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Biomedical subjects

K Kashima

Publications and source records attributed to K Kashima.

At least 163 records · Page 9Linked to original sources

Ischemic colitis during interferon-alpha treatment for chronic active hepatitis C.

Between 1991 and 1994, at Hoshigaoka Koseinenkin Hospital, we treated 280 patients with chronic hepatitis C with interferon (IFN), and ischemic colitis occurred in two patients (0.7%) during the treatment. Melena appeared in case 1 in the 2nd month after the initiation of IFN-alpha treatment, and in case 2 in the 6th month. In both patients, longitudinal ulcerations in the descending colon were revealed by urgent colonoscopy, and these resolved within 2 weeks after discontinuation of the IFN treatment. It appears that ischemic colitis was associated with the IFN treatment, suggesting that attention should be paid to this possible complication.

Aged↗

Hypertonic glucose impairs glucose-induced increases in cytosol Ca2+ concentration and insulin secretion by HIT-T 15 cells.

To evaluate the mechanism of an impaired insulin secretion under diabetic state, we studied the influence of graded degrees of isotonic and hypertonic glucose on the rise in cytosol Ca2+ concentration ([Ca2+]i) and insulin secretion by HIT-T 15 cells. [Ca2+]i was monitored with Fura-2 and insulin secretion was measured with static culture. Both isotonic and hypertonic glucose induced a dose-dependent [Ca2+]i rise and insulin secretion. Although low degrees of isotonic and hypertonic glucose (5 and 15 mM) were equally effective to cause both increases in [Ca2+]i and insulin secretion, high degrees of isotonic glucose (30 and 60 mM) were clearly more effective than the same degrees of hypertonic glucose. The addition of 30 mM sucrose in isotonic 30 mM glucose also decreased the induced increases in [Ca2+]i and insulin secretion, and isotonic sucrose was ineffective in inducing either an increase in [Ca2+]i or insulin secretion. Removal of medium Ca2+ inhibited the 30 mM isotonic glucose-induced [Ca2+]i rise and insulin secretion. These data suggest that an impaired rise in [Ca2+]i, which was caused by blocking of Ca2+ influx due to hyperosmolarity, may be one mechanism by which glucose can not stimulate appropriate insulin secretion under diabetic state.

Calcium↗

Side effects of high-dose interferon therapy for chronic hepatitis C.

BACKGROUND/AIMS: Various side effects have been reported in patients treated with alpha interferon, but their incidence and prognosis remain unknown. METHODS: Nine hundred and eighty-seven patients with chronic active hepatitis C received 6 to 10 MU of alpha interferon per day for 2 weeks and 3 times per week for 22 weeks. Autoantibodies, thyroid function tests, and fasting plasma glucose concentrations were evaluated prior to alpha interferon therapy. RESULTS: Of the 987 patients, 310 were required reduction in the dose of alpha interferon to 3 MU/day or cessation of alpha interferon therapy because of adverse reactions such as flu-like symptoms, leukopenia, and thrombocytopenia. Of the remaining 677, five developed diabetes mellitus, 12 had hyperthyroidism, and six acquired hypothyroidism. Of the 18 with thyroid disorders, five demonstrated antimicrosomal antibodies before therapy. Forty-four patients revealed high or low concentrations of thyroid stimulating hormone at the end of alpha interferon therapy. Three patients developed interstitial pneumonia, one acquired systemic lupus erythematosus-like syndrome, two had autoimmune hepatitis, two developed rheumatoid arthritis, and one developed autoimmune thrombocytopenic purpura. No patients had a history of an autoimmune disorder. One patient experienced sudden hearing impairment and one had retinal detachment. Melena was seen in three patients; two of these cases were compatible with ischemic colitis. Symptoms of depression were seen in 23 patients, and one patient manifested memory loss. CONCLUSION: High-dose alpha interferon therapy induces various adverse effects. Most of the side effects cannot be predicted, but are reversible.

Adult↗

Second case of zoonotic Onchocerca infection in a resident of Oita in Japan.

A non-gravid female Onchocerca was found in histopathological sections of a biopsy specimen taken from a painful nodule in the wrist of a 57-year old woman in Oita, in southern Japan. Six species of Onchocerca have been found in animals in Japan: two in wild bovids, one in equids, and three in domestic bovids of which one, Onchocerca sp., is only known by the microfilaria and infective stage. Distinctive morphological features of the worm, including a three-layered thick cuticle with prominent annular ridges at wide intervals, high somatic muscles and narrow lateral chords, resembled those of O. gutturosa, one of the three bovine Onchocerca species transmitted in the Oita region. However Onchocerca sp., which is also transmitted in this region, cannot be excluded. An ELISA test of the patient serum suggests that infections by Onchocerca spp. might be distinguished from those by Dirofilaria immitis, of which the number of human cases is increasing in Japan.

