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Biomedical subjects

T Iwanaga

Publications and source records attributed to T Iwanaga.

At least 217 records · Page 12Linked to original sources

Calcitonin gene-related peptide (CGRP)-immunoreactive nerves in the tracheal epithelium of rats: an immunohistochemical study by means of whole mount preparations.

The airway mucosa is known to be densely supplied with several types of peptidergic nerve fibers. The distribution of the nerve fibers in a large extent of the mucosa, however, has been difficult to visualize by observation of conventional thin sections. In the present study, whole mount preparations of the rat tracheal mucosa were designed to demonstrate calcitonin gene-related peptide (CGRP)-containing nerves which are most predominant among peptidergic nerves in the trachea. The mucosal sheet of the trachea was separated from the cartilaginous base by means of dispase, a protease, to be processed to immunohistochemistry for CGRP. In the cartilaginous portion, thick nerve bundles immunoreactive for CGRP ran transversely between the cartilage rings, sending terminal branches toward the epithelium. In the membranous portion, immunoreactive nerve bundles were thinner than those in the cartilaginous portion and ran longitudinally. A very dense nerve plexus of CGRP-immunoreactive fibers was demonstrated to extend in the basal part of the epithelium; every epithelial cell appeared to contact more than one nerve fiber. Immunohistochemistry of the whole mount preparations also clearly demonstrated the distribution and entire shape of broncho-pulmonary paraneurons scattered in the epithelium. Ultrastructurally, the CGRP-immunoreactive intraepithelial nerves were found to lack myelin and Schwann sheaths, and to run through the bases of the epithelial cells; they were most frequently surrounded by the cytoplasmic processes of the epithelial cells. The present study demonstrates that immunohistochemistry of whole mount preparations is a useful tool to morphologically analyze neuronal and paraneuronal distribution throughout the tracheal epithelium.

Animals↗

[Relationship between health services for maternal and child health and working hours of public health nurses].

Based on the "Maternal and Child Health Service Act", public health centers and municipalities offer health education, health counseling, health examination, and home visits for district children and for their mothers. The relationship between the number of the MCH services offered and the working hours of public health nurses at the public health centers and the municipalities was analyzed. Data were taken by a survey in 1989, which was used for evaluating services provided to the children and their mothers in 1988. Questionnaires were sent to 23 health centers and their districts and 100 responses from 8 wards, 20 cities, 47 towns, and 25 villages were analyzed. When total working hours of the public health nurse for MCH are allocated to the four parts-planning, implementation, evaluation and training-86.7% of working hours are for implementation itself. The correlation coefficient between the total working hours of the public health nurse for MCH and the population, and the number of births per year, were significantly positive. A total of 107 hours were supplied for the infant child health examination per 100 births per year, for which 64% was for implementation itself. In the case of the health examination for three-year-old children, total working hours were 143 hours, for with 79% was for implementation itself. The number of mother-child handbooks issued, the number of health education classes and health counselings conducted, various health examinations performed, and home visits made were correlated significantly with the working hours of the public health nurse.

Child↗

A new method of intraoperative cytodiagnosis for more precisely locating the occult neoplasms of the pancreas.

We have done endoscopic retrograde pancreatography-aspiration cytology for 81 consecutive patients in whom there had been neither pancreatic mass nor duct stenosis; cancer cells were detected in four cases (5%). This report reviews a new method of intraoperative cytodiagnosis, which was done for these four cases, to locate the original lesion of the cancer cells. This method involved dividing the pancreatic neck at a right angle to the main pancreatic duct. A catheter was then inserted in both the caudal and cranial ducts of Wirsung. With the aid of an intravenous injection of secretin, pure pancreatic secretions were collected separately and used for intraoperative cytodiagnosis. With this method, all four occult neoplasms of the pancreas were correctly identified as to whether they were located in the cranial, caudal, or both portions. In one case in which carcinoma in situ extended throughout the entire pancreas, total pancreatectomy had been indicated by the positive results obtained from both portions. Likewise, in the other three cases in which, the occult neoplasms were limited to the cranial or caudal pancreas, either a Whipple procedure (one case) or a caudal pancreatectomy (two cases) had been quite correctly indicated. Since this method is simple, safe, and reliable, it is beneficial to the patient with occult neoplasm, because it prevents blind resection of the entire pancreas without any fear of leaving the neoplastic lesion behind.

Adenocarcinoma↗

Immunocytochemical localization of nerve growth factor receptor (NGFR) in human teeth.

