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Biomedical subjects

H Itoh

Publications and source records attributed to H Itoh.

At least 487 records · Page 27Linked to original sources

[Mutual connection between sleep-wake rhythm and other circadian rhythms].

The desynchronaization between sleep-wakefulness rhythm and other biological rhythms such as rectal temperature rhythm and melatonin rhythm is the most unique characteristics for human circadian rhythms. Based on the findings of desynchronaization, a multi-oscillator hypothesis has been advanced for the human circadian clock. Three kind of the hypotheses such as Wever, Kronauer and two-process model were introduced in this article. According to the multi-oscillator hypothesis, one clock regulates rectal temperature and melatonin rhythm and another clock regulates sleep-wake rhythm. There are a few differences between the two different kind of circadian rhythms. For example, the oscillator mechanism which regulates the rectal temperature and the melatonin rhythm are reseted directly by the bright light, but the sleep-wake rhythm is entrained by the bright light through an internal coupling to the former mechanism. And it is also recognized that the length and the structure of sleep are depended strongly on the phase of biological clock which regulates the rectal temperature rhythm.

Body Temperature Regulation↗

[Idiopathic insomnia].

Idiopathic insomnia (Childhood-onset insomnia) which belongs to Intrinsic Sleep Disorders in ICSD, has some dysfunction in sleep-wake center in brain. Sleep-wake center consists of two parts, one is sleep center which is present in the anterior parts of hypothalamus, and the other is wake center which is present in the ascending reticular activating system including posterior parts of hypothalamus. Idiopathic insomnia patients are said to have hyperactivity in wake center or hypoactivity in sleep center. And these patients have sleep disturbances such as inability to fall asleep, frequent awakenings and early morning wakefulness. Most patients have sleep disturbances from their childhood and after the onset of sleep disturbances, these disturbances show no improvement during all their life. Concerning about the drug treatment, probably benzodiazepin or barbiturate are effective. Because of long-term use of drugs, drug dependence and tolerance are often observed in patients. So it is necessary to take special care when choosing type or dosage level of drugs.

Humans↗

[Arousal disorders].

Arousal disorders, which belong to parasomnias in ICSD, have some disfunction in the process from sleep to awakenings. And the undesirable behaviors, such as wandering and screaming, are observed in the middle of awakening. Arousal disorders contain 1) confusional arousal, 2) sleepwalking, and 3) sleep terrors. Their common characteristics are the following items. 1) these symptoms frequently can be observable in infants, 2) these symptoms appear after awakenings especially from slow wave sleep, 3) the organic change has not been proven, 4) patients lose memory about the episode in the next morning, 5) natural improvement of symptoms can be expected after puberty. Confusional arousal is considered as a partial episode of sleepwalking and sleep terrors.

Anti-Anxiety Agents↗

[Clinical effects of sodium ozagrel and urokinase in patients with acute cerebral infarction in the territory of the internal carotid artery].

