[The clinico-pathological study of acute hepatic failure].
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Acute Disease↗
Biomedical subjects
S Shimizu
Publications and source records attributed to S Shimizu.
[A case of localized pleural mesothelioma].
A 68-year-old male with localized pleural mesothelioma was described. The tumor was removed surgically in association with left upper pulmonary lobe and regional lymph nodes, since low grade malignancy had been suggested by preoperative needle biopsy. The operative and macroscopic findings revealed that the tumor was well encapsulated and arise from visceral pleura of S3 segment of left upper lobe, projecting into pleural cavity as a pedunculated mass. The tumor measured 9 X 6 X 4 cm in diameter. Based on electron microscopic and immunohistochemical findings of the tumor, the origin of tumor cells was discussed.
Aged↗
[Megakaryocyte proportion versus nucleated cells in the peripheral blood showing leukoerythroblastosis].
Megakaryocytes in the peripheral blood in which leukoerythroblastosis was recognized were studied by electron microscopy on the vertically cut section of the buffy coat of the blood, and percentages of them in 10,000 nucleated cells distributed from the top of the bottom of the buffy coat were counted. In 15 of 31 patients, percentages of peripheral blood megakaryocytes ranging from 0.01% to 0.64% were seen. There was difference of the result among diseases shown peripheral blood megakaryocytes. Namely, in patients with myelofibrosis and CML, in whom extramedullary hematopoiesis was predominant, many cases ascertained peripheral blood megakaryocytes were demonstrated. Because of this result, the extramedullary hematopoiesis appears to play an important role to the presentation of megakaryocytes in the peripheral blood. On the other hand, patients indicating both megakaryocytes and abnormal sideroblasts in the peripheral blood had sideroblastic anemia marrow. This result seems to show that a part of megakaryocytes are directly flowed out from the marrow into the blood simultaneously accompanied with abnormal sideroblasts.
Adolescent↗
[Ga-67 citrate accumulation in heart in malignant lymphoma of B-cell type accompanied with repeated ECG abnormalities which were normalized with chemotherapy--report of an autopsy case].
A 37y/o male developed mass formation in right tibia in Oct. 1986. He had generalized lymphadenopathy. Diagnosis of malignant lymphoma of B cell type (follicular, large cell type) stage IV B was made because of bone marrow involvement. Surface marker analysis of pathologic cells in the peripheral blood, bone marrow, lymph nodes revealed that they were of B cell type with positive EA gamma rosette formation, positive surface immunoglobulin with IgM-kappa and cytoplasmic immunoglobulin with IgM-kappa and positive responses to monoclonal antibodies of OKIal and B1. He responded partially to VEPAM therapy but in Jan. 1987 he developed Ga accumulation in heart and ECG abnormalities such as depression of ST and inverted T in II, III, AVF, V1-V6 leads. After treatment with VEP, ECG abnormalities disappeared in a month. The same ECG abnormalities recurred once more and disappeared again. Autopsy findings revealed accumulation of lymphoma cells in epicardium and myocardial degeneration in right ventricle. Ga scan appears to be a valuable method for detection of early cardiac involvement by malignant lymphoma.
Adult↗
[Cytokines and rheumatoid arthritis].
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Arthritis, Rheumatoid↗
[Pharmacokinetic and clinical studies on sulbactam/ampicillin in the pediatric field].
The new antibiotic, sulbactam/ampicillin (SBT/ABPC) was administered to 25 children. The results obtained are summarized as follows. 1. In 5 cases of children administered with SBT/ABPC (30 mg/kg) by intravenous drip infusion for 30 minutes, the mean values of T 1/2 (beta) were 0.94 hour (SBT) and 0.86 hour (ABPC) and the mean 6.5 hour urinary excretion rates were 64.2% and 42.9%, respectively. 2. The antibiotic was administered to a total of 25 patients with bronchopneumonia, pneumonia, bronchitis, cervical lymphadenitis, tonsillitis, streptococcal infection, urinary tract infection, felon, periappendicular abscess, sepsis or purulent meningitis. Response to the treatment were excellent in 17 cases, good in 7, fair in 1, and poor in none. The efficacy rate was 96%. From our results, this drug appears to be particularly effective against bronchopneumonia, bronchitis and urinary tract infection. 3. Eruption occurred in 1 of 25 patients and elevation of eosinophil, GOT/GPT, platelet in 3 and descent of WBC in 1 were observed, but these were transient. These results showed that SBT/ABPC is a drug which can be safely used in the pediatric field as well as for adults.
