[Studies on renal damage in percutaneous nephroureterolithotomy: a morphological study].
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Biomedical subjects
Publications and source records attributed to S Ueda.
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This report extends our previous study on experimental autoimmune hepatitis in C57BL/6(B6) mice. Cellular immunity involved in the induction of liver injury in this model was studied by transfer of primed spleen cells from hepatitis donor mice to syngeneic normal recipient mice. The most prominent liver damage in recipient B6 mice was induced by transfer of nylon wool adherent spleen cells from hepatitis donor mice, and T cells in this fraction were the essential requirement for the liver damage in the recipient mice. Nylon wool adherent spleen cells from hepatitis donor mice after depletion of the suppressor T-cell function by low-dose (300 rad) irradiation induced more severe liver injury compared to the same cells without irradiation. When the recipient mice were depleted of lymphocytes by low or high dose (700 rad) whole body irradiation, transfer of primed spleen cells from hepatitis donor mice did not induce liver lesion in the lymphocyte-depleted mice. This low susceptibility of lymphocyte-depleted recipient mice to primed spleen cells of hepatitis mice was no longer demonstrated after reconstitution with normal spleen cells. In a cell-migration study using 51Cr-labelled spleen cells, it was shown that a considerable number of infiltrating cells in the liver of recipient mice were derived from recipient mice themselves. These results seem to indicate that cell-to-cell interaction between radiosensitive precursor cells of recipient mice and liver-antigen-primed T cells from hepatitis donor mice play an essential role in the induction of liver injury in the recipient mice.
A case of transorbital intracranial foreign bodies due to windshield impact was reported. A 17-year-old man was admitted to our department after he had his face injured in a traffic accident. He was fully conscious, and had no neurological deterioration except for a disturbance in his left external ocular movement. Plain skull X-rays and a plain CT revealed foreign bodies in the left orbit and the left frontal lobe. Combined surgery, through the orbit and the subfrontal approach, was performed to remove many foreign bodies (crushed windshield glass). His external ocular movement returned to normal postoperatively. There were no complications of meningitis and liquorrhea, and he was discharged without any neurological deficiency. The law, enacted in 1988, obliges the use of high penetration resistant (H.P.R.) laminated windshield in all new cars in Japan. But many motor cars equipped with partially enhanced windshields are still in use. It should be noted that partially enhanced windshields cause more severe injuries than H.P.R. laminated ones.
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From May 1976, through May 1985, eighty-nine patients with hypertensive cerebellar hemorrhage were admitted to our university hospital and affiliated hospitals. The age at onset ranged from 42 to 86 years, with a mean of 65.1 years. Thirty-one of these patients underwent conservative treatment, 20 were given ventricular drainage, 23 underwent suboccipital craniectomy and 15 underwent stereotaxic aspiration surgery. The patients were classified into four categories according to the grading of hypertensive cerebellar hemorrhage proposed by Matsumoto in 1982. Twenty-two cases were of benign type, 20 were moderate type, 30 were severe type, and 17 were fulminant type. The 22 benign type cases showed good recovery (ADL 1 or ADL 2), whereas the mortality rate of severe type cases was 26.7%, and that of fulminant type cases was 70.6%. The site and extension of hematoma were identified by CT. Fourty cases (45.0%) were confined to the left hemisphere, and 19 (21.3%) were localized in the vermis. When the hematoma volume was more than 15 ml, surgical evacuation of the hematoma was considered. Since 1981, stereotaxic aspiration surgery has been performed in cases of hypertensive cerebellar hemorrhage with a mean patient age of 66.9 years, ranging from 51 to 82 years. Patients treated have consisted of 2 with moderate type hemorrhage, 10 with severe type, and 3 with fulminant type, with an overall surgical mortality rate of 33.3%. However, the outcome of fulminant type hemorrhage has remained ADL 2 or ADL 3. The benefits of this type of surgery are that it is not only indicated as an emergency treatment for patients who are aged or at high risk, but that it can be also performed for fulminant type hemorrhage.
