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Biomedical subjects

Y Harabuchi

Publications and source records attributed to Y Harabuchi.

At least 37 records · Page 2Linked to original sources

Serum antibodies specific to CD outer membrane protein of Moraxella catarrhalis, P6 outer membrane protein of non-typeable Haemophilus influenzae and capsular polysaccharides of Streptococcus pneumoniae in children with otitis media with effusion.

We measured the levels of serum IgG antibodies to CD outer membrane protein of Moraxella catarrhalis, P6 outer membrane protein of non-typeable Haemophilus influenzae and capsular polysaccharides of Streptococcus pneumoniae in 168 children with otitis media with effusion (OME) who were followed prospectively, using ELISA. Serum IgG antibodies to CD, P6 and pneumococcal capsular polysaccharides were detected in all samples. The anti-pneumococcal polysaccharides antibody level was highest, followed by the anti-P6 antibody level and anti-CD antibody was lowest (median:interquartile ranges were 45.9:19.1-100 microg/ml, 15.6:9.70-23.2 microg/ml and 1.06:0.73-1.87 microg/ml, respectively). In children aged 0-6 years, there were positive correlations among the antibody levels (anti-CD vs anti-P6, r=0.325, p <0.001; anti-CD vs anti-polysaccharide, r=0.397, p <0.0001; anti-P6 vs anti-polysaccharide, r=0.175, p=0.057). However, no relationship was seen in children aged 7-15 years. Children were classified according to severity of OME during the 1-year follow-up. In children aged 0-6 years, the severity of OME correlated inversely with the levels of anti-CD antibody (r=-.23, p=0.012), of anti-P6 antibody (r=-0.292, p=0.0015), and of anti-pneumococcal polysaccharides antibody (r=-0.25, p=0.0064). However, no correlation was found between antibody levels and severity of OME in children aged 7-15 years. These data suggest that persistence and/or recurrence of OME may be due to an insufficient serum antibody response to middle ear pathogens in young children.

Adolescent↗

Diagnosis and treatment of malignant lymphoma of the parotid gland.

BACKGROUND: To correlate the imaging and pathological features and to discuss therapeutic modalities and the prognosis of malignant lymphoma originating in the parotid gland, which is relatively rare. METHODS: The subjects were five patients with malignant lymphoma originating in the parotid gland. Three and two patients were stage I and stage II, respectively. CT examination was applied to all, whereas only one case was examined by MRI. All were treated with radiotherapy following surgery or chemotherapy. Three patients underwent combination chemotherapy, such as with MACOP-P or VEPA, following surgery. RESULTS: Although malignant lymphoma originating in the parotid gland is histologically described as low-grade non-Hodgkin's lymphoma, two and one of the cases were classified as intermediate and high grade in the present series, respectively. These three exhibited a tendency for infiltration into the adjacent tissue and tumor inhomogeneity in the imaging findings, suggesting a correlation with histologically intermediate or high-grade non-Hodgkin's lymphoma. It was successfully controlled by radiotherapy, with dosages ranging from 40 to 44 Gy. The patients were followed for 2-8 years. No relapse was found in the three patients with stage I. However, both stage II patients had relapses and were subjected to additional radiotherapy combined with chemotherapy. Since then, no tumor relapse has been noted at either this or other sites. CONCLUSIONS: Malignant lymphoma including intermediate or high grade originating in the parotid gland indicated satisfactory prognosis following radiotherapy and chemotherapy.

Aged↗

[Clinical study of hypopharyngeal carcinoma].

A clinical study was performed of 83 patients with hypopharyngeal cancer treated in the Sapporo Medical University Hospital from 1982 to 1995. Five-year cumulative survival rate was 34.9% in the whole group and 37.2% in the radical surgical and/or radiation treatment group. In the radiation treatment group, the patients with T1, T2, N0 or N1 stage disease, especially those whose original disease responded almost completely to 40Gy irradiation, showed high tumor control rates following full-dose irradiation with or without radical neck dissection. In the radical surgery group, the patients with T4 or N2 stage disease showed better prognosis than those in the radiation group. However, among the patients with N3 lymph node metastases, there were no long-term survivors in either the radiation or the surgery groups.

