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Biomedical subjects

H Murakami

Publications and source records attributed to H Murakami.

At least 253 records · Page 14Linked to original sources

Changes in granulocyte-macrophage colony formation in relation to chemotherapy and clinical progress in acute myeloblastic leukaemia patients.

To investigate the correlation between granulocyte-macrophage colony formation and the prognosis of acute myelocytic leukaemia, an in vitro colony formation assay using a practical method was performed at diagnosis in 50 patients newly diagnosed with acute myelocytic leukaemia. Granulocyte-macrophage colony counts were significantly lower in acute myelocytic leukaemia patients than in the control group (n = 5). The diminished colony formation was restored to within the normal range in 15 patients after complete remission was achieved. In eight patients, serial evaluation of granulocyte-macrophage colony formation was performed, and suppression of colony formation was observed at relapse. The comparison of granulocyte-macrophage colony counts at diagnosis between a group of patients with complete remission (n = 26) and a group of treatment failure cases (n = 24) revealed a significant difference suggesting that high counts of granulocyte-macrophage colony formation are predictive of a favourable prognosis for acute myelocytic leukaemia.

Adolescent↗

Effect of growth hormone (GH) on serum concentrations of leptin: study in patients with acromegaly and GH deficiency.

As leptin, an ob gene product, plays a pivotal role in the regulation of adiposity and energy homeostasis, the level of its expression is likely to fluctuate under various physiological, nutritional, and disease conditions. Reports regarding the effect of GH on serum leptin levels are inconsistent. We have measured serum leptin levels and correlated them with several variables in patients with acromegaly, patients with adult GH deficiency (GHD), and normal controls. In 116 normal subjects, the mean serum concentration of leptin was 5.0+/-2.8 (mean +/- SD) ng/mL in men (n = 42) and 10.7+/-7.3 ng/mL in women (n = 73), respectively. As reported previously, the leptin levels in women were significantly (P < 0.001) higher than in men, and there was a strong positive correlation between log-transformed serum leptin levels and percent body fat in simple regression analysis (in men: r = 0.606; P < 0.0001; in women: r = 0.707; P < 0.0001). In 36 acromegalic patients, the percent body fat mass was significantly lower than that in normal subjects, and the mean serum leptin level was 2.2+/-1.8 ng/mL in men (n = 18) and 3.6+/-2.5 ng/mL in women (n = 18). Analysis of covariance revealed that serum leptin levels in acromegalics were significantly lower than those in normal subjects after correcting percent body fat (P = 0.016 for men and P < 0001 for women). In male patients with GHD (n = 20), the mean percent body fat was significantly (P < 0.05) higher than that in age-matched controls, whereas the value in female GHD patients (n = 15) did not differ from that in age-matched controls. Serum leptin levels in GHD patients were 5.1+/-2.5 ng/mL in men and 11.5+/-8.1 ng/mL in women, which were not different from those in normal subjects adjusted for percent body fat mass. In multiple regression analysis models with log-transformed leptin as the dependent variable, gender, percent body fat (or body fat mass), and serum insulin-like growth factor I levels entered the equations at a statistically significant level. These data suggest that excess GH/insulin-like growth factor I reduces serum leptin levels by reducing body fat mass and/or by unknown mechanisms.

Acromegaly↗

Association of insulin resistance and hyperinsulinemia with disturbed lipid metabolism in patients with essential hypertension.

