Search PubMed⌕ Search

Biomedical subjects

H Miwa

Publications and source records attributed to H Miwa.

At least 145 records · Page 8Linked to original sources
PubMed1997

Polyarteritis nodosa associated with gastric carcinoma and hepatitis B virus infection.

Several cases of polyarteritis nodosa associated with malignant disorders have been reported, most with bone marrow-related tumors. We report polyarteritis nodosa presenting with a fever of unknown origin and muscle weakness that was complicated by advanced gastric carcinoma and hepatitis B virus-positive cirrhosis. Vasculitis was diagnosed after gastrectomy from histologic findings of arterial vasculitis on the resected gastric carcinoma. Our case is so far the second such report of polyarteritis nodosa associated with gastric cancer.

Hepatitis B↗
PubMed1997

Radiological retrospective study of gastric cancer in humans: two patterns of development in elevated type gastric cancer.

A better understanding of the process of gastric cancer development would undoubtedly be helpful in diagnosis and treatment. However, there is little literature available concerning the natural history of elevated type gastric cancer in humans and this disease had not been systematically investigated. In this study the natural history of elevated type human gastric cancer was retrospectively investigated in 12 radiologically followed-up patients. The cases were divided into two groups according the whether obvious abnormal findings were absent (group A, n = 5) or present (group B, n = 7) at initial examination. Clinico-pathological features, including outcomes and DNA content of the tumours in both groups, were investigated and compared. Although the mean period between the initial and final examinations was significantly shorter in group A (19.6 +/- 11.7 months) than in group B (43.4 +/- 17.3 months), tumour size was significantly larger in group A (5.5 +/- 2.5 cm) than in group B (2.4 +/- 2.5 cm). Furthermore, group A showed deeper neoplastic cell invasion and worse outcomes. The DNA content of two cases in group A and four cases in group B was examined. One case in group A showed and aneuploid pattern, while all of those in group B showed a diploid pattern. These results indicate that the tumours in group A grew much faster than those in group B, which suggests the presence of two different patterns of development in elevated type gastric cancer.

Aged↗
PubMed1997

Effect of fasting subjects' posture on 13C-urea breath test for detection of Helicobacter pylori infection.

BACKGROUND: Although many factors that may affect the 13C-urea value have been verified, no literature is available regarding the effect of the posture of the patient on the shape of the delta 13C excretion curve. In an effort to contribute to the development of a simple and standard procedure for the 13C-urea breath test, we investigated whether either the posture of the patient during the procedure or the mouthwash after dosing affects the shape of the delta 13C excretion curve. MATERIALS AND METHODS: Seventy-two Helicobacter pylori-infected subjects were divided into four groups according to the position during procedure and the mouthwash after dosing: group A, in the supine position with mouthwash; group B, in the sitting position with mouthwash; group C, changed position by rolling with mouthwash; and group D, changed position (as did group C) without mouthwash. Absolute values of delta 13C at each sampling point were compared in the four groups. RESULTS: delta 13C values in group A gradually increased until the 15-minute point; those in group B were almost stable from 5 to 30 minutes, and those in group C peaked at the 5-minute point, then decreased until 30 minutes, the values becoming similar at the 20-minute point. Significant differences were seen between groups A, B, C, and D at the 5- and 10-minute points. CONCLUSION: These results suggest that posture and mouthwash affect delta 13C value at the 5- and 10-minute points. Sampling at 20 (maybe 15 or 30) minutes for fasting patients in a sitting position is considered to be appropriate for detection of H. pylori infection in a standard two-sampling-point 13C-urea breath test.

Breath Tests↗
PubMed1997

Random amplified polymorphic DNA (RAPD) analyses for discriminating genotypes of Microcystis cyanobacteria.

