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Biomedical subjects

K Maeda

Publications and source records attributed to K Maeda.

At least 523 records · Page 29Linked to original sources

[A patient with systemic scleroderma showing improvement during long-term hemodialysis after renal crisis].

A 68-year-old man experienced systemic pruritus since he was 63 years old, and systemic sclerosis and skin pigmentation were observed when he was 64. When he developed dyspnea the same year, he was admitted and SSc was diagnosed on the basis of the clinical and skin biopsy findings, lung fibrosis on X-P and TBLB findings. At 65, his dyspnea reappeared along with elevated blood pressure, acute renal failure and lung congestion, and he was diagnosed as having a scleroderma renal crisis (SRC) from the clinical and renal biopsy findings. Hemodialysis was started because he showed mental disturbance, and this and other acute symptoms were subsequently reduced. As he showed no recovery from his renal failure, the patient has been maintained on hemodialysis for over four years now. In the meantime, his sclerosis has improved and antinuclear antibody almost disappeared. Hemodialysis appears to be the most likely reason for his improvement, although spontaneous remission, D-penicillamine and angiotensin converting enzyme (ACE) inhibitor therapy may also have contributed, considering the short period and the small amount of drugs given until improvement.

Aged↗

Pregnancy and neonatal outcomes in unexplained recurrent/habitual aborters treated by allogenic leukocyte immunization.

Allogenic leukocyte immunization is a common treatment of unexplained recurrent abortions, whose immunological side effects have hardly been reported. In this study, pregnancy and neonatal outcomes of unexplained recurrent/habitual aborters, who were treated by their husbands' leukocyte immunization, are reviewed. Seventy-seven patients were treated by their husbands' leukocyte immunization at the Infertility Cline of Osaka City University Hospital from 1985 to 1995. Among the 63 pregnancies after the immunizations, 47 cases succeeded in livebirths. Ten of the 47 cases were delivered by cesarean sections. There found no possible relationship between their operative indications and leukocyte immunizations in the 10 cases. As for pregnancy complications, two patients showed liver dysfunction. However we did not find any specific side effects in the pregnancy complications. There was no specific fetal/neonatal complications to the immunotherapy but a case of neonatal thrombocytopenia caused by maternal anti-HLA IgGs.

Abortion, Habitual↗

[Apolipoprotein E genotype as a risk factor in Japanese patients with early-onset and late-onset Alzheimer's disease].

Recent studies have provided evidence of an association of apolipoprotein E (apoE) epsilon 4 allele and late-onset sporadic Alzheimer's disease (AD). Some studies have shown the possibility that apoE epsilon 4 is a risk factor of developing AD in early-onset type. We have analyzed the apoE gene polymorphism in a sample of 310 Japanese AD subjects and 237 age-matched Japanese controls. We divided the sporadic AD patients into two subgroups of 237 late-onset (> 65 years) and 73 early-onset (< or = 65 years) patients, and into three subgroups according to their apoE genotype, no epsilon 4, one epsilon 4, and two epsilon 4 alleles. Our data confirmed an association between epsilon 4 allele and early-onset AD and late-onset AD. The odds ratios (95% confidence interval) referred to no epsilon 4 allele for AD were 3.4 (1.7-7.0) for one epsilon 4 allele and 20.3 (2.5-166.6) for two epsilon 4 alleles in early-onset type, and 6.7 (3.9-11.3) for one epsilon 4 allele and 19.0 (2.5-145.6) for two epsilon 4 alleles in late-onset type. These ratios were significantly increased in both early-onset AD and late-onset AD. Kaplan-Meier survival analysis, which estimates the age of onset for subjects with no, one, and two epsilon 4 alleles in early-onset and late-onset type, revealed a significant dose effect where each additional epsilon 4 allele made the age of onset earlier (p < 0.0001). The age of onset is 9.7 years earlier for two epsilon 4 bearers and 3.9 years earlier for one epsilon 4 bearers than no epsilon 4 bearers in late-onset AD, 2.9 years earlier for two epsilon 4 bearers and 1.4 years earlier for one epsilon 4 bearers than no epsilon 4 bearers in early-onset AD. Moreover, we studied an association between apoE epsilon 2 allele and early-onset AD and late-onset AD. There was a significantly decreased frequency of apoE epsilon 2 allele in patients with late-onset AD (p = 0.026), although the frequency of apoE epsilon 2 was not changed significantly in early-onset AD (p = 0.360). The odds ratios referred to no epsilon 2 allele for AD were 1.9 (0.6-5.7) for one epsilon 2 allele in early-onset type, and 0.4 (0.2-0.9) for one epsilon 2 allele in late-onset type. Our study suggested the difference in the effect of apoE genotype on developing AD between early-onset and late-onset type in Japanese patients.

