Biomedical subjects

K Kono

Publications and source records attributed to K Kono.

At least 91 records · Page 5Linked to original sources

PubMed1998

[Usefulness and problems of percutaneous endoscopic gastrostomy in a geriatric hospital].

Usefulness and problems of percutaneous endoscopic gastrostomy (PEG) placement in a geriatric hospital where most patients were severely demented or bed-ridden were evaluated. The variables examined were acute complications, chronic complications, restraint of patients before and after PEG placement, change in physical activity, and ability of oral intake. Results showed that both acute and chronic complications were not rare, but these problems are not peculiar to geriatric hospitals. Quality of life (QOL) was clearly improved. Restraint could be reduced or stopped in 65.2% of restrained patients after PEG tube placement, activity was improved in 55.5% of patients, and oral intake became possible in 14.0% of patients. There were also some improvements in the management of PEG, as the incidence of self-extubation decreased, and tube exchange became easier. In conclusion, it is possible to insert and manage the PEG tubes even in geriatric hospitals, and PEG tubes are quite useful in managing patients with chronic disease and in improving QOL.

Aged↗

PubMed1998

[Radiation therapy for non-small cell lung cancer with postoperative intrathoracic recurrence].

We reviewed patients with intrathoracic recurrence of non-small cell lung cancer after surgery, with reference to the feasibility of radiotherapy. The series consisted of 46 patients (39 males and 7 females) treated by radiotherapy from 1982 to 1995. Histology included squamous cell carcinoma (28 patients), adenocarcinoma (17), and large cell carcinoma (1). Clinical stage by UICC classification (1987) was as follows: stage I(2 patients), stage II(1), stage IIIa(13), stage IIIb(23), and stage IV(7). Recurrences were noted in bronchial stump (18 patients) and surgical scar (4). Metastases occurred in hilar-mediastinal lymphnodes (15), lung fields (7), and pleuropericardium (2). The mean interval from surgery to recurrence was 27 months. Delivered dose ranged from 45 to 80 Gy, and 19 patients received combined chemotherapy. Therapeutic results were as follows: complete response in 16 patients, partial response in 27, no response in 12 and progressive disease in 1, Overall 2- and 5-year survival rates were 17% and 11%, respectively, and 10 months in MST. On univariate analysis, significant prognostic factors were sex, stage at recurrence, recurrence pattern, performance status and initial response to radiotherapy, while multivariate analysis showed sex and initial response. From these data, we are encouraged by effective radiotherapy for postoperative intrathoracic recurrence of non-small cell lung cancer, especially in patients with stump or lymphnode recurrence.

Adenocarcinoma↗

PubMed1998

[Factors influencing admission to nursing homes among frail and bedridden elderly persons receiving public health and welfare services].

A prospective study was conducted to elucidate the factors influencing admission to nursing homes among frail and bedridden elderly persons. The subjects were 149 persons, 70 years of age and above, who were living in Goshiki-cho, Hyogo prefecture and were receiving services from public health and welfare organizations. All of the subjects had a family physician and their own residence or own room at home. A follow-up study of admissions to nursing homes was performed from 1991 to 1996. The main results were as follows: 1. During the study (about 5 years), 42.9% (N = 64) of subjects were staying at home, 38.9% (N = 58) died at home, and 16.8% (N = 25) were admitted to nursing homes. 2. To find factors influencing admission to nursing homes, an analysis using Cox proportional, hazard model was conducted. Major factors found were high age, women, disabilities of hearing and eyesight, and difficulty in communication. The admission rate to nursing homes was especially high among patients 90 years of age or greater. 3. The admission rate to nursing homes was higher in subjects receiving home help services compared to the rest of the group. 4. Remarkable differences in household composition were observed between those who continued to stay at home and those admitted to nursing homes. Among the subjects living alone or living with a spouse, the mean age was significantly higher in the group who were admitted to nursing homes than those staying at home. In the case of two or three-generation households, the admission rate to nursing homes was high when the household lacked caregivers.