To clarify the association of insulin resistance and hyperinsulinemia with lipid metabolism in patients with essential hypertension (EHT), we used the euglycemic hyperinsulinemic glucose clamp technique (GC) and the 75-g oral glucose tolerance test (OGTT) to compare the characteristics of glucose and lipid metabolism in insulin-resistant patients with essential hypertension (EHT-R) with those in insulin-non-resistant patients with essential hypertension (EHT-N) and normotensive subjects (NT). Twenty-eight NT and 42 EHT whose body mass index (BMI) was less than 28 kg/m2 were studied to eliminate the effects of obesity on insulin sensitivity and lipid metabolism. Insulin sensitivity was evaluated by GC and expressed as metabolic clearance rate of glucose (M value, mg/m2/min). Mean -ISD of the M value in NT (145.0 mg/m2/min) was chosen as the cutoff point for insulin resistance. On the basis of this value, 33.3% of the EHT were EHT-R. There was no significant difference in age or BMI among the three groups. Blood samples were collected before GC to measure levels of total cholesterol (TC), triglyceride (TG), free fatty acid (FFA), and HDL cholesterol (HDL-C). EHT-R had significantly higher levels of fasting blood sugar, fasting immunoreactive insulin, insulin at 120 min (IRI-120), and summation of insulin or blood sugar (BS) during the OGTT, as compared with NT and EHT-N. EHT-R also had significantly higher FFA and TG than the other two groups, while there was no difference in FFA or TG between EHT-N and NT. TC and HDL-C were similar in the three groups. There was either a significant negative correlation, or a trend toward negative correlation, between M value and FFA (r= -0.50, p < 0.05) or TG (r= -0.24, p < 0.1). There were significant positive correlations between IRI-120 and FFA (r=0.35, p< 0.05) or TG (r=0.29, p< 0.05). There was a positive correlation (r= -0.36, p< 0.01) between sigma BS and FFA, while no other significant relation was found between sigma BS and serum lipids. In summary, (i) 33.3% of EHT were found to be insulin resistant, when insulin resistance was defined as M value < 145.0 mg/m2/min, i.e., mean -ISD of the M value of NT; (ii) these EHT-R had higher levels of BS, insulin, FFA, and TG than did NT and EHT-N; (iii) EHT-N showed no difference in the levels of BS, insulin, or lipid, as compared with NT; and (iv) the levels of FFA and of TG correlated negatively with insulin sensitivity and positively with the insulin level during the OGTT. These results suggest that disturbances of glucose and lipid metabolism in EHT may be related to both insulin resistance and compensatory hyperinsulinemia, and that EHT-R may have more risk factors for arteriosclerotic complications than EHT-N.

Blood Glucose↗

Improvement of sensitivity in HLA-DRB1 typing by semi-nested PCR-RFLP.

A sensitive method of HLA-DRB1 typing was devised using a semi-nested polymerase chain reaction (PCR) followed by a restriction fragment length polymorphism (RFLP) analysis (semi-nested PCR-RFLP method). The first-round amplification (30 cycles) of the semi-nested PCR was performed using DRB generic primer pairs and the second round of PCRs (20 cycles) were performed using DRB1 group-specific primers. The products of the second round PCRs were digested with restriction endonucleases for the typing of HLA-DRB1 alleles. By this method, HLA-DRB1 typing was possible from 10 pg of genomic DNA extracted from lymphocytes and from 0.5 microliter of 1,000 times diluted blood without DNA extraction. HLA-DRB1 alleles could be typed from a 2-mm long bloodstained cotton thread prepared from 10 times diluted blood and from a 2-mm thread of whole blood bloodstains stored at room temperature for 2 years. From the mixture of blood of two individuals with different genotypes, DRB1 alleles of the minor component were detected down to 1/1,000 of the major component. This semi-nested PCR-RFLP method is useful for HLA-DRB1 typing from extremely small amounts of DNA and from mixed samples.

Genotype↗

The effect of high-salt diet intake on muscular exercise ability in young Japanese women.

This study was designed to test whether high-salt diet intake has some acute impaired effect to the muscular exercise ability due to the calcium deficit in muscle cell via the accelerated sodium-calcium exchanger. Six healthy young Japanese women (aged: 22.3 +/- 1.9 yr) performed two types of muscle strength tests and ramp mode cycle ergometer exercise until exhaustion after normal- (NaCl is approximately 5.6 g) and high-salt (21.0 g) controlled diet intake on two separate days in random order. The urinary sodium excretion sampled during 12 hours on the high-salt diet day was significantly higher compared to that of normal-salt diet day (3301 +/- 992 vs 1595 +/- 540 mg; P < 0.05), while there was no substantial difference between the urinary calcium excretion in high- and normal-salt diet days (58.6 +/- 19.7 vs 55.0 +/- 17.2 mg; ns). There were no significant differences in back strength, repeated maximal hand grip exercise ability, and VO2max and duration time during ramp exercise between high- and normal-salt diet conditions. It was concluded that high-salt diet intake even exceeding 20 g per day had substantially no acute effect on muscular exercise ability in young Japanese women.

