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Biomedical subjects

J Kato

Publications and source records attributed to J Kato.

At least 271 records · Page 15Linked to original sources

Hepatocyte growth factor is involved in the morphogenesis of tooth germ in murine molars.

The patterns of gene expression for hepatocyte growth factor (HGF) and its receptor, c-Met, were revealed in the tooth germ of rat mandibular molars using RT-PCR. In situ hybridization demonstrated that the HGF gene was expressed only in the cells of the dental papilla of the tooth germ in vivo. The characteristic temporospatial distribution of HGF and c-Met during germ development was revealed using immunohistochemical studies in vivo. In order to demonstrate the functional role played by HGF in tooth development, HGF translation arrest by antisense phosphorothioate oligodeoxynucleotide (ODN) was carried out in vitro. In the control experiment, explants of tooth germs from embryonic 14 day mice were cultured in a modification of Trowell's system under serum-free and chemically defined conditions for two weeks. Other explants were cultured with 15mer antisense or sense ODN targeted to the HGF mRNA. Both the control and the sense-treated explants showed normal histological structure, as observed in vivo. On the other hand, antisense-treated explants exhibited an abnormal structure in which the enamel organs were surrounded by a thin layer of dentin and dental papilla, appearing 'inside-out' compared to the control and sense-treated explants, although the cytodifferentiation of ameloblasts and odontoblasts was not inhibited. The explants treated with recombinant human HGF combined with antisense ODN showed normal development, indicating that exogenous HGF rescued the explants from the abnormal structure caused by antisense ODN. The findings of a BrdU incorporation experiment suggested that the imbalance between the proliferation activity of the inner enamel epithelium and that of the dental papilla caused by HGF translation arrest results in the abnormal structure of the tooth germ. These results indicate that HGF is involved in the morphogenesis of the murine molar.

Animals↗

Superior vena cava syndrome due to a permanent transvenous pacing lead.

Superior vena cava (SVC) syndrome after pacemaker implantation is a very rare complication. We present a 56-year-old man with severe swelling of the face, neck, and upper arms about 6 years after pacemaker implantation. Digital subtraction angiography showed occlusion of the left innominate vein and severe stenosis of the SVC. The patient eventually required surgical treatment, since anticoagulant therapy and balloon venoplasty were not effective. We conclude that surgical repair is the most effective method for treating similar patients.

Humans↗

Chronic effect of beta-adrenoceptor blockade on plasma levels of brain natriuretic peptide during exercise in essential hypertension.

Many factors have been reported to stimulate the release of brain natriuretic peptide (BNP) as well as atrial natriuretic peptide (ANP). In hypertensive patients, however, little is known about whether these factors differ from those in normotensive subjects or if they are influenced by antihypertensive treatment. We measured the plasma concentrations of BNP and ANP in 12 hypertensive patients and examined the chronic effects of beta-adrenoceptor blockade on BNP secretion during exercise with a bicycle ergometer. The exercise raised both plasma BNP and ANP with concomitant increases in systolic blood pressure, heart rate (HR) and plasma norepinephrine (NE) and epinephrine (Epi) before and after treatment. Before treatment, the changes in ANP and BNP correlated with that in HR (p < 0.05). After treatment 4 wk of treatment, the change in ANP correlated with those in NE and Epi as well as HR. Multivariate regression analysis indicated that only NE was a significant stimulus for ANP secretion during the treatment period. As for BNP, HR was the only significant stimulant for its secretion both before and after treatment. In essential hypertension, beta-adrenergic receptor blockade affected the factors stimulating exercise-induced ANP release but not those stimulating BNP release. BNP release, therefore, seems to be stimulated by similar but distinct factors from those that stimulate ANP release.

Adrenergic beta-Antagonists↗

Concentrations of serum markers of type I collagen synthesis and degradation and serum osteocalcin in maternal and umbilical circulation.

Measurement was made of the serum carboxyl-terminal propeptide of type I procollagen (PICP), carboxyl terminal cross-linked telopeptide of type I collagen (ICTP) and osteocalcin in 17 full-term mother-infant pairs and 17 age-matched nonpregnant women. Serum PICP and ICTP of term women at the time of delivery were significantly higher (P < 0.025, P < 0.01, respectively) and serum osteocalcin was significantly lower (P < 0.001) than in nonpregnant women. The ratio of PICP to ICTP was essentially the same for term and nonpregnant women. Serum PICP, ICTP, and osteocalcin were virtually the same in the umbilical arteries and vein. PICP, ICTP, and osteocalcin were much higher in fetal than maternal circulation (P < 0.001). The fetal levels of these proteins were not correlated with maternal levels, nor with birth weight. Thus, during pregnancy, either osteoclastic or osteoblastic activity would appear to increase slightly, but the balance between bone formation and resorption is maintained. During fetal life, bone turnover may be greatly accelerated and bone metabolism may occur independently of maternal bone metabolism.

