Biomedical subjects
Publications and source records attributed to T Asai.
A 11-year-old boy with supravalvular aortic stenosis was treated by extended aortoplasty (Doty's operation) with excellent results. The extended aortoplasty provided satisfactory relief of aortic stenosis and improved function of the aortic valve.
A Case of delivery in a 23-year-old woman after a prophylactic infusion of DDAVP is described. She had a life-long history of easy bruising and frequent epistaxis, with the diagnosis of vWD being made when she was 14 years old. A hemostatic examination showed a prolonged bleeding time, a moderate reduction in the factor VIII level (VIII: C) and von Willebrand Factor Antigen (vWF: Ag), decreased platelet aggregation by ristocetin, and depletion of platelet retention. In April, 1988, in the 34th week of pregnancy, she was admitted to our clinic in order to avoid abnormal bleeding during labor. On admission, the level of factor VIII, ristocetin aggregation, and platelet retention were normal, but the bleeding time remained prolonged. The diagnosis of vWD type I was made on the normal multimeric structure. The DDAVP infusion test revealed a shortening of the bleeding time and an increase in the vWF: Ag. In the 41st week of pregnancy, labor was induced, accompanied by infusion of DDAVP, she gave birth to an infant without any abnormal bleeding. Since conventional treatments with human plasma derivatives may cause complicating viral infections, we propose the infusion of DDAVP is one of the treatments to prevent the abnormal bleeding of the patient with vWD during labor.
A 36-year-old male with acute promyelocytic leukemia in second relapse was admitted to receive reinduction therapy in June, 1985, and entered into third complete remission, but he developed spiky fever after chemotherapy. Ultrasonic tomography revealed multiple liver abscesses and culture of the aspirates demonstrated Candida albicans in the abscesses. He was treated with intravenous administration of amphotericin B (AMPH-B) but the effect on the liver abscesses was unsatisfactory and consolidation therapy was difficult to start. AMPH-B (30 mg/day) was administered by percutaneous transhepatic intraportal administration (PTIA). About two months later, multiple liver abscesses disappeared. No remarkable complications such as severe fever, chill and renal dysfunction were recognized during PTIA of AMPH-B. So PTIA of AMPH-B is considered to be useful and safe for the management of fungal liver abscesses.
Toxoplasma gondii expresses high levels of an active nucleoside triphosphate hydrolase (NTPase; EC 3.6.1.3) with several unique properties. It has been detected as a circulating antigen in mice, making it an ideal candidate for diagnostic tests for toxoplasmosis. A cDNA library constructed from T. gondii poly(A)+RNA was made in lambda gt11. One hundred thousand members of this library were immunoscreened with a rabbit polyclonal antibody to the purified NTPase. Six positive clones were subcloned into the plasmid, pGEX-IN, and the inserts were restriction-mapped. All clones had identical partial restriction enzyme maps. One insert was subcloned into M13mp18 and sequencing by the deoxy/dideoxy method showed an NTPase-encoding gene (ntp) fragment of 571 bp. The insert was also purified, radiolabelled, and used to hybridize to Northern blots of tachyzoite RNA and quantitative Southern blots of tachyzoite DNA. Northern blotting revealed that the NTPase mRNA was in great abundance and had a length of about 2800 nucleotides. Southern blotting showed a gene copy number of between one and five, and the possibility that ntp is tandemly repeated over a large length of DNA. The NTPase was expressed as a glutathione S-transferase (EC 2.5.1.18) fusion protein of about 50 kDa, which reacted with polyclonal rabbit antibody on Western blotting.
Two-dimensional gel electrophoresis, at high and low temperatures, and gel mobilities of circularly permuted DNA segments showed a large bending locus about 50 bp downstream from the right border of the 245 bp oriC box, a minimal essential region of autonomous replication on the Escherichia coli chromosome. Bending was strongly enhanced by Dam methylation. In DNA from a Dam- strain, the mobility anomaly arising from altered conformation was much reduced, but was raised to the original level by methylation in vivo or in vitro. Enhancement of the mobility anomaly was also observed by hybrid formation of the Dam- strand with the Dam+ strand. Near the bending center, GATC, the target of Dam methylase, occurs seven times arranged essentially on the same face of the helix with 10.5 bp per turn. We concluded that small bends at each Dam site added up to the large bending detectable by gel electrophoresis.
