Search for η

We measured missing mass spectrum of the ^{12}C(γ,p) reaction for the first time in coincidence with potential decay products from η^{'} bound nuclei. We tagged an (η+p) pair associated with the η^{'}N→ηN process in a nucleus. After applying kinematical selections to reduce backgrounds, no signal events were observed in the bound-state region. An upper limit of the signal cross section in the opening angle cosθ_{lab}^{ηp}<-0.9 was obtained to be 2.2 nb/sr at the 90% confidence level. It is compared with theoretical cross sections, whose normalization ambiguity is suppressed by measuring a quasifree η^{'} production rate. Our results indicate a small branching fraction of the η^{'}N→ηN process and/or a shallow η^{'}-nucleus potential.

HLA expression by trophoblast of invasive moles.

HLA expression by the trophoblast in invasive hydatidiform mole was analysed by immunoperoxidase staining. In the invading villi of an invasive mole, villous trophoblast, both syncytiotrophoblast and cytotrophoblast, failed to show a positive reaction for HLA-A, -B and -C and HLA-DR. By contrast, extravillous trophoblast showed an intense reaction for HLA-A, -B and -C. The distribution of HLA antigens in the invading villi was the same as in the non-invading villi, and the antigens were also indistinguishable from those noted in non-invasive hydatidiform moles. The histopathology of invasive mole may suggest that it is a malignant neoplasm. This immunohistochemical study, however, lends support to the current view that invasive mole is a variant of a benign hydatidiform mole rather than a form of malignant trophoblastic disease.

Immunohistochemical localization of HLA antigens and placental proteins (alpha hCG, beta hCG CTP, hPL and SP1 in villous and extravillous trophoblast in normal human pregnancy: a distinctive pathway of differentiation of extravillous trophoblast.

Immunohistochemical localization of HLA antigens and placental proteins (alpha hCG, beta hCG CTP, hPL and SP1) in villous and extravillous trophoblast at various stages of normal human gestation were studied, using hysterectomy specimens. In the chorionic villi, the capacity for synthesizing placental proteins seemed to develop in parallel with the morphological change from mononuclear cells to multinucleated syncytiotrophoblast and no villous trophoblast expressed HLA antigens. In contrast, extravillous trophoblast, including the multinucleated trophoblastic cells at the deciduomuscular junction, expressed HLA-A, -B, and -C, and their capacity for synthesizing placental proteins did not seem to correspond with the degree of morphological change: the location of alpha hCG, beta hCG CTP and SP1 was restricted to mononuclear trophoblast in the superficial decidua, while hPL was present extensively in extravillous trophoblast. These findings strongly suggest that extravillous trophoblast possesses many distinctive biological features and differentiates in an independent manner. Mononuclear trophoblast forming the cell columns was also positive for HLA-A, -B, and -C, and no placental protein was demonstrated in these cells; this, together with previous morphological observations, may indicate the germinative nature of these cells.

Immunohistochemical studies of fetal trophoblast and maternal decidua in hydatidiform mole and choriocarcinoma.

Immunohistochemical techniques have been used to investigate the expression of fetal trophoblast antigens and the maternal leucocytic response in molar pregnancy and choriocarcinoma. The antigenic phenotype of morphologically defined trophoblast populations in complete, partial and invasive moles was analogous to that in normal pregnancy. All trophoblast phenotypes described in normal pregnancy were also identified in choriocarcinoma, suggesting that extensive differentiation into heterogeneous subgroups occurs in malignant trophoblast. The maternal leucocytic infiltrate in molar pregnancy consisted of T lymphocytes and class II MHC-positive macrophages. CD2-positive, CD3-negative lymphocytes were identified in molar decidua but not in uterine tissue in choriocarcinoma. Similarly, endometrial granulocytes were present in molar decidua but not in choriocarcinoma; these cells were associated with decidualization rather than with fetal trophoblast.

Utility of low-dose helical CT as a second step after plain chest radiography for mass screening for lung cancer.

We evaluated the usefulness of low-dose helical computed tomography (CT) as a routine second step in patients screened for lung cancer with plain chest radiography (PCR). Of 5,437 people who underwent mass screening for lung cancer by PCR, further work-up was required for 230 because of abnormal findings. Of 221 subjects who had CT as a second step, abnormal shadows were detected in 110 and no abnormal shadows were seen in 111. Screening CT (helical scan; beam collination, 10 mm; pitch of 2:20 mm/s; and tube current, 50 mA) detected 17 lung cancers, 87 benign lesions, and 6 extrapulmonary lesions, with an average diameter of 10 mm (range, 2-35 mm). All lung cancers were peripheral (12 stage I, 4 stage IIIA, and 1 stage IV). In 40% of screened subjects, 37 with benign lesions and 7 with lung cancer (6 stage I), lesions were delineated only by screening CT. In conclusion, low-dose helical CT was found to be useful as a second step in patients who have been screened for lung cancer by PCR and can delineate the early stage of lung cancer.

