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Biomedical subjects

K Sugimoto

Publications and source records attributed to K Sugimoto.

At least 199 records · Page 11Linked to original sources

Acute tubulointerstitial nephritis following intravenous immunoglobulin therapy in a male infant with minimal-change nephrotic syndrome.

A boy aged 4 years with nephrotic syndrome (NS) was referred to our hospital because of the third relapse of NS. Hypogammaglobulinemia associated with massive proteinuria was observed at the presentation. Residual urinary tract infection required intravenous piperacillin and immunoglobulin therapy (IVIG). Soon after IVIG, he complained of high fever with chills, bilateral knee joint pain, dry cough and chest discomfort. Although he did not develop renal insufficiency, a transient increase in the urinary beta2-microglobulin and decrease in the serum complement hemolytic activity were observed. These clinical manifestations spontaneously ceased. A percutaneous renal biopsy for his NS performed 19 days after the episode of allergic reaction revealed tubulointerstitial nephritis (TIN) with marked eosinophil infiltrates. Glomeruli showed minor glomerular abnormalities. Renal complications associated with IVIG treatment have been reported to date, however, acute TIN has rarely been seen.

Acute Disease↗

IgA interaction with carboxy-terminal 43-kD fragment of fibronectin in IgA nephropathy.

IgA deposition in the glomerular mesangial matrix is a prerequisite for the diagnosis of IgA nephropathy, and circulating IgA-containing complex has been implicated in this process. Since fibronectin is known to be involved in the assembly of extracellular matrix, this study was conducted to investigate whether fibronectin and its fragments are present in sera of patients and are capable of binding IgA1. Sera from patients with IgA nephropathy were purified by heparin-affinity chromatography, and column eluate were analyzed for the presence of fibronectin using Western blot and a set of anti-fibronectin monoclonal antibodies. Native fibronectin was digested with cathepsin D to obtain fragments similar to those of serum fibronectin. The capacity of fibronectin to bind IgA was examined with a mixture of purified IgA1 and cathepsin D-digested fibronectin fragments. A 43-kD carboxy-terminal fragment of fibronectin was detected in samples derived from sera of patients with IgA nephropathy but not in healthy control subjects. A similar-sized fragment was generated by cathepsin D digestion of the native molecule and was shown to bind to IgA1 in vitro. Since the carboxy-terminal domain is known to be critical in assembling exogenous fibronectin into the extracellular matrix, the affinity to IgA1 to a fragment found in patients may have pathogenic potential to mediate extracellular IgA deposition in IgA nephropathy.

Chromatography, Affinity↗

[Prognostic factors in a patients with renal cell carcinoma].

PURPOSE: The purpose of this study is to evaluate prognostic factors of renal cell carcinoma using univariate statistics. MATERIALS AND METHODS: Materials are 182 patients treated from 1976 to 1992. Kaplan-Meier method and generalized wilcoxon test were used for statistical analysis. RESULTS: Seventy cases were found incidentally without any symptoms. The overall 5- and 10-year survival rates by Kaplan-Meier method were 73.8% and 66.2%, respectively. In the univariate analysis, sex, chief complaints, tumor sizes, T-Stages, venous invasions and grades were statistically significant prognostic factors. The prognosis of males more than 60 years of age was significantly poor. The prognosis of patients with incidentalomas was far better than that of symptomatic patients. CONCLUSION: Sex and chief complaints were pointed out as significant prognostic factors for renal cell carcinoma.

Adult↗

[Two cases in which the presence of ciliospinal response led to indecisiveness in the evaluation of brain death].

The ciliospinal reflex was first described by Budge in 1852. This reflex is used as an indicator of brain stem and autonomic nervous system functioning. In the Japanese guideline for determining brain death, the absence of this reflex is considered essential. We reported two cases in which the ciliospinal responses judged to be present resulted in the authors' indecision in determining brain death. They were the cases of a 74-year-old woman who suffered a right putaminal hemorrhage and that of a 28 year-old male with severe head and cervical cord injury. Although brain death was suspected in both cases from its clinical courses, the fact that the ciliospinal reflex was present in each case kept us from declaring that these patients were in the state of brain death. The center of the ciliospinal reflex lies in the first three segments of the thoracic spinal segments and two pathways are involved in this reflex. A noxious stimulation to the face will be registered through the brain stem, but if stimulation is in the neck or upper trunk, it may go directly to the spinal center. Because of the latter pathway to the spinal center, this reflex might remain in patients in whom the brain stem is completely nonfunctioning. Therefore, the presence of this reflex dose not always preclude a state of brain death.