Recently percutaneous transluminal coronary recanalization therapy (PTCR) with urokinase infusion has became one of popular technique for coronary arterial occlusion. This paper reported clinical experience of intraarterial urokinase infusion therapy for acute or superacute stroke patients. The procedure was followed by angiographical study which revealed the major intracerebral arterial occlusion in three cases. Case 1: A 74-year-old female had sudden onset of clouding of consciousness with complete left hemiplegia. The patient was in our urological ward because of treatment for her right ureter tumor, as the patient was immediately subjected to angiographical study and complete occlusion of the trunk of the right middle cerebral artery was revealed four hours after onset. Successively 240,000 IU of urokinase solution was injected through the arterial catheter after angiographical study. This procedure repeated two times with 10 minute intervals. So total amount of 720,000 IU of urokinase was given by intraarterial injection. Immediately after the last urokinase injection the patient started to recover her consciousness and weakness. Simultaneous angiogram demonstrated partial recanalization of the proximal branches of the middle cerebral artery. The following day, she had complete recovery from her neurological deficits although she had transient hemorrhagic tendency. The final angiogram showed no existence of obstructed cerebral arteries as well as no low density areas in computed tomographic images. Case 2: A 73-year-old female, with the left internal carotid occlusion at the site of C1-2 portion, was instituted infusion therapy of similar procedure with total amount of 960,000 IU oi urokinase ten to twenty hours after onset. However, no rewarding was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)
A case of 3-month-old girl with lumbosacral lipoma is reported. She had a large soft tissue mass (4 X 5 cm) in the lumbosacral region initially noted at birth. Interpendicular distances below L2 were dilated on X-P. CT image demonstrated a sharply outlined low density area (approximately -80 H. U.) which occupied the latter half of the spinal canal in the level of L2 to S1 level. Defect of vertebral arch was also seen. Lipoma was removed subtotally with laminectomy. CT image demonstrated clear sharp margin of the tumor, neural tissue free zone were not found intraoperatively. Post-operative course was uneventful. Specimen showed the mature adipose tissue which contained rich blood vessels and connective tissue. Connective tissue was composed of collagen fibers and elastic fibers. Small aberrant nerve fibers and smooth muscle fibers were sporadically noted in specimens obtained from nearby transitional area of its lipoma and spinal cord. Although there were a few reports about the morphology of lipoma, the existence of nerve cell, neuroglia, embryonic bone, cartilage, smooth muscle fiber, striated muscle fiber, respiratory-like cell and others were reported in the previous reports. Our histological findings also suggest that the lipoma possibly arise from pluripotential caudal cell mass which survived by disturbance of the 3rd stage of neural tube formation (retrogressive differentiation).
Advances in the surgical approach to the orbital fossa have resulted in an increase in the cure of tumors involving the optic nerve and the external ocular muscles. In the past 10 years we have encountered 12 cases with orbital fossa tumors, excluding ocular tumors and inflammatory disease case. After tumor removal surgery, new neurological deficits such as total ophthalmoplegia were caused in many cases, where surgery was performed by classical Krönlein's technique or Dandy's transfrontal approach. So we thought that a new method for tumor removal should be contrived to improve postoperative results. Recently we have had four cases with large orbital tumors (3 cavernous angiomas and one schwannoma). In order to protect visual acuity and external ocular muscle function, we have devised a modification of the frontal craniotomy technique, the "combined fronto-orbital approach". Using our new method, we have successfully removed these four orbital tumors and with good postoperative results. We have concluded that our new technique is superior to other transfrontal approaches on several points as follows: 1) Decreased avoidable compression against the orbital contents and a decrease in the risk of tearing the frontal lobe dura and the peri-orbital during fronto-orbital craniotomy. 2) Satisfactory external decompression and a wide operative field are obtained with simple and safe procedures. 3) Previously detaching the superior rectal muscle makes it easy to distinguish the orbital fossa pathoanatomy and to remove a tumor. 4) Good results are easily obtained in the reconstruction of the orbital roof and the orbital rim, especially in the prevention of postoperative bulbar pulsation and from cosmetic view point.
Purified murine tubular basement membrane (TBM) antigen (molecular weight, 32,000) induced interstitial lesions in Brown Norway (BN) rats. TBM antigen prepared from mice of 3 inbred strains--BALB/c, C3H/He, and C57BL/6--and outbred ddY mice possessed both antigenicity and nephritogenecity. Using these TBM antigens, the roles of humoral and cellular immunity in the development of interstitial nephritis (IN) and the genetic control of the induction of IN in inbred mice were investigated. BALB/c mice were highly susceptible to IN and showed a high antibody response and a high lymphocyte proliferative response to syngeneic and allogeneic TBM antigen, whereas C57BL/6 mice did not. C3H/He mice, in which minimal interstitial lesions developed, showed a high antibody response but a low proliferative response of T cells to TBM antigen. TBM antigen sensitized T cells induced interstitial lesions, but anti-TBM antisera did not do so. Thus, the development of IN seemed to be related closely to cellular immunity. Further studies with their hybrids, backcrosses, congenic mice, and recombinant mice suggested that the induction of IN and the immune response to TBM antigen are controlled by 1 or a few dominant genes, whose loci are within, or closely linked to, the H-2 complex.
