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Biomedical subjects

M Hamada

Publications and source records attributed to M Hamada.

At least 235 records · Page 13Linked to original sources

Hepatocyte regeneration in chronic hepatitis C and interferon treatment: analysis of immunohistological identification of proliferating cell nuclear antigen (PCNA).

To evaluate the usefulness of proliferating cell nuclear antigen (PCNA) immunostaining in the assessment of the efficacy of interferon (IFN) therapy in chronic hepatitis C, we investigated the proliferative activity of hepatocytes in 67 patients with chronic hepatitis C, using this immunostaining method. The percentage of PCNA-positive hepatocytes was 2.4% in patients with chronic persistent hepatitis, 2.5% in those with chronic aggressive hepatitis 2A, and 3.9% in those with chronic aggressive hepatitis 2B. The PCNA count increased with the progression of the liver disease. Patients were classified as complete, partial, and non-responders to IFN; the percentage of PCNA-positive hepatocytes before IFN therapy was 1.6% in the complete responders, 3.9% in the partial responders, and 4.9% in the non-responders. There was a significant negative correlation between the percentage of PCNA-positive hepatocytes and the response to IFN treatment. Thirty-two of 53 cases (60.4%) in which the PCNA labeling index (LI) was less than 5.0 were complete responders compared with 13 of 14 cases (92.9%) in which the PCNA LI was higher than 5.0, representing partial responders or non-responders (P < 0.001). Most complete responders had a low PCNA LI, irrespective of HCV genotype. Our findings indicate that PCNA immunostaining is a simple and reliable index of cell proliferation in liver regeneration, and may be a useful predictor of the response to IFN treatment in chronic hepatitis C.

Adult↗

Hemolytic anemia provoked by recombinant alpha-interferon.

A 30-year-old female with chronic hepatitis C treated with recombinant alpha-interferon developed serious hemolytic anemia after receiving 10 million units a day for 4 weeks. The results of Coombs' tests were negative before and after interferon therapy. The hemolytic anemia gradually improved after the withdrawal of recombinant alpha-interferon and the administration of methyl-prednisolone. The clinical course suggested that the recombinant alpha-interferon had provoked the hemolytic anemia.

Adult↗

Late onset hepatic failure due to hepatitis B virus with mutations in the pre-core region.

A 60-year-old man complained of severe general fatigue on October 11, 1992. Pertinent laboratory findings were: aspantate aminotransferase (AST) 1920 IU, alanine aminotransferase (ALT) 2050 IU, and total bilirubin (T. Bil) 124 micromol/l (normal range, 0-17 micromol/l). Virological assay revealed that hepatitis B surface antigen (HBsAg), anti-hepatitis B e (HBe), anti-HBc, and immunoglobulin M (IgM) anti-HBc were positive, and anti-HBs, HBeAg, and anti-delta antibody were negative. A diagnosis of acute hepatitis due to hepatitis B virus was made. Despite a decrease in transaminase, jaundice worsened and prothrombin time was prolonged. On the 60th day of hospitalization, massive ascites developed, but the patient's consciousness was not impaired. Although, albumin and diuretics were given, the ascites further increased. Paracentesis of 2000 ml of ascitic fluid was performed twice a week. On the 120th day of hospitalization, the patient passed black stools and he exhibited renal failure 3 weeks later. Although severe jaundice persisted, he was still alert. On the 150th day of hospitalization, massive gastrointestinal bleeding occurred, due to hemorrhagic gastritis. Despite receiving intensive care, the patient died. Determination of the HBV DNA sequence revealed two point mutations in the pre-core region; these have not been reported elsewhere.

DNA, Viral↗

Arthroscopic repair for a flap tear of the posterior horn of the lateral meniscus adjacent to its tibial insertion.

A flap tear of the posterior horn of the lateral meniscus adjacent to its tibial insertion combined with acute rupture of the anterior cruciate ligament was successfully repaired arthroscopically by a combination of advancement of the tip of the flap into a drill hole created in the tibia and an inside-out stacked suture technique using Henning instrumentation in two cases. However, the long-term function of the repaired menisci, which was reduced several millimeters in circumferential length, is still unknown.

