[Clinical analysis of the small kidney with VUR].
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Biomedical subjects
Publications and source records attributed to T Ogino.
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We experienced fifteen cases (3.9%) out of 387 with gastric cancer showing elevation of alphafetoprotein (AFP) in serum. In these cases AFP producing cells in primary lesion demonstrated positive for anti-AFP by means of immunohistochemical study. In this report, clinicopathological feature and clinical significance as a tumor marker of gastric cancer were discussed. Gross type showed Borrmann II and III which were located in atrophic area in the stomach. Histological type revealed papillary, moderately differentiated and poorly differentiated adenocarcinoma, all of which showed medullary growth in stroma. In clinical field, liver metastasis was observed in 12(80%) of 15 cases. In these cases, elevation of serum AFP was already observed before the detection of liver metastases by CT or Echo. Immunohistochemical study showed no difference between primary tumor and metastases, and no AFP positive cells were seen in 68 early gastric cancers without elevation of serum AFP.
Peplomycin, derivative of Bleomycin which was developed because of a lower pulmonary toxicity and broader anti-tumor spectrum in animal study, also showed to be effective in clinical studies on adenocarcinomas such as prostatic cancer, breast cancer, etc. as well as on squamous cell carcinoma and the anti-tumor spectrum were observed to be broader than those of Bleomycin. Further, the combination therapy with other anti-cancer drugs showed higher effectiveness. Clinically lower pulmonary toxicity was also observed. Liblomycin, derivative of Bleomycin having a lipophyllic characteristics, was developed since it showed in animal studies a lower pulmonary toxicity than that of Peplomycin and broader anti-tumor spectrum. At present, this substance is under Phase I study in Japan.
A 72 year-old man visited our hospital complaining of anorexia and hungry epigastric pain. Gastroscopy and upper G-I series examination established the diagnosis of double gastric cancers. Total gastrectomy, R2 lymphadenectomy and beta anastomosis were performed. The type IIc early cancer lesion at the pyloric vestibule was sm in depth and revealed a histological pattern of tubular adenocarcinoma. The multiple lesions on the anterior and posterior walls of the lesser curvature were a cluster of submucosal cysts, and were partially accompanied by signet-ring cell carcinoma having the depth m. The two lesions were histologically isolated without continuity, and the histology progress was PoHoeta (-) ps(-), Stage I, aw(-), ow(-). Postoperative course was uneventful. Though multiple diffuse ectopic gastric mucosa is seemed to be benign submucosal tumor of the stomach, occasional co-existence of cancer has been frequently reported. Even if the results of gastroscopy and upper G-I series results are negative, there is always a possible risk of overlooking a small cancerous focus. On detecting ectopic gastric mucosa, immediate and thorough resection seems desirable, especially when accompanied by cancer. The pathogenesis of multiple diffuse ectopic gastric mucosa has remained controversial and has been explained by the theory of either congenital or acquired aberration. From the histological findings, the pathogenesis of this case could not be determined.
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Late rupture of the extensor pollicis longus tendon is an occasional complication following a fracture of the distal end of the radius. Previous reports have been exclusively in middle aged or elderly patients. The present case is unique in that it affected a 14 year old girl.
Thirty-six cases with recurrent gastric carcinoma were treated with radiation at the National Cancer Center Hospital between 1962 and 1983. There are 17 local, 12 peritoneal and 7 lymph node recurrences, and the 50% survival months were 7.2, 5.1, and 3.8 months respectively. The survival rates of these patients were 17% at one year, 5% at two year, and 3% at three year. As a conclusion, it was suggested that combined radiation therapy with some anticancer drugs should be effective procedure to prolong the life of patients with recurrent gastric carcinoma.
A case of congenital fusion of metacarpal bones with polydactyly is reported. The fusion occurred between the proximal parts of the third and the fourth metacarpal bones. The same type of anomaly was induced in rat fetuses by oral administration of myleran. The anomalies for which the critical period is the same as both metacarpal fusion and polydactyly, were analysed. From the results of the experimental study, the authors propose that the cause of the metacarpal fusion associated with polydactyly is the combination of a disorder of ectoderm-mesoderm interaction and a deficit of mesenchymal cells in the limb bud.
A case of retroperitoneal metastasis of a malignant testicular tumor treated by transarterial embolization (TAE) is reported. The tumor feeders were the intercostal and lumbar arteries. Improvement of the patient's condition could be obtained by TAE. It is suggested that TAE has some effectiveness for chemoresistant, radio-resistant or inoperable cases of metastatic retroperitoneal tumors.
Using a 1.89-Tesla spectrometer, 1H and 31P nuclear magnetic resonance spectra were acquired from the brains of paralyzed rabbits ventilated with 30% oxygen in nitrous oxide. Intracellular pH and changes in lactate concentration in the cerebrum were monitored by nuclear magnetic resonance methods during and after bicuculline-induced seizures, together with the electroencephalogram, heart rate, and arterial blood pressure. During seizures lasting more than an hour, cerebral intracellular pH became acidic, the cerebral lactate level rose rapidly, and both changes persisted as long as 2 hours without signs of recovery. After less prolonged seizures, lactate elevations were no less persistent, despite nearly complete recovery of intracellular pH and the electroencephalogram.
