Biomedical subjects
Publications and source records attributed to K Fujimoto.
The susceptibility of Dacron grafts to infection is compared with Dacron grafts applied with levofloxacin-bonded albumin (LVFX-ALB) following the inoculation of 10(7) cells Staphylococcus aureus in rats. Staphylococcus epidermidis was inoculated in the same manner. While the control grafts were infected at the time of removal, the LVFX-ALB Dacron grafts resisted infection, thus demonstrating their effectiveness.
beta-N-Acetylglucosaminidase (EC 3.2.1.30) was purified from the outer membrane of a marine bacterium, Alteromonas sp. strain O-7. The enzyme (GlcNAcase A) was purified by successive column chromatographies. The purified enzyme was found to be homogeneous on sodium dodecyl sulfate polyacrylamide gel electrophoresis. The molecular mass and pI of GlcNAcase A were 92kDa and 4.9, respectively. The optimum pH and temperature were 6.0-7.0 and 45 degrees C, respectively. GlcNAcase A was stable up to 40 degrees C at pH 7.0, and hydrolyzed N-acetylchitooligosaccharides from dimer to hexamer. The amino-terminal 16 amino acid residues of GlcNAcase A were sequenced.
The clinical effectiveness of erythromycin for patients with diffuse panbronchiolitis (DPB) was previously recognized. However, it remains unknown what kind of airway lesions change with the clinical effectiveness induced by erythromycin. We performed the present study to clarify this unknown. We devised a method for scoring findings on high-resolution computed tomography (HRCT) to aid in the objective evaluation of the airway lesions in patients with DPB. The 18 patients with DPB were treated with oral erythromycin, 600 mg/d. All patients were evaluated by pulmonary function tests and HRCT before and after 3 months of therapy. Characteristic HRCT findings in patients with DPB pretherapy were small nodules, airway ectasia, periairway thickening, and mucus plugging. After erythromycin therapy, there was significant reduction in scores for the extent of small nodular opacities, the severity of periairway thickening, and the extent of mucus plugging with a corresponding significant improvement in results of the pulmonary function test parameters. The present study demonstrated reversible airway lesions in patients with DPB in response to erythromycin therapy.
The eosinophil count and concentrations of eosinophil cationic protein (ECP) were measured in bronchoalveolar lavage fluid (BALF) from patients with idiopathic pulmonary fibrosis (IPF), pulmonary fibrosis associated with a collagen vascular disorder (PF-CVD), sarcoidosis, and healthy controls. The patients with IPF and PF-CVD showed significant increased eosinophil count and ECP levels in BALF compared with the controls. When the patients with IPF and PF-CVD were subclassified into chronic stable, progressive, and acute progressive subgroups in accordance with the observed progression of pulmonary dysfunction during the preceding 3- to 6-month period, those in the acute progressive subgroup showed significantly elevated recovered eosinophil count and ECP level, as well as recovered lymphocyte count and total protein, albumin, and type III procollagen aminoterminal peptide-related antigens (pIIIp) in BALF, compared with either of the other two subgroups. Multivariate stepwise logistic regression analysis revealed that, among these variables, only ECP and pIIIp significantly contributed to discrimination among the three subgroups differing in disease activity. These findings suggest that eosinophils are involved in the inflammatory process in pulmonary fibrosis and that the released ECP and other cytotoxic eosinophil products may contribute to the lung injury and development of fibrosis.
We describe a patient with obstructive sleep apnea (OSA) whose apnea-hypopnea index (AHI) improved remarkably in the prone position accompanied by an improved sleep quality, despite a higher AHI in the supine position and even in the lateral position. Magnetic resonance imaging revealed the most dilated upper airway in the prone position, which suggests the role of anatomical narrowing of the upper airway as an important component in the pathophysiology of positional apnea patients. Further studies are needed to determine the therapeutic efficacy of a prone sleeping position in patients with OSA.
We describe an acute eosinophilic pneumonia (AEP) patient with bronchoalveolar lavage fluid (BALF). Eosinophil cell number (47%), content of interleukin (IL)-5 (8.22 x 10(2) pg/ml) and eosinophil cationic protein (9.25 micrograms/ml) were high in BALF. No eosinophilia was seen in peripheral blood on admission; however, content of IL-5 was 9.47 x 10(2) pg/ml. After methylprednisolone pulse therapy, he improved rapidly with a reduction in eosinophil cell number (7%) and the content of IL-5 (< 100 pg/ml) in BALF. However, a high content of IL-5 (6.9 x 10(2) pg/ml) and transient eosinophilia (17.5%) were seen in peripheral blood. It is important to distinguish between AEP and infectious pneumonia, because of the differing treatments. If the diagnosis of AEP is doubtful, BALF should be performed early.
