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Biomedical subjects

M Kubota

Publications and source records attributed to M Kubota.

At least 181 records · Page 10Linked to original sources

A case of parietal lobe epilepsy with distinctive clinical and neuroradiological features.

We present a case of parietal lobe epilepsy, the epileptogenic focus of which was conspicuously demonstrated on magnetoencephalography (MEG). The remarkable fluctuation in the seizure frequency and the presence of atonic seizures were suggestive of atypical partial benign epilepsy of childhood (APBEC). An interictal positron emission tomography (PET) scan performed during the cluster of fits revealed hypermetabolism around the epileptogenic focus, which might be related to the marked tendency of clustering of seizures in this patient.

Electroencephalography↗

Second malignancy following treatment of acute lymphoblastic leukemia in children.

Second malignancy is one of the serious late effects among long-term survivors of acute lymphoblastic leukemia (ALL) in children. Of 83 newly diagnosed pediatric ALL patients at our hospital between January 1980 and December 1995, four patients were found to have second malignancies. These included MDS/AML after B-ALL, rhabdomyosarcoma after early pre-B ALL, ependymoma after B-ALL, and astrocytoma after early pre-B ALL. The mean duration from initial ALL to second malignancy was 5.2 years. The possible causes of second malignancy in these patients are discussed in this report, along with a review of recent literature.

Antineoplastic Combined Chemotherapy Protocols↗

Analysis of mutations at the DNA repair genes in acute childhood leukaemia.

Deficiency in DNA repair capability is considered to be responsible for oncogenesis. Hereditary and sporadic cancers in various tissues have been reported to have mutations at the DNA repair genes. In this study we analysed two excision repair genes (ERCC1 and XPCC) and two mismatch repair genes (hMSH2 and hMTH1) in the leukaemic blasts of newly diagnosed paediatric patients by use of reverse transcriptase (RT)-polymerase chain reaction (PCR). Analysis of the leukaemic blasts from 15 patients demonstrated no alterations at the XPCC, hMSH2 or hMTH1 genes. Blasts from one patient with acute mixed lineage leukaemia revealed an abnormally migrated product of the ERCC1 gene by RT-PCR. His leukaemic blasts showed a reduced expression of ERCC1 protein by Western blotting. Since bone marrow cells at remission showed only normally migrated product, the ERCC1 gene mutation was considered to be specific for the leukaemic blasts. This is the first report describing a mutation at the ERCC1 gene in acute childhood leukaemia.

Acute Disease↗

Long-term results and clinical problems after portoenterostomy in patients with biliary atresia.

From January 1962 through December 1986, 71 cases of biliary atresia were operated on. Nine of these patients underwent only an exploratory laparotomy. A hepatic portoenterostomy (Kasai's operation) was performed on 62 infants with biliary atresia. Of these 62 children, 18 survived more than 10 years. However, 4 of the 18 died shortly thereafter because of persistent or recurrent jaundice and hepatic failure. Fourteen patients, however, are still alive more than ten years after portoenterostomy, today the actual 10-year survival rate is thus 22.5%. Six of them have no severe complications and their serum total bilirubin is less than 1.0 mg/dl. However, 8 patients, whose serum total bilirubin is more than 1.0 mg/dl, demonstrated numerous clinical problems such as esophageal varices, hypersplenism and recurrent jaundice after cholangitis. One of the patients in the latter group eventually underwent a liver transplantation because of the recurrent jaundice and hepatic insufficiency. In the treatment of biliary atresia, a close and careful follow-up is therefore essential especially for patients whose serum total bilirubin is more than 1.0 mg/dl.

Biliary Atresia↗

Induction of Th2 cytokine expression for p27-specific IgA B cell responses after targeted lymph node immunization with simian immunodeficiency virus antigens in rhesus macaques.