Adolescent↗

Increased secretion of atrial and brain natriuretic peptides during acute myocardial ischaemia induced by dynamic exercise in patients with angina pectoris.

1. This study was conducted to assess the role of artrial and brain natriuretic peptides during acute myocardial ischaemia associated with dynamic exercise. 2. Study subjects consisted of 35 angiographically proven patients with angina pectoris and 35 angiographically normal control subjects. All subjects underwent 201Tl dynamic exercise testing. The presence and localization of the exercise-induced acute myocardial perfusion defect were assessed by 201Tl single-photon emission computed tomography. The severity score was calculated using the early image for quantitative assessment of the acute myocardial perfusion defect. 3. Plasma levels of atrial natriuretic peptide increased from 21.3 +/- 3.8 to 72.2 +/- 26.7 pg/ml (P < 0.01) in the angina pectoris group, and increased from 19.4 +/- 2.4 to 36.4 +/- 17.4 pg/ml (P < 0.01) in the control group during dynamic exercise. Plasma levels of brain natriuretic peptide increased from 2.8 +/- 0.8 to 6.9 +/- 2.6 pg/ml (P < 0.01) in the angina pectoris group, but did not change significantly in the control group (from 2.7 +/- 0.7 to 2.9 +/- 1.0 pg/ml) during dynamic exercise. At peak exercise, plasma levels of these natriuretic peptides in the angina pectoris group were significantly higher than those in the control group (P < 0.01). 4. At peak exercise, there were correlations between the plasma level of atrial natriuretic peptide and heart rate in both the angina pectoris and control groups (P < 0.01, r = 0.46; P < 0.01, r = 0.51, respectively), but no significant correlations between the plasma level of brain natriuretic peptide and heart rate in either group. The plasma levels of these peptides at peak exercise correlated well with the severity score in the angina pectoris group (atrial natriuretic peptide, r = 0.71, P < 0.01; brain natriuretic peptide, r = 0.69, P < 0.01).

Acute Disease↗

Clinical and serological courses of a newborn with post-transfusion hepatitis C.

The clinical and serological course of a haemophilic baby who was transfused with 160 ml of blood containing the hepatitis C virus (HCV) (0.70 Meq. ml-1) on the sixth-post-natal day is described. He is the infant of an HCV-negative mother. One month after the transfusion, there was a marked increase in HCV RNA and a small amount of HCV antibody was detected. This case provides evidence that a newborn is capable of producing HCV antibodies.

DNA, Viral↗

Altered production of nerve growth factor in cultured vascular smooth muscle cells from genetically hypertensive rats.

1. Nerve growth factor (NGF) is a neurotrophic peptide for peripheral sympathetic nerves. Hypotrophy of sympathetic nerve ganglia and reduced content of neuropeptide Y were reported in genetically hypertensive (GH) rats. These facts led us to consider that production of NGF might be altered in GH rat cells. 2. Vascular smooth muscle cells (VSMC) were prepared from the aortic media of 12 week old GH rats and age-matched normotensive (NT) rats by enzyme digestion method. Growth rates and the maximum cell densities were fairly equivalent between GH cells and NT cells. 3. The NGF content in the medium was measured using an enzyme immunoassay against mouse beta NGF. The amount of NGF secreted from VSMC of GH were 1.2 pg/10(4) cells per 48 h in the progressive phase and 0.7 pg/10(4) cells per 48 h in the quiescent phase, while those of NT were 8 pg/10(4) cells per 48 h and 1 pg/10(4) cells per 48 h, respectively. The levels of NGF secretion per cells were greater in NT cells. In summary, NGF secretion from VSMC were reduced in GH. 4. These results suggested that a reduced production of NGF from VSMC might be involved in the reported hypotrophy of sympathetic nerve cells in GH.

Animals↗

Effect of felodipine on blood pressure, body sodium, plasma renin activity and plasma aldosterone in hypertensive and normotensive rats.

