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Biomedical subjects

H Kojima

Publications and source records attributed to H Kojima.

At least 775 records · Page 43Linked to original sources

Involvement of interleukin-1 in middle ear cholesteatoma.

PURPOSE: The histopathological characteristics of middle ear cholesteatoma are hyperproliferation and differentiation of the epithelium and accompanying destruction of the bones. We directed our attention to interleukin 1 alpha (IL-1 alpha) and demonstrated localization of IL-1 alpha in the epidermis of cholesteatoma. In addition, a comparative study was made of the relationship of IL-1 alpha with the developmental stage of cholesteatoma, the degree of destruction of the auditory ossicles, presence/absence of otorrhea, and the state of subepithelium. MATERIALS AND METHODS: Middle ear cholesteatoma tissues collected during operations were used as the experimental material, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Western blot, and immunohistological techniques were used as methods. RESULTS: An anti-IL-1 alpha antibody-positive 17-kd band was observed in 2 of the 17 cases, whereas a 31-kd band was observed in 10 of the 17 cases. Neither the 17-kd band nor the 31-kd band was detected in normal skin tissues. The immunohistological staining showed the presence of IL-1 alpha in a region near the basal membrane of cholesteatoma epithelium. CONCLUSION: A correlation was observed between IL-1 alpha and patients with vigorous proliferation of granulation in the subepithelium. The presence of granulation in the reverse side of the eardrum plays an important role in the proliferation of cholesteatoma epithelium.

Adult↗

Multiple mechanisms are involved in apoptotic cell death in the mouse uterus and vagina after ovariectomy.

Withdrawal of sex hormones by gonadectomy results in rapid involution of mouse reproductive organs. To study the regression mechanism in the uterus and vagina after ovariectomy, histologic and biochemical changes were examined. Apoptotic cells were detected by in situ 3'-DNA nick end labeling method and electron microscopy, while the number of cells showing incorporation of bromo-deoxyuridine (BrdU) decreased in the uterus and vagina after ovariectomy. DNA fragmentation in the uterus was observed even at estrus and the degree of fragmentation increased after ovariectomy. DNA fragmentation in the vagina occurred 1-5 days after ovariectomy. Semi-quantitative RT-PCR revealed that expression of Fas-ligand and tumor necrosis factor-alpha (TNF-alpha) mRNA in the uterus and vagina was increased by ovariectomy. These results suggest that apoptotic cell death is induced by ovariectomy through the mediation of both Fas and TNF-alpha in the mouse uterus and vagina; however, uterine and vaginal cells in CBA lpr(cg)/lpr(cg) mice lacking functional Fas showed apoptosis, indicating that Fas is not the sole regulator of apoptosis in female reproductive organs in mice.

Animals↗

Multiple myeloma: short T2 on MR imaging.

We describe a rare case of multiple myeloma with marked hypointense areas on both T1- and T2-weighted images. Amyloid deposition and calcification were not found histologically. Hypointensity on T2-weighted images may be caused by distributed free radicals produced by significant macrophages.

Back Pain↗

Insulin resistance in diabetic microangiopathies.

To investigate whether insulin resistance is associated with diabetic microangiopathies in type 2 diabetes mellitus, insulin sensitivity was measured in 133 type 2 diabetic subjects with or without diabetic retinopathy and/or nephropathy. Insulin sensitivity was measured by steady-state plasma glucose method or euglycemic glucose clamp method. Regarding retinopathy, in the insulin-resistant group, advanced retinopathy (preproliferative and proliferative retinopathy) was more frequently observed compared with the insulin-sensitive group (significance: p<0.02). Similarly, as for nephropathy, the occurrence of continuous proteinuria in the insulin-resistant group was significantly (p<0.01) more frequent compared with the insulin-sensitive group. Insulin sensitivity expressed as glucose utilization and glucose clearance was significantly (p<0.05) lower in diabetic subjects with retinopathy (without nephropathy) compared with subjects without the microangiopathies after adjustment for age, body mass index (BMI), fasting blood glucose (FBS), and diabetic duration. Similarly, insulin sensitivity in subjects with nephropathy (without retinopathy) was significantly (p<0.05) decreased compared with those without microangiopathies. Furthermore, insulin resistance was significantly (p<0.01) severe in the subjects with both retinopathy and nephropathy than in those without the two microangiopathies. Insulin resistance of type 2 diabetes is closely associated with the progression of microangiopathies, and causal relationship between insulin resistance and microangiopathies has remained to be solved.

