[Two case reports of cerebrovascular disorder after radiation therapy].
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Biomedical subjects
Publications and source records attributed to J Tanaka.
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The changes in the phagocytic function of the reticuloendothelial (RE) system after 67% hepatectomy in rats were studied by use of 51Cr-endotoxin as the phagocytable material. The humoral opsonic index was significantly increased to approximately 1.2 to 1.8 (control, 1.0 +/- 0.2, mean +/- SD) until the fourteenth postoperative day. In contrast, the phagocytic index was decreased to 0.068 +/- 0.016 (control, 0.103 +/- 0.015) on the first day, then returned to the normal level on the second day. In this early postoperative period, uptake rates of 51Cr-endotoxin in the liver were remarkably decreased to about 50% to 70% of control, whereas those in the spleen and lung were increased two- to threefold of control. From the third to the fourteenth day, the phagocytic index was significantly increased compared with the preoperative level. During this period, the uptake rates in the liver and spleen were within the normal range. These results suggest that the increases in the opsonic index of 67% hepatectomized rats represent the homeostatic response for maintaining or stimulating RE system phagocytic function, and that high or normal phagocytic index, concomitant with the increase in the opsonic index, implies an enhanced or compensatory stage, respectively. The decrease in the phagocytic index despite the high opsonic index is assumed to represent a compromised stage of the RE system.
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Electrical stimulation of the rat A1 noradrenergic region produced orthodromic inhibition (34%), excitation (23%) or excitation-inhibition sequence (25%) of the spontaneous activity of phasically firing units in the paraventricular nucleus of the hypothalamus (PVH). Excitatory responses could be distinguished into two types on the basis of their latency and duration. Both the primary and post-excitatory inhibitory responses were significantly attenuated by intravenous injection of propranolol, a beta-adrenoceptor antagonist, whereas neither type of excitatory response was affected.
An epithelial human hepatoma cell line (PLC/PRF/5) and a primary epithelial human baby kidney (HBK) cell culture showed restricted growth of human cytomegalovirus (HCMV). Treatment of these two epithelial cell cultures with dexamethasone greatly enhanced their ability to support HCMV replication. Growth kinetic experiments and infectious center assay revealed that in both the hormone-treated cultures infectious progeny virus appeared earlier by 1 or 2 days and 5- or 10-fold more cells are able to produce infectious virus. There was an approximate 50- or 100-fold increase in virus yield compared to that in the untreated control cultures. Enhanced HCMV replication in the hormone-treated cultures was not due to differences in the cell growth or the virus adsorption and was supported by evidence of increased synthesis of HCMV-specific immediate early antigens and DNA.
The distribution of histidine decarboxylase-like immunoreactivity (HDCI) in the rat central nervous system was studied by the indirect immunofluorescence technique. HDCI cell bodies were concentrated in the posterior hypothalamic area, such as in the tuberal magnocellular nucleus, caudal magnocellular nucleus, posterior hypothalamic nucleus and lateral hypothalamus just lateral to the fasciculus mammillothalamicus at the level of the posterior hypothalamic nucleus. Extensive networks of HDCI fibers of various densities were found in many areas of the brain; they were particularly dense in the hypothalamus but were also found in the following areas: rostrally in the cerebral cortex, olfactory nuclei, medial amygdaloid nucleus, n. tractus diagonalis, and bed nucleus of the stria terminalis, and caudally in the central gray matter of the midbrain and pons, auditory system, n. vestibularis medialis, n. originis nervi facialis, n. parabrachialis, n. commissuralis, n. tractus solitarii, and n. raphe dorsalis.
The renal excretion of methotrexate (MTX) and its major metabolite 7-hydroxymethotrexate (7-OH-MTX) was analysed in 12 children with malignancies during 52 courses of high-dose methotrexate (H-D-MTX) infusion at dosages ranging from 0.7 to 8.4 g/m2. The peak concentrations of both MTX and 7-OH-MTX exceeded the aqueous solubilities of these compounds at low pH (less than or equal to 6.0). The cumulative MTX excretion in urine was 75%-98% of the administered amount of MTX, and the cumulative 7-OH-MTX excretion in the urine was 3%-15%. The theoretically required urinary flow (TRUF) was estimated as the minimum urine volume needed for complete resolution of MTX and its metabolites in urine. TRUF during MTX infusion from 0 to 6 h and from 6 to 12 h was correlated with the dosage of MTX, and these values were 0.1-1.8 ml/min/m2 at pH 7.0, 0.5-11.1 ml/min/m2 at pH 6.0, and 1.9-42.2 ml/min/m2 at pH 5.0 with dosages of 0.7 to 8.4 g/m2. The value of the theoretically required urinary flow is important to ensure adequate hydration and the optimum alkalinization schedule for massive MTX infusion.
