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Biomedical subjects

H Nawata

Publications and source records attributed to H Nawata.

At least 361 records · Page 20Linked to original sources

Endoscopic ultrasonographic evaluation of gastric ulcer healing on treatment with proton pump inhibitors versus H2-receptor antagonists.

BACKGROUND: It has been reported that time to peptic ulcer healing is shorter with proton pump inhibitors (PPI) than with H2-receptor antagonists (H2-RA). This study was designed to examine the difference in the healing process between gastric ulcers treated with PPI and those treated with H2-RA. METHODS: The healing of deep gastric ulcers treated with PPI (n = 11) or H2-RA (n = 13) was evaluated with endoscopic ultrasonography (EUS). Every 2 weeks during treatment EUS variables such as the width and the depth of the ulcer crater, the thickness and size of the low echoic area of the ulcer base, and the distance of the disrupted muscularis propria were measured. The contraction rates of EUS variables, the ratios of the contraction rate of the depth to that of the width of the ulcer crater (D/W ratio) and the contraction rate of the distance of the disrupted muscularis propria layer to that of the width of the ulcer crater (Dm/W ratio) were calculated. RESULTS: Only at week 2 were the D/W ratio and Dm/W ratio significantly higher in the group receiving PPI (D/W ratio, 1.79 +/- 0.701; Dm/W ratio, 0.938 +/- 0.207) than in the group receiving H2-RA (D/W ratio, 1.10 +/- 0.559; Dm/W ratio, 0.641 +/- 0.166). CONCLUSION: This study demonstrated that PPI therapy is associated with more rapid and stronger healing than obtained with H2-RA during the early treatment period.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Utility of Albusure test in screening for early stage of diabetic nephropathy.

All diabetic patients should be screened for the early stage of diabetic nephropathy, because microalbuminuria has a great prognostic significance. The albusure test (AT), alatex agglutination nephelometric immunoassay, is a rapid and low cost test for the detection of microalbuminuria of 30 mg/L or more. We compared the results of AT and of radioimmunoassay (RIA) for urinary albumin to evaluate the clinical utility of AT using fresh urine samples from 74 diabetic patients without persistent proteinuria and from 11 healthy subjects. Urinary albumin levels measured by RIA were 6.0 +/- 2.3 mg/L in the healthy subjects, 11.0 +/- 8.7 mg/L in the AT-negative group (n = 61), and 38.1 +/- 10.2 mg/L in the AT-positive group (n = 13). Using a cut-off value of 30 mg/L by RIA, the rate of coincidence between AT and RIA was 89.2%, although five subjects were false-positive by AT, and three were false-negative. These results show that AT may provide a useful monitor microalbuminuria, a reliable early mark of diabetic nephropathy.

Adult↗

[A case of syndrome X whose hyperglycemia, hyperlipidemia and hypertension were improved as accompanying with decreased insulin resistance].

A 60-year-old man was admitted to the Kyushu University Hospital because of poor glycemic control of diabetes mellitus. Although he had been treated with glicrazide and nifedipine for his diabetes and hypertension, the controls of the diseases were unsatisfactory. Plasma triglyceride level was 186 mg/dl. Furthermore, extreme insulin resistance was found by measuring glucose infusion rate with an euglycemic hyperinsulinemic clamp method. These findings were compatible to those seen in syndrome X. After admission, diet therapy of 1,800 Cal was started and his metabolic disorders such as hyperglycemia, hyperlipidemia, and hypertension were all improved. Moreover, euglycemic hyperinsulinemic clamp study also revealed a decreased insulin resistance after diet therapy. Our experience from the case suggested that insulin resistance may closely related with the metabolic disorders of the disease "syndrome X".

Diet, Reducing↗

Age-related increase in neuropeptide Y-like immunoreactivity in cerebrospinal fluid in women.

In order to investigate the age-related changes in neuropeptide Y (NPY) in cerebrospinal fluid (CSF) of men and women, we examined the concentration of NPY-like immunoreactivity (NPY-LI) in CSF of a large population of Japanese men and women by specific radioimmunoassay (RIA). The dilution curve of CSF extract paralleled the standard curve of RIA for human NPY. Gel chromatographic studies revealed the presence of two peaks of NPY-LI, one emerging at the elution position of synthetic NPY and another emerging at a higher-molecular-weight position. NPY-LI in the CSF in 201 men (aged 17 to 69y) and 118 women (aged 17 to 69y) was 124 +/- 4 and 136 +/- 6 pg/ml (mean +/- SE), respectively. NPY-LI in the CSF of women, but not of men, increased significantly with aging. This finding suggests that the level of NPY with aging in the central nervous system (CNS) may be regulated somewhat differently in men and women.