Adult↗

Treatment of lethal midline granuloma type nasal T-cell lymphoma.

Nasal T-cell lymphoma of the LMG type (LMG-NTL) is characterized by progressive, unrelenting ulceration, and necrosis of the nasal cavity and midline facial tissues. The clinical behavior of this tumor in 16 patients is compared with that of a nasal lymphoma of non-LMG-NTL type (non-LMG-NTL) in 8 patients and a paranasal sinus lymphoma (PSL) in 6 patients. All patients had stage I or II disease. Fourteen of the 16 patients with LMG-NTL received chemotherapy before and/or after radiotherapy. Cause-specific 5-year survival rates for patients with LMG-NTL, non-LMG-NTL, and PSL were 22%, 75%, and 67% respectively. Seven patients with LMG-NTL, had complete response, although 3 recurred, whereas it was incomplete in 9 patients. The data indicates that it is desirable to deliver 50 Gy or more to achieve in-field control of LMG-NTL.

Adult↗

Prognostic factors and treatment outcome in non-Hodgkin's lymphoma of Waldeyer's ring.

Prognostic factors and treatment outcome of 71 patients with non-Hodgkin's lymphoma of Waldeyer's ring were analyzed retrospectively. In univariate analyses, unfavorable prognosis was associated with primary disease in the base of the tongue, stage III-IV diseases, B-symptoms, high-grade histology, T-cell phenotype, elevated serum LDH levels, decreased peripheral blood lymphocyte counts, and negative response on delayed type hypersensitivity skin reactions. Multivariate analysis showed that stage III-IV and T-cell phenotype were significant independent risk factors for death. In stage I-II lymphomas, patients with unilateral large or bilateral cervical lymph node involvement had a poorer prognosis. In stage I-II lymphomas with intermediate or high-grade histology, patients who had received radiotherapy with MTCOP-P chemotherapy (pirarubicin, cyclophosphamide, vincristine, methotrexate with leucovorin rescue, peplomycin, and predonisolone) showed significantly better 5-year disease-free survival rate compared with patients treated with radiotherapy alone.

Adolescent↗

[Clinical, phenotypic and genotypic aspects of nasal T-cell lymphoma and its causal association with Epstein-Barr virus].

The authors reviewed the clinical, phenotypic, genotypic, and Epstein-Barr virus (EBV)-findings of 18 patients with nasal T-cell lymphoma(NTL). The clinical features were characterized as prolonged fever, widespread dissemination into distant sites, and poor prognosis with median survival of only 6 months. EBV-encoded small nuclear early region(EBER) transcripts were identified in 16 of 18 patients. Monoclonal EBV genome, EBV-encoded nuclear antigen(EBNA)-1, and latent membrane protein(LMP)-1 were also detected in all EBER-positive cases tested. All EBV-positive NTL showed coexpression of natural killer(NK) cell phenotype CD56 and CD2. Of 9 EBV-positive NTL, seven cases expressed T-cell receptor (TCR)-delta chain with rearranged beta-, gamma- and/or delta- genes. These data suggest that some cases of EBV-positive NTL may be derived from the lineage of NK-like T-cells or gamma delta T-cells, and that EBV may play a role in the lymphomagenesis.

Adult↗

Nasal T-cell lymphoma causally associated with Epstein-Barr virus: clinicopathologic, phenotypic, and genotypic studies.

