KITAOKA, H. and ITOH, H. Computer Assisted Three-Dimensional Volumetryof the Human Pulmonary Acini. Tohoku J. Exp. Med., 1992, 167 (1), 1-12- Computer-aided three-dimensional (3-D) volumetry of human pulmonary acini was undertaken using the left upper lobe of a 51-year-old female operated for small lung cancer. A normal part of this lobe, fixed by intrabronchial infusion with a mixture of polyethylene glycol and formalin, was subjected to serial sectioning, using a special slicer, into 48 serial slices of 0.5mm in thickness. A soft x-ray radiograph was prepared from each slice at ×12, and the contours of airways and acinar boundaries contained in it were inputted by digitization into a microcomputer for 3-D reconstruction and volumetry. The estimated volumes of 130 acini were unexpectedly uniform, showing a normal type distribution with a mean of 172.7±37.9mm3. No significant correlation proved to exist between the volume of acini and the number of branching generation of the terminal bronchioles (TBs) they received. Furthermore, there was no significant difference in volume among the acini facing the costal surface, those facing the mediastinal surface and those not facing any pleural surface. However, the generation number of TBs was shown to differ significantly with the location of acini. These results suggest that the tree of conductive airways is designed so as to meet the requirement of constant acinar volume.
KOHNO, S., KOGA, H., KAKU, M., YASUOKA, A., MAESAKI, S., TANAKA, K., MITSUTAKE, K., MATSUDA, H., ARAKI, J. and HARA, K. Prevalence of HTLV-IAntibody in Pulmonary Cryptococcosis. Tohoku J. Exp. Med., 1992, 167 (1), 13-18-A retrospective study was done to determine the prevalence of anti-HTLV-I antibodies in patients with pulmonary cryptococcosis. None of the 19 patients with pulmonary cryptococcosis had underlying immunodeficiency. Anti-HTLV-I antibody was present in 6 (32%) of 19 patients with pulmonary cryptococcosis, a significantly higher prevalence than found in patients with bronchial asthma (4 (7%) of 58) (p<0.01, chi-square test). No statistical difference was noted when anti-HTLV-I antibody seropositivity was compared to that of patients with pulmonary tuberculosis (16% (17/105)), lung cancer (17% (22/129)) and pneumonia (9% (6/64)). A reduced cellular immunity as shown by lymphopenia, the CD4/CD8 ratio and purified protein derivative skin test was found in only 1 (5%) of 19, 2 (12%) of 17, and 6 (33%) of 18 patients, respectively. These results do not explain the susceptibility to pulmonary cryptococcosis in HTLV-I carriers. This is the first report of high prevalence of pulmonary cryptococcosis in HTLV-I carriers and it raises the question whether HTLV-I carriers are more susceptible to opportunistic infections and other malignancies probably due to subtle immunological abnormalities.
NUSHIRO, N., ABE, K., MISAWA, S., SEINO, M., OMATA, K., IMAI, Y., SEKINO, H. and YOSHINAGA, K. The Effects of Intrarenal Infusion of Recombinant HumanErythropoietin on Mean Arterial Pressure and Renal Hemodynamics in AnesthetizedRabbits. Tohoku J. Exp. Med., 1992, 167 (1), 19-25-The effects of recombinant human erythropoietin (rHuEPO) on mean arterial pressure (MAP) and renal hemodynamics were studied in anesthetized rabbits without renal failure. Intrarenal infusion of rHuEPO at a rate of 100U/min for 30min resulted in no change in MAP, renal blood flow, or renal vascular resistance, rHuEPO also produced no significant change in glomerular filtration rate, filtration fraction, or arterial hematocrit. These results demonstrate that rHuEPO has no direct effects on MAP or renal hemodynamics in anesthetized rabbits without renal failure.
