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Biomedical subjects

H Nakae

Publications and source records attributed to H Nakae.

At least 73 records · Page 4Linked to original sources
PubMed1994

Plasma endotoxin and cytokine concentrations in patients with hemorrhagic shock.

OBJECTIVES: The roles of cytokines and endotoxin in hemorrhagic shock, particularly the translocation of endotoxin and bacteria during hemorrhagic shock, were investigated. DESIGN: Prospective study. SETTING: Critical care and emergency center of a university hospital. PATIENTS: Twenty-nine patients with hemorrhagic shock and 20 healthy controls. INTERVENTIONS: Serial blood samples were collected from both study and control patients. Standard resuscitation techniques were used. MEASUREMENTS AND MAIN RESULTS: Plasma levels of endotoxin and various cytokines were determined repeatedly during hemorrhagic shock. Endotoxin was measured using an endotoxin-specific assay in addition to a new perchloric acid method for pretreatment of plasma. Cytokines were measured by commercial enzyme-linked immunosorbent assays. Plasma endotoxin concentrations remained within the normal range for 7 days after admission. Although levels of tumor necrosis factor-alpha and several interleukins increased slightly in some patients, these cytokines did not reach the levels seen in septic shock. CONCLUSIONS: Translocation of bacteria or endotoxin from the gastrointestinal tract into the bloodstream has been noted in animal experiments; however, translocation was not detected in our patients with hemorrhagic shock.

Adolescent↗
PubMed1994

A quantitative comparison of selected bacteria in human carious dentine by microscopic counts.

The levels of selected cariogenic and obligately anaerobic bacteria have been compared in carious dentine taken from fissures, smooth surfaces, and root surfaces. The numbers of infected dentinal tubules were determined by immunohistological staining using species-specific antisera against selected bacteria. Selective localization was observed; mutans streptococci were the predominant bacteria in dentine from fissures and smooth surface coronal caries, but not from root surface caries. The proportion of mutans streptococci was higher in the shallow and middle layers of dentine from fissures and smooth surface coronal carious lesions than from the deep layers. In root surface caries, Actinomyces spp. were the predominant bacteria, and were present at higher levels in the deep layer of root lesions than in the shallow and middle layers. The proportion of Lactobacillus spp. was relatively low despite its high detection frequency in all layers of the three types of carious lesion. Immunohistological staining with species-specific antisera was able to reveal the distribution and the localization of various bacteria in carious dentine.

Actinomyces viscosus↗
PubMed1994

Evaluation of recombinant human granulocyte colony-stimulating factor (rhG-CSF) therapy in granulopoetic patients complicated with sepsis.

A study was carried out to investigate the efficacy of therapy with recombinant human granulocyte colony-stimulating factor (rhG-CSF) in 24 patients with granulocytopenia and sepsis who had failed to respond to antibiotics. The mean leukocyte count at the start of the study was 911 +/- 334/microliter. Patients were injected subcutaneously with 75 micrograms rhG-CSF once daily for a mean of 5.2 days. The plasma G-CSF concentration was measured by ELISA. The leukocyte count increased approximately 9-fold after 1 week in 19 patients and the percentage of granulocytes rose from 46.2% to 78.9%. These 19 patients survived, while the 5 patients with no leukocyte response to rhG-CSF died. High plasma G-CSF levels were found in patients with granulocytopenia. Plasma G-CSF levels decreased as levels of granulocyte increased in survivors. A high plasma G-CSF concentration persisted in the 5 non-responding patients resulting in a fatal outcome. This study suggests that rhG-CSF both increased the leukocyte count and was a useful therapeutic manoeuvre for sepsis.

Adult↗
PubMed1994

Soluble CD14 (sCD14) levels in patients with multiple organ failure (MOF).

We measured soluble CD14 (sCD14), plasma endotoxin, tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), IL-6, and interferon-gamma (IFN-gamma) in patients with multiple organ failure (MOF). The sCD14 level was significantly higher in septic patients with MOF than that in those without MOF and also higher in non-septic trauma patients with MOF than that in those without MOF. In the septic group with MOF, the sCD14 level correlated significantly with the TNF-alpha level but not the plasma endotoxin, IL-1 beta, IL-6, or IFN-gamma level. These results suggest that the sCD14 level reflects the degree of pathophysiology and that TNF-alpha is involved in stimulating sCD14 production.

Adult↗
PubMed1994

Relationship between plasma levels of type II phospholipase A2, PAF acetylhydrolase, endothelin-1, and thrombomodulin in patients with infected burns.