BACKGROUND: The authors have previously demonstrated nasal T-cell lymphoma (NTL) associated with Epstein-Barr virus (EBV). The detailed clinical, phenotypic, and genotypic features and the role of EBV in lymphomagenesis remain to be clarified. METHODS: The study group consisted of 18 patients with NTL. The phenotype was determined by immunoperoxidase staining with various monoclonal antibodies. Genotypic study was done using Southern blot hybridization. The presence of EBV-encoded small nuclear early region (EBER) RNA and EBV DNA were determined by in situ hybridization. The expression of EBV-encoded nuclear antigen (EBNA) and latent membrane protein (LMP1) were identified by immunohistologic methods. Clonotypic analysis of EBV genomes was performed by Southern blot hybridization with EBV termini fragment probe. RESULTS: The clinical features of NTL were characterized as prolonged fever (16 patients), widespread dissemination into distant sites (13 patients), and poor prognosis with a median survival of only 6 months. EBER transcripts were identified in 16 of 18 patients. Monoclonal EBV genomes EBNA1 and LMP1 were also detected in all EBER-positive cases tested. All 18 patients expressed pan-T antigens such as MT1, CD45RO, and/or CD2. The rearrangements of T-cell receptor (TCR)-beta, -gamma, and/or -delta genes were shown in all 11 patients tested. The natural killer (NK) cell phenotype CD56 was expressed in all EBV-positive cases tested, and was not detected in EBV-negative cases. Seven EBV-positive cases expressed a TCR-delta chain with rearranged TCR-gamma or -delta genes whereas both EBV-negative cases corresponded to alpha beta T-cell lymphoma, which expressed a TCR-beta chain with a rearranged TCR-beta gene. CONCLUSIONS: These data suggest that EBV-positive NTL may be derived from the lineage of NK-like T-cells or gamma delta T-cells, and that EBV may play a role in lymphomagenesis. Therefore, we propose that NTL which has peculiar clinical and histologic features could be classified as a new lymphoma entity.

Adult↗

Spontaneous immunoglobulin production by adenoidal and tonsillar lymphocytes in relation to age and otitis media with effusion.

Spontaneous immunoglobulin (Ig) production by autologous adenoidal and tonsillar lymphocytes cultured without any mitogen was measured by an enzyme-linked immunosorbent assay (ELISA) in 18 children with or without otitis media with effusion (OME). Both IgG and IgA levels synthesized by adenoidal or tonsillar lymphocytes significantly increased with age. The average concentrations of IgG and IgA produced by adenoidal lymphocytes from children with OME were significantly lower than those from children without OME. Adenoidal lymphocytes produced IgG and IgM at significantly lower levels than autologous tonsillar lymphocytes did in children with OME. In contrast, no significant difference between adenoidal and tonsillar lymphocytes was seen on Ig production for any isotypes in children without OME. These results may indicate immunological impairment of the adenoids associated with OME.

Adenoids↗

Circulating intercellular adhesion molecule-1 and its cellular expression in head and neck non-Hodgkin's lymphomas, including lethal midline granuloma.

Extranodal non-Hodgkin's lymphoma in the head and neck, especially T-cell lymphoma of the lethal midline granuloma (LMG) type, has unique clinical and histologic features differentiating it from other lymphomas. The authors measured soluble intercellular adhesion molecule-1 (ICAM-1) in sera from 12 patients with T-cell lymphoma of the LMG type and from 52 patients with other head and neck non-Hodgkin's lymphomas, by double-determinant immunoassay. The expression of ICAM-1 in lymphoma tissue was examined in 26 patients by the avidin-biotin immunoperoxidase method. The serum ICAM-1 levels were significantly higher in T-cell lymphoma of the LMG type than in other head and neck lymphomas or in healthy adult controls. Elevated levels of serum ICAM-1 were associated with increased levels of serum lactate dehydrogenase, poor prognosis, and impaired T-cell-dependent immune functions, both in T-cell lymphoma of the LMG type and in other head and neck lymphomas. When we monitored serum ICAM-1 levels in individual patients, the level decreased in the complete remission interval compared to before treatment and went up again when the lymphoma relapsed. Although the staining intensities of ICAM-1 in lymphoma cells were not related to serum ICAM-1 levels, a markedly intense expression of ICAM-1 was found on the angiocentric or angiodestructive lymphoreticular infiltrate region in the tissues from T-cell lymphoma of the LMG type. A higher serum ICAM-1 level and its tissue expression in T-cell lymphoma of the LMG type may be one of the clues to understanding this particular lymphoma. The serum ICAM-1 level could be an efficient parameter for monitoring the clinical course of head and neck non-Hodgkin's lymphomas.

Adult↗

Interaction and immunological effect of very late antigen-4, 5, and fibronectin in tonsillar lymphocytes and their relation to age.