Aged↗

PubMed1998

[Results of radiation therapy for limited small-cell lung cancer].

Results of radiotherapy were reviewed in 68 patients with limited small-cell lung cancer from the aspect of local control. Thirty-one patients achieved CR (46%), while the other 31 remained at PR. The 1-, 2-, 3-, and 5-year cumulative survival rates were 57%, 28%, 21%, and 16%, respectively, for 15 months in MST. Thirty-six patients developed local recurrence (53%) and 46 had distant metastasis (68%). The thirty-one patients with CR had a 43% 2-year-survival rate and 23 months in MST. The remaining 37 patients (PR + NC) had respective figures of 13% and 13 months (p < 0.025). There was no statistically significant difference between radiation dose and local thoracic failure among the patients. Of the 31 patients with CR, 28 had achieved CR at 45Gy (17 received 55Gy or more, and 11 less than 55Gy). In the former, the local control rate, 2-year-survival and MST were 94%, 53% and 44 months, while in the latter these were 45%, 27% and 17 months, respectively. Thirty-five patients were irradiated by the shrinking field technique according to tumor reduction; however, this technique did not influence the treatment results. To obtain better results, it is first necessary to achieve CR at initial chemo-radiotherapy. As to irradiation, randomized trials between 50Gy and 60Gy would require patients with CR at 45Gy.

Aged↗

PubMed1998

[Endoscopic findings of esophagitis in concurrent chemo-radiotherapy for lung cancer].

We performed esophageal endoscopy with concurrent chemo-radiotherapy for lung cancer in 19 patients. Endoscopical examination proved that seven patients (36.8%) had esophageal erosion or coating (grade 2), four patients (21.1%) had ulcer or bleeding (grade 3) confined to the radiation field, and only one patient (5.3%) had severe symptoms (WHO grade 3). There was a discrepancy between patients' symptoms and endoscopical findings. Endoscopically proven esophagitis, that is, erosion or coating (grade 2), and ulcer or bleeding (grade 3), was more frequent in the daily low-dose chemotherapy group (5/5) than in the full dose chemotherapy group (5/14) (p < 0.05). One patient with grade 3 endoscopial damage showed less recovery in spite of three months medication. In concurrent radiochemotherapy in which the radiation field includes the esophagus, careful attention should be given to radiation esophagitis, which may be underestimated when assessed on the basis of subjective symptoms alone. Therefore, endoscopy is recommended even if patients have few complaints, and once the esophageal ulcer is proven (grade 3), it should be closely followed up using endoscopy.

Adult↗

PubMed1998

[A case of male who was taken systemic lupus erythematosus with chilblain lupus].

A 38-year-old male was admitted to our hospital because of high grade fever, erythema of face and extremities and oral ulcer. The laboratory examination showed leukopenia, high titer (320 dil.) of antinuclear antibody, a positive reaction of anti-Sm antibody. Especially histopathology of hand erythema showed hydrophilic degeneration consist with chilblain lupus. Because his symptoms were consistent with the criteria of American College of Rheumatology (1982), he was diagnosed as systemic lupus erythematosus (SLE). After administration of 60 mg prednisolone daily, the symptoms gradually improved. Any recrudescence of serological abnormalities or clinical symptoms was not observed until now, although chilblain lupus still persisted. Originally SLE is frequent in young female and often attended with renal disease, central nerve disease and serositis. We reported a case of middle-aged male who developed SLE with chilblain lupus which was rare skin lesion of SLE without severe organic lesion and discussed the relation among chilblain lupus, discoid lupus erythematosus (DLE) and SLE.

Adult↗

PubMed1997

Differences in the recognition of tumor-specific CD8+ T cells derived from solid tumor, metastatic lymph nodes and ascites in patients with gastric cancer.

