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Biomedical subjects

T Hachiya

Publications and source records attributed to T Hachiya.

At least 127 records · Page 7Linked to original sources
PubMed1995

Invasive thymoma with hypogammaglobulinemia spreading within the bronchial lumen.

A case of invasive thymoma with hypogammaglobulinemia showing endobronchial growth is presented. A 63-year-old man was admitted for evaluation of a left hilar mass. A biopsy specimen obtained from the intraluminal mass, which occluded the left upper division bronchus, was highly suggestive of thymoma. The laboratory tests were almost normal except for hypogammaglobulinemia. The tumor was resected with the left upper lobe. Most of the tumor invaded the left upper lobe, and grew into the bronchi. The case was diagnosed histologically as invasive thymoma spreading within the bronchial lumen.

Agammaglobulinemia↗
PubMed1995

Maternal autoimmune response to recombinant Ro/SSA and La/SSB proteins in Japanese neonatal lupus erythem atosus.

BACKGROUND: Neonatal lupus erythematosus (NLE) is a syndrome characterized by dermatitis and congenital heart block (CHB). The disease is mostly associated with transplacental passage of maternal anti-Ro/SSA and/or La/SSB antibodies. OBJECTIVE: To examine maternal autoimmune response to recombinant Ro/SSA and La/SSB proteins in NLE with a single ethnic background. METHODS: This study examined 12 NLE infants and their mothers. Serum samples were tested by enzyme-linked immunosorbent assay for reactivity with full-length recombinant human 60-kd Ro/SSA, 52-kd Ro/SSA, and 48-kd La/SSB proteins. RESULTS: All 10 infants with skin lesions and/or CHB had maternal antibodies reactive to both the 60- and 52-kd Ro/SSA polypeptide components of the Ro/SSA particle. Anti-60-kd Ro/SSA without anti-52-kd Ro/SSA, or vice versa, was found in mothers of infants who had only hepatic manifestation of NLE. Nine of 12 NLE infants had anti-48-kd La/SSB. CONCLUSION: In the majority of Japanese infants with NLE, maternal anti-Ro/SSA autoimmune response was directed against both of 60-kd and 52-kd recombinant Ro/SSA proteins. There was no profile of anti-Ro/SSA and La/SSB response unique to mothers of children with CHB or cutaneous manifestations of NLE.

Adenosine Triphosphatases↗
PubMed1995

Quantification of antiribosomal P0 protein antibodies by ELISA with recombinant P0 fusion protein and their association with central nervous system disease in systemic lupus erythematosus.

OBJECTIVE: Using solid phase ELISA with recombinant P0 fusion protein as the antigen for detecting antiribosomal P0 protein antibody, we analyzed the association of this antibody and anticardiolipin antibody (aCL) with central nervous system (CNS) disease in patients with active systemic lupus erythematosus (SLE). METHODS: Sera from 70 randomly selected Japanese patients with active SLE were assayed for IgG and IgM antiribosomal P0 protein antibody titers and IgG aCL. RESULTS: IgG and IgM antiribosomal P0 protein antibodies were present in 29 and 12 (41.4 and 17.1%) of the 70 patients, respectively. The incidence of CNS disease, excluding lupus psychosis, was significantly higher in patients with IgG and IgM antiribosomal P0 protein antibodies than in those who lacked them (IgG antiribosomal P0 protein antibody 11/29 vs 3/41; IgM antiribosomal P0 protein antibody 7/12 vs 7/58). In addition, both IgG and IgM antiribosomal P0 protein antibody titers were significantly higher in patients with CNS disease, excluding lupus psychosis, than those without. No significant association was observed between antiribosomal P0 protein antibodies and lupus psychosis. No significant association was observed between IgG aCL and CNS disease. Serial studies of antiribosomal P0 protein antibodies and aCL in patients with transverse myelopathy also showed that IgG and IgM antiribosomal P0 protein antibodies, but not IgG aCL, were associated with CNS disease, excluding lupus psychosis. CONCLUSION: These data suggest a strong association of IgG and IgM antiribosomal P0 protein antibodies with CNS disease, excluding lupus psychosis, in SLE.

