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Yamaji S, Kamezaki K, Shinchi M, Takizawa K, Abe C, Koike A, Kuroiwa M. Cardiac Tamponade as an Initial Manifestation of Diffuse Large B-cell Lymphoma One Year after IgG4-related Disease in Remission. Intern Med 2024; 63:721-727. [PMID: 37438135 PMCID: PMC10982006 DOI: 10.2169/internalmedicine.2044-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/30/2023] [Indexed: 07/14/2023] Open
Abstract
A 65-year-old man with multiple lymphadenopathies was diagnosed with IgG4-related disease (IgG4-RD) based on findings of a cervical lymph node biopsy and an elevated serum IgG4 level. Treatment was initiated after the onset of autoimmune pancreatitis, and he achieved remission. He developed diffuse large B-cell lymphoma one year later. Pericardial involvement of lymphoma resulted in cardiac tamponade, and he died before histopathological confirmation of lymphoma was made due to a lethal arrhythmia caused by massive involvement of lymphoma into the myocardium. Because patients with IgG4-RD might have an increased risk of malignant diseases, including lymphoma, histopathological examinations should be considered at any time during the course of IgG4-RD.
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Affiliation(s)
- Soichiro Yamaji
- Department of Hematology, National Hospital Organization Fukuokahigashi Medical Center, Japan
- Department of Cardiology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Kenjiro Kamezaki
- Department of Hematology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Maroka Shinchi
- Department of Cardiology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Katsumi Takizawa
- Department of Pathology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Chie Abe
- Department of Pathology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Akihiro Koike
- Department of Cardiology, National Hospital Organization Fukuokahigashi Medical Center, Japan
| | - Mika Kuroiwa
- Department of Hematology, National Hospital Organization Fukuokahigashi Medical Center, Japan
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Takeuchi M, Shojima M, Matsueda S, Nagae H, Kuroiwa M, Fujita A, Kawano M, Inoue D, Komori T, Takeuchi M, Ooshima K, Kuroki Y, Katafuchi R. A Rare Manifestation of IgG4-Related Disease and Secondary Hypereosinophilic Syndrome: A Case Report. Mod Rheumatol Case Rep 2024:rxae009. [PMID: 38407323 DOI: 10.1093/mrcr/rxae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/24/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024]
Abstract
We report a case of IgG4-related disease with marked eosinophilia. A 79-year-old woman was admitted due to diarrhea, and weight loss. Cervical lymphadenopathy, bilateral submandibular glands swelling, anemia (Hb8.5g/dl), hypereosinophilia (9,750/μL), and elevated serum creatinine (1.57 mg/dL), pancreatic amylase (191 IU/L), and IgG4 (3,380 mg/dL) were found. Diffusion-weighted image on MRI showed high intensity signals inside of both the pancreas and the kidney. The echogram of submandibular glands revealed cobblestone pattern. Kidney biopsy revealed acute tubulointerstitial nephritis. Biopsies of lip, gastrointestinal tract and bone marrow showed infiltration of lymphoplasmacytic cells and IgG4 positive plasma cells (30-67/HPF). Gastrointestinal and bone marrow biopsies also showed eosinophilic infiltration. Adrenal insufficiency, rheumatic disease, tuberculosis, parasite infection, drug induced eosinophilia, and eosinophilic leukemia were all ruled out. We started treatment with 40mg of prednisolone and her general condition rapidly improved. The eosinophil count, serum IgG4, and serum creatinine decreased. We gradually tapered prednisolone and maintained 5mg/day. During the 5 years of treatment, she had no recurrence of the symptom. According to the 2019 American College of Rheumatology/European League Against Rheumatism classification criteria for IgG4-related disease, eosinophils > 3000/μL is one of the exclusion criteria. If we comply this criterion, the diagnosis of IgG4-related disease should be avoided. However, our case fit the diagnostic criteria of type I autoimmune pancreatitis, IgG4-related sialadenitis and global diagnosis of IgG4-related disease. We finally diagnosed our case as IgG4-related disease with secondary hypereosinophilic syndrome. This case suggests that IgG4-related disease with eosinophils > 3000/μL does exist in the real world.
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Affiliation(s)
- Miyoshi Takeuchi
- Kidney Unit, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Masumi Shojima
- Kidney Unit, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Shumei Matsueda
- Kidney Unit, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Hiroshi Nagae
- Kidney Unit, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Mika Kuroiwa
- Division of Hematology, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Aya Fujita
- Division of Pathology, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Mitsuhiro Kawano
- Innovative Clinical Research Center, Department of Rheumatology, Kanazawa University Hospital, Ishikawa, Japan
| | - Dai Inoue
- Department of Radiology, Kanazawa University Hospital, Ishikawa, Japan
| | - Takahiro Komori
- Department of Radiology, Kanazawa University Hospital, Ishikawa, Japan
| | - Mai Takeuchi
- Department of Pathology, Kurume University, Fukuoka, Japan
| | - Koichi Ooshima
- Department of Pathology, Kurume University, Fukuoka, Japan
| | - Yusuke Kuroki
- Kidney Unit, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
| | - Ritsuko Katafuchi
- Kidney Unit, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan
- Kidney Unit, Medical Corporation Houshikai Kano Hospital, Fukuoka, Japan
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Nishihara T, Shibata M, Ohashi A, Hiyama K, Yamashita T, Kuroiwa M, Sudo N. The relation between vaccination status and referral to a consultation-liaison psychiatry service for hospitalized patients with COVID-19. Biopsychosoc Med 2023; 17:40. [PMID: 37968660 PMCID: PMC10647145 DOI: 10.1186/s13030-023-00296-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Previous studies have shown that patients with Coronavirus Disease 2019 (COVID-19) are likely to be affected by delirium and other psychiatric complications. We aimed to evaluate the relation between COVID-19 vaccination status and referral of patients hospitalized with COVID-19 for consultation-liaison psychiatry services. METHOD From the medical records used for this retrospective, single hospital-based study, 576 patients were identified who were over 18 years-of-age and hospitalized with a diagnosis of COVID-19 between March 2020 and March 2022. The data of 531 for whom the vaccine history was obtained from the medical records were available for analysis: 455 without and 76 with referral to consultation-liaison psychiatry. A history of COVID-19 vaccination at least two times was used in the analysis of the odds for referral to liaison psychiatric consultation: 95% confidence interval (CI) in multivariable logistic regression. The adjustment factors included sex, age, body mass index (BMI), severity of COVID-19, C-reactive protein level, medical history, and therapeutic factors such as the use of remdesivir, steroids, or mechanical ventilation. RESULTS The prevalence of psychiatric consultation was 14.3%. Patients without vaccination had a 7-times greater OR (95%CI:2.08-23.58) than vaccinated patients for a referral for consultation-liaison psychiatry services after adjusting for confounding factors. CONCLUSION Non-vaccination was associated with a greater likelihood of referral for consultation-liaison psychiatry service among these hospitalized Japanese patients with COVID-19, even after adjusting for clinical and therapeutic factors. It is possible that vaccination greatly lessens the need for the referral of COVID-19 patients for consultation-liaison psychiatry services.
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Affiliation(s)
- Tomoe Nishihara
- Department of Psychosomatic Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan.
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Clinical Education Center, Kyushu University Hospital, Fukuoka, Japan.
| | - Mao Shibata
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayako Ohashi
- Department of Psychiatry, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazutoshi Hiyama
- Department of Infectious Disease, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Takafumi Yamashita
- Department of Respiratory Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Mika Kuroiwa
- Clinical Research Center, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Imi T, Mizumaki H, Hosomichi K, Nannya Y, Zaimoku Y, Yoroidaka T, Katagiri T, Ishiyama K, Yamazaki H, Ogawa R, Kuroiwa M, Tajima A, Ogawa S, Nakao S. Familial immune-mediated aplastic anaemia in six different families. EJHaem 2023; 4:714-718. [PMID: 37601868 PMCID: PMC10435714 DOI: 10.1002/jha2.722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/16/2023] [Accepted: 05/15/2023] [Indexed: 08/22/2023]
Abstract
We studied the pathophysiology of aplastic anaemia (AA) in six different pairs of relatives without a family history of hematologic disorders or congenital AA. Five and four of the six pairs shared the HLA-DRB1*15:01 and B*40:02 alleles, respectively. Glycosylphosphatidylinositol-anchored protein-deficient blood cells were detected in eight of the 10 patients evaluated. In a mother-daughter pair from one family, flow cytometry detected leukocytes lacking HLA-A2 due to loss of heterogeneity in chromosome 6p. Whole-exome sequencing of the family pair revealed a missense mutation in MYSM1. These results suggest that genetic inheritance of immune traits might underlie familial AA in some patients.
