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Biomedical subjects

Y Kasuga

Publications and source records attributed to Y Kasuga.

At least 73 records · Page 4Linked to original sources
PubMed1990

In vitro production of interferon-gamma by peripheral blood from patients with Graves' disease, Hashimoto's thyroiditis and rheumatoid arthritis.

The production of interferon-gamma (IFN-gamma) by peripheral blood mononuclear cells (PBMC), CD4 cells, or CD8 cells in response to interleukin-2 (IL-2) stimulation has been studied; the samples were obtained from 12 healthy control subjects, 19 patients with Graves' disease (10 hyperthyroid and nine euthyroid), 13 patients with Hashimoto's thyroiditis (four hypothyroid and nine euthyroid), and 15 patients with rheumatoid arthritis (11 active and four inactive). A dose of IL-2 (25 U/ml) was utilized to induce IFN-gamma by PBMC from all four groups. The incremental increase in IFN-gamma values (with IL-2 stimulation minus without stimulation) was significantly less in PBMC from patients with Graves' disease, Hashimoto's thyroiditis, and rheumatoid arthritis than that in PBMC from control subjects. The values from PBMC in patients with Graves' disease in a euthyroid state were below normal but greater than those from patients with Graves' disease in a hyperthyroid state. The incremental increase in IFN-gamma values from Graves' disease PBMC correlated with the serum TSH values (r = 0.622, P less than 0.01), but not with thyroid autoantibodies (anti-thyroid microsomal antibodies, anti-thyroid microsomal antibodies, nor TSH-binding inhibitory immunoglobulin activities). The incremental increase in IFN-gamma from PBMC from both control subjects and Graves' disease was correlated with that from CD4 cells (r = 0.711, P less than 0.01), but not with that from CD8 cells. The production of IFN-gamma in response to IL-2 from PBMC in Graves' disease correlated inversely with thyroid function, appearing to reflect the very effect of hyperthyroidism in this process. The precise explanation of these phenomena remains unclear. The decreased response of IFN-gamma to IL-2 stimulation by PBMC from patients with Graves' disease, Hashimoto's thyroiditis, and rheumatoid arthritis seems to be a non-specific phenomenon occurring in both organ specific autoimmune disease and systemic autoimmune disease. It may be due to a down-regulation in autoimmune disease of CD4 cells in response to IL-2, a decreased level of IL-2 cellular receptors or a decreased receptor affinity, associated increased soluble IL-2 receptors, or a defect of the intra-CD4 cellular IL-2 signal to produce or release IFN-gamma in the conditions studied.

Adult↗
PubMed1990

Effects of supernatants of peripheral blood mononuclear cells stimulated by thyroid microsomal antigen on thyrocyte HLA-dr expression in vitro.

Supernatants of 5 day cultures of peripheral blood mononuclear cells (PBMC) stimulated by thyroid microsomal antigens (TMA), and liver microsomal antigens (LMA) have been utilized to induce HLA-DR expression on human thyroid epithelial cells (TEC). The PBMC were obtained from 8 normal control persons and 13 patients with autoimmune thyroid disease (AITD) (7 Graves' disease and 6 Hashimoto's thyroiditis). The TEC HLA-DR expression was measured by an enzyme-linked immunosorbent assay (ELISA) technique. TEC HLA-DR expression was calculated as follows: (experimental optical density-control optical density) x 10(3): TEC HLA-DR index: % HLA-DR expression of IFN gamma 100 U/ml stimulation; and stimulation index (SI): TEC HLA-DR expression index induced by PBMC supernatants with antigen stimulation/TEC HLA-DR expression index induced by PBMC supernatants without antigen stimulation x 100. Supernatants without antigen stimulation from both normal control subjects and patients were able to induce TEC HLA-DR expression only minimally: 36.7 +/- 32.6 (mean +/- SD) TEC HLA-DR index for normal controls and 21.3 +/- 15.5 TEC HLA-DR index for AITD (not significant). The SI curves of both TMA and LMA were significantly different between control and AITD using two-way ANOVA test (p less than 0.01). TMA-stimulated PBMC supernatants from the patients increased TEC HLA-DR expression when compared to basal level using paired t-test; TMA 1 ng/ml, SI 179 +/- 99, less than 0.05.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Peripheral blood T lymphocyte sensitization to thyroid microsomal antigen from patients with Graves' disease negative for circulating anti-thyroid microsomal antibodies.

