[Cytokine network within the central nervous system].
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Blood-Brain Barrier↗
Biomedical subjects
T Nitta
Publications and source records attributed to T Nitta.
[A 52-year-old man with sensory aphasia and multiple intracranial masses].
We report a 52-year-old-man who developed aphasia, apraxia and agnosia. He was well until December of 1991 when he noted an onset of skin scaling in the extensor sides of his elbow joints; he was admitted to the dermatology service of our hospital and was diagnosed as having pemphigoid. Treatment with PDN 30 to 60 mg/day and azathioprine 50-100 mg was started. While in the hospital there was a insidious onset of right tinnitus and tingling sensation in his right leg in the middle of March, 1991. During next one week, his family noted that the patient responded incoherently in his speech once in a while. Neurological consult was requested on April 2, 1991. On neurologic examination, he was alert but incoherent in his speech. His spontaneous speech was reduced but it was fluent. However, he had a difficulty in understanding spoken as well as written language. Naming and repetition were also impaired, and he appeared to have Wernicke's aphasia. Ideational apraxia, ideomotor apraxia, constructional apraxia, left-right disorientation, finger agnosia, and body agnosia were noted as well, but he did not have dressing apraxia or spatial disorientation. Right homonymous hemianopsia was present, but any other cranial nerves were not disturbed. He had no weakness or ataxia; gait was normal. Deep reflexes were normal and symmetric. Sensations were intact. Complete blood counts and routine blood chemistries were normal. The lung was clear. Opening pressure at spinal tap of CSF was under a normal pressure; CSF contained 6 lymphocytes/microliters and 78mg/dl of protein; a cytological study showed no malignant cells.(ABSTRACT TRUNCATED AT 250 WORDS)
Aphasia, Wernicke↗
[A clinicopathological study of 21 cases of primary central nervous system lymphoma].
A clinico-pathological study was carried out in 21 cases of primary central nervous system-non-Hodgkin's lymphoma (CNS-NHL). Their clinical profiles (age, prognosis, modalities of treatment) and findings of radio-imaging were analyzed. All specimens from surgery and/or autopsy were histologically classified according to the working formulation (WF) classification of the National Cancer Institute. Ontogeny of lymphoma cells was determined by immunohistochemical study in all cases and some cases were subjected to light (kappa, lambda) and heavy chain (IgG, IgA, IgM) analysis as well. Among 21 cases, 12 cases were located in the cerebral hemisphere, 7 in the thalamus-basal ganglia and 4 in the cerebellum. Radio-imaging study showed that 18 cases (86%) revealed isodensity mass lesions on plain CT, which were homogeneously enhanced by contrast medium. The pathological study showed that all cases were derived from B-cells. Five were classified as immunoblastic type (IBL), 9 as diffuse large type (DL), and the others were classified according to WF. 17 of 21 cases (81%) were sensitive to radiotherapy, and 15 of 19 cases (79%) responded to corticosteroid. A prognostic study revealed that patients with IBL had less hope than those with DL. From this result, it seems that WF classification is better than LSG classification for obtaining a prognosis in malignant lymphoma patients. The frequency of primary CNS-NHL has been increasing for the past several decades and will surpass that of any other brain tumors in the near future because of the explosive expansion of AIDS patients. Therefore, not only clinicopathological analysis but also biological study for CNS-NHL might be important.
Adult↗
[Electrophysiological study of experimental atrial fibrillation].
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Animals↗
[Efficacy of combining mapping with surgery of atrial fibrillation].
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Adult↗
[Mapping of the entry circuit in ventricular tachycardia].
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Humans↗
Enigmatic double-stranded RNA in Japonica rice.
We have found a linear, 16 kb, double-stranded RNA (dsRNA) in symptomless Japonica rice (Oryza sativa L.) that is not found in Indica rice (Oryza sativa L.). The dsRNA was detected in every tissue and at every developmental stage, and its copy number was approximately constant (about 20 copies/cell). Double-stranded RNA was also detected in two strains of Oryza rufipogon (an ancestor of O. sativa). Hybridization experiments indicated that the dsRNA of O. rufipogon was homologous but not identical to that of O. sativa. The sequence of about 13.2 kb of the dsRNA was determined and two open reading frames (ORFs) were found. The larger ORF (ORF B) was more than 12,351 nucleotides long and encoded more than 4,117 amino acid residues.
