Biomedical subjects

K Murase

Publications and source records attributed to K Murase.

303 records · Page 17Linked to original sources

PubMedDate not supplied

Interferon-gamma production by peripheral blood mononuclear cells of patients with chronic liver disease.

We investigated the role of the interferon system in the pathogenesis of chronic liver disease. Interferon-gamma production by peripheral blood mononuclear cells was measured with an ELISA. While concanavalin A-stimulated and recombinant interleukin 2-stimulated production of interferon-gamma in patients with chronic active hepatitis and liver cirrhosis was significantly decreased when compared with that of controls (518 +/- 189 and 729 +/- 195 units per ml, mean +/- S.D.), there was also a lot of overlap. Addition of indomethacin to the cultures partially restored interferon-gamma production in patients with chronic active hepatitis and liver cirrhosis, indicating that suppressor function of monocytes was, in part, responsible for the diminished interferon-gamma production. Serial studies showed that interferon-gamma production rose during acute deterioration of illness, during treatment with interleukin 2 and with the improvement of clinical course. Interferon-gamma production was not different among hepatitis B e antigen or antibody positive, and non-A, non-B patients with chronic active hepatitis and liver cirrhosis. Our findings suggest that diminished interferon-gamma production is associated with disease severity in chronic liver disease, irrespective of the hepatitis B virus carrier state. It would be interesting to compare the efficacy of treatment with interferon-gamma or interferon-gamma inducers such as interleukin 2 in chronic hepatitis B patients with and without decreased in vitro interferon-gamma production.

Adult↗

PubMedDate not supplied

Pilot study of recombinant human interleukin 2 for chronic type B hepatitis.

Recombinant human interleukin 2 was administered to 10 patients with chronic type B hepatitis as a part of a pilot study to evaluate its antiviral activity. Patients received 1 to 3 x 10(5) units per day of interleukin 2 for 21 to 28 days, and all completed the treatment schedule. During therapy, serum values of DNA polymerase decreased in 6 and became negative in four patients. However, when therapy was discontinued, DNA polymerase levels increased to pretreatment levels in most cases. Serum HBeAg levels did not change during treatment. Serum aminotransferase levels transiently increased in 6 of the 10 patients during therapy; but once therapy was stopped, levels fell markedly. Side effects of interleukin 2 therapy included fever, chills, anorexia and fatigue. After 1 year of follow-up, three treated patients had lost HBeAg and had marked improvement in aminotransferase levels. These serologic and biochemical improvements occurred 1.5 to 11 months after therapy was stopped. Whether a 3- to 4-week course of interleukin 2 therapy leads to an increased rate of seroconversion from HBeAg to antibody in chronic type B hepatitis deserves further evaluation in prospectively randomized, controlled trials.

Chronic Disease↗

PubMedDate not supplied

Validity of microsphere model in cerebral blood flow measurement using N-isopropyl-p-(I-123) iodoamphetamine.

A microsphere model is sometimes used when calculating cerebral blood flow (CBF) using N-isopropyl-p-[I-123]iodoamphetamine (IMP), and is based on the assumption that there is essentially no washout of IMP. The validity of a microsphere model was investigated by comparison with the values of CBF obtained by means of a model which takes into consideration the diffusion of IMP from brain tissue to blood (nonmicrosphere model). When calculating CBF by the latter model, the look-up table method was used with expression of the double integral in the model equation by the recursion relations, a method which is useful for obtaining pixel-by-pixel values. The average rate constants for diffusion from brain to blood of gray and white matter were 0.021 and 0.0016 min-1, respectively. The values of CBF obtained by applying a microsphere model to the data acquired from 0 to 3.2 min after IMP injection were overestimated by approximately 23% compared with those values obtained using a nonmicrosphere model. This is considered to be due to the effect of the IMP activity in the vascular space. Values obtained using the data acquired from 3.2 to 6.4 min were underestimated by approximately 15%. When the values of CBF obtained by a microsphere model were interpolated, they became nearly equal to those obtained using a nonmicrosphere model at about 4 to 5 min after injection. This is suggested to be the reason why the underestimation due to diffusion from brain to blood is cancelled out by the overestimation due to the IMP in the vascular space. Our preliminary results suggest that it is necessary to take the diffusion of IMP from brain tissue to blood into account for the quantification of CBF using IMP.

