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Biomedical subjects

K Kodama

Publications and source records attributed to K Kodama.

At least 271 records · Page 15Linked to original sources

[Emergency percutaneous cardiopulmonary support for patients with cardiac arrest or severe cardiogenic shock].

A total of 20 patients who developed cardiac arrest or severe cardiogenic shock were resuscitated with percutaneous cardiopulmonary support system (PCPS). The etiology of shock was acute myocardial infarction (n = 8), post-infarction left ventricular (LV) free wall rupture (n = 9) and others (n = 3). After successful resuscitation with PCPS, 17 patients underwent therapeutic interventions: either closure of an LV rupture (n = 9), coronary artery bypass grafting (n = 4), percutaneous transluminal angioplasty (n = 1) and percutaneous transluminal coronary recanalization (n = 1). Of the 20 patients, 17 were weaned from PCPS or standard cardiopulmonary bypass. Nine patients survived longer than 30 days and 6 patients were discharged from the hospital. In nine patients with LV free wall rupture, one could be discharged from the hospital. Even though our experience is still small in number, it can be concluded that cardiopulmonary resuscitation using PCPS improves survival in fatally ill patients.

Adolescent↗

Expression of vacuolating cytotoxin in clinical isolates of Helicobacter pylori.

Our objective was to determine whether the prevalence of vacuolating cytotoxin production differed among Helicobacter pylori isolates obtained from patients with chronic gastritis, gastric ulcer, or duodenal ulcer. We examined the vacuolating cytotoxin production of 114 clinical H. pylori isolates in rabbit gastic epithelial cells (RGECs). We also tested two positive control strains (NCTC 11637 and NCTC 11916). Seventy-four of the 114 H. pylori clinical isolates (64.9%) produced intracellular vacuolation in RGEC cells, but there was no significant difference in the prevalence of intracellular vacuolation among the isolates of patients with chronic gastritis, gastric ulcers, and duodenal ulcers. We found no strong correlation between vacuolating cytotoxin production and peptic ulceration.

Animals↗

[Thrombotic thrombocytopenic purpura after administration of ticlopidine].

On June 29, 1995, a 49-year-old man was admitted with acute onset of fever, petechiae on his legs, and mental confusion He had suffered hypertension since 6 months previously and was on nicardipine (60 mg/day), ifenprodil (60 mg/day) and ticlopidine (300 mg/day). He had been on ticlopidine for 4 weeks and on the other drugs for 6 months. Soon after admission he had frequent grand mal seizures and needed mechanical ventilation. A diagnosis of TTP was made. He was treated with plasmapheresis (50 ml/kg per day), aspirin 81 mg/day and dipyridamole 300 mg/day. On the sixth day his mental status returned to normal. He recovered gradually from microangiopathic hemolytic anemia, thrombocytopenia and elevated serum creatinine. We reviewed the literature and discussed the possible mechanism of TTP related to the use of ticlopidine.

Humans↗

Reduced motility related protein-1 (MRP-1/CD9) gene expression as a factor of poor prognosis in non-small cell lung cancer.

Motility related protein-1 (MRP-1) is a transmembrane glycoprotein that is identical to the CD9 antigen. In previous studies, we showed that various types of cultured tumor cells transfected with MRP-1/CD9 cDNA have low motility and diminished metastatic potential to the lung. More recently we used immunohistochemical procedures, immunoblotting, and reverse transcription-PCR to demonstrate that the level of MRP-1/CD9 expression was inversely related to the clinical stage of a given carcinoma of the breast. In addition, we found that the primary tumors of almost 50% of the patients had higher MRP-1/CD9 levels than their respective metastatic lymph nodes. In consideration of these findings, we have now applied reverse transcription-PCR to determine MRP-1/CD9 gene expression in lung cancer. We analyzed tumor tissues of 109 patients: 49 tumors were stage I; 15 were stage II; and 45 were stage III. We found that 67 patients had MRP-1/CD9-positive tumors, and that gene expression was reduced in the tumors of the remaining 42 individuals. The overall rate of survival was strikingly higher among patients with positive tumors than in those whose tumors had reduced gene expression (62.3 versus 34.9%; P < 0.001). This also pertained to patients with adenocarcinomas of the lung (55.4 versus 26.0%; P < 0.001). Multivariate analysis with the Cox regression model indicated that MRP-1/CD9 positivity correlated better with overall survival rate than did other variables, except lymph node status. Our data suggest that low MRP-1/CD9 expression by tumors of the lung may be associated with poor prognosis. It is conceivable that testing for MRP-1/CD9 may identify node-negative lung cancer patients and patients with adenocarcinomas who are at high risk for early disease recurrence.

