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Biomedical subjects

H Kawakami

Publications and source records attributed to H Kawakami.

At least 145 records · Page 8Linked to original sources
PubMed1996

[A 66-year-old woman with a patent ductus arteriosus and no significant progression of pulmonary arterial pressure over 17 years].

We report the case of a 66-year-old woman with a patent ductus arteriosus and no significant progression of pulmonary arterial pressure over 17 years. She was admitted to our hospital in 1978 because of palpitations on exertion and chest discomfort. Cardiac catheterization was done, and she was given a diagnosis of patent ductus arteriosus. Because the left-to-right shunt was small (15%) and because there was no evidence of pulmonary hypertension (38/18 mmHg), she was treated medically. In 1995 she was admitted again, to determine the cause of a cerebral infarction. The cerebral infarction was believed to have been caused by an embolism due to atrial fibrillation. She underwent cardiac catheterization again. The left-to-right shunt had increased to 41%, but the pulmonary artery pressure had not changed (27/14 mmHg). Intravascular ultrasound imaging was used to evaluate the ductus arteriosus. The diameter of the ductus was 4.4 mm and calcification was not observed. During the 17 years of follow-up, heart size increased slightly, but pulmonary artery pressure did not change. In addition, intravascular ultrasound was very useful for evaluating the condition of the ductus arteriosus.

Aged↗
PubMed1996

[Kinetics of peripheral blood CD34-positive cells and optimal timing of blood stem cell harvest after urological anticancer chemotherapy].

PURPOSE: We evaluated the changes in stem cells in peripheral blood and the optimal timing for harvesting peripheral blood stem cells (PBSCs) following the administration of conventional cancer chemotherapy in patients with urological malignancies. PATIENTS AND METHODS: We evaluated the changes in PBSCs after the administration of cancer chemotherapy in 12 patients with urological malignancies (6 testis cancer, 3 bladder cancer, 3 prostate cancer) using flowcytometry analysis of CD34, a marker of blood stem cell. We evaluated the optimal timing for PBSCs harvesting following the administration of conventional cancer chemotherapy in 6 patients with urological malignancies (2 patients with testis cancer, 3 patients with prostate cancer, 1 patient with bladder cancer) using flowcytometry analysis of CD34 and granulocyte-macrophage colony-forming units (CFU-GM) counts. PBSC samples from 2 patients with prostate cancer were analyzed by the reverse transcriptase-polymerase chain reaction (RT-PCR) method to detect prostate cancer cells. RESULTS: The percentages of CD34-positive cells tended to increase in the peripheral blood during the period of convalescence that followed the induction of marked myelosuppression produced by the cancer chemotherapy. The peak in CD34-positive cells occurred between days 15 and 31 after beginning of cancer chemotherapy. The percentage of CD34-positive cells was increased in the mononuclear cells in harvested PBSCs. The percentages of CD34-positive cells in peripheral blood and in mononuclear cells harvested from PBSCs was correlated with the CFU-GM counts in harvested PBSCs. The CFU-GM counts peaked between days 16 to 31 following cancer chemotherapy. RT-PCR detected prostate-specific antigen (PSA) mRNA expression in PBSCs obtained from 1 of the 2 patients with prostate cancer. An amount of contamination with PSA mRNA reduced as chemotherapy was repeated. CONCLUSION: A sufficient number of PBSCs can be harvested after conventional cancer chemotherapy without the need for special cytotoxic mobilization that may be delayed the patient's treatment. RT-PCR results suggested that the harvested PBSCs should be examined for tumor cell contamination in patients with metastasis in bone marrow. If a sufficient amount of PBSCs will be harvested, the PBSC samples from the patient with bone marrow metastasis after repeated chemotherapy should be used by priority for PBSC transplantation as of today.

Adolescent↗
PubMed1996

[Biochemical markers of bone formation in osteoporosis].