Adult↗

[In vitro activities of 23 antimicrobial agents against 4,993 gram-positive and gram-negative bacterial strains isolated from multicenter of Japan during 1994--in vitro susceptibility surveillance.Levofloxacin-Surveillance Group].

In a surveillance study conducted during 1994 at 24 medical institutes from different geographical areas of Japan, the susceptibility of clinical isolates to twenty three comparative agents, such as ofloxacin, levofloxacin, ciprofloxacin, tosufloxacin, ampicillin, clavulanic acid/amoxicillin, oxacillin, piperacillin, cefaclor, cefotiam, cefdinir, cefclidin, ceftazidime, cefpirome, imipenem, aztreonam, vancomycin, minocycline, chloramphenicol, clarithromycin, sulfamethoxazole/trimethoprim, amikacin, and gentamicin, were tested by the standard broth micro-dilution method. A total of 4,993 isolates tested in this study included Streptococcus pneumoniae, methicillin susceptible Staphylococcus aureus (MSSA), methicillin resistant Staphylococcus aureus (MRSA), coagllase negative streptococci (CNS), Enterococcus faecalis, Enterococcus faecium, Enterobactericeae, Pseudomonas aeruginosa from patients with urinary tract infections or respiratory tract infections, and Haemophilus influenzae. For MSSA, S. pneumoniae, Enterobacteriaceae, and H. influenzae, more than 70% of the isolates was susceptible to fluoloquinolones. However, resistance occurred in more than 50% of MRSA and P. aeruginosa isolated from UTI. Fluoroquinolones were found to be effective against high level penicillin-resistant S. pneumoniae, the third generation cephem-resistant Enterobacteriaceae and ampicillin-resistant H. influenzae.

Anti-Bacterial Agents↗

Impaired beta-adrenoceptor mediated venodilation in patients with diabetes mellitus.

AIMS: We investigated whether venoconstriction by alpha-adrenoceptor stimulation, and venodilation by beta-adrenoceptor stimulation and nitroglycerin are altered in patients with diabetes mellitus (DM). METHODS: Eight male patients with non insulin-dependent DM and eight age-matched control subjects were included. The patients had neither hypertension nor hyperlipidaemia. Noradrenaline (1 to 512 ng min-1 ), isoprenaline (1 to 256 ng min-1 ) and nitroglycerin (0.5 to 128 ng min-1 ) were infused into a dorsal hand vein and its diameter was measured using a linear variable differential transformer. RESULTS: The venoconstricting response to noradrenaline and the venodilating response to nitroglycerin in DM patients were similar to those in control subjects, while the venodilation by isoprenaline was significantly (P<0.05) smaller in DM patients than in control subjects at the dose of 32 ng min-1 or more [32 ng min-1: 11.5% vs 29.8% (DM vs control subjects), 64 ng min-1: 19.0% vs 40.1%, 128 ng min-1: 25.2% vs 49.0%, 256 ng min-1: 34.3% vs 56.7%]. CONCLUSIONS: These data suggested that venoconstriction by alpha-adrenoceptor stimulation and venodilation by nitroglycerin are not altered, whereas venodilation by beta-adrenoceptor stimulation might be impaired in patients with DM.

Adult↗

Noninvasive measurement of cerebral metabolic rate of glucose using standardized input function.

UNLABELLED: The purpose of this study was to propose and validate a method for the noninvasive measurement of cerebral metabolic rate of glucose (CMRGlc) by fluorodeoxyglucose (FDG) PET with a standardized input function (SIF) and an autoradiographic method. METHODS: Plasma input functions, measured by intermittent arterial blood samplings after the intravenous injection of FDG, in 44 patients who had fasted for at least 6 h, were used to generate the SIF. The input function of each patient was normalized with the net injected dose (nID) of FDG and body mass as indicated by body surface area (BSA) or body weight (BW). The SIF was generated as an average of 44 normalized input functions. The estimation of the input function and CMRGlc with SIF was validated in 10 additional patients, who underwent FDG PET after fasting for at least 6 h. CMRGlc was estimated with a simulated input function (IFsim) generated with the following equation: IFsim = SIF x (nID/body mass). The estimated CMRGlc was compared with the measured CMRGlc. RESULTS: Based on BSA, the percentage error of the area under the curve of IFsim was 3.5%+/-2.2%. The percentage error of CMRGlc was 2.9%+/-1.9% in gray matter and 3.4%+/-2.2% in white matter. A similar percentage error was obtained based on BW. CONCLUSION: The proposed method is noninvasive and accurate, and therefore is clinically acceptable for measuring CMRGlc in patients in fasting states.

