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Biomedical subjects

K Hirata

Publications and source records attributed to K Hirata.

At least 145 records · Page 8Linked to original sources
PubMed2001

Elevation of N-(carboxymethyl)valine residue in hemoglobin of diabetic patients. Its role in the development of diabetic nephropathy.

OBJECTIVE: Advanced glycation end products (AGEs) are a risk factor for diabetic complications. We have developed an assay method for N-(carboxymethyl)valine (CMV) of the hemoglobin (CMV-Hb), which is an AGE generated from HbA1c. Herein we describe the clinical utility of CMV-Hb measurement for the diagnosis of diabetic nephropathy RESEARCH DESIGN AND METHODS: BALB/c mice were immunized with carboxy-methylated Hb and monoclonal antibody raised against CMV-Hb. This antibody was characterized by a surface plasmon resonance. We developed a latex immunoassay using the antibody and measured CMV-Hb from erythrocytes in type 2 diabetic patients and healthy control subjects (age 64.6 +/- 12.0 vs. 61.1 +/- 13.2 years, NS: HbA1c 69 +/- 1.5 vs. 5.2 +/- 0.4%, P < 0.0001). RESULTS: A monoclonal antibody against CMV-Hb beta-chain NH2-terminal and an assay method for measurement for CNMV-Hb were both developed in our laboratory. CMV-Hb levels were significantly greater in the diabetic patients than in the control subjects (18.2 +/- 6.9 vs. 12.7 +/- 0.9 pmol CMV/mg Hb, P < 0.0001). No correlation was found between CMV-Hb and HbA1c or CMV-Hb and glycated albumin. Levels of CMV-Hb increased as the diabetic nephropathy progressed. CONCLUSIONS: We established an assay method for CMV-Hb and confirmed the presence of CMV-Hb in circulating erythrocytes. CMV-Hb was more prevalent in diabetic patients than in healthy subjects. Furthermore, it was significantly higher in patients with diabetic nephropathy, suggesting that the presence of CMV-Hb may be a valuable marker for the progression of diabetic nephropathy.

Animals↗
PubMed2001

Potential fascial dome made by the upper leaf of the phreno-esophageal membrane.

We describe the configuration and size of the artificial fascial dome created in 57 cadavers. This dome protrudes into the thoracic cavity from the esophageal hiatus. This dome was a potential space realized by finger dissection (i.e., a specific but common surgical procedure during surgery of the upper part of the stomach). The vagus nerves penetrated the top of the dome and ran down along the esophagus. The height of the ventral wall of the dome ranged from 10-60 mm, while the dorsal wall was 10-40 mm longer than the ventral one since the dorsal wall attached to the lower, dorsal limb of the esophageal hiatus. Accordingly, the dorsal wall separated the "thoracic" aorta from the "abdominal" esophagus. We considered that the upper leaf of the phreno-esophageal membrane forms the fascial dome, although the lower leaf of the membrane was not identified in this study. According to the results, we proposed a schematic representation of the phreno-esophageal membrane.

Aged↗
PubMed2001

Liver segment S2 is consistently located at the dorsal side of S3 but sometimes at the right and/or caudal side of S3.

After preparing the frontal section including the origin of the left portal trunk at the hilar region, the left anatomical lobes of 111 human livers were dissected to reveal the segmental configuration based on the supplying portal vein branches. S2 was consistently located dorsal to S3. However, in contrast to the description in common textbooks for medical students, 19.8% of the specimens carried a paradoxical segmental configuration showing a "caudal and/or rightward" S2 in combination with a "cranial and/or leftward" S3 in the frontal section through the ventral part of the hilar region. The caudal and rightward cases were associated with a specific arrangement of S2 and S3 segmental stems in which the S3 stem ran relatively upward to spread over S2 or both stems ran almost horizontal, respectively. In routine diagnostic radiology, identification of S2 and S3 might sometimes be biased by the generally accepted notion that S2 should be located at the dorsal, cranial and left side of S3.

Humans↗
PubMed2001

Ramification pattern and topographical relationship between the portal and hepatic veins in the left anatomical lobe of the human liver.

