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Biomedical subjects

M Kihara

Publications and source records attributed to M Kihara.

At least 73 records · Page 4Linked to original sources
PubMed1999

Sensorimotor polyneuropathy associated with chronic lymphocytic leukemia, IgM antigangliosides antibody and human T-cell leukemia virus I infection.

A 65-year-old man presented with a sensorimotor polyneuropathy associated with B-cell chronic lymphocytic leukemia (CLL) and immunoglobulin M (IgM) antibody to various gangliosides. Electrophysiological studies denoted significant abnormalities of motor and sensory nerve conduction. Although the pathology of sural nerve biopsy looked minimally affected, immunohistochemical studies showed specific binding of IgM to the human peripheral nerve. Our patient also had high titer of antibody to human T-cell leukemia virus I (HTLV-I) in both serum and cerebrospinal fluid (CSF), which might activate B-cell-mediated immunity and facilitate the production of IgM antibody. The other unique feature is the reactivity of antibody to gangliosides. The patient had IgM antibody reactivities to gangliosides with disialosyl residue such as GT1b, GQ1b and GD3, but not to GD1b. IgM antibody to gangliosides with disialosyl residue has been reported in ataxic symptoms, but our patient failed to demonstrate ataxia. Without reactivity to GD1b, sensory ataxic neuropathy might not develop even in the presence of antibody reactive to other gangliosides with disialosyl residue.

Aged↗
PubMed1999

Successful autotransplantation of an adrenal gland using a new method of omental wrapping: report of a case.

Bilateral total adrenalectomy results in the need for patients to take lifelong supplements of adrenal steroids, with the risk of possible Addisonian crisis. Few reports of the successful autotransplantation of adrenal tissue in muscular pockets have been documented; however, we describe herein the case of a 22-year-old woman in whom autotransplantation of an adrenal gland was successfully performed employing a new method of omental wrapping. The patient underwent bilateral total adrenalectomy for bilateral pheochromocytoma at which time adrenal tissue was sliced into 1-2-mm thick pieces, half of which were placed in muscular pockets in the abdominal rectus muscles, and the remaining half put onto the omentum and wrapped with it. Laboratory examinations done 6 months after surgery showed recovery of her adrenal function, and 4 months later steroid supplements were able to be discontinued. Scintigraphic studies using [131I]-iodomethyl-norcholesterol ([131]I-Adosterol) demonstrated clear activity in the omentum, weak activity in the rectus muscles, and no activity in the adrenal beds. These findings suggest that the omentum may be more suitable as an implantation site for adrenal tissue than muscular pockets.

Adrenal Gland Neoplasms↗
PubMed1999

Modified functional hemispherectomy in hemimegalencephaly.

We report a case of hemimegalencephaly in a 13-month-old girl successfully treated with modified functional hemispherectomy. Instead of total temporal lobectomy, medial temporal lobectomy with excision of the hippocampus and amygdala was carried out. The central region including the parasagittal tissue was preserved. A few days after the surgery seizures completely ceased. Administration of anticonvulsants was stopped 5 months after the surgery, and she has been seizure-free for 42 months.

Amygdala↗
PubMed1999

Angiotensin II inhibits interleukin-1 beta-induced nitric oxide production in cultured rat mesangial cells.

BACKGROUND: Macrophage-type nitric oxide synthase (NOS-II) is expressed in glomerular mesangial cells in response to inflammatory cytokines. Nitric oxide (NO) has antithrombotic and cytostatic activities in glomerular diseases. Recent studies have suggested that several vasoactive substances and growth factors modulate NO production in a tissue-specific manner. The aim of this study was to examine whether angiotensin II and transforming growth factor-beta (TGF-beta) modulate cytokine-stimulated NO production and NOS-II gene expression in rat glomerular mesangial cells. METHODS: Cultured rat mesangial cells were incubated with interleukin-1 beta (IL-1 beta) for 24 hours. The effects of angiotensin II and TGF-beta on stimulated nitrite accumulation and NOS-II mRNA levels were determined. RESULTS: Angiotensin II and TGF-beta significantly decreased IL-1 beta-stimulated nitrite accumulation. The angiotensin type 1 receptor antagonist CV11974 prevented angiotensin II-mediated inhibition of NO production. TGF-beta-neutralizing antibody reversed the effect of TGF-beta without affecting angiotensin II-mediated inhibition of NO production. TGF-beta markedly decreased steady-state levels of NOS-II mRNA and the half-life of the message, whereas angiotensin II did not alter these parameters. CONCLUSIONS: These results suggest that in mesangial cells, angiotensin II and TGF-beta participate in the inhibitory regulation of cytokine-induced NO production. TGF-beta inhibits NO production by decreasing NOS-II mRNA levels, whereas angiotensin II may regulate NO production at the levels after NOS-II gene expression. An autocrine action of TGF-beta induced by angiotensin II is unlikely to contribute to angiotensin II-mediated inhibition of NO production.