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Affiliation(s)
- Tatsuya Imi
- Department of HematologyGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Hiroki Mizumaki
- Department of HematologyGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Kazuyoshi Hosomichi
- Department of Bioinformatics and GenomicsGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Yasuhito Nannya
- Pathology and Tumor BiologyGraduate School of MedicineKyoto UniversityKyotoJapan
- Division of Hematopoietic Disease ControlInstitute of Medical SciecenThe University of TokyoTokyoJapan
| | - Yoshitaka Zaimoku
- Department of HematologyGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Takeshi Yoroidaka
- Department of HematologyGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Takamasa Katagiri
- Department of Clinical Laboratory SciencesGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Ken Ishiyama
- Department of HematologyGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Hirohito Yamazaki
- Department of HematologyGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
| | - Ryosuke Ogawa
- Department of Hematology and OncologyJapan Community Health Care Organization Kyushu HospitalFukuokaJapan
| | - Mika Kuroiwa
- Department of Hematology and OncologyNational Hospital Organization Fukuoka Higashi Medical CenterFukuokaJapan
| | - Atsushi Tajima
- Department of Bioinformatics and GenomicsGraduate School of Advanced Preventive Medical SciencesKanazawa UniversityKanazawaJapan
| | - Seishi Ogawa
- Pathology and Tumor BiologyGraduate School of MedicineKyoto UniversityKyotoJapan
| | - Shinji Nakao
- Department of HematologyGraduate School of Medical SciencesKanazawa UniversityKanazawaJapan
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Nishihara T, Yoshihara K, Ohashi A, Kuroiwa M, Sudo N. Differences in the presentation of COVID-19-related psychosocial stress and general psychological distress and the relation between the number of care days and these symptoms among Japanese ward staff working exclusively with COVID-19 and support staff. Biopsychosoc Med 2023; 17:17. [PMID: 37118770 PMCID: PMC10147353 DOI: 10.1186/s13030-023-00272-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 04/13/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Psychological distress has been frequently observed in frontline healthcare workers under stress during the coronavirus disease 2019 (COVID-19) epidemic; however, it is unclear if there are differences in the stress and symptoms experienced by staff members who work exclusively in a COVID-19 ward and support staff temporarily deployed to a COVID-19 ward. The present study investigated psychosocial stress specific to the care for patients with COVID-19 and psychological distress among ward staff working exclusively with COVID-19 and temporary support staff. METHODS The participants were full-time nurses and doctors working in COVID-19 wards or the ICU who provided face-to-face care to patients with COVID-19 during the COVID-19 outbreak in February of 2021. The data of 67 staff members (21 exclusively working with Covid-19 patients (group A) and 46 in the temporary support group (group B)) was available for study. Psychosocial stress specific to healthcare professionals during this COVID-19 outbreak (Tokyo Metropolitan Distress Scale for Pandemic [TMDP]) and general psychological distress (K6) were assessed. RESULTS The K6 score was significantly lower in group B than in group A (p = .006), but no significant difference was found in the total score of TMDP or its subscales. Positive correlations were found between TMDP and K6 for group B (p = .011), as was the number of days of care on TMDP-social (rs = .456, p = .001). CONCLUSION Even though support staff members experienced lower psychological distress than staff working exclusively with COVID-19, COVID-19-related psychosocial stress specific to HCWs was comparable. The support staff also presented psychological distress associated with psychosocial stress specific to healthcare professionals during this COVID-19 outbreak, and the COVID-19-related social stress was enhanced as the number of working days increased. Our results show that all staff, not only those working exclusively with COVID-19 patients but also other support staff should be provided with care focusing on COVID-19-related psychosocial occupational stress.
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Affiliation(s)
- Tomoe Nishihara
- Department of Psychosomatic Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka-City, 812-8582, Japan
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka-City, 812-8582, Japan.
- Division of Health Promotion and Development, Center for Health Sciences and Counseling, Kyushu University, Fukuoka, Japan.
| | - Ayako Ohashi
- Department of Psychiatry, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mika Kuroiwa
- Department of Clinical Research Center, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka-City, 812-8582, Japan
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Nishihara T, Yoshihara K, Ohashi A, Kuroiwa M, Sudo N. Occupational stress, psychological distress, physical symptoms, and their interrelationships among frontline nurses caring for COVID-19 patients in Japan. Medicine (Baltimore) 2022; 101:e31687. [PMID: 36482556 PMCID: PMC9726358 DOI: 10.1097/md.0000000000031687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study aimed to identify occupational stress, psychosomatic symptoms, psychological distress, and their correlations among frontline nurses during and after the first peak of the coronavirus disease 2019 (COVID-19) outbreak in Japan. Sixteen frontline nurses, aged 25 to 52 years, working in a ward with COVID-19 patients participated in this study. Two months after the peak of the first wave of the COVID-19 outbreak in Japan, the COVID-19-related occupational stress scale (COS; questionnaire items: fear of infection and increased workload) and physical symptom scale (PS; questionnaire items: gastrointestinal symptoms, pain, appetite loss, and insomnia) were assessed. The degree of general psychological distress was evaluated using the 6-item Kessler Scale (K6). Simultaneously, participants were asked to recall their condition during the peak period of the first wave and rate it using the same scale. K6 was positively correlated with COS and PS during the peak period (rs = 0.574, P = .020 and rs = 0.587, P = .017, respectively). Increased workload was positively correlated with the K6 score both during and after the peak period (rs = 0.869, P < .001 and rs = 0.732, P = <.001, respectively) and was positively correlated with insomnia during the peak period (rs = 0.498, P < .05). The COS, PS, and K6 scores during the peak period were significantly higher than those after the peak period. Psychological distress at the peak was associated with PS and occupational stress. An increased workload during peak periods can cause psychological distress and insomnia. The occupational stress, PS, and psychological distress of nurses working in COVID-19 wards improved after the peak of COVID-19.
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Affiliation(s)
- Tomoe Nishihara
- Department of Psychosomatic Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- * Correspondence: Tomoe Nishihara, Department of Psychosomatic Medicine, National Hospital Organization Fukuoka Higashi Medical Center, Japan., 1-1-1 Chidori, Koga-city, Fukuoka 811-3195, Japan (e-mail: )
| | - Kazufumi Yoshihara
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ayako Ohashi
- Department of Psychiatry, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Mika Kuroiwa
- Department of Clinical Research Center, National Hospital Organization Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Shibahara T, Sakamoto K, Yoshino F, Matsuoka M, Tachibana M, Kamezaki K, Kuroda J, Kuroiwa M, Nakane H. Usefulness of arterial spin labeling in identifying status epilepticus secondary to acquired thrombotic thrombocytopenic purpura. eNeurologicalSci 2022; 29:100435. [DOI: 10.1016/j.ensci.2022.100435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022] Open
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Nishihara T, Ohashi A, Nakashima Y, Yamashita T, Hiyama K, Kuroiwa M. Compassion fatigue in a health care worker treating COVID-19 patients: a case report. Biopsychosoc Med 2022; 16:10. [PMID: 35428306 PMCID: PMC9012067 DOI: 10.1186/s13030-022-00239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/29/2022] [Indexed: 12/04/2022] Open
Abstract
Background Doctors treating COVID-19 are under extreme stress. It was reported that healthcare workers providing palliative care could present elevated levels of compassion fatigue. We herein report a case if the attending doctor of severe COVID-19 cases who felt extreme psychological difficulty and suffered from compassion fatigue. Case presentation A 29-year-old female doctor presented with anxiety and insomnia. Her stress from overwork was exacerbated during the treatment of two related COVID-19 patients, a 47-year-old man with COVID-19 and his 76-year-old mother, who suffered acute stress disorder after the death of her son. The mother first refused treatment, but with psychiatric intervention she was able to recover and be discharged. In the course of these cases of COVID-19, their attending physician felt psychological distress and presented with insomnia and anticipatory anxiety due to the poor prognosis of the mother. After being presented with a systematic approach to improve her work situation by the hospital executive staff and undergoing psychotherapy for compassion fatigue, she recovered and was able to return to work. Conclusions We report a physician in charge of severe cases of COVID-19, who suffered an adverse impact on her mental health. Excessively empathic engagement in the care of patients who do not survive and their relatives provides high risk for compassion fatigue. The stress-related distress of HCWs should be more widely recognized in order to improve support systems for them.
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Daitoku S, Onimaru M, Tanimoto K, Kuroiwa M. Atraumatic splenic ruptures triggered both remission and death in a single case of blastic plasmacytoid dendritic cell neoplasm. J Clin Exp Hematop 2019; 59:40-45. [PMID: 30918143 PMCID: PMC6528142 DOI: 10.3960/jslrt.18021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Shinya Daitoku
- Department of Hematology, National Hospital Organization Fukuoka Higashi Medical Center, Koga, Japan.,Department of Hematology and Oncology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Mitsuho Onimaru
- Division of Pathophysiological and Experimental Pathology, Department of Pathology, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Kazuki Tanimoto
- Department of Hematology and Oncology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan
| | - Mika Kuroiwa
- Department of Hematology, National Hospital Organization Fukuoka Higashi Medical Center, Koga, Japan
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Okamoto K, Ohishi T, Kuroiwa M, Iemura SI, Natsume T, Seimiya H. MERIT40-dependent recruitment of tankyrase to damaged DNA and its implication for cell sensitivity to DNA-damaging anticancer drugs. Oncotarget 2018; 9:35844-35855. [PMID: 30533199 PMCID: PMC6254674 DOI: 10.18632/oncotarget.26312] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/24/2018] [Indexed: 12/22/2022] Open
Abstract
Tankyrase, a member of the poly(ADP-ribose) polymerase (PARP) family, regulates various intracellular responses, such as telomere maintenance, Wnt/β-catenin signaling and cell cycle progression through its interactions with multiple target proteins. Tankyrase contains a long stretch of 24 ankyrin repeats that are further divided into five subdomains, called ANK repeat clusters (ARCs). Each ARC works as an independent ligand-binding unit, which implicates tankyrase as a platform for multiple protein-protein interactions. Furthermore, tankyrase distributes to various intracellular loci, suggesting potential distinct but yet unidentified physiological functions. To explore the novel functions of tankyrase, we performed liquid chromatography-mass spectrometry analysis and identified the BRE-BRCC36-MERIT40 complex, a regulator of homologous recombination, as tankyrase-binding proteins. Among the complex components, MERIT40 was directly associated with tankyrase via a tankyrase-binding consensus motif, as previously reported. In X-ray-irradiated non-small cell lung cancer cells, tankyrase localized to DNA double-stranded break sites in a MERIT40-dependent manner. MERIT40 knockdown increased the cell sensitivity to X-ray, whereas the wild-type, but not the tankyrase-unbound mutant, MERIT40 rescued the phenotype of the knockdown cells. Tankyrase inhibitors, such as G007-LK and XAV939, increased the cellular sensitivity to X-ray irradiation and anticancer drugs that induce DNA double-stranded breaks. These observations suggest that tankyrase plays a role in the DNA damage repair response and implicates a potential therapeutic utility of tankyrase inhibitors in combination treatments with DNA-damaging anticancer drugs.
