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Biomedical subjects

H Kojima

Publications and source records attributed to H Kojima.

At least 325 records · Page 18Linked to original sources
PubMed1996

Prostaglandin E2 increases the calcium concentration in rat brown adipocytes and their consumption of oxygen.

Effects of prostaglandin E2 (PGE2) were examined on the oxygen consumption and intracellular calcium concentration of rat brown adipose tissue (BAT). PGE2 0.1 nM-1 microM increased oxygen consumption of the tissue blocks of BAT, with a maximum 2-13 min after PGE2 administration. PGE2 was most effective at 1 and 10 nM, and the oxygen consumption was elevated for over 40 min. Pretreatment of BAT with indomethacin, a prostaglandin synthesis inhibitor, did not affect the increase in oxygen consumption induced by noradrenaline. PGE2 at 1-10 nM gradually increased the intracellular calcium concentration of freshly dispersed single brown adipocytes by 3-4 times in 30 min. PGF2 also increased the intracellular calcium concentration of brown adipocytes in calcium-free medium. These results raise the possibility that PGE2 and noradrenaline affect heat genesis and metabolism of BAT independently.

Adipose Tissue, Brown↗
PubMed1996

Radiation therapy for T1,2 glottic carcinoma: impact of overall treatment time on local control.

PURPOSE: Local control probabilities of T1,2 glottic laryngeal cancer were evaluated in relation to dose and fractionation of radiation therapy (RT). MATERIALS AND METHODS: Between 1975 and 1993, 96 T1N0M0 glottic cancers and 32 T2N0M0 glottic cancers were treated with definitive RT. Total RT dose was 60-66 Gy/2 Gy for most of the T1 and T2 tumors, although 10 T2 tumors were treated with hyperfractionation (72-74.4 Gy/1.2 Gy bid). Of the 128 patients, 90 T1 glottic tumors and 30 T2 glottic tumors were followed for > 2 years after treatment. Multivariate analyses using the Cox proportional hazards model and a logistic regression analysis were performed to evaluate the significance of prognostic variables on local control. RESULTS: The 5-year local control probability for T1 tumors was 85%, whereas that for T2 tumors was 71%. Multivariate analyses demonstrated that only overall treatment time (OTT) was a significant variable for local control. Total RT dose, normalized total doses at a fraction size of 2 Gy, and fraction size were not significant. Local control probability of T1 tumors with an OTT of 42-49 days was significantly higher than that of tumors with an OTT of > 49 days (P < 0.02). Only a 1-week interruption of RT, due to holidays, significantly reduced the 5-year local control probability of T1 glottic tumors from 89 to 74% (P < 0.05). CONCLUSIONS: These results indicate that OTT is a significant prognostic factor for local control of T1 glottic tumors.

Adult↗
PubMed1996

Clinicopathological characteristics of primary Ki-1 anaplastic large cell lymphoma.

The clinical findings and prognosis in 15 patients with primary Ki-1 anaplastic large cell lymphoma (ALCL) were analyzed and compared with those of patients with T cell and B cell lymphoma and Hodgkin's disease. Clinical data revealed lymphadenopathy in 13 patients (87%) and skin lesions in eight (53%). Other organic involvements were hepatomegaly in two patients (13%), splenomegaly in five (33%), and bone marrow involvement in three (20%). The rate of skin involvement was significantly higher than that in B cell lymphoma and Hodgkin's disease. In laboratory findings the gamma-globulin concentration was significantly higher than that in T cell lymphoma, and the erythrocyte sedimentation rate (ESR) was significantly higher than that in B cell lymphoma. Complete remission was achieved in 11 patients (73%) and the five-year relapse-free survival was 27%. The overall survival was 4.0-69.8 months (mean 30.6 months). The mean survival was compatible with that of T cell lymphoma and was significantly shorter than that in Hodgkin's disease. Ki-1 ALCL can be distinguished from other lymphomas clinically as well as pathologically. Because Ki-1 ALCL is chemosensitive and the prognosis is as poor as that of T cell lymphoma, aggressive chemotherapy should be employed for the treatment of this disease.

