Search PubMed⌕ Search

Biomedical subjects

K Kawabata

Publications and source records attributed to K Kawabata.

At least 163 records · Page 9Linked to original sources

Disposition characteristics of plasmid DNA in the single-pass rat liver perfusion system.

PURPOSE: To define the hepatic uptake mechanism of a plasmid DNA, we quantitated the uptake of pCAT (plasmid DNA encoding chloramphenicol acetyltransferase reporter gene fused to simian virus 40 promoter), a model plasmid, after a single pass through the perfused rat liver using albumin- and erythrocyte-free Krebs-Ringer bicarbonate buffer (pH 7.4). METHODS: [32P]pCAT was introduced momentarily into this system from the portal vein as a bolus input or constant infusion mode, and the outflow patterns and hepatic uptake were evaluated using statistical moment analysis. RESULTS: The venous outflow samples had electrophoretic bands similar to that of the standard pCAT, suggesting that the plasmid is fairly stable in the perfusate during liver perfusion. In bolus experiments, pCAT was largely taken up by the liver and the uptake was decreased with increase in injected dose. Statistical moment analysis against outflow patterns demonstrated that the apparent volume of distribution of pCAT was greater than that of human serum albumin, indicating a significant reversible interaction with the tissues. The results of collagenase perfusion experiments suggest that the hepatic accumulation of pCAT occurred preferentially in the nonparenchymal cells (NPC). The amount of total recovery in the liver decreased substantially by preceding administration of polyinosinic acid, dextran sulfate, succinylated bovine serum albumin, but not by polycytidylic acid. This suggests that pCAT is taken up by the liver via scavenger receptors for polyanions on the NPC. In constant infusion experiments, the presence of 2,4-dinitrophenol and NH4Cl caused a significant increase in the outflow concentration of [32P]pCAT and decrease by half in the total hepatic recovery than that of plasmid DNA administered alone, suggesting that plasmid DNA may undergo internalization by the NPC. CONCLUSIONS: The liver plays an important role in the elimination of plasmid DNA and a successful delivery system will be required to avoid its recognition by the scavenger receptors on the liver NPC.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗

Subcapsular hematoma and hypertension following percutaneous needle biopsy of a transplanted kidney.

Percutaneous needle biopsy of a transplanted kidney is indicated as a diagnostic procedure in the evaluation of unexplained deteriorated renal function after renal transplantation. This procedure is not always without complications. We report a case of a subcapsular hematoma and hypertension following a percutaneous needle biopsy of a transplanted kidney. The cause of hypertension in this patient and the management of the subcapsular hematoma are discussed.

Adult↗

Visual form agnosia in multiple sclerosis.

We report a case of multiple sclerosis with visual form agnosia and callosal syndromes. Initially, the patient's visual recognition of object form was severely disturbed at the perceptual stage, in association with left-sided ideomotor apraxia and agraphia. Magnetic resonance imaging showed large white matter lesions in the bilateral frontal and occipital lobes, the latter extending to the occipitotemporal junction, and widespread corpus callosum lesions. Over the course of one year follow-up, neuropsychological examinations indicated that the patient's visual recognition defects occurred not only at the early substage of form perception, but also at the stage of reproducing the shape of objects from visual memory store. The present case suggests that neural connections between the striate cortex and occipitotemporal visual areas are crucial for both the perceptual and associative stages of visual object recognition.

Agnosia↗

Impaired activity of protease inhibitors towards neutrophil elastase bound to human articular cartilage.