Sixty-one human livers obtained from donated Japanese adult cadavers were dissected to reveal the ramification pattern of the portal and hepatic veins, and their topographical relationship in the left anatomical lobe. The segmental portal vein supplying S2 (P2) tended to form a single stem, whereas that of S3 (P3) was usually double. An intermediate branch between P2 and P3 was observed in 23.0% of livers. In spite of variation between livers, definite P2 and P3 were identified in 47 specimens. One tributary of the left hepatic vein (LHV) was usually present for drainage of S2, and two tributaries were present for S3 (sometimes also for S2 and/or S4). The latter two tributaries of the LHV and the two subsegmental branches of S3 showed three patterns of three-dimensional interdigitations. From these results, the portal vein system did not seem to have a two segmental composition (i.e., S2 and S3) in 23.0% of specimens, whereas the hepatic vein system did not have an intersegmental course in 23.4%. Thus, there were obvious limitations in using each system to determine the liver segment. Taking the overlapping cases into consideration, the left anatomical lobe of 41.0% of specimens did not seem to fit the definition of Couinaud's liver segment. In addition, four patterns of fissure vein (or scissural vein), > 5 mm in diameter at its terminal, were identified: (1) middle hepatic vein type (left median vein, 9.8%); (2) LHV type (left medial vein, 41.0%); (3) true fissure vein (3.3%); and (4) absent cases (45.9%). The former two types also suggested limitations of the hepatic vein system as an indicator of the segmental border.

Adult↗
PubMed2001

[Analysis of main pigments and other ingredients in lac color product].

The contents of the main pigments and other ingredients in commercial lac color products were determined by HPLC using an RP-18 column with 0.1 mol/L citric acid buffer solution-methanol (16:5) as the mobile phase, and a photodiode array (PDA) detector set at 280 nm and 490 nm. The main pigments were confirmed by PDA and electrospray ionization mass spectrometry. Laccaic acids A, B, C and E were detected in all lac color products, and the ratio of content of laccaic acid A in all products was over 50%. The total contents of laccaic acids A, B and C in lac color food additive products and reagent products were 775-858, 797 and 779 g/kg, respectively. As for the contents of ingredients except pigments in commercial food additive products, the maximum moisture content was about 10%, and ether-soluble substances amounted to 0.5-3.6%.

Azo Compounds↗
PubMed2001

[Pathophysiological diagnosis of facial paralysis using 3-D MRI].

Bilateral facial paralysis(facial diplesia) is often observed in Guillain-Barré syndrome(GBS) and Fisher's syndrome (FS). We tried to observe injured facial nerves using three-dimensional(3-D) MRI in facial diplesia due to GBS and its variants and examined function of blood nerve barrier and clinical use of 3-D MRI for detecting injured facial nerves. In the four patients with GBS and its variants(GBS three cases, FS one case), while routine brain MRI did not show any abnormal findings, contrast-enhanced 3-D MRI revealed Gd-enhancement of the facial nerves. On the other hand, only one case showed visualization using contrast-enhanced 3-D MRI in twelve cases of Bell's palsy. Therefore, it may be presumed that the reason why the significantly higher rate of visualization in facial paralysis in GBS and its variants than in Bell's palsy is attributable to a difference in the mechanism of injury or the extreme seriousness of the disease. In conclusion, the observation of facial nerve using 3-D MRI was very useful to know the condition of the facial diplesia in GBS and its variants.

Adult↗
PubMed2001

[Configuration of the liver segment observed in the frontal section including the origin of the left portal trunk at the hepatic hilum].

After preparing threparing the frontal section including the origin of the left portal trunk at the hepatic hilum, 60 human livers (35, entirely; 25, partly) were dissected to reveal segmental configuration and the supplying portal vein branches. We usually observed two combinations of segments, i.e., S2, 4, 5 and 8 or S2, 3, 4, 5 and 8, in the frontal section including the origin of the left portal trunk. However, S8 was sometimes absent in the section when S4 extended to the right and/or upper side. S2 was consistently located dorsal to S3 despite the fact that 11.7% of the specimens carried an unexpected configuration showing a "lower" S2 in combined with an "upper" S3 in the frontal section. The latter case was associated with specific S2 and S3 segmental branches maintaining horizontal courses along a common plane. S4, S5 and S8 were usually arranged from the ventral to the dorsal aspect in this order. Four types of ventral short branches originated at or near the primary portal divisions and supplied the hilar parenchyme adjacent to S4 and/or the anterior segment (S5 or S8). These ventral short branches tended to be associated with the variations of the primary division. Dissection of the liver after frontal section provided a better understanding of the segmental configuration rather than an approach from the hepatic hilum.

Aged↗
PubMed2001

Animal model of axonal Guillain-Barré syndrome induced by sensitization with GM1 ganglioside.

