MIZUTANI, N., OKADA, S., TANAKA, J., MINEMATU, S., TOBE, T., MIDORIKAWA, O. and KANOH, T. Multicentric Giant Lymph Node Hyperplasia with Ascites and Double Cancers, An Autopsy Case. Tohoku J. Exp. Med., 1989, 158 (1), 1-7-A 70-year-old man, diagnosed to have multicentric giant lymph node hyperplasia (MGLNH) of the plasma cell type by postmortem examination, had double cancers of the thyroid and kidney, as well as a large amount of ascites and persistent serositis. Serum immunoelectrophoresis showed monoclonal IgG (lambda). Using the paired immunofluorescent technique, monoclonal plasma cell proliferation was observed on the section of a lymph node. The cause of the ascites was speculated to be the combined influence of peritonitis, renal dysfunction and obstruction of abdominal lymphatic ducts. Occurrence of double cancers and persistent peritonitis suggest the long-standing faulty immune regulation in MGLNH.
NAKAMURA, R., MOJICA, J.A.P., YAMADA, Y, and YOKOCHI, F. Loss of Reaction Time Specificity for Movement Direction in Parkinson's Disease. Tohoku J. Exp. Med., 1989, 158 (1), 9-16-Electromyographic (EMG) reaction times (RTs) of the right biceps brachii muscle and its integrated EMG (iEMG) from the onset until 50msec after the start of activities for elbow flexion and forearm supination in the condition with or without warning signal were examined in seven patients with Parkinson's disease and seven age- and sex-matched normal subjects. In the control group RT of forearm supination with warning tended to be faster than that of elbow flexion and the reverse occurred without warning, and iEMG of forearm supination were significantly small compared to those of elbow flexion in each condition. In the Parkinson group both RT and iEMG of elbow flexion were nearly the same as that of forearm supination regardless the presence or absence of warning signal, indicating the loss of RT and iEMG specificity for the two direction of movement in Parkinson's disease.
KAWAMURA, S., MIKAMI, T., SAWADA, Y., CHIBA, Y. and YOSHIDA, Y. An Eight Year Experience with Gradually Longer Interval Postremission Therapy for Adults with Acute Leukemia. Tohoku J. Exp. Med., 1989, 158 (1), 17-24-Between January 1980 and March 1983, a study was conducted into the effects of postremission therapy on 20 patients with acute leukemia who had achieved complete remission through induction therapy. Postremission therapy consisted of cyclic administration of six combination therapies given at gradually longer intervals. Postremission therapy used RCMP (D, daunorubicin; C, cytosine arabinoside; M, 6-mercaptopurine; P, prednisolone), DCyMP (Cy, cyclocytidine), DCVP (V, vincristine), BHAC-DMP (BHAC, behenoyl-ara-c), BHAC-AMP (A, aclarubicin) and ACM-MP (ACM, aclacinomycin). Six combinations were given sequentially starting at one month interval, and then at 2, 3, 4, 5 and eventually 6 month intervals until 5 year survival was reached. The median remission duration was 38 months for acute myelogenous leukemia (AML), and 17 months for acute lymphoblastic leukemia (ALL). The median survival was 66 months for AML, and 33 months for ALL. The survival rate at 5 years was 60% for AML., 40% for ALL, and 50% in all 20 patients. Methotrexate and prednisolone were administrered intrathecally for prophylaxis of CNS leukemia on Day 4 of each stage of postremission therapy. There was no CNS leukemia. This postremission therapy was shown to be effective in improving the prognosis of adults with acute leukemia.