Random amplified polymorphic DNA (RAPD) analysis was used to discriminate genotypes in five species of Microcystis cyanobacteria. Strains of each group with the identical allozyme genotype (T. Kato et al., Algol. Stud., 1991, 129-140; M. Watanabe, in "Toxic Microcystis," ed. by M.F. Watanabe et al., CRC Press, Tokyo, 1966, pp. 13-34) gave similar RAPD patterns characterizing the respective group. On the other hand, no similarities in RAPD patterns were observed among strains of which allozyme genotypes were different. A good accordance between the RAPD analysis and allozyme divergence indicated a high reliability of both methods for discrimination of the affiliated groups of Microcystis. Several amplified DNA fragments, which were expected to be markers for a particular taxon with identical allozyme genotype, were also observed on the RAPD patterns. Genetic homogeneities of M. novacekii, M. viridis, and M. wesenbergii were shown by RAPD analysis as well as the allozyme genotype. However, significant variations were observed in M. aeruginosa and M. ichthyoblabe in the levels of DNA and proteins (allozymes).

DNA Primers↗
PubMed1997

Clinical importance of interleukin-2 receptor alpha-chain expression in acute leukemia. The Japan Cooperative Group of Leukemia/Lymphoma.

To clarify the clinical importance of interleukin-2 (IL-2) receptor (IL-2R) expression in acute leukemia, we examined 517 adult patients with acute leukemia and CML blast crisis (CML-BC). IL-2R alpha was expressed in 42/311 AML, 5/11 acute unclassified leukemia, 24/116 pre-B ALL, 2/32 T-ALL, and 27/47 CML-BC, while IL-2R beta was expressed only in 2 T-ALL. Expression of IL-2R alpha was closely associated with that of different lineage markers, CD11b, CD34, and Ph1+ abnormality. IL-2R alpha(+) non-T leukemic cells did not respond to IL-2. Clinical outcome of IL-2R alpha (+) leukemia showed lower response to conventional chemotherapy and poorer prognosis than IL-2R alpha (-) cases. Serum IL-2R alpha level in IL-2R alpha (+) cases increased at the onset. Our findings indicate the diagnostic importance of IL-2R alpha expression in acute leukemia as a prognostic risk factor with a close relation to the particular cellular characteristics.

Acute Disease↗
PubMed1997

[Progressive loss of speech output with festinating speech--a case report].

Primary progressive aphasia is a rare disorder of unknown cause. We report a patient with progressive loss of speech output, a clinical variant of PPA, characterized by festinating speech. A 60-year-old right handed woman was admitted to our hospital, because of progressive deterioration of her speech. On admission, she was alert and orientated without dementia. A severe impairment of her articulation was observed: her speech rate was so fast that her speech became almost intelligible. The orofacial apraxia and difficulty in tapping were also present. The other neurological findings were normal. Neuroradiological studies showed the left perisylvian atrophy. Festinating speech has not been previously reported in patients with PPA; patient with PPA usually show a slow speech rate with effortful expression. Since festinating speech is occasionally present in the extrapyramidal disorders, such as Parkinson's disease, progressive supranuclear palsy, or pure akinesia, it appears likely that the combined lesions of the perisylvian region and the basal ganglia are responsible for her characteristic speech disorder with festinating speech.

Aphasia↗
PubMed1997

[Neurological CPC.57. An 80-year-old woman with four years history of muscle atrophy involving lower extremities predominantly on the right side].