Animals↗

Synthesis of secretory protein in regenerating liver of rat after partial hepatectomy.

Albumin immunoreactivity in the liver was examined on days 2, 5 and 10 after two-thirds partial hepatectomy by light and ultrastructural immunoperoxidase methods and the ultrastructural area of the rough endoplasmic reticulum (ER) in hepatocytes was measured. Albumin immunoreactivity was seen in the rough ER and Golgi apparatus of all hepatocytes in the hepatectomized liver and ultrastructural analysis showed a significantly greater area of rough ER on day 5 than on days 2 or 10. Albumin mRNA was studied by the in situ hybridization technique using radioisotopes and their numbers were determined visually. Albumin mRNA was present as grains in all hepatocytes and the grains varied in number during regeneration of the liver, being more abundant on day 5 than on days 2 or 10. The activity of [3H]-leucine incorporated into albumin synthesis, an indicator of translational activity, was higher on days 5 and 10 than on day 2 and was highest on day 5. In conclusion, albumin synthesis varied during liver regeneration after partial hepatectomy, being reduced at the peak of cell proliferation on day 2 and being most active on day 5.

Albumins↗

Haemodynamic effects of combined treatment with molsidomine and propranolol on portal hypertension in conscious and unrestrained cirrhotic rats.

We investigated the systemic and splanchnic haemodynamic effects of combined treatment with molsidomine and propranolol on cirrhotic rats. Liver cirrhosis was produced by repeated intraperitoneal injections of thioacetamide. The blood flow of each organ was measured serially using the radioactive microsphere method in the awake state before and after the administration of each agent. Cirrhotic rats received molsidomine (0-.5 mg/kg), propranolol (0.1 or 0.2 mg/min), both agents or placebo. Combination treatment with molsidomine and 0.1 mg/min propranolol significantly reduced portal pressure compared with molsidomine or propranolol alone (21 +/- 4 vs 15 +/- 3 or 11 +/- 2% P < 0.05). Systemic haemodynamic changes with this combined treatment were mild. This combined treatment slightly inhibited the molsidomine-induced decrease in portal vascular resistance (27 +/- 9 vs 31 +/- 6; NS) and markedly inhibited the molsidomine-induced decrease in splanchnic arterial resistance (7 +/- 6 vs 27 +/- 5% P < 0.05). Compared with low-dose propranolol administration, the combined treatment was associated with a significant decrease in portal vascular resistance (27 +/- 9% decrease vs 2 +/- 2% increase; P < 0.001) and a significant decrease in splanchnic arterial resistance (7 +/- 6% decrease vs 5 +/- 4% increase P < 0.05). The combination of molsidomine and high-dose propranolol (0.2 mg/min) caused a marked reduction in portal venous inflow, mean arterial pressure and cardiac index. We conclude that propranolol enhances the molsidomine-induced decrease in portal pressure by splanchnic vasoconstriction in association with a slight decrease in portal vascular resistance. The combination therapy with molsidomine and low-dose propranolol combination had more beneficial and less harmful effects on systemic and splanchnic haemodynamics and thus appears to be a superior method for treating portal hypertension.

Animals↗

Oncofetal expression of blood group-related antigen on morules in thyroid carcinoma.

Morule formation in association with characteristic biotinrich 'optically clear nuclei' were found in 7 of 2514 cases of thyroid carcinoma. The seven patients were all young females aged from 20 to 36 years who were suffering from either papillary carcinoma (six cases) or follicular carcinoma (one case). The ABH (O) blood group (BG) types were A in three, AB in two and H(O) in two patients. Immunohistochemical study revealed that ABH(O) and Lewis BG antigens were expressed more specifically on morules than on ordinary neoplastic cells of papillary or follicular carcinoma. Lewis BG antigens tested in the present study were as follows: CA50, CA19-9, stage-specific embryonic antigen 1 (SSEA-1), and sialyl SSEA-1. Ulex europaeus agglutinin I (UEA-I) histochemistry showed a positive reaction on all the morules of blood groups A and H(O) patients, but yielded completely negative results on the morules of type AB patients. Sequential digestion by neuraminidase and alpha-galactosidase unmasked the reactivity for UEA-I even on the morules of type AB patients. The consistent reactivity for UEA-I on the morules seemed to be related to specific expression of BG antigens, which were characterized as oncofetal expression. It is suggested that the morules in thyroid carcinoma might be a kind of fetal component induced by the differentiation of the neoplastic cells to the stage of immature embryonic cells.

Adenocarcinoma, Follicular↗

Insular component as a risk factor of thyroid carcinoma.

