Biomedical subjects
H Hamada
Publications and source records attributed to H Hamada.
[Immunogene therapy of cancer using cytokine genes].
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Thrombocytopenia: a risk factor for acute myocardial infarction during the acute phase of Kawasaki disease.
BACKGROUND: We report on 10 patients with Kawasaki disease and thrombocytopenia who were found to have a high incidence of coronary artery aneurysm and acute myocardial infarction. The clinical features of these patients, the cause of their thrombocytopenia and the relationship between cardiovascular pathology and thrombocytopenia were analyzed. METHODS: The clinical features of 10 patients with Kawasaki disease found to have thrombocytopenia (group A: mean age 8.0 +/- 7.0 months) and those of 293 patients with Kawasaki disease (group B, controls: mean age 13 +/- 20 months) were analyzed. Coagulation studies and bone marrow aspiration were performed to ascertain the cause of the thrombocytopenia in nine out of 10 subjects in group A. RESULTS: The minimum platelet count was 4-12 x 10(4)/mm3 (average day of illness, 10.3) and platelet counts were elevated to the baseline value within 1-2 weeks of onset of the illness. Low fibrinogen concentrations, high levels of fibrin degradation products, and low erythrocyte sedimentation rates with high C-reactive protein levels were observed in seven patients. In two other patients, immature megakaryocytes with normal coagulation values were observed. The differences in the incidence of coronary artery aneurysm and acute myocardial infarction between groups A and B were highly significant (coronary artery aneurysm: 60% in group A, 8.9% in group B; acute myocardial infarction: 40% in group A, 0.3% in group B). CONCLUSIONS: In many patients with Kawasaki disease and thrombocytopenia, the thrombocytopenia appears to be a result of intravascular coagulation, and to be one of the risk factors for acute myocardial infarction.
[Successful repair of distal type of aortopulmonary window by deep hypothermia with circulatory arrest].
A one year old boy with the distal type of aortopulmonary window was successfully repaired by the transaortic approach and discharged two weeks after operation. Exposure of the defect was enhanced by using deep hypothermia with circulatory arrest so that aortic cannula and cross-clamp could be removed. 2 months before the operation, he needed the respiratory support during a month because of respiratory syncytial viral infection, cardiac failure and equivalent pulmonary hypertension. Postoperative cardiac catheterization after 4 months revealed that PA pressure decreased to 25/5 mmHg without any medication. Aortogram showed the left single coronary artery.
Adoptive immunotherapy with murine tumor-specific T lymphocytes engineered to secrete interleukin 2.
Adoptive immunogene therapy of cancer is not widely studied, although it has been proposed as a promising strategy for cancer gene therapy. One of the major obstacles to this approach is the difficulty in introducing cytokine genes efficiently into T lymphocytes. In this report, we developed an adoptive immunotherapy model with murine tumor-specific cytotoxic T lymphocytes. By using an adenoviral vector, we achieved up to 100% gene transduction of murine T lymphocytes. Treatment of mice with the cytotoxic T lymphocytes genetically modified to produce interleukin 2 resulted in reduction of tumor metastasis and longer survival from intracerebral tumor death, providing a hopeful strategy for treatments of human cancers.
Difference in sero-diagnostic values among KL-6-associated mucins classified as cluster 9.
KL-6 classified as Cluster 9 (MUC-I) is a circulating high-molecular-weight mucin-like molecule. Serum level of KL-6 was measured by a sandwich assay using KL-6 antibody as not only a catcher but also as a tracer. We established 2 additional monoclonal antibodies (MAbs), LISA 101 and EH-123, reacting with KL-6 epitopes different from the epitope recognized by KL-6 antibody. The KL-6-associated mucins detected by the sandwich assay using LISA 101 or EH-123 antibody as a catcher and KL-6 antibody as a tracer were designated as LISA 1-6 and CAM 123-6 respectively. The diagnostic values as the serum markers of KL-6, LISA 1-6 and CAM 123-6 were evaluated measuring their levels in the same serum from healthy individuals and from patients with pulmonary, pancreatic and breast adenocarcinomas. KL-6 was increased abnormally at high rates of more than 50% in pancreatic cancer and in benign lung diseases, LISA 1-6 only in pancreatic cancer, and CAM 123-6 only in pulmonary adenocarcinoma. In benign lung diseases, however, LISA 1-6 and CAM 123-6 were increased abnormally at the rates of only 5.3% and 0% respectively. These observations clearly indicate that LISA 1-6 and CAM 123-6 constitute a part of KL-6, but that they are superior to KL-6 as tumor markers for pancreatic cancer and for pulmonary adenocarcinoma respectively, because of their much lower false-positive rates.
Bone mineral assessment by dual-energy X-ray absorptiometry in patients with coxarthrosis.
