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Biomedical subjects

Hiroshi Takahashi

Publications and source records attributed to Hiroshi Takahashi.

At least 19 recordsLinked to original sources

Detection of sentinel nodes by a novel red-fluorescent dye, ATX-S10Na (II), in an orthotopic xenograft rat model of human gastric carcinoma.

BACKGROUND AND OBJECTIVE: We developed a new imaging system to detect sentinel nodes (SNs) using a novel fluorescent tracer, ATX-S10Na(II), and investigated its usefulness in an animal model. STUDY DESIGN/MATERIALS AND METHODS: Human gastric carcinoma cells were implanted orthotopically into nude rats. ATX-S10Na(II) was injected subserosally into the primary tumor lesion, and visualized by a fluorescence spectro-laparoscope. Presence of tumor cells in lymph nodes (LNs) was determined by RT-PCR specific for human beta-actin. RESULTS: Injection of ATX-S10Na(II) was successful in 27 tumor-bearing rats. A red fluorescence was incorporated into the left gastric and hepatic LNs in 25 and 2 rats, respectively. Of note, human beta-actin was detected in most of these LNs. Fluorescence was not detected in LNs that did not contain cancer. CONCLUSION: ATX-S10Na(II) is useful for the detection of cancer-containing SNs in an animal model of gastric carcinoma, and may serve as a novel tracer in SN navigation surgery.

Actins↗

Multiple papillary fibroelastomas of the aortic valve: case report.

Papillary fibroelastoma is the third most common primary tumor of the heart and most commonly involve the cardiac valves. Most papillary fibroelastomas do not cause symptoms and they are usually incidental findings by routine echocardiography or at autopsy. However, multiple papillary fibroelastomas are extremely rare. We report a case with papillary fibroelastoma which was incidentally found on echocardiography. Upon surgery, a tumor was found on each aortic cusp. Pathological findings of these tumors were consistent with those of papillary fibroelastoma.

Aortic Valve↗

B7-H1-induced apoptosis as a mechanism of immune privilege of corneal allografts.

The programmed death-1 (PD-1) costimulatory pathway has been demonstrated to play a role in the regulation of immune responses and peripheral tolerance. We investigated the role of this pathway in establishing an immune privilege status of corneal allografts in mice. B7-H1, but not B7-DC or PD-1, was expressed constitutively in the eye, i.e., cornea, iris-ciliary body, and retina. After corneal allografting, PD-1(+)CD4(+) T cells infiltrated and adhered with B7-H1(+) corneal endothelium. Blockade of PD-1 or B7-H1, but not B7-DC, led to accelerated corneal allograft rejection. In B7-H1-expressing corneal allografts, apoptosis of the infiltrating PD-1(+)CD4(+) or CD8(+) T cells was observed, after which there was allograft acceptance. In contrast, B7-H1 blockade suppressed apoptosis of infiltrating PD-1(+) T cells, which led to allograft rejection. In vitro, destruction of corneal endothelial cells by alloreactive T cells was enhanced when the cornea was pretreated with anti-B7-H1 Ab. This is the first demonstration that the constitutive expression of B7-H1 plays a critical role in corneal allograft survival. B7-H1 expressed on corneal endothelial cells maintains long-term acceptance of the corneal allografts by inducing apoptosis of effector T cells within the cornea.

Animals↗

pH-dependent formation of membranous cytoplasmic body-like structure of ganglioside G(M1)/bis(monoacylglycero)phosphate mixed membranes.

Membrane structures of the mixtures of ganglioside G(M1) and endosome specific lipid, bis (monoacylglycero) phosphate (BMP, also known as lysobisphosphatidic acid) were examined at various pH conditions by freeze-fracture electron microscopy and small-angle x-ray scattering. At pH 8.5-6.5, a G(M1)/BMP (1:1 mol/mol) mixture formed small vesicular aggregates, whereas the mixture formed closely packed lamellar structures under acidic conditions (pH 5.5, 4.6) with the lamellar repeat distance of 8.06 nm. Since BMP alone exhibits a diffuse lamellar structure at a broad range of pH values and G(M1) forms a micelle, the results indicate that both G(M1) and BMP are required to produce closely stacked multilamellar vesicles. These vesicles resemble membranous cytoplasmic bodies in cells derived from patients suffering from G(M1) gangliosidosis. Similar to G(M1) gangliosidosis, cholesterol was trapped in BMP vesicles in G(M1)- and in a low pH-dependent manner. Studies employing different gangliosides and a G(M1) analog suggest the importance of sugar chains and a sialic acid of G(M1) in the pH-dependent structural change of G(M1)/BMP membranes.

