[Virus-associated malignancies].
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Burkitt Lymphoma↗
Biomedical subjects
K Takada
Publications and source records attributed to K Takada.
[Anesthetic management of parturients with cerebrovascular diseases].
From January 1992 to December 1997, 13 parturients with cerebrovascular diseases had childbirth at our institution. Among them, 8 patients received anesthesia for delivery. Five patients had a history of ruptured arteriovenous malformation (AVM), cerebral aneurysm, or intraventricular bleeding due to moyamoya disease, and they had radical operations. Of these 5 patients after radical operations, three had a repeat cesarean section under spinal anesthesia, and two had a vaginal delivery under epidural anesthesia to avoid excessive hypertension and hyperventilation. There were two patients with a history of cerebrovascular diseases but had no radical operations. Of these two, one patient who was diagnosed as having aneurysm underwent elective cesarean section under spinal anesthesia, and another patient with a history of cerebral bleeding underwent cesarean section under general anesthesia for abruptio placentae. These 7 patients did well during pregnancy and puerperium. The eighth patient experienced severe headache followed by loss of consciousness caused by ruptured AVM, and required an emergency operation. Simultaneous cesarean section and craniotomy were performed at another hospital. Intrauterine fetal death (IUFD) occurred, but mother survived.
Adult↗
[Predictive evaluation and efficient management of medical examinations using Mahalanobis Taguchi System Method].
UNLABELLED: The Mahalanobis-Taguchi System (MTS), an evaluative technique used in quality engineering, was utilized in a system analysis of medical examinations to determine practicability, to differentiate cost reduction benefits of specific components for increasing efficiency, and to determine possibility of utility on forecasting of future health condition of individuals. METHODS: 1. Medical examination date over a two year period were utilized to differentiate subject into two groups: Group A--Healthy or normal; and Group C--Patient group requiring treatment or currently undergoing treatment. The Mahalanobis distance for Group C from the Mahalanobis space of Group A was calculated for each subject to determine differentiability. 2. Utilizing the MTS method specific components of the examination system were selected and analyzed for effectiveness in diagnosis and screening to enhance efficiency of the examination. 3. Group A subjects (determined from the two year data), were analyzed using the data at the end of 1 year to develop the Mahalanobis space and the Mahalanobis distance at the 2nd year point was calculated and analyzed. RESULTS: 1. Subjects who were classified as group A at both 1st and 2nd year points numbered 159. With a cutoff point of 2.0 for Mahalanobis distance 98.1% of the healthy subjects (Group A) were classified as belonging to the healthy group, and 91.9% of C group as belonging to the patient group. 2. Blood pressure, GOT, GPT, gamma-GTP, T Chol, TG, UA, Cr, BS, HbA1c, Hb, and MCH were found to be effective components in the examination. Based on this result the items included in the examination can be reduced by approximately 60%. 3. With cutoff value of 1.5, the results of 90% of subjects 1 year later could be predicted. The prediction that 15% of Group C subjects would improve to join Group A could be made. Overall, the results 1 year later could be predicted at a level of 90% accuracy. CONCLUSION: These results suggest that the Mahalanobis-Taguchi System technique can accurately assess medical examination quality and can also be used, with reasonable accuracy, to predict the condition of individuals one year later. Therefore, the MTS can be used to help determine which patients should be receiving the examination 1 year later. In addition, components of the examination can be assessed using the MTS for benefits and costs to determine levels of essentiality of components. As a result, it can be used an effective tool for development and improvements in the examination system. With further development in the technique, it may become possible for use as a tool in disease diagnosis and treatment.
Cost-Benefit Analysis↗
[DDS preparations of drugs for inflammatory bowel disease].
To increase the therapeutic efficiency of the drugs used for inflammatory bowel disease(IBD), DDS technology is useful. Drugs used for IBD are glucocorticosteroids and 5-aminosalicylic acid(5-ASA) and its derivatives. DDS preparations of these drugs are classified according to their delivery mechanisms, i.e., chemical DDS, sustained release DDS and colon delivery system. Recent development of DDS technology has enabled the colon delivery of these drugs. They are 1)pH sensitive device, 2) time-controlled device, 3)polymer coating device that is degradable by intestinal microflora and 4)pressure-controlled device. Several DDS preparations of prednisolone and 5-ASA and their pharmacokinetic characteristics are described precisely.
Animals↗
[The role of Epstein-Barr virus in oncogenesis].
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Apoptosis↗
[A case of Miller Fisher syndrome with gadolinium-enhancing lesions in the cranial nerves and the cauda equina on magnetic resonance imaging].
