Search PubMed⌕ Search

Biomedical subjects

H Wada

Publications and source records attributed to H Wada.

At least 289 records · Page 16Linked to original sources
PubMed1999

Fluconazole versus amphotericin B for the prevention of fungal infection in neutropenic patients with hematologic malignancy.

Effective prophylaxis against fungal infection is important in neutropenic patients with hematologic malignancies, but the best method remains unclear. We investigated the effectiveness of fungal prophylaxis with amphotericin B or fluconazole. We reviewed the data on fungal isolates, plasma (1-->3)-beta-D glucan (beta-D glucan) levels, febrile periods (the number of days with an axillary temperature > 38 degrees C), and the duration of an axillary temperature > 38 degrees C when the neutrophil count was < 500/microliter. Of the 124 patients studied, 57 had acute myelogenous leukemia, 19 had acute lymphoblastic leukemia, 18 had non-Hodgkin's lymphoma, six had chronic myeloid leukemia, three had adult T-cell leukemia, and five had chronic lymphocytic leukemia. There were no significant differences in clinical characteristics between the 70 patients treated with amphotericin B and the 54 patients given fluconazole. There was a significant decrease of fungal isolates (chi 2-test, p < 0.001), the plasma beta-D glucan level (Wilcoxon test, p = 0.0001), and the febrile period (t-test, p < 0.05) in the patients given fluconazole compared with those given amphotericin B. In neutropenic patients with hematologic malignancies, prophylaxis with fluconazole significantly decreased fungal isolation and other indicators of fungal infection when compared with amphotericin B. Fluconazole may therefore be more effective for fungal prophylaxis in these patients.

Adolescent↗
PubMed1999

Adjuvant treatment of early stage non-small-cell lung cancer.

Cure rates for non-small-cell lung cancer (NSCLC) remain low and the prognosis for patients with even stage IA disease is poor. Complete surgical resection is still the first-line treatment for NSCLC, but many investigators are studying the benefit of postoperative adjuvant chemotherapy as a means of destroying residual tumor and micrometastasis. However, given the high recurrence rate and the trauma of surgery, consideration of drug toxicity and the patient's quality of life is important. Uracil and tegafur (UFT) is a tolerable and active drug in NSCLC that, as a prodrug and biochemical modulator, provides extended tumor exposure to 5-fluorouracil (5-FU). Early evidence from studies with UFT described here indicate that it may be a safe and effective alternative to cisplatin (Platinol)-based therapy for the postoperative adjuvant chemotherapy of early stage NSCLC. Further results are awaited.

Antineoplastic Agents↗
PubMed1999

[Primary splenic lymphoma with t(3;14)(q27;q32) chromosomal abnormality and rearrangement of BCL-6 gene].

Primary splenic lymphoma (PSL) is extremely rare, accounting for less than 1% of all reported cases of extranodal lymphoma. A 62-year-old woman was referred to our hospital because of general fatigue. A heterogenous mass with irregular margins was detected in the spleen by abdominal computed tomographic scan, and Gallium scintigraphy demonstrated abnormal accumulation only in the spleen. Malignant lymphoma was strongly suspected on the basis of histologic findings from an ultrasonically guided needle biopsy. The final diagnosis was established by splenectomy as PSL of diffuse large B-cell type. After 6 courses of CHOP chemotherapy, the patient recovered and has been disease-free more than a year. Chromosomal analysis of her tumor cells detected t(3;14)(q27;q32), an abnormality not reported in cases of PSL to date. The rearrangement of BCL-6 was also observed. We discuss the possibility of BCL-6 involvement in Japanese cases of PSL, with reference to case reports dating back over the past decade.

Chromosomes, Human, Pair 14↗
PubMed1999

[B cell acute lymphocytic leukemia with marked leukocytosis and t(3;15)(q27;q2?2)].

We report on a 16-year-old boy with B cell acute lymphocytic leukemia presenting marked leukocytosis (388,000/microliter) and resistance to multidrug chemotherapy. Karyotypical analysis revealed a novel t(3;15)(q27;q2?2) chromosomal abnormality. Because 3q27 is known to be a locus of the bcl-6 gene, which is frequently involved in B cell malignancies, molecular biological analyses were performed. Although no rearrangement was detected in 5 genes including bcl-6 on 3q27 and 2 genes on 15q2, reverse transcriptase-polymerase chain reaction procedures detected relatively strong mRNA expression of the bcl-6, smrp, dvl3, and tpml genes. These results indicate that immature leukemic cells with CD10 and CD34 positivity and rearrangement of the T cell receptor beta gene may coexist with relatively mature subpopulations that are positive for CD19 and CD20 surface markers, bcl-6 expression, and rearrangement of the gene for immunoglobulin kappa.