To determine if there is an association between the isotype of simian immunodeficiency virus (SIV)-specific B cell responses and the profile of Th1 and Th2 cytokine expression, rhesus macaques were immunized with SIV antigens via the iliac lymph nodes, using a targeted lymph node (TLN) immunization procedure. When CD4+ T cells purified from antigen-stimulated peripheral blood mononuclear cells were analyzed, the levels of Th2 cytokine production were gradually increased after the second and third immunizations. However, interferon-gamma production did not change. Analysis of SIV-specific B cell responses revealed that the main isotype was IgG after the second and third immunizations. In addition, a peak of SIV-specific IgA B cell responses was noted following the third immunization. These findings suggest that the induction of Th2 type responses in TLN-immunized rhesus macaques reflects the sequence of initial induction of SIV-specific IgG-producing cells followed by IgA-secreting cells.

Animals↗

Maxillofacial morphology and masseter muscle thickness in adults.

The aim of this study was to investigate how the thickness of the masseter muscle relates to the maxillofacial morphology, including the thickness of alveolar process in the mandibular incisor region, and the thickness of the mandibular symphysis. The subjects consisted of 80 adult male volunteers (mean age: 23 years 8 months). The relationship between masseter muscle thickness and the maxillofacial skeleton was investigated by measuring the former by ultrasonography and the latter by roentgenographic cephalometry. The data were initially analysed using a multiple regression analysis. Thereafter, correlation coefficients were obtained by a simple regression analysis. The following results were found: 1. The thickness of the masseter muscle (mean +/- SD) was 15.8 +/- 3.0 mm in the relaxed state and 16.7 +/- 2.7 mm at maximal clenching. 2. Masseter muscle thickness was negatively correlated with the mandibular plane angle. 3. Masseter muscle thickness was positively correlated with the mandibular ramus height (Cd-Go), and the thickness of the alveolar process and that of the mandibular symphysis. It is therefore suggested that masticatory function influences the morphology of the mandible.

Adult↗

Transferring profile of dietary sulphaquinoxaline into eggs.

Sulphaquinoxaline (SQ) was fed to laying hens at the dietary levels of 25, 50, 100 and 200 ppm, respectively, for 7 successive days. The increasing amount of SQ transferred into the whole egg during SQ feeding could be well described by the following equation: [equation: see text] where y is the SQ content (ppm) in the whole egg, x is the dietary SQ level (ppm), T is days on SQ feeding (T < or = 4). After 4 days of SQ feeding, the SQ content in the homogenized eggs reached a plateau at 0.0292.x (= 0.007318.4x) ppm. This equation permits to predict SQ content in the eggs.

Administration, Oral↗

Efficacy of CS-834 against experimental pneumonia caused by penicillin-susceptible and -resistant Streptococcus pneumoniae in mice.

The efficacy of CS-834, a novel oral carbapenem, was assessed by using a murine model of pneumonia caused by penicillin-susceptible and penicillin-resistant Streptococcus pneumoniae and was compared with those of oral cephems, i.e., cefteram pivoxil, cefpodoxime proxetil, cefdinir, and cefditoren pivoxil. Intranasal inoculation of 10(6) CFU of penicillin-susceptible or penicillin-resistant S. pneumoniae in the exponential growth phase induced pneumonia and bacteremia in ddY mice within 48 h. For the treatment of infections caused by the penicillin-susceptible strain the antibiotics were administered orally at 0.4, 2, and 10 mg/kg of body weight twice daily for 2 days beginning at 24 h after bacterial inoculation, and for the treatment of infections caused by a penicillin-resistant strain the antibiotics were administered at 2, 10, and 50 mg/kg twice daily for 2 days beginning at 24 h after bacterial inoculation. Among the antibiotics tested, CS-834 exhibited the most potent efficacy against both types of strains. Against infections caused by penicillin-susceptible S. pneumoniae, CS-834 at all doses significantly reduced the numbers of viable cells in both the lungs and blood. Cefpodoxime proxetil at all doses and cefteram pivoxil and cefditoren pivoxil at doses of 2 and 10 mg/kg showed comparable efficacies. Against infections caused by penicillin-resistant S. pneumoniae, CS-834 at doses of 10 and 50 mg/kg showed the most potent efficacy among the antibiotics tested, resulting in the maximum decrease in the numbers of viable cells in the lungs. Comparable efficacies were observed with cefteram pivoxil and cefpodoxime proxetil at doses of 50 mg/kg each. The concentration of CS-834 in the lungs and blood was higher than that of cefdinir and was lower than those of the other antibiotics tested, suggesting that the potent therapeutic efficacy of CS-834 reflects its strong activity against S. pneumoniae.

