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Biomedical subjects

K Yamaoka

Publications and source records attributed to K Yamaoka.

At least 19 recordsLinked to original sources

Conceptual equivalence and health-related quality of life: an exploratory study in Japanese and Dutch cancer patients.

Research into the equivalence of Western and Japanese conceptualizations of health-related quality of life (HR-QOL) is scarce. We used the Western (European Organization for Research and Treatment of Cancer, EORTC-QLQ-C30) and the Japanese (HRQoL-20) questionnaire in order to analyze the conceptual similarity of HR-QOL factors, and the associations between specific symptom items with overall HR-QOL in Japanese (n=265) and Dutch (n=174) patients with various types of cancer. Both populations completed both instruments. In both patient groups, the overall health scale of the EORTC-QLQ-C30 correlated highly (r=0.59; p<0.001) with the HRQOL-20 composite average score, indicating substantial conceptual comparability. Relationships between all EORTC-QLQ-C30 symptom items with HR-QOL were examined by ranking their correlations with the two overall measures of HR-QOL. Comparable patterns in the Japanese and Dutch samples were observed. The results suggest a considerable conceptual equivalence of HR-QOL in Japanese and Dutch cancer patients, and indicate a satisfactory structural and cross-cultural equivalence for the EORTC-QLQ-C30 with regard to items measuring functioning and specific symptoms. Longitudinal studies are needed to examine the impact of specific symptoms on general quality of life.

Attitude to Health↗

Na+ channel pharmacology and molecular mechanisms of gating.

Electrogenesis of efficiently propagated action potentials requires synchronized opening of transmembrane Na+ channels possessing a sodium selectivity-filter, a high-throughput ion-conductance pathway, and voltage-dependent gating functions. These properties of the Na+ channel have long been the target of molecular analysis. Several toxins and drugs, known to selectively bind to Na+ channels, have been used as pharmacological tools to investigate Na+ channel properties either electrophysiologically or chemically. Recent analyses of the protein crystal structure of bacterial voltage-dependent K+ channels have provided important clues to the identity of mobile structures involved in channel gating. The new information may be applicable to Na+ channels, and may well require a total revision of our understanding of gating mechanisms of sodium channels. Several experiments challenge the emerging view that channel gating by S6 transmembrane segments is triggered by signals from voltage sensors floating in membrane lipid. Herein, we review the various toxin and drug molecules that affect the gating behavior of Na+ channels in this new structural framework, by characterizing the binding sites of these toxins, and assessing the pharmacological effects resulting from changes in the structure of the toxin or sodium channel.

Animals↗

Novel mutations in the a3 subunit of vacuolar H(+)-adenosine triphosphatase in a Japanese patient with infantile malignant osteopetrosis.

A case of infantile malignant osteopetrosis is described. The patient died from respiratory hemorrhage at 7 months of age despite treatment that included high doses of active vitamin D and administration of interferon-gamma. A postmortem examination revealed the presence of many osteoclasts in the bone, which lacked ruffled borders. This observation was consistent with the histology of bone reported in Atp6i-knockout mice, which lack the gene encoding the a3 subunit of vacuolar-type H(+)-adenosine triphosphatase (ATPase). Sequence analysis of the TCIRG1 gene encoding the a3 subunit revealed two novel mutations: a deletion/insertion mutation in exon 9 and a T-to-C transition at the splice donor site of intron 19. The former mutation caused a frame shift and premature stop codon. The latter was associated with abnormal splicing, which was confirmed by sequencing the products amplified by reverse transcription-polymerase chain reaction (RT-PCR), using total RNA from the liver specimen as template. Although several mutations in the TCIRG1 gene in infantile malignant osteopetrosis have been reported in other populations, this is the first case of a Japanese patient with a mutation identified in this gene. These results support the important role of the subunit in the function of the proton pump.

Codon, Terminator↗

State-dependent action of grayanotoxin I on Na(+) channels in frog ventricular myocytes.