MORI, K., SAKAI, H., SUZUKI, S., SUGAI, K., AKUTSU, Y., ISHIKAWA, M., SEINO, Y., ISHIDA, N., UCHIDA, T., KARIYONE, S., ENDO, Y. and MIURA, A. Effects of Glycyrrhizin (SNMC: Stronger Neo-Minophagen C®) in Hemophilia Patients with HIV Infection. Tohoku J. Exp. Med., 1989, 158 (1), 25-35 - Glycyrrhizin (GL) not only has an inhibitory effect on HIV replication but also exhibits interferon-inducing and natural killer (NK)-enhancing effects and improves liver dysfunction. Thus, large doses of GL (200-800mg day) were intravenously administered for more than 8 weeks to 9 hemophilia A patients with HIV infection (asymptomatic carrier, AC). Lymphocyte count increased in all 9 cases. OKT4/ OKT8 ratio was elevated in 6 out of the 9 cases and OKT4-positive lymphocytes increased in 8 out of the 9 cases; 66.7% and 88.9% improvement, respectively. Changes in NK cell activity and mitogenic responsiveness to PHA, Con A and PWM were not significant. Liver dysfunction, noted in 4 cases, clearly improved. Serum electrolytes, protein, lipids, and renal function were within normal levels and no serious side-effects were observed during treatment. On the other hand, in 3 cases of hemophilia without HIV infection, the number of OKT4 lymphocytes was not significantly altered during treatment. From these results, large dose administration of GL to HIV-positive hemophilia patients (AC) seems to be effective in preventing development of AC into AIDS by raising the number of decreased OKT4 lymphocytes and improving liver dysfunction.
OKAYAMA, H., OKAYAMA, M., ISHII, M., SASAKI, H. and TAKISHIMA, T. Effect of Duration of Vagal Stimulation on Shortening Velocity of In Vivo Canine Trachealis Muscle. Tohoku J. Exp. Med., 1989, 158 (1), 37-46 - We studied shortening velocity of in vivo canine trachealis muscle contracted by bilateral vagus nerve stimulation, as a function of duration of contraction. The cervical trachea was transected at two locations, cut at the ventral portion, and opened. One side of the cartilage cut was connected to a force transducer and the other to a lever with a given weight as an afterload, the length of which was measured by a linear displacement transducer. Bilateral vagosympathetic trunks were stimulated by supramaximal electrical impulses. With vagal stimulation, the trachealis muscle started to contract isometrically and at a given time the muscle was allowed to contract isotonically by unlocking a stopper at a given afterload. The shortening velocity was reduced with longer duration of active state. Ten sec after vagal stimulation the maximum force was 730±105g/cm2 (mean±S.D.) and maximum velocity at zero load calculated by Hill's equation was 0.092 l0 /sec. We conclude that the force-velocity relationship of in vivo canine trachealis muscle stimulated by vagus nerves exhibits a time-dependency similar to that in vitro.
TAKEUCHI, K., ABE, K., YASUJIMA, M., SATO, M., KANAZAWA, M. and YOSHINAGA, K. The Effect of Atrial Natriuretic Peptide on Cytosolic FreeCalcium in Cultured Vascular Smooth Muscle Cells. Tohoku J. Exp. Med., 1989, 158 (1), 47-56 - Effect of atrial natriuretic peptide (ANP) on cytosolic free calcium ([Ca2+]i) was studied in monolayers of cultured vascular smooth muscle (VSM) cells loaded with a fluorescent calcium indicator, fura-2. Vasoconstrictive hormones, angiotensin II (AII) and Arg8-vasopressin (AVP) induced initial rapid rises in [Ca2+]i, followed by sustained elevation of [Ca2+]i. ANP (Atriopeptin III 10-8M) decreased both the resting level and the sustained elevation of [Ca2+] i induced by AII and AVP. ANP also decreased the rise in [Ca2+]i induced by high potassium (K+) depolarization. AVP-induced initial rapid rise in [Ca2+]i was not inhibited by ANP in the presence or absence of the phosphodiesterase inhibitor, isobutylmethylxanthine 0.1mM, which has been shown to fully enhance ANP-induced cyclic GMP accumulation. On the other hand, a calcium antagonist, nicardipine, inhibited the high K+-induced rise in [Ca2+]i, whereas it had no effect on not only initial but also sustained rises in [Ca2+]i induced by AVP or AII. These results suggest that ANP has an ability to decrease [Ca2+]i not through inhibition of voltage-sensitive calcium channels, and that neither ANP nor ANP-induced cyclic GMP may affect initial hormone-induced rise in [Ca2+]i. In conclusion, an ability to decrease [Ca2+]i is implicated in ANP-induced relaxation of VSM.
