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Biomedical subjects

K Harada

Publications and source records attributed to K Harada.

At least 361 records · Page 20Linked to original sources

Transition of the craniocaudal velocity of the spinal cord: from cervical segment to lumbar enlargement.

RATIONALE AND OBJECTIVES: The authors investigate the craniocaudal velocity of the spinal cord over its full length by using magnetic resonance imaging. METHODS: A spin-echo pulse sequence with velocity encoding gradients was used to examine five normal volunteers. Oblique-axial phase images at nine levels, from cervical spinal cord to lumbar enlargement, were obtained with prospective electrocardiogram gating. Time-velocity curves were then generated for these levels. RESULTS: Every part of the spinal cord moves first caudally after the R-wave of the electrocardiogram, then cranially. When compared with the cranial levels, peak velocity tend to occur later and their values tend to be smaller at the more caudal levels. CONCLUSIONS: Craniocaudal velocity is transmitted from cervical segment to lumbar enlargement.

Adult↗

Coronary risk factors in school children in relation to their family history of coronary heart disease and hyperlipidemia.

A school-based study was implemented to assess the family history of coronary heart disease (CHD) and hyperlipidemia (HL) in relation to serum lipoprotein and apolipoprotein levels. One hundred and twenty-five elementary school students (aged 9-10 years) and 297 junior high school students (aged 12-13 years) participated. Family history was evaluated by the following scoring method: positive family history in a parent, 2 points; in a grandparent, 1 point; and onset of CHD before age 60, 1 additional point. Family history of HL was positive in 8.2% of elementary school students, and 4.2% in junior high school students. Family history of CHD was positive in 11.5% of elementary students, and 11.0% in junior students. Family history score (FHS) for HL was related to serum total cholesterol (TC), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol, apolipoprotein A-I, apolipoprotein B (apoB) and lipoprotein (a) in elementary students, and to TC, LDLC, triglyceride and apoB in junior students. There was no relationship between FHS for CHD and serum lipoprotein or apolipoprotein levels in any student. The children with a positive FH of HL already demonstrated an atherogenic lipid profile while those with FH of CHD did not, which was probably because lipid profiles in children are more genetically mediated by a FH of HL than of CHD.

Adolescent↗

Relationship between fat distribution and lipid and apolipoprotein profiles in young teenagers.

The influence of obesity and fat distribution on serum levels of lipoprotein and apolipoprotein was investigated in 294 Japanese junior high school children (12-13 years of age). Serum levels of low-density lipoprotein cholesterol (LDLC) (P = 0.013), triglycerides (TG) (P = 0.0006), and apolipoprotein B (apoB) (P = 0.003), and the apoB/A-I ratio (P = 0.005) were significantly higher and serum levels of high-density lipoprotein cholesterol (HDLC) (P = 0.00003) and apoA-1(P = 0.003) were significantly lower in obese boys than in non-obese boys. The serum levels of TG (P = 0.013) and the apoB/A-I ratio (P = 0.011) were significantly higher and the serum levels of HDLC (P = 0.004) was significantly lower in obese girls than in non-obese girls. The LDLC/apoB ratio was lower in obese girls than in non-obese girls (P = 0.03). Obesity (> or = 20% of ideal weight) was strongly correlated with the serum levels of lipids and apolipoproteins in boys; this relationship was less clear in girls. The degree of obesity and the body mass index (BMI) were more strongly correlated with serum levels of lipids and apolipoproteins in boys than in girls. In boys, atherogenic lipoproteins and apolipoproteins, such as LDLC and apoB, showed a stronger correlation with the thickness of the triceps skinfold, while in girls the anti-atherogenic lipoproteins and apolipoproteins, such as HDLC and apoA-I, showed a stronger correlation with both the triceps and the subscapular skinfold thicknesses. In girls the relationships between the BMI and the degree of obesity and the thickness of the subscapular skinfold (S) thickness were similar to the relationships between those parameters and the triceps skinfold (T) thickness. In boys, these parameters showed a stronger correlation with the subscapular skinfold thickness than with the triceps skinfold thickness. The correlation coefficients for the relationships between skinfold thickness and lipid and apolipoprotein levels were similar to the coefficients for the relationships between skinfold thicknesses and the severity of obesity and the BMI. The distribution of central-type fat accumulation, which is indicated by the thickness of the subscapular skinfold, the S/T ratio and S-T value, was inversely correlated with the HDLC level in both boys and girls. The degree of obesity was strongly correlated with the atherogenic lipoprotein profile in boys, in part because the subscapular skinfold thickness was strongly correlated with the degree of obesity and the BMI. In girls, the correlations between indices of central-type obesity and atherogenic lipid and apolipoprotein profiles were stronger than in boys. These data suggest that childhood obesity may be an early cardiovascular risk factor.