Biomarkers↗

Hyperlipidemia associated with multiple myeloma.

A 70-year-old woman with type IIb therapy-refractory hyperlipidemia was diagnosed as having IgA kappa type multiple myeloma. She had neither a family history nor any other disease known to accompany hyperlipidemia. The serum IgA concentration fell from 3.42 g/dl to 1.24 g/dl following chemotherapy with melphalan and prednisolone, and a concomitant decrease in both the serum cholesterol and triglyceride levels was observed. These serum lipids were positively correlated with the serum IgA concentration (p < 0.001) during the three cycles of chemotherapy. These findings suggest the involvement of the monoclonal protein of IgA in the development of hyperlipidemia in the present case.

Aged↗

Extramedullary plasmacytoma of the jejunum.

A case of extramedullary plasmacytoma (EMP) of the jejunum, an uncommon neoplasia, is reported. A 56-year-old Japanese woman who experienced intermittent upper abdominal pain and weight loss had a large movable mass in the upper abdomen. The mass was hypervascular in an angiographic study and positive for gallium-67 citrate scintigraphy. Immunoelectrophoresis showed the presence of an M-component of immunoglobulin (Ig) A-lambda in the serum. It was identified as an EMP immunohistochemically positive for IgA-lambda. This M-component disappeared after resection and chemotherapy. The clinical features of this rare neoplastic disorder are discussed.

Antineoplastic Combined Chemotherapy Protocols↗

Prevalence of hypertension and rate of blood pressure control as assessed by home blood pressure measurements in a rural Japanese community, Ohasama.

A cross-sectional community survey using home blood pressure measurements was performed in northern Japan to estimate the prevalence of definite hypertension, white coat hypertension and the success of blood pressure control in patients receiving antihypertensive drugs. A total of 1334 subjects (mean age +/- SD, 53.8 +/- 17.3 years; 8-91 years) participated in the screening and home blood pressure measurement program. They measured blood pressure at home at least 3 times (mean measurement frequency, 20.8 +/- 8.3 times). Of these 1334 subjects, 314 (65.1 +/- 8.9 years) were taking drugs (treated group) while 1020 (50.3 +/- 17.8 years) were not (untreated group). The WHO criteria were used to categorize screening blood pressure. Criteria for diagnosis of hypertension by home blood pressure measurements were as follows: definitely hypertensive (systolic blood pressure > or = 144 mmHg and/or diastolic blood pressure > or = 89 mmHg) and normotensive (104 < systolic blood pressure < or = 131 mmHg and 60 < diastolic blood pressure < or = 79 mmHg). Of the 1018 subjects identified as normotensive on screening measurements, home measurements indicated that 73 (7.2%) were hypertensive and 765 (74.7%) were normotensive or lower. Of the 112 subjects identified as hypertensive on screening measurements, home measurements showed that 42 (37.5%) were hypertensive and 30 (26.8%) were normotensive or lower. Of the 314 treated subjects, 45 (14.3%) were identified as hypertensive by screening measurements and 88 (28.0%) as hypertensive by home measurements. Only 20 (44.4%) of the former 45 subjects were also defined as definitely hypertensive by home measurements. Of the 1020 untreated subjects, 67 (6.6%) were hypertensive by screening measurements and 84 (8.2%) by home measurements. Only 22 (32.8%) of the former 67 subjects were classified as hypertensive by home measurements. Of the 67 untreated subjects identified as hypertensive by screening measurements, 20 (29.9%) were normotensive or lower by home measurements, suggesting that these subjects were "white coat" hypertensives. The study first confirmed based on the large community data that there are large discrepancies between screening (casual) blood pressure and home blood pressure measurements for recognition of hypertension and normotension. Determination of blood pressure levels by home blood pressure measurements may predict prognosis of hypertension differently from that by screening blood pressure measurements. Further prospectively study is needed to validate the prognostic value of home blood pressure measurements.

Adolescent↗

Communication difficulties of nursing home residents. How can staff help?

Recent studies have found a high prevalence of communication disorders in elderly residents of nursing homes. This study was undertaken to investigate staff attitudes to the communication problems and communicative needs of residents in their care. A questionnaire was administered to 32 staff members from one nursing home. Responses indicate little evidence of the negative staff attitudes previously reported in the literature. Staff wanted more time to spend communicating with residents and wanted to learn more about the residents' communication problems. Implications of the questionnaire responses for staff training are presented.