Adolescent↗

Benign recurrent intrahepatic cholestasis: a long-term follow-up.

We report on a case with a 50-year history of benign recurrent intrahepatic cholestasis, including 33 years of follow-up at our hospital. The attacks of jaundice began at the age of 1 year and have been repeated more than 14 times to date. During the follow-up period at our hospital, the patient has suffered 6 attacks of cholestasis. During the episodes of cholestasis, a dissociation between the serum level of bilirubin and that of bile acids was observed. The analysis of serum bile acids during cholestasis showed that cholic acid and chenodeoxycholic acid were the main bile acids, and no appreciable amounts of the secondary bile acids were detected. Between episodes the liver function tests, including serum bile acids, were normal. Despite multiple attacks of cholestasis over many years, no permanent liver damage has occurred. This case reaffirms the essentially benign nature of this disease.

Adolescent↗

A point mutation in the bile acid biosynthetic enzyme sterol 27-hydroxylase in a family with cerebrotendinous xanthomatosis.

Cerebrotendinous xanthomatosis (CTX) is a rare familial disorder characterized by progressive neurological dysfunction, atherosclerosis, and xanthomas with sterol storage in the nervous system, vessels, and tendons. Increased serum cholestanol, derived from intermediates of cholesterol catabolism, may possibly be a major cause of the disease. An examination was made of the cDNA encoding cytochrome P450 sterol 27-hydroxylase (CYP27) in hepatic mitochondria, considered a defective enzyme inducing CTX, in a Japanese housewife afflicted with CTX and her family. The proposita and one of her brothers, who also had CTX symptoms and hypercholestanolemia, were found to be homozygotic, carrying a point mutation in the CYP27 gene at Arg104 (CGG) to Trp104 (TGG). The mutant position has a 100% conserved positive charge in all known vertebrate cytochrome P450s and even in bacterial cytochrome P450cam. The mother of the proposita and another brother were both free of CTX symptoms and were heterozygotic for the mutation, although their plasma cholesterol increased moderately. An increase in plasma cholestanol alone would, thus, not appear to be a direct cause of sterol storage in CTX, while CTX is strongly suggested to be caused by defects in both alleles of the CYP27 gene.

Aged↗

Reserved Sertoli cell function in the hypogonadic male patients with myotonic dystrophy.

To clarify the Sertoli cell and Leydig cell function in hypogonadic male patients with myotonic dystrophy (DM), serum concentrations of inhibin, total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured by radioimmunoassay in 6 male DM patients (41 to 56 years old, 47.7 +/- 5.05 years old) and compared with those in normal adult men. In 116 healthy men aged from 24 to 92 years, serum inhibin and TT levels decreased and serum FSH and LH concentrations increased with advancing age. There was an inverse correlation between serum inhibin and FSH. These results support the concept of negative feedback regulation system of FSH secretion by inhibin. Male DM patients showed significantly lower serum TT and higher concentrations of FSH and LH, compared with the age-matched 39 normal adult men (49-59 years old, 48.2 +/- 6.14 years old). However, there was no significant difference in serum inhibin levels between the patients and normal counterparts. These results indicate that the Sertoli cell function is reserved in male DM patient, although the Leydig cell function is impaired. It is also suggested that in these patients a negative feedback control system between inhibin and FSH may be disordered to some extent.

Adult↗

Detection of bcr/abl mRNA in stained bone marrow smears.

