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T Akimoto

Publications and source records attributed to T Akimoto.

At least 127 records · Page 7Linked to original sources

Stress-dependent antinociceptive effects of carbamazepine: a study in stressed and nonstressed rats.

1. The present study examined the antinociceptive effects of carbamazepine on the tail flick test in stressed and nonstressed rats. 2. Carbamazepine produced a bimodal antinociceptive effect in stressed rats, the first peak appearing 30 min and the second 4 h after injection. Antinociceptive effect was not observed in nonstressed rats. 3. The secondary, but not the initial, carbamazepine antinociception in stressed rats was blocked by naloxone (0.2 mg/kg, i.p.), an opioid receptor antagonist. 4. Caffeine (5 mg/kg, i.p.), an adenosine A1/A2 receptor antagonist, inhibited the both initial and secondary antinociceptive effects of carbamazepine in stressed rats. 5. Carbamazepine increased the antinociceptive effect induced by either i.p. or i.c.v. administration of N6-cyclohexyl adenosine (CHA), an adenosine A1 receptor agonist, in stressed rats, but decreased it in nonstressed rats. 6. These results suggest that the initial antinociceptive effect of carbamazepine in stressed rats may be produced via an activation of the adenosine A1 receptors, such as was produced by CHA. The secondary long-lasting antinociceptive effects of carbamazepine may be mediated by an activation of opioid systems. 7. Furthermore, the initial activation of the adenosine A1 receptors by carbamazepine may be a triggering factor for the subsequent long-lasting activation of the opioid system, which results in the antinociception effects.

Adenosine↗

Modification of cataleptic responses to dopamine receptor antagonists after withdrawal from chronic cocaine or cocaine plus dopamine antagonist administration.

1. In mice pretreated chronically with cocaine (indirect dopamine agonist: 10 mg/kg, s.c. on alternating days for 15 days), haloperidol (dopamine D2 antagonist: 0.3 mg/kg i.p.) exerted an enhanced cataleptic response, but SCH23390 (dopamine D1 antagonist: 0.3 mg/kg i.p.) produced an attenuated response at 24 h, which converted to a supernormal response, when it was administered 15-60 days after withdrawal from cocaine. 2. A challenge dose of SCH23390 exhibited enhanced catalepsy when given 15 days, but not at 24 h, after the last pretreatment dose of SCH23390 (0.1-1.0 mg/kg s.c.). In contrast, haloperidol catalepsy was not affected by the SCH23390 pretreatment. 3. However, in animals chronically pretreated with haloperidol (0.1-1.0 mg/kg s.c.), a challenge dose of SCH23390 as well as haloperidol exhibited attenuated cataleptic effects at 24 h and normal cataleptic responses at 15 days after the last dose of the pretreatment regimen. 4. Challenge doses of haloperidol or SCH23390 given to mice 24 h after chronic cocaine pretreatment produced enhanced and attenuated cataleptic responses, respectively; however, these responses were no longer produced when haloperidol or SCH23390 was given to mice pretreated chronically with a combination of cocaine and either haloperidol or SCH23390. 5. The enhanced catalepsy produced by a challenge dose of SCH23390 (15-60 days after chronic cocaine) was further potentiated when it was administered to animals that had been pretreated chronically with a combination of SCH23390 and cocaine, but was antagonized in animals pretreated chronically with haloperidol and cocaine. In contrast, the degree of enhanced cataleptic responses produced by a challenge dose of haloperidol 30-60 days after pretreatment chronically with a combination of cocaine + SCH23390 was similar to that seen after chronic cocaine alone. However, this enhanced response was antagonized in animals that had been pretreated chronically with the combination of cocaine + haloperidol. 6. The results suggest that the coadministration of SCH23390 with cocaine was able to block indirectly dopamine D2 receptor inhibition (subsensitivity) induced during the early withdrawal period from chronic cocaine, despite the fact that by itself SCH23390 did not have an effect on haloperidol catalepsy. Accordingly, the stimulatory effects of dopamine D2 receptors by a single administration of cocaine may be mediated mainly by an indirect stimulation of dopamine D2 receptor function via its D1 receptor stimulating action. 7. The coadministration of SCH23390 with cocaine rather aggravate the subsensitive effect of dopamine D1 receptors (increased SCH23390 catalepsy) produced during long-term withdrawal period from chronic cocaine, but did not affect that of the dopamine D2 receptor. On the other hand, the coadministration of haloperidol with cocaine normalized both D1 and D2 receptor subsensitive effect. 8. These result suggest that a single administration of SCH23390 or haloperidol after long-term withdrawal periods from chronic cocaine may not be effective as antipsychotic drugs because of further aggravation of suppressive behaviors. These results also provide evidence that D2 receptor antagonists may be more effective as antipsychotic drugs than dopamine D1 receptor antagonist, since the coadministration of haloperidol with cocaine normalized the abnormal behaviors seen during early and long-term withdrawal periods from chronic cocaine.