1. Distinct properties of grayanotoxin (GTX) among other lipid-soluble toxins were elucidated by quantitative analysis made on the Na(+) channel in frog ventricular myocytes. 2. GTX-modified current (I(GTX)) was induced strictly in proportion to the open probability of Na(+) channels during preconditioning pulses irrespective of its duration, amplitude or partial removal of inactivation by chloramine-T. This confirms that GTX binds to the Na(+) channel exclusively in its open state, while batrachotoxin (BTX) was reported to be capable of modifying slow-inactivated Na(+) channels, and veratridine exhibited voltage-dependent modification. 3. The GTX-modified channel did not show any inactivation property, which is different from reported results with veratridine and BTX. 4. Estimated unbinding rates of GTX were in reverse proportion to the activation curve of GTX-modified Na(+) channels. This was not the previously reported case with veratridine. 5. A model including unbinding kinetics of GTX and slow inactivation of unmodified Na(+) channels in which GTX was permitted to bind only to the open state of Na(+) channels indicated that unbinding reactions of GTX occur only in the closed state.

Animals↗

Localization of human airway trypsin-like protease in the airway: an immunohistochemical study.

Human airway trypsin-like protease (HAT) has been isolated from mucoid sputum of patients with chronic airway diseases. In order to clarify the cellular source of this novel protease in the human airway, we examined the localization of immunoreactive HAT in bronchial tissues obtained at surgery and fixed in 4% paraformaldehyde using an extremely sensitive immunohistochemical technique called a catalyzed signal amplification method and a monoclonal antibody against recombinant HAT. HAT immunoreactivity was demonstrated in cytoplasm of ciliated cells of bronchial epithelium and/or at the basal part of cilia. No positive reaction was found in submucosal glands or mast cells. The heterogeneous distribution of HAT immunoreactivity within the bronchial epithelium indicates that its expression might be changeable and that it might be closely related to the physiological status of the airway epithelium. Non-specific but intense reaction caused by endogenous avidin-binding activity (EABA) was selectively detected in submucosal glands, but was effectively blocked by successive treatments with avidin and biotin. These results indicate that HAT may be synthesized in the ciliated cells and that it may play some physiological roles within the epithelial layer and on the airway surface. It is necessary to keep in mind that some cells show strong EABA, especially when a highly sensitive immunohistochemical technique is applied.

Antibodies, Monoclonal↗

Effect of intermittent cyclical treatment with etidronate disodium (HEBP) and calcium plus alphacalcidol in postmenopausal osteoporosis.

We evaluated intermittent cyclical treatment with etidronate disodium (HEBP) and calcium plus alphacalcidol in postmenopausal osteoporosis, with special reference to bone mineral density (BMD) and prevention of spinal fracture. The patients were 40 women, over 50 years of age, with lumbo-dorsal pain and low BMD (less than 0.70 g/cm(2)), measured by dual-energy X-ray absorptiometry (DXA). The patients were randomly assigned to two groups. The first group (HEBP) received 200 mg of HEBP per day for 2 weeks, followed by 2 g calcium lactate and 0.5 microg alphacalcidol per day for the next 10 weeks. This 12-week cycle was repeated eight times for 2 years. The second group (Ca. D) received 2 g calcium lactate and 0.5 microg alphacalcidol per day for 2 years. Lumbar BMD was measured before the treatment and every 6 months during the treatment until 24 months, and changes were evaluated. The number of fractured vertebrae was counted on X-ray films before treatment and at the final assessment. After 6 months of treatment, a significant and continuous increase in BMD was observed in the HEBP group. Moreover, the percentage of patients with new vertebral compression fractures in the HEBP group was one-tenth of that in the Ca. D group. These results suggest that intermittent cyclical treatment with HEBP and calcium plus alphacalcidol may be effective for increasing BMD and preventing fractures in postmenopausal osteoporosis.

Aged↗

Test validity of periodic liver function tests in a population of Japanese male bank employees.

The validity (sensitivity and specificity) of annual liver function tests, determined by assaying blood levels of aspartate aminotransferase, alanine aminotransferase and gammaglutamyl transpeptidase, was evaluated using the results of health checkups of male bank workers. The specificity of each liver function test to detect persons with fatty liver, excess alcohol users, and hepatic virus carriers, diagnosed respectively by ultrasound, detailed inquiry, and virus marker tests, was always higher than 80%, except for alanine aminotransferase in excess alcohol users (63.5%). However, the highest sensitivity to detect virus carriers was alanine aminotransferase to detect HCV antibody-positive workers, but it was only 45.5%. The highest sensitivity of the liver function tests to detect excess alcohol users in obese subjects was only 33.3%. The highest sensitivity by liver function tests to detect fatty liver was 35.7% which was inferior to that of the body mass index. These results indicate that the liver function tests mandated in the workplace periodic health checkups in Japan exhibit very low sensitivity for the detection of any of the proposed target clinical conditions.

