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Biomedical subjects

J Wada

Publications and source records attributed to J Wada.

At least 415 records · Page 23Linked to original sources
PubMedDate not supplied

Status of glucose transporters in the mammalian kidney and renal development.

Glucose is the main source or energy for the mammalian cells and its entry is mediated via various transporters. About 7 facilitative (GULT-1 to -7) and 2 concentrative glucose transporters (SGLT-1 and -2) have been identified. The facilitative glucose transporters allow the glucose entry into the cell interior due to the concentration gradient and the latter via the Na+-dependent electrochemical gradient. They have similar structural motifs with 12-14 putative transmembrane domains with a predicted protein size varying from 50 to 76kDa. Some of the facilitative glucose transporters (GLUT-1, -2, -4 and -5) and both the sodium glucose co-transporters (SGLT-1 and -2) are expressed in the kidney. The transporters that are involved in the major transport of glucose in the kidney include GLUT-2 and SGLT-2. They are of high capacity and low affinity type and are expressed in the S1 segment of the proximal tubule. All the transporters expressed in the kidney are developmentally regulated. The mRNA expression of renal GLUTs is variable during the fetal and postnatal periods. On the other hand the mRNA of SGLTs increases steadily from the fetal period to maturity along with the increase in their functional activity, i.e., glucose uptake. Recent studies indicate that the SGLTs are believed to selectively regulate tubulogenesis since they are expressed in the metanephric tubules very early in the embryonic life in mammals.

Animals↗
PubMedDate not supplied

Relevance of aldo-keto reductase family members to the pathobiology of diabetic nephropathy and renal development.

Aldo-keto reductases (AKRs) are a family of monomeric oxido-reductases with molecular weight ranging from 35-40 kDa and currently includes upwards of 60 members. They are expressed in a wide variety of tissues, where they catalyze the NADPH-dependent reduction of various aliphatic and aromatic aldehydes and ketones. The functions of most of the family members are not well defined. But two members, aldehyde reductase (AKRIA) and aldose reductase (AKRIB), have been extensively studied. The latter has received the most attention since being relevant to the complications of diabetes mellitus. It is up-regulated during hyperglycemia, and at the same time there is an increased activity of the sorbitol pathway and non-enzymatic glycation of proteins with ensuing damage in various tissues. It is developmentally regulated in the ocular lens, and is believed to modulate lens fiber morphogenesis during fetal life. Unlike the other AKR family members that are ubiquitously expressed, recently a renal-specific oxio-reductase has been described that is expressed exclusively in the proximal tubules. Although, it has no homology with other AKR members, it binds to NADPH with high affinity and is up-regulated in streptozotocin-induced diabetes in mice. It is also developmentally regulated and seems to selectively modulate renal tubulogenesis during embryonic life.

Alcohol Oxidoreductases↗
PubMedDate not supplied

Malignant hypertension with a rare complication of pulmonary alveolar hemorrhage.

A 34-year-old Japanese male was admitted to Okayama University Hospital with severe hypertension, rapidly progressive renal failure, blurred vision, dyspnea and hemoptysis. Clinical diagnosis of malignant hypertension was given and antihypertensive therapy and hemodialysis were immediately started. Renal biopsy was performed on the sixth day in hospital to examine the underlying disease, such as microscopic form of polyarteritis, since the complaint of hemoptysis and pulmonary alveolar hemorrhage was noted by computed tomography of the lungs. Typical pathological changes of malignant hypertension, i.e. fibrinoid necrosis of the afferent arterioles and proliferative endoarteritis at the interlobular arteries were observed. There was no evidence of active necrotizing glomerulonephritis and crescent formation. Renal function was gradually recovered and pulmonary hemorrhage completely disappeared by treatment with antihypertensive agents. The authors report a case of malignant hypertension with a rare complication of pulmonary alveolar hemorrhage and speculate that it may be related to vascular injuries at the alveolar capillary level caused by malignant hypertension.

