Biomedical subjects
Publications and source records attributed to T Nishimura.
Magnetic resonance imaging of pericardial malignant mesothelioma in two patients is reported. Magnetic resonance imaging clearly depicted the tumor location and expansion, and was useful in delineating the anatomic extent of pericardial malignant mesothelioma.
Treatment of B16 melanoma-bearing mice with recombinant tumour necrosis factor (rTNF) caused a marked inhibition of tumour growth but did not result in the complete cure of the tumour-bearing mice. In contrast, combination therapy of B16-bearing mice with r-TNF and recombinant interleukin 2 (rIL-2) potentiated the therapeutic effect of rTNF and 30% of the mice were totally cured from tumour. Spleen cells obtained from B16-bearing mice showed markedly decreased immune responses including IL-2 production, IL-2 responsiveness and mixed lymphocyte reaction owing to the existence of suppressor macrophages. However, spleen cells obtained from mice cured with rTNF plus rIL-2 showed the same level of T cell responsiveness as that from normal mice. The decreased induction of alloantigen-specific cytotoxic T lymphocytes (CTL) in B16-bearing mice was also recovered after treatment with rTNF plus rIL-2. Moreover, B16-specific CTL, which could not be induced in normal or B16-bearing mice, was effectively induced from the spleen cells of B16-cured mice by rTNF and rIL-2. These results demonstrated that local therapy of melanoma with rTNF and rIL-2 was effective and induced systemic antitumour immunity in vivo.
We describe a rare case of long-term indwelling bilateral ureteral stents that were replaced yearly for 7 years because of azotemia associated with bilateral hydronephrosis of undetermined etiology on radiological examinations. During year 5 the patient had an uneventful gestation with delivery of a normal neonate by cesarean section. Hydronephrosis remained improved for 2 years after withdrawal of the stents.
A case of malignant schwannoma arising in a paranasal sinus is reported. In this case, histological hallmarks were lost because of the poorly differentiated nature of the tumour. Immunohistological techniques were applied to the diagnosis, confirming the neural origin of this tumour. Malignant schwannoma is a relatively rare disease in the nasal cavity and paranasal sinuses. For the treatment of this tumour, wide resection is recommended. In this patient, radical resection of the maxilla with orbital and ethmoid exenteration was performed. The patient recovered uneventfully with no evidence of disease three years after surgery.
In the diagnosis, treatment, and care of dementia patients in the senile stage, comprehensive evaluation of ability in daily life and mental function is needed. Using a simple behavioral rating scale for the mental states (NM scale) and activities of daily living (N-ADL) of the elderly, we evaluated 250 elderly subjects. According to the NM scale, the scores for subjects in whom the severity was clinically diagnosed were as follows: normal, 50-48; borderline, 47-43; mild dementia, 42-31; moderate dementia, 30-17; and severe dementia, 16-0. Screening for dementia and determining its severity were readily accomplished using the NM scale, and basic activities in the daily life of the elderly could be evaluated effectively using the N-ADL. There was a significant correlation (r = 0.863) between the Hasegawa dementia scale and the NM scale (p < 0.001), a significant correlation (r = -0.947) between intellectual function scores of the GBS scale and the NM scale, and a significant correlation (r = 0.944) between motor function score of the GBS scale and the N-ADL score. Evaluations of daily life activities can be made not only by psychiatrists and clinical psychologists, but by nonspecialists as well, because they are based on data obtained by observation of daily life behaviors; thus, assessment is appropriate both in clinical settings and in places of living.
Bispecific antibody (BSAb) consisting of anti-CD3 plus anti-c-erbB-2 Fab fragments for the application to adoptive tumour immunotherapy was prepared. This bifunctional hetero-F(ab')2 antibody reacted with both human CD3+ T cells and c-erbB-2 positive human tumour cells. Human CD8+ T cells activated with immobilized anti-CD3 plus interleukin 2 showed marginal cytotoxicity against tumour cells. However, addition of the prepared BSAb into the culture resulted in a marked augmentation of the cytotoxicity by the activated CD8+ T cells in a dose-dependent manner. The enhanced cytotoxicity of CD8+ T cells in the presence of BSAb was specific for c-erbB-2 positive tumour cells. Moreover, it was demonstrated that anti-CD3 x anti-c-erbB-2 BSAb was also effective for the specific targeting of various kinds of in vitro-activated antitumour effector cells such as lymphokine-activated killer cells, CD4+ helper/killer cells, gamma delta T cells and activated tumour-infiltrating CD8+ T cells. These results indicated that BSAb consisted of anti-CD3 and anti-c-erbB-2 will become a useful tool for the adoptive tumour immunotherapy of human cancer expressing c-erbB-2 oncogene products.