The relations between type II phospholipase A2 (PLA2) and PAF acetylhydrolase (PAFAH) levels and those of endothelin-1 (ET-1) and thrombomodulin (TM) were examined in samples containing the maximum amount of TNF-alpha detected over the clinical course for each patient with burn wound infection. The study included 23 patients with a total burn surface area of > 20%. Plasma levels of tumor necrosis factor-alpha (TNF-alpha), type II PLA2, PAFAH, TM, and ET-1 were 174.1 +/- 239.5 pg/ml, 229.5 +/- 190.8 ng/ml, 22.68 +/- 7.07 nmol/min per ml, 6.62 +/- 2.78 ng/ml, and 7.45 +/- 2.99 pg/ml, respectively. There were significant correlations between plasma levels of type II PLA2 and TM (r = 0.767, p < 0.0001), between PAFAH and TM (r = 0.542, p = 0.0076), between type II PLA2 and ET-1 (r = 0.688, p = 0.0003), and between PAFAH and ET-1 (r = 0.516, p = 0.0117). These results suggest that the increases in plasma type II PLA2 and PAFAH are related to vascular endothelial disorders in patients with infected burns.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1994

Relationship between leukotriene B4 and prostaglandin I2 in patients with sepsis.

To examine the roles of leukotriene B4 (LTB4) and prostaglandin I2 (PGI2), the metabolites of arachidonic acid found in patients with sepsis, we measured the serum levels of LTB4 and a stable metabolite of PGI2, 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), in 22 patients with sepsis. Results were analyzed in relation to patients' survival. The serum levels of both LTB4 and 6-keto-PGF1 alpha were significantly higher in patients who died than in those who survived, thus serving as indicators of illness severity. There was a significant correlation between LTB4 and 6-keto-PGF1 alpha levels. The present study suggests that LTB4, a potent leukocyte activator, induces damage to vascular endothelial cells in patients with sepsis, resulting in the excessive production of PGI2 and, consequently, serious illness.

6-Ketoprostaglandin F1 alpha↗
PubMed1994

Plasma levels of TNF-alpha, endothelin-1 and thrombomodulin in patients with sepsis.

To investigate the roles of tumor necrosis factor-alpha (TNF-alpha), endothelin-1 (ET-1) and thrombomodulin (TM) in the plasma of patients with sepsis, plasma levels of endotoxin (Et), TNF-alpha, ET-1 and TM were determined in 30 such patients. Plasma levels of Et, TNF-alpha, ET-1 and TM at the time sepsis was diagnosed were 4.0 +/- 6.7 pg/ml, 98.5 +/- 92.1 pg/ml, 7.0 +/- 4.1 pg/ml and 7.8 +/- 3.3 ng/ml, respectively. There was no significant difference in the plasma Et level between the group of patients that survived (n = 13) or died (n = 17). Plasma levels of TNF-alpha, Et-1 and TM were significantly higher in the group that died than in the surviving group (TNF-alpha, p < 0.0001; ET-1, p = 0.028; TM, p = 0.0004). There were significant correlations between the plasma levels of TNF-alpha and ET-1, of TNF-alpha and TM, and of ET-1 and TM (r = 0.37, p < 0.046; r = 0.61, p = 0.0008; r = 0.63, p = 0.004), respectively. Results suggest that TNF-alpha is involved in the production of ET-1 and TM. Both of those substances appear to be involved in the morbidity of sepsis, and their plasma levels reflect its severity.

Adult↗
PubMed1994

Relationships between plasma levels of type-II phospholipase A2, PAF-acetylhydrolase, leukotriene B4, complements, endothelin-1, and thrombomodulin in patients with sepsis.

We determined the plasma levels of type-II phospholipase A2 (type II PLA2), platelet-activating factor acetylhydrolase (PAFAH) leukotriene B4 (LTB4) and of several complements (C3a, C4a, and C5a), which are considered to be among the cytokines and eicosanoids involved in vascular endothelial disorders and that vary in concentration during sepsis. We investigated the relationship between those levels and those of ET-1 and TM levels in plasma. Plasma levels of type II PLA2, PAFAH, LTB4, C3a, C4a, ET-1, and TM at the time that sepsis was diagnosed in 30 patients were 218.3 +/- 179.9 ng/ml, 23.92 +/- 9.66 nmol/min/ml, 90.35 +/- 31.49 pg/ml, 838.73 +/- 2.30 pg/ml, 1951.46 +/- 1697.78 pg/ml, 6.98 +/- 4.08 pg/ml and 7.80 +/- 3.34 ng/ml, respectively. The C5a plasma level was below the limit of detection in all cases. There were significant correlations between type II PLA2 and ET-1 plasma levels (r = 0.39, p = 0.032) and C3a and ET-1 plasma levels (r = 0.60, p = 0.03). There were also significant correlations between type II PLA2 and TM levels in plasma (r = 0.76, p = 0.0017), PAFAH and TM plasma levels (r = 0.53, p = 0.037), LTB4 and TM plasma levels (r = 0.46, p = 0.016) and C4a and TM plasma levels (r = 0.58, p = 0.037). Results suggest that the elevation of type II PLA2, PAFAH, LTB4 and complement in plasma is involved in vascular endothelial disorders in patients with sepsis.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1994

PAF acetylhydrolase and arachidonic acid metabolite levels in patients with sepsis.

