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Biomedical subjects

H Kondo

Publications and source records attributed to H Kondo.

At least 271 records · Page 15Linked to original sources
PubMed1999

Detection of hepatocellular carcinoma: comparison of low- and high-spatial-resolution dynamic MR images.

OBJECTIVE: The purpose of our study was to compare the diagnostic performance of low- and high-spatial-resolution gadolinium chelate-enhanced triphasic dynamic gradient-recalled echo (GRE) MR images in the detection of hepatocellular carcinoma. MATERIALS AND METHODS: Triphasic dynamic MR images obtained with low (256 x 128) and high (512 x 224) image matrices in 28 patients with 65 hepatocellular carcinomas (HCCs) were retrospectively analyzed. Image review was conducted on a segment-by-segment basis; a total of 215 liver segments, including 56 segments with tumor burden, were reviewed for the presence of HCC by three independent radiologists. Detectability was evaluated with relative sensitivity, specificity, and receiver operating characteristic (ROC) analysis. Image quality was evaluated with rank order analysis. RESULTS: Relative sensitivity was statistically significantly better with high-spatial-resolution images than with low-spatial-resolution images (p < .005). Relative specificity was statistically significantly better with low-spatial-resolution images than with high-spatial-resolution images (p < .001). Diagnostic accuracy determined by ROC curve analysis was marginally higher with high-spatial-resolution (area under ROC curve [Az] = .97) than with low-spatial-resolution (Az = .94, p < .09) images. Image quality was statistically significantly better with high-spatial-resolution images (p < .005). CONCLUSION: High-spatial-resolution dynamic GRE images were superior to low-spatial-resolution images in sensitivity of detecting HCC and in image quality. Triphasic dynamic GRE imaging in the screening and follow-up programs of patients with suspected HCC should be performed using high image matrices.

Adult↗
PubMed1999

Alpha1-adrenergic stimulation induced hypertrophy in protein kinase C down-regulated cultured cardiac myocytes.

To examine whether protein kinase C (PKC) activation is essential for the induction of cardiac myocyte hypertrophy caused by alpha1-adrenergic stimulation, we investigated the hypertrophic effect of phenylephrine in PKC down-regulated and non-treated cultured cardiac myocytes obtained from neonatal Sprague-Dawley rat ventricles. The treatment with 10 nmol/L 12-tetra decanoylphorbol-13-acetate (TPA) for more than 2 hours decreased PKC activity by approximately 80% without marked hypertrophy. Phenylephrine increased [14C] phenylalanine (Phe) incorporation in both TPA non-treated and treated cells, 1.54- and 1.71-fold as large as control, respectively. The cell surface area also enlarged in both groups, 1.67- and 1.74-fold, respectively. Thus, phenylephrine induced the similar grade hypertrophy in cultured cardiac myocytes even when PKC was down-regulated. These results suggest that conventional PKC activation may not be essential for mediating myocyte hypertrophy by alpha1-adrenergic stimulation.

Adrenergic alpha-Agonists↗
PubMed1999

[Immunosuppressive treatment strategy in connective tissue diseases].

In this review, we summarized important articles published about immunosuppressive agents in connective tissue diseases. Intravenous cyclophosphamide therapy for lupus nephritis and oral cyclophosphamide therapy for Wegener's granulomatosis are major progress in past one decade. Newer immunosuppressive agents such as cyclosporin, tacrorimus are also introduced in steroid refractory organ involvements. And we discussed also the monitoring and prevention of adverse effects of immunosuppressive agents. This review will focus on immunosuppressive treatment strategy of connective tissue diseases.

Connective Tissue Diseases↗
PubMed1999

[Complement activation in citrate plasma--inhibitory effect of anticoagulants on serum complement activation].