Adult↗

Rheumatoid arthritis associated with renal amyloidosis and crescentic glomerulonephritis.

A 43-year-old woman with rheumatoid arthritis (RA), renal amyloidosis and crescentic glomerulonephritis had severe abdominal pain, melena and progressive renal failure. Autopsy findings revealed vasculitis of small and middle size of vessels and there was a deposition of amyloid in the small intestines. Although there were no findings of vasculitis in the kidney, amyloid deposition was noticed and 70-80% of glomeruli showed a crescentic formation. No immunological abnormality was found in glomeruli. Although the immunological mechanisms of crescentic glomerulonephritis were not necessarily eliminated, amyloid deposition may play a role in crescent formation.

Acute Kidney Injury↗

Abducens nerve palsy caused by basilar impression associated with atlanto-occipital assimilation.

A 47-year-old male presented with abducens nerve palsy due to basilar impression associated with atlanto-occipital assimilation manifesting as slowly progressive bilateral trigeminal neuralgia and diplopia in the right lateral gaze. X-ray and computed tomography of the skull confirmed the diagnosis of basilar impression and atlanto-occipital assimilation, and magnetic resonance imaging disclosed tightness of the posterior cranial fossa. Surgical suboccipital decompression resulted in gradual resolution of the patient's complaints, and no additional symptoms were recognized. Impairment of the sixth cranial nerve is a rare symptom compared to those of the fifth or the eighth cranial nerve in a patient with a craniocervical malformation. However, the present case shows the possibility of cranial nerve dysfunction due to tightness of the posterior cranial fossa, and suggests that surgical treatment for basilar impression with atlanto-occipital assimilation should be considered in patients with uncommon and unusual symptoms.

Abducens Nerve↗

Ossification of transverse ligament of the atlas associated with atlanto-axial dislocation--case report.

A 68-year-old male presented with progressive quadriparesis. Twelve years previously he had undergone anterior decompression with bone grafting for cervical ossification of the posterior longitudinal ligament associated with spinal trauma. Radiological examination showed ossification of the transverse ligament of the atlas (TLA) and severe stenosis of the upper cervical canal. Anterior dislocation of the atlas was also present, but the occiput/atlas/axis unit was perfectly stable due to the prior anterior fusion. Suboccipital decompression and laminectomy of the atlas were performed, and his symptoms improved. Based on the atlanto-axial dislocation, the TLA might have been damaged at the time of the primary trauma and became the trigger for the ossification of the TLA, showing that marked ossification of a vertebral ligament can occur after injury.

Aged↗

Hemangiopericytoma arising at the site of a dural graft 13 years after total removal of a benign meningioma--case report.

A 64-year-old female presented with hemangiopericytoma arising from a dural fascia graft placed after a previous operation for the total removal of a benign meningioma. The patient also had multiple pulmonary metastases identified as hemangiopericytoma. The tumor resected at the first operation was benign based on all grading systems for meningiomas. We considered that the tumor was a kind of scar tumor. The hemangiopericytoma probably developed from a scar tumor at the graft. We emphasize the importance of long-term follow-up for patients who have undergone surgery for benign tumors.

Bioprosthesis↗

Clinical importance of c-Met protein expression in high grade astrocytic tumors.

The clinical importance of the expression of c-Met protein, the receptor of hepatocyte growth factor/scatter factor, was evaluated in neuroepithelial tissue tumors. c-Met immunohistochemistry was performed using the streptavidin-biotin-peroxidase complex method with anti-c-Met polyclonal antibody. Specimens were classified as c-Met negative (< 30%) or c-Met positive (> or = 30%) according to the proportion of immunopositive cells under microscopic examination. All c-Met-positive cases occurred in high grade astrocytic tumors, not in other neuroepithelial tissue tumors. Most c-Met-positive astrocytic tumors were classified histologically as high grade tumors. Epidermal growth factor-receptor (EGFR) and MIB-1 immunohistochemistry were also performed for high grade astrocytic tumors. Survival analysis was performed for patients with these tumors with variables including c-Met positivity, EGFR positivity, and MIB-1 labeling index. Positivity of c-Met was independent from EGFR positivity and MIB-1 labeling index, and the c-Met-positive group showed a significant shorter survival (p < 0.05). c-Met immunopositivity may be a parameter of biological aggressiveness in high grade astrocytic tumors. Examination of c-Met expression in astrocytic tumors provides significant clinical information, especially as a prognostic factor.

