RESUMEN
An additional extremity monitoring using a ring badge must be appropriately conducted for inhomogeneous exposure around radiation workers' extremity. Commercially available glass dosemeters are characterized in terms of Hp(0.07) for the application of additional extremity monitoring. A series of experiments demonstrated that the response of the model GD-352M radiophotoluminescence dosemeter fully matched the IEC's criteria for an extremity dosemeter for medical personnel. Although the model GD-302M has excellent angular dependence, the material and the shape of energy compensation filter still need to be optimized to improve its energy dependence in the range between 30 and 100 keV. The combine use of both types of glass dosemeters for 'paired dosemeter' together with introduction of a simple algorithm may be a promising method to improve the response in the energy range below 20 keV.
Asunto(s)
Extremidades , Personal de Salud , Exposición Profesional , Dosis de Radiación , Monitoreo de Radiación , Humanos , Luminiscencia , Exposición Profesional/análisis , Equipos de Seguridad , Dosímetros de RadiaciónRESUMEN
A 63-year-old female, who had undergone a modified radical mastectomy for breast cancer at the age of 45, was suffered from trachyphonia due to left recurrent nerve paralysis at the age of 53. She presented left phrenic nerve paralysis and dysphagia at the age of 61. Computed tomography (CT) revealed mediastinal fibrosis, stenosis of esophagus and superior vena cava, and slight lymph nodes swelling. Video-assisted thoracoscopic mediastinal biopsy was performed and the mediastinal fibrosis was diagnosed as recurrence of breast cancer 17 years after the breast cancer operation. She underwent mediastinal radiation and chemotherapy for mediastinal recurrence and stenting for esophageal stenosis.
Asunto(s)
Neoplasias de la Mama/cirugía , Carcinoma Ductal de Mama/cirugía , Enfermedades del Mediastino/etiología , Enfermedades del Mediastino/patología , Mediastino/patología , Complicaciones Posoperatorias , Biopsia , Estenosis Esofágica/etiología , Estenosis Esofágica/terapia , Femenino , Fibrosis/etiología , Humanos , Escisión del Ganglio Linfático , Mastectomía Radical Modificada , Persona de Mediana Edad , Stents , Cirugía Torácica Asistida por VideoRESUMEN
In order to investigate the mechanism of anti-rheumatic action of mizoribine (MZR), antiproliferative effect of MZR on synovial fibroblasts obtained from rheumatoid arthritis (RA) patients were examined. To examine the effect of MZR on DNA synthesis, total radioactivity of 3H-thymidine (3H-TdR) incorporated into the synovial fibroblasts was measured. Also quantification of DNA fragmentation of synovial fibroblasts in the cultured supernatant and cell associated Bcl-2 protein, which is suspected of interfering with apoptosis, were performed with enzyme-linked immunosorbent assay. MZR suppressed 3H-TdR incorporation into synovial fibroblasts in a dose dependent fashion. Significant inhibition (P < 0.01) was attained at the concentration of more than 1 microgram/ml of MZR. However, induction of DNA fragmentation which is characteristic of apoptosis, were observed at only 10 micrograms/ml of MZR over 72 h-incubation significantly. In terms of the Bcl-2 expression of synovial fibroblasts, up to 10 micrograms/ml of MZR has no effect on the expression of this protooncogene bcl-2 expression. These results suggest that MZR might suppress the growth of rheumatoid pannus by inhibition of synovial fibroblast proliferation partially through the induction of apoptosis of synovial fibroblast without modulating Bcl-2 expression.