It is generally accepted that complement activation does not proceed in EDTA- and citrate-plasma because of calcium chelation by EDTA and citrate. However, there were several cases with low CH50 level in serum and citrate plasma and normal CH50 level in EDTA plasma, suggesting that complement might be activated in citrate-plasma but not in EDTA-plasma. The present study deals with the inhibitory effect of EDTA and citrate on complement activation. CH50 was assayed in serum or plasma containing various concentrations of EDTA or citrate after incubation with latex particles bearing immunoglobulin. It was revealed that complement activation proceeded in the presence of 2.0 mmol/l of EDTA but was inhibited in the presence of 2.5 mmol/l of EDTA, while blood coagulation was inhibited in plasma containing EDTA higher than 2.0 mmol/l. As to citrate, complement activation proceeded in the presence of 25 mmol/l of citrate but was inhibited in the presence of 50 mmol/l of citrate, while blood coagulation was inhibited in plasma containing citrate higher than 6.2 mmol/l. Thus, it was indicated that, as usual plasma in clinic contains 3.5 mmol/l of EDTA or 10.9 mmol/l of citrate, complement can be activated in citrate-plasma but not in EDTA-plasma. Similar conclusion was obtained by another experiment using ordinary vacuum-type blood collection tube for EDTA-2K plasma, EDTA-2Na plasma and citrate plasma.

Anticoagulants↗
PubMed1999

[Mobility in the community-dwelling elderly and its correlates].

OBJECTIVE: To examine mobility level in community-dwelling elderly using a questionnaire of walking ability over a distance of 1 km and its relationship to activities of daily living (ADL) and quality of life (QOL) indices, and to obtain clues to mobility impairment in the elderly. SUBJECTS AND METHODS: A total of 3,266 community-dwelling elderly aged 60 to 84 years were interviewed with questionnaires for assessing mobility, ADL and QOL levels. The mobility was assessed by walking ability over a distance of 1 km, and the ADL levels were by conventional basic ADL, comprehensive mobility index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, and the QOL levels were by self-rated health, Geriatric Depression Scale (GDS) short-version and Life Satisfaction Index-K (LSIK). They were also asked about diseases for which they regularly consult doctors, and about subjective symptoms. RESULTS: Eighty-seven percent of the subjects responded to the interview, with 86.3% of male responders and 77.6% of female responders answering that they could walk on foot over a distance of 1 km without any difficulty. The percentages of subjects who answered that they could walk but with difficulty or could not walk over a distance of 1 km increased with advancing age. The correlation analysis between 1 km-walking ability and other mobility indices showed that 1 km-walking ability was a better index for identifying a slight to moderate mobility impairment, and that the mobility level was closely associated with daily activity levels in the community-dwelling elderly. The elderly with an impaired mobility had lowered self-rated health, GDS and LSIK scores. After controlling for sex and age, it was shown that prevalences of musculoskeltal (knee arthritis, lower back pain, etc.), cerebrovascular and heart diseases, and complaints of subjective symptoms which were associated with physical frailty, were closely associated with impaired mobility. Hearing and visual disturbances also had a significant relation to a lowered mobility. CONCLUSIONS: Walking ability over a distance of 1 km may be a good index for discriminating differing mobility levels which community-dwelling elderly have intrinsically. The possible etiological factors for a lowered mobility in the elderly include musculoskeletal, cerebrovascular and heart diseases; physical frailty; and hearing and visual disturbances.

Activities of Daily Living↗
PubMed1999

[A case of seronegative spondylarthropathy with iritis and retroperitoneal fibrosis].

In 1985 a 41-year old male visited a local hospital because of congestion in the bulbar conjunctiva, which was diagnosed as iritis. In August 1990, right coxalgia and arthralgia of metatarsophalangeal joints appeared, with recurrence of iritis. In October, stiffness in the hands and arthralgia of proximal interphalangeal joints also started. In July 1991, the right coxalgia worsened, resulting in walking difficulty. He was admitted to the Kitasato University Hospital. He presented with bilateral iritis, polyarthritis with limited ranges of motion and sacroilitis. The Schober's test was positive at 3 cm. Serological tests for rheumatoid factor and HLA-B 27 were negative. Abdominal computer tomographic scan revealed low density lesion around the aorta. PSL 10 mg was initiated, and iritis and arthritis remitted. Progression of the periaortic lesion was not observed during the subsequent 5 years. In this case, iritis preceded limited ranges of motion in the vertebrae and sacroilitis. From these findings, seronegative spondylarthropathy with peripheral arthritis was diagnosed. The periaortic lesion seen in this case probably corresponds to chronic periaortitis recently reported as a subset of idiopathic retroperitoneal fibrosis. The two lesions observed in the present case may be interpreted as caused by inflammation of the connective tissue initially either at the vertebrae or around the aorta, which had advanced to involve the other lesion.