Adult↗

Cortical dysfunction of the supplementary motor area in a spasmodic dysphonia patient.

The etiology of spasmodic dysphonia (SD) is still unknown. In the present study, cortical function of a 59-year-old male patient with adductor type SD was examined during phonation with positron emission tomography (PET). Magnetic resonance imaging showed no organic abnormality in the brain. However, PET showed remarkable activities during phonation in the left motor cortex, Broca's area, the cerebellum, and the auditory cortices, whereas the supplementary motor area (SMA) was not activated. The SMA is known to function for motor planning and programming and is usually activated in normal phonation. Several previous reports have shown that the damage of the SMA caused a severe disturbance of voluntary vocalization. In the present case, it was suggested that the functional deficit of the SMA might be related to SD.

Cerebrovascular Circulation↗

Distribution of the 3.05-Mdal "Toronto" beta-lactamase plasmid among penicillinase-producing isolates of Neisseria gonorrhoeae in the Far East.

One hundred and fifty-two beta-lactamase-producing Neisseria gonorrhoeae isolates from Japan (n = 25; 1983, 1985, 1986), Taiwan (n = 14; 1983, 1984), and the Republics of Singapore (n = 58; 1986, 1987) and the Philippines (n = 55; 1989) isolated from 1983 through 1989 were characterized by auxotype, serovar, and plasmid content to determine the distribution and diversity of penicillinase-producing N. gonorrhoeae (PPNG) strains possessing the 3.05-Mdal "Toronto" beta-lactamase plasmid. PPNG isolates possessing a 3.05-Mdal beta-lactamase plasmid were isolated in Japan (1/25: 4%), Taiwan (4/14: 29%), and the Republic of the Philippines (3/55: 5%); no PPNG isolates with the 3.05-Mdal plasmid were isolated in the Republic of Singapore. All isolates possessing the 3.05-Mdal plasmid also possessed a 24.5-Mdal conjugative plasmid and belonged to the auxotype/serovar class, Proto/IB-1. Studies with five isolates possessing the 3.05-Mdal plasmid, and representing isolates from each country in which they were found, confirmed that the beta-lactamase plasmid in these strains could not be transferred to another gonococcal isolate by conjugation. PPNG isolates possessing the "Toronto" plasmid are widespread in the Far East; spread of these isolates may, however, be limited to the physical spread of a single strain.

Bacterial Typing Techniques↗

Prevalence of antibody against non-A, non-B hepatitis virus in Japanese patients with hepatocellular carcinoma.

Antibodies against a possible causative agent of non-A, non-B hepatitis, hepatitis C virus (HCV), in Japanese patients with hepatocellular carcinoma were analyzed using the enzyme-linked immunosorbent assay (ELISA) system from Ortho Diagnostic Systems, Japan. Fifty of 58 cases of hepatitis B virus surface antigen (HBsAg)-negative hepatocellular carcinoma were positive for the antibody (86%) and 8 of 42 cases of HBsAg-positive hepatocellular carcinoma were positive (19%). Among patients with HBsAg-negative hepatocellular carcinoma, the prevalence of the antibody was greater among those who had received a blood transfusion (97%) than among those with no history of transfusion (70%). Only 3 of 54 patients with cancers other than hepatocellular carcinoma were found to be antibody-positive (5.6%) and all three patients had a history of blood transfusion. These results show a close relationship between the presence of anti-HCV antibody and HBsAg-negative hepatocellular carcinoma in Japan.