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Affiliation(s)
- Keiji Okamoto
- Division of Molecular Biotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan
| | - Tomokazu Ohishi
- Division of Molecular Biotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.,Current address: Institute of Microbial Chemistry (BIKAKEN), Numazu, Shizuoka, Japan
| | - Mika Kuroiwa
- Division of Molecular Biotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.,Laboratory of Molecular Target Therapy of Cancer, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Koto-ku, Tokyo, Japan
| | - Shun-Ichiro Iemura
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Koto-ku, Tokyo, Japan.,Current address: Translational Research Center, Fukushima Medical University, Fukushima, Japan
| | - Tohru Natsume
- Molecular Profiling Research Center for Drug Discovery, National Institute of Advanced Industrial Science and Technology, Koto-ku, Tokyo, Japan
| | - Hiroyuki Seimiya
- Division of Molecular Biotherapy, Cancer Chemotherapy Center, Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan.,Laboratory of Molecular Target Therapy of Cancer, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Koto-ku, Tokyo, Japan
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Abstract
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening syndrome that occurs as a complication in many clinical settings. Malignancy-associated HLH develops in patients with hematopoietic neoplasms, particularly in those with lymphoma, and its development in those with myelodysplastic syndrome (MDS) is uncommon. We herein report a case of HLH in a patient with low-risk MDS that was successfully treated with azacitidine. The prevalence of immune abnormalities among MDS patients and the immune effects of azacitidine have recently been elucidated, suggesting that MDS-associated HLH occurs as a result of immune impairment, and azacitidine improves this condition by restoring the immune system.
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Affiliation(s)
- Shinya Daitoku
- Department of Hematology, National Hospital Organization Fukuoka Higashi Medical Center, Japan
| | - Tomomi Aoyagi
- Department of Gastroenterology and Hepatology, National Hospital Organization Fukuoka Higashi Medical Center, Japan
| | - Shinichiro Takao
- Department of Gastroenterology and Hepatology, National Hospital Organization Fukuoka Higashi Medical Center, Japan
| | - Seiya Tada
- Department of Gastroenterology and Hepatology, National Hospital Organization Fukuoka Higashi Medical Center, Japan
| | - Mika Kuroiwa
- Department of Hematology, National Hospital Organization Fukuoka Higashi Medical Center, Japan
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12
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Kanaji T, Okamura T, Kuroiwa M, Noda M, Fujimura KL, Kuramoto A, Sano M, Nakano S, Niho Y. Molecular and Genetic Analysis of Two Patients with Bernard-Soulier Syndrome – Identification of New Mutations in Glycoprotein Ibα Gene. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1656111] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryWe investigated two unrelated patients with Bernard-Soulier syndrome (BSS) by performing molecular and genetic analysis.A flow cytometric and immunoblotting analysis showed GP Ibα to be absent from the platelet membrane of both patients. Other glycoproteins that formed GP Ib/IX/V complex were present on the platelets, but in decreased amounts. Therefore, GP Ibα gene from both cases was sequenced after PCR amplification and subcloning. We identified a homozygous mutation of a dinucleotide deletion within the TGTG repeat at cDNA number 972 to 975 in GP Ibα gene from Case 1. In Case 2, compound heterozygosity was demonstrated in GP Ibα gene; an insertion of a single base (T) at cDNA number 1,418 in one allele, and a deletion of a single base (A) within the 7-adenine repeat at cDNA number 1,438 to 1,444 in another allele. The three new mutations in both patients appeared to cause a frameshift, which created a new termination codon shortly thereafter, and thus lead to a GP Ibα deficiency on the platelet membrane. Truncated mutant proteins could be detected in the plasma and platelets of Case 2, but not of Case 1. According to these findings, it is thus supposed that the properties and conformation of additional COOH-terminal peptides, which were supposedly synthesized as results of the mutations, may have an important role on the processing of mutant GP Ibα in megakaryocytes and platelets.
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Affiliation(s)
- Taisuke Kanaji
- The First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Takashi Okamura
- The First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Mika Kuroiwa
- The First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Masaaki Noda
- Department of Internal Medicine, Research Institute for Nuclear Medicine and Biology, Hiroshima University, . Hiroshima, Japan
| | - Kingo L Fujimura
- Department of Internal Medicine, Research Institute for Nuclear Medicine and Biology, Hiroshima University, . Hiroshima, Japan
| | - Atsushi Kuramoto
- Department of Internal Medicine, Research Institute for Nuclear Medicine and Biology, Hiroshima University, . Hiroshima, Japan
| | - Masayuki Sano
- Department of Transfusion Medicine, Saga Medical School, Saga, Japan
| | - Shuji Nakano
- The First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
| | - Yoshiyuki Niho
- The First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan
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Kanaji S, Osaki K, Kuroiwa M, Sakaguchi M, Mihara K, Niho Y, Okamura T, Kanaji T. Identification and Characterization of Two Novel Mutations (Q421K and R123P) in Congenital Factor XII Deficiency. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1616743] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
SummaryThe factor XII genes of two unrelated factor XII-deficient Japanese families were screened, and two novel mutations were identified. A heterozygous mutation (Q421K) was identified in the gene of a cross-reacting material (CRM)-negative patient with reduced FXII activity (entitled Case 1). No mutations were discovered in the other allele. Case 2 was a CRM-negative patient with severe FXII deficiency. In this case, a homozygous mutation (R123P) was discerned. Expression studies in Chinese Hamster Ovary (CHO) cells demonstrated accumulation of mutant Q421K factor XII in the cell, and insufficient secretion, while the R123P mutant showed lower levels of accumulation than wild-type, and no evidence of secretion in culture supernatant. In the presence of proteasome inhibitor, all types of FXII (wild-type, Q421K, R123P) accumulated in the cells. Protease protection experiments using the microsomal fraction of these cell lines demonstrated that while 20% wild-type FXII (total wild-type:100%) and 10% R123P mutant (total R123P-type: 40%) were resistant to treatment with trypsin, 50% Q421K-type FXII (total Q421K-type:130%) remained resistant to digestion. From these results, we conclude that Q421K is less susceptible to proteasome degradation than wild-type, but is unable to exit the ER efficiently, resulting in insufficient secretion phenotype. In contrast, R123P is susceptible to proteasome degradation and is not secreted.
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14
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Arai M, Koike T, Moriyasu M, Ito S, Ootsuka T, Inagaki T, Hattori J, Yoshino K, Kuroiwa M. Implementation of critical care staff based rapid response team. effect of rapid response system to the unpredicted death. Intensive Care Med Exp 2015. [PMCID: PMC4796971 DOI: 10.1186/2197-425x-3-s1-a67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Arai M, Ito S, Kosaka Y, Toda M, Kuroiwa M, Okamoto H. 0597. The relation between intestinal intramucosal ph and stress hormones in pig hemorrhagic shock model. Intensive Care Med Exp 2014. [PMCID: PMC4798586 DOI: 10.1186/2197-425x-2-s1-p40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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16
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Nonami A, Miyamoto T, Kuroiwa M, Kunisaki Y, Kamezaki K, Takenaka K, Harada N, Teshima T, Harada M, Nagafuji K. Successful Treatment of Primary Plasma Cell Leukaemia by Allogeneic Stem Cell Transplantation from Haploidentical Sibling. Jpn J Clin Oncol 2007; 37:969-72. [DOI: 10.1093/jjco/hym130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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17
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Iino D, Takakura Y, Kuroiwa M, Kawakami R, Sasaki Y, Hoshino T, Ohsawa K, Nakamura A, Yajima S. Crystallization and preliminary crystallographic analysis of hygromycin B phosphotransferase from Escherichia coli. Acta Crystallogr Sect F Struct Biol Cryst Commun 2007; 63:685-8. [PMID: 17671368 PMCID: PMC2335168 DOI: 10.1107/s1744309107032757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Accepted: 07/05/2007] [Indexed: 11/11/2022]
Abstract
Aminoglycoside antibiotics, such as hygromycin, kanamycin, neomycin, spectinomycin and streptomycin, inhibit protein synthesis by acting on bacterial and eukaryotic ribosomes. Hygromycin B phosphotransferase (Hph; EC 2.7.1.119) converts hygromycin B to 7''-O-phosphohygromycin using a phosphate moiety from ATP, resulting in the loss of its cell-killing activity. The Hph protein has been crystallized for the first time using a thermostable mutant and the hanging-drop vapour-diffusion method. The crystal provided diffraction data to a resolution of 2.1 A and belongs to space group P3(2)21, with unit-cell parameters a = b = 71.0, c = 125.0 A. Crystals of complexes of Hph with hygromycin B and AMP-PNP or ADP have also been obtained in the same crystal form as that of the apoprotein.