Animals↗

Force-velocity relation of sliding of skeletal muscle myosin, arranged on a paramyosin filament, on actin cables.

To investigate in vitro ATP-dependent sliding of regularly arranged myosin molecules on actin filaments, we prepared thick hybrid filaments in which myosin molecules isolated from rabbit skeletal muscle were arranged around the paramyosin core (length, 10-20 micron; diameter, </=0.2 micron) obtained from a molluscan smooth muscle. A single to a few thick hybrid filaments were attached to a polystyrene bead (diameter, 4.5 micron; specific gravity, 1.5) and made to slide on actin filament arrays (actin cables) in the internodal cell of an alga, mounted on the rotor of a centrifuge microscope. The bead was subjected to centrifugal forces serving as external loads to the ATP-dependent actin-myosin sliding. The maximum unloaded sliding velocity of the thick filament attached-bead (mean, 3.4 micron/s; 20-23 degrees C) was significantly higher than that of the bead coated with randomly oriented myosin molecules reported previously. The steady-state force-velocity (P-V) relations obtained were qualitatively similar to those in intact skeletal muscle fibers. These results indicate that this in vitro motility assay system retains the basic characteristics of contracting skeletal muscle fibers, and that it may be effectively used to study mechanisms underlying the steady-state P-V characteristics of ATP-dependent actin-myosin sliding using various recombinant myosins produced in nonmuscle cells.

Actin Cytoskeleton↗

Dynamic electron microscopy of ATP-induced myosin head movement in living muscle thick filaments.

Although muscle contraction is known to result from movement of the myosin heads on the thick filaments while attached to the thin filaments, the myosin head movement coupled with ATP hydrolysis still remains to be investigated. Using a gas environmental (hydration) chamber, in which biological specimens can be kept in wet state, we succeeded in recording images of living muscle thick filaments with gold position markers attached to the myosin heads. The position of individual myosin heads did not change appreciably with time in the absence of ATP, indicating stability of the myosin head mean position. On application of ATP, the position of individual myosin heads was found to move by approximately 20 nm along the filament axis, whereas no appreciable movement of the filaments was detected. The ATP-induced myosin head movement was not observed in filaments in which ATPase activity of the myosin heads was eliminated. Application of ADP produced no appreciable myosin head movement. These results show that the ATP-induced myosin head movement takes place in the absence of the thin filaments. Because ATP reacts rapidly with the myosin head (M) to form the complex (M. ADP.Pi) with an average lifetime of >10 s, the observed myosin head movement may be mostly associated with reaction, M + ATP --> M.ADP. Pi. This work will open a new research field to study dynamic structural changes of individual biomolecules, which are kept in a living state in an electron microscope.

Actin Cytoskeleton↗

Antirheumatic agents: novel methotrexate derivatives bearing a benzoxazine or benzothiazine moiety.