Amphetamines↗

PubMedDate not supplied

Micronutrient status and glutathione peroxidase in bedridden patients on tube feeding.

Deficiency of micronutrients, especially selenium, is common in critically ill patients. We investigated the micronutrient status (selenium, zinc, copper and manganese) and glutathione peroxidase (GSH-Px) activity in 30 tube-fed patients and 21 hospitalized non-tube-fed control patients. Serum levels of selenium, copper and manganese in tube-fed patients were significantly lower than in control patients (selenium: 4.85+/-1.38 microg/dl versus 8.67+/-1.45 pg/dl; copper: 44.7+/-36.9 microg/dl versus 92.1+/-21.2 microg/dl; manganese 0.59+/-0.41 microg/dl versus 1.52+/-0.59 microg/dl). However, zinc and log GSH-Px in the serum were similar in the two groups. Serum selenium concentration correlated with the daily intake of selenium in tube-fed patients, but zinc, copper and manganese concentrations did not correlate with the daily intake of the respective trace elements in tube-fed patients. Blood GSH-Px activity correlated positively with serum selenium concentrations in the control patients, but not in tube-fed patients. These results demonstrate that selenium content of enteral feed appears to be insufficient to maintain normal serum levels in elderly bedridden patients. Our findings emphasize the importance of monitoring micronutrient status in patients on enteral feeding to avoid trace element deficiencies.

Aged↗

PubMedDate not supplied

Polymorphism of CYP2C19 and gastric emptying in patients with proton pump inhibitor-resistant gastric ulcers.

The aim of the present study was to investigate whether CYP2C19 polymorphism status and gastric emptying are related to healing in patients with gastric ulcers. We studied the CYP2C19 status in seven patients with proton pump inhibitor (PPI)-resistant ulcers, 21 with PPI-sensitive ulcers and 46 healthy volunteers using polymerase chain reaction restriction fragment length polymorphism to detect CYP2C19m1 mutation in exon 5 and CYP2C19m2 mutation in exon 4. Gastric emptying was evaluated using the 13C-acetate breath test. The frequency of phenotypes, indicated by genotypes, did not differ significantly between the three patient groups. The peak time of 13C excretion in patients with PPI-resistant ulcers was significantly longer than that of patients with PPI-sensitive ulcers and healthy volunteers. Our results suggest that rate of gastric emptying, but not CYP2C19 polymorphism, is likely to be an important factor in the delayed healing of patients with PPI-resistant gastric ulcer.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMedDate not supplied

Expression of interleukin 6 and its receptor in human gastric and colorectal cancers.

Interleukin 6 (IL-6) is a pleiotropic cytokine with many physiological functions. The present study was designed to determine the expression of IL-6 and its receptor (IL-6R) in human gastric and colorectal cancers. Nine gastric- and nine colorectal cancer cell lines were analysed. The IL-6 gene was expressed in two gastric cancer cell lines and one colorectal cancer cell line; however, most of the cancer cell lines studied expressed the IL-6R gene. The level of IL-6 secretion in the gastric cancer cell lines correlated with the level of soluble IL-6R secretion, and was significantly higher (< approximately 100 pg/ml) than the level of IL-6 secretion in the colorectal cancer cell lines (< approximately 50 pg/ml). These results suggest that IL-6 may act in a paracrine fashion rather than an autocrine fashion in these cell lines.

Cell Line, Tumor↗

PubMedDate not supplied

Impact of CagA status on serum gastrin and pepsinogen I and II concentrations in Japanese children with Helicobacter pylori infection.