Base Sequence↗
Successful combined operation for mitral stenosis and atrial fibrillation.
Simultaneous surgical treatment of mitral stenosis and atrial fibrillation was performed. The patient's postoperative course was uneventful, the rhythm changed to sinus rhythm, and the patient was discharged on the 21st postoperative day in stable condition.
Atrial Fibrillation↗
Skewed distribution of TCR V alpha 7-bearing T cells within tumor-infiltrating lymphocytes of HLA-A24(9)-positive patients with malignant glioma.
The identification and propagation of T cells with anti-tumor reactivity is critical for understanding the human immune response to tumors, which may possibly be useful in the successful implementation of adoptive immunotherapy against cancer. In order to address this question, we examined the diversity of mRNA transcripts of T-cell receptor (TCR) V alpha and V beta genes in tumor-infiltrating lymphocytes (TIL) of 12 glioma specimens obtained at surgery. Using the polymerase chain reaction (PCR) method and primers for 18 different human TCR V alpha and 22 V beta families to analyze TCR V-(D)-J-C gene rearrangements, we detected a limited expression of TCR variable region, V alpha genes and predominant usage of V alpha 7 within glioma TIL. TCR V beta gene usage was more diverse than that for V alpha, but TCR V beta 13.1 was dominantly expressed in 9 out of 12 patients. In addition, we analyzed the percentage of each V alpha- and V beta-bearing T-cell subpopulation in TIL as well as in peripheral blood lymphocytes (PBL) quantitatively. The distribution of T-cell subpopulation bearing each V alpha or V beta subfamily was variable and uneven in all cases. In 3 cases, the distribution of V alpha 7-bearing T cells in TIL was far higher than in PBL. This phenomenon was not found in T cells bearing TCR V beta 13.1. We also performed human leukocyte antigen (HLA) typing in these patients, and A24(9) was observed in 8 out of 11 patients. Among them all 3 patients who showed a skewed distribution of V alpha 7-bearing T cells in TIL expressed HLA-A24(9). There was no correlation between particular class I or II type and TCR V beta gene usage. From these results, it was strongly suggested that T cells bearing TCR V alpha 7 might be targeted to antigenic determinants on glioma cells, and such T-cell population may be useful as effector cells for cancer immunotherapy.
Adult↗
Phase I and pharmacologic study of irinotecan in combination with cisplatin for advanced lung cancer.
We have conducted a Phase I trial to determine the maximum tolerated dose of CPT-11 together with a fixed dose of cisplatin in patients with advanced lung cancer, and the dose-limiting toxicities of this combination. Fourteen previously untreated patients with stage IIIB or IV disease were treated with CPT-11 (90-min intravenous infusion on days 1, 8, and 15) plus cisplatin (60 mg m-2, intravenously on day 1). The starting dose of CPT-11 was 60 mg m-2, and diarrhea was the dose-limiting toxicity at the 90 mg m-2 dose level. All three patients (all four cycles) given 90 mg m-2 of CPT-11 experienced grade 3 diarrhea. Hematologic toxicity was relatively mild. Elimination of CPT-11 was biphasic with a mean (+/- s.d.) beta half-life of 11.36 +/- 7.26 h. The mean terminal half-life of the major metabolite (7-ethyl-10-hydroxycamptothecin; SN-38) was 22.13 +/- 13.28 (s.d.) h, and modest escalation of the CPT-11 dose from 80 mg m-2 to 90 mg m-2 resulted in a statistically significant apparent increase in the plasma concentrations of SN-38. There were one complete response (7%) and five partial responses (36%) among the 14 patients for an overall response rate of 43%. The recommended dose for Phase II studies is 80 mg m-2 of CPT-11 and 60 mg m-2 of cisplatin.
Adult↗
Antigen-specific proliferative response of peritoneal exudate lymphocytes primed with antigen and bacterial lipopolysaccharide: the roles of Ia+ accessory cells and IL-2.