Asunto(s)
Apoptosis/efectos de los fármacos , Artritis Reumatoide/patología , División Celular/efectos de los fármacos , Fibroblastos/patología , Ribonucleósidos/farmacología , Membrana Sinovial/patología , Células Cultivadas , ADN/biosíntesis , Fragmentación del ADN , Relación Dosis-Respuesta a Droga , Humanos , Inmunosupresores/administración & dosificación , Inmunosupresores/farmacología , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , Ribonucleósidos/administración & dosificaciónRESUMEN
Experimental autoimmune encephalomyelitis (EAE) is an animal model for multiple sclerosis in humans. EAE can be passively transferred into naive syngeneic animals by administration of MOG-specific T cell clones. Lymphocytes isolated from green fluorescent protein (GFP)-transgenic (Tg) mice can light up by emitting green fluorescence, thus making it feasible to use such animals in a passive transfer model for EAE. When MOG-sensitized splenic lymphocytes from GFP-Tg mice were adoptively transferred to irradiated, syngeneic C57BL/6 and RAG-1(-/-)mice, typical symptoms of EAE developed. Analysis of the reconstituted mice with EAE revealed prominent infiltration of fluorescing (GFP+), CD4+ T cells into the central nervous system (CNS). Real-time confocal imaging revealed these cells in the spinal cords and brains of recipient mice. This infiltration was also confirmed by anti-GFP monoclonal antibodies. Furthermore, quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) evaluation indicated that the infiltrating GFP+, CD4+ T cells exclusively produced T helper type 1 (Th1) cytokines, especially interferon-gamma (IFN-gamma). These results clearly show that MOG-specific CD4+ T cells preferentially invade into the CNS and mediate the development of EAE by producing Th1-biased cytokines.
Asunto(s)
Encefalomielitis Autoinmune Experimental/inmunología , Encefalomielitis Autoinmune Experimental/patología , Proteínas Luminiscentes/biosíntesis , Activación de Linfocitos/inmunología , Glicoproteína Asociada a Mielina/inmunología , Subgrupos de Linfocitos T/inmunología , Células TH1/inmunología , Traslado Adoptivo , Secuencia de Aminoácidos , Animales , Antígenos de Superficie/química , Antígenos de Superficie/inmunología , Encéfalo/inmunología , Encéfalo/patología , Movimiento Celular/inmunología , Citocinas/biosíntesis , Femenino , Proteínas Fluorescentes Verdes , Proteínas Luminiscentes/inmunología , Ratones , Ratones Endogámicos C57BL , Datos de Secuencia Molecular , Proteínas de la Mielina , Glicoproteína Asociada a Mielina/química , Glicoproteína Mielina-Oligodendrócito , Fragmentos de Péptidos/inmunología , Médula Espinal/inmunología , Médula Espinal/patología , Subgrupos de Linfocitos T/metabolismo , Subgrupos de Linfocitos T/patología , Células TH1/metabolismo , Células TH1/patologíaRESUMEN
A 68-year-old man underwent curative pancreaticoduodenectomy for bile duct cancer. The histological diagnosis was well differentiated, invasive type tubular adenocarcinoma, which was 2 x 2 cm in size and had invaded to the adventitia. Lymph node metastasis was not present. The postoperative course was uneventful, but lymph node and peritoneum metastases were detected 18 months after surgery. Chronochemotherapy of 5-FU (500 mg/body), leucovorin (21 mg/body), mitomycin C (2 mg/body) and cisplatin (80 mg/body) was performed without significant side effects. One course of chronochemotherapy was effective for lymph node and peritoneum metastases. The patient died of peritonitis carcinomatosa 10 months after recurrence.
Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/secundario , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de los Conductos Biliares/tratamiento farmacológico , Neoplasias de los Conductos Biliares/patología , Ganglios Linfáticos/patología , Neoplasias Peritoneales/tratamiento farmacológico , Neoplasias Peritoneales/secundario , Anciano , Cisplatino , Esquema de Medicación , Fluorouracilo , Humanos , Leucovorina , Metástasis Linfática , Masculino , MitomicinaRESUMEN
Nuclear magnetic resonance spectroscopy has detected elevated phosphocholine levels in human tumor tissues and cells, and in cells that were transformed with the activated Ha-ras gene and stimulated in vitro with growth-promoting factors such as platelet-derived growth factor, epidermal growth factor, and phorbol ester. However, the mechanism of the elevation and the function of the increased phosphocholine levels have not been clearly demonstrated. We studied phosphocholine levels enzymatically and analyzed the activity of choline kinase, which catalyzes the phosphorylation of choline to produce phosphocholine, in human colon cancer and adenoma. Both choline kinase activity and phosphocholine levels were increased in colon cancer and adenoma tissue. The activation of choline kinase and the increased levels of choline kinase alpha were partly responsible for the elevated phosphocholine levels. This study suggests that choline kinase might play a role in growth promotion or signal transduction in carcinogenesis.
