N-acetylation polymorphism in Japanese patients with sarcoidosis.
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Acetylation↗
Biomedical subjects
M Asada
Publications and source records attributed to M Asada.
Inhibitory effect of alginic acids on hyaluronidase and on histamine release from mast cells.
The effects of various types of alginic acid consisting of L-guluronic acids (G) and D-mannuronic acids (M) on hyaluronidase and mast cell degranulation were examined. Alginic acid with an M/G ratio of 1.0 exhibited the strongest inhibition of both activities, the higher molecular weight alginic acids of 150 to 370 kDa being preferable in both cases. Esterification of the carboxyl residue enhanced the latter activity.
Alginates↗
Cerebellopontine angle ependymoma with internal auditory canal enlargement and pineal extension--case report.
A 38-year-old male presented with a posterior fossa ependymoma with unusual extension from the cerebellopontine angle to the pineal region. Magnetic resonance imaging clearly demonstrated that these two components were continuous through the right ambient cistern. Computed tomography using a bone algorithm revealed enlargement of the right internal auditory canal. This case suggests that ependymoma can extend anywhere within the subarachnoid space along the path of least resistance.
Adult↗
[Effect of factor XIII on intractable CSF leakage after a transpetrosal-approach operation: a case report].
The authors reported an experience showing that the XIII factor was effective for intractable cerebrospinal fluid (CSF) leakage after a transpetrosal operation to deal with cerebellopontine angle meningioma. A 63-year-old female noted a slight headache and a floating feeling. She became dependent on a stick for walking alone because of gradual gait disturbance. As the headache became more severe, she consulted the outpatient clinic of the department of neurosurgery of Kobe University Hospital. Magnetic resonance images (MRI) revealed a 4.3 x 3.0cm sized right cerebellopontine angle tumor. She was admitted for the purpose of removal of the tumor and preoperative examinations were performed. Neurological findings on admission showed only slight right cerebellar signs. The operation was performed via the transpetrosal approach and the tumor was totally removed (Simpson Grade II). It took 12 hours 40 minutes for the operation. The amount of blood loss was 1970ml and the blood transfusion volume was 1200ml. Postoperative course was uneventful and her complaints disappeared. There were no postoperative complications at all, but 2 weeks after the operation, CSF leakage under the skin flap appeared. As subcutaneous fluid collection after skull base surgery is usual, spinal drainage and compression of the skin flap was carried out but these measures were not effective. The collection of fluid did not disappear for 2 weeks. Based on our successful experience with the XIII factor therapy in intractable cerebrospinal fluid leakage from the nose after a transsphenoidal approach operation for recurrent pituitary adenoma, the blood level of the XIII factor activity was examined. As the result was far below the normal limit in this case, the XIII factor was infused at a rate of 750 units per day for 5 days. One week after the administration, the level of the XIII factor became normal. Fluid collection disappeared and the drainage tube was removed. Recently, in neurosurgery, skull base surgery has been used widely and the range of craniotomy has been extended because operations can now be performed without compression of cerebral cortexes. However, operation time has increased and the volumes of bleeding and of blood transfusion are increasing. Postoperative complications such as CSF leakage and infection have become new problems. In this case, the XIII factor was still far below the normal level 2 weeks after the operation and it could be considered to have caused delayed CSF leakage. Some papers have reported that the XIII factor was effective in treating intractable fistula after operations in other surgical areas. However, this is the first report of skull base surgery such as an operation using transpetrosal approach taking advantage of the effect of the XIII factor.
Cerebellopontine Angle↗
[A case of traumatic extracranial internal carotid artery dissecting aneurysm treated by proximal ligation and STA-MCA bypass].
We present a case with the traumatic extracranial internal carotid artery dissecting aneurysm. A 21-year-old man was involved in a motorcycle accident, resulting in multiple injuries but no apparent head and neck injuries. Head CT was normal on his admission. He was discharged from his local hospital 3 weeks after the accident without any neurological deficits. Five weeks after the accident, he suddenly presented with a motor aphasia and a right hemiparesis. CT and MRI showed infarctions in the left para-Sylvian and the left angular areas. Angiography showed a left extracranial carotid artery dissecting aneurysm at the level of C1 vertebral arch. The patient was initially managed by an anticoagulant agent, but he suffered from another transient ischemic attack due to distal embolism from the aneurysm. Balloon occlusion test of the left ICA was performed under monitoring EEG, SEP. Mean stump pressure (MSP) revealed 60 mmHg. and MSP/Mean systematic blood pressure revealed 67%. We judged that the left ICA ligation was a safe method to treat this patient, however, considering the patient's age and the side of the lesion, left STA-MICA bypass and ligation of the left ICA were carried out in one stage. Postoperatively, the patient did not show any cerebral ischemic complications and angiography showed disappearance of the aneurysm and patency of the bypass. The left MCA territories were filled well by cross circulation and the bypass.
