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Biomedical subjects

Y Kodera

Publications and source records attributed to Y Kodera.

At least 235 records · Page 13Linked to original sources

Correlation of response of aplastic anemia patients to antilymphocyte globulin with in vitro lymphocyte stimulatory effect: predictive value of in vitro test for clinical response.

Therapy with antilymphocyte globulin (ALG) has been shown to be effective in restoring hematopoiesis to some patients with aplastic anemia. It would be useful to have a method for predicting those likely to be responders versus nonresponders. The mode of immunostimulatory action of ALG is of interest in addition to its immunosuppressive action. We examined in vitro the distribution of the proliferative responses of ALG-stimulated peripheral blood mononuclear cells (PBMCs) obtained from 18 patients with aplastic anemia, eight of whom responded to ALG and 10 who did not. We found a significant difference in the proliferative response of PBMCs obtained from the eight responders versus the 10 nonresponders (P less than .01). Two-color flow cytometry analysis of the patients' PBMCs stimulated by ALG in vitro showed that the CD4-positive subsets were activated to a greater extent by ALG than the CD8-positive subsets. Moreover, a positive correlation with the clinical response of patients to ALG with granulocyte-macrophage colony-stimulating factor produced by their PBMCs stimulated by ALG suggests that the immunostimulatory property of ALG has an important role in the treatment of aplastic anemia. Our results suggest that the clinical response to ALG therapy is correlated with its lymphocyte proliferative effect in vitro, and indicates that the assessment of the proliferative response of PBMCs in vitro would be useful in predicting the clinical response to ALG therapy.

Adolescent↗

Image salvage in panoramic radiography using histogram optimization.

Optical density and contrast recovery from poor quality panoramic radiographs was studied using the histogram modification technique. A series of experimental images of varying density and contrast were obtained by exposing a phantom in 4 kV steps between 50 and 94 kV. A standard of good image quality was selected by 10 observers grading the radiographs. Images were processed using the histogram specification technique and re-evaluated. All the processed images were found to be of acceptable quality. This technique was also shown to be applicable for salvaging unacceptable clinical radiographs.

Humans↗

[Laboratory and clinical studies on imipenem/cilastatin sodium plus amikacin sulfate in patients with severe infections complicating hematological disorders].

Imipenem/cilastatin sodium (IPM/CS) and amikacin sulfate (AMK) were administered to 111 patients with severe infections complicating hematological disorders. Of the 111 patients, 93 were included in the present analysis of efficacy and 108 in that of safety. Twenty patients were evaluated as excellent, 37 as good, 8 as fair, and 28 as poor, with an overall rate of effectiveness of 61.3% (57/93). The synergistic interaction of IPM and AMK against clinical isolates (6 strains) was assessed in vitro using the checker board technique. Synergistic and additive effects were observed in 66.7% and 33.3% of the samples, respectively. Side effects were observed in 9 patients and abnormal laboratory test results in 2. These disappeared or returned to normal values after completion of therapy or discontinuation of IPM/CS and AMK. From the above findings, IPM/CS with AMK is considered to be a useful antibiotic combination for the treatment of severe infections complicating hematological disorders.

Adolescent↗

[Bone marrow transplantation for patients with Philadelphia chromosome-positive acute lymphoblastic leukemia].

We reported the results of 6 allogenic bone marrow transplantation (BMT) and 3 autologous BMT for patients with Philadelphia chromosome (Ph1)-positive acute lymphoblastic leukemia (ALL) by Nagoya BMT group. Two of six patients who received allogenic BMT have continued complete remission (CR) on +639 days and +1,597 days. Four of six patients relapsed on +134, +203, +216, and +267 days. Two patients with a disease-free survival for a long time had both acute and chronic GVHD. It is suggested that graft-versus-leukemia (GVL) effect might prevent the relapse. On the contrary, one patient who received with monoclonal antibodies plus complement-treated autologous bone marrow is free of leukemia on +439 days. Our results suggest the follows. 1) We do chromosomal analysis at initial diagnosis in all cases to do BMT in first CR. 2) We intensify the conditioning regimen for BMT. 3) We study on application of GVL effect to prevent the relapse. 4) We establish the best purging method to eradicate residual leukemic cells for autologous BMT. 5) We do allogenic BMT using HLA-matched unrelated donor for patients without related donor.