Angiotensin II↗
PubMed1999

Hypothermic neuroprotection of peripheral nerve of rats from ischaemia-reperfusion injury.

Although there is much information on experimental ischaemic neuropathy, there are only scant data on neuroprotection. We evaluated the effectiveness of hypothermia in protecting peripheral nerve from ischaemia-reperfusion injury using the model of experimental nerve ischaemia. Forty-eight male Sprague-Dawley rats were divided into six groups. We used a ligation-reperfusion model of nerve ischaemia where each of the supplying arteries to the sciatic-tibial nerves of the right hind limb was ligated and the ligatures were released after a predetermined period of ischaemia. The right hind limbs of one group (24 rats) were made ischaemic for 5 h and those of the other group (24 rats) for 3 h. Each group was further divided into three and the limbs were maintained at 37 degrees C (36 degrees C for 5 h of ischaemia) in one, 32 degrees C in the second and 28 degrees C in the third of these groups for the final 2 h of the ischaemic period and an additional 2 h of the reperfusion period. A behavioural score was recorded and nerve electrophysiology of motor and sensory nerves was undertaken 1 week after surgical procedures. At that time, entire sciatic-tibial nerves were harvested and fixed in situ. Four portions of each nerve were examined: proximal sciatic nerve, distal sciatic nerve, mid-tibial nerve and distal tibial nerve. To determine the degree of fibre degeneration, each section was studied by light microscopy, and we estimated an oedema index and a fibre degeneration index. The groups treated at 36-37 degrees C underwent marked fibre degeneration, associated with a reduction in action potential and impairment in behavioural score. The groups treated at 28 degrees C (for both 3 and 5 h) showed significantly less (P < 0.01; ANOVA, Bonferoni post hoc test) reperfusion injury for all indices (behavioural score, electrophysiology and neuropathology), and the groups treated at 32 degrees C had scores intermediate between the groups treated at 36-37 degrees C and 28 degrees C. Our results showed that cooling the limbs dramatically protects the peripheral nerve from ischaemia-reperfusion injury.

Action Potentials↗
PubMed1999

Trends in HIV and AIDS based on HIV/AIDS surveillance data in Japan.

BACKGROUND: In recent years a decline in the number of new AIDS cases has been observed in several industrialized countries. It is important to know whether these recent trends observed in North America and Europe are also occurring in Japan. METHODS: The number of people reported with HIV and AIDS by nationality, route of infection, and sex was calculated based on the HIV/AIDS surveillance data available in Japan through December 1997. The effect of reporting delay, which was defined as those HIV and AIDS cases reported in the calendar year following diagnosis, on the trends was examined. The coverage rate in reporting HIV cases was estimated as the ratio of the reported AIDS cases with prior report as an HIV-positive to the total number of reported AIDS cases. RESULTS: The cumulative number of reported cases of HIV among Japanese and non-Japanese residents of Japan up to the end of 1997 were 1,300 and 1,190, respectively. The cumulative number of reported cases of AIDS among Japanese and non-Japanese up to the end of 1997 were 758 and 298, respectively. The number of reported cases of HIV among Japanese was found to be still increasing, with the major contribution from male cases. The increasing trend in the number of reported AIDS cases among Japanese began to slow in 1996 and 1997. The number of reported cases of HIV among non-Japanese residents of Japan peaked in 1992, and has decreased since then, and remained constant after 1994. In contrast, the number of reported AIDS cases among these non-Japanese tended to increase gradually. There was a slight reporting delay for people with HIV and AIDS. The estimated coverage rate in reporting HIV cases tended to decrease in 1996 and 1997 (1/7.2, 1/10.2, respectively). We point out several reasons for this recent decline and suggest the possibility of an ostensible decline in the estimates. CONCLUSIONS: We suggest that the number of people with HIV among Japanese has continued to increase, and that the increase in the number of AIDS cases among Japanese is now slowing.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Simultaneous improvement of minimal-change nephrotic syndrome and anemia with steroid therapy.