1860 primary school children, aged from 6 to 12 years, from urban suburban and rural areas in Japan were assessed by their school teachers according to the Rutter scale. The prevalence of children with deviant scores in the general population was 3% and this figure was lower than that for any other country assessed by the same scale. Eighty-four percent of the deviants were of an antisocial type but only 7% were neurotic. The ratio of antisocial to neurotic was higher than those from other countries. The prevalence of children with deviant scores was higher in boys than in girls, and also higher in early and middle school years than in late school years. Area, family occupation, sibship size, birth order and one-parent family had only limited effects on the deviant behaviour of the children.
Immunohistochemical analysis was performed on the annular erythema associated with Sjögren syndrome. This type of annular erythema is characterized by a doughnutlike appearance with an elevated border and central pallor; it is distinct from subacute cutaneous lupus erythematosus. Histologically this erythema is characterized by coat sleeve-like infiltration of lymphocytes around blood vessels and by nuclear debris in the connective tissue. Vasculitis or epidermal changes suggestive of lupus erythematosus were not observed in any of the cases, although immunoglobulin or complement deposition along the basement membrane zone and focal liquefaction degeneration of the basal layer in involved skin were seen in some cases. Major dermal infiltrates consisted primarily of CD4+ and 4B4+ lymphocytes.
Since 1981, we have been conducting research on percutaneous transhepatic cholecystoscopy through the sinus tract of percutaneous cholecystostomy and this method has been employed in 72 patients with gallbladder diseases. We have already reported on percutaneous transhepatic cholecystoscopy and its usefulness for the diagnosis of early gallbladder carcinoma. Histological diagnosis was possible on the basis of cholecystoscopic biopsies in all 21 patients with gallbladder carcinoma, including eight patients with early carcinoma. Percutaneous cholecystoscopy is a reliable method for making the differential diagnosis between carcinoma and polypoid lesions of the gallbladder, and the diagnosis of cancer extension on the mucosa to the cystic duct. This method is recommended as a further and final step for the early diagnosis of gallbladder carcinoma. We performed endoscopic lithotripsy with the Nd:YAG laser or electrohydraulic lithotripter, and treated 21 patients with cholecystolithiasis. We report here on the results and features of this method as a nonsurgical treatment for cholecystolithiasis.
Eight patients with senile erythroderma with serum hyper IgE were studied. Characteristic laboratory findings were persistently elevated IgE levels, high peripheral-blood eosinophils, and high lactic dehydrogenase (LDH). Immunologic analysis using immunoglobulin antibodies showed frozen sections of inguinal lymph nodes to stain with anti-IgE antibody, particularly in the germinal center. Five of the patients had an atopic history, suggesting hereditary factors.
We describe a patient with transient ischemic attacks secondary to a giant aneurysm who showed increased activity on platelet scintigrams at the origin of the left vertebral artery. This is assumed to be the first report of a presumed embolizing aneurysm with positive activity of labeled platelets. Platelet scintigraphy is useful for diagnosing transient ischemic attacks as being secondary to an aneurysm and was proved to provide direct evidence of a thromboembolic source in vivo.
The subjects were 37 female patients with juvenile TMJ arthrosis (T group) and 27 healthy females (N group) who visited the Dept. of Oral Surgery, Nagoya University Hospital or the Dept. of Dent-Oral Surgery, Nagoya University Branch Hospital. Following evaluations were made: 1) L6 to L7 angle 2) L6 to occlusal plane 3) L7 to occlusal plane 4) L6 to mandibular plane 5) L7 to mandibular plane 6) occlusal plane angle 7) mandibular plane angle Following results were obtained: 1. Significant differences between T group and N group were not seen in the occlusal plane angle. 2. A majority in the T group showed a mesial inclination of the lower second molar. 3. Mandibular plane angle in the T group was larger than that in the N group.
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Differences between advanced gastric cancer of the medullary type (med.: 138 cases) and the scirrhous type (sci: 164 cases) with regard to the amount of connective tissue that was cancerous have been studied clinicopathologically. A correlation was found between med and liver metastasis, and sci and peritoneal dissemination in metastatic types, whereas no correlation was observed in other factors except between med and a localized type, sci and infiltrating type in gross type. The study of tumorigenicity in nude mice showed remarkable difference between med (86.7%) and sci. (0%). These results indicate that there is definite relationship between the amount of connective tissue and the biological behavior of a gastric cancer.
The distribution of diameters of axons and somas at the level of the optic nerve, lamina cribrosa and retina were compared between human glaucomatous eye and normal control eyes. At the level of lamina scleralis of the glaucomatous eye, there was a tendency for large nerve fibers to be lost in the arcuate nerve fiber area particularly in the inferior arcuate nerve fiber area, where the corresponding visual field defect was detected. The percentages of large axons and somas in the arcuate nerve fiber area decreased in the glaucomatous eye both at the level of the optic nerve, retina but most of all at the level of lamina cribrosa. These results suggest that the mode of optic nerve damage in early glaucoma is characterized by the selective damage of large nerve fibers, which is most severe at the lamina cribrosa.