Novel methotrexate (MTX) derivatives bearing dihydro-2H-1,4-benzothiazine or dihydro-2H-1,4-benzoxazine were synthesized and tested for in vitro antiproliferative activities against human synovial cells (hSC) and human peripheral blood mononuclear cells (hPBMC) obtained from patients with rheumatoid arthritis and healthy volunteers, respectively. In vivo antiarthritic activities of these derivatives were also evaluated in a rat adjuvant arthritis model. N-[[4-[(2,4-Diaminopteridin-6-yl)methyl]-3,4-dihydro-2H-1, 4-benzothiazin-7-yl]carbonyl]-L-glutamic acid (3c) exhibited more potent antiproliferative activities in hSC and hPBMC than MTX in vitro. Antiproliferative activities of N-[[4-[(2,4-diaminopteridin-6-yl)methyl]-3,4-dihydro-2H-1, 4-benzoxazin-7-yl]carbonyl]-L-homoglutamic acid (3b) and N-[[4-[(2,4-diaminopteridin-6-yl)methyl]-3,4-dihydro-2H-1, 4-benzothiazin-7-yl]carbonyl]-L-homoglutamic acid (3d) (MX-68) were comparable to that of MTX in these in vitro assays. Compounds 3b,d (MX-68) significantly suppressed progression of the adjuvant arthritis in a dose-dependent manner ranging from 0.5 to 2.5 mg/kg (po). In addition, 3d (MX-68) completely suppressed this progression at the dose of 2.5 mg/kg (po). Importantly, 3d (MX-68) having benzothiazine and homoglutamate, as expected, did not undergo polyglutamation, a process which may be responsible for the associated side effects of MTX. These results suggest that 3d (MX-68) is a potent and safe candidate antirheumatic agent, absent of the side effects of MTX.

Animals↗

Split-course accelerated hyperfractionation radiotherapy for advanced head and neck cancer: influence of split time and overall treatment time on local control.

We analyzed 52 patients with stage III and IV head and neck cancer who were given split-course accelerated hyperfractionated radiotherapy with curative intent, focusing particularly on the influence of split-time on local control. An initial complete response was achieved in 16 patients (31%), and the rate of persistent local control at 3 years was 23%. The cause specific survival rate at 3 years was 29%. Univariate analysis of local control according to the split-time duration and overall treatment time showed that shorter duration (< or = 14 days or < or = 45 days, respectively) had a significantly positive impact on local control (P < 0.05). Multivariate analysis using local control as an endpoint also demonstrated that gender (women showing a better outcome than men) and split-time (< or = 14 days was better than > 14 days) were statistically significant factors for local control. These results suggest that shortening the split-time during radiotherapy might improve local control in accelerated hyperfractionation.

Adult↗

Evaluation of effect of treatment for invasive bladder cancer by ultrasonography with intra-arterial infusion of carbon dioxide microbubbles.

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the diagnostic usefulness of the ultrasonography with intra-arterial infusion of carbon dioxide microbubbles (CO2) for invasive bladder cancer. METHODS: Twelve patients with muscle-invading bladder cancer who were treated by concurrent radiotherapy and intra-arterial infusion of daily low dose of cisplatin using an implanted infusion port were included. A total of 30 studies was performed during the treatment to evaluate the visualization of the tumor and effect of the treatment compared with conventional ultrasonography, computed tomography, or cystoscopy. RESULTS: Satisfactory visualization of the tumor in CO2 ultrasonography was obtained in all patients, in particular in those with flat tumor or prostatic invasion. The enhancement effect of CO2 on the tumor, which was maintained well in the late period of the treatment, made possible evaluation of the therapeutic effect. With respect to the evaluation of local response, disagreement between clinical response and the evaluation of CO2 ultrasonography was observed in two patients with definite differentiation between wall edema and residual tumor after treatment being difficult. CONCLUSIONS: Carbon dioxide ultrasonography is easy to perform in patients treated with arterial infusion therapy using an implanted infusion port and provides practical information in evaluating therapeutic effect.

Aged↗

Effective cross-circulation technique of venoarterial bypass for differential hypoxia condition.

We examined a new technique of cross-circulation (CC) venoarterial bypass (VAB) with femoral arterial perfusion and superior vena cava drainage through a long femoral venous cannula. Six adult mongrel dogs weighing 15 to 20 kg underwent the CC-VAB with oxygenation after introduction of respiratory failure (RF). The flow of the CC-VAB was maintained at half the level of the control cardiac output, and the hemodynamic parameters were monitored. To evaluate hypoxia in the upper body, the arterial partial pressure of oxygen (PaO2 [mm Hg]) in the carotid artery and the venous saturation of oxygen (SvO2 [%]) in the pulmonary artery were measured during control, RF, standard VAB, and CC-VAB conditions. The PaO2 decreased significantly after the introduction of RF (41.7 +/- 12.4), and it returned to normal levels only after CC-VAB (151.2 +/- 24.5, p < 0.05). The SvO2 during CC-VAB (98.6 +/- 2.1) was significantly higher than that during VAB without CC (53.5 +/- 3.4, p < 0.05). These results suggest that this cross-circulation technique could be applied to patients with differential hypoxia during femoral VAB with oxygenation or percutaneous cardiopulmonary support (PCPS).