Carcinoma, Hepatocellular↗

Plasma endotoxin concentration and endotoxin binding capacity of plasma acute phase proteins in cirrhotics with variceal bleeding: an analysis by new methods.

Plasma endotoxin levels in 12 cirrhotics with bleeding from oesophageal varices and 50 cirrhotics without bleeding were measured by the chromogenic assay after the pretreatment of sample by perchloric acid (HClO4) and triethylamine. Endotoxin in cirrhotics with bleeding from varices was significantly higher than those without bleeding. In patients with bleeding, endotoxin increased for 3 days after the bleeding, first in the supernatant fraction and then in the precipitate fraction by HClO4 treatment. Peak plasma alpha 1-acid glycoprotein and haptoglobin were observed 3 days after the bleeding. Alpha 1-antitrypsin gradually increased for 14 days. Transferrin did not markedly change. The endotoxin-binding capacity of transferrin and alpha 1-acid glycoprotein increased immediately after bleeding and thereafter decreased, but that of alpha 1-antitrypsin tended to increase in the recovery period. In summary, the plasma endotoxin concentration and endotoxin-binding capacity of alpha 1-acid glycoprotein and transferrin were shown to have increased after bleeding from varices by this new method. There may be a close relationship between endotoxaemia and acute phase reaction in this situation.

Acute-Phase Proteins↗

Stepped care medical treatment for cirrhotic ascites: analysis of factors influencing the response to treatment.

Thirty-two patients with liver cirrhosis and ascites were treated by stepped care diuretic treatment as follows: step 1, placed on a 35 mEq sodium diet; step 2, given 400 mg/day of potassium canrenoate in addition to step 1 treatment; step 3, given 40-80 mg/day of furosemide in addition to step 2 treatment. Eleven out of 32 patients (34.4%, group 1) and 12 of 21 patients (57.1%, group 2) lost their ascites at step 1 and step 2, respectively. The remaining nine patients (group 3) required step 3 treatment. Basal urinary sodium excretion and creatinine clearance were significantly lower and beta 2-microglobulin was significantly higher in group 3 than those in groups 1 and 2. Elevation of basal plasma renin activity and norepinephrine was evident only in group 3. In group 1, urinary sodium excretion decreased after the treatment. In group 2, plasma alpha-atrial natriuretic polypeptide was lowered and plasma renin activity and norepinephrine were elevated after the treatment. These results suggest that basal renal function and plasma renin activity and norepinephrine levels are useful indices to predict the effect of ascites treatment and that responders to sodium restriction or potassium canrenoate may be in the state of vascular overflow, while non-responders to potassium canrenoate may be in the state of vascular underfilling. In summary, this stepped care treatment is safe without any side effects, although the diuretics themselves may lead to relative vascular underfilling.

Aged↗

Negative association between T102C polymorphism of the 5-HT2a receptor gene and schizophrenia in Japan.

Serotonin (5-hydroxytryptamine, 5-HT) may play an important role in the pathogenesis of schizophrenia. Previous studies suggested that the efficacy of atypical neuroleptic drugs (e.g., risperidone and clozapine) on negative symptoms may be related to the 5-HT2a receptor. Although association studies between MspI polymorphism (T102C) and the 5-HT2a receptor gene and schizophrenia have been reported, their results are still controversial. The aim of this study was to examine the association between T102C polymorphism of the 5-HT2a receptor gene and schizophrenia as well as the association between the polymorphism and negative symptoms in a Japanese population (106 patients with schizophrenia and 109 healthy controls). No significant positive associations were observed. Our results suggest that the 5-HT2a receptor gene is not involved in the pathogenesis of schizophrenia or negative symptoms.

Adolescent↗

Auditory brainstem response and neuropathology in a case of systemic T-cell lymphoma with intracranial metastasis.

