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Biomedical subjects

K Kishi

Publications and source records attributed to K Kishi.

At least 343 records · Page 19Linked to original sources

Amino acids and glucose differentially increased extracellular 5-hydroxyindoleacetic acid in the rat brain.

To reveal the role of serotonergic neurons in the regulation of feeding, the levels of 5-hydroxyindoleacetic acid (5-HIAA), a metabolite of serotonin, in the striatum and the hypothalamus were continuously monitored by an in vivo microdialysis technique. Intake of 20% casein diet did not induce significant changes in the 5-HIAA level in these regions. When rats were fed on 5% casein diet (83.5% carbohydrate diet) for 2 h, the level of 5-HIAA in the striatum gradually increased and reached a maximum (226 +/- 44% of basal level, M +/- SEM, n = 7) at 4 h after stopping the diet. In the medial hypothalamus, its level also increased to 183 +/- 19% (n = 10) at 2 h after starting the diet. On the other hand, a 60% casein diet increased the level of 5-HIAA in the lateral hypothalamus to 138 +/- 19% (n = 10) at 2 h after starting the diet. The intravenous infusion of each of these nutrients, glucose, amino acid mixture or lipid, produced more rapid elevation of the 5-HIAA level than oral intake of the diets. When rats were infused with glucose, its level in the striatum continued to be elevated. In the medial hypothalamus, glucose infusion increased 5-HIAA to the maximum (189 +/- 38%, n = 7) at 4 h after starting infusion. In contrast, serotonergic neurons in the lateral hypothalamus seemed to respond only to infusion of the amino acid mixture, and the level of 5-HIAA reached 163 +/- 14% (n = 5) of the basal level at 1 h after starting the infusion. These results suggest that rapid elevation of glucose or amino acids may independently stimulate serotonin metabolism in these brain areas, participating in the feedback regulation of nutrient intake.

Amino Acids↗

[Initial and short-term results of percutaneous transluminal coronary angioplasty in patients over 70 years old: recent improvements in effectiveness].

Elderly patients have a higher incidence of procedure-related complications and recurrent angina after percutaneous transluminal coronary angioplasty (PTCA). However, early success rates seem to have improved. To determine whether outcome of PTCA in the elderly has changed recently, we compared initial results and short-term outcome in patients over 70 years old in two groups; 64 patients with 70 PTCA lesions who underwent first elective PTCA in 1982-1989 (early group) and 140 patients with 153 PTCA lesions in 1990-1993 (late group). The mean age of the late group was significantly older than that of the early group (74 +/- 3 vs 73 +/- 2 years, p < 0.01). The two groups had similar clinical characteristics including sex, prior myocardial infarction and multivessel disease. The overall success rate of PTCA was significantly higher in the late group than in the early group (92.8% vs 82.8%, p < 0.05). The rate of abrupt closure was similar in the two groups (2.9% vs 2.6%). Major complications (procedural myocardial infarction, emergency bypass surgery, hospital death) occurred in 4.7% of the early group and in 3.6% of the late group. Angiographic restenosis occurred in 41.5% of the early group and in 33.6% of the late group. Cardiac events (cardiac death and/or myocardial infarction) occurred in 6.6% of the early group and in 1.5% of the late group (p = 0.06). The initial success rate of PTCA has improved in the elderly as well as younger patients (< 70; 92.8% vs 91.6%). We conclude that PTCA can be performed with high initial success and satisfactory short-term outcome in patients over 70 years old.

Aged↗

Cell dynamics of undifferentiated carcinomas of the ovary. Immunohistochemical estimation of their growth fraction and apoptotic status.

The proliferative and apoptotic status of undifferentiated carcinomas of the ovary was estimated immunohistochemically by antibody for Ki-67 proliferative antigen and Le(Y) apoptotic antigen. Well-differentiated types of ovarian carcinoma were examined for comparison. In 8 cases of undifferentiated carcinomas, the proliferative activity in terms of the growth fraction expressed as percentage of positive nuclei for Ki-67 antigen ranged from 28.2 to 81.2% (mean 60%). In well-differentiated carcinomas, which included 8 serous, 8 mucinous, 4 endometrioid and 4 clear cell adenocarcinomas, the growth fraction ranged from 8.2 to 33.4% (mean 20%). Thus, statistically significant differences were found in the proliferative activity between undifferentiated and well-differentiated ovarian carcinomas. On the other hand, apoptotic status as estimated by Le(Y) staining varied considerably among the cases in both undifferentiated and differentiated carcinoma groups. Nevertheless, in general, undifferentiated carcinomas seemed to be more prone to apoptosis than well-differentiated carcinomas. It is concluded that in ovarian undifferentiated carcinomas, more active cell proliferation takes place with a concomitant cell loss compared to their differentiated counterparts.