To examine the relationship between arachidonic acid metabolism and sepsis, we determined the blood concentration of platelet-activating factor acetylhydrolase (PAFAH) and of arachidonic acid cascade substances, leukotriene B4 (LTB4), thromboxane B2 (TXB2), and 6-keto-prostaglandin Fla (PGF1a), in patients with clinical sepsis. Blood concentrations of PAFAH, LTB4, TXB2 and PGF1a at the time of the initial diagnosis of sepsis were 23.9 +/- 9.7 nmol/min/mL, 90.4 +/- 31.5 pg/mL, 55.3 +/- 44.1 pg/mL and 22.3 +/- 11.9 pg/mL, respectively. There was a significant correlation between the blood PAFAH and LTB4 concentration (r = 0.520, p = 0.0033) and the diagnosis of sepsis. There also was a significant correlation between the blood PAFAH and TXB2 concentration (r = 0.460, p = 0.0311). There was no correlation between the blood PAFAH and PGF1a concentrations. Elevated LTB4 and TXB2 concentrations showed a significant correlation with the PAFAH concentration in patients with sepsis, suggesting a direct relationship between these substances.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1994

Blood cytokine and complement levels in patients with sepsis.

We measured serum levels of endotoxin, cytokines, and eicosanoids and investigated their relationship to serum complement levels in patients with sepsis. Serum endotoxin (Et) levels (5.3 +/- 2.4 pg/ml) were within the normal range, but levels of tumor necrosis factor-alpha (TNF-alpha, 114 +/- 104.94 pg/ml), interleukin 6 (IL-6, 86.7 +/- 50.9 pg/ml), interleukin 8 (IL-8, 86.8 +/- 49.7 pg/ml), type-II phospholipase A2 (type II PLA2, 211.3 +/- 193.9 ng/ml), leukotriene B4 (LTB4, 88.7 +/- 27.2 pg/ml), thromboxane B2 (TXB2, 58.7 +/- 50.9 pg/ml) and 6-keto-prostaglandin F1 alpha (PGF1 alpha, 21.0 +/- 11.0 pg/ml) levels were above normal. Levels of C3a (1088.4 +/- 83.8.7 ng/ml) and C4a (1951.5 +/- 1697.8 ng/ml) were also above normal; C3 (66.0 +/- 25.6 mg/dl) and C4 (23.6 +/- 5.3 mg/dl) were within the normal range, and C5a was lower than the detectable limit in all but one of the subjects. Serum TNF-alpha was significantly correlated with C3a (p < 0.001). Serum IL-6 had a significant negative correlation with C3 (p = 0.002) and C4 (p = 0.010). Type II PLA2 was significantly correlated with C3a (p < 0.001). There were no significant correlations between serum Et or IL-8 and serum C3, C4, C3a or C4a. Our findings suggest that increased levels of TNF-alpha, IL-6, and Type II PLA/ in patients with sepsis contribute to activation of the complement system.

Adult↗
PubMed1994

Platelet-activating factor (PAF) acetylhydrolase activity, type II phospholipase A2, and cytokine levels in patients with sepsis.

Platelet activating factor acetylhydrolase (PAF-AH) activity was measured in patients with sepsis, and its relationships with various cytokines and endotoxin were evaluated. PAF-AH activity was significantly higher (p = 0.0136) in 17 patients who died than 13 patients who survived. PAF-AH activity showed significant correlations with the plasma endotoxin, TNF-alpha, and IL-8 levels. These findings suggest that PAF-AH activity reflects the severity of the pathological condition.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗
PubMed1994

Relationship between thromboxane B2 and 6-keto-prostaglandin F1 alpha in sepsis.

To examine the roles of thromboxane A2 and prostaglandin I2, which are arachidonic acid metabolites found in patients with sepsis, we measured the serum levels of their respective stable metabolites, thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) in 22 patients with sepsis. Results were analyzed in relation to patients' survival. The levels of both TXB2 and 6-keto-PGF1 alpha were significantly higher in patients who died than in those who survived, thus reflecting the severity of the patients' illness. There was a significant correlation between the levels of TXB2 and 6-keto-PGF1 alpha. These findings suggest that TXA2 and PGI2 are chemical mediators involved in the severity of clinical sepsis.