Hodgkin Disease↗
PubMed1996

Multiple- and single-molecule analysis of the actomyosin motor by nanometer-piconewton manipulation with a microneedle: unitary steps and forces.

We have developed a new technique for measurements of piconewton forces and nanometer displacements in the millisecond time range caused by actin-myosin interaction in vitro by manipulating single actin filaments with a glass microneedle. Here, we describe in full the details of this method. Using this method, the elementary events in energy transduction by the actomyosin motor, driven by ATP hydrolysis, were directly recorded from multiple and single molecules. We found that not only the velocity but also the force greatly depended on the orientations of myosin relative to the actin filament axis. Therefore, to avoid the effects of random orientation of myosin and association of myosin with an artificial substrate in the surface motility assay, we measured forces and displacements by myosin molecules correctly oriented in single synthetic myosin rod cofilaments. At a high myosin-to-rod ratio, large force fluctuations were observed when the actin filament interacted in the correct orientation with a cofilament. The noise analysis of the force fluctuations caused by a small number of heads showed that the myosin head generated a force of 5.9 +/- 0.8 pN at peak and 2.1 +/- 0.4 pN on average over the whole ATPase cycle. The rate constants for transitions into (k+) and out of (k-) the force generation state and the duty ratio were 12 +/- 2 s-1, and 22 +/- 4 s-1, and 0.36 +/- 0.07, respectively. The stiffness was 0.14 pN nm-1 head-1 for slow length change (100 Hz), which would be approximately 0.28 pN nm-1 head-1 for rapid length change or in rigor. At a very low myosin-to-rod ratio, distinct actomyosin attachment, force generation (the power stroke), and detachment events were directly detected. At high load, one power stroke generated a force spike with a peak value of 5-6 pN and a duration of 50 ms (k(-)-1), which were compatible with those of individual myosin heads deduced from the force fluctuations. As the load was reduced, the force of the power stroke decreased and the needle displacement increased. At near zero load, the mean size of single displacement spikes, i.e., the unitary steps caused by correctly oriented myosin, which were corrected for the stiffness of the needle-to-myosin linkage and the randomizing effect by the thermal vibration of the needle, was approximately 20 nm.

Actomyosin↗
PubMed1996

Chronic neutrophilic leukemia associated with monoclonal gammopathy of undetermined significance.

A 30-year-old man with chronic neutrophilic leukemia (CNL) in association with monoclonal gammopathy is presented. Physical examination on admission revealed moderate hepatosplenomegaly. Initial blood count showed neutrophilic leukocytosis (42.2 x 10(9)/1 with 90% mature neutrophils). Leukocyte alkaline phosphatase (LAP) score was elevated. Bone marrow aspiration showed myeloid hyperplasia without dysplastic features. Karyotypic and molecular analyses of bone marrow cells showed the absence of Philadelphia (Ph1) chromosome and bcr gene rearrangement. Because there was no underlying infection or neoplasm, he was diagnosed as having CNL associated with IgG kappa-type monoclonal gammopathy (IgG, 1,269 mg/dl). In addition to its association with monoclonal gammopathy of undetermined significance (MGUS), the present case was also characterized by spontaneous remission of CNL during the 12-year follow-up, accompanied by a gradual increase in serum IgG levels up to 3,000 mg/dl. As far as we know, there have been 19 cases of CNL associated with monoclonal gammopathy in the literature. The median survival of these cases was 5 years. Although there have been only 6 cases of CNL associated with MGUS, survival of these cases was particularly favorable. Taken together with the observation that leukocytosis and hepatosplenomegaly in the present case subsided without specific treatment, we speculate that myeloid proliferation in the present case may have been a leukemoid reaction to underlying monoclonal gammopathy.

Adult↗
PubMed1996

Vocal fold atrophy and its surgical treatment.

