly found in damaged lung tissue obtained at autopsy or during surgery. Morphological diagnosis is sometimes very difficult, but recently these lesions have been regarded as hyperplastic lesions arising in pulmonary neuroendocrine cells (Kultschitzky cells) and caused by chronic pulmonary damage, such as hypoxia and inflammation. Pulmonary tumorlets must be considered in the differential diagnosis of minute lesions suspected to be small cell carcinoma or peripheral carcinoid tumor.

Aged↗
PubMed1998

Summer-type hypersensitivity pneumonitis. T-cell receptor V gene usage in BALF T-cells from 3 cases in one family.

BACKGROUND AND AIM OF THE WORK: Hypersensitivity pneumonitis (HP) is a granulomatous lung disease characterized by a T lymphocyte bronchiolalveolitis and in several recent studies the preferential use of V beta regions of T-cell receptor (TCR) has been demonstrated. In Japan, summer-type HP, caused by Trichosporon cutaneum, is the most prevalent type of HP, and it is known by the familial occurrence. To clarify whether TCR expression could be restricted on lung T-cell and associate with the HLA type in an organic antigen-driven hyperimmune status, we examined three cases of summer-type HP in one Japanese family. METHODS: TCR expression on bronchoalveolar lavage (BAL) fluid T-cells was analyzed with 13 TCR V gene specific monoclonal antibodies. In addition, HLA types were analyzed using the microlymphocyte toxicity method. RESULTS: The changes in TCR expression were most frequently found in the BAL fluid CD8+ subset, but we found no preferential TCR V gene usage common to the three cases or correlation between the HLA type and the V gene usage. In two of the three cases who underwent a second lavage three months after the first one, some of the TCR expansions were preserved. CONCLUSION: Preferential usage of several TCR V genes was observed in three cases with summer-type HP in one family, but we could find neither a common T cell expansion nor any correlation between the HLA type and the TCR V gene usage.

Adult↗
PubMed1997

Bronchoalveolar lavage. Still useful in diagnosing sarcoidosis?

BALF parameters, if evaluated as a diagnostic or prognostic tool, should be based on a full understanding of the clinical profiles and course of pulmonary sarcoidosis. The various markers that have been reported so far are unreliable in determining the prognosis, although BALF lymphocytes and CD4/CD8 ratios are still useful for diagnosing sarcoidosis. It is critical to find feasible markers that relate to a change in disease activity and prognosis, because markers of chronicity may be different from those of progressively worsening sarcoidosis.

Bronchoalveolar Lavage Fluid↗
PubMed1997

Mapping of V beta 11+ helper T cell epitopes on mycobacterial antigen in mouse primed with Mycobacterium tuberculosis.

Antigenic epitopes for Mycobacterium tuberculosis-reactive T cell immune responses have been mapped using the purified Mycobacterium protein antigen. Lymph node cells from C57BL/6 mice that had been immunized with heat-killed M. tuberculosis were cultured with various Mycobacterium protein antigens and their reactivity was monitored by proliferative response. Usage of the TCR beta chain repertoire was analyzed by flow cytometry. Stimulation of M. tuberculosis-primed lymph node cells with MPT59 (antigen 85B, alpha antigen) induced proliferative response, production of IL-2 and IFN-gamma, and the expansion of V beta 11+ CD4+ T cells in conjunction with antigen-presenting cells in an I-Ab-restricted manner. Lymph node cells from non-primed mice failed to proliferate in response to MPT59. Using peptides covering the complete mature 285 amino acids long MPT59 protein as 15-mer molecules overlapping by five amino acids, we identified the antigenic epitope for MPT59-specific V beta 11+ T cells. The 15-mer peptide, covering amino acid residues 240-254 of MPT59 [peptide-25 (amino acids 240-254)], contains the motif that is conserved for I-Ab and requires processing by antigen-presenting cells to trigger peptide-25-specific V beta 11+ CD4+ T cells. We conclude from these results that MPT59 and peptide-25 (amino acids 240-254) are not superantigens and require antigen processing in order to stimulate V beta 11+ Th1 cells. This experimental system will provide us with a useful tool for delineating the regulation of T cell development in a particular subset of M. tuberculosis infection and for developing antigenic peptides for Th1-dominant immune responses.

Acyltransferases↗
PubMed1997

Mass effect caused by clinically unruptured cerebral arteriovenous malformations.