Age Factors↗
[Appearance of chromosomally normal hemopoiesis during busulfan-induced remission in a case of Ph1 positive chronic myelogenous leukemia].
A 33-year-old female was admitted to St. Marianna University hospital in April 1983 for the purpose of examination for leukocytosis. Physical examination revealed a marked splenomegaly. The white cell count was 174 x 10(9)/l. The hemoglobin was 9.0 g/dl and the platelet was 790 x 10(9)/l. Microscopical examination of aspirated specimen of bone marrow revealed hypercellularity with granulocytic hyperplasia. The chromosomal analysis of bone marrow cells showed Philadelphia chromosomes in all metaphases analyzed. The neutrophil alkaline phosphatase activity was reduced. A diagnosis of CML was made. She was treated with busulfan in a dose of 2 mg/day until the white cell count was 14.5 x 10(9)/l. She has been followed without any therapy and clinical remission state has been continued. In April 1985, the chromosomal analysis of bone marrow cells revealed the recovery of normal karyotype hemopoiesis in 57% of metaphases analyzed. These findings of this case suggest that some of Ph1-positive cells may reduce their growth advantage over normal cells without any bone marrow hypoplasia.
Adult↗
[Recent problems in colonoscopy for the diagnosis of colorectal cancer].
Colonoscopy is valuable for the correct diagnosis of colorectal cancers and polyps, and it is widely utilized as the routine examination. One of our recent interests in colonoscopy has been how to diagnose minute lesions accurately. For the purpose, magnifying endoscopy using the magnifying colonoscope (type CF-HM and CF-UHM, Olympus), videoendoscopy, endoscopic ultrasonography, and so on, have been evaluated as a future colonoscopy.
Colonic Polyps↗
[Development of laser systems in the treatment of hyperpigmented skin lesions].
Laser beams have been in common use for the treatment of hyperpigmented skin lesions. However, therapeutic efficacy has been limited mainly because the output is circular with a Gaussian distribution of intensity, which makes it difficult to apply a uniformly distributed dose to the lesions. We have developed a technique whereby a laser beam is converted to have a square and uniform output intensity distribution. The principle of this technique is that the divergent laser beam enters a glass square pillar, propagates through the pillar repeating the total reflection and emerges with a uniform intensity distribution over the cross-section at the end of the pillar. The device applied this technique is incorporated in a hand-piece and both ruby and argon laser systems have been developed. The ruby laser has been used for the treatment of the melanistic skin lesions such as nevus cell nevus and nevus spilus. In clinical application, 36 of 67 cases have shown remarkably effective results with an improvement rate of 53.7%. The argon laser has been used for the treatment of vasogenic skin lesions such as portwine stain. In clinical application, 44 of 66 cases have shown effective results and the improvement rate is 66.7%. These results are excellent when compared with the other methods of treatment and with laser therapy previously used.
Humans↗
[Topographical anatomy of the atrioventricular node of Tawara--findings by macro-microscopic dissection under dissecting microscope].
The atrioventricular node of Tawara was dissected macroscopically under dissecting microscope with scalpel and microforceps. The node is a flat and fan-shape mass of the specialized cardiac muscular tissue, which is sandwiched between the floor of the right atrium and the right fibrous trigone as an epi- or extra-myocardial structure, in the center of the heart as a whole. The node is situated in the apical (anterior) angle of the triangle of Koch, and does not show any individual variation in its location, occupying the same site topographically. Orifice of the coronary sinus is not proper to indicate the location of the node, because orifice of the coronary sinus changes its position individually. Clinically, the location of the node can be presumed correctly by identifying the important anatomical landmarks; postero-inferior angle of the membranous portion of the interventricular septum, commissure between the septal and the accessory (or anterior) cusps of the tricuspid valve, attachment line of the septal cusp, and the tendon of Todaro.
Adult↗
[Graft versus host disease in a human T cell leukemia virus-I carrier].
