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Biomedical subjects

J Inoue

Publications and source records attributed to J Inoue.

At least 199 records · Page 11Linked to original sources
PubMed1989

[A case of sick sinus syndrome, considered to develop to atrial standstill].

A 25 year old man was admitted to our hospital because of dizziness and bradycardia. Physical examination was normal except for an irregular pulse of 90 beats/min. Chest X-ray film showed no cardiomegaly and no pulmonary congestive changes. ECG showed 2:1 or 3:1 atrial flutter on admission. After atrial flutter was terminated spontaneously, ECG revealed absent P waves, a QRS interval of 0.10 seconds, and A-V junctional rhythm with irregular R-R interval ranging from 1.20 to 2.12 seconds. At times, cardiac arrest was noted. Esophageal electrocardiogram also failed to demonstrate atrial activity while A-V junctional rhythm continued. Mitral valve echocardiogram lacked A point, and then ä waves were absent in both the right atrial and pulmonary capillary pressure recordings. Transient atrial standstill was suspected from these findings, so that electrophysiological study was performed. Right atrial electrogram revealed complete absence of atrial activity. His bundle electrogram revealed H-V prolongation [80-83 msec]. Right atrial pacing was attempted at several atrial sites, including the high lateral, middle lateral, low lateral right atrium, and low right atrial septum. Atrial activity could be elicited with stimulus strength of 3 to 5 volts. These atrial pacing thresholds were mild or moderately higher than usual. After the cessation of atrial pacing at 90 beats for two minutes, the recovery time of the first beat prolonged to 8.46 second. We considered that this case was sick sinus syndrome in young adult which revealed generalized disturbance of conduction system including the atrial muscle, and would develop to atrial standstill in the near future.

Adult↗
PubMed1989

[Disorders of fluid and electrolyte metabolism in elderly diabetics].

Disorders of fluid and electrolyte metabolism in elderly diabetics were studied. High frequency of hyperkalemia (20.8%), hypomagnesemia (14.6%), hypocalcemia (13.7%), hyperphosphatemia (8.6%), hyponatremia (8.1%) and hyperchloremia (7.2%) was observed among 332 elderly diabetics. Furthermore, hyperkalemia, hyperphosphatemia, hyponatremia, hyperchloremia, hypercalcemia and hypermagnesemia were more frequent in diabetics with renal insufficiency (serum Cr greater than or equal to 1.5 mg/dl) than in diabetics with normal renal function (serum Cr less than or equal to 1.4 mg/dl). In addition, statistically significant negative correlation were observed between plasma glucose levels and serum levels of sodium and chloride in diabetics with normal renal function. These results clearly demonstrated that the most important causal factor of electrolyte disorders in elderly diabetics might be the renal dysfunction due to diabetic nephropathy and/or nephrosclerosis. Moreover, glucose intolerance is also one of the causal factors for hyponatremia and hypochloremia. Disorders of fluid and electrolyte metabolism were manifest in 31 diabetic patients with hyperosmolar non-ketotic coma. The frequency of patients with abnormally elevated serum levels of sodium, potassium and chloride, and patients with abnormally lowered serum levels of calcium was high in this morbid state. Water and sodium deficit, examined in 11 cases of hyperosmolar non-ketotic coma, was 4780 +/- 2100 ml (107 +/- 43 ml/kg body weight) and 290 +/- 170 mEq (6.8 +/- 4.2 mEq/kg body weight), respectively. However, no significant deficit of potassium was observed in the patients. Statistically significant positive correlations between water deficit and serum Cr levels and with serum effective osmolarity were observed. However, there were no significant correlations between water deficit and plasma glucose levels, serum sodium levels and serum osmolarity.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

[Lateralisation of aldosterone-producing adenoma in primary aldosteronism].