We report an 80-year-old woman with progressive muscular atrophy predominantly involving her right lower extremity. She was well until 1992 (75 years of age) when she noted an onset of weakness in her right leg which had got progressively worse. She was admitted to our service in July 1994. On admission, general physical examination was unremarkable. She was alert and well oriented without dementia. Higher cerebral functions were normal. Cranial nerves also appeared intact. She dragged her right leg in walking. Mild to moderate weakness (2/5 to 4/5) was noted in muscles in her right lower extremity more in the distal part. Deep tendon reflexes were within normal limits, and the plantar response was flexor bilaterally. Sensation was intact. Laboratory examinations were also unremarkable except for slight increase in CK which was 470 IU/l. CSF was also normal. EMG revealed neurogenic changes in the lower extremities. She was admitted to Aoki Hospital on October 21, 1994, by that time, her weakness in the right lower extremity had gotten worse in that the muscle strength of the right extensor hallucis longus was 0 and tibialis anterior 2; muscle atrophy was also prominent in her right leg; the right ankle jerk could not be elicited. In the subsequent course, weakness and atrophy appeared in her left lower extremity, however, upper extremities and cranial nerves had never been affected. Babinski sign was always negative. In February 1996, she developed delusional ideation of self persecution, and showed difficulty in communication with medical staffs. She developed fever of 38.7 degrees C on June 13, 1996 expired on the next day. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that the patient had a form of spinal muscular atrophy. Opinions were divided between ALS and spinal muscular atrophy. Post-mortem examination revealed marked loss of anterior horn neurons in the lumbar area with astrogliosis. Bunina bodies were seen in some of the remaining neurons. No myelin pallor was noted in the pyramidal tracts, however, atrophy and loss of Betz cells were noted in the motor cortex. Other cortical areas were unremarkable. The neuropathologist arrived at the conclusion that the patient had ALS. This patient was unique in that she had asymmetric atrophy and weakness limited to the lower extremities. This is quite unusual as ALS of four years duration. In addition, the patient developed some mental change which was thought to represent dementia by some participants. But no clear morphologic changes were seen to account for her mental change.

Aged↗
PubMed1997

[Acute myelogenous leukemia (M4) occurring during chronic lymphocytic leukemia].

A 68 year-old-man was first found to have CLL with IgG, kappa monoclonal gammopathy 6 years ago. Bestrabucil (total dose 35,150 mg) was taken orally from August 1989 to December 1989. Etoposide (total dose 23,100 mg) was then orally administered from January 1990 to December 1995. He was then referred to our hospital in January 1996 because of progressive anemia and thrombocytopenia. Peripheral blood showed a WBC of 21,200/microliter with 4% myeloblasts and 79% lymphocytes, Hb 7.9 g/dl and Plt 5 x 10(4)/microliter. The serum level of lysozyme was increased (75.6 micrograms/ml). Bone marrow aspiration disclosed hyper-cellularity with proliferation of the blasts and a monocytoid cell population, which cytochemical studies demonstrated to be of the myelo-monocytic series, thus indicating acute myelogenous leukemia (AML-M4) superimposed on CLL. Surface marker analysis of bone marrow mononuclear cells revealed reactivity for CD 11c, CD13, CD15, CD33, HLA-DR. The karyotype was normal. Southern blot analysis and reverse transcriptase-polymerase chain reaction did not reveal rearrangement of the MLL gene. Complete remission was achieved by chemotherapy consisted of BHAC, idarubicine, 6MP, vincristine and predonisolone. Long-term treatment with oral etoposide may contribute to secondary AML.

Aged↗
PubMed1997

[A case of post-hemiplegic painful dystonia following thalamic infarction with good response to botulinus toxin].

We report a 67-year-old hypertensive right-handed woman who developed severe pain and dystonia in her left upper and lower extremity after a thalamic infarction. She was well until 9 months prior to the present admission to our hospital, when she had an acute onset of left hemiparesis which turned out to have been caused by a thalamic infarct. Her hemiparesis showed nearly complete recovery during the next four months. She noted an onset of severe spontaneous pain and difficulty in using her left hand four months prior to the present admission. Neurologic examination on admission revealed an alert and well oriented Japanese woman. Cranial nerves were intact. Although she did not have weakness, her left hand showed thalamic posture, and upon standing, she showed a dystonic posture in which her left forearm took pronation and flexion at the elbow joint and her left lower extremity took extension in the knee joint and planter flexion in the ankle joint. Her dystonic posture increased during walking and disappeared in the supine position. She complained of severe spontaneous pain and tingling sensation in her left extremities. Position sense was diminished in her left leg. However other sensations were intact. She had slight ataxia on the left side. Deep tendon reflexes were symmetric, but the planter response was extensor on the left side. MRI revealed a small lacunar infarct involving the right posterolateral thalamic region. EMG with surface electrodes revealed non-reciprocal tonic discharges in the left biceps brachii and forearm flexor and extensor muscles. She responded poorly to various medications. Only trihexyphenidyl showed partial alleviation of her pain and dystonic posture. We thought her pain might be caused by dystonic contraction of the skeletal muscles, at least in part. We injected 25 IU of botulinus toxin as a total dose into her biceps brachii, triceps brachii, and wrist flexor muscles. A few days after the injection, her dystonic posture began to show marked improvement; as her dystonia improved, her pain also showed marked improvement. This patient appeared to represent a case of post-hemiplegic dystonia. Her pain was initially thought to be the thalamic pain. However, as her pain disappeared with improvement of her dystonia, her pain is most likely to have been caused by the dystonic muscle contraction. Botulinus toxin treatment appears to be useful for post-hemiplegic painful dystonia.