IKEDA, M., NAKATSUKA, H., WATANABE, T., HISAMICHI, S., SHIMIZU, H., FUJISAKU, S., ICHINOWATARI, Y., KONNO, J., KURODA, S., HIRAI, J., IDA, Y., SUDA, S. and KATO, K. Urban-Rural Difference in the Acceptance of Mass HealthExamination in North-Eastern Japan. Tohoku J. Exp. Med., 1989, 158 (1), 57-72 - Over 40000 residents (≤40 years of age) in a city (Sendai; the city group), a town (Shiroishi; the town group) and two villages (Wakuya and Tajiri; the village group) in Miyagi prefecture in north-eastern Japan responded in a questionnaire survey on their attitude towards mass health examinations (i.e., whether they underwent in the previous year and if so where) on 4 items of blood pressure measurement, chest x-ray examination and screening tests for stomach and cervical cancer. The coverage rates were about 70% on an average both for blood pressure measurement and for chest x-ray examination, whereas the rates for cancer screening were between 30-40%. As for the opportunity of the former two examinations, the workplace mass examination played a large role in the case of the city and town groups (especially among men but not women) in addition to visit to clinics, in contrast to the case of the village group in which people depended much on regional mass examination service. The trend was essentially reproducible in stomach cancer screening although the over-all coverage rate was low, whereas women in the three groups almost exclusively utilized clinics for cervical cancer screening with one exception that the mobile unit service appeared to be equally accepted in the village group.
SUGAI, Y. and OKAMOTO, H. State of Hepatitis B Virus DNA in PeripheralBlood Mononuclear Cells from Persistently Infected Individuals: Correlation withe Antigen and Viral DNA in the Serum as Well as with the Activity of Liver Disease. Tohoku J. Exp., Med., 1989, 158 (1), 73-84 - Peripheral blood mononuclear cells (PBMC) were harvested from 76 asymptomatic carriers of hepatitis B virus (HBV) and 100 patients with type B chronic liver disease. DNA was extracted from cells and tested for the binding with radiolabeled HBV DNA probe by Southern blot hybridization technique. Among 34 asymptomatic carriers who had hepatitis B e antigen (HBeAg) and HBV DNA in the serum, HBV DNA was detected in 29 (85%) PBMC. In remarkable contrast, of the remaining 42 carriers seronegative for HBeAg, only 1(2%) had HBV DNA in the serum, and none exhibited HBV DNA in PBMC. Among 32 patients seropositive for HBeAg, HBV DNA was detected in 28 (88%) sera, and in 24 (75%) PBMC. Of 68 patients seronegative for HBeAg, HBV DNA was found in 10 (15%) sera, and in 7 (10%) PBMC. Among 62 cases with HBV DNA in PBMC, only 1 had it integrated into the host's DNA. The remaining 61 had free HBV DNA in PBMC. Only 8 of them possessed replicative intermediate forms of HBV DNA, with molecular sizes less than 2.0 kilobases as observed in liver infected with HBV, and they all were patients with chronic active hepatitis. HBV DNA was not detectable in PBMC from 172 controls comprising 44 healthy individuals and 128 patients with non-A, non-B hepatitis. Based on these results, the state of HBV DNA in PBMC reflects the phase of HBV infection with HBeAg in the serum, and a high activity of hepatitis accompanied by active HBV replication.