Four lateralizing methods were carried out in 14 patients with primary aldosteronism (PA): ultrasonography, CT scan, adrenal scintiscan and determination of adrenal venous aldosterone levels. In all cases, unilateral aldosterone-producing adenomas were verified by surgery. Of four lateralizing methods, determination of adrenal venous aldosterone, in spite of high diagnostic value, has two big problems: difficulty in selective catheterization of right adrenal vein and dilution of adrenal vein efflux from non-adrenal sources. To solve these problems, cortisol (C, micrograms/dl) levels along with aldosterone (A, ng/dl) were determined in samples from the left adrenal vein (LAV) and the inferior vena cava (IVC) in 8 patients with PA, and the (LAV A/C)/(IVC A/C) ratio was calculated. That ratio was also obtained in 7 patients with other types of hypertension for comparison. Accuracy of lateralisation by ultrasonography, CT scan and adrenal scintiscan was 23%, 64% and 69% respectively, in the first studies. Those rates changed to 23%, 93% and 85% when the second studies were performed. Venous blood was obtained from both adrenal veins in 46% (6/13), while lateralisation of adenoma was also predicted in 46% (6/13) by the measurement of aldosterone concentrations alone. On the other hand, (LAV A/C)/(IVC A/C) ratios were 3.54-6.98 in the cases of left APA, 0.15-0.98 in those of right APA and 1.10-2.86 in cases of other types of hypertension. There was no overlap of ratios among the three groups, resulting in correct prediction of lateralisation in all cases (8/8) of APA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1988

The effect of low and high NaCl diets on oral glucose tolerance.

The effects of low and high NaCl diets on plasma glucose and insulin responses to glucose ingestion were investigated in 15 patients with essential hypertension. Oral glucose (75 g) tolerance tests were carried out while patients were taking diets with low (2 g/day) and high (20 g/day) NaCl content. Fasting plasma glucose and insulin levels were both significantly lower during ingestion of the high NaCl diet (p less than 0.05). After glucose ingestion, the incremental areas under the two hour plasma glucose and insulin curves were significantly smaller during ingestion of the high NaCl diet (glucose p less than 0.005 and insulin p less than 0.025). These findings that low NaCl diets increase the glycemic response to glucose loads suggest that use of NaCl restriction for the treatment of essential hypertension may not always be desirable.

Adult↗
PubMed1988

Hemolytic activity of a cyclic peptide Ro09-0198 isolated from Streptoverticillium.

Ro09-0198, a cyclic peptide isolated from culture filtrates of Streptoverticillium griseoverticillatum, induced lysis of erythrocytes. Preincubation of the peptide with phosphatidylethanolamine reduced the hemolytic activity, whereas other phospholipids present in erythrocytes in nature had no effect. A study of the structural requirements on phosphatidylethanolamine necessary for interaction with the peptide indicates that Ro09-0198 recognizes strictly a particular chemical structure of phosphatidylethanolamine: dialkylphosphoethanolamine as well as 1-acylglycerophosphoethanolamine showed the same inhibitory effect on hemolysis induced by Ro09-0198 as diacylphosphatidylethanolamine, whereas phosphoethanolamine gave no inhibitory effect. Neither phosphatidyl-N-monomethylethanolamine nor alkylphosphopropanolamine had an inhibitory effect. Consequently, the hydrophobic chain is necessary for the interaction and the phosphoethanolamine moiety is exactly recognized by the peptide. Ro-09-0198-induced hemolysis was temperature-dependent and the sensitivity of hemolysis differed greatly among animal species.

Actinomycetales↗
PubMed1988

Post-transcriptional regulator (rex) of HTLV-1 initiates expression of viral structural proteins but suppresses expression of regulatory proteins.

Gene expression of human T-cell leukemia virus type 1 (HTLV-1) is regulated by two trans-acting factors encoded by the pX region, p40tax and p27tax.p40tax is a transcriptional activator and p27rex is a post-transcriptional regulator. Using full-length viral DNA, we studied the regulatory effects of rex on HTLV-1 gene expression. p27rex is required for expression of both gag and env proteins, increasing the level of their mRNAs. The effect was dependent on the dose of p27rex expression plasmid. In parallel, increased doses of p27rex suppressed the expression of fully spliced pX mRNA, which encodes the regulatory proteins. These two effects of p27rex operated at the post-transcriptional level and were independent of transcriptional regulation. Lowering the level of pX mRNA down-regulates transcription of the proviral genome. These observations demonstrate that rex is a positive post-transcriptional regulator for gag, pol and env protein expression, and acts at the same time as an indirect negative regulator of viral transcription.

