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Biomedical subjects

H Kawamoto

Publications and source records attributed to H Kawamoto.

At least 73 records · Page 4Linked to original sources
PubMed2000

[Development of a case of Mycobacterium avium complex disease from right pleural effusion].

Moist pleurisy in patients with Mycobacterium avium Complex (MAC) is rarer than tuberculosis. We encountered an extremely rare case of MAC disease in a 75-year-old man who initially had only right pleural effusion. Gaffky VII was detected in the pleural effusion, and Mycobacterium avium was identified by culture and PCR. Although administration of antitubercular agents (RFP, INH, EB, and SM) + CAM and thoracic lavage were repeated, the Gaffky persisted strongly. Accordingly, pulmonary decortication and filling of the cavity with an omental flap were performed as surgical treatments. However, fistulas were formed between the remaining empyema cavity and the surgical wounds. Fenestration was also carried out. Postoperatively, centriacinar abnormalities appeared on computed tomography (CT). It has been reported that MAC disease begins with centriacinar abnormalities and the incidence of the lymphatic developmental pattern was low. Tuberculosis (the idiopathic pleuritis type) is considered to be caused this pattern from the primary infection focus. Therefore, the onset of unilateral effusion is extremely rare in patient with MAC disease, suggesting that the lymphatic developmental pattern occurs less frequently in patients with MAC disease. Furthermore, in this case, we speculated that centriacinar abnormalities were the MAC infection foci and could be detected by CT due to surgical invasion.

Aged↗
PubMed2000

[Two cases with coil embolization following incomplete neck clipping].

We report two cases with embolization (coil embolization) using Guglielumi detachable coils of residual aneurysms following incomplete neck clipping. The first case, a 75-year-old woman suffered from a subarachnoid hemorrhage due to the rupture of a left internal carotid posterior communicating aneurysm in June, 1997. Neck clipping of the aneurysm was performed at day 1. Follow-up angiogram at day 7 showed a residual aneurysm involving the dome of the initial aneurysm. We performed coil embolization of the residual aneurysm following the angiogram. Almost complete obliteration of the aneurysm lasted during the follow-up period of two and a half years. The second case, a 71-year-old woman suffered from a subarachnoid hemorrhage due to the rupture of a right internal carotid posterior communicating aneurysm in May, 1999. Neck clipping of the aneurysm was performed at day 1. Follow-up angiogram at day 7 showed a residual aneurysm involving only a part of the initial aneurysm near the neck. Because no spontaneous thrombosis of the residual aneurysm was obtained after 2 months, we performed coil embolization of the residual aneurysm. Almost complete obliteration of the aneurysm lasted during the follow-up period of 7 months. These patients were discharged with good performance status. We consider the morphologic feature of the residural aneurysm to be most important for determining when to perform coil embolization of such residual aneurysms.

Aged↗
PubMed1999

Commitment of common T/Natural killer (NK) progenitors to unipotent T and NK progenitors in the murine fetal thymus revealed by a single progenitor assay.

We have established a new clonal assay system that can evenly support the development of T and natural killer (NK) cells. With this system, we show that all T cell progenitors in the earliest CD44(+)CD25(-)FcgammaRII/III(-) fetal thymus (FT) cell population retain NK potential, and that the NK lineage-committed progenitors (p-NK) also exist in this population. T cell lineage-committed progenitors (p-T), which are unable to generate NK cells, first appear at the CD44(+)CD25(-) FcgammaRII/III(+) stage in day 12 FT. The proportion of p-T markedly increases during the transition from the CD44(+)CD25(-) stage to the CD44(+)CD25(+) stage in day 14 FT. On the other hand, p-NK preferentially increase in number at the CD44(+)CD25(-) stage between days 12 and 14 of gestation. The production of p-NK continues up to the CD44(+)CD25(+) stage, but ceases before the rearrangement of T cell receptor beta chain genes. It was further shown that the CD44(+)CD25(-) CD122(+) population of day 14 FT exclusively contains p-NK. These results indicate that the earliest T cell progenitor migrating into the FT is T/NK bipotent, and strongly suggest that the bipotent progenitor continuously produces p-NK and p-T until the CD44(+)CD25(+) stage.

