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Biomedical subjects

K Sano

Publications and source records attributed to K Sano.

At least 397 records · Page 22Linked to original sources
PubMed1993

Low mitogenic activity of synthetic lipid A analog, 2,3-acyloxyacylgalactosamine-4-phosphate, in cultured murine splenocytes.

The mitogenicity of chemically synthesized lipid A analogs, 2,3-acyloxyacylglucosamine-4-phosphate (A-103) and 2,3-acyloxyacylgalactosamine-4-phosphate (A-113), was compared. Synthetic lipid A analogs of the disaccharide-type (506), the monosaccharide-type (A-103) suspended in RPMI-1640 medium supplemented with triethylamine, and Salmonella typhimurium LT-2 lipopolysaccharide (LPS) were capable of increasing the incorporation of [3H]thymidine into splenocytes of C57BL/6 mice at various doses ranging from 1.0 to 100 micrograms/ml. However, the mitogenic activity of A-113 at these doses was markedly weaker than the activity of the above materials. When the A-103 and A-113 were suspended in RPMI-1640 medium supplemented with ethanol, the mitogenic activity of A-113 also showed lower activity than that of A-103 in the splenocytes of C57BL/6 mice. These findings indicate that the mitogenic activity of synthetic lipid A of the monosaccharide-type is affected by a kind of composed sugar.

Animals↗
PubMed1993

Vertebral artery dissecting aneurysm rebleeding after proximal occlusion--case report.

A 38-year-old male presented with vertebral artery dissecting aneurysm manifesting as subarachnoid hemorrhage. An attempt at trapping the aneurysm failed, so the vertebral artery could only be clipped proximally. Rebleeding occurred, resulting in death, probably due to excessive length of the dissection requiring thrombosis and/or retrograde dissection due to back pressure from the contralateral vertebral artery.

Adult↗
PubMed1993

Relief of hepatic vein stenosis by balloon angioplasty after living-related donor liver transplantation.

We have experienced 5 hepatic vein stenoses in 3 children (8 to 23 months old) after living-related liver transplantation (total 48 liver transplants for 48 children between June 1990 and November 1992). The initial symptoms of hepatic vein stenosis were ascites and/or edema. The blood flow of hepatic vessels was monitored by duplex sonography. The mean velocity of the hepatic vein and the portal vein was decreased and flow wave pattern of the stenotic hepatic vein was flat. The patients were treated by percutaneous transhepatic balloon angioplasty. After a successful angioplasty, the mean velocity of the hepatic vein and portal vein increased and pulsatile waves returned to the hepatic vein. Arterial ketone body ratio (acetoacetate/3-hydroxybutylate) increased, promptly followed by recovery of other liver function tests. In 1 patient, this complication occurred three times with intervals of 7 months and 3 months between episodes of hepatic vein stenosis. In conclusion, hepatic vein flow should be monitored routinely with duplex sonography after living-related donor liver transplantation. Percutaneous transhepatic balloon angioplasty is a primary treatment for the stenosis.

Anastomosis, Surgical↗
PubMed1993

Living-related liver transplantation for biliary atresia.

We reviewed our initial experience of 29 living-related liver transplantations (LRLT) for children with biliary atresia in terms of postoperative complications and management to analyze the factors that may influence the outcome. All patients underwent an initial portoenterostomy at 17-134 days of age. The age distribution at the time of LRLT ranged from 6 months to 12 years, following revised portoenterostomy 0 to 3 times, and with (n=5) or without enteric stoma (n=24). Living-related donors provided the partial liver grafts weighing 170 to 630 g according to recipient size. Twenty-six of the 29 recipients are alive and well with follow-up between 1 and 27 (mean=14) months. Three patients died of extrahepatic complications including aspiration asphyxia, Candida infection and lymphoproliferative disorder. Four of 5 children with enteric stoma had 9 incidences of postoperative complication, while only 4 incidences occurred in 4 out of 24 children without stoma (p=0.007). Children hospitalized at the time of transplantation seemed to have early postoperative complications more frequently than home-bound children (p=0.06). The present results indicated that LRLT could offer satisfactory outcome for children in whom repeated Kasai's operation could not attain adequate biliary diversion and for those who developed cirrhosis despite good initial bile drainage.(ABSTRACT TRUNCATED AT 250 WORDS)

Biliary Atresia↗
PubMed1993

[The characteristic flow of the superior vena cava in cardiac tamponade: a case report].