Cell Line↗
PubMed1988

Two cis-acting elements responsible for posttranscriptional trans-regulation of gene expression of human T-cell leukemia virus type I.

The pX sequence of human T-cell leukemia virus type I codes for two nuclear proteins, p40tax and p27rex, and a cytoplasmic protein, p21x-III.p40tax activates transcription from the long terminal repeat (LTR), whereas p27rex modulates posttranscriptional processing to accumulate gag and env mRNAs that retain intron sequences. In this paper, we identify two cis-acting sequence elements needed for regulation by p27rex: a 5' splice signal and a specific sequence in the 3' LTR. These two sequence elements are sufficient for regulation by p27rex; expression of a cellular gene (metallothionein I) became sensitive to rex regulation when the LTR was inserted at the 3' end of this gene. The requirement for these two elements suggests an unusual regulatory mechanism of RNA processing in the nucleus.

Gene Expression Regulation↗
PubMed1988

An incidentally discovered case of Cushing's syndrome without clinical signs.

This paper describes a middle-aged man in whom an adrenal mass was incidentally discovered by upper abdominal echogram. Physical examination revealed no signs of Cushing's syndrome. The plasma cortisol level at 0800 h was within the normal range, but the diurnal rhythm had disappeared. Plasma ACTH was undetectable throughout the whole day. Urinary 17-OHCS was slightly increased and was not suppressed by 2 mg or 8 mg dexamethasone. Metyrapone test and CRF test revealed no response. A left adrenalectomy was performed and histological diagnosis of the removed tumor was an adrenal adenoma. After operation, oral steroid supplementation was necessary. These data suggest that the autonomous cortisol secretion by the tumor accounted for all his daily cortisol secretion, but it was too small to be clinically functional. We propose that every patient with an incidentally discovered adrenal mass should be subjected to endocrinological evaluations.

17-Hydroxycorticosteroids↗
PubMed1988

Supraventricular tachycardia in a patient with Lown-Ganong-Levine syndrome associated with apical hypertrophic cardiomyopathy.

Electrophysiologic study of a 55-year-old patient with Lown-Ganong-Levine syndrome associated with apical hypertrophic cardiomyopathy is reported. The patient had a history of recurrent attacks of tachyarrhythmia and his electrocardiogram showed a short P-R interval (0.10 sec) with narrow QRS complex and left ventricular hypertrophy with giant negative T waves. His cineangiogram showed severe apical hypertrophy. An electrophysiologic study was performed. The results of programmed atrial pacing show the existence of the dual A-V nodal pathways. The A-H interval at rapid atrial pacing increased maximally by 103 msec. Atrial stimulation could depolarize parts of the atrium without altering the supraventricular tachycardia. These findings suggested that preferential rapidly conducting A-V nodal and intranodal reentry are the responsible mechanisms in this reciprocating tachycardia. We conclude that the short P-R interval was due to intranodal reentry through the dual A-V nodal pathways. To our knowledge, a case of Lown-Ganong-Levine syndrome with apical hypertrophic cardiomyopathy has not been previously described in the literature.

Cardiac Catheterization↗
PubMed1988

Effect of human parathyroid hormone (PTH(1-34)) on experimental osteopenia of rats induced by ovariectomy.

The effect of human PTH(1-34) on the development of osteopenia induced by ovariectomy was investigated in immature female Sprague-Dawley rats. After the surgery, human PTH(1-34) was injected subcutaneously three times a week for 25 weeks. A reduction of serum calcium level and a tendency to increased serum alkaline phosphatase activity were seen in ovariectomized rats. The ovariectomized rat bones were characterized by reduction of dry weight, ash weight, calcium content and phosphorus content, but there was no change in length, volume and ash content in these bones. Human PTH(1-34) prevented the reduction of dry weight, ash weight, calcium content and phosphorus content dose dependently (1.5-6.0 micrograms/kg) in ovariectomized rats. It was concluded that pulsatile administration of human PTH(1-34) prevented the development of osteopenia induced by ovariectomy.