Animals↗
PubMed1999

Emergence of T, B, and myeloid lineage-committed as well as multipotent hemopoietic progenitors in the aorta-gonad-mesonephros region of day 10 fetuses of the mouse.

We investigated the developmental potential of hemopoietic progenitors in the aorta-gonad-mesonephros (AGM) region, where the definitive type hemopoietic progenitors have been shown to emerge before the fetal liver develops. By using an assay system that is able to determine the developmental potential of individual progenitors toward the T, B, and myeloid lineages, we show that not only multipotent progenitors but also progenitors committed to the T, B, or myeloid lineage already exist in this region of day 10 fetuses. Bipotent progenitors generating myeloid and T cells or those generating myeloid and B cells were also detected, suggesting that the commitment to T and B cell lineages is in progress in the AGM region. The numbers of these progenitors, however, were only 1/200-1/1000 of those in fetal liver of day 12 fetuses. Such small numbers of progenitors suggest that hemopoiesis has just started in the AGM region of day 10 fetuses. Although most of T cell lineage-committed progenitors in the AGM region generated only a small number of immature T cells, some were able to generate a large number of mature T cells. The detection of various types of lineage-committed progenitors strongly suggests that the AGM region is not only the site of stem cell emergence, but also the site of hemopoiesis, including lineage commitment. The T cell progenitors found in the AGM region may represent the first immigrants to the thymus anlage.

Animals↗
PubMed1999

Extracapsular invasion of lymph node metastasis. A good indicator of disease recurrence and poor prognosis in patients with thyroid microcarcinoma.

BACKGROUND: The majority of patients with thyroid microcarcinoma have a favorable prognosis. However, some patients may die from this tumor. Although the incidence of microcarcinoma is high, to the authors' knowledge no histologic risk factors have been identified. The objective of this study was to establish risk factors for patients with thyroid microcarcinoma. METHODS: The histologic findings for 1743 surgically excised thyroid microcarcinomas (</=10 mm in greatest dimension) and simultaneously obtained lymph nodes from 324 microcancer patients were reexamined to determine risk factors. Follow-up for the patients was 11.2 +/- 6.3 years (mean +/- standard deviation). These thyroid carcinomas were classified according to the World Health Organization Histological Classification system, and lymph node involvement was classified into two groups: those patients with extracapsular invasion of the lymph node metastasis (ECI) (62 patients) and those patients without (1681 patients). A Fisher exact test, an F test, univariate and multivariate proportional hazards regression analyses, and a Kendall correlation measurement were performed. RESULTS: No undifferentiated tumors were found among the microcarcinomas. During the follow-up period, 1643 of 1743 patients were alive without recurrence, 25 were alive with recurrence, 71 had died of thyroid-unrelated diseases including 2 patients with recurrence, and 4 had died of recurrent thyroid carcinoma. In total, recurrence was noted in 31 patients. Multivariate proportional hazards regression analysis revealed that the absence of Graves disease (risk ratio = 5) and the presence of ECI (risk ratio = 7) were significant risk factors for disease recurrence. Univariate analysis revealed that patient age and the presence of ECI were significant risk factors for thyroid carcinoma-related deaths. CONCLUSIONS: The presence of ECI of lymph node metastasis in patients with thyroid microcarcinoma was found to be a significant indicator of disease recurrence and a poorer prognosis.

Adult↗
PubMed1999

A cell-autonomous requirement for CXCR4 in long-term lymphoid and myeloid reconstitution.