Adult↗
PubMedDate not supplied

Ultrastructure of glomerular basement membrane in active heymann nephritis rats revealed by tissue-negative staining method.

Recently, we have developed a tissue-negative staining method, and successfully visualized fine meshwork structure of the glomerular basement membrane (GBM). To clarify the mechanism of proteinuria in active Heymann nephritis, we performed tissue-negative staining and investigated the ultrastructural alterations of the GBM. Active Heymann nephritis, the animal model of human membranous nephropathy, was induced in Lewis rats by the injection of proximal tubular brush border antigen, i.e. Fx1A. Urinary protein excretion was measured and histological studies were performed over 15 weeks following the Fx1A injection. Proteinuria developed at 10 weeks after injection (38.2 +/- 7.4 mg/day) and progressively increased (160.2 +/- 20.6 mg/day at 15 weeks). Capillary fine deposits of IgG and C3 were seen by immunofluorescence, and subepithelial electron dense deposits (EDD) by transmission electron microscopy (TEM). Using the tissue-negative staining method, regular meshwork structure consisted of fine fibrils and pores (2.5 +/- 0.7 nm in short dimension) was observed in the GBM of control rats. At 10 and 15 weeks after injection, the GBM, directly facing the endothelial side of EDD, contained enlarged pores and nephrotic tunnels. Mean values of the short dimension of enlarged pores were 2.9 +/- 0.5 nm at 10 weeks and 3.1 +/- 0.4 nm at 15 weeks, which were significantly larger than that of control rats (p < 0.01). The rest area of the GBM, including newly produced GBM covering the epithelial side of EDD, had no significant difference in size of the pores from control GBM and no tunnels. Although there was no significant difference in the size of enlarged pores between 10 and 15 weeks, the percentage area of GBM with impaired size barrier increased at 15 weeks (51.4 +/- 8.1%) compared with 10 weeks (24.0 +/- 8.3%) and related to severity of proteinuria. The density of the tunnels also increased at 15 weeks. In conclusion, immune deposits may affect the GBM biosynthesis and induce the defect of size barrier of the GBM, which is responsible for proteinuria in active Heymann nephritis.

Animals↗
PubMedDate not supplied

Hematocrit as a risk factor of cerebral infarction: long-term prospective population survey in a Japanese rural community.

To elucidate the relation of hematocrit (Hct) to the incidence of cerebral infarction, a prospective follow-up study of 16 years (1965-81) was performed in a general population sample of 1220 Hisayama residents aged 44 and over, of both sexes. Most of the subjects who died during the follow-up period were autopsied, the rate being 89.0%. Hct decreased with advancing age in men, but not in women. The average value for Hct was significantly lower in women than in men. According to the mean value +/- 1 SD of Hct, the subjects were grouped into 3, in each sex as follows: low (less than 35%), normal (35-45%) and high (greater than or equal to 45%) for men, and, low (less than 30%), normal (30-40%) and high (greater than or equal to 40%) for women. During the follow-up period, cerebral infarction occurred in 117 patients. The cumulative incidence of cerebral infarction in the low Hct group for men was the lowest, even after adjustments for age and blood pressure. Conversely, the incidence in the low Hct group of women was significantly higher than that in the normal Hct group and was consistently increased with time during 2-5 years of the follow-up. After the 6th year or later, however, the incidence was gradually but significantly increased in the high Hct group, compared with the normal Hct group. Since Hct levels were related with other variables such as serum total cholesterol, serum total protein, Quetelet index and prevalence of hypertension in both sexes, heavy alcohol consumption in men, and glucose intolerance in women, such variables were taken into account using Cox's proportional hazards regression model.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Transient cerebral ischemic attacks in a Japanese community, Hisayama, Japan.

