Biomedical subjects

M Miyazaki

Publications and source records attributed to M Miyazaki.

At least 541 records · Page 30Linked to original sources

PubMed1993

Blindness due to non-ketotic hyperglycinemia: report of a 38-year-old, the oldest case to date.

We report a 38-year-old woman with a mild form of hyperglycinemia complicated with optic nerve atrophy and convulsion. She was normal at birth and showed normal mental and physical development. After the age of 13, her visual acuity rapidly decreased. At the age of 33, she had numerous episodes of tonic seizures lasting for 1-2 minutes. She had optic atrophy, but no intellectual impairment. Glycine levels of the plasma, urine and cerebrospinal fluid were markedly increased, but the CSF/serum glycine ratio was slightly higher than the normal range. Although there is one case of retinal impairment of hyperglycinemia in the literature, this is the first report of blindness with hyperglycinemia in a 38-year-old woman.

Adult↗

PubMed1993

Niceritrol reduces plasma lipoprotein(a) levels in patients undergoing maintenance hemodialysis.

Lp(a) is an LDL-like lipoprotein carrying the apoprotein(a) glycoprotein and has recently been recognized to be an independent risk factor for coronary heart disease. We studied plasma Lp(a) levels in 40 patients undergoing maintenance hemodialysis (24 male, 16 female; aged 16-83 years). Fasting plasma Lp(a) levels were measured by an enzyme-linked immunosorbent assay. The median value of plasma Lp(a) concentrations in hemodialysis patients was significantly higher than that of the normal volunteers (26.0 +/- 2.7 vs. 10.8 +/- 3.7 mg/dL, p < .05). Lp(a) levels did not correlate with age, duration of hemodialysis, total cholesterol, triglyceride, HDL cholesterol, or LDL cholesterol. The 11 patients whose plasma Lp(a) concentrations exceeded 20 mg/dL received niceritrol, a prodrug of nicotinic acid, at a dosage of 500 mg t.i.d. for 4 weeks. The plasma Lp(a) levels were significantly lower after 4 weeks of treatment (38.3 +/- 4.2 vs. 31.5 +/- 3.2 mg/dL, p < .01).

Adult↗

PubMed1993

[Hepatic protein synthesis in regenerating liver after partial hepatectomy].

The process of hepatic protein synthesis was studied in the regenerating liver after partial hepatectomy (HTX). Hepatocellular protein synthesis (HPS) and secretory protein synthesis (SPS) were determined in the regenerating liver of rats after 68% HTX. The serum levels of the following items were determined in 10 patients before and after HTX: interleukin-6 (IL-6), acute-phase proteins (APP), and negative acute-phase proteins (NAPP). HPS has markedly increased after HTX, with the peak occurring at 48 hours. The regenerating rat liver showed an increase of 80% over normal livers in HPS and 200% in SPS 48 hours after HTX. A remarkable increase in IL-6 levels occurred on the first day after HTX. In