A 24 year-old woman developed severe congestive heart failure due to combined aortic and mitral valve failures associated with infectious endocarditis. She was operated on double valve replacement. At the open heart surgery, 7 units of blood were transfused. Her postoperative course was complicated with LOS and renal failure. She recovered gradually with assistance of intraaortic balloon pumping and hemodialysis. High fever, diarrhea, skin rash and impaired liver function appeared on the 10th postoperative day. Neither leukocytopenia or pancytopenia was seen. In blood cultures, organism was negative and endotoxemia was also negated after operation. Erythroderma developed rapidly after desquamation of skin rash. The skin sample showed the typical features which were observed in a graft-versus-host (GVH) disease. The patient died of cerebral bleeding on the 32nd postoperative day. In the HLA typing, two unmatched antigens of class II were exhibited in her lymphocyte sample but all of class I were matched. Y-chromatin was not detected in her lymphocytes. Anti-nuclear antibody was positive. The fact is noteworthy that she and her parents were human T lymphotropic virus-I (HTLV-I) carriers. In the literature, HTLV-I is activated in the immunocompromised state and yields alien antigens of major histocompatibility complex (MHC) in T cells, then the reaction is very similar to it in autoimmune disease. That mechanism may be involved in the cause of GVH reaction in our case. These results suggested that the GVH reaction in our case.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Laboratory and clinical investigations of cefodizime in infectious diseases in childhood].
In this study, cefodizime (CDZM, THR-221) was administered to 34 children with infections and the efficacy was evaluated in 30 patients. The efficacy rate was 90.0% and CDZM was proved to be a highly effective antibiotic for infectious diseases in childhood. We also demonstrated that CDZM had strong antibacterial activities against both Gram-positive and Gram-negative bacteria. No severe toxicity related to intravenous injection of CDZM was observed in our 34 cases.
Age Factors↗
[Spontaneous remission in a case of non-Hodgkin's lymphoma].
A 59-year-old-male was admitted in September 1984 with fever and right hypochondrial pain. On computed tomography, a bulky retroperitoneal tumor involving the intestine was detected. Exploratory laparatomy yielded a diagnosis of non-Hodgkin's lymphoma. Although intensive and aggressive treatment combined chemotherapy and radiotherapy was administered, no conclusion could be drawn about its efficiency, and no remission was indicated by followup studies. He refused further treatment because of bone marrow depression. However, 9 months after the last treatment disappearance of the tumor was recognized on computed tomography examination. This phenomenon was confirmed by the second laparatomy performed in order to treat skin-colon fistula caused from diverticulitis of the colon. It was recognized no evidence of malignant lymphoma in the resected colon specimen. He remains in excellent health 26 months after this events. The clinical course of this case was probably compatible with the concept of spontaneous remission of malignant lymphoma.
Humans↗
[A clinical experience of ofloxacin in patients with respiratory infection].
To a total of 31 patients (18 in- and 13 out-patients) having respiratory infections, we administered ofloxacin (OFLX) orally at a daily dose of 300 to 600 mg and examined its clinical effect. The clinical effect in the 31 cases was as good as 83.9%. Among these cases, 6 cases showed Pseudomonas aeruginosa, thereby indicating the effective rate of OFLX at 50%. In the present examination, we experienced cases in which OFLX-resistant P. aeruginosa appeared in the cases of long-term administration of OFLX. Therefore, our clinic carried out the sensitivity test of P. aeruginosa against OFLX, gentamicin (GM) and imipenem (IPM) in 1987, using clinically-segregated strains of P. aeruginosa obtained by sputum tests. The sensitive strains, which were 100% sensitive to OFLX, GM, IPM respectively in 1985, showed, in segregated strains in 1987, sensitivity of OFLX 57.1%, GM 85.7% and IPM 100%, thus indicating the high resistance-acquiring frequency of P. aeruginosa against OFLX.
Adult↗
Identification of two novel members of erbA superfamily by molecular cloning: the gene products of the two are highly related to each other.
Two v-erbA-related genes, named ear-2 and ear-3, have been identified in the human genome and characterized by cDNA cloning. These genes are predicted to encode proteins that are very similar in primary structure to receptors for steroid hormones or thyroid hormone (T3). In addition, amino acid sequences of the ear-2 and ear-3 gene products are very similar each other especially at the DNA binding domain (86% homology) and at the putative ligand binding domain (76% homology). Northern hybridization with ear DNA probes of RNAs from various tissues of a human fetus reveals that the expression of ear-2 is high in the liver whereas the expression of ear-3 is relatively ubiquitous. Hybridization analysis of DNAs from sorted chromosomes shows that the ear-2 gene is located on chromosome 19 and ear-3 on chromosome 5, indicating that the two genes are clearly different from each other.
