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T Toyohara

Publications and source records attributed to T Toyohara.

At least 19 recordsLinked to original sources

Distribution of neuropeptide Y-like immunoreactivity in the normoganglionic and aganglionic segments of human colon.

The localisation and distribution of neuropeptide Y (NPY)-like immunoreactivity were studied by use of immunohistochemical methods in gut tissues from 19 patients with Hirschsprung's disease, including 4 cases of long segment aganglionosis. In the normoganglionic segment, immunoreactive cell bodies and nonvaricose processes were seen within both myenteric and submucous plexuses. A scarce supply of varicose fibres was found in the lamina propria mucosae, muscularis mucosae and longitudinal muscle layer. NPY fibres were more frequently encountered in the circular muscle layer, although with a weakly immunostaining intensity. In addition, blood vessels in the submucosal connective tissue were surrounded by a typical plexus of varicose, NPY-positive fibres. Immunoreactive endocrine cells could be detected in the colonic epithelium. In the aganglionic segment, numerous nerve fasciculi comprising a small to moderate number of NPY fibres with varicosities were observed throughout the entire layer of the colonic wall. A few varicose, NPY-positive fibres were also contained in the relatively large, hypertrophic nerve fasciculi located in the intermuscular zone and submucosal connective tissue. NPY-immunoreactive fasciculi were more densely distributed in the distal aganglionic segment than in the proximal aganglionic one. On the other hand, the distribution of NPY-positive fibres in long segment aganglionosis was quite different from that in short segment type; in cases of long segment type, no immunoreactive nerve fibres were detected within the circular muscle layer of the proximal aganglionic segment near the oligoganglionic segment and only a few fibres were observed within the hypertrophic nerve bundle of the intermuscular zone.(ABSTRACT TRUNCATED AT 250 WORDS)

Child

An immunohistochemical study of somatostatin-containing nerves in the aganglionic colon of human and rat.

The distribution of somatostatin-like immunoreactive (SOM-LI) nerves was elucidated immunohistochemically in the gut tissues from patients with Hirschsprung's disease and congenital aganglionosis rats. In the normoganglionic human colon, SOM-LI nerve cell bodies were found to a greater extent in the submucous plexus and to a lesser extent in the myenteric plexus. However, they were rarely observed in both the plexuses of the oligoganglionic segment. SOM-LI nerve fibres were widely distributed in the aganglionic bowel. The circular muscle layer of the distal aganglionic segment was densely innervated by SOM-LI nerve fibres which are probably derived from the extrinsic, hypertrophic nerve bundles. A decreased number of the intramuscular nerves fibres were seen in the proximal aganglionic segment. In the colon and rectum from adult and 21-day-old rats, SOM-LI cell bodies were numerous in both plexuses. On the other hand, enteric neurons were completely lacking from the colon and rectum of congenital aganglionosis rats of 21 days old. No neuronal elements staining for SOM were disclosed in these aganglionic segments of mutant rats. A possible origin and pathophysiological role of the extrinsic nerve fibres containing SOM in the diseased bowel are discussed. It is concluded that SOM-LI nerves in the human distal colon comprise both intrinsic and extrinsic elements, while SOM nerves in the rat colon and rectum are of only intrinsic origin.

Animals

Giant epiphrenic diverticulum in a boy with Ehlers-Danlos syndrome.

We treated a 12 year old boy with Ehlers-Danlos syndrome. There were multiple diverticula in the oesophagus, stomach, colon and urinary bladder. Most prominent was the giant epiphrenic diverticulum of the oesophagus, a rare finding as a complication of Ehlers-Danlos syndrome.

Child

Distribution and localization of glial fibrillary acidic protein in colons affected by Hirschsprung's disease.

The distribution and localization of glial fibrillary acidic (GFA) protein were examined by means of immunohistochemistry in normoganglionic, oligoganglionic, and aganglionic segments of colons from 25 patients with Hirschsprung's disease, including four cases of long segment aganglionosis. In normoganglionic segments, GFA protein-positive glial cells were densely distributed within the myenteric plexus, but sparse in the submucous plexus. Aganglionic segments were completely devoid of glial cells with GFA protein immunoreactivity, coinciding with the lack of enteric ganglia. Instead, GFA protein was found specifically in association with the hypertrophic nerve fasciculi and their branches, which were mainly located in the intermuscular zone and submucosal connective tissue in the distal aganglionic segment of diseased bowels. However, two types of short and long segment aganglionosis differed in the distribution pattern of GFA protein; the extrinsic nerve fasciculi in short segment disease extended toward the normoganglionic segment, but in long segment disease they did not reach this area. A moderate number of GFA protein-positive fasciculi were observed within the circular muscle layer of proximal aganglionic and oligoganglionic parts in short segment aganglionosis, while no immunoreactive fasciculi were encountered within the circular muscle layer of the corresponding parts in long segment aganglionosis. Immunohistochemistry for GFA protein can be of excellent diagnostic value for the aganglionic colon with Hirschsprung's disease, since GFA protein immunohistochemistry discloses exclusively extrinsic, hypertrophic nerve fasciculi, characteristic of the bowel in cases of Hirschsprung's disease.

