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Biomedical subjects

T Nishimaki

Publications and source records attributed to T Nishimaki.

At least 127 records · Page 7Linked to original sources

[Detection of autoantibody to mitotic spindle associated antigen (MSA) in sera from patients with positive mycoplasma pneumoniae particle agglutination (PA) test].

Autoantibody to mitotic spindle associated antigen (MSA) was examined in sera from patients with positive mycoplasma pneumoniae particle agglutination (PA) test along with various autoimmune diseases and healthy subjects by means of indirect immunofluorescence (IF) using HEp-2 cells as substrates. Anti-MSA antibody was identified in 9 patients sera including 7 out of 180 sera with positive mycoplasma pneumoniae PA test, one with systemic lupus erythematosus (SLE) and one with scleroderma (PSS) respectively. Five of 9 sera with positive anti-MSA antibody contained anti-nuclear antibody (ANA) including 4 with speckled staining ANA and one with homogeneous + nucleolar staining ANA. Two collagen diseases sera positive for anti-MSA antibody showed negative mycoplasma pneumoniae PA test. In addition, there was no correlation between the presence of anti-MSA antibody and the titers of mycoplasma pneumoniae PA test. Our results indicated that anti-MSA antibody was not limited to such connective tissue diseases as previously described by other workers. It would be speculated that mycoplasma pneumoniae infection might induce anti-MSA antibody production.

Antibodies, Bacterial↗

[Preliminary criteria for the diagnosis of pulmonary hypertension in mixed connective tissue disease].

Based on analysis of data obtained from multicenter patients with collagen diseases (83 with pulmonary hypertension(PH) and 472 without PH), preliminary criteria for the diagnosis of PH in mixed connective tissue disease (MCTD) were proposed by the Research Committee for MCTD of the Ministry of Health and Welfare of Japan. The diagnosis of PH requires four or more out of six clinical and laboratory findings, including exertional dyspnea, systolic pulsation on the left sternum, increased 2nd pulmonary sound, dilatation of the pulmonary artery on chest X-ray, right ventricular hypertrophy on the electrocardiogram, and right ventricular enlargement on the echocardiogram. Alternatively, either an increase of mean pulmonary artery pressure over 25 mmHg measured by right ventricle catheterization, or the corresponding finding on Doppler echocardiography is also valid for the diagnosis of PH. When these criteria were applied to the patients in this study, the sensitivity was 92% and the specificity 100%, showing that PH may be adequately diagnosed using non-invasive methods. The number of criteria satisfied by patients with PH was well correlated with their mean pulmonary artery pressure measured by heart catheterization.

Cardiac Catheterization↗

[A case of pustulotic arthro-osteitis with secondary amyloidosis].

A 63-year-old man with a history of Pustulosis Palmaris et Plantaris since 1960 was suffered from lumbago and anterior chest pain in 1973. Chest X-ray film showed inter-sterno-costo-clavicular ossification. Spondylodiscitis, Syndesmophyte of lumbal spine, Sacro-iliitis were seen by abdominal X-ray film. He was admitted to near hospital with generalized edema and urinary protein (10-20 g/day) in April 1986. Laboratory studies showed hypoproteinemia, positive C-reactive protein, high serum amyloid A protein(240 ng/100 microliters) and negative HL-A B27. He was diagnosed Pustulotic arthro-osteitis and Secondary Amyloidosis by renal biopsy and rectal biopsy in 1987. He was treated with high-dose oral prednisolone(60 mg/day)and dimethyl sulfoxide. After treatment, Edema and Nephrose improved. Increasement of renal function was not observed.

Amyloidosis↗

Pulmonary hypertension in connective tissue disease. Clinical analysis of sixty patients in multi-institutional study.

