Biomedical subjects
Publications and source records attributed to S Furuse.
We describe a patient in whom pemphigus foliaceus developed after cutaneous squamous cell carcinoma (SCC) metastasized to regional lymph nodes. Immunologic analysis revealed that production of anti-desmoglein 1 autoantibodies started when SCC metastasized, and the SCC expressed desmoglein 1, suggesting a pathogenic role of metastasized SCC in developing pemphigus foliaceus.
The effects in vitro of tea tree oil (TTO) and plaunotol were examined by monitoring the growth of a standard strain of Staphylococcus aureus FDA 209P and of fourteen methicillin-susceptible strains of S. aureus (MSSA), together with twenty methicillin-resistant strains (MRSA). The minimum inhibitory concentrations (MIC) and the doses for 50% inhibition of growth (ID50) were determined by the micro-broth dilution (MD) method, and the broth dilution with shaking (BDS) method, respectively. The MIC of plaunotol for 50 and 90% of the MSSA and MRSA were assessed by the MD method, as 16 microg/ml and > or = 1,024 microg/ml, respectively. No antibacterial effects of TTO on MSSA and MRSA were detected by the MD method. The growth-inhibitory effects of TTO on S. aureus by the BDS method were examined, and it appeared that TTO was effective over a lower range of concentrations than previously reported. It seems that TTO is very effective in vitro against MSSA and MRSA at high concentrations but less effective below 40 microg/ml of TTO.
A feruloylesterase was purified from the extracellular broth of Aspergillus awamori grown on wheat bran culture. The purified enzyme gave a single band on SDS-polyacrylamide gel electrophoresis and isoelectric focusing, with an apparent M(r) of 35,000 and a pI of 3.8, respectively. The substrate specificity of the purified enzyme differed obviously from that of acetylesterase of A. awamori. The enzyme bound to microcrystalline cellulose.
An inducible acetylesterase was purified from the culture medium of Aspergillus awamori strain IFO4033 growing on wheat-bran culture by ion-exchange, gel-filtration and hydrophobic-interaction chromatographies. The purified enzyme had an Mr of 31000 and contained Asn-linked oligosaccharides. The enzyme liberated acetic acid from wheat bran, hydrolysed only alpha-naphthyl acetate and propionate when aromatic esters were used for the substrate, and was tentatively classified as a carboxylic esterase (EC 3.1.1.1). The gene encoding acetylesterase was cloned and sequenced. The deduced amino acid sequence showed that acetylesterase was produced as a 304-amino-acid-residue precursor, which was converted post-translationally into a 275-amino-acid-residue mature protein. Part of the sequence of acetylesterase was similar to the region near the active-site serine of lipases of Geotrichum candidum and Candida cylindracea. A unique site of putative Asn-linked oligosaccharides was presented.
The patient was a 40-year-old female (154 cm, 45 kg). Several months after receiving radiotherapy, surgery and chemotherapy (Epi-ADR, CDDP, PEP) for an undifferentiated carcinoma of the left parotid gland, she had multiple pulmonary metastases without local recurrence. Following 2 cycles of combination chemotherapy with CDDP (30 mg/1 hr, days 1 approximately 5) and 5-FU (1,000 mg/24 hrs, days 2 approximately 6), most pulmonary nodules disappeared. For the remaining pulmonary nodules, one cycle of combination chemotherapy with 5-FU (850 mg/24 hrs, days 1 approximately 5), leucovorin (9 mg x 3/day, days 1 approximately 5) and CDDP (110 mg/2 hrs, day 7) was added, but further improvement was not obtained on chest CT. Side effects were tolerable in both regimens. It was suggested that the combination chemotherapy with CDDP and 5-FU might be useful for the treatment of advanced parotid gland carcinomas.
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A case of congenital subclavian steal is reported. A 7-year-old girl was admitted on July 1980 to Shimane Medical University for evaluation of murmur over the region of the chest. Heart murmur was pointed out at the age of three month, however, she had no complaints and was growing normally. On admission, the blood pressure was 108/48 mmHg in the left arm and unobtainable in the right arm. The length of the arm was 53 cm on the right side and 55.4 cm on the left side. On auscultation, a systolic murmur was present over the chest and the right neck. The arch aortography disclosed the left aortic arch, the isolation of the right subclavian artery and the right patent ductus arteriosus (PDA). The left transfemoral vertebral angiography showed the retro-grade filling from the right vertebral artery to the right subclavian and pulmonary artery via the right PDA. The right external carotid angiography showed the filling of the right vertebral artery through muscular branches of the right occipital artery. The right retrograde brachial angiography showed small right subclavian artery and the filling of the pulmonary artery through the right PDA. The recorrective operation was made. Postoperatively, normal blood flow was recognized in angiography. The blood pressure improved in the right side and the murmur was diminished.