We describe the polymerase chain reaction (PCR) method using stained bone marrow smears as sources of RNA. The amount of extractable RNA decreased during the process of making and staining bone marrow smears. The sensitivity of the reverse transcriptase-based polymerase chain reaction (RT-PCR) method for detecting target mRNA-positive cells in 5 x 10(5) suspended cells and stained bone marrow smears were 1:10(5) and 1:5000, when we used K562 cells. The bone marrow smears of 21 patients with chronic myelogenous leukemia (CML) were examined using this method. We extracted RNA from stained specimens stored at room temperature for 5-14 years. Twelve of 21 (57%) smears showed positive results for bcr/abl. The carrier RNA improved the recovery when added at the step of RNA extraction. These data indicate that mRNA is present in stained bone marrow smears for at least 14 years and that the sensitivity of RT-PCR is adequate for molecular analysis.

Base Sequence↗

The re-evaluation of sex steroids metabolism in patients with non-alcoholic liver cirrhosis.

We examined the serum levels of testosterone (T), androstenedione (delta 4-A), estrone (E1), estradiol (E2), and dehydroepiandrosterone sulfate (DHEA-S) in the non-alcoholic cirrhotic male patients when divided into compensated or decompensated state. Serum level of T was significantly elevated in compensated cirrhotic patients (9.63 +/- 1.00 ng/ml, mean +/- SE) compared to that in decompensated cirrhotic patients (5.63 +/- 0.69 ng/ml, p < 0.01) and in aged-matched normal controls (4.95 +/- 0.38 ng/ml, p < 0.01). Serum levels of E1, E2 and delta 4-A tended to be increased in decompensated cirrhotic patients, while there was not a significant difference decompensated cirrhosis compared to those of normal controls. Serum concentration of cholinesterase, indicative one of the representative residual liver function, showed a good positive correlation to T (r = 0.53, p < 0.01), and a negative correlations to E1 (r = -0.67, p < 0.01), E2 (r = -0.77, p < 0.01), delta 4-A (r = -0.57, r = p < 0.01). Also, we examined the relationship of the serum levels to gynecomastia or esophageal varices. The cirrhotics with gynecomastia showed significantly higher serum levels of E1, E2, and delta 4-A, and lower level of T than those without gynecomastia. And the cirrhotics with esophageal varices showed the greater level of T than those without esophageal varices. Our study suggests that low serum testosterone level of men with nonalcoholic cirrhotic is not a common finding, especially in compensated state.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Unique imagings of CT and MR in liver metastasis from gastric leiomyosarcoma.

We report unique features of computed tomography (CT) and magnetic resonance (MR) imaging in the metastatic lesion of the liver in a case of gastric leiomyosarcoma. A CT scan and MR image demonstrated presence of a huge multilocular cystic lesion in the liver, of which finding were unlike to those of usual smooth muscle tumors, but mimicked to those of cystadenomatous tumors. In addition, this case had an extremely long elapsing time over ten years from the radical operation for the primary site.

Aged↗

Detection of minimal residual disease in a patient with acute promyelocytic leukemia by RT-PCR: necessity of chemotherapy following ATRA therapy.

The PML/RAR alpha fusion gene resulting from the t (15;17) translocation is a specific marker for acute promyelocytic leukemia (APL). We examined bone marrow cells by reverse transcriptase-polymerase chain reaction (RT-PCR) to detect residual PML/RAR alpha mRNA-containing cells following treatment with all-trans retinoic acid (ATRA) and cytotoxic chemotherapy in a patient with APL. This RT-PCR assay can detect one leukemic cell in 10(2) normal cells in vitro. We show that PML/RAR alpha mRNA was still detectable despite clinical remission following ATRA treatment, but undetectable following consolidation with chemotherapy. These data show that this technique is useful for the identification of minimal residual disease in patients with APL and that cytotoxic chemotherapy following ATRA therapy is required for the elimination of APL cells.

Base Sequence↗

[Action mechanism of synthetic glucocorticoids].

Molecular and cellular mechanisms of glucocorticoids (GCs) action and the effects of GCs have been briefly reviewed. GCs exert their effect by binding to GC receptor, which are direct modulators of gene transcription. GC receptor is a member of steroid receptor superfamily and consists of several functional domains including DNA binding and hormone binding. GC receptor was first shown to be a potent activator of transcription, but recently, GC receptor has also been shown to repress expression of various of genes through interaction with other transcriptional factors. GC has a variety of physiological and pharmacological effects on carbohydrate and lipid metabolism, immunological functions and inflammatory processes, fluid and electrolyte homeostasis, bone and mineral metabolism, musculoskeletal tissues and so on. The details of these effects have been described.