In vitro antigen-specific proliferation was investigated in a lymphocyte population that had been taken from the peritoneal exudate cells (PEC) of C3H/HeN mice (Iak) primed in vivo with both bacterial lipopolysaccharide (LPS) and horse red blood cells (HRBC) and had been purified by passage through a nylon fiber column (Nfc). The proliferative response of the Nfc-passed lymphocytes primed with HRBC and LPS [T(HRBC+LPS) cells] depended on the dose of antigen in the cultures, and the response was higher than that of cells prepared from mice primed with HRBC alone [T(HRBC) cells]. No response was seen in the cells prepared from the LPS-primed mice [T(LPS) cells] or normal mice [T(N) cells]. The response of the T(HRBC) cells was abolished by previous treatment of the cells with anti-Iak antibody and complement (C), whereas the response of the T(HRBC+LPS) cells was retained after the same treatment, indicating that the Ia- T(HRBC+LPS) cells can proliferate in response to antigen in spite of Ia+ accessory cell-depletion. Supernatants from the cultures of Ia- T(HRBC+LPS) cells in the presence of HRBC showed abundant IL-2 activity, while those of Ia- T(HRBC) cells did not. The IL-2 should be produced by the L3T4 cell population in T(HRBC+LPS) cells in response to antigen, since the previous treatment of the cells with anti-L3T4 antibody and C abrogated the production.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Characterization and surgical ablation of acute atrial flutter following the Mustard procedure. A canine model.
BACKGROUND: A high incidence of refractory atrial flutter has been reported as a late postoperative complication of the Mustard procedure. The objective of this study was to reproduce experimentally the long-cycle-length atrial flutter that occurs in these patients and attempt to ablate the arrhythmia surgically. METHODS AND RESULTS: Nine dogs underwent a simulated Mustard procedure, which included a longitudinal right atriotomy, a septectomy, and a continuous suture line placed in the usual baffle location. All animals were subsequently inducible into sustained atrial flutter after surgery. Activation-time electrophysiological maps of the various pathways of atrial reentry were determined using atrial endocardial molds containing 252 bipolar electrodes. Four distinct reentrant circuits were observed in the following locations: (1) around the tricuspid value annulus (n = 5; cycle length, 175 +/- 5 milliseconds), (2) around the atriotomy incision (n = 2; cycle length, 208 +/- 3 milliseconds), (3) in a pathway involving both atria (n = 1; cycle length, 180 milliseconds), and (4) around the mitral valve (n = 1; cycle length, 135 milliseconds). A common pathway for eight of the nine reentrant circuits included the free-wall segment of the right atrium (excluding the mitral valve circuit). In the first three animals, surgical ablation of the atrial flutter was not attempted, but an incision made perpendicular to the atriotomy down to the tricuspid valve annulus resulted in termination of the atrial flutter in the other six animals. One of these animals was subsequently inducible into an atrial flutter of different morphology (cycle length, 125 milliseconds) that involved an isolated left atrial reentrant circuit. CONCLUSIONS: The Mustard procedure creates several anatomic substrates that increase the probability of the heart to develop atrial flutter, and these may be amenable to subsequent surgical correction.
Animals↗
Profound systemic hypothermia protects the spinal cord in a primate model of spinal cord ischemia.
Spinal cord ischemia with resultant paraplegia or paraparesis remains an important clinical problem after operations on the thoracoabdominal aorta. Because hypothermia has a protective effect on ischemic neural tissue, we developed a baboon model of spinal cord ischemia to simulate the situation encountered clinically for resection of aneurysms of the thoracoabdominal aorta and to determine whether profound hypothermia produced by hypothermic cardiopulmonary bypass has a protective effect on spinal cord function. After cardiopulmonary bypass was established, the aorta was clamped distal to the left subclavian artery and proximal to the renal arteries for 60 minutes. Group I animals (n = 9) underwent aortic clamping at normothermia (37 degrees C), and group II animals (n = 9) were cooled to a rectal temperature of 15 degrees C before aortic clamping and underwent cardiopulmonary bypass at this temperature until the aorta was unclamped. Of the eight operative survivors in group I, six animals were paraplegic and two were paraparetic, whereas all six group II animals that survived the procedure were neurologically intact (p = 0.0002). The protective effect of hypothermia was associated with blunting of the hyperemic response of spinal cord blood flow (determined by the radioactive microsphere technique) in the lower thoracic and the lumbar segments of the spinal cord after unclamping of the aorta. Profound hypothermia produced by hypothermic cardiopulmonary bypass may be an effective method of protection of the spinal cord in patients undergoing repair of aneurysms of the thoracoabdominal aorta and may reduce the prevalence of ischemic injury to the spinal cord.