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Affiliation(s)
- Daisuke Iino
- Department of Bioscience, Tokyo University of Agriculture, Tokyo 156-8502, Japan
| | - Yasuaki Takakura
- Division of Integrative Environmental Sciences, Graduate School of Life and Environmental Sciences, University of Tsukuba, Ibaraki 305-8572, Japan
| | - Mika Kuroiwa
- Department of Bioscience, Tokyo University of Agriculture, Tokyo 156-8502, Japan
| | - Ryouta Kawakami
- Department of Bioscience, Tokyo University of Agriculture, Tokyo 156-8502, Japan
| | - Yasuyuki Sasaki
- Department of Bioscience, Tokyo University of Agriculture, Tokyo 156-8502, Japan
| | - Takayuki Hoshino
- Division of Integrative Environmental Sciences, Graduate School of Life and Environmental Sciences, University of Tsukuba, Ibaraki 305-8572, Japan
| | - Kanju Ohsawa
- Department of Bioscience, Tokyo University of Agriculture, Tokyo 156-8502, Japan
| | - Akira Nakamura
- Division of Integrative Environmental Sciences, Graduate School of Life and Environmental Sciences, University of Tsukuba, Ibaraki 305-8572, Japan
| | - Shunsuke Yajima
- Department of Bioscience, Tokyo University of Agriculture, Tokyo 156-8502, Japan
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18
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Kobayashi T, Nakamura M, Sakuma M, Yamada N, Kuroiwa M, Seo N. ID: 090 Japanese guidelines for pulmonary thromboembolism (PTE) prophylaxis is effective for a decrease in the occurrence of PTE. J Thromb Haemost 2006. [DOI: 10.1111/j.1538-7836.2006.00090.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Yabuuchi K, Kuroiwa M, Shuto T, Sotogaku N, Snyder GL, Higashi H, Tanaka M, Greengard P, Nishi A. Role of adenosine A1 receptors in the modulation of dopamine D1 and adenosine A2a receptor signaling in the neostriatum. Neuroscience 2006; 141:19-25. [PMID: 16750892 DOI: 10.1016/j.neuroscience.2006.04.047] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2006] [Revised: 04/21/2006] [Accepted: 04/21/2006] [Indexed: 11/15/2022]
Abstract
Adenosine is known to modulate the function of neostriatal neurons. Adenosine acting on A(2A) receptors increases the phosphorylation of dopamine- and cAMP-regulated phosphoprotein of M(r) 32 kDa (DARPP-32) at Thr34 (the cAMP-dependent protein kinase [PKA] site) in striatopallidal neurons, and opposes dopamine D2 receptor signaling. In contrast, the role of adenosine A(1) receptors in the regulation of dopamine/DARPP-32 signaling is not clearly understood. Here, we investigated the effect of adenosine A(1) receptors on D(1), D(2) and A(2A) receptor signaling using mouse neostriatal slices. An A(1) receptor agonist, 2-chloro-N(6)-cyclopentyladenosine (100 nM), caused a transient increase, followed by a transient decrease, in DARPP-32 Thr34 phosphorylation. Our data support the following model for the actions of the A(1) receptor agonist. The A(1) receptor-induced early increase in Thr34 phosphorylation was mediated by presynaptic inhibition of dopamine release, and the subsequent removal of tonic inhibition by D(2) receptors of A(2A) receptor/G(olf)/cAMP/PKA signaling. The A(1) receptor-induced late decrease in Thr34 phosphorylation was mediated by a postsynaptic G(i) mechanism, resulting in inhibition of D(1) and A(2A) receptor-coupled G(olf)/cAMP/PKA signaling in direct and indirect pathway neurons, respectively. In conclusion, A(1) receptors play a major modulatory role in dopamine and adenosine receptor signaling.
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Affiliation(s)
- K Yabuuchi
- Oita University Faculty of Medicine, Yufu, Oita 879-5593, Japan
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20
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Hashiguchi M, Okamura T, Yoshimoto K, Ono N, Imamura R, Yakushiji K, Ogata H, Seki R, Otsubo K, Oku E, Kuroiwa M, Higuchi M, Kato K, Taniguchi S, Gondo H, Shibuya T, Nagafuji K, Harada M, Sata M. Demonstration of reversed flow in segmental branches of the portal vein with hand-held color Doppler ultrasonography after hematopoietic stem cell transplantation. Bone Marrow Transplant 2005; 36:1071-5. [PMID: 16247437 DOI: 10.1038/sj.bmt.1705170] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Hepatic veno-occlusive disease (VOD) is a severe complication of hematopoietic stem cell transplantation (SCT). When monitored with hand-held color Doppler ultrasonography during day -7 to +35 around SCT, reversed blood flow in the segmental branches of the portal vein was detected in nine of 56 patients who had undergone SCT. Three of nine patients had clinical evidence of VOD, but six patients did not fulfill the criteria for diagnosis of VOD initially. Two patients progressed to clinical VOD at a later date and the reversed portal flow disappeared with or without treatment for VOD in the other four patients. Monitoring for reversed portal flow with color Doppler ultrasonography may be a useful tool for the early diagnosis of VOD, and may improve prognosis by allowing early initiation of treatment.
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Affiliation(s)
- M Hashiguchi
- Second Department of Internal Medicine, Kurume University School of Medicine, Fukuoka, Japan
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21
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Niiyama S, Tanaka E, Tsuji S, Murai Y, Satani M, Sakamoto H, Takahashi K, Kuroiwa M, Yamada A, Noguchi M, Higashi H. Neuroprotective mechanisms of lidocaine against in vitro ischemic insult of the rat hippocampal CA1 pyramidal neurons. Neurosci Res 2005; 53:271-8. [PMID: 16102862 DOI: 10.1016/j.neures.2005.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2005] [Revised: 07/11/2005] [Accepted: 07/13/2005] [Indexed: 10/25/2022]
Abstract
To compare neuroprotective effects of lidocaine and procaine against ischemic insult, intracellular recordings were made from rat hippocampal CA1 pyramidal neurons in slice preparations. Superfusion of the slices with oxygen- and glucose-deprived medium (in vitro ischemia) produced a rapid depolarization 6 min from the onset. When oxygen and glucose were reintroduced, the membrane depolarized further until it reached 0 mV, and thereafter the membrane showed no functional recovery. Pretreatment with lidocaine (10 microM), but not procaine (50 microM), restored the membrane potential after the reintroduction of oxygen and glucose. Lidocaine, compared to procaine, significantly inhibited the reduction in both tissue ATP content and flavoprotein fluorescence during and after in vitro ischemia. Under electron microscopy, only lidocaine well preserved the structure of mitochondria in the CA1 pyramidal cell body. Extracellular recordings revealed that procaine reduced the field postsynaptic potential whereas lidocaine augmented it. Both drugs reduced the presynaptic volley dose-dependently. Neither lidocaine nor procaine significantly affected a rapid rise of the intracellular Ca2+ level produced by in vitro ischemia in the CA1 region. All the results suggest that the neuroprotective lidocaine action is due to the protection of the mitochondria to maintain the tissue ATP content during and after in vitro ischemia.
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Affiliation(s)
- S Niiyama
- Department of Physiology, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan
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22
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Gondo H, Himeji D, Kamezaki K, Numata A, Tanimoto T, Takase K, Aoki K, Henzan H, Nagafuji K, Miyamoto T, Ishikawa F, Shimoda K, Inaba S, Tsukamoto H, Horiuchi T, Nakashima H, Otsuka T, Kato K, Kuroiwa M, Higuchi M, Shibuya T, Kamimura T, Kuzushima K, Tsurumi T, Kanda Y, Harada M. Reconstitution of HLA-A*2402-restricted cytomegalovirus-specific T-cells following stem cell transplantation. Int J Hematol 2005; 80:441-8. [PMID: 15646657 DOI: 10.1532/ijh97.04109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cytomegalovirus (CMV)-specific immune reconstitution early after stem cell transplantation (SCT) was evaluated prospectively by detecting CD8+ T-cells, which recognize the peptide QYDPVAALF in the context of HLA-A*2402. Fifteen allogeneic SCT recipients were included in the study. All recipients and donors were seropositive for CMV and had the HLA-A*2402 allele. CMV-specific T-cells were detected as early as 1 month after transplantation, and their numbers increased to peak levels 2 to 5 months after transplantation. The numbers of CMV-specific T-cells in patients who developed grade II to IV acute graft-versus-host disease (GVHD) and received corticosteroids for acute GVHD were low in the early period after allogeneic SCT. There was a trend toward earlier reconstitution of CMV-specific CD8+ T-cells in allogeneic peripheral blood SCT (PBSCT) patients than in allogeneic bone marrow transplantation patients. The contribution of T-cells in the graft to the recovery of CMV-specific immune responses was also suggested by the finding that the reconstitution of CMV-specific CD8+ T-cells was delayed in CD34-selected autologous PBSCT compared with unpurged autologous PBSCT. The reconstitution of CMV-specific CD8+ T-cells was delayed in patients with CMV disease or recurrent CMV reactivation. These observations suggest that the detection of CMV-specific T-cells with an HLA-peptide tetramer is useful to assess immune reconstitution against CMV and to identify patients at risk for CMV disease or recurrent CMV reactivation after SCT.
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Affiliation(s)
- Hisashi Gondo
- Department of Hematology, Hamanomachi Hospital, Fukuoka, Japan.
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23
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Yamasaki S, Henzan H, Ohno Y, Yamanaka T, Iino T, Itou Y, Kuroiwa M, Maeda M, Kawano N, Kinukawa N, Miyamoto T, Nagafuji K, Shimoda K, Inaba S, Hayashi S, Taniguchi S, Shibuya T, Gondo H, Otsuka T, Harada M. Influence of transplanted dose of CD56+ cells on development of graft-versus-host disease in patients receiving G-CSF-mobilized peripheral blood progenitor cells from HLA-identical sibling donors. Bone Marrow Transplant 2003; 32:505-10. [PMID: 12942097 DOI: 10.1038/sj.bmt.1704165] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We investigated effects of variations in the cellular composition of G-CSF-mobilized peripheral blood progenitor cell (G-PBPC) allografts on clinical outcomes of allogeneic PBPC transplantation. We retrospectively analyzed transplanted doses of various immunocompetent cells from 27 HLA-identical sibling donors in relation to engraftment, incidence of graft-versus-host disease (GVHD), and survival. Significant variability was documented in both absolute numbers and relative proportions of CD34+, CD2+, CD3+, CD4(high)+, CD4+25+, CD8(high)+, CD19+, CD56+, and CD56+16+ cells contained in these allografts. Stepwise Cox regression analysis revealed that the CD56+ cell dose was significantly inversely correlated with the incidence of GVHD. Thus, there was a significantly higher incidence of grade II acute GVHD in patients receiving a lower CD56+16+ cell dose (hazard ratio (HR) 0.0090; 95% confidence interval (CI), <0.00001-3.38; P=0.031), a higher incidence of chronic GVHD in those receiving allografts with a lower CD56+16+ to CD34+ ratio (HR <0.00001; 95% CI <0.00001-0.0007; P=0.0035), and a higher incidence of extensive chronic GVHD in those receiving allografts with a lower CD56+ to CD34+ ratio (HR <0.00001; 95% CI <0.00001-0.053; P=0.0083). These results suggest that CD56+ cells in G-PBPC allografts from HLA-identical sibling donors may play an important role in preventing the development of GVHD.
