A new strategy for treating patients with CD7+, CD4-, CD8- acute lymphoblastic leukaemia.
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Aged↗
Biomedical subjects
Y Shimamoto
Publications and source records attributed to Y Shimamoto.
Benidipine counteracts sodium-induced alterations in systemic and regional hemodynamics.
We compared hemodynamic and humoral responses to benidipine and nifedipine during different sodium intakes in essential hypertensives. The study had a single-blind crossover design. Doppler flowmetry and laboratory examinations were performed. During low sodium intake, both benidipine and nifedipine significantly reduced mean arterial pressure to the same extent. Benidipine increased cardiac index, superior mesenteric and renal flows, whereas nifedipine had no effect on either cardiac index or regional blood flows. In the salt-sensitive patients whose mean arterial pressure increased more than 5 mmHg during high sodium intake, sodium loading increased cardiac index and terminal aortic flow, but decreased superior mesenteric and renal flows, while plasma noradrenaline concentrations remained unchanged and plasma arginine vasopressin increased significantly. These hemodynamic responses to sodium in the salt-sensitive patients were more effectively inhibited by benidipine than by nifedipine, although neither of them had any influence on sodium-induced changes in plasma noradrenaline or arginine vasopressin concentration.
Aged↗
Clinical indications of multiple integrations of human T-cell lymphotropic virus type I proviral DNA in adult T-cell leukemia/lymphoma.
In this review, we discuss the possible relationship between the clinical characteristics and the multiple integration of human T-cell lymphotropic virus type I (HTLV-I) proviral DNA in patients with adult T-cell leukemia/lymphoma (ATL). Some patients with ATL show multiple HTLV-I integrations and exhibit clinical characteristics unlike those of ATL patients who show the typical integration of a single provirus. Multiple HTLV-I integrations can be detected by Southern blotting as multiple bands having varied intensities. These multiple integration conditions can arise from one tumor cell clone carrying multiple copies of the provirus, or from multiple cell clones, each carrying one copy of the provirus. The former patients manifest an extremely aggressive clinical course with the infiltration of unusual organs such as the retina and uvea. The latter patients show an indolent clinical course with skin lesions. These findings suggest that the clinical implications for multiple HTLV-I integrations exist in ATL. This may be one of the explanations for the heterogeneous findings in the disease. Such observations may provide information linking viral integration with clinical manifestations, and improve our understanding of the pathogenesis of ATL.
DNA, Viral↗
Does gender make a difference in the risk of falls? A Japanese study.
The number of elderly people in the world is increasing at a remarkable rate and the rate of aging in Japan is the world's highest. According to a statistical survey done in 1994, people over 65 years of age constitute 14.1% of the Japanese population. In addition, the Japanese average life expectancy in 1991 was the highest in the world, reaching 76.1 years for men and 82.1 years for women. A prominent health problem among elderly people is immobility which can result in elderly patients becoming bedridden (Eto, 1992). Recently, the problem of falls among the frail elderly has received increased interest. Although fall mortality in the Japanese elderly was not as high as those of France or the United States (Rockett & Smith, 1989), falls lead to deterioration in the health and physical status of the elderly. If falls could be reduced among the elderly, many of the health problems attributed to immobility among the Japanese elderly would be reduced. Some falls have a single and obvious cause, but most appear to result from several factors. With better knowledge of the causes and risk factors for falls among the elderly, effective preventive measures can be instituted (Tinetti, Speechley, & Ginter, 1988; Ryynanen, 1994; Teno, Kiel, & Mor 1990). There are few studies concerning falls among the institutionalized elderly (Haga, Shibata, Shichida, Matsuzaki, & Hatano, 1986) and community-dwelling elderly in Japan (Yasumura et al., 1994; Niino et al., 1995; Suzuki et al., 1991, 1992; Suzuki, Yamada, Takahashi, & Tsuchiya, 1991; Suzuki, Yamada, & Tsuchiya, 1993). The purpose of this study was to investigate falls among the elderly, selected at random, who live in Koga, a city in eastern Japan.
Accidental Falls↗
[Bitemporal hemianopsia after skull base fracture].
