Biomedical subjects
Publications and source records attributed to M Takai.
The clinical, histological, and electron microscopic features of a case of malignant amelanotic melanoma of the esophagus are described. Amelanotic melanoma is difficult to distinguish from other malignant lesions, but in our case electron microscopy was helpful in the diagnosis.
From January 1983 to December 1989, we performed esophagojejunostomy on 379 patients who underwent total gastrectomy for gastric cancer. A mechanical EEA stapler or conventional manual suturing was used. The clinical outcomes of 199 patients in whom stapling was used (stapler group) and 180 patients in whom manual suturing was done (manual group) were compared. Two of the 199 patients in the stapler group and 3 of the 180 patients in the manual group died of causes directly related to the anastomosis. In the stapler group, 16 stapled anastomoses were formed supradiaphragmatically, and manual suturing was done for 6 patients. The highly placed anastomosis was formed without left thoracotomy or with median sternotomy in 8 of the 16 patients in whom the stapling device was used and in 1 of the 6 patients in whom manual suturing was used. The incidence of anastomotic leakage and stenosis did not differ between the groups. Thus, the mechanical stapler facilitated the construction of a rapid, reliable esophagojejunostomic anastomosis.
A cDNA library was prepared in lambda gt 11 from poly(A)+ mRNA isolated from a pure population of Xenopus round spermatids and screened with an antibody against SP3-5 (sperm-specific proteins) of Xenopus sperm. Positive clones were sequenced and an arginine-rich clone, designated pXSP531, was obtained. The 473-nucleotide sequence of pXSP531 contained an open reading frame of 237 nucleotides which was preceded by a 5' untranslated region of 67 nucleotides. The 3' untranslated region contained 149 nucleotides, including a consensus polyadenylation signal (AAATAAAA). Twenty nucleotides of a poly(A) tail was contained in the pXSP531. SP3-5 were separated from each other by reverse-phase chromatography and sequenced. The amino acid sequence of the peptide fragments which were obtained by digestion of SP4 with V8 protease and separated by reverse-phase chromatography was identical to the sequence of the N-terminal 43 and C-terminal 15 amino acids deduced from the nucleotide sequence of pXSP531. This result demonstrates that pXSP531 encodes SP4. Northern hybridization of RNA extracted from primary spermatocytes and round spermatids on Days 0 and 6 with SP4 cDNA probe (pXSP531) showed that SP4 mRNA is present both in primary spermatocytes and in round spermatids as is protamine mRNA in the rainbow trout. The size of the SP4 mRNA in round spermatids on Day 0 was longer by 60 nucleotides compared to that in primary spermatocytes and that in spermatids on Day 6 was shorter by 30 nucleotides compared to that on Day 0. These size differences were due to differences in the length of the poly(A) tracts because digestion of poly(A) with ribonuclease H resulted in the shortening of mRNA to the same size for three stages.
Intraoperative pelvic hyperthermochemotherapy (IOPHC) with mitomycin C (MMC) was prescribed for 14 patients with resectable advanced rectal cancer in an attempt to prevent a postoperative local recurrence. Immediately after rectal amputation and extended lymphadenectomy, IOPHC was performed using physiologic saline containing 40 micrograms/mL of MMC at 45.5 +/- 0.6 C for 90 minutes, with an apparatus devised for IOPHC. At the end of IOPHC, the esophageal temperature was 37.2 +/- 0.8 C and cooling was not required. Antitumor efficacy and complications in the IOPHC group were compared with findings in 12 rectal cancer patients who underwent surgery only within the same period of time. Operation time was not prolonged with IOPHC treatment. In cytologic examinations of the pelvic lavage just before IOPHC treatment, viable cancer cells were detected in 6 of the 14 patients but were never detected in the postoperative exudate drained from the pelvic cavity. Of the 12 patients in the control group, 2 had a local recurrence, while in the IOPHC group there was no local recurrence for 16.9 +/- 9.7 months at this writing. Postoperative complications did not differ between the groups. This IOPHC treatment is a favorable method in eradicating cancer cells for postoperative local recurrence of rectal cancer.