OBJECTIVE: To investigate the effects of protease inhibitors on the ability of free and cartilage bound neutrophil elastase to degrade cartilage proteoglycan in vitro. METHODS: Cryostat sections of human articular cartilage were used as substrate, and proteoglycan loss induced by free or cartilage bound elastase was quantified by alcian blue staining, followed by scanning and integrating microdensitometry. RESULTS: High molecular mass protease inhibitors (alpha 1 protease inhibitor, alpha 2 macroglobulin, and soya bean trypsin inhibitor) and synovial fluid from patients with rheumatoid arthritis were effective in blocking proteoglycan loss from sections treated with free elastase, but their activity towards cartilage bound elastase was much reduced. In contrast, low molecular mass elastase inhibitors (N-methoxysuccinyl-Ala-Ala-Pro-Val chloromethyl ketone and ONO-5046 (N-[2-[4-(2,2-dimethylpropionyloxy) phenylsulphonylamino]benzoyl] amino-acetic acid) were effective against free and cartilage bound elastase. CONCLUSION: The binding of elastase to cartilage appears to be a mechanism whereby the enzyme can remain active in the presence of high molecular mass protease inhibitors.

Adult↗

The changes of Mac-1 and L-selectin expression on granulocytes and soluble L-selectin level during hemodialysis.

L-selectin and Mac-1 expressed on leukocytes are critical for leukocyte adhesion to inflamed endothelium. L-selectin is known to be rapidly shed from the cell surface of granulocytes after activation. In the present study the change of expressions of these adhesion molecules on granulocytes were analyzed by flow cytometry, and the serum concentration of shed L-selectin (soluble L-selectin; sL-selectin) was measured by enzyme-linked immunosorbent assay (ELISA) during hemodialysis in patients treated with regenerated cellulose membranes (RC group) versus polysulfone membranes (PS group). In the RC group, Mac-1 expression on granulocytes increased significantly at 30 min after the initiation of hemodialysis (p < 0.05) compared with predialysis values, coinciding with the nadir of dialysis-induced granulocytopenia. Granulocyte L-selectin expression decreased significantly at 15 min after the initiation of hemodialysis (p < 0.05) and remained decreased through the course of dialysis session, compared with predialysis values. Serum sL-selectin level significantly increased at 15 min after the initiation of hemodialysis (p < 0.05), compared with predialysis values. In the PS group, no significant variation in Mac-1 and L-selectin expression on granulocytes and serum sL-selectin level were detected. This reciprocal change of Mac-1 and L-selectin on granulocyte cell surface was attributed to development of granulocytopenia and subsequent reversal during dialysis with cellulose membranes. In this study, we confirmed the shedding of L-selectin during cellulosic dialysis by ELISA. The increase in sL-selectin, which has potential activity of inhibiting L-selectin-dependent adhesion of granulocyte to endothelium, might be involved in rebound granulocytosis during dialysis with cellulose membranes and impairment of the granulocyte function in patients on chronic hemodialysis.

Aged↗

Multimodal evoked potentials in Alzheimer's disease and Binswanger's disease.

Somatosensory evoked potentials (SEPs), brainstem auditory evoked potentials (BAEPs), visual evoked potentials (VEPs), and auditory event-related potentials (ERPs) were studied in 15 patients with Alzheimer's disease (AD), eight patients with Binswanger's disease (BD), and 15 normal subjects. Patients with BD showed significant prolongation of the interpeak latency between N13 and N20 (N13-N20) and N20-P40 of SEPs as compared with the normal controls, whereas patients with AD only demonstrated significant prolongation of N20-P40. The interpeak latency between waves I and V of BAEPs in patients with both AD and BD was significantly longer than that of controls. There were no significant differences in P100 latency of VEPs among these three groups. Both groups with dementia showed significant prolongation of N200 and P300 latencies of ERPs compared with normal controls. In addition, patients with AD showed significant prolongation of P200 latency. We conclude that these two dementing diseases have different electrophysiologic features that may be related to their underlying pathogenetic mechanisms. Furthermore, the measurement of multimodal evoked potentials may be helpful in the differential diagnosis of AD and BD.

Aged↗

Sudden death during Holter electrocardiogram monitoring in a patient with variant angina.