Animals↗

Analysis of mumps vaccine failure by means of avidity testing for mumps virus-specific immunoglobulin G.

To characterize patients with mumps vaccine failure, avidity testing was performed with the Enzygnost Anti-Parotitis Virus/IgG kit using a single-dilution-6 M urea denaturation method. Five groups of patients were tested. Group 1 consisted of 29 patients with primary mumps infections; group 2 was 20 children and adults with a definite history of natural infection; group 3 was 7 patients with a recent mumps vaccination, 1 of whom developed parotid gland swelling and aseptic meningitis; group 4 was 14 patients with mumps vaccine failure; and group 5 was 6 patients with recurrent episodes of parotitis in addition to a history of vaccination. On the basis of the results of groups 1 and 2, an avidity of </=31% was determined to be low, and >/=32% was determined to be high. Avidity maturation from low to high appears to occur around 180 days after the acute illness. The results of group 3 showed that the vaccine-induced immunoglobulin G (IgG) had very low avidity. Among the 14 patients in group 4, 12 patients, including 7 with a positive IgM response, were diagnosed as having secondary vaccine failures. The results of group 5 suggested the possibility that the avidity of the mumps vaccine-induced IgG remains low or borderline. These results showed that secondary mumps vaccine failure occurs not infrequently, even among school age children under condition in which the vaccine coverage is low (i.e., 33% in our study population), and therefore, vaccinees are prone to be exposed to wild-type viruses. Avidity testing should provide information useful for the analysis of mumps virus infections.

Adolescent↗

Electrophysiological characteristics of classes of neuron in the HVc of the zebra finch.

Whole cell recordings were made from zebra finch HVc neurons in slice preparations. Four distinct classes of neuron were found on the basis of their electrophysiological properties. The morphological characteristics of some of these neurons were also examined by intracellular injection of Lucifer yellow. Type I neurons (21 of 65 cells) had longer time-to-peak of an afterhyperpolarization following an action potential than the other classes. They exhibited both fast and time-dependent inward rectification and an initial high-frequency firing followed by a slower constant firing. Type I neurons had large somata and thick dendrites with many spines. The axons of some of the neurons in this class projected in the direction of area X of the parolfactory lobe. Type II neurons (30 of 65 cells) had a more negative resting membrane potential than the other classes. They exhibited fast inward rectification. Type II neurons could be divided into two subclasses by the absence (IIa; 22 cells) and the presence (IIb; 8 cells) of a low-threshold transient depolarization. Type IIa neurons had relatively small somata and thin, spiny dendrites. The axons of some of the neurons in this class projected in the direction of the robust nucleus of the archistriatum (RA). Type IIb neurons had relatively large somata and thick dendrites with many spines. Type III neurons (6 of 65 cells) had a shorter action-potential duration than the other classes. They exhibited prominent time-dependent inward rectification and a regular tonic firing with little or no accommodation. Type III neurons had beaded, aspiny dendrites. Type IV neurons (8 of 65 cells) had a longer action-potential duration, a much larger input resistance, and longer membrane time constant than the other classes. Type IV neurons had small somata and thin, short, sparsely spiny dendrites. The axons of some of the neurons in this class projected in the direction of the RA. These classes of neuron may play distinct roles in song production and representation in the HVc.

Action Potentials↗

High plasma free fatty acids decrease splanchnic glucose uptake in patients with non-insulin-dependent diabetes mellitus.