Adult↗
PubMed1999

Distribution and intracellular localization of a mouse homologue of Ca2+/calmodulin-dependent protein kinase Ibeta2 in the nervous system.

Ca2+/calmodulin-dependent protein kinases (CaMKs) are believed to play important roles in the development and function of the nervous system. We report here the identification and expression of mouse CaMKIbeta (mCaMKIbeta), in particular mCaMKIbeta2, an isoform of mCaMKIbeta. During embryogenesis, the mCaMKIbeta2 gene is expressed mainly in the nervous system, including brain, spinal cord, trigeminal ganglion, and retina. Within the CNS, the expression of mCaMKIbeta2 is detected in the mantle zone, but not in the ventricular zone, suggesting its possible involvement in the differentiation of neurons. In the adult brain, mCaMKIbeta2 transcripts are detected at high levels in the anterior olfactory nuclei, piriform cortex, septal nuclei, bed nuclei of the stria terminalis, hippocampal pyramidal cells, dentate granule cells, amygdala, hypothalamic nuclei, parabrachial nucleus, and nucleus of the solitary tract. The distinct gene expression pattern suggests that mCaMKIbeta2 may also be involved in different mature neuronal functions from other CaMKs. In addition, mCaMKI/beta2 proteins are localized to the cytoplasm and nuclei, but not to nucleoli, suggesting that mCaMKIbeta2 proteins might be involved in the cytoplasmic and nuclear signal transduction of the nervous system.

Amino Acid Sequence↗
PubMed1999

Immunological analysis of pulmonary hypertension in connective tissue diseases.

OBJECTIVE: To analyze the immunological characteristics of the sera of patients with inflammatory connective tissue diseases complicated by pulmonary hypertension (PH). METHODS: Sera of 24 patients with mixed connective tissue disease complicated by PH (MCTD-PH), sera of 11 patients with other connective tissue diseases complicated by PH (Other-PH; 6 systemic sclerosis, 3 systemic lupus erythematosus, 2 rheumatoid arthritis), and sera of 15 patients with MCTD not complicated by PH (MCTD-non-PH) were tested for IgG antibodies against U1RNP proteins, U1RNP-70K protein, U1RNP-A protein, and U1RNP-C protein, and for IgG and IgM antibodies to beta2-glycoprotein I dependent cardiolipin (CL) and human umbilical vein endothelial cells. We also measured the serum levels of von Willebrand factor related antigens and interleukin 6 (IL-6). RESULTS: (1) The titers of the anti-U1RNP, anti-U1RNP-70K, anti-U1RNP-A, and anti-U1RNP-C antibodies were significantly higher in the MCTD-PH and MCTD-non-PH groups than in the Other-PH group. However, there were no statistically significant differences in the titers of these 4 antibodies between the MCTD-PH and MCTD-non-PH groups. (2) The titers of the IgG aCL and the serum IL-6 levels were significantly higher in the MCTD-PH group than in the MCTD-non-PH group. (3) Statistically significant correlations between the anti-U1RNP and IgG anti-CL antibody titers, and between the IgG anti-endothelial cell and IgG anti-CL antibody titers were observed within the MCTD-PH and Other-PH groups, but not within the MCTD-non-PH group. CONCLUSION: The occurrence of anti-U1RNP, anti-endothelial cell, and anti-CL antibodies is associated with PH in certain patients with connective tissue disease.

Autoantibodies↗
PubMed1999

[Assessing the physiologic significance of intermediate coronary lesions: comparison of coronary flow measurements with exercise electrocardiography].

