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Biomedical subjects

M Hashimoto

Publications and source records attributed to M Hashimoto.

At least 109 records · Page 6Linked to original sources

[To promote hospital activities for the patient safety].

Recently, increasing news reports of adverse events in health care suggest the need for reconsideration of the role and responsibility of health care in society. In this paper, after reviewing the history and the characteristics of the health care delivery system in Japan, central issues of patient safety management are sorted out. A good example of a team approach that has prevented progress of a serious disease is also presented. It is suggested that the total quality improvement activities are useful for the patient safety management.

Hospital Administration↗

In vitro prevention of cell-mediated xeno-graft rejection via the Fas/FasL-pathway in CrmA-transducted porcine kidney cells.

Cell-mediated cytotoxicity may be involved in delayed and/or chronic xenograft rejection in which apoptosis is induced in the grafted cells via the Fas/Fas-ligand (FasL) and perforin/granzyme pathways. One barrier to the potential use of xeonogenic grafts for humans may be Fas/FasL-mediated apoptosis, which would be blocked by the gene expression of cytokine response modifier A (CrmA), a cowpox virus gene product. The purpose of this study is to explore whether crmA is an effective candidate gene for inhibiting apoptosis in an in vitro model of xenograft rejection, using Fas-expressing non-primate cells cultured with a soluble recombinant human FasL (sFasL). A recombinant adenovirus vector expressing CrmA (AxCALNLCrmA) was successfully generated with a Cre-mediated switching system. PK15 cells, derived from a porcine kidney and infected with AxCALNLCrmA and/or AxCANCre at a multiplicity of infection (MOI) ranging from 0.1 to 100, were cultured with human sFasL derived from KFL74.18, a human FasL-overexpressed cell line. The gene-expression level of the PK15 cells was confirmed by CrmA-immune staining. Approximately 70% of the control PK15 cells showed induced apoptosis when cultured with sFasL. In contrast, the apoptosis was dramatically reduced in crmA-gene-transduced PK15 cells. The inhibitory effect of apoptosis increased with an increase in the infection dose of AxCANCre. In addition, the activity of caspases 3 and 8 was significantly inhibited in the crmA-transduced cells. These results indicate that CrmA is an effective gene product for inhibiting Fas/FasL-mediated apoptosis, which suggests the potential therapeutic use of its gene transduction to protect against graft damage due to delayed and/or chronic xenograft rejection.

Animals↗

[Influences of uncommon isoenzymes on determination of alkaline phosphatase activity by dry-chemistry analyzers].

Dry-chemistry(DC) analysis may be influenced by some matrix effects for measuring uncommon isoenzyme forms. Placental and intestinal alkaline phosphatase(AP) are overestimated by the VITROS DC, compared with results obtained with the wet-chemistry(WC) method of Bretaudiere, et al. using 2-amino-2-methyl-1-propanol (AMP) buffer, however, no such discrepancy between AP results in any DC method and that with a routine WC method recommended by Japanese Society of Clinical Chemistry in that 2-ethylaminoethanol(EAE) buffer is used, has been demonstrated. The type of buffer used affects differently the rates of AP isoenzymes activities. We therefore examined whether the presence of uncommon AP isoenzyme forms in serum caused aberrant DC results for AP in comparison with a routine WC method using EAE buffer. Here, serum samples with only liver AP and bone AP(n : 32); high-molecular-mass AP(n : 11); placental AP(n : 12); intestinal AP(n : 13) and immunoglobulin (Ig) bound AP(n : 12) were analyzed for total AP activity on three different DC analyzers: VITROS 700XR, FUJIDRYCHEM 5000, SPOTCHEM 4410 and a WC analyzer: HITACHI 7350. Values obtained in all of the DCs for sera containing only liver/bone AP agreed with those with the WC method. For sera containing placental AP, the VITROS values were higher than those with the WC method, while the FUJIDRYCHEM values and the SPOTCHEM values were lower. The VITROS values and the FUJIDRYCHEM values for sera containing intestinal AP were lower than those with the WC method, while the SPOTCHEM values were higher. All of the DCs did not affect high-molecular-mass AP and Ig bound liver/bone AP types of macro AP, but underestimated Ig bound intestinal type. Ig bound intestinal AP may be sieved by DC multilayer elements.