The distribution and subcellular localization of nerve growth factor receptor (NGFR) in human teeth has been investigated by immunohistochemistry at the light and electron microscopic levels. Many nerves in the dental pulp were intensely immunoreactive for NGFR. The pattern of distribution was largely similar to that of nerve fibers demonstrated by immunostaining for neurofilament protein (NFP), the most universal marker protein for pulpal nerves. In the predentin and dentin, more nerve fibers were intensely immunoreactive for NGFR than were demonstrable with NFP-antibodies. Immunoelectron microscopy showed that the NGFR-immunoreactivity was localized on the axoplasmic membrane in unmyelinated axons and on the outside of accompanying Schwann cells. No NGFR-immunoreactivity was found on the axons of myelinated nerves nor their supporting cells.

Axons↗

Influence of coexisting cirrhosis on long-term prognosis after surgery in patients with hepatocellular carcinoma.

BACKGROUND: As one of the reasons for the poor prognosis of patients with hepatocellular carcinoma (HCC) and cirrhosis, the influence of cirrhosis itself has not been clarified. METHODS: We compared the postoperative long-term courses of patients with HCC and cirrhosis with the courses of patients with HCC and without cirrhosis to determine how the coexisting cirrhosis affected the prognosis after surgery. The patients with HCC who underwent curative hepatic resection consisted of 142 with associated histologically confirmed cirrhosis and 48 without cirrhosis. RESULTS: The 5-, 7-, and 9-year survival rates were 44%, 32%, and 26%, respectively, in the patients with cirrhosis and 68%, 57%, and 57%, respectively, in the patients without cirrhosis. The prognosis of the group with cirrhosis was significantly worse than that of the group without cirrhosis. The main cause of death in both groups was cancer recurrence. The patients with cirrhosis had significantly lower recurrence-free survival rates at 3 years and later than had the patients without cirrhosis. A comparison of the background factors revealed no substantive disadvantages with regard to tumor-related and surgical factors in the patients with cirrhosis compared with the patients without cirrhosis. The recurrence-free survival rates after minor and major resection indicated fewer disadvantages of limited hepatectomy in the group with cirrhosis than in the group without cirrhosis. Moreover, the recurrence-free survival of the group with cirrhosis was shorter at less advanced stages than at more advanced stages when compared with that of the group without cirrhosis. CONCLUSIONS: The higher carcinogenic potential in cirrhosis could be presumed to be the most likely reason for the poorer prognosis after surgery in the patients with HCC and cirrhosis.

Carcinoma, Hepatocellular↗

[Evaluation of hepatic resection for stage IV hepatocellular carcinoma-comparison with arterial embolization therapy].

To evaluate the application of hepatic resection (HR) for patients with Stage IV hepatocellular carcinoma (HCC), we compared the back-ground factors and survivals after therapies between Stage IV HCC patients who underwent HR (n = 38) and those who received arterial embolization (n = 186, group C). Of the patients who had HR, 17 (45.1) had relative noncurative (RN) resection (group A) and the remaining 21 (55%) had absolute noncurative (AN) resection (group B). Back-ground factors in relation to liver function were significantly better in both A and B than in C. On the other hand, tumor-relating factors were better in A than in both B and C, and were worse in B than in C. Five-year survival rates of group A and group C were 37.1 and 13.1 respectively (A to C; p < 0.05) and there were no longer survivors than two years in group B. These results suggested that the group which had better back-ground factors gained the better prognosis. To compare the survivals in the patients having well back-ground factors who were dominant in group A, the patients whose clinical stage was I or the number of tumors was two or less were selected from each group. Among these selected patients, the survivals of group A were significantly better than those of the other groups.

Aged↗

[Breast preserving operation for early breast cancer--clinical implications and biological aspects of residual tumor].

Among the 93 surgical specimens of stage I breast cancer treated by breast preserving operation, surgical margins were less than 10mm in 23 (25%) cases because of intraductal spread. Such tumors with extensive intraductal component, however, were frequently positive for estrogen receptor (ER). Possible risk factors for local failure have been studied in an attempt to exclude high-risk patients not suitable for breast preserving operation. The results so far obtained suggest that biological markers such as c-erb B-2 or PS2 proteins may provide useful informations to select patients who are most likely to recur. In addition, adjuvant endocrine therapy may be recommended for the patients treated by breast preserving operation.

Aged↗

[Prognosis of intractable asthma].

