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Biomedical subjects

H Seki

Publications and source records attributed to H Seki.

At least 127 records · Page 7Linked to original sources

[Efficacy of chemotherapy for clear cell adenocarcinoma of the ovary].

In line with various protocols for chemotherapy of ovarian carcinoma, we used EP (etoposide-cisplatin or carboplatin) therapy in 10 patients with clear cell adenocarcinoma as the first line chemotherapy. Four of these cases were in advanced stage at IIIc, and had residual tumor after the operation. One of these patients with measurable tumor responded to semi-high dose treatment, and 5-days of continuous infusion of etoposide resulted in CR. Three cases of a patient at the stages of Ic and IIc are in disease free status after two years of standard-dose EP therapy. Therefore, high-dose EP therapy might be an effective chemotherapy for some patients with ovarian clear cell adenocarcinoma.

Adenocarcinoma, Clear Cell↗

[A study of gastroesophageal reflux by 24-hour esophageal pH monitoring in patients with bronchial asthma].

To evaluate the incidence of abnormal gastroesophageal reflux in patients with bronchial asthma and the influence of drug therapy on the gastroesophageal reflux, we investigated the gastroesophageal reflux patterns using an ambulatory 24-hour esophageal monitoring in 25 healthy volunteers and 58 asthmatics. All the patients were stable conditions at the time of the study. Bronchodilator therapy was continued, if necessary along with steroid inhalation and xanthines. Compared with healthy volunteers, the asthmatics had significantly greater esophageal acid exposure time, more frequent reflux episode, and longer single reflux time. About 70% of asthmatics had abnormal gastroesophageal reflux. Asthma medications were not associated with the incidence of abnormal gastroesophageal reflux. However, asthmatics receiving beta(2)-stimulants therapy (n = 27) had significantly greater esophageal reflux exposure time than those not receiving (n = 31). Our study suggested that most asthmatics have abnormal gastroesophageal reflux unrelated to asthma attack or asthma medications and that beta(2)-stimulants used in asthmatics may worsen gastroesophageal reflux.

Adult↗

[An autopsy case of a ruptured cerebral aneurysm treated with interlocking detachable coils].

We described an autopsy case of a ruptured aneurysmal subarachnoid hemorrhage treated with endovascular embolization by interlocking detachable coils. An 85-year-old male presented with sudden onset of severe subarachnoid hemorrhage. Cerebral angiogram revealed a right internal carotid-posterior communicating artery aneurysm. Post-operative angiogram revealed complete obliteration of the aneurysm, except for its orifice. Following the embolization of the aneurysm, tissue plasminogen activator was intrathecally perfused for anti-vasospasm treatment. Follow-up angiogram showed stable obliteration of the aneurysm, and no particular findings of cerebral vasospasm. The patient had been recovering without any neurological deficits, but died from pneumonia on the 25th day after the embolization. Autopsy findings revealed the disappearance of the subarachnoid hemorrhage, and no visible finding of cerebral infarction or edema. The inner lumen of the aneurysm was occupied by a mixture of the coils and the clots. The surface of the embolized coils was directly observed through the orifice of the aneurysm without any membranous substance from the inner lumen of the internal carotid artery. This pathological finding is different from the previously reported animal models in which the surface of the embolized coils was covered with endothelial membrane 2 weeks after embolization. Further examinations are required to clarify the pathogenesis of the endothelial regrowth.

Aged↗

Analysis of cis-regulatory elements involved in the activation of a member of chalcone synthase gene family (PsChs1) in pea.