Autoradiography↗

[Intra- and inter-individual variations in diets of the middle-aged and the elderly].

This study was conducted to examine intra- and inter-individual variations in diets of the middle-aged and the elderly (40 years or older, 46 men and 42 women). The coefficients of variations for intakes of nutrients and food groups were computed from four 4-day weighed dietary records performed at 3-month intervals from June 1996. The results were as follows: a) The highest intra-individual variation (%) for nutrient intake was observed in retinol (men 293.5, women 283.8) and the lowest in carbohydrate (men 17.7, women 22.1). b) The highest inter-individual variation (%) was found in retinol (58.2) in men, and in carotene (56.7) in women. The lowest inter-individual variation (%) was observed in magnesium (17.0) in men, and in carbohydrate (14.4) in women. c) Nuts and seeds showed the highest intra-individual variation (%) for food group intake (men 291.5, women 391.8), while rice presented the lowest (men 30.5, women 38.9). d) The highest inter-individual variation for food group intake (%) was seen in milk and dairy products (111.7) in men and in alcoholic beverages (162.3) in women. The lowest inter-individual variation was observed in potatoes and starches (20.7) in men and in pulses (26.0) in women. e) The number of days necessary to estimate true average nutrient intake was much longer for such vitamins as retinol and carotene (over 50 days) than for macronutrients (3-5 days) except for fat. More than one year was required to estimate intake of nuts and seeds in both sexes and alcoholic beverages or seaweeds in women, whereas only 9-15 days for intake of rice. In conclusion, energy, protein and carbohydrate can be estimated by short-period dietary recalls or records, since their intra-individual variations were relatively small. On the other hand, many days, were found to be required to estimate usual dietary intake of such vitamins as retinol or carotene and that of each food group except for rice. It would therefore be very difficult to estimate usual intake of these nutrients and food groups by short-period dietary recalls or records.

Diet↗

[A case of primary brain-stem injury recovered from persistent vegetative state after L-dopa administration].

A 51-year-old male was transferred to our hospital just after traffic accident. On admission, the patient was comatose (Glasgow Coma Scale of 6) and showed a left hemiparesis with a left oculomotor nerve palsy. Computed tomography demonstrated a traumatic subarachnoid hemorrhage without mass lesion. Magnetic resonance imaging showed high intensity lesions on the left dorsolateral midbrain and the right cerebral peduncle. The distribution of lesions implied diffuse axonal injury involving dopaminergic systems such as the substantia nigra and the ventral tegmental area. After several months of conservative management, the patient showed no recovery and was diagnosed as persistent vegetable state. The administration of L-dopa was then started and the patient showed remarkable neurological improvement. Therefore the patient's neurological status was thought to be modified with primary brain stem injury and accompanying traumatic Parkinson's syndrome. It is important to understand "pseudo" persistent vegetative state in the management of patients showing prolonged consciousness disturbance. L-dopa should be considered as the drugs of pharmacological intervention for the patients of masked parkinsonism behind "pseudo" persistent vegetative state whose dopaminergic systems might have been damaged.

Accidents, Traffic↗

Study on urine boron reference values of Japanese men: use of confidence intervals as an indicator of exposure to boron compounds.

A simple and rapid method for the determination of urine boron by inductively-coupled plasma argon emission spectrometry (ICPAES) has been developed to establish boron exposure guidelines. After 11-fold dilution in 18.25 M omega cm ultra-pure water and vigorous shaking, urine may be directly injected into the spectrometer, providing accurate and reproducible results. We report the results obtained with urine samples obtained from a group of male Japanese electronic workers (n = 102) who had not been exposed to boron; boron concentrations were corrected with use of a specific gravity of 1.024 g/ml. The frequency distribution resulted in a log-normal distribution diagram for anatomical spread. The geometric mean values for urine boron in the non-exposed workers was 798.0 micrograms/l, while the confidence interval (C.I.) was between 398.1 and 1599.6 micrograms/l. Taking into consideration the short biological half-life of boron and its major excretion route via urine, urine was considered to be a suitable means for monitoring of exposure to this element. We conclude that the guidelines established by determining boron reference values are useful for the protection of individuals exposed to boron in their working environments.