Clinical features and prognosis of sixty patients with connective tissue disease accompanied by pulmonary hypertension (PH) (26 MCTD, 20 SLE, and 14 PSS) reported retrospectively by multi-institutions were compared. Though the obtained data were incomplete and lacking in uniformity, no significant difference in the clinical features among the three diseases were observed except high incidence of pulmonary fibrosis and low % VC in PSS and PH patients. Statistically significant difference, however, was observed between live and dead patients of three diseases gathered in post sternal pain, pulmonary diastolic murmur, right ventricular hypertrophy on ECG and mean pressure of pulmonary artery. Higher incidence of anti-nRNP antibody was observed in SLE with PH and PSS with PH patients than with the general population. A quicker occurrence of PH and shorter survival time were observed in MCTD patients with PH than in SLE and PSS patients with PH.

Adult↗

[Eosinophilia in primary biliary cirrhosis].

The numbers and the percent of eosinophils in peripheral blood of thirty patients with primary biliary cirrhosis were serially measured and were compared with their clinical data. eosinophils of 22 patients at non icteric stage (total bilirubin less than 2.0 mg/dl) were significantly higher (P less than 0.05) than those of 8 patients at icteric stage (total bilirubin more than 2.0 mg/dl). Seven patients (23.3%) showed eosinophilia with value of 6% or more and in which four patients (13.3%) showed eosinophilia more than 8%. These eosinophilia was found in non icteric patients alone but not in icteric. In two patients who have shown eosinophilia at their non icteric stage, numbers of their eosinophils decreased gradually following the increment of their total bilirubin levels. These results would indicate that eosinophils in the peripheral bloods of PBC patients could reflect some clinical conditions at their non icteric stage.

Adult↗

[The significance of autoantibodies coexisting with anti-centromere antibodies in sera of patients with primary biliary cirrhosis].

Anti-centromere antibody (ACA) has been believed to be specific to patients with CREST syndrome, a variant of scleroderma (PSS). This study was undertaken to clarify the distribution of ACA in various diseases and the significance of autoantibodies coexisting with it. The sera of patients with primary biliary cirrhosis (PBC) along with collagen diseases and aged subjects were examined for ACA by immunofluorescence method (IF) using cultured HEp-2 cells and chromosomes prepared from K 562 cells. ACA were found in sera of 10 patients with PBC, one with scleroderma, one with cerebral infarction and one with chronic renal failure respectively. ACA positive sera were examined for antibodies against other nuclear antigens including nRNP, Sm, Scl-70, SS-A and SS-B and cytoplasmic antigens by double immunodiffusion methods using rabbit thymus extract etc. as the antigens and by IF method using cryostat sections of rat kidney and stomach. In 13 sera with ACA, antimitochondrial antibody (AMA), anti-smooth muscle antibody (ASMA) and anti SS-A antibody were found in 10, 4 and one sera respectively. In 10 PBC patients with ACA, various collagen disease-related disorders were found to coexist; CREST syndrome in one, CRST syndrome in one, Raynaud's phenomenon in two and Sjögren's syndrome in 5. These results would indicate that ACA may be one of the common serological abnormalities among patients with PBC, CREST syndrome and Sjögren's syndrome.

Adult↗

Adenocarcinoma arising in Barrett's esophagus after total gastrectomy.

A 64-yr-old Japanese male who underwent a partial gastrectomy for a duodenal ulcer at the age of 21, a total resection of the remnant stomach for a stomal ulcer at age 25, and in whom Barrett's esophagus was diagnosed at age 47, was found to have a tumor at the distal esophagus and was operated on by thoracic esophagectomy. The tumor was a well to moderately differentiated adenocarcinoma invading down to the muscularis propria. The entire esophageal mucosa in the resected specimen was lined by columnar epithelium. This tumor was thought to derive from the Barrett's esophageal epithelium.

Adenocarcinoma↗

[Group specific component protein (Gc) in patients with acute hepatic necrosis].