NAKAMURA, M., TAKAHASHI, T., SATO, H., HOSHI, M., WAKUI, A. and KANAMARU, R. Histopathological Evaluation on the Effect of Induced HypertensionChemotherapy Presurgically Performed in Patients with Advanced Carcinomaof the Stomach. Tohoku J. Exp. Med., 1992, 167 (1), 27-37-Stomachs resected from 13 patients with an advanced gastric carcinoma were examined histopathologically to evaluate the effect of induced hypertension chemotherapy (IHC) using angiotensin II. Eight of the 13 patients, randomly chosen, were treated presurgically by IHC with a regimen of 5-fluorouracil, adriamycin and mitomycin C; the same regimen was used in the remaining five patients but without inducing hypertension. Clinical evaluation of the effect gave rise to the confirmation, presurgically, of complete response in three and partial response(PR) in two patients in the IHC group, whereas in the non-IHC group, the highest rating was PR, which was attained in only one patient. Also in the histopathological assessment based on a five-step grading, the IHC group earned in average a higher score than the non-IHC group, with a difference proved significant by Wilcoxon' s test. A histological rating of Grade 3, the highest effectiveness, was given to three patients in the IHC group, in one of whom the resected stomach disclosed no viable carcinoma cells but only fibrotic areas replacing carcinoma. There was also a correlation between the clinical and histological ratings as proved to be significant by Spearman's test. We conclude that in gastric carcinoma, the effect of chemotherapy is enhanced by angiotensin II-IHC.
ANAZAWA, Y., NAGAI, H., MOTOMIYA, M., ISAWA, T., SAITO, Y., TAKAHASHI, T. and KAWABATA, Y. A Case of Pulmonary Hyalinizing Granuloma. Tohoku J. Exp. Med., 1992, 167 (1), 39-45-A case of pulmonary hyalinizing granuloma was presented. The patient was a 37-year-old male who was found to have abnormal chest roentgenograms showing multiple pulmonary nodules taken at the annual chest mass survey in October 1989. The largest nodule measured 35mm in diameter. He was asymptomatic. No definite diagnosis was established either by brushing cytology, biopsy through bronchoscopy or percutaneous needle biopsy. No abnormalities were found in the GI tract, the urogenital system or the bone. Brain CT indicated an iso-density area surrounded by low density in the left fronto-parietal region. Two nodules of the lingula removed by open lung biopsy revealed a homogeneous cut surface. Histological diagnosis was pulmonary hyalinizing granuloma, consisting of hyalinized collagen fibers and bundles infiltrated with chronic inflammatory cells. No therapeutic effect was recognized with prednisolone. Craniotomy was performed and the brain lesion was removed. Anaplastic astrocytoma was the diagnosis. The brain lesion had no etiological correlation with pulmonary hyalinizing granuloma. Pulmonary hyalinizing granuloma itself is a rare benign disease with no specific therapy and is important in the differential diagnosis of lung diseases showing multiple pulmonary nodules.
TAZAWA, Y., NISHINOMIYA, F., NOGUCHI, H., TSUCHIYA, S., HAYASHI, Y., ABUKAWA, D., WATABE, M., NAKAGAWA, M., IMAIZUMI, M., OHI, R., TADA, K. and KONNO, T. Hepatocellular Carcinoma in Children with Hepatitis B SurfaceAntigen. Tohoku J. Exp. Med., 1992, 167 (1), 47-55-This study discusses four children of hepatocellular carcinoma (HCC) who were asymptomatic HBsAg carriers or had HBsAg-positive chronic hepatitis for 3 to 11 years before the occurrence of the carcinoma. Three of these four patients were positive for anti-HBe at 3 to 5 years before the diagnosis of hepatocellular carcinoma. Autopsy findings disclosed liver cirrhosis in all the four patients. To the best of our knowledge few reports have documented children in HBsAg carrier status or with HBsAg-positive hepatitis prior to the development of hepatocellular carcinoma. It is emphasized that HBsAg-positive children, with or without detectable hepatic lesions in routine examinations, have a possibility of developing HCC, and should be carefully monitored for long periods.