The effectiveness of surgical treatment for vocal fold atrophy of various causes was examined. Type I thyroplasty was performed on 31 patients with vocal fold atrophy, often bilaterally and occasionally combined with type III thyroplasty. Of these 31 patients, 3 patients underwent the operation twice, for a total of 34 operations. The surgery was found to be effective in improving the voice quality and the ease of phonation. When a scar or sulcus was present, the results were not as satisfactory. The intraoperative decision-making process as to which procedure to perform is extremely important for achieving an optimal voice, and should be based on the intraoperative voice quality, fiberoptic findings, and manual tests. In operations for vocal fold atrophy in which the vocal folds are mobile, a silicone shim should be firmly fixed to prevent migration. Overcorrection is generally recommended. No complications were encountered. It was often the increased ease of phonation rather than the improved voice quality that patients appreciated after surgery.

Adult↗
PubMed1996

Omohyoid muscle transposition for the treatment of bowed vocal fold.

Imperfect glottal closure is usually the most important factor causing dysphonia in patients with bowing of the vocal folds. We have performed laryngeal framework surgery, which allows the medialization of the vocal folds from the outside without creating any scar tissue on them. Over the past 6 years, however, we encountered three cases with marked bowing of the vocal folds that could not be cured by laryngeal framework surgery alone. We used an open laryngeal procedure in these cases, even though such procedures had been considered contraindicated in the treatment of hoarseness. After performing a laryngofissure, we made a small pocket beneath the vocal fold mucosa at the anterior commissure. The superiorly based omohyoid muscle flap was then transposed into the mucosal pocket and sutured to the vocal process. This procedure should be considered an option in treating highly bowed vocal folds.

Adult↗
PubMed1996

Insulin resistance, hypertension and nephropathy.

Although insulin resistance has been involved in the pathogenesis of essential hypertension in non-diabetic patients, few studies were performed regarding to the association between insulin resistance, hypertension and nephropathy in diabetes mellitus. We observed the changes of blood pressure and proteinuria for 7 years in normotensive 28 patients with non-insulin-dependent diabetes mellitus (NIDDM), following measurement of insulin sensitivity. Patients were over 40 years old and not obese, and fasting plasma glucose levels were less than 140 mg/dl. Insulin sensitivity was determined using glucose-clamp method or glucose, insulin, and somatostatin infusion method. In 28 subjects, 12 subjects developed hypertension and 16 subjects were remained normotensive. Insulin induced glucose clearance was significantly decreased in subjects developed hypertension (30 +/- 12 ml/kg/10 min) than in subjects remained normotensive (50 +/- 19 ml/kg/10 min). Furthermore, we found significantly higher incidence of proteinuria in patients developed hypertensive (7 out of 12 patient) than in patients remained normotensive (one out of 16 patients; p < 0.05). These results suggest that insulin resistance is involved in the etiology of hypertension in NIDDM patients, and that this derangement has an important role for the progression of diabetic nephropathy.

Blood Pressure↗
PubMed1996

[Five cases of hereditary high red cell membrane phosphatidylcholine hemolytic anemia in three families].

Five cases of hereditary high red cell membrane phosphatidylcholine hemolytic anemia in three families were described. All cases were clinically manifested by jaundice and splenomegaly. Hemolysis was evident from indirect hyperbilrubinemia, reticulocytosis and decrement of serum haptoglobin. Red blood cells showed morphological abnormalities such as poikylocytosis, anisocytosis and target cells on blood smears. Both direct and indirect Coombs' tests were negative. Ham test, sugar water test and hemoglobin electrophoresis showed no abnormalities. Osmotic fragility test showed decreased membrane fragility. Lipid analysis of red cell membrane showed increment of phosphatidylcholine content and decrement of sphingomyelin content, although plasma lipids were essentially normal. Influx and efflux of sodium through the red cell membrane were both increased. Splenectomy was performed without effect on one patient and the mother of other patients.

Adult↗
PubMed1996

["High jugular bulb": clinical feature, radiographical findings and differential diagnosis, a case report].