In this study, the clinical effects were compared between a thromboxane synthetase inhibitor (sodium ozagrel) and a thrombolytic agent (urokinase) in patients with acute cerebral infarction. The subjects consisted of 598 patients admitted on the day of the onset of the cerebral infarction in the territory of the internal carotid artery who showed a low density area on CT images within 5 days. Of these patients, 300 were treated with sodium ozagrel and classified as Group Oz, while the remaining 298 were treated with urokinase and classified as Group Ur. The results were as follows: 1. In group Oz, complete recovery of motor impairment was seen in 209 (69.7%) patients. Complete recovery within 3 weeks after onset was seen in 186 (62.0%) patients. In group Ur, complete recovery of motor impairment was seen in 175 (58.7%) patients. Complete recovery within 3 weeks after onset was seen in 120 (40.3%) patients. Therefore, a higher incidence of complete recovery of the motor impairment was noted in group Oz [p < 0.001: chi 2 test]. Similarly, complete recovery within 3 weeks after onset was more frequent in group Oz [p < 0.001: chi 2 test]. 2. In group Oz, complete recovery was made contribution statistically by Anosognosia (Ag) and unilateral neglect (UN) on admission [multivariate analysis: p < 0.01]. In group Ur, complete recovery was made contribution statistically by Ag (p < 0.01), UN (p < 0.01) and aphasia (p < 0.05). 3. Progressive stroke was observed in 29 (9.5%) patients in the group Oz and in 71 (23.0%) patients in group Ur. There was a higher incidence of progressive stroke in group Ur [p < 0.001: chi 2 test] 4. All patients with progressive stroke had initial evidence of deterioration of neurological deficits within 6 days after the onset in group Oz, and within 5 days after the onset in group Ur. The maximal period from the beginning to the end of the deterioration of neurological deficit was 7 days. 5. In group Oz, progressive stroke was only seen in 29 (29.9%) of the patients who were admitted with motor disturbances and unilateral neglect. In group Ur, progressive stroke was seen in 8 (4.3%) of the 187 patients with motor disturbances without higher cortical dysfunction, in 17 (47.2%) of the 36 patients with motor disturbances and higher cortical dysfunction without unilateral neglect and was seen in 46 (61.3%) of the patients with motor disturbances and unilateral neglect. 6. Hemorrhagic infarction was observed in 14 (4.6%) patients in group Oz and in 31 (10.0%) patients in group Ur. There was a higher incidence of hemorrhagic infarction in group Ur [p < 0.001: chi 2 test]. 7. In group Oz, there was a higher incidence of hemorrhagic infarction among patients with atrial fibrillation (Af) on the ECG [p < 0.001: chi 2 test]. Similarly, in group Ur, hemorrhagic infarction was more frequent among patients with atrial fibrillation (Af) on the ECG [p < 0.001: chi 2 test]. Therefore, sodium ozagrel was clinically more efficient and safer than urokinase in patients with acute cerebral infarction.

Adult↗

[Comparison of transarterial technique and paresthesia technique of axillary brachial plexus block].

Axillary brachial plexus blocks were established in 40 patients using transarterial technique (n = 20) or paresthesia technique (n = 20). Sensory and motor blockades of nerves supplying the upper extremity were compared at 10, 20 and 30 minutes after the injection of local anesthetics (1.5% plain mepivacaine 40 ml). Sensory blockades of the radial nerve and axillary nerve were significantly higher with transarterial technique than paresthesia technique. The incidence of analgesia of the radial nerve at 30 min was 100% with transarterial technique and 70% with paresthesia technique. Sensory blockades of the other nerves and motor blockades of all nerves did not show any significant differences between the two techniques. Proximal and distal spreads of the local anesthetic-contrast medium mixture within the axillary neurovascular sheath were studied in 20 patients. No statistically significant difference was observed in the spread of contrast agent between the two techniques. Transarterial technique is a recommendable method for hand surgery and especially indicated for the surgery of the area supplied by the radial nerve.

Adult↗

[Discussion on the technical terms in enhancement of ultrasonography using contrast agents].

Recent advances in enhancement of ultrasonography (US) using contrast agents have been extended rapidly. However, there was no exact technical term which was received much recognition. The Japan society of ultrasonics in medicine carried out a questionnaire to 110 institutions in Japan and a symposium for the technical terms of contrast enhancement of US in the abdominal field. Based on the results of the questionnaire and the symposium, "Enhanced US" seems to be a most suitable term for the US using contrast agents. The terms of contrast effects of enhanced US for analysis are also discussed in this article.

Contrast Media↗

Living related partial liver transplantation for primary biliary cirrhosis--a case report.

An adult living related partial liver transplantation was performed on a 49 year old female with terminal hepatic failure due to primary biliary cirrhosis (PBC). The donor was her 53 year-old sister. A sufficient volume of graft tissue was obtained, which comprised 1.5% of the body weight of the recipient. The recipient had an excellent recovery without any major complications, and was discharged 35 days after the operation. At 15 months after the operation, the patient has shown no signs of rejection while using FK506 and prednisolone as immunosuppressants. The progression of symptomatic PBC can be predicted, and the timing of the transplantation can be easily determined. In addition, the results of liver transplantation for PBC are good. Therefore, adult living related partial liver transplantation is an excellent treatment for primary biliary cirrhosis.