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Affiliation(s)
- S Yamasaki
- Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
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24
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Hasegawa N, Kato K, Morita K, Kuroiwa M, Shinkai M, Hayashi T, Kamioka T, Otagiri H, Shindo Y, Goto H. Covered expandable metallic stent placement for hemostasis of colonic bleeding caused by invasion of gallbladder carcinoma. Endoscopy 2003; 35:178-80. [PMID: 12561012 DOI: 10.1055/s-2003-37018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
A 72-year-old Japanese man was admitted to our hospital complaining of right upper-quadrant abdominal pain, blood in his stool, and symptoms of anemia. On physical examination a hard mass, about 6 cm in diameter, was palpable in the right upper quadrant of the abdomen. Computed tomography revealed a gallbladder carcinoma which had invaded the transverse colon, with liver metastasis. We diagnosed gallbladder carcinoma, stage IVB. Colonoscopy was performed for persistent blood in the stools. This revealed an elevated lesion which appeared to be an invasion of gallbladder carcinoma, with diffuse bleeding from the right-side of the transverse colon. It proved difficult to stop this bleeding by ordinary therapeutic endoscopy. In order to achieve hemostasis we therefore inserted a covered Ultraflex metallic stent to compress the tumor. After stent placement, blood was no longer seen in the patient's stools, he became able to eat soft food and was discharged. This treatment was uninvasive and effective. Covered stent placement appears to be a new and useful method in the management of bleeding from malignant gastrointestinal tumors.
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Affiliation(s)
- N Hasegawa
- Department of Internal Medicine, Tosei General Hospital, Seto, Japan
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25
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Yakushiji K, Gondo H, Kamezaki K, Shigematsu K, Hayashi S, Kuroiwa M, Taniguchi S, Ohno Y, Takase K, Numata A, Aoki K, Kato K, Nagafuji K, Shimoda K, Okamura T, Kinukawa N, Kasuga N, Sata M, Harada M. Monitoring of cytomegalovirus reactivation after allogeneic stem cell transplantation: comparison of an antigenemia assay and quantitative real-time polymerase chain reaction. Bone Marrow Transplant 2002; 29:599-606. [PMID: 11979310 DOI: 10.1038/sj.bmt.1703513] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2001] [Accepted: 02/04/2002] [Indexed: 11/08/2022]
Abstract
Cytomegalovirus (CMV) antigenemia and quantitative real-time polymerase chain reaction (PCR) were compared for monitoring of CMV reactivation after allogeneic stem cell transplantation. The number of CMV antigen-positive cells by the antigenemia assay and the level of CMV DNA by real-time PCR correlated well. The sensitivity and specificity of the antigenemia assay was 55.4% and 95.5%, respectively, using real-time PCR as the reference standard. The probability of positive antigenemia at day 100 was 76.5%, with a median of first detection at day 37 in 51 patients, compared with a positive PCR of 84.3% and day 33, respectively. When HLA-identical sibling donor transplant recipients and other donor transplant recipients were analyzed separately, there was no difference between the two tests. However, temporal patterns of first detection of CMV antigen-positive cells and CMV DNA differed between HLA-identical and alternative recipients; patients without CMV (29%) or with sporadic positive PCR results (14%) were more common in HLA-identical sibling transplants, whereas patients with simultaneous antigenemia and positive PCR occurred more in alternative transplants (48%). Two of 51 patients (4%) developed CMV colitis despite antigenemia-guided prophylaxis, but both were successfully treated with ganciclovir. Although PCR is more sensitive than antigenemia, both tests are useful in the early detection of CMV after allogeneic stem cell transplantation.
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Affiliation(s)
- K Yakushiji
- Second Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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Takahashi A, Suzuki N, Ikeda H, Kuroiwa M, Tomomasa T, Tsuchida Y, Kuwano H. Results of bowel plication in addition to primary anastomosis in patients with jejunal atresia. J Pediatr Surg 2001; 36:1752-6. [PMID: 11733899 DOI: 10.1053/jpsu.2001.28814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE Disturbed intestinal transit (DIT) associated with bowel dilation occurs in some postoperative patients with jejunal atresia. Bowel plication (BP) has been introduced to prevent the DIT, but the long-term results of BP are unclear. METHODS The authors reviewed the preoperative and operative records and postoperative clinical courses (for 2.3 to 7.0 years; mean period, 3.7 years) of 19 jejunal atresia patients, 4 of whom had undergone additional BP with primary anastomosis after dilated bowel resection or tapering jejunoplasty at neonatal surgery. The degree of DIT was evaluated by the clinical symptoms, weight gain, whether reoperation was performed, and duration from the operation to receiving an oral feeding volume of at least 130 mL/kg/d. The patients then were assigned 4 grades (0 to 3). To determine the presence or absence of bowel dilation at the BP site, the plain abdominal x-rays were reviewed. RESULTS (1) Within 2 months after surgery, 4 patients without BP underwent operation because of severe DIT. The degree of postoperative DIT in patients who had received additional BP at neonatal surgery was less than that in patients without BP (mean grade, 0.50 v. 2.08). (2) The preoperative clinical features, operative method, and postoperative weight gain were almost similar in patients with and without BP. (3) On abdominal x-ray the bowel dilation remained 6 to 12 months after the operation, but was not observed over 1 year after the operation. CONCLUSIONS In this preliminary study, the addition of BP after tapering jejunoplasty or resection of dilated bowel may be effective in preventing early postoperative DIT. Further study is necessary to evaluate the long-term results of additional BP at neonatal surgery. J Pediatr Surg 36:1752-1756.
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Affiliation(s)
- A Takahashi
- Department of Surgery I, Faculty of Medicine, Gunma University, Gunma, Japan
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27
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Kanaji T, Kanaji S, Osaki K, Kuroiwa M, Sakaguchi M, Mihara K, Niho Y, Okamura T. Identification and characterization of two novel mutations (Q421 K and R123P) in congenital factor XII deficiency. Thromb Haemost 2001; 86:1409-15. [PMID: 11776307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The factor XII genes of two unrelated factor XII-deficient Japanese families were screened, and two novel mutations were identified. A heterozygous mutation (Q421K) was identified in the gene of a cross-reacting material (CRM)-negative patient with reduced FXII activity (entitled Case 1). No mutations were discovered in the other allele. Case 2 was a CRM-negative patient with severe FXII deficiency. In this case, a homozygous mutation (R123P) was discerned. Expression studies in Chinese Hamster Ovary (CHO) cells demonstrated accumulation of mutant Q421 K factor XII in the cell, and insufficient secretion, while the R123P mutant showed lower levels of accumulation than wild-type, and no evidence of secretion in culture supernatant. In the presence of proteasome inhibitor, all types of FXII (wild-type. Q421K, R123P) accumulated in the cells. Protease protection experiments using the microsomal fraction of these cell lines demonstrated that while 20% wild-type FXII (total wild-type:100%) and 10% R123P mutant (total R123P-type: 40%) were resistant to treatment with trypsin, 50% Q421K-type FXII (total Q421K-type:130%) remained resistant to digestion. From these results, we conclude that Q421K is less susceptible to proteasome degradation than wild-type, but is unable to exit the ER efficiently, resulting in insufficient secretion phenotype. In contrast, R123P is susceptible to proteasome degradation and is not secreted.
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Affiliation(s)
- T Kanaji
- Kyushu University Graduate School of Medicine, The First Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
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Ikeda H, Hirato J, Suzuki N, Kuroiwa M, Maruyama K, Tsuchida Y. Detection of hepatic oxidative DNA damage in patients with hepatoblastoma and children with non-neoplastic disease. Med Pediatr Oncol 2001; 37:505-10. [PMID: 11745888 DOI: 10.1002/mpo.1243] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The authors have revealed a significant association between hepatoblastoma and low birth weight. This study was done to explore the evidence that liver cells were oxidatively damaged, based on the hypothesis that oxidative damage to DNA is involved in the development of hepatoblastoma in children of low birth weight. PROCEDURE Oxidative DNA damage in the liver was examined by immunohistochemically detecting the presence of a DNA repair product, 8-hydroxy-2'-deoxyguanosine (8-OHdG), in five patients with hepatoblastoma and 14 children with non-neoplastic disease. RESULTS Positive staining for 8-OHdG was observed in all five patients with hepatoblastoma. Distribution of 8-OHdG positivity was diffuse in the intralobular area in one patient and was restricted to the periportal area of the lobules in four patients. There was no apparent correlation between birth weight of the patients, histological findings in the liver, and the distribution of 8-OHdG positivity. In children with non-neoplastic disease, 8-OHdG was detected in nine of 14 patients, and 8-OHdG was positive in the intralobular area of the liver parenchyma except in one patient. CONCLUSIONS These results suggest that the cause of oxidative DNA damage in patients with hepatoblastoma may be different from the cause, extensive parenchymal damage to the liver, in children with non-neoplastic disease, but the 8-OHdG formation is not specific to hepatoblastoma patients of low birth weight. Further studies to elucidate the true reason for the high incidence of hepatoblastoma in children of low birth weight are necessary.
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Affiliation(s)
- H Ikeda
- Department of Pediatric Surgery, Dokkyo University School of Medicine, Koshigaya Hospital, Saitama, Japan.