Biophysics↗

Outbreak of Chlamydia pneumoniae infection in a Japanese nursing home, 1999-2000.

OBJECTIVE: To identify risk factors for infection and severe illness due to Chlamydia pneumoniae. METHODS: To identify risk factors for infection, we conducted a case-control study among nursing home residents who had onset of symptoms during December 1, 1999, to February 20, 2000. To identify risk factors for severe illness among nursing home residents, we conducted a retrospective cohort study. SETTING: A nursing home providing long-term and day care services for elderly patients in Japan.Participants. Fifty-nine residents and 41 staff members of a nursing home. RESULTS: The attack rates for respiratory illness were 53% (31 of 59) among residents and 22% (9 of 41) among staff. Infection was confirmed in 15 resident and 2 staff case patients by isolation of C. pneumoniae from nasal swab specimens. Fifteen resident case patients developed severe illness (ie, bronchitis, pneumonia, and hypoxia); one case patient died. The median age of resident case patients was 87 years. We could identify neither the source of the outbreak nor significant risk factors for infection and severe illness in residents. However, residents with a higher level of physical activity were more likely to become infected, whereas older residents (aged more than 85 years) and those with a lower level of physical activity were more likely to develop severe illness (P>.05). Contact with residents was a risk factor for infection in staff (relative risk, undefined; P=.04). CONCLUSIONS: C. pneumoniae can cause large outbreaks of infection and severe illness among elderly persons, and its transmission is likely to be enhanced by close contacts among people in nursing homes. Therefore, early detection of an outbreak by means of better surveillance, and subsequent isolation of patients, may be effective control measures.

Aged↗

Inchinkoto, a herbal medicine, and its ingredients dually exert Mrp2/MRP2-mediated choleresis and Nrf2-mediated antioxidative action in rat livers.

Inchinkoto (ICKT), a herbal medicine, has been recognized in Japan and China as a "magic bullet" for jaundice. To explore potent therapeutic agents for cholestasis, the effects of ICKT or its ingredients on multidrug resistance-associated protein 2 (Mrp2/ MRP2)-mediated choleretic activity, as well as on antioxidative action, were investigated using rats and chimeric mice with livers that were almost completely repopulated with human hepatocytes. Biliary excretion of Mrp2 substrates and the protein mass, subcellular localization, and mRNA level of Mrp2 were assessed in rats after 1-wk oral administration of ICKT or genipin, a major ingredient of ICKT. Administration of ICKT or genipin to rats for 7 days increased bile flow and biliary excretion of bilirubin conjugates. Mrp2 protein and mRNA levels and Mrp2 membrane densities in the bile canaliculi and renal proximal tubules were significantly increased in ICKT- or genipin-treated rat livers and kidneys. ICKT and genipin, thereby, accelerated the disposal of intravenously infused bilirubin. The treatment also increased hepatic levels of heme oxygenase-1 and GSH by a nuclear factor-E2-related factor (Nrf2)-dependent mechanism. Similar effects of ICKT on MRP2 expression levels were observed in humanized livers of chimeric mice. In conclusion, these findings provide the rationale for therapeutic options of ICKT and its ingredients that should potentiate bilirubin disposal in vivo by enhancing Mrp2/MRP2-mediated secretory capacities in both livers and kidneys as well as Nrf2-mediated antioxidative actions in the treatment of cholestatic liver diseases associated with jaundice.

ATP-Binding Cassette Transporters↗

Cervical dural arteriovenous fistula presenting with brainstem dysfunction: case report and review.