Accidents, Traffic↗
Operative results of thoracoabdominal repair for chronic type B aortic dissection.
From January 1991 to May 1994, we have operated on 15 cases of Type B aortic dissection. In 10 of these patients, thoracoabdominal repair was performed. According to Crawford's classification, 2 patients fell into Type I, 6 patients into Type II, and 2 patients into Type III. The aneurysms were exposed through a left thoracotomy extending into the retroperitoneum with the hemidiaphragm divided circumferentially. The operations were performed under femoro-femoral partial cardiopulmonary bypass. In 6 of these cases selective perfusion of the visceral branches was used. The celiac axis was reconstructed in 10 patients, superior mesenteric artery in 9, right renal artery in 7, left renal artery in 6. Abdominal vessels were reconstructed by the "inclusion" technique described by Crawford in 2 patients, by "beveling" the distal prosthetic end in 6 and by the "interposition" technique in 4 patients. Vessels arising from the false lumen were reconstructed by the "interposition" technique. To prevent paraplegia, the evoked spinal cord potentials by direct stimulation of the cord (ESPs-dsc) were monitored perioperatively and the aneurysms were repaired sequentially in segments. In all patients except 2 with Crawford type III aneurysms, spinal cord ischemia was detected by ESPs-dsc. In 7 of these patients, 2 to 8 pairs of intercostal/lumbar arteries (I/L aa.) that arose from the "responsible" aortic segment were reconstructed. Reconstruction techniques included the "inclusion" technique in 2 patients, the "beveling" technique in 1, the "interposition" technique in 1 and the "on lay grafting" technique in 3 patients. One hospital death occurred in a patient who had chronic renal insufficiency and liver cirrhosis preoperatively. Spinal cord injury occurred in 5 patients, including 4 paraparesis and 1 delayed-onset paraplegia. In 2 of these patients, responsible I/L aa., were not reconstructed correctly despite ESPs changes, and injury might have been prevented if reconstruction of the "responsible" arteries had been performed. Thoracoabdominal repair for chronic Type B aortic dissection could be performed safely with an acceptable mortality rate. Spinal cord injury remains an unsolved problem.
Aortic Dissection↗
An ulcerated lesion at the BCG vaccination site during the course of Kawasaki disease.
We describe a bacillus Calmette-Guérin (BCG) granuloma that occurred during the course of Kawasaki disease. A 12-month-old male infant with Kawasaki disease had an erythematous indurated plaque with prominent necrotic ulceration at the BCG vaccination site on the left upper arm. Histologic study showed a granulomatous reaction consisting of epithelioid histiocytes, lymphoid cells, and Langhans-type giant cells. No evidence of mycobacterial infection was obtained. The lesion healed completely within 2 weeks without administration of antituberculous agents. We believe that the granulomatous reaction occurred as a result of hypersensitivity to proteins in the BCG vaccine, which appeared after the onset of Kawasaki disease.
Adjuvants, Immunologic↗
Thrombolytic therapy with tissue plasminogen activator for prevention of vasospasm in experimental subarachnoid hemorrhage: its efficacy and problems.
We investigated the efficacy of two different tissue plasminogen activators (t-PA) for preventing vasospasm after experimental subarachnoid hemorrhage (SAH) in rabbits. Intrathecal injection of Silteplase and Alteplase showed significant preventive action against vasospasm following SAH and thrombolytic effect. The low dose groups with both t-PA showed more preventive action on day 1 than the high dose groups. The data suggest that the determination of optimum dose of t-PA is essential in clinical use of t-PA.
Animals↗
Ehlers-Danlos syndrome and congenital heart anomalies.
Two sisters with Ehlers-Danlos syndrome, inherited as an autosomal recessive trait, and congenital heart disease are herein reported. One was a 20-year-old woman with Ehlers-Danlos syndrome and multiple aphthous stomatitis, bronchial asthma, an emphysematous lung, a ventricular septal defect and a bilateral inguinal hernia due to hyperextensibility and joint hypermobility. The other was a 17-year-old girl with the same syndrome and an atrial septal defect, a ventricular septal defect and patent ductus arteriosus. The combination of Ehlers-Danlos syndrome and congenital heart anomalies in these siblings suggest a common genetic defect to be the cause of these diseases.
Adult↗
Plasma and urinary metabolites of efonidipine hydrochloride in man.
1. The plasma and urinary metabolite profiles of efonidipine hydrochloride, a new dihydropyridine calcium antagonist, have been examined in six healthy male volunteers after oral dosing. 2. Unchanged drug in plasma was determined by hplc-ms. Five metabolites in plasma and five metabolites and unchanged drug in urine were identified by hplc. 3. The main plasma metabolites were N-dephenylated-efonidipine and deaminated-efonidipine. 4. No significant amount of unchanged drug was excreted in urine. In the urine collected for 24 h after a oral dosing, 1.1% of the dose was excreted as deaminated-efonidipine, and 0.5% as a pyridine analogue of deaminated-efonidipine.