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Kuroiwa M, Ikeda H, Hongo T, Tsuchida Y, Hirato J, Kaneko Y, Suzuki N, Obana K, Makino SI. Effects of recombinant human endostatin on a human neuroblastoma xenograft. Int J Mol Med 2001; 8:391-6. [PMID: 11562777 DOI: 10.3892/ijmm.8.4.391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
New antitumor agents must be added to the current neuroblastoma treatment regimens to improve the clinical results. We investigated whether recombinant human endostatin (rhEndostatin), an antiangiogenic agent, is effective against human neuroblastoma in the human neuroblastoma xenograft model designated TNB9. When tumors on the back of nude mice grew to a weight of 90-95 mg, rhEndostatin 10 mg/kg/day was administered subcutaneously every day for 10 consecutive days. Mean relative tumor weight in mice administered rhEndostatin (n=5) was significantly less than that in controls (n=12) on days 2, 4, and 6 after the start of administration (p<0.01 on day 2, p<0.05 on days 4 and 6), and regression of tumor growth (TRW<1.0) was marked on day 2. The maximum inhibition rate (MIR) by rhEndostatin was 46.4%, indicating inefficacy, but it may not be appropriate to apply Battelle Columbus Laboratories criteria to this experimental model because rhEndostatin is a protein. After day 8, tumors in the experimental group increased in weight and were not statistically significantly different from those in controls. Recombinant human endostatin was used in tumors in the arterial system of the mouse in this experiment because eventually rhEndostatin, not recombinant mouse endostatin, may be used to treat advanced neuroblastoma in the clinical setting. The results show that there is little cross-reactivity of rhEndostatin with the human and mouse models and indicate that rhEndostatin could become an effective agent for the treatment of human neuroblastoma.
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Affiliation(s)
- M Kuroiwa
- Department of Surgery, Gunma Children's Medical Center, Hokkitsu, Seta-gun, Gunma 377-8577, Japan
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30
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Kuroiwa M, Suzuki N, Hatakeyama S, Takahashi A, Ikeda H, Sakai M, Tsuchida Y. Magnetic resonance angiography of portal collateral pathways after hepatic portoenterostomy in biliary atresia: comparisons with endoscopic findings. J Pediatr Surg 2001; 36:1012-6. [PMID: 11431767 DOI: 10.1053/jpsu.2001.24729] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/PURPOSE This study was undertaken to assess the usefulness of magnetic resonance angiography (MRA) in detecting varices and to investigate the possibility of avoiding routine endoscopy after surgery for biliary atresia (BA). METHODS The subjects are 21 patients who have undergone periodical MRA since 1996. The esophageal and gastric vessels were investigated as the sites of potential development of collateral vessels. The collateral vessels on MRA were compared with endoscopic findings. RESULTS (1) Detection of collateral vessels: of 21 patients examined, 9 patients had 12 varices. MRA depicted collateral vessels in all of the 12 varices (sensitivity, 100%). However, all MRA findings, but one was compatible with endoscopic findings (specificity, 92.9%). Outside of a series of these 21 patients, there were 3 additional patients who had undergone endoscopic treatments previously with success, and in whom esophageal vessels were not depicted on MRA, but endoscopy showed remnant varices. (2) Time-dependent relationship between the appearance of collateral vessels and varices: of 4 varices that appeared after the start of MRA, 3 esophageal varices were found endoscopically simultaneously with or after delineation of collateral vessels on MRA. In the remaining patient, varices were found enodscopically 6 months before the MRA delineation, because a simultaneous MRA was not performed in this case. All these varices were in the early stage. CONCLUSIONS MRA was highly sensitive and specific in detecting esophagogastric collateral vessels of the portal venous system. An endoscopic examination is unnecessary until collateral vessels are seen on MRA after surgery for BA.
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Affiliation(s)
- M Kuroiwa
- Department of Surgery, Gunma Children's Medical Center, Gunma, Japan
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Hasegawa N, Kato K, Yamada K, Morita K, Kuroiwa M, Ito H, Kamioka T, Matsuura T, Taguchi A, Ono K, Suzuki Y, Goto H. Early-stage gastric adenocarcinoma: revealed after anti-Helicobacter pylori therapy of MALT lymphoma. Gastrointest Endosc 2001; 53:495. [PMID: 11275894 DOI: 10.1067/mge.2001.112720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- N Hasegawa
- Departments of Internal Medicine and Pathology, Tosei General Hospital, Seto, Department of Endoscopy, Nagoya University School of Medicine, Nagoya, Japan
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Abstract
Inflammatory pseudotumor is a rare lesion that generally is considered to be benign in biological behavior, although some may recur or metastasize. The authors report on a patient with inflammatory pseudotumor of the liver whose preoperative radiologic findings resembled those of focal nodular hyperplasia. The biological investigation showed a polyclonality of the cells and diploidy of the DNA content and suggested benign characteristics of the lesion. J Pediatr Surg 36:663-666.
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Affiliation(s)
- M Sakai
- Department of Surgery, Gunma Children's Medical Center, Gunma, Japan
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Abstract
This report describes a newborn with a large mediastinal teratoma (MT) presenting with severe respiratory distress (RD) at birth. At operation, there was no space for dissection because the huge cystic and solid tumor completely occupied the left hemithorax. After evacuation of the cystic component, the tumor was removed successfully. To our knowledge, only 16 newborn infants with MT presenting with RD have been reported. Operative morbidities occurred in one-half of the cases. We have reviewed the literature to discuss the potential risks of this entity.
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Affiliation(s)
- M Kuroiwa
- Department of Surgery, Gunma Children's Medical Center, 779, Shimohakoda, Hokkitsu, Seta-gun, Gunma 377-8577, Japan
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Kodaka T, Kuroiwa M, Kuroiwa M, Okumura J, Mori R, Hirasawa S, Kobori M. Effects of brushing with a dentifrice for sensitive teeth on tubule occlusion and abrasion of dentin. QJM 2001; 50:57-64. [PMID: 11291961 DOI: 10.1093/jmicro/50.1.57] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2023] Open
Abstract
By using a dentifrice or toothpaste for sensitive teeth, the brushing-induced effects on dentinal tubule occlusion and abrasion of human sound dentin were investigated with a scanning electron microscope and a scanning laser microscope. The dentifrice contained diatomaceous earth and silica as abrasives and strontium chloride hexahydrate as an active ingredient. Thirty dentin pieces of human premolar teeth with an average of 20% occluded dentinal tubules were attached to resin plates and exposed to the oral cavities of five adult subjects for 2, 4, and 8 weeks. Brushing with and without dentifrice was performed 1 min per day, respectively. Brushing with the dentifrice gradually decreased the mean average of occluded tubules from about 91 to 77% during 2 to 8 weeks, although there were no significant differences among the individual values. However, the mean abrasive loss of the dentin surfaces brushed with dentifrice significantly increased from about 52 to 143 microm in depth. The brushed surfaces of the dentin showed a rough topography with numerous toothbrush scratches but no organic pellicle was found. On the other hand, brushing without dentifrice caused about 99% of the dentinal tubules to occlude in 2 and 4 weeks and 100% in 8 weeks. The brushed dentin surfaces at 8 weeks were entirely covered with organic pellicle containing fine mineral granules derived from saliva, and the abrasive loss was about 1.4 microm in mean depth. Such results indicate that brushing with abrasive dentifrices for sensitive teeth remarkably erodes dentin, and suggest that the brushing should cause the dentinal tubules to open again for a certain period of time.
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Affiliation(s)
- T Kodaka
- Second Department of Oral Anatomy, Showa University School of Dentistry, Tokyo, Japan.
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35
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Hasegawa N, Kato K, Yamada K, Morita K, Kuroiwa M, Ito H, Kamioka T, Matsuura T, Sato M, Ono K, Suzuki Y, Goto H. Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) of the sigmoid colon. Gastrointest Endosc 2000; 52:802-4. [PMID: 11115928 DOI: 10.1067/mge.2000.110737] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- N Hasegawa
- Departments of Internal Medicine and Pathology, Tosei General Hospital, Nishioiwake, Seto, Aichi-Prefecture, Japan
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36
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Ikeda H, Suzuki N, Takahashi A, Kuroiwa M, Sakai M, Tsuchida Y. Risk of contralateral manifestation in children with unilateral inguinal hernia: should hernia in children be treated contralaterally? J Pediatr Surg 2000; 35:1746-8. [PMID: 11101728 DOI: 10.1053/jpsu.2000.19239] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE This study was done to identify risk factors for metachronous manifestation of contralateral inguinal hernia in patients with unilateral inguinal hernia. METHODS Characteristics of 156 patients with metachronous contralateral hernia were compared with those of 156 patients with unilateral hernia who were ascertained not to have presented with contralateral hernia. RESULTS There was a tendency for the hernia to be more often on the left side in 88 of 156 patients (56.4%) with contralateral manifestation compared with 70 of 156 patients (44.9%) in the control group (P =.054). The age at hernia repair of the patients with contralateral manifestation, 1 to 120 months (median, 14 months), was significantly younger than the 1 to 149 months (median, 20 months) of the control patients (P =.016). More patients with contralateral manifestation had a family history of inguinal hernia, and the percentage, 24.4%, was significantly higher than the 14.7% in the control group (P =.046). A univariate analysis with the Cox regression models found that hernia on the left side and a positive family history were significantly associated with the metachronous manifestation of contralateral hernia (hazard ratio [HR], 1.40; P =. 037 and HR, 1.59; P =.013, respectively). CONCLUSION The risk of metachronous manifestation of contralateral hernia is high in patients with left-side hernia and in those with a family history, and the incidence of contralateral hernia is at most 10% in these patients. The authors think that the incidence is still too low to justify routine exploration and surgery for a patent processus vaginalis. Contralateral exploration should therefore be reserved for high-risk patients in whom second anesthesia and surgery have to be avoided.