Angiography may provide limited assessment of intermediate coronary stenoses. Doppler coronary flow reserve has been applied to determine the physiologic significance of such lesions. This study compared coronary flow reserve derived from intracoronary Doppler flow wire with the results of the exercise tolerance test to evaluate the validity of intracoronary flow measurements in the assessment of intermediate stenoses. Sixty eight patients with 91 vessels harboring angiographically mild-to-severe coronary stenoses in the left anterior descending or right coronary artery were studied. All patients had single-vessel disease, and angiography showed the target vessel. Distal coronary flow reserve was measured with the Doppler guide wire during cardiac catheterization. Exercise tolerance tests by bicycle ergometer were performed the day before catheterization. Quantitative coronary angiography showed a mean percentage diameter stenosis of 44 +/- 21%(range 0-90%). Forty seven of 91 vessels combined intermediate lesions(40% to 70%). Percentage diameter stenosis and coronary flow reserve were linearly correlated in both overall and intermediate lesions(r = -0.52 vs -0.42; both p < 0.0001). Percentage diameter stenosis of overall lesions was significantly higher in the positive exercise test group than the negative group(59.8 +/- 17.2% vs 37.7 +/- 18.1%, p < 0.0001), but not significantly different in intermediate lesions(49.1 +/- 7.8% vs 54.7 +/- 6.6%, p = 0.03). The positive exercise test group showed significantly lower coronary flow reserve compared to the negative group in both overall and intermediate lesions(overall: 1.6 +/- 0.5 vs 2.6 +/- 0.9, p < 0.0001; intermediate: 1.6 +/- 0.5 vs 2.5 +/- 0.7, p < 0.0001). Coronary flow reserve < 2.0 and positive exercise test agreed in 38 of 46 intermediate lesions(83%), and percentage diameter stenosis > or = 50% and positive exercise test agreed in 34 of these 46 lesions(74%). Coronary flow reserve, more than percentage diameter stenosis, correlated with the results of the exercise tolerance test, and is considered to be useful to evaluate the functional severity of intermediate stenosis.

Aged↗
PubMed1999

[A case of microscopic polyangiitis with severe cardiac and respiratory muscle involvement].

A 66-year-old female was admitted to our hospital in January, 1998, complaining of low grade fever and muscle weakness of her legs. Physical examination revealed muscle weakness of her neck (4/5) and proximal skeletal muscles of her bilateral legs (3/5-4/5). She showed proteinuria and microhematuria. Her serum levels of ureanitrogen, creatinine, aspartate aminotransferase, alanine aminotransferase, creatinekinase, aldolase and myoglobin were all within the normal ranges. Antinuclear antibodies were negative, but her serum levels of pANCA (743 EU) and C reactive protein (18.0 mg/dl) were elevated. Neuroconduction velocity of her left common peroneal nerve was decreased to 40.8 m/sec and electric myograph showed neurogenic changes. Magnetic resonance images (MRI) of her bilateral thigh depicted high signal intensity in quadriceps by T 2 weighed images, but the signals were not enhanced by gadolinium injection. Muscle and renal biopsies revealed necrotizing vasculitis of the small arteries. Crescentic glomerulonephritis was also observed by renal biopsy. These findings supported the diagnosis of microscopic PN. On 16 th admission day, she developed acute cardiac and respiratory failures due to cardiac and respiratory muscle involvements with PN, and was assisted by mechanical ventilation. She was treated with methylprednisolone pulse therapy (500 mg/day, three consecutive days) on 18 th admission day, followed by 40 mg of oral prednisolone daily. However, her symptoms deteriorated, and herserum creatinine levels increased to 2.4 mg/dl. On 24 th admission day, intravenous cyclophosphamide pulse therapy (500 mg/day) was instituted. Her cardiac wall motion on echocardiography and serum creatinine levels gradually improved, but her skeletal and respiratory muscle weakness did not improve. On 38 th admission day, she was complicated with respiratory infection by methicillin resistant Staphylococcus aures. On 62 th admission day, she died of endotoxic shock. This is the first report describing respiratory muscle involvement with PN, and the second report describing MRI findings of muscle involvement by PN. Therefore, our case provides important clinical information for the diagnosis and treatment of the disease.