We report a case of sudden death due to variant angina during Holter electrocardiogram (ECG) monitoring. The patient, a 60-year-old man, had been aware of chest discomfort lasting less than one minute at midnight 2 days earlier. Because variant angina or arrhythmia was suspected, Holter ECG monitoring was performed. The patient spent a whole day without a recurrence of chest pain before going to bed, but at midnight he developed sudden chest pain, and died immediately after taking a sublingual tablet of isosorbide-dinitrite. Analysis of the Holter ECG revealed ventricular fibrillation after several ventricular premature beats following ST-segment elevation in both the CM5 and NASA leads. This case shows that sudden death from variant angina may occur within a few days after the first onset, and also highlights whether priority should be given to making a definite diagnosis or giving treatment when variant angina is strongly suspected.

Angina Pectoris, Variant↗

Mitochondrial encephalomyopathy with elderly onset of stroke-like episodes.

A 52-year-old woman with a history of a hearing disturbance since age 20 experienced visual hallucinations and convulsions, followed by right hemiparesis and aphasia. On the basis of a muscle biopsy and mitochondrial DNA analysis, she was diagnosed as mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS). This case is unique in that the stroke-like episodes occurred 30 years after disease onset.

Age of Onset↗

[Prognostic factors of lateral wall oropharyngeal squamous cell carcinoma--retrospective study of 79 patients].

We reviewed 79 patients with squamous cell carcinoma of the lateral wall of the oropharynx who received treatment at the Cancer Institute Hospital. Tokyo, between 1971 and 1990. There were 67 men and 12 women, aged 31 to 81 years (average 59.2 years). The tumors could be staged by TNM classification (UICC 1987) as follows: Stage 10 Stage II 12, Stage III 27, Stage IV 40. It must be noted that more than 50% of the tumors were classified as stage IV. As the initial treatment, 50 patients underwent radical radiotherapy, and the remaining 29 were treated mainly by surgery after pre-operative radiation. Some patients underwent adjuvant chemotherapy, but the role of chemotherapy was not considered in this study. The purpose of the present study was to determine the prognostic factors and to determine the survival rate after each treatment modality. The results were as follows: i) Patients with either T4, over N2b or a stage IV tumor had a significantly poor prognosis. ii) Cox multivariate analysis revealed that age, local extension (base of tongue, anterior pillar, soft palate and mid-line), pathological findings (poorly, moderately or well differentiated), tumor type (exophytic or endophytic) were not useful prognostic factors. iii) Radiosensitivity was not reflected in the survival rate judging from the high recurrence rate (44%) after radical radiotherapy. On the other hand, local recurrence after radical resection was seen in 18% of the patients. iv) Analysis of the data supported the recommendation of surgery after preoperative radiation as the treatment for stage III patients. It seems difficult to find the best treatment modality for stage IV patients in order to improve the survival rate, and this is an issue that still remains to be resolved. v) From the study of the surgical specimens, we are unable to demonstrate a significant survival advantage of the patients with a high grade radiation effect, or patients with no vessel involvement.

Adult↗

[Efficacy of adjuvant chemotherapy in nasopharyngeal cancer].

A total of 36 patients with nasopharyngeal cancer underwent radiotherapy followed by CDDP-based adjuvant chemotherapy during the period from 1983 to 1991. The survival rate in the cases treated with radiotherapy followed by adjuvant chemotherapy was better than in 53 cases treated with radiotherapy alone. Distant metastasis was noted in only 8 (22%) of the former cases as opposed to 21 (40%) of the latter. In particular, multiple metastasis to both sides of the neck was found in 12 (63%) of 19 cases treated with radiotherapy alone, but in only 1 of the 10 cases treated with adjuvant chemotherapy. The interval until the detection of metastasis was also longer in the latter group. The above results suggest that adjuvant chemotherapy suppresses distant metastasis and contributes to the improvement of the clinical outcome in nasopharyngeal cancer.

Adolescent↗

Absence of exogenous interleukin-4-induced apoptosis of gingival macrophages may contribute to chronic inflammation in periodontal diseases.

