Biomedical subjects
Publications and source records attributed to N Fujino.
Three weeks prior to admission, cough and dyspnea developed in a 49-year-old man and progressed to acute respiratory failure. The patient was treated with a mechanical ventilator. Open lung biopsy revealed diagnosis of BOOP. With corticosteroid therapy, the patient recovered dramatically.
Cross sectional echocardiography combined with Doppler echocardiography was used to record either ductal morphology or the flow profile within the ductus arteriosus before and after infusion of prostaglandin E1 in 25 newborn infants with cyanotic and acyanotic congenital heart disease with ductus dependent blood flow. The ultrasound results were compared with changes in arterial oxygen tension and the overall clinical response to prostaglandin E1 seen during the same period in 24 of the 25 patients in whom the degree of ductal narrowing could be determined with the ultrasound method. At the time of the study, the ductus was widely patent or slightly narrowed in 12 patients and was closed in two patients. These patients did not respond to prostaglandin E1. There was prominent localised narrowing of the ductus in seven patients and generalised narrowing in three. After the infusion of prostaglandin E1 there was no ductal narrowing in these patients, except for one patient who had slight residual localised narrowing. There was also a considerable change in the ductal flow profiles in each patient. In these 10 patients infusion of prostaglandin E1 resulted in an increase in arterial oxygen tension, clinical improvement, or both. The present study indicates that prostaglandin E1 is effective in patients with prominent narrowing of the ductus but is not in patients in whom the ductus is widely patent or closed. Cross sectional echocardiography combined with Doppler echocardiography was useful for predicting the responsiveness of the ductus arteriosus to the infusion.
The status of dental caries prevalence in the child patients, having visited the pedodontic clinic of Ohu University Dental Hospital, was surveyed longitudinally for 2 years (between 3 and 5 years of age) or 3 years (between 2 and 5 years). Also the dental caries attack patterns used at the dental health examination in infants aged 3 years, were investigated longitudinally. The surveyed child patients were 132 boys and 143 girls who had 20 deciduous teeth in their mouth through the surveyed period. The results were as follows: 1. The dental caries prevalence rate in the child patients was high at each age. 2. B and C caries attack patterns showing extensive caries increased remarkably at 3 or 4 years of age, and O patterns decreased with advanced age. 3. The child patients having no change in the caries attack patterns for 3 years decreased about 70%, and the severe type group transmitted to C caries attack patterns increased with advanced age. 4. Most of O caries attack patterns at 2 years of age changed to other patterns between 3 and 4 years of age, and they were few at 5 years.
The congenital teeth are not only classified by Massler et al. as a natal tooth that has erupted at birth and a neonatal tooth that erupts at neonatal period, but also divided into a normal deciduous tooth and a supernumerary tooth. The congenital teeth are mostly found in the mandibular anterior region, but extremely rare in other regions. The authors met a rare case, that had a so-called congenital tooth in the maxillary anterior region, which was a supernumerary and fused tooth. The case was a boy patient, 4 months of age, who visited the pedodontic clinic, of Ohu University Dental Hospital, with the complaint of ruber and swelling of the maxillary anterior gum pad, October 17th in 1986. By oral inspection of the dental radiogram and his past history, the authors found a odontoid material in the swelled gum pad and diagnosed it as a so-called congenital and supernumerary tooth. The tooth was extracted. The extracted tooth was investigated histopathologically. It had the v-shaped incisula at the middle of its edge, and seemed as if two teeth had coalesced. The serial preparations by the labio-lingual section showed no partition, such cementum as to divide the enamel, the dentin and the pulp near the incisula. Therefore it was diagnosed as fused tooth correctly. In the labial surface of the root formed about a third root length, the thickness of the cellular cementum was observed. It was considered as a physiological reaction to no support of the alveolar bone and to the excess mobility of the tooth. The prognosis after its extraction was good, and all normal deciduous incisors appeared in his mouth, 7 month later.
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Estrogen receptors (ER) were analyzed in 63 human breast cancers by immunocytochemical assay, and by enzyme-immunoassay, using monoclonal antibodies against human ER protein, and also by the dextran-coated charcoal method. The specific staining was observed only in the nucleus of cancer cells by the immunocytochemical assay, and the presence of nuclear staining by this assay was closely associated with the estimation of the cytosolic ER content by both the dextran-coated charcoal method and the enzyme-immunoassay. In the latter, the cytosolic ER content correspondingly increased with the nuclear ER content. Both the cytosolic and nuclear ER contents correlated well with those obtained by the dextran-coated charcoal method. Furthermore, the cytosolic ER contents obtained by the enzyme-immunoassay and the dextran-coated charcoal method correlated significantly with the age of the patient, but not with the nuclear ER contents. These above mentioned results suggest that ER is present mainly in the nucleus of breast cancer cells and that the cytosolic ER obtained by these two assays is the unoccupied one released from the nucleus.
