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Biomedical subjects

Y Monden

Publications and source records attributed to Y Monden.

At least 199 records · Page 11Linked to original sources
PubMed1986

Specific activation of lymphocytes against acetylcholine receptor in the thymus in myasthenia gravis.

In 13 patients with myasthenia gravis, spontaneous in vitro production of antibody to acetylcholine receptor (AChR) by thymic cells was observed in seven patients, by bone marrow cells in nine, by peripheral blood cells (PBL) in six, and by lymph node cells in nine. The rate of anti-AChR production in culture closely correlated with the serum anti-AChR level. Specific activity of the immunoglobulin (Ig) G spontaneously produced (anti-AChR/total IgG) was about 10-fold higher in the thymus than in bone marrow, peripheral blood, or lymph node cultures. Pokeweed mitogen (PWM) enhanced anti-AChR production only by PBL. With neither thymus nor lymph node cells did PWM stimulate anti-AChR production, although it greatly enhanced total IgG production. In bone marrow, it depressed both, and it appeared that the anti-AChR was derived from long-lived plasma cells that may be responsible for delaying the fall of serum anti-AChR levels after thymectomy. The results suggest that AChR-specific cells are selectively activated in the thymus, and this may help to explain the benefits of thymectomy in myasthenia gravis.

Adult↗
PubMed1986

Malignancy and differentiation of neoplastic epithelial cells of thymoma.

Fifteen fetal thymuses and 100 thymomas were examined concerning the degree of differentiation of thymic epithelial cells by light and electron microscopy. The following results were obtained. The embryologic process of the fetal thymus was categorized into four stages (8, 12, 15, and 17 weeks or more of gestation) based on the morphological features of epithelial cells and the maturity of thymic tissues. Thymomas were classified into the undifferentiated, and poorly, moderately, and well-differentiated types by their morphological features in comparison with the fetal thymuses. The incidences of the respective types in the 100 thymomas were 5, 16, 68, and 11 cases. The moderately differentiated type was divided into three subtypes; namely, polygonal cell (49 cases), clear cell (6), and spindle cell type (13). The degree of differentiation of the thymomatous epithelial cells showed strong correlations with both the invasiveness and the prognosis of the thymoma. The ratios of invasive thymomas were 36, 47, 25, and 100% for the well-differentiated, moderately-differentiated, poorly-differentiated, and undifferentiated types, respectively. The 10-year survival rates were 87.5, 62.5, 46.9 and 0% for the well-differentiated, moderately-differentiated, poorly-differentiated, and undifferentiated thymomas.

Adolescent↗
PubMed1986

Clinical characteristics and prognosis of myasthenia gravis with other autoimmune diseases.

Of 277 patients with myasthenia gravis (MG) who underwent thymectomy, including 78 with thymomatous MG, 33 patients had other autoimmune diseases. The clinical characteristics of MG with other autoimmune disease were investigated. Graves's disease and rheumatoid arthritis were the most common autoimmune diseases seen. The association rate of autoimmune disease in patients with thymomatous MG (3.8%) was significantly lower than that in patients with nonthymomatous MG (15.1%). The positive rate for a germinal center in the thymus was significantly higher in patients with other autoimmune disease than in those without such disease. Thymectomy was effective for MG in patients with an associated disease as well as in those without such a complication. The clinical course of the associated autoimmune disease did not seem to be adversely affected by thymectomy. Therefore, thymectomy should be performed in MG patients with other autoimmune disease.

Arthritis, Rheumatoid↗
PubMed1986

Schwannoma of the trachea.

We recently encountered a tracheal schwannoma presenting as a polypoid mass. Computed tomography (CT) was very effective in evaluation of the size, shape and site of this rare tumour. Furthermore, CT images in the prone position made it easy to exclude tumour extension into the mediastinum.

Humans↗
PubMed1986

[Pharmacokinetics of cefoperazone concentration in human lung tissue].

In 11 patients, the concentration of cefoperazone (CPZ) in the lung tissue were studied after a 2 g intravenous bolus injection. Samples of lung tissue and blood were taken during surgery at 15, 30, 60, 120, 180, 240, and 300 minutes after administration of CPZ. All samples were assayed by the paper disc method using Micrococcus luteus ATCC 9341 as the indicator strain. All assay results of lung tissue were corrected for the amount of blood contained in the tissue samples by the hemoglobin content in the homogenate of lung tissue. The CPZ levels in the lung tissue were 116.2 micrograms/g at 15 min., 94.1 micrograms/g at 30 min., 74.6 micrograms/g at 60 min., 67.9 micrograms/g at 120 min., 54.6 micrograms/g at 180 min., 29.2 micrograms/g at 240 min. and 22.7 micrograms/g at 300 min. after administration, respectively. These values were higher than MIC90 values of CPZ for Pseudomonas aeruginosa, Streptococcus pneumoniae, Haemophilus influenzae and Enterobacteriaceae. The level of CPZ in the lung tissue was higher than 50% of the level in the serum until 180 minutes after administration of CPZ.