A case of cardiac tamponade showing the characteristic flow pattern in the superior vena cava is reported. An 80-year-old man was admitted to our hospital complaining of anorexia and general fatigue. We observed a paradoxical pulse of 25 mmHg, dilatation of the jugular vein, and marked cardiomegaly on chest radiography. A two-dimensional echocardiogram demonstrated a massive pericardial effusion and collapse of the right atrial and right ventricular walls. On the basis of his echocardiograms and clinical signs, we diagnosed his condition as cardiac tamponade. Pulsed Doppler echocardiograms showed two-peaked flow in the superior vena cava in systole. To assess the diagnostic significance of this characteristic flow pattern, the superior vena cava flow was recorded simultaneously with the intrapericardial pressure and the right atrial pressure. The intrapericardial pressure was higher than the right atrial pressure in early systole. After pericardial drainage, these pressures became reversed and the two-peaked flow disappeared. The two-peaked flow is attributed to collapse of the right atrial wall caused by the higher intrapericardial pressure than the right atrial pressure. The superior vena cava flow represents the right heart filling dynamics in cardiac tamponade.

Aged↗
PubMed1993

[Multi-center cooperative phase II study of combined infusion of PJ-203 (degradable starch microspheres) into hepatic artery in metastatic liver cancer].

In the present multi-center cooperative phase II study, in which 16 institutions participated, PJ-203 and mitomycin C were concomitantly infused into the hepatic artery of patients with metastatic liver cancer and the tumor response and safety of the combined therapy were examined. Of 81 patients treated with PJ-203, 52 patients were complete cases in which bidimensionally measurable lesions could be assessed for anticancer effect in accordance with the Direct Evaluation Criteria of Chemotherapy. The number of treatments given to the complete cases until the assessment of therapeutic effect ranged from 1 to 11 times, with the mean of 3.1 times. The overall response rate was 48.1% (25/52). The response rate for each primary lesion was 68.8% (11/16) for stomach cancer, 40.7% (11/27) for colorectal cancer and 33.3% (3/9) for other types of cancer including the gallbladder. The 25 patients with CR or PR, a 50% decrease in tumor size was confirmed after the treatment ranged from 1 to 5 times, with the treatment periods of 2 to 3 weeks. Adverse reactions were found in 56 (69.1%) out of 81 patients assessed for safety. Relatively frequent symptoms were pain in 49.4% (40/81), nausea and vomiting in 33.3% (27/81), fever in 30.9% (25/81) and anorexia in 6.2% (5/81). Principal abnormal laboratory values included a transient elevation of GOT (26.3%), GPT (22.5%), LDH (12.7%) and Al-p (8.8%). Blockade of blood flow could be observed by angiography when the amount of PJ-203 infused was in the range from 180 to 900 mg as degradable starch microspheres. The blood flow blockade could be observed most frequently at the amount of 600 mg (37.7%). The period attaining over 50% of tumor response in 25 complete cases was 42 days as a median. After the treatment was initiated in 81 patients, 50% survival duration and one-year survival rate averaged 277 days and 35.7%, respectively. The corresponding figures for each primary cancer were 419 days and 51.0% for patients with liver cancer metastasized from colorectal cancer, against 239 days and 11.8% for those with liver cancer metastasized from stomach cancer.

Adult↗
PubMed1993

[A long-term hemodialysis patient complicated with systemic calciphylaxis].