We studied the clinical significance of serum Gc levels in the sera of patients with acute hepatic necrosis. Gc concentration were measured using an EIA in double sandwich technique with purified Gc as standard. Mean levels of serum Gc were 6.0 +/- 7.4 mg/dl in fulminant hepatitis, 20.8 +/- 13.6 mg/dl in acute hepatitis and 39.4 +/- 13.8 mg/dl in normal subjects respectively. There was slight correlation between Gc and PTT (P less than 0.05). In the observation of sequential study in patients with fulminant hepatitis, serum Gc levels of live cases elevated but those of dead cases slightly elevated, thereafter decreased. These results suggested that serum Gc levels was the useful marker as a grade of liver cell damage and a parameter of regeneration in liver cells.

Acute Disease↗

Studies on anti-liver cell membrane antibodies in sera of patients with autoimmune chronic active hepatitis.

In using the rat hepatocytes isolated and treated with formalin as antigen, IgG class antibodies to the liver cell membrane (LM-Abs) in sera of patients with chronic active hepatitis were examined by both indirect immunofluorescence (IF) and solid-phase enzyme immunoassay (EIA). Specificity of the reaction in IF and EIA was confirmed by an absorption test using different tissues and by inhibition test using the liver specific protein. Indirect IF test using isolated hepatocytes showed the linear staining in eight of 14 sera of patients with autoimmune chronic active hepatitis (CAH). Mean binding values and positive frequency of LM-Abs to the isolated hepatocytes which were detected by EIA were 4.18 +/- 2.99 and 71.4% (10/14) in autoimmune CAH, 3.16 +/- 2.50 and 50% (6/12) in primary biliary cirrhosis, 1.40 +/- 2.12 and 28.6% (4/14) in non-A, non-B, chronic hepatitis (NANB-CH) with serum gamma-globulin showing more than 2.0 gr/dl, 1.02 +/- 1.30 and 0% (0/13) in NANB-CH with gamma-globulin showing less than 2.0 gr/dl, 1.04 +/- 1.20 and 0% (0/15) in HB-CH, and 1.80 +/- 3.60 and 25.0% (3/12) in SLE. Titers of LM-Abs in serum of a autoimmune CAH patient decreased significantly after treatment with prednisolone, but their titers did not correlate with the activities of anti-nuclear antibodies or anti-smooth muscle antibodies. From these results, it was considered that some of NANB-CH patients with both LM-Abs and higher serum gamma-globulin more than 2.0 gr/dl might have some autoimmune characters similar to CAH.

Animals↗

[An autopsy case of a patient with myasthenia gravis who showed various symptoms of collagen diseases and complicated with malignant thymoma].

A 37-year-old man suffered from photosensitivity and urinary casts with serological findings of positive anti-DNA antibody, LE cells and false positive VD reaction in September of 1979. He developed general fatigue, dyspnea and diplopia with ptosis of bilateral eyelids in November of 1979, which were improved by the anti-cholinesterase drugs. In January of 1980, he had an attack of unconsciousness and his chest X-ray film showed several tumorous shadows in the anterior mediastinum and middle and lower lung fields. Treating him with chemotherapy of VEMP, the pulmonary shadows disappeared. However, he developed severe muscle weakness with an elevated CPK (430 mU/ml) and a myogenic EMG pattern along with an increased anti-acetylcholine receptor antibody (243 n Mol/l), dysphagia and eyelid-ptosis. He died in September of 1985 and his autopsy disclosed a malignant thymoma of mixed type in the anterior mediastinum and an atrophy and fibrosis with infiltration of inflammatory cells in the striated muscles.

Adult↗

Early gastric cancer of the small cell type.

A case of early gastric cancer of the small cell type is presented. The small cell carcinoma was situated in the antrum and arose in association with well-differentiated adenocarcinoma. Well-differentiated adenocarcinomas were limited to the mucosa, whereas small cell carcinoma infiltrated into the submucosa with evident vascular invasion. Small cell carcinoma revealed argyrophilia and focal squamous cell differentiation. The patient died of massive hepatic metastasis of small cell carcinoma 6 months later. We will describe clinicopathological features of our case and review the literature.

Aged↗