We examined the expressions of alpha-subunits of very late antigen (VLA)-4 (alpha4) and VLA-5 (alpha5) on tonsillar lymphocytes and the interaction between these integrin receptors and their ligand, fibronectin (FN). Immunohistological and flow cytometric analyses showed that alpha4 and alpha5 were expressed in the lymphoid follicle and were positive on about 10% each of T cells and on 55% and 35% of B cells. When tonsillar B cells were separated by a discontinuous Percoll gradient, the number of alpha4- and 5-positive cells decreased as the cell density went down, while the number of activated cells went up. After in vitro activation of tonsillar B cells by Staphylococcus aureus Cowan I strain (SAC), the expression of alpha5 and the adhesiveness to FN decreased. The increased proliferation of B cells was observed when tonsillar B cells were cultured with immobilized FN. The expressions of alpha-subunits of VLA-4 and VLA-5 on tonsillar T and B lymphocytes increased with age. These results suggest that: i) B cell activation may cause decreased expressions of VLA-4 and -5, which gives a costimulatory effect on B cell activation itself again in cooperation with FN, ii) Increased expressions of VLA-4 and -5 on tonsillar lymphocytes with age may be related to regional immune response of the palatine tonsils.

Adolescent↗

Systemic immune response to Streptococcal and Staphylococcal lipoteichoic acids in children with recurrent tonsillitis.

The antibodies to LTA of Streptococcus pyogenes (S. pyogenes) and of Staphylococcus aureus (S. aureus) in sera from 110 children with or without recurrent tonsillitis were assayed by enzyme-linked immunosorbent assay (ELISA). The antibody of IgA class was not detected in any sera. There was a significant positive correlation between IgG and IgM antibody levels to LTA of S. pyogenes and those to LTA of S. aureus. There was no significant correlation between anti-LTA IgM antibody and age or episodes of tonsillitis. However, serum anti-LTA IgG levels in younger patients ( < or = 7 y.o.) were significantly lower than those in their elders (>7 y.o.) (anti-S. pyogenes; p = 0.0007, anti-S. aureus; p = 0.007). Serum anti-LTA IgG antibody levels correlated inversely with episodes of tonsillitis in younger patients ( < 7 y.o.) (S. pyogenes: r = -0.362, p = 0.0082, S. aureus: r = -0.276, p = 0.047). These findings suggest that systemic hyposensitivity to LTA of S. pyogenes and S. aureus may be a possible cause of habitualness of tonsillitis in young children.

Child↗

Adenoid lymphocyte responses to outer membrane protein P6 of nontypable Haemophilus influenzae in children with and without otitis media.

The cellular immune responses to nontypable Haemophilus influenzae in adenoids were determined in children by measuring lymphocyte blast transformation and antibody secretion in response to the P6 outer membrane protein. In the lymphocyte transformation assay, stimulation index of adenoid lymphocytes stimulated by P6 in otitis children (2.34 +/- 0.25) was significantly lower than that in non-otitis children (3.91 +/- 0.64, p <0.05). The number of IgM as well as IgA secreting cells after 8 days' culture with P6 were significantly smaller in otitis children (IgM: 7,534 +/- 2,843/10(6) lymphocyte; IgA: 1,573 +/- 620/10(6) lymphocyte) than those in non-otitis children (IgM: 12,994 +/- 2,533, p <0.05; IgA: 2,828 +/- 528, p <0.05). These data suggest that P6 protein is a target for the cellular immune response of the adenoid, and failure of adenoid lymphocytes to recognize it as a specific immunogen may be one of the causes of recurrent otitis media.

Adenoids↗

Immunological role of human palatine tonsil in Epstein-Barr virus persistence.

To determine whether EBV-specific cellular immunity persists and controls EBV in the palatine tonsil, we compared EBV-specific cellular immune responses in the palatine tonsil and peripheral blood. In 32 EBV-seropositive donors, we performed in vitro growth inhibition assays of EBV-induced B-lymphocyte transformation (regression assay). The results showed that EBV-specific cytotoxic T lymphocytes (CTL) precursor frequency was higher in the palatine tonsil than in the peripheral blood. After a first stimulation with autologous lymphoblastoid cell line (LCL), the EBV-specific cytotoxicity of reactivated CTL was higher in the palatine tonsil than in the peripheral blood. Furthermore EBV-specific CTL lines established from the palatine tonsil had significantly higher EBV-specific cytotoxicity in comparison with those from the peripheral blood. Both the EBV-specific CTLs from tonsils and peripheral blood were restricted by HLA class-I determinants. These data indicate that the palatine tonsil, which is frequently exposed to EBV, plays an important role in controlling EBV infection in the oropharynx.