Alkaline Phosphatase↗

Effects of docosahexaenoic acid on annular lipid fluidity of the rat bile canalicular plasma membrane.

The role of docosahexaenoic acid (DHA) in the fluidity of the annular lipid regions and their associated membrane-bound proteins is still not as well understood as that in the global (bulk) lipid regions. We therefore studied the effects of dietary DHA on the relationship between annular and global lipid fluidity and membrane-bound enzymes such as 5'-nucleotidase and Mg(2)+-ATPase in the rat bile canalicular membrane. Dietary DHA caused significant increases in 5'-nucleotidase and Mg(2)+-ATPase activity and in global and annular lipid fluidity, a higher increase in fluidity in the annular lipids than the global lipids, and a decrease in the cholesterol-to-phospholipid molar ratio in the canalicular membrane. Plasma total cholesterol and LDL cholesterol decreased, and fecal cholesterol increased in the DHA-fed rats. No changes were observed in oxidative markers, but glutathione peroxidase increased in the liver with DHA feeding. Annular lipid fluidity, but not global lipid fluidity, correlated remarkably well with DHA, synchronously with the activities of 5'-nucleotidase and Mg(2)+-ATPase. The data indicate that the DHA-induced increase in annular lipid fluidity is responsible for the increases observed in the enzyme activity. We therefore concluded that the increased activity of membrane-bound enzymes and transporters induced by DHA and the concomitant increase in annular lipid fluidity comprise one of the mechanisms involved in DHA-induced clearance of plasma cholesterol.

5'-Nucleotidase↗

[Mid-term results of triple valve operation].

UNLABELLED: From January 1995 to August 2000, 34 patients received the triple valve operation in our hospital. We evaluated the mortality, the cause of death, postoperative complications and mid-term results in these patients. Five-years'survival rate was determined by means of the Kaplan-Meire method. RESULTS: Two patient died after operation due to cardiac failure and cerebral infarction. Postoperativery, all patients had anticoagurant therapy with warfarin sodium. Mean follow-up was 3.2 years (0-5.6 years). There was one late sudden death among 32 perioerative survivors. There were 3 episodes of cerebral infarction. The rate of freedom from cardiac event at 5 years was 79%. Overall survival rate at 5 years was 94%. CONCLUSION: We obtained good mid-term results of triple valve operation. We recommend aggressive treatment for functional tricuspid valve regurgitation.

Aged↗

Clinical studies of bioabsorbable poly-L-lactide sternal coaptation pins.

BACKGROUND: Median sternotomy has become the most commonly used incision in cardiac surgery. Since sternal dehiscence, however, is a major complication, we used bioabsorbable poly-L-lactide (P-L-LA) sternal coaptation pins for sternal closure to prevent it. METHODS: From February 1998 to October 1999, 99 patients (64 men, 35 women; mean age, 63+/-1.2 years) underwent median sternotomy for cardiac surgery using sternal coaptation pins. Nineteen patients had diabetes mellitus and seven had renal failure. In closure, two sternal pins were inserted into the bone marrow of the sternum, one into the manubrium, the other into the body, and the sternum was sutured with five stainless steel wires. RESULTS: Five patients died in the hospital. The causes of death were cardiac failure in two patients, respiratory problem in two and perforation of the stomach in one. The average length of hospitalization was 2 4.5+/-2.5 days. Sternal dehiscence occurred in one patient and mediastinitis in four. There was no bleeding from the bone marrow and no complication related to the use of the sternal pins. CONCLUSIONS: P-L-LA sternal pins were easy to insert and may be effective in preventing dehiscence of the sternum.

Absorbable Implants↗

Resin-tooth adhesive interfaces after long-term function.