Inflamed gingival tissues are enriched in macrophages (MOs) and CD4-positive T cells; however, T helper-type cytokines such as interleukin (IL)-2 and IL-4 are absent. Therefore, we investigated whether a relationship exists between IL-4 receptor (IL-4R) expression and MO persistence in the absence of exogenous IL-4. Gingival MOs, when compared with monocyte(MN)/MOs from peripheral blood mononuclear cells, expressed high levels of IL-4R mRNA. Furthermore, in vitro cultures of gingival MOs remained viable whereas identically treated peripheral blood MN/MOs rapidly lost viability. However, when gingival MOs were incubated with recombinant IL-4 (rIL-4), the cell viability was dramatically reduced. When the frequency of apoptotic cells was assessed in rIL-4-treated gingival MO cultures, higher numbers of apoptotic cells were noted in rIL-4-treated versus control cultures. Furthermore, rIL-4-treated MOs from inflamed gingiva showed DNA fragmentation as assessed by electrophoresis. These findings clearly show that addition of exogenous rIL-4 to gingival MO cultures leads to cell death by apoptosis. This finding would suggest that topical application of rIL-4 may inhibit the persistence of MOs in adult periodontitis, which could then lead to decreased inflammation.

Adult↗

A case of Trichuris trichiura infection diagnosed by colonoscopy.

A 65-year-old Japanese female was admitted to our hospital because of right lower abdominal pain. Laboratory and roentgenological tests revealed no abnormalities. Repeated stool examinations revealed no ovum or parasite. However, colonoscopic examination demonstrated the presence of a parasite on the edematous mucosa of cecum. The adult male whipworm (Trichuris trichiura) was then removed endoscopically. Her symptoms disappeared quickly, and no additional parasite was found in the feces during or after the mebendazole treatment. Repeated stool examinations failed to show any ova, because this patient was infected by a single male parasite. Colonoscopic study should be considered a useful tool for the diagnosis of T. trichiura infection, even if no ovum is found in stool examination.

Aged↗

[Impairment of benzodiazepine receptor in Parkinson's disease evaluated by 123I-iomazenil SPECT].

123I-iomazenil is a partial inverse agonist of central-type benzodiazepine receptor (BZR). Single photon emission tomography (SPECT) using 123I-iomazenil was performed in 15 patients with Parkinson's disease (PD). SPECT images were obtained 3 hours after intravenous injection of 167 MBq of 123I-iomazenil. The ratio of 123I-iomazenil SPECT count in the cerebral cortex to that in the cerebellum was calculated as the binding potential index (BPI). The BPIs in the lower frontal, temporal, parietal and occipital cortices correlated with the motor disability evaluated by Yahr's stage. The BPI in the upper frontal cortex showed the same tendency as in the other regions but did not reach a significant level. These results suggest that BZR in the cerebral cortex of patients with PD may be impaired in proportion to the severity of the disease and that 123I-iomazenil SPECT is useful for evaluating the pathophysiological condition in PD.

Aged↗

A patient with sarcoidosis associated with recurrent urolithiasis and tubular injury caused by calcium deposition.

A 38-year-old woman was hospitalized in January 1994 with renal dysfunction and hypercalcemia. Before admission, she was diagnosed as having urolithiasis, and had been treated twice with extracorporeal shock wave lithotripsy (ESWL). Ophthalmologically, she exhibited iritis and secondary glaucoma. Hypercalcemia, an extremely low titer of parathyroid hormone (PTH), and elevation of angiotensin-converting enzyme (ACE) and lysozyme activity were noted. These findings suggested sarcoidosis, although the chest X-ray showed only fibrotic changes. Hypercalcemia was suspected of having been caused secondarily by sarcoidosis. Since her laboratory data also showed renal dysfunction and abnormal urinalysis, a renal biopsy was performed. The histological findings indicated a tubular and interstitial disorder without glomerular abnormality; calcium deposition, which was detected by X-ray energy dispersive analysis, was observed in the tubular cytoplasm. Administration of prednisolone alleviated the renal dysfunction and decreased the elevation of ACE activity and lysozyme level of the blood. Sarcoidosis is sometimes associated with hypercalcemia, but rarely with renal dysfunction. These findings suggested that sarcoidosis may be associated with renal dysfunction due to tubular injury caused by calcium deposition in the tubules, and that glucocorticoid therapy was effective for these disorders.