It has been proposed that high plasma free fatty acid (FFA) levels observed in patients with non-insulin dependent diabetes mellitus (NIDDM) contribute to the development of their insulin resistance. We examined patients with NIDDM to find whether maintaining plasma FFA levels in the fasting range with a euglycemic hyperinsulinemic clamp combined with an oral glucose load (clamp OGL) would affect insulin-mediated peripheral glucose uptake (PGU) and splanchnic glucose uptake (SGU). Nine NIDDM subjects (age, 55 +/- 3 years; duration of diabetes, 11 +/- 2 years; body mass index, 21.0 +/- 0.4 kg/m2; hemoglobin A1c, 9.0 +/- 0.3%; fasting plasma glucose, 9.4 +/- 3.0 mmol/l, means +/- SEM) were hospitalized and treated with diet, oral hypoglycemic agents or insulin for at least 2 weeks to maintain fasting plasma glucose < 8 mmol/l. All the patients were subjected to two different protocols in a random order. On one protocol, under the hyperinsulinemic condition, FFAs were maintained at the their fasting levels (1.19 +/- 0.08) by triglyceride emulsion infusion (Lipid infusion study, L), and on the other protocol, FFAs were made to fall (0.26 +/- 0.06 mmol/l) with saline instead of triglyceride emulsion infusion (Saline infusion study, S). During euglycemic (L, 5.4 +/- 0.2; S, 5.1 +/- 0.2 mmol/l) hyperinsulinemic (L, 1377 +/- 108; S, 1328 +/- 67 pmol/l) clamp, high FFA levels significantly reduced PGU (L, 26.7 +/- 3.6; S, 32.1 +/- 3.4 mumol.kg-1.min-1, P < 0.05) and SGU (L, 12.1 +/- 4.2; S, 27.5 +/- 5.6%, P < 0.05). In conclusion, high FFA levels in patients with NIDDM impaired insulin-mediated glucose uptake in the splanchnic as well as peripheral tissues.

3-Hydroxybutyric Acid↗

Membrane properties and the neuro-effector transmission of smooth muscle cells in the canine internal anal sphincter.

The most distal part of the circular muscle layer functions as the internal anal sphincter, which constitutes a high pressure zone at rest, but maintains a relaxed state during defecation. To elucidate such sphincter mechanisms of the smooth muscle cells, the circular muscle layer in the canine anal canal was examined within 2 cm from the anal verge. Both the mechanical and intracellular electrical activities were recorded simultaneously. The examined region could be divided into three different regions according to the pattern of spontaneous activity and innervation and consisted of an upper region (20-15 mm from the anal verge), a transitional region (15-5 mm from the anal verge) and a lower region (within 5 mm from the anal verge), respectively. The spontaneous membrane activity was characterized by ongoing slow potential changes and each potential change was associated with a phasic contraction in the three regions. The mean frequencies of spontaneous electrical activity were 6.8, 15.9, and 24.1 c/min in the upper, transitional and lower regions, respectively. In the transitional and lower region, muscle tone generation was observed. Transmural field stimulation (0.4 msec in pulse duration) evoked membrane depolarization and contractions in the lower region. The application of an alfa adrenergic blocking agent completely suppressed the generation of excitatory responses, leaving a long lasting hyperpolarization associated with relaxation. In the transitional and upper region, stimulation consistently evoked membrane hyperpolarization with relaxation. The characteristics of this hyperpolarization response varied among the three regions. The total duration of hyperpolarization increased distally, while the time to peak hyperpolarization became decreases in a reverse direction. These regional differences in the characteristics of spontaneous membrane activity and innervation indicate that the transitional and lower region might therefore function as the internal anal sphincter.

Anal Canal↗

[Effect of diltiazem on jugular bulb oxygen saturation (SjO2)].

We investigated the effect of diltiazem on jugular bulb oxygen saturation (SjO2) in patients undergoing superficial temporal artery-middle cerebral artery anastomosis. In the presence of stable vital signs, diltiazem was administered by continuous infusion (2 micrograms.kg-1.min-1). There was no significant change in blood pressure, heart rate, SjO2 in response to diltiazem administration. The arterial plasma concentration of diltiazem reached 75 +/- 14.2 ng.ml-1 after 180 min. The difference of areas under the curve between the arterial and jugular venous diltiazem concentrations from start of infusion to the end was significant. We conclude that this dose of diltiazem produced effective concentration and uptake in the brain tissue, but produced no significant effect on jugular bulb oxygen saturation (SjO2).

Aged↗

[Clinical evaluation of hepatic bruit audible in patients with alcoholic hepatitis].