Alkaline Phosphatase↗
PubMed1987

Evidence for aberrant activation of the interleukin-2 autocrine loop by HTLV-1-encoded p40x and T3/Ti complex triggering.

In this study we provide evidence that distinct DNA sequences within the 5'-flanking regions of the genes for interleukin-2 (IL-2) and its receptor (IL-2R) are involved in human T-cell-specific activation of transcription by p40x, a product of human T cell leukemia virus type I (HTLV-1). The same DNA sequences appear to be responsible for induction of the genes in a T cell line, Jurkat, by mitogens. Although the IL-2 gene sequences are activated by p40x with much lower efficiency than the IL-2R gene sequences, they are synergistically activated by the p40x expression and subsequent extracellular stimulation by Concanavalin-A or anti-T3. We propose a model for two-step activation of the IL-2 autocrine loop in ATL development.

Cell Line↗
PubMed1987

Transcriptional (p40x) and post-transcriptional (p27x-III) regulators are required for the expression and replication of human T-cell leukemia virus type I genes.

The pX sequence of human T-cell leukemia virus type I codes for three products: p40x, p27x-III, and p21x-III. p40x is a transcriptional trans-activator that activates not only the viral long terminal repeat but also cellular genes for interleukin 2 and its receptor. p27x-III and p21x-III are not required for transcriptional activation, and their functions were unknown. Cotransfection experiments with defective human T-cell leukemia virus type I proviruses and various pX expression plasmids revealed that p27x-III, in addition to p40x, was required for gag gene expression. Furthermore, it was shown that p27x-III induced accumulation of a high level of unspliced viral gag mRNA. These results indicate that p27x-III is a post-transcriptional modulator of viral RNA whose transcription has been fully activated by p40x.

Cell Line↗
PubMed1987

Assay of a circulating sodium pump inhibitor in patients with essential hypertension and normotensive subjects.

The plasma levels of a sodium pump inhibitor (Na+ PI) were measured by a modified method of Hamlyn et al, using dog kidney Na+, K+-ATPase. When the level of Na+ PI was expressed as the % inhibition of the enzyme and compared with that of a control solution, it was found to be 9.0 +/- 0.7% in 43 untreated patients with essential hypertension. This was significantly higher than 5.0 +/- 0.4% for 56 normotensive subjects (p less than 0.01). Male patients with essential hypertension showed the highest mean value of 10.5 +/- 1.1%, disclosing an apparent sex difference in the patient group (p less than 0.01). Only in female patients was there a significant positive correlation between the inhibitor's level and the mean blood pressure (r = 0.649, p less than 0.01). These results provided additional evidence for increased Na+ PI in the plasma of patients with essential hypertension, which might bear an important role in the pathogenesis of the disease.

Adult↗
PubMed1986

The second pX product p27 chi-III of HTLV-1 is required for gag gene expression.

The human T-cell leukemia virus type-1 (HTLV-1) contains a unique pX region, which encodes the gene products p40 chi, p27 chi-III and p21 chi-III. p40 chi is required for transcriptional trans-activation, whereas p27 chi-III and p21 chi-III have no such function. Transfection of pX expression plasmids containing different combinations for the three gene products into cells integrated with HTLV-1 proviruses defective in pX expression revealed that both p40 chi and p27 chi-III are required for expression of the gag protein and accumulation of gag mRNA. These observations suggest that the pX product p40 chi activates transcription and p27 chi-III controls the level of gag mRNA by post-transcriptional modulation.

Cell Line↗
PubMed1986

[Measurement of knee joint sounds by microphone].

The use of a microphone to detect sound emitted from knee joint and tissues is a significant advance on acoustic detection systems. All possible artifact signals encountered by the sound detection technique were investigated. Background noise is minimized by measuring in an anechoic chamber. Coupler noise is eliminated by ventilation holes. Skin friction noise is effectively eliminated using ultrasonic-gel. The use of a double microphone with differential amplifier to subtract the signals between two microphones is not suitable for the measurement of knee joint sound, because of the appearance of peak and dip frequency in a spectrum. It is possible to obtain the actual spectrum of knee joint sound by subtracting the spectrum of background sound from the spectrum of recorded knee joint sound.

Auscultation↗