A survey on the survival of a total of 160 patients with paroxysmal nocturnal hemoglobinuria (PNH) was conducted by questionnaires to hematologists at the 86 major hospitals in Japan. Ten, 20 and 30 year-survival rates from the day of diagnosis was 71%, 57.5% and 57.5%, respectively. The survival curves by sex showed no statistical difference between males and females. The cause of death in 56 patients with PNH was investigated. Twenty cases, representing 38.5% of 52 patients excluding 4 cases of unknown cause, died of hemorrhage. Death from thrombosis occurred only in 3 cases. The incidence of hemorrhage and thrombosis as a cause of death in Japanese patients was clearly different from that in the United States and England. Various causes other than hemorrhage and thrombosis were disclosed. Patients died 4.5 years (median) from diagnosis and at a mean age of 50.4 years. Hypoplastic bone marrow was found histologically in 40.4% of 52 patients by biopsy. The findings of peripheral blood and aspirated bone marrow were nearly consistent with those of hypoplasia. A higher incidence of hemorrhagic death in Japanese patients might be related to thrombocytopenia by hypoplastic bone marrow. On initial diagnosis, 41.2% had aplastic anemia-PNH syndrome. Prevention against complications in PNH with special reference to blood transfusions are discussed.
Examination including residual urine measurement, cystometry and urethral pressure profile was performed before and 8 weeks, 3 months and 6 months after the operation in 17 patients with rectal cancer who were divided into mecobalamin administered group (8 patients) and non-administered group (9 patients) at random. Administration of mecobalamin (500 gamma i.m., 3 times a week for 4 weeks) was started within 3 weeks after the operation. In the 17 patients, the rate of patients with residual urine over 51 ml was 65% at 8 weeks, 24% at 3 months and 24% at 6 months. The mean value of bladder pressure at maximum capacity after the operation in the 17 patients showed a significant increase compared to that before the operation, while the mean value of maximum urethral pressure after the operation showed a significant decrease compared to that before the operation. The bladder pressure in patients with residual urine less than 50 ml was significantly lower than that in patients with residual urine over than 5 ml. The bladder pressure in patients with residual urine reduced to less than 50 ml at 3 months showed a tendency to decline. The rate of patients with residual urine of less than 50 ml at 8 weeks was 50% in the mecobalamin administered group and 22% in the non-administered group. There was no significant difference in bladder pressure between the two groups, or before and after the administration of mecobalamin.
A vasodepressor phospholipid fraction named Depressor-IA from a bovine brain lipid extract was analyzed by capillary gas-liquid chromatography-mass spectrometry as tert-butyldimethylsilyl derivatives after hydrolysis with phospholipase C. Results show that Depressor-IA is a mixture of 3 platelet-activating factors and 17 1-acyl analogues. Three platelet-activating factors having sn-1-O-hexadecyl, octadecyl, and octadecenyl groups were suggested to account for the hypotensive activity of Depressor-IA, although the total amount of 1-acyl analogues of platelet-activating factor was much more than that of platelet-activating factor in the purified Depressor-IA. 1-Long-chain acyl-2-short-chain acyl-glycero-3-phosphocholines identified in Depressor-IA included novel molecular analogues having sn-2-propionyl, acryloyl, butyryl, valeryl, caproyl, and hepatonoyl groups.
A 53-year-old female, who had been having xerostomia and xerophthalmia for two years, was admitted in November 1984, because of subfever and malaise. Laboratory examination revealed pancytopenia with appearance of blasts, mild hypergammaglobulinemia, and elevated titers of ANA, anti SS-A and anti SS-B. Bone marrow aspirate showed increased myeloblasts. Schirmer's test and Rose Bengal's test were both positive, and sialography showed apple tree like appearance. Pathological findings of biopsied lip mucosa showed remarkable infiltration of lymphocytes. The patient was diagnosed acute myelocytic leukemia and Sjögren's syndrome. In spite of recovery of peripheral blood after combination chemotherapy (BHAC-DMP), a disturbance of consciousness appeared and she died of its progression. It was suspected clinically that she was suffered from progressive multifocal leukoencephalopathy (PML). It is sometimes reported that patients with Sjögren's syndrome develop malignant lymphoma, but it is very rare that Sjögren syndrome develop AML.