During a 20-year follow-up of 1,621 men and women aged 40 and over in Hisayama, Japan, 18 were found to have suffered transient cerebral ischemic attacks (TIAs) determined by clinical symptoms based on criteria proposed by the US Joint Committee for Stroke Facilities. The average annual incidence rate for the first TIA was 0.56 per 1,000 residents. Age and high blood pressure were strong determinants of TIAs for men. Nine of the 18 cases with TIAs (50%) subsequently developed cerebral infarction, an incidence significantly higher than that in the 1,603 subjects without TIAs (10.9%). Lacunar infarcts were most commonly found on pathologic examination of patients with TIAs who had had a subsequent stroke.

Age Factors↗
PubMedDate not supplied

Epithelial changes in or of the middle ear mucoperiosteum. An experimental study.

In this study the time necessary for the increase of the secretory cells in the middle ear mucosa was investigated by EM and SEM and by histochemical observation of the secretory cells. The first experiment revealed that a minimum of six to seven days was required for the renewal of the columnar cytoarchitecture after the exposure to silver protein solution. In the next experiment 35 guinea pigs were subjected to tubal obstruction. Columnar metaplasia was found in one case sacrificed after the third month, and gland formations without myoepithelial cells and nerve endings were seen in those after the fourth month. In an additional experiment, since the frontal sinus of the dogs is simple and pneumatized, duct obstruction was performed. Slight epithelial change and accumulation of glue-like thick mucus, which was negative in culture, was found in all four cases after three months. In one of the two cases with obstruction for four months, typical exophthalmus in the pseduostratified epithelium with an increase in secretory cells or cuboidal epithelium with nonciliated cells was demonstrated.

Animals↗
PubMedDate not supplied

Hemolysis due to aortic insufficiency following closure of ventricular septal defect.

A two-year-old girl with ventricular septal defect (VSD) developed a severe degree of intravascular hemolysis following VSD closure. The cause of hemolysis was considered to be due to the aortic insufficiency (AI) jet against the VSD patch. The patient was reoperated on the seventh post-operative day. There was a small hole on the right coronary cusp, which was closed by five interrupted sutures. However, a third operation was performed on the following day because of the reappearance of AI. The use of pericardial flap to cover the whole right coronary cusp resulted in disappearance of hemolysis. The patient was discharged in a satisfactory condition.

Anemia, Hemolytic↗
PubMedDate not supplied

Autoregulated extra- and intracorporeal pump system for perfusion.

Recent statistics indicate that one serious event occurs once in every 300 perfusions. We have devised a cybernetic approach using photosensors and pressure sensors at critical points of the circuit which should allow feedback regulation of the bypass according to the changes in venous return. In order to avoid overtransfusion, left atrial pressure control is employed. This also enables automatic weaning and facilitates partial bypass. In the clinical setting a test system proved to be accommodated to prevent gross air contamination of the arterial line. Based on vast clinical experience with the conventional method of extrapulmonary circulation, the logical extension of this work will be the development of a compact pump oxygenator utilizing hemofilters, the pump portion of which can be temporarily implanted until the cardiac function has been restored. It is autoregulated and, if the need arises, controlled by the anesthetist, one of whose primary concerns will be physiological perfusion.

Adult↗
PubMedDate not supplied

New wire suture for sternal fixation.

A new sternal fixation wire, 60 cm in length, was tested clinically. The center portion of the wire is 30 cm in length and 0.8 mm in diameter, while the two end portions of the wire are 15 cm in length and 0.3 mm in diameter. A drill or gimlet with a small hole in the tip was employed to bore a hole in the sternum. The thin ends of the wire were inserted into the hole of the drill, making it easier to pass the wire through the sternal bone. We have found wire penetration through the sternum to be simpler and less traumatic using this technique.

Humans↗
PubMedDate not supplied

Chronic dissecting aorta aneurysm: a medical or surgical disease?

The surgical results obtained in 40 cases of chronic dissecting aorta aneurysm are reported and compared with the results obtained in medically treated cases. Improved results with improved surgical techniques are described and the superiority of surgical treatment as opposed to medical treatment is stressed. Although mortality is decreasing, it is still very high and many surgical problems remain unsolved.

Adult↗