Background and Aims : Complete surgical resection of glioma is difficult due to its characteristic infiltrative proliferation. However, as the extent of resection directly affects the prognosis of the disease, we evaluated a fluorescent technique using 5-aminolevulinic acid (ALA), an intrinsic precursor of Hem, for accurate intraoperative distinction of tumor cells from normal brain tissues. Methods : We performed intraoperative fluorescent tumor detection after administration of ALA using ALA-induced protoporphyrin IX (PpIX) as a guide in 11 patients who were preoperatively suspected to have glioma, starting in November, 2001. The extent of removal of the tumor was evaluated using contrast-enhanced MRI, and the localization ALA-induced PpIX in the resected tissues was analyzed histopathologically. Results : Tumor tissues could be identified in 9 of the 11 patients, including subcortical areas invaded by the tumor, and the findings were useful in their resection. ALA-induced PpIX was localized in the cytoplasm of tumor cells, with no uptake being noted in normal tissue. Conclusions : Intraoperative fluorescent tumor detection using 5-ALA was useful for increasing tumor resection, and can be performed as a useful diagnostic tool for resection of brain tumors.
Background and Aims : A diagnostic feature of chronic myelogenous leukemia (CML) is the presence of BCR/ABL fusion genes. There are two types BCR/ABL transcripts : CML-and acute lymphoblastic leukemia (ALL) -types. ALL-type BCR/ABL transcript is detectable in approximately 50% of CML patients, and its abundance is generally less than that of CML-type BCR/ABL. However, the exact stoichiometry has not been established. In this report, we sought to quantify these two types of BCR/ ABL transcripts in patients with CML in chronic phase (CP) by highly sensitive quantitative PCR methods. Methods : We examined two types of the BCR/ABL transcripts in seven patients with CML in chronic phase using reverse transcription and real-time quantitative polymerase chain reaction (RQ-PCR). The BCR/ABL expression was normalized to the expression of GAPDH. Results : In 5 out of 7 patients, ALL-type BCR/ABL could be detected. The ratio of CML-type BCR/ABL to GAPDH ranged from 4.94 × 10-3 to 81.8 × 10-3, and that of ALL-type to GAPDH ranged from 0.15 × 10-3 to 0.85 × 10-3. Thus, ALL-type transcript levels ranged from 1.3 to 54.3% of the CML-type levels. Conclusions : In CML patients, expression of ALL-type BCR/ABL was 1 to 2 orders of magnitude lower than expression of CML-type BCR/ABL..
Background & Aims : A new DNA polymerase activity (temporally designated-C) isolated from a rapidly growing apical tissue of cauliflower (Brassica oleracea var. botrytis) inflorescence has been characterized and compared with cauliflower DNA polymerases, -A and-B, and with DNA polymerases α, β and γ from mouse myeloma. Methods : Enzyme activity was determined in vitro by measuring the incorporation of [3H] dTMP into the DNA polymer under a variety of conditions (inhibitor : NEM, ddTTP, template-primer utilities and so on). Results : DNA polymerase-C from cauliflower had distinct elution pattern discriminated from these of polymerase-A and-B. Poly (rA) (dT) 10 was utilized as template effectively for polymerase-C, but no significant utilization of polymerase-A was observed. Polymerase-C was sensitive to NEM and was resistant to ddTTP. Conclusions : These results strongly indicate that DNA polymerase-C from cauliflower is to be a new enzyme for DNA synthesis in cauliflower.
Background & Aims : We retrospectively examined the incidence of duodenal ulcers (DU) among children in Gunma prefecture over the past two decades, from 1980 to 1999, by data from Gunma University Hospital and its subsidiary hospitals, in order to test the hypothesis that the incidence of DU among children in Japan is decreasing. Method : By our own experience and by the interview to doctors in 23 major hospitals in Gunma prefecture. In addition, to study trends in the prevalence of anti-Helicobacter pylori (HP) infection, we measured anti-HP Ig-G antibody in the serum from children who come to the Department of Pediatrics, Gunma University Hospital during the same period with a complaint because of low body height for a growth hormone secretion stimulating test. Result : We identified 48 children with DU in 1980-1989 and 16 children in 1990-1999. The prevalence of HP antibody showed a declining trend from the 1980s to the 1990s, but there was not a statistically significant difference. Conclusions : The incidence of DU among children in Gunma prefecture is declining recently. Further study is needed to determine whether this is due to the decline in HP infection or not.