We have studied thyrocyte HLA-DR expression induced by supernatants of peripheral blood mononuclear cells (PBMC) stimulated by thyroid microsomal antigen (TMA), as an index of sensitization of the T lymphocyte in autoimmune thyroid diseases; we have studied PBMC from 11 normal control persons and 19 patients with Graves' disease (GD) in whom serum anti-thyroid microsomal antibodies (AMA) were either not detectable (9 patients) or were positive (10 patients). Thyrocyte HLA-DR induction in response to TMA-treated PBMC supernatants from GD was significantly different from that of normal controls (p less than 0.05, ANOVA). TMA-stimulated GD PBMC supernatants increased thyrocyte HLA-DR index [TMA 1 ng/ml, SI 143 +/- 82 (mean +/- SD), p less than 0.05], but normal PBMC supernatants did not. However there was no significant difference in response in terms of the thyrocyte HLA-DR expression induced by TMA-stimulated PBMC supernatants between AMA seronegative vs seropositive GD. These results suggest the possibility of some dissociation of the activities of T lymphocytes and B lymphocytes in patients with GD in response to thyroid microsomal antigen with or without anti-thyroid microsomal antibodies.

Adult↗
PubMed1990

Serum interferon gamma levels in autoimmune thyroid disease.

The lymphokine, interferon gamma (IFN gamma) is considered to play an important role in the development of autoimmune thyroid disease (AITD); the main source of IFN gamma has been shown to be CD4 cells when stimulated by soluble antigen. We have measured the serum IFN gamma concentration in 42 patients with AITD (24 Graves' disease and 18 Hashimoto's thyroiditis) and 9 normal control subjects, using a sandwich enzyme-linked immunosorbent assay (ELISA) (detectable limit, 1 IU/ml). One of normal controls, 14 of the 24 patients with Graves' disease, and 5 of the 18 patients with Hashimoto's thyroiditis had detectable IFN gamma levels. Patients with Graves' disease were found to have higher concentrations of serum IFN gamma (11.6 +/- 15.8 IU/ml, mean +/- SD) than normal controls (1.1 +/- 0.3 IU/ml). However, the values in patients with Hashimoto's thyroiditis (9.4 +/- 15.5 IU/ml) were not significant when compared to those in normal controls. Serum IFN gamma values in patients with AITD did not correlate with serum anti thyroid autoantibodies (antithyroglobulin, antithyroid microsomal antibody, or TSH binding inhibitory immunoglobulin activity) or with thyroid function. Thus, increased in vivo production of IFN gamma in Graves' disease as evidenced in these serum concentrations might reflect T cell activity, but does not appear to be an accurate reflection of intrathyroidal events.

Autoantibodies↗
PubMed1990

Clinical evaluation of the response to surgical treatment of Graves' disease.

Included in this study are 513 patients with Graves' disease who underwent thyroidectomy between 1970 and 1983. The patients were divided into three groups by dividing the period in which the surgical procedures were done. The weight of the remnant of the thyroid gland and the incidence of surgical complications were collated for the patients in each group studied. Postoperative function of the thyroid gland was evaluated clinically and biochemically and compared with the remnant weight and total weight of the thyroid gland. The remnant weight was greatest in the first period and least in the third period. There were no differences between the frequencies of postoperative complications among the three groups in site of a remarkable decrease of the remnant weight in the third period. Remission of hyperthyroidism, including those with a latent hypothyroid state, was most frequently observed in the group in which the remnant weight was from 4 to less than 8 grams. These results indicate that the remnant weight appears to be one of the most crucial factors influencing the postoperative outcome; it thus seems appropriate to leave only small remnants of the thyroid gland (4 to less than 8 grams) at thyroidectomy. In our hands, surgical treatment is an effective and safe procedure for Graves' disease, although the precise mechanism for the remission induced by this procedure has not been elucidated.

Graves Disease↗
PubMed1990

[Clinical evaluation of extended neck differentiated thyroid carcinoma].

In some patients with advanced differentiated thyroid carcinoma, an upper mediastinal dissection is recommended. Both 17 primary and 6 non-primary patients who had undergone an upper mediastinal dissection in Shinshu University Hospital, from 1984 to 1987, were surveyed. We also studied 198 patients who had been performed a modified radical neck dissection from 1984 to 1986. In the 17 primary cases, 6 (35%) had positive nodes in the upper mediastinum (M group), and 11 (65%) negative (NM group). And we analysed these two groups. In addition, 5 non-primary cases and 198 patients were analyzed in terms of the nodal metastatic status of the tumor-free side. From these results, we conclude the indication of mediastinal dissection for thyroid carcinoma as follows: (1) positive lymph node is suspected in the upper mediastinum by the study of CT or 201thallium scintigram. (2) nodal metastases are suspected in the deep cervical location of the tumor-free side. (3) a male patient whose age is younger than 50, and tumor is located in the left lobe and its size is larger than 3.0 cm.