Cis-regulatory elements involved in the activation of the plant defense-related gene encoding chalcone synthase 1 (PsChs1) in pea (Pisum sativum L.) were examined by transient transfection, gel mobility shift assay and in vitro DNase I-footprinting analysis. Transient transfection assay revealed that a 61 bp DNA fragment spanning from -242 to -182 of PsChs1 was required for the maximal promoter activity and possibly involved in the enhancement of elicitor-mediated activation. Nuclear isolate from elicitor-treated pea epicotyl tissues contained some factor(s) that specifically bound to this DNA fragment to form a complex with low mobility (LMC, low mobility complex) in gel mobility shift assay. DNase I-footprinting analysis of LMC revealed that among three protected regions detected in a 61 bp DNA fragment, two regions contained identical AT-rich sequence, TAAAATACT. Site directed mutation in either or both identical sequences, TAAAATACT to TGGAATACT, resulted in the reduction or loss in the ability to form LMC. Detailed analysis of 61 bp DNA fragment demonstrated that the region from -242 to -226 containing promoter-distal TAAAATACT motif was imperative for the maximal elicitor-mediated activation of PsChs1.

Acyltransferases↗

Outcome of major hepatectomy with pancreatoduodenectomy for advanced biliary malignancies.

In patients with advanced biliary malignancies a chance of curability is obtained by performing only major hepatectomy with concomitant pancreatoduodenectomy. This aggressive procedure carries two major risks: hepatic failure and pancreatic anastomotic leakage. Ten patients with advanced biliary malignancies were treated by major hepatectomy with pancreatoduodenectomy. Nine patients underwent right portal venous embolization before hepatectomy. Complete external drainage of pancreatic juice followed by second-stage pancreatojejunostomy was performed in five patients. Three of these five underwent concomitant resection of the hepatic artery, portal vein, or both. Pancreatogastrostomy was chosen for five patients who required no concomitant vascular resection. There were no hospital deaths or hepatic failures. Leaks from pancreatogastrostomy occurred in two patients. In five patients who underwent external drainage of pancreatic juice, there were no complications related to the pancreatic stump, although one had ischemic necrosis of the jejunal segment and laparotomy was repeated. Mean survival time was 31.8 months (range 13-59 months). Portal venous embolization and complete external drainage of pancreatic juice followed by late stage pancreatojejunostomy are recommended surgical procedures for patients undergoing major hepatectomy with pancreatoduodenectomy, especially when concomitant vascular resection is required for curative resection of the tumor in patients with a soft pancreatic parenchyma and thin pancreatic duct.

Adult↗

Elevated levels of nitric oxide in synovial fluid from patients with temporomandibular disorders.

OBJECTIVE: The objective of this study was to measure nitric oxide activity in synovial fluid samples taken from patients with temporomandibular disorders. STUDY DESIGN: We investigated six volunteers without symptoms and 56 patients with temporomandibular disorders. Nitric oxide activity was measured in temporomandibular joint synovial fluid with a highly sensitive and specific chemiluminescence detection method. RESULTS: A detectable nitrite concentration was found in only 1 of 10 joints in the control group. Measurable levels (> 0.001 mol/l) of nitrites in the synovial fluid were found in 8 (72.7%) of 11 joints with disk derangement with clicking, 24 (85.7%) of 28 joints with disk derangement with locking, and all 26 (100%) joints with osteoarthritis. The mean nitrite concentrations in the temporomandibular joint synovial fluid in the disk derangement with clicking, disk derangement with locking, and osteoarthritis groups were significantly higher than that in the control group (p < 0.05, p < 0.001, p < 0.001, respectively). CONCLUSIONS: These data clearly show increased nitric oxide production in certain temporomandibular disorders and suggest that nitric oxide may play a role in the pathogenesis of synovitis and degenerative changes of cartilaginous tissue and bone of the temporomandibular joint.

Adolescent↗

Chronic persistent Epstein-Barr virus infection of natural killer cells and B cells associated with granular lymphocytes expansion.