Anatomically, the top portion of the jugular bulb lies just below the floor of the hypotympanum. In rare instances, it can protrude upward and elevate the floor of the hypotympanum thus placing it in the middle ear. Such a case is called high jugular bulb. This anatomical variation has been found in 3.5% to 6% of the temporal bones studied in several reports. But, clinically, only 43 cases have been reported, because in most cases they are asymptomatic. A 17-year-old female was hospitalized with right hearing disturbance and dizziness. Neurootological examination revealed sensory neuronal hearing disturbance. A caloric test was scaled out. Axial bone window CT scan demonstrated an enlarged jugular bulb and an extended upward projecting hypotympanum. MRI indicated flow void in the same region. Retrograde jugulography has been the most useful method for diagnosis but we were able to diagnose it by noninvasive MR angiography. High jugular bulb is an unfamiliar disease entity for neurosurgeons, but we should remember that it is one of the differential diagnosis for c-p angle regions or jugular foramen regions.

Adolescent↗
PubMed1996

[Distribution of Chlamydia trachomatis (CT) antigen on the area surrounding the cervix in patients with CT cervicitis].

The initial site of infection with female chlamydia trachomatis (CT) genital infection is known to be the cervix. CT can often be detected in vaginal discharge, urethral swabs and urinary sediment. In order to determine the distribution of CT around the cervix, CT detection by Chlamydiazyme was performed on specimens other than cervical swabs, obtained from females whose cervical swabs were positive for CT. Positive rates and mean reaction values for Chlamydiazyme were 97.4% and 0.762 +/- 0.570 for cervical discharge, 75.4% and 0.503 +/- 0.536 for vaginal wall swab, 72.1% and 0.489 +/- 0.516 for vaginal swab, 62.7% and 0.696 +/- 0.760 for urethral swab and 43.8% and 0.228 +/- 0.328 for urinary sediment. Both the positive rate and the mean reactive value were revealed to be in the order: vaginal wall = vestbule swab < vaginal discharge < cervical swab. The results are consistent with the assumption that CT was contained in discharge in the infected area in the cervix and spread to other areas. Both a high positive rate and high reactive value for vaginal discharge sustain the assumption that CT rectal infection could mainly be caused by direct contamination by cervical discharge, not by rectal intercourse.

Antigens, Bacterial↗
PubMed1996

[Distribution of EIA reactive values and serum antibody titers of Chlamydia trachomatis urethritis and cervicitis at the first visit].

Among 120 non-gonococcal male urethritis, 83 were found to be Chlamydia trachomatis (CT) positive by Chlamydiazyme with 2 to 5 times repeated urethral swab collection during pre-treatment period. Among 97 female partner of male CT urethritis, 76 were CT positive by the same repeated specimen collection from cervix. In the 83 male CT urethritis and the 76 female CT cervicitis, EIA reactive values by Chlamydiazyme and serum CT antibody titer by FA at the first visit were investigated. The EIA reactive values of cervicitis were lower than those of urethritis. There was no case of "CT negative at the first visit and positive at repeated detection" in male urethritis. 3 case of "CT negative at the first visit and CT positive at repeated detection" were experienced among females who were the partner of male CT urethritis. The sensitivity of Chlamydiazyme was found to be enough to decide presence or absence of CT by single specimen collection in male urethritis but not enough in female cervicitis. It could be assumed that by the improved sensitivity of CT detection, CT detection rate would be raised among female cervicitis but not in male urethritis. Positive rate CT serum antibody were 63.9% in male urethritis and 100% in female cervicitis. The clinical value of CT antibody detection might be not as detection method of CT infection in progress, but as non-invasive screening for CT infection up to the present, namely the risk factor of STD, especially in females in whom detection of CT is not complete.

Antibodies, Bacterial↗
PubMed1996

[The effect of the AIDS campaign on case numbers of male urethritis].

