Biomedical subjects

M Konishi

Publications and source records attributed to M Konishi.

At least 163 records · Page 9Linked to original sources

PubMed1997

Therapeutic results of resection, transcatheter arterial embolization and percutaneous transhepatic ethanol injection in 3225 patients with hepatocellular carcinoma: a retrospective multicenter study.

The outcome in 3225 patients with hepatocellular carcinoma (HCC) was studied in groups with equivalent prognosis treated with resection, transcatheter arterial embolization (TAE), and percutaneous transhepatic ethanol injection (PEI). Significant factors for better clinical background included a tumor diameter of < or = 30 mm, tumor number < or = 3 and (clinical) Stage I. In patients with Stage I disease having tumors of < or = 30 mm and < or = 3 in number, survival afer resection and PEI did not differ, while survival after TAE was significantly worse. In those patients with Stage II disease, survival after PEI was significantly better than after resection or TAE. In patients with Stage I or II disease having tumors > or = 31 in size and < or = 3 number, survival after resection was significantly better than after TAE. In patients with Stage I disease having tumors of > or = 31 mm and > or = 4 in number, survival after resection was significantly better than after TAE. Our conclusions are as follows. Firstly, resection or PEI is recommended for patients with Stage I disease having < or = 3 tumors all < or = 30 mm in size. Secondly, PEI is recommended for patients with Stage II disease having < or = 3 tumors all < or = 30 mm in size. Thirdly, for patients with Stage I disease having tumors 31 mm or larger in size, whatever the number of tumors, resection should be selected rather than TAE.

Adolescent↗

PubMed1997

Enhanced gene expression of scavenger receptor in peripheral blood monocytes from patients on cuprophane haemodialysis.

BACKGROUND: Macrophage scavenger receptor (SR) is implicated in playing a key role in macrophage-derived foam cell formation by taking up a large amount of modified low-density lipoproteins (LDL). It has also been postulated that alpha 2-macroglobulin receptor/LDL receptor-related protein (alpha 2MG/LRP) is involved in the development of foam cells by taking up apo E-enriched chylomicrons and VLDL remnants, and lipoprotein lipase-triglyceride-rich lipoprotein complexes. Accumulation of these lipid-loaded monocyte/ macrophages in the subendothelial space is considered to be an early event of atherogenesis. Since atherogenesis is considered to be accelerated in dialysis patients, we attempted to investigate whether gene expression of SR and alpha 2MG/LRP are altered in peripheral blood monocytes from patients on haemodialysis with a cuprophane (Cu) or polymethylmethacrylate (PMMA) membranes. METHODS: Peripheral blood monocytes (PBM) were prepared from patients undergoing haemodialysis with a Cu membrane (n = 9), patients undergoing haemodialysis with a PMMA membrane (n = 9), and healthy controls (n = 7). In a separate experiment we examined SR gene expression in uraemic patients (n = 12) and healthy controls (n = 9). SR and alpha 2MG/LRP mRNA were semiquantitated using reverse-transcription polymerase chain reaction (RT-PCR) assay followed by Southern blotting. RESULTS: SR mRNA expression in PBM from patients on chronic haemodialysis with a Cu membrane was about twofold higher than that in PBM from patients on chronic haemodialysis with a PMMA membrane or the controls (P < 0.05). alpha 2MG/LRP mRNA expression in PBM showed no difference among these, three groups. SR gene expression in monocytes from uraemic patients was not increased compared with that in the controls. CONCLUSION: PBM from patients under Cu membrane dialysis showed higher gene expression of SR than patients under PMMA membrane dialysis, uraemic patients, or healthy controls. This increased gene expression of SR in monocytes may be associated with the pathogenesis of accelerated atherosclerosis in patients on dialysis with a Cu membrane.

Arteriosclerosis↗

PubMed1997

Bile acid profiles in a peroxisomal D-3-hydroxyacyl-CoA dehydratase/D-3-hydroxyacyl-CoA dehydrogenase bifunctional protein deficiency.