B lymphocytes and epithelial cells are the only cell types known to be infected with Epstein-Barr virus (EBV) in normal individuals. Rarely, EBV also infects other cells, including natural killer (NK) cells, almost always in the context of fatal leukaemias or lymphoproliferative disorders. We report on a 6-year-old previously healthy girl who developed fevers and liver function abnormalities for 3 months. The peripheral blood revealed an abnormal expansion of large granular lymphocytes, comprising 24% of the white blood cells. Flow cytometric analysis of the peripheral blood mononuclear cells showed an abnormal increase of CD16-positive NK cells, 62% of which were EBV-infected by in situ EBER-1 hybridization. The circulating B cells were normal in number, but 18% were infected with EBV by in situ EBER-1 hybridization. Approximately 2 years after resolution of all symptoms and continued good health. 35% of the circulating mononuclear cells were EBV-infected, indicative of persistent expansion of EBV-infected cells. We conclude that abnormal expansions of EBV-infected NK and B cells can be associated with a chronic benign course.

B-Lymphocytes↗

Effect of dobutamine of ventriculoarterial coupling in acute regional myocardial ischemia in dogs.

We assessed the effect of dobutamine on left ventricoarterial coupling during acute regional ischemia. Using a conductance catheter, we analyzed the end-systolic pressure-volume relation (ESPVR) in anesthetized dogs. We calculated the slope of ESPVR (Ees), the slope of the end-systolic pressure-stroke volume relation (Ea), (Ea/Ees) and the ratio (work efficiency) of external work to pressure-volume area at base-line during ischemia induced by occlusion of the left anterior descending coronary artery and during low-dose (1-3 micrograms.min-1.kg-1) and high-dose (4-10 micrograms.min-1.kg-1)dobutamine infusions with ischemia. ESPVR shifted to the right without a change in Ees during ischemia. Dobutamine caused dose-dependent increases in Ees but did not affect the intercept of ESPVR. During ischemia, Ea/Ees increased and work efficiency decreased. Low-dose dobutamine was associated with a return in control for Ea/Ees and work efficiency. High-dose dobutamine increased Ees and Ea but produced no further increase in Ea/Ees or work efficiency. Low-dose dobutamine would appear to be the preferable regimen to achieve the optimal ventriculoarterial coupling in acute regional ischemia associated with mismatched ventriculoarterial coupling and depressed left ventricular work efficiency.

Acute Disease↗

Effect of deaerated water on serum biochemical values and on the cecum concentration of short-chain fatty acids in the rat.

The effects of drinking deaerated water on serum biochemical values, and on the concentrations of short-chain fatty acids (SCFAs) derived from bacterial fermentation in the colon were examined in rats. Drinking deaerated water decreased the levels of serum alkaline phosphatase (SAP) and serum urea nitrogen (SUN), and increased the serum potassium (SK) and serum phosphorus (SP) levels. Although the concentration of propionic acid in the cecum was decreased by drinking deaerated water, the concentrations of isobutyric, valeric, and isovaleric acid in the cecum were increased.

Alkaline Phosphatase↗

Perivascular coating with fibrin glue of cerebral arteries in patients with aneurysmal subarachnoid hemorrhage; incidence of chronic hydrocephalus.

The incidence of chronic hydrocephalus was studied in 39 patients with subarachnoid hemorrhage, who underwent perivascular coating with fibrin glue of cerebral arteries after clipping of aneurysm. A use was made of this procedure in order to prevent vasospasm by keeping the main cerebral arteries away from direct contact with subarachnoid clots. Most cases in this series belonged to group 3 of Fisher's CT grade (33/39, 84.6%). As a result, despite the high CT grade, the incidence of chronic hydrocephalus was as low as 17.9% (7/39), almost in agreement with those of the previous literature. In conclusion, (1) coating with fibrin glue did not increase the incidence of chronic hydrocephalus and (2) intrathecal application of fibrin glue is a promising method in the field of clinical neurosurgery.

Adhesives↗

Anomalous internal carotid artery-anterior cerebral artery anastomosis associated with fenestration and cerebral aneurysm.

A 69-year-old female presented with a ruptured aneurysm at the distal tip of a fenestrated anomalous artery which originated in the ophthalmic segment of the internal carotid artery (ICA), passed between the optic nerves, ascended along the midline, and formed the fenestration before dividing into the bilateral pericallosal arteries. The anomalous artery manifested as subarachnoid hemorrhage. Four days later, she died from severe pulmonary edema. The angiographic finding was confirmed by postmortem examination. Numerous perforating vessels from the anomalous artery and the distal ICA supplied the optic nerves and chiasm. This finding supports the idea that this anomalous vessel may be an extreme developmental variation of the prechiasmal arterial plexus.