YASUJIMA, M., ABE, K., KANAZAWA, M., YOSHIDA, K., KOHZUKI, M., SATO, M., TAKEUCHI, K., OMATA, K., TSUNODA, K., KUDO, K., OTA, K., KIMURA, T. and YOSHINAGA, K. Effects of Antihypertensive Drugs on Renal Function and AtrialNatriuretic Polypeptide in Spontaneously Hypertensive Rats with Renal Ablation. Tohoku J. Exp. Med., 1989, 158 (1), 85-94 - To determine whether pharmacological control of blood pressure could affect the renal function and levels of atrial natriuretic polypeptide (ANP) in spontaneously hypertensive rats (SHR) with renal ablation, and to ascertain the benefits of antihypertensive drugs, we studied effects of oral administration of captopril (50mg/kg/day), an inhibitor of angiotensin converting enzyme, benidipine (3mg/kg/day) and nilvadipine (10 mg/kg/day), newly developed blockers of calcium channel, and indapamide (10 mg/kg/day) for 14 days on systolic blood pressure, serum creatrnine, blood urea nitrogen, and plasma ANP concentration in SHR subjected to surgical removal of the left kidney and infarction of two-thirds of the right kidney (5/6 nephrectomy) a week before. Three weeks after the surgery, systolic blood pressure (mmHg) in the untreated group was 253±9 (n=10), in the captopril group 156±9 (n=7, p< 0.05), in the benidipine group 197±9 (n=7, p<0.05), in the nilvadipine group 146±9 (n=7, p<0.05) and in the indapamide group 206±5 (n=7, p<0.05). Serum creatinine (mg/100ml) was lower in the captopril group (0.58±0.02, n=7, p<0.05) and in the benidipine group (0.50±0.03, n=7, p<0.05) but not in the nilvadipine group and in the indapamide group 3 weeks after 5/6 nephrectomy compared to the untreated group. Blood urea nitrogen was also lower in the captopril group and in the benidipine group but not in the nilvadipine group and in the indapamide group. Plasma ANP concentration was significantly reduced by the treatment with captopril and benidipine but not with nilvadipine and indapamide. These results suggest that the reduction of blood pressure by the inhibition of angiotensin converting enzyme with captopril has the potential to ameliorate renal function of the SHR with remnant kidney, a model of chronic renal failure with hypertension, associated with the decreased concentration of plasma ANP. However, it remains to be determined whether the reduction of blood pressure by calcium channel blockers may be involved in the delayed progression of renal failure in this model since there were disparate effects on renal function and plasma ANP concentration with these two calcium channel blockers.
SAITO, H. and YANAGISAWA, T. Acute Cerebellar Ataxia after InfluenzaVaccination with Recurrence and Marked Cerebellar Atrophy. Tohoku J. Exp. Med., 1989, 158 (1), 95-103 - A 5-year-old, previously healthy girl developed symptoms and signs of acute cerebellar ataxia (ACA) 8 days after having received an influenza vaccination. Brain CT was normal, but the CSF showed moderate pleocytosis. Symptoms almost disappeared within 4 months. Thirty-three months later, cerebellar symptoms recurred without apparent preceding episode, and persisted. Sixteen months after the recurrence of ataxia, CT and MRI revealed marked cerebellar atrophy. No further augmentation of ataxia or of cerebellar atrophy was abserved during following 30 months. The patient appears to be the first documented case of ACA with recurrence of ataxia and severe atrophy of the cerebellum, though the etiology and pathogenesis are still to be determined. Clinical pictures and the course of the patient were compared with follow-up data on 8 cases of ACA.
KATSUMATA, U., SEKIZAWA, K., INOUE, H., SASAKI, H. and TAKISHIMA, T. Inhibitory Actions of Procaterol, a Beta-2 Stimulant, on Substance P-InducedCough in Normal Subjects during Upper Respiratory Tract Infection. Tohoku J. Exp. Med., 1989, 158 (1), 105-106 - We studied substance P (SP)-induced cough in normal subjects without and with colds, and the effects of orally administered procaterol on SP-induced cough in normal subjects with colds. SP aerosols caused cough at a concentration of approximately 10-15M in subjects with colds whereas it did not cause cough at a concentration of up to 10-5M in subjects without colds. Procaterol (50μg) completely inhibited SP-induced cough in normal subjects with colds. These results suggest that cough response to SP remarkably increases during colds and that beta-2 stimulant may be a useful tool for treatment of cough during colds in normal subjects