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Biomedical subjects

K Ueno

Publications and source records attributed to K Ueno.

At least 235 records · Page 13Linked to original sources

Metoclopramide inhibits development of esophageal varices in rat model.

We examined the preventive effect of metoclopramide on the development of esophageal varices in a rat model. Thirty rats were divided into three groups: metoclopramide (7.5 mg/kg twice a day, intraperitoneally), control group I (saline 2 ml/kg twice a day, intraperitoneally), and control group II (incised lower esophageal sphincter and metoclopramide 7.5 mg/kg twice a day, intraperitoneally). On the 14th postoperative day, lower esophageal sphincter pressure in the metoclopramide group (8.6 +/- 1.4 cm H2O) increased more than in the control groups (5.4 +/- 0.5, 5.0 +/- 0.5 cm H2O, P < 0.01). Development of small collateral vessels from the spleen to the retroperitoneum was evident only in the metoclopramide group, as seen on the portography (P < 0.01). Histologically, the variceal area of the horizontal cross section of the esophagus in the metoclopramide group (0.62 +/- 0.26 mm2) was significantly smaller than in the controls (2.67 +/- 0.95, 2.78 +/- 0.82 mm2), determined using an image processor-analyzer for photographing histological specimens (P < 0.01). We also investigated the effect of metoclopramide on smooth muscle cells in the rat portal vein, using isometric-tension recording. Metoclopramide relaxed the smooth muscle precontracted with norepinephrine, in a concentration-dependent manner. Thus, metoclopramide inhibits the development of esophageal varices in this rat model due to both an increase in resistance of the lower esophagus and to development of small collaterals.

Animals↗

Three-dimensional studies on the structure of the tissue surrounding the superior mesenteric artery.

The anatomy and topography of tissue surrounding the superior mesenteric artery were examined histopathologically, and the structure surrounding the superior mesenteric artery (SMA) was reconstructed with data from histologic examination and three-dimensional analyses. Specimens were obtained from three autopsy cases without abnormalities, two surgically resected cases of cancer of the pancreatic head, and one autopsy case of cancer of the pancreatic head. The endothelium or basal membrane of blood and lymph vessels were identified immunohistochemically, and the distribution of lymph nodes, blood vessels, lymph vessels, and collagen fibers was determined. The superior mesenteric plexus was found to be a relatively dense structure with a thickness of about 2 mm, composed of collagen fibers and connective tissue, which concentrically enveloped the small arteries, the superior mesenteric artery, nerve bundles, and capillaries. Lymph vessels larger than a few micrometers in diameter were often found outside of the plexus, and this plexus contained no lymph nodes in any sections. The three-dimensional study of the modes of spread along the superior mesenteric artery of pancreatic cancer revealed two types of spread: the tumor extends mainly by neural invasion, and the tumor extends mainly by lymph node metastases. These morphologic features suggest that lymphatic flow in the vicinity of the superior mesenteric artery passes primarily outside of the plexus, and complete excision of lymph nodes close to the superior mesenteric artery with preservation of the superior mesenteric plexus is feasible if there is no neural invasion into retropancreatic tissues.

Biomarkers↗

Laparoscopic splenectomy.

A technique for laparoscopic splenectomy is described. The patient is placed in the right semidecubitus position and pneumoperitoneum is prepared. The splenic artery and vein are exposed near the hilum, using a laparoscopic ultrasonic dissector. The larger vessels are doubly ligated, and the spleen is resected and maneuvered into a nylon surgical sack; the sack is removed through a 2-cm incision along the midaxillary line. This procedure has been used for four patients requiring splenectomy for benign disease, and the outcome has been entirely satisfactory for all concerned.

Adult↗

Detailed deletion mapping of the short arm of chromosome 3 in small cell and non-small cell carcinoma of the lung.