Bile acid profiles in serum, urine and bile from an infant with a peroxisomal D-3-hydroxyacyl-CoA dehydratase/D-3-hydroxyacyl-CoA dehydrogenase bifunctional protein (D-bifunctional protein) deficiency were analyzed by means of gas-liquid chromatography, gas-liquid chromatography-mass spectrometry, and high-performance liquid chromatography. As in such several peroxisomal disorders as Zellweger syndrome, neonatal adrenoleukodystrophy, and infantile Refsum disease, the accumulation of C27-bile acid intermediates was also demonstrated in the infant with D-bifunctional protein deficiency, accounting for 74% of the total bile acids in serum, 59% in urine, and 35% in bile. In addition, the major constituents of the C27-bile acids were (24R,25R)- and (24R,25S)-3alpha,7alpha,12alpha,24-tetrahydroxy-5be ta-cholestanoic acids along with small amounts of their 24S counterparts. Since immunoreactive acyl-CoA oxidase, L-bifunctional protein, and thiolase were all present in the liver, the impairment of the oxidative side-chain cleavage in bile acid biosynthesis is considered to be due to the defect of D-bifunctional protein.

17-Hydroxysteroid Dehydrogenases↗

PubMed1997

Mechanism of gastric hyperemic response during acid secretion in rats: relation to nitric oxide, prostaglandins, and sensory neurons.

The mechanism of gastric mucosal hyperemic response during pentagastrin-induced acid secretion was investigated in anesthetized rats in relation to prostaglandins (PGs), nitric oxide (NO), and sensory neurons. A rat stomach was mounted in an ex vivo chamber and perfused with saline or glycine (200 mM), and the mucosal blood flow (GMBF), determined by laser Doppler flowmetry, and acid secretion was measured simultaneously. Intravenous infusion with a submaximal dose of pentagastrin (60 micrograms/kg/h) caused a significant increase in GMBF as well as acid secretion. Such GMBF responses were totally attenuated when acid secretion was inhibited by omeprazole and cimetidine or when the luminal H+ was buffered by mucosal perfusion with glycine (200 mM). Tripelennamine, an H1 antagonist, did not have any affect on acid secretory and GMBF responses to pentagastrin. On the other hand, prior administration of NG-nitro-L-arginine methyl ester (L-NAME), the NO synthase inhibitor, significantly mitigated the increase of GMBF induced by pentagastrin without any influence on acid secretion, and this effect was antagonized by simultaneous administration of L-arginine. The gastric hyperemic response to pentagastrin was also significantly mitigated by indomethacin or sensory deafferentation after capsaicin pretreatment, with no effect on acid secretion, and was totally inhibited by combined treatments with indomethacin plus L-NAME in addition to sensory deafferentation. Pentagastrin infusion for 8 h did not by itself cause macroscopic damage in the stomach, but additional treatments with L-NAME and indomethacin plus sensory deafferentation provoked severe lesions in the gastric mucosa. These results suggest that the gastric hyperemic response to pentagastrin (submaximal dose) is totally dependent on H+ and that this process is mediated by endogenous NO and PGs as well as by capsaicin-sensitive sensory neurons and plays a pivotal role in maintaining mucosal integrity during acid secretion.

Animals↗

PubMed1997

Effect of oral adsorbent AST-120 on cyclosporin absorption in rats.

The oral adsorbent AST-120 is used to inhibit the progression of renal failure by adsorbing uraemic toxins in the gastrointestinal tract. When AST-120 is administered to patients receiving immunosuppressive medicines, it is important to study the effect of AST-120 on the amount of these and other drugs absorbed. We have, therefore, studied the in-vitro adsorption of cyclosporin by AST-120 and investigated the effect of oral administration of AST-120 on the absorption of cyclosporin in rats. The in-vitro adsorption ratios of AST-120 for cyclosporin were more than 80%. When pure cyclosporin powder was administered with AST-120, blood cyclosporin concentrations were significantly higher than when cyclosporin was administered alone. When cyclosporin dissolved in medium-chain triglyceride was administered to rats by intramuscular injection there was no significant difference in the blood cyclosporin concentration of rats given combined AST-120 and cyclosporin and those given cyclosporin alone. There was no significant difference between the serum concentration of total bile acids, in rats receiving combined oral AST-120 and cyclosporin dissolved in olive oil, and those receiving orally solely a solution of cyclosporin dissolved in olive oil. These results suggest that oral administration of AST-120 accelerates the absorption of orally administered cyclosporin from the gastrointestinal tract and does not affect the metabolism of cyclosporin. When a solution of cyclosporin in olive oil is administered orally, however, oral administration of AST-120 has no influence on cyclosporin absorption and does not affect the enterohepatic circulation of bile acids.