Adipose Tissue↗

Myasthenia gravis with alopecia totalis.

Myasthenia gravis was diagnosed on the basis of a positive Tensilon test in a 4-year-old male child with alopecia totalis. His scalp hair and eyebrows had began to disappear at the age of 10 months. No other physical abnormalities such as motor paralysis, were seen except for left ptosis and alopecia totalis. His serum titer of anti-acetylcholine receptor antibody was elevated. No immune system abnormalities (C3, C4, CH50, C-reactive protein, antinuclear antibody or lymphocyte function disorders) were detected. Although alopecia areata and alopecia totalis are sometimes present in adults with autoimmune diseases and myasthenia gravis, this association is rare in children. The present case represents the youngest patient with myasthenia gravis associated with alopecia totalis.

Alopecia↗

Using polymerase chain reaction for rapid sex-determination of a case of sirenomelia.

A rare case of sirenomelia with its autopsy findings is reported. The 1188 g infant was delivered by cesarean section at the 36th week of gestation, and died at 4 h of life. Physical and pathologic findings included sirenomelia (a single lower extremity mass), lung hypoplasia, bilateral renal agenesis, blind-ending colon, severe deformity of the bony pelvis, an imperforate anus, absence of the bladder, and a single umbilical artery. Because of the difficulty in determining the sex of the infant, PCR directed against the SRY gene was performed. The PCR-based sex determination is a rapid technique in patients with ambiguous genitalia.

Autopsy↗

Mortality among patients with a history of Kawasaki disease: the third look. The Kawasaki Disease Follow-up Group.

BACKGROUND: Long-term prognosis of Kawasaki disease is still unclear. METHODS: In a cohort study, 6576 patients with Kawasaki disease were observed from their first medical encounter because of the disease through the end of 1994, or until death. Standardized mortality ratios (SMR) with 95% confidence intervals (CI) were calculated with vital statistics data of Japan used for the control. RESULTS: Of 6576 patients who met the eligibility criteria, 6550 (99.6%) were followed through either the end of the study or the date of death. Twenty patients (14 male, 6 female subjects) died during the study period; an overall SMR of 1.35 (95% CI 0.82-2.08) was calculated. The SMR was 1.45 (95% CI 0.79-2.44) for male subjects and 1.15 (95% CI 0.42-2.52) for female subjects. During the acute phase of the disease (the first 2 months after the first visit to hospital), the SMR was higher, particularly in male subjects (SMR 10.13, 95% CI 3.72-22.08). After the acute phase, however, both boys and girls had low SMR. Nine of the 20 deaths were caused by Kawasaki disease; there were three deaths as a result of congenital heart diseases and two subjects died of malignant neoplasms of lymphatic or hematopoietic tissues. CONCLUSIONS: Although the mortality rate among those with a history of Kawasaki disease was elevated in Japan, many of the deaths that caused the elevation occurred during the acute phase of the disease. The mortality rate was not increased after the acute phase of the disease.

Adolescent↗

Cell-kinetic study of proliferating bile ductules in various hepatobiliary diseases.