Adult↗
Evolution of Mirizzi syndrome with biliobiliary fistula.
The mechanisms of fistula formation were analyzed in eight patients with Mirizzi syndrome with biliobiliary fistula. The fistula was type 1 in three patients and type 2 in five, according to the Corlette-Bismuth classification. The apparent mechanisms of fistula formation include inflammation of the gallbladder, its subsequent fusion to the bile duct, and increase in the internal pressure due to either contraction of the gallbladder or multiple stones. However, no predisposing conditions other than a longstanding history of cholelithiasis have been suggested. Differences in the type of fistula are considered to be due to the mode of fusion of the gallbladder to the bile duct, and the size of the perforation, which is apparently determined by the area in contact with the stone.
Adult↗
Primary hypoparathyroidism in Turner's syndrome.
A case of hypoparathyroidism accompanied with Turner's syndrome is reported. On admission, a 44-year-old woman had facial dystonia, deafness, and primary amenorrhea. Laboratory examinations showed a decrease in serum PTH and mosaicism of 45,X and 46,XX(6:34). A brain CT revealed marked calcification in the basal ganglia, cerebellum and periventricular area. Antiparkinsonian drugs were found to be effective for the dystonia. This case therefore suggests that some relationship may exist between intracranial calcification and Turner's syndrome.
Adult↗
Streptococcal toxic shock syndrome: report of two cases.
Two Japanese cases of streptococcal toxic shock syndrome (STSS) are reported. The first patient was a 45-year-old male who developed necrotizing fasciitis and myositis of the left thigh, refractory hypotension, hepatic dysfunction and acute renal failure; the patient died despite treatment. Streptococcus pyogenes was isolated from the inflamed fascia. The second patient was a 69-year-old female who had coagulopathy, polymyositis and hepatic function abnormality. Streptococcus pyogenes was isolated from blood culture. She was immediately placed on high-dose ampicillin as well as other supportive measures, and she survived.
Aged↗
External radiotherapy for biliary decompression of hilar cholangiocarcinoma.
Obstructive jaundice due to hilar cholangiocarcinoma is difficult to decompress because of the location of the tumor. We used external radiation alone for biliary decompression and reviewed its efficacy in this study. Subjects comprised 14 patients diagnosed as having inoperable hilar cholangiocarcinoma by ultrasonography, percutaneous transhepatic cholangiography, and CT scanning. The total bilirubin level on admission ranged from 0.4 to 34.6 mg/dl (mean: 11.0 mg/dl). These patients were irradiated with a 4MeV linear accelerator using parallel opposing fields measuring from 7 x 7 cm to 8 x 10 cm. The total radiation dose ranged from 50 Gy to 60 Gy and in fractions of 1.8-2.0 Gy per day. No patient underwent further biliary decompression after percutaneous transhepatic cholangiography, and irradiation was performed immediately after diagnosis. Eleven of the 14 patients received the full dose of external radiation. Three patients discontinued radiotherapy because of severe vomiting and nausea, pneumonia, and a hemorrhagic gastric ulcer. In 10 of the 11 patients, the serum total bilirubin level returned to normal (p < 0.005) and no cholangitis occurred. Obstructive jaundice recurred in one patient, and serum total bilirubin returned to normal again after further irradiation. Eight of the 11 patients could be discharged from hospital and returned to society. The survival time of the 11 patients ranged from 3 to 25 months and the 12-month survival rate was 50% (Kaplan-Meier method). This study suggests that external radiation therapy is an effective treatment for biliary decompression in patients with unresectable hilar cholangiocarcinoma.
Aged↗
[Effects of arterial carbon dioxide (PaCO2 not equal to 60 mmHg) on regional myocardial tissue oxygen tension and metabolism].
We investigated the effects of increased arterial carbon dioxide (PaCO2 not equal to 60 mmHg) on myocardial tissue oxygen tension and metabolism in anesthetized dogs. Ten adult mongrel dogs weighing 15.3 +/- 4.1 kg were anesthetized with 0.5% isoflurane in 50% oxygen and ventilated mechanically to maintain normocapnia. After thoracotomy, regional myocardial tissue PO2 was measured using a monopolar polarographic needle electrode inserted in the myocardium. Electromagnetic blood flow probes were applied on the left anterior descending artery and the circumflex artery. A 23-gauge catheter was inserted into a coronary vein to obtain coronary venous blood for measuring oxygen content, lactate and pyruvate. After control normocapnic ventilation, hypercapnia (PaCO2 62.7 +/- 3.2 mmHg) was induced by adding 10% carbon dioxide to the inspired gas for 20 minutes. As a result, the coronary blood flow and myocardial oxygen tension increased during hypercapnia. The myocardial lactate extraction and coronary venous lactate were unchanged and excess lactate was kept below zero, although coronary venous L/P ratio increased during hypercapnia. These results indicate that hypercapnia (PaCO2 not equal to 60 mmHg) increases coronary blood flow and myocardial oxygen tension, while myocardial aerobic metabolism is not impaired under hypercapnia.