Apoptosis↗

[The efficacy of transarterial immuno-embolization therapy in patients with unresectable hepatocellular carcinoma].

We devised a new therapeutic modality for multiple hepatocellular carcinoma (HCC) consisting of transarterial immuno-embolization (TIE) using OK-432 and fibrinogen, and applied the treatment to 22 patients with advanced HCC who had been insensitive to TAE, and 21 patients who had no treatment. Nineteen patients had a high AFP level of more than 200 ng/ml. The serum AFP level decreased in 15 patients after TIE, and in 7 patients the AFP level decreased to less than 30%. Furthermore, a marked reduction in tumor size was observed in 69% after TIE. We report 61% 1-year, and 3-year survival rate for cases who had been insensitive to TAE, and 86% 2-year survival rate for those who selected TIE as the first choice. A high fever of more than 38 degrees C occurred in all cases, and hypotension less than 80 mmHg was observed in 42% patients. No deterioration of liver function and no disturbance of the coagulation-fibrinolysis system due to TIE except in one patient with liver failure after TIE.

Carcinoma, Hepatocellular↗

[Effect of the ketogenic diet for West syndrome into which early infantile epileptic encephalopathy with suppression-burst was evolved].

A male infant with early infantile epileptic encephalopathy (EIEE) was reported. Tonic spasms in series appeared since 1 month after birth and EEG showed a typical suppression-burst pattern. The patient was treated with a high-dose pyridoxal phosphate and thyrotropin-releasing hormone (TRH), but seizures were not controlled. ACTH was administered and the seizures disappeared transiently. The seizures reappeared during tapering ACTH and apparent cerebral shrinkage followed the ACTH therapy. Then, the patient who evolved into West syndrome was treated with ketogenic diet. The seizures disappeared immediately and EEG findings were improved. It is suggested that the ketogenic diet should be tried early for the treatment of EIEE.

Electroencephalography↗

Nephrotic syndrome in a bone marrow transplant recipient with chronic graft-versus-host disease.

A 21-year-old male developed massive proteinuria and microscopic hematuria, 1 year after allogeneic BMT for acute lymphoblastic leukemia. These symptoms occurred during an exacerbation of chronic cutaneous graft-versus-host disease (GVHD). Renal biopsy revealed granular deposits of IgG and IgM along the glomerular basement membrane, and subepithelial electron dense deposits. A diagnosis of membranous nephropathy was made. With prednisolone therapy proteinuria decreased gradually, and amelioration of cutaneous lesions was also noted. It was speculated that the disordered immune regulation of chronic GVHD resulted in the development of immune complex nephritis.

Adult↗

[Efficacy and safety of percutaneous transluminal coronary angioplasty of other coronary arteries in patients with chronic total occlusion of the left anterior descending artery].

The acute and long-term outcomes of percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery (RCA) or left circumflex branch (LCS) in patients with chronic occlusion of the left anterior descending branch (LAD) (group A) were compared with those of sex and age matched patients undergoing PTCA of the RCA or LCX with a normal LAD (group B). Before the procedure, group A had more frequent prior myocardial infarction (96% vs 33%, p < 0.001), and a lower left ventricular ejection fraction (LVEF) (49 +/- 14% vs 71 +/- 13%, p < 0.001). The acute results were similar in the two groups with respect to primary success (group A 90%, group B 91%) and major complications (group A 6%, group B 2%). At 3 months, the rate of restenosis was 33% in group A and 27% in group B. In group A, LVEF increased significantly in patients without restenosis (53 +/- 11% vs 62 +/- 11%, p < 0.01). At long-term follow-up, group A had higher rates of persistent angina but there was no difference in outcome between the two groups. In patients with chronic total occlusion of LAD, PTCA for RCA or LCX can be performed with a low complication rate and provides a significant improvement in LVEF at 3 months in the absence of restenosis. However, at short-term follow-up, these patients have a greater incidence of persistent angina.

Adult↗

Atypical polypoid adenomyoma of the uterus in a very old woman. Report of a case with immunohistochemical characterization of its stromal components and proliferative status.