Adult↗

Quantitative evaluation of capacity-limited hepatobiliary transport based on hepatocellular diffusion model by MULTI(FEM).

The dose-dependency of hepatic uptake and hepatobiliary transport of a drug was evaluated by means of a nonlinear least square program incorporating the finite element method, MULTI(FEM). A perfusion experiment using isolated rat livers following a pulse input (i.e., under nonsteady-state conditions) was performed at three dose levels of cefpiramide as a model drug. The hepatic extraction ratio (E(H)) of cefpiramide decreased with an increase in dose, which demonstrates that the hepatic uptake is capacity-limited. The outflow time-profiles from the liver were represented by a two-compartment dispersion model with central Michaelis-Menten elimination, and the maximal elimination rate per central compartment volume (Vmax) and the Michaelis constant (Km) were estimated to be 1420 microg/ml/min and 235 microg/ml, respectively. The biliary mean transit time (t(bile)) increased slightly with an increase in dose. The hepatocellular diffusion model under non-steady-state conditions considering nonlinear transport across the bile canalicular membrane was adopted to evaluate dose-dependency in the biliary excretion of cefpiramide. The maximal penetration velocity across the bile canalicular membrane per liver (V=(bcm)max) and the affinity constant of penetration across the bile canalicular membrane (k(bcm)m = K(bcm)m A(H)L) were estimated to be 40.1 microg/min and 123 microg, respectively. Considering that the volume of a rat liver (A(H)L) is approximately 10 ml, the Michaelis constant of penetration (K(bcm)m), which is an apparent parameter, was estimated to be approximately 12.3 microg/ml. In conclusion, MULTI(FEM) is useful for evaluation of capacity-limited local disposition.

Animals↗

Novel mechanism of blocking axonal Na(+) channels by three macrocyclic polyamine analogues and two spider toxins.

1. The mechanism of Na(+) channel block by three macrocyclic polyamine derivatives and two spider toxins was studied with voltage clamp and internal perfusion method in squid axons. 2. All these chemicals specifically block Na(+) channels in the open state only from the internal surface, and do not affect K(+) channels. 3. The blocking effect is enhanced as the depolarizing pulse becomes larger. Blocked channels are unable to shift to the inactivated state. 4. In the case of cyclam and guanidyl-side armed cyclam (G-cyclam), quick release of these chemicals from the binding sites is proven by the increase in the tail current and prolongation of the time course of the off gating current. On the other hand, in the presence of N-4 and the spider toxins, their detachment was delayed significantly. 5. Molecular requirements for the block of Na(+) channels by these molecules are the presence of positive charge and hydrophobicity.

Algorithms↗

Open carpal tunnel decompression in long-term haemodialysis patients [corrected].

This retrospective study assessed the treatment of 91 cases of carpal tunnel syndrome in long-term haemodialysis patients. One group of patients underwent an enlargement reconstruction of the flexor retinaculum with synovectomy and the other group was treated with a conventional carpal tunnel release. There were no major changes or differences between the outcomes of the two groups. However, there was an earlier functional recovery of grip strength and a lower recurrence rate in the enlargement plasty with synovectomy group.

Aged↗

Introduction of recirculatory analysis into portal and systemic concentration difference method.

Recirculatory analysis was introduced into the portal and systemic concentration difference method with double dosing (PS-DD method), which is an evaluation system for the local intestinal and hepatic first-pass effect. 5-Fluorouracil (5-FU) and cephalexin (CEX) were selected as model drugs. A new recirculatory system was constructed to predict the time courses of a drug concentration in the systemic and portal bloods. Bioavailability (F), local absorption ratio (Fa), hepatic recovery ratio (FH), and local mean absorption time (ta) estimated by recirculatory analysis were close to those calculated by moment analysis with numerical integration. Using recirculatory analysis, the sampling period was considerably shortened and the sampling number was also reduced, which demonstrates that recirculatory analysis is useful in PS-DD method.

Administration, Oral↗

Transport characteristics of ebastine and its metabolites across human intestinal epithelial Caco-2 cell monolayers.