Forty-nine intractable asthma patients from January 1981 were divided into three groups. Group I consisted of patients still alive after ten years (January 1991) who were receiving decreased doses of steroids or no steroids at all. Group II patients were also alive, but the doses of steroids they were receiving were unchanged. Group III consisted of patients who had died during the ten years. Of the 49 patients, nine were in Group I, 13 in Group II and 17 in Group III. The condition of the other 10 patients was unknown. The mortality rate of the known 39 patients over 10 years was 43.6%, a very high rate. The groups of living patients (I + II) were younger than the patients in the dead group (III) and the latter patients had more obstructive ventilatory dysfunction in the stable state (FEV1.0/FVC%, and %FEV1.0 were 56.1% and 52.8%) in 1980. In the therapy carried out over the 10 years, antiallergic drugs and inhaled steroids were administered in order to decrease oral steroids in both Group I, II and III. In Group I, however, more patients had received immunotherapy (hyposensitization) or gold therapy than in Group II and III. There were more complications due to steroids during the ten years in Group II and III than in Group I. Aging and obstructive ventilatory dysfunction may be factors which worsen the prognosis of intractable asthma, and decreasing of the doses of oral steroids may be important to prevent complications.

Adolescent↗

Ontogeny and development of extrathymic T cells in mouse liver.

We previously demonstrated that the liver may be a major site of extrathymic T-cell differentiation in mice. In the present study, the ontogeny and subsequent development of such T cells in the liver and other organs were investigated. This study was possible because these T cells have T-cell receptors (TcR) of intermediate intensity (i.e. intermediate TcR cells) and constitutively express a high level of interleukin-2 receptor beta chain (IL-2R beta). Therefore the two-colour staining for CD3 (or alpha beta TcR) and IL-2R beta identifies even a small proportion of intermediate TcR cells. The total numbers of mononuclear cells obtained from the liver, thymus and spleen varied from foetal to adult life. Especially in the liver, many haematopoietic cells were present in the parenchymal space at the foetal stage. There were no lymphocytes in the sinusoidal lumen at this period. In contrast, lymphocytes appeared in the hepatic sinusoids after birth and increased with ageing. Phenotypic analysis revealed that intermediate TcR cells appeared in the liver and spleen on Day 4 after birth. Bright TcR cells of thymic origin were also present in the peripheral organs on Day 4. Thereafter, intermediate TcR cells increased in the liver, whereas bright TcR cells increased in the periphery as a function of age. Similarly, thymectomized and congenitally athymic mice had mainly intermediate TcR cells in the liver and, to some extent, periphery. It is concluded that intermediate TcR cells, possibly of extrathymic origin, are generated only after birth and expand with ageing.

Aging↗

[Adjuvant chemotherapy therapy of breast cancer].

Six to 12 cycles of CMF is regarded as the standard regimen for adjuvant chemotherapy for breast cancer, producing 10-20% increase in survival for premenopausal and node-positive patients. Tamoxifen combined with CMF has induced an additional reduction in recurrence rate only in postmenopausal patients. Oral administration of 5-FU or its derivatives combined with tamoxifen for as long as 1-2 years is the regimen most widely used in Japan for considerable improvement in survival. But it needs further evaluation in comparison with CMF, and in ultimate duration of treatment and better combination with other drugs. Adjuvant chemotherapy for node-negative patients is advocated in the U.S., where the recurrence rate is as high as 30%. Only 10% of Japanese n0 patients undergo recurrence. Therefore, adjuvant therapy should be given only to high-risk patients.

Aged↗

A possible mechanism of mechanoreception in Ruffini endings in the periodontal ligament of hamster incisors.

The topographical relationship between Ruffini endings and the surrounding collagen fibers in the periodontal ligament of hamster incisors was investigated by means of both immunohistochemistry for neurofilament protein (NFP) and electron microscopy. Periodontal Ruffini endings, a type of stretch receptor, were present exclusively in the alveolar half of the periodontal ligament. Their axon terminals were densely and regularly associated with transverse collagen fibers, possibly forming a mechanoreceptive complex. Since blood sinuses with frequent anastomoses extended throughout the alveolus-related part, the densely innervated collagen bundles were separated from each other by the vascular spaces. Electron microscopic observation of specimens stained with tannic acid revealed a linkage between the axon terminals of the Ruffini endings and the surrounding collagen filaments. The axon terminals were enveloped by multiple layers of the basal lamina, which were penetrated by collagen filaments. The irregularly arranged collagen filaments were sandwiched between electron-dense laminae of the multilayered basal lamina. The possible mechanism of mechanoreception by the periodontal Ruffini endings is discussed on the basis of the immunohistochemical and ultrastructural findings.