A 46-year-old male patient underwent long-term hemodialysis treatment had suffered from calciphylaxis (defined by Selye), such symptoms as advanced systemic vascular calcification, rapid progression of gangrene on both fingers and toes, disturbance of consciousness, and sclerosis and obstruction of the superficial vein after venipuncture during 11.5 years of dialysis. Furthermore, he had a long history (30 years) of heavy smoking. He died as a result of sepsis due to pneumonia after 12.5 years of dialysis. He had received dialysis treatment using a small amount of dialysate (50 liters on a recirculating system) for 8.5 years and had been dialysed 2 and 2 or 3 times a week for 10 years. As a result of this insufficient dialysis treatment, his characteristic laboratory data showed hypocalcemia, hyperphosphatemia, elevated calcium-phosphorus product, advanced metabolic acidosis, hyperalkaliphosphatemia and elevated serum parathyroid hormone. Autopsy revealed the following: 1) enlargement parathyroid gland enlarged in two (4.0 g and 2.0 g, respectively) showing adenomatous hyperplasia presenting cord-like arrangement of chief cells and water-clear cells, 2) systemic medial calcification in radial, ulnar, renal, mesenteric and brain arteries, and 3) Berline-blue positive iron deposit in calcified arteries in mesenteric and parathyroid tissue. From these results, we concluded that factors (challengers) related to the appearance of calciphylaxis might be as follows: 1) advanced secondary hyperparathyroidism, 2) long-term uremic state, 3) administration of VD2 and VD3, 4) iron salt injection, and 5) a long history of heavy smoking. We speculated that these challengers might act synergistically to cause calciphylaxis.

Calciphylaxis↗
PubMed1993

[The diagnosis of HIV infection by detecting specific nucleotide sequence].

There are several methods to detect human immunodeficiency virus (HIV) infection; the detection of antibodies against HIV, the detection of HIV particles, and the detection of HIV infected cells. The detection of anti-HIV antibodies is practical, but the antibodies are undetectable both on a seronegative person at the superacute phase, and the new-born baby from a seropositive mother. No other method is ideal for all purposes. Thus the detection of the HIV-specific nucleotide sequence especially using the PCR method has been expected. We developed a quantitational PCR method to assay HIV-infected PBMC cell number, and the result correlated with that of the quantitational culture method, and also correlated with the CD4 count, that is inversely related to the clinical stage of HIV infection. Our quantitational PCR method must be improved before application to a practical routine test. A new PCR kit to detect HIV infected cells qualitatively has been developed and purchased in Europe. This kit is especially workable to test specimens where the antibody detection method cannot be used. PCR can be used on other specimens and can be applied to HIV infection. HIV RNA (both genomic RNA and viral mRNA) can be detected by a combination with the reverse transcriptase reaction. This method (RT-PCR) will be ideal to detect HIV particles. With PCR, the sequence-differentiation between each clinical virus strain may be detected, thus the characterization of a virus strain such as drug resistance, latency, or the prognosis may be recognized. PCR is indeed a valuable method to detect HIV-infection, provided its limits are properly understood.

Adult↗
PubMed1993

[A case of ureteritis with a course of rapidly progressing stricture].

Rapidly progressing stricture of the ureter with non-specific ureteritis is very rare and neither pathogenesis nor reliable treatment is known. We report a case of ureteritis in a 51-year-old woman with a stricture rapidly progressing over a course of 2 months. She was sent to us for left hydronephrosis. Retrograde pyelography (RP) revealed a 5 cm stricture in the left ureter. CT showed no abnormal mass in the retroperitoneum. Gastro-intestinal and gynecological inspection revealed no abnormalities. As a second RP showed 9 cm stricture 2 months later, we performed a biopsy of the ureter and examined it pathologically. There was no evidence of malignancy, but we performed a left nephroureterectomy, because of the stricture in the entire left ureter. Pathological study of the kidney and the ureter showed a non-specific inflammation of the entire urothelium without malignancy. There has been no recurrence in the right ureter.

Constriction, Pathologic↗
PubMed1993

[A case of distal aneurysms of bilateral posterior inferior cerebellar arteries].

A case of aneurysms of bilateral distal posterior inferior cerebellar arteries (PICAs) is reported. A 61-year-old man experienced a sudden onset of headache and nausea and was admitted to a hospital immediately. His neurological examination showed no abnormalities, but headache and nausea continued in spite of conservative treatment. The patient was referred to our hospital two days after the onset and the neurological examination revealed slight dysmetria of the right upper extremity. A computed tomography (CT) scan demonstrated a round and heterogeneous high density mass at the cerebellar vermis and some blood coagula at the fourth ventricle and vermis. Angiography showed two aneurysms of the bilateral distal PICAs: The right aneurysm was at the cortical segment and the left one was at the telovelotonsillar segment. The patient underwent a suboccipital craniectomy and both aneurysms were clipped successfully. Sleepiness and headache continued postoperatively due to hydrocephalus. After ventricular drainage he soon recovered without having V-P shunt and was discharged with no neurological deficits. Aneurysms of bilateral distal PICAs are very rare and only three cases have been reported in the literature. The etiology, clinical symptom, CT finding and prognosis in the literature reviewed were briefly discussed.