1. To explore its effect on blood pressure (BP) in relation to body sodium (Na), felodipine was given to New Zealand genetically hypertensive (GH) and normotensive (N) rats and to Japanese SHR and WKY rats, prepared for repeated measurements of body sodium (Na) by a whole body counting technique (22Na) using an Na-free pelleted diet and 22Na-NaCl fluid as the sole source of Na, with water also available. The drug was added to the food before pelleting pellets, 0.5 mg/g food. 2. Felodipine reduced BP in each strain; this effect was as great on normal Na intake as when on a zero Na intake. Felodipine caused an increase in plasma renin activity in each strain but the increase reached significant levels only in GH, SHR and WKY. Plasma aldosterone was decreased by treatment in GH and N and increased in SHR and WKY. 3. In rats on a zero Na intake (water sole drinking fluid), felodipine caused no fall in body Na (i.e. no natriuretic effect was detectable) except in WKY. When saline was freely available, felodipine tended to stimulate saline intake and was associated with an increase in body Na in all strains except SHR; body Na was high in SHR even in the absence of felodipine and did not increase further with felodipine treatment. Felodipine slightly speeded up the excretion of an Na load in rats on an ample NaCl intake (choice of 0.5% 22Na-NaCl and water) but this may have been due, in part, to the treated rats having taken, by choice, a greater intake of saline in the pre-load period. 4. In this study, felodipine reduced BP and stimulated PRA and salt appetite. Its effects on Na handling varied to some extent between the strains; there was no consistent natriuretic effect, but rather some evidence of Na retention.

Aldosterone↗

Blood pressure response to the Valsalva maneuver in pheochromocytoma and pseudopheochromocytoma.

To elucidate whether a difference in blood pressure reactivity exists between patients with pheochromocytoma (n = 8) and pseudopheochromocytoma (n = 22), we evaluated blood pressure changes during a Valsalva maneuver and baroreceptor reflex sensitivity. We also examined the effects of propranolol and prazosin on blood pressure reactivity during a Valsalva maneuver in patients with pseudopheochromocytoma. Pseudopheochromocytoma was defined as a paroxysmal rise in blood pressure accompanying pheochromocytoma-like symptoms and normal catecholamine values. The difference in systolic blood pressure between phase IV of the Valsalva maneuver and baseline (delta SBP) was markedly smaller in the pheochromocytoma patients (8.4 +/- 18.4 mm Hg) than in the essential hypertension patients (n = 30, 30.9 +/- 19.4 mm Hg) and normotensive control subjects (n = 10, 31.3 +/- 11.4 mm Hg), whereas delta SBP in the pseudopheochromocytoma patients (77.8 +/- 11.2 mm Hg) was markedly greater than in the other three groups. delta SBP was markedly suppressed by the administration of both propranolol and prazosin. Baroreceptor reflex sensitivity index was lower in the pheochromocytoma group than in the other three groups. In conclusion, blood pressure reactivity responses to a Valsalva maneuver are disparate between pheochromocytoma and pseudopheochromocytoma. The high blood pressure reactivity to a Valsalva maneuver in pseudopheochromocytoma is due to hyperactivity in both beta- and alpha 1-adrenergic receptor functions, and the low blood pressure reactivity to a Valsalva maneuver in pheochromocytoma seems to be mainly due to the desensitization of both adrenergic systems associated with chronic catecholamine excess. In addition, the impaired baroreceptor function in pheochromocytoma is partially responsible for it.

Adrenal Gland Neoplasms↗

Acute effect of glyceryl trinitrate on systolic blood pressure and other hemodynamic variables.

The acute effect of glyceryl trinitrate (GTN) is mainly the reduction of systolic blood pressure (SBP) rather than diastolic blood pressure (DBP). To examine the mechanisms for decrease in SBP by GTN, the authors measured arterial compliance (AC), cardiac output (CO), stroke volume (SV), pulmonary capillary wedge pressure, right ventricular end-diastolic pressure, right atrial pressure, and left ventricular end-diastolic pressure before and after administration of GTN. Fourteen patients who underwent cardiac catheterization were included in this study. The change of each variable was estimated by the differences between values just before and at three minutes after GTN. After administration of GTN, SBP was significantly decreased from 158 +/- 21 to 138 +/- 12 mmHg (P < 0.01). AC was significantly increased, and pulmonary capillary wedge pressure, CO, and SV were significantly decreased. The change in SBP was inversely correlated with the change in AC and positively correlated with the change in CO or SV. The authors conclude that the mechanism for decrease in SBP by GTN is associated with both an increase in AC and a decrease in venous return.

