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Biomedical subjects

J Sakamoto

Publications and source records attributed to J Sakamoto.

188 records · Page 11Linked to original sources

Menaquinol oxidase activity and primary structure of cytochrome bd from the amino-acid fermenting bacterium Corynebacterium glutamicum.

Cytochrome d was spectroscopically detected in membrane fractions of the amino-acid-fermenting, high-G+C gram-positive bacterium Corynebacterium glutamicum. Inhibition of NADH oxidase activity in the membranes by cyanide suggested that the main terminal respiratory oxidase during the stationary phase was a type of cytochrome bd. Cytochrome bd-type quinol oxidase, purified from the membranes, was composed of two subunits. Its reduced form showed absorption peaks at 627, 595, and 560 nm, which were due to haem d, high-spin protohaem, and low-spin protohaem, respectively. The air-oxidised form showed a peak at 645 nm, which might be due to oxygenated ferrous haem d. The spectral features and the size of subunit I are more similar to the properties of cytochromes bd from Proteobacteria, such as Escherichia coli, than to those of cytochrome bd from low-G+C gram-positive bacteria, such as Bacillus stearothermophilus. The menaquinol oxidase activity of the purified cytochrome bd was low, but was enhanced about fivefold by pre-incubating the enzyme with menaquinones. The order of effectiveness of quinols as oxidase substrates was clearly different from that of quinones as the activators of enzyme activity. Furthermore, activation was destroyed by ultraviolet irradiation of the pre-incubated enzyme and then restored by a second incubation with menaquinone. These results indicate that the enzymatic properties of this new oxidase are more similar to the properties of cytochromes bd from low-G+C gram-positive bacterial than to those of proteobacterial counterparts. They also suggest that the enzyme has a second quinone-binding site essential for full activity, in addition to the active centre for substrate oxidation. By using probes based on partial peptide sequences of the subunits, the genes for the two subunits of C. glutamicum cytochrome bd were cloned. The deduced amino acid sequence demonstrated that subunit I lacks the C-terminal half of the Q loop and that the primary structure of C. glutamicum cytochrome bd is more similar to that of other gram-positive bacteria than to proteobacterial cytochromes bd.

Amino Acid Motifs↗

A phase III randomized study comparing doxifluridine and 5-fluorouracil as supportive chemotherapy in advanced and recurrent gastric cancer.

We conducted a phase III randomized study to investigate effects of supportive chemotherapy with oral doxifluridine (group A, 75 patients) or 5-fluorouracil (group B, 75 patients) in advanced gastric cancer when intensive chemotherapy was not an option. Although there were no significant differences between the groups with regard to survival, hospital-free survival and time to progression, median values of 3 endpoints were superior in group A. Secondary analysis showed that group A patients with prior chemotherapy tended to have longer survival and hospital-free survival and significantly longer time to progression.

Adult↗

Blood loss and ICG clearance as best prognostic markers of post-hepatectomy liver failure.

BACKGROUND/AIMS: Hepatic failure after hepatic resection is a lethal complication. Various factors affecting the occurrence of hepatic failure were examined. METHODOLOGY: The subjects were 315 patients who underwent hepatic resection for hepatocellular carcinoma during the 11-year period between 1985 and 1995. Univariate analyses of 14 variables were performed among living and dead patients after hepatic resection. With the significant prognostic variables obtained in the multivariate analysis, the predicted probability of death (PPD) was calculated for each patient. RESULTS: There were 291 survivors and 24 patients with post-operative liver failure. Among the factors showing statistical or near significance in the univariate analysis, KICG and blood loss were disclosed to be factors independently correlating with survival. PPD was calculated for each patient according to the following equation: PPD = 1/Exp(1.6766 - 0.0004394 x blood loss + 16.69 x KICG) + 1. Assessing the goodness-of-fit model by Hosmer-Lemeshow test indicated the model seemed to fit quite well. CONCLUSIONS: Minimizing the blood loss during hepatic resection is important to avoid post-operative liver failure. Careful hemostatic procedure is necessary for patients with unexpected massive blood loss during hepatic resection so as to prevent post-operative bleeding.

Adult↗

Effects of nafamostat mesilate, a synthetic protease inhibitor, on immunity and coagulation after hepatic resection.

BACKGROUND/AIMS: Effects of nafamostat mesilate (NM), a serine protease inhibitor, on both coagulation-fibrinolysis activity and post-operative changes in immune responsiveness were investigated in a clinical study of 20 patients who underwent an extensive hepatic resection. METHODOLOGY: The patients were randomly allocated into 2 groups of 10 patients each: The NM group was administered nafamostat mesilate (2 mg/kg/day) during and after the operation for 7 days. The control group received standard post-operative intensive therapies except NM. RESULTS: The post-operative increase in coagulation in the control group was significantly suppressed in the NM-treated group on post-operative day (POD) 7. Natural killer (NK) activity, which was impaired after the operation, was recovered in the NM group on POD 7 and was significantly higher than in the control group. Helper/suppressor ratios of T lymphocytes were significantly increased post-operatively by the administration of NM. CONCLUSIONS: These results demonstrate that NM controls the enhanced coagulation which occur in patients with extensive hepatic resection. It is also suggested that NM promptly restores the impaired immune responsiveness and decreases the risk of post-operative complications, as well as the risk of recurrence in patients with hepatic tumors.