Cerebellar Diseases↗
PubMed1993

[Acute aneurysm surgery and the Glasgow Coma Scale: relationship with 6-month outcome].

A series of 610 patients who had aneurysm surgery within 7 days of the hemorrhage were analyzed as to the relationship between the preoperative Glasgow Coma Scale (GCS) score and the outcome assessed by using the Glasgow Outcome Scale (GOS) at 6 months after surgery. The patient distribution in accordance with the GCS scores in descending order from 15 to 3 was as follows: 265, 109, 44, 24, 17, 20, 25, 15, 18, 12, 16, 23, and 22 cases, respectively. In general, the larger the GCS score, the better the outcome. Thus, the overall results proved to be significantly correlated with the GCS score prior to surgery (r = 0.608, P < 0.01). As for demarcation levels along the GCS axis in terms of the GOS, a significant difference in the outcome was observed at the level of GCS scores between 15 and 14 (P < 0.0001, Wilcoxon test). However, no borderlines were evident at any GCS levels other than 15/14. The problems of applying the GCS to the grading system of aneurysmal subarachnoid hemorrhage are discussed.

Adult↗
PubMed1993

[Vasospasm and its outcome after early surgery for ruptured cerebral aneurysms: changing pattern of its incidence and outcome during this 9-year period].

The occurrence and outcome of vasospasm (VS) were analyzed in 240 patients who had aneurysm surgery within 7 days of a hemorrhage during 9-year period (1981-89). Occurrence of VS was evaluated by the appearance of ischemic symptoms, (A) with or (B) without CT evidence of infarcts. The surgical outcome was assessed by the Glasgow Outcome Scale 6 months postoperatively. The results in the first and the latter halves of the period were compared. The overall incidence of VS (A+B) was 34.8% (A: 23.5%, B: 11.3%) and 33.6% (A: 15.2%, B: 18.4%) in the first and the latter halves, respectively. Thus, VS leading to infarction showed a tendency to decrease in the latter half of the period, though the overall incidence of VS itself was almost identical in both the first and second halves of the period. The results were also analyzed according to preoperative grading based on the Glasgow Coma Scale (GCS). The tendency toward decreased severity of VS in the latter term was most remarkable in patients with GCS total scores between 14 and 13. The decreased incidence of severe VS proved to be reflected in decreased mortality and in increased rate of good outcome in the latter half of the period. In order to confirm whether the results obtained in our clinic are universal, we applied the same analysis for control groups in four cooperative double-blind clinical trials performed during this period in Japan. The study again showed that the rate of infarction has decreased significantly over the decade, resulting in the improved surgical outcome.(ABSTRACT TRUNCATED AT 250 WORDS)

Cerebral Infarction↗
PubMed1993

[Vasospasm and its outcome after early surgery for ruptured cerebral aneurysms: relationship with the clinical grade based on the Glasgow Coma Scale].

Over a 9 year period, 270 patients who had early aneurysm surgery within 7 days after subarachnoid hemorrhage were analyzed regarding occurrence of vasospasm (VS) and its outcome. Occurrence of VS was recognized by ischemic neurological deterioration, with or without CT evidence of infarcts. Surgical outcome was assessed by the Glasgow Outcome Scale 6 months postoperatively. The results were correlated with age, aneurysm site, day of surgery, and preoperative clinical grade evaluated by the Glasgow Coma Scale (GCS). Thirty patients with the GCS sum score of less than 6 were excluded from the analysis of VS. Eighty two patients (34%) developed VS, of which 36 patients (15%) showed ischemic symptoms only, and 46 (19%) had infarct on CT. The incidence of symptomatic VS was 12% in GCS 15 group (117 patients), 23% in GCS 14-13 group (70 patients), and 11% in GCS 12-7 group (53 patients). That of VS with infarct was 14%, 23%, and 26% in GCS 15, GCS 14-13, and GCS 12-7 groups, respectively. Thus, there was a close correlation between the clinical grade based on the GCS and the incidence of VS, especially with infarct. The grade was also useful in predicting the surgical outcome. VS was more common in the older age group. The site of aneurysm or the day of surgery had no apparent influences on the incidence of VS or its outcome. Overall, the incidence of poor outcome due to VS proved to be 12%, which accounted for one-third of the cases in which there was poor outcome due to various causes.