Child

Autonomic innervation of the intestine from a baby with megacystis microcolon intestinal hypoperistalsis syndrome: I. Immunohistochemical study.

A typical case of megacystis microcolon intestinal hypoperistalsis syndrome (MMIHS) is reported. The patient, an infant girl, was fed only by total intravenous nutrition and is now 3 years old. The distribution of several gut peptides was examined in the resected small intestine using an immunohistochemical method. Vasoactive intestinal polypeptide (VIP) and peptide histidine methionine (PHM)-containing nerve fibers were decreased; however, substance P- and leucine enkephalin (Leu-ENK)-containing fibers were increased. The imbalance between several kinds of gut peptides might be one the causes of aperistalsis in MMIHS. This is the first report about the gut peptides of MMIHS.

Autonomic Nervous System

[The report of the 12th and 13th clinical practical training of the Tsurumi University School of Dental Medicine].

This report concerns the state of the patients and the progress of the 12th and 13th clinical practical training. A questionnaire was carried out with the trainees of the 13th clinical practical training and their leaders. Consequently it was learned that a trainee was in charge of ten patients on the average a year. He was able to complete the treatments of 3.5 patients, but was obligated to discontinue them for 1.4 patients, while handling over treatments for 5.2 patients to the next year's trainees or doctors. The progress of the clinical practical training was slow during the first 9 months but the pace increased rapidly during the last 3 months. The results of the questionnaire showed 37% of the trainees were satisfied with the present clinical practical training, but 17% of the trainees were not satisfied. On the other hand 15% of the leaders were satisfied with it, but 48% of the leaders were not satisfied.

Education, Dental

Efficacy of absolute ethanol injection for upper gastrointestinal massive bleedings with hemorrhagic shock.

We applied the absolute ethanol injection method in 182 cases of massive bleeding with hemorrhagic shock before the performance of emergency endoscopy in 627 cases of upper gastrointestinal bleeding at our department and five related institutions since June 1979. Following results were obtained: Temporary hemostasis could not be obtained in only 2 (1.1%) out of 182 cases; in the remaining 180 cases bleeding was ceased. Rebleeding was seen in 15 cases (8.2%) and new bleeding in 17 cases (9.3%). In 21 (66%) of these cases hemostasis was obtained again by the absolute ethanol injection method. Eight patients (4.4%) underwent emergency operation and 4 patients (2.2%) died from bleeding. The complete hemostasis was obtained in 170 cases (93.4%).

Adolescent

An immunohistochemical study of serotonin-containing nerves in the colon of rats.

The localization of the serotonin-like immunoreactive nerves of the rat colon was investigated by means of immunohistochemistry, utilizing an antibody against serotonin. In non-treated colons, serotonin-positive neuropils were consistently detected around the myenteric plexus. In pargyline-treated colons, serotonin-like fibres were demonstrated in association with either the small intramural blood vessels of the submucosa or the extramural nerve bundles. Treatment with 5-hydroxytryptophan (5-HTP) permitted the visualization of additional serotonin-immunoreactive fibres around the large extramural blood vessels. Immunoreactive nerve cell bodies were demonstrated in the myenteric plexus of colons treated with 5-HTP or colchicine. From these observations, it is suggested that the serotoninergic nerves of the rat colon comprise both intrinsic and extrinsic elements.

5-Hydroxytryptophan

Intratumorous distribution of catecholaminergic clone cells of human neuroblastoma. A catecholamine fluorescence study.

The intratumorous distribution of catecholaminergic clone cells in 23 human neuroblastomas was studied using Falck-Hillarp's method, and the findings compared with the catecholamine (CA) content within the tumour. All the specimens contained elements with CA fluorescence, and the pattern of fluorescence was classified from the distribution of CA-positive cells and neurofibrils, as diffuse cellular (DC), diffuse fibrillary (DF), sporadic (S), clustered (C), island-shaped (I), and bundled (B). The strength of CA fluorescence of both cellular and fibrillary elements correlated well with the CA content within the tumour. In addition, all tumours of urinary VMA-negative cases also contained significantly larger amounts of CA than other, non-functioning, tumours in the paediatric age group. The results of this study suggest that firstly, the ratio of CA-positive cells to CA-positive neuronal processes is proportionately higher in the poorly-differentiated neuroblastomas and that secondly, even tumours negative for urinary VMA or HVA might be polyclonal and contain catecholaminergic elements.

Adrenal Gland Neoplasms

Catecholaminergic differentiation associated with S100 protein-positive elements in human neuroblastoma.