Asunto(s)
Colina Quinasa/metabolismo , Neoplasias del Colon/metabolismo , Fosforilcolina/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Western Blotting , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isoformas de Proteínas/metabolismoRESUMEN
BACKGROUND/AIMS: Glutaraldehyde-fixed heterologous pericardium has been widely used for grafts in cardiac surgery. We applied it for inferior vena cava (IVC) patch grafting following combined resection of the liver and the IVC. METHODOLOGY: IVC grafting using a glutaraldehyde-fixed horse pericardium following combined resection of the liver and the IVC was performed in 2 patients--one with hepatocellular carcinoma and the other with hepatic metastasis following rectal cancer. The retrohepatic vena cava defect was closed with a 10 x 5 cm patch in one patient and a 7 x 4 cm patch in the other. RESULTS: Hepatic vascular exclusion was avoided in both patients. The IVC exclusion period was 40 min for the first patient and 25 min for the second. One patient required a veno-venous bypass with an active centrifugal pump of 153 min. There was no complication and no graft infection. The microscopic extension to the IVC was evident in one patient, and fibrous adhesive was evident in the IVC wall of the other. One patient died of hepatic failure 3 years and 6 months after surgery, and the other died of hepatic recurrence 7 months after surgery. Both grafts were patent, without calcification and stricture, until the patients' death. CONCLUSIONS: Glutaraldehyde-fixed heterologous pericardium is an option for IVC grafting.
Asunto(s)
Bioprótesis , Implantación de Prótesis Vascular , Carcinoma Hepatocelular/cirugía , Hepatectomía , Neoplasias Hepáticas/cirugía , Neoplasias del Recto/cirugía , Vena Cava Inferior/cirugía , Causas de Muerte , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hepáticas/secundario , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/mortalidadRESUMEN
A 59-year-old woman underwent a radical hysterectomy for a metastatic uterine cervix tumor caused by rectal carcinoma, which had been previously resected. Metastatic carcinoma from the large bowel to the uterus is rare. A total of 48 patients (including nine Japanese patients) with metastasis from the large bowel to the uterus were reviewed. The metastatic site of the uterus was the cervix in 27 cases and the corpus in 18. The interval between primary carcinoma and the secondary diagnosis was 17 months. The mean survival after the diagnosis of the secondary deposit was 11 months. Our patient died of lymph node, lung, local and bone metastases 7 months after the diagnosis of the secondary deposit.
Asunto(s)
Adenocarcinoma/secundario , Neoplasias del Recto/patología , Neoplasias del Cuello Uterino/secundario , Adenocarcinoma/cirugía , Neoplasias Óseas/secundario , Femenino , Humanos , Histerectomía , Neoplasias Hepáticas/secundario , Neoplasias Pulmonares/secundario , Metástasis Linfática , Persona de Mediana Edad , Pronóstico , Neoplasias del Cuello Uterino/cirugíaRESUMEN
Cancer cells acquire particular characteristics that benefit their proliferation. We previously reported that human colon cancers examined had increased choline kinase activity and phosphocholine levels. The elevated phosphocholine levels were in part due to both activation of choline kinase and increased choline kinase alpha protein levels. In this report, we analyzed choline kinase, which catalyzes the phosphorylation of choline to produce phosphocholine, in rat 1,2-dimethylhydrazine (DMH)-induced colon cancer. This study is the first to demonstrate increased choline kinase alpha enzymatic activity, protein levels, and mRNA levels in DMH-induced colon cancer as well as human colon cancer, although phosphocholine was not increased in DMH-induced rat cancer. The increase in the mRNA level was partly due to an increase in the transcription of the choline kinase alpha gene. The increased choline kinase activity may be a specific characteristic acquired by cancer cells that benefits their proliferation.