Antigens, CD↗

Alpha-1-antichymotrypsin expression in lung adenocarcinoma and its possible association with tumor progression.

BACKGROUND: Alpha-1-antichymotrypsin (ACT) is a serine protease inhibitor, expression of which has been shown in various tumor types, but its biologic and clinical implications in tumor tissues are obscure. The authors examined ACT expression in lung adenocarcinoma to determine its clinicopathologic and prognostic significance. METHODS: First, reverse transcriptase-polymerase chain reaction (RT-PCR) using oligonucleotide primers specific for ACT and Western blotting and immunohistochemical methods using anti-ACT antibodies were performed in several lung adenocarcinoma cell lines. Secondly, ACT expression in clinical materials was examined immunohistochemically. RESULTS: By RT-PCR, Western blotting, and immunohistochemical methods, ACT synthesis was confirmed in several lung adenocarcinoma cell lines. Seventy-five (52%) of 170 surgically resected lung adenocarcinomas showed positive staining for ACT mainly in the cytoplasm, and the incidence of ACT expression was significantly higher in advanced T classification tumors (P = 0.009) or large sized tumors (P = 0.004). Tumors with a higher rate of mitosis were significantly positive for ACT expression (P = 0.023). Patients with ACT-positive adenocarcinoma had a shorter disease free survival (DFS) and a poor prognosis compared with those who were ACT-negative, most significantly among Stage I tumors (DFS, P = 0.003; overall survival, P = 0.006). In a multivariate analysis, the P value of ACT expression status in Stage I tumors was marginally significant (overall survival; P = 0.058). CONCLUSIONS: These results using cell lines suggest the potential productivity of ACT by lung adenocarcinoma cells. The data in clinical materials, combined with results of the previous report that ACT in breast cancer acts as a minor growth factor-like substance, suggest that ACT expression in lung adenocarcinoma also may be associated closely with tumor progression and especially with tumor growth. Alpha-1-antichymotrypsin expression status in Stage I tumors may be a potential independent prognostic factor.

Adenocarcinoma↗

Radiation studies.

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Government Agencies↗

Cloning and sequencing of the murine Mxi1 cDNA.

The cloning and sequencing of the murine Mxi1 gene encoding Mxi1, one of Max-associated proteins, is described. Murine and human sequences showed 87.9% nucleotide (nt) and 90.3% amino acid (aa) sequence homology, whereas murine and zebra fish sequences showed 67.2% nt and 67.8% aa sequence homology.

Amino Acid Sequence↗

A new approach for performing a one-stage operation through the mediastinum to resect bilateral lung metastases: report of a case.

We describe herein a new operative technique for reaching the opposite lung from the thoracotomy site through the mediastinum. This procedure was successfully performed on a 76-year-old woman with bilateral lung metastases whose case is presented. After resection of the right lower lobe which contained two metastases, the anterior mediastinum was opened, and contralateral metastasis located in the lingular segment was resected using a neodymium:yttrium-aluminum-garnet (Nd:YAG) laser. A chest drainage tube was inserted through the mediastinal window. This transmediastinal approach seems to be a feasible technique for preserving the respiratory function of the chest wall in patients with imbalanced bilateral metastases.