SAIJO, M., SUZUTANI, T. and YOSHIDA, I. Effects of Acyclovir, Oxetanocin-G, and Carbocyclic Oxetanocin-G in Combinations on the Replications of HerpesSimplex Virus Type 1 and Type 2 in Vero Cells. Tohoku J. Exp. Med., 1992, 167 (1), 57-68-9-(2-hydroxyethoxymethyl)guanine (acyclovir, ACV) and novel nucleosides, 9-(2-deoxy-2-hydroxymethyl-β-D-erythro-oxetanocyl)guanine (oxetanocin-G, OXT-G) and (+)-9-[(1R, 2R, 3S)-2, 3-bis(hydroxymethyl)cyclobutyl] guanine (carbocyclic oxetanocin-G, carbocyclic OXT-G) possessed substantial antiviral activities against herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2). ACV inhibited only viral thymidine kinase positive (TK+) herpes viruses, although the latter two compounds inhibited the replications of the TK deficient (TK-) mutants of HSV-1 and HSV-2 as well as the TK+ parent strains in vitro. The TK- mutants of HSV-1 and HSV-2 (HSV-1 TK- and HSV-2 TK-) were as susceptible to OXT-G as the TK parent strains. However, the TK- mutants were less susceptible to carbocyclic OXT-G than the TK+ parent strains. We demonstrated synergistic inhibition of the replications of HSV-1 and HSV-2 by ACV and OXT-G in combination, additive inhibition of HSV-1 and HSV-2 by ACV and carbocyclic OXT-G in combination, synergistic inhibition of HSV-1 by OXT-G and carbocyclic OXT-G in combination, and additive inhibition of HSV-2 by these two compounds. We investigated the metabolism of ACV and OXT-G in HSV-1 TK+-, HSV-1 TK-- and mock-infected Vero cells by thin layer chromatography. ACV-triphosphate increased more in HSV-1 TK+-infected Vero cells than in HSV-1 TK-- and mock-infected Vero cells. The metabolism of OXT-G had almost the same pattern in HSV-1 TK+-, HSV-1 TK-- and mock-infected Vero cells. These results suggest that ACV is phosphorylated by virus-induced TK, and OXT-G is phosphorylated by cellular nucleoside and nucleotide kinases.
ENDO, M., HANEDA, K., MOHRI, H. and YAMAKI, S. Tetralogy of Fallot withAnomalous Origin of Left Pulmonary Artery. Tohoku J. Exp. Med., 1992, 167 (1), 69-77-Between 1971 and 1990, 7 patients of tetralogy of Fallot with anomalous origin of left pulmonary artery underwent intracardiac repairs at Tohoku University Hospital. They were 2 males and 5 females with ages ranging from 4 to 26 years old. The right pulmonary artery connected to right ventricle in all cases, whereas no communications between right ventricle and the left pulmonary artery were found. The left pulmonary artery directly originated from the ascending aorta in 2 patients (group I) and connected to the ductus arteriosus in 5 patients (groups II and III). In 2 patients (group II), the left pulmonary artery was separated from the pulmonary arterial trunk by the intraluminal membrane, receiving blood supply through the ductus. In the remaining 3 patients (group III), there were no continuations between both pulmonary arteries. At the correction, communication between the left pulmonary artery and the pulmonary arterial trunk could be reconstructed in groups I and II. However, it was not possible in group III, because the ductus arteriosus and the left pulmonary artery had already been occluded before the intracardiac repair. In group III, ventricular septal defect was closed using a one-way valved patch or a perforated patch to decrease supersystemic right ventricular pressure. Postoperative right ventricular aortic pressure ratio was between 0.5 and 0.8 in groups I and II, and between 0.8 and 1.0 in group III. Three patients (one in each group) died after the operation. Severe pulmonary vascular obstructive disease was found in the left lung of group I. Tetralogy of Fallot with anomalous origin of unilateral pulmonary artery should be corrected before the advance of pulmonary vascular obstructive disease in case pulmonary artery originates from the ascending aorta, and before the occlusion of the ductus arteriosus in case pulmonary artery originates from it.
YAMADA, S., TAKAI, Y., NEMOTO, K., OGAWA, Y., KAKUTO, Y., HOSHI, A., SAKAMOTO, K., KAYAMA, T, and YOSHIMOTO, T. Radioresponse and Prognosis ofMalignant Glioma. Tohoku J. Exp. Med., 1992, 167 (1), 79-87-Radioresponse and prognosis of 91 malignant gliomas were studied to examine the efficacy of radiotherapy. There was no case of complete response. No statistically significant difference was observed among the prognoses of patients with various radiation methods. General survival rate was significantly higher than relapse-free survival rate both in astrocytoma grade III and in glioblastoma. This means that the retreatment after relapse is exceedingly important in any malignant glioma. In comparison with reported resection alone data, the efficiency of radiotherapy was evident in astrocytoma grade III and a part of glioblastoma; cases with minimal or no contrast enhanced area (CEA) in CT scans prior to irradiation. Poor radioresponders of glioblastoma with CEA should be reoperated.