Adult↗

Cytokine production by tonsillar lymphocytes stimulated with alpha-streptococci in patients with pustulosis palmaris et plantaris.

To clarify the cellular immune response to alpha-streptococci in tonsillar lymphocytes from patients with pustulosis palmaris et plantaris (PPP) we have investigated cytokine production of tonsillar lymphocytes from patients with PPP recurrent tonsillitis (RT). Interleukin (IL)-1 alpha, IL-2, IL-4, IL-5, IL-6, interferon (IFN)-gamma and tumor necrotizing factor (TNF)-alpha were measured. The stimulation index of IFN-gamma production was significantly higher in tonsillar lymphocytes from PPP than that from RT when cultured with alpha-streptococci (stimulation index: the ratio of cytokine level produced by tonsillar lymphocytes with bacterial antigens to that without antigens). The same results were seen in the case of TNF-alpha, but IL-4 and IL-5 were not detected in any supernatants. These data suggest that increased production of IFN-gamma and TNF-alpha in tonsillar lymphocytes may play a key role in this kind of immunologic abnormalities.

Adult↗

Cytokine expression and production by tonsillar lymphocytes.

Expression of various cytokines in the tonsillar compartments, and in vitro cytokine production and cytokine mRNA expression by tonsillar lymphocytes (TL), were investigated. In immunohistological analysis, a wide variety of cytokines such as interleukin (IL)-1 beta, IL-2, IL-4, IL-5, IL-10 was expressed intensively in the lymphoepithelial symbiosis (LES). A certain number of cells producing IL-6, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha was distributed not only in the LES but also in the extrafollicular area. A significant amount of IL-6, IFN-gamma, and TNF-alpha was detected by enzyme-linked immunosorbent assay in the culture supernatants of TL cultured with streptococcal antigen, even without any mitogens. Furthermore, mRNA of IL-6, IFN-gamma, and TNF-alpha was determined by reverse transcription polymerase chain reaction on the TL freshly isolated and with streptococcal stimulated antigen, whereas, production of IL-1 alpha, IL-4, and IL-5, and expression of their mRNA were not found on TL with or without streptococcal stimulation. These data indicate that tonsils are highly active immunological organs containing a wide variety of cytokine-producing cells, and suggest that IFN-gamma, TNF-alpha, and IL-6 may play an important role on the immune response to bacteria in the tonsil.

Antigens↗

[Vestibular function in cochlear implants--prognostic factors and postoperative damage].

Eighteen patients with a 22-channel cochlear implant were evaluated both pre- and postoperatively with vestibular function tests; caloric test and body balance test using stabilometry. Preoperative promontory stimulation results and postoperative psychophysical factors of the cochlear implant showed no correlation with the preoperative vestibular function test results. The results of speech perception tests were not affected by the degree of residual vestibular function in any of the patients. However, for patients with deafness for a period of 10 to 20 years, the degree of the residual vestibular function estimated by the caloric test showed a correlation with the results of speech perception tests, significantly in the consonant recognition score. The results, not of length or the Rombberg ratio, but rather of the area of body sway, showed a correlation with the results of speech perception tests; consonant recognition, in patients with a short duration of deafness. Therefore preoperative vestibular function results may be useful as a predictive factor in postoperative speech perception; consonant recognition, for patients with a short duration of deafness. Reduced results of caloric testing after surgery were found in one of 11 patients (9%) with residual vestibular function. The occurrence of vertigo immediately after surgery was observed in 5 of 18 patients (28%), but this symptom was transient. No change in stabilometry results, pre-versus post-operatively, was observed. Thus, vestibular damage after surgery was considered to be minimal.

Adult↗