AIMS AND METHODS: Proliferat bile ductules are classifiable histologically into typical and atypical types. To clarify their histogenesis and regulation, we examined their phenotype, proliferating and degrading characteristics, using liver sections from 58 patients with various hepatobiliary diseases. RESULTS: Typical ductules were found in all cases. Atypical ductules were also frequently found in extrahepatic biliary obstruction (EBO), chronic hepatitis (CH), as well as in primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC). Typical ductules completely expressed biliary-type cytokeratins, while atypical ductules lacked complete biliary-type cytokeratins and often connected with periportal hepatocytes. Proliferative indices of typical ductules in diseased livers were higher than those in normal livers, while those of atypical ductules were low in PBC and PSC and high in EBO and CH. Apoptosis was detected in typical and atypical ductules. Perforin was preferably expressed on typical and atypical ductules, compared with CD95. CONCLUSIONS: These findings suggest that typical ductules reflect active proliferation of preexisting ductules. Atypical ductules might be classifiable into two categories: those in PBC and PSC primarily reflect ductular transformation (metaplasia) of periportal hepatocytes, while those in EBO and CH reflect active proliferation and transformation of hepatocytes. Apoptosis via perforin/granzyme B pathway may be involved in the maintenance of homeostasis in ductular proliferation as degrading fraction.

Biliary Tract↗

Mandibular stability after sagittal split ramus osteotomy without post-operative maxillomandibular fixation in the treatment of prognathic patients with symmetric mandibles.

This study was designed to examine post-operative stability in prognathic patients with symmetric lower jaws who underwent sagittal split ramus osteotomy (SSRO) of the mandible without post-operative maxillomandibular fixation (MMF). Twenty prognathic patients with symmetric mandibles were investigated. An appliance for repositioning the proximal segment and titanium screw fixation was applied in all patients. Ten patients underwent post-operative MMF with stainless steel wire (mean duration, 9.6 days) and intermaxillary rubber traction after removal of the MMF (Group I), and the remaining ten underwent intermaxillary rubber traction only (Group II) post-operatively. Cephalograms were obtained 2-3 days post-operatively, and 3, 6, and 12 months after surgery. Changes in the positions of upper incisors (U-1), lower incisors (L-1), B-point, and pogonion were examined on lateral cephalograms. In the early stages of follow-up, decreases in the overbite tended to be more marked in Group I than in Group II, and the forward movement of each standard point was significantly larger in Group I than in Group II. No significant differences, however, were revealed between the two groups at 12 months after surgery. Forward movement of anterior cephalometric landmarks, post-operatively, in Group II were significant, however, this pattern differed from Group I, in which big changes occurred in the early stages after surgery. Although the patterns of post-operative changes in the two groups are different, there are no significant differences in their post-operative stability in long-term follow-up. Therefore, post-operative MMF may be avoided when prognathic patients with symmetric mandibles undergo SSRO with an appliance for repositioning the proximal segment and titanium screw fixation.

Adult↗

Clinical features associated with the homozygous Trp64Arg mutation of the beta3-adrenergic receptor: no evidence for its association with obesity in Japanese.

To characterize the clinical features associated with the Trp64Arg mutation of the beta3-adrenergic receptor (beta3-AR), the effects of this mutation, in particular the homozygous state (Arg/Arg), on obesity, blood pressure, and plasma lipoproteins were investigated in 2 populations: subjects residing on a small isolated island (group 1; n=746) and patients residing in Tokyo who attend a clinic for metabolic diseases (group 2; n=371). The allelic frequency of the Trp64Arg mutation was 23.4% in group 1 and 18.3% in group 2. No significant difference in the body mass index was observed between subjects with 3 different genotypes in each group. There was a trend that the Arg/Arg had higher systolic blood pressure than the Trp/Trp in both groups, but the differences were not statistically significant. The plasma LDL cholesterol levels were significantly lower in Arg/Arg than in Trp/Trp in men from the group 1 cohort (2.82+/-0.84 versus 3.19+/-0.7 mmol/L, P<0.05). These results suggest that the homozygous Trp64Arg mutation is not a major contributing factor for obesity, but potentially contributed to higher systolic blood pressure and low plasma levels of LDL cholesterol in Japanese men.