Forty patients with unilateral osteoarthritis of the hip were studied with dual energy X-ray absorptiometry to quantify disuse osteopenia in their affected leg by examining the proximal femur and tibia. Bone loss was assessed as a percentage of the contralateral value which compares bone mineral density of the affected and normal sides. The percentage contralateral value in the femoral neck and Ward's triangle was 113% and 118% respectively, while that in the tibia was 75%. Bone loss in the proximal tibia of the affected leg could be of value in assessing gait since it correlates with the gait parameters on the hip rating scale. By contrast, bone mineral increase in the proximal femur and correlates only with the degree of valgus deformity of the femoral neck.
Introduction of oxygenated functional groups into 3-carene and 2-pinene by cultured cells.
The biotransformation of the monoterpene hydrocarbons 3-carene and 2-pinene by cell suspension cultures of Nicotiana tabacum and Catharanthus roseus was investigated. The cultures have the ability to regio- and enantioselectively introduce the oxygenated functional groups into the C = C double bond and the allylic positions of the substrates.
Fetal nucleated cells in maternal peripheral blood after delivery.
OBJECTIVE: The purpose of this study was to determine the frequency of fetal nucleated cells and their serial changes in maternal peripheral blood after delivery. STUDY DESIGN: A total of 135 blood samples were investigated by means of fluorescence in situ hybridization by observing cells with Y chromosomes. Polymerase chain reaction amplifying two different Y-specific fragments were also carried out for genomic deoxyribonucleic acid from the same samples. RESULTS: The mean frequency of the Y-positive cells detected by fluorescence in situ hybridization in mothers who gave birth to male children was about 1 in 17,500 1 day after delivery. The frequency of these cells decreased with time, dropping below detectable levels 3 months after delivery. The frequency estimated by polymerase chain reaction experiments was significant and positively correlated with those found by fluorescence in situ hybridization. CONCLUSION: Fetal nucleated cells in maternal peripheral blood decrease in frequency with time after delivery. These cells disappear from maternal circulation 3 months after delivery in most, if not all, mothers.
Congenital biliary dilatation with pancreatico-biliary maljunction: a comparative study between children and adults.
A comparative study of congenital biliary dilatation with pancreatico-biliary maljunction in 15 children and 16 adults was undertaken. Cystic and fusiform dilatation of the common bile duct was seen in 9 and 6 cases respectively in the child group, with 8 and 8 cases respectively in the adult group. Cholangiographically, neither the length of the common channel nor the type of pancreatico-ductal union varied significantly between groups. Furthermore the incidence of higher amylase levels of bile showed no apparent variance from group to group. This was also true when looking histologically at the number and distribution of periductal glands surrounding the intra-hepatic bile duct. Therefore, we concluded that there was no essential etiological difference between the two groups.
A new serum tumor marker, CAM 123-6, highly specific to pulmonary adenocarcinoma.
KL-6, a circulating mucin-like glycoprotein, is a pulmonary adenocarcinoma-associated antigen and is also regarded as an indicator of disease activity of interstitial pneumonitis. KL-6 has extensive heterogeneous antigenic determinants and consists of multiple heterogeneous antigen molecules. We have searched for circulating KL-6-associated glycoproteins with superior diagnostic value to KL-6 as a tumor marker for pulmonary adenocarcinoma. A new murine monoclonal antibody EH-123 reacting with an asialosugar chain on KL-6 was established. A new KL-6-associated molecule detected by a bimonoclonal bideterminant sandwich assay using the EH-123 antibody as a catcher and horseradish peroxidase-labeled KL-6 as a tracer was designated as CAM 123-6. In 59% (22 of 37) of patients with pulmonary adenocarcinoma, serum levels of CAM 123-6 were abnormally elevated and the positive rate increased with the progression of clinical stage. Elevated levels were not detected in normal individuals or in patients with benign lung diseases, other histologic types of lung cancer, gastric cancer, colon cancer or breast cancer. CAM 123-6 was more specific to pulmonary adenocarcinoma than carcinoembryonic antigen (CEA), but the sensitivity of CAM 123-6 for pulmonary adenocarcinoma was similar to that of CEA. CAM 123-6 is a promising candidate as a serum tumor marker for pulmonary adenocarcinoma.
t-PA activity in peripheral blood obtained from pregnant women.
Concentrations of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI) were measured in blood obtained from pregnant women to elucidate the fluctuations in the fibrinolytic system which occur during the course of pregnancy. The t-PA activity was measured with a modified bioimmunoassay using anti-t-PA monoclonal antibody (SP-322) against a single chain of recombinant t-PA. The t-PA antigen was measured by ELISA using the same antibody. PAI activity was determined with a competitive inhibition assay of t-PA activity. In early pregnancy, t-PA activity was found to be close to the standard range seen in nonpregnant women, and gradually decreased during the course of pregnancy, then recovered to rise to the normal range within 48 hours after delivery. The t-PA antigen and PAI activity levels rose slowly during the course of pregnancy, and fell promptly after delivery. t-PA activity and t-PA antigen in levels in umbilical cord blood were higher after vaginal delivery than after cesarean section. These findings suggest that there may be an important physiological balance of the fibrinolytic system between mother and fetus during the course of pregnancy and the puerperium.
