Cultured nail keratinocytes express hard keratins characteristic of nail and hair in vivo.
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Biomedical subjects
Publications and source records attributed to T Kitahara.
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We have reported previously [Sakakibara, et al. (1991) Chem. Pharm. Bull. 39, 146-149] that a protein purified from a partially purified pharmaceutical preparation of human chorionic gonadotropin (a urinary protein preparation from pregnant women) is a unique nonsecretory ribonuclease (RNase)-like protein on the basis of its amino terminal sequence homology. We purified the protein further from the same materials by gel filtration and reversed-phase column chromatographies with RNase activity as an index. The purified protein was designated RNase UpI-2. The catalytic activity and its sensitivity to inhibition by divalent cations suggest that the protein is related to nonsecretory RNase. The estimated molecular weight of RNase UpI-2 (38 kDa) by sodium dodecyl sulfate-polyacrylamide gel electrophoresis was significantly higher than that of urinary nonsecretory RNases (13 to 19 kDa) reported so far. After trifluoromethanesulfonic acid treatment, the molecular weight of RNase UpI-2 was reduced and approached that of nonsecretory RNase, which indicated that the protein contains a significant amount of carbohydrate (approximately 50%). RNase UpI-2 was immunoreactive with antibodies to a nonsecretory RNase, RNAase 1 [Yasuda et al. (1988) Biochim. Biophys. Acta 965, 185-194]. By immunoblot analysis of the protein freshly prepared from various urine samples, it was shown that a considerable amount of RNase UpI-2 is present in urine of pregnant women, but only a trace of RNase UpI-2, if any, was detected in urine of nonpregnant women and men. These results suggest the possibility that RNase UpI-2 may have been formed via a specific protein modification in pregnant women.
Among 24 arteriovenous malformations (AVMs) involving the choroid plexus, 11 were plexal type AVMs predominantly located in the choroid plexus of the lateral ventricle, and 13 were parenchymal type AVMs mainly situated in the paraventricular cerebral parenchyma. 83% of all AVMs involved both the choroid plexus and the paraventricular cerebral parenchyma. Most cases presented with intracranial hemorrhage, particularly intraventricular hemorrhage. The most serious surgical problem was a small residual nidus unrecognized at the initial operation causing postoperative hemorrhage. Five parenchymal type AVMs presented residual niduses in the choroid plexus, causing death in two cases. Two plexal type AVMs resulted in residual AVMs supplied by the cisternal segment of the anterior choroidal artery, situated in the medial temporal lobe. To prevent postoperative hemorrhage from a small residual nidus, immediate postoperative angiography while the patient is still under general anesthesia should be performed to identify any residual nidus.
The authors studied the venous drainage system and its impairment in relation to risk of hemorrhage in 108 cases of supratentorial arteriovenous malformation (AVM). The proportion of AVM's undergoing hemorrhage (hemorrhagic rate) was calculated in relation to: 1) the number of draining veins (one, two, or three or more); 2) the presence or absence of impairment in venous drainage (severe stenosis or occlusion in draining veins); and 3) the location of draining veins (deep venous drainage alone, superficial venous drainage alone, or a combination of the two). Statistical analysis demonstrated that AVM's with the following characteristics had a high risk of hemorrhage: 1) one draining vein (hemorrhagic rate 89% in 54 patients); 2) severely impaired venous drainage (hemorrhagic rate 94% in 18 patients); and 3) deep venous drainage alone (hemorrhagic rate 94% in 32 patients). The present study suggests that the venous drainage system of AVM's is significantly associated with the risk of hemorrhage of these lesions. Therefore, careful preoperative angiographic evaluation of the venous drainage system is mandatory for decision making in the management of patients with AVM's.