We report a case of bitemporal hemianopsia after skullbase fracture. An 18-year-old male presented with frontal head hit due to a traffic accident. Consciousness level on admission was JCS 10. Initial CT scan revealed traumatic SAH and pneumocephalus. We treated him conservatively. Ten hours after the accident, consciousness level went down, and CT imaging disclosed bilateral frontal hemorrhage. The three dimensional CT (3D-CT) imaging showed two fracture lines from the roof of the ethmoid sinus to the planum sphenoidale. Although his consciousness improved gradually, he complained of rhinorrhea, anosmia and double vision. On preoperative visual field examination, bitemporal hemianopsia was noticed. Repair operation for CSF rhinorrhea was performed. Operative findings revealed two fracture lines corresponding to the 3D-CT scan. The optic chiasm was compressed by the tuberculum sellae. We could not find obvious tearings or stretchings of the chiasm. Reports on operative findings of traumatic chiasmal syndrome are rare, and most of the reports presume that bitemporal hemianopsia results from tearing or stretching of the chiasm. We could confirm that, in some cases, bitemporal hemianopsia could result from direct pressure of the tuberculum sellae.
Adolescent↗
Refractory anaemia with ringed sideroblasts concurrent with multiple myeloma--a brief review of the recent literature.
The report describes a patient in whom myelodysplastic syndrome and multiple myeloma (MM) were simultaneously present. This patient manifested an IgA-lambda type of MM concurrent with a refractory anaemia with ringed sideroblasts (RARS) without prior therapy. His bicytopenia could not be improved by vitamin B6 regardless of a reduced serum vitamin B6 concentration. A review of the literature suggests that myelodysplastic syndrome (MDS), chronic neutrophilic leukaemia (CNL) and idiopathic myelofibrosis (IMF) are the most frequent disorders associated with MM. The IgA type seems to be associated more commonly with these disorders. The mechanisms responsible for the development of plasma cell proliferation are diverse; the neoplastic transformation of a common progenitor, the involvement of the lymphoplasmacytic system and/or chronic reticuloendothelial stimulation may play a role in the occurrence of such hybrid haematological disorders.
Aged↗
Gastric lesions in 76 patients with adult T-cell leukemia/lymphoma. Endoscopic evaluation.
BACKGROUND: Adult T-cell leukemia/lymphoma (ATLL) is caused by human T-lymphotropic virus type I. Gastric lesions in ATLL have not been described precisely, whereas the clinical features of ATLL have been well documented. The goal of the present study was to review gastric lesions, including gastric involvement, of patients with ATLL who were admitted to our hospital. METHODS: Endoscopic examination of the upper gastrointestinal tract was performed on 76 of 110 patients who were admitted to our hospital between 1981 and 1994. Gastric involvement was diagnosed by histologic examination of biopsy specimens of gastric lesions. Types of gastric lesions, histologic features, and survival periods in patients with ATLL were summarized. RESULTS: Of the 76 patients with ATLL who underwent an endoscopic examination, 23 had gastric involvement (30.3%). Twenty-seven patients had other gastric lesions: 10 with peptic ulcers (13.2%), 8 with gastric erosions (10.5%), 3 with submucosal tumors (3.9%), 2 with hyperplastic polyps (2.6%), 1 with gastric adenoma (1.3%), and 3 with gastric carcinomas (3.9%). The most frequent endoscopic configuration of gastric involvement with ATLL was the diffuse type with ulceration, and the most common histology was large cell type. Among those with the acute type ATLL, the survival period of those patients with gastric involvement was less than that of the patients without gastric involvement. In contrast, the survival period for lymphoma type ATLL did not differ among the groups regardless of gastric involvement. CONCLUSIONS: This study demonstrated that 30.3% of patients with ATLL had gastric involvement and 13.2% had peptic ulcers. Gastric involvement of ATLL was one of the prognostic factors in acute type ATLL, whereas it had no influence on the prognosis of lymphoma type ATLL.
Female↗
Differences in immune functions between human T-lymphotropic virus type I carriers and patients with adult T-cell leukemia/lymphoma.