Reduction of beta-adrenergic receptors in atrial cell membranes of patients following mild to moderate heart failure.
The density of cardiac beta-adrenoceptors (Bmax) was measured in eighteen patients [2 with atrial septal defect (ostium secundum), 4 with aortic valve disease, 3 with mitral valve disease, 1 with aortic and mitral valve disease, 5 with a history of myocardial infarction, and 3 with angina pectoris] following mild to moderate cardiac failure. Measures were obtained by cardiac catheterization prior to cardiac surgery and also during the surgical procedures. On the basis of symptoms immediately preceding surgery, the severity of the condition in each patient was categorized as either Class I (n = 5) or Class II (n = 13) following the New York Heart Association (NYHA) functional classification system. The Bmax was measured using right atrial appendage tissue obtained during cardiac surgery. [125I]-iodocyanopindolol was used for the assay. The Bmax of atrial cell membranes in patients with NYHA class II was significantly lower than that of class I (34.1 +/- 2.5 vs 55.4 +/- 9.3 fmol/mg protein, M +/- SE, p < 0.05). Correlation coefficients between the Bmax and hemodynamic parameters measured just prior to cardiac surgery were examined, but only that between Bmax and the minimum value of the time derivative of left ventricular pressure (max negative dp/dt) was significant (r = -0.552, p < 0.05). Further study is needed to understand and clarify the relationship between Bmax and dp/dt min.
[Extracorporeal shock wave lithotripsy in a patient with hemophilia A. A case report].
We treated a 25-year-old hemophilia A patient (FVIII:C activity 2%) with left ureteral stone by means of extracorporeal shock wave lithotripsy under replacement therapy of concentrated Factor VIII material. The patient was attacked by sudden onset of left renal colic with gross hematuria on the 12th postoperative day. Renal ultrasonography and computed tomography demonstrated subcapsular bleeding of the left kidney. In spite of usual antihemophiliac replacement therapy, bleeding was extended from the retroperitoneal space to intraperitoneal and intrapleural space because potent Factor VIII inhibitors (14 Bethesda Unit) was produced. After embolization of the left renal artery, double filtration plasmapheresis and bypassing therapy using prothrombin complex concentrate were performed effectively to save the patient's life.
[Compression of medulla oblongata by the dissecting aneurysm of the vertebral artery 7 years after its rupture: case report].
A 56-year-old female, who suffered a subarachnoid hemorrhage (SAH) due to spontaneous dissection of the right vertebral artery 7 years previously, was admitted to our hospital with headache and vertigo. She hadn't had any attacks of SAH for 7 years. A magnetic resonance imaging (MRI) showed a high signal intensity mass and a low signal intensity due to calcification on the right ventrolateral surface of the medulla on both T1 and T2 weighted images. Vertebral angiography showed complete occlusion of the cervical segment of the right vertebral artery (VA). Left vertebral angiography didn't reveal any retrograde filling of the intracranial segment of the right VA through VA union. Thus, the spontaneous entrapment by dissection of the vertebral artery was demonstrated 7 years after SAH with MRI and serial angiography.
[Evaluation of serum thrombomodulin in patients with interstitial pneumonia].
We encountered a 63-year-old man whose dry cough due to interstitial pneumonia had been successfully with an anti-thrombin drug, argatroban, which was given to treat exacerbated Buerger's disease. We therefore prospectively evaluated fibrinogen, fibrin-degradating product D-dimer, thrombin anti-thrombin III complex, and plasmin anti-plasmin complex in patients with interstitisal lung diseases. In a preliminary study, we found that some patients actually had elevated levels of these markers. These findings suggested that increased coagulability was involved in the pathophysiology of interstitial pneumonia. In this study, we measured the levels of serum-soluble thrombomodulin as a marker of endothelial cell damages that lead to hemostasis. We found that serum levels of thrombomodulin were high in about 35% of patients with sarcoidosis, interstitial pneumonia associated with collagen diseases, or idiopathic interstitial pneumonia. Furthermore, these levels decreased as the patients' conditions improved. Although further evaluation is needed, these results suggest that endothelial cell damage and hemostasis are involved in the pathophysiology of interstitial pneumonia.
Pediatric liver transplantation: effect of the site of arterial inflow on the incidence of hepatic artery thrombosis according to recipient weight.
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Choledochojejunostomy without stent in pediatric liver transplantation.
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