Daily injections of 100 micrograms 17 beta-estradiol, or 250 micrograms tamoxifen, for 10 days led to a regression of the 7,12-dimethylbenz(a)anthracene (DMBA)-induced rat mammary tumor. Estrogen receptor (ER), progesterone receptor (PgR), and prolactin receptor (PRL-R) in the regressed tumor were significantly reduced in the estrogen-treated rats. ER and PRL-R were low but PgR increased significantly in the tumor of the tamoxifen-treated rats. A single administration of 100 micrograms estradiol induced a transient decrease of ER and PRL-R, and an increase of PgR, in the DMBA-tumor. Similar decreases in ER and PRL-R and the increase of PgR were observed 8 hours after the 5th injection of 100 micrograms estradiol--a time when the tumor had already regressed. These results suggest that high dose-estrogen has a direct inhibitory effect on the concentration of both ER and PRL-R in the DMBA-tumor, and that this effect might be accumulative with repeated administrations. It is unlikely that the inhibition of the estrogenic effect caused by loss of ER is the sole mechanism of the regression of the DMBA-tumor, since the increased synthesis of PgR as a marker of estrogen action was observed even after the ER-reduction and tumor-regression.
To elucidate the mechanism involved in closure of the ductus arteriosus (DA), 50 normal full-term infants were examined with two-dimensional and pulsed Doppler echocardiography. The examinations were performed initially within 1 hour after delivery and serially for 3 days. The two-dimensionally derived long-axis plane of the DA disclosed a characteristic localized protrusion into its lumen in 30% of the subjects within 1 hour, in 80% by 4 hours, in 96% by 8 hours, and in all by 24 hours after birth. In 10 infants in whom the intraluminal protrusion did not appear within 4 hours after birth, none had any recognizable changes in the inner diameter or length of the DA during this initial period. The development of the intraluminal protrusion resulted in localized narrowing of the ductal lumen. Doppler echocardiography revealed a high-velocity jet within and downstream from the narrowed portion of the DA. Thereafter, ductal narrowing progressed along the entire length. The intraluminal protrusion may be early evidence of ductal changes leading to eventual functional and anatomic closure.
The pulsed Doppler technique was used to record the flow velocity patterns in the ductus arteriosus and the pulmonary artery in 26 patients with either isolated or complicated patent ductus arteriosus (PDA). In all patients, abnormal Doppler signals indicating left-to-right (L-R) or right-to-left shunt flow or both could be obtained at the site of the ductus arteriosus. These Doppler flow patterns determined within the ductus coincided with the direction of ductal flow seen on the contrast two-dimensional echocardiogram. No Doppler signals of shunt flow were demonstrated in any of 42 control subjects. The peak, mean, and diastolic velocities of the L-R shunt flow within the ductus were measured from the ductal flow velocity profiles. With the Doppler-derived measurements of the mean and diastolic velocities, patients with normal pulmonary arterial pressure and those with evidence of pulmonary hypertension could be correctly identified. In addition, the mean velocity of the diastolic antegrade flow portion obtained from the proximal left pulmonary artery, which was related to ductal L-R shunting, was measured in 16 patients with isolated PDA. This Doppler flow determinant showed a good linear correlation with the L-R shunt ratio determined by Fick's method (r = .88, p less than .01). Our technique permits the noninvasive evaluation of shunt flow dynamics in patients with PDA.
Tamoxifen binding sites (TBS) were measured using 3H-tamoxifen, the objective being to evaluate the relationships among TBS and hormone receptors and/or clinical and pathological characteristics in malignant tissues from 60 patients with mammary cancer. TBS were detected in most (96.7 per cent) cancers in the breast tissues, and the mean content and affinity were 569 fmol/mg X protein with Kd: 1.98 nM. There was no significant correlation between TBS and the estrogen receptor and/or progesterone receptor, with respect to positivity or content. However, there was a significant correlation between TBS and histological grading, thereby indicating the differentiation and the proliferative activity in this tissue. The content of TBS was significantly higher in the group with a high grade of malignancy. The TBS content significantly increased in parallel with the degree of malignancy, as related to tubule formation, nuclear pleomorphism and mitotic activity. On the other hand, there was no significant correlation between TBS and age, tumor size, lymph node status or clinical stage. These results suggest the possibility that TBS may be associated with differentiation and cell-proliferation in breast cancer tissues.