Arginine↗

Synthesis and quantitative structure-activity relationships of N-(3-oxo-3,4-dihydro-2H-benzo[1,4]oxazine-6-carbonyl)guanidines as Na/H exchange inhibitors.

N-(3-Oxo-3,4-dihydro-2H-benzo[1,4]oxazine-6-carbonyl)guanidines 4 were prepared and tested for Na/H exchange inhibitory activities in order to clarify the structure-activity relationship (SAR). Quantitative SAR (QSAR) analysis of 6-carbonylguanidines 4 indicated that the length of the 4-substituent was parabolically related to activity and that the calculated optimum 4-substituents were propyl, ethyl and isopropyl groups. This SAR was similar to the SAR of the 2- and 4-substituents of 7-carbonylguanidine derivatives 3, although the position relative to the essential guanidinocarbonyl group was different. Larger 2-substituents, such as a phenyl group were unfavorable. The most potent derivative in this series was N-(4-isopropyl-2,2-dimethyl-3-oxo-3,4-dihydro- 2H-benzo[1,4]oxazine-6-carbonyl)guanidine 4 g, with an IC50 value of 0.12 microM. The methanesulfonate salt (KB-R9032) of 4g had excellent water-solubility and showed anti-arrhythmia activity against a rat acute myocardial infarction model. KB-R9032 was selected for further investigation as a therapy for ischemia-reperfusion induced injury.

Animals↗

Effect of amezinium metilsulfate on the finger skin vasoconstrictor response to cold stimulation and venoconstrictor response to noradrenaline.

Orthostatic hypotension can be caused by an inadequate vasoconstrictor response. The effects of amezinium on vasoconstrictor response to sympathetic stimulation and to exogenous noradrenaline were investigated and compared with those of midodrine. In 8 healthy men, the following experiments were performed after a single oral dose of 10mg of amezinium, 2mg of midodrine or a placebo. First, finger-tip blood flow (FTBF) was recorded using a laser Doppler flowmeter before and during the contralateral hand cooling and a reduction ratio of FTBF was calculated as an index of the vasoconstrictor response. Second, dose-response curves to increasing doses (1-512ng/min) of noradrenaline infused locally to the dorsal hand vein were determined using a linear variable differential transformer. The reduction ratio of FTBF was significantly increased (p<0.05) by amezimium [placebo, 75.9 +/- 9.8(mean +/- SD)%; amezinium, 85.1 +/- 7.9%; midodrine, 78.1 +/- 9.3%]. The infusion rate of noradrenaline producing a half-maximum venoconstriction was significantly decreased (p<0.05) by amezinium (placebo, 40.6 +/- 33.9 ng/min; amezinium, 21.0 +/- 21.3 ng/min; midodrine, 33.2 +/- 31.5 ng/min). These findings indicate that amezinium increases the vasoconstrictor response to sympathetic stimulation and to noradrenaline in normal subjects, and this mechanism might contribute to the improvement by amezinium of the symptoms of orthostatic hypotension.

Adrenergic alpha-Agonists↗

[Effects of KB-R7943, a novel Na+/Ca2+ exchange inhibitor, on myocardial ischemia/reperfusion injury].

The effects of KB-R7943 (2-[2-[4-(4-nitrobenzyloxy)phenyl]ethyl]isothiourea methanesulfonate) on major ion transporters were studied in canine cardiac sarcolemmal and sarcoplasmic reticular vesicles. KB-R7943 inhibited the Na+/Ca2+ exchange more potently than the Na+/H+ exchange, the Na+/K(+)-ATPase and the Ca2(+)-ATPase. The effects of KB-R7943 on ischemia/reperfusion-induced injury were studied in isolated rat perfused hearts in comparison with those of diltiazem and lidocaine. In normal hearts, diltiazem (10 microM) and lidocaine (100 microM) markedly reduced contractile function, but KB-R7943 (1, 10 microM) had no such effect. In the hearts subjected to 25-min ischemia and 30-min reperfusion, KB-R7943 concentration-dependently and significantly improved post-ischemic recovery of left ventricular developed pressure, left ventricular dP/dtmax and left ventricular end-diastolic pressure by pre-ischemic treatment (5 min) or post-ischemic treatment (10 min). Diltiazem and lidocaine showed similar improvement of recovery by pre-ischemic treatment, but they had no effect by post-ischemic treatment. Furthermore, the effect of KB-R7943 on arrhythmia was studied in anesthetized rats subjected to 5-min cardiac ischmeia and 10-min reperfusion. KB-R7943 (1, 10 mg/kg, i.v.) dose-dependently reduced the incidence and the duration of ventricular fibrillation. These results indicate that KB-R7943, a selective Na+/Ca2+ exchange inhibitor, has beneficial effects against myocardial ischemia/reperfusion injury and suggest that activation of the Na+/Ca2+ exchange mainly occurs immediately after reperfusion in the pathophysiological process of myocardial ischemia/reperfusion injury.