Adolescent↗
PubMed1995

[Septic lung caused by methicillin-resistant Staphylococcus epidermidis].

A 55-year-old man was admitted to our department one month after resection of rectal carcinoma, with complaints of fever and general malaise. Shock developed rapidly after admission. The chest X-ray film and computed tomography showed diffuse small nodular shadows and bilateral pleural effusion. Septic lung caused by Methicillin-resistant Staphylococcus epidermidis (MRSE) was diagnosed from the results of a bacteriological study. This bacteria is a Coagulase Negative Staphylococcus (CNS). Chemotherapy with Minocycline and Cefotiam was effective. Characteristic radiologic features of this case may be related to the early stage of adult respiratory distress syndrome (ARDS) and septic pulmonary microembolism.

Anti-Bacterial Agents↗
PubMed1994

Prevalence of antihuman parvovirus B19 IgG antibodies in patients with refractory rheumatoid arthritis and polyarticular juvenile rheumatoid arthritis.

We investigated the prevalence of antihuman parvovirus B19 immunoglobulin G (IgG) antibody in 108 Japanese patients with rheumatoid arthritis (RA) and 11 patients with polyarticular juvenile rheumatoid arthritis (JRA). Seropositivity of anti-B19 was significantly higher in patients with refractory RA (57.6%, 38/66) compared with patients with remittent RA (19.0%, 8/42; P < 0.001) or age-matched controls (24.3%, 19/78; P < 0.001). Patients with refractory polyarticular JRA had a significantly higher frequency of anti-B19 seropositivity (71.4%, 5/7) than age-matched controls (8.3%, 5/60; P < 0.001), while none of the remittent group was positive for the antibody (0/4).

Adolescent↗
PubMed1994

Patterns of nuclear immunofluorescence and reactivities to recombinant nuclear antigens in autoimmune hepatitis.

BACKGROUND/AIMS: Antibodies to nuclear antigens have not been fully characterized in autoimmune hepatitis. The aims of this study were to determine the different patterns of immunofluorescence associated with antinuclear antibodies and to correlate these patterns with reactivities to recombinant nuclear antigens and clinical manifestations of autoimmune hepatitis. METHODS: Sera from 65 patients were tested by indirect immunofluorescence and by enzyme immunoassay for antibodies to recombinant centromere, ribonucleoproteins, and ribonucleoprotein complexes. RESULTS: Homogeneous and speckled patterns of immunofluorescence occurred with similar frequencies (34% vs. 38%) in the majority of patients (72%). Patients with speckled patterns were younger and had higher serum aspartate aminotransferase levels at presentation than counterparts with other patterns. Antibodies to centromere (42%) and 52K ribonucleoprotein complex (23%) were the most common reactivities. Of the 35 patients with antibodies, 16 (46%) had multiple specificities. Individual reactivities were not associated with specific immunofluorescent patterns, and they did not identify patients with distinctive features. CONCLUSIONS: Antinuclear antibodies produce mainly homogeneous and speckled patterns of immunofluorescence in patients with autoimmune hepatitis. Speckled patterns are associated with a younger age and greater aminotransferase activity. Multiple autoantibodies are frequently associated with each immunofluorescent pattern. Antibodies to centromere and the 52K ribonucleoprotein complex have a previously unrecognized high frequency and uncertain significance.

Adult↗
PubMed1994

Androgen deprivation prior to radical prostatectomy for T2b and T3 prostate cancer.