Helical computed tomography diagnosis of pleural dissemination in lung cancer: comparison of thick-section and thin-section helical computed tomography.

Pleural dissemination in lung cancer was prospectively evaluated by helical computed tomography (CT), and the usefulness of thick-section CT (10-mm collimation; pitch 1) and thin-section CT (2-mm collimation; pitch 1) were compared. The study included 54 patients with pulmonary adenocarcinoma in whom plain chest radiographs showed no evidence of pleural effusion and in whom the primary lesion was seen to be contiguous with the pleural surface on thick-section CT. Thin-section CT was performed for evaluation of the costal, mediastinal, interlobar, and diaphragmatic pleural surfaces. Pathologic examination revealed pleural dissemination in 20 patients (8 resected, 12 nonresected). Pleural dissemination was diagnosed in 12 patients on thick-section CT, and in 20 patients on thin-section CT. False negatives occurred in ten and two patients, respectively. The same two patients were false positives by both methods. Accuracy was 78% for thick-section CT and 93% for thin-section CT, and sensitivity was 50% and 90%, respectively. Thin-section CT provided more useful information than thick-section CT for the evaluation of pleural dissemination in lung cancer.

Anomalous insertion of the right hepatic duct into the cystic duct: report of a case diagnosed before laparoscopic cholecystectomy.

Although an aberrant hepatic duct entering the cystic duct is not especially rare, the main right hepatic duct entering the cystic duct is extremely rare, with only six cases reported thus far. All of the reported patients underwent open cholecystectomy, during which one patient received a bile duct injury. The anomaly was unsuspected preoperatively in all of these cases. We report an additional patient with this anomaly, the first such case diagnosed before laparoscopic cholecystectomy using direct cholangiography. Cholangiography may be mandatory whenever biliary anomalies are suspected during laparoscopic cholecystectomy. As the right hepatic duct entering the cystic duct can lead to ductal injury, this anomaly should be kept in mind when performing laparoscopic cholecystectomy.

[Identification of Mycobacterium avium and Mycobacterium intracellulare using DNA probe test, and their ratio in Niigata area].

Using Gen-Probe test, both the Mycobacterium avium and Mycobacterium intracellulare strains were identified in the 76 disease-associated Mycobacterium-avium complex (MAC) strains isolated in the NIIGATA area. The following results were obtained: 1) Fifty-four MAC strains (71.1%) reacted with M. avium-probe and 22 strains (28.9%) reacted with M. intracellulare-probe. 2) There were no significant differences between the ratio of two strains before and after 1991. 3) The ratio of female cases with M. avium was significantly higher (22/32) in the later period (after 1991) than in the former period (9/22).

[Epilepsy surgery for focal cortical dysplasia and dysembryoplastic neuroepithelial tumor].

We studied six patients with focal cortical dysplasia (CD) and four patients with dysembryoplastic neuroepithelial tumor (DNT) who had surgical resection for medically intractable epilepsy. In all CD patients, ictal single photon emission computed tomography (SPECT) using 99mTc-ECD revealed hyperperfusion in the regions where magnetic resonance (MR) imaging showed CD abnormalities. Interictal epileptiform activity and ictal seizure onset on electrocorticography using subdural strip or grid electrodes were demonstrated in the CD itself. In contrast, in all DNT patients, interictal SPECT disclosed hypoperfusion in the area of the lesions. Ictal SPECT in one DNT patient disclosed hyperperfusion in the superior area of the region where MR imaging showed cystic abnormalities. Interictal spiking in all DNT patients and ictal seizure onset in two DNT patients were demonstrated not in the lesions themselves but in the distinct zone from the region of the tumor-involved brain. All CD patients who underwent lesionectomy became seizure-free with a mean follow-up period of 33.5 months. All DNT patients who underwent lesionectomy and resection of the epileptogenic cortex became seizure-free or had their seizure significantly reduced a mean follow-up period of 41.5 months. We conclude that CDs have intrinsic epileptogenicity, while DNTs have epileptogenicity not intrinsically but in encompassed cortical surface areas.