MRI findings for a patient with Miller Fisher syndrome (MFS) are reported. A 25-year-old woman presented with blephaloptosis, double vision, and gait disturbance after antecedent upper respiratory infection. Neurologic examination on admission revealed bilateral blephaloptosis and restriction of extraocular movement. She was unable to maintain an upright posture, nor able to walk because of severe truncal ataxia. Mild limb ataxia was also seen. The tendon reflexes were generally absent and she had hypesthesia in her shoulder and upper limbs. On the next day, her eyes became fixed in the central position. Based on these characteristic symptoms, she was diagnosed as having MFS and underwent plasmapheresis therapy six times. Although ataxia gradually reduced, ophthalmoplegia did not improve and severe symmetric facial nerve palsy appeared. Antiganglioside IgG antibodies (anti-GQ1b and GD1b) were detected in the sera on admission. Spinal fluid examination on day 18 revealed 5 cells/microliter and protein 171 mg/dl. T1-weighted images with Gd-DTPA on day 15 demonstrated enhancement of the posterior nerve roots of the cauda equina. MRI on day 32 revealed swelling and enhancement of the bilateral oculomotor nerves, as well as the facial nerves and the abducens nerves. Marked improvement of ophthalmoplegia followed high dose intravenous immunoglobulin therapy. Gd-enhanced MRI after recovery showed no enhancement of the cauda equina, nor the cranial nerves. These findings well correlated with her clinical features. Although abnormal Gd-enhancement of the cranial nerves or cauda equina in several neurological disorders has been documented, similar findings have been rarely reported in MFS. In our patient, IgG anti-GQ1b and GD1b antibodies were detected and the distribution of Gd-enhanced lesions was compatible with the distribution of the involved gangliosides. We suggest that contrast enhanced MRI is useful for identifying affected cranial nerves and cauda equina nerve roots. In addition, MRI may play a significant role in disclosing the pathophysiology of this disease.
Adult↗
New preparation method of intestinal pressure-controlled colon delivery capsules by coating machine and evaluation in beagle dogs.
A new method for preparing large amounts of pressure-controlled colon delivery capsules (PCDCs) which employs a pharmaceutical coating machine, Hicoater-mini, has been developed. In contrast to our original method for preparing PCDCs where the inner surfaces of gelatin capsule were coated with the water-insoluble polymer ethylcellulose (EC), PCDC were directly prepared by coating the capsular shaped suppositories with EC. As a model drug, fluorescein (FL) was used in this study. FL powder was suspended with the suppository base, polyethylene glycol (PEG) 1000, at 50 degreesC, and was hardened in the capsular shape the sizes of which were #0 and #2. The capsular shaped suppositories were coated with 5% w/v ethanolic EC (7G grade) solution by a coating machine. By increasing the coating time from 55 to 75 min, the mean coating thickness of #0 PCDCs increased from 141+/-7 to 211+/-4 micrometer. In the case of #2 PDDCs, the mean coating thickness increased from 102+/-3 to 110+/-5 micrometer by increasing the coating time from 35 min to 40 min. Several kinds of #0 PCDCs having the mean EC coating membrane thickness of 141+/-7 micrometer (type 1), 166+/-4 micrometer (type 2), 188+/-4 micrometer (type 3), 211+/-4 micrometer (type 4) as well as #2 PCDCs having thickness of 102+/-3 micrometer (type 5) and 110+/-5 micrometer (type 6) were used for in vivo evaluation using beagle dogs. After oral administration of the test preparations containing 30 mg of FL, blood samples were obtained from the jugular vein and plasma FL levels were measured. The first appearance time, Ti, of FL in the plasma was used as a parameter for the estimation of the release time of FL from PCDCs in the gastrointestinal tract. The mean Ti of #0 PCDCs were 2.3+/-0.5 for type 1, 3.3+/-0.5 for type 2, 4.8+/-1.0 for type 3 and 7.8+/-1.7 h for type 4 preparations while the mean Ti of #2 PCDCs were 3.2+/-0.4 for type 5 and 3.8+/-0.4 h for type 6, respectively. There were good correlations between EC coatings.
Animals↗
The truncated form of the Epstein-Barr virus LMP-1 is dispensable or complimentable by the full-length form in virus infection and replication.
The Epstein-Barr virus (EBV) latent membrane protein-1 (LMP-1) gene of the Akata virus strain was cloned, and its nucleotide sequence was determined. Compared with the B95-8 strain, the translation initiation codon for the truncated LMP-1 gene, which is expressed in the lytic cycle, was lost. Immunoblotting showed that Akata EBV produces no truncated LMP-1 protein in any state and that the full-length LMP-1 protein is expressed at a significant level during lytic infection. The results suggest that the truncated LMP-1 protein is dispensable for EBV infection and replication or that the full-length form can "functionally" complement the truncated form if the truncated form has a function.