STUDY DESIGN: We present a rare case of cervical dural arteriovenous fistula (C-DAVF) presenting with brainstem dysfunction. We discuss the details of the case and review previous articles on C-DAVF. OBJECTIVES: Our case study illustrates the relation between uncommon neurologic findings and altered hemodynamics resulting from the anatomic features of the neural pathway. Based on a review of 31 cases of C-DAVFs published since 1990 (30 patients, including our own), we sought to determine which surgical treatment for C-DAVF, endovascular surgery, or direct interruption of the draining vein, is more effective. SUMMARY OF THE BACKGROUND DATA: A combination of endovascular techniques and direct interruption procedures was successful in curing the C-DAVF in our patient. The selection between endovascular surgery and surgical interruption in the treatment of C-DAVF is controversial. METHODS: We sought to identify the characteristics and surgical methods most closely associated with complete cure for C-DAVF. RESULTS.: According to the reports on 31 cases of C-DAVF treated surgically (including our own), 20 DAVFs were managed by open surgery with interruption, 8 were treated by endovascular surgery, and 3 underwent a combined open and endovascular approach. Twenty-one patients showed symptomatic improvement or stabilization without additional treatment during the postsurgical course. Surgical revisions were performed in 3 patients (10.0%) (including the present case), all of whom initially underwent endovascular surgery. None of the cases treated by surgical interruption of the draining vein showed signs of recurrence. CONCLUSIONS: Surgical interruption of the draining vein is more effective than endovascular surgery in bringing about an absolute cure for C-DAVF. In exceptional cases, however, endovascular surgery is the preferred treatment. This is particularly so for elderly or medically compromised cases with contraindications against general anesthesia, as well as for moribund cases which, like our own case, present with rapidly deteriorating neurologic status on admission.

Aged↗

Differential membrane packing of stereoisomers of bis(monoacylglycero)phosphate.

Bis(monoacylglycero)phosphate (BMP) reveals an unusual sn-1,sn-1' stereoconfiguration of glycerophosphate. We synthesized sn-(3-myristoyl-2-hydroxy)glycerol-1-phospho-sn-1'-(3'-myristoyl-2'-hydroxy)glycerol (1,1'-DMBMP) and characterized the thermotropic phase behavior and membrane structure, in comparison with those of the corresponding sn-3:sn-1' stereoisomer (3,1'-DMBMP), by means of differential scanning calorimetry (DSC), small- and wide-angle X-ray scattering (SAXS and WAXS, respectively), pressure-area (pi-A) isotherms, epifluorescence microscopy of monolayers, and molecular dynamics (MD) simulations. In DSC, these lipids exhibited weakly energetic broad peaks with an onset temperature of 9 degrees C for 1,1'-DMBMP and 18 degrees C for 3,1'-DMBMP. In addition, a highly cooperative, strongly energetic transition peak was observed at approximately 40 degrees C for 1,1'-DMBMP and approximately 42 degrees C for 3,1'-DMBMP. These results are supported by the observation that 1,1'-DMBMP exhibited a larger phase transition pressure (pi(c)) than 3,1'-DMBMP. Small- and wide-angle X-ray scattering measurements identified these small and large energetic transitions as a quasi-crystalline (L(c1))-quasi-crystalline with different tilt angle (L(c2)) phase transition and an L(c2)-L(alpha) main phase transition, respectively. X-ray measurements also revealed that these DMBMPs undergo an unbinding at the main phase transition temperature. The MD simulations estimated stronger hydrogen bonding formation in the 3,1'-DMBMP membrane than in 1,1'-DMBMP, supporting the experimental data.

Calorimetry, Differential Scanning↗

Comparison of percutaneous coronary intervention with medication in the treatment of coronary artery disease in hemodialysis patients.

It has been reported that percutaneous coronary intervention (PCI) is beneficial for coronary artery disease (CAD) among the general population. However, its effects in patients who are on hemodialysis (HD) remain unclear. A prospective cohort study was performed to clarify whether PCI has a therapeutic advantage over medical therapy among HD patients with CAD. A follow-up study to 5 yr was conducted among 259 HD patients with ischemic heart disease. Mean follow-up was 39 mo. Patients were divided into three groups: 122 patients without significant stenosis, 88 patients who had significant stenosis and were treated with PCI, and 49 patients who had significant stenosis and were treated with medication only. The primary end point was cardiac death, and the secondary end point was all-cause death. The results showed that the 5-yr cardiac survival rate was 41.6% in the medication group, 77.1% in the PCI group (P = 0.0006), and 84.5% in the nonstenosis group (P < 0.0001). The 5-yr all-cause survival rate was 19.3% in the medication group, 48.4% in the PCI group (P = 0.004), and 64.3% in the nonstenosis group (P < 0.0001). Even after adjustment for other risk factors, effects of PCI on the risk for cardiac and all-cause death remained significant and independent (odds ratio 0.14; 95% confidence interval 0.08 to 0.25, P = 0.0006; and odds ratio 0.37; 95% confidence interval 0.26 to 0.54, P = 0.0062, respectively). Results were consistent when the therapeutic effect of PCI or medication was analyzed using propensity-matched patients. These data suggested that PCI could improve the prognosis of HD patients with CAD. PCI would be recommended for HD patients with CAD.