OBJECTIVE: It is generally considered that mass effect caused by arteriovenous malformations (AVMs) is evidence of ruptures. In the present study, the incidence of mass effect in clinically unruptured AVMs was evaluated, and the underlying causative factors and pathophysiological mechanisms were studied. METHODS: Twenty-seven patients with clinically unruptured supratentorial pial AVMs were examined. The majority were suffering from epilepsy, and frontal lobe involvement was revealed in approximately half of the patients. Angiographic studies, computed tomographic scans, and magnetic resonance images were obtained for all patients. Twenty-one patients underwent removal of AVMs. In 10 of the surgically treated patients, intraoperative vascular pressure measurements were obtained before removal of the AVMs. RESULTS: Mass effect was detected in 12 (44%) of the 27 patients. Cortical sulci obliteration (eight patients) and lateral ventricle displacement (seven patients) were frequently noted. The volume of AVMs was significantly larger in patients with mass effect than in those without mass effect (P < 0.001). Large dilated venous sacs or ectatic veins were observed to be associated with mass effect (P < 0.001). In only one patient was gross displacement related to a surrounding massive brain edema. Draining vein pressure in patients with mass effect was significantly elevated as compared to the average value in patients without mass effect (22 +/- 5 versus 12 +/- 3 mm Hg) (P < 0.01). CONCLUSION: The present study suggests that mass effect is not infrequent in clinically unruptured AVMs. Furthermore, multiple causative factors were detected, including the large size of AVMs, marked draining vein dilatation, and brain edema around the AVMs. Findings also indicated that a pathophysiologically high pressure in the venous drainage system may contribute to mass effect.

Adolescent↗
PubMed1997

Effect of oocyte retrieval from a small leading follicle in fixed-schedule in vitro fertilization program.

OBJECTIVE: To evaluate the propriety of oocyte retrieval (OR) form a small leading follicle during a fixed-schedule in vitro fertilization (IVF) program. METHODS: OR was fixed only to take place on Wednesdays. Gonadotropin-releasing hormone agonist treatment was initiated on the first day of the cycle, human menopausal gonadotrophin was given for 7 days starting on the next Monday, and human chorionic gonadotrophin (hCG) was given on the Tuesday before the OR. Patients were divided into 2 groups according to the follicular size observed before the day of hCG administration: Group 1 (141 cycles), with follicles > 16 mm in mean diameter; and Group 2 (38 cycles) with follicles of 10 to 16 mm in mean diameter. RESULTS: Fertilization rates and the incidence of mature oocytes were higher in Group 1 than in Group 2. However, the mean number of oocytes recovered and pregnancy rates were similar in the 2 groups. CONCLUSION: It is worthwhile to retrieve the oocyte from a small leading follicle in a fixed-schedule IVF program.

Adult↗
PubMed1997

Type II pneumocytes release chemoattractant activity for monocytes constitutively.

In the present investigation, we determined whether A549 cells, a type II pneumocyte cell line, might release mediators that are responsible for monocyte chemoattractant activity (MCA) constitutively. To test this hypothesis, A549 cell supernatant fluids were harvested and evaluated for monocyte chemotaxis. A549 cell supernatant fluids showed MCA in a time-dependent manner (P < 0.001). Checkerboard analysis of 24- and 72-h supernatant fluids showed that the activity was chemokinetic rather than chemotactic. Partial characterization of 24- and 72-h supernatant fluids revealed that the mediator was composed of lipid-soluble activity that was blocked by lipoxygenase inhibitors and trypsin-sensitive activity blocked by cycloheximide. Molecular sieve column chromatography identified four molecular weight peaks. Two of four peaks were blocked by anti-monocyte chemoattractant protein-1 (MCP-1) and anti-transforming growth factor-beta (TGF-beta) polyclonal antibodies. MCP-1 and TGF-beta were detected by enzyme-linked immunosorbent assay. Leukotriene B4 (LTB4) receptor antagonist attenuated the lowest-molecular-weight peak chemotactic response, and the concentration of LTB4 was high enough for chemotactic activity. These findings suggest that type II pneumocytes may modulate the recruitment of monocytes into the alveolar space by releasing MCP-1, TGF-beta, and LTB4 constitutively.

Antibodies↗
PubMed1997

Studies on cardiac ingredients of plants. XIII: Chemical modification of gitoxin to cardiotonic compounds without vascular effect.

Nitrated gitoxins (4) and bufotoxin homologues with various lengths of alkyl chain at C-3 of the steroid nucleus (10) were prepared from gitoxin (1). The pharmacological activities of the resulting compounds (4 and 10) were evaluated by measurement of inhibitory effect on NA+, K(+)-adenosine triphosphatase (ATPase) prepared from dog kidney, positive inotropic effect (PIE) on isolated guinea-pig papillary muscle preparations, and the effect on smooth muscle using the mesenteric artery from spontaneously hypertensive rats. Most of the compounds showed a smaller contractile effect on the arterial muscle. Among these compounds, gitoxin 3"-nitrate (4g) exhibited the most desirable biological activities, such as PIE comparable to that of 1, 1.25 times wider concentration-dependent range than 1, and lack of contractile activity on vascular muscle.

Animals↗
PubMed1997

Studies on chemical modification of monensin. VI. Preparation of C-7 modified monensins via protected 7-oxomonensin and evaluation of their ion transport activity.

7-Carboxymethylmonensin (3), 7-aminomonensin (4), and 7-oxomonensin (5) were synthesized via protected 7-oxomonensin (2), which is expected to be a useful intermediate for the preparation of various monensin derivatives. intermediate for the preparation of various monensin derivatives. Compounds 3-5 exhibited smaller ion transport activity than monensin (1).