Animals↗

Effects of KRN4884 (a novel K+ channel opener), levcromakalim, nilvadipine and propranolol on endothelin-1-induced heart disorders in anesthetized rats.

The effects of KRN4884 (5-amino-N-[2-(2-chrolophenyl)ethyl]-N'-cyano-3-pyridinecarboxa midine), a novel K+ channel opener, on the electrocardiogram changes caused by the intracoronary administration of endothelin-1 (ET-1) were studied in anesthetized rats and compared with the effects of levcromakalim, a K+ channel opener; nilvadipine, a Ca2+ antagonist; and propranolol, a beta-adrenoceptor antagonist. KRN4884 (50 microg/kg, i.v.) and levcromakalim (300 microg/kg, i.v.) inhibited the ST segment elevation and the development of arrhythmias induced by ET-1 (5 microg, i.c.) and decreased the incidence of death. Nilvadipine (300 microg/kg, i.v.) and propranolol (1000 and 3000 microg/kg, i.v.) each prevented the ST segment elevation, but the suppressions of the occurrence of arrhythmias produced by nilvadipine and propranolol were less than that shown by KRN4884. KRN4884 (30 and 50 microg/kg, i.v.), levcromakalim (100 and 300 microg/kg, i.v.) and nilvadipine (100 and 300 microg/kg, i.v.) significantly decreased the mean blood pressure in a dose-dependent manner, but propranolol did not. The heart rate was decreased by nilvadipine (100 and 300 microg/kg, i.v.) and propranolol (1000 and 3000 microg/kg, i.v.), but was not affected by KRN4884 (30 and 50 microg/kg, i.v.) or levcromakalim (100 and 300 microg/kg, i.v.). These results suggest that pretreatments with KRN4884 and levcromakalim are more effective on ET-1-induced electrocardiogram changes than those with nilvadipine and propranolol.

Anesthesia↗

[An analysis on a relationship between perinatal mortality and live births of low birthweight, in Kumamoto Prefecture, 1968-1994].

The aims of this investigation were to describe the relationship between perinatal mortality rates and the proportions of live births among low birth weight (LBW) infants from 1968 to 1994, and to determine risk factors in infants of low birth weight. Using vital statistics from 1968 to 1994 of the Japanese government and the Kumamoto Prefecture and Maternal and Child Health Statistics of Japan from 1968 to 1995, perinatal deaths and live births of infants of low birth weight were studied according to national statistics criteria. In Japanese and Kumamoto Prefecture, there was an association between perinatal deaths and live births of LBW. The significant decline of perinatal mortality rates from 1968 to 1976, of which the fetal death ratio at 28 weeks and over mostly declined, was closely related to the decline of live births of LBW. In this period, the improvement of socioeconomic conditions and the comprehensive health care provided by the government contributed in improving perinatal mortality rates. From 1977 to 1988, the annual variation of Kumamoto was different from that of all Japan. Both perinatal mortality rates continued to decline due to a general decrease in early neonatal mortality rates. The number of Live births of LBW infants in Kumamoto prefecture increased in 1977 and once again started to decline in 1982. In 1977, the insufficient maternal-child health care and the increase of female workers contributed to increasing rates of live births of LBW. Advances in neonatal medicine contributed to the increase in survival rates of infants of LBW. Although, after 1982, the improvement of maternal-child health care and the perinatal care system contributed to the declining rates of live births of LBW. On the other hand, those rates in all Japan continued to gradually increase from 1977 to 1988. After 1989, perinatal mortality rates continued to decline, and live births of LBW continued to increase in both Kumamoto prefecture and all Japan. These results were contrary to the above results from 1968 to 1976. It was considered that medical advances in the care of pregnant women and neonates increased survival rates of the LBW. In future, the perinatal mortality rates will appear to approach a minimum constant, that is, a minimum of fetal death rates. It is important to reduce the number of LBW infants, particularly birthweight of 2000 g-2499 g, with maternal-child health care.