Adult↗

Plasma concentrations of natriuretic peptides in patients on hemodialysis.

The usefulness of plasma atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and cyclic guanosine 3',5'- monophosphate (cGMP) as markers of fluid overload was examined in hemodialysis (HD) patients without diabetes mellitus. Plasma concentrations of ANP, BNP, CNP, and cGMP all decreased significantly during HD. Before HD, there was a strong correlation between plasma concentrations of ANP and those of BNP, and plasma concentrations of cGMP correlated significantly with those of all three natriuretic peptides. The cardiothoracic ratio also correlated significantly with plasma concentrations of ANP and those of BNP before HD. Systolic blood pressure correlated significantly only with plasma concentrations of CNP, both before and after HD. Changes in body weight during HD correlated only with those in plasma ANP; there was thus no correlation between changes in body weight and those in plasma CNP. In conclusion, only plasma ANP is a useful marker of the proper volume and dry weight of HD patients. Furthermore, CNP may participate in cardiovascular regulation in HD patients in a manner different from those of ANP and BNP.

Adult↗

What is the best index of glycemic control in patients with diabetes mellitus on hemodialysis?

Since red blood cell survival time is shortened in patients with diabetes mellitus (DM) on hemodialysis (HD), it is unlikely that indices of glycemic control accurately reflect the glycemic state of these individuals. In this study, in order to determine the best index of glycemic control in diabetic patients on HD, we measured HbAlc, 1,5-anhydroglucitol (1,5-AG), fructosamine (Fr) and glycated albumin (GA) in 31 diabetic patients on HD (20 males and 11 females, mean age: 66.9 years), and examined the correlation between each index and predialysis plasma glucose level. Since the mean values of predialysis plasma glucose during the final 2 and 4 weeks before the study were best correlated with HbAlc, this parameter was considered to be the most reliable index of glycemic control in diabetic patients on HD. GA was more closely correlated with mean values of predialysis plasma glucose during the final 2 and 4 weeks, than any other index of glycemic control, followed by HbAlc. In conclusion, HbAlc is considered to be the most reliable index of glycemic control in diabetic patients on HD.

Aged↗

[Expression of pS2-protein in breast cancer].

We studied the relationship between pS2-protein and estrogen receptor in breast cancer tissue immunohistochemically using paraffin-embedded sections obtained from 96 primary breast cancer tissues in which the estrogen receptor had been examined by ERICA using frozen section. ER-negative breast cancer specimens were negative for pS2 in 85% of the cases, and ER-positive breast cancers were positive for pS2 in 66% of the cases, the entire concurrence rate between pS2 and ER being 73%. Although the agreement was statistically significant, it seemed to be unreasonable that pS2 could replace ERICA in the routine detection of ER. However, the cases with pS2 stained (+2) or (+3) might be ER positive. pS2 showed a positive correlation to ER and PgR, and negative correlation to p53. This suggested that pS2 is a prognostic factor in breast cancers. Our findings suggested that pS2 also is a new marker of hormonal therapy for breast cancer.

Breast Neoplasms↗

A successfully treated case of multiple liver abscesses accompanied by portal venous gas.

A case with multiple liver abscess accompanied by massive portal venous gas is reported. A 61-yr-old male was admitted because of left lower abdominal pain, fever, and diarrhea. Abdominal x-ray examination demonstrated multiple branching lucencies in the liver. Computed tomography revealed multiple liver abscesses and massive gas in the portal system as well as a thickened wall of the sigmoid colon. Enema study using contrast medium revealed a perforation of the sigmoid colon with diverticulitis. The outcome was favorable after sigmoid colectomy in addition to intensive treatment with antibiotics. Bacteroides fragilis, which produces gas (H2 and NH3) by fermentation, was isolated not only from the resected specimen but also from blood samples. Although the presence of portal venous gas is a sign of poor prognosis in patients with intestinal infectious diseases, the sensitive detection of hepatic portal venous gas by computed tomography and the appropriate treatment may improve the patient's prognosis.

Anti-Bacterial Agents↗