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Biomedical subjects

K Tanikawa

Publications and source records attributed to K Tanikawa.

At least 163 records · Page 9Linked to original sources
PubMed1996

A patient with chronic hepatitis C and a history of abuse of analeptic drugs, who showed hallucination and delusion with interferon administration.

We experienced a case of chronic hepatitis type C accompanied with hallucination and delusion induced by interferon (IFN) therapy positive. The case was a 47-year-old male, whose laboratory data showed positive for anti-Hepatitis C Virus (HCV) and elevated transaminase level. He was treated with 6 MU/day of natural-type IFN-alpha (HLBI). Sleeplessness and delusions of persecution developed about 2 months after the start of IFN therapy. The interview of the psychiatrist disclosed that the patient had a history of addiction to drugs, and these psychiatric symptoms were diagnosed as being of "the flashback phenomenon." These side effects were improved after the administration of psychotropics and it was suggested that we had to take care of the development of flashback phenomenon during the treatment of IFN in cases of chronic hepatitis with a history of addiction to drugs.

Delusions↗
PubMed1996

Prognostic factors for short-term survival in alcoholic hepatitis in Japan: analysis by logistic regression.

Prognostic factors for the outcome of patients with alcoholic hepatitis were identified by logistic regression analysis. To predict the outcome immediately after admission, clinical data from 97 patients with alcoholic hepatitis on admission were introduced to multivariate analysis. Independent prognostic factors for favorable outcome were hepaplastin time, peripheral white blood cell count, age (40 to 60 years), and serum creatinine level (below 1.4 mg/dl). Sensitivity, specificity, positive predictive value, negative predictive value, and predictive accuracy were 0.78, 0.89, 0.78, 0.89, and 0.86, respectively. The resultant equation for the death rate was applied to another set of patients with alcoholic hepatitis as a validation study. Predictive accuracy estimated 0.95 in validation. The prognostic index derived was simple, accurate, and useful in the prediction of the outcome in patients with alcoholic hepatitis. Furthermore, it provides the clinician with an indication of the necessity for the intensive care of patients in a critical condition.

Adult↗
PubMed1996

Two survival cases of alcoholic lactic acidosis complicated with diabetes mellitus and alcoholic liver disease.

We have experienced two patients with alcoholic lactic acidosis complicated with liver disease and diabetes mellitus who were successfully treated. They developed hypoglycemia, dehydration, lactic acidosis, and renal failure after drinking a large volume of alcohol without eating for 1 week before onset. Acidosis was thought to be directly related to excessive alcoholic intake, because it was no associated with severe liver failure and rhabdomyolysis. During monitoring of respiratory and circulatory functions, a rapid infusion of fluids adjusting to water and electrolyte imbalance was performed. A mixture of physiological saline and 5% glucose solution was thought to be effective in these cases. Patients recovered from renal failure and lactic acidosis without hemodialysis. Our experience will hopefully provide a key to successful treatment of fatal alcoholic lactic acidosis.

Acidosis, Lactic↗
PubMed1995

Effects of exercise-induced sympathoadrenergic activation on portal blood flow.

We examined the relationship between portal venous blood flow and sympathoadrenergic activation after muscle exercise. For this purpose, we used echo Doppler and measured plasma noradrenaline concentration before and after mild (7 metabolic units, N = 8) and maximal exercise (14 metabolic units, N = 8) in 16 patients without significant disease. Portal venous flow did not change after mild exercise. In contrast, a significant reduction in portal venous flow was observed after maximal exercise (P < 0.01). This was due to reductions in both cross-sectional area of the portal vein (P < 0.01) and portal venous velocity (P < 0.01). Overall, there were significant inverse relationships between the change in plasma noradrenaline concentration and that in cross-sectional area of the portal vein [r = -0.44, P < 0.01 (absolute change); r = -0.47, P < 0.01 (relative change)], that in portal venous velocity (r = -0.63, P < 0.01; r = -0.61, P < 0.01), and that in portal venous flow (r = -0.54, P < 0.01; r = -0.59, P < 0.01). These results suggest that the reduction in portal venous flow after exercise is related to the degree of sympathoadrenergic activation. This reduction may be due mainly to splanchnic vasoconstriction.

Adult↗
PubMed1995

Role of hepatocytes in direct clearance of lipopolysaccharide in rats.

BACKGROUND & AIMS: The liver is the clearance organ for lipopolysaccharide (LPS). The aim of this study was to investigate the biliary excretion of LPS using fluorescein isothiocyanate (FITC)-labeled LPS. METHODS: After FITC-LPS was injected intravenously into rats, the cellular localization of fluorescence in the liver was examined and the biliary excretion of fluorescence was measured. The effects of gadolinium chloride, a blocker of Kupffer cells, and colchicine, an inhibitor of microtubules, on the biliary excretion of fluorescence was investigated, and bile was analyzed using high-performance liquid chromatography. RESULTS: Laser scanning confocal microscopy showed that fluorescence was taken up by hepatocytes 5 minutes after injection of FITC-LPS into the portal vein. When FITC-LPS was injected into the portal vein, fluorescence was rapidly secreted into bile, peaking at 20 minutes, and 25.1% of the injected dose appeared in bile within 60 minutes. When the same dose of FITC-LPS was injected into the tail vein, 15.8% appeared in bile within 60 minutes. Chromatography showed that FITC-LPS was excreted into bile in an unchanged form over a period of 20 minutes after injection. Colchicine significantly reduced the biliary excretion of fluorescence, but gadolinium chloride had no effect. CONCLUSIONS: LPS was directly and effectively processed by hepatocytes and secreted into the bile canalicular system via a microtubule-dependent vesicular pathway.

Animals↗
PubMed1995

Omeprazole administration does not impair gastrointestinal mucosal perfusion, oxygenation, and hexosamine generation.

Omeprazole is a potent antisecretory drug that acts by inhibiting the gastric proton pump. In the present study, we have observed the effects of this drug on gastrointestinal mucosal perfusion, oxygenation, and hexosamine generation in humans. Sixteen healthy volunteers were included. Gastrointestinal mucosal perfusion and oxygenation (duodenum, antrum, and corpus) were assessed by laser-Doppler flowmetry and reflectance spectrophotometry. Biopsy specimens were also taken from each location to determine hexosamine content as a quantitative indicator of mucus generation. In addition, serum gastrin level was measured. After baseline data were obtained, subjects were randomly assigned to receive 20 mg of oral omeprazole once daily for 7 days (n = 8) or placebo (n = 8). All measurements were performed again after double-blinded drug administration. No effect was found after placebo administration. In contrast, omeprazole administration significantly increased serum gastrin level (p < .05), suggesting an inhibition of acid secretion. However, this drug did not alter either laser-Doppler signal or oxygen saturation at each location. In addition, no change in mucosal hexosamine content was observed at each location. We conclude that oral omeprazole, despite its well-established antisecretory effect, has no adverse effect on the mucosal defense in humans.

Adult↗
PubMed1995

Ethanolamine oleate versus butyl cyanoacrylate for bleeding gastric varices: a nonrandomized study.

BACKGROUND AND STUDY AIMS: Sclerotherapy may be useful in patients with bleeding gastric varices. The aim of this study was to compare the effects of two sclerosants in these patients. PATIENTS AND METHODS: In a prospective nonrandomized trial, we performed single sclerotherapy for bleeding gastric varices using ethanolamine oleate (n = 24) or butyl cyanoacrylate (n = 29). The patients were followed for a mean of 14 months. RESULTS: The rate of initial hemostasis (no bleeding occurred for 48 hours after sclerotherapy) was significantly higher in the butyl cyanoacrylate group (93%) than in the ethanolamine oleate group (67%) (p = 0.014). The rate of initial hemostasis in cardiac variceal bleeding did not differ significantly between the ethanolamine oleate and butyl cyanoacrylate groups (83% vs. 100%, p = 0.140). In contrast, the hemostasis rate for fundal variceal bleeding was significantly higher in the butyl cyanoacrylate group than in the ethanolamine oleate group (88% vs. 50%, p = 0.023). Although the rebleeding rate did not differ between the two groups (30% vs. 25%, p = 0.921), the mortality rate was significantly higher in the ethanolamine oleate group (67% vs. 38%, p = 0.043). In addition, the incidence of complications in the butyl cyanoacrylate group was similar to that in the ethanolamine oleate group (46% vs. 41%, p = 0.745). CONCLUSIONS: These results suggest that initial control of fundal varices is more difficult than it is with cardiac varices, but butyl cyanoacrylate is superior to ethanolamine oleate, and the survival advantage from butyl cyanoacrylate seems to be partially related to the increased early bleeding deaths in the ethanolamine oleate group.

Adult↗
PubMed1995

Lichen planus and hepatitis C virus in the northern Kyushu region of Japan.

Oral lichen planus (OLP) is a common oral disorder that manifests a mucosal reaction to a variety of aetiological factors, including liver disorder. This study investigated the relationship between OLP and hepatitis C virus (HCV) infection by studying the prevalence of hepatitis B and C virus infection or liver disease in 45 patients with OLP in the Northern Kyushu region of Japan where the prevalence of HCV infection is the highest in the country. Serum hepatitis B virus surface antigen (HBsAg) was positive in only four patients. Serum anti-HCV or serum HCV RNA was positive in 28 (62%) and 27 (60%) of 45 OLP patients, respectively. The majority (35 of 45, 78%) of OLP patients suffered from liver disease, including chronic hepatitis C (22/45, 49%), HCV-related liver cirrhosis (two), and HCV-related hepatocellular carcinoma (two). These results suggest that HCV is a major cause of OLP.

Adolescent↗
PubMed1995

Hepatic sinusoidal cells and sinusoidal circulation.

Ito cells, located in the space of Disse, extend their numerous long cytoplasmic processes to surround the sinusoidal wall. Conventional and immune electron microscopy demonstrates abundant microfilaments and a great amount of actin and myosin in these cytoplasmic processes. These morphological findings suggest the possibility of control of the sinusoidal circulation by their contraction. Two mechanisms may be involved in their contraction: namely nervous and humoral factors. Ito cells, often in close contact with the nerve endings, which contain many granules of substance P (SP), have numerous receptors for this peptide. Ito cells also have receptors for endothelin-I (ET-1), more commonly found in the periportal area of the hepatic lobule. Experimental studies using cultured Ito cells showed their contraction following treatment with ET-1 or SP. These results suggest that Ito cells play an important role in the regulation of hepatic sinusoidal circulation.

Animals↗
PubMed1995

Sequential analysis of recurrent calcium calculi by infrared spectroscopy.

BACKGROUND: While the incidence of calcium urolithiasis increases, the precise mechanism of calcium oxalate stone formation is still controversial. Is the composition of a recurrent calcium oxalate stones always the same as previous ones? There are few reports that specifically address the question by study of sequential changes of the composition of recurrent calcium calculi. METHOD: From our medical records 70 patients with a history of two or more recurrent episodes of calcium oxalate stone disease were selected and the analyses of 190 stones were reviewed. Infrared spectroscopic analysis was done using a Perkin Elmer 1740 spectrophotometer. RESULTS: Calcium oxalate monohydrate were detected in 63 stones, calcium oxalate dihydrate in 12, calcium oxalate monohydrate mixed with dihydrate in 28, calcium oxalate monohydrate mixed with calcium phosphate in 30, calcium oxalate dihydrate mixed with calcium phosphate in 20, calcium oxalate monohydrate mixed with dihydrate and calcium phosphate in 20, calcium oxalate monohydrate mixed with dihydrate and calcium phosphate in 37. Alterations of stone components during follow-up were found in 43 stones from 40 patients. The shift of a main composition from calcium oxalate monohydrate to calcium oxalate dihydrate was found in 24 stones and vice versa in 19 stones. CONCLUSIONS: Sequential changes of the compositions of recurrent calcium calculi are highly likely to occur with time in individual recurrent calcium stone formers. Calcium oxalate monohydrate was a most common component of the studied recurrent calcium stones.

Apatites↗
PubMed1995

A histopathological study of alcoholics with chronic HCV infection: comparison with chronic hepatitis C and alcoholic liver disease.

To clarify the relationship between hepatitis C virus infection and excessive alcohol intake, we carried out histological examination of the liver in 46 alcoholics with chronic hepatitis C virus infection and compared the findings in 55 patients with chronic hepatitis C, 38 with alcoholic liver disease, and 27 with chronic hepatitis B. The majority of alcoholics with chronic hepatitis C virus infection displayed virus-related histological changes very similar to those in chronic hepatitis C, including frequent lymphoid follicles (34.7%) or aggregates (93.3%) in the portal tracts, mild necroinflammatory change (76.1%) in the parenchyma, and lymphocytosis in sinusoids (83.7%). Liver cell dysplasia and irregular regenerative activity of hepatocytes were rarely observed. The effects of alcohol on the liver were found to be minimal in the majority. These findings could suggest that the hepatic injury in the majority of alcoholics with chronic hepatitis C virus infection in Japan is due to persistent hepatitis C virus infection rather than to alcoholic injury. In addition, our study disclosed that the perivenular fibrosis which is designated as a histological characteristic of alcoholic liver disease is frequently observed in chronic hepatitis C. These similarities suggest that a similar fibrogenesis is present in chronic hepatitis C and alcoholic liver disease.

Adult↗
PubMed1995

High prevalence of hepatitis C virus antibody and RNA in patients with oral cancer.

We have investigated the correlation between the prevalence of hepatitis C virus (HCV), which is detectable in saliva, and oral cancer and other digestive tract cancers in the Northern Kyushu region of Japan. Anti-HCV antibodies were detected in sera from 24 of the 100 patients with oral cancer (24%, p < 0.05 vs the control group, p < 0.01 vs the stomach cancer group), in 11 of 104 patients with non-malignant diseases receiving dental treatment (the control group, 10.6%), and in 12 of 113 patients with stomach cancer (10.6%). HCV-RNA was detected in sera from 17 of 100 oral cancer patients (17%, p < 0.05 vs the control group) and 4 of 104 patients of the control group (3.9%). These results indicate a high prevalence of HCV infection in oral cancer patients, which warrants a systematic study of etiological associations between oral cancer and HCV.

Adolescent↗
PubMed1995

Decrease of interferon-induced 2',5'-oligoadenylate synthetase activity in cirrhotic rat liver.

We evaluated the effect of hepatic fibrosis on the induction of hepatic 2',5'-oligoadenylate synthetase (2-5AS) by interferon (IFN) in a rat model of liver cirrhosis, induced with thioacetamide. Although there was no difference in serum 2-5AS activity between the control and cirrhotic rats given murine IFN, 2-5AS activity in the liver homogenates of cirrhotic rats was significantly lower than in the controls (105 +/- 18.5 vs. 171 +/- 10.2 pmol/micrograms, p < 0.01). These results suggested that hepatic fibrosis attenuated the effect of IFN and one of the reasons for this may be the decreased induction of hepatic 2-5AS activity after IFN administration in the presence of a cirrhotic liver.

2',5'-Oligoadenylate Synthetase↗
PubMed1995

Soluble interleukin-6 receptors in inflammatory bowel disease: relation to circulating interleukin-6.

The in vivo appearance of soluble interleukin (IL)-6 receptor (sIL-6R) in serum from patients with inflammatory bowel disease was examined using an enzyme linked immunosorbent assay (ELISA). The serum sIL-6R concentrations in patients with active disease (ulcerative colitis, 148.4 (5.1); Crohn's disease, 142.3 (9.3) ng/ml; mean (SEM)) were significantly raised compared with those in patients with inactive disease (ulcerative colitis, 116.2 (7.2); Crohn's disease, 114.3 (7.1) ng/ml), some other type of colitis (104.8 (11.6) ng/ml), or in normal subjects (107.3 (2.4) ng/ml). These differences were also seen in paired samples examined during both active and inactive phases. Additionally, serum sIL-6R and IL-6 concentrations correlated significantly with C-reactive protein levels in both ulcerative colitis and Crohn's disease patients (r = 0.23 and 0.56, respectively; p < 0.05 for both). Furthermore, gel filtration analysis of serum from these patients showed two major peaks of immunoreactive IL-6-one peak corresponding to free IL-6 and another peak to sIL-6R-bound IL-6-this was further confirmed by a luminescence sandwich ELISA. These results, together with its in vitro effects, indicate that natural sIL-6R may function as a powerful enhancer of the IL-6-dependent immune processes observed in inflammatory bowel disease.

Adolescent↗
PubMed1995

Evaluation of intestinal permeability in patients with inflammatory bowel disease using lactulose and measuring antibodies to lipid A.

This study looked at the intestinal permeability and the immune response to enteric bacterial antigens in patients with inflammatory bowel disease (IBD). They were evaluated by using a lactulose tolerance test and measuring blood anti-lipid A antibody concentrations, respectively. The lactulose tolerance tests were performed 22 times in 14 patients with Crohn's disease (CD), 19 times in 12 patients with ulcerative colitis (UC), and 12 times in 12 healthy controls. Blood lactulose concentrations were measured after oral administration every two hours for eight hours, also blood C reactive protein concentrations and anti-lipid A antibody concentrations were measured just before lactulose administration. Blood lactulose concentrations were significantly higher in patients with CD than in the controls from two to eight hours after administration, while in UC they were significantly higher than in the controls from six to eight hours. Maximum blood lactulose concentrations in each tolerance test in patients with the active phase significantly exceeded those in the inactive phase of either CD or UC. A significant correlation was also seen between the maximum blood lactulose concentrations and the C reactive protein concentrations. Blood anti-lipid A antibody concentrations in patients with CD were significantly higher than in the controls as well as in patients with UC in immunoglobulin (Ig) A class and IgG class. In UC they were significantly higher than in the controls in IgA class. But, they were not related to the severity of the disease of either CD or UC, and not correlated significantly with the maximum blood lactulose concentrations in either CD or UC. The intestinal permeability and the immune response to enteric bacterial antigens in patients with inactive CD were significantly increased over those in the controls as well as in patients with inactive UC. These findings suggest that an increase of the intestinal permeability and that of producing antibodies to enteric bacterial antigens are both important for the pathogenesis of IBD, and that the characteristics of CD and UC differ.

Adolescent↗