Although atrial natriuretic peptide (ANP) has recently been verified to function as a neuropeptide in the central nervous system, its definite identification has not been done so far. We have isolated two ANP-related peptides from porcine brain by utilizing alpha-ANP specific radiommunoassay coupled with immunoaffinity chromatography and reverse phase HPLC. By structural analyses, these two peptides were determined to be alpha-ANP [4-28] and alpha-ANP [5-28]. They were found to elicit chick rectum relaxant activity comparable to alpha-ANP. These results indicate that proteolytic processing of ANP precursor in the central nervous system takes place in a manner different from that in heart and plasma, where gamma-ANP and alpha-ANP are known to be the main components of ANP, respectively.
Liver-specific F antigen was detected in serum using human-specific guinea pig antiserum, in 75 out of 121 patients with various liver diseases. The antigen was detectable in most of the patients (86.7%) with hepatocellular carcinoma, and the levels of F antigen were often high in these patients. There was no correlation between the levels of F antigen and alpha-fetoprotein. Temporal changes of serum F antigen level were also studied in patients with hepatocellular carcinoma. In 8 out of 13 patients with hepatocellular carcinoma, serum F antigen level remained continuously high, and in these patients, it had been significantly high for several months to one year before hepatocellular carcinoma became clinically detectable. Extracts of hepatocellular carcinomas obtained by necropsy was examined for the presence of F antigen, and it was found that most of hepatocellular carcinomas contained the human-specific determinant of F antigen, but lacked the species non-specific determinant of the antigen. The use of human-specific anti-F antiserum may facilitate early detection of hepatocellular carcinoma in some patients.
Continuously proliferating T-lymphoblastoid cells, named MDCC-MTB1, were obtained by infection of chick embryo lymphocytes with Marek's disease virus serotype I (MDV1) in culture and subsequent cultivation in the presence of human interleukin 2 (IL-2). The MTB1 cells have now been growing well for at least 4 months with a doubling time of about 10 hr, irrespective of the presence of IL-2. The MTB1 cells show lymphoblastoid morphology, and carry T-lymphocyte marker surface antigens and a karyotype of female chick origin with several abnormal chromosomes. Southern blot hybridization showed that they contain about 10 virus genome equivalents/cell of almost the whole MDV genome. Infectious virus could not be rescued from MTB1 cells by co-cultivation of these with chick embryo fibroblasts. In addition, no virus particles were found in thin-sectioned MTB1 cells by electron microscopy. An immunofluorescence test with monoclonal antibody (MAb) to MDV-specific phosphorylated proteins showed that MTB1 cells expressed the MDV-specific antigen in the cytoplasm only after the cells had been treated with 5-iodo-2-deoxyuridine for 48 hr at 41 degrees C. MTB1 cells can form colonies in 0.33% soft agar, and can be transplanted into chicks by i.p. injection. Thus, continuously growing lymphoblastoid cells were obtained by in vitro infection of chick embryo lymphocytes with oncogenic MDV1 and cultivation of the cells in the presence of human IL-2 during the transformation step. These cells appear to show a similar phenotype to an MD lymphoma-derived cell line.
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Verapamil inhibited Na+-dependent uptake of serotonin (5-HT) by bovine pulmonary artery endothelial cells in culture both exposed to room air and stimulated by prior exposure to anoxia. The effect of verapamil occurred even in the absence of Ca2+ from the assay medium. Although absence of Ca2+ from the medium moderately reduced 5-HT uptake, stimulation of uptake was nevertheless observed for cells previously exposed to anoxia. Verapamil altered the Km, but not the Vmax, of 5-HT uptake. There was no change in 45Ca2+ uptake or release by cells previously exposed to anoxia as compared to those exposed to room air and verapamil did not influence 45Ca2+ fluxes by either set of cells. It is concluded that verapamil inhibits 5-HT uptake by endothelial cells through a mechanism other than Ca2+ channel blockade; the results are consistent with competitive inhibition of a 5-HT carrier. The stimulatory effect of anoxia on 5-HT uptake does not occur through a change in Ca2+ fluxes.