A variety of immunologic tests were compared between human T-lymphotropic virus type I (HTLV-I) carriers and patients with adult T-cell leukemia/lymphoma (ATL). The mitogenic responses of the lymphocytes to concanavalin A and phytohemagglutinin were depressed in the ATL patients but not in the carriers, while the response to pokeweed mitogen in the carriers and ATL patients was depressed compared to the HTLV-I-seronegative controls. A positive tuberculin reaction in the carriers was as frequent as in the controls, but less frequent in the ATL patients. A marked inhibition of the intracellular multiplication of Legionella pneumophila was observed within the monocytes isolated from the carriers, but not in the ATL patients or the normal controls. These results indicate that the ATL patients have severe immunodeficiency, while the HTLV-I carriers have some activation of anti-microbial activity in monocytes although they are somewhat immunosuppressed.
Adult↗
Natural killing activity in patients with spontaneous regression of malignant lymphoma.
Previously, we proposed a new analysis of natural killing activity, for comparison, employing an "individual effector/target cell ratio" according to the number of effector cells in blood. The activity could be measured in four patients with spontaneous regression of malignant lymphoma. Despite the absence of episodes suggesting viral infections, patients with spontaneous regression had significantly higher activities prior to their regressions than either controls or patients without regression. In one patient who had a spontaneous regression accompanied by a high level of natural killing activity, subsequent exacerbation of the disease with a reduced activity was never followed by a regression and became life-threatening. In another patient, a spontaneous regression was accelerated after greater augmentation of natural killing activity was induced by a superimposed viral infection. These facts suggest that highly elevated natural killing activity may be one of the possible mechanisms responsible for spontaneous regression of malignant lymphoma.
Adult↗
Increased production of interferon gamma but not interleukin 4 in human T-lymphotropic virus type I carriers.
We investigated the production of interferon gamma (IFN-gamma), interleukin 4 (IL-4), IL-1 alpha, and tumor necrosis factor alpha (TNF-alpha) by peripheral blood mononuclear cells (PBMCs) from human T-lymphotropic virus type I(HTLV-I) carriers during short-term in vitro culture, in comparison with that by those from HTLV-I seronegative controls. PBMCs isolated from eight carriers and eight controls were cultured, and cytokine levels were measured in 1- and 3-day culture supernatants. Enhanced production of IFN-gamma was observed in all HTLV-I carriers but none of the controls. IL-4 production was not increased in the carriers except for one with a past history of toxoplasma lymphadenitis. IL-1 alpha and TNF-alpha levels were higher in the carriers. CD4+ cells were responsible for the enhanced IFN-gamma production, while monocytes were responsible for the increased IL-1 alpha and TNF-alpha production. The present study showed that the PBMCs from HTLV-I carriers consistently produced large amounts of some cytokines (IFN-gamma, IL-1 alpha, TNF-alpha) but not of other cytokines (IL-4). This imbalance in cytokine production in HTLV-I carriers may be related to the development of opportunistic infections and/or HTLV-I associated diseases including adult T-cell leukemia/lymphoma.
Adult↗
Adult T-cell leukaemia/lymphoma with multiple integrations of human T-cell lymphotropic virus type I proviral DNA: differing clinical features are linked to varied proviral integration.
Multiple integrations of human T-cell lymphotropic virus type I (HTLV-I) proviral DNA are occasionally found in tumor cells from patients with adult T-cell leukaemia/lymphoma (ATL). However, the clinical implications of multiple integrations of HTLV-I in ATL have not been well established. We studied 95 patients with ATL to elucidate the relationship between the multiple integrations of HTLV-I and the clinical characteristics. The proviral DNA of HTLV-I was examined by standard Southern blot analysis using the probe of an entire HTLV-I genome and the endonucleases with or without cleavage sites within the provirus. Multiple integrations of HTLV-I were detected in eight patients as extraordinary multiple bands; five patients showed multiple bands of the same intensity, and the remaining three showed multiple bands of differing intensities. The patients were divided into two groups based on these band patterns. One group was considered to exhibit one tumour cell clone carrying multiple copies of the provirus, whereas the other was considered to exhibit multiple tumour cell clones, each carrying one copy of the provirus. The former group of patients manifested a highly aggressive clinical course with frequent peculiar organ infiltrations, including the retina, uvea and muscle, along with the presence of large peripheral leukaemic T cells having flower-like nuclei. The latter group demonstrated an indolent clinical course with skin lesions or small leukaemic T cells having cleaved or lobulated nuclei. These findings suggest that the pattern of multiple HTLV-integrations into the tumor cell(s) has clinical implications in ATL. This may help to explain the heterogeneity of this disease.