The transport characteristics of a selective peripheral H1 receptor antagonist, ebastine, a substrate for cytochrome P450 3A4, and its three major metabolites, i.e., the hydroxy metabolite of ebastine (M-OH), the pharmacologically active metabolite carebastine (Car), and the desbutyrophenone metabolite (des-BP), were studied in cultured human intestinal Caco-2 cells expressing a drug efflux pump, P-glycoprotein (P-gp), on the apical membrane. The polarized transport of [3H]cyclosporin A (CyA), mediated by P-gp in the basolateral to apical direction across the Caco-2 cell monolayers, was affected by the presence of ebastine in a concentration-dependent manner and significant inhibition was observed at high concentrations (>50 microM). M-OH (300 microM) also significantly inhibited whereas Car and des-BP did not. Although no marked polarized transport of [14C]ebastine in a secretory direction was observed in the Caco-2 systems, the flux in the basolateral to apical direction was slightly higher than that in the opposite direction at concentrations less than 30 microm. [14C]Ebastine (2 microM) uptake from the apical side was significantly increased in the presence of an excess of cold CyA, suggesting that the efflux process mediated by P-gp may be involved in the ebastine uptake by Caco-2 cells. Collectively, these results indicate that ebastine (and presumably M-OH) is transported via P-gp in Caco-2 cells, however, the affinity for P-gp is very low. It is unlikely that the secretory transport of ebastine mediated by P-gp will dramatically affect overall intestinal absorption in vivo because efficient passive diffusion of this drug should occur due to its high lipophilicity. However, it may be advantageous for its efficient first-pass metabolism.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Response of the stroke volume and blood pressure of young patients with nonobstructive hypertrophic cardiomyopathy to exercise.

Stroke volume (SV), cardiac output (CO) and systolic blood pressure (SBP) were measured during maximal symptom-limited bicycle exercise testing in 13 young patients (age, 11-26 years) with nonobstructive hypertrophic cardiomyopathy (HCM). SV was measured by impedance plethysmocardiography; %SVend, %COend, and %SBPend represent the ratio of the value at termination of the exercise to the respective value at rest. In all patients of HCM-I (the Cardiac Event Group, 3 patients) and 3 of HCM-II (the Non-Cardiac Event Group, 10 patients), the %SVend was less than 100%. The %SVend of HCM-I was significantly lower than the respective values of the HCM-II and Control groups. The %COend values of the HCM-I and HCM-II groups were each significantly lower than that of the Control. The %SBPend values of the HCM-I and HCM-II groups were each significantly lower than that of the Control. Among the HCM patients, the %SVend value was positively correlated with the %SBPend value. The patients who had more severe HCM had poorer exercise-induced increases in SV and SBP. These results suggest that sudden cardiac death in young HCM patients is associated with inhibition of the increase in SV upon exercise.

Adolescent↗

Novel wasp toxin discriminates between neuronal and cardiac sodium channels.

Pompilidotoxins (PMTXs), derived from the venom of solitary wasp has been known to facilitate synaptic transmission in the lobster neuromuscular junction, and a recent further study from rat trigeminal neurons revealed that the toxin slows Na+ channel inactivation without modifying activation process. Here we report that beta-PMTX modifies rat brain type II Na+ channel alpha-subunit (rBII) expressed in human embryonic kidney cells but fails to act on the rat heart alpha-subunit (rH1) at similar concentrations. We constructed a series of chimeric mutants of rBII and rH1 Na+ channels and compared modification of the steady-state Na+ currents by beta-PMTX. We found that a difference in a single amino acid between Glu-1616 in rBII and Gln-1615 in rH1 at the extracellular loop of D4S3-S4 is crucial for the action of beta-PMTX. PMTXs, which are small peptides with 13 amino acids, would be a potential tool for exploring a new functional moiety of Na+ channels.

Cells, Cultured↗

Hepatic uptake and gene expression mechanisms following intravenous administration of plasmid DNA by conventional and hydrodynamics-based procedures.