Adolescent↗
PubMed1999

Monoclonal antibody specific for tissue factor pathway inhibitor-factor Xa complex: its characterization and application to plasmas from patients with disseminated intravascular coagulation and pre-disseminated intravascular coagulation.

Tissue factor pathway inhibitor (TFPI), a Kunitz-type protease inhibitor with three tandem inhibitory domains (K1, K2 and K3), inhibits the initial reactions of the extrinsic blood coagulation pathway through its K1 and K2 domains. We prepared and characterized a monoclonal antibody (Mab8-1) against TFPI-factor Xa (TFPI-Xa) complex. The reactivities of Mab8-1 toward TFPI-Xa complex, TFPI without C-terminal (TFPI-C)-Xa complex, K1K2-Xa complex and K2K3-Xa complex were examined using a surface plasmon resonance analysis (Biacore). The Biacore system allowed a quantitative analysis of antibody-antigen interaction, in real time, from which the association and dissociation rate constants could readily be obtained. The bindings of Mab8-1 to TFPI-Xa complex, TFPI-C-Xa complex and K2K3-Xa complex were each concentration-dependent. However, no binding of Mab8-1 to the K1K2-Xa complex was observed. The binding of Mab8-1 to TFPI or Xa was also not observed. These results suggested that the epitope for Mab8-1 was exposed in the K3 domain of TFPI, which was generated by the conformational change after the formation of TFPI-Xa complex. We then developed an enzyme-linked immunosorbent assay method specific for TFPI-Xa complex using Mab8-1, and we used this assay to measure plasma levels of TFPI-Xa. The normal range assessed from analyses of plasma from 30 normal healthy volunteers was 17.7-66.7 with a mean of 35.5 +/- 11.7 pmol/l. In order to asses the clinical implication of TFPI-Xa complex in the plasma of patients with thrombotic disorders, plasma concentrations were measured in 37 patients with disseminated intravascular coagulation (DIC) caused by a variety of underlying diseases. The TFPI-Xa antigen levels were significantly higher in the patients with DIC (51.9 +/- 21.6 pmol/l) and the 36 patients with pre-DIC (55.1 +/- 20.2 pmol/l) than in the 137 non-DIC patients (37.9 +/- 13.1 pmol/l). In the patients with DIC or pre-DIC, there was no significant correlation between TFPI-Xa complex and the elevated levels of thrombin-antithrombin complex, plasmin-alpha2 plasmin inhibitor complex, D-dimer, soluble fibrin monomer, soluble thrombomodulin or tissue factor. These data indicate that the plasma level of TFPI-Xa seems to be a novel independent molecular marker of DIC and pre-DIC.

Antibodies, Monoclonal↗
PubMed1999

[Plasma D-dimer levels in patients with deep vein thrombosis].

Hemostatic abnormalities were examined in 40 patients with deep vein thrombosis (DVT), 40 patients treated with warfarin, and 30 healthy volunteers. Plasma D-dimer levels were measured by an enzyme linked fluorescent assay (ELFA; Vidas-D-dimer) and an enzyme immunosorbent assay (ELISA; D-dimer-ELISA). Plasma levels of D-dimer, thrombin-antithrombin complex (TAT), soluble fibrin monomer (SFM) were significantly higher in patients with DVT than in the other groups. Both the sensitivity and specificity of D-dimer for diagnosis of DVT were the highest among hemostatic molecular markers examined. The most adequate cut off value of Vidas-D-dimer was 0.6 microgram/ml. Plasma levels of Vidas-D-dimer were well correlated with D-dimer ELISA, SFM and TAT. As the time of measurement for Vidas-D-dimer is less than one hour, the measurement of D-dimer using a EFLA might be useful for the diagnosis of DVT in bed side.

Enzyme-Linked Immunosorbent Assay↗
PubMed1999

Evoked spinal cord potential monitoring reveals peroneal nerve ischemia during thoracoabdominal repair: a case report.