A 35-year-old male presented with trigeminal neuralgia associated with venous angioma at the root entry zone. Magnetic resonance imaging and angiography demonstrated a venous angioma with a dilated petrosal draining vein, and displacement of the anterior inferior cerebellar artery (AICA). The AICA and dilated petrosal vein were both decompressed, resulting in complete relief from symptoms of trigeminal neuralgia for 30 months. Microvascular decompression rather than resection of venous angioma is recommended for treatment of such cases. The possibility of a venous anomaly should be considered in younger patients with trigeminal neuralgia.
Our previous study suggested that histamine might enhance the increase of ornithine decarboxylase activity in injured intestinal mucosa. To test this hypothesis, we measured histamine content in mesenteric lymph and ornithine decarboxylase activity in intestinal mucosa after ischemia-reperfusion in the rat. We examined the effect of alpha-fluoromethylhistidine, a suicide inhibitor of histidine decarboxylase, on ornithine decarboxylase activity after ischemia-reperfusion and compared this with its effect on the rat after refeeding. Ischemia-reperfusion was performed by 15-min occlusion of the superior mesenteric artery. After ischemia-reperfusion, histamine content in mesenteric lymph increased, and this increase was completely suppressed by alpha-fluoromethylhistidine pretreatment. In contrast to ischemia-reperfusion, histamine content in mesenteric lymph did not change after refeeding. Ornithine decarboxylase activity increased markedly 3 and 6 hr after ischemia-reperfusion and refeeding, whereas alpha-fluoromethylhistidine attenuated the increase in ornithine decarboxylase activity only in the ischemia-reperfusion group. These results indicate that increase in histamine synthesis in the intestinal mucosa plays an important role in the increase of ornithine decarboxylase activity after ischemia-reperfusion but that histamine is not related to the increase in ornithine decarboxylase activity after refeeding.
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Thirteen cases, including 10 relapse cases, of refractory acute myeloid leukemia (AML) (aged 17-70, median 46) by cytosine arabinoside (Ara-C) combined with granulocyte colony-stimulating factor (G-CSF) simultaneously to enhance the sensitivity to Ara-C. Low dose Ara-C (10-40 mg/day) combined with G-CSF was administered in most of them. Complete (CR) and partial remission (PR) were achieved in 5 and 4 patients, respectively, and response (CR + PR) rate was 69.2%. We obtained 5 CRs and 3 PRs in 10 patients with relapsed AML. However, CR and PR duration was short in all cases. None of the 3 patients with MO, AML transformed from myelodysplastic syndrome (MDS), and de novo AML with trilineage myelodysplasia (TMDS) had any response. There was no leukemic colony formation in the culture medium containing G-CSF in the nonresponding patients. The combination therapy caused severe myelosuppression, and most patients experienced prolonged neutropenia, and suffered from infections. In some patients enhanced chemosensitivity of leukemic cells induced by G-CSF was indicated but, the effect of this approach must be determined by large scale controlled studies.
A case of congenital patent urachus is reported. A 12-month-old boy was referred to our outpatient clinic with the complaint of watery discharge from the navel. A cystography revealed the communication between the dome of the urinary bladder and the umbilicus. Excretion from the umbilicus of indigocarmine solution instilled into the urinary bladder was recognized. There were no complicated abnormalities in other organs. The patient underwent radical operation. Herein, we collected 164 cases of urachal disorders reported in Japan and reviewed the incidence, clinical symptoms, diagnosis and treatment. The classifications of the disease were briefly discussed.
OBJECTIVE: Angiotensin converting enzyme (ACE) inhibitors have been shown to improve left ventricular dysfunction and survival in patients with chronic myocardial infarction. The aim of this study was to examine the ACE activity in infarcted tissues in such patients in comparison with non-diseased tissues from control subjects obtained at necropsy. METHODS: ACE activity was measured in the left ventricles and right atrial auricles of patients (n = 9) with chronic myocardial infarction obtained at left ventricular aneurysmectomy, and in the hearts of control subjects at necropsy (n = 10). RESULTS: In non-diseased hearts, the ACE activity was highest in right atria and auricles [2.4(SEM 0.2), 2.2(0.3) nmol.mg-1 protein.min-1, NS, respectively], followed by left atria [1.7(0.2)], left auricles [1.5(0.1)], right ventricles [1.0(0.2)], and left ventricles [0.5(0.1)]. The ACE activity was significantly increased in aneurysmal tissues of patients with chronic myocardial infarction relative to left ventricles of control subjects [4.2(0.4) v 0.5(0.1) nmol.mg-1 protein.min-1, P < 0.01]. There was, however, no difference in the ACE activity of right atrial auricles between patients with chronic myocardial infarction and control subjects [2.8(0.5) v 2.2(0.3), NS]. In patients with chronic myocardial infarction, the ACE activity was higher in left ventricles than in right auricles (P < 0.01). The ACE activities in the infarcted and control ventricles were negatively correlated with the membrane protein content (r = -0.77, P < 0.01). CONCLUSIONS: In non-diseased human hearts, the ACE activity is higher in atria than in ventricles and higher in the right than in the left ventricle. Furthermore, the ACE activity in aneurysmal left ventricular tissue after myocardial infarction is higher than in non-diseased left ventricular myocardium. These results suggest that the local ACE in the human heart may play an important role in the pathophysiological state after myocardial infarction.