Carcinoma↗
PubMed1989

TSH-binding inhibitor immunoglobulin (TBII) in thyroidal venous blood and histological grade of intrathyroidal lymphocyte appearance in Graves' disease.

The aim of this study is to investigate the possibility of determining the appropriate amount of thyroid tissue to leave behind as remnant weight in subtotal thyroidectomy for Graves' disease by measuring the TBII value, and correlating the outcome to the grade of intrathyroidal lymphocyte infiltration. We therefore have investigated the levels of TBII in the thyroidal (T-TBII) and peripheral (P-TBII) venous blood, and the grade of lymphocytic infiltration and lymph follicle formation in the intrathyroidal tissue. There was no parallel relationship between the T-TBII value and the grade of lymphocytic infiltration and lymph follicle formation. There was no marked difference between the T-TBII value and the P-TBII value. It was thus not possible to use these data to determine the proper remnant weight of Graves' thyroid tissue at the time of surgery.

Adolescent↗
PubMed1989

[A scirrhous carcinoma of the nipple suspected of being Paget's disease].

Discussed is a 38-year-old woman, whose chief complaints were an eczema-like lesion and itching of the nipple in the left breast. Thus, Paget's disease was suspected, and touch cytology and a cytological biopsy of an aspirated specimen were done. The results indicated a class II and class V status, respectively. A radical mastectomy, therefore, was performed immediately. Macroscopic findings of the resected tissue showed no tumor in the nipple or in the mammary gland. A histological examination led to the determination of a scirrhous carcinoma of the nipple. Seventeen months after the operation, the patient has had no recurrence.

Adenocarcinoma, Scirrhous↗
PubMed1989

[Clinical evaluation of surgical treatment of Graves' disease].

Five hundred and thirteen surgical patients with Graves' disease from 1970 to 1983 were subjected to this study. They were divided into three groups by period in which operation was performed; 1st period from 1970 to 1974, 2nd from 1975 to 1979, and 3rd from 1980 to 1983. Postoperative thyroid function was evaluated. The weight of remnant thyroid was the greatest in the first period and the smallest in the third. There were no differences of frequency of postoperative complications among these periods in spite of remarkable decrease of weight of remnant thyroid tissue in the third period. Remission of thyroid function, was most frequently observed in the group of the remnant thyroid weight from 4 to 8 grams. Recurrence of hyperthyroidism was frequently observed in the group of the greatest weight of remnant thyroid and hypothyroid state was frequently observed in the group of the smallest remnant thyroid. These results indicate that the remnant thyroid weight may be one of the most crucial factors which influence on the postoperative functional state of patients with Graves' disease, and remnant thyroid tissue weighing from 4 to 8 grams may be the most appropriate in subtotal thyroidectomy.

Evaluation Studies as Topic↗
PubMed1989

[A case of tubular adenoma of the breast preoperatively suspected to be an advanced cancer].

A very rare case of a tubular adenoma of the breast is reported. The patient, 59-year-old woman, was admitted to hospital because of a large, left breast tumor. The tumor, 11 cm in diameter, was adhered to the surface skin. Because a malignancy was suspected, an incisional biopsy was first carried out. A pathologic examination revealed it to be a tubular adenoma, and a simple mastectomy was chosen as the operative procedure because a latent malignancy was not ruled out. The removed tumor was grossly cystic and a histological examination supported the finding that it was a non-malignant tubular adenoma.

Adenoma↗
PubMed1988

Reconstruction of the carotid artery using a temporary shunt during an operation for advanced thyroid carcinoma--a case report.

A case of a patient who required reconstruction of the carotid artery during a radical operation for advanced thyroid cancer is reported herein. The patient, a 64-year-old female who had had three previous operations for thyroid cancer, underwent a two-stage operation. In the first stage, the left cervical lymphnodes were dissected, but as a large metastatic node invading the left carotid artery could not be completely removed, some carcinoma tissue was left attached to the wall of the artery. The second stage involved a temporary shunt being set up between the common carotid artery and the internal carotid artery following heparinization, after which the invaded portion was resected, and the defect patched with a saphenous vein graft. Monitoring with a Doppler flow-meter and EEG were conducted throughout the operation. At present, cancer has recurred in the left submandibular and supraclavicular regions.

Carcinoma, Papillary↗
PubMed1988

An evaluation of the intraoperative staining technique using methylene blue for the detection of hyperplastic parathyroid glands.