Adolescent↗

[Delay in red blood cell recovery after major ABO incompatible bone marrow transplantation].

In 6 of 27 patients in whom major ABO incompatible marrow was transplanted, the recovery of red blood cells (reticulocyte count greater than or equal to 1%) required more than 50 days after the transplantation. In 3 of them, more than 100 days were required. High titers of pre-transplant anti-A or anti-B agglutinin correlated with the delay in red blood cell recovery (IgM: p less than 0.01, IgG: p less than 0.05). In all of the patients whose pre-transplant IgM titers were 4 or less, and whose IgG titers were 32 or less, the red blood cells recovered within 50 days. Administration of cyclosporine did not correlate with the delay in red blood cell recovery. All the patients finally developed red cell production within 8 months without any treatment.

ABO Blood-Group System↗

Single clonal origin of neoplastic B-cells with different immunoglobulin light chains in a patient with Richter's syndrome.

A 71-year-old man was found to have chronic lymphocytic leukemia (CLL) and diffuse large cell lymphoma (DLC) simultaneously and was diagnosed as Richter's syndrome. The CLL had mu lambda surface immunoglobulin (sIg) whereas the DLC had mu kappa sIg. However, the immunoglobulin (Ig) gene rearrangement and surface marker analysis demonstrated that both CLL and DLC had identical rearrangement patterns of the Ig heavy chain (IgH) and identical surface markers CD5+, CD19+, and CD20+. These facts imply that in this case the two malignancies are of single clonal origin initially, and that different sIg of CLL and DLC do not, therefore, necessarily indicate the biclonality of these malignancies. The origin of DLC in Richter's syndrome remains controversial. This case suggests difficulty in concluding the biclonality of these malignancies. For a conclusion on clonality to be definitive, there is a need for cloning and nucleotide sequencing of rearranged Ig genes in more patients with Richter's syndrome.

Aged↗

Activation of kallikrein-kinin system in human plasma with purified serine protease from Dermatophagoides farinae.

An aqueous extract from a mite culture, of Dermatophagoides farinae, activated prekallikrein to kallikrein in normal plasma. Crude protein preparation, obtained by ammonium sulfate precipitation (95% saturation) from the extract, exhibited high activity (0.81 units/mg protein) towards a synthetic substrate of coagulation factor XIIa, Boc-Gln-Gly-Arg-MCA, and had also activity to form kallikrein in human plasma deficient in coagulation factor XII. Treatment of the protein preparation with phenylmethylsulfonyl fluoride (PMSF), an inhibitor of serine enzyme, gave rise to inactivation of both activities. Thus, the serine protease specific for Boc-Gln-Gly-Arg-MCA in mite cultures of D. farinae was purified by ammonium sulfate precipitation and chromatographies on p-aminobenzamidine-sepharose CL-4B, DEAE-Toyopearl 650M, Sephadex G-75 superfine and Sephacryl S-200. The purified protease was homogeneous electrophoretically, and its molecular weight was estimated to be 30,000. The optimum pH and temperature were around 7.5 and 50 degrees C, respectively. The specific activity was 36 units/mg protein at pH 7.4 and 37 degrees C. The activity was completely inhibited by PMSF. The serine protease had the activity to activate the kallikrein-kinin system in normal human plasma.

Animals↗

High dose chemotherapy with autologous bone marrow transplantation for limited small cell lung cancer.

UNLABELLED: In 1980 we initiated a pilot study of high dose chemotherapy intensified with autologous bone marrow transplantation (ABMT) for seven patients with limited small cell lung cancer. Six patients were given the ABMT initially while one male patient received the ABMT late to intensify three courses of induction therapy. He further received radiotherapy and underwent a left pneumonectomy and adoptive immunotherapy, because the presence of residual tumor cells, and has maintained disease-free survival for over 117 weeks. Among the first six patients there were two with complete responses, two with partial responses and one who experienced no change, a total response rate of 80%. One patient died of cardiac tamponade at day 7 and could not be evaluated. The median survival time of 41 (range 34-108) weeks was not encouraging. IN CONCLUSION: an increased drug dose with ABMT to intensify the chemotherapy provided disappointing results both when the ABMT was used initially and when it was given late, after induction chemotherapy.