An 82-year-old man underwent thoracoabdominal aortic replacement under cardiopulmonary bypass with left femoral artery cannulation. Lumber descending evoked spinal cord potentials and segmental evoked spinal cord potentials were monitored simultaneously for detecting spinal cord damage. When the cardiopulmonary bypass was terminated, a peripheral nerve ischemia pattern was evident. Left peroneal nerve paralysis was present at emergence from anesthesia. This monitoring system revealed that peroneal nerve paralysis can occur due to leg ischemia caused by femoral artery cannulation. This is, to our knowledge, the first report that segmental evoked spinal cord potential monitoring reveals peroneal nerve ischemia during thoracoabdominal surgery.

Aged↗
PubMed1999

[Tracheobronchial stents for management of airway stenosis].

Airway prostheses provide an excellent method for providing relief for patients with malignant or benign stenoses. Two types of prostheses are currently available: rigid silicone stents and metallic expandable stents. Silicone stents have been proven to be well tolerated, nonreactive, and easily removable during several decades of clinical application. However, they impair the drainage of sputum because of interrupted ciliary movement. Subsequently, retained secretions within the stent lumen can be obstructive. In addition, dislodgment frequently occurs because of their rigidity. The advantages of metallic expandable stents are as follows: 1) they can be inserted under local anesthesia with relative simplicity: 2) they do not impair the drainage of sputum: 3) ventilation is usually possible even if the metallic mesh stent covers another bronchus: and 4) their flexibility allows them to bend and conform better than rigid stents to tortuous airway stenoses. The disadvantages of metallic stents are: 1) tumor or granulation ingrowth can occur because of their porosity: 2) removal is difficult: and 3) there is limited experience with their use because they have only recently been employed for airway stenoses.

Bronchial Diseases↗
PubMed1999

[A case of stage IV esophageal cancer successfully treated by chemoradiation].

A 63-year-old man was admitted to our institution with a hard tumor on the left side of the neck. He was diagnosed as having advanced esophageal cancer (Stage IV) with a massive supraclavicular lymph node metastasis, and the lesion was thought to be unresectable. He was treated with chemotherapy (CDDP-VDS-5-FU) and radiation therapy, and all the tumors completely disappeared on endoscopic and CT examination. A stricture with scarring was detected in the esophagus at 6 months after treatment. No neoplastic tissue was detected in the lesion, and his dysphagia was relieved by dilation of the stricture. Recurrence on the left side of the neck was detected by CT at 2.5 years after chemoradiation therapy. However, the tumor has not grown over the 2-year interval since then, so it seems to be dormant. He has now survived with a good QOL for 5 years since the first hospital admission. We conclude that advanced esophageal cancer can be treated with chemoradiation therapy if the patient is in sufficiently good overall condition.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Cleavage of the C-terminus of NEDD8 by UCH-L3.

NEDD8 is a novel ubiquitin-like protein that has been shown to conjugate to nuclear proteins in a manner analogous to ubiquitination and sentrinization. To identify proteins that are involved in the NEDD8-conjugation and de-conjugation pathway, the yeast two-hybrid system was used to screen a human heart cDNA library using NEDD8 as a bait. Seven strongly positive clones were found to contain a cDNA insert encoding the ubiquitin C-terminal hydrolase, UCH-L3. In vitro GST pull-down assay demonstrated that UCH-L3 bound to both NEDD8 and ubiquitin. In contrast, UCH-L3 did not bind to sentrin-1, sentrin-2, or sentrin-3. Recombinant UCH-L3, but not UCH-L1, was able to cleave the C-terminus of NEDD8. Thus, UCH-L3 can function as a C-terminal hydrolase for both NEDD8 and ubiquitin. UCH-L3 may play a physiologically significant role in the cleavage of the C-terminus of NEDD8, which is required for NEDD8 to conjugate to target proteins.

Down-Regulation↗
PubMed1998

Species differences in L-tryptophan-kynurenine pathway metabolism: quantification of anthranilic acid and its related enzymes.