The study aimed to determine the association between cytotoxin-associated gene product (CagA), serum gastrin and pepsinogen levels in Japanese children infected with Helicobacter pylori. Three hundred children were enrolled in the study. H. pylori infection was assessed using an enzyme-linked immunosorbent assay, and CagA status was assessed using immunoblotting. Serum gastrin and pepsinogen concentrations were measured by radioimmunoassay. H. pylori seroprevalence was 12.3% (37/300) and CagA status was identified in 28/37 H. pylori-seropositive children (75.7%). Serum pepsinogen I and II levels were significantly higher in CagA-seropositive than CagA-seronegative children with H. pylori infection. There was no significant relationship between CagA seropositivity and serum gastrin levels. In conclusion, CagA status has a significant impact on serum pepsinogen levels, possibly through enhanced gastric mucosal inflammation.

Adolescent↗

PubMedDate not supplied

Comparison of the microbicidal activities of superoxidized and ozonated water in the disinfection of endoscopes.

The microbicidal activities of superoxidized water (electrolysed strong acid water [ESAW] or electrolysed weak acid water [EWAW]), ozonated water, 0.05% chlorhexidine and 2% glutaraldehyde were tested against seven strains of clinical micro-organism isolates. Following incubation of bacterial suspensions in ESAW and EWAW for 10 s, the number of micro-organisms was reduced below the detection limit. The microbicidal activities of ESAW and EWAW were similar to that of glutaraldehyde, and superior to ozonated water and 0.05% chlorhexidine. The microbicidal activities of ESAW, EWAW and ozonated water were markedly diminished in the presence of albumin. Microbial contamination of upper gastrointestinal endoscopes was detected after 90 endoscopic procedures, but treatment of the endoscope with ESAW, EWAW or ozonated water eradicated the microbes. These results indicate that ESAW and EWAW are effective disinfectants after mechanical cleaning of upper gastrointestinal endoscopes, and can, therefore, be used in the endoscopy unit.

Acids↗

PubMedDate not supplied

Autoimmunity to heat shock protein 40 in ulcerative colitis.

Autoantibodies against heat shock protein 40 (HSP40) and their clinical significance in ulcerative colitis (UC) have not been evaluated before. Twenty-six tissue specimens of inflamed areas from patients with UC, 16 from patients with Crohn's disease (CD) and 16 endoscopically normal tissues were analysed for HSP40 expression. Sera from 47 patients with UC and 44 healthy volunteers were examined for the presence of autoantibodies against HSP40 by enzyme-linked immunosorbent assay test. Immunohistochemistry showed that 17 out of 26 specimens from UC patients, one specimen from a CD patient and one normal tissue specimen were positive for HSP40. Most HSP40-positive cells expressed CD68. Higher titres of anti-HSP40 autoantibodies were detected in sera from UC patients compared with healthy volunteers. In patients with inactive disease, those with proctitis or left-sided colitis had higher titres of anti-HSP40 autoantibodies than those with total colitis. Our study suggests that autoimmunity against HSP40 may have a beneficial effect in UC patients by limiting the extent of the disease.

Adolescent↗

PubMedDate not supplied

Ultrastructural study of a perineurioma.

A case of soft tissue tumor in the left brachialis muscle of a 49-year-old Japanese female patient was studied by electron microscopy. The tumor was diagnosed as intramuscular myxoma by light microscopy, but electron microscopic observation revealed that the tumor almost entirely consisted of cells similar to normal perineurial cells. The tumor cells possessed long, slender cytoplasmic processes covered by well-developed but discontinuous basal laminae, clusters of pinocytotic vesicles, and infrequent intercellular junctions. Perineurial cells have also been observed in other peripheral nerve lesions: neurofibromas, nerve sheath myxomas, and localized hypertrophic neuropathies. However, the term "perineurioma" or "perineurial cell tumor" should be reserved for discrete tumorous masses that are almost entirely composed of perineurial cells without evidence of residual axons, Schwann cells, fibroblasts, or tactile corpusclelike structures. Perineurioma may represent a third category of peripheral nerve sheath tumors, ultrastructurally distinct from schwannomas and neurofibromas.