Animals↗
Expression of Bcl-2 protein in murine neural cells in culture.
To explore the role of the protooncogene bcl-2 in the prevention of programmed cell death in the nervous system, we investigated its expression in mouse neural cells in primary culture. The 26 kDa protein product, Bcl-2, was detected by immunocytochemistry and immunoblotting in cultured neurons, astrocytes and oligodendrocytes, but the immunoreactivity of microglial cells was not detectable by immunoblotting. The subcellular distribution of Bcl-2 was similar between in vivo (brain) and in vitro (culture) and between cultured neurons and astrocytes, while the content was higher in astrocytes than in neurons. The substantial expression of bcl-2 in primary cultured brain cells suggests that it has some physiological control in the brain over programmed cell death, which may be exerted not only in neurons but also in some glial cells such as astrocytes.
Animals↗
Characteristics of antitumor activity of KW-2189, a novel water-soluble derivative of duocarmycin, against murine and human tumors.
Methyl(1S)-1-bromomethyl-7-methyl-5-[(4-methylpiperazinyl)-carb onyloxy]- 3-[(5,6,7-trimethoxy-2-indolyl)-carbonyl]-1,2-dihydro-3H-pyrolo[3, 2-e] indole-8-carboxylate hydrobromide (KW-2189), a novel derivative of duocarmycin B2, was selected for extensive evaluation based on its improved antitumor activity, water solubility, and stability in the culture medium, as compared with duocarmycin B2. Although the in vitro cell growth-inhibitory activity of KW-2189 was less potent than that of duocarmycin B2, it significantly inhibited the growth of five murine solid tumors including Colon 26 adenocarcinoma, Colon 38 adenocarcinoma, and B16 melanoma in vivo. KW-2189 was also effective against murine P388 leukemia and L1210 leukemia not only by local administration (i.p.-i.p. system), but also by systemic administration (i.p.-i.v. or i.v.-i.v. system). The most remarkable feature of KW-2189 was its efficacy against various human xenografts, which was observed in 14 tumors among 16 tested tumors including drug-insensitive tumors by single i.v. administration. Tumor regression was observed in mice bearing LC-6 lung, St-4 and St-40 stomach, Li-7 liver, PAN-2 pancreas, and MX-1 breast carcinomas. In many cases, the activities of KW-2189 were more than those of clinically active agents, mitomycin C, Adriamycin, cisplatin, and cyclophosphamide. Delayed lethal toxicity, which was reported in mice treated with CC-1065 whose structure was similar to KW-2189, was not observed in mice treated with KW-2189. KW-2189 inhibited DNA synthesis more significantly than RNA or protein synthesis, although DNA strand breaks were not observed. KW-2189 was activated by porcine liver esterase, mouse liver homogenate or Hep G2 homogenate, and DU-86-DNA adducts were detected in KW-2189-treated HeLa S3 cells, suggesting that KW-2189 was converted to DU-86 in the cells. These results indicate that KW-2189 is an interesting candidate for further development as a novel antitumor agent.
Animals↗
Mutations of the N-ras gene in juvenile chronic myelogenous leukemia.
Juvenile chronic myelogenous leukemia (JCML), a myeloproliferative disorder of childhood, is distinct from adult-type chronic myelogenous leukemia (CML) and bears resemblance to chronic myelomonocytic leukemia (CMMoL). Since mutations in the N-ras gene have been found at high frequencies in CMMoL, but only rarely in CML, we analyzed mutations activating the N-ras gene in 20 patients with JCML. We used the strategy for analysis of gene mutations based on in vitro DNA amplification by polymerase chain reaction (PCR) followed by single-strand conformation polymorphism (SSCP) analysis and/or direct sequence analysis. Nucleotide sequence analysis showed single nucleotide substitutions involving codons 12, 13, or 61 in six of 20 patients (30%). Four of six patients with mutations were in chronic phase and the other two in blast crisis, indicating no apparent correlation with disease stage. Most of the patients with mutations were in the older age group with poor prognosis, although one patient in the younger age group also harbored the mutation. These data suggest that N-ras gene mutations may be involved in the pathogenesis and/or prognosis of JCML and provide further evidence that JCML is an entity distinct from CML.
Base Sequence↗