Adolescent↗
PubMed1986

CT of intrathoracic neurogenic tumours.

Fifteen patients with primary intrathoracic neurogenic tumours were evaluated using computed tomography (CT) scans. Schwannomas were demonstrated as homogeneous or slightly inhomogeneous densities on plain CT images; 4 of 5 schwannomas showed rim enhancement with some enhancement in the central portion of the tumour on post-enhancement CT images. Neurofibromas and ganglioneuromas were visualized as homogeneous densities on plain CT images. Three of 5 ganglioneuromas revealed homogeneous contrast enhancement of post-contrast CT images. A ganglioneuroblastoma and 2 neuroblastomas manifested slightly inhomogeneous tumour density on plain CT images. The inhomogeneity of the tumours was accentuated on contrast enhancement CT images.

Adolescent↗
PubMed1985

Clinicopathologic study of thyroid carcinoma infiltrating the trachea.

Eighteen patients (10 women and 8 men), ranging in age from 37 to 80 years, with thyroid carcinoma infiltrating the trachea comprised this series. Eleven had primary and 7 had recurrent cases. Total laryngectomy was performed in 4 patients, and tracheal resection was carried out followed by end-to-end anastomosis in 13 patients. In one patient, reconstruction was done with Naville's artificial trachea after tracheal resection. Eleven patients were alive after 1 year and 8 months to 6 years and 7 months after the operation. This result was significantly better than that of a group of ten patients without resection of the infiltrated trachea (seven patients died within 6 months). Thus, combined resection of the upper airway improved the prognosis of advanced thyroid carcinoma with tracheal infiltration. Histologic examination of surgical specimens demonstrated well-differentiated carcinoma in seven patients, poorly differentiated carcinoma in seven patients, undifferentiated carcinoma in three patients, and squamous cell carcinoma in one patient. The result showed a higher frequency of poorly differentiated carcinoma than in the control group of 70 patients without tracheal infiltration.

Adenocarcinoma↗
PubMed1985

Benign mediastinal teratoma associated with Klinefelter's syndrome.

We treated a patient with a benign mediastinal teratoma associated with Klinefelter's syndrome which was first thought to be a malignant germ cell tumor because of an anterior mass shadow, gynecomastia, atrophic testis and a high level of HCG. Chromosomal analysis showed a total of 47 XXY. Median sternotomy revealed a tumor originating from the right lobe of thymus. The postoperative course and 2 year follow-up have been uneventful.

Adult↗
PubMed1985

Prediction of lung cancer spread and functional resectability by 133Xe radiospirometry.

Sixty-six patients with primary lung cancer who underwent thoracotomy were studied to determine the correlations among 133Xe radiospirometry, surgical procedures and histological extension of the lung cancer. Disturbance in the regional perfusion (Q per cent) was more prominent than disturbance of the regional ventilation (V per cent), as the pathological stage and t factor proceeded, while V per cent and Q per cent were disturbed almost equally in relation to the pathological n factor. Lobectomy was impossible in patients with a Q per cent of less than 33 per cent of the total, but low perfusion did not necessarily contraindicate surgery. The predicted postoperative FEV1.0 was calculated according to the equation of (1-b/a x (V per cent or Q per cent)) x (preoperative FEV1.0), where a and b were the number of subsegments in the lung lobes on the involved side and the resected lobe. The predicted and actually measured postoperative FEV1.0 showed significant correlations (less than 0.001) in both equations. We conclude that Q per cent reflects a complex pattern of lung cancer spread more sensitively than does V per cent, and the significance of V per cent and Q per cent in terms of prediction of postoperative EFV1.0 seems to be equivocal.

Aged↗
PubMed1985

Acetylcholine receptor antibody-producing cells in thymus and lymph nodes in myasthenia gravis.

Eleven patients with myasthenia gravis (5 with thymoma) were studied and spontaneous production of antibody to acetylcholine receptor (AChR) in vitro was found by thymus cells in 10 (and in all 5 with thymoma) and by lymph node cells in 8 (and in 3 with thymoma). The rate of AChR antibody production by thymus cells was greater than that by lymph node cells (10.7 +/- 11.6 and 1.4 +/- 1.5 fmol/10(6) cells/week, respectively, mean +/- SD, P less than 0.05 by paired t test), although the B-cell population was always smaller in the thymus than in the lymph nodes (9.5 +/- 9.4 and 31 +/- 12.7%, P less than 0.001), suggesting the principal role of the thymus in AChR antibody production. It is suggested that lymph nodes can be one of the main sites of AChR antibody production in myasthenia gravis but the antibody-producing cells may originate in the thymus.