A 58-year-old male with systemic T-cell lymphoma involving the brainstem eccentrically, showed varying abnormal auditory brainstem responses (ABRs). The initial ABR demonstrated a prolonged V wave peak latency and an I-V IPL on admission. Four months later, all waves were absent bilaterally. Neuropathological examination at autopsy revealed that most of the nuclei and tracts associated with the auditory system were destroyed by lymphoid cell infiltration. It suggested that in the early stages of this disease, lymphoid cells could have involved the lower brainstem and, subsequently, in the advanced stages invaded the inferior colliculus.

Brain Neoplasms↗

Homing receptor expression on cord blood T lymphocytes and the development of atopic eczema in infants.

Expression of the gut-homing receptor integrin alphaEbeta7, but not cutaneous lymphocyte-associated antigen (CLA), on milk allergen-stimulated cord blood T lymphocytes precedes the development of milk-induced eczema in early infancy. The data indicate the involvement of integrin alphaEbeta7 in the development of infantile allergic eczema and provide a clue to the avoidance of specific allergens and novel therapy targeting homing receptors in food allergy.

Allergens↗

Development of paper-strip test for 3-hydroxybutyrate and its clinical application.

A rapid paper-strip test for the semiquantitating 3-hydroxybutyrate (3-OHBA) has been developed. The color develops within 5 min after applying the serum to the paper strip, and the purple color was read either visually or by reflectance meter. This can detect 3-OHBA levels as low as 0.1 mmol/L up to 2.0 mmol/L. The more concentrated sample can be measured on serial dilution. Clinical usefulness has been tested in a summer camp for insulin-dependent diabetic children as well as in a routine diabetes clinic. Serum 3-OHBA levels ranged from greater than 100 mumol/L to 4 mmol/L in all the subjects before breakfast in a summer camp. In four subjects, 3-OHBA was elevated to the level of 2-4 mmol/L, and only one of these four subjects exhibited ketonuria by nitroprusside test. In a diabetes clinic, a new paper-strip test for 3-OHBA has revealed ketonemia in 34 (74%) of 46 diabetic subjects, while nitro-prusside test revealed ketonemia in only 4 (13%). The present paper-strip test for 3-OHBA is sensitive enough to detect levels as low as 0.1 mmol/L and is clinically useful for rapid detection of ketosis proneness as well as for monitoring of diabetes control.

3-Hydroxybutyric Acid↗

Computer analysis of hoarseness.

The harmonic components in hoarse voice were separated from the noise components by using a small laboratory computer. The ratio of harmonics to noise or S/N ratio, was calculated and compared with the auditory impression for 58 subjects. The calculated results showed a definite correlation to the auditory impression, and it is suggested that this would be a useful method for the quantitative evaluation of hoarseness.

Computers↗

Interferon treatment in patients with chronic hepatitis C with normal alanine-aminotransferase activity.

BACKGROUND/AIMS: Chronic hepatitis C virus carriers may have repeatedly normal alanine aminotransferase activity despite detectable viremia and histological hepatitis. We aimed to evaluate the effect of interferon treatment in these cases. METHODOLOGY: Twelve patients with persistently normal alanine aminotransferase levels at least 6 months before therapy were treated with recombinant interferon (IFN)alpha-2b for 6 months, totaling 840 MU in amount. Alanine aminotransferase levels were measured monthly during treatment and after treatment withdrawal, and HCV-RNA levels were measured by polymerase chain reaction before treatment, and 6 and 12 months after treatment withdrawal. RESULTS: At treatment withdrawal, HCV-RNA levels had significantly decreased and HCV-RNA disappeared in 9 of the 12 patients by polymerase chain reaction. At 6 months after treatment withdrawal, HCV-RNA reappeared in 6 of the 9 patients whose HCV-RNA was negative at treatment withdrawal. Over all, only 4 of the 12 patients (33%) were sustained virological responders (HCV-RNA is negative more than 6 months after treatment withdrawal). Pre-treatment HCV-RNA levels in a sustained virological responder was significantly lower than that of transient and non-responders (4.9 +/- 1.6 vs. 7.7 +/- 1.6 log10[copies/ml], p < 0.05). Of 8 patients who did not achieved sustained virological response, alanine aminotransferase levels had transiently increased above normal during treatment in one patient and after treatment withdrawal in 6 patients; however, in the remaining one patient abnormal values have continued from 8 months after treatment withdrawal till now for 24 months. CONCLUSIONS: In patients with chronic hepatitis C with normal alanine aminotransferase levels, the response to interferon therapy was by no means satisfactory. However, if it would be used in cases with the lower pre-treatment HCV-RNA levels with careful attention to a transient alanine aminotransferase elevation, the more a sustained virological response might be expected.