Age of Onset↗

[Cystic renal cell carcinoma: report of four cases].

We report 4 cases of cystic renal cell carcinoma (RCC), one of simple cystic type (case 2) and three of multilocular cystic type (case 1, 3 and 4). All cases were diagnosed preoperatively as malignant neoplasms on the basis of radiological examinations, including CT scan and angiography. Pathological examination revealed that intrinsic cystic growth was the probable cause in the three cases of multilocular cystic RCC, while the simple cystic case was probably caused by secondary cyst formation as a result of tumor necrosis. Radical nephrectomy was performed in cases 1, 2 and 4 and partial nephrectomy in case 3. We recommend nephron-sparing surgery as an option in the management of select cystic RCC, given that many cystic RCCs are low grade and enveloped by distinct pseudocapsules with fibrous tissues.

Adenocarcinoma, Bronchiolo-Alveolar↗

[Effect of cessation of erythromycin therapy on diffuse panbronchiolitis].

The effect of cessation of erythromycin (EM) therapy against diffuse panbronchiolitis was studied. Nine cases were examined. After cessation of EM therapy, the manifestations of disease were stable in five cases, but worsened in the other four. In the former five, the period from the onset of disease until EM therapy began was relatively short; when EM therapy was stopped the manifestations of disease had almost completely disappeared and chest roentgenography revealed resolution of diffuse, small, nodular opacities without remarkable bronchiectasis. In contrast, in the latter four cases, the clinical manifestations of disease did not disappear, and chest-roentgenographic evidence of bronchiectasis was common before the cessation of EM therapy. In conclusion, EM therapy for diffuse panbronchiolitis may be stopped if the clinical manifestations of disease (especially purulent sputum) disappear, if diffuse, nodular opacities resolve almost completely and if there is no evidence of bronchiectasis.

Adolescent↗

Three-dimensional reconstruction of intravascular ultrasound images of coronary stents using an ECG-gated pull-back device.

Three-dimensional reconstruction (3D-R) of intravascular ultrasound (IVUS) images is not yet satisfactory because of artifacts caused by cardiac movement. This problem can be overcome with a new device, an electrocardiographic (ECG)-gated pull-back system. Using this device a catheter is pulled back stepwise gated by the ECG, and IVUS dynamic images of an entire cardiac cycle are acquired at each step. We performed 3D-R of IVUS images of stents using this new device in six patients with Palmaz-Schatz coronary stent implantation. We obtained precise 3D images in all cases, and stent structure was visualized in detail. In conclusion, use of an ECG-gated pull-back device enables precise 3D-R of IVUS images and provides useful information on the coronary artery.

Aged↗

[Traditional remedy-induced Chinese herbs nephropathy showing rapid deterioration of renal function].

A 19-year-old female was referred to our hospital for azotemia and anemia. She had been taking a health food for atopic dermatitis for about three years. Urinalysis showed proteinuria, glycosuria and microscopic hematuria. Generalized aminoaciduria was observed. Moreover, severe anemia, azotemia, hypokalemia and hypophosphatemia were also observed. Renal biopsy specimen disclosed hypocellular interstitial fibrosis and degeneration of the proximal tubular epithelial cells. No remarkable changes were observed in the glomeruli. Aristolochic acid was detected in the health food. From these findings, she was diagnosed as having Chinese herbs nephropathy (CHN). Although consumption of the food intake was stopped, her renal function deteriorated rapidly. Previously, we reported that certain kinds of Chinese herbal drugs contain aristolochic acid and that the drugs should be prohibited if aristolochic acid is identified. However, we experienced a patient of CHN arising from traditional remedy, which was not proved to be safe. It should be awared that health foods may contain aristolochic acid.

Adult↗

[Efficacy and safety of intramuscular imipenem/cilastatin (IPM/CS) for complicated urinary tract infections].