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Affiliation(s)
- H Ikeda
- Department of Surgery, Gunma Children's Medical Center, Gunma, Japan
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Ikeda H, Tsuchida Y, Wu J, Suzuki N, Kuroiwa M, Choi SH, Morikawa A. Antitumor effects of fotemustine and busulfan against a human neuroblastoma xenograft. Oncol Rep 2000; 7:1265-8. [PMID: 11032927 DOI: 10.3892/or.7.6.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We examined whether or not fotemustine, a new nitrosourea derivative, and busulfan, an agent already clinically used, are effective against human neuroblastoma, using a human neuroblastoma xenograft model designated TNB9. The maximum inhibition rate (MIR) of fotemustine against the TNB9 model was 44.6% with a total dose of fotemustine of 75 mg/kg, indicating that fotemustine is not effective against TNB9. The MIR of busulfan against the same model was 26.7% when a total dose of 135 mg/kg was administered orally to nude mice. Busulfan was also suspended in carboxy-methylcellulose, and was administered intraperitoneally. The MIRs were 19.4% and 36. 4% when busulfan was administered intraperitoneally at a total dose of 40 mg/kg and 60 mg/kg, respectively. The total doses of 40 mg/kg and 60 mg/kg did not show any adverse effects on mice, but were found to be ineffective against TNB9, indicating that busulfan might not be an effective chemotherapeutic agent against human neuroblastoma.
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Affiliation(s)
- H Ikeda
- The Department of Surgery, Gunma Children's Medical Center, Hokkitsu, Seta-gun, Gunma 377-8577, Japan
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38
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Sakuma T, Takai M, Endo Y, Kuroiwa M, Ohara A, Jarukamjorn K, Honma R, Nemoto N. A novel female-specific member of the CYP3A gene subfamily in the mouse liver. Arch Biochem Biophys 2000; 377:153-62. [PMID: 10775455 DOI: 10.1006/abbi.2000.1747] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Expression of a female-specific CYP3A in the adult mouse liver was observed on immunoblotting analysis. To characterize this cytochrome P450, we determined the primary structure of its cDNA and examined its expression profile. This cytochrome P450 consisted of 504 amino acids and showed 92, 68, 88, and 69% amino acid sequence identity with mouse CYP3A11, 3A13, 3A16, and 3A25, respectively, and was designated as CYP3A41, a new mouse CYP3A gene. In the female liver, levels of CYP3A41 mRNA expression were comparable to those of CYP3A11, the major CYP3A enzyme in the adult mouse liver. Expression of CYP3A41 mRNA was detected immediately after birth in the livers of animals of both sexes, but increased with age in females, whereas it was gradually reduced in males, resulting in predominantly female-specific expression in livers. Lesser amounts of CYP3A41 mRNA were detected in the kidneys of female mice, with traces in the stomach, ovary, and heart of female mice and in the testis of male mice. Gonadectomy and sex hormone treatment indicated that estradiol and testosterone were able to induce and suppress the expression of CYP3A41 mRNA in the liver, respectively. Among the classical CYP3A inducers, dexamethasone, rifampicin, and 3-methylcholanthrene did not affect the level of CYP3A41 mRNA in the liver of either sex. On the other hand, pregnenolone 16alpha-carbonitrile and phenobarbital suppressed CYP3A41 level to half that of untreated female mice. These observations indicated that CYP3A41 is a female-specific CYP3A and one of the major CYP3A forms in the female mouse liver.
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Affiliation(s)
- T Sakuma
- Department of Toxicology, Faculty of Pharmaceutical Sciences, Toyama Medical and Pharmaceutical University, Toyama, Japan.
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39
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Sugiyama H, Sasaki M, Asano T, Kawai H, Kato T, Moriwaki H, Kuroiwa M. [A case of pancreatic pseudocyst intruded into the left lobe of the liver]. Nihon Shokakibyo Gakkai Zasshi 2000; 97:605-11. [PMID: 10846418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Affiliation(s)
- H Sugiyama
- Department of Gastroenterology, Kizawa Memorial Hospital
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40
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Tsuchida Y, Ikeda H, Suzuki N, Takahashi A, Kuroiwa M, Sakai M, Shimizu H, Shitara T, Yamanouchi H, Hirato J. A case of well-differentiated, fetal-type hepatoblastoma with very low serum alpha-fetoprotein. J Pediatr Surg 1999; 34:1762-4. [PMID: 10626849 DOI: 10.1016/s0022-3468(99)90307-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Serum alpha-fetoprotein (AFP) is elevated in 96.6% of infants and children with hepatoblastoma and hepatocarcinoma. Serum AFP was of normal level in only one case of immature-type hepatoblastoma, and very low in only one case of fetal-type hepatoblastoma among 43 cases reviewed in 1986. Recently, a case of hepatoblastoma with very low serum AFP was encountered in the authors' surgical department. In October 1998, a 55-month-old girl was admitted. Her birth weight was 717 g. A large space-occupying lesion (SOL) located in the left lobe of the liver was seen by magnetic resonance imaging (MRI), and her serum AFP level was 322 ng/mL with a subfractionation pattern of the "benign liver disease" type based on reactivity with lens culnaris hemagglutinin and concanavalin A. The patient underwent successful left lobectomy, and histological examination showed that the tumor, weighing 268 g, was hepatoblastoma of the well-differentiated, fetal type. Immunohistochemistry findings for AFP were negative. A hepatic mass in infants and children with low serum AFP level indicates the presence of either well-differentiated or immature hepatoblastoma, or fibrolamellar hepatocellular carcinoma. Subfractionation of AFP may contribute to the differential diagnosis of these subtypes.
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Affiliation(s)
- Y Tsuchida
- Department of Surgery, Gunma Children's Medical Center, Japan
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41
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Takahashi A, Tsuchida Y, Suzuki N, Kuroiwa M, Ikeda H, Hirato J, Hatakeyama S. Incidence of intrahepatic biliary cysts in biliary atresia after hepatic portoenterostomy and associated histopathologic findings in the liver and porta hepatis at diagnosis. J Pediatr Surg 1999; 34:1364-8. [PMID: 10507430 DOI: 10.1016/s0022-3468(99)90012-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND/PURPOSE The association of intrahepatic biliary cysts in biliary atresia (BA) after hepatic portoenterostomy has drawn the attention of many pediatric surgeons and has become an important subject in clinical management, but the incidence and causes of this association are not well known. METHODS During the last 14 years, we operated on 33 BA patients by hepatic portoenterostomy. Five patients could not be followed up over a 1-year period, so the remaining 28 patients had their intrahepatic structure investigated by periodic magnetic resonance imaging (MRI), and were confirmed at autopsy. The authors also reviewed the preoperative conditions of these patients and the histopathologic changes in the liver biopsy and the porta hepatis specimens taken at portoenterostomy. RESULTS (1) Intrahepatic biliary cysts were found in 6 of the 28 patients studied (21%). Of 16 patients who were operated on after 1989 and are undergoing follow-up by MRI, 4 (25%) had cysts. (2) Five of the 6 patients with cysts had episodes of cholangitis before or at the time of discovery of the cysts, and 4 of them have had their jaundice reappear since the discovery of the cysts. (3) The intralobular spaces (ILS) with fibrosis and the number of bile ducts had increased in the group with cysts compared with those in the group without cysts. (4) The bile duct maximum size in the porta hepatis (PH) was similar in the groups with and without cysts, but a denudation of the mucosal lining cells in the duct, and a fibrosis and inflammation around the duct had increased in the group with cysts compared with those in the group without cysts. (5) Statistically, the fibrosis found in the ILS and the inflammation around the bile duct found in the PH were induced as a correlative factor affecting cyst formation. CONCLUSIONS The association of intrahepatic biliary cysts in BA after portoenterostomy is frequent. The fibrous change in the ILS and the inflammatory process around the bile ducts might be potential causes of cyst formation.
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Affiliation(s)
- A Takahashi
- Department of Surgery, Gunma Children's Medical Center, Seta-gun, Japan
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42
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Hasegawa N, Tsuboi Y, Kato K, Yamada K, Morita K, Kuroiwa M, Ito H, Matsushima T, Ono K, Oshiro M. Endoscopic diagnosis of ileocecal mucosa-associated lymphoid tissue lymphoma. Gastrointest Endosc 1999; 50:115-7. [PMID: 10385738 DOI: 10.1016/s0016-5107(99)70360-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- N Hasegawa
- Department of Internal Medicine, Tosei General Hospital, Seto, Aichi-Prefecture, Japan
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Inoue S, Kuroiwa M, Kisilevsky R. Basement membranes, microfibrils and beta amyloid fibrillogenesis in Alzheimer's disease: high resolution ultrastructural findings. Brain Res Brain Res Rev 1999; 29:218-31. [PMID: 10209233 DOI: 10.1016/s0165-0173(98)00055-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is known that beta amyloid fibrils are deposited at the basement membrane of the cerebromicrovasculature in the brains of patients with Alzheimer's disease, and the assembly of the fibrils may be in continuation with the core of senile plaques. The fibrils accumulate in a manner similar to that in which microfibrils accumulate in the glomerular basement membrane of the rat kidney during long-term experimental diabetes, and in the alveolar-capillary basement membrane of the normal lung. beta amyloid fibrils in-situ are known to be about 10 nm wide tubular structures and they closely resemble connective tissue microfibrils. Our recent high resolution ultrastructural studies combined with immunogold labeling demonstrated that beta amyloid fibrils in-situ are indeed microfibril-like structures, and the beta protein is associated with their surface in the form of loose assemblies of 1 nm wide flexible filaments. Thus, the result of this study indicates that in-situ a major component of the beta amyloid deposit is the microfibril-like structure. The elucidation of the mechanism of cerebral beta amyloid fibrillogenesis in Alzheimer's disease may therefore require understanding the mechanism of 'normal' microfibrils biogenesis.