Adult↗

[Tumor size and DNA ploidy changes in renal cell carcinomas--flow cytometric analysis of DNA content in renal cell carcinomas associated with von Hippel-Lindau disease].

BACKGROUND: Renal cell carcinomas (RCCs) develop in 8-63% of von Hippel-Lindau disease (VHL) patients, and loss of 3p segments, chromosome aberrations found in 90% of sporadic RCCs, has also been observed in RCCs associated with VHL. In fact, comparative analysis showed that the chromosome aberrations in RCCs associated with VHL are similar to those found in sporadic RCCs. VHL patients have the whole spectrum of tumors from small early lesions to large ones in the same kidney, providing a unique opportunity to analyze tumors in different stages of development. Subsequently deoxyribonucleic acid (DNA) content in RCCs of VHL patients was examined and correlated to their tumor size to gain some insight in the progression of sporadic RCCs. METHODS: From 1988 to 1991, we have experienced 6 cases of RCCs associated with VHL who underwent partial or radical nephrectomy. A total number of 52 paraffin-embedded samples from 33 RCCs from 6 patients with VHL was analyzed by flow cytometry. RESULTS: The sizes of tumors ranged from 0.2 to 8.2 cm. DNA aneuploid patterns demonstrated in none of 9 tumors less than 1.6 cm, 4 of 14 tumors (29%) as large as 1.6 to 2.5 cm, and 5 of 10 tumors (50%) larger than 2.5 cm (p < 0.05). Twelve tumors less than 1.8 cm showed DNA diploid, so the smallest size of aneuploid tumors was 1.8 cm. CONCLUSION: These data suggest that DNA ploidy change (diploid to aneuploid) in RCCs probably takes place as tumors grow approximately 1.8 cm in size.

Adult↗

[The course of gastric type epithelium in duodenal ulcer and duodenitis; role on the eradication of Helicobacter pylori].

The course of gastric type epithelium during the healing process and beyond the scarring stage of duodenal ulcer was studied in patients with and without Helicobacter pylori (H. pylori) eradication. Materials were consist of 110 patients with active H. pylori ulcers, 27 patients with H. pylori positive ulcer scars and 6 patients with active H. pylori positive duodenitis. The results obtained were as follows. 1) In the non-eradication group, the degree of gastric type epithelium increased as the ulcers healed, but gastric type epithelium remained immature compared with the eradication group. 2) In the non-eradication group, the degree of gastric type epithelium decreased subsequently with or without recurrence of the duodenal ulcer. Under H. pylori positive condition, the degree of gastric type epithelium appeared to be reduced because of invasion by H. pylori. When this condition continued, ulcers probably recurred because of diminished defences against acid in damaged areas of gastric type epithelium. 3) In the successful eradication group, gastric type epithelium became well developed and mature state (grade 4), and remained in this condition for long period because it was not invaded by H. pylori. The appearance of mature state of gastric type epithelium appears to play a role in the prevention of ulcer recurrences by maintaining an adequate defence mechanisms against acid. 4) In the unsuccessful eradication group, the degree of gastric type epithelium remained lower mature state than that of successful eradication group. 5) In cases of H. pylori positive ulcer scar, the degree of gastric type epithelium reached also well developed and mature state when H. pylori was successfully eradicated, and maintained in this condition for a prolonged period. Ulcer recurrence was not observed. 6) In case of H. pylori positive duodenitis, the degree of gastric type epithelium reached mature state after successful eradication, and endoscopic findings of inflammation was improved.

Duodenal Ulcer↗

Interleukin-1 beta independently stimulates production of prostaglandin E2 and cyclic AMP from human decidual cells.