An intramuscular preparation of imipenem/cilastatin (IPM/CS, 500 mg/500 mg) was administered to 59 patients with complicated urinary tract infections (UTI; cystitis and pyelonephritis) to evaluate its efficacy and safety. The obtained results are summarized as follows: In patients with cystitis, evaluations based on daily frequencies of administration were also performed. 1) According to the treating doctors, the drug showed an overall efficacy rate of 80% (45/56 patients). The efficacy rate was 89% in patients with cystitis treated by a u.i.d. regimen. Among patients treated by a b.i.d. regimen, the efficacy rate was 67% for cystitis cases and 84% for pyelonephritis cases. 2) When clinical efficacy was assessed according to the criteria for UTI drug efficacy evaluation, the drug was 'markedly effective' in 14 patients, 'effective' in 23, and ineffective in 11 patients, for an efficacy rate of 77% (37/48 patients). 3) The microbiological eradication rate was 88% (59/67 strains). The rate was 95% (20/21 strains) for Gram-positive bacteria and 85% (39/46 strains) for Gram-negative bacteria. The efficacy for Enterobacter faecalis and Pseudomonas aeruginosa was 100% and 73%, respectively. 4) As side effects, pain at the injection site was reported by one patient and abnormal laboratory test values were observed in 2 patients. All of these reactions were mild and resolved shortly after the completion of treatment. Based on these findings, it is concluded that this intramuscular preparation of IPM/CS is effective for treating complicated urinary tract infections.

Adolescent↗

Immunohistochemical study of advanced glycation end products in aging and Alzheimer's disease brain.

Advanced glycation end products (AGEs) in the brain were immunohistochemically examined in Alzheimer's disease (AD) and aging using anti-AGE antibody recognizing mainly carboxymethyllysine. AGE positive staining diffusely located in the neuronal perikarya of hippocampus and parahippocampus in AD and aged brains without dementia, but not in young brains less than 17 years of age. Extra-neuroperikaryal AGE deposits were also detected in the neuropil of AD and aged brains. The extra-neuroperikaryal AGE deposits markedly increased in AD brains as compared to aged brains. These AGE-positive deposits in the neuropil were not related to the senile plaque identified by anti-beta amyloid protein antibody. These findings suggest a potential link of AGE accumulation in the central nervous system to the aging process of neurons and the degenerating process of AD neurons.

Adolescent↗

Phencyclidine alters regional concentrations of neuropeptide Y and peptide YY in rat brain.

The psychotomimetic effects of Phencyclidine (PCP) often have a delayed onset and extend far from the time plasma drug levels reach their peak. PCP at a low dose is considered selective for actions on the N-methyl-D-aspartate-PCP receptor. We evaluated effects of PCP (2 and 10 mg/kg, IP) on regional content of neuropeptide Y (NPY)-like immunoreactivity (LI) and peptide YY (PYY)-LI, in the rat brain. Thirty minutes after administration of PCP, NPY-LI levels were significantly elevated in some limbic structures following both doses. A significant, widespread increase in NPY-LI levels was induced 2 hours after administration of the higher dose of PCP. On the contrary, NPY-LI was significantly decreased in a number of the regions 24 hours after PCP. The extent of reduction was less following the higher dose of PCP than following the lower dose. PCP did not cause a consistent effect on PYY-LI. The findings suggest that effects of PCP on brain NPY content might depend on the dose and the interval between administration of the drug and sacrifice.

Animals↗

Purification and characterization of perlecan fragment in urine of end-stage renal failure patients.

We found a new spot on the two-dimensional electrophoresis pattern of the urine protein from hemodialysis patients. In order to identify the protein forming this new spot, the protein was purified by five steps of chromatography. It was shown that the amino acid sequence of this new protein from the N-terminal to the 20th amino acid was identical with the sequence from the 4197th to 4216th amino acid of perlecan, which is the core protein of the proteoglycan localizing in the systemic capillary basement membranes. It was also found that the molecular weight (25,000 daltons) of this new protein was comparable to the calculated molecular weight of the molecular region of the perlecan from the 4197th amino acid to the C-terminal. Lastly, it was shown that the antibodies against this new protein reacted with the perlecan produced by human fibroblasts. All these findings indicated that the new protein is a perlecan fragment.

Amino Acid Sequence↗

Induction of L-lysine epsilon-aminotransferase by L-lysine in Streptomyces clavuligerus, producer of cephalosporins.

L-Lysine epsilon-aminotransferase (LAT) catalyzes the first reaction in the two-step conversion of L-lysine (Lys) to 1-alpha-aminoadipic acid (Aaa), a direct precursor of cephalosporins (including cephamycin C) in Streptomyces clavuligerus. Previous work showed that addition of Lys to chemically defined medium improved antibiotic production. We show that in S. clavuligerus cultures supplemented with high concentrations of Lys, Lys enhances antibiotic production by a dual effect, i.e. as a substrate of LAT thus providing Aaa and also as an inducer of LAT yielding even more Aaa. On the other hand, LAT is not induced by Aaa.

Cephalosporins↗