Astrocytoma↗

Secondary glioblastoma remarkably reduced by steroid administration after anaplastic transformation from gliomatosis cerebri--case report.

A 45-year-old female presented with gliomatosis cerebri manifesting as hemiballismus-like involuntary movement in the arm, motor weakness in the leg, and hypesthesia in her left side. Computed tomography showed only diffuse swelling of the right cerebral hemisphere, but T2-weighted magnetic resonance imaging revealed a diffuse lesion spreading from the right thalamus to the temporal, parietal, and occipital lobes on the same side. No abnormal enhancement was recognized. Cerebral angiography showed no specific finding. A right occipital lobectomy was performed to confirm the diagnosis of gliomatosis cerebri. Anaplastic transformation was recognized 5 months later. The disease did not resolve with radiation or interferon administration, but steroid therapy achieved remarkably effective tumor regression. The patient died due to pneumonia. Autopsy showed the features of diffuse glioblastoma. Steroid therapy may be an effective treatment for gliomatosis cerebri before the terminal stage.

Astrocytoma↗

[Relationship between ultrastructure of myeloma cells and clinical features in elderly patients with multiple myeloma].

The relationship between the ultrastructure of plasma cells and clinical features was analyzed in 54 patients with multiple myeloma: 20 elderly patients (9,8 and 3 cases of IgG, IgA and BJP types, respectively; 5,3 and 12 cases in clinical stage I, II and III, respectively) and 34 young patients (16, 10, 1 and 7 cases of IgG, IgA, IgD and BJP types, respectively; 5, 10 and 19 cases in clinical stage I, II and III, respectively). Five-year survival rates of the elderly and young groups were 41.5 and 60.5%, respectively, though the difference of both survival curves was not significant. Response rates of initial therapy in the elderly and young groups were 55 and 56%, respectively (not significant). The number of patients presenting disarrangement of organelles was significantly larger in the elderly group, but those presenting other abnormal structures were equal between both groups. The ratios of dense body, intramitochondrial granules and multilamellar body in bone marrow plasma cells were significantly higher in nonresponders than in responders of the elderly group. The ratios of disarrangement of organelles, single sac loop-like structure and intramitochondrial granules in bone marrow plasma cells were significantly higher in nonresponders than in responders of the young group. It is suggested that the ultrastructure of plasma cells in multiple myeloma differs between elderly and young patients and is useful in predicting the respective clinical features, although drug responses and survival curves do not show a significant difference.

Age Factors↗

[A study of minimally invasive direct coronary artery bypass (MIDCAB): comparison of low risk group and high risk group].

We started to perform MIDCAB for the cases of markedly low cardiac function from June, 1996 and obtained satisfactory results. So we expanded the indications to include only left anterior descending artery (LAD) lesion from June, 1997 and have since performed this operation on 14 cases. The 14 cases of MIDCAB were divided into two groups, Group L consisting of 6 low risk cases: 1 lesion alone without any complications involving other organ before operation and Group H made up of 8 high risk cases: multi branch lesion but rated as high risk because of the extracorporeal circulation being used. Both Group L and Group H were free of operation death and hospital death. In Group L, all the cases underwent operation without blood transfusion, the period of postoperative stay in ICU was not longer than 1 day, on catecholamine was required after operation and complications were not found either. The patency of the graft was 100 percent. The patients were discharged 13.7 days after operation. In Group H, 2 cases required blood transfusion and 3 cases required catecholamine after operation. Complication arising from operative wound were noted in 3 cases. One GEA graft to the right coronary artery and one LITA to the LAD buried in the muscle were occluded. After operation, hospital stay for 23.9 days was required. In Group L, the postoperative course was excellent, so MIDCAB was considered indicated well for this group. In Group H too, the selection of MIDCAB was considered adequate that the risk of conventional CABG is considered much higher.