Anthranilic acid (AA) has attracted considerable attention as one of the L-tryptophan-kynurenine pathway metabolites in the central nervous system. In this study, a highly sensitive and accurate method for the quantification of AA has been developed using reversed-phase high-performance liquid chromatography with electrochemical detection. Serum and cerebrospinal fluid (CSF) AA concentrations in different animal species were measured. CSF AA concentrations in rabbits were 1.1 +/- 0.1 nmol/liter, which were 5. 7-33.0 times lower than those in other species studied. Serum AA concentrations, however, were slightly higher in rabbits than in other species. In contrast, the concentrations of L-kynurenine (L-KYN) in both serum and CSF were substantially higher in rabbits than in other species. Tissue kynurenine pathway enzymes, indoleamine 2,3-dioxygenase (IDO), tryptophan 2,3-dioxygenase, kynurenine 3-hydroxylase, and kynureninase were determined in rabbits, rats, gerbils, and mice. These enzymes varied among species, especially lung IDO activities in rabbits were 146-516 times higher than those found in other species, but rabbit liver kynurenine 3-hydroxylase activities were lower by one order of magnitude than those of the other species tested. Furthermore, brain kynurenine 3-hydroxylasae activities were 12.3-23.2 times higher in gerbils than those in the other species tested. In addition, AA concentrations in serum following intravenous administration of L-KYN (5 mg/kg) were also measured in rabbits. AA levels peaked sharply within 5 min after administration and decreased in a time-dependent manner. At 5 min after administration, CSF L-KYN and AA concentrations were also increased by 1.76- and 2.56-fold, respectively, compared with basal levels. Increased AA concentrations in CSF following L-KYN administration may reflect the entry of AA into the CSF after conversion to AA in systemic tissue and/or the local synthesis of AA from L-KYN in the CNS.

Animals↗
PubMed1998

Identification of three major sentrinization sites in PML.

Acute promyelocytic leukemia arises following a reciprocal chromosome translocation t(15;17), which generates PML-retinoic acid receptor alpha fusion proteins (PML-RARalpha). We have shown previously that wild type PML, but not PML-RARalpha, is covalently modified by the sentrin family of ubiquitin-like proteins (Kamitani, T., Nguyen, H. P., Kito, K., Fukuda-Kamitani, T., and Yeh, E. T. H. (1998) J. Biol. Chem. 273, 3117-3120). To understand the mechanisms underlying the differential sentrinization of PML versus PML-RARalpha, extensive mutational analysis was carried out to determine which Lys residues are sentrinized. We show that Lys65 in the RING finger domain, Lys160 in the B1 Box, and Lys490 in the nuclear localization signal contributes three major sentrinization sites. The PML mutant with Lys to Arg substitutions in all three sites is expressed normally, but cannot be sentrinized. Furthermore, the triple substitution mutant is localized predominantly to the nucleoplasm, in contrast to wild type PML, which is localized to the nuclear bodies. Thus, sentrinization of PML, in the context of the RING finger and the B1 box, regulates nuclear body formation. Furthermore, we showed that sentrinization of PML-RARalpha could be restored by overexpression of sentrin, but not by retinoic acid treatment. These studies provide novel insight into the pathobiochemistry of acute promyelocytic leukemia and the sentrinization pathway.

Animals↗
PubMed1998

Light-induced expression of fatty acid desaturase genes.

In cyanobacterial cells, fatty acid desaturation is one of the crucial steps in the acclimation processes to low-temperature conditions. The expression of all the four acyl lipid desaturase genes of Synechocystis PCC 6803 was studied as a function of temperature and separately as a function of light. We used cells grown at 25 degreesC in light-activated heterotrophic growth conditions. In these cells, the production of alpha-linolenic acid and 18:4 fatty acids was negligible and the synthesis of gamma-linolenic acid was remarkably suppressed compared with those of the cells grown photoautotrophically. The cells grown in the light in the presence of glucose showed no difference in fatty acid composition compared with cells grown photoautotrophically. The level of desC mRNA for delta9 desaturase was not affected by either the temperature or the light. It was constitutively expressed at 25 degreesC with and without illumination. The level of desB transcripts was negligible in the dark-grown cells and was enhanced about 10-fold by exposure of the cells to light. The maximum level of expression occurred within 15 min. The level of desA and desD mRNAs was higher in dark-grown cells than that of desB mRNA for omega3 desaturase. However, the induction of both desA and desD mRNAs for delta12 and delta6 desaturases, respectively, was enhanced by light about 10-fold. Rifampicin, chloramphenicol, and 3-(3, 4-dichlorophenyl)-1,1-dimethylurea completely blocked the induction of the expression of desA, desB, and desD. Consequently, we suggest the regulatory role of light via photosynthetic processes in the induction of the expression of acyl lipid desaturases.

Cyanobacteria↗
PubMed1998

Aberrant FHIT transcripts in squamous cell carcinoma of the uterine cervix.