Two sibling cases of familial amyotrophic lateral sclerosis (ALS) revealed degeneration usually associated with other systemic degenerative disorders. The changes in the 41-year-old sister were compatible with those reported in other familial ALS cases affecting the upper and lower motor neurons, posterior columns, and spinocerebellar tracts. The 45-year-old sister revealed more wide-spread degenerative changes involving not only motor neuron systems, but also proprioceptive, general somatic afferent and spinocerebellar afferent systems. Intracytoplasmic hyaline inclusions were observed in the oculomotor nuclei. Clinical manifestations of urinary disturbance and oculomotor impairment seldom seen in sporadic ALS were interpreted to be due to the unusual distribution of the morbid process. These pathologic findings suggest that familial ALS may be a multisystemic degenerative disorder, frequently involving the spinocerebellar tracts, but occasionally involving other systems as well.
A 16-year-old Japanese girl with a persistent left superior vena cava draining into the coronary sinus was surgically treated. Both coronary sinus and left superior vena cava were totally unroofed in the posterior wall of the left atrium, but the routes were recognized as a deep ditch. Both preoperative diagnosis and the ensuing successful correction were performed only after the third cardiac catheterization and the third operation, respectively. The importance of preoperative diagnosis and the surgical procedures to correct this anomaly were discussed.
A retrospective study of 161 consecutive patients undergoing mitral valve replacement with or without other valve surgery was undertaken to examine the relation between cardiac cachexia and postoperative acute renal failure. The preoperative nutritional state was assessed according to percent of the ideal body weight (W/IW). There were 37 malnourished patients (W/IW less than 0.80) and 124 normally nourished patients (W/IW greater than or equal to 0.80). In nineteen in the malnourished group (51 per cent) and 37 of normal-nourished (28 per cent), postoperative acute renal failure developed. Malnourished patients showed a severe clinical picture preoperatively and complicated operative procedures had to be carried out. To match these clinical factors between the two groups, the observation was limited to the high risk patients who showed severe New York Heart Association Functional Class (III or IV) large cardiothoracic ratio (more than 65 per cent), and long cardio-pulmonary bypass time (exceeding 120 minutes). Even in this subgroup, malnourished patients were susceptible to renal failure (64 per cent versus 20 per cent, malnourished versus normal-nourished respectively). Thus, when malnutrition is superimposed on diminished cardiac performance, acute renal failure may ensue.
In the cirrhotic rat liver induced by phenobarbitone and carbon tetrachloride, adenylate energy charge, mitochondrial oxidative phosphorylation, and respiratory enzyme concentrations were studied along with serum albumin concentrations. Cytochrome a (+a3) concentrations of the liver increased with the severity of cirrhosis and were negatively correlated with the ATP-synthesizing ability per unit of cytochrome a (+a3). These changes were associated with the decrease in hepatic energy charge. Such decreased energy charge may be responsible for the decreased serum albumin level in the cirrhotic rat. It is suggested that such falls in hepatic energy charge may be one of the most important factors contributing to the decreased functional reserve of cirrhotic patients.
Focal white matter necrosis is frequently seen in the brains of infants with perinatal cerebral hypoperfusion. Periventricular leukomalacia (PL) occurs in the deep white matter of premature and term neonates and subcortical leukomalacia (SL) in the subcortical white matter of young infants. Using immunoperoxidase methods in normal infants, glia positive for glial fibrillary acidic protein (GFAP) were found first in the deep zones of white matter and with increasing age they became more prominent in the subcortical zone. They increased diffusely in the deep or subcortical zones of the cases of PL or SL, respectively. The number of myelin basic protein-positive glia is much larger than that of GFAP-positive glia in the cases of old PL. These findings suggest that an increased number of positive glia may be a reaction to hypoxic, ischemic, or toxic insults, or this shifting, transient increase of positive glia in cerebral white matter may be one of several predisposing factors leading to perinatal leukomalacia. Furthermore, positive staining of GFAP and MBP for reactive astrocytes in old PL suggests that at a certain stage of gliogenesis both GFAP and myelin basic protein may be present within the same cell.
This paper describes an 11-month-old male who died of Sandhoff disease. Diagnosis was based on detection of cherry red spots and total deficiency of hexosaminidase A and B activities. Sections of the brain revealed swollen neuronal cells and their degeneration and disappearance, leaving a distorted cortical architecture. Ultrastructurally, numerous inclusions showing concentric lamellar or stacked lamellar profiles were found in ballooned neuronal cells, astrocytes and histiocytes. The parafoveal retina in the region of the cherry red spot contained ballooned ganglion and amacrine cells filled with PAS and LFB positive granules. Electron microscopically, these cells showed a greater accumulation of inclusions with stacked lamellar profiles, than the concentric lamellar ones, of classically membranous cytoplasmic bodies (MCB). Hepatocytes and Kupffer cells and epithelial cells of renal glomeruli contained pleomorphic inclusions. Biochemical analysis by thin-layer chromatography of lipid extracts from the cerebral cortex showed a marked increment of the GM2 fraction, without an increase in globoside.