Asunto(s)
Colina Quinasa/metabolismo , Neoplasias del Colon/inducido químicamente , Neoplasias del Colon/enzimología , 1,2-Dimetilhidrazina , Animales , Carcinógenos , Colina Quinasa/genética , Masculino , ARN Mensajero/análisis , Ratas , Ratas WistarRESUMEN
BACKGROUND: Massive hepatic necrosis from hepatic artery (HA) interruption is a complication after extended pancreatobiliary operation. The effectiveness of a mesenteric arterioportal shunt in preventing liver failure after massive hepatic necrosis was evaluated. METHODS: Of 98 patients who underwent pancreatic or hepatic resection for pancreatobiliary carcinoma between January 1989 and December 1995, six received a mesenteric arterioportal shunt. Clinical and hemodynamic analyses were done retrospectively. RESULTS: The six patients were classified into groups: A, postoperative hepatic arterial occlusion and, B, main HA excision without reconstruction. One patient in group A and three patients in group B had good arterioportal shunt patency and favorable clinical courses. However, fatal hepatic necrosis after ligation of the HA proper occurred in one patient in group A from small portal flow despite a presumed patent shunt. In another patient in group A angiogram revealed shunt occlusion. CONCLUSIONS: A mesenteric arterioportal shunt is beneficial when massive hepatic necrosis has occurred or is expected after main HA interruption under such conditions as postoperative hepatic arterial occlusion or HA excision without reconstruction. The procedure has the advantages of appropriate selection of artery size, a lower abdominal site apart from the primary operative field, and easy shunt closure by transarterial embolization.
Asunto(s)
Derivación Arteriovenosa Quirúrgica , Neoplasias de la Vesícula Biliar/cirugía , Arteria Hepática/cirugía , Neoplasias Hepáticas/cirugía , Arterias Mesentéricas/cirugía , Neoplasias Pancreáticas/cirugía , Vena Porta/cirugía , Anciano , Femenino , Estudios de Seguimiento , Humanos , Hígado/patología , Masculino , Persona de Mediana Edad , Necrosis , Complicaciones Posoperatorias/prevención & controlRESUMEN
The patient was a 73-year-old woman who was admitted to our hospital for epigastric discomfort and body weight loss. She had undergone radical right mastectomy in March 1982. Ultrasonography and computed tomography revealed multiple tumors in the liver. Three of the tumor markers (CA-125, CA 19-9, and CA 15-3) were positive. US-guided fine needle aspiration biopsy of the liver tumor showed small atypical cells with solid cell nests. Immunohistochemical tests revealed estrogen receptor was positive. We diagnosed the patient as recurrent breast cancer metastatic to liver, 14 years postoperatively. The liver tumors were successfully controlled with the combination of intra-arterial infusion chemotherapy (5-fluorouracil, epirubicin, and mitomycin C) along with systemic endocrine therapy (medroxyprogesterone acetate and fadrozole hydrochloride hydrate).
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/patología , Bombas de Infusión Implantables , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Mastectomía Radical , Anciano , Neoplasias de la Mama/cirugía , Epirrubicina/administración & dosificación , Fadrozol/administración & dosificación , Femenino , Fluorouracilo/administración & dosificación , Arteria Hepática , Humanos , Infusiones Intraarteriales , Metástasis Linfática , Medroxiprogesterona/administración & dosificación , Mitomicina/administración & dosificación , Factores de TiempoRESUMEN
It has been reported that the immunosuppressant mizoribine (MZR) inhibits T cell proliferation by depleting intracellular guanine nucleotides via competitive inhibition of inosine 5'-monophosphate (IMP) dehydrogenase in the purine metabolism pathway. This study was performed to determine if the mechanism by which MZR suppresses the proliferation of mouse B cells and antibody production by these cells is dependent on the depletion of intracellular guanine nucleotides. Stimulation of purified splenic B cells of mice with lipopolysaccharide (LPS), a mitogen to B cells, increased both proliferation and antibody production. MZR suppressed both of these functions in a dose-dependent fashion. MZR also caused a decrease in the amount of intracellular guanosine 5'-triphosphate (GTP). When the cultures were grown on plates containing guanosine plus 8-aminoguanosine, the amount of intracellular GTP, which had been reduced by MZR, was restored. Furthermore, the repletion of GTP pools restored both proliferation and antibody production almost to their previous levels. These results suggest that MZR suppresses antibody production and proliferation of B cells by acting directly on B cells. Furthermore, it is suggested that the inhibitory effect of MZR on antibody production, as well as on T cell proliferation, is dependent on the decrease in intracellular guanine nucleotide pools of mouse B cells.