Animals↗

Concomitant benefit of preoperative irradiation in preventing pancreas fistula formation after pancreatoduodenectomy.

Preoperative irradiation improves both the resectability and curability of carcinoma of the pancreas head area and should improve patient survival. We retrospectively investigated the value of preoperative irradiation in preventing pancreatic fistula formation. Of 76 consecutive patients who underwent pancreaticojejunostomy by mucosa-to-mucosa anastomosis with a stent catheter after pancreatoduodenectomy, 22 had received preoperative irradiation. The irradiation field included the anastomotic site. In two patients, accidental dislocation of the stent catheter was the apparent cause of fistula formation, but the other 21 patients in the irradiated group developed no fistula. In contrast, nine (17%) of 53 patients in the nonirradiated group developed fistulas. In the irradiated group, preoperative selenomethionine Se 75 scintigraphy revealed a cold area corresponding to the pancreas body, which was included in the irradiation field. Thus, a putative decrease in exocrine function at the pancreatic anastomotic site could explain why fistula formation was prevented by preoperative irradiation.

Aged↗

Immunohistochemical, ultrastructural and biochemical studies of an amylase-producing breast carcinoma.

We describe a breast cancer with ectopic production of amylase, found in the patient's serum, urine and in the tumour. Clinically, serum amylase levels reflected both the progression of the disease and regression induced by various therapies. Using agarose gel electrophoresis and a wheat protein inhibitor assay, the predominant serum amylase appeared to be identical to pancreatic-type isoenzyme. However, the action mode analysis using a new fluorogenic substrate revealed that the serum contained non-salivary, non-pancreatic amylase. The tumour had microscopic features of invasive ductal carcinoma with some argyrophilic differentiation. The component cells stained positively for amylase, and ultrastructurally numerous secretory granules were seen.

Adult↗

Response of the taste receptor cell to the umami-substance stimulus. An electron-microscopic study.

The chemosensory gustatory cells in taste buds form chemical synapses with intragemmal neurites. We investigated the ultrastructure of the guinea pig gustatory cells after stimulation with a mixture of monosodium L-glutamate and guanosine 5'-monophosphate. The gustatory cells responded to the stimulus. The dense-cored vesicles localized in the presynaptic regions discharged the contents into the synaptic cleft by means of exocytosis, which resulted in a marked decrease of their population. These findings strongly suggest that the transmitter or transmitters contained in the vesicles are released in response to the taste stimulation at the cell apex, to conduct the excitement of the cell to the nerves.

Animals↗

Changes in hematologic parameters during treatment with medroxyprogesterone acetate for breast cancer.

To elucidate the etiology of the thrombogenic effects of high-dose medroxyprogesterone acetate (MPA) in the treatment of breast cancer, hematologic parameters were sequentially assessed in 12 patients receiving MPA 800 mg p.o. daily for 6 months as adjuvant hormone therapy after mastectomy. The results were as follows. (1) Coagulation system: levels of factor VII and fibrinogen decreased significantly, whereas factors II and IX increased significantly, with a shortened activated partial thromboplastin time. (2) Fibrinolytic system: plasminogen and alpha 2-plasmin inhibitor-plasmin complex increased, whereas fibrinogen degradation products remained low. (3) Anticoagulation system: antithrombin III increased significantly. (4) These changes were most marked after 2 or 4 weeks of MPA treatment, and returned to the pretreatment level one month after discontinuation of treatment. (5) No patients in this study developed thromboembolic disease during or after MPA administration. These results indicate that MPA may induce a hypercoagulable state, but this state does not directly lead to the development of thrombosis.

Adult↗

Fine structure of the taste bud in guinea pigs. II. Localization of spot 35 protein, a cerebellar Purkinje cell-specific protein, as revealed by electron-microscopic immunocytochemistry.

The localization of spot 35 protein, a cerebellar Purkinje cell-specific protein, was studied in guinea pig taste buds by means of electron-microscopic immunocytochemistry. The immunoreactivity was localized in the cytoplasmic matrix of discrete bud cells. The ultrastructural features of the reactive cells indicated that they corresponded to the Type III or gustatory cells making a synaptic contact with the intragemmal nerves. All other cells specified as basal, Type I, and Type II were immunonegative for spot 35 protein. This finding indicates a method for specifically demonstrating the gustatory cells in the guinea pig taste bud and, further, gives new evidence that paraneurons may share neuron-specific substances with neurons.

Animals↗