Some humans develop the axonal form of Guillain-Barré syndrome after receiving bovine brain ganglioside. On sensitization with the ganglioside mixture, all of a group of rabbits injected developed high anti-GM1 IgG antibody titers, flaccid limb weakness of acute onset, and a monophasic illness course. Pathological findings for the peripheral nerves showed predominant Wallerian-like degeneration, with neither lymphocytic infiltration nor demyelination. IgG was deposited on the axons of the anterior roots, and GM1 was proved to be present on the axons of peripheral nerves. Sensitization with purified GM1 also induced axonal neuropathy, indicating that GM1 was the immunogen in the mixture. A model of human axonal Guillain-Barré syndrome has been established that uses inoculation with a bovine brain ganglioside mixture or isolated GM1. This model may help to clarify the molecular pathogenesis of the syndrome and to develop new treatments for it.

Animals↗
PubMed2001

[Pure dysarthria due to pontine infarction].

A 60-year-old man developed dysarthria in the morning. Neurological examination revealed no abnormality except for dysarthria. We diagnosed the patient as having a lacunar infarction. T2-weighted brain MRI revealed hyperintense lesion in the ventrolateral portion of the left upper pontine base. The clinical symptom completely disappeared on day 20. This is the first report on the MRI findings of the patient who showed pure dysarthria, which responsible lesion is in the pontine base. Involvement of corticopontine and corticobulbar tracts were considered to be responsible for the dysarthria in this case. This case may be useful for the somatotopy of corticopontine and corticobulbar tracts with articulation in the pontine base.

Cerebral Infarction↗
PubMed2001

Adenosquamous carcinoma of the colorectum: report of two cases.

Adenosquamous carcinomas of the colorectum are rare neoplasms. Our experience with two cases is presented in this paper. One patient, who complained of bloody stool, was found to have adenocarcinoma in the sigmoid colon. He received a laparoscopy-assisted sigmoidectomy. The histological examination revealed that the tumor was adenosquamous carcinoma. To date, he has survived six months post operatively without evidence of recurrence. The other patient, who complained of anal bleeding, was found to have rectal adenocarcinoma and received a low anterior resection. Histological examination revealed that the tumor was an adenosquamous carcinoma. He remains alive, with no evidence of recurrence, nine years post operatively. Both cases showed paracolic lymph node metastasis. Because of its very low incidence, the histogenesis, malignancy and prognosis of this disease remain unclear. Thus, further clinical and histological study of this disease entity is required.

Carcinoma, Adenosquamous↗
PubMed2001

[Bilateral chylothorax as initial manifestation of gastric cancer].

We describe a case in which bilateral chylothorax was the initial presenting manifestation of a gastric cancer (scirrhous type). A 58-year-old woman was admitted because of acute right subclavian vein thrombosis. Following admission, she complained of dyspnea on effort and on the 14th hospital day chest X-ray examination revealed bilateral pleural effusion. Biochemical tests of the pleural fluid detected chyle, and cytological examinations revealed mucinous adenocarcinoma bilaterally. An upper gastrointestinal examination revealed gastric cancer (scirrhous type). Carcinoma of the stomach has very rarely been described as the cause of chylothorax, but our findings indicate the need to rule out a gastric neoplasm in patients with chylothorax of no clear cause.

Adenocarcinoma, Scirrhous↗
PubMed2001

[A case of slowly progressive "pharyngeal-cervical-brachial variant of Guillain-Barré syndrome (PCB)"].

A 69-year-old woman was admitted to our hospital because of slowly progressive weakness in the neck, shoulders, proximal arms, oropharyngeal muscles. From a viewpoint of clinical course and signs, it was suspected that the patient was suffered from motor neuron disease. However, serial electrophysiological studies showed the existence of local demyelination of the motor nerves. The immunoadsorption was then performed and marked recovery of symptoms was obtained. In this case, we could not detect any established anti-ganglioside antibodies which was related to pharyngeal-cervical-brachial variant of Guillain-Barré syndrome(PCB) or Guillain-Barré syndrome (GBS). It is suggested that unknown anti-ganglioside antibody may play an important role in cases of PCB. Despite of atypical slowliness of clinical progression and negative results of immunological studies, this patient is considered to be suffered from PCB, because of the results of electrophysiological studies and effectiveness of immunoadsorption therapy. Accordingly it may be important to take the possibility of PCB into diagnostic consideration, whenever the patient shows slowly progressive weakness in proximal arms, oropharyngeal muscles.

Aged↗
PubMed2001

[A coronary artery bypass grafting using cardiopulmonary bypass with intraaortic balloon pumping in patient with low cardiac function combined with cerebral vascular disease].