Absorption↗

PubMed1997

[Campylobacter jejuni enteritis in three patients with HIV infection].

Gatrointestinal symptoms, which include diarrhea, are as common as respiratory symptoms in patients with HIV infection. Gastrointestinal symptoms may result from infections, neoplasma, HIV enteropathy or drug toxicity. Three HIV-infected patients admitted to our hospital complaining of diarrhea and fever. We confirmed their diagnosis as Campylobacter jejuni enteritis by bacteriological examination of their feces. All of them had eaten inadequately cooked meat in restaurants before the onset of their enteritis. Their symptoms immediately improved after the administration of antimicrobial agents. One strain of C. jejuni isolated in our cases, however, was resistant to ofloxacin. This case report suggests that we must counsel HIV-infected patients to avoid inadequately cooked food and observe resistant patterns of C. jejuni to antimicrobial agents in Japan in the future.

AIDS-Related Opportunistic Infections↗

PubMed1997

[Analysis of prognosis of bronchopulmonary infectious disease with lung cancer].

Bronchopulmonary infection affects the prognosis of lung cancer patients. Thus, we investigated the relationship between the prognosis of bronchopulmonary infectious diseases and their causative bacteria isolated by transtracheal aspiration (TTA) in lung cancer patients. In the present study, we determined which factor is more predisposing for the outcome of bronchopulmonary infections, the type of causative bacteria or the host nutritional status. A total of 107 lung cancer patients, which consisted of 105 males and 5 females (mean age 67.3 +/- 8.0), were included in this study. The study was conducted from 1981 to 1994. They were classified into the survival group and the deceased group. Causative agents of infection were compared between these 2 groups. S. pneumoniae, alpha-Streptococcus sp., M. catarrhalis, and Neisseria sp. were predominant in organisms isolated from TTA-specimens of lung cancer patients with bronchopulmonary infections, regardless of prognosis. Nutritional status, as determined by serum levels of cholinesterase, albumin, and cholesterol, was poor in the deceased group than in the survival group. These results indicate that the outcome of bronchopulmonary infections in lung cancer patients are affected mainly by the nutritional status of the host.

Aged↗

PubMed1997

[Prognostic analysis of sepsis in patients with lung cancer].

Sepsis is one of the most serious infections occurring in patients with lung cancer. Thus, we determined what is most predisposing factor in prognosis of sepsis in lung cancer patients; the type of causative bacteria, neutropenia or host nutritional status. A total of 27 lung cancer patients with sepsis, which consisted of 23 males and 4 females (mean age 70.7 +/- 6.6), were included in this study. The study was conducted from 1991 to 1995. All subjects were classified into the survival group and the dead group. Staphylococcus aureus or Esherichia coli most frequently isolated from the blood of the patients in the survival group, while either E. coli alone or multiple organisms were predominant in the dead group. Neutropenia did not affect the outcome of sepsis in lung cancer patients. In contrast nutritional status, as determined by serum albumin levels, was closely related to the mortality in septic lung cancer patients. These results predict that the prognosis of sepsis is dependent on nutritional status of lung cancer patients.

Aged↗

PubMed1997

[A case of multiple muscular abscesses of the lower limbs by Staphylococcus aureus after chemotherapy for lung cancer].

A 67-year-old male was admitted to our hospital because of lung cancer and interstitial pneumonia. Cisplatin, vindesie and mitomycin C were administered for treatment of lung cancer. The leucocyte-counts declined to 1700/microliter on the eighth day after the chemotherapy. Though granulocyte colony-stimulating factor was administered, pain in the right thigh and high grade fever developed. Because Staphylococcus aureus was isolated from the blood specimen, piperacillin was administered. But the high grade fever continued and the pain was expanded to the right hip, left hip, thigh and leg. Because a computed tomograph of the lower limbs showed low density areas in bilateral gluteus maximus muscle right adductor magnus muscle, left biceps femoris muscle and left soleus muscle and the culture of an aspirate from abscess of right leg detected S. aureus, multiple muscular abscesses of the lower limbs was confirmed. We changed the antibiotics from PIPC to imipenem/cilastatin and minocycline on nineteenth day after the chemotherapy. His symptoms improved after the change of antibacterial agents. But he died of acute exacerbation of interstitial pneumonia, after about two months of the chemotherapy. Muscular abscesses of the limbs are very rare in Japan. Only four cases with muscular abscess of the limbs were reported in Japan, since 1988. This case suggests that a muscular abscess must be considered in the differential diagnosis of fever in patients with neutropenia.