We measured circulating bone Gla-protein(BGP) changes following short-term(2 weeks) active vitamin D treatment in elderly men with osteoporosis (73.0 +/- 9.4 years, n = 9) to evaluate osteoblastic function. We also measured serum levels of BGP(n = 245) and bone specific ALP(B-ALP) in women (n = 113) with normal lumbar bone mineral density, and evaluated the difference in clinical significance between these markers of bone formation. Serum BGP was significantly increased at the end of the first and 2nd week of daily oral 2 micrograms of 1 alpha(OH)D3 administration. BGP measurement is a clinically useful method to detect osteoblastic function after active vitamin D3 treatment. Significant positive correlations were found between age and BGP (r = 0.402, p < 0.01) or B-ALP (r = 0.494, p < 0.01). These markers were significantly higher in postmenopausal women compared with age-matched premenopausal women. The z-score of the difference in B-ALP was 1.47 and that of BGP was 0.7. Although B-ALP and P1CP in sera remained stable even at room temperature for at least 4 hours, the BGP level was significantly lower when the blood sample was kept at room temperature for more than 1 hour. These findings suggest that B-ALP is a more sensitive and stable marker than BGP in evaluating bone formation, although both markers have significant correlations with each other, and BGP is useful to detect the active vitamin D3 effect on osteoblastic function.

Aged↗
PubMed1996

[Molecular genetics of Machado-Joseph disease].

Machado-Joseph disease (MJD) is an autosomal dominant spinocerebellar degeneration. The CAG expansions of the MJD1 gene at chromosome 14q32.1 was identified as the cause of the disease. MJD has three factors that influence the age of the onset. The MJD1 repeat length inversely correlated with the age of onset (r = -0.87). Homozygosity of the gene exhibited an additive effect on age of onset. MJD has a gender-specific effect on the age of onset. A parent-child analysis showed the unidirectional expansion of CAG repeats. Among the three clinical subtypes, type I of MJD, with dystonia, showed a larger degree of expansion in CAG repeats of the gene and younger ages of onset than the other types.

Age of Onset↗
PubMed1996

[Autosomal recessive early-onset parkinsonism with diurnal fluctuation (AR-EPDF)--clinical characteristics].

Among heterogeneous diseases manifested by parkinsonism beginning early in life, there is a disease presenting with marked diurnal fluctuation of symptoms, called autosomal recessive early-onset parkinsonism with diurnal fluctuation (AR-EPDF). To identify the characteristics of this condition as a disease entity, we examined the clinical manifestations of AR-EPDF patients (Group I, n = 42) in comparison with those of early-onset parkinsonism patients without diurnal fluctuation (Group II, n = 34). Family history suggesting autosomal recessive inheritance was noted in 85.7% of Group I patients and 17.6% of Group II. The male-to-female ratio was 1: 1.8 in Group I, and 1:0.89 in Group II. Age at onset showed a standard distribution with an average of 25.6 years (SD: +/- 7.7) in Group I and an average of 32.7 with an increasing pattern toward 40 years in Group II. The initial symptom was dystonic gait disturbance in 42.9% of Group I and 5.9% of Group II, parkinsonian gait in 19.9% of Group I and 2.9% of Group II, and tremor in 28.6% of Group I and 41.2% of Group II. The main clinical feature was parkinsonism in both groups. Diurnal fluctuation of parkinsonism was remarkable in all but one (97.6%) of Group I, while it was not observed in Group II. Dystonic postures were noted in 79.4% of Group I and in 37.1% of Group II; hyperactive tendon reflexes in 74.3% of Group I patients and in 20% of Group II. Autonomic symptoms were mild in both groups. None of the Group I patients had dementia while two of Group II did. Levodopa was markedly effective in both groups. Dopa-induced dyskinesia was observed in 96.8% of Group I and in 61.8% of Group II. As for progression of the disease, the Hoehn-Yahr stage of patients on medication was evaluated as 2.2 +/- 0.7 (mean +/- SD) in Group I and 3.1 +/- 1.1 in Group II for a period of 10 to 20 years of onset, 2.5 +/- 0.8 in Group I and 3.3 +/- 0.5 in Group II for 20 to 30 years, and 3.2 +/- 0.9 in Group I and 4.3 +/- 0.6 in Group II after 30 years. There were significant differences between the two groups in the frequency of positive family history, in the mean and distribution of age at onset, in the incidence of dystonic gait as the initial symptom, and in the incidences and medians of the variables including dystonia, hyperreflexia and dopa-induced dyskinesia, as well as in the progression of the disease. Thus, we have successfully characterized the clinical features of AR-EPDF and demonstrated that diurnal fluctuation is a cardinal symptom of this disease. Reported pathologic studies on AR-EPDF showed the nigral lesion characterized by non-Lewy body type degeneration and the occurrence of melanin-poor neurons. These pathologic findings as well as the clinical manifestations differentiate AR-EPDF from Parkinson's disease and from autosomal-dominant familial parkinsonism. Low melanin-content of the nigral neurons is also a striking feature of hereditary progressive dystonia with diurnal fluctuation, in which unlike AR-EPDF there is no neuronal loss in the substantia nigra.

