Riichiro Morita

Anti-inflammatory effect of the conjugate of superoxide dismutase with the copolymer of divinyl ether and maleic anhydride against rat re-expansion pulmonary edema

Abstract Bovine erythrocyte superoxide dismutase (SOD) was conjugated with the copolymer of divinyl ether and maleic anhydride, known as DIVEMA or pyran copolymer. The DM–SOD conjugate was resistant against the proteolytic enzymes in serum, and showed a prolonged half-life in vivo after intravenous injection. DM–SOD was applied for the treatment of rat lung edema caused by the re-expansion after the left bronchus has been clipped for 3 days. The anti-inflammatory effect was evaluated by the inhibition rate of the water content due to the edema. Neither SOD nor DIVEMA reduced the increase in water content in the lung, whereas DM–SOD could effectively protect against the increase in water content such that the water content of the re-expanded lung was the same as that of the control right lung. Using electron microscopic observation the difference between the SOD and DM–SOD treatment in the water swelling of the interalveolar septum was clearly indicated. Observation of the surface of the endothelial wall in the blood vessel of the lung showed more a drastic difference. The leukocyte attachment on the endothelial layer observed following the treatment with SOD was not observed following that with DM–SOD. This observation indicates that DM–SOD had stopped the inflammation process at the first step of leukocyte adhesion, which should be followed by the rolling and expansion of the leukocytes to initiate the normal inflammation process.

Increased plasma concentrations of endothelin-1 during and after pulmonary surgery.

We studied the involvement of endothelin-1 (ET-1) in the physiological response to surgical stress. Plasma concentrations of ET-1 were measured by a sandwich-type enzyme immunoassay. The blood samples were collected from the pulmonary artery (PA), the left atrium (LA), and the median cubital vein (MCV) in four patients who had undergone pulmonary lobectomy. The samples were collected before, during, and after surgery. Plasma ET-1 concentrations increased in the blood from all sampling sites. The highest concentration of plasma ET-1 was observed at 6 h after surgery in MCV (3.97 +/- 1.47 pg/ml, mean +/- SD) and at the end of surgery in PA (1.79 +/- 0.48 pg/ml) and in LA (1.93 +/- 0.43 pg/ml). These values returned to the baseline value within 72 h after surgery [1.21 +/- 0.19 (MCV), 1.00 +/- 0.18 (PA)]. Although the lung has a large capacity to remove ET-1 from the circulating blood, ET-1 concentrations measured in plasma samples obtained from the LA were not different from those obtained from the PA. This may suggest that the lungs have the ability to absorb and release ET-1 simultaneously during pulmonary surgery. The increase of ET-1 in MCV was greater than that in PA or in LA. This suggests the possibility of ET-1 release from the forearm.

Arteriovenous hemangioma in the middle mediastinum: Report of a case

Hemangiomas in the mediastinum are uncommon, and the majority of these tumors are located in the anterior mediastinum. The present report describes an extremely rare case of a hemangioma in the middle mediastinum. A 40-year-old male patient presented with a mass in the left lower lung field on radiographic screening. Chest computed tomography and magnetic resonance imaging revealed a mass measuring 2.5 cm in diameter, which was close to the descending aorta in the left middle mediastinum. The tumor resection was performed by video-assisted thoracic surgery. The thoracoscopic findings revealed a blackish brown mass with a capsule, which had not invaded the descending aorta or cardiac sac. Histologically, the tumor was composed of typical thick-walled vessels and was therefore classified as an arteriovenous hemangioma.

The Relationship between Histocytological Features of Superficial Layer of Tumor and the Tumor Extent of Early Squamous Cell Carcinoma of the Bronchus.

早期肺扁平上皮癌組織表層の角化の程度と, 表層細胞の核形態および腫瘍進展度との関係を検討した. 対象は切除した早期肺扁平上皮癌32例の33病巣で, これらを腫瘍表層の角化の程度によって, 明らかな角化のない軽度角化7病巣, 角化は明らかだが最表層の数層に留まる中等度角化8病巣, 角化の著明な高度角化18病巣に分類した. 角化の明らかな中等度ないし高度角化8病巣が, 異型の少ない小型核を持つ角化細胞で覆われていた. これらは細胞診にて見逃され易いものである. 高度角化18病巣中, 中心型が14病巣, 気管支軟骨外進展が7病巣で, いずれも3型中最も多かった. 一方, 軽度角化7病巣では, 表層進展型が5病巣, 20mm以上の大きさの病巣が4病巣と多数を占めた. 従って, 高度角化病巣には中心型で深達進展高度なものが多く, 軽度角化病巣には表層進展型で比較的広がりの大きいものの多いことが知られた.

Re-evaluation of the Classification of Atypical Cells and the Method of Post-screening Management in Sputum Cytology Mass Screening.

喀痰検診5年間の成績を踏まえて, より効率的な早期肺扁平上皮癌の発見をめざした異型扁平上皮細胞判定基準と事後指導の方法を検討することを目的とした.延べ37015名の受診者のうち, 肺癌学会分類を基にして作成した筆者らの細胞判定基準による判定C (中等度異型) からの癌の発見はなかったが, 判定D (高度異型扁平上皮および癌疑い) では, 高度異型扁平上皮の精検受診者77名から4名 (5.2%), 癌疑いでは36名から10名 (27.8%) の癌が発見された. 従って, 判定Cでは次年度の喀痰検診による追跡で十分であると思われ, 判定Dでは, 癌が疑われると判定された場合には直ちに精検が必要だが, それよりも異型が弱く高度異型と判定された場合には直ちに喀痰細胞診を再検し, 細胞異型が同様に比較的弱ければ, 以後喀痰細胞診と胸部X線写真で追跡すればよいものと思われた.

A Resected Case of Granular Cell Tumor of the Bronchus Associated with Obstructive Pneumonia.

症例は22歳男性で, 発熱・咳を主訴とし, 胸部X線写真上, 右下葉の閉塞性肺炎像を認めた. 6カ月後に再度閉塞性肺炎を起こしたため気管支鏡検査を行った. 気管支鏡検査で右肺底支を閉塞する腫瘤を認め, 生検にて顆粒細胞腫と診断された. 右下葉切除を施行. 腫瘍は右B7入口部に発生する30×10×10mmのポリープ状であった. 腫瘍細胞は, S-100蛋白・NSE陽性であった.気管, 気管支, 肺に発生した顆粒細胞腫は比較的まれな腫瘍で, 比較的大きな本腫瘍の治療は原則として外科的切除が選択されるべきと考える.

Cytology of the non-neoplastic pulmonary diseases with a tumorous shadow on a chest roentgenogram.

胸部X線写真上肺野腫瘤状陰影を呈した2例の非腫瘍性肺良性疾患の擦過細胞診に出現した異型細胞について検討した. 第1例は4O歳主婦の器質化肺炎例で, 核小体の著しく肥大した大型の類円形の核を有する異型細胞を認めた. この細胞の核所見からのみでは高分化腺癌との鑑別が困難であったが, 細胞の数が少なく結合性の強いことが悪性との鑑別の要点であると考えられた. 第2例は33歳の主婦で, 肺硬塞発症後3～4日めに核小体の目立つ未熟な扁平上皮化生細胞に類似した細胞を認め, 組織修復細胞との関連が考えられた.