Aged↗

Corrective effect on Fabry mice of yeast recombinant human alpha-galactosidase with N-linked sugar chains suitable for lysosomal delivery.

We have previously reported the production of a recombinant alpha-galactosidase with engineered N-linked sugar chains facilitating uptake and transport to lysosomes in a Saccharomyces cerevisiae mutant. In this study, we improved the purification procedure, allowing us to obtain a large amount of highly purified enzyme protein with mannose-6-phosphate residues at the non-reducing ends of sugar chains. The products were incorporated into cultured fibroblasts derived from a patient with Fabry disease via mannose-6-phosphate receptors. The ceramide trihexoside (CTH) accumulated in lysosomes was cleaved dose-dependently, and the disappearance of deposited CTH was maintained for at least 7 days after administration. We next examined the effect of the recombinant alpha-galactosidase on Fabry mice. Repeated intravascular administration of the enzyme led to successful degradation of CTH accumulated in the liver, kidneys, heart, and spleen. However, cleavage of the accumulated CTH in the dorsal root ganglia was insufficient. As the culture of yeast cells is easy and economical, and does not require fetal calf serum, the recombinant alpha-galactosidase produced in yeast cells is highly promising as an enzyme source for enzyme replacement therapy in Fabry disease.

Animals↗

Measuring mouse sperm parameters using a particle counter and sperm quality analyzer: a simple and inexpensive method.

This study examined a method for analyzing the count, motility, and morphology of mouse epididymal sperm, optimizing the diluent, incubation time, sample concentration, and temperature, using a particle counter (CDA-500) to count and size sperm and a sperm quality analyzer (SQA-IIC) to measure sperm motility, quantified as the sperm motility index (SMI). The optimal conditions consisted of a 30-min incubation in D-MEM (Dulbecco's modified Eagle's medium; considering cost and availability) at 37 degrees C, with 5 x 10(6)cells mL(-1) in the original solution. Furthermore, the influence of formalin fixation, and the correlation between the automated counter and a manual method were investigated. The sample fixation had no marked effect on the sperm count or morphology assessment. A linear correlation was observed between the manual and automated methods (y=0.920x +0.276; r(2)=0.571; p<0.001; range: (3-6) x 10(6)). The suitability of the proposed method was confirmed using spermatozoa prepared from mice treated with the reproductive toxin diethylstilbestrol (DES). Using sperm from the cauda epididymidis on one side per mouse, we confirmed that measurement of these sperm parameters using the two devices was simple, rapid, inexpensive, and reproducible.

Animals↗

Genetic patterning of the mammalian telencephalon by morphogenetic molecules and transcription factors.

Patterning centers that produce gradients of morphogenetic molecules, including fibroblast growth factor (FGF), bone morphogenetic proteins (BMP), Wnt, Sonic hedgehog (Shh), and retinoic acid (RA), are located in telencephalic anlage during early stages of development. Genetic evidence based on loss-of-function and gain-of-function studies indicate that they are involved in regional specification of the dorsal, ventral, and lateral telencephalon. For patterning of the dorsal telencephalon, FGF8 controls the anteroposterior patterning, while BMP and Wnt molecules regulate the mediolateral patterning. Shh and retinoic acid regulate patterning of the ventral and the lateral telencephalon. The regionalization of telencephalon is accompanied by expression of region-specific codes of transcription factors, which in turn regulate different phases of neuronal development to generate different cell types in each brain region. Therefore, bioactive signals of morphogenetic molecules are translated into transcription factor codes for regional specification, which subsequently leads to neurogenesis of the diversity of cell types in different regions of the telencephalon.