Aged↗

Retinal complications during interferon therapy for chronic hepatitis C.

OBJECTIVES: Various side effects of interferon (IFN) therapy have been reported. In this study, we examined retinal change during IFN therapy. METHODS: We performed ophthalmological examinations before, during, and after therapy on 63 patients with chronic hepatitis C who were receiving either natural IFA-alpha or recombinant IFN-alpha 2a or 2b. RESULTS: No retinal lesion was detected before IFN therapy, but, during therapy, retinal abnormality or retinopathy developed in 36 (57.1%) of 63 patients, including retinal hemorrhage in 25 patients and cotton-wool spots in 28 patients. They were noted early in the course of IFN therapy, within the first 4 wk in 67% (24/36) and within 8 wk in 86% (31/36). The incidence was not influenced by the type of IFN but was higher among diabetic (11/12, 92%, p < 0.05) or hypertensive patients (4/5, 80%, not significant) than among patients without either diabetes or hypertension (24/49, 49%). There was no relation between the incidence of retinopathy and the level of ALT activity or white blood cell or platelet counts. However, retinopathy occurred in most patients receiving IFN therapy after white blood cell count and platelet count reached a nadir. The levels of LDL-cholesterol and the atherosclerotic index in patients with retinopathy were slightly higher than those in the patients without retinopathy. CONCLUSIONS: These results suggest that retinopathy often occurs in patients with chronic hepatitis C who are receiving IFN and that we should closely monitor patients for retinal complications during IFN therapy.

Adult↗

Adrenomedullin and proadrenomedullin N-terminal 20 peptide in impaired renal function.

Proadrenomedullin N-terminal 20 peptide (PAMP) is a novel hypotensive peptide found in the N-terminal portion of the prohormone of adrenomedullin (AM), a vasodilator peptide. In this study, we examined the pathophysiological roles of the two peptides. Plasma concentrations of both peptides in patients with impaired renal function were measured and compared to those of the control subjects. Plasma AM concentrations in the study patients were significantly (P < 0.01) higher than in the controls with a serum creatinine of < 1 mg/dl (2.94 +/- 0.18 fmol/ml), and higher concentrations in those patients with a serum creatinine of > or = 2 mg/dl (Group II; 14.8 +/- 1.9 fmol/ml) were observed as compared to those at the 1 to 2 mg/dl level (Group I; 10.3 +/- 1.2 fmol/ml). Similarly, plasma PAMP concentrations tended to be higher in the Group I patients (0.82 +/- 0.05 fmol/ml) and significantly (P < 0.01) increased in the Group II patients (1.42 +/- 0.17 fmol/ml) when compared to the controls (0.53 +/- 0.04 fmol/ml). A significantly (P < 0.05) positive correlation was noted between the plasma AM and PAMP in the study patients. These findings suggest a potential role for these biologically active peptides in the regulation of blood pressure in impaired renal function.

Adrenomedullin↗

[Changes of coronary artery diameter during follow-up in patients with vasospastic angina: comparison of spastic and non-spastic sites].

The relationship between coronary vasospasticity and the development of atherosclerotic lesion was studied in 24 patients with vasospastic angina. All patients had no organic stenosis initially and underwent follow-up coronary angiography at 66 +/- 9 months after the initial examination. The coronary artery diameter was measured with the contour detection method. The spastic and non-spastic sites were identified at the initial coronary angiography with the acetylcholine provocation test. The change of the luminal diameter (delta LD) and the ratio of the change of luminal diameter (% delta LD) were compared at the spastic and the non-spastic sites. The follow-up examination showed significant decreases of coronary artery diameter in both the spastic (2.35 +/- 0.67 vs 2.16 +/- 0.58 mm, p < 0.001) and non-spastic sites (2.66 +/- 0.91 vs 2.54 +/- 0.84 mm, p = 0.02). However, delta LD and % delta LD were not different between the spastic and non-spastic sites (delta LD: -0.19 +/- 0.40 vs -0.12 +/- 0.46 mm, NS; % delta LD: -6.7 +/- 14.8% vs -3.2 +/- 17.0%, NS). In conclusion, coronary vasospasticity does not promote the development of atherosclerotic lesion.

Aged↗

[Neoadjuvant chemotherapy in high-grade advanced gastric cancer with protracted infusional 5-fluorouracil and consecutive low-dose cisplatin].