Adult↗
PubMed1996

[Glutamate transporter and neuronal cell death].

Glutamate transporters play an important role in keeping extracellular glutamate concentrations below the neurotoxic levels. We cloned a human glutamate transporter hGluT-1. In ischemic states, glutamate efflux via glutamate transporters and the extracellular glutamate concentrations are rapidly increased. These phenomenon enlarges the area of neuronal cell death. We showed that L-CCG-III, IV and glutamate block the reverse uptake (efflux) of glutamate in the hGluT-1 expressing HeLa cells. In amyotrophic lateral sclerosis, a glutamate transporter GLT1 was decreased. Decrease of the glutamate transporter will cause the elevation of extracellular glutamate concentrations and will lead to the neuronal injury. Bromocriptine enhances glutamate uptake 1.5 times than in its absence in the hGluT-1 expressing HeLa cells. Enhancing the removal of extracellular glutamate may produce similar effect as those achieved by glutamate-receptor antagonists. At two neuronal death conditions, we showed new possibilities of preventing neuronal cell death by the glutamate transporter regulators.

ATP-Binding Cassette Transporters↗
PubMed1995

Inhibition by folded isomers of L-2-(carboxycyclopropyl)glycine of glutamate uptake via the human glutamate transporter hGluT-1.

The effects of isomers of 2-(carboxycyclopropyl)glycine (CCG) on uptake of L-glutamate were investigated in COS-7 cells that expressed a cloned human glutamate transporter (hGluT-1). The (2S, 3S, 4R)-isomer (L-CCG-III) and the (2S, 3R, 4S)-isomer (L-CCG-IV) markedly inhibited glutamate uptake with a 50% inhibitory concentration of 290 nM and 1.1 microM, respectively. The (2S, 3S, 4S)-isomer (L-CCG-I) and the (2S, 3R, 4R)-isomer (L-CCG-II) did not inhibit glutamate uptake at concentrations of < or = 10 microM. Thus, hGluT-1 showed a markedly higher affinity for L-CCG-III and L-CCG-IV with a folded conformation of the glutamate skeleton, than for L-CCG-I or L-CCG-II with an extended conformation.

ATP-Binding Cassette Transporters↗
PubMed1995

Radiographic diagnosis and surgical repair of a sciatic hernia: report of a case.

We report the case of a 44-year-old woman who presented with a reducible painless swelling in her left buttock. The mass was preoperatively diagnosed as a sciatic hernia by herniography, which showed the peritoneal sac through the sciatic foramen, and by enterography, intravenous pyelography, and cystography, which demonstrated that the small intestine and urinary bladder had herniated into the sac. The diagnosis and management of this patient are described, followed by a review of the literature on sciatic hernias.

Adult↗
PubMed1995

Peanut agglutinin binding to human prolactin-producing pituitary adenomas.