Bilirubin↗

Immunoradiometric assay for the N-terminal fragment of proatrial natriuretic peptide in human plasma.

Recently, the N-terminal fragment of proatrial natriuretic peptide (N-terminal proANP) has been proposed as a marker of chronic congestive heart failure. In this study, we established a two-step immunoradiometric assay using monoclonal antibodies and synthetic N-terminal proANP (1-67) as a standard. It allows us to measure plasma N-terminal proANP in only 4 h without prior extraction. The detection limit of this assay was 15 pmol/L for a 100 microL sample of plasma. Within-run CVs ranged from 1.7% to 2.9% and between-run CVs ranged from 4.2% to 5.1%. The dilution curves of plasma samples showed good linearity and analytical recovery was 89-104%. The mean (+/-SD) N-terminal proANP in plasma of 33 healthy subjects was 188 (+/-71) pmol/L and 1030 (+/-411) pmol/L in 25 patients with heart failure. Our immunoradiometric assay is rapid and precise enough for routine determination of N-terminal proANP in human plasma.

Antibodies, Monoclonal↗

Effects of branched-chain amino acid-enriched nutrient mixture on natural killer cell activity in viral cirrhosis.

A controlled study was performed in 18 viral cirrhosis patients to evaluate whether immune function, as indicated by natural killer (NK) cell activity, was improved by a branched-chain amino acid-enriched nutrient mixture (nutrient-mixture), Aminoleban EN. Five patients received the nutrient-mixture (100 g/day) for 2 to 6 weeks preceded by control periods. Five additional patients received the nutrient-mixture for 2 to 4 weeks, and the remaining 8 patients did not receive the nutrient-mixture. NK cell activity, CD16, CD8, CD11b, and amino acids were assayed before and after the administration of the drug in the nutrient-mixture-supplemented group, and two times with 1 to 6 month intervals in the control group. In the nutrient-mixture-supplemented group (n = 10), increasing NK cell activity, expressed as the ratio of values of post-treatment to that of baseline (ratio > 1.25) was detected in 7 (70%) patients, whereas in the control group (n = 13), it was detected in only 1 (7.7%) (p < 0.01). While in the affected group (NK cell activity ratio > 1.25, n = 7), all patients had compensated liver cirrhosis, in the unaffected group (NK cell activity ratio < 1.25, n = 3), 2 of 3 patients had decompensated liver cirrhosis (p < 0.02). Laboratory data, indicating severity of liver cirrhosis, such as total bilirubin and albumin, showed better values (p < 0.01, p < 0.05 respectively), and baseline NK cell activity was low (8.7 +/- 7.2% vs 33.3 +/- 13.0%, p < 0.05) in the affected group than unaffected group. NK cell subpopulations such as CD16 (%), CD11b (%) and one of the populations of T cell such as CD8 (%) showed no significant change throughout the study. As for amino acids analysis, Fischer's ratio was increased in the nutrient-mixture-supplemented group compared to the control group (p < 0.05), but none of the amino acids showed significant change. Thus the changes in NK cell activity were not explained by increase in NK cell subpopulations nor changes of amino acids. These results suggest that the branched-chain amino acid-enriched nutrient mixture increases NK cell activity moderately in patients who have compensated liver cirrhosis and shows lower values of baseline NK cell activity.

Adult↗

Alterations in Pur(alpha) levels and intracellular localization in the CV-1 cell cycle.

Levels of the single-stranded DNA-binding protein Pur(alpha), previously implicated in control of both DNA replication and gene transcription, are altered during the CV-1 cell cycle. Just prior to the onset of S phase, Pur(alpha) levels drop precipitously, after which they recover nearly 8-fold throughout S and G2 to peak just after mitosis. As observed previously, Pur(alpha) binds the hypophosphorylated form of the retinoblastoma protein, Rb. Coimmunoprecipitation of Pur(alpha) and Rb reveals that the complex declines as cells enter S phase and does not reform as Pur(alpha) levels recover in S and G2. As Pur(alpha) levels recover, the protein is localized to nuclear foci containing newly replicated DNA, as determined by immunoelectron microscopy using different sized gold beads and antibodies against Pur(alpha) and bromodeoxyuridine-labeled DNA. These foci also contain cyclin A, and Pur(alpha) coimmunoprecipitates with cyclin A from extracts of cells in S and G2 phases. Pur(alpha) remains with these foci throughout G2, after the bulk of DNA synthesis has ceased. Changing levels of Pur(alpha) may affect Pur(alpha) functions at the onset of S phase and during progression to mitosis.