[Clinical studies on medical disorders of patients with benign prostatic hypertrophy over 65 years of age].

The medical disorders of 269 in-patients with benign prostatic hypertrophy who were over 65 years old and hospitalized between September 1974 and March 1985, were reviewed. The most frequent preoperative disorder was of the cardiovascular system. A comparative examination of the operative group with the non-operative group was made by nine preoperative risk factors, which showed a statistically significant difference at the 0.1% level.

[Clinical evaluation in 69 cases with neurogenic bladder].

Clinical evaluation was made in 69 cases of neurogenic bladder experienced during the past 3 years. Thirty seven of the patients were male and 32 female, and they ranged in age from 4 to 88 years with an average of 63.2 years, The basic diseases of neurogenic bladder were brain lesions in 27 cases, spinal cord lesions in 18 cases, and peripheral nerve lesions in 13 cases. Three cases were of the mixed type and the basic disease was unknown in 8 cases. Cerebrovascular diseases were the most frequent, followed by spinal cord injuries and intrapelvic operations. Duration from the onset of urological symptoms to the first visit to our clinic was less than 1 month in half of the patients. The chief complaints at the first visit were pollakisuria in 25 cases (25.8%), incontinence in 18 cases (18.6%), urinary difficulty in 25 cases (25.8%) and urinary retention in 13 cases (13.4%). Urological conditions at the first visit were spontaneous urination in 53 cases (76.8%), indwelling catheterization in 12 cases (17.4%) and clean intermittent catheterization in 4 cases (5.8%). Urological complications seen at the first examination were urinary tract infections (UTI) in 27 cases (39.1%) and chronic renal failure in 2 cases (2.9%). The patients were classified by cystometrography into 3 patterns: 42 cases (60.9%) with underactive detrusor, 21 cases (30.4%) with overactive detrusor and 6 cases (8.7%) with normal detrusor. Detrusor sphincter dyssynergia was observed in 29 cases (42.0%), 40.7% had brain lesions, 44.4% spinal cord lesions, and 46.2% peripheral nerve lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical experience with a Terumo guide wire in the urinary tract].

TERUMO guide wire was used for treatment of urinary tract diseases in 30 cases of percutaneous nephrolithotomy, 35 cases of transurethral retrieval for ureteral stones and one case each of stricture of uretero-ileal junction with a ureteral stone, urethral stricture after mechanical instrumentation, and cystic dilatation of terminal seminal duct with hematospermia. The advantages of the use of TERUMO guide wire in the urinary tract are described. The rigid stem wire with a floppy terminal portion is superior to other types of guide wires concerning flexibility, elasticity, degree of sliding and maneuverability.

[Prophylaxis of recurrence of superficial bladder tumor by intravesical chemotherapy].

During the past 10 years, we have experienced 110 bladder tumor cases. Among them, 70 patients were diagnosed superficial bladder tumor. Of these 70 cases, 30 were treated with intravesical adriamycin (ADR) and peplomycin (PEP), 13 with ADR only and one case with PEP and remaining 26 with TUR and hydrostatic pressure technique. We studied the efficacy of combination intravesical chemotherapy with ADR and PEP and other treatments in the prevention of recurrence in the superficial bladder tumor cases. The recurrence rate during 3 years of each group, was 25% in the group treated with ADR and PEP, 35% with ADR and 55% in remaining group. 3 years recurrence rate in the group treated with ADR and PEP was significantly low than that in the group tread with TUR and hydrostatic pressure technique alone (Wilcoxon test). Side effects was pollakisuria, pain after micturition and others. Anaphylactic shock appeared in one case. From these results we concluded that intravesical chemotherapy with combined agents is more effective than that with a single one or no treatment after TUR.

[Total parathyroidectomy with autotransplantation in secondary hyperparathyroidism].

Five patients with chronic renal failure were undergone total parathyroidectomy and immediate autotransplantation into the muscle of the forearm. All patients had relief of symptoms and restoration of PTH levels to normal. This technique of parathyroid transplantation offers the surgeon versatility in managing patients with hyperparathyroidism.

[Urological complications after renal transplantation].

Urological complications occurred in 17.5% of the 80 patients who had received renal transplantations in our clinic between March, 1975 and May, 1984. Urinary fistulas occurred in 3 patients, urolithiasis occurred in 6 patients, ureteral stenosis occurred in 1 patient and urinary tract bleeding occurred in 4 patients. Graft loss was observed in 1 patient, but there were no patients whose death was directly attributable to urological complications. Urological complications can be avoided by careful procedures in donor nephrectomy and urinary tract reconstruction.

