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Biomedical subjects

J Sugihara

Publications and source records attributed to J Sugihara.

At least 37 records · Page 2Linked to original sources

Psychiatric liaison issues in cancer care in Japan.

To clarify the psychiatric liaison issues in Japan, this paper briefly introduces a survey of physician attitudes and practices regarding cancer care in Japan and preliminarily reports on an "active" liaison program developed at one Japanese general hospital. The survey of physicians from 31 teaching hospitals, including all cancer centers, revealed that 56% of physicians do not inform patients of a diagnosis of cancer. Thus, actual psychiatric consultation referrals were very few due to the physician's fear of harming his relationship with the cancer patient. One medical unit, in which about one-quarter of the cancer patients were told their diagnoses by the unit chief physician, showed significantly higher rates of psychiatric consultation after the introduction of an "active" liaison program in that hospital. These results suggest that the liaison program can positively influence the rate of psychiatric consultation referrals for cancer patients when the physician discloses the diagnosis to the patient. Consultation-liaison psychiatry in cancer care is expected to develop in Japan, because most physicians report a trend toward informing patients of their cancer diagnosis.

Attitude of Health Personnel↗

Natural killer cell may impair liver regeneration in fulminant hepatic failure.

The authors established a new experimental model of fulminant hepatic failure (FHF) with prolonged hepatocellular necrosis and impaired liver regeneration, and evaluated the immunological mechanisms related to the impaired liver regeneration in this model. A novel lipid A analogue, FS-112, was injected intravenously into male Balb/c mice, followed by a 70% partial hepatectomy 2 days later. Serum levels of T.Bil. and ALT rose 7 days after the partial hepatectomy, as compared with controls. In mice pretreated with FS-112, labeling indices of both BrdU and PCNA 36 hrs after the partial hepatectomy were significantly lower than those in the controls. Splenic lymphocytes harvested from the FHF mice 1-5 days after the partial hepatectomy showed a cytotoxic activity against regenerating hepatocytes with a peak effect on day 5. Cytotoxic activity against YAC-1 cells was also found up to 5 days after the partial hepatectomy, and resembled that directed against the regenerating hepatocytes. On the 5th day of FS-112 administration, there was a marked rise in the production of IFN-gamma from splenocytes. When FK-506, an immunosuppressive agent, was given intracutaneously daily for 7 days, serum levels of T.Bil. and ALT significantly decreased, as compared with controls. Furthermore, the PCNA-labeling index 36 hrs after the partial hepatectomy was enhanced by the administration with FK-506 in the FHF mice. These results strongly suggest that the NK cells activated by IFN-gamma may be involved in killing the regenerating liver cells, and thus play a role in the pathogenesis of the impaired liver regeneration in FHF.2+ recovery from the impaired liver regeneration in FHF.

Animals↗

[Determination and clinical significance of human hepatocyte growth factor in serum].

Hepatocyte growth factor (HGF) is the most potent mitogen for mature parenchymal hepatocytes in primary culture, and seems to be a hepatotrophic factor that acts as a trigger for liver regeneration after partial hepatectomy and liver injury. In the present study, we evaluated an enzyme-linked immunosorbent assay, using monoclonal antihuman HGF (h-HGF) antibody, for measuring serum h-HGF levels. Intra- and inter-assay coefficients of variation were 2.2-3.3% and 3.4-4.0%, respectively. Detection limit of this method was 0.1 ng/ml, determining by the dilution test. The substances tested did not interfere with this assay, except for high concentrations of hemoglobin. Furthermore, no interference was observed with plasminogen and lipoprotein (a), which show the structural homology to h-HGF, and with various kinds of cytokines. Reference ranges of serum h-HGF determined with 187 healthy subjects were 0.1-0.23 ng/ml. Serum h-HGF concentrations were increased in various kinds of liver diseases, in particular those were significantly higher in fulminant hepatic failure. Furthermore, prognosis of the patients with higher h-HGF values were strikingly worse than those with lower levels. We concluded that the determination of serum h-HGF plays important roles in the early diagnosis and prognosis of fulminant hepatic failure.

Antibodies, Monoclonal↗

Detection of anti-hepatitis C virus antibody in fulminant hepatic failure.

Serial serum samples obtained from 27 patients with fulminant hepatic failure (FHF) in a variety of etiology were tested for anti-hepatitis C virus antibody (anti-HCV) with uses of two different assay systems. The incidence of anti-HCV in patients with FHF due to hepatitis B (Ortho test system; 7/11, 63.6%: Abbott test system; 9/11, 81.8%) was found to be significantly higher than that in acute HBV hepatitis (Ortho test system; 0/17, 0%) (P less than 0.001). In particular, all 3 post-transfusion HBV-FHF patients were positive for the antibody using both Ortho and Abbott test systems, and cut-off index in those patients was serially increased. On the other hand, cut-off index in anti-HCV positive patients with sporadic hepatitis A virus (HAV)- and HBV-FHF was high even prior to plasma exchange therapy, and gradually decreased. These results strongly suggest that in patients with post-transfusion HBV-FHF, HCV was superinfected over HBV and in the sporadic HAV- and HBV-FHF patients, HAV or HBV were co-infected over HCV carrier. In any events, co-infection and/or superinfection of HCV may play an important role in the development of this fatal disease.