Forty-four thyroid carcinomas with an insular component (IC) were reviewed from 2457 tumors diagnosed as papillary (PC) or follicular carcinoma (FC). These tumors were classified as FC with an IC (FCIC; 30 cases) and PC with an IC (PCIC; 14 cases). Both tumors were composed of solid cell nests in some areas and had a tendency toward a characteristic nuclear size: FCIC had a small nucleus and PCIC contained a nucleus of an intermediate type or a large nucleus similar to that of PC, although there were numerous tumors with an exceptional nuclear size. The mean age and tumor diameter were the highest and largest in FCIC, respectively, followed by PCIC. Among the 44 cases, 17 patients died of the disease, two were alive with the disease and 18 were alive without the disease. From 13 clinicopathological factors, the presence of an IC, age, non-encapsulation, tumor size, vascular invasion and necrosis were found to be independent variables for actual prognosis of FC and PC based on univariate analysis followed by multivariate analysis. The results of the present study indicate that the presence of an IC is an independent aggressive prognostic factor for patients with PC and FC.

Adenocarcinoma, Follicular↗

Circulating HCV-RNA, HCV genotype, and liver histology in asymptomatic individuals reactive for anti-HCV antibody and their follow-up study.

The present study was aimed to clarify the virologic status, liver histologies, and the results of follow-up liver tests in symptom-free individuals with anti-HCV antibodies and normal liver tests. Forty-nine individuals with normal liver tests and positive second generation anti-HCV antibody assay were entered into this study. Cases with hepatitis C viremia were evaluated for HCV genotype, amount of circulating HCV-RNA, and liver histology and were followed-up for more than one year. Of the forty-nine individuals, 36 had hepatitis C viremia, indicated by polymerase chain reaction (PCR) assay. Liver histology was as follows: 3 had non-specific changes, 25 had chronic persistent hepatitis (CPH), and 8 had chronic active hepatitis (CAH). Twenty-four cases with CPH and CAH developed an elevated AST and/or ALT concentration (> 30 IU/l) between 12 and 32 months of follow-up. The amount of circulating HCV-RNA ranged from 10(2) to 10(7) copies/50 microliters serum. The distribution of HCV genotypes was nearly the same as that for symptomatic CAH. These data suggest that the histological examination and follow-up examination are very important for following symptom-free individuals with hepatitis C viremia because there are some candidates for interferon therapy among them. There are few individuals who will remain healthy among asymptomatic HCV carriers.

Adult↗

Pulmonary surfactant migrates into the alveolar capillaries of newborn rats: an immunoelectron microscopic study.

The goal of the present study was to elucidate the migration of surfactant-like material into the alveolar capillaries of newborn rats. The lungs of experimental animals were studied by ultrastructural techniques-standard electron microscopy as well as immunoelectron microscopy-using antibodies against synthetic polypeptide complementary to the noncollagenous part of surfactant protein A (SP-A). Antibodies exhibited specific reaction with native rat SP-A in Western blot and immunohistochemical analysis. Surfactant was observed in the alveolar space, type II pneumocytes, macrophages, type I pneumocytes, endothelial cells, the extracellular space of the alveolar septa and in the alveolar capillaries. Lamellar structures observed in all elements of the blood-air barrier as well as in the alveolar capillaries were stained positively with anti-SP-A antibodies. Transport of the pulmonary surfactant into the circulatory system was observed more frequently during the first 6-8 h of extrauterine life of newborn rats, although it was also seen in the blood vessels till 48 h after delivery. The results of our investigation suggest that clearance of surfactant via the circulatory system plays an important role in the early postnatal period.

Animals↗

The connective tissue compartment in the terminal region of the developing rat lung. An ultrastructural study.

The present study was designed to analyze the connective tissue compartment in the terminal region of the developing rat lung. Lungs of rat fetuses (at 17, 19 and 21 days of gestation) and of newborns (2, 4, 7, 10, 14 and 21 days after birth) were examined by several ultrastructural techniques; staining with tannic acid for elastic fibers (EFs), collagen fibers (CFs) and basement membranes (BMs); staining with ruthenium red for glycosaminoglycans; and immunoelectron microscopy for visualization of collagen type IV, laminin and fibronectin (FN). Dynamic changes in the levels and distribution of the components of the extracellular connective tissue were observed in parallel with the formation and maturation of the alveoli. The terminal regions of the respiratory tract of the rat fetus and of the lungs of early newborns contained few CFs and EFs, and the Bms in these lungs were incomplete. However, strong immunolabeling of FN was observed (in BMs, CFs and in spaces among fibroblasts). Starting from 4 to 7 days newborns had increasing numbers of Cfs and EFs and BMs became more extensive. In rat newborns, immunolabeling specific for FN was weak and irregularly distributed. Furthermore, the present results provide a summary of the changes in connective tissue that occur in the rat lung during different stages of its development, from the pseudoglandular stage, through the canalicular and saccular stages, to the alveolar stage.