Birth Weight↗

Peak systolic stress-rate-corrected mean velocity of fiber shortening in preterm and fullterm infants.

The relation of rate-corrected mean velocity of fiber shortening (mVcfc)-end-systolic wall stress (ESS) is a load-independent index of left ventricular contractility, but involves simultaneous M-mode echocardiography, carotid or axillary pulse tracing and blood pressure determination, which may be impractical in younger infants. We examined whether the relation of the peak systolic wall stress (PSS)-mVcfc could be used as a simpler method of assessing left ventricular contractility in preterm and fullterm infants. In 45 preterm and fullterm infants, mVcfc, ESS, and PSS were determined using echocardiography, axillary pulse tracing and blood pressure measurement. Five patients with left ventricular dysfunction or low cardiac output state were also studied. The relation of PSS and ESS was PSS=5.19+1.04 ESS (r=0.98, p<0.01). The slope of mVcfc=1.58-0.012 ESS (r=-0.78, p<0.01) was nearly identical to that of mVcfc=1.60-0.011 PSS (r=-0.75, p<0.01), with no difference in the regression coefficients. The relationship of PSS and ESS in 5 patients was very close and the slope of the regression line was nearly identical to that of 45 infants. The relation of mVcfc PSS correlates well with the relation using ESS and can be used as a simple method of assessing left ventricular contractility.

Blood Pressure↗

Pilocytic astrocytoma of the velum interpositum.

A 72-year-old male presented with a pilocytic astrocytoma in the velum interpositum manifesting as a 5-day history of dizziness attacks and unstable gait. Computed tomography and T1-weighted magnetic resonance imaging with gadolinium enhancement demonstrated a small, homogeneously enhanced mass in the velum interpositum. The tumor was removed subtotally, and the structure of the splenium was intact. The histological diagnosis was pilocytic astrocytoma. The MIB-1 growth fraction was 5%. The tumor may have originated from the splenium or the thalamus. The aggressive histology indicates the need for close neuroimaging follow-up.

Aged↗

Immune function and lifestyle of taxi drivers in Japan.

Many studies have reported that stress affects the immune system. It is known that professional drivers are exposed to various forms of job-related stress. The aim of the present study was to investigate the job stress of taxi drivers based on the mitogen responses and cytokine production of peripheral blood lymphocytes (PBMC), combined with interviews on lifestyles and income. We examined randomly selected male taxi drivers aged 40-59 years who were members of the Kansai District Union of Private Railway, Hire, and Taxi at the end of 1992 and 1993. At the end of 1993, they were struck by a severe economic depression. The lymphocyte proliferative responses to phytohemagglutinin (PHA), concanavalin A (ConA), poke weed mitogen (PWM), and PHA-induced interleukin-2 (IL-2) and IL-4 production of the taxi drivers were at the same level as those of the control subjects as measured in 1992. The mitogen responses and IL-2 production of taxi drivers were found to have significantly decreased in 1993, while their IL-4 production was significantly elevated. Lifestyles of normal PHA respondents were significantly different from those of low-PHA respondents in 1992. However, in 1993, these differences were unclear. The immune alterations of taxi drivers who were prohibited from working overtime were more profound than those of the drivers who were allowed to do so. These results indicate that in addition to driving stress, the daily earnings affect taxi drivers as a strong stress or that induces immunological changes.

Adult↗