Translocation of dimethyl sulfoxide (DMSO) reductase to the periplasmic space was studied in vivo with a photodenitrifier, Rhodobacter sphaeroides f. sp. denitrificans, using immunoblotting analysis and radioactive labeling. A polypeptide with an apparent molecular mass about 2,000 Da higher than that of DMSO reductase accumulated during induction of the reductase with DMSO. An uncoupler, carbonyl cyanide-m-chlorophenylhydrazone, inhibited the processing of the polypeptide after cells had been radioactively pulse-labeled with [35S]methionine. These results indicated that the higher-molecular-mass polypeptide was the precursor form of DMSO reductase. The precursor form accumulated in either the cytoplasm or the membrane, whereas the mature form accumulated in the periplasmic space. The membrane-bound precursor was sensitive to proteinase K treatment from both the cytoplasmic and periplasmic sides of the membrane, indicating that the polypeptide binds to the membrane, exposing it to both the outer and inner surfaces of the cytoplasmic membrane. Processing of the precursor was hampered by removal of molybdate from the medium and was restored by its readdition. It was also inhibited by the addition of tungstate in the medium.
In order to prevent local recurrence, intra-operative pelvic hyperthermochemotherapy (IOPHC) combined with surgery for rectal cancer has been performed. In this study, we evaluated the clinical effect of IOPHC in 20 patients who were given IOPHC, compared with 13 patients who underwent curative surgery without IOPHC (control group). The IOPHC procedure was as follows: After rectal amputation, the pelvic cavity was filled with a physiological saline containing 40 micrograms/ml of MMC. Then, the physiological saline was warmed and maintained by the apparatus (heater) we devised at 45 degrees C for 90 minutes. Local recurrence occurred in 2 cases of IOPHC group (2/20:10.0%), and in 3 cases in the control group (3/13:23.1%). On the other hand, distant metastases developed approximately at the same rate in the IOPHC group (4/20:20.0%) and control group (2/13:15.4%). Thus, IOPHC is a feasible approach to reduce local recurrence of rectal cancer.
Bone injury after the radiotherapy for carcinoma of the uterine cervix has been reported since early days of this century. Recently, the concept of insufficiency fracture has been confirmed. Insufficiency fracture is one of the stress fractures and occurs when the elastic resistance of bone is inadequate to withstand normal or physiological stress. In the American and European studies, radiotherapy is known as a cause of insufficiency fracture. There are no reports on insufficiency fracture in the Japanese literatures. Four cases of carcinomas of the uterine cervix presented pelvic insufficiency fractures following radiotherapy. In the public bone, a vertical para-symphyseal fracture with mixed lytic and sclerotic changes of surrounding tissue is characteristic. Sacral insufficiency fracture shows a vertical or horizontal line with lytic and sclerotic appearance. Bone scintigraphy is a sensitive modality for the early detection. H-shaped configuration is diagnostic for sacral insufficiency fracture. CT is an accurate technique demonstrating a vertical fracture and excluding the malignant bony lesion. Although radiological findings of insufficiency fracture are similar to bone malignancy, differential diagnosis from malignant lesions is possible. Bony symptoms of all patients disappeared without specific treatments. In the follow-up study of patients with carcinomas of the uterine cervix after radiotherapy, it is important to have the consideration on insufficiency fracture.
A digital fluoroscopic (DF) imaging system has been constructed to obtain portal images for verification during external beam radiotherapy. The imaging device consists of a fluorescent screen viewed by a highly sensitive video camera through a mirror. The video signal is digitized and processed by an image processor which is linked on-line with a host microcomputer. The image quality of the DF system was compared with that of film for portal images of the Burger phantom and the Alderson anthropomorphic phantom using 10 MV X-rays. Contrast resolution of the DF image integrated for 8.5 sec. was superior to the film resolution, while spatial resolution was slightly inferior. The DF image of the Alderson phantom processed by the adaptive histogram equalization was better in showing anatomical landmarks than the film portal image. The DF image integrated for 1 sec. which is used for movie mode can show patient movement during treatment.
In order to prevent local recurrence after curative surgery for rectal cancer, intra-operative pelvic hyperthermochemotherapy (IOPHC) was performed, combined with surgery. Nineteen patients with rectal cancer were given IOPHC (IOPHC group) and 25 patients who underwent curative surgery without IOPHC served as control, in the same period of time. IOPHC was done as follows: After rectal amputation or resection combined with extended lymphadenectomy, the pelvic cavity was filled with a prewarmed perfusate (physiological saline) containing 40 micrograms/ml of MMC. Then, an apparatus for IOPHC we devised was submerged in the perfusate to warm and maintain it at 45 degrees C for 90 minutes. The mean temperature of the esophagus was 37.2 degrees C, so it was not necessary to cool down the body throughout IOPHC. There was no significant postoperative morbidity between the two groups except that the total amount of exudate drained from pelvic cavity was larger in the IOPHC group. Local recurrence occurred in 3 controls, but in only one of the IOPHC group. Thus, IOPHC is a safe and reliable approach to prevent local recurrence of rectal cancer.