In an attempt to investigate the influence of the AIDS campaign on the number of cases of STD in Japan, the case numbers of both gonococcal and chlamydial urethritis diagnosed in Japanese Red Cross Medical Center (JRMC) from 1980 to 1992 were surveyed. The case number of gonococcal urethritis (GU) in JRMC increased from 1980 to 1984 reaching a peak case number of 300% of 1980. Since 1984 the number of cases decreased until 1989 returning to the same case number of 1980. After a slight increase in 1990 and 1991 the case number decreased to 20% of the peak number of cases of 1984. The above trend in case numbers for GU in JRMC is similar to national statistics. The increase seen up to 1984 is thought to be similar to the increase recorded in the 1970's in developed countries. The decrease after 1984 is assumed to be due to the AIDS campaign. No remarkable change was observed in the case numbers for chlamydial urethritis (CTU) in JRMC in the same period. The results suggest that the AIDS campaign had less effect on the case numbers for CTU than that of GU, because the source of CTU infection is not limited to partners defined as hypothetically risky under the AIDS campaign. Though the sites and the route of infection are identical with gonococcal infection, the symptoms of CTU are much less fewer and less severer than that of GU, and chlamydia genital infection has already spread into every social class in Japan. The proportion of the GU that was due to gonococcal urethritis infection from the female pharynx to whole case number of gonococcal urethritis increased. This may reflect ignorance concerning the role of the pharynx as an infectious sources of gonococcal urethritis.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Treatment results for unselected patients with acute myelogenous leukemia. During a 10-year period, August 1984 to July 1994].

In order to analyse the clinical characteristics and outcome in acute myelogenous leukemia, 129 consecutive adult patients admitted to our hospital over a 10-year period, from August 1984 to July 1994, were studied. Their median age was 51 years, 17 (13.2%) of them had antecedent myelodysplastic syndrome (MDS) and 9 (7.0%) had secondary leukemia. Seventy-eight patients (60.5%) were considered eligible for cure-oriented intensive chemotherapy. Forty-four patients were ineligible of one or more of the following; age over 70, antecedent MDS or secondary leukemia. Additional 7 patients were excluded due to concurrent severe diseases. The median survival of the 129 patients was 441 days with an actuarial 5-year survival of 28.6 +/- 4.4%, and the disease-free survival (DFS) decreased with the increasing age of the patient. In 78 patients who were eligible for intensive chemotherapy, complete remission was achieved in 84.6% and overall DFS was 41.1 +/- 5.9% at 5 years, and their survival was longer than that of ineligible patients. It was suggested that considerable selection of patients, for example, due to old age, already existed before visiting our hospital. Analysis of clinical data of unselected patients might enable the development of a rational approach to the management of elderly patients.

Adolescent↗
PubMed1996

Serum thrombopoietin (TPO) levels in patients with amegakaryocytic thrombocytopenia are much higher than those with immune thrombocytopenic purpura.

We assayed serum thrombopoietin (TPO) levels in amegakaryocytic thrombocytopenia (AMT) and immune thrombocytopenic purpura (ITP) patients by using a newly established enzyme-linked immunosorbent assay (ELISA). TPO levels in AMT patients were quite high (mean +/- SD = 13.7 +/- 11.2 fmoles/ml, n = 4), whereas those in ITP patients were only slightly higher (1.25 +/- 0.39, n = 12) than those of the healthy donors (0.55 +/- 0.2, n = 20). Furthermore, in ITP patients no correlation was observed between platelet counts and serum TPO levels (correlation coefficient = 0.14). We further assayed serum TPO levels sequentially during steroid treatment in patients with AMT and ITP. In one AMT patient serum TPO levels started to decrease in accordance with the increase of megakaryocyte counts, which preceded the increase in platelet counts. However, in ITP patients serum TPO levels did not change significantly throughout the course of the treatment despite the recovery of platelet counts. Based on these findings, we conclude that serum TPO levels may be regulated at least in part by megakaryocyte counts.

Adult↗
PubMed1996

Involvement of a CrmA-insensitive ICE/Ced-3-like protease in ceramide-induced apoptosis.

Ceramide has emerged as a novel lipid mediator of tumor necrosis factor (TNF)-induced apoptosis. However, the signals involved in this response are unknown. The present study demonstrates that ceramide-induced internucleosomal DNA cleavage is temporally associated with proteolytic cleavage of poly(ADP-ribose) polymerase (PARP) and protein kinase C (PKC) delta. Overexpression of baculovirus protein p35 blocked ceramide-induced DNA fragmentation and proteolytic activity, whereas overexpression of cowpox virus protein CrmA had no effect on these events. By contrast, TNF-induced DNA cleavage and proteolytic activity was inhibited by CrmA as well as p35. These results indicate that ceramide-induced apoptosis involves the activation of a CrmA-insensitive protease that is distinct from that induced by TNF.

Apoptosis↗