Asunto(s)
Formación de Anticuerpos/efectos de los fármacos , Linfocitos B/efectos de los fármacos , Linfocitos B/inmunología , Guanosina Trifosfato/metabolismo , Inmunosupresores/farmacología , Lipopolisacáridos/toxicidad , Ribonucleósidos/farmacología , Animales , Antiinflamatorios no Esteroideos/farmacología , Formación de Anticuerpos/inmunología , Especificidad de Anticuerpos/efectos de los fármacos , Especificidad de Anticuerpos/inmunología , División Celular/efectos de los fármacos , División Celular/inmunología , Células Cultivadas , Relación Dosis-Respuesta a Droga , Guanosina/análogos & derivados , Guanosina/farmacología , Masculino , Ratones , Ratones Endogámicos ICR , Bazo/citología , Bazo/efectos de los fármacos , Bazo/inmunologíaRESUMEN
T cells play a principal role in cellular immunity and govern the regulatory mechanism in humoral immunity. Therefore, T cells play a key role as either effectors or regulators in the immune network. Mizoribine (MZR), an immunosuppressive agent, suppresses both humoral and cellular immunity by acting on both T cells and B cells. In this study, we examined the effect of MZR on various effector T cell-mediated immune responses in mice. MZR prolonged skin graft survival and suppressed a localized graft-versus-host reaction (GvHR) and sheep red blood cell (SRBC)-induced delayed-type hypersensitivity (DTH) reaction. In a collagen-induced arthritic mice model, MZR reduced the arthritic index and the swelling of the hind limbs. Furthermore, MZR suppressed both bone damage and histopathological changes in the hind limbs. Interestingly, MZR markedly suppressed the DTH reaction to type II collagen (CII) but had no effect on anti-CII antibody levels in this arthritic model. In these models, effector T cells such as cytotoxic T lymphocyte (CTL) and TDTH cell play an important part in the development of these reactions. It is suggested that MZR inhibited these reactions via the inhibition of the effector T cell-mediated immune response. Therefore, it is also suggested that the suppressive effect of MZR on clinical rejection and autoimmune disease is based on its suppression of the effector T cell-mediated immune response, that is cellular immunity, in addition to humoral immunity.
Asunto(s)
Inmunosupresores/farmacología , Ribonucleósidos/farmacología , Linfocitos T Reguladores/inmunología , Animales , Artritis Experimental/inmunología , Artritis Experimental/patología , Colágeno , Eritrocitos/inmunología , Enfermedad Injerto contra Huésped/inmunología , Miembro Posterior/patología , Hipersensibilidad Tardía/inmunología , Inmunidad Celular/efectos de los fármacos , Masculino , Ratones , Ratones Endogámicos , Ovinos/inmunología , Trasplante de Piel/inmunología , Trasplante de Piel/fisiología , Linfocitos T Reguladores/efectos de los fármacosRESUMEN
This study examines the effect of mizoribine (MZR), an immunosuppressant, on collagen-induced arthritis in mice. DBA/1J mice, immunized on days 0 and 21 with 200 micrograms of type II collagen in complete Freund adjuvant, were treated with various doses of MZR for 12 weeks, beginning on the day after the primary immunization. MZR reduced the arthritis score in a dose-dependent fashion, showing significant suppression, even at a dose of 10 mg/kg. At doses of more than 20 mg/kg, MZR also significantly suppressed bone damage in the hind limbs. MZR significantly suppressed the delayed-type hypersensitivity response to type II collagen, but only slightly decreased anti-type II collagen antibody levels. MZR restored the L3T4+/Lyt-2+ ratio, which was increased in arthritic mice, to the level found in normal mice. These findings show that MZR suppresses collagen-induced arthritis and bone damage in mice, and suggest that the inhibitory effect of MZR is based on its suppression of cellular immunity. These results provide a theoretical basis for the clinical use of MZR in rheumatoid arthritis.