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Affiliation(s)
- S Inoue
- Department of Anatomy and Cell Biology, McGill University, 3640 University Street, Montreal, Quebec, Canada
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44
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Noguchi O, Kuroiwa M, Kogure S, Kohno N, Yoshida K, Zama A, Tamura M. [Cranial fasciitis of a neonatal case with massive intra- and extracranial extension]. No Shinkei Geka 1999; 27:163-9. [PMID: 10065449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
We report a neonatal male case of cranial fasciitis in childhood. He was born with a large skull tumor in his left fronto-parietal region. The day after his birth, he was admitted to our hospital. On inspection, the mass was firm, non mobile, and had two humped peaks. The size of the mass was 7 x 5 x 4 cm, and it was located on the left coronal suture and fontanelle. The overlying skin was normal. Skull X-rays revealed osteolytic defect and linear bone remnant skirted the outer rim of the tumor. CT scan showed a slightly high-density large frontal mass with a low density area in the center of it and marked enhancement. MR images revealed a large mass with massive intra- and extracranial extension. Cerebral angiography showed the remarkable vascularization of the tumor. Preoperatively, the branches of the external carotid artery were partly embolized. On surgery, the profusely bleeding, elastic hard, yellowish-white mass arising from the dura was partially removed with the surrounding bone. A small mass remained subdurally. The boundary of the mass and the dura was not well demarcated. After the operation, no neurological deficits were seen. 16 months after the surgery, MRI revealed the unfolded brain with no evidence of tumor. Histological examination showed characteristic proliferation of spindle-shaped fibroblasts embedded in a collagenous stroma. Inflammatory lymphocytes and acidophils were also noted. Electron micrograph revealed a tumor cell rich in rough endoplasmic reticulum and nuclei with numerous indentations. Immunostaining confirmed that these cells were positive for vimentin but negative for smooth muscle actin, GFAP, S-100 protein, and desmin. No recurrence of this tumor has been detected at four years of follow-up.
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Affiliation(s)
- O Noguchi
- Department of Neurosurgery, Kiryu Kohsei General Hospital, Gunma, Japan
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Inoue S, Kuroiwa M, Saraiva MJ, Guimarães A, Kisilevsky R. Ultrastructure of familial amyloid polyneuropathy amyloid fibrils: examination with high-resolution electron microscopy. J Struct Biol 1998; 124:1-12. [PMID: 9931270 DOI: 10.1006/jsbi.1998.4052] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The ultrastructure of familial amyloid polyneuropathy (FAP) amyloid fibrils was examined with high-resolution electron microscopy and immunolabeling. Sural nerve biopsies from FAP (Met 30) patients as well as control tissues were prepared for thin-section observations. Extracellular spaces in the vicinity of myelinated and unmyelinated peripheral nerves were found to be filled with amyloid fibrils as well as with deposits of an "amorphous" material. The fibril was composed of a surface layer and a core. The surface layer was made up of heparan sulfate proteoglycan and was externally associated with a loose assembly of 0.5- to 1-nm-wide filaments. The core was a microfibril-like structure in which amyloid P component was enclosed in a tight helical structure by chondroitin sulfate proteoglycan. Immunogold labeling showed that the peripheral fine filaments were composed of transthyretin. The dimensions of the transthyretin filament suggest that its basic unit is a modified monomer. The deposited amorphous material was a mixture of individual components of the fibril. These results suggest that the main body of FAP amyloid fibrils is similar to that of recently observed fibrils of experimental murine AA and hemodialysis-associated amyloid as well as of connective tissue microfibrils. The differences in the fibrils of these various types of amyloid are in the peripheral filaments which are composed of a protein specific to each type of amyloid.
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Affiliation(s)
- S Inoue
- Department of Anatomy and Cell Biology, McGill University, Montreal, Quebec, H3A 2B2, Canada
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Abstract
BACKGROUND/PURPOSE Prenatally diagnosed cystic lymphangioma (CL) is often associated with chromosomal anomalies, hydrops fetalis, and, in the case of cervical CL, occasionally respiratory distress just after birth. Often it is difficult to treat prenatally diagnosed CL because of the large size and associated symptoms. METHODS Between 1988 and 1997, 11 cases of prenatally diagnosed CL were treated. Five pregnancies were terminated electively and one aborted spontaneously (nondelivered, non-D group), and another five delivered (delivered, D group). Thirteen infants nondiagnosed prenatally were also seen in the same period (prenatally nondiagnosed, without pre-D group). RESULTS In the non-D group, massive CLs were diagnosed by ultrasound scan between 16 and 20 weeks' gestation. They occurred in the head and neck in all six cases, and four had associated pleural effusions or hydrops. In the D group, CL occurred in the face and neck in four cases. Three were born by cesarean section with neonatologists and surgeons standing by, then transferred to our hospital immediately after birth. Respiratory distress appeared in two cases; tracheostomy was carried out in one case. One patient with a huge CL in the chest and abdominal wall necessitated partial resection after OK-432 sclerotherapy. In the without pre-D group, there was CL in the face or neck in 10 cases, abdominal wall in two cases, and chest wall in one case. Respiratory distress was observed in three cases of cervical CL, and tracheostomy was required in two cases. One patient with hypoxic brain damage sequela died of pneumonia afterward. CONCLUSIONS Prenatal diagnosis permits planned delivery, prompt postnatal resuscitation, and improve prognosis. Infants with massive CL diagnosed early in pregnancy have other associated anomalies as well as hydrops fetalis, and a poor outcome or difficult management can be expected.
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Affiliation(s)
- N Suzuki
- Department of Surgery, Gunma Children's Medical Center, Setagun, Japan
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Sawada H, Morimoto H, Wake A, Yamasaki Y, Izumi Y, Kuroiwa M, Osabe S, Imamura Y, Egami K, Tsukamoto A, Sanada I, Kiyokawa T, Kawano F. [Allogeneic peripheral blood stem cell transplantation in 30 patients with hematologic disorders]. Rinsho Ketsueki 1998; 39:1085-91. [PMID: 9866419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Thirty patients (median age of 32 years; range, 6-61) with hematologic disorders received unmanipulated peripheral blood stem cell transplants from HLA-matched or one-antigen-mismatched related donors following myeloablative therapy for acute lymphoblastic leukemia (7), acute myelogenous leukemia (6), chronic myelogenous leukemia (8), myelodysplastic syndrome (3), or other disorders (6). Granulocyte colony stimulating factor (G-CSF) mobilized peripheral blood stem cells were collected from donors in 1 to 3 aphereses. The apheresis products contained mean counts of 11.3 x 10(8) (range, 3.8-17.2) nucleated cells/kg and 6.7 x 10(6) (range, 1.3-16.7) CD34+ cells/kg. Graft-versus-host-disease (GVHD) prophylaxis consisted of cyclosporin A plus methotrexate, or FK506 plus methotrexate. All patients received G-CSF following their transplant. Although 1 patient died of pneumonia 6 days after transplantation, the others demonstrated rapid engraftment. Median days to recovery to 500/microliter neutrophils and 20,000/microliter platelets were 13 (range, 8-21) and 14 (range, 1-23) days, respectively. The incidence of acute GVHD grade II-IV was 33%; chronic GVHD developed in 57% of the assessable patients. There were no episodes of graft failure or rejection. Nineteen patients (63%) were alive and in complete remission from 147 to 839 days following their transplant (median follow-up of 560 days). Further follow-up study will be required to assess the incidence of chronic GVHD and graft-versus-leukemia (GVL) effects.
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Affiliation(s)
- H Sawada
- Department of Internal Medicine, Kokura Memorial Hospital
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Abstract
BACKGROUND Surgical treatment of neuroblastomas, both those detected by screening and those detected clinically, in infants less than 12 months of age, is controversial, because some tumors in this age group potentially have the ability to regress spontaneously. METHODS From January 1985 to March 1997, the authors treated 50 infants (under 1 year of age) with neuroblastoma: 23 boys and 27 girls. Forty-one cases were detected preclinically by screening when the patients were 6 to 11 months of age (median, 7 months), and nine patients were discovered to have clinical manifestations at the age of 1 to 10 months (median, 4 months). RESULTS The tumor was INSS stage 3 or 4 in 10 patients (24%) with screening-detected tumor and in five (56%) with clinically detected tumor, although the difference was not statistically significant. Four screening-positive patients had multifocal primary tumors, and three of them were synchronous bilateral adrenal neuroblastomas. There was no statistically significant difference between the screening-detected tumors and the clinically detected tumors in biological characteristics such as Shimada's histology, DNA ploidy, and N-myc amplification. Complete resection of the primary lesion was accomplished by either primary surgery or second look (delayed primary) surgery in 46 patients (92%), and the resection was incomplete in the remaining four. In patients with bilateral adrenal tumors, the larger one was primarily resected, and the smaller contralateral tumor was enucleated or resected by partial adrenalectomy. Surgical complications included postoperative adhesive ileus (n=2), Horner's syndrome (n=2), renal atrophy (n=1), renal failure (n=1), phrenic nerve injury (n=1), chylous ascites (n=1), chylothorax (n=1) and intussusception (n=1). One patient died of respiratory failure caused by a complication, but 49 patients (98%) were alive at the time of evaluation. CONCLUSION When considering surgical treatment of infants with biologically favorable neuroblastoma, the risk involved in treatment should be weighed against the risk inherent in a tumor capable of spontaneous regression, and aggressive surgery is unacceptable.
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Affiliation(s)
- H Ikeda
- Department of Surgery, Gunma Children's Medical Center, Gunma University Hospital, Japan
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Oshima K, Suzuki N, Ikeda H, Takahashi A, Kuroiwa M, Ohki S, Hatakeyama S, Tsuchida Y, Morishita Y. Infected duodenal duplication with unusual clinical and radiological manifestations: a case report. Pediatr Radiol 1998; 28:518-20. [PMID: 9662572 DOI: 10.1007/s002470050400] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Infected cystic duplication of the duodenum is an unusual lesion. We report a case in which pre-operative MR imaging revealed a huge multicystic mass masquerading as a cystic lymphangioma or mesenteric cyst. The differential diagnosis of this unusual appearance is discussed.
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Affiliation(s)
- K Oshima
- Department of Surgery, Gunma Children's Medical Centre, Gunma, Japan
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