PURPOSE: To characterize with scanning electron microscopy (SEM), the morphology of adhesive interfaces that had been functioning in an oral cavity for several years. MATERIALS AND METHODS: Cavities were prepared in vivo in caries-affected primary molars under local anesthesia. After removal of the entire carious lesion, the cavity was restored with a dentin adhesive system (Scotchbond Multi-Purpose). After several yrs, as the successor permanent teeth erupted, the resin-filled teeth were extracted. Then, the extracted resin-restored primary molars were cross-sectioned perpendicular to the adhesive interface using a low speed diamond saw and then polished for SEM examination. RESULTS: Morphological changes, such as digestion of the collagen fibrils and deterioration of the bonding resin and hybrid layer, were observed at the interface of the oral environment specimens. The results of this study demonstrated that degradation of resin-dentin bond structures appeared to occur in the human oral environment over time.

Child↗

[Mid-term results of double valve (mitral-aortic) replacement for cases with poor LV function].

UNLABELLED: From March 1989 to July 2000, 82 patients have received the aortic-mitral replacement in our hospital. Among these patients, 11 patients had left ventricular ejection fraction less than 40%. We evaluated the mortality, the cause of death, postoperative complications and mid-term results of these patients. Five-years' survival rate was determined by means of the Kaplan-Meire method. Follow-up was complete for 100% of the patients. RESULTS: One patient (9%) died on 7 days after operation, due to multiorgan failure. Postoperativery, all patients had anticoagurant therapy with warfarin sodium and showed improvement in functional class. Mean follow-up was 3.4 years (0-5.9 years). The late death rate was 20% (2 patients). But there were no valve-related deaths during the follow-up periods. Overall survivals rate at 5 years was 70%. CONCLUSION: Despite the poor left ventricular function, we obtained satisfactory mid-term results of mitral-aortic valve operations.

Aged↗

[Surgical repair of postinfarction ventricular septal perforation by endocardial patch with infarction exclusion].

UNLABELLED: We evaluated the surgical results of postinfarction ventricular septal perforation by endocardial patch with infarction exclusion. MATERIALS AND METHODS: We reviewed 8 patients complicating AMI who underwent surgical treatment at our institution from July 1997 to August 2000 (6 males, 2 females, mean age 73.9 +/- 9, range 57-87). The localization of AMI and VSP was anterior in 6 patients, inferior in 2. All patients had coronary angiography preoperatively. And 7 patients had the percutaneous transluminal coronary angioplasty of the infarct artery. RESULTS: There were 2 hospital deaths due to cerebral infarction and pulmonary hemorrhage. All deaths occurred in patients with cardiogenic shock. CONCLUSION: Good results were obtained by infarction exclusion technique. Better operative results may be expected with the preoperative coronary angioplasty of the infarct artery.

Aged↗

Fractographical analysis of resin-dentin bonds.

PURPOSE: To characterize resin-dentin bond structures of three adhesive resin systems using fractographic analysis to measure the area of failure at the fractured surface. MATERIALS AND METHODS: Flat dentin surfaces were ground perpendicular to the long axis of the tooth. The prepared dentin surfaces were treated by one of three adhesive resin systems (Mac Bond II, One-Step, and Single Bond). The samples were sectioned perpendicular to the adhesive interface to produce a square bar-shaped specimen (adhesive area: 0.9 mm2) using a diamond saw. A micro-tensile test was then conducted at a crosshead speed of 1.0 mm/min. The mean tensile bond strengths were statistically compared using one-way ANOVA and Fisher's PLSD test (P< 0.05). The fractured surfaces of all specimens were examined using SEM and the area of failure was measured using an image analyzer on SEM microphotographs. RESULTS: No significant differences in tensile bond strength were observed between Single Bond (62.1+/-18.2 MPa) and One-Step (53.8+/-13.1 MPa) (P > 0.05). However, the bond strength of Mac Bond II (36.5+/-13.7 MPa) was significantly lower than that of One-Step or Single Bond (P< 0.05). At the fractured surface, except for the cohesive failure of the bonding resin and resin-based composite, different failure patterns were observed for each resin system as follows: the failure of the hybrid layer and demineralized dentin was observed in the two wet bonding systems (One-Step and Single Bond) and of the hybrid layer but not the demineralized dentin in the self-etching primer system (Mac Bond II). The results demonstrated that the integrity of the hybrid layer depends on the adhesive system.