Animals↗
[Malfunction of mitral and tricuspid Ionescu-Shiley pericardial xenografts].
We report a case of the malfunction of Ionescu-Shiley pericardial xenografts (ISPX) in the mitral and tricuspid positions at 6 years after implantation. The patient underwent an emergency operation successfully despite his high age (75 years) and extremely poor preoperative condition. The valve extracted from the mitral position showed spontaneous disruption of the leaflet, while the tricuspid valve graft was entangled with the preserved native septal leaflet around the stents. This former complication is now widely recognized, but the latter one appears to be rare. Care should be taken in replacing the atrioventricular valve with a bioprosthesis when the native valve leaflets are not removed. Although the ISPX is no longer in clinical use, careful follow-up is mandatory in patients with this prosthesis especially when it was implanted in the mitral position.
Aged↗
Retraction. An analysis of T-cell-receptor variable-region genes in tumor-infiltrating lymphocytes within malignant tumors.
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Retraction Notice↗
Expression of granulocyte colony stimulating factor and granulocyte-macrophage colony stimulating factor genes in human astrocytoma cell lines and in glioma specimens.
Expression of granulocyte (G) and granulocyte-macrophage (GM) colony stimulating factor (CSF) genes in human cells of astroglial lineage was studied. Primers for CSFs were used to analyze RNA transcripts in 5 cultured human astrocytoma cell lines and 8 fresh brain specimens by polymerase chain reaction. Constitutive expression of mRNA transcripts of GM-CSF could be detected in all astrocytoma and one neuroblastoma cell lines, and two out of 5 unstimulated astrocytomas, U87MG and U138 MG, expressed G-CSF genes. After stimulation with interleukin (IL)-1 beta + tumor necrosis factor (TNF)-alpha, all cell lines expressed G-CSF. In addition to the cultured cells, we examined gene expression within human malignant astrocytoma, peritumoral brain and autopsied normal brains. The results show that some of the tumor and its surrounding reactive lesions express G- and GM-CSF genes but normal brains do not. The concentration of G- and GM-CSF in supernatants of cultured cells was assessed at the protein level by ELISA. A low level of GM-CSF activity was constitutively present in all astrocytomas. G-CSF was detected in unstimulated U87MG and U138MG and other cell lines could synthesize G-CSF after the stimulation of IL-1 beta and TNF-alpha at the level of mRNA. Furthermore, the concentration of CSFs increased markedly upon stimulation with IL-1 beta and/or TNF-alpha in both a time- and dose-dependent fashion. From these results, it is suspected that astroglial cell-derived CSFs may participate in local immune reactions accompanying infection, degeneration and malignancies in the brain.
Astrocytoma↗
Neoplastic and reactive human astrocytes express interleukin-8 gene.
Expression of lymphokine genes in the human astroglial cell lineage was studied. Primers for 9 different human lymphokines, from IL-1 alpha to IL-8, were used to analyze RNA transcripts in 5 cultured human astrocytoma cell lines and fresh brain specimens by PCR. mRNA transcripts for IL-8 were detected in all neuroglial cells. In addition to the cultured cells, we examined IL-8 gene expression within human malignant astrocytoma, peritumoral brain and autopsied normal brains. The result shows that tumor and cells of the surrounding reactive lesion express IL-8 genes, but it is not expressed in normal brains. Next, the concentration of IL-8 in supernatants of cultured cells was measured quantitatively by a solid phase ELISA assay. IL-8 activity was produced constitutively in all astrocytomas and increased markedly upon stimulation with IL-1 beta or TNF alpha, in both a time- and dose-dependent fashion. From these results, it is suspected that astroglial cell-derived IL-8 may take part in neutrophil-mediated inflammation which accompanies infection, degeneration and malignancy in the brain.
Astrocytes↗
Surgical laser ablation of a pediatric idiopathic ventricular tachycardia.
A pediatric patient with medically refractory idiopathic ventricular tachycardia was successfully treated by surgical laser ablation. Application of laser on the normothermic beating heart enables continuous electrophysiological assessment. The histopathology of idiopathic ventricular tachycardia and the advantages of laser ablation are presented.
Atrioventricular Node↗