A 56-year-old man presented with transient anemia in minimal-change nephrotic syndrome. Following nephrotic syndrome, anemia suddenly appeared without renal dysfunction. The anemia might be attributable to hemodilution because of significant correlations between the values of hemoglobin concentration and serum total protein or blood urea nitrogen during the clinical course. A low serum level and a low urinary excretion of erythropoietin were found, and when nephrotic syndrome ameliorated with steroid therapy, urinary erythropoietin excretion and anemia disappeared. This case indicated disappearance of the exponential increase of endogenous erythropoietin in acute anemia in nephrotic syndrome probably due to urinary losses and altered biosynthesis of erythropoietin. We report a case of the simultaneous improvement of both nephrotic syndrome and anemia with steroid therapy.

Anemia↗
PubMed1999

Angiotensinogen gene polymorphism near transcription start site and blood pressure: role of a T-to-C transition at intron I.

Molecular variants of the angiotensinogen gene, a key component of the renin-angiotensin system, are considered genetic risk factors for primary hypertension. A relation between the angiotensinogen gene locus and hypertension has been found in whites, Japanese, and African Caribbeans but not in Chinese. The lack of a consistent association between M235T polymorphism at exon 2 and hypertension has suggested that another site in linkage disequilibrium with M235T is the causal mutation. We studied the relations among plasma angiotensinogen concentrations, blood pressure, related clinical variables, and mutations of the 5' upstream core promoter region of the human angiotensinogen gene in 274 subjects recruited from our outpatient clinic. We confirmed that plasma angiotensinogen concentration was significantly correlated with A-20C mutation and percent body fat and found that systolic and diastolic blood pressures were significantly correlated with G-6A and T+68C mutations. These results suggest that mutations near the transcription start site may be associated with increased blood pressure.

Angiotensinogen↗
PubMed1999

Tissue-specific changes of type 1 angiotensin II receptor and angiotensin-converting enzyme mRNA in angiotensinogen gene-knockout mice.

This study examined whether type 1 angiotensin II receptor (AT1) and angiotensin-converting enzyme (ACE) mRNAs are regulated during dietary salt loading in angiotensinogen gene-knockout (Atg-/-) mice which are genetically deficient in endogenous production of angiotensin II. Wild-type (Atg+/+) and Atg-/- mice were fed a normal-salt (0.3% NaCl) or a high-salt (4% NaCl) diet for 2 weeks. The mRNA levels were measured by Northern blot analysis. In Atg+/+ mice, concentrations of plasma angiotensin peptides were decreased by salt loading, whereas the treatment increased the brainstem, cardiac, pulmonary, renal cortex, gastric and intestinal AT1 mRNA levels. Salt loading also enhanced renal cortex ACE mRNA levels in Atg+/+ mice. Although plasma angiotensin peptides and urinary aldosterone excretion were not detected in Atg-/- mice, salt loading increased blood pressure in Atg-/- mice. In Atg-/- mice, pulmonary, renal cortex, gastric and intestinal AT1, and renal cortex and intestinal ACE mRNA levels were higher than those in Atg+/+ mice. However, salt loading upregulated AT1 mRNA expression only in the liver of Atg-/- mice, and the treatment did not affect ACE mRNA levels in Atg-/- mice. Furthermore, although the levels of ACE enzymatic activity showed the same trend with the ACE mRNA levels in the lung, renal cortex and intestine of both Atg-/- and Atg+/+ mice, the results of radioligand binding assay showed that cardiac expression of AT1 protein was regulated differently from AT1 mRNA expression both in Atg-/- and Atg+/+ mice. Thus, expression of AT1 and ACE is regulated by salt loading in a tissue-specific manner that appears to be mediated, at least partly, by a mechanism other than changes in the circulating or tissue levels of angiotensin peptides.

Angiotensin II↗
PubMed1999

[The blood sugar levels after hypothermic cardiopulmonary bypass in diabetic patients: their relation to preoperative values of hemoglobin-A1c and medication].

We studied the blood sugar levels after hypothermic cardiopulmonary bypass (CPB) in diabetics and non-diabetics. Twenty eight patients were divided to the following four groups by the preoperative value of hemoglobin-A1c (HbA1c) and medication; (1) HbA1c < 6.0 and given oral anti-diabetic medication, (2) HbA1c > 6.0 and given oral anti-diabetic medication, (3) HbA1c > 6.0 and given insulin injection, and (4) non-diabetics. Both in diabetics and non-diabetics, the blood sugar levels were higher than 300 mg.dl-1 during cardiopulmonary bypass. In group (1) and (4), the blood sugar levels went down lower than 250 mg.dl-1 at 60 minutes after CPB, without any treatment. In group (2) and (3), the blood sugar levels after 60 minutes of CPB were higher than 250 mg.dl-1, and insulin 8 units were given. After 30 minutes of insulin injection, the blood sugar levels of group (2) were lower than 250 mg.dl-1, but those in group (3), the blood sugar levels were still higher than 250 mg.dl-1, and another 8 units of insulin were given. The diabetic patients whose HbA1c levels were higher than 6.0 and given anti-diabetic medication before operation, need insulin after CPB.