Backgrounds & Aims : In daily practice, we have sometimes encountered patients with both Oketsu syndrome and livid telangiectasis on the colon mucosa detected by colonoscopy. The object of this study was to examine the relationship between livid telangiectasis on the colon mucosa and abdominal Kampo diagnosis. Methods : We enrolled consecutive 30 patients with various diseases who underwent total colonoscopy in our department. Clinical characteristics including age, sex, colon adenoma, hemorrhoids and livid telangiectasis on the colon mucosa were examined in each patient. After colonoscopy, abdominal Kampo diagnosis was determined in each patient based on medical records. Results : About half of telangiectasis-negative patients did not have the symptom of “resistance or tenderness on pressure of the para-umbilical region”, whereas all telangiectasis-positive patients had this symptom (p = 0.017). Colon polyps were observed more frequently in telangiectasis-positive patients than in telangiectasis-negative patients (p = 0.029). Conclusions : Livid telangiectasis on the colon mucosa may be related to “resistance or tenderness on pressure of the para-umbilical region” and Oketsu syndrome. Understanding of telangiectasis of the colon mucosa and Oketsu syndrome may contribute to the care of people's health. (173 words)
Aims and Methods : To clarify the difference of liver disease in Egypt and Japan, we analyzed fifty-seven patients with liver disease in Alexandria Armed Forces Hospital and compared with Japanese patients. All the patients were native Egyptian and already seen by another doctors in Egypt then introduced to us to obtain the second opinion. Results : Fifty-seven including 45 male and 12 female patients came to see us in the outpatient department of Alexandria Armed Forces Hospital. Mean age was 48.9 in male and 40.4 in female. Thirty-seven (82.2%) of male and 10 (83.3%) in female had anti-HCV. Fifteen of 45 male (33.3%) and 2 of 12 (16.7%) female had positive anti-Schistosomiasis antibody. All 17 patients having anti-Schistosomiasis had anti-HCV antibody including 10 Liver cirrhosis, 6 chronic hepatitis and one hepatocellular carcinoma. Mean age of patients of liver cirrhosis with co-infection with Schistosoma and HCV was 51.4 years old which is younger than those with Japan (62.5 years old, personal data). Ten anti-HCV-Ab negative patients included one Gilbert syndrome, 2 patients with autoimmune hepatitis, 3 with HBV carrier in which one patient recovered from hepatitis A and the other had fascioliasis co-infection, 2 of hepatitis A and one of each patient with liver cirrhosis and obstructive jaundice. Conclusion : Many Egyptian patients with liver disease were infected with both HCV and Schistosomiasis. Co-infection or previous infection of schistosomiasis could be a factor of progression of hepatitis C but the progression to hepatocellular carcinoma in the same situation was controversial.
Background : The Japanese Society for Pediatric Asthma proposed a scoring system for the intensity of treatment in its guidelines for bronchial asthma published in 1998. To characterize the scoring system, we analyzed what factors had an effect on the treatment point in asthma patients, and whether the scoring system was useful for evaluation of asthma severity. Methods : We enrolled 125 children (77 boys and 48 girls, mean age± S.D. : 7.6 ± 3.4 years old) with bronchial asthma who visited our asthma clinic throughout a year (1999). We calculated the treatment points by reviewing the diary in which symptoms and treatments in each subject were recorded by his/her parents through a year. Results : Either age, gender, or type of asthma had no significant effect on either the maximum (p = 0.89) or the minimum (p = 0.15) values of the treatment point with in the study year. The component of the treatment points depended on the asthma severity. The greatest component of the maximum treatment point was the use of oral theophylline in patients with mild and moderate asthma-severity (35.7% and 26.0% of total point, respectively) whereas intravenous theophylline in patients with severe asthma. Significant determinants of maximum treatment point were the asthma severity in the preceding year (1998), that in the study year (1999) and minimum treatment point. Conclusions : Proper use of the treatment point might help physicians to provide better medical treatment in each patient.
Background & Aims : CXC chemokine receptor 3 (CXCR3) appears to serve as a useful marker for the identification of circulating type 1 T helper cells (Th1), whereas CC chemokine receptor 4 (CCR4) is a useful marker for circulating Th2 cells. Suplatast tosilate (IPD) is a Th2 cytokine inhibitor that decreases IgE antibody levels through specific inhibition of interleukin-4 (IL-4) and IL-5 production by T cells. We examined the effects of IPD on CXCR3-or CCR4-positive cells among CD4 and CD45RO double-positive T cells (CD4-positive memory T cells) in patients with asthma. Methods : We analyzed the T cell subsets of 10 patients with stable mild asthma before and after 4 weeks of treatment with IPD (300mg/day) in a prospective single-arm study. Results : The number of CXCR3-positive and CCR4-positive memory T cells was measured by flow cytometry. There was no significant increase of CXCR3-positive T cells in the asthma patients, but the patients showed a decrease of CCR4-positive T cells and an increase in the ratio of CXCR3-positive to CCR4-positive T cells. Conclusions : These findings indicate that IPD therapy altered the balance between CXCR3-and CCR4-positive cells in patients with asthma.
Background & Aims : Human Toll-like receptor 1 (TLR1) is a receptor which mediated immune response to microbial lipoproteins, associates with TLR2 and recognizes the native mycobacterial lipoprotein along with TLR2. Methods : We examined the regulation of TLR1 surface expression in human peripheral blood monocytes and B cells by interferon-γ (IFN-γ) and interleukin-4 (IL-4). Results : IFN-γ up-regulated TLR1 surface expression on human peripheral blood monocytes and B cells. By contrast, IL-4 down-regulated TLR1 surface expression on human peripheral blood monocytes, but up-regulated TLR1 surface expression on human peripheral B cells. Conclusions : These results indicate that Th 1 cytokine IFN-γ enhances receptors involved in the response to native mycobacterial lipoprotein and that activation of cellular immunity may enhance defense against mycobacterium through both monocytes and B cells, whereas Th2 cytokine IL-4 modulates the receptor response to native mycobacterial lipoprotein and that activation of humoral immunity may enhance defense against mycobacterium through B cells, but not monocytes.