Administration, Sublingual↗

Noninvasive physiological assessment of vascular wall sclerosis using carotid pulse tracing and cine magnetic resonance.

In order to evaluate vascular wall sclerosis, the authors compared parameters of carotid pulse tracing with ascending aortic wall distensibility by using cine magnetic resonance (MR). Cine MR and carotid pulse tracing were performed in 20 healthy volunteers (mean age fifty-six years). They measured the interval from aortic second heart sound (A2) to the dicrotic notch (DN) (A2-DN interval), and the height from dicrotic notch to top/total height of carotid pulse tracing (b/a ratio). Ascending aortic distensibility was calculated from the following formula: max area - min area/min area x pulse pressure. There were significant positive correlations (r = 0.70) between the A2-DN interval and ascending aortic distensibility and between b/a ratio and ascending aortic distensibility (r = 0.63). The measurement of A2-DN interval and b/a ratio using carotid pulse tracing is a useful method for assessing ascending aortic wall sclerosis.

Adult↗

Relation between postpacing T wave changes and myocardial scintigraphic characteristics in patients with ventricular demand pacemaker.

The aim of this study was to elucidate the cause of T wave changes after ventricular pacing using thallium 201 single photon emission computed tomography (Tl-SPECT). Tl-SPECT was performed in 20 patients with sick sinus syndrome who had negative T wave after ventricular pacing and had had a ventricular demand pacemaker (VVI) implanted. Patients who have stenotic coronary arteries were excluded from the study. From the analysis of Tl-SPECT, extent score was calculated as the ischemic region. Data in patients with SSS were compared with those in 20 normal controls (NC). Thallium perfusion defects in patients with VVI were observed and distributed mainly in apex and inferior regions on the polar map. The extent score in patients with VVI was significantly higher than that in NC (56.4 +/- 21.6% vs 3.2 +/- 6.4%, P < 0.01). The washout rate of thallium 201 in the defect area was significantly lower in patients with VVI than in NC (27.4 +/- 10.2% vs 46.8 +/- 12.3%, P < 0.01). These results suggest that T wave changes after ventricular pacing are closely related to myocardial ischemia.

Aged↗

Mechanism of atrial fibrillation and increased incidence of thromboembolism in patients with hypertrophic cardiomyopathy.

To elucidate the morphologic characteristics of the left ventricle in patients with hypertrophic cardiomyopathy who developed atrial fibrillation, we studied left ventricular geometry by two-dimensional echocardiography in 92 patients with hypertrophic cardiomyopathy. These patients were divided into two groups; 24 patients with transient or persistent atrial fibrillation (group I) and 68 patients with sinus rhythm (group II). Left ventricular chamber size in group I was significantly smaller than that in group II. Left ventricular chamber size was correlated positively with stroke volume, and was correlated negatively with left ventricular end-diastolic pressure. The incidence of systemic thromboembolism in group I was 7.1% per patient year. In hypertrophic cardiomyopathy, the size of the left ventricle appears to have major pathophysiologic significance in the development of atrial fibrillation. In addition, since patients with hypertrophic cardiomyopathy who develop atrial fibrillation have a potential risk of systemic thromboembolism, prophylactic anticoagulant therapy should be performed in these patients.

Adult↗

Augmented secretion of atrial and brain natriuretic peptides during dynamic exercise in patients with old myocardial infarction.