Chi-Square Distribution↗

[Simultaneous coronary artery bypass grafting and cholecystectomy: a report of three cases].

The frequency of patients requiring non-cardiac surgery complicates ischemic heart disease (IHD) is increasing, however, there have been few reports of combined coronary revascularization and abdominal surgery. In this paper, we describe three patients with IHD and cholecystolithiasis in whom simultaneous coronary artery bypass grafting (CABG) and cholecystectomy was successfully performed. Initially, CABG was performed employing standard extracorporeal circulation through median sternotomy. After closure of chest, cholecystectomy was carried out through right pararectal laparotomy. Their postoperative course was uneventful. Relief of angina and freedom from epigastralgia were obtained in all patients. Combined CABG and cholecystectomy is beneficial for the selected patients.

Aged↗

Anti-hepatitis C virus antibody prevails in fulminant hepatic failure.

Serial serum samples obtained from 27 patients with fulminant hepatic failure (FHF) in a variety of etiology were tested for anti-hepatitis C virus antibody (anti-HCV). Seven out of 10 patients (70%) with FHF due to hepatitis B virus (HBV) infection were positive for anti-HCV, showing a significantly higher rate than that in acute HBV hepatitis (0/17, 0%): In particular, all 3 post-transfusion HBV-FHF cases were found to be positive for the antibody. The incidence of anti-HCV in sporadic non-A non-B (NANB)-FHF patients (7/11, 64%) tended to be greater than that in acute sporadic NANB hepatitis as recently surveyed in this country. In addition, anti-HCV was also detected in a patient with hepatitis A virus (HAV)-FHF and in 2 out of 4 drug-induced FHF patients. Moreover, anti-HCV appeared earlier in FHF (median; 27.5 days, n = 9) regardless of etiology, when compared to acute NANB hepatitis (3 to 6 months). Hence, co-infection and/or superinfection of HCV with enhanced antibody response may play an important role in the development of this fatal disease.

Acute Disease↗

Clinical significance of human hepatocyte growth factor in blood from patients with fulminant hepatic failure.

We have recently found the presence of human hepatocyte growth factor in sera of patients with fulminant hepatic failure and have purified human hepatocyte growth factor from plasma of a patient with fulminant hepatic failure. In this paper, we report the clinical significance of human hepatocyte growth factor in blood from patients with fulminant hepatic failure. The effect of sera or plasma from 17 patients with fulminant hepatic failure on liver cell growth was examined by use of adult rat hepatocytes in primary cultures. Sera or plasma from 16 of the 17 patients with fulminant hepatic failure stimulated DNA synthesis in hepatocytes more effectively than normal human serum. The mean growth-promoting activity for the 17 patients with fulminant hepatic failure was about 16 times higher than that obtained for normal human serum. This growth-promoting activity of the patients' blood was not related to sex, age, clinical outcome of the patients or type of fulminant hepatic failure, but was intimately related to the clinical grade of hepatic coma. Sera or plasma with Grade III and IV coma showed stimulatory activity on DNA synthesis more markedly than sera or plasma from patients with coma of less than Grade II. In the surviving group, this activity decreased as the hepatic coma of patients improved. In fact, this activity of sera from patients at the recovery stage showed no significant increase compared with that of normal human serum. In the group of terminal patients, this activity increased as the coma developed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Electron microscopic study of the blood-brain barrier in rats with brain edema and encephalopathy due to acute hepatic failure.

An electron microscopy study was conducted to investigate structural as well as functional changes of the blood-brain barrier in hepatic encephalopathy. Hepatic encephalopathy was induced in rats by two-stage hepatic devascularization producing ischemic liver damage. The permeability of the blood-brain barrier to lanthanum, horseradish peroxidase and [3H]inulin was determined, with electron microscopy performed on capillaries from different regions of rat brain. Marked swelling of the perivascular astroglial foot process and dilatation of extracellular spaces were observed in the cerebral cortex, pons, basal ganglia and cerebellar cortex in rats with acute hepatic failure. Diffusion of lanthanum and reaction products of horseradish peroxidase were completely restricted by intercellular tight junctions, but there was a significant increase in the amount of [3H]inulin leaking out of the capillaries in the cerebral cortex in rats with acute hepatic failure as compared with controls. [3H]inulin was found mainly in vesicles, vacuoles and endoplasmic reticulum. Our results indicate that brain edema in acute hepatic encephalopathy is mainly of the cytotoxic type and, to a lesser extent, of the vasogenic type, due to the increase of vascular permeability via the vesicle system.

Animals↗

Tetramer Bence Jones protein in the immunoproliferative diseases. Angioimmunoblastic lymphadenopathy, primary amyloidosis, and multiple myeloma.