6-Ketoprostaglandin F1 alpha↗
PubMed1994

Serum complement levels and severity of sepsis.

The activities (C3a, C4a, C5a) and concentrations (CH50, C3, C4, C5) of serum complement were measured to evaluate the involvement of complement in sepsis. We studied 27 patients with sepsis who were divided into the survivors (Group 1) and the nonsurvivors (Group 2). The levels of C3a, C4a, and C5a were all significantly higher in Group 2 than in Group 1 and closely reflected the severity of sepsis. Levels of C3 and C4 were significantly lower in Group 2 than in Group 1, presumably because these components were consumed as a result of activation of both the alternative and classical pathways. The levels of CH50 and C5 did not differ significantly between the two groups. These findings suggest that complement is closely involved in the exacerbation of the condition of septic patients, and that the measurement of complement activity is useful for evaluating the severity of sepsis.

Adult↗
PubMed1994

Significance of alpha-tocopherol and interleukin 8 in septic adult respiratory distress syndrome.

To elucidate the relationship between active oxygen and interleukin 8 (IL-8) in patients with septic adult respiratory distress syndrome (ARDS), we determined the serum levels of alpha-tocopherol, which has an antioxidant action, and IL-8 in seven patients with this disease. Serum alpha-tocopherol and IL-8 levels determined at the time of diagnosis of septic ARDS were 0.97 +/- 0.36 mg/dl and 0.98 +/- 0.99 ng/ml, respectively. A significant correlation was found between serum alpha-tocopherol level and IL-8 level (r = -0.758, p = 0.0473). These findings suggest that IL-8 activates neutrophils, which produce active oxygen.

Adolescent↗
PubMed1994

[Penetrating craniocerebral injuries during downhill skiing].

Two cases of penetrating craniocerebral injuries which occurred during alpine skiing were presented. The first was a 25-year-old lady whose calvarium was impaled with a ski pole in the anterior part of the orbital roof following an interpersonal collision. She was brought to the Critical Care and Emergency Center, Iwate Medical University. On admission, her consciousness was clear and a stab wound was observed in her upper eyelid. Initial CT showed bone fracture of the anterior part of the orbital roof and a small intracerebral hematoma associated with bone fragment was revealed. Immediate removal of the hematoma and foreign body was carried out and duralplasty was performed. She had a very good postoperative course but residual anosmia. The second was a 9-year-old boy who lost control and collided with a tree during downhill skiing. A twig penetrated through his left maxillary sinus. He was brought to the Critical Care and Emergency Center, Iwate Medical University. On admission, his consciousness was clear. CT showed a round low density area from his anterior lobe to the Nucleus caudatus, indicating the tract of the twig. Immediately, duralplasty and removal of the foreign body was performed. He had a very good postoperative course.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Relationship between cytokines and leukotriene B4 in sepsis.

To clarify the relationship between cytokines and arachidonic acid metabolites, we measured tumor necrosis factor (TNF-alpha), interleukin 8 (IL-8), and leukotriene B4 (LTB4). The subjects consisted of 30 patients with sepsis. The results were compared between patients who died (Group A) and those who survived (Group B). All TNF-alpha, IL-8, and LTB4 levels were significantly higher in Group A than in Group B, reflecting the severity of the disease. The LTB4 levels were significantly correlated with the TNF-alpha level and the IL-8 level. These results suggest that inflammatory cytokines, excessively produced due to inflammatory reactions, stimulate as a mediator the release of arachidonic acid, increasing LTB4 production.

Adult↗
PubMed1994

Clinical effects of intramuscular administration of a small dose of polymyxin B to patients with endotoxemia.

The effects of intramuscular injections of minute amounts of polymyxin B were studied in 42 patients with endotoxemia. Plasma endotoxin was measured by means of an endotoxin-specific Endospecy test (Seikagaku Corp., Tokyo, Japan) after pretreatment of the plasma with a new perchloric acid method that we developed. The normal value of plasma endotoxin is less than 9.8 pg/mL. Polymyxin B was administered at a dose of 12,500 U every 6 hours. Plasma endotoxin rapidly decreased to the normal range in 40 of the 42 patients. Body temperature fell significantly. APACHE II scores were also significantly improved. Tumor necrosis factor-alpha and interleukin-6 (IL-6) decreased in survivors, while tending to persist in high values in patients who died. No side effects were observed in any of the patients. In conclusion, intramuscular injections of small doses of polymyxin B were useful in the treatment of endotoxemia.

Adolescent↗