Female↗

PubMedDate not supplied

Jejunal perforation in a patient with adult T-cell leukemia.

We present a case of adult T-cell leukemia (ATL) with jejunal perforation at the site of intestinal involvement by ATL. A 39-year-old woman presented with sudden-onset abdominal pain. Physical examination showed generalized severe abdominal tenderness and intraabdominal free air was seen on radiographic examination. Under a diagnosis of peritonitis due to intestinal perforation, an emergency operation was performed. A pinhole-like perforation was found in the jejunum 80 cm distal to Treitz's ligament, and the patient underwent partial resection of the affected jejunum. Microscopic examination revealed diffuse infiltration of abnormal lymphocytes into the entire wall of the jejunum and mesenteric lymph nodes. A diagnosis of ATL was confirmed by the presence of antibody to human T-lymphotropic virus type 1 (HTLV-1) in the serum, a positive result for T-cell markers and the HTLV-1 proviral genome in the mononuclear cells in the specimens. The final diagnosis was thus lymphoma subtype of ATL. Combination chemotherapy was repeated until the patient died 14 months postoperatively. Emergent surgery followed by intense chemotherapy might improve survival in patients with ATL and perforated intestine.

Adult↗

PubMedDate not supplied

Heterotopic gastric mucosa in intrahepatic bile duct, presenting with hemobilia: a case report.

We present a 66-year-old man with unique heterotopic gastric mucosa in the intrahepatic bile duct causing hemobilia. Endoscopic retrograde cholangiography showed irregular stenosis of the left intrahepatic bile duct, and a provisional diagnosis of cholangiocarcinoma was made. Therefore, partial hepatic lobectomy and cholecystectomy were performed. Histological examination of the liver showed the presence of ectopic gastric mucosa in the intrahepatic bile duct containing mucous glands with parietal and chief cells and bile. Heterotopic gastric mucosa in the intrahepatic bile duct is a rare cause of hemobilia.

Aged↗

PubMedDate not supplied

Clinical features and treatment of hepatocellular carcinoma in eight patients older than eighty years of age.

BACKGROUND/AIMS: Most-hepatocellular carcinoma patients are between 40 and 60 years of age, but an increasing number of elderly patients with hepatocellular carcinoma is expected in the future because of the increase in life expectancy seen in many countries. Since elderly patients have a high incidence of comorbid illnesses, it should be useful to examine the clinical features of these patients to select the optimal management strategy for hepatocellular carcinoma. METHODOLOGY: A retrospective review of 111 patients with hepatocellular carcinoma was undertaken to examine the clinical features of 8 patients older than 80 years of age. RESULTS: In the 111 patients with hepatocellular carcinoma, the ratio of males to females was 81:30 and the peak incidence of hepatocellular carcinoma was noted in the seventh and eighth decades in males and females, respectively. Of these, 21 (19%) were type "B" [seropositive for hepatitis B surface antigen (HBsAg) and seronegative for antibody to the hepatitis C virus (anti-HCV)], 69 (62%) were type "C" (seronegative for HBsAg and seropositive for anti-HCV), 3 (3%) were type "B + C" (seropositive for both HBsAg and anti-HCV), and 18 (16%) were type "non-B non-C" (seronegative for both HBsAg and anti-HCV). The peak incidences of type "B" were in the sixth decade, whereas those of type "C" were in the seventh decade in both males and females. Patients with "non-B non-C" were common in their seventies. Of the 111 patients, 6 (5 males and 1 female) were older than 80 years at the time of diagnosis and 2 females became 80 years old during the course of follow-up of hepatocellular carcinoma. All but one of these patients were anti-HCV-positive, stage and clinical stage I or II according to the criteria defined by the Liver Cancer Study Group of Japan, and underwent transcatheter arterial embolization and/or transcatheter arterial infusion chemotherapy. Transcatheter arterial embolization/transcatheter arterial infusion or percutaneous ethanol injection therapy was well tolerated in these patients, and the outcome of these patients was good. However, concomitant underlying diseases other than liver diseases made it impossible or difficult to apply an aggressive management protocol for hepatocellular carcinoma in some patients. CONCLUSIONS: Our results suggest that the overall treatment of hepatocellular carcinoma in the elderly should be similar to that in younger patients, but may be restricted by the concomitant underlying diseases specific to advanced age.