Animals↗

Phacoemulsification associated corneal damage evaluated by corneal volume.

PURPOSE: To determine the usefulness of the Pentacam corneal volume assay in the assessment of corneal endothelial damage caused by phacoemulsification and aspiration (PEA). DESIGN: Prospective, comparative, observational case series. METHODS: PEA was performed in 85 eyes by three surgeons under different conditions. Central cell density (CD) was determined using a specular microscope before and one month after surgery. Pentacam was used before and one day, one week, and one month after surgery to determine 3- and 10-mm corneal volumes. RESULTS: For all surgeons, no significant differences in the 3-mm corneal volumes were noted between the before and one-month after surgery values. However, 10-mm corneal volumes at one month were significantly higher than preoperative levels. No correlation was noted between the increasing rate of the 10-mm corneal volume and decreasing rate of CD. CONCLUSIONS: Pentacam-determined corneal volumes may be useful in assessing PEA-caused corneal damage.

Cell Count↗

Alteration of free radical development by ophthalmic viscosurgical devices in phacoemulsification.

PURPOSE: To determine the effect of ophthalmic viscosurgical devices (OVDs) and irrigation/aspiration (I/A) settings on free radical development during phacoemulsification. SETTING: Department of Ophthalmology, Nippon Medical School, Tokyo, Japan. METHODS: Free radicals were detected by the electron spin resonance (ESR) spin-trap method. After a spin-trapping agent, 5,5-dimethyl-1-pyrroline N-oxide 1%, was mixed with the irrigating solution, phacoemulsification simulation was performed in an eye model at 100% ultrasound power levels for 10, 20, and 30 seconds. A high I/A setting (35 mL/min with 250 mm Hg vacuum) and a low I/A setting (15 mL/min with 60 mm Hg vacuum) were used in combination with no OVD, sodium hyaluronate 1% (Healon), sodium hyaluronate 2.3% (Healon5), sodium hyaluronate 3%-chondroitin sulfate 4% (Viscoat), or sodium hyaluronate 1% (Opegan). Immediately after phacoemulsification, the solution in the anterior chamber was collected and signals from the spin adduct were measured using an ESR spectrometer. RESULTS: With the low setting, all OVDs significantly suppressed the signals for up to 20 seconds. At 30 seconds, the signals were still significantly smaller in all OVD groups, except Healon, than those in the no-OVD. With the high setting, the effect was not significant in the Healon and Opegan groups at 10 seconds; by 20 seconds and after, only Viscoat showed significant suppression. CONCLUSIONS: Free radical development in phacoemulsification can be altered by OVD properties and I/A settings. To reduce oxidative stress to the corneal endothelium, attention should be paid to the retention of OVDs in the anterior chamber during phacoemulsification.

Animals↗

Immunological characteristics of amniotic epithelium.

We review recent experimental evidence of the immunosuppressive and immunogenic potential of amniotic epithelial cells. Since cryopreserved amniotic membrane (AM) has been used in clinical applications, much research has focused on the beneficial effects of amniotic stromal matrix rather than on the function of viable amniotic cells. However, viable human amniotic epithelial cells (HAECs) have been shown to elicit beneficial effects on secretion of anti-inflammatory factors. Topical application of culture supernatant from HAECs leads to profound suppression of suture-induced neovascularization in cornea and fewer major histocompatibility complex (MHC) class II antigen-presenting cells (APCs) in inflamed cornea after thermal cautery. Furthermore, expression of interleukin (IL)-1beta mRNA was suppressed in cauterized cornea. These results suggest that HAECs are a source of soluble anti-inflammatory factors that suppress corneal inflammation. However, viable amniotic epithelial cells display antigenicity and immunogenicity as allografts. Fresh allogeneic amniotic epithelium (AE) expresses MHC class I antigens and sensitizes recipients when placed in the eye, although long-term memory of allo-specific delayed hypersensitivity (DH) was not acquired. Allogeneic AE was clearly vulnerable to acute immune rejection in specifically sensitized recipients and recipients of repeated AE transplantation. We therefore suggest that immunogenicity of AE should not be ignored, and use of AM from different donor placentas should be emphasized when repeated AM transplantation is required in patients clinically.