A case of atypical polypoid adenomyoma (APA) of the uterus in an 81-year-old patient is reported. The tumor arose in the uterine fundus as a polypoid mass and measured 9 cm in its longest diameter. Its histological appearance was similar to that of the reported cases, i.e. presence of atypical endometrial glands and a cellular smooth muscle stroma. However, the patient's age was extremely advanced, since APA has predominantly been reported to arise in premenopausal women. APA has been suggested as being related to prolonged estrogenic stimulation. But the fact that in this case the uninvolved endometrium was absolutely atrophic, negated this possibility. Immunohistochemistry for alpha smooth muscle actin was positive diffusely in the stroma. The proliferative status of the neoplastic glands was assessed by immunostaining for Ki-67 antigen. About 30% of the glands contained Ki-67 positive nuclei, and about 3% of the nuclei were positive in the glands. These figures are far below those of the usual endometrial adenocarcinoma, strongly suggesting that the APA was benign in nature.

Adenomyoma↗

[Allogenic bone marrow transplantation for Fanconi's anemia with leukemic transformation from an HLA identical father].

We report a case of a 19-year-old male with congenital aplastic anemia and multiple abnormalities; short stature, hypoplastic thumb, skin pigmentation and mental retardation. He was admitted to our hospital because of severe pancytopenia. Bone marrow aspiration showed markedly hypocellular marrow with 42% myeloblasts. He was diagnosed as AML (M2) transformed from Fanconi's anemia and underwent allo-BMT from an HLA-identical father. The conditioning regimen consisted of high dose Ara-C, high dose etoposide and 12Gy fractionated total body irradiation. Severe toxicity associated with the conditioning regimen was not observed. Cyclosporin A and short-term methotrexate were administered for prophylaxis of acute GVHD. Neither acute nor chronic GVHD were observed. He is well and free of disease for 15 months since BMT. Very few cases of Fanconi's anemia with leukemic transformation treated by BMT have been reported. Long-term observation will be necessary to evaluate our conditioning regimen for Fanconi's anemia with leukemic transformation.

Adult↗

Basement membrane status in undifferentiated carcinomas of the ovary. Immunohistochemical distribution of type IV collagen and laminin.

Basement membrane status in well-differentiated and undifferentiated carcinomas of the ovary was examined and compared immunohistochemically by using antibodies which react with type IV collagen and laminin. In well-differentiated carcinomas, which included 8 serous, 8 mucinous, 4 endometrioid and 4 clear cell adenocarcinomas, the staining showed a regular and linear pattern in the interface between epithelium and stroma. However, in 8 cases of undifferentiated carcinoma, the staining for two antibodies was irregular, being either completely negative or focally positive in the portion surrounding the carcinoma cell nests. In some cases, intracytoplasmic staining was observed. Staining patterns for two antibodies were somewhat different within undifferentiated carcinoma cases. It is concluded that in ovarian undifferentiated carcinomas, the architecture of basement membrane is substantially altered compared to their differentiated counterparts.

Adenocarcinoma↗

Correlation of alpha-1-antitrypsin (PI) polymorphism between blood and semen.

The correlation between isoprotein types of alpha-1-antitrypsin (PI) in blood and semen samples from the same individual was determined in 48 Japanese men by the combined technique of isoelectric focusing with immobilized pH gradients and immunoblotting. Five common PI types (M1, M1M2, M1M3, M2 and M2M3) were detected in the blood plasma samples. However, PI-specific bands in semen migrated more cathodally than those in plasma into a pI region of approximately 5.05, and about 17% of the semen samples could not be phenotyped: the rest were easily phenotyped and their PI types were found to correlate with the type found in the corresponding blood samples. PI typing could therefore provide an additional discriminant characteristic for the forensic examination of individualization from semen samples.

Forensic Medicine↗

[Alginate gel beads for chemoembolization: initial report].

Alginate gel beads (AGB) were studied as a new material for chemoembolization therapy. AGB were quickly produced by dripping a sodium alginate solution through a cannula into a calcium chloride solution, with bead size controlled by cannular size. AGB containing adriamycin or contrast medium were produced from the corresponding mixture. Sixty percent of adriamycin was eluted from AGB within one hour and 90% within 24 hours, while 95% of iopamidol was eluted in 30 minutes. AGB released these contents slower than gelatin sponge particles. Four dogs underwent transcatheter hepatic arterial embolization with AGB. Normal daily activity was recorded until sacrifice on the fourteenth day. There was no hepatic infarction in those embolized with AGB of 0.5 to 1.0 mm in diameter. Partial liver infarction was found in one with compelled embolization and in two with fragile beads. These observations suggested that AGB constitute an instantly preparable embolic material with slow-release activity and flexible solidity.