Abscess↗

PubMed1997

Hepatocellular carcinoma with portal vein tumor thrombus: embolization of arterioportal shunts.

PURPOSE: To evaluate transcatheter arterial embolization in patients with hepatocellular carcinoma, portal vein tumor thrombus, and arterioportal shunts. MATERIALS AND METHODS: Ten patients with hepatocellular carcinoma, portal vein tumor thrombus, and severe arterioportal shunting were identified; in these patients, portal blood flow before embolization was hepatofugal. Embolization of arterioportal shunts was performed with steel coils that were introduced through a catheter during arteriography. After embolization, changes in portal hemodynamics and clinical signs and performance status of patients were evaluated; survival rates of patients with and patients without severe arterioportal shunting were compared. RESULTS: In all patients after embolization, angiography showed resolution of arterioportal shunting, and portography showed hepatopetal blood flow in the portal vein trunk. After embolization, performance status of five patients with initial scores of 2 or 3 improved. Ascites resolved in four patients and improved in four patients. One patient died of hepatic failure caused by rupture of esophageal varices 7 days after embolization. Median survival was 4.3 months, and the 6-month and 1-year survival rates were 45% and 12%, respectively. There were no significant differences between survival rates in patients with and patients without severe arterioportal shunting. CONCLUSION: Transcatheter arterial embolization of arterioportal shunts is a useful treatment for improving quality of life in patients with hepatocellular carcinoma.

Adult↗

PubMed1997

In vivo aortic wall characteristics at the early stage of atherosclerosis in rabbits.

To assess whether vascular responsiveness to alpha-receptor agonist is altered at the early stage of atherosclerosis, in vivo aortic pressure-diameter relationship of the aorta over a wide range of pressures was analyzed before and after the acute administration of alpha-receptor agonist (phenylephrine) in nine hypercholesterolemic fat-fed (7-wk-old) rabbits and eight normal diet-fed (7-wk-old) rabbits. In hypercholesterolemic fat-fed rabbits, there was no major structural change in the aortic wall except fatty streak, despite a marked increase in the level of plasma cholesterol, indicating the early stage of atherosclerosis of the aorta. By using a modified three-element Maxwell model, diastolic stress-strain relationship was computed after applying several assumptions to the actual aortic pressure-diameter relationship. After the intravenous administration of phenylephrine at a rate of 5 micrograms.kg-1.min-1, the stress (ordinate)-strain (abscissa) relationship curves were shifted to the left, indicating the activation of aortic smooth muscle by phenylephrine. The difference between the stress before and after phenylephrine showed a single peak at a certain strain. The peak difference in the stress was smaller in hypercholesterolemic fat-fed rabbits than in normal diet-fed rabbits, indicating the reduction of vascular responsiveness at the early stage of atherosclerosis of the aorta.

Adrenergic alpha-Agonists↗

PubMed1997

Prevalence of asymptomatic carotid atherosclerotic lesions detected by high-resolution ultrasonography and its relation to cardiovascular risk factors in the general population of a Japanese city: the Suita study.