Adult↗

Cystic, myxomatous adventitial degeneration of a saphenous vein.

We describe the case of a 75-year-old woman with adventitial cystic degeneration of the great saphenous vein. Involvement of the great saphenous vein has been unreported previously. Intravenous cysts containing mucinous material were found in the great saphenous vein. Histopathologic examination revealed mucus-filled cysts in the adventitia of the vein, and myxomatous degeneration of the adventitial connective tissue was found.

Aged↗

[Neural protective agents, propentofylline (PPF) could induce apoptotic cell death in the human glioma cells: analysis of Bcl-2 and Bax alpha/Bax beta expressions].

In the previous study, we have shown that propentofylline (PPF) could induce the cellular differentiation and apoptosis-related growth regression in the human glioma cell lines. Its biological functions were partly due to the increasing endogeneous NGF and its high affinity receptor, trk A productions. Although little has been known about the precise machinary regulating the propentofylline induced apoptosis. Recently, we have found that propentofylline could modulate some apoptosis related genes products in the glioma cell lines, i.e. NGF, trk A mRNA levels and Fas protein expressions were increased, whereas bcl-2 mRNA level was decreased. In the present study, we examined the apoptotic signal cascade, especially focusing on the expressing pattern of Bcl-2/Bax gene products. In the normal human astrocyte cells, Bax-beta was markedly expressed, whereas Bcl-2 and Bax-alpha proteins and mRNA were weakly or even nondetectable. Accordingly, Bax beta might be a dominant variant in the normal glial cells, which could have the appropriate balance of proapoptotic (Bax beta) and anti-apoptotic proteins (Bcl-2). In the glioma cells, we showed the over-expressions of Bcl-2 and Bax alpha compared with the normal counterparts. According to Bax dominant theory, Bax, not Bcl-2 may have a major role in regulating apoptosis by means of homodimerization. In might be implied that in the glioma cells, excessive expressions of Bcl-2 and Bax alpha would favor the formation of the Bax alpha/Bax beta heterodimer or the Bax beta/Bcl-2 heterodimer rather than the Bax beta/Bax beta homodimer, which might be presumed to be functional proteins. And finally the increasing relative ratio of Bax alpha/ Bax beta or Bax beta/Bcl-2 to Bax beta/Bax beta could allow the tumor cells to survive. Thus over-expression of the bcl-2 and bax alpha gene renders the glioma cells resistant to apoptosis. In the present study, PPF could promote Bax beta over-expression and Bcl-2 retardative expression in the glioma cells, whereas had no effect on Bax alpha expression. Therefore, PPF might promote apoptotic cell death through the mechanism that restore the glioma cells to the appropriate balance of proapoptotic and anti-apoptotic proteins like as normal astrocytes. Our results indicated that propentofylline might have a potential role as apoptotic modulators in the human glioma cell lines, not only its protective activities against neuronal ischemic damages.

Apoptosis↗

[Induction of apoptosis through NGF/p75NTR in human glioma cells treated with propentofylline].

Propentofylline (PPF) is a xanthine derivative and it has been reported that PPF stimulated the synthesis/secretion of nerve growth factor (NGF) by cultured astroglial cells. We have reported that PPF induced apoptosis in human glioma cells and as its mechanism, up-regulation of NGF, Fas, Bax beta and down-regulation of Bcl-2 were assumed. Recent studies demonstrated the presence of apoptosis induced via NGF/p75NTR in developmental neuron, oligodendroglia. In the present study, to examine whether signal cascade via NGF/p75NTR participates the apoptosis in human glioma cells treated with PPF, we investigated the immunohistochemical study using anti-mouse monoclonal antibody, immunoprecipitation and northern blot analysis for p75NTR, NF-kappa B in human glioma cells (U251MG, T98G, U87) treated with PPF. We observed the up-regulation of p75NTR, translocation of NF-kappa B to the nucleus after treatment with PPF in these cell lines. According to above results, it is assumed that apoptosis in human glioma cells treated with PPF was induced via NGF/p75NTR.

Apoptosis↗