Adult↗

Mutual education between hematopoietic cells and bone marrow stromal cells through direct cell-to-cell contact: factors that determine the growth of bone marrow stroma-dependent leukemic (HB-1) cells.

A stroma-dependent cell line (HB-1) was established from myelogenous leukemic cells of CBA/N mouse. Characterization of the cells showed that HB-1 proliferated on hematopoietic supportive stromal cells (MS-10), but did not survive or proliferate on hematopoietic nonsupportive cells (MS-K). Direct contact between HB-1 and MS-10 appears to be necessary for HB-1 to proliferate on MS-10. We found that interleukin-1alpha (IL-1alpha) produced by MS-10 plays a major role in the survival and proliferation of HB-1. IL-11 did not support the proliferation of HB-1 cells by itself, but enhanced the proliferation of HB-1 cells in the presence of IL-1alpha. The expression of IL-1alpha and IL-11 was induced in MS-10 by the direct contact with HB-1 cells, and the expression of IL-1 receptor type I (IL-1RI) and interleukin-11 receptor (IL-11R) was induced in HB-1 cells by the attachment of the cells to MS-10. These findings show the existence of two-way interactions between HB-1 and MS-10.

Acute Disease↗

Temporal and spatial distribution of DNA topoisomerase II alters during proliferation, differentiation, and apoptosis in HL-60 cells.

We related cellular content of DNA topoisomerase (topo) IIalpha and IIbeta with the cell cycle position in proliferating, differentiated, and apoptotic HL-60 cells using two-dimensional flow cytometry. In logarithmically growing HL-60 cells, topo IIalpha increased especially in late S to G2/M phases, although the topo IIbeta level was almost constant throughout the cell cycle. Induction of differentiation by all-trans retinoic acid dramatically reduced the topo IIalpha but not the topo IIbeta level. A new G2/M population containing virtually no topo IIalpha appeared during differentiation and was supposed to be alive and noncycling. Two-dimensional flow cytometry of topo IIalpha or IIbeta staining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling assay showed that one topo IIbeta epitope situated at the C-terminal end decreased specifically in apoptotic HL-60 cells treated with Ara-C, etoposide, and vincristine. The amounts of a topo IIalpha epitope and another topo IIbeta epitope located at a more central portion were almost equal between apoptotic and nonapoptotic cells. Western blot analysis confirmed that topo IIbeta protein was completely degraded into smaller fragments and lost its C-terminal end during apoptosis. On the contrary, a large portion of topo IIalpha remained of its original size, although both topo IIalpha and IIbeta left from the nuclear fraction in apoptotic cells. Confocal laser microscopy showed nuclear localization of topo IIalpha and IIbeta in growing HL-60 cells. Although topo IIalpha and IIbeta were distributed throughout the cell during mitosis, only topo IIalpha was densely concentrated in the mitotic chromosomes. Both enzymes were dissociated from the genomic DNA even at an early phase of apoptosis and completely separated from the propidium iodide signal of DNA in the advanced stage. Chromatin condensation process in apoptosis is therefore completely topo II-independent and obviously differs from the mitotic one.

Apoptosis↗

Effect of diltiazem on sympathetic hyperactivity in patients with vasospastic angina as assessed by spectral analysis of arterial pressure and heart rate variability.

The autonomic nervous system importantly regulates coronary arterial tone and vascular resistance. To evaluate a role of autonomic nervous activity and the effects of calcium antagonist in patients with vasospastic angina (VSA), 13 VSA patients with patent coronary arteries (58+/-8 years) and 8 normal subjects (58+/-12 years) were studied. Arterial pressure and electrocardiogram were continuously recorded with the patient in a supine position under controlled respiration (0.2 Hz). Low-frequency (LF) and high-frequency (HF) components of the beat-to-beat variabilities of systolic arterial pressure and RR interval were then estimated by autoregressive power spectral analysis. The LF power (normalized unit) of both systolic arterial pressure (0.53+/-0.17 vs 0.30+/-0.17, p < 0.01) and RR variabilities (0.51+/-0.20 vs 0.31+/-0.16, p < 0.05) in patients with VSA were greater than that in normal subjects. There was no significant difference in the HF power. Seven patients with VSA who were treated with diltiazem (60 to 200 mg/day) had normalized LF power (normalized unit) of both systolic arterial pressure (0.62+/-0.12 vs 0.33+/-0.16, p < 0.01) and RR variabilities (0.55+/-0.23 vs 0.36+/-0.14, p < 0.05), together with clinical improvement. An increased sympathetic vasomotor tone and cardiac sympathetic predominance may play an important role in patients with VSA. Diltiazem improves these sympathetic hyperactivities.