201-thallium myocardial imaging studies were performed to evaluate systolic pressures in the right ventricle of 194 patients. These patients were classified to four groups. Group A (95 cases) consists of 77 patients with congenital cardiac disease, five patients with primary pulmonary hypertension, and 13 patients with history of MCLS. Congenital cardiac diseases included 30 patients with tetralogy of Fallot, 20 with ventricular septal defect, nine with atrial septal defect, and eight with pulmonary stenosis. Group B (35 cases); preoperative state of transposition of the great arteries. Group C (43 cases); post-operative state of congenital cardiac disease whose pre-operative right ventricular systolic pressures represented more than 70% of the left ventricular systolic pressures. This group included 31 patients with tetralogy of Fallot, seven with ventricular septal defect, four with atrial septal defect and one with patent ductus arteriosus. Group D (21 cases); post-operative state of transposition of the great arteries. Fifteen min after intravenous infusion of 30-50 microCi/kg 201-TlCl, myocardial images were obtained in five projections (anterior, LAO 30 degrees, 45 degrees, 60 degrees, and lateral). The angles were determined to demonstrate clearly the interventricular septum and the ventricular free wall. The images of end-diastolic phase were obtained using the ECG-synchronized gated method in each projection. The region of interest (ROI) was defined as a section or slice by drawing two lines perpendicular to the septum, and the counts of the systemic and pulmonic ventricular free wall (Cs and Cp) were analyzed to evaluate the pressure of the pulmonic ventricle. The pressures of the ventricles were obtained by cardiac catheterization performed concomitantly with the cardiac imaging.(ABSTRACT TRUNCATED AT 250 WORDS)
Serum levels of CA15-3, a mammary tumor associated antigen recognized by two different murine monoclonal antibodies (115D8 and DF3), were investigated in patients with mammary carcinoma and other benign or malignant diseases. The reference value of the serum CA15-3 level was obtained as 24 units/ml at the 99% confidence limit among healthy individuals (n = 462). Elevation of serum CA15-3 levels was observed in 24.3% of overall patients with mammary carcinoma. Serum CA15-3 levels in breast cancer patients correlated with the clinical stage; higher percentages of positivity were observed in those with advanced breast cancer (stage IV, 64.7%, recurrent, 52.4% and metastatic, 70.3%). Furthermore, elevated serum CA15-3 levels in breast cancer patients responded well to the effect of therapy. Although the serum CA15-3 test gave percentages of positivity of breast cancer similar to those found by the serum CEA test, the serum CA15-3 test revealed lower percentages of positivity than the serum CEA test among patients with benign breast lesions, liver cirrhosis or other carcinomas. These results suggest that the serum CA15-3 antigen level provides a very useful marker for diagnosis and clinical monitoring of patients with breast cancer.
Intact gamma-globulin (SM-4300) was studied for its clinical efficacy in 13 of 23 cases of surgical severe bacterial infections. The drug was administered intravenously either 2.5 g/day for 3 days or 5 g for a day and the results were as follows. Clinical effects of SM-4300 in 13 cases of surgical severe bacterial infections were excellent in 1 case, good in 3, fair in 3 and poor in 6. SM-4300 was effective in all of 5 cases of intraperitoneal abscess. The elevation of serum IgG was observed after the administration of SM-4300 in all cases tested. As to complement, the slight elevation of serum CH50 was observed in the half of cases documented. Clinical side effects were not confirmed in any case. These results suggest that intact gamma-globulin (SM-4300) was effective in combination with antibiotics.
Hormonal regulation of plasminogen activator in rat mammary tumor induced by 7,12-dimethylbenz[a]anthracene (DMBA) was studied both in vivo and in vitro. Plasminogen activator activity in DMBA-induced tumor (DMBA-tumor) was markedly decreased by ovariectomy, and recovered in a dose-dependent fashion upon estradiol administration, reaching a maximal level at 12 hr. This estrogen-stimulated production of the enzyme was prevented by actinomycin D, cycloheximide, and tamoxifen, indicating that in DMBA-tumor, estrogen might regulate de novo synthesis of plasminogen activator at a transcriptional level via an estrogen receptor system. Furthermore, DMBA-tumor cells in primary culture displayed similar estrogen-dependency toward the production of the enzyme without any cell proliferation. This indicates that the action of estrogen is mediated neither by cell division nor by prolactin, another hormone pastulated to be responsible for the development and growth of DMBA-tumor. Taken together, the present results have led to support the view that the primary function of estrogen is to induce plasminogen activator, which is probably essential to maintain the malignant state of DMBA-tumor.
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