The fragile histidine triad (FHIT) tumor suppressor gene at 3p14.2 has abnormalities in several types of human cancers. To investigate the potential role of FHIT in cervical cancer, which exhibits frequent loss of heterozygosity of 3p, we have examined primary cervical cancer samples from 28 patients for alterations of the FHIT gene. Abnormal FHIT transcripts were detected using reverse transcription-polymerase chain reaction (PCR) and subsequently by sequencing. Of 28 primary cervical carcinomas analyzed, 12 tumors (43%) showed abnormal FHIT transcripts, including deletion, insertion and point mutation. Loss of a FHIT transcript was observed in 2 cases (7%). Allelic loss of the FHIT gene was detected in 16 of 27 informative cases (59%). Oncogenic human papillomavirus (HPV) type 16, 18, 33, 35, 58 and 59 were not only present but were expressed in 24 of 28 cases (85%) by consensus PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) analysis for the HPV E6 and E7 genes. Our data indicate that alteration of the FHIT gene is an important genetic event associated with cervical cancer and oncogenic

Acid Anhydride Hydrolases↗
PubMed1998

The effects of glucose, mannose, fructose and lactate on the preservation of neural activity in the hippocampal slices from the guinea pig.

Using hippocampal slices from guinea pigs, we investigated the effect of different concentrations of glucose and replacement of glucose with mannose, fructose and lactate on neural activity. As an index of neural activity, the population spikes (PS) were recorded in the granule cell layer of the dentate gyrus (DG) and the pyramidal cell layer of the CA3 area in the hippocampal slices. Lowering the concentration of glucose from 10 mM to 5, 3, 2, 1 and 0 mM caused a reduction in the PS amplitude. There were differences in the decay times of the PS evoked in these two regions. PS evoked in CA3 region decayed faster even at a concentration of 3 mM glucose at which PS in granule cell layer was well maintained. The decay time of the PS in the CA3 region in the presence of glucose up to a concentration of 3 mM was shorter than that evoked in the DG. After the replacement of glucose with mannose, fructose or lactate, the PS disappeared within 35 min and there were no significant differences between the decay times in the two regions of slices incubated in the same medium. ATP, creatine phosphate (CrP) and lactate levels in each slice were determined. To investigate whether mannose and fructose could be metabolized or not in the tissue slice, anaerobic production of lactate from glucose, mannose and fructose were measured during oxygen and glucose deprivation. Under anaerobic conditions for 60 min, the levels of high-energy phosphates decreased to 50% of the initial level and lactate was produced from glucose, mannose or fructose. However, there were significant differences in the rate of lactate production between the DG and CA3 areas during application of 3 mM glucose, 10 mM mannose and 10 mM fructose. These results indicate that mannose, fructose and lactate can be metabolized and are available for maintaining the levels of high-energy phosphates but not for neural activity in the tissue slices and that the presence of glucose is indispensable for the maintenance of neural activity.

Adenosine Triphosphate↗
PubMed1998

Expression of CD44 variant exon 6 in stage I non-small cell lung carcinoma as a prognostic factor.

Specific CD44 isoforms are the surface adhesion molecules that have been shown to be associated with metastasis. In the present study, the role of the expression of standard and variant CD44 isoform (CD44s and CD44v6) as prognostic indicators in pathological stage I non-small cell lung carcinoma was investigated immunohistologically using monoclonal antibodies. The results showed that the expression of CD44v6 correlates with adverse prognosis in stage I non-small cell lung carcinoma but not CD44s. The 5-year survival rate of the patients with CD44v6-positive tumors was 50%, which was significantly lower than that of CD44v6-negative patients (88%; P = 0.001). The incidence of recurrent distant metastasis in the CD44v6-positive patients (45%; 9 of 20 patients) was significantly higher than that in the CD44v6-negative patients (20%; 10 of 49 patients; P = 0.038), suggesting the involvement of CD44v6 in hematogeneous metastasis of lung carcinoma. Although the incidence of the expression of CD44v6 in squamous cell carcinoma was significantly higher than that in adenocarcinoma, histological type was not a significant prognostic factor. No significant correlation was found between the expression of CD44v6 and lymphatic or vascular vessel invasion, although lymphatic vessel invasion was found to be an independent prognostic factor in the multivariate analysis. To investigate the relationship between the expression of CD44v6 and proliferative activity of tumor cells, the expression of proliferating cell nuclear antigen (PCNA) was examined. The expression of CD44v6 was more frequently observed in PCNA-positive patients than in PCNA-negative patients (P = 0.019), but the expression of PCNA was not a statistically significant prognostic indicator. The results of multivariate analysis by the Cox proportional hazards model showed that CD44v6 was an independent prognostic indicator. We concluded that the expression of CD44v6 is a useful prognostic factor in stage I non-small cell lung carcinoma.

Carcinoma, Non-Small-Cell Lung↗