Aged↗

Volatile anaesthetic actions on norepinephrine-induced contraction of small splanchnic resistance arteries.

The aim of this study was to investigate volatile anaesthetic action on small splanchnic resistance arteries. Employing isometric tension recording, we studied the effects of clinically relevant concentrations (0.25-1.25 minimum alveolar concentration (MAC)) of isoflurane, sevoflurane and enflurane on contractions induced by norepinephrine (NE), a sympathetic neurotransmitter, in the rabbit small mesenteric artery. Rhythmic oscillations were observed in contractile responses to NE. Both isoflurane (> or = 0.25 MAC, 0.5% (approximately 0.11 mM)) and sevoflurane (> or = 0.75 MAC, 2.8% (approximately 0.38 mM)) inhibited the NE (10 microM)-induced contraction with concomitant inhibition of average amplitude of the oscillations. Only enflurane (> or = 0.25 MAC, 0.7% (approximately 0.20 mM)) generated vasoconstriction superimposed on the NE-induced contraction; however, the vasoconstriction was transient and was followed by vasorelaxation. Concurrently, enflurane (> or = 0.25 MAC) strongly inhibited the average amplitude of the oscillations; higher concentrations (> or = 1.0 MAC) of enflurane completely eliminated the oscillations. The frequency of the NE-induced oscillations was less affected by the anaesthetics. The observed vasodilator action of these anaesthetics in small resistance arteries may contribute to their hypotensive effects in vivo. The potent inhibition of the rhythmic oscillations also may play a role in volatile anaesthetic-induced alterations in cardiovascular homeostasis.

Analysis of Variance↗

Lymphoepithelioma-like carcinoma of the lung: analysis of two cases for Epstein-Barr virus infection.

Lymphoepithelioma-like carcinoma, which is an uncommon histological type of epithelial tumor, has been described as being closely associated with Epstein-Barr virus (EBV) infection in organs other than the lung. Recently, we experienced two surgically resected cases of pulmonary tumors mimicking lymphoepithelioma-like carcinoma. Both cases contained EBV DNA genomes as shown by polymerase chain reaction (PCR) using EBV DNA-specific primers, one positive for EBV DNA in virtually all cancer cells, and the other showing positive hybridization in a small number of cancer cells by in situ hybridization (ISH) using digoxigenin-labeled olignucletide probes for each of EBV DNA for EBV DNA. EBV-encoded RNA-1 (EBER-1) was typically detected in one case. These results are highly suggestive of EBV-associated tumors in one of the current cases, although in the other case, no such close association was determined. It seems that lymphoepithelioma-like pulmonary carcinoma, which seems extremely unusual, may be closely associated with EBV infection in tumorigenesis.

Adenocarcinoma↗

Auditory brainstem responses in children with Cornelia de Lange syndrome.

Auditory brainstem evoked responses (ABRs) were recorded in 10 Japanese infants and children with Cornelia de Lange syndrome to determine the level of the lesion causing their poor response to sound. Behavioral audiometry showed severe threshold elevation compared to an age-matched control group. ABR thresholds, peak latencies of wave I and IV and the peak interval latency of waves I-V were measured. ABR abnormalities of 4 types: no ABRs following 85 dB clicks in both ears (4 cases), no ABRs in one ear but normal ABR in the other (2 cases), mild wave V threshold elevation of ABR with a markedly prolonged wave V (2 cases) and normal ABR pattern in the one side and abnormal ABR pattern in the opposite side suggesting brainstem immaturity for age (2 cases). Our results demonstrate a high prevalence of peripheral sensorineural hearing loss in Cornelia de Lange syndrome, but brainstem immaturity was not ruled out in 2 cases.

Adolescent↗

Vertebral fracture prevalence in women in Hiroshima compared to Caucasians or Japanese in the US.