Mice lacking the chemokine stromal cell-derived factor/pre-B cell growth stimulating factor or its primary physiological receptor CXCR4 revealed defects in B lymphopoiesis and bone marrow myelopoiesis during embryogenesis. We show here that adoptive transfer experiments reveal a deficiency in long-term lymphoid and myeloid repopulation in adult bone marrow by CXCR4-/- fetal liver cells, although stromal cell-derived factor/pre-B cell growth stimulating factor-/- fetal liver cells yield normal multilineage reconstitution. These findings indicate that CXCR4 is required cell autonomously for lymphoid and myeloid repopulation in bone marrow. In addition, CXCR4-/- fetal liver cells generated much more severely reduced numbers of B cells relative to other lineages in bone marrow. Furthermore, the repopulation of c-kit+ Sca-1(+) linlow/- cells by CXCR4-/- fetal liver cells was less affected compared with c-kit+ Sca-1(-) linlow/- cells. By previous studies, it has been shown that c-kit+ Sca-1(+) linlow/- cells are highly purified primitive hematopoietic progenitors and that c-kit+ Sca-1(-) linlow/- cells are more committed hematopoietic progenitors in mice. Thus, CXCR4 may play an essential role in generation and/or expansion of early hematopoietic progenitors within bone marrow.

Animals↗
PubMed1999

Synthesis and biological activities of topoisomerase I inhibitors, 6-N-amino analogues of NB-506.

6-N-Amino analogues of NB-506 [6-N-formylamino-12,13-dihydro-1,11-dihydroxy-13-(beta-D-glucopyranosyl) -5H-indolo[2,3-a]pyrrolo[3,4-c]carbazole-5,7(6H)-dione] (3b) were synthesized and tested with respect to topoisomerase inhibition, cytotoxicity and anticancer effects. Among them, a 1,3-dihydroxypropane analogue (J-109,404, 5t) showed more than ten times more potent anticancer activity in MKN-45 human stomach cancer cells implanted in mice than NB-506.

Animals↗
PubMed1999

Emergence of T cell progenitors without B cell or myeloid differentiation potential at the earliest stage of hematopoiesis in the murine fetal liver.

It has been unclear whether the progenitors colonizing the thymus are multipotent or T cell lineage restricted. We investigated the developmental potential of hematopoietic progenitors in various populations of liver and blood cells from day 12 fetuses using the recently established in vitro experimental system effective in determining the capability of individual progenitors to generate T, B, and myeloid cells. Multipotent progenitors (p-Multi) were exclusively found in the Sca-1 high-positive (Sca-1high) subpopulation of lineage marker (Lin)-c-kit+CD45+ fetal liver cells. Restriction of developmental capacity begins at the Sca-1high stage, and a large majority of progenitors in the Sca-1low or Sca-1- population are restricted to generate T, B, or myeloid cells. Such a lineage commitment or restriction taking place in the fetal liver is independent of the thymus, because no difference in the proportion of different types of progenitors were seen between nu/nu and nu/+ fetuses. T cell lineage-restricted progenitors (p-T) were abundant in the blood of day 12 fetuses, whereas p-Multi were undetectable. It was further shown that the p-Multi generated a large number of B and myeloid cells in the thymic lobe. These results strongly suggest that it is p-T but not p-Multi that migrate into the thymus.

Animals↗
PubMed1999

Thymic microenvironments, 3-D versus 2-D?

Lympho-stromal interactions in the thymus crucially de- termine the fate of developing T cells. Epithelial cells, inter- digitating reticular cells, macrophages and fibroblasts all play a role in the shaping of the T cell repertoire. Recently published evidence shows that lympho-stromal interaction acts bi-directional. Developing T cell themselves, at different stages of differentiation, control the microarchitecture of thymic microenvironments, a phenomenon designated as 'crosstalk'. This paper reviews experiments showing that developing T cells crosstalk to different thymic epithelial cells in a stepwise fashion. In this way, correctly organized thymic microenvironments guarantee normal thymopoiesis.

Animals↗
PubMed1999

Disappearance of serum HCV-RNA after short-term prednisolone therapy in a patient with chronic hepatitis C associated with autoimmune hepatitis-like serological manifestations.