To assess the role of atrial and brain natriuretic peptides (ANP, BNP) in maintaining cardiac performance at rest and during exercise in patients with cardiac dysfunction, we measured plasma levels of ANP and BNP during 201Tl dynamic exercise testing in 32 patients with angiographically proven old myocardial infarction (OMI) and 35 normal control subjects (CS). Plasma levels of ANP and BNP at rest were significantly higher in patients with OMI than in CS (ANP, 42.6 +/- 19.3 vs 19.4 +/- 2.4 pg/ml, p < 0.01; BNP, 53.4 +/- 32.5 vs 2.8 +/- 0.8 pg/ml, p < 0.01, respectively). Correlations were found between plasma levels of these peptides and left ventricular ejection fraction (LVEF), cardiac index (CI), pulmonary capillary wedge pressure (PCWP) and left ventricular end-diastolic pressure (LVEDP) in patients with OMI. In addition, a strong positive correlation was found between plasma levels of these peptides and the severity score obtained from 201TI myocardial scintigraphy. During exercise, both ANP and BNP significantly increased in patients with OMI. However, in CS, although ANP increased, BNP remained unchanged. The changes in plasma levels of ANP or BNP from at rest to peak exercise correlated with LVEF, CI, PCWP, LVEDP and the severity score in patients with OMI. These findings indicate that ANP and BNP play an important role in maintaining cardiac performance at rest and during exercise in patients with cardiac dysfunction.

Adult↗

Effects of thyroid hormone on coenzyme Q and other free radical scavengers in rat heart muscle.

Active oxygen species are reported to cause organ damage. This study was therefore designed to determine the behaviour of antioxidants and free radical scavengers so as to reveal changes in animals in the hyper- and hypothyroid state. Levels of antioxidant factors (i.e. coenzyme Q (CoQ)10, CoQ9 and vitamin E) and free radical scavengers (catalase, glutathione peroxidase (GSH-PX) and superoxide dismutase (SOD)) were measured in the heart muscles of rats rendered hyper- or hypothyroid by 4 weeks of thyroxine (T4) or methimazol treatment. Serum levels of CoQ9 and total SOD were also measured. A significant reduction in CoQ9 levels was observed in the heart muscles of both hyper- and hypothyroid rats when compared with control hearts. There was no difference in serum CoQ9 levels in thyroid dysfunction when compared with control animals. Levels of vitamin E in the heart muscles of hyperthyroid rats were significantly increased, and there was no reduction in vitamin E levels in hypothyroid rats when compared with control hearts. GSH-PX levels in the heart muscle were reduced in hyperthyroid rats and increased in hypothyroid rats when compared with control hearts. However, there were no differences in catalase levels in heart muscle between hyper- and hypothyroid rats. The concentration of SOD in heart muscle was increased in hyperthyroid rats and was not decreased in hypothyroid rats compared with control rats, suggesting the induction of SOD by excessive production of O2-. These data suggest that the changes in these scavengers have some role in cardiac dysfunction in the hyper- and hypothyroid state in the rat.

Animals↗

Changes in lipid peroxidation and free radical scavengers in the brain of hyper- and hypothyroid aged rats.

To determine how lipid peroxides and free radical scavengers are changed in the brain of hyper- or hypothyroid rats, we examined the behavior of lipid peroxide and free radical scavengers in the cerebral cortex of aged (1.5 years old) rats that had been made hyper- or hypothyroid by the administration of thyroxine or methimazol for 4 weeks. Concentrations of catalase, Mn-superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) were increased in hyperthyroid rats compared with euthyroid rats. Concentrations of total SOD, Cu,Zn-SOD and GSH-PX were increased but that of Mn-SOD was decreased in hypothyroid animals. There were no differences among hyperthyroid, hypothyroid and euthyroid rats in the levels of coenzymes 9 or 10. The concentration of lipid peroxides, determined indirectly by the measurement of thiobarbituric acid reactants, was decreased in hyperthyroid rats but not in hypothyroid rats when compared with euthyroid animals. These findings suggest that free radicals and lipid peroxides are scavenged to compensate for the changes induced by hyper- or hypothyroidism.

Animals↗

Rotationplasty for patients with osteosarcoma around the knee joint.

The results of rotationplasty for patients with osteosarcoma around the knee joint are presented. After an average observation period of 13.3 months, there has been no local recurrence or metastasis. The ankle joints (the new knee joints) of the patients were able to support their body weight with an average range of motion of 75 degrees. All patients could walk well without crutches and without risk of the giving way phenomenon. The average rate of the functional evaluation according to the re-modified system by Enneking was 84.5% (range, 80.0-86.7%). No patient had psychological trouble in accepting the shortened and rotated extremity. The results show that rotationplasty is a useful reconstructive method for the treatment of osteosarcoma around the knee joint.

Adolescent↗