Interleukin-1 beta (IL-1 beta) increased the production of cyclic AMP and prostaglandin E2 (PGE2) by cultured human decidual cells during 24 h of stimulation, but not over short incubation times (< 6 h). At concentrations of IL-1 beta ranging from 1 to 100 pg/ml, there were parallel changes in cyclic AMP and PGE2 levels, but 1000 pg of IL-1 beta/ml inhibited cyclic AMP production while still stimulating PGE2 synthesis. The possible link between cyclic AMP and PGE2 was therefore studied further. Inhibition of IL-1 beta-stimulated PGE2 synthesis by indomethacin and direct addition of PGE2 had no effect on cyclic AMP levels, indicating that PGE2 did not increase cyclic AMP production by human decidual cells and confirming the independent synthesis of cyclic AMP and PGE2. The increase in cyclic AMP production induced by IL-1 beta is dependent on protein synthesis, but it is not known which component of the adenylate cyclase is increased. A phosphodiesterase inhibitor potentiated the effects of IL-1 beta on cyclic AMP synthesis, indicating that the cytokine may increase cyclic AMP metabolism. We suggest that high concentrations of IL-1 beta activate phosphodiesterase activity more than adenylate cyclase, which gives rise to the low levels of cyclic AMP noted above. IL-1 beta also decreased forskolin-stimulated cyclic AMP production, which again indicates increased cyclic AMP metabolism. Since most concentrations of IL-1 beta alone increased cyclic AMP levels, this stimulation must out-weigh the increase in metabolism apparent in the presence of forskolin, phosphodiesterase inhibitor or high levels of interleukin. It is clear that IL-1 beta increased decidual PGE2 production independently of cyclic AMP, and that other second messenger must mediate the action of this cytokine.

1-Methyl-3-isobutylxanthine↗

Noninvasive prediction of coronary atherosclerosis by quantification of coronary artery calcification using electron beam computed tomography: comparison with electrocardiographic and thallium exercise stress test results.

OBJECTIVES: This study was designed to compare the usefulness of electron beam computed tomography for prediction of coronary stenosis with that of electrocardiographic (ECG) and thallium exercise tests. BACKGROUND: Electron beam computed tomography can quantify coronary calcifications; however, its clinical value has yet to be established. METHODS: Using the volume mode of electron beam computed tomography, we studied 251 consecutive patients who underwent elective coronary angiography because of suspected coronary artery disease and compared the results with those of ECG and thallium exercise tests. The total coronary calcification score was calculated by multiplying the area ( > or = 2 pixels) of calcification (peak density > or = 130 Hounsfield units) by an arbitrarily weighted density score (0 to 4) based on its peak density. The mean of two scans was log transformed. RESULTS: Calcification was first noted in women in the 4th decade of life, approximately 10 years later than its occurrence in men. Among patients with advanced atherosclerosis (two- and three-vessel disease), calcification scores were uniformly high in women but ranged widely in men. Nine percent of patients with significant stenoses ( > or = 75% by densitometry) had no calcification. The calcification scores of patients with significant stenosis in at least one vessel were significantly higher than those of patients without significant stenosis in the study group as a whole and in most patient subgroups classified according to age and gender. A cutoff calcification score for prediction of significant stenosis, determined by receiver operating characteristic curve analysis, showed high sensitivity (0.77) and specificity (0.86) in all study patients; sensitivity was similarly high even in older patients ( > or = 70 years) and was enhanced in middle-aged patients (40 to < or = 60 years). The difference in specificity between calcification scores and ECG exercise test results had borderline significance (p = 0.058) and that between calcification scores and thallium test results was significant (p = 0.001). The latter difference became small but remained significant (p = 0.01) even after the reevaluation of thallium test results in light of each subject's clinical data. CONCLUSIONS: Quantification of coronary artery calcification with electron beam computed tomography noninvasively predicted angiographically confirmed coronary stenosis. Results obtained with this method were at least as useful and potentially better in some patient groups than those obtained with thallium and ECG exercise testing.

Adolescent↗