We established gastric cancer-specific CD8+ T-cell (T(CD8+)) lines derived from different lymphocyte sources in the same patients by repeated stimulation with mitomycin-C-treated autologous tumor cells with low-dose interleukin-2, and we compared recognition patterns among the T(CD8+) derived from solid tumor, lymph node metastasis and ascites in the same patient (n = 3) to determine their similarities and differences for therapeutic purposes. We confirmed that gastric cancer-specific T(CD8+) lines can be isolated, in a MHC class I-restricted manner, from solid tumors, metastatic lymph nodes and malignant ascites. T(CD8+) lines derived from tumor-infiltrating lymphocytes (TIL) in solid tumor recognized autologous tumor cells derived from solid tumor, but not autologous tumor cells derived from ascites or metastatic lymph node, while T(CD8+) lines derived from tumor-associated lymphocytes (TAL) in malignant ascites recognized autologous tumor cells derived from ascites, but not tumor cells from solid tumor or metastatic lymph node. Furthermore, T(CD8+) lines derived from regional lymph node lymphocytes (RLNL) recognized autologous tumor cells derived from metastatic lymph nodes, but not tumor cells derived from ascites. No significant differences were seen in MHC class I expression among the tumors derived from solid tumor, lymph node metastasis or ascites in the same patient. This suggests that there are differences of recognition patterns among the TILs, TALs and RLNLs in the same patient and that it is important to consider the source of lymphocytes, e.g., a combination of TILs, TALs and RLNLs, for adoptive immunotherapy in gastric cancer patients.

Aged↗

PubMed1997

Cytoplasmic delivery of calcein mediated by liposomes modified with a pH-sensitive poly(ethylene glycol) derivative.

Previously, as a new type of pH-sensitive liposome, we prepared egg yolk phosphatidylcholine (EYPC) liposomes bearing succinylated poly(glycidol), that is a poly(ethylene glycol) derivative having carboxyl groups, and showed that fusion ability of the liposomes increases under weakly acidic and acidic conditions (Kono, K., Zenitani, K. and Takagishi, T. (1994) Biochim. Biophys. Acta 1193, 1-9). In this study, we examined intracellular delivery of a water-soluble molecule, calcein, mediated by the succinylated poly(glycidol)-modified liposomes. When CV-1 cells, an established line of African green monkey kidney cells, were incubated with bare EYPC liposomes containing calcein at 37 degrees C, only weak and vesicular fluorescence of calcein was observed by using a fluorescence microscope. In contrast, the cells treated with the polymer-modified liposomes containing calcein displayed more intensive and diffuse fluorescence, indicating that calcein was transferred into the cytoplasm. Uptake of the polymer-modified liposomes by the cells was shown to decrease slightly as amount of the polymer fixed on the liposome increases. However, the fluorescence of calcein observed in the liposome-treated cell was, on the contrary, enhanced as amount of the polymer fixed on the liposome increases, indicating that the liposome modified with a higher amount of the polymer transfers its content into cytoplasm more efficiently after internalization into the cell. Fusion assay by resonance energy transfer using N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)phosphatidylethanolamine and lissamine rhodamine B-sulfonylphosphatidylethanolamine suggested occurrence of fusion between the polymer-modified liposomes and endosomal and/or lysosomal membranes. Moreover, the liposome with a higher polymer content revealed higher percent fusion after internalization into the cell. These results imply that the polymer-modified liposomes transfer the content into the cytoplasm by fusing with the endosomal membrane after internalization into the cells through an endocytic pathway.

Animals↗

PubMed1997

Mechanisms of escape from CD8+ T-cell clones specific for the HER-2/neu proto-oncogene expressed in ovarian carcinomas: related and unrelated to decreased MHC class 1 expression.