Animals↗

[Structure and function of the promoter region of the TSH receptor gene].

TSH receptor (TSHR) is expressed almost exclusively in thyroid cells. The rat TSHR gene has a TATA-less, GC-rich promoter, with multiple transcriptional start sites. The minimal promoter region, sufficient for the basal promoter activity, thyroid-specific expression and negative regulation by TSH/cAMP signal, is located between -195 and -39 bp relative to the ATG start codon, and is highly conserved in the rat and human genes. This region comprises three important elements. First, a cAMP response element (CRE), which functions as a constitutive enhancer essential for the basal promoter activity. Second, tandem repeat sequences just 5' to the CRE, which are recognized by two distinct ssDNA-binding proteins. This element suppresses the function of the CRE, thus repressing the promoter activity. Third, a binding site for the thyroid-specific transcription factor TTF-1, which dictates thyroid-specific expression and negative regulation by TSH/cAMP of the gene. Thus, the expression of the TSHR gene is exquisitely regulated by these multiple factors in thyroid and non-thyroid cells.

Animals↗

The effect of percutaneous ethanol injection therapy on small solitary hepatocellular carcinoma is comparable to that of hepatectomy.

OBJECTIVES: Forty patients with solitary hepatocellular carcinoma (HCC) smaller than 20 mm in diameter were admitted to our hospitals from March 1986 to December 1989. Of that 40 patients, 17 were treated with hepatectomy, 12 with percutaneous ethanol injection therapy, and 11 with the combination of percutaneous ethanol injection therapy and transcatheter arterial embolization. METHOD: Following up the patients after their first treatment for 2 months to 6 yr, as of April 30, 1993, we evaluated the effects of hepatectomy, percutaneous ethanol injection therapy, and the combination of percutaneous ethanol injection therapy and transcatheter arterial embolization. RESULTS: Of the 23 patients who did not undergo surgery, eight died from recurrence of HCC and one died from ruptured varices. Of the 14 surviving patients, 10 experienced recurrences during the follow-up period. Of the 17 patients who underwent surgery, one died in hospital and four died from recurrence of carcinoma. Of the remaining 12 patients, nine experienced recurrences. The cumulative survival and recurrence rates were similar in operated and nonoperated patients. There was no significant difference in these rates in patients treated with versus without transcatheter arterial embolization. CONCLUSION: Our results showed that the efficacy of hepatectomy and the efficacy percutaneous ethanol injection therapy for small solitary HCC were similar. However, percutaneous ethanol injection therapy was safer and less expensive than hepatectomy.

Carcinoma, Hepatocellular↗

Purification and characterization of a phosphoramidon-sensitive endothelin-converting enzyme in porcine aortic endothelium. OFF.

An enzyme that catalyzes the conversion of big endothelin-1 to endothelin-1, designated as endothelin-converting enzyme, was solubilized with Lubrol PX from the membrane fraction of porcine aortic endothelium and was purified by sequential chromatography on DEAE-agarose, Ricinus communis agglutinin 120-agarose, peanut agglutinin-agarose, Mono Q, and TSK G3000SWXL columns. Approximately 12,000-fold purification of the membrane fraction enzyme was achieved. The purified enzyme had a very narrow neutral pH optimum and was inhibited by EDTA, 1,10-phenanthroline, phosphoramidon, and low concentrations of some divalent cations (Cu2+,Zn2+,Co2+,Fe2+) but not by thiorphan. Addition of Zn2+ was most effective for the restoration of the EDTA-inactivated enzyme. The purified enzyme showed the highest affinity for big endothelin-1 among big endothelin isopeptides, and the Km for big endothelin-1 and the corresponding Vmax for endothelin-1 formation were 3.3 +/- 0.3 microM and 0.41 +/- 0.02 mumol/min/mg of protein, respectively. The carboxyl-terminal sequence from His27 to Gly34 and Trp21 was essential for recognition by this enzyme, while the presence of the amino-terminal loop structure reduced the hydrolysis rate. The purified enzyme showed an isoelectric point of 4.1. The molecular mass was estimated to be 131 kDa by sucrose density gradient centrifugation, and a value of 120 kDa was obtained by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, indicating that endothelin-converting enzyme is a monomeric glycoprotein.

Amino Acid Sequence↗