BACKGROUND: Although vertebral fractures are very common among elderly Caucasian women, no studies have compared the prevalence to that among Asian populations. Any observed differences in prevalence might lead to the identification of important environmental and/or genetic factors. We therefore compared the prevalence of vertebral fractures among US Caucasians to native Japanese and Japanese immigrants in Hawaii using a standardized approach. METHODS: Spinal radiographs of women aged > 50 years were obtained from native Japanese in Hiroshima, Japanese-Americans in Hawaii, and North American Caucasians in Minnesota between 1982 and 1991. Fractures were defined as vertebral heights > 3 standard deviations (SD) below the vertebra-specific mean. RESULTS: Compared to Japanese-Americans, odds ratios (OR) and 95% confidence intervals (CI) for prevalent vertebral fractures were 1.8 (95% CI: 1.3-2.5) for native Japanese women and 1.5 (95% CI: 1.1-2.1) for Minnesota Caucasians. The OR tended to be higher when comparing the prevalence of two or more fractures per person: OR = 3.2 (95% CI: 2.0-5.3) for native Japanese and OR = 1.9 (95% CI: 1.2-3.2) for Minnesota Caucasians. Similar results were observed for native Japanese using a fracture definition of > or = 4 SD below the mean, but the OR for Caucasians was reduced to 1.2 (95% CI: 0.6-2.3). CONCLUSION: The observation that, among these three populations, hip fracture incidence is lowest but spine fracture prevalence is greatest among native Japanese suggests that different risk factors may be responsible.

Age Factors↗

Effects of volatile anesthetics on acetylcholine-induced relaxation in the rabbit mesenteric resistance artery.

BACKGROUND: Vascular endothelium plays an important role in the regulation of vascular tone. Volatile anesthetics have been shown to attenuate endothelium-mediated relaxation in conductance arteries, such as aorta. However, significant differences in volatile anesthetic pharmacology between these large vessels and the small vessels that regulate systemic vascular resistance and blood flow have been documented, yet little is known about volatile anesthetic action on endothelial function in resistance arteries. Furthermore, endothelium-dependent relaxation mediated by factors other than endothelium-derived relaxing factor (EDRF) has recently been recognized, and there is no information available regarding volatile anesthetic action on non-EDRF-mediated endothelium-dependent relaxation. METHODS: Employing isometric tension recording and microelectrode methods, the authors first characterized the endothelium-dependent relaxing and hyperpolarizing actions of acetylcholine (ACh) in rabbit small mesenteric arteries, and tested the sensitivities of these actions to EDRF pathway inhibitors and K+ channel blockers. They then examined the effects of the volatile anesthetics isoflurane, enflurane, and sevoflurane on ACh-induced endothelium-dependent relaxation that was sensitive to EDRF inhibitors and that which was resistant to the EDRF inhibitors but sensitive to blockers of ACh-induced hyperpolarization. The effects of the volatile anesthetics on endothelium-independent sodium nitroprusside (SNP)-induced relaxation were also studied. RESULTS: Acetylcholine concentration-dependently caused both endothelium-dependent relaxation and hyperpolarization of vascular smooth muscle. The relaxation elicited by low concentrations of ACh (< or = 0.1 microM) was almost completely abolished by the EDRF inhibitors NG-nitro-L-arginine (LNNA), oxyhemoglobin (HbO2), and methylene blue (MB). The relaxation elicited by higher concentrations of ACh (> or = 0.3 microM) was only attenuated by the EDRF inhibitors. The remaining relaxation, as well as the ACh-induced hyperpolarization that was also resistant to EDRF inhibitors, were both specifically blocked by tetraethylammonium (TEA > or = 10 mM). Sodium nitroprusside, a NO donor, produced dose-dependent relaxation, but not hyperpolarization, in the endothelium-denuded (E[-]) strips, and the relaxation was inhibited by MB and HbO2, but not TEA (> or = 10 mM). One MAC isoflurane, enflurane, and sevoflurane inhibited both ACh relaxation that was sensitive to the EDRF inhibitors and the ACh relaxation resistant to the EDRF inhibitors and sensitive to TEA, but not SNP relaxation (in the E[-] strips). An additional finding was that the anesthetics all significantly inhibited norepinephrine (NE) contractions in the presence and absence of the endothelium or after exposure to the EDRF inhibitors. CONCLUSIONS: The results confirm that ACh has a hyperpolarizing action in rabbit small mesenteric resistance arteries that is independent of EDRF inhibitors but blocked by the K+ channel blocker TEA. The ACh relaxation in these resistance arteries thus appears to consist of distinct EDRF-mediated and hyperpolarization-mediated components. Isoflurane, enflurane, and sevoflurane inhibited both components of the ACh-induced relaxation in these small arteries, indicating a more global depression of endothelial function or ACh signaling in endothelial cells, rather than a specific effect on the EDRF pathway. All these anesthetics exerted vasodilating action in the presence of NE, the primary neurotransmitter of the sympathetic nervous system, which plays a major role in maintaining vasomotor tone in vivo. This strongly indicates that the vasodilating action of these anesthetics probably dominates over their inhibitory action on the EDRF pathway and, presumably, contributes to their known hypotensive effects in vivo. Finally, the vasodilating action of these anesthetics is, at least in part, independent from endothelium.