Analysis of Variance↗

Membrane potential-dependent conformational changes in mitochondrially bound hexokinase of brain.

Previously characterized monoclonal antibodies (Mabs) were used in a study of Type I hexokinase from rat brain. Based on the relative reactivity of these Mabs with soluble and mitochondrially bound forms, binding to mitochondria was shown to affect specific epitopic regions in both N- and C-terminal halves of the enzyme and to modulate conformational changes induced by binding of the ligands, Glc or ATP. Reactivities with Mabs recognizing epitopes in two defined regions of the N-terminal half and one defined region of the C-terminal half of the mitochondrially bound enzyme were selectively affected by mitochondrial membrane potential, or by addition of oligomycin, carboxyatractyloside, or bongkrekic acid. The Glc-6-P analog, 1 ,5-anhydroglucitol-6-P, was much more effective as a competitive inhibitor against extramitochondrial ATP than against intramitochondrial ATP generated by oxidative phosphorylation. These results provide further insight into the role of hexokinase-mitochondrial interactions in regulation of cerebral glucose metabolism.

Adenosine Triphosphate↗

Novel photoreactive cinnamic acid analogues to elucidate phenylalanine ammonia-lyase.

4-[3-(Trifluoromethyl) diazirinyl] cinnamic acid derivatives were synthesized to elucidate properties of phenylalanine ammonia-lyase (PAL). 2-Methoxy and 2-biotinylated alkoxy compounds have inhibitory activity on the formation of phenylalanine from cinnamic acid. Specific photolabeling of the enzyme was detected using biotinylated derivatives without the use of radioisotopes. The results indicated that the 4-[3-(trifluoromethyl) diazirinyl] skeleton will be a suitable photoreactive compound to elucidate regulation of phenylpropanoid biosynthesis.

Cinnamates↗

Contribution of endogenous nitric oxide to basal vasomotor tone of peripheral vessels and plasma B-type natriuretic peptide levels in patients with congestive heart failure.

OBJECTIVES: We examined whether a relationship exists between the vasoconstrictive response to endogenous nitric oxide (NO) synthesis inhibition and the severity of heart failure in patients with congestive heart failure (CHF). BACKGROUND: Controversy exists as to whether the vasoconstrictive response to NO synthesis inhibition in patients with CHF is comparable to that in normal subjects or is enhanced. METHODS: Forearm blood flow (FBF) and calculated forearm vascular conductance (FVC) were obtained using plethysmography before and after administration of the NO synthesis inhibitor L-NMMA (NG-monomethyl-L-arginine) in 40 patients with CHF due to dilated cardiomyopathy and in 16 normal control subjects. Basal plasma B-type natriuretic peptide (BNP) and nitric oxide concentrations were measured in all subjects. RESULTS: Plasma BNP and nitrite/nitrate (NOx) levels in the patients group were significantly greater and baseline FBF was significantly less. Administration of L-NMMA significantly decreased FBF and FVC in both groups. The percent changes in FBF (%FBF) and FVC (%FVC) from the baseline after L-NMMA correlated significantly with plasma BNP level (%FBF: r = 0.72; %FVC: r = 0.76; both p < 0.001). Percent changes in both FBF and FVC were greater in patients with BNP > or = 100 pg/ml than in normal subjects; however, in patients with BNP < 100 pg/ml they were comparable to those in normal subjects. CONCLUSIONS: Vasoconstrictive response to L-NMMA in patients with CHF was preserved or enhanced in proportion to the basal plasma BNP level, indicating a close relationship between the contribution of endogenous NO to basal vasomotor tone and the severity of heart failure.

Adult↗

Pulmonary arteriovenous malformations: cerebral ischemia and neurologic manifestations.