Animals↗

Delineation of premature P waves on four-dimensional electrocardiography, a new display of electrical forces by computer techniques.

This study investigated the feasibility of four-dimensional electrocardiography (4-D ECG), a new display in which the vector loop was rotated and scanned along a timed axis to overcome the shortcomings of vectorcardiography (VCG). The subjects consisted of 38 patients with premature atrial complexes and 30 controls. The orthogonal Frank electrocardiograms were rotated three-dimensionally according to the right-hand rectangular coordinate system and scanned along a timed axis. The P wave delineation score, signifying good agreement with the intraobserver and interobserver variability, was significantly higher in 4-D ECG than those in the orthogonal leads or those on the transverse and frontal projections (P < 0.001). The authors measured the premature P loop areas as viewed from 361 directions. P loop areas were best delineated when viewed from cranial directions of 42.6 +/- 34.0 degrees and from rightward directions of 11.3 +/- 30.7 degrees. Adequate cranial rotation followed by scanning along a timed axis will maximally delineate premature atrial signals and provide comprehensive visualization of electrical forces.

Atrial Premature Complexes↗

c-myc expression is associated with increased proliferation activity in thyroid follicular cells of Graves' disease as stimulated by autoantibodies.

Expression on thyroid follicular cells of HLA-DR, c-myc protein and proliferating cell nuclear antigen (PCNA) was examined immunohistochemically in 28 cases of Graves' disease (GD) and in 29 cases of Hashimoto's thyroiditis (HT). Immunoreactivity for PCNA in GD was seen not only in follicular cells adjacent to a lymphocytic infiltration, where the follicular cells were positive for HLA-DR, but also in hyperplastic follicular cells without the infiltration. The distribution of expressed c-myc protein was similar to that of PCNA in GD but not in HT. Semiquantitatively graded degrees of lymphocytic infiltration and expression of HLA-DR, c-myc and PCNA in GD showed a high correlation with one another. However, the degrees of c-myc expression in HT showed no significant correlation with any other degrees. Intraperitoneal injection of bovine TSH or of immunoglobulins derived from a patient with GD in rabbits induced hyperplastic change of thyroid follicular cells, as reflected in PCNA and c-myc immunoreactivity, as well as strong peroxidase and acid phosphatase activity. Immunization with synthesized peptide of thyrotropin receptor also exhibited the same results in the rabbit thyroids. Our results indicate that c-myc expression on follicular cells of GD may reflect a stimulation by autoantibodies mediated through the thyrotropin receptor.

Adolescent↗

T-cell lymphoma presenting with pericardial and pleural effusion as the initial and primary lesion: cytogenetic and molecular evidence.

A 90-year-old woman was admitted with progressive dyspnea. Chest roentgenogram and computed tomography revealed a massive pericardial effusion and bilateral pleural effusion, but no lymphomatous lesion was seen. A diagnosis of malignant lymphoma was made by cytological and immunological studies of the cells obtained from the pericardial effusion. Chromosome analysis showed a clonal abnormality and T-lineage clonality was determined by the rearrangement of the T-cell receptor gamma gene. The patient achieved remission with chemotherapy, but she later relapsed, with right pleural effusion, and died. She exhibited no lymphomatous features throughout the clinical course, indicating the possibility of malignant lymphoma originating from the pericardium and/or pleura.

Aged↗

Endogenous nitric oxide production is augmented as the severity advances in patients with liver cirrhosis.

1. Since endothelium-derived nitric oxide (NO) is a potent vasodilator and degraded into nitrous ions, we measured the serum nitrate ion (NO3-) and the amount of urinary excretions of NO3- as an index for endogenous NO to ascertain whether NO formation is augmented in patients with chronic liver diseases. 2. Using inpatients suffering from chronic liver diseases, serum levels and urinary excretions of NO3- were measured by using high-performance liquid chromatography with an anion exchange column. 3. Among the four patient groups of normal controls, and those with chronic liver diseases such as chronic active hepatitis, compensated cirrhosis, and decompensated cirrhosis the serum level of NO3- showed the highest level in a patient group with decompensated cirrhosis. The amount of urinary excretion of NO3- was significantly increased in both groups of patients with liver cirrhosis compared with the control group and patients with chronic active hepatitis. Patients with chronic active hepatitis did not show any difference between the normal control group. The amount of urinary excretion of NO3- correlated significantly and negatively with the level of serum albumin (P < 0.05) and counts of platelets (P < 0.01) in patients with compensated cirrhosis. 4. These findings suggest that the production of endogenous NO is augmented in patients with liver cirrhosis, particularly in a decompensated subgroup. Increases in the production of endogenous NO correspond to the progress of liver cirrhosis, but not in patients with chronic hepatitis.

Adult↗