Asunto(s)
Artritis/tratamiento farmacológico , Colágeno/farmacología , Inmunosupresores/farmacología , Ribonucleósidos/farmacología , Animales , Modelos Animales de Enfermedad , Relación Dosis-Respuesta a Droga , Masculino , Ratones , Ratones Endogámicos DBA , Factores de TiempoRESUMEN
Postoperative hepatic failure was treated by plasma adsorption (PA) to charcoal and ion-exchange resin in five patients suffering from pancreatic or biliary carcinoma that was not accompanied by liver cirrhosis. Four of these patients recovered completely from the hepatic failure, while the fifth patient recovered sufficiently to be taken off the treatment for three weeks. Reactions in platelet counts and circulatory system during and after the PA treatment were minimal in all these patients. PA proved to be an effective liver support system for treating non-cirrhotic patients with postoperative hepatic failure.
Asunto(s)
Carbón Orgánico , Procedimientos Quirúrgicos del Sistema Digestivo , Resinas de Intercambio Iónico , Fallo Hepático/terapia , Plasma , Complicaciones Posoperatorias/terapia , Adsorción , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Propiedades de SuperficieRESUMEN
5'-Phosphatidyl-5-fluorouridines, with the same backbone structure as that of natural phospholipids, in which a polar-head group of usual phospholipids is replaced by 5-fluorouridine, were designed to be potent antitumor agents. 5'-Phosphatidyl-5-fluorouridines with a variety of diacyl or dialkyl residues in the glycerol moiety, were synthesized by phospholipase D-catalyzed transphosphatidylation from the corresponding phosphatidylcholine and 5-fluorouridine. These new compounds were evaluated in mice with experimental tumors by ip and po administration. Dipalmitoyl and distearoyl derivatives 1b and 1c had the greatest antitumor activity against both P388 leukemia and Meth A fibrosarcoma in mice.
Asunto(s)
Antineoplásicos/síntesis química , Ácidos Fosfatidicos/síntesis química , Fosfolipasa D/metabolismo , Uridina/análogos & derivados , Uridina/síntesis química , Animales , Antineoplásicos/química , Antineoplásicos/farmacología , Fibrosarcoma/tratamiento farmacológico , Leucemia P388/tratamiento farmacológico , Espectroscopía de Resonancia Magnética , Ratones , Trasplante de Neoplasias , Ácidos Fosfatidicos/química , Ácidos Fosfatidicos/farmacología , Relación Estructura-Actividad , Células Tumorales Cultivadas , Uridina/química , Uridina/farmacologíaRESUMEN
The antitumor activity of a nucleotide derivative, 5'-(1,2-dipalmitoyl-sn-glycero-3-phospho)-5-fluorouridine (TJ14026), was confirmed following both intraperitoneal and oral administration against a number of murine experimental tumor systems in vivo, which included Meth A fibrosarcoma, B16 melanoma, 5-fluorouracil (5-FU) resistant P388 leukemia, P815 mastocytoma and L5178Y-ML lymphoma. Successive i.p. injections of a small dose (10 mg/kg/d x 10) or intermittent i.p. injections of a larger dose (50 mg/kg/d x 3) were equally effective against the solid form of Meth A fibrosarcoma. Intraperitoneal injection of TJ14026 prolonged the life of mice with 5-FU resistant P388 leukemia. Oral administration of TJ14026 was also effective against P815 mastocytoma and L-5178Y-ML lymphoma in the liver, an P388 leukemia metastasized to the lymph nodes. Glutamate oxaloacetate transaminase (GOT) and glutamate pyruvate transaminase (GPT) levels were elevated in the serum of un-treated mice bearing P815 mastocytoma but not in mice treated with TJ14026.