Analysis of Variance↗

[Relapsing polychondritis: a case with respiratory failure].

A 48-year-old woman was admitted to our hospital with respiratory failure (Hugh-Jones IV-V). She was diagnosed as relapsing polychondritis 6 years ago. Her respiratory failure was due to pharyngial stenosis, deformity and inflammation of a trachea and lobar bronchus, and bronchial collapse. Her tracheobronchochondritis was managed by 500-700 mg/day of hydrocortisone and 50 mg/day of cyclophosphamide. Laboratory examination revealed only slight elevation of CRP and no elevation of anti-type II collagen antibody, although these parameters were very high on her first admission when she had severe polyarthritis, polychondritis of nose and auricles. Bronchoscopic findings were compatible with tracheobronchomalacia since pharyngial stenosis due to inflammatory pharyngitis and bronchial collapse due to tracheobronchochondritis were shown without lung parenchymal damage. We referred to the literature on tracheobronchomalacia which was associated by the varieties of respiratory and rheumatic diseases.

Female↗

Antitumor effect of DT-5461, a lipid A derivative, against human tumor xenografts is mediated by intratumoral production of tumor necrosis factor and affected by host immunosuppressive factors in nude mice.

We previously reported that DT-5461, a synthetic low-toxic lipid A analog, inhibits growth of various murine tumors through activation of host immune systems. In the present study, DT-5461 also exhibited significant antitumor effects against 5 out of 6 human tumor xenografts in nude mice. The antitumor activity was similar to or greater than those of chemotherapeutics. Antitumor effects of DT-5461 significantly correlated with intratumoral levels of tumor necrosis factor (TNF) induced by the compound (r = 0.701, p < 0.05). In vitro TNF production by DT-5461-stimulated macrophages was augmented by tumor cells, and the augmentative effect correlated with TNF activity detected in these tumor tissues. Meanwhile, a weaker therapeutic efficacy of DT-5461 was observed against certain tumors that caused a significant increase in the level of immunosuppressive factors in host blood. These findings support the idea that intratumoral TNF plays a crucial role in the antitumor mechanisms of DT-5461 and suggest that its antitumor action is influenced by an augmentative effect of tumor cells on TNF production and by blood levels of immunosuppressive factors.

Adjuvants, Immunologic↗

[Case report of coronary artery bypass performed on a patient implanted with a single-lead atrial triggered ventricular VDD pacemaker].

Single-lead atrial synchronized ventricular pacing using a floating atrial sensing electrode enables physiologic pacing in patients with complete atrioventricular block and normal sinus function. Open heart surgery performed on patient implanted with a single-lead atrial triggered ventricular VDD pacemaker is rarely reported. A 71-year-old male had been implanted with a single-lead VDD pacemaker because of Mobitz II atrioventricular block. He had a history of old myocardial infarction and diabetes mellitus. Coronary angiography revealed stenoses in the left main trunk and two main vessels. Bypass grafting of two coronary vessels under cardiopulmonary bypass was performed. Just before surgery, the pacemaker was reset to VVI mode at minimum pacing rate (50 beats per minute). During surgery, precautions were taken to ensure that the lead was not touched and that the position of the atrial electrode was not altered by atrial cannulation. After surgery, temporary VVI pacing at 90 beats per minute was conducted using a temporary ventricular pacing lead. However, this temporary lead was not absolutely necessary because the VVD pacemaker could be used. If a temporary lead was to be placed during surgery, placing it in the atrium to utilize the VDD pacemaker would be preferable because it would contribute to the cardiac function. The patient recovered uneventfully and was discharged one month after the surgery. This case demonstrates that special precautions different to those needed for a fixed electrode are required for a floating electrode placed in the atrium.

Aged↗

[A successful surgical case report of acute aortic dissection involving entire sinus of Valsalva].