We have developed an in vitro model to study mechanisms by which ovarian tumor cells that over-express the HER-2/neu proto-oncogene escape recognition by TCD8+. Nine tumor-specific, HLA A2-restricted TCD8+ clones were isolated from 2 ovarian tumor-specific TCD8+ lines derived from tumor-infiltrating or -associated lymphocytes. Of these, 2 clones recognized the previously defined HER-2/neu epitope E75 (a.a. 369-377) and one recognized the C85 epitope (a.a. 971-979), whereas the specificity of the remaining 6 clones was unknown. Three different tumor escape variants (EVC8, EVC22 and EVC36) were produced by co-culturing an ovarian tumor line over-expressing HER-2/neu with these autologous TCD8+ clones. Cell surface expression of HLA A2 was markedly decreased on all 3 escape variants, relative to the parental tumor line, while no significant decrease in their expression of the HER-2/neu, ICAM-1 or LFA-3 molecules was found. There was a correlation between the level of tumor-specific recognition and HLA A2 expression among the tumor clones isolated from 2 of the escape variants (EVC8 and EVC36). In contrast, high HLA A2-expressing tumor clones isolated from the EVC22 variant, or EVC22 which had regained high HLA A2 expression through IFN-gamma treatment, were not recognized by the HER-2/neu-specific TCD8+ clone C-22. No mutations were found in the cDNA or the genomic DNA derived from the PCR product corresponding to a 496 bp fragment including the region coding for the E75 epitope of the HER2/neu gene in the EVC22 variant. Collectively, this in vitro model underlines the importance of decreased expression of the HLA restriction element for escape from tumor-specific TCD8+ but also demonstrates that additional mechanisms exist.

Down-Regulation↗

PubMed1997

CD28 is not required for rejection of unmanipulated syngeneic and autologous tumors.

To gain a better understanding of the requirement of CD28 co-stimulation in different types of T cell-dependent tumor rejection responses, we performed a series of syngeneic and autologous tumor rejection experiments on CD28 knockout mice. In a preimmunization-challenge model, virally-induced ALC lymphoma and methylcholanthrene-induced MC57X fibrosarcoma transplants were rejected similarly by syngeneic CD28 knockout and immunocompetent controls. ALC-specific cytotoxic T lymphocytes (CTL) and MC57X-specific tumor necrosis factor (TNF) release were induced in CD28 knockouts, although at a reduced level in the latter case. Secondly, the spontaneous regression of Moloney murine sarcoma virus (MMSV)-induced primary tumors in the autologous hosts occurred equally in CD28 knockouts and in immunocompetent control mice. A comparable virus-specific CTL response was generated in both, as revealed in cytolytic assays against RBL-5 targets. Thirdly, the spontaneous rejection of the B7-transfected EL-4 lymphoma by immunocompetent hosts was abrogated in CD28 knockout mice, since more than 82% CD28 knockouts developed tumors after inoculation with B7-transfected EL-4 cells. Our results therefore show that CD28 co-stimulatory molecules are not required for the rejection of unmanipulated syngeneic tumors in hyperimmunized hosts and the regression of MMSV-induced sarcoma in autochthonous hosts.

Animals↗

PubMed1997

Serum boron concentration from inhabitants of an urban area in Japan. Reference value and interval for the health screening of boron exposure.

Boron (B) levels were determined in the serum of 980 healthy inhabitants living in an urban area of Japan by means of inductively coupled plasma emission spectrometry (ICPES). The results showed a log-normal distribution of serum B for both sexes, although there are age-related differences. In male subjects, serum B increases rapidly up to 49 yr of age, reaching a plateau between ages 50 and 69 yr old, followed by a gradual increase up to 70 yr or older. Female subjects exhibit a gradual increase up to the age of 70 yr old. The reference value for male and female subjects was 79.8 micrograms/L and 67.9 micrograms/L, and the reference interval was 33.3-191.2 micrograms/L and 29.5-154.9 micrograms/L, respectively. The obtained reference value and interval of the nonexposed group may be useful for health screening for B exposure, either for people living in regions with high levels of B in the environment, or for workers who are exposed to this element.

Adolescent↗

PubMed1997

Frequency and significance of antibodies to P450IID6 protein in Japanese patients with chronic hepatitis C.