Adult↗
Effects of interferon-alpha, beta, and gamma on the function of differentiated leukemic HL-60 cells induced by 1,25-dihydroxyvitamin D3.
The differentiation of HL-60, a human leukemic cell line, into monocyte-like cells (D3-HL-60 cells) is induced by 1,25-dihydroxyvitamin D3 (D3). We examined the effects of interferon (IFN) treatment of D3-HL-60 cells on the expression of cell surface antigens, the phagocytic activity for fluorescent beads, production of oxygen radicals, and intracellular growth of Legionella pneumophila. Activation of D3-HL-60 cells with IFN-gamma, Beta, and alpha for 24 h significantly increased expression of CD16, CD36, CD71, and HLA-DR antigens. IFN-gamma markedly enhanced the phagocytic activity of beads in D3-HL-60 cells. There was no significant difference in phagocytic activity between cells exposed to IFN-alpha or beta and untreated D3-HL-60 cells. IFN-alpha, beta, and gamma enhanced production of oxygen radicals, including superoxide, by D3-HL-60 cells. Superoxide production was enhanced to the greatest degree by IFN-gamma, followed by IFN-beta and then IFN-gamma. Intracellular growth of L. pneumophila in D3-HL-60 cells was inhibited by interferons (IFN-gamma > beta > gamma). Similar results were obtained in human mononuclear cells. These data indicate that interferons can act as biologic response modifiers not only in human mononuclear cells but also in differentiated leukemic cells. Our results may have implications for the development of differentiation therapy for treatment of leukemia.
Animals↗
Multiple organ failure associated with dimethylsulfoxide and hydroxyethyl starch in autologous blood stem cell transplantation.
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Adult↗
Immunoglobulin gene rearrangement in T-cell-rich reactive pleural effusion of a patient with B-cell chronic lymphocytic leukemia.
Pleural effusion in chronic lymphocytic leukemia (CLL) is a relatively rare phenomenon. We report a case of a pleural effusion associated with B-cell CLL but with predominantly reactive T lymphocytes in the effusion. A cell surface phenotype study showed that T lymphocytes predominated in the pleural effusion, although B lymphocytes were predominant in the peripheral blood. Genotypic analysis of the cells in the peripheral blood, bone marrow, lymph node, and pleural effusion showed the same rearrangement pattern of the immunoglobulin heavy chain genes consistent with a B-lymphocytic neoplasm (CLL). A pleural biopsy demonstrated diffuse infiltration of lymphoid cells. Most of the cells demonstrated T cell markers, although some cells revealed B cell markers by immunologic staining. These results suggested that the pleural involvement by B-CLL may have caused a reactive T-lymphocyte proliferation in the pleura and pleural effusion. To our knowledge, this is the first published case indicating that genotypic analysis of immunoglobulin heavy chain gene rearrangement may be useful in the diagnosis of a pleural effusion associated with B-cell CLL.
Aged↗
Lisinopril reverses left ventricular hypertrophy through improved aortic compliance.
We treated with nifedipine or lisinopril 38 essential hypertensive patients with left ventricular hypertrophy. The study had a single-blind crossover design; nifedipine or lisinopril was given for the first 24 weeks, and then patients were crossed over to the other antihypertensive agent for another 24 weeks. Both nifedipine and lisinopril significantly decreased mean arterial pressure to the same extent. Although lisinopril decreased left ventricular mass index more rapidly than nifedipine, 48 weeks of antihypertensive treatment with nifedipine or lisinopril reduced the extent of left ventricular hypertrophy to the same level. Stepwise multiple linear regression analysis revealed that the reversal of left ventricular hypertrophy may be mainly due to a reduction in mean arterial pressure during the 24-week nifedipine treatment and due to an improvement of aortic compliance during the lisinopril treatment. Both nifedipine and lisinopril are effective in the reversal of hypertensive left ventricular hypertrophy; however, the agents have disparate actions on hemodynamic factors.