Adult↗

[Clinical evaluation of imipenem/cilastatin sodium in infectious complications of hematological malignancies. Tohkai Research Group on Infections in Hematological Disorders].

Imipenem/cilastatin sodium (IPM/CS), a newly developed carbapenem antibiotic, was administered to a total of 152 patients with severe infections complicating hematological disorders, of whom 138 patients are included in the present analysis of efficacy and 152 in that of safety. Most of the underlying diseases were acute leukemia (76/138), and most patients suffered from sepsis or suspicion of sepsis (84/138). Out of 138 patients in whom efficacy was evaluable, responses were excellent in 41 patients, good in 55, fair in 19, and poor in 23. The overall clinical efficacy rate was 69.6% (96/138). Prior antibiotic treatment and peripheral neutrophil count had significant effects on the clinical response. The overall eradication rate of bacteria was 76.2%. Adverse reactions were observed in 15 patients (9.9%) and abnormal laboratory test results in 19 patients (12.5%). From the above findings, IPM/CS is considered to be a useful antibiotic for the treatment of severe infections accompanying hematopoietic disorders.

Adolescent↗

A filter for use in lateral cephalography.

A new filter was devised for density compensation and absorbed-dose reduction in cephalometric radiographs. It is composed of a rare earth screen that plays a role in depicting soft tissue shadows and cephalometric points. The greatest reduction of the absorbed dose was about one seventh at the tube side of the thyroid gland when it was included in the direct x-ray beam. Smaller collimation was the most important factor in reducing the absorbed dose.

Aluminum↗

Circulating activated suppressor T lymphocytes in hepatitis-associated aplastic anaemia.

Lymphocyte subpopulations were measured in the blood of 21 children with severe aplastic anaemia (SAA). Five children with hepatitis-associated AA appeared to constitute a unique group. Compared with children with idiopathic AA, four of five children had a striking increase in percentage of activated suppressor T lymphocytes, which were defined by binding of both anti-Leu 2a and anti-HLA DR monoclonal antibodies (children with hepatitis-associated AA, 21.8 +/- 19.9% [mean +/- SD], children with idiopathic AA, 2.9 +/- 1.2%). However, there was no difference in the mean absolute number of the activated suppressor T lymphocytes between the two groups, because the mean number of lymphocytes was markedly less in children with hepatitis-associated AA (0.28 +/- 0.06 x 10(9)/l) than in those with idiopathic AA (1.64 +/- 0.74 x 10(9)/l). The mean helper: suppressor T lymphocyte ratio was significantly lower in children with hepatitis-associated AA (0.58 +/- 0.74) than in those with idiopathic AA (1.22 +/- 0.44). On the other hand, we did not find such a remarkable alteration of lymphocyte subpopulations in children with non-A non-B hepatitis who did not develop AA. These findings suggested that an imbalance of lymphocyte subpopulations and T lymphocyte activation may have pathogenetic relevance in some of the children with hepatitis-associated AA.

Adolescent↗

Aplastic anemia: lack of increase of in vitro colony formation after T cell depletion with monoclonal antibodies and complement.

To detect suppressor T cells to hematopoietic stem cells, growth of granulocyte-macrophage colony-forming cells (CFU-GM) and burst-forming unit (BFU-E) was compared before and after treatment of bone marrow cells with anti-T monoclonal antibodies and complement in 29 patients with aplastic anemia. The anti-T monoclonal antibodies used were 35.1 (CD2), Tp120 (CD6) and ATL27 (not clustered). Treatment of normal bone marrow with anti-T monoclonal antibodies and complement resulted in complete (greater than 99%) lysis of T cells with negligible effects on colony growth. Preincubation of marrow samples with monoclonal antibodies and complement did not enhance CFU-GM or BFU-E colony growth in patients with aplastic anemia. Using this assay, there was no evidence of T cell-mediated inhibition of colony proliferation in any of 29 patients.

Adolescent↗