Aged↗
PubMed1999

[Five cases of systemic sclerosis with associated with intestinal pseudo-obstruction].

OBJECTIVES: We experienced five cases of systemic sclerosis (SSc) associated with pseudo-obstruction, and evaluated their clinical characteristics and outcome. METHODS: Five patients with SSc were found to have intestinal pseudo-obstruction. We studied the clinical characteristics, treatments and outcome of these five case from medical records. RESULTS: The intestinal symptoms were free air in three and pneumatosis cystoides intestinalis (PCI) in two of the five patients. Cisapride was administered to all patients and octreotide and dinoprost to three patients, but the effects were not adequate and intravenous hyperalimentation (IVH) had to be introduced in four patients. Drug treatment was effective in patients in the early stage of intestinal symptoms, but IVH had to be introduced in patients with a long course. Septicemia occurred in two of the four patients on IVH and an infection occurred at the catheter insertion site in one patient. These two patients died of septicemia. Of five patients we experienced with SSc associated with intestinal pseudo-obstruction, two had PCI and four required IVH at home. Two of the four on home IVH developed septicemia. CONCLUSIONS: Intestinal pseudo-obstruction is one of the poor prognostic factors for SSc.

Aged↗
PubMed1999

Endoscopic and histological reversibility of gastric adenoma after eradication of Helicobacter pylori.

Although epidemiological studies strongly suggest an association between Helicobacter pylori infection and gastric carcinogenesis via a multistage process, a causal link between them has not been demonstrated. We evaluated the endoscopic and histological changes of gastric adenoma, which is considered a premalignant condition, after eradication of H. pylori. Thirty-five H. pylori-infected patients with gastric adenoma were treated with triple therapy (lansoprazole 30mg/day, clarithromycin 400mg/day, and amoxicillin 1500 mg/day) for 1 week. Of these 35 patients, 30 (86%) exhibited no H. pylori by culture or histology after the therapy. Of the 30 gastric adenomas, 7 decreased in size endoscopically; three gastric adenomas especially showed apparent remission, although histological cure in these three patients was not apparent. Our results suggest that removal of H. pylori infection may only mask a gastric adenoma endoscopically owing to the change around the gastric mucosa.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1999

Evaluation of adjunctive intracoronary administration of acetylcholine following intravenous infusion of ergonovine to provoke coronary artery spasm.

A dilemma arises in patients with chest pain or other symptoms suggestive of coronary artery disease but without significant coronary artery stenosis or spasm even after the spasm provocation test by either ergonovine or acetylcholine. Incremental doses of intracoronary acetylcholine (up to 100 micrograms for left coronary artery and 50 micrograms for right coronary artery) were administered when intravenous infusion of ergonovine 0.4 mg showed negative results. A total of 39 patients were studied. Provocation test was performed because of chest pain suggestive of coronary artery disease (n = 19), atypical chest pain (n = 6), post balloon angioplasty status (n = 6), silent ischemia (n = 4), Adams-Stokes syndrome (n = 3), and dead-on-arrival (n = 1). Characteristics of chest pain indicated variant angina (n = 11), rest angina (n = 4), and effort angina (n = 4). No electrocardiographic evidence of ischemia was detected before this test in any patient. Spasm was induced in 23 patients (59.0%) with complete obstruction in 7 (30.4%), diffuse vasoconstriction (90-99%) in 14 (60.9%), and focal spasm in 2 (8.7%). The patients with chest pain showed the highest positive rate of 78.9%. Further, the patients with atypical chest pain and miscellaneous reasons also revealed positive rates of 33.3% and 42.9%, respectively. One ventricular tachycardia and 2 atrial fibrillations occurred but terminated spontaneously. This test is useful for detecting spasm in a variety of patients in whom intravenous ergonovine infusion fails to induce spasm.

Acetylcholine↗