Alpharetrovirus↗
Anti-bilirubin monoclonal antibody. I. Preparation and properties of monoclonal antibodies to covalently coupled bilirubin-albumin.
We have prepared 16 anti-bilirubin monoclonal antibodies and described their unique reactivity to bilirubin and related compounds. Using the modified mixed anhydride method, bilirubin was covalently coupled to bovine serum albumin. We performed somatic cell fusion between murine spleen cells immunized with this bilirubin-albumin complex and murine myeloma P3-X63-Ag8-U1 cells. After screening assays, 16 clones were identified which were producing antibodies not to albumin but to haptenic bilirubin. In inhibition analysis, the antibodies in the culture supernatants cross-reacted with bilirubin glucuronides to varying degrees, but rarely reacted with structurally related biliverdin, hemin, and azodipyrroles of bilirubin. Albumin, when present in the solution, much reduced the reactivity of several monoclonal antibodies to unconjugated bilirubin, and this effect was partly reversed by addition of salicylate which dissociates the binding between bilirubin and albumin.
Animals↗
Anti-bilirubin monoclonal antibody. II. Enzyme-linked immunosorbent assay for bilirubin fractions by combination of two monoclonal antibodies.
Among 16 monoclonal antibodies raised against covalently coupled bilirubin-bovine serum albumin, we selected two antibodies: one (designated 24G7) reacted with unconjugated and conjugated bilirubin and the other (designated 25H17) reacted only with unconjugated bilirubin. Combination of these two antibodies enabled us to determine extremely low concentrations of unconjugated and conjugated bilirubin independently by enzyme-linked immunosorbent assay (ELISA). In the assay, samples were incubated with each anti-bilirubin IgG, and then free remaining IgG was allowed to bind to the immunotiter plates coated with bilirubin-bovine serum albumin. The bound fraction of the IgG was visualized with horseradish peroxidase-conjugated rabbit anti-mouse IgG and substrate. Bilirubin concentration was determined from the absorbance at 425 nm. In this system, we could measure 10(-7)-10(-5) M unconjugated and conjugated bilirubin in samples, which is 100-fold more sensitive than Michaëlsson's diazocoupling method. The assay results gave a good correlation coefficient (0.86) compared with those determined with high performance liquid chromatography.
Antibodies, Monoclonal↗
Ketopantoic acid reductase of Pseudomonas maltophilia 845. Purification, characterization, and role in pantothenate biosynthesis.
Ketopantoic acid reductase (EC 1.1.1.169), an enzyme that catalyzes the formation of D-(-)-pantoic acid from ketopantoic acid, was purified 6,000-fold to apparent homogeneity with a 35% overall recovery from Pseudomonas maltophilia 845 and then crystallized. The relative molecular mass of the native enzyme, as estimated by the sedimentation equilibrium method, is 87,000 +/- 5,000, and the subunit molecular mass is 30,500. The enzyme shows high specificity for ketopantoic acid as a substrate (Km = 400 microM, Vm = 1,310 units/mg of protein) and NADPH as a coenzyme (Km = 31.8 microM). Only 2-keto-3-hydroxyisovalerate (Km = 8.55 mM, Vm = 35.8 units/mg) was reduced among a variety of other carbonyl compounds tested. The reaction is reversible (Km for D-(-)-pantoic acid = 52.1 mM), although the reaction equilibrium greatly favors the direction of D-(-)-pantoic acid formation. That the enzyme is responsible for the synthesis of D-(-)-pantoic acid necessary for the biosynthesis of pantothenic acid in P. maltophilia 845 is indicated by the observations that only this enzyme is missing in D-(-)-pantoate (or pantothenate)-requiring mutants derived from P. maltophilia 845 among several enzymes (i.e. ketopantoyl lactone reductase (EC 1.1.1.168) and acetohydroxy acid isomeroreductase (EC 1.1.1.86], which may be concerned in the formation of D-(-)-pantoic acid, assayed, whereas it is present in substantial amounts in the parent strain and in spontaneous revertants of the mutants.
Alcohol Oxidoreductases↗