Base Sequence↗
Simultaneous determination of glucocorticoids in plasma or urine by high-performance liquid chromatography with precolumn fluorimetric derivatization by 9-anthroyl nitrile.
A new method for simultaneous determination of glucocorticoids (GCs) in plasma or urine by high-performance liquid chromatography (HPLC) with fluorimetric detection has been developed. Following extraction with ethyl acetate using a reversed-phase disposable cartridge, the six GCs [cortisol (F), cortisone (E), prednisolone (PL), prednisone (PN), 6beta-hydroxycortisol (6beta-OHF) and 6beta-hydroxyprednisolone (6beta-OHP)] and an internal standard (6beta-hydroxycotortisone) were derivatized by treatment with 9-anthroyl nitrile (9-AN) in a mixture of basic catalysts (triethylamine and quinuclidine) to give the fluorescent esters through the 21-hydroxyl group. The GC derivatives so obtained were then cleaned by a straight-phase disposable cartridge and chromatographed on a straight-phase column with an isocratic HPLC technique. The fluorescence derivatives of the GCs, including the internal standard, were separated as clear single peaks and no interfering peaks were observed on the chromatograms. The lower limits of detection for F, E, PL and PN in plasma or urine were 0.1 ng/ml and those for 6beta-OHF and 6beta-OHP in plasma or urine were 0.5 ng/ml, at a signal-to-noise ratio of 3. The analytical recovery of known amounts of the GCs added to plasma or urine were almost 100%. This method can be applied to the determination of plasma or urinary F in renal transplant patients who received PL and can be applied for other metabolic investigations in relation to the change in blood pressure via 11beta-hydroxysteroid dehydrogenase or in hepatic metabolizing via CYP3A4.
Adult↗
Evaluation of intestinal pressure-controlled colon delivery capsule containing caffeine as a model drug in human volunteers.
The delivery ability of a pressure-controlled colon delivery capsule (PCDC) containing caffeine as a test drug was evaluated after oral administration to healthy male human volunteers. The driving force causing PCDC disintegration in the intestinal tract is the physiological luminal pressure which results from peristalsis. Three kinds of PCDCs having different thickness of a water-insoluble polymer membrane was prepared by coating the inner surface of the gelatin capsules with ethylcellulose (EC). The mean thickness were 40 +/- 1 (SE) for type 1, 44 +/- 1 for type 2 and 50 +/- 1 micron for type 3 PCDC, respectively. Caffeine was dissolved with a suppository base (PEGs 400 and 1000) and the capsules were filled. Doses were 15, 45 or 75 mg. After blank saliva samples were obtained, test preparations were orally administered to the volunteers and saliva samples were collected for 1 min intervals hourly from 1 to 10 h in the fasted state study, and from 1 to 20 h and at 25 h in the fed state study. Caffeine concentrations in the saliva samples were analyzed by HPLC. The maximum salivary caffeine excretion rate increased as the oral caffeine dose increased. The maximum salivary caffeine excretion rate increased predominantly compared to the pre-dose level in 75 mg dose study. Therefore, all following studies were performed with this dose. The first appearance time of caffeine into the saliva, TI, was used as a parameter to estimate the disintegration time of test preparations in the gastrointestinal tract. The mean TI of types 1, 2, and 3 PCDCs were 3.0 +/- 0.4, 4.0 +/- 0.4 and 4.5 +/- 0.3 h, respectively. After oral administration of 75 mg caffeine in pain gelatin capsule as a reference preparation, caffeine appeared in the saliva within 0.5 h. The mean hardness of the PCDCs were 1.05 +/- 0.10 (type 1), 1.55 +/- 0.06 (type 2) and 2.08 +/- 0.15 newton (type 3), respectively. There were good correlations between three parameters: EC coating membrane thickness, hardness and TI (determination coefficient r2 = 0.935 between TI and thickness, r2 = 0.998 between thickness and hardness, r2 = 0.958 between hardness and TI). The effect of food intake on the delivery ability was examined with type 3 PCDCs. Food intake prolonged the mean TI, from 4.5 +/- 0.3 to 7.8 +/- 1.3 h. This increase is thought to be ascribed to prolonged gastric emptying time. Comparison with reported colon arrival times indicates that the type 3 PCDC functions in colon delivery of caffeine and is thought to be applicable to other drugs.
Adult↗
Importance of dissolution process on systemic availability of drugs delivered by colon delivery system.
The relationship between in vitro drug release characteristics from colon delivery systems and in vivo drug absorption was investigated using three kinds of delayed-release systems. 5-aminosalicylic acid (5-ASA), tegafur (FT) and carbamazepine (CBZ) were selected as model drugs. Pressure-controlled colon delivery capsules (PCC) for liquid preparations, time-controlled colon delivery capsules (TCC) for liquid and solid preparations and Eudragit S coated tablets for solid preparations were used in this study. At first, in vitro dissolution tests for all preparations were performed. Drug release from solid preparations was delayed compared to that from liquid preparations with all three drugs. Next, these preparations were administered to fasted beagle dogs. For 5-ASA, the mean Cmaxs (peak level) of Eudragit S coated tablets and PCC were 5.52 and 16.89 micrograms ml-1, respectively. The mean Tmaxs (time when drug reached peak level) were 3.0 and 5.3 h. AUCs were 22.57 and 48.09 micrograms.h ml-1, respectively. For FT, Cmaxs of Eudragit S coated tablet and PCC were 0.87 and 1.46 micrograms ml-1, and Tmaxs were 7.0 and 6.7 h, respectively. AUCs were 9.73 and 15.55 micrograms.h ml-1 and bioavailabilities were 43.79 and 70.84%. For CBZ, the mean Cmaxs of liquid preparations and solid preparations were 0.37 and 0.22 micrograms ml-1, respectively. The mean Tmaxs were 4.7 and 4.3 h. AUCs were 0.673 and 0.392 micrograms.h ml-1. With liquid preparations, drug was thought to contact to the colonic membrane easily because of lack of interference by stools, and to be absorbed well as compared with solid preparations. From these findings, drug release from colon delivery systems and drug dissolution in the colonic lumen are very important factors for the systemic availability of drugs from the colon delivery systems.
Animals↗
Neoplastic involvement of granulocytic lineage, not granulocytic-monocytic, monocytic, or erythrocytic lineage, in a patient with chronic neutrophilic leukemia.
Chronic neutrophilic leukemia (CNL) is a very rare myeloproliferative disorder. To determine the neoplastic origin of CNL, morphological and cytogenetical studies were made of colonies derived from hematopoietic progenitors of a patient with CNL. The patient's hematopoietic progenitors spontaneously formed colonies consisting of mature granulocytes, and cytogenetical study of the colonies indicated chromosome abnormalities identical to those in the patient's bone marrow cells. Analysis of colonies consisting of granulocytes and macrophages, macrophages, or erythrocytes disclosed a normal karyotype. These results demonstrated that the neoplastic process in this patient with CNL originated in hematopoietic progenitors capable of differentiating only into granulocytes, and not granulocytes and monocytes, monocytes, or erythrocytes.
Cell Lineage↗
Preparation and evaluation of micro-porous ethylcellulose capsule as oral sustained-release preparation of theophylline.
Micro-porous ethylcellulose (EC) membrane capsules were prepared by dissolving polyvinylalcohol (PVA) particles from membranes which were made of a mixture of EC (a water-insoluble polymer). The pore size was approximately 400 microns. Since the dissolution rate of theophylline from the micro-porous EC membrane capsules was fast, gel-forming polymer, poly(acyclic) acid (Carbomer), was incorporated inside the capsule at 10, 20 or 30 mg. Using test capsules containing 100 microns of theophylline, in vitro dissolution studies were performed. By including Carbomer in capsule formulations, the dissolution rate of theophylline was decreased. However, there were not significant differences in dissolution rates between preparations containing the three different amounts of Carbomer. In vivo evaluation studies using beagle dogs showed that AUC, Cmax and Tmax were inversely proportional to the formulated amount of Carbomer. The capsule containing 20 mg of Carbomer gave plasma theophylline concentrations between 5 and 15 micrograms mL-1, which reflect levels within the therapeutic window. The effect of food intake on the pharmacokinetics of theophylline was also studied with the same capsule. Food increased AUC, Cmax and Tmax, although plasma theophylline levels were maintained within the therapeutic range.
Administration, Oral↗
Isolation and characterization of non-pigmented rough colony of Porphyromonas gingivalis from periodontitis.
During isolation of Porphyromonas gingivalis from periodontal pockets of patients, the appearance of an unusual rough colony form, designated NUM 114, was observed. The NUM 114 strain grew in aggregated cell form in a liquid culture and formed a light-beige rough colony on blood agar medium. The identifications and DNA studies confirmed that the NUM 114 strain was P. gingivalis. The enzymatic activities and fatty acid end products were in lower levels than found in P. gingivalis 381, a representative strain. The NUM 114 strain had enhanced hydrophobicity, hemagglutination of human erythrocytes and adherence to human buccal epithelial cells. The NUM 114 cells were phagocytized at a two-fold higher rate compared with the 381 strain. NUM 114 cells were also more susceptible to killing by phagocytosis than the 381 cells. The carbohydrates of the outer membrane and crude lipopolysaccharide preparation from the NUM 114 strain were in larger amounts than those of 381 strain. LPS from NUM 114 were observed to be smooth-type.
Journal Article↗
Spiral computed tomography for bilioenteric anastomotic stricture.
Spiral computed tomography scanning after intravenous cholangiography (IVC-SCT) was used to assess the anatomy of the biliary tree and anastomosis in a 7-year-old girl with recurrent cholangitis 5 years after surgical excision of a choledochal cyst. The technique clearly visualized the stenosis of the hepaticojejunostomy and hepatic duct and the dilated intrahepatic ducts. IVC-SCT provides a precise, prompt, and accurate image with minimal invasiveness and is especially suitable for the preoperative evaluation of pediatric patients.
Anastomosis, Surgical↗
Cystic lymphangioma of the scrotum.
A 7-year-old boy who presented with a painful left hemiscrotal mass was diagnosed with acquired lymphangioma of the scrotum. Chronic friction from a cast for Perthes' disease might have been the cause of sudden enlargement of a congenital lymphangioma of the scrotum. Magnetic resonance imaging (MRI) was useful for preoperative diagnosis and determining the extent of the scrotal lesions. Total excision of the mass leaving the overlying skin was successfully performed. The clinical significance of MRI for preoperative diagnosis and planning surgical resection of this lesion is discussed.
Child↗
Expression of oncogenic molecules in primary central nervous system lymphomas in immunocompetent patients.
We studied overexpression of p53, Bcl-2, Bcl-6, c-Myc and Mdm2 proteins by immunohistochemistry for a total of 27 primary central nervous system B cell lymphomas (CNS lymphomas) in immunocompetent patients and one CNS lymphoma in an AIDS patient. The expression of Epstein-Barr (EB) virus-encoded small RNA-1 (EBER-1) was also analysed using in situ hybridisation. Overexpression (more than 20% of cells stained) of p53 protein was detected in 8 of 27 immunocompetent cases (30%); 6 cases showed a nuclear stain and 2 cases showed cytoplasmic stain (nuclear exclusion). Strong Bcl-2 or Bcl-6 immunoreactivity suggestive of overexpression was seen, respectively, in 5 (19%) and 6 (22%) cases; 2 cases were positive for both immunoreactivities. Interestingly, overexpression of Bcl-2 or Bcl-6 was not seen in the cases which showed p53 overexpression (P < 0.03; chi-square test). EBER-1 expression was not detected in any of the 27 immunocompetent cases, but was found in the AIDS-related CNS lymphoma, which also showed an overexpression of Bcl-6, but not Bcl-2. None of the cases showed c-Myc or Mdm2 overexpression. Taken together, it is suggested that CNS lymphoma in immunocompetent hosts is a distinct disease that has a different molecular profile from those of systemic lymphoma and/or AIDS-related CNS lymphoma.
Acquired Immunodeficiency Syndrome↗
Suppressive effect of ethanol on the expression of hepatic asialoglycoprotein receptors augmented by interleukin-1beta, interleukin-6, and tumor necrosis factor-alpha.
Blood levels of inflammatory-related cytokines, including interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha, are elevated in patients with alcoholic liver diseases. We investigated the effects of these cytokines and ethanol on the expression of hepatic asialoglycoprotein receptors (AGPRs) in a human hepatoblastoma cell line, HepG2. An [125I]-asialo-orosomucoid binding assay showed significant increases in surface AGPR numbers in HepG2 cells by treatment with IL-1beta, IL-6, and TNF-alpha, to levels which were approximately 130% of the values in untreated control cells. However, the enhanced AGPR numbers induced by treatment with these cytokines were markedly suppressed, to 70%-80% of the number in the untreated cells, by treatment with ethanol. Immunological detection of AGPR with a specific antibody demonstrated that the modulation of surface AGPR numbers was correlated with the cellular expression levels of AGPR. These results suggest that, although IL-1beta, IL-6, and TNF-alpha stimulate the synthesis of hepatic AGPR, ethanol suppresses the expression of AGPR augmented by these cytokines. This leads to an increase in serum asialo-orosomucoid levels caused by the disordered catabolism mediated by AGPR in patients with alcoholic liver disease.
Asialoglycoprotein Receptor↗