We report a 70-year-old woman with chronic hepatitis C associated with autoimmune hepatitis (AIH)-like serological manifestations, in whom elimination of hepatitis C virus (HCV) was observed after corticosteroid treatment. The patient was infected with HCV, genotype Ib, but had several laboratory findings, such as markedly elevated serum gamma-globulin and IgG, characteristic of AIH, as well as a high titer of an anti-nuclear antibody. An ultrasound (US)-guided liver biopsy disclosed chronic active hepatitis F3. Corticosteroid worsened her liver function test results and raised amounts of HCV-RNA in the serum. Withdrawal of the corticosteroid led to prompt normalization of transaminase levels and the disappearance of serum HCV-RNA, determined by reverse transcription-polymerase chain reaction (RT-PCR). For 4 years, up to the time of this study, her transaminase values have been normal and HCV viremia was not detected by repeated RT-PCR. We believe this to be the first reported case in which eradication of HCV was achieved by corticosteroid therapy alone, without the introduction of interferon.

Aged↗
PubMed1999

Secretion of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 by meningiomas detected by cell immunoblot analysis.

To identify features of meningiomas that infiltrate dura mater, and to examine the role Matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) secretion in meningiomas, a cell immunoblot assay study was performed in 20 meningiomas. MMP-9 secretion was detected in 20 (100%) meningiomas and was independent of histological features. TIMP-1 secretion was detected in 8 (40%) meningiomas. For a cell immunoblot volume which included approximately 1350 cells, there were 50.4 +/- 49.4 dots which showed immunoreactivity to MMP-9 and 2.0 +/- 4.2 which showed immunoreactivity to TIMP-1. The number of dots that showed immunoreactivity to MMP-9 was not significantly different between tumours with atypical and benign histological features. TIMP-1 secretion was found in only 8 (40%) specimens and the percentage of TIMP-1 secreting cells was significantly lower than that of MMP-9 secretion. Thus, we propose that meningiomas classified histologically as both atypical and benign have the potential to infiltrate dura mater.

Adult↗
PubMed1999

Dissecting aneurysm of basilar artery presenting with recurrent subarachnoid hemorrhage.

Spontaneous basilar dissecting aneurysms secondary to subarachnoid hemorrhage are rare, usually presenting with ischemia rather than a subarachnoid hemorrhage (SAH). A 63-year-old man who had SAH repeatedly from a ruptured basilar dissecting aneurysm was treated with endovascular occlusion of the unilateral vertebral artery. Postoperative angiograms 1 month after the procedure showed complete obliteration of the aneurysm. The clinical follow-up at 20 months showed no evidence of recurrent hemorrhage.

Aortic Dissection↗
PubMed1999

Postoperative tetany in Graves disease: important role of vitamin D metabolites.

OBJECTIVE: To test the authors' hypothesis of the causal mechanism(s) of postoperative tetany in patients with Graves disease. SUMMARY BACKGROUND DATA: Previous studies by the authors suggested that postoperative tetany in patients with Graves disease occurs during the period of bone restoration and resulted from continuation of a calcium flux into bone concomitant with transient hypoparathyroidism induced by surgery. PATIENTS AND METHODS: A prospective study was carried out to investigate sequential changes in serum levels of intact parathyroid hormone (iPTH), calcium and other electrolytes, 25-hydroxyvitamin D (25OHD), 1,25-dihydroxyvitamin D (1,25(OH)2D), and bone metabolic markers in 109 consecutive patients with Graves disease who underwent subtotal thyroidectomy. RESULTS: Preoperative serum iPTH levels negatively correlated with ionized calcium levels and positively correlated with 1,25(OH)2D or 1,25(OH)2D/25OHD. After the operation, there was a significant decline in levels of ionized calcium, magnesium, and iPTH. Serum iPTH was not detected in 15 patients after surgery. Four of these 15 patients, and 1 patient whose iPTH level was below normal, developed tetany. Preoperative serum ionized calcium levels were significantly lower, and iPTH levels were higher, in the 5 patients with tetany than in the 11 patients who did not develop tetany despite undetectable iPTH levels. The tetany group had significantly lower serum 25OHD levels and higher 1,25(OH)2D levels, and had increased 1,25(OH)2D/25OHD as an index of the renal 25OHD-1-hydroxylase activity than those in the nontetany group. These results suggest that patients with a high serum level of iPTH as a result of low serum calcium levels (secondary hyperparathyroidism) are susceptible to tetany under conditions of hypoparathyroid function after surgery. CONCLUSIONS: Postoperative tetany occurs in patients with secondary hyperparathyroidism caused by a relative deficiency in calcium and vitamin D because of their increased demand for bone restoration after preoperative medical therapy concomitant with transient hypoparathyroidism after surgery. Calcium and vitamin D supplements may be recommended before and/or after surgery for patients in whom postoperative tetany is expected to develop.