BACKGROUND/AIMS: The aims of the current study were to assess the frequency and the significance of antibodies to cytochrome P450IID6 protein (anti-P450IID6) in various diseases among Japanese patients. METHODS: Sera from 541 patients were tested by indirect immunofluorescence, and the specificity of anti-P450IID6 was ascertained by either enzyme immunoassay (ELISA) or Western blot using recombinant antigen or rat liver microsomes. RESULTS: Anti-P450IID6 was found in only 6 of 235 patients (2.6%) with chronic active hepatitis (CAH) positive for hepatitis C virus (HCV) antibody and quantitative HCV-RNA with genotypes II and IV. The predominant epitopes on immunoblots were 66 and 50KD, a 10KD band being the newly underfined microsomal antigen. Even in the patients negative for autoantibodies to nuclear antigens (ANA) by routine indirect immunofluorescence test, various ANA were detected by the newly developed recombinant ELISA. These patients were younger, with lower gamma-globulin and IgG levels than patients with autoimmune hepatitis. Three of five patients with anti-P450IID6 responded well to interferon therapy and one received prednisone when interferon was ineffective. Interestingly, only this patient was diagnosed as definite autoimmune hepatitis according to the criteria proposed by the International Autoimmune Hepatitis Group (IAHG). The other five patients who did not satisfy the IAHG criteria might be considered as CAH-C with autoimmune features. No autoimmune hepatitis patients positive for anti-P450IID6 were identified in the current study, indicating that the variant is very rare in Japan. CONCLUSIONS: Anti-P450IID6 in CAH-C patients in Japan is not as rare as expected. Anti-P450IID6 among Japanese patients has uncertain significance and precludes further characterization of CAH-C with autoimmune features, which might require interferon therapy.

Adult↗

PubMed1997

Conversion of in vitro cultured human monocytes into effective presenters of an HER2/neu-encoded CTL peptide epitope.

Tumour-derived peptides have been surveyed, in a variety of systems, for their ability to elicit cytokine release from class I restricted T cells. Analogous studies on ovarian carcinoma have employed the antigen-processing defective T2 cell line, Purified dendritic cells (DC) have been reported to act as highly effective APC. A facile method was developed whereby DC-like cells were generated from monocyte precursors. Herein, evidence is presented suggesting DC-like cells are superior to T2 with respect to their ability to present a defined CTL epitope associated with ovarian carcinoma.

Antigen-Presenting Cells↗

PubMed1997

Antibodies to P450IID6, SLA, PDH-E2 and BCKD-E2 in Japanese patients with chronic hepatitis.

Auto-antibodies specific to various antigens in chronic hepatitis (CH) have been detected but their specificities and implications were uncertain. The aims of the present study were to investigate the frequency and the significance of seropositivity of antibodies to P450IID6 or liver/kidney microsome 1 (LKM1), soluble liver antigen (SLA), pyruvate dehydrogenase (PDH) and branched-chain keto acid dehydrogenase (BCKD) in 188 Japanese patients with different forms of CH by western blot or enzyme immunoassay (EIA). Anti-LKM1 was also measured by indirect immunofluorescent test. Anti-P450IID6 was found in 6/188 (3.2%) CH patients including 5/104 (4.8%) with hepatitis C virus (C) infection and 1/12 (8.3%) CH-C patients with antibodies to nuclear and smooth muscle antigens and hypergammaglobulinaemia (> 2.5 g/dL). This patient was the only one diagnosed with autoimmune hepatitis (AIH). All CH patients with hepatitis B (B), hepatitis non-B non-C (NBNC) and AIH were seronegative for anti-LKM1. Antibodies to soluble liver antigen were found in two of 188 (1%) patients, one with AIH and one with CH-B. Anti-BCKD-E2 but not anti-PDH-E2 was found in four patients (2.5%), one with AIH, two with CH-C, and one with NBNC. There was no obvious difference in age, sex ratio and laboratory findings in patients with or without anti-SLA and anti-BCKD-E2. Antibodies to P450IID6, SLA, PDH-E2 and BCKD-E2 are uncommon in adult CH-C, CH-B, CH-NBNC and AIH patients in Japan. Some of these patients positive for auto-antibodies appear to have autoimmune features and might require a careful follow up. The heterogeneity of these antibodies in CH preclude further justification for subtyping of AIH by the presence of the distinct auto-antibodies.