Angina Pectoris, Variant↗

Nuclear targeted suppression of NF-kappa B activity by the novel quinone derivative E3330.

The activation of NF-kappa B consists of at least three steps: degradation of I kappa B alpha, translocation of NF-kappa B into the nucleus, ai post-translational modification of NF-kappa B (e.g., phosphorylation of p65). In the present study, we found that a novel quinone derivative E3330 selectively inhibited NF-kappa B-mediated gene expression without affecting any of these steps. E3330, when included in the culture medium, suppressed NF-kappa B DNA-binding activity in PMA-induced Jurkat cell nuclear extracts, suggesting that the inhibition by E3330 of NF-kappa B-mediated gene expression was due to its ability to suppress NF-kappa B DNA-binding activity. Fractionation of the nuclear extracts by column chromatography revealed that a nuclear factor enhanced NF-kappa B DNA-binding activity and that this enhancing activity was interrupted after treatment with E3330. Moreover, a major polypeptide with a molecular mass of 40 kDa was found to be in the highly purified fraction containing the NF-kappa B-enhancing activity and predominantly bind E3330. Taken together, these results suggest that the NF-kappa B activity, after dissociation from I kappa B, is enhanced by a nuclear factor that is active irrespective of PMA treatment, and the nuclear factor-mediated enhancement is selectively inhibited by E3330. Thus, we conclude that E3330 may belong to a novel class of anti-NF-kappa B drugs.

Benzoquinones↗

Cough-challenge trial with a new angiotensin-converting enzyme inhibitor, imidapril.

This study was conducted to examine whether imidaprilat, an active diacid of the angiotensin-converting enzyme (ACE) inhibitor imidapril, preferentially inhibits angiotensin I degradation rather than bradykinin degradation, and whether imidapril is less active than other ACE inhibitors in inducing cough in patients with hypertension. The effect of imidaprilat on the inhibition of pressor response to angiotensin I and augmentation of depressor response to bradykinin was compared with that of enalaprilat and captopril in anesthetized rats. To determine the incidence of cough associated with imidapril, patients with a history of ACE inhibitor-induced dry cough were enrolled in a randomized, open-labeled, crossover trial with two 6-week periods to be treated with imidapril or amlodipine, a calcium-channel blocker. The recurrence of cough was assessed during both treatments. In the animal study, there were no significant differences in the ratio of inhibition of pressor response to angiotensin I and the augmentation of depressor response to bradykinin among the ACE inhibitors. In the cough-challenge trial, a total of 60 patients with hypertension were enrolled in the study. Cough and cough related symptoms recurred in 98.3% of the patients (59/ 60) during imidapril therapy. In contrast, only two patients reported cough during treatment with amlodipine. These results indicate that imidapril has no selectivity in inhibiting angiotensin I- and bradykinin-degradation in rats, and that clinically it is not different from other ACE inhibitors in inducing cough in patients with hypertension.

Angiotensin-Converting Enzyme Inhibitors↗

Evaluation of the expression of human CAP18 gene during neutrophil maturation in the bone marrow.

To understand the gene expression of CAP18 (18-kDa cationic antibacterial protein), a member of cathelicidins, we evaluated mRNA and protein expression of CAP18 using human bone marrow cells and mature neutrophils. Northern blot analysis revealed that CAP18 mRNA was expressed more abundantly in bone marrow cells than mature neutrophils, whereas Western blot analysis indicated that CAP18 protein was more abundant in mature neutrophils than bone marrow cells. Consistent with this, in situ hybridization using bone marrow cells demonstrated that the expression of CAP18 mRNA was neutrophil lineage-specific and was observed primarily in myelocytes (>95%) with limited expression in more immature cells (promyelocytes) and mature cells (metamyelocytes, band cells, and segmented neutrophils). Furthermore, immunohistochemical study indicated that, coincident with the increase of CAP18 mRNA levels, CAP18-positive cells increased markedly at myelocyte stage, and the increased levels remained almost constant (>95%) in metamyelocytes, band cells, and segmented neutrophils, although the mRNA levels were remarkably reduced in these cells. Together these observations indicate that CAP18 gene transcription likely occurs lineage- and stage-specifically at the myelocyte stage of neutrophil maturation in the bone marrow and results in the synthesis and cytoplasmic accumulation of CAP18, which is present in the subsequent stages of neutrophil maturation.

Anti-Bacterial Agents↗