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Porcine C5a anaphylatoxin, the primary structure of which was first determined by Gerard and Hugli in 1980 as a 74-amino acid peptide having three intramolecular disulfide bonds, was synthesized by the solution procedure applying our maximum protection strategy. The fully deprotected peptide was subjected to air oxidation in an acetate buffer at pH 7.5, and the product was isolated as a single entity by HPLC. Amino acid analysis and biological activities of the synthetic peptide agreed well with the reported values. However, the retention time of the synthetic C5a was different from that of the natural product, supplied by Dr. Hugli, on both reversed phase (RP) and ion-exchange (IEX) HPLC systems. The tryptic peptide mapping on HPLC revealed that Gln which was incorporated into the peptide at position 65 was replaced by Glu in the natural product. The elution pattern of tryptic peptides containing three disulfide bonds was identical with natural and synthetic C5a. It was also identical with that of a peptide which was synthesized following the estimated secondary structure proposed by Zimmermann and Vogt in 1984.
An evaluation of the ring scan and the spot scan was made for the pion irradiation of head and neck tumors with the Piotron. For the geometry of the Piotron, with its 60 radially converging beams, two scanning techniques have been developed, ring scan and spot scan. They have different characteristics concerning achievable dose distributions and sensitivity to tissue inhomogenities. The optimized 3-dimensional dose distributions for the treatment with ring scan and spot scan techniques were calculated for two examples of the target volume. The comparison of the dose distributions has shown that the ring scan is better in sparing normal tissues than the spot scan for a simple shape target volume but not for an irregular shape target volume with the present status of the technique. The irradiation time needed for the ring scan is longer, for the present examples three times, than for the spot scan. From the practical view point the spot scan is preferable to the ring scan for the treatment of head and neck tumors with the Piotron.
A total of 6346 swine sera collected at an abattoir in the city of Obihiro, Hokkaido during the years 1978-87 were tested for the presence of antibodies to swine and human influenza viruses. A high incidence of antibody to A/New Jersey/8/76 (swine type H1N1) virus was observed throughout the 10 years except for the occasional month and a single long period of 15 months. Antibodies to human H3N2 virus in swine appeared to be related to the epidemics of human influenza which occurred in the study area during the years 1980-3, but unrelated to the epidemics during the years 1984-7. A large number of swine were found to be antibody positive to a human H1N1 virus during the period April to June 1964, and a smaller number, during the period November 1986 to June 1987. Both were in relation to human influenza epidemics. However, there were long periods where human H1N1 antibodies in swine could not be found.
The radiation absorbed dose was estimated for 131I therapy of metastatic lesions of thyroid cancer, by the quantitative gamma-camera imaging. Uptake for eleven lesions in five cases (out of four patients) was measured for two times after 131I administration. Activities were calculated from opposed images with corrections for distance and depth using empirical formulae. An activity time curve was assumed as a reminder of two exponentials and fitted to measured values. The sizes of lesions were evaluated using the multi-slice CT images. An increase of frequency of activity measurement, particularly within a few days after 131I administration is desirable, for the purpose of an improvement of accuracy of dosimetry.
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This study was performed to investigate the role of cell-mediated immunity in primary glomerular diseases (PGD), by estimating natural killer (NK) activity from peripheral blood mononuclear cells (PBMC) assayed against K562 cells, and antibody-dependent cell-mediated cytotoxicity (ADCC) activity from PBMC assayed against chicken red blood cells. The proportion of PBMC was examined by flow cytometry using the monoclonal antibodies OKT and Leu series. NK activity in patients with nephrotics of minimal change nephrotic syndrome (MCNS), membranous glomerulonephritis (MGN) and membranoproliferative glomerulonephritis (MPGN) was significantly lower compared to those of the normal controls. In addition, ADCC activity in patients with nephrotics of MPGN was significantly lower compared to the normal controls. The sera from patients with diminished NK activity inhibited NK activity of PBMC from healthy individuals. Furthermore, OKM1 positive lymphocytes were significantly higher in the MCNS, MGN and MPGN patients and Leu7 positive lymphocytes were significantly higher in the MPGN patients. These data suggest that several mechanisms contribute to the defects of NK and ADCC activities in patients with PGD, and the defects in NK and killer cells are common in patients with nephrotics of MCNS, MGN and MPGN, and may be important in the pathogenesis of PGD.