The intratumorous distribution of catecholaminergic tumour cells and S100 protein-positive elements of 8 neuroblastomas, 8 ganglioneuroblastomas and 2 ganglioneuromas were studied using catecholamine fluorescence and immunohistochemical staining, respectively. The elements of catecholamine fluorescence were observed in all tumour specimens, even in urinary VMA-negative cases, but the patterns of distribution were not uniform. Catecholamine fluorescence was observed in both tumour cell bodies and neurofibres, and the appearance of the latter but not that of the former correlated with the histological grade of differentiation, thereby suggesting the occurrence of catecholaminergic differentiation within the tumour. S100 protein-positive elements also correlated with the histological differentiation, and were distributed mostly in the area where the catecholamine-containing neurofibres were located. The possible correlation between catecholaminergic differentiation and the appearance of S100 protein-positive elements in neuroblastoma requires close attention.

Antibodies, Monoclonal

Influence of ischemia on noradrenergic nerves in the terminal colon of humans and rats.

Sympathetic innervation was examined by fluorescence histochemistry in the aganglionic colon from 13 patients with Hirschsprung's disease. The 2 aganglionic colons subjected to ischemia were virtually devoid of fluorescent noradrenergic nerves. However, the sympathetic nerves of the ischemic colons fluoresced brightly after an in vitro loading of noradrenaline. Such being the case, we investigated the influence of ischemia on the sympathetic nerves in the distal colon of rats. Even 1 h of ischemia depleted the fluorescence of sympathetic nerves in the rat distal colon. Loading of noradrenaline resulted in restoration of the fluorescence in the sympathetic nerves in the distal colon subjected to 2, but not 3 h, of ischemia. The dense noradrenergic innervation, together with the occurrence of small nerve bundles, was characteristically evident in the longitudinal muscle of the distal aganglionic colon from children with Hirschsprung's disease.

Animals

An immunohistochemical study of serotoninergic nerves in the colon and rectum of children with Hirschsprung's disease.

Serotonin (5-HT)-like immunoreactive nerve fibers were investigated in gut tissue obtained from seven Japanese children with Hirschsprung's disease. In the control untreated tissues, 5-HT-like immunoreactive fibers were observed neither in the normoganglionic nor in the aganglionic regions. After pargyline treatment, 5-HT-positive neuropils were consistently detected in association with the myenteric plexus in the normoganglionic segment, while in the aganglionic segment immunoreactive fibers could not be demonstrated through the entire layer of the bowel tissue. The occurrence of 5-HT-like immunoreactive neuropils by pargyline treatment strongly suggests that the infant bowel is innervated with serotoninergic elements. After treatment with 5-hydroxy-L-tryptophan (5-HTP), the immunoreactive neuropils were localized in the myenteric and submucous plexuses of the normoganglionic segment. On the other hand, another type of 5-HT-positive fibers was characteristically demonstrated in aganglionic segments following the drug treatment; moderate numbers of 5-HT-like immunoreactive fibers appeared in the intermuscular zone and within the circular and longitudinal muscle layers. Several 5-HT-positive fibers were present in the hypertrophic nerve bundles seen in a diseased bowel. A possible origin of this type of 5-HT-positive nerve fibers was discussed.

Child

Multiinstitutional evaluation of local injection of absolute ethanol as the new hemostatic method for upper G-I tract bleeding.

Local injection of absolute ethanol was proven effective for hemostasis of gastrointestinal bleeding in our fundamental (Asaki et al. 1983a) and clinical (Asaki et al. 1983b) studies. The purpose of the present paper is to report the results obtained in 258 hemorrhagic foci in 152 unselected cases treated with this method at 6 major hospitals in the Tohoku area in Japan. Sixty (39%) of these 152 cases had shock symptoms due to hemorrhage. Gastric and duodenal ulcers were responsible for the hemorrhage in about 90% of the cases in which our method was applied to hemostasis. Eighty-nine (59%) of the 152 cases had some form of complications such as malignant tumors or liver cirrhosis. Hemorrhage due to postoperative stress ulcer after major surgeries including renal implantation or laryngectomy for resection of cancer was seen in 20 cases (13%). The condition of hemorrhage immediately before the treatment with our technique was classified as spouting hemorrhage for 8 foci (3%), pulsating hemorrhage for 22 foci (9%), adhesion of clot for 179 foci (69%), and hemorrhage from veins and capillaries for 49 foci (19%). In all of these cases temporary hemostasis was obtained. Rebleeding occurred in 17 cases (7%) including 5 cases in which hemostasis was successfully obtained by the repeated use of our method. In 4 of the 17 cases, in which repeated endoscopy was infeasible, emergency surgery was performed. In the remaining 8 lesions in 8 cases, new bleeding or rebleeding occurred more than 1 week after the initial hemostasis had been obtained. Six of these 8 cases died from rebleeding due to DIC syndrome. With our method complete hemostasis was obtained in 144 of 152 cases (95%) including 11 cases (7%) which underwent elective surgical operation.

Adolescent