BACKGROUND: There is an increasingly recognized association between pulmonary arteriovenous malformations (PAVM) and cerebral ischemia, frequently attributed to paradoxical embolization. PAVM occur in 20 to 30% of the hereditary hemorrhagic telangiectasia (HHT) population. OBJECTIVE: To evaluate the risk determinants for cerebral ischemia and neurologic manifestations in patients with PAVM. METHODS: A retrospective cross-sectional study was performed on consecutive patients admitted between 1988 and 1992 for treatment of PAVM. The number of PAVM, feeding artery (FA) diameters, and aneurysmal sizes were determined by pulmonary angiography. Patients were categorized as having single or multiple PAVM with an FA diameter of > or = 3 mm. History, examination, and cerebral imaging studies were used to determine the prevalence of neurologic manifestations. Patients were defined as having cerebral paradoxical embolization if there was radiologic evidence of cortical infarction. RESULTS: There were 75 cases: 26 single PAVM and 49 multiple PAVM. Cortical infarction was present in 14% of patients with single PAVM. Patients with multiple PAVM had a greater prevalence of any infarction (OR 3.2; 95% CI, 1.2 to 9.44, p = 0.030), cortical infarctions (OR 2.3; 95% CI, 0.58 to 9.2, p = 0.230), subcortical infarctions (OR 2.1; 95% CI, 0.58 to 7.95, p = 0.249), abscesses (OR 2.3; 95% CI, 0.46 to 11.94; p = 0.295), and seizures (OR 6.4, 95% CI 0.77 to 53.2, p = 0.054). Patients with multiple PAVM had markedly greater odds of having any clinical or radiologic evidence of cerebral ischemic involvement (OR 4.5; 95% CI, 1.47 to 14; p = 0.008). CONCLUSION: There is a strong association between single PAVM and various neurologic manifestations. The prevalence is greater for patients with multiple PAVM, suggesting increased predisposition for paradoxical embolization with a greater number of malformations.

Adolescent↗

Preventive effects of danazol on endometrial carcinogenesis in mice.

Short and long-term experiments were designed to determine effects of danazol on estrogen-related endometrial carcinogenesis in mice. The short-term assays showed that danazol decreased expression levels of c-fos/jun mRNA and their oncoproteins induced by estradiol-17beta (E2). For the long-term assay, 85 female ICR mice were given N-methyl-N-nitrsourea solution into their uterine corpora. The animals were divided into three groups as follows: Group 1, E2-diet (5 ppm) plus danazol (2 mg/body (s.c.), every 4 weeks); Group 2, E2-diet alone, Group 3, basal diet alone. At 30 weeks, incidences of atypical and complex endometrial hyperplasia were significantly decreased by danazol-treatment. These results suggest that danazol has preventive effects on estrogen-related endometrial carcinogenesis in mice, through the suppression of estrogen-induced c-fos/jun-expression.

Administration, Oral↗

Corticosteroid-responsive diabetes mellitus associated with autoimmune pancreatitis.

Autoimmune pancreatitis, which can be treated with corticosteroid therapy, has the potential to induce diabetes. In a cohort study of 2220 patients with suspected chronic pancreatitis, we found that all four patients with autoimmune chronic pancreatitis also had diabetes. Treatment with prednisolone subsequently improved insulin secretion and glycaemic control in these patients.

Aged↗

Structural significance of the acyl group at the C-10 position and the A ring of the taxane core of paclitaxel for inducing nitric oxide and tumor necrosis factor production by murine macrophages.

The antitumor agent, paclitaxel (Taxol), mimics the actions of lipopolysaccharide (LPS) on murine macrophages (Mphi). Various synthetic analogs of paclitaxel were examined for their potencies to induce nitric oxide (NO) and tumor necrosis factor (TNF) production by murine peritoneal Mphi, and by human peripheral blood cells. The benzoyl group at C-2, the hydroxy group at C-7 and the acetyl group at C-10 were found to be critically important sites to activate murine Mphi. Nor-seco-taxoid analogs lacking the A ring of the taxane core of paclitaxel were inactive, but inhibit paclitaxel- or LPS-induced NO production. All the compounds tested did not induce TNF production by human blood cells.

Acylation↗