Amnion↗

Immunogenicity and antigenicity of allogeneic amniotic epithelial transplants grafted to the cornea, conjunctiva, and anterior chamber.

PURPOSE: To determine the immunogenic characterization of amniotic epithelium (AE), by examining the fate of allogeneic AE grafts heterotopically transplanted in the eye. METHODS: Intact AE from enhanced green fluorescence protein (EGFP) transgenic mice (C57BL/6 background) and wild-type C57BL/6 mice were transplanted onto cornea or conjunctiva, or inserted into the anterior chamber (AC) of normal BALB/c mice, C57BL/6 mice, or BALB/c mice presensitized to donor antigens. For repeated AE transplantation experiments, AE was grafted in the other eye 7 days after the first grafting. Graft fate was assessed clinically and histologically at selected intervals after grafting. Infiltrating inflammatory cells were examined immunohistochemically. Sensitization to alloantigens by AE was assessed by the delayed hypersensitivity (DH) response. RESULTS: In normal recipients, GFP+ cells were absent in EGFP donor-derived AE grafts by day 21 on cornea and by day 7 on conjunctiva. AE grafts implanted in the AC survived for >8 weeks. In presensitized recipients and recipients that underwent repeated AE implantation, graft survival was markedly shorter than in normal recipients. DH was induced at 2 weeks, but failed to be induced at 4 weeks after grafting on cornea or at 8 weeks after grafting on conjunctiva and in the AC of normal recipients. CONCLUSIONS: Fresh allogeneic AE expressed immunogenicity when placed on the ocular surface, although no memory of allospecific DH was acquired. Allogeneic AE is clearly vulnerable to immune rejection in specifically sensitized recipients.

Amnion↗

[Gefitinib as a first-line therapy in patients with advanced non-small cell lung cancer].

BACKGROUND: The objective of this study was to evaluate the efficacy and toxicity of gefitinib as a first-line therapy in patients with advanced non-small cell lung cancer (NSCLC). METHODS: We analyzed 19 patients with advanced NSCLC retrospectively, who were treated with gefitinib as a first-line therapy. These patients were not considered for systemic chemotherapy secondary to co-morbid conditions, poor performance status (PS) or refusal of chemotherapy. RESULTS: Median age 68 years, male/female 10/9, stage III/IV 7/12, smoker/non-smoker 12/7, adenocarcinoma/non-adeno 13/6, PS 0/1/2/3/4 0/4/7/5/3. Four patients had a partial response and the overall response rate was 21.0%. The median survival time was 6.8 months and 1-year survival was 27%. Overall toxicities were mild. Grade (G) 3 diarrhea was observed in one patient and G1 interstitial pneumonia in one. CONCLUSIONS: These results demonstrate that gefitinib is active as a first-line therapy in patients with advanced NSCLC.

Adult↗

[Combination chemotherapy with carboplatin and weekly Paclitaxel in patients with advanced non-small cell lung cancer].

BACKGROUND: The objective of this study was to evaluate the efficacy and toxicity of carboplatin plus weekly paclitaxel as first-line therapy in patients with advanced non-small cell lung cancer (NSCLC). METHODS: Forty-nine patients were analyzed retrospectively. Every 4 weeks patients received 70 mg/m(2)paclitaxel on days 1, 8, and 15, and AUC 5-6 carboplatin on day 1. RESULTS: A median of four cycles (range, 1-7) was administered. Twenty-four patients had a partial response, and the overall response rate was 48.9%. The median survival time was 12.8 months and the 1-year survival was 50.7%. Overall toxicities were mild. The most common toxicity was neutropenia, grade 3/4 in 32% of the patients. Grade 3/4 hematologic toxicities included anemia (16%) and thrombocytopenia (8%). Grade 3/4 non-hematologic toxicities included febrile neutropenia (2%), pneumonia (10%) and interstitial pneumonia (2%). Grade 2 peripheral neuropathy was seen in one patient (2%). CONCLUSIONS: These results demonstrate that this regimen is an active and tolerable treatment for patients with advanced NSCLC. It is suggested that this weekly regimen should be considered as one of the standard therapies for future chemotherapy in advanced NSCLC.

Adult↗