Twenty-one evaluable patients with primary gastric cancer/local invasion, liver metastasis and peritoneal metastasis were entered in a pilot study of neoadjuvant chemotherapy that used continuous 24-hour infusion 5-FU, 330 mg/m2/day plus low dose CDDP, 6 mg/m2 daily by bolus infusion d1-5. This regimen was repeated for 4 weeks. The overall response rate was 52%, including one complete and ten partial responses. The response rate of differentiated adenocarcinomas was significantly higher than that of poorly differentiated adenocarcinomas. In 15 patients (71%), gastrectomy and lymphadenectomy could be done after this regimen. chemotherapy-induced downstaging from the initial clinical stage was pathologically found in 5 patients who underwent gastrectomy. Toxicity was primarily hematologic. Leukopenia and thrombocytopenia of grade 3 or 4 occurred in 19% and 14% of patients, respectively. The patients were able to take meals during therapy and preserved good quality of life. Median survival time was 11 months for the cancers with liver metastasis and five of the 8 locally advanced cancers are alive 11 months after the therapy. This therapy was effective for patients with high-grade advanced gastric cancer.

Adenocarcinoma↗

[Decreased bone mineral density in premenopausal women with amenorrhea].

To examine the impact of amenorrhea on bone mineral density in women of reproductive age, bone mineral density in the lumbar spine (L2-L4) was measured by Dual-energy X-ray absorptiometry in 43 amenorrheal women. There was a significant lower bone mineral density in this test group (0.917 +/- 0.121 g/cm2) than in a normally menstruating control group (1.032 +/- 0.095 g/cm2). In premature ovarian failure, we found lower bone mineral density (0.863 +/- 0.112 g/cm2) than in any other subclass. Seven women with premature ovarian failure received cyclic hormone replacement therapy for 12 months (day 1-28, 0.625 mg conjugated estrogen, and on days 14-28, 5 mg medroxyprogesterone, followed by a seven-day pause). After 12 months, bone mineral density had increased significantly (p < 0.05) compared to the initial bone mineral density. We conclude that amenorrhea is a cause of bone loss in young women and that estrogen therapy is effective in preventing bone loss.

Adult↗

[Analgesic effect of dextromethorphan for postherpetic neuralgia].

We investigated the analgesic effect of dextromethorphan (DM), a non-selective NMDA receptor antagonist, in 25 patients with postherpetic neuralgia (PHN). We administered DM 45mg.day-1 orally for 14 days and then 90mg.day-1 for next 14 days. Decrease in pain intensity and alleviation of allodynia were observed in 9 patients (36%). Side effects with no severe cases occurred in 8 patients (32%) and these were mainly digestive symptoms. We concluded that DM might be useful to treat PHN with allodynia probably due to central sensitization.

Aged↗

[Anesthetic management of a patient with ornithine transcarbamylase deficiency].

A 6-year-old female with disturbance of consciousness (JCS: 3 points) due to hyperammonemia caused by ornithine transcarbamylase deficiency is presented. She underwent an emergency insertion of a catheter for peritoneal dialysis under general anesthesia. Anesthesia was induced by intravenous administration of thiamylal sodium and maintained with inhalation of sevoflurane and oxygen after tracheal intubation. One percent mepivacaine was infiltrated around the surgical field to diminish the dose of sevoflurane. The operation proceeded uneventfully, although her consciousness could not recover rapidly to the normal level during the emergence from anesthesia. Peritoneal dialysis was started immediately after the operation and her consciousness recovered to the normal level gradually during the following six days with decreasing plasma ammonia levels. Ten days later, extirpation of the peritoneal catheter was scheduled. The course of anesthesia and operation was uneventful using the same anesthetic method as with the former anesthesia. In the anesthetic management for a patient with ornithine transcarbamylase deficiency, we have to be careful about the nitrogen balance, which can be affected by the kind and doses of anesthetic drugs, to avoid hyperammonemia. From this point of view, local anesthesia combined with general anesthesia might be useful to prevent the serum ammonia level from increasing.

Ammonia↗

[3D contrast MR angiography of lower extremity : additional imaging with subtraction].

Immediately after pelvic contrast MRA, subtraction MRA with additional administration of contrast agent was performed for evaluation of the femoropopliteal artery. Mask images were taken with three- dimensional spoiled GRASS (24/6.9/40 degrees), followed by contrast images with 7.5 - 10 ml of Gd-DTPA. The subtracted images provided excellent depiction of the arteries without the disruption of overlapping from the venous system or surrounding tissues. Seven lesions of arterial occlusion or stenosis were pointed out by subtraction MRA in the nine lesions confirmed with IADSA. Subtraction MRA is feasible for long segment imaging of the lower extremities with Gd-DTPA.

Adult↗