3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide)↗

PubMed1997

[Relation between candidiasis and nutrition of patients and MRSA infection].

We evaluated the relation with nutritional state and methicillin-resistant Staphylococcus aureus (MRSA) infection of 20 patients who isolated Candida of 31 patients who were suspected as candidiasis. All of the patients who were hospitalized in internal medicine wards in our hospital between February 1993 and January 1994. All patients with hematological disease were excluded. MRSA is now gotten much attention as pathogen of hospital infection, but each MRSA is detected not only alone but also concomitant with other bacterium. In our hospital MRSA was detected alone 36.8% (39/106). Candida 9.4% (10/106) was frequent as mixed infectious pathogen concomitant with MRSA following Pseudomonas aeruginosa 19.8% (21/106) and Enterococcus faecalis 12.3% (13/106). Intension of host-immunity is a important factor as prevention of both infection. We evaluated the nutritional state of patients with 7 cases of infection group and 13 cases of colonization group. There was no significance between two groups as for serum total protein (mean) were 5.97 g/dl in infection group and 5.96% g/dl in colonization group. Furthermore there were significance (p < 0.01) for mean serum albumin (mean) were 3.11 g/dl v.s. 3.27 g/dl. But both serum total protein and serum albumin of these evaluated patients who isolated Candida were less than normal limit. Therefore we considered nutritional disturbance was important addition to over-use of antibiotics and severe underlying diseases as risk factor of candidiasis, and revealed the importance of improvement of nutritional state at the prevention and therapy.

Adult↗

PubMed1997

The effect of hemodialysis upon serum levels of fluoride.

Serum and dialysate ionic fluoride (F-) were determined in 29 patients under hemodialysis (HD) treatment. Serum creatinine (Cr), blood urea nitrogen (BUN) and phosphorus (P) were also examined before and after HD in 92 patients including the above 29 patients under the same treatment. Results reveal that serum F- levels of the patients before and after HD were statistically higher than those of the healthy subjects. The dialysis clearance of F- was 55.6 +/- 101.3 ml/min and the value was statistically significantly lower than those of Cr, BUN (95%, p < 0.001) and P (95%, p < 0.01). Based on these results, it is concluded that despite a net clearance of F- during a given HD procedure, serum F- failed to return to normal.

Adult↗

PubMed1997

Immunopotentiating activity of the water-soluble lignin rich fraction prepared from LEM--the extract of the solid culture medium of Lentinus edodes mycelia.

The water-soluble lignin in LEM (the extract of the solid culture medium of Lentinus edodes mycelia) has been known to have antiviral and immunopotentiating activities in vivo and in vitro. The water-soluble lignin rich fraction (JLS-18) was prepared from LEM using ultrafiltration and hydrophobic column chromatography. JLS-18 showed about 70 times higher antiviral activity than LEM in vitro. JLS-18 activated the cytotoxicity of NK cells and macrophages, and activated T cells in vitro. JLS-18 also induced interleukin 6 (IL-6) secretion from human leukocytes infected with Sendai virus in vitro. These data showed that JLS-18, the water-soluble rich fraction of LEM, had antiviral and immunopotentiating activities.

Adjuvants, Immunologic↗

PubMed1997

[Gastro-esophageal reflux successfully treated with transgastrostomal jejunal tube feeding].

An 82-year-old man suffered from recurrent melena due to reflux esophagitis and aspiration pneumonia, which were caused by severe gastroesophageal reflux. We constructed a gastric stoma by percutaneous endoscopic gastrostomy (PEG) and fixed a transgastrostomal jejunal tube (TGJ tube) in the jejunum through the stoma. Direct administration of fluid into the jejunum was followed by a significant reduction in gastro-esophageal reflux. The reflux esophagitis and aspiration pneumonia did not recur. There was no vomiting, self-extubation, or restlessness that might have been caused by dementia, and the patient was could discharged cared for at into home.

Aged↗