Adult↗
PubMed1985

Myasthenia gravis in elderly patients.

The clinical features and the effect of thymectomy were compared between 27 elderly patients (Group 2) and 119 young adult patients (Group 1) with myasthenia gravis (MG). In the elderly group, MG was type I in 3 patients, type IIA in 6, type IIB in 17, and type III in 1; and in the young group, type I in 6, type IIA in 36, type IIB in 73, and type III in 4. The association rate with autoimmune disease in patients without thymoma was 12.5% (1/8) in Group 2 and 21.3% (20/94) in Group 1. Autoimmune diseases were not seen in any patients with thymoma. The clinical stage of thymoma was not significantly different between the two groups. The rates of remission and of palliation at 3 years after thymectomy were 18.2% and 72.7%, respectively, in Group 2 patients with thymoma, 21.4% and 78.6% in Group 1 patients with thymoma, 50% and 100% in Group 2 patients without thymoma, and 50% and 98.1% in Group 1 patients without thymoma.

Adolescent↗
PubMed1985

Recurrence of thymoma: clinicopathological features, therapy, and prognosis.

Factors influencing the recurrence or persistence of thymoma after therapy were investigated in 127 patients with thymoma, including 75 with thymoma and myasthenia gravis. The rate of recurrence or persistence was 19% (24 of 127 patients) overall, 11% (8 of 75 patients) in myasthenic thymoma, and 31% (16 of 52 patients) in nonmyasthenic thymoma. The more advanced the clinical stage, the higher the rate of recurrence or persistence. The recurrence/persistence rate for patients with the same clinical stage was higher in those with nonmyasthenic thymoma (8% in Stage I, 11% in Stage II, 36% in Stage III, and 75% in Stage IV) than in those with myasthenic thymoma (0 in Stage I, 13% in Stage II, 18% in Stage III, and 20% in Stage IV). The prognosis for patients having subtotal resection of tumor was good in myasthenic thymoma (recurrence/persistence rate, 17%) in contrast with nonmyasthenic thymoma (recurrence/persistence rate, 78%). These results suggest that nonmyasthenic thymoma is more malignant than myasthenic thymoma. Postoperative radiotherapy was effective in preventing the recurrence or persistence of thymoma after therapy.

Adult↗
PubMed1985

A method for predicting postoperative lung function and its relation to postoperative complications in patients with lung cancer.

We predicted the postoperative forced expiratory volume in 1 second (FEV1) with a formula based on the premise that the total number of subsegments was 42: postop FEV1 = [1 - (b - n)/(42 - n)] (preop FEV1), where n and b are the number of obstructed subsegments and total subsegments, respectively, in the resected lobe. It was assumed that b was 6, 4, and 12 in the right upper, middle, and lower lobes, respectively, and 10 each in the left upper and the left lower lobes. The obstructed subsegments, n, were obtained from the findings on bronchography or bronchofiberscopy or both before operation. The linear regression line derived from the correlation between predicted (x) and measured (y) FEV1 was y = 0.850x + 0.286 +/- 0.296 (standard error) (N = 52; r = 0.821; p less than 0.001). We calculated the predicted postoperative FEV1 in 188 patients with primary lung cancer. The predicted values were corrected with the regression equation just mentioned and then normalized by the patient's height and sex (%FEV1(p,c). The correlation between %FEV1(p,c) and the surgical risk was studied. Postoperative respiratory complications were inversely related to %FEV1(p,c), and a significantly high incidence of complications (p less than 0.05) was observed in those whose %FEV1(p,c) was less than 60% of predicted normal. In aged patients (65 years old or more) without complications, %FEV1(p,c) was 67.3 +/- 18.0%; it was 52.2 +/- 12.8% in those with respiratory trouble and 53.3% +/- 9.6% in those with circulatory complications. The difference between groups with and without complications was significant (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Acetylcholine receptor antibody production by bone marrow cells in a patient with myasthenia gravis.

We briefly report antiacetylcholine receptor antibody production by cultured bone marrow cells (4.9 +/- 0.9 fmol/10(6) cells/wk, mean +/- SD) in a 65-year-old man with myasthenia gravis without thymoma. Lymphocytes from peripheral blood, thymus, and lymph nodes produced less antibody (1.8 +/- 0.1, 0.9 +/- 0.3, and 1.0 +/- 0.4, respectively). The thymus was involuted, and the effect of thymectomy was doubtful 6 months postoperatively.

Aged↗