Animals↗

[Multicentric Castleman's disease with lymphoid interstitial pneumonia and polyneuropathy].

A 51-year-old woman was admitted to a local hospital because of pneumonia, and received a diagnosis of cervical lymphadenopathy, anemia, and hyperimmunoglobulinemia with suspected multicentric Castleman's disease (MCD). At the age of 53 she was transferred to our hospital because of numbness and muscle weakness. Polyclonal hyperimmunoglobulinemia was observed, and biopsy specimens of lymph node tissue revealed infiltration of plasma cells in the interfollicular areas, thus leading to a diagnosis of MCD. A chest computed tomography scan revealed diffuse nodular shadows in all lung fields, and a transbronchial lung biopsy disclosed infiltration of plasma cells in the alveolar septa. Together, these findings indicated lymphoid interstitial pneumonia (LIP). Polyneuropathy was diagnosed by neurological examination and nerve conduction studies. Treatment with prednisolone and cyclophosphamide was ineffective against LIP probably because the patient had coexising pulmonary fibrosis. Since pulmonary complications of MCD determine its prognosis, their early detection and treatment are essential.

Castleman Disease↗

[Disseminated carcinomatosis of the bone marrow occurring 11 years after subtotal gastrectomy for gastric cancer].

A 44-year-old man was admitted to our hospital because of purpura, increased serum alkaline phosphatase, and thrombocytopenia. He had undergone subtotal gastrectomy for gastric cancer 11 years earlier. A biopsy specimen of the bone marrow revealed metastatic mucin-forming, moderately differentiated adenocarcinoma. Because the primary tumor was not detected in any other organ, the gastric cancer the patient was treated for 11 years earlier was suspected as the primary tumor. Microangiopathic hemolytic anemia and disseminated intravascular coagulation developed during the clinical course, and the patient deteriorated despite treatment with anticoagulants. Finally, he died of pulmonary carcinomatous lymphangitis. Autopsy revealed a small number of adenocarcinomatous cells in the lymphoduct of the remaining stomach in spite of its mucosa being intact. We concluded that the bone marrow was infiltrated by cancer cells which originated in the stomach 11 years before. It is unclear why adenocarcinoma cells remained dormant for as long as 11 years in the gastric lymphoduct and bone marrow.

Adenocarcinoma↗

Pathological and histological study on retinoblastoma.

We studied 30 cases of retinoblastoma (Rb) pathologically and histochemically. Rb cases were classified into two types, 18 cases of differentiated (D-type) and 12 undifferentiated type (U-type) according to International Classification of Diseases for Oncology(1990, WHO). D-type of Rb is found more commonly in younger infants less than 1 year, but U-type found more frequently in aged infants from 2 to 4 years. D-type Rb showed more marked necrotic areas, degeneration and calcification. Immunohistochemical stains were carried out in 21 cases of Rb by use of MIB-1, PCNA, bcl-2, Fas, BAX, NF, SP and Tunel stains, respectively. MIB-1 is a good marker of proliferation of Rb cells and its high positivity correlates closely to more extensive necrotic areas of Rb cases. There are only a few positive cells by Tunel stain suggesting apoptotic cells, but diffuse positive cells by bcl-2 and Fas and completely negative by BAX gene. From these results, it can be seen that differentiation of Rb cells may be affected by bcl-2 and Fas but not by BAX gene.

Age Factors↗

Expression and localization of the urokinase-type plasminogen activator receptor (uPAR) in the human placenta.