We constructed a detailed deletion map of the short arm of chromosome 3 (3p) for 55 lung cancer cases by using 17 restriction fragment length polymorphism (RFLP) probes. Initially, we examined 40 small cell lung cancer (SCLC) cases and found three regions of deletion at 3p25-26, 3p21.3 and 3p14-cen, suggesting the possibility of at least three different tumor-suppressor genes on 3p. In order to obtain more detailed deletion area, and to compare the pattern of 3p deletion, we also examined 15 non-small cell lung cancer (NSCLC) cases. Compared to NSCLC cases, most of SCLC cases have widespread deletion on 3p, suggesting multiple tumor-suppressor genes on 3p may be inactivated in this type of cancer. In 3p21.3 area, minimum overlapping area of deletion lays between two probes which are close to each other. These data will be useful to isolate the putative tumor-suppressor genes located on the chromosome 3p.

Carcinoma, Non-Small-Cell Lung↗

Preoperative computerized tomography detection of extensive invasion of the inferior vena cava by renal cell carcinoma: possible indication for resection with partial cardiopulmonary bypass and patch grafting.

The relationship of the diameter of the inferior vena cava as measured by computerized tomography (CT) and tumor invasion of the inferior vena caval wall was determined in patients with renal cell carcinoma. In addition, the indications and usefulness of surgery using partial cardiopulmonary bypass and a polytetrafluoroethylene (Gore-Tex) patch graft are discussed. In all 7 patients with an inferior vena caval diameter of 40 mm. or larger on CT tumor had extensively invaded the vessel wall macroscopically and microscopically. Therefore, resection of the inferior vena caval wall and repair with a patch graft were necessary. Partial cardiopulmonary bypass was used in 6 of these 7 patients. On the other hand, of 11 patients with an inferior vena cava less than 40 mm. in diameter only 2 with extensive tumor invasion of the vessel wall underwent a patch graft procedure without partial cardiopulmonary bypass. One patient who had massive hemorrhage before bypass was started died while in a coma. The survival of the remaining patients ranged from 6 to 131 months (median 19 months). Blood loss in patients who underwent surgery with partial cardiopulmonary bypass was much less than that in patients without bypass. In our series, there were no complications related to the graft itself and graft patency was excellent. Our results indicate that an inferior vena caval diameter of 40 mm. or more on CT probably indicates extensive tumor invasion. Although further experience and observation are necessary to evaluate whether partial cardiopulmonary bypass and/or a patch graft improves the prognosis of patients with extensive inferior vena caval invasion by renal cell carcinoma, this method was relatively safe and decreased blood loss.

Aged↗

Surgical management in the patient with congenital factor XII deficiency. Report of a case.

A rare case of blood coagulation disorder, congenital factor XII deficiency, detected in a patient with mandibular osteomyelitis is presented. Routine laboratory tests showed prolonged clotting and activated partial thromboplastin time. Detailed investigations for the intrinsic and extrinsic pathways of coagulation, fibrinolytic system, kinin-kallikrein system, and complement system were performed because factor XII is known as an activator of these systems. No hemorrhagic or thromboembolic complication occurred during and after surgery. Substitution therapy with fresh frozen plasma was not necessary. Magnetic resonance imaging and electrocardiography were used to examine the possible occurrence of postoperative cerebral hemorrhage or myocardial infarction.

Dental Care for Chronically Ill↗

Ciliary motility and surface morphology of cultured human respiratory epithelial cells during ciliogenesis.

We used human respiratory epithelial cells in floating culture to study the motility and surface morphology of the cilia during ciliogenesis. Ciliary motility and surface morphology was examined by a high-speed video system and electron microscopy, respectively. On day 8 of floating culture, but rarely before, cells with numerous moving short cilia with mean ciliary beat frequency (CBF) of 17.8 +/- 2.5 Hz (mean +/- SD) were seen. The mean CBF was highest on day 10 (19.6 +/- 3.9 Hz) and reached 17.4 +/- 2.5 Hz on day 14. The ciliary beat amplitude (CBA) was recognized on day 8, abruptly increased on day 9, then continued with aging of the culture. The intracellular coordination of ciliary beats was poor on day 8 with random beat direction but improved up to day 12 when the intracellular uniform beat direction was established. However, intercellular coordination remained absent even on day 14. Results suggest that immature short cilia have a rigid beat pattern. With the elongation of the resulting whip-like movement, the ciliary beat was gradually synchronized. Although a ciliary elongation seems to be required for making intracellular coordination, other factors are involved in intercellular coordination. Also, a high CBF does not always indicate the activity of mature cilia.