Adolescent↗
PubMed1999

Increased expression of inducible nitric oxide synthase in nasal epithelial cells in patients with allergic rhinitis.

OBJECTIVES: Although ciliated epithelial cells of human nose and paranasal sinuses have recently been reported to be the major source of locally detected nitric oxide (NO), changes to the NO production by these cells and their functional roles remain uncertain in relation to allergic rhinitis. The objective of this study is to investigate differences in the ability of induction of nitric oxide synthase (NOS) isoforms by nasal epithelial cells. STUDY DESIGN: Epithelial cells of the inferior turbinate taken from 12 normal subjects and 12 allergic patients against house dust mite were used. Samples from the house dust group were taken both before and after antigen provocation. METHODS: Immunoreactivity for two NOS isoforms, inducible NOS (iNOS) and endothelial NOS (eNOS), was examined by the laser scanning confocal microscope. The labeled cells were processed into digital images, and the fluorescence intensity was assessed quantitatively. RESULTS: The degree of iNOS expression of the epithelial cells was significantly elevated in the house dust group compared with that of the control group. The expression appeared identical both before and after antigen provocation in the house dust group. On the other hand, there was no significant difference in eNOS expression between the two groups. CONCLUSIONS: We assume that the increased iNOS expression of the epithelial cells in the house dust group might result from stimulated secretion of proinflammatory cytokines during allergic responses. This further suggests profound contribution of nasal epithelial cells to modifying the airway clearance through the production of high levels of NO.

Adult↗
PubMed1999

Human NELL-1 expressed in unilateral coronal synostosis.

Surgical correction of unilateral coronal synostosis offers a unique opportunity to examine the molecular differences between an abnormal and a normal cranial suture. We isolated and identified a cDNA fragment whose expression was up-regulated in the premature fusing and fused coronal sutures, as compared with normal coronal sutures. The nucleotide sequence of the full-length cDNA of this gene, human NELL-1, has approximately 61% homology with the chicken Nel gene. Both chicken Nel and human NELL-1 are comprised of six epidermal growth factor-like repeats. The human NELL-1 messages were localized primarily in the mesenchymal cells and osteoblasts at the osteogenic front, along the parasutural bone margins, and within the condensing mesenchymal cells of newly formed bone in sites of premature sutural fusion. Human multiorgan tissue mRNA blot showed that NELL-1 was specifically expressed in fetal brain but not in fetal kidney, liver, or lung. We also showed that Nell-1 was expressed in rat calvarial osteoprogenitor cells and was largely absent in rat tibiae and fibroblast cell cultures. In conclusion, our data suggest that the NELL-1 gene is preferentially expressed in cranial intramembranous bone and neural tissue (both of neural crest cell origin) and is up-regulated during unilateral premature closure of the coronal suture. The precise role of this gene is unknown.

Amino Acid Sequence↗
PubMed1999

[The present and future of the pulmonary function tests. The relationship between respiratory and non-respiratory function].

Pulmonary function is classified as respiratory and non-respiratory function. Respiratory pulmonary function involves exchange of O2 and CO2 gas at alveolar units in the lung and non-respiratory pulmonary function concerns metabolism of enzymes, hormones, surfactants vaso-active substances and immunological factors in the lung. The purpose of this study was to examine the relationship between respiratory and non-respiratory function using our newly developed expired NO gas continuous analytic method and the calculation method of ventilatory energy of the lung. Furthermore, we analyzed the relationship between arterial blood O2 pressure (PaO2) and mitochondrial function.

Humans↗