[Clinical studies on cefoperazone in renal transplantation].

Two grams of Cefoperazone was intravenously administered twice a day for 5 days by drip infusion to 10 donors and 9 recipients after renal transplantation. The concentration of cefoperazone in the blood after administration in both donors and recipients did not show any accumulation tendency. The urinary recovery rate of cefoperazone for 24 hours in donors was 8.8% and that in recipients was 8.1%. There was no change in the renal function in donors after administration of cefoperazone. No change was observed in blood examination, BUN or creatinine, but S-GOT and S-GPT showed a temporary increase in 1 donor and 1 recipient. It is considered that Cefoperazone is a very useful drug for prophylactic chemotherapy after renal transplantation.

[Clinical studies with antimicrobic agent "Dolcol" for chronic prostatitis].

Chronic prostatitis is possibly the most common infectious disease in middle-aged men. Clinical investigation was made on 24 outpatients with chronic prostatitis at our department, during the period of October, 1983 to August, 1984. The diagnostic criterion of the prostatitis was detection of more than ten leukocytes per high power field on microscopic examination of the expressed prostatic secretion and urine after prostatic massage. Twenty-four patients with chronic prostatitis were treated with 2 tablets of Dolcol (Pipemidic acid, PPA) three times daily for 7-30 days. The effectiveness was evaluated by improvement of subjective symptoms and objective findings. The results of the therapy with PPA on chronic prostatitis were excellent in 8 patients (33.3%), good in 10 (41.7%), fair in 2 (8.3%), and poor in 4 (16.7%). The effective rate was 83.3%, while no side effects were noted. Therefore, PPA was suggested to be effective against chronic prostatitis.

[Juvenile ischemic type of moyamoya disease: a case report].

Moyamoya disease is a rare, chronic cerebrovascular disorder characterized by progressive stenosis of the arteries composing the circle of Willis. The ischemic type of Moyamoya disease progresses insidiously. To prevent irreversible cerebral damage and psychomotor deterioration, early surgical treatment is considered indispensable. The patient may present with nonspecific symptoms and no specific abnormalities on brain MRI, and might be erroneously suspected as having psychosomatic disorder. The disease must be diagnosed as early as possible. Electroencephalography (EEG) is of little value in the diagnosis of the juvenile type of Moyamoya disease, except for the demonstration of "re-build up" after hyperventilation. Half of the children with Moyamoya disease have been demonstrated to exhibit "re-build up" after hyperventilation. Our patient showed normal background activities, no spike discharges and no slowing during hyperventilation. Nonetheless, we emphasize the appearance of irregular high voltage slow waves de novo after hyperventilation. The findings may be potentially useful for the screening of patients with the juvenile type of Moyamoya disease.

[Release of leukotrienes (LTC4, D4, E4, B4) from peripheral leukocytes in patients with bronchial asthma].

To evaluate the pathogenetic role of leukotrienes in bronchial asthma, the levels of leukotrienes released from leukocytes stimulated by calcium ionophore A23187 were measured by the HPLC-RIA method in 32 asthmatic patients (12 infectious type, 12 non-hyposensitized atopic type, and 8 hyposensitized atopic type). The following results were obtained: 1) The level of leukotrienes released from the leukocytes of asthmatic patients were higher than those of healthy subjects, but there was no significant difference in the levels of leukotrienes between mild and moderate asthmatic patients. 2) The levels of leukotriene B4 released from the leukocytes of the infectious-type asthmatic patients were higher than those of the atopic asthmatic patients (non-hyposensitized group). There was a tendency for levels of leukotriene C4 released from the leukocytes of the infectious-type asthmatic patients to be higher than those of the atopic-type asthmatic patients. 3) The levels of peptide leukotriene released from the leukocytes of the atopic hyposensitized patients were lower than those of the patients in the atopic non-hyposensitized group, but there were no significant differences in leukotriene B4 between the groups. In addition, the levels of leukotriene C4 released spontaneously from the leukocytes of the hyposensitized group of patients were lower than those in the non-hyposensitized group. 4) Though the mechanism of the efficacy of hyposensitization has not been completely clarified, the reduction of leukocyte ability to release peptide leukotrienes through immunotherapy seems to be part of this mechanism. These results suggest that leukotrienes may play some role in the pathogenesis of both atopic- and infectious-type bronchial asthma.