In pregnancy the decrease in fibrinolytic activity has been described to date by many researchers. The placenta is a source of both plasminogen activator inhibitor type 2 (PAI-2) and type 1 (PAI-1). The PAI-2 was originally detected in the human placenta, which inhibits urokinase-type plasminogen activator (uPA) while it is unable to inhibit tissue type plasminogen activator (tPA). The urokinase-type plasminogen (uP) is activated by u-PA and urokinase-type plasminogen activator receptor (uPAR). We studied the expression and the localization of u-PAR in the human placenta by in situ hybridization, immunohistochemically and by use of Northern blot analysis. These data show that the decidualized endometorium have the cells with the greatest uPAR mRNA expression in the placenta, and syncytiotrophoblasts express lower level of uPAR mRNA.

Adolescent↗

Cloning of rat uncoupling protein-3 and uncoupling protein-2 cDNAs: their gene expression in rats fed high-fat diet.

In order to elucidate energy balance in the skeletal muscle, we cloned cDNA of a homologue of uncoupling protein (UCP) from rat skeletal muscle. We also cloned rat UCP-2 cDNA from rat brown adipose tissue (BAT). The UCP cloned from rat skeletal muscle showed 57% and 72% identity with rat UCP-1 and UCP-2. The mRNA was expressed abundantly in the skeletal muscle, moderately in the BAT, and slightly in the white adipose tissue (WAT) with a major band at 2.5 kb and a minor band at 2.8 kb, while the UCP-2 gene expression was widely detected in the whole body with substantial levels in the WAT and with slight levels in the skeletal muscle and BAT. The rat UCP cloned in the present study showed 86% identity with the recently cloned human UCP-3, which was also expressed abundantly in the skeletal muscle with a signal of 2.4 kb. Therefore, the rat UCP was considered to be rat UCP-3. In rats fed high-fat diet the UCP-3 gene expression was augmented 2-fold in the skeletal muscle while UCP-2 mRNA levels were increased significantly (1.6-fold) in the epididymal WAT. Augmented expression of UCPs may provide defense against high-fat induced obesity and impairment of glucose metabolism.

Adipose Tissue↗

Significance of ventricular myocytes and nonmyocytes interaction during cardiocyte hypertrophy: evidence for endothelin-1 as a paracrine hypertrophic factor from cardiac nonmyocytes.

BACKGROUND: In cardiac hypertrophy, both excessive enlargement of cardiac myocytes and progressive interstitial fibrosis are well known to occur simultaneously. In the present study, to investigate the interaction between ventricular myocytes (MCs) and cardiac nonmyocytes (NMCs), mostly fibroblasts, during cardiocytes hypertrophy, we examined the change in cell size and gene expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in cultured MCs as markers for hypertrophy in the neonatal rat ventricular cardiac cell culture system. METHODS AND RESULTS: The size of cultured MCs significantly increased in the MC-NMC coculture. Concomitantly, secretions of ANP and BNP into culture media were significantly increased in the MC-NMC coculture compared with in the MC culture (with the possible contamination of NMC <1% of MC). Moreover, in the MC culture, enlargement of MC and an increase in ANP and BNP secretions were induced by treatment with conditioned media of the NMC culture. A considerable amount of endothelin (ET)-1 production was detected in the NMC-conditioned media. BQ-123, an ET-A receptor antagonist, and bosentan, a nonselective ET receptor antagonist, significantly blocked the hypertrophic response of MCs induced by treatment with NMC-conditioned media. Angiotensin II (Ang II) (10(-10) to 10(-6) mol/L) and transforming growth factor-beta1 (TGF-beta1) (10(-13) to 10(-9) mol/L), both of which are known to be cardiac hypertrophic factors, did not induce hypertrophy in MC culture, but both Ang II and TGF-beta1 increased the size of MCs and augmented ANP and BNP productions in the MC-NMC coculture. This hypertrophic activity of Ang II and TGF-beta1 was associated with the potentiation of ET-1 production in the MC-NMC coculture, and the effect of Ang II or TGF-beta1 on the secretions of ANP and BNP in the coculture was significantly suppressed by pretreatment with BQ-123. CONCLUSIONS: These results demonstrate that NMCs regulate MC hypertrophy at least partially via ET-1 secretion and that the interaction between MCs and NMCs plays a critical role during the process of Ang II- or TGF-beta1-induced cardiocyte hypertrophy.

Angiotensin II↗