Intraoperative staining with methylene blue was employed during parathyroid surgery on 50 glands from 13 patients, 5 with primary and 8 with secondary hyperparathyroidism. Forty-seven out of the 50 glands (94 per cent) were visualized by the staining and 2 out of the 13 patients were revealed to have supernumerary parathyroid glands. Since we started using this technique, there have been no cases of persistent hypercalcemia. The results of this study support the clinical usefulness of this staining procedure for detecting hyperplastic parathyroid glands in both primary and secondary hyperparathyroidism.

Diagnosis, Differential↗
PubMed1988

Gastric carcinoma metastatic to the breast diagnosed by mucosubstance histochemistry and electron microscopy.

Bilateral breast tumors with a histologically scirrhous pattern were conclusively diagnosed as gastric carcinoma metastatic to the breast using mucosubstance histochemistry and electron microscopy. The majority of the carcinoma cells gave histochemically positive reactions for galactose oxidase-Schiff, stable class III con A, and high-iron diamine-alcian blue (HID-AB). Also electron microscopically, numerous HID-positive mucus droplets (sulfomucin) were seen in the carcinoma cells. These findings invalidated the possibility that the carcinomas were primary breast cancer. The practical applications of distinctive patterns of mucus secretion are discussed.

Adenocarcinoma, Scirrhous↗
PubMed1987

Parathyroid imaging: comparison of 201Tl-99mTc subtraction scintigraphy, computed tomography and ultrasonography.

From 1982 to 1985, twenty-nine patients with suspected hyperparathyroidism were examined using 201Tl-99mTc subtraction scintigraphy (Tl-Tc), computed tomography (CT) and ultrasonography (US). For diagnosing neoplasm (adenoma or cancer), the sensitivities of the three procedures were 80 per cent or more, with no statistically significant differences. For diagnosing hyperplasia of the parathyroid glands, CT scan had the highest sensitivity (47 per cent). The most frequent source of error was minimally enlarged glands, weighing less than 500 mg. The second highest source of error was thyroid nodules, such as adenomatous goiter or cancer. Serum calcium and c-PTH levels were significantly higher in those with a parathyroid neoplasm than in those with hyperplasia (p less than 0.01, p less than 0.05, respectively). We concluded that hyperplasia is less easy to detect than neoplasm, and CT scan is superior to Tl-Tc or US scan for localizing hyperplasia.

Humans↗
PubMed1987

The usefulness and significance of naso-pharyngo-laryngo-tracheal fiberscopy in thyroid surgery.

The authors conducted naso-pharyngo-laryngo-tracheal fiberscopic examinations before and after thyroid surgery. Preoperative examination included an inspection of vocal cord movement, the compression and deformity of the trachea caused by goiters, changes in the color of the tunica mucosa tracheae, and the presence of tumorous invasion. Postoperatively, this method was employed primarily to determine the presence of recurrent laryngeal nerve paralysis, changes in the tracheal mucosa caused by manipulations in thyroid surgery and in cases in which surgery involved the tracheal wall, and to inspect the treated condition at the original tracheal site and detect the presence of possible recurrences. The manipulations can be easily carried out, causing little pain, and the procedure is economically feasible. Since it can provide more useful information than any other examination method, the active use of endoscopic examination by surgeons themselves at numerous facilities would appear desirable.

Endoscopy↗
PubMed1987

Transmission characteristics of pulse waves in the intracranial cavity of dogs.

Systems analysis of intracranial pressure pulse waveforms was carried out in six dogs under conditions of normocapnia and intracranial normotension to determine how the pressure pulse is transmitted through the intracranial cavity. Since the intracranial cavity can be regarded as a system, systems analysis was applied to it. The pressure pulse wave of the common carotid artery was used as the input signal and the epidural pressure pulse wave as the output signal. An attempt was made to randomize the input signal using a cardiac pacemaker or an aorta balloon. The transfer function of the system was estimated numerically from the autocorrelation function of the input signal and the cross-correlation function of the input and output signals by means of the least-squares method. Some characteristics of pressure transmission through the system were observed. The gain curve of the system decreased between 1 and 7 Hz, then suddenly increased to form a marked peak at about 10 to 15 Hz, where the phase curve also changed from positive to negative. These results suggest that the lower frequencies of the pulse wave were suppressed during transmission through the intracranial cavity, whereas the greatest acceleration in transmission occurred at about 10 to 15 Hz. In addition, resonance was evident in the intracranial cavity under normal intracranial conditions. This is the first report of such resonance.

Animals↗