To clarify the significance of fundus hemorrhage in the acute stage of intracranial hemorrhage due to cerebrovascular disease (HCVD), the incidence of such hemorrhage (retinal, preretinal, and subhyaloid hemorrhage) was examined and its correlations with the severity of the disturbance of consciousness and the prognosis were investigated. Two hundred sixteen HCVD patients with intracranial hemorrhage were the subjects of this study, including 87 cases of subarachnoid hemorrhage (SAH), 60 cases of hypertensive intracerebral hemorrhage (HICH), 54 cases of arteriovenous malformation (AVM), and 15 cases of Moyamoya disease. Fundus hemorrhage was recognized in 41 cases of SAH (47%), 5 cases of HICH (8%), 3 cases of AVM (6%), and 2 cases of Moyamoya disease (13%). The incidence of fundus hemorrhage was significantly higher in SAH than in the other type of HCVD associated with intracranial hemorrhage. Among patients with severe disturbance of consciousness (JCS 100-300), fundus hemorrhage was recognized in 69% with SAH, 13% with HICH, 17% with AVM, and none with Moyamoya disease. Therefore, patients with both fundus hemorrhage and severe disturbance of consciousness in the acute stage are most likely to have SAH, but HICH and AVM should be also taken into consideration. In patients with slight disturbance of consciousness (JCS 0-30), fundus hemorrhage was only noted in SAH (27%) and not in other types of HCVD associated with intracranial hemorrhage. Thus, SAH is highly likely to be the primary HCVD associated with intracranial hemorrhage, if we recognize fundus hemorrhage in patients with slight disturbance of consciousness in the acute stage.(ABSTRACT TRUNCATED AT 250 WORDS)
We investigated nail keratins obtained by sequential extraction with increasing reducing agent concentrations (50 mM and 200 mM 2-mercaptoethanol) and examined each of the extracted keratins by gel electrophoresis followed by immunoblotting. It was found that nail contained epidermal and hair keratins. With 50 mM 2-mercaptoethanol, only epidermal type of keratins including skin differentiation specific-keratin could be extracted, whereas hair type of keratins required 200 mM 2-mercaptoethanol for extraction from nail. These results may indicate that nail has unique properties with respect to it's keratin compositions. The difference in durabilities of epidermal and hair keratins in nail against 2-mercaptoethanol suggests that two different types of the keratin filaments which are composed of epidermal or hair keratin polypeptides may have differing structural features, despite of co-existence in nail.
We report the case of a 14-year-old Japanese boy with peripheral T-cell malignant lymphoma, showing progression from immunoblastic lymphadenopathy (IBL) to overt malignant lymphoma. He suffered recurrent fever, generalized lymphadenopathy, hepatosplenomegaly and maculopapular exanthema. Leukocytosis with eosinophilia and polyclonal hypergammaglobulinemia were observed during the aggressive course of the disease. In the early phase, human immunoglobulin and steroids improved the symptoms but did not induce complete remission, and the patient died one year after the onset of the illness. Four biopsies of lymph nodes revealed progression from IBL to CD4 positive T-cell lymphoma through IBL-like T-cell lymphoma. Though IBL-like T-cell lymphoma is defined as IBL with neoplastic features and overt T-cell malignant lymphoma progressed from IBL-like T-cell lymphoma is excluded from the definition, it may be preferable that such malignant lymphoma as our case should also be included in IBL-like T-cell lymphoma.
A five-year-old boy initially diagnosed common ALL was developed to acute myelomonocytic leukemia. At onset, the bone marrow was hypercellular and 77% of the cells were blasts, mainly lymphoblast-like cells and cytogenetic study demonstrated 45, XY, -7 in all blasts. Cytochemically most of those blasts were negative for peroxidase, sudan black B, alpha-NB esterase staining. The immunological phenotype was J5 (CD10)+, I2 (HLA-DR)+, SmIg-, CyIgmu-, Leu1 (CD5)-, OKT11 (CD2)-, MY7 (CD13)-, suggesting common ALL. Eight months later, the bone marrow cells were occupied with large sized blasts which were almost positive for peroxidase stain and the cells showed coexpression of Mo1 (CD11b)+, MY4 (CD14)+, MY7+, MY9 (CD33)+, MCS2 (CD13)+, I2+, J5-, B4 (CD19)-, Mo2 (CDw14)-, at relapse. He died 2 years and 6 months after his initial diagnosis. An autopsy was performed which revealed generalized infiltration of leukemic cells and aspergillosis of the lung. In general, monosomy 7 is associated with myelodysplastic syndrome in childhood, and is terminated to acute myeloblastic leukemia. In this case, bone marrow blasts demonstrated monosomy 7 cytogenetically, and this case was considered as an acute mixed lineage leukemia of bilineal type. And this case proved that a monosomy 7 can also be terminated to acute mixed lineage leukemia with both lymphoid and myeloid phenotypes.