We reported a 55-year-old man, who had coronary and cerebral vascular disease. Cerebral angiography showed occlusion at left internal carotid artery (ICA) and 50% stenosis at right ICA C4 portion. But acetazolamide reactivity was kept symmetrically. Coronary angiography showed severe three vessel disease, and left ventriculography showed diffuse severe hypokinesis/akinesis, and EF was below 30%. The patient underwent coronary artery bypass grafting using cardiopulmonary bypass with intraaortic balloon pumping to keep intraoperative blood pressure high. After the operation he recovered uneventfully without neurological complication.

Cardiac Output, Low↗
PubMed2001

Vascular endothelial growth factor C promotes human gastric carcinoma lymph node metastasis in mice.

Vascular endothelial growth factor (VEGF)-C, one of several members of the VEGF family, is a relatively specific lymphangiogenic growth factor. VEGF receptor (VEGFR)-3 (or Flt4) is a VEGF-C receptor with expression restricted to lymphatic endothelial cells. Since the mechanisms by which carcinoma cells metastasize to lymph nodes remain unclear, we constructed a VEGF-C transfectant (AZ-VEGF-C) from the AZ521 human gastric carcinoma cell line, which ordinarily shows little nodal metastatic potential and little VEGF-C expression. We orthotopically implanted transfected tumor cells into the stomachs of nude mice. The number of mice developing lymph node metastases and the number of lymph node metastases per mouse with nodal metastases were higher than with implants of mock-transfected control cells. Specifically, percentages of mice with lymph node metastases were 95.5% (21/22) for AZ-VEGF-C and 29.4% (5/17) for controls (P<0.01), while mean numbers of involved lymph nodes were 3.76 for AZ-VEGF-C and 1.00 for controls (P<0.01). No difference was found between AZ-VEGF-C and controls regarding cell growth and chemotactic responses in vitro, or in volumes of tumors arising from implanted cells. When we performed immunohistochemical staining for VEGFR-3 in these tumors to investigate lymphangiogenesis by VEGF-C, the number of vessels stained for VEGFR-3 in tumors and surrounding tissues was higher for AZ-VEGF-C than for controls. VEGFR-3-positive vessels occupied 14.9/1000 of microscopically examined areas for AZ-VEGF-C, but only 1.30/1000 for controls (P<0.001). Our results suggest that VEGF-C is a specific lymphangiogenic growth factor with an important role in lymph node metastasis.

Animals↗
PubMed2001

[Bacteria isolated from surgical infections and their susceptibilities to antimicrobial agents. Special references to bacteria isolated between April 1998 and March 1999].

The annual multicenter studies on isolated bacteria from infections in general surgery and their antimicrobial susceptibility have been conducted in Japan since July 1982. This paper describes the results obtained in fiscal 1998 (from April 1998 to March 1999). The number of cases investigated as objectives was 225 for one year. A total of 429 strains (121 strains from primary infections and 308 strains from postoperative infections) were isolated from 183 cases (81.3% of total cases). In primary infections, the isolation rates of anaerobes and Escherichia coli were higher than in postoperative infections, while in postoperative infections, those of Gram-positive aerobes and Pseudomonas aeruginosa were higher than in primary infections. On the whole, among Gram-positive aerobes, the isolation rate of Enterococcus faecalis was the highest, followed by Staphylococcus aureus with high frequency in isolation from postoperative infections. Among Gram-positive anaerobes, Peptostreptococcus spp. and Streptococcus spp. were predominantly isolated. Among Gram-negative aerobes, E. coli, P. aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae were frequently isolated. Among Gram-negative anaerobes, Bacteroides fragilis group was the majority of isolates. In primary infections, the percentage of Gram-negative aerobes has gradually increased since fiscal 1995 or 1996 with these years as the turning point, while those of Gram-positive and Gram-negative anaerobes have gradually declined. In postoperative infections, the percentage of Gram-negative anaerobes has increased continuously since the mid-1980s. The percentage of MRSA among S. aureus rose to 89.7%, which was the highest level since the beginning of this study. The susceptibilities of B. fragilis, which did not show apparent changes, were recognized to have decreased against cephems in fiscal 1998. Among other bacteria in B. fragilis group, development of resistance to cephems has continued on a long-term basis since the mid-1980s. E. coli and K. pneuminiae have obviously not changed in susceptibilities, however, the susceptibilities of isolated strains in fiscal 1998 against high-generation cephems, oxacephems and monobactams have declined. We found neither vancomycin-resistant nor teicoplanin-resistant strains of S. aureus and Enterococcus spp.

Anti-Bacterial Agents↗