A 57-year-old woman was admitted because of dry cough and middle-grade fever. Chest rentogenogram showed a diffuse infiltrative shadow in the right middle and lower lung fields. The symptoms disappeared after treatment with minocycline, but a new dense shadow appeared in the right upper and middle lung fields. Eosinophilic pneumonia was diagnosed from the results of bronchoalveolar lavage and transbronchial lung biopsy. The symptoms were alleviated and the infiltrative shadow was effaced after treatment with predonisolone (40 mg/day). The results of a biopsy with human eosinophils suggested that the serum and bronchoalveolar lavage fluid contained IL-5 and GM-CSF.
The prognostic significance of clinicopathologic factors in colorectal cancer was evaluated in a multivariate analysis. The most important independent factor affecting survival was stage (depth of penetration through the bowel wall and the presence of positive lymph nodes). All other clinicopathologic factors were of less importance than stage in determining prognosis. Although the prognostic relevance of biologic and molecular variables has been investigated extensively, the importance of these factors as prognostic predictors remains uncertain and further studies are needed.
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The detectability and signal intensity on MR imaging of mediastinal and hilar lymph nodes were studied in cases of lung cancer. Additionally, short inversion time inversion recovery (STIR) images and pathologic findings were compared. In the detection of resected metastatic mediastinal and hilar lymph nodes (n = 146), the STIR image (82%) was superior to the T1-weighted image (71%) and the T2-weighted image (60%). On STIR imaging, 212 (60%) of 412 resected non-metastatic mediastinal nodes and 38 (33%) of 116 resected non-metastatic hilar lymph nodes were detected. Characteristics of signal intensities of metastatic nodes were mainly low on T1-weighted images, high on T2-weighted images, and very high on STIR images. The rate of these characteristics of signal intensity of metastatic nodes was 59%. However, the rate of very high signal intensity of metastatic nodes on STIR imaging was 81%. Pathologically, lymph nodes with high or very high signal intensities on STIR images were metastatic, reactive and hyperplastic, or non-metastatic. Lymph nodes with slightly high signal intensity or high intensity with a low focus on STIR images were anthracotic, anthrasilicotic, caseous necrotic, calcified, or fibrotic. Thus, when the signal intensity of a lymph node was decreased on the STIR image, there was no definite evidence of metastasis excluding micro-metastasis or coagulation necrosis of a metastatic tumor. We conclude that the signal characteristics on STIR imaging are useful for distinguishing between macro-metastatic and non-metastatic lymph nodes when enlarged nodes are detected by various other types of medical imaging.
The effects of halothane on energy metabolism of isolated perfused rat kidney were studied by 31P-NMR spectroscopy. Rat kidney was perfused by physiological medium containing halothane. Perfusion was carried out continuously in addition to ischemic period of 30 or 10 minutes. In continuous perfusion study, halothane concentration below 4% did not affect renal ATP level but halothane above 6% decreased ATP level significantly. In ischemic study, changes of renal energy metabolism were not influenced by halothane below 4% throughout the experiment, but halothane above 6% decreased ATP levels significantly after reperfusion. From the viewpoint of energy metabolism, it can be said that a low concentration of halothane does not damage renal cells but a high concentration of halothane has possibility to damage them. During and after ischemic insult, halothane does not diminish renal damage, but on the contrary a high concentration of halothane reversely worsens it.
Studies were carried out to elucidate the efficacy and safety of E2078, a metabolically stable dynorphin analog, in patients with severe pain following lower abdominal surgery. E2078 was administered intramuscularly in a single dose of 1 to 15 mg. The efficacy was determined by evaluating the pain intensity score (PI) and global improvement rating (GIR) by the investigator. E2078 exhibited analgesic effect at doses of 10 mg or more. At the dose of 10 mg (n = 24). PI decreased from 3.0 to 1.3, and GIR was 83%. When the dose was increased to 12.5 mg (n = 15), PI improved from 3.0 to 1.3, and GIR was 100%. The improvement in PI, GIR and the duration of efficacy were 3.0 to 0.8, 100% and 6 hours 40 minutes with E2078 15 mg (n = 10), respectively. E2078 did not produce any adverse effects at doses of up to 15 mg. The results of the present study indicate that E2078 begins to exhibit analgesic effect at a dose of 10 mg, and at 15 mg its effect is comparable to that of pentazocine 15 mg.