A case of I-cell disease is reported. The patient suffered from several episodes of pneumonia, and died of pneumonia at 12 months of age. Tissue specimens obtained at autopsy were stained with colloidal iron to demonstrate acid mucopolysaccharides. Characteristic foamy changes were observed in organs such as the heart, kidneys, liver, spleen and brain. An interesting finding in this case was that not only the interstitial cells but the alveolar epithelium in the lung showed the same foamy changes. The major causes of death of patients with I-cell disease are congestive heart failure and recurrent respiratory infections. However, there have been few reports on the histological changes in the lungs, and none have described the changes in the alveolar epithelium. Further cases must be investigated to examine the pathological relation between the histological changes in the lungs and the cause of death, because recurrent respiratory infections are the major contributor to death in patients with I-cell disease.
Five cases of retrograde thrombosis of former feeding arteries after removal of an arteriovenous malformation (AVM) are reported. The clinical features of these patients were studied and compared to those of 71 patients without this complication. The following characteristics were found to correlate with retrograde thrombosis: 1) advancing age of the patient; 2) large AVM size; and 3) markedly dilated and elongated feeders. It is suggested that the slow flow in the former feeding arteries that was observed immediately after AVM removal and pathological changes in these vessels due to long-standing hemodynamic stresses contributed to the development of retrograde thrombosis. Neurological manifestations related to retrograde thrombosis were noted in three of the five cases. Although infrequent, this complication should be considered as a serious possibility following removal of an AVM.
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5'-DFUR was administered orally at 800 mg/day, for total dosage of 57.6 g to the gastric cancer patient, classified Borrmann Type 2, with Virchow's node metastasis. Gastric tumor had diminished in size on the fluoroscopy and the endoscopy. We then made distal gastrectomy. The resected stomach showed moderately differentiated tubular adenocarcinoma on the pathological examination. Side effect was diarrhea.
Septicemia in hematologic malignancies and infection of herpes zoster in cancer patients were studied, and trend in organisms in a cancer hospital was investigated. 1) Septicemia in hematologic malignancies. The success rate of antibiotic therapy for septicemia was 76% if the patients were not under antibiotic therapy when septicemia developed. But recovery from septicemia was only 25% if the patients were undergoing antibiotic therapy when septicemia developed. Some 90% of neutropenic patients under 500/microliters, who were not under antibiotic therapy when septicemia developed, recovered from septicemia if the neutrophil count increased in the following 5 days. Change in the neutrophil count was an important factor determining the success or failure of antibiotic therapy for septicemia. The use of granulocyte colony-stimulating factor may prevent chemotherapy-induced neutropenia. Shortening of the period of neutropenia or preventing its occurrence should reduce the incidence and the severity of infection. 2) Infection of herpes zoster in cancer patients. Thirty-four cancer patients were associated with herpes zoster. Eleven of them were patients with malignant lymphoma and ten of them were patients of breast cancer. Most patients were heavily pretreated by chemotherapy and/or radiotherapy before the development of herpes zoster. Marked lymphocytopenia was observed at the onset of herpes zoster. Absolute lymphocyte count was under 1000/microliters in 71% of these patients. Development of herpes zoster in cancer patients was considered to be due to the depression of cell-mediated immunity which was the result of repeated and continued anticancer therapy. Acyclovir was found to be effective to treat herpes zoster in these patients. 3) Trend of organisms detected in cancer hospital. The frequency of organisms isolated from clinical materials in the National Cancer Center Hospital was compared during the period from 1978 to 1982 and the period from 1983 to 1987. The most common organism detected in both periods was P. aeruginosa and no change in frequency was observed. But the frequency of gram-negative bacilli, E. coli, Klebsiella and Serratia, decreased significantly in the latter period while the frequency of gram-positive cocci, Enterococcus and Staphylococcus increased markedly in the latter period. The use of cephems of third generation in the latter period could be one reason for the recent change of organisms detected in the hospital. Appropriate therapy for infection based on the latest and accurate information should be used.