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Case 1. A 38-year-old male was admitted with an 8-month history of progressive visual disturbance in his right eye. He had a past history of operations for paranasal sinusitis 24 years and 5 years prior to admission. Neurological examination revealed right anosmia, left hyposmia and vision in his right eye reducing to light perception. Case 2. A 61-year-old male was admitted with complaint of headache and a 2-month history of deteriorating vision in his right eye. On admission, vision in his right eye was found to be reduced to hand motions and associated with a concentric contraction of the visual field. Bilateral hyposmia and the right exophthalmos were also noticed. Plain x-ray films, tomography and especially CT scan were useful to demonstrate the definite inflammatory changes of the paranasal sinuses and the extension of the lesion beyond the confines of the sinuses. In both cases, external ethmoidectomy and sphenoidectomy with removal of the infected granulation tissue from the sinuses were performed, but neither mucocele nor pyocele was found. Vision improved postoperatively. Previous reports about ocular complications of infection in the paranasal sinuses without mucocele or pyocele are few. Early diagnosis of ocular complications of sinusitis is important. Once the diagnosis established, a timely surgical approach is essential to prevent visual loss.
A 67-year-old male was admitted to our clinic on May 1, 1981, because of mild confusion and a left hemiparesis. About 6 years ago, when he had a left-sided homonymous hemianopia, carotid angiography revealed moyamoya disease. CT scan on the admission showed an intracerebral hematoma in the right temporal lobe, which ruptured to the lateral ventricle. An angiogram demonstrated the net work of moyamoya vessels in the base of the brain and a "newly-appeared" aneurysm at the peripheral portion of the right anterior choroidal artery. This artery was shown on the previous angiogram also but did not bear the aneurysm. At the emergent operation the hematoma was evacuated and the aneurysm was excised, which was proved histologically to be a false aneurysm. Thirty-six cases of moyamoya diseases associated with aneurysm including the present case were reviewed. There were 44 aneurysms in this series. They were classified into groups--1) the major artery aneurysms arising from the major cerebral arterial segments; 2) the peripheral artery aneurysms arising from the distal segments of the peripheral cerebral arteries. The major artery aneurysms were found more frequently in the vertebro-basilar system, and the peripheral artery aneurysms in the basal ganglia, near or in the moyamoya vessels. Of 26 major artery aneurysms 12 were proved to be saccular aneurysms, 9 by surgeries and 3 by autopsy studies respectively. Of 18 cases of the peripheral group the aneurysms were excised operatively in two cases, and autopsy studies were performed in other two cases. The peripheral artery aneurysms were examined histologically in three cases; one was proved to be a false aneurysm, the other was thought to be a true aneurysm, and the third one was not verified. In 8 cases, the peripheral artery aneurysms disappeared on the follow-up angiograms and were supposed to be false aneurysms. From these reported cases, it may be suggested that major artery aneurysms are mainly true aneurysms and peripheral artery aneurysms are false aneurysms.
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A 27-year-old woman in the ninth month of her pregnancy suddently developed nausea and motor weakness of her right lower extremity while shopping. Subsequently a disturbance of consciousness and right-sided hemiparesis developed. Spinal puncture yielded clear CSF but CT scan demonstrated a left subependymal hematoma. Angiographical examination led to a diagnosis of "Moyamoya" disease. The source of the intracranial hemorrhage could not be identified. The hematoma could not have been diagnosed accurately without the CT scan.
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Moyamoya disease is a chronic occlusive cerebrovascular disease of unknown etiology for which no effective treatment has been found. The authors report the result of 23 superficial temporal-middle cerebral artery (STA-MCA) anastomoses and seven encephalomyosynangioses, performed on 13 cases with moyamoya disease and on four additional atypical cases. There were 10 children and seven adults in this study. The follow-up period ranged from 1 year and 4 months to 4 years and 1 month postoperatively; nine patients had excellent results, five good, and one fair; two patients were unchanged. The anastomotic procedure was most effective for transient ischemic attacks, reversible ischemic neurological deficits, and even minor or moderate neurological symptoms. The STA-MCA anastomosis appears to be an effective treatment for moyamoya disease.
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