Aged↗

PubMedDate not supplied

Accumulation of mast cells and macrophages in focal active gastritis of patients with Crohn's disease.

BACKGROUND/AIMS: Recent studies have shown that focal active gastritis seems to be the typical gastric pathology in Crohn's disease. The aim of this study was to compare the incidence of focal active gastritis, Helicobacter pylori infection and distribution of gastric mast cells and macrophages in patients with Crohn's disease, ulcerative colitis and H. pylori gastritis without inflammatory bowel disease. METHODOLOGY: Patients with histologically confirmed Crohn's disease (n = 25) or ulcerative colitis (n = 25) and control patients without inflammatory bowel disease (n = 25) were included in this study. Biopsy specimens were obtained from the antrum and corpus of each patient, and stained with hematoxylin and eosin and immunostained using antibodies to tryptase (AA1) and CD68. The number of mast cells and macrophages located in the lamina propria was determined. RESULTS: Focal active gastritis was detected in 54% of H. pylori-negative patients with Crohn's disease, but it was not found in patients with ulcerative colitis nor in the control group. The density of mast cells and macrophages in the lamina propria of H. pylori-positive patients was significantly higher than in H. pylori-negative patients in all groups. In the Crohn's disease group, the number of mast cells (antrum; 83 +/- 11, body; 89 +/- 11/mm2) and macrophages (antrum; 94 +/- 22, body; 92 +/- 17/mm2) in the lamina propria of H. pylori-negative patients with focal active gastritis was halfway between that in H. pylori-positive and H. pylori-negative patients. In focal active gastritis, mast cells accumulated at the border of focal active gastritis, whereas macrophages accumulated in the center of such lesions. CONCLUSIONS: Our findings indicated that the diagnosis of focal active gastritis, using immunostain for mast cells and macrophages, is the histological hallmark of gastric Crohn's disease. Macrophages might be associated with the formation of focal active gastritis in patients with Crohn's disease.

Adult↗

PubMedDate not supplied

Application of Hilbert transform to radionuclide-gated cardiac studies: analysis of asynchronous emptying and filling in various heart diseases.

Fourier phase analysis has generally been used to investigate asynchronous emptying and filling in various heart diseases. A potential limitation of this form of analysis is curve fitting error, since a truncated Fourier series may not adequately describe the shape of a time-volume curve (TVC) and thus may produce errors in indices calculated from the fit. To overcome this problem, we developed a new method using Hilbert transform. Using Hilbert transform, the instantaneous phase (IP) curve was calculated directly from the TVC obtained from multigated cardiac blood pool images. Four parameters [time to maximum IP [T(max)], time to 0 in IP[T(0)], time to minimum IP[T(min)], and time from 0 to minimum IP [T(min-0)]] were extracted from the IP curves for each pixel, and functional images were constructed in 40 patients with ischemic heart disease (IHD), 16 with hypertrophic cardiomyopathy (HCM), 3 with dilated cardiomyopathy (DCM), and 7 normal controls (N). The standard deviations (SD) of these parameters were then calculated for the left ventricle. In IHD patients with a left ventricle ejection fraction (LVEF) of less than 50% and in DCM, the SDs of all parameters were significantly higher than in group N. In IHD patients with an LVEF of greater than 50%, the SDs of T(min), T(0), and T(min-0) were significantly higher than in group N, but there was no significant difference in the SD of T(max). In HCM patients, the SDs of T(min) and T(min-0) were significantly higher than in group N, suggesting the presence of asynchronous filling. In conclusion, this method appears to be promising for the quantitative analysis of asynchronous emptying and filling in various heart diseases.

Cardiomyopathy, Dilated↗