Aged↗
PubMed1996

Injection of a GABA antagonist into the mesopontine reticular formation abolishes haloperidol-induced catalepsy in rats.

THE pedunculopontine nucleus and its adjacent structure of the mesopontine reticular formation are known as a mesencephalic locomotor region, since either electrical or chemical stimulation of these regions induces locomotion in decerebrate animals. In parkinsonism, it is presumed that the pedunculopontine nucleus is under GABAergic overinhibition from the basal ganglia. To reveal the behavioural effects of GABAergic disinhibition of the mesopontine reticular formation in parkinsonism, picrotoxin, a GABAA antagonist, (5 or 10 ng/ 0.25 microliter) or vehicle was injected unilaterally into the mesopontine reticular formation of rats via implanted cannulae after induction of catalepsy using haloperidol (1.5 mg kg-1, i.p.). Injection of the larger dose of picrotoxin, but not the smaller dose nor the vehicle, abolished the catalepsy with or without spontaneous locomotor activity. The present result suggests that the disinhibition of the brainstem output structures contributes to the recovery of mobility in the cataleptic state induced by blocking the dopaminergic transmission of the basal ganglia.

Animals↗
PubMed1996

A dislocated and enlarged proliferative zone in human gastric intestinal metaplasia.

There are many published reports suggesting a close relationship between intestinal metaplasia and gastric carcinogenesis, but there are few studies that examine the cellular kinetics of these tissues in humans. Thus, we sought to characterize the proliferative zone of intestinal metaplasia of the human stomach and correlate this with its known malignant potential. We examined the incorporation of bromodeoxyuridine into 228 human endoscopic biopsy specimens from duodenal mucosa (n=35) and non-intestinalized antral mucosa (n=127) as well as antral mucosa with intestinal metaplasia (n = 66). The proliferative zone in specimens with intestinal metaplasia was deeper when compared to non-intestinalized antral mucosa, but was more superficial than that of duodenal mucosa. Although the labeling index of intestinalized mucosa was similar to that of non-intestinalized antral mucosa, the size of the proliferative zone was significantly increased in intestinal metaplasia. The dislocation of the proliferative zone with an increase in its size in intestinal metaplasia is considered to be a hallmark of gastric intestinal metaplasia.

Bromodeoxyuridine↗
PubMed1996

High-performance liquid chromatographic measurements of urinary hydroxycarboxylic acids as an index of the metabolic control in non-insulin-dependent diabetic patients.

Hydroxycarboxylic acids in urine of patients with non-insulin-dependent diabetes mellitus and of healthy subjects are analyzed as 2-nitrophenylhydrazides by an improved high-performance liquid chromatographic method which has advantages with respect to resolution and analysis time. Variations in levels of hydroxycarboxylic acids, originated from the metabolism of valine, leucine and isoleucine, have been described in the diabetic patients who have good and poor metabolic controls. The sum of the hydroxycarboxylic acids in both groups of diabetic patients was significantly increased compared with the values of the healthy subjects. Statistically significant difference was present between the two groups. In the whole group of diabetic patients, the sum of the hydroxycarboxylic acids correlated with fasting plasma glucose or hemoglobin A1c (r = 0.548, P < 0.01 and r = 0.629, P < 0.01, respectively). These results suggest that the relevance of these abnormalities may be used as an index of metabolic control in diabetic patients.