Alginates↗

[A case report: postoperative recurrence of peritoneal dissemination of gastric cancer responding to sequential methotrexate and 5-FU (5-fluorouracil)].

In a 61-year-old female patient, the recurrence of peritoneal dissemination after total gastrectomy due to gastric cancer responded well to chemotherapy of sequential methotrexate and 5-FU. A total of 10 courses of this chemotherapy diminished ascites, normalized the value of CA 19-9, and re-opened the left obstructed ureter. During this therapy, the patient's condition was good, with no experience of nausea or leukopenia.

Adenocarcinoma↗

Expression of the proto-oncogene bcl-2 in uterine cervical squamous cell carcinoma: its relationship to clinical outcome.

We studied bcl-2 expression in patients with uterine cervical squamous cell carcinoma and correlated this phenomenon with survival. Immunohistochemical analysis with a monoclonal antibody specific for bcl-2 was used to detect the protein in tumor samples from 259 patients undergoing surgery for squamous cell carcinoma of the uterine cervix. Of the total, 67% (174) of the tumors were bcl-2 negative, and 33% (85) were positive. No significant difference in survival at five years was noted between patients with negative (78%) and positive (82%) tumors. However, when bcl-2 positive tumors were divided into partially stained (62 of 85, 73%), and diffusely stained (23 of 85, 27%) groups, the patients with partial staining had a better prognosis than those with diffused or negative (p < 0.01), staining (p < 0.05) (5 year survivals, respectively; 92%, 61%, and 78%). Though detection of bcl-2 positivity may itself not have clinical value for uterine cervical squamous cell carcinoma, the staining characters may add to predicting prognosis.

Adult↗

[Primary Sjögren's syndrome accompanied by pleural effusion].

A 40-year-old woman was admitted to the hospital because of fever and right cervical pain. Facial erythema developed after admission, along with interstitial shadows and pleural effusion in both lower lung fields. Microscopical examination of transbronchial lung biopsy specimens showed infiltration by lymphocytes and thickening of alveolar walls. Analysis of bronchoalveolar lavage fluid revealed an abnormally high number of cells and CD8 lymphocytes. Schirmer's test and a gum test showed abnormally low lacrimation and salivation. Anti-nuclear antibody, and antibodies against SS-R, and SS-B were present. These findings led to the diagnosis of primary Sjögren's syndrome accompanied by pleural effusion. Facial erythema was regarded as a symptom of Sjögren's syndrome. Prednisolone was given (60 m/day), and the symptoms and the abnormality on the chest roentgenogram resolved within about 1 month.

Adult↗

The crystal structure of manganese peroxidase from Phanerochaete chrysosporium at 2.06-A resolution.

The crystal structure of manganese peroxidase (MnP) from the lignin-degrading basidiomycetous fungus Phanerochaete chrysosporium has been solved using molecular replacement techniques and refined to R = 0.20 at 2.0 A. The overall structure is similar to that of two other fungal peroxidases, lignin peroxidase from P. chrysosporium and Arthromyces ramosus peroxidase. Like the other fungal peroxidases, MnP has two structural calcium ions. MnP also has two N-acetylglucosamine residues N-linked to Asn131 that are readily visible in the electron density map. The active site, consisting of a proximal His ligand H-bonded to an Asp residue and a distal side peroxide binding pocket consisting of a catalytic His and Arg, is the same as in the aforementioned fungal peroxidases as well as yeast cytochrome c peroxidase. MnP differs in having five rather than four disulfide bonds. The additional disulfide bond, Cys341-Cys348, is located near the C terminus of the polypeptide chain. Importantly, a new cation binding site, which we propose is the manganese-binding site of MnP, was located in the crystal structure. The ligands constituting the Mn(2+)-binding site include Asp179, Glu35, Glu39, a heme propionate, and two water molecules. Electron transfer from Mn2+ to the heme edge or iron center is envisioned to occur through a sigma-bonded pathway along a heme propionate.

Amino Acid Sequence↗

[Intimal hyperplasia growth after stenting of modified gianturco Z stent in an experimental study].

Three types of modified Gianturco Z stents, which included some solder at the bend portion in group 1, a little solder in group 2 and no solder in group 3, were placed in the jugular vein in order to evaluate the degree of intimal hyperplasia growth in five dogs. Four weeks later, venography and histological examination after venectomy were performed. Stenosis was 32.7 +/- 6.9% at the bend portion in group 1, 27.0 +/- 6.0% in group 2 and 14.0 +/- 6.5% in group 3. The results indicate that stents without solder are preferable for the venous system.

Animals↗