A review has been made of 36 patients who, after initial treatment for early non-Hodgkin's lymphoma originating in the head or neck, incurred a relapse, and factors relating to their chances of long-term survival, i.e., greater than three years, have been sought. Informatively, the overall 1-year and 5-year survival after such a relapse has been 18% and 15% respectively. The factor most significantly related to long-term survival was the site of the lymphoma and the extent of the initial relapse. For those affected in the neck region alone, four out of five survived for more than 48 months after the relapse (p less than 0.0001). The pathological subtype of the initial lymphoma was the second most significant factor (p less than 0.02). Another factor drawing our attention was the history of the prophylactic adjuvant therapy. No patient survived for more than a year after relapse if they had a history of prophylactic adjuvant therapy (0/10), whereas five long-term survivors were patients with no history of such therapy (0.1 less than p less than 0.2).
In selecting the method of treating uterine cervical cancer, radiosensitivity is one of the most important factors. To know this factor before treatment, we are trying to estimate radiosensitivity with changes of primary tumors before and after the irradiation. Tumors must be irradiated uniformly with small doses, and based on these considerations, we are attempting external test irradiation for estimation of radiosensitivity. Radiosensitivity was determined histopathologically by comparing the results of histological specimens taken before and seven days after test irradiation. Radiosensitivity is closely related to prognosis: of 183 cases with good sensitivity, 146 cases (79.8%) were surviving at five years after radiotherapy. On the other hand, the five-year survival rate of cases with poor sensitivity was only 37.2%. Comparing radiation with operation in operable cases of stage I and II, the five-year survival rate in cases with good sensitivity was about the same (90%). On the contrary, in cases with poor sensitivity, there was a substantial difference: that is, 66.0% of operated cases had a five-year survival compared with 39.7% of radiated cases.
We studied the vitamin C status of smokers and nonsmokers among staff members of our university in 1982. This paper describes the results from the 1983-85 studies. Plasma vitamin C levels (M +/- SD, mg/dl) from smokers and nonsmokers, respectively, were as follows: 0.49 +/- 0.15 (n = 51) and 0.72 +/- 0.23 (n = 73) in 1983, 0.56 +/- 0.13 (n = 48) and 0.84 +/- 0.21 (n = 88) in 1984, and 0.52 +/- 0.15 (n = 56) and 0.86 +/- 0.24 (n = 93) in 1985. The differences between smokers and nonsmokers are all highly significant. Urinary vitamin C levels (M +/- SD, mg/dl) from smokers and nonsmokers, respectively, were 1.8 +/- 0.6 and 2.6 +/- 0.9 in 1983 and 2.0 +/- 0.7 and 2.9 +/- 1.0 in 1984. These differences between the two groups are also highly significant. Both groups were similar in age, height, weight, general health parameters, and vegetable and fruit consumption. Plasma and urinary vitamin C levels were significantly higher in smokers taking vitamin C supplement than in those not taking vitamin C supplement.
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To estimate the actual states of uterine body invasion of carcinoma of the uterine cervix, 301 radically hysterectomized specimens were reviewed histologically. Incidence of uterine body invasion was 21.6% in all cases (65 cases out of 301), 7.8% in stage Ib, 25.5% in stage IIa, and 38.2% in stage IIb. Most of the positive invasion cases had spread to other surrounding tissues. Vaginal wall was invaded in 58.5% of all positive cases, parametrial infiltration was recognized in 87.7%, and pelvic lymph node metastasis was seen in 52.3%. On the contrary, in negative cases these were 33.9, 19.1, and 15.7%, respectively. There was a higher incidence of the L type of Imai's CPL classification among positive cases of uterine body invasion than among negative cases (81.5% vs 38.1%). When cervical cancer spread into the uterine body, peritoneal carcinomatosis and distant metastasis increased. Thus the outcome of patients with positive invasion was, naturally, poor. Patients with negative invasion had a 5-year survival rate of 92.4%, compared to 53.8% in patients with positive uterine body invasion. These results suggest that uterine body invasion of carcinoma of the uterine cervix is an important prognostic factor and treatment should be modified in such cases.