Adult↗
PubMed1999

[Optimal length of nasopharyngeal airway and its correlation with height and body weight].

We studied 26 patients (11 males and 15 females) undergoing elective surgery under general anesthesia. The purpose of this study was to decide how long the length of nasopharyngeal airway should be by measuring distance A (permitting airway obstruction to be released), distance B (giving the most effective ventilation), and distance C (between nostril and arytenoid). The values of distance A in male group and female group were 12.73 +/- 0.85 cm and 11.70 +/- 0.75 cm, respectively. The values of distance B were 14.55 +/- 0.96 cm in male group and 13.93 +/- 1.12 cm in female group. The values of distance C were 18.84 +/- 0.90 cm in male group and 17.40 +/- 0.97 cm in female group. This showed that it is necessary to advance the nasopharyngeal airway about 2 cm from the distance A to give the most effective ventilation to the patients with airway obstruction. Therefore, most of standard nasopharyngeal airways commercially available are too short. In addition, the distance B has no correlation with height and body weight and it is difficult to predict the optimal length of the airway.

Anesthesia, General↗
PubMed1999

[The survey of HIV infection among clients of foreign female prostitutes in Tokyo Metropolitan].

OBJECTIVES: It is important to elucidate the risks to foreign female prostitutes of HIV infection from their clients. We determined the prevalence of HIV among clients of foreign female prostitutes using anonymous testing of condom semen samples. METHODS: A total of 250 client condom semen samples were collected with client age and nationality by 15 Latin American and 37 Thai female prostitutes in Tokyo from March to May 1995. We screened by ELISA (GENELAVIA MIXT, Pasteur Sanofi Diagnostics) for antibody to HIV 1 and 2, and then confirmed by Western Blot (LAV Blot 1, LAV Blot 2, Sanofi Diagnostics Pasteur) and distinguished by Immuno Blot PEPTI-LAV 1, 2, (Sanofi Diagnostics Pasteur). RESULTS: The nationality of customers was reported as Japanese (74.8%), Iranian (7.6%), Pakistan (5.6%), Indian (2.8%), Taiwanese (2.0%), and Chinese (1.2%) with other nationalities less than 1.0%. Estimated age categories of the clients were < 20 (1.2%), 20-29 (41.2%), 30-39 (36.4%), 40-49 (12.4%), > or = 50 (6.4%) and undetermined (2.4%). Of the 250 samples collected, only 219 were sufficient for testing. Two samples (0.90%, 95% CI = 0.4-2.2%) were HIV 1 positive, both from Japanese clients (1.2% of Japanese clients, 95% CI = 0.5-2.9%). These data suggested that the prevalence of HIV in clients of female prostitutes was relatively high, and can be considered a risk group in Japan. The sentinel surveillance by anonymous of client condom semen samples is a very useful method to quantify HIV prevalence in this risk group.

Acquired Immunodeficiency Syndrome↗
PubMed1999

[PGE1 and dopamine administration in a pediatric patient during hepatectomy].

A 2-year-old male underwent medial inferior hepatectomy for the treatment of metastatic tumors. Due to congenital hepatoblastoma, at 6-months of age, right lobectomy of his liver had been performed. To protect liver functions, PGE1 and dopamine were administered during the surgery. Although half of his circulating blood volume was lost, his perioperative hemodynamics was stable, with no development of postoperative liver dysfunction. PGE1 and dopamine may thus be beneficial in pediatric hepatectomy.

Alprostadil↗
PubMed1998

A dysautonomia case of Guillain-Barré syndrome with recovery: monitored by Composite Autonomic Scoring Scale.

To investigate the usefulness of the Composite Autonomic Scoring Scale (CASS) as an indication for autonomic dysfunction with Guillain-Barré syndrome, we quantitated autonomic deficits on follow-up using CASS in a patient with Guillain-Barré syndrome who did not have any autonomic symptoms and had good clinical recovery. Using the CASS we found the patient to have mild autonomic dysfunction but with a period of recovery. The scale showed that adrenergic deficits improved quickly, sudomotor deficits recovered moderately and cardiovagal deficits did not improve. These results suggested that the patient with Guillain-Barré syndrome might have dysautonomia although she did not have any autonomic symptoms. Results also suggest that there might be difference on the degree of improvement among adrenergic, sudomotor and cardiovagal deficits in Guillain-Barré syndrome. The CASS may be a sensitive tool for the detection of autonomic dysfunction in Guillain-Barre syndrome.

Autonomic Nervous System↗