We successfully performed aortic root replacement for acute aortic dissection, Stanford type A involving the entire sinus of Valsalva, associated with acute anterior wall myocardial infarction and aortic valve insufficiency. A 57-year-old man was admitted complaining of chest pain. An emergency operation was performed after a perfusion catheter was inserted to 99% stenotic lesion of the left anterior descending artery (LAD) on the same day. The dissection extended to both ostia of the coronary arteries and disrupted all commissures of the aortic valve, resulting in severe prolapse of the aortic valve leaflets. Aortic root replacement was performed using a valved conduit. The left main coronary artery was reattached to the graft using interposition technique with a 8 mm diameter woven Dacron tube graft. In addition, the LAD and right coronary artery were bypassed using saphenous vein. The postoperative course was uneventful and the patient was discharged from hospital on the 35th postoperative day. Retaining no aortic sinus and adequate coronary artery reconstruction is important for surgical repair of aortic dissection involving the entire sinus portion of the ascending aorta.

Aortic Dissection↗

[The waffle procedure (multiple incision of epicardium) with pericardiectomy for constrictive pericarditis].

Pericardiectomy is the only effective surgical procedure for constrictive pericarditis, but we have often experienced a lack of significant improvement of hemodynamic parameters, this being attributed to the presence of residual constriction. We have had two patients with constrictive pericarditis. In these patients, we decorticated the pericardium as usual, anterior to the bilateral phrenic nerves without cardiopulmonary bypass, and then, multiple longitudinal and transverse incisions were carefully made in the fibrous epicardium, avoiding the predicted course of major coronary branches and the myocardium. At the end of the procedure, the epicardial fibrous surface acquired a waffle-like appearance. With this maneuver, relief of constriction was achieved and the myocardium was able to reexpand, thus obtaining an adequate hemodynamic response. Our two patients recovered fully, and were discharged on the 18th and 19th postoperative day. They are presently free of clinical symptoms.

Aged↗

Binding and labeling of omega-conotoxin GVIA in crude membranes from subfractionated fractions and various areas of chick brain.

Specific binding and specific labeling of 125I-omega-CgTX were investigated in crude membranes from both subfractionated fractions and various brain areas in chick whole brain. The specific activities of the marker enzymes 2',3'-cyclic nucleotide 3'-phosphorylase, Na/K ATPase and succinic dehydrogenase in the subfractionated fractions were three- to five-fold higher than those in the P2 fraction. However, the amount of specific [125I] omega-CgTX binding in the fractions of synaptosomes and synaptic plasma membranes was only about 1.2-times higher than that in the P2 fraction. The characteristics of specific 125I-omega-CgTX labeling with disuccinimidyl suberate to the 135-kDa band were generally comparable to those of specific [125I] omega-CgTX binding sites. These results suggest that the specific binding sites of [125I] omega-CgTX were not localized the synaptosomes and synaptic plasma membranes fractions, although each fraction was well isolated from the others from which were decided by the strength of specific activity for marker enzymes.

Animals↗

A radioresistant variant cell line, NMT-1R, isolated from a radiosensitive rat yolk sac tumour cell line, NMT-1: differences of early radiation-induced morphological changes, especially apoptosis.

A radioresistant variant cell line, NMT-1R, was isolated by repeated radiation exposure of a radiosensitive rat yolk sac tumour cell line, NMT-1, producing alpha-fetoprotein, with the potential for lymphatic metastasis in the inbred Wistar rat. Cultured NMT-1R cells showed more cobblestone-like appearances, although the morphological features were almost the same as radiosensitive NMT-1 cells reported previously. The doubling time of NMT-1R cells was 13.6 h, being shorter than that of NMT-1 cells (16.0 h). For NMT-1R cells, D0 for radiation sensitivity was 165 +/- 3 cGy, 1.7 times as large as for NMT-1 cells. The extrapolation number, n, was 1.48 +/- 0.17 for NMT-1R cells although that for NMT-1 cells was 1.08 +/- 0.15. The surviving fractions at 2 Gy (SF2) were 0.42 for NMT-1R cells and 0.28 for NMT-1 cells. The population of G2-M phase for NMT-1R cells was larger than for NMT-1 cells (32.5 versus 26.8%) in exponentially growing cells. Although a clear G2 delay was observed after irradiation with a dose of 182 cGy for both cell lines, NMT-1R cells had a shorter recovery time from G2 block than NMT-1 cells, G1 arrest was observed in NMT-1 cells. NMT-1 cells showed much higher incidence of early morphological changes, especially apoptosis, after irradiation with a dose > 500 cGy compared with NMT-1R cells.

Animals↗

Results of radiation therapy for hypopharyngeal carcinoma: impact of accelerated hyperfractionation on prognosis.