Aged↗
Clinical implication of the integration patterns of human T-cell lymphotropic virus type I proviral DNA in adult T-cell leukemia/lymphoma.
In this review, we discuss the possible relationship between the clinical characteristics and the integration patterns of human T-cell lymphotropic virus type I (HTLV-I) proviral DNA in patients with adult T-cell leukemia/ lymphoma (ATL). Some ATL patients show unusual integration patterns such as multiple or defective HTLV-I and have clinical characteristics unlike those of most ATL patients who have the characteristic integration pattern of one complete provirus. Multiple HTLV-I integrations can be detected as two or more bands using the standard Southern blotting method when the tumor cellular DNA is digested with an endonuclease that does not cleave within the provirus. This includes cases of one tumor cell clone carrying two or more copies of the provirus, or alternatively two or more cell clones, each carrying one copy of the provirus. The former group of patients always manifest severe dyspnea and hypoxemia with unusual organ infiltrations including the retina and muscle and an extremely aggressive clinical course. On the other hand, the latter group of patients have an indolent course with skin lesions or small T lymphocytes with cleaved or lobulated nuclei. A solitary defective HTLV-I in some ATL patients can be detected as one smaller band after digestion of cellular DNA with an endonuclease that does not cleave within the provirus. These patients generally have a favourable clinical course with small cleaved or bilobulated T lymphocytes without lymphadenopathy or skin lesions. These findings suggest that there are clinical implications for the integration patterns of HTLV-I and this may be one of the explanations for the heterogeneous behaviour of the disease. Such studies may provide information on the relationship between virus integration and the clinical manifestations and also improve our understanding of the pathogenesis of ATL.
Adult↗
Hemobilia and Bernard-Soulier syndrome.
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Adult↗
Effect of 3-methylcholanthrene on bunitrolol metabolism. Kinetics and immunological studies on 4-hydroxylation of bunitrolol catalyzed by two species of cytochromes P450 in rat liver microsomes.
Effect of the induction of cytochrome P4501A1 with 3-methylcholanthrene (3-MC) treatment on kinetics of bunitrolol (BTL) 4-hydroxylase activity of rat liver microsomes was investigated. The relationship between the rate and BTL concentration showed monophasic kinetics (KM = 0.74 +/- 0.13 microM) when microsomes from untreated rats were used, whereas microsomes from 3-MC-treated rats showed biphasic kinetics (KM1 = 0.76 +/- 0.13, KM2 = 646 +/- 16 microM). Anti-cytochrome P450 (P450) BTL (P4502D subfamily) antiserum inhibited the reaction > 90% when low concentrations (approximately 10 microM) of BTL were used in both microsomes. However, at high BTL concentrations (approximately 2,000 microM), the inhibition was only up to a half of control in microsomes from 3-MC-treated rats, whereas in microsomes from untreated rats, the rates were suppressed > 90%. Kinetics observed in microsomes from 3-MC-treated rats changed to nearly monophasic, with a KM value corresponding to KM2. Anti-P4501A1 IgG, on the other hand, hardly inhibited the reaction conducted by liver microsomes from 3-MC-treated rats when substrate concentrations were low, whereas at higher concentrations, it inhibited up to 50%, resulting in a monophasic kinetics with a KM value corresponding to KM1. These results clearly indicate that the biphasicity of kinetics in BTL metabolism in liver microsomes from 3-MC-treated rats is caused by the involvement of two P450 species: P450 BTL and P4501A1 in the reaction. This is the first direct evidence to the theoretical hypothesis that the biphasic kinetics of the enzyme reaction is caused by the involvement of at least two enzymes with different kinetic parameters.
Animals↗