Antifibrinolytic Agents↗

An individual patient data meta-analysis of long supported adjuvant chemotherapy with oral carmofur in patients with curatively resected colorectal cancer.

To reappraise the benefits of the long supported chemotherapy with carmofur, a meta-analysis based on individual patient data from the three clinical trials was performed by pooling 614 patients from three trials, there is a statistically significant survival benefit (2p=0.032) and disease-free survival (DFS) benefit (2p=0.021) for carmofur; and a highly significant advantage for carmofur in DFS (2p=0.0004) and in survival (2p=0.004) in Dukes' C patients. This IPD meta-analysis strongly suggested an effect of oral carmofur in a long supported chemotherapy for curatively resected colorectal carcinoma.

Administration, Oral↗

Meta-analysis of adjuvant immunochemotherapy using OK-432 in patients with resected non-small-cell lung cancer.

The benefits of immunochemotherapy with a penicillin-treated, lyophilized preparation of Streptococcus pyogenes, OK-432 (Picibanil), were reassessed in patients with resected non-small-cell lung cancer through a meta-analysis based on data from 1,520 patients enrolled in 11 randomized clinical trials. All 11 trials were started before 1991, and the subjects had been followed up for at least 5 years after surgery and randomization. In these trials, standard chemotherapy was compared with the same therapy plus OK-432. The endpoint of interest was overall survival, and analysis was based on intent-to-treat population without patient exclusion. Data were analyzed using the Mantel-Haenszel method. The 5-year survival rate for all eligible patients in the 11 trials was 51.2% in the immunochemotherapy group versus 43.7% in the chemotherapy group. The odds ratio (OR) for overall survival was 0.70 (95% CI = 0.56-0.87, p = 0.0010). Analysis of four trials in which central randomization was performed also reconfirmed a significantly longer survival time for the immunochemotherapy group (OR = 0.66, 95% CI = 0.44-1.00, p = 0.049). Based on these results of meta-analysis, it is postulated that postoperative adjuvant immunochemotherapy using OK-432 might improve the survival of patients after resection of non-small-cell lung cancer.

Antineoplastic Agents↗

Clinical usefulness of the immunostaining of the tumor markers in pancreatic cancer.

The effect of the rapid immunostaining of gastrointestinal cancer-associated antigens, CA19-9, CEA, DUPAN2, and CA50 was discussed for intraoperative pathological diagnosis of pancreatic cancer. The method can be completed in only 13 minutes with microwave irradiation to accelerate the incubation of the primary antibody. Only 3 seconds of irradiation at 500 W for fresh-frozen sections produced specific antigen staining of greater intensity than that obtained with longer incubation by the conventional method. Preservation of the tissue structure was satisfactory with minimal nonspecific background staining enabling us to diagnose the intrapancreatic spread of cancer. This method was also applied to intraoperative peritoneal washing cytology. As with frozen section biopsy, the sensitivity of intraoperative cytology is greater than by the conventional staining method, which is able to achieve more precise staging of pancreatic cancers. Our rapid immunoperoxidase staining method on the cryostat section of pancreatic biopsy specimens and on cytology samples provides important information to determine an appropriate operative approach for pancreatic cancer.

Adenocarcinoma↗

The importance of the real-time fluoroscopic intraoperative direct cholangiogram in the laparoscopic cholecystectomy using a new instrument.

BACKGROUND/AIMS: Laparoscopic cholecystectomy (LC) has become an accepted standard operative technique for gallstone treatment worldwide. On the other hand, complications, such as bile duct injuries, have been reported recently with the expansion of indication for LC. Intraoperative cholangiogram (IOC), to minimize the risk of bile duct injury, is now considered to be essential for safe LC. There are disadvantages to IOC such as increased operating time, the possibility of bile duct injury and the difficulties of manipulation. MATERIAL AND METHODS: We have developed a method for real-time fluoroscopic cholangiograms using a new instrument designed by our group for safe LC. First, a round-tip stylet is inserted through a sheath to coax it gently through the spiral valves of the cystic duct. Secondly, the stylet is removed and the cholangiogram catheter is inserted smoothly. Digital C-arm fluoroscopy provides "real-time" imaging of biliary tree. As a result, we became able to obtain a clear cholangiogram easily in a very short time. RESULTS: In the first 136 patients, direct cholangiograms were attempted in 106 cases and successfully completed in 102 cases (96.2%). CONCLUSION: With the development of real-time fluoroscopic intraoperative direct cholangiogram, we are able to cope with bile duct injuries and anomalies, and unsuspected bile duct stones.

Adult↗