It is well accepted that many patients with alcoholic hepatitis have an audible bruit over the liver (hepatic bruit) in western countries. However, this sign has not been discussed in Japan. The aim of this study was to assess the significance of the hepatic bruit in Japanese patients with alcoholic hepatitis. Hepatic bruit was specifically searched for on auscultation by two physician in consecutive patients (6 alcoholic hepatitis, 58 other alcoholic liver disease, 128 nonalcoholic liver disease including 16 hepatocellular carcinoma). Hepatic bruit was detected in 5 of 6 (83%) patients with alcoholic hepatitis, and in 1 of 16 (6%) patients with hepatocellular carcinoma. In any of other liver diseases, hepatic bruit was not detected. We conclude that hepatic bruit may be an important diagnostic finding in Japanese patient with alcoholic hepatitis as it is in western countries.

Adult↗

Prospective study of mutant frequencies at the hprt and T-cell receptor gene loci in pediatric cancer patients during chemotherapy.

Mutant frequencies (MFs) at the hypoxanthine phosphoribosyl transferase gene and the T-cell receptor (TCR) gene loci were evaluated in nine pediatric cancer patients before and during anticancer chemotherapy. The study population consisted of three patients with Hodgkin's disease, four patients with neuroblastoma, and two patients with Wilms' tumor. Except for one patient with neuroblastoma and one patient with Wilms' tumor, MFs at the hypoxanthine phosphoribosyl transferase locus tended to increase during the early cycles of treatment. The elevation was most striking and persistent in patients with Hodgkin's disease. The clonal relationship was determined in mutant cells derived from Hodgkin's disease patients by TCR-gamma gene rearrangement pattern and showed that the elevation of MFs resulted from increased mutational events rather than from clonal expansion of mutants. An increase in TCR MF was also found during chemotherapy in most patients, but the time of TCR MF elevation was variable among patients. Among the chemotherapeutic agents used in this study, cyclophosphamide was considered to be the most mutagenic. Our present study clearly demonstrates that anticancer chemotherapy can induce mutagenesis in vivo in various pediatric cancer patients.

Antineoplastic Combined Chemotherapy Protocols↗

[Anesthetic management of a patient with a right kidney tumor associated with complete occlusion of the inferior vena cava by tumor embolism].

We gave anesthesia to a patient with a right kidney tumor associated with complete occlusion of the inferior vena cava (IVC) by tumor embolism. The upper end of the tumor embolism was below the junction of the IVC and the hepatic vein, and the operation was considered possible by simply clamping the IVC. To prevent complications including pulmonary embolism, the circulatory change at the time of clamping of the IVC, and massive bleeding, monitoring was made by pulmonary artery catheter and transesophageal echocardiography, and extracorporeal circulation was prepared. The blood pressure was stable and massive bleeding did not occur at the time of clamping of the IVC, because the IVC was completely occluded. The monitor showed no signs of pulmonary embolism. In a case of kidney tumor with tumor embolism in the IVC, it is necessary to be fully prepared for pulmonary embolism, the change of blood pressure before and after clamping of the IVC and for the bleeding at the time of IVC excision.

Aged↗

[Treatment of advanced breast cancer: current issues].

Because the great majority of patients with advanced breast cancer have been traditionally placed under the care of surgeons, therapeutic planning is usually done by making operative management the key even at the present time when operable breast cancer is appropriately recognized to represent a systemic disease. For advanced breast cancer to be treated more effectively, systematically planned multimodality treatment must be undertaken. The development of G-CSF and stem cell transplantation to counter hematopoietic toxicity have allowed the safe use of high-dose intensity chemotherapy, which has also been applied in the neoadjuvant setting. Recent experience with neoadjuvant chemotherapy (NACT) has shown promise and indeed some good responders have been offered breast conserving surgery. NACT also serves as an in vivo chemosensitivity test, the results of which are to be exploited in chemo-hormonal therapy after locoregional treatment. Although further studies are required to evaluate this treatment more precisely, multicycle dose-intensified chemotherapy can now be safely and liberally incorporated into systematically planned multimodality treatment for advanced breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