OBJECTIVE: In an effort to improve on the results of radical prostatectomy for clinical stages T2b and T3 prostate cancer, a selected group of patients received androgen deprivation for three to sixteen months prior to surgery. METHODS: Fifteen men with clinical T2b and 22 with small T3 tumors received a luteinizing hormone-releasing hormone analog (n = 34) or a bilateral orchiectomy (n = 3) three to sixteen months prior to radical retropubic prostatectomy. The prostate was evaluated with particular attention to tumor grade, presence of extracapsular extension, tumor at the inked margin, seminal vesicle invasion, and tumor in the lymph nodes. RESULTS: No patient had clinical or chemical (prostate-specific antigen [PSA]) progression during androgen deprivation. The PSA level declined a mean 90 percent and remained above 4 ng/mL in only two patients. The prostate volume decreased an estimated 30-50 percent. Prostate cancer at the inked margin was found in 15 (41%) and seminal vesicle involvement in 11 (30%) patients. Five (14%) had tumor in regional lymph nodes. There was no difference in regard to positive margins or lymph node metastases between those clinically staged as T2b and those preoperatively staged as T3. Fourteen patients have received adjuvant therapy (13 androgen deprivation, one radiation therapy). None has progressed (mean follow-up, 38.4 months). Of 23 who did not receive immediate additional therapy, six (26%) had progression, as was evident from an increase in PSA and have since been treated. Only one continued to progress. Thirty-five of the 37 patients are alive. Seventeen (46%) are tumor free (PSA < 0.4 ng/mL) without further androgen deprivation. CONCLUSIONS: Only a prospective randomized trial can determine whether androgen deprivation prior to radical prostatectomy has a role. The results from this trial are encouraging for several reasons. The prostate is much smaller as a result of androgen deprivation and this may facilitate surgery. Although the great majority of these patients were expected to be margin positive, 60 percent had negative margins and only 14 percent had positive lymph nodes.

Combined Modality Therapy↗
PubMed1994

Production of thyroid stimulation blocking antibody without TSH receptor binding activity in rabbits with experimental autoimmune thyroiditis.

When rabbits were immunized with porcine thyroid plasma membrane, some cases of produced antibodies showed the blocking activity for TSH stimulated cAMP production in cultured porcine thyroid cells in spite of negative TSH binding inhibitory immunoglobulin (TBII) activity. The inhibitory effect of these thyroid stimulation blocking antibodies (TSBAbs) on cAMP increase by forskolin and GTP gamma S in porcine thyroid cells was observed in 1 and 3 rabbits, respectively. When the blocking activity of these antibodies for stimulated cAMP production by forskolin, GTP gamma S and NaF was examined in the isolated porcine thyroid membrane, no blocking activity for these 3 stimulators except in 1 case was found. The blocking activity of these antibodies could be absorbed significantly by incubation with porcine thyroid plasma membrane as antigen. The blocking activity was not observed in rabbits immunized with porcine thyroglobulin. The present experiment demonstrated that the produced antibody in rabbits against porcine thyroid membrane had the blocking activity for TSH stimulation to thyroid cells without affecting TSH binding to its receptor. These facts suggest that this type of blocking antibody may be produced against any antigen of thyroid membrane origin except the TSH receptor.

Adenylyl Cyclases↗
PubMed1994

Clinical experience of lower urinary tract reconstruction using a urethral Kock pouch.

The operative procedure used in the present series involved a nerve-sparing radical cystectomy, with anastomosis of the urethra using a pouch made of detubularized ileum. The 36 patients who underwent this operation were all male with an average age of 58. No deaths resulted from the operation. As far as late complications were concerned, malfunction of the antireflux nipple valve was noted in 1 patient and stenosis occurred between the urethra and pouch in 2. One patient was found to have multiple stones in the pouch and reservoir decompensation was recognized in 2. Thus, the late complication rate was 17%. There were no cases of total incontinence, but nocturnal incontinence appeared in 11 out of 31 (35%). A total of 20 out of 25 patients (80%) recovered their erectile function during the postoperative follow-up period and the disease-free survival rate at 5 years was 78%. Therefore, the urethral Kock pouch combined with nerve-sparing cystectomy has proved to be a useful procedure as far as the quality of life is concerned.

Adult↗
PubMed1994

[Preliminary clinical results of surgery for type A acute aortic dissections using gelatin-resorcin-formaldehyde glue].