BACKGROUND AND PURPOSE: Because extracranial carotid atherosclerotic lesions have been considered rare, no reports have been published on the prevalence and distribution of these lesions in a general Japanese population. However, recent changes in lifestyle are thought to have caused an increase in these lesions. The aim of this study was to use high-resolution ultrasonography to examine the prevalence of asymptomatic extracranial carotid artery lesions and its relation to cardiovascular risk factors in an urban Japanese population. METHODS: The subjects were 814 men and 880 women aged 50 to 79 years randomly sampled from the residents of Suita, a city located in the second largest urban area of Japan. Asymptomatic carotid lesions were detected and evaluated by a single physician with high-resolution B-mode ultrasonography. RESULTS: We found significant sex differences in the prevalence of atherosclerotic lesions in the extracranial carotid artery; 4.4% of all the subjects, 7.9% of the men, and 1.3% of the women had atherosclerosis accompanied by stenosis of >50%. A strong association between these lesions and the results of a 75-g oral glucose tolerance test was found in both sexes. Multiple regression analysis of carotid atherosclerosis showed significant relationships with age, systolic blood pressure, fasting blood glucose, pack-years of smoking, total serum cholesterol, and HDL cholesterol in men (P<.05) and significant relationships with age, systolic blood pressure, pack-years of smoking, and total serum cholesterol in women (P<.05). CONCLUSIONS: Our data showed that cardiovascular risk factors were strongly related to carotid atherosclerosis and that the proportion of severe carotid atherosclerosis with >50% stenosis was not low and was almost equal to that reported in developed western countries.

Aged↗

PubMed1997

Morphological and flow cytofluorometrical analyses of regenerated rat thymus after irradiation.

Reconstituted rat thymuses were studied by immunohistochemistry, transmission electron microscopy (TEM) and flow cytofluorometry on days 0, 1, 2, 3, 5, and 7 after whole-body sublethal irradiation (6 Gy). One day after irradiation, numerous apoptotic cells were seen in the cortical thymus; the percentage of the sub-G1 peak representing apoptotic cells was 8.9% in the DNA content histogram of cytofluorometry. On day 3, the thymic structure had been destroyed and no distinction was drawn between the cortex and medulla. In this stage, few thymocytes but many macrophages were present, and the percentage of the sub-G1 peak reached a peak at 13.0%. Bromodeoxyuridine (BrdU) incorporated cells gradually increased after irradiation, and immunohistochemically numerous apoptotic cells were found primarily in the cortex on day 7. These thymocytes showed some levels of electron density of the nucleus as revealed by TEM. The percentage of S phase cells did not change markedly (20-30%) based on one-color DNA content histograms, but the percentage of early S and S phase cells was extremely high on day 7 (70%). These data indicate that a part of DNA synthetic cells may result in apoptosis. The combination of immunohistochemistry, TEM and flow cytofluorometry to analyze DNA content and BrdU incorporation proved a useful tool for investigating the reconstituted thymus.

Animals↗

PubMed1997

Mixed-cryoglobulinemia associated with cutaneous vasculitis and pulmonary symptoms.

A 45-year-old Japanese man with Sjögren's syndrome developed recurrent skin ulcers, palpable purpura, and dyspnea. Serum mixed-type cryoglobulin level was elevated. A biopsy of his skin lesion showed the characteristic leukocytoclastic vasculitis of mixed-type cryoglobulinemia. Dyspnea, skin ulcers, and purpura resolved along with a reduction in the serum cryoglobulin level after prednisolone administration. This patient demonstrated cryoglobulinemia-associated vasculitis, as well as possible cryoglobulinemia-associated pulmonary symptoms.

Cryoglobulinemia↗

PubMed1997

Aging, exercise, training, and the immune system.

Human immune function undergoes adverse changes with aging, including development of a relative immune deficiency and an immune dysregulated state. The T cells show the largest age-related differences in distribution and function. The antibody production capacity of B cells also shows an age-related decline. Acute bouts of exercise modulate many immune parameters as seen in peripheral blood. With regard to NK cell activity, a single bout of moderate exercise seems to be well tolerated by the elderly, and the resting NK cell activity of elderly subjects seems to increase with training. Cross-sectional comparisons of immune status imply that habitual physical activity may enhance NK cell activity and check certain aspects of the age-related decline in T cell function. Future studies are required to clarify whether such long-term exercise and resulting improvements of immune function give rise to any beneficial effects on infections, malignancies, and autoimmune disorders.

Adult↗

PubMed1997

[Prevalence of glucose intolerance, diabetes mellitus, and high serum insulin levels in a Japanese urban population].