Asunto(s)
Antineoplásicos/uso terapéutico , Diglicéridos/uso terapéutico , Neoplasias Experimentales/tratamiento farmacológico , Nucleótidos de Uracilo/uso terapéutico , Administración Oral , Alanina Transaminasa/sangre , Animales , Antineoplásicos/administración & dosificación , Aspartato Aminotransferasas/sangre , Diglicéridos/administración & dosificación , Resistencia a Medicamentos , Inyecciones Intraperitoneales , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/secundario , Neoplasias Hepáticas Experimentales/tratamiento farmacológico , Neoplasias Hepáticas Experimentales/secundario , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos , Trasplante de Neoplasias , Neoplasias Experimentales/patología , Nucleótidos de Uracilo/administración & dosificaciónRESUMEN
Examination by thoracoscopy, using flexible fiberoptic bronchoscope, was performed in 43 patients with pleural effusion according to our reported method. In these patients, 14 cases were diagnosed as tuberculous pleuritis. These 14 cases were investigated with respect to clinical and thoracoscopic findings. Their mean age was 38.1 years, and 11 cases were younger than 50 years old (78.5%). The male:female ratio was 2/1. Clinical symptoms recognised were fever (100%), cough (64.2%), chest oppression (50%) and sputum (35.7%). In 5 cases, gastrointestinal symptoms were recognized such as vomiting, abdominal pain, and diarrhea. Tuberculin reaction was positive in all patients with tuberculous pleuritis on admission. With respect to the thoracoscopic findings of tuberculous pleuritis, yellow-white miliary granulomas were observed on the parietal pleura in 12 cases (85.7%), and this characteristic finding was especially observed at the apex. Biopsy specimens, obtained from these miliary granulomas on the parietal pleura showed histological findings of tubercles. In the other 2 cases, generalized reddening of the entire parietal pleura was observed, with no yellow-white miliary granulomas. Biopsy specimens obtained from the reddened lesions on the parietal pleura showed histological findings of tubercles, and these 2 cases were also diagnosed as tuberculous pleuritis. These results indicate that this method may be very useful for the diagnosis of tuberculous pleuritis in patients with pleural effusion.
Asunto(s)
Broncoscopía , Toracoscopía , Tuberculosis Pleural/diagnóstico , Adolescente , Adulto , Anciano , Femenino , Tecnología de Fibra Óptica , Humanos , Masculino , Persona de Mediana Edad , Derrame Pleural/diagnósticoRESUMEN
Massive liver necrosis, which is a severe and highly fatal complication after extended pancreatobiliary surgery, may occur due to an interruption of the hepatic arterial flow caused by such events as an excision of the hepatic artery invaded by cancer, a ligation of the postoperatively ruptured hepatic artery, or a thrombotic obstruction of the reconstructed hepatic artery. In order to improve this ischemic state of the liver, we have performed a partial arterialization of the portal vein by making an arteriovenous shunt at the mesenteric vascular branches in two cases. Although a sufficient pathophysiological investigation could not be fully conducted, partial portal arterialization was considered to be effective in one patient, while no clinically noticeable adverse effects were revealed in the other patient.
Asunto(s)
Derivación Arteriovenosa Quirúrgica , Arteria Hepática/cirugía , Hígado/patología , Pancreatectomía , Complicaciones Posoperatorias/prevención & control , Humanos , Masculino , Arterias Mesentéricas/cirugía , Venas Mesentéricas/cirugía , Persona de Mediana Edad , Necrosis/etiología , Necrosis/prevención & control , Vena Porta/cirugíaRESUMEN
We investigated the effect of liposome-r-h-SOD on the lung injury induced by Forssman antiserum in guinea pigs. Intravenous injection of Forssman antiserum produced a biphasic increase in pulmonary resistance in guinea pigs. Liposome-r-h-SOD blocked this biphasic increase in a dose-dependent manner. Exudate and hemorrhage in the alveolar spaces and connective tissues were blocked by liposome-r-h-SOD. Liposome-r-h-SOD was more effective when it was injected 30 min prior to challenge than 5 min prior to challenge. On the other hand, free r-h-SOD or a mixture of free r-h-SOD and empty liposome did not block the lung injury. SOD activity in porcine endothelial cells cultured with liposome-r-h-SOD increased in a dose-dependent and time-dependent manner, while it did not increase with free r-h-SOD. Exogenous SOD was detected by immunoperoxidase staining in endothelial cells of arterioles and capillaries and in alveolar epithelial cells of the lung of guinea pigs injected with liposome-r-h-SOD. These findings suggest that superoxide radical may take part in the lung injury induced by Forssman antiserum. Liposome-r-h-SOD, which adheres to and/or is endocytosed by endothelial cells, may protect the lung from oxygen radicals.