We used gelatin-resorcin-form-aldehyde (GRF) glue to fuse the false lumen of type A acute aortic dissection in four patients. All were operated on within 3-24 hours after onset, and gluing of the two cylinders of the dissecting aorta could be done safely in a short time. Initial intimal tears were located in the transverse aorta in three patients and in the proximal descending aorta in one. Simple transection and end-to-end anastomosis of the ascending aorta was done for the first two cases. But in the last two patients, we resected the intimal tear in the transverse aorta and applied GRF glue to the stump of the aortic arch and to that of the aortic root, followed by graft replacement of the ascending aorta. There were no hospital deaths. But we had to reoperate on one patient five months after the first operation due to potentially residual dissection in the aortic root. GRF glue is a very useful adhesive for acute aortic dissection operations, but further refinement of the operative technique using it is necessary.

Acute Disease↗
PubMed1994

[Clinicopathological study of 4 patients with idiopathic BOOP, interstitial type on chest X-ray].

We studied four patients with idiopathic Bronchiolitis Obliterans Organizing Pneumonia (BOOP) diagnosed by open lung biopsy. All of four presented with acute onset and a rapid course with progressive dyspnea. Their chest X-ray films showed ground-glass opacities with reduced volumes in the bilateral lower lobes. Their chest CT revealed marked increases in lung density with air bronchograms. Radiologically, it was difficult to distinguish these cases from patients with acute interstitial pneumonia. Histologically, in the uninflated specimens, the collapse of alveoli and alveolar spaces filled with foamy macrophages and proteinous exudates were observed. The organizing tissues were present predominantly in the alveolar ducts, but varied in extent among cases. We considered the reduced lung volumes on chest X-ray films and the marked increases in lung density on chest CT to reflect alveolar collapse. Proliferation of type II pneumocytes was remarkable in all cases, but reactivity to antisurfactant protein-A antibody staining was decreased in the collapsed alveoli. It was suggested that the alveolar collapse was caused, in part, by decreased pulmonary surfactant in addition to obstruction of the alveolar ducts. The rapid responses to of these patients corticosteroid therapy may be due to improvement of the alveolar collapse.

Adult↗
PubMed1994

[A case of partial atrioventricular canal with discrete subvalvular aortic stenosis worsened 3 years after the replacement of the mitral valve].

The extension of the left ventricular outflow tract is provoked by a partial atrioventricular canal, and is easy to cause stenosis after a radical operation and/or a replacement of the left atrioventricular valve because of its anatomical structure. This report shows a case of a partial atrioventricular canal with a discrete subvalvular aortic stenosis which was worsened three years after the replacement of mitral valve. In this case the left ventricular outflow tract obstruction (LVOTO) had been found before the replacement of mitral valve but it was kept observing without surgical treatment because the degree was judged slight. Subvalvular aortic stenosis was worsened three years after the replacement. It was suspected that the stenosis developed because of the proliferation of heterologous tissue by a turbulent flow of a site of stenosis. For this diagnosis, the transesophageal echocardiography was very effective, and in this case the cause of LVOTO is uncertain, so a careful observation is necessary for it.

Adult↗
PubMed1993

Stimulatory action of pituitary adenylate cyclase-activating polypeptide (PACAP) on thyroid gland.

PACAP 27 and 38 (27 and 38 amino acids, respectively) increased rapidly cAMP production in porcine thyroid cells in vitro. Both PACAPs also increased T4 production from mouse thyroid in vivo similar to TSH. Both PACAPs (especially 38) inhibited the binding of 125I-labeled TSH to thyroid membrane in the medium containing bovine serum albumin. This inhibitory action remarkably decreased in the medium containing normal human serum. Decrease of inhibition of TSH binding by serum containing PACAP could not be explained simply by proteolytic destruction of PACAP, although the labeled PACAP (especially 38) was destructed by proteases in thyroid membrane or human serum. These facts showed that PACAP had the thyroid stimulating action and the inhibitory action on the binding of TSH to thyroid receptor.

Animals↗
PubMed1993

Significance of androgen deprivation prior to radical prostatectomy, with special reference to prostate-specific antigen.