S100 extract prepared from rapidly growing mouse FM3A cells (approx. 5 x 10(5) cells/ml) transcribed ribosomal RNA gene (rDNA) much more actively in vitro than that from stationary phase cells (1-2 x 10(6) cells/ml). When the inactive S100 extract was preincubated with NAD+, rDNA transcriptional activity was restored almost to the level of the active extract. The extract activated with NAD+ exhibited a gel-shift band in the gel mobility shift assay and enhancement of protection of the sequence between -44 and -8 nt from the initiation site from exonuclease III digestion. Such an extract labeled with [32P]NAD+ was analyzed by immunoprecipitation with anti-RNA polymerase I (pol I) antibody; a protein with M(r) 130 kDa was detected. In contrast, the polypeptide was hardly labeled in the active extract. 3-Aminobenzamide, a specific inhibitor of poly ADP-ribosylation, did not inhibit the activation by NAD+. These results suggest that the activation by NAD+ is due to enhancement of the formation of initiation complex by mono ADP-ribosylation of the second-largest subunit (130 kDa) of pol I.
We previously reported the partial sequence of a cloned genomic DNA, mC26, which codes for a protein highly expressed in the lactating mouse mammary gland [mC26: Satow et al. (1986) J. Biochem. 99, 1639-1643; partial sequence: Kawamura et al. (1987) J. Biochem. 101, 103-110]. In this study, we sequenced the EcoRI-HindIII fragment (5,394 bp) of this gene and found that this gene contains a sequence completely (100%) homologous to the cDNA sequence currently reported to code for GlyCAM-1, a putative ligand for L-selectin. We show by means of an RNA protection assay that the mRNA of this gene is expressed in the mammary glands of lactating mice as well as in the lymph nodes. Semi-quantitative analysis of expression of the mC26 gene in the mammary glands revealed that the amount of mRNA was not detectable in the early stage of pregnancy, increased in the late stage, and remained quite abundant during lactation. The potential role of this gene highly expressed in the mammary gland in a stage-specific and tissue-specific manner is discussed.
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A 57-year-old man was found to have a tumor in the ascending colon after hepatic segmentectomy for ruptured hepatocellular carcinoma. Colonoscopy was performed, and metastasis of the hepatocellular carcinoma to the ascending colon was suspected based on the biopsy specimens obtained from the tumor. On hepatobiliary scintigraphy using Tc-99m PMT performed to confirm this diagnosis, Tc-99m PMT was clearly observed to accumulate in the tumor. Thus, the tumor was diagnosed as metastasis of hepatocellular carcinoma.
We studied the status of myocardial perfusion before and after coronary angioplasty (PTCA) of infarct-related artery using stress thallium scan in patients with prior myocardial infarction. Twenty-six patients who had anterior myocardial infarction caused by single-vessel disease at the left anterior descending coronary artery were involved. Patients were classified into the following four groups according to the stress-redistribution thallium scintigraphic findings before PTCA: complete redistribution (two cases), incomplete redistribution (12 cases), partial redistribution (seven cases) and no redistribution (five cases). In the group with complete redistribution, the extent of residual ischaemia in the infarct area decreased significantly after PTCA but infarct size only slightly. In the groups with incomplete and partial redistribution, the extent of residual ischaemia and infarct size decreased significantly after PTCA. In contrast, the group with no redistribution showed a slight decrease in the extent of residual ischaemia and a gradual decrease in infarct size beginning 3 months after PTCA. Clinical findings including electrocardiogram indicated that the patients with incomplete redistribution had more viable myocardium and the patients with no redistribution had more scarring. The groups with incomplete and partial redistribution showed characteristics intermediate between complete and no redistribution. The change of infarct area after PTCA was different between the four groups, but both residual ischaemia and infarct size decreased in all groups. Thus, PTCA of the infarct-related coronary artery is useful even in the patients with prior myocardial infarction, even in patients with no redistribution shown by stress thallium scan.
Noninvasive first-pass radionuclide ventriculography may permit the assessment of global and regional left ventricular function during dipyridamole infusion. Twenty patients with > or = 75% stenosis of at least one coronary artery were studied to assess the sensitivity of the technique in detecting coronary artery disease. Seven (35%) had regional dysfunction after dipyridamole infusion, and 16 (80%) developed lower than normal response in left ventricular ejection fraction (an increase of less than 5%) after dipyridamole infusion. When both regional dysfunction and subnormal rejection fraction were considered together, the sensitivity was 80%. Eight normal subjects were studied to assess specificity. None developed regional dysfunction, and left ventricular ejection fraction invariably increased after dipyridamole infusion in all normal subjects, with an increase of less than 5% in only one subject; therefore, the specificity was 88%. It is concluded that the assessment of regional dysfunction with dipyridamole infusion itself is not sensitive, whereas the assessment of changes in left ventricular ejection fraction is sensitive and specific in detecting coronary artery disease.