An epidemiological study was conducted to investigate the prevalence of diabetes mellitus, glucose intolerance and hyperinsulinemia in an urban population. Twelve thousand two hundred people aged 30 to 79 were randomly selected from residents of S-city in Osaka Prefecture and were urged to attend a cardiovascular examination at the National Cardiovascular Center. In 1992 and 1993, among 5,284 people who received the examination, 75 g oral glucose tolerance tests (OGTT) were performed and plasma glucose and serum insulin concentrations were determined for 2,147 subjects, who participated in the morning course of examination and who were fasting. The prevalence of diabetes and hyperinsulinemia (fasting serum insulin level > or = 15 microU/ml) was higher in older than in the younger generation, and was higher in men than in women. The prevalence of diabetes in those aged 40 and over in S-city was 7.3% in men and 5.6% in women, 17.2% of men and 10.7% of women had impaired glucose tolerance, and 7.5% of men and 5.2% of women had hyperinsulinemia. A comparison of prevalences of diabetes was performed between 4 populations, one being our urban population and others being 3 rural populations where population-based surveys had been accomplished with OGTT but without a screening as ours was with regard to detecting diabetes. The prevalence of diabetes in our urban population did not appear to be higher than in the other 3 rural populations. From a questionnaire survey of responders and non-responders to OGTT, it was considered that the degree of selection bias in this study was small, if any.

Adult↗

PubMed1997

[Effects of health examination and follow-up educational programs on awareness and modification of risk factors for cardiovascular disease in a Japanese urban population].

This study in a Japanese urban population evaluated the effects of health examinations and follow-up educational programs on the risk factors for cardiovascular disease (blood pressure, serum total cholesterol, and smoking) and the level of awareness regarding these factors (e.g. having had their blood pressure and serum total cholesterol whether they checked, and knowing whether their level is high or normal, and whether they can state their own level). In both 1990 and 1991, 4,000 adults aged 30 to 79 were randomly selected from residents of S-city in Osaka Prefecture, and urged to attend the baseline health examination for cardiovascular disease at the National Cardiovascular Center. From among 1,879 persons who had received health examinations and follow-up educational programs in 1990, 600 subjects were selected at random and invited to participate in the follow-up examination in the next year. Four hundred forty five persons received the follow-up examination, and in addition, 1,791 persons attended newly the baseline health examination in 1991. Two sets of analyses were conducted. First, the 1990 baseline examination data and the 1991 follow-up examination data of 445 subjects were compared for change of awareness and risk factors. Second, the 1991 follow-up examination data and the 1991 baseline examination data were compared for difference of risk factors level. Initial awareness concerning serum total cholesterol was lower than that concerning blood pressure among people who had attended the 1990 baseline examination. After the health examination and the educational program, awareness for both blood pressure and serum total cholesterol increased significantly. Significant decreases in systolic blood pressure and serum total cholesterol were shown. But, no significant changes were observed for diastolic blood pressure and smoking rate. The means of systolic blood pressure and serum total cholesterol among subjects who received the follow-up examination were significantly lower than subjects who newly participated in the baseline examinations in 1991. Participation in health examinations and follow-up health educational programs can result in positive changes in awareness of risk factors and reduction of these factors.

Adult↗

PubMed1997

Granular-lattice (Avellino) corneal dystrophy in Japanese patients.

PURPOSE: To determine amyloid deposition in the corneas of granular corneal dystrophy in Japanese patients. METHODS: Eight Japanese patients (10 eyes) with a clinical diagnosis of granular corneal dystrophy were investigated clinically and histologically. Each specimen obtained at surgery was stained with hematoxylin-eosin, Masson trichrome or Mallory, and Congo red stain. Amyloid deposit was identified by birefringence and dichroism under cross-polarized light after staining with Congo red. RESULTS: Seven (70%) of the 10 corneal buttons (six of eight patients) had amyloid deposits, as shown by Congo red staining with birefringence and dichroism. Of the six amyloid-positive patients, two patients (who were siblings) showed discrete gray-white corneal deposits with additional linear deposits. This finding is typical of Avellino corneal dystrophy. The corneas of the remaining four patients showed the discrete deposits typical of granular dystrophy. Some of them showed a few whitish fusiform and stellate opacities in the mid stroma, suggestive of Avellino corneal dystrophy. CONCLUSION: The high frequency of amyloid deposits in Japanese patients with granular corneal dystrophy may be caused by an allelic heterogeneity of the gene.

Aged↗