A total of 37 selected patients with clinical stage T2b or T3 prostate cancer received androgen deprivation prior to radical retropubic prostatectomy. A luteinizing hormone-releasing hormone (LHRH) analog alone was given to 15 individuals; 19 received an LHRH analog with flutamide. Three underwent bilateral orchiectomy instead of chemical castration. The duration of androgen deprivation prior to radical prostatectomy varied from 3 to 16 months, with 31 individuals undergoing induction therapy for 3-6 months. Three received androgen deprivation for more than 1 year. In all, 15 patients had clinical stage T2b disease and 22, stage T3 prostate cancer. The prostate size decreased approximately 30%-50% following induction therapy. Prostate-specific antigen (PSA) values decreased in all 19 instances where this was obtained. In all, 6 of 15 (40%) patients with clinical T2b lesions and 9 of 22 (41%) with clinical T3 tumors had a positive surgical margin; 5 (13%) had 1 or more positive lymph nodes. Androgen deprivation was continued following surgery in 13 cases. Only one patient received postoperative radiation therapy. After a mean follow-up period of 33 months, 35 (95%) patients are alive. Two patients died, one of poorly differentiated prostate cancer with subsequent metastasis and one of a myocardial infarction 33 months after surgery without showing any evidence of disease. Of 23 patients without postoperative adjuvant therapy, 6 (26.1%) progressed (PSA level, > 0.4 ng/ml). None of the patients who underwent adjuvant therapy progressed over a follow-up period of 6-75 months (mean, 38 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

The coexistence of abdominal aortic aneurysm and early gastric cancer: report of three cases.

The surgical approach for patients with abdominal aortic aneurysm (AAA) and coexistent abdominal malignancy remains controversial. We report herein three cases of coincident AAA and early gastric cancer, all of whom were treated by a two-stage operation and underwent curative surgery for their gastric cancer. The principles of our surgical approach are as follows: (1) the lesion which requires urgent surgery should be operated on first, and if both lesions show absolute indications, a one-stage surgical procedure should then be performed; (2) a two-stage surgical procedure in which aneurysmectomy is performed first should be undertaken when no absolute indications for urgent surgery exist for either lesion; (3) a one-stage surgical procedure should only be performed when surgery on one lesion makes the other lesion highly dangerous; and (4) in patients with a poor prognosis because of far advanced cancer in whom the AAA shows no sign of rupturing, only a gastrectomy should be performed.

Aged↗
PubMed1993

Bladder neck preservation and its impact on positive surgical margins during radical prostatectomy.

To modify the bladder neck dissection during radical prostatectomy, in an effort to improve continence and diminish the incidence of anastomotic stricture, without compromising the primary surgical objective of complete cancer removal. Between December 1991 and August 1992, 50 patients underwent radical retropubic prostatectomy with anatomic dissection and preservation of the bladder neck and most proximal portion of the prostatic urethra, thus creating a mucosal cuff for anastomosis to the urethral stump. There was tumor at the inked margin in 18 patients (36%), however, in only 3 instances (6%) was there tumor at the bladder neck margin. In no instance was the bladder neck margin the only positive margin. At a minimum follow-up of six months, all patients are fully continent during routine activities, and in no patient has an anastomotic stricture developed. Anatomic dissection and preservation of the bladder neck and proximal urethra does not compromise surgical margins. We believe this technique may play a role in preservation of continence after radical prostatectomy and probably decreases the likelihood of anastomotic stricture, by allowing for a circumferential mucosa-to-mucosa anastomosis without the need for bladder neck reconstruction.

Aged↗
PubMed1993

[A case of coronary artery bypass grafting in a patient with active systemic lupus erythematosus].

A 59-year-old female was admitted to our hospital because of chest pain. Coronary angiography revealed severe obstruction of the left coronary artery. The findings of hematology and renal biopsy were interpreted as showing active systemic lupus erythematosus (SLE). Coronary artery bypass grafting was performed before steroid therapy because of worsening cardiac function due to myocardial ischemia. Postoperative course had been satisfactory immediately after operation, but the patient showed pulmonary infection about two months after operation and died three months after surgery. In open heart surgery for a patient with active SLE, special care must be taken to the prevention and treatment for infection.

Coronary Artery Bypass↗