Adult↗
PubMed1996

Thin-layer chromatography and high-performance liquid chromatography for the assay of fatty acid compositions of individual phospholipids in platelets from non-insulin-dependent diabetes mellitus patients: effect of eicosapentaenoic acid ethyl ester administration.

Eight major phospholipids were separated by a TLC method with a one-dimensional developing system without any pretreatment of the plate and the fatty acids incorporated into each phospholipid class were analysed by an improved HPLC method with a simple elution system, which has advantages with respect to resolution and analysis time. The fatty acid compositions of individual phospholipids in platelets were investigated following administration of ethyl cis-5,8,11,14,17-eicosapentaenoate for more than 13 weeks to patients with non-insulin-dependent diabetes mellitus. The cis-5,8,11,14,17-eicosapentaenoic acid compositions of all phospholipid classes were significantly increased with decreasing platelet aggregation rates after the administration. These results suggested that the present method provides the complete separation of individual phospholipids in sufficient amounts to allow fatty acid analysis on the isolated phospholipid moieties.

Blood Platelets↗
PubMed1996

Accelerated cell-cycling of hematopoietic progenitors by the flt3 ligand that is modulated by transforming growth factor-beta.

Although hematopoietic growth factors have been extensively studied as to their roles in recruitment of hematopoietic progenitors from quiescence state to cell division state, little is known of their effects on cell-cycling of progenitors that have already transited from quiescence into active cell-cycling. We examined the effects of the flt3 ligand (FL) on cell-cycling of hematopoietic progenitors in serum-free culture. Results from our serial observations of colony formation and replating experiments suggest that FL enhances the rate of growth of interleukin-3 (IL-3)-dependent colonies by shortening the time for each progenitor in the colonies to divide. Cell-cycle analysis showed that shortening of cell-cycle time induced by FL is mainly because of alteration in the G1 phase that hematopoietic progenitors go through. We next investigated the role of transforming growth factor-beta (TGF-beta) in cell-cycling of progenitors, using TGF-beta protein and TGF-beta antisense oligonucleotides, because mRNA of TGF-beta was detected by reverse transcriptase polymerase reaction in blast cells that we used as a source of progenitors. TGF-beta lengthened the time required for IL-3-dependent progenitors to become two daughter cells, whereas the effects of TGF-beta antisense oligonucleotides were opposite to those of TGF-beta. The addition of TGF-beta neutralizing monoclonal antibodies to the cultures resulted in effects similar to those seen with TGF-beta antisense oligonucleotides. DNA studies indicated that both TBF-beta and TGF-beta antisense oligonucleotides change the length of G1 phase of the cell-cycle. TGF-beta abrogated the effects of FL on the growth rate of hematopoietic progenitors, whereas the combination of FL with TGF-beta antisense oligonucleotides exerted additive effects. These data show that FL has the potential to accelerate cell-cycling of hematopoietic progenitors, which is susceptible to the modulation by TGF-beta.

Animals↗
PubMed1996

Characterizations of the unusual dissociation properties of melanotropin peptides from the melanocortin receptor, hMC1R.

Variation in the degree of prolonged (residual) biological activity of the melanotropin peptides alpha-MSH (alpha-melanocyte-stimulating hormone, Ac-Ser-Tyr-Met-Glu- His-Phe-Arg-Trp-Gly-Lys-Pro-Val-NH2) and the superpotent analogues [Nle4,DPhe7]alpha-MSH (MT-I) and Ac-[Nle4,Asp5,DPhe7,Lys10]alpha-MSH(4-10-NH2 (MT-II) has stimulated considerable interest regarding this biological phenomena. We have examined the differences in their relative dissociation rates from the melanocortin receptor, hMC1R, to try and correlate peptide dissociation rates with the observations of prolonged biological activity. Interestingly, these studies revealed that alpha-MSH remained 25% bound, MT-I 65% bound, and MT-II 86% bound 6 h after the ligand had been removed from the assay medium. The relative dissociation rate of MT-II was 4 times slower than that for alpha-MSH and 2 times slower than that for MT-I, which was 2 times slower than that for alpha-MSH. These data suggest that slow dissociation kinetics (hours) may contribute to the prolonged biological activities observed for both MT-I and MT-II peptides in vitro and in vivo. The prolonged binding, biological activities, and enzymatic stability of MT-I and MT-II make them putative candidates for clinical uses such as external scintigraphy for the localization of tumors (i.e., melanoma).