The authors report the clinical features and the results of immunochemical studies of patients with angioimmunoblastic lymphadenopathy, primary amyloidosis, and multiple myeloma, each of whom had in the serum and urine multiple forms of Bence Jones protein (BJP). The BJPs were isolated and purified and were shown by electrophoretic, gel filtration, and ultracentrifugal analyses to exist as tetramers and dimers. The components in two cases were kappa type and in one lambda type. The kappa tetramers consisted of two covalent dimers and the lambda tetramer two noncovalently bound dimers present in both serum and urine.

Aged↗

[Enzymatic determination of a molar ratio of free branched-chain amino acids to tyrosine (BTR) and its clinical significance in plasma of patients with various liver diseases].

A molar ratio of free branched-chain amino acids to tyrosine (BTR) was determined in the plasma of patients with liver diseases using a new enzymatic method. In addition, clinical significance of BTR was studied by comparing particularly with that of Fischer's ratio (a molar ratio of branched-chain amino acids to aromatic amino acids (tyrosine+phenylalanine], which was obtained by conventional HPLC (Amino acid autoanalyzer, Hitachi 835). Following results were obtained: 1) Enzymatically determined branched-chain amino acids and tyrosine showed significant correlations with respective results obtained by HPLC (r = 0.937, 0.972). 2) Significant correlation was also found between enzymatically determined BTR and Fischer's ratio obtained by HPLC. Changes of BTR in clinical courses were found to be in parallel with those of Fischer's ratio. 3) BTR as well as Fischer's ratio correlated significantly with ICG R15, KICG, prothrombin time (%) and serum albumin level. 4) BTRs in patients with decompensated liver cirrhosis or with fulminant hepatitis were significantly lower than those in patients with acute or chronic hepatitis. In conclusion, new enzymatic assay of branched-chain amino acids and tyrosine as described here is quite simple method, and is also considered to be very useful parameter of the clinical conditions of patients with liver diseases, particularly representing the severity of liver diseases and the protein nutritional status.

Amino Acids, Branched-Chain↗

Rubidium (Rb) treatment of rats: biological effects and implications for psychiatry.

Experiments were carried out on rats in order to find out the implications for psychiatry of the basic biological effects of rubidium (Rb). The forced swimming test (FST), used to evaluate the effects on rats of treatment with Rb, was conducted after 1 or 3 mEq/kg Rb was given chronically or subacutely. The weight of rats treated with 1 or 3 mEq/kg Rb, once daily, was observed daily for two weeks. Rb levels in the blood and brain of rats treated with Rb chronically or subacutely were determined by atomic absorption spectrophotometry. The rectal temperature was observed at 30, 60, 90, 120, 180, and 240 min after injections of 1 or 3 mEq/kg Rb. The increase in the mean body weight of treated rats was almost the same as that of the control. The rectal temperature in rats treated with Rb showed a hyperthermic response. With both the 1 and 3 mEq/kg Rb treatments, Rb levels in the brains were significantly higher in the chronic experiments than in the subacute experiments. The experiments conducted to determine the effect of chronic and subacute treatment of Rb are hereafter termed 'chronic experiment' and 'subacute experiment' respectively. Almost the same significant difference was also observed in the Rb levels in the blood. In the FST, a decrease in the mean immobility time was not observed in either the subacute or the chronic experiments. Thus, antidepressant effects, as judged from the FST, were not observed although Rb did actually accumulate in both brain and blood.

Animals↗

Effects of 3' end deletions from the Vibrio harveyi luxB gene on luciferase subunit folding and enzyme assembly: generation of temperature-sensitive polypeptide folding mutants.

Ten recombinant plasmids have been constructed by deletion of specific regions from the plasmid pTB7 that carries the luxA and luxB genes, encoding the alpha and beta subunits of luciferase from Vibrio harveyi, such that luciferases with normal alpha subunits and variant beta subunits were produced in Escherichia coli cells carrying the recombinant plasmids. The original plasmid, which conferred bioluminescence (upon addition of exogenous aldehyde substrate) on E. coli carrying it, was constructed by insertion of a 4.0-kb HindIII fragment of V. harveyi DNA into the HindIII site of plasmid pBR322 [Baldwin, T.O., Berends, T., Bunch, T. A., Holzman, T. F., Rausch, S. K., Shamansky, L., Treat, M. L., & Ziegler, M. M. (1984) Biochemistry 23, 3663-3667]. Deletion mutants in the 3' region of luxB were divided into three groups: (A) those with deletions in the 3' untranslated region that left the coding sequences intact, (B) those that left the 3' untranslated sequences intact but deleted short stretches of the 3' coding region of the beta subunit, and (C) those for which the 3' deletions extended from the untranslated region into the coding sequences. Analysis of the expression of luciferase from these variant plasmids has demonstrated two points concerning the synthesis of luciferase subunits and the assembly of those subunits into active luciferase in E. coli. First, deletion of DNA sequences 3' to the translational open reading frame of the beta subunit that contain a potential stem and loop structure resulted in dramatic reduction in the level of accumulation of active luciferase in cells carrying the variant plasmids, even though the luxAB coding regions remained intact.

Amino Acid Sequence↗