An estimation of cell kinetic parameters was made by simultaneous flow cytometric measurements of DNA and bromodeoxyuridine (BrdUrd) contents of cells. The procedure described in this paper involves the incorporation of BrdUrd by S phase cells, labeling the BrdUrd with an indirect immunofluorescent technique using a monoclonal anti-BrdUrd antibody, and staining DNA with propidium iodide (PI). The amount of incorporated BrdUrd in HeLa cells was proportional to that of synthesized DNA through S phase. For all cell lines examined, the pattern of BrdUrd incorporation was essentially the same and the rate of DNA synthesis during S phase was not constant. The bivariate BrdUrd/DNA distributions showed a horse-shoe pattern, maximum in the mid S phase and minimum in the early and late S phases. Furthermore, the durations of cell cycle (Tc) and S phase (Ts) were estimated from a FLSm (fraction of labeled cells in mid S phase) curve that was generated by plotting the percentage of BrdUrd pulse-labeled cells in a narrow window defined in the mid S phase of the DNA histogram. The values of these parameters in NIH 3T3, HeLa S3, and HL-60 cells were in good accordance with the reported data. This FCM method using the monoclonal anti-BrdUrd antibody allows rapid determination of both cell cycle compartments and also Ts and Tc without the use of radioactive DNA precursors.
It has been very difficult to accomplish simultaneous reconstruction of a massive defect of the long bone associated with a large skin defect. Yoshimura et al reported a new procedure using a vascularized free fibular transplant with a monitoring flap. This procedure was used in four cases that had resulted in massive bone and skin defects after wide resection of benign and malignant bone tumors occurring in the long bones. Our results using the composite vascularized fibular graft were gratifying.
Glycoprotein gp3 (64K) is one of the major proteins specified by varicella-zoster virus (VZV). This glycoprotein was purified on an immunoadsorbent consisting of monoclonal antibody (clone 8) against gp3 linked to protein A-Sepharose. Rabbits were then immunized with the purified antigen to obtain monospecific antisera against gp3. The monospecific antisera and monoclonal antibody immunoprecipitated polypeptides with the same molecular weights of approximately 64,000 (64K), 106K, and 116K from a lysate of labeled cells infected with VZV. The monoclonal antibodies against gp3 did not have neutralizing activity against VZV, but anti-gp3 monospecific sera neutralized VZV infectivity. The antigenic relation of VZV to herpes simplex virus (HSV) was investigated by the immunofluorescent test, immunoprecipitation followed by analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and the neutralizing antibody test with monoclonal antibodies and monospecific antisera. In the indirect immunofluorescent test, the cytoplasm of cells infected with HSV-type 1 or HSV-type 2 was stained with anti-gp3 monospecific antiserum but not with anti-gp3 monoclonal antibodies. This serum also precipitated the polypeptides of HSV-type 1 and HSV-type 2 with molecular weight of approximately 120,000, possibly corresponding to gB of HSV-1 or HSV-2, and this immunoprecipitation was blocked by anti-gB monoclonal antibody. However, anti-gp3 monospecific antisera did not neutralize either HSV-type 1 or HSV-type 2 infectivity. These results suggest that gp3 induces neutralizing antibody against VZV and that it also has a cross-reacting antigenic determinant with gB of HSV.
Clinical features and X-rays of thirty-four cases with cubitus varus deformity were analysed in order to explain the occurrence of tardy ulnar nerve palsy caused by cubitus varus deformity. Cubitus varus cases with tardy ulnar nerve palsy, compared to cases without it, were older at the first visit to the clinic for cubitus varus deformity. There were no other differences between the two groups in clinical features. Computed tomography showed that the olecranon moved to the ulnar side against the olecranon fossa. Operative findings showed that the medial head of triceps brachii shifted medially and covered the ulnar nerve. Both from computed tomography and operative findings we conjectured the possibility that tardy ulnar nerve palsy was caused because the ulnar nerve was compressed by the forward medial movement of the medial head of the triceps brachii caused by cubitus varus deformity.
Nine hundred and forty three patients with nine hundred and fifty-five congenital upper limb anomalies are classified according to the Swanson's classification. Relative incidence of each type of anomaly, sex incidence, affected side, associated abnormalities and familial history are analysed. The occurrence of congenital upper limb anomalies is also compared with Chinese and Western studies. The characteristic feature in this series is that the incidence of typical syndactyly is not as high as expected. Two problems of Swanson's classification encountered in this analysis are discussed. One of the problems is the relation between polydactyly, syndactyly and typical cleft hand. The other is the relation between brachysyndactyly, atypical cleft hand and transverse deficiency.
Ten cases of hypoplastic thumbs were treated by abductor digiti minimi opponensplasty in order to restore opposition of the thumb and reform the wasted thenar eminence. In eight of these ten cases operations were combined with multiple Z-plasty or rotation flap to correct the narrowing of the first web space. Adductor plasty using extensor indicis proprius was performed in six cases to restore the stability of the metacarpophalangeal joint of the thumb and ligament reconstruction of the carpometacarpal joint in one hand. In all cases, the transferred abductor digiti minimi was strong enough to abduct the thumb and provide good functional and cosmetic results. We modified Littler's procedure by transferring the origins of abductor digiti minimi muscle from the flexor carpi ulnaris to the palmaris longus tendon. Our modified method gave a better cosmetic appearance than that provided by Littler's method.