Adult↗

Effect of intraperitoneal administration of heparin on advanced glycation end-products in CAPD.

OBJECTIVE: To evaluate the effect of intraperitoneal (IP) administration of heparin on clearance of advanced glycation end-products (AGEs) and peritoneal dialysis efficiency. DESIGN: Sequential self-controlled intervention study. SETTING: University hospital, Department of Nephrology. PATIENTS AND METHODS: Pyrraline, urea, and creatinine levels in plasma and dialysate, along with AGE-derived fluorescence intensity (excitation, 370 nm; emission, 440 nm) in dialysate were measured 0, 30, and 60 days after IP administration of heparin in 11 patients on continuous ambulatory peritoneal dialysis (CAPD). Pyrraline levels were determined by ELISA. RESULTS: Heparin induced a significant decrease in plasma pyrraline levels; the values on days 0, 30, and 60 were 162.0+/-89.8 micromol/L, 101.1+/-32.1 micromol/L (p < 0.01), and 94.0+/-19.8 micromol/L (p < 0.001), respectively. Heparin also induced a tendency of increased dialysate pyrraline levels and a significant increase in AGE-derived fluorescence intensity in the dialysate. The values for the latter on days 0, 30, and 60 were 51.0+/-9.3 AU (arbitrary units/ mg of collagen), 73.5+/-16.0 AU (p < 0.001), and 65.6+/-15.5 AU (p < 0.01), respectively. Furthermore, heparin administration resulted in a significant (p < 0.01) increase in the dialysate/plasma ratio of urea (means 0.80, 0.90, and 0.94 on days 0, 30, and 60, respectively). CONCLUSION: These results suggest that a beneficial effect of IP administration of heparin is in part due to its action on AGE kinetics, supporting a potential preventive strategy for peritoneal membrane distortion in CAPD.

Creatinine↗

Natural course of lymphocytic infundibuloneurohypophysitis.

Natural course of lymphocytic infundibuloneurohypophysitis is poorly understood. A 49-year-old male had noticed being unnaturally thirsty since about two years previously. An enlargement of the pituitary stalk and pituitary gland was thus observed by MR at that time. However, no medical care had been given. Two years later, he was admitted to our hospital due to headache in addition to panhypopituitarism. The histologic features included T cell dominant lymphocytes infiltrating prominently the entire pituitary gland with a small amount of multinucleated giant cells, focal and small necrosis, cholesterin crystals and granuloma. Neither tuberculosis nor Langerhans histiocytosis were observed. In addition, the patient was found to have a unique massive well-encapusulated lesion in the sphenoid sinus, just below the pituitary fossa, consisting of serous fluid, normal columnar epithelium and submucosal fibrosis. This patient had a fairly typical clinical manifestation of lymphocytic infundibuloneurohypophysitis with invason of the posterior lobe and the stalk. The lesion became chronic and leaked to the sphenoid sinus. As a result, chronic hypophysitis with granuloma formation thus occurred. This case may show the course of this disease if not treated.

Adult↗