To test the hypothesis that there are discrepancies between 201Tl- and 123I-beta-methylpentadecanoic acid (BMIPP) distribution in the left ventricular myocardium and to assess whether BMIPP is a useful tracer agent for the assessment of left ventricular function in hypertrophic cardiomyopathy (HCM), myocardial single photon emission computed tomography (SPECT) was performed with 201Tl and BMIPP in five normal subjects and 12 patients with asymmetric septal hypertrophy. Tracer uptake in the left ventricular myocardium was scored using a four-point grading system. A homogenous distribution of the tracer with no discrepancy between 201Tl and BMIPP uptake in the left ventricular myocardium was observed in each normal subject. In contrast, BMIPP uptake was reduced compared to 201Tl in 58 segments (40%) of the 144 myocardial segments in patients with HCM. Such discordant BMIPP uptake was observed in 15 segments (42%) of the septal segments, in 19 segments (53%) of the anterior segments, in eight segments (22%) of the lateral segments, and in 16 segments (44%) of the inferior segments. There was no significant correlation between 201Tl perfusion score and left ventricular ejection fraction, whereas there was a significant correlation between BMIPP perfusion score and left ventricular ejection fraction (r = 0.748; P < 0.01). The results indicated that there were discrepancies between 201Tl and BMIPP uptake in a significant proportion of myocardial segments, suggesting the impairment of fatty acid metabolism and that BMIPP is a useful tracer agent for the assessment of left ventricular function in hypertrophic cardiomyopathy.
The interrelationship between carotenemia and biliary dyskinesia was studied in eighty-two biliary dyskinesia patients and twenty-seven normal subjects. Incidence of serum carotene levels of more than 300 micrograms/dl was more frequent in biliary dyskinesia patients without liver damage or hyperlipemia. Among the carotenemia patients, no dietary cases were found, but metabolic and hyperlipemic ones were observed. Significant relationships were found between gall bladder contraction rate and the levels of serum carotene, vitamin A, and lipids in metabolic carotenemia. A close relationship between metabolic carotenemia and biliary dyskinesia was strongly suggested.
Only limited information is available concerning left ventricular (LV) response to exercise after an external conduit operation for cyanotic congenital heart disease. Sixteen patients who had undergone external conduit repair (EC group) were studied with multi-gated cardiac pool imaging using a supine bicycle ergometer on 20 occasions. Six patients with a history of Kawasaki disease without coronary artery stenosis served as controls (control group). Myocardial imaging and cardiac catheterization were also performed in the EC group. There was no significant difference in left ventricular ejection fraction (LVEF) at rest between the groups. However, on exercise, LVEF of the EC group was significantly lower than that of the control group. Nine patients in the EC group showed a perfusion defect (PD) on 12 occasions. LVEF on exercise of the patients with PD was significantly lower than that of the patients without PD. Furthermore, only the patients with PD showed a LVEF decrease of 5% or more in response to exercise. In the EC group, a significant inverse relationship was demonstrated between right ventricular systolic pressure (RVP) and LVEF response to exercise. However, two out of four patients who underwent external conduit replacement improved their LVEF response to exercise with successful reduction of RVP. These findings indicate that an impaired left ventricular response to exercise was common in patients after external conduit operations. Myocardial damage and right ventricular outflow tract obstruction could be the causes of this left ventricular dysfunction.
In order to clarify the diagnostic problems relating to, and the proper treatment of, uterine cervical polyps, 951 polyps were analyzed clinicopathologically. All polyps were examined histopathologically and divided into 2 groups: benign polyps (Group-1), and polyps with neoplastic or malignant lesions (Group-2). Polyp size and cervical cytology are not always reliable for predicting the correct diagnosis of neoplastic or malignant lesions. Colposcopic diagnostic accuracy was 56.3%, but increased to 75.0% when combined with cytology. Neoplastic or malignant lesions were found at both the cervical polyp and the cervix in 21 out of 24 Group-2 patients (87.5%). These results suggest that in order not to miss rare neoplastic or malignant lesions in polyps and/or cervices, histopathological examinations of all polyps, aided by cervical cytology and colposcopic observation, are necessary.
The patient, a 34-year-old Japanese woman who noticed worsening of her rash after using topical corticosteroid preparations on her neck, was patch tested for both commercial preparations and corticosteroids themselves. The patch test results revealed that she had a contact allergy to gold, oxytetracycline, and 2 types of corticosteroid (acetonides and esters) in 7 compounds (betamethasone valerate and dipropionate, hydrocortisone butyrate and hydrocortisone butyrate propionate, amcinonide, budesonide, and fluocinonide).
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