Hepatic uptake and gene expression mechanisms following intravenous administration of naked plasmid DNA (pDNA) by conventional and hydrodynamics-based procedures were studied in mice. After conventional (normal) intravenous injection, (32)P-labeled pDNA was rapidly eliminated from the circulation and predominantly taken up by the liver nonparenchymal cells while no significant gene expression was observed in this organ. The hepatic uptake process was saturable. Involvement of a specific mechanism was demonstrated since the hepatic uptake of [(32)P]pDNA was dramatically inhibited by cold pDNA, calf thymus DNA, and some polyanions [polyinosinic acid (poly I), dextran sulfate], but not by others (polycytidylic acid, chondroitin sulfate). The liver endothelial cells appeared to be a major contributor because gadolinium chloride (GdCl(3))-induced Kupffer cell blockade did not affect the hepatic uptake. After intravenous injection of naked pDNA with a large volume of saline at a high velocity (hydrodynamics-based procedure), the apparent hepatic uptake profile was similar to that after normal injection. The hepatic uptake was not inhibited by prior administration of polyanions, including poly I, dextran sulfate, and heparin. The hydrodynamics-based procedure resulted in marked gene expression in the liver, which was not inhibited by prior administration of polyanions or GdCl(3) treatment. These results indicate that pDNA uptake is a nonspecific process. This hypothesis was supported by the finding that significant hepatic uptake of bovine serum albumin and immunoglobulin G was observed after the hydrodynamics-based procedure.

Animals↗

[Topics of clinical physiological tests--pulmonary function--proposal of physio-chemical tests].

Pulmonary functions are classified as respiratory and non-respiratory. Although the mechanisms of non-respiratory pulmonary function have already been established, no new tests of respiratory pulmonary function have been developed for a long time. Thus, we report here a new analytic test of respiratory pulmonary functions. The new analytic method is physio-chemical analysis, in which the chemical factors of lungs are estimated from the physiological characteristics of lung during respiration. As examples, this report shows the method of exchanging mechanical energy to chemical energy in a comparison of lung ventilatory work between smokers and non-smokers. This report discusses the relationship between chemical energy and ATP in the blood of pneumoconiosis patients.

Aged↗

Novel site on sodium channel alpha-subunit responsible for the differential sensitivity of grayanotoxin in skeletal and cardiac muscle.

We searched for sites on the alpha-subunit of the fast Na(+) channel responsible for the difference in GTX (grayanotoxin) sensitivity of the skeletal- and cardiac-muscle Na(+) current. cDNA clones, encoding the skeletal or cardiac isoforms of the alpha-subunit, were inserted into a mammalian expression vector and transiently transfected into human embryonic kidney cells. The expressed channels were measured using whole-cell patch-clamp techniques and examined for GTX sensitivity. As a measure of GTX sensitivity, we used relative chord conductance (ratio of maximum chord conductance of noninactivating GTX-modified Na(+) currents to that of unmodified peak currents). Wild-type channels from skeletal muscle (mu 1) were more sensitive to GTX modification than wild-type cardiac channels (rH1) by a factor of 1.6. To facilitate exploration of alpha-subunit sites determining GTX sensitivity, we used SHHH, a chimera of skeletal muscle (S) domain D1 and heart muscle (H) domains D2D3D4 with supernormal sensitivity to GTX I (1.5-fold of wild-type mu 1). Successive replacement of Ser-251 (D1S4-S5 intracellular loop) and Ile-433 (D1S6 transmembrane segment), with corresponding rH1 residues Ala and Val, reduced, in a stepwise manner, the GTX sensitivity of the chimera and related mutants to that of wild-type rHl. We concluded that, in addition to Ile-433, known as the GTX-binding site, Ser-251 represents a novel site for GTX modification.

Binding Sites↗

Basic study on radon effects and thermal effects on humans in radon therapy.

Because most of the diseases to which radon (222Rn) therapy is applied are related to activated oxygen, in this study the effect of the radioactivity of radon and the thermal effect were compared under a room or a hot spring condition with the same chemical component using as the parameters the activity of superoxide dismutase (SOD), which is an oxidation inhibitor, and lipid peroxide and low density lipoprotein (LDL)-cholesterol, which are closely involved in arteriosclerosis. Results show that the SOD activity was significantly increased, and the lipid peroxide and LDL-cholesterol levels were significantly decreased on days 6 and 7 of study. The results were about 2-fold larger in the radon group than in the thermo group. This suggests that the anti-oxidation function was more enhanced by radon therapy than by thermo therapy, and suggests that radon therapy may help to prevent the causes of life style-related diseases such as arteriosclerosis. These findings are important in understanding the mechanism of diseases in which radon therapy is used as treatment, and most of which are called activated oxygen-related diseases.

Administration, Inhalation↗