We reviewed the results of treatment in 52 patients with hypopharyngeal carcinoma who underwent radical radiation therapy using a two-fractionation scheme--conventional fractionation (CF) and accelerated hyperfractionation (AHF)--in order to evaluate the impact of the fractionation scheme on prognosis. The 5-year survival rate for the 52 patients was 19.5%, and a significantly better rate was obtained with AHF (44.4%) than with CF (12.4%). Of 27 patients who showed a complete response (CR), a higher CR rate (61%) was achieved with AHF than with CF (47%). A similar trend was also observed for T3 and T4 tumors (55% with AHF vs. 36% with CF). Multivariate analysis demonstrated that neck node status was a significant factor related to local control, and that local response and the fractionation scheme employed were significant prognostic factors for survival. The recurrence rate and recurrence within the radiation field in the AHF group was lower than in the CF group (27% vs. 50%), although the time to recurrence in the two groups did not differ greatly. Voice preservation was achieved in 20% of the patients. Considering the better survival and local control rate compared with conventional fractionation, accelerated hyperfractionation seems a preferable treatment for hypopharyngeal carcinoma.

Adult↗

The effect of overall treatment time of radiation therapy on local control of T1-stage squamous cell carcinoma of the glottis.

From 1975 to 1990, 72 patients with T1 glottic cancer, excluding a verrucous type of carcinoma, were treated with radiation therapy (RT). All treatments were given with a standard fractionation of 2 Gy per day. The total dose to the tumor ranged from 60 to 70 Gy. Six patients received a split-course RT. The overall local control rate was 87% at 5 years. Forty-one patients who completed RT in 45 days or less had a 5-year local control rate of 95%. Sixteen patients who completed a treatment course in 46 to 49 days had a local control rate of 81%. Fifteen patients with a treatment course of more than 50 days had a local control rate of 73%. There was a statistically significant difference in local control rates among the three groups (P<.05). The split-course RT group had a 5-year local control rate of 50%; that rate was statistically significantly inferior to that of the continuous course group (P<.001). Multivariate analysis also showed that an interruption of the treatment course was an important parameter in relation to the local control. The prolongation of standard RT schedules adversely affected local control of T1 glottic carcinoma and, therefore, should be avoided whenever possible.

Carcinoma, Squamous Cell↗

[Serum CA 19-9 levels in rheumatic diseases with interstitial pneumonia].

Serum CA 19-9 (2-3 sialyl Le(a)) is a marker of malignant disorder such as pancreas or gall bladder cancers. It has been reported that sera from patients with interstitial pneumonia show elevated level of CA 19-9. To investigate the relationship between the elevation of serum CA 19-9 (sCA 19-9) and the presence of pulmonary fibrosis, we examined the level of sCA 19-9 in sera from patients with rheumatic diseases with or without interstitial pneumonia (IP). The sCA 19-9 level was determined by enzyme-linked immunosorbent assay (ELISA). Fourteen sera of 129 (10.9%) patients with rheumatic diseases without malignant disorders were positive for sCA 19-9 when normal range was determined as less than 100 U/ml (mean +/- 5 SD), and 26.7% of sera from poly/dermatomyositis (PM/DM) and 11.8% of systemic sclerosis (PSS) were positive for CA 19-9. Whereas only 8.0% of rheumatoid arthritis (RA) was positive. Twelve (28.6%) of 42 rheumatic patients with IP showed positive levels for sCA 19-9 (mean 142.5 +/- 363.0 U/ml), whereas only two (2.3%) of 87 without IP were positive (mean 33.9 +/- 65.8 U/ml; p < 0.05). The correlation between the level of sCA 19-9 and pulmonary diffusing capacity (%DLCO) revealed an inverse correlation in 32 rheumatic patients with IP (r = -0.43, p < 0.05). Furthermore, the elevated sCA 19-9 levels decreased after treatment with corticosteroid and/or cyclophosphamide or cyclosporin A. Therefore, elevation of the level of sCA 19-9 seems to be involved in the pathogenesis of IP and sCA 19-9 will be a useful parameter for IP. It has been reported that the CA 19-9 is produced from the bronchial glands and suggested that during chronic fibrotic process of the lung, the metaplastic change of the bronchial glandular cells occur and the cells produce CA 19-9.

Biomarkers↗