Adult↗
PubMed1992

Chondrocytic differentiation of peripheral neuroectodermal tumor cell line in nude mouse xenograft.

We have established a cell line (KU-SN) from a peripheral neuroectodermal tumor originating in the left scapula of a 4-year-old girl. The original tumor was immunoreactive with antibodies for neurofilament proteins, neuron-specific enolase, vimentin, S100 protein, and beta 2-microglobulin. Dense core granules, 50-150 nm in diameter, were identified by electron microscopy. The cell line was established from tumor cells in metastatic lung fluid. KU-SN cells were immunoreactive with the antibodies for neurofilament proteins, vimentin, neuron-specific enolase, S100 protein, glial fibrillary acidic protein, cytokeratin, and carcinoembryonic antigen. Besides these neuronal features, KU-SN cells express type 2 collagen and insulin-like growth factor 1 receptor. The addition of insulin-like growth factor 1 (100 ng/ml) increased the growth rate of KU-SN cells 2.1-fold over control. Some cells were positive for Alcian blue and alkaline phosphatase staining. Cytogenetic analysis of KU-SN cells disclosed a reciprocal chromosomal translocation [t(11,22)]. Northern blot analysis of KU-SN cells demonstrated amplified expression of the c-myc gene but not the N-myc gene. When tumor cells were transplanted into nude mice, cartilage was formed. The cartilage was immunoreactive with the antibody for HLA-ABC, indicating that it was derived from the tumor cells, not from mouse tissue. Chondrocytic differentiation was not observed in xenografts of Ewing's sarcoma cell lines SK-ES or RD-ES or the peripheral neuroectodermal tumor cell line SK-N-MC. These results indicate that KU-SN cells represent primitive neural crest cells having the potential for chondrocytic differentiation.

Animals↗
PubMed1992

Establishment of stable CD8+ suppressor T cell clones and the analysis of their suppressive function.

Stable CD8+ suppressor T cell (Ts) clones were established by a relatively simple method. Keyhole limpet hemocyanin (KLH)-primed spleen cells from C3H mice were depleted of B cells and CD4+ T cells by panning and cytotoxic treatment, and the resulting CD8+ T cells were periodically stimulated with antigen and irradiated syngeneic spleen cells followed by manifestation in interleukin-2 (IL-2) containing medium. T cell clones with a definite suppressor function were established by limiting dilution. They were defined as classical effector type Ts of CD8+ phenotype as they had constant and definite suppressor functions in antigen-induced T cell proliferation and specific antibody response against T cell-dependent antigens without detectable cytotoxic activity against both antigen presenting cells (APC) and helper T cells (Th). They showed no helper activity for B cells and produced no detectable helper type lymphokines such as IL-2 and IL-4. CD8+ Ts clones were able to inhibit the antigen-induced IL-2 production of normal and cloned T cells. Their suppressive activity was antigen-nonspecific and major histocompatibility complex-unrestricted. CD8+ Ts clones were also able to suppress the proliferative response of Th clones induced by immobilized anti-T cell receptor (TcR) and anti-CD3 mAbs but not the response induced by concanavalin A (ConA) and IL-2. All the CD8+ T cell clones established independently utilized the TcR V beta 8 gene. Syngeneic antigen presenting cells could induce proliferation of these CD8+ clones, which was blocked by anti-CD8 and anti-I-Ak monoclonal antibody (mAb) but not by anti-class I mAbs. The stimulation of CD8+ Ts clones with immobilized anti-CD3 resulted in the release of a suppressor factor(s) that potently inhibited the antigen-induced proliferation of CD4+ Th clones and the in vitro secondary antibody formation.

Animals↗