Peanut agglutinin (PNA)-binding sites in human prolactin (PRL)-producing pituitary adenomas were examined by light and electron microscopy together with immunoblot analysis. At the light microscopic level, the majority of the PRL-producing adenoma cells stained positively for PNA in 15 of 20 cases. PNA binding observed in the cytoplasm had a granular appearance. PRL-producing cells adjacent to the adenoma tissue showed negative PNA staining. In normal pituitary glands, the PRL-positive glandular cells were negative for PNA staining. By electron microscopy, reaction products showing PNA-binding sites were detected in some of the secretory granules. Immunoblotting analysis revealed that the PRL bands corresponded to PNA-stained ones with the exception of the main 23-kDa band. PNA-binding sites have some relation to the secretory granules containing glycosylated forms of PRL. These observations suggest that PNA staining can be used as a valuable method to analyze human PRL-producing pituitary adenomas.

Adenoma↗
PubMed1995

Inhibition of mitogen-induced proliferative responses of lymphocytes by bovine kappa-caseinoglycopeptides having different carbohydrate chains.

Bovine kappa-caseinoglycopeptides (i.e. residues 106-169, CGP) were prepared from kappa-casein digested with rennin and a commercial whey protein concentrate. CGP from whey protein concentrate was further divided into seven CGP fractions having different carbohydrate compositions using FPLC. Unfractionated CGP inhibited lipopolysaccharide (LPS)- and phytohaemagglutinin (PHA)-induced proliferative responses of mouse spleen cells and rabbit Peyer's patch cells. The unfractionated CGP also inhibited antibody responses to sheep red blood cells in mouse spleen cell cultures. However, seven CGP fractions having zero to five N-acetylneuraminic acid (NANA) residues had different inhibitory effects on both LPS- and PHA-induced proliferative responses of mouse spleen cells. The inhibitory effect on PHA-induced proliferative responses increased with increasing numbers of NANA residues, whereas that on LPS-induced proliferation was highest with the CGP fraction having two NANA residues. Both inhibitory effects decreased significantly after neuraminidase or chymotrypsin digestion. These findings indicate that both the carbohydrate (particularly the NANA residues) and the polypeptide portions are essential for inhibitory effects on LPS- and PHA-induced proliferative responses of mouse spleen cells.

Animals↗
PubMed1995

Hypercalcemia associated with Aeromonas hydrophila gastro-enteritis.

We describe a 4 year old girl with acute Aeromonas hydrophila gastro-enteritis who presented with a combination of hypercalcemia, metabolic alkalosis, and renal impairment. Serum parathyroid hormone was not elevated. Both milk-alkali syndrome and intoxication of vitamins A and D were ruled out. The hypercalcemia, metabolic alkalosis, and renal impairment were improved by fluid infusion and intravenous administration of furosemide. Gastro-enteritis also improved with oral administration of the antibiotic norfloxacin. The association of A. hydrophila gastro-enteritis with hypercalcemia has not been described previously.

Aeromonas hydrophila↗
PubMed1995

Acute effect of glyceryl trinitrate on systolic blood pressure and other hemodynamic variables.

The acute effect of glyceryl trinitrate (GTN) is mainly the reduction of systolic blood pressure (SBP) rather than diastolic blood pressure (DBP). To examine the mechanisms for decrease in SBP by GTN, the authors measured arterial compliance (AC), cardiac output (CO), stroke volume (SV), pulmonary capillary wedge pressure, right ventricular end-diastolic pressure, right atrial pressure, and left ventricular end-diastolic pressure before and after administration of GTN. Fourteen patients who underwent cardiac catheterization were included in this study. The change of each variable was estimated by the differences between values just before and at three minutes after GTN. After administration of GTN, SBP was significantly decreased from 158 +/- 21 to 138 +/- 12 mmHg (P < 0.01). AC was significantly increased, and pulmonary capillary wedge pressure, CO, and SV were significantly decreased. The change in SBP was inversely correlated with the change in AC and positively correlated with the change in CO or SV. The authors conclude that the mechanism for decrease in SBP by GTN is associated with both an increase in AC and a decrease in venous return.

Administration, Sublingual↗