Amino Acid Sequence↗
PubMed1996

Effects of heart rate on flow velocity of the left atrial appendage in patients with nonvalvular atrial fibrillation.

BACKGROUND AND HYPOTHESIS: Flow velocity of the left atrial appendage (LAA) is thought to be important in thrombus formation in association with blood stasis and the development of spontaneous echo contrast. The effects of heart rate on peak flow velocity of LAA have not been studied in patients with nonvalvular atrial fibrillation. METHODS: Using transesophageal Doppler echocardiography, peak flow velocity of the LAA was measured at the junction between the left atrium and the LAA during left ventricular (LV) systole and diastole in 21 patients with nonvalvular atrial fibrillation. In six cases, the average peak flow velocity of the LAA for 10 consecutive beats with moderately long R-R intervals (LI beats) was compared with those of 3-5 consecutive beats with extremely short R-R intervals (SI beats). RESULTS: Average peak flow velocity of the LAA during LV diastole was significantly higher than that during LV systole (26.5 +/- 15.7 vs. 19.3 +/- 10.4 cm/s, p < 0.01). In SI beats, average peak flow velocity of the LAA was significantly lower than that in LI beats (17.1 +/- 12.1 vs. 21.2 +/- 12.9 cm/s, p < 0.01). CONCLUSION: An increased heart rate reduced the peak flow velocity of the LAA in patients with nonvalvular atrial fibrillation, which would promote blood stasis in the LAA.

Adult↗
PubMed1996

Atrial reservoir and active transport function after cardioversion of chronic atrial fibrillation.

Atrial reservoir function has not been studied after successful cardioversion of chronic atrial fibrillation. Using transthoracic and transesophageal Doppler echocardiography, we measured flow velocity-time integrals of the systolic forward (Sa), diastolic forward (Da), and diastolic reversed (rAa) waves of flow velocity waveforms in the pulmonary vein and the superior vena cava, and those of the early diastolic (Ea) and late diastolic (Aa) waves of the transmitral and transtricuspid flow velocity waveforms. The left and right atrial storage fractions (LASF, RASF), indexes of atrial reservoir function, were determined as the ratios of the atrial storage volume to the ventricular stroke volume; (Sa - rAa)/(Sa - rAa + Da). The left and right atrial active contraction fractions (LAACF, RAACF), indexes of atrial active transport function, were also determined as the ratios of the atrial active contraction volume to the left ventricular stroke volume; Aa/(Ea + Aa). These indices were evaluated periodically in 12 patients with non-valvular chronic atrial fibrillation before and 1-4 days after direct current cardioversion of atrial fibrillation; in 8 of the patients, the indices were also evaluated 1-3 months after the cardioversion. An additional 10 patients in sinus rhythm served as controls. Both the LASF and RASF were low during atrial fibrillation; the values increased significantly 14 days after successful cardioversion (P < 0.01 P < 0.01), and continued to increase at 1-3 months. The LASF and RASF values 1-3 months after cardioversion were comparable to those in control subjects. Both the LAACF and RAACF also increased significantly from 1-4 days to 1-3 months after cardioversion (P < 0.05, P < 0.01), becoming comparable to those in control subjects. During the 3 months after successful cardioversion of non-valvular chronic atrial fibrillation, left and right atrial reservoir function and left and right atrial active transport function increased progressively, becoming comparable to values in the control subjects.

Aged↗