Acetylcholine↗

Thrombin inhibition in the acute phase of ischaemic stroke using argatroban.

We studied the effect of argatroban, a new selective thrombin inhibitor, on the haemostatic system in seven patients with acute ischaemic stroke (the argatroban group). Argatroban was infused continuously at 2.5 mg/h for the first 48 h, and then 10 mg of argatroban was infused over 3 h twice a day on days 3-7. The placebo group consisted of six acute ischaemic stroke patients. As a combination therapy, intravenous administration of glycerol was also performed at the same time in five of the seven patients in the argatroban group and in four of the six patients in the placebo group. D-dimer levels were measured by a latex photometric immunoassay that allowed immediate quantitative assessment. The D-dimer levels of our 13 patients with acute ischaemic stroke were raised at the time of admission (day 1) and 69% of the values were above the 97th percentile ( > 500 ng/ml) in healthy subjects. D-dimer levels were significantly reduced in the argatroban group on days 2 and 7 after admission when compared with the placebo group (day 2: P = 0.032; day 7: P = 0.046). Thus, haemostatic activation occurred in acute ischaemic stroke was effectively blocked by argatroban.

Aged↗

Effects of heparin on the inhibitory action of protamine on endothelium-mediated vasorelaxation.

The precise mechanism(s) of inhibitory action of protamine on endothelium-mediated vasorelaxation has not been fully elucidated. In addition, no information is available regarding the effects of a heparin-protamine complex on the endothelium-mediated relaxation. Employing isometric tension recording methods, we studied the effects of heparin, an anionic substance, on the protamine-induced inhibition of acetylcholine (ACh)-induced vasorelaxation in isolated rabbit small mesenteric artery. Protamine (> or = 50 micrograms/ml) inhibited ACh (0.03-10 microM)-induced relaxation under a norepinephrine (10 microM)-stimulated condition (P < 0.05). The ACh relaxation, even 20 min after washout of protamine (150 micrograms/ml), was still significantly inhibited as compared to the control (before protamine) ACh relaxation, and further, it was not significantly different from the ACh relaxation maximally inhibited in the presence of protamine. Preapplication of heparin (700 U/ml) almost abolished the protamine inhibition (50 & 150 micrograms/ml) of the ACh relaxation. However, heparin (700 U/ml), applied on washout of protamine (150 micrograms/ml), had no effect on the prolonged protamine inhibition. In conclusion, a heparin-protamine complex had no direct effect on the endothelium-mediated relaxation, and the inhibitory action of protamine on the endothelium-mediated relaxation might be due to its polycationic property. The prolongation of protamine inhibition and the lack of effects of heparin on the prolonged protamine inhibition may suggest a toxic effect of protamine on the endothelium.

Acetylcholine↗