Calcium↗
PubMed1997

[A case of crush syndrome resulting from continuous compression of the upper arm by automatically cycled blood pressure cuff].

We report a case of crush syndrome (rhabdomyolysis) resulting from the prolonged compression of the inadvertently inflated blood pressure cuff around her upper arm. A 61-yr-old woman had undergone total gastrectomy, splenectomy and cholecystectomy for gastric cancer. At the end of the surgery lasting for 5 hrs 40 mins, we found the right upper arm extremely swollen with cyanotic petechiae beyond the inflated cuff. Failure of deflation of the automatically cycled blood pressure cuff was strongly suspected as a cause. She complained numbness and ardor on her hand with motor nerve disturbance and plasma CPK level was elevated. Diuretics were given and fluids were infused vigorously to prevent the renal failure, and continuous cervical epidural block was instituted to increase the blood flow to the injured arm. Prostaglandin E1 and ulinastatin (a protease inhibitor) were also effective for recovery from the crush syndrome. One month later she was discharged home accompanied with a slight numbness on the arm. Attention should be paid to deflation of the automatically cycled blood pressure cuff during anesthesia.

Alprostadil↗
PubMed1997

Quantitative evaluation of the IL-1 beta and IL-1 receptor antagonist obtained from BALF macrophages in patients with interstitial lung diseases.

Our previous reports demonstrated the concomitant release of IL-1 beta and IL-1 inhibitory activity in the culture supernatants of BALF macrophages in both healthy subjects and patients with interstitial lung diseases. IL-1 inhibitory activities decreased in healthy smokers (HS), and patients with sarcoidosis (Sar), or idiopathic pulmonary fibrosis (IPF), compared with those in healthy nonsmokers (HNS), though an increase in IL-1 beta release was not detected. IL-1 inhibitory activity was mainly characterized as IL-1 receptor antagonist (IL-1ra). In this study, we confirmed a decrease in IL-1ra in terms of the amounts of protein (enzyme-linked immunoassay) and gene transcripts (reverse transcriptase polymerase chain reaction followed by high performance liquid chromatography). Imbalance between IL-1ra and IL-1 beta was expressed as a molar ratio of IL-1ra/IL-1 beta protein: (Sar; 4.20 +/- 2.06, IPF; 4.26 +/- 3.41, HS; 3.44 +/- 3.09 versus NS 8.33 +/- 2.77: P < 0.001). These results were similar in terms of the amounts of gene transcripts. In conclusion, the imbalance of IL-1 beta and IL-1ra production was confirmed at three levels: biological activity, amounts of protein, and gene transcript obtained from BALF macrophages in chronic inflammatory processes in the lungs.

Adult↗
PubMed1997

[The usefulness of fibrin glue spraying combined with CDDP for lung cancer].

The local slow release of an anticancer agent by one route is a form of treatment. There have been numerous reports to date that this approach might be a promising adjuvant for systemic therapy. We investigated the spraying of the operative field at a local site with cisplatin, which is considered the most effective carcinostatic in the field of lung cancer, and reported it in clinical cases selected in applying a Pilot-Study. The feature of this method is to use fibrin to spray drugs uniformly over a wide field. We expect it will be an adjuvant for postoperative purification and other uses.

Adenocarcinoma↗
PubMed1997

[A case of thymic epidermoid carcinoma recurred in the pericardial cavity].

A 61-year-old woman with cough and sputum and right scapular pain was referred to our hospital with a suspected anterior mediastinal tumor by Chest X-rays and CT-scan. The tumor was diagnosed as thymic cancer cytologically by fine needle biopsy. At the the thoracotomy via median sternotomy, the tumor adhered to left brachial vein, superior vena cava and pericardium and it was dissected by maneuver. It was diagnosed as moderately differentiated epidermoid carcinoma by histology of the surgical specimen and involvement of the pericardium was histologically presumed. The patient received postoperative radiation therapy. A year after operation, the tumor recurred in the pericardial cavity. Inspite of resection of the recurred tumor and an anticancer chemotherapy, the patient died of cardiac failure due to the proliferated tumor around the heart. There are some reports that epidermoid carcinoma of the thymus may have different responses to radiation therapy according to histologic tumor differentiations. At resection of epidermoid carcinoma of thymus, therefore, intraoperative pathologic examination of the adhesive part of excised specimen and additional resection were essential to resect thymic cancer radically.

Carcinoma, Squamous Cell↗
PubMed1997

Immunopathology of collagen vascular disease.

In this review, we focus on the heterogeneity of interstitial lung diseases detected in patients with collagen vascular diseases. By recognizing the heterogeneity of histopathology and comparing them with bronchoalveolar lavage fluid cell findings, we can understand profiles of lung inflammation and injuries and fibrosis in collagen vascular diseases. We focus on the significance of lung lymphocytosis in the lesions of patients with collagen vascular diseases, looking most closely at lesions in unusual interstitial pneumonia. The current understanding of immunopathogenesis and immunopathological findings is reviewed in the context of subsets of collagen vascular diseases.

Collagen Diseases↗