Biomedical subjects
Publications and source records attributed to T Endo.
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Arterial infusion chemotherapy was performed in 21 patients with liver metastasis of breast cancer, which was suspected to be the limiting factor of the prognosis, and the relationship between the morphological types of liver metastases, percentage of the liver involved, their angiographic features and chemotherapeutic response was discussed. Four morphological types of liver metastases could be classified; solitary mass type, multiple nodular type, diffuse small nodular type, and mixed type. In most cases, metastatic lesions were detected as a hypoechoic area on US and as a low-density area on pre-enhanced CT scan. In their angiographic features, these lesions were revealed as hypervascular tumors in most cases. Enlargement of the common or proper hepatic artery and obstruction of the 1st or 2nd branch of the portal vein were seen in over 50% of cases. In 13 evaluable cases, the response rate was 84.6% (PR 11, NC 1, PD 1), and the 50% survival time was 13.5 months in responders and 11.0 months for all cases. With regard to the morphological type, 1, 2 and 4-type cases revealed partial response, but NC or PD cases belonged to morphological type 3. No relation between obstruction of the portal vein and the chemotherapeutic response was observed. Arterial infusion chemotherapy was thus shown to be an effective treatment for liver metastasis of breast cancer, but that the response to the treatment differed for each morphological type.
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Immunostained sections and whole-mount preparations of the layers of the guinea pig jejunum were investigated by an improved peroxidase-antiperoxidase method using an antiserum to S-100 protein. A delicate latticework of S-100 protein immunopositive glial cells was demonstrated extending in the longitudinal muscle layer, myenteric or Auerbach's plexus, circular muscle layer including the deep muscular plexus, submucous layer including the submucous or Meissner's plexus, lamina muscularis mucosae and lamina propria mucosae. The whole enteric nerve plexuses consisted of two subsystems; nerve plexuses of the muscular coat and those of the submucous and mucous coats. These two subsystems were joined to each other by thick, connecting branches perforating the inner circular muscle layer. Extrinsic nerves entering the myenteric plexus formed a specialized junctional structure containing S-100 protein immunopositive glial cells, whereas those entering the submucous plexus ran along the submucous arteries. We proposed the term enteroglial cells to designate the S-100 protein immunopositive cells which ensheathed the somata and processes of the enteric neurons. The frameworks of all structures in the enteric nerve plexuses from the largest ganglia to the thinnest nerve fasciculi were constructed of these enteroglial cells. A spectrum of the enteroglial cells was presented. Those in the myenteric and submucous ganglia were found similar to the astroglia of the central nervous system and to the satellite cells in the peripheral ganglia. Those in the primary and secondary fasciculi of the myenteric plexus formed a kind of neuropil together with the neuronal processes. Those in the tertiary fasciculi of the muscular coat formed the framework of the autonomic ground plexus. We tentatively concluded that the interstitial cells of Cajal contain an immunoreactivity for S-100 protein, and thus are glial in nature. The occurrence of specialized enteroglial cells with a neuron-like function was discussed in the autonomic ground plexus of the muscular coat. In the lamina propria mucosae, there was a fine latticework of the S-100 protein immunopositive enteroglial cells. This latticework corresponded to that of the interstitial cells of Cajal in the villous and periglandular plexuses.
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Acute myocardial ischemia followed by protracted asynergy and subsequent resolution was defined as reversible ischemic myocardial damage. The purpose of this study was to confirm the existence of this entity and to illustrate the clinical features. The subjects consisted of 26 patients with typical acute myocardial ischemia who satisfied the above definition, and serial changes in left ventricular wall motion were observed by two-dimensional echocardiography. The left ventricle was divided into 11 segments and the movement was scored according to the dynamic behavior of each segment by five points ranging from normal (0) to dyskinesis (4), and evaluated semiquantitatively using the total score sum as the total asynergy score. Compared to the initial value, this score decreased to 57% after one week, 38% in two weeks, 22% in three weeks and 17% in four weeks. The asynergy persisted 23.7 +/- 13.5 days and ranged from two days to three months. The peak CPK ranged from 32 to 561 IU (mean 212 +/- 157 IU). Coronary arteriography revealed undisturbed flow of the responsible artery in both acute and chronic phases including four cases of successful PTCR. Comparison of the electrocardiographic changes and asynergy showed that diminished R wave amplitude, ST segment elevation and inverted T waves are frequently associated with persistence of asynergy, extensive asynergy can even occur in cases without a diminished R wave or abnormal Q wave and when asynergy resolves, ST segments tend to return to the baseline, but T wave inversion commonly persists. A transient Q wave was observed in 38% of the patients examined. The electrocardiogram became normal in an average of 111.3 +/- 75 days. In conclusion, there is a subgroup of reversible asynergy among cases of unstable angina pectoris or subendocardial infarction. The mechanism for this may be myocardial "stunning" following transient transmural ischemia. Recognition of this fact seems very important in the diagnosis and treatment of acute myocardial ischemia.
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Sixteen cases of primary renal pelvic tumor treated at our Department between July, 1971 and June, 1984, were reviewed. The sixth decade predominated over other age groups and occupied 47.3% of all cases (average: 63.9 years). The sex ratio was 4.3:1 with male patients predominating over female patients. The incidence of the affected side was equal; 8 cases in the right and 8 cases in the left renal pelvis. The most common initial symptom was macroscopic hematuria in 13 cases (81.2%), followed by flank pain in 2 cases (12.5%). The major findings in IVP were filling defect in 11 cases (68.7%) and non-visualizing kidney in 4 cases (25.0%). Positive urinary cytology was obtained in 6 cases (49.1%) by voided urine specimen and 4 cases (50.0%) by catheterized urine specimen. Histologically, all cases were transitional cell carcinoma; 11 of them were low stage and 5 were high stage at the initial diagnosis. Nine patients(56.1%) were treated by total nephroureterectomy associated with partial cystectomy. The over all survival rate at 1,2,3,4 and 5 years was 86%, 78%, 78%, 68% and 68%, respectively, by the Kaplan-Meier method. The five year survival rate was 80% for the low stage group and 0% for the high stage group. (p less than 0.05, generalized Wilcoxon test). The five year survival rate was 83% for the low grade group and 40% for the high grade group. (p less than 0.05, Generalized Wilcoxon test) Among several factors, stage and grade of the tumor were the most influencing factors for prognosis.
Twenty-two cases of primary ureteral tumors treated at our Department between July 1971 and December 1984, were reviewed. The patients ranged from 28 to 83 years old (average 63.6 years). There were 17 males and 5 females (3.4:1). The affected side was predominantly the left (15) than the right (7). The most common site of the tumor growth was at the lower third of the ureter (14 cases, 63.6%). The most common initial symptom was macroscopic hematuria, which was seen in 17 cases (77.3%). The major finding of IVP was non-visualizing kidney in 11 cases (50.0%) and filling defect in 7 cases (31.8%). Positive urinary cytology was obtained in 9 cases (52.9%) by voided urine and 6 cases (66.6%) by catheterized urine. Total nephroureterectomy associated with partial cystectomy was performed in 14 cases (63.6%). Histologically, 19 cases were transitional cell carcinoma (86.8%). Associated growth of urothelial tumor in the bladder was found in 4 cases preoperatively and in 3 cases during the course of postoperative follow up. All of them were treated by transurethral resection. Overall survival rate at 1,2,3,4 and 5 years was 84, 71, 55, 46 and 35%, respectively, by the Kaplan-Meier method. The five year survival rate was 54% for the low stage group and 0% for the high stage group; 54% for the low grade group and 26% for the high grade group. (p value = not significant, generalized Wilcoxon test).
The serum from a colonic cancer patient was examined showing anti-CEA (carcinoembryonic antigen) activity but not anti-NCA (nonspecific cross-reacting antigen) activity. Conventional immunoelectrophoresis and radioimmunoelectrophoresis in conjunction with iodine 125-labeled CEA strongly suggested that this serum contained M-protein (IgG kappa). Most of the anti-CEA activity was found in the M-component using radioimmunoelectrophoresis, suggesting the monoclonal nature of anti-CEA autoantibodies. With the use of this serum the histologic distribution of the antigen by the immunoperoxidase method was demonstrated for the first time. Anti-CEA specificity of this serum was confirmed by the fact that the absorbed antibody with purified CEA gave negative staining of the serial sections of the tissues that formerly had immunostaining. Interestingly, this distribution was almost superimposed on that detected by the murine monoclonal anti-CEA antibody AS802. The data suggested that the antibody in the serum reacted with the CEA molecule in the tissue sections, the majority of which were found in the cancerous tissues.