Cell Membrane↗

Daily intakes of alkaline earth metals in Japanese males.

Diet samples were collected for two duplicate portion studies and one market basket study. 226Ra in the diet samples was determined by alpha spectrometry and daily intake was estimated as 23 mBq (0.62 pCi) per person. Other alkaline earth metals were determined by inductively coupled plasma atomic-emission spectrometry. Average mineral intakes of calcium, magnesium, strontium, and barium were 0.55 g, 0.21 g, 2.3 mg, and 0.39 mg, respectively. Element ratios magnesium:calcium 0.38, strontium:calcium 4.2 x 10(-3), barium:calcium 7.1 x 10(-4), and 226Ra:calcium 1.1 x 10(-12) were found in the diet; these compared with element ratios in Japanese vertebrae of magnesium:calcium 0.1:1, strontium:calcium 3.1 x 10(-4), barium:calcium 2.7 x 10(-5), and radium:calcium 2.6 x 10(-14). Observed ratios, defined as the element ratio in bone divided by the respective element intake ratio in Japanese males, were as follows: 226Ra 0.02, magnesium 0.03, strontium 0.07, and barium 0.04.

Adult↗

Concentration of 226Ra in human teeth.

226Ra concentrations in human teeth from several cities, mainly Tokyo, Japan, were determined with emphasis on the measurement of low-level 226Ra by alpha-ray spectrometry following chemical separation. No appreciable differences in 226Ra concentration were found among various permanent teeth samples of different age groups in Tokyo. The mean 226Ra concentration for Tokyo was 0.51 +/- 0.06 mBq (g Ca)-1. 226Ra concentration [mean: 0.67 +/- 0.11 mBq (g Ca)-1] in teeth in western regions of the country was statistically higher than that [mean: 0.48 +/- 0.09 mBq (g Ca)-1] in eastern ones. The mean 226Ra concentration [0.51 mBq (g Ca)-1] in teeth from Tokyo was less than the concentration [1.11 mBq (g Ca)-1] reported for vertebral bone samples of this city.

Adolescent↗

Effect of Escherichia coli lipopolysaccharide on Bacteroides fragilis abscess formation and mortality in mice.

To study the mechanism of synergism between Bacteroides fragilis and Escherichia coli, the effect of sublethal dose of E. coli lipopolysaccharide (LPS) (25 micrograms/mouse) was checked on B. fragilis abscess formation. LPS was administered prior or after inoculum injection. No significant difference in the abscess size was observed at necropsy on day 6. However, all the groups receiving LPS showed higher incidence of recovery of additional intestinal bacteria (23.5-45.5%) from the abscess pus. When LPS was given 4 hr prior to inoculum administration, 83-100% mortality was observed. Detailed investigation showed autoclaved cecal contents alone could also cause similar mortality. Studies with stimulation of endogenous cytokines by E. coli LPS demonstrated induction of all of them within 3 hr in the blood stream with TNF-alpha demonstrating peak at 1 hr, IL-1 alpha and IL-6 at 4 hr and IFN-gamma between 6-9 hr with moderately high levels at 4 hr. This E. coli LPS-triggered cytokine cascade possibly gets further stimulated by injection of autoclaved cecal contents containing high concentration of endotoxins (1.6 x 10(5) EU/ml) contributed by dead bacteria and lead to the mortality of animals.

Abscess↗

Comparison of cytokine induction by lipopolysaccharide of Bacteroides fragilis with Salmonella typhimurium in mice.

Comparison of cytokine stimulation by lipopolysaccharide (LPS) of Bacteroides fragilis and Salmonella typhimurium was done to study the early events occurring in vivo. Mice injected intraperitoneally with either LPS demonstrated endogenous production of all the cytokines studied (tumor necrosis factor-alpha, interferon-gamma and interleukin-6) within 6 hr in the bloodstream. However induction of all the cytokines by B. fragilis LPS (50 micrograms/mouse) was much weaker compared with S. typhimurium LPS (50 micrograms/mouse). Even a dose of S. typhimurium LPS 40 times smaller (1.2 micrograms/mouse) induced cytokines more strongly compared with B. fragilis LPS. Thus, a weak biological response to B. fragilis LPS as evidenced by chick embryo lethality, limulus lysate gelation, LD50 for mice and rabbit pyrogenicity could be due to weak induction of bioactive mediators by LPS.

Animals↗

Emergency cardiopulmonary bypass support in patients with cardiac arrest caused by myocardial infarction.

Emergency percutaneous cardiopulmonary bypass support (PCPS) was instituted in 3 patients with acute myocardial infarction in cardiac arrest refractory to conventional resuscitation measures. All had severe double or triple vessel disease. Percutaneous transluminal coronary angioplasty (PTCA) was performed in 1 patient and PTCA and directional coronary atherectomy (DCA) were performed in the other 2 patients on combined intraaortic balloon pumping (IABP) and PCPS. Flow rates of 2 to 5 L/min were achieved, with restoration of mean arterial pressure to more than 60 mm Hg during PCPS. The status of all patients was improved hemodynamically with PCPS. One patient died of hemorrhage during PCPS. DCA was successfully performed in the other 2 patients, and PCPS and IABP was discontinued. Time on PCPS ranged from 10 h to 8 days. Time on IABP ranged from 10 days to 2 weeks. These 2 patients died of pneumonia or multiorgan failure after 1.5 months. In conclusion, emergency PCPS is a powerful resuscitative tool that may stabilize the condition of patients in cardiac arrest to allow for definitive intervention.

Aged↗

Application of typing by pulsed-field gel electrophoresis to the study of Clostridium difficile in a neonatal intensive care unit.

Pulsed-field gel electrophoresis (PFGE) analysis of restriction pattern polymorphism was applied to type Clostridium difficile isolated from neonates hospitalized in a neonatal intensive care unit, and the results were compared with those of immunoblot analysis. C. difficile was isolated from fecal specimens of 41 (61%) of 67 neonates during a 5-month investigation. All of these neonates were asymptomatic. Fifty-five C. difficile isolates from 32 patients were analyzed by PFGE after digestion with SmaI and SacII endonucleases and by immunoblotting with 10 different antisera. Fifty-three of 55 isolates from 30 patients were identical by PFGE analysis after SmaI and SacII digestion and immunoblot analysis. Two isolates were different from each other and from the epidemic group by both PFGE and immunoblot analysis. All 53 epidemic isolates were nontoxigenic, while the two remaining isolates were toxigenic. These results suggest that nosocomial spread of nontoxigenic C. difficile infection in the neonatal intensive care unit and suggest that both PFGE and immunoblot are powerful typing tools for the epidemiological study of C. difficile.

Antibodies, Bacterial↗

[Magnetic resonance spectroscopy of naso-sinus tumors].

Magnetic Resonance Spectroscopy (MRS) has been developed as a new application of nuclear magnetic resonance. By means of MRS, internal chemical information can be non-invasively measured. In this study, the 31P MRS of naso-sinus tumors was measured and evaluated. The peaks of 31P MRS, such as Adenosine tri-phosphate (ATP), Creatine phosphate (PCr), Phosphodiester (PME), Inorganic phosphate (Pi), and Phosphomonoester (PME) can be identified. Phosphomonoesters (PME) are precursors of membrane phospholipids. Phosphodiesters (PDE) are metabolites of phospholipids. Compared with benign tumors, the 31P MRS of malignant tumors shows a higher PME peak and lower PDE and PCr peaks. These results indicate that malignant tumors are characterized by chemical changes in membrane metabolism.

Adenosine Triphosphate↗

Donor stromal cells support hematopoiesis in CFU-S colonies.

To examine the effect of hematopoietic stromal cells on bone marrow transplantation (BMT), CF-1 cells, which were previously established from splenic stroma of a mouse that was administered recombinant human granulocyte colony-stimulating factor (rhG-CSF), were transplanted with bone marrow cells. The stromal cells were transfected with the plasmid DNA of beta-galactosidase (beta G-CF-1) cells for studying immunohistochemistry. Using immunohistochemistry, the spleen and bone marrow of the recipient mice were examined for beta-galactosidase on the 8th and 12th day after BMT. In the spleen, beta G-CF-1 cells were observed within and in the regions immediately surrounding the colony-forming unit-spleen (CFU-S) on the 8th and 12th day after BMT. In certain regions, beta G-CF-1 cells existed in or surrounded the CFU-S colonies that consisted of the undifferentiated hematopoietic cells, while in other regions the granulopoiesis increased, especially in correspondence with the existence of beta G-CF-1 cells. In the bone marrow cavity, beta G-CF-1 cells were also recognized, though hematopoiesis was lower than the normal bone marrow. These data demonstrate that CF-1 cells, that is, donor stromal cells, can be transplanted to the hematopoietic organs and can then support hematopoiesis.

Animals↗

Pancreas cancer-associated antigen (PCAA) in medullary thyroid carcinoma.

Pancreas cancer-associated antigen (PCAA), primarily isolated from the ascites of pancreatic cancer (PC) patients, is strongly positive in PC, colon cancer and normal colonic mucosa. In immunohistochemical staining of tumor tissues with antibodies, medullary thyroid carcinoma (MTC) was no less strongly positive for PCAA than PC, and we studied its details. Antibodies to PCAA, calcitonin and CEA were used in the immunostaining of normal thyroid tissues and thyroid tissues from patients with adenomas, MTC, papillary carcinomas, and follicular carcinomas. The PCAA from the liver metastases of MTC was studied for molecular weight and antigenicity in comparison with the PCAA from the ascites of PC patients. Serum levels of PCAA were determined in MTC patients. Of 11 patients with MTC, PCAA, calcitonin and CEA were studied immunohistologically and positive in 10, 11 and 10 patients, respectively. The PCAA from the metastases had a molecular weight of about 700,000, and was immunochemically identical to that from the ascites of PC patients. Serum levels of PCAA were elevated in 4 of 6 MTC patients. The thyroid tissues from the MTC patients, familial or non-familial, were as strongly positive for PCAA as for calcitonin and CEA. It was antigenically identical to that of PC origin, and positive in the serum of MTC patients.

Adenocarcinoma, Follicular↗

Variable loading cholangiomanometry and clinical applications.

We have designed a variable loading cholangiomanometric method, which permits a precise and objective evaluation of distal bile duct function. Normal resistance (R) values (1-7 units) and residual pressure (P) values (50-150 mm H2O) have been defined by this method. We have performed this procedure on 138 patients with cholelithiasis, and have found that 13 patients with cholecystolithiasis and 14 patients with choledocholithiasis have elevated R and P values in the distal bile duct. These patients also had morphological abnormalities in the distal bile duct. There was a high percentage of patients with abnormal pressure/flow curves at high flow rates among patients with morphologically dilated bile ducts. Division of pressure/flow curve patterns at low flow rates into three types made it possible to differentiate between functional and structural abnormalities. Patients in whom the residual P values were high and morphological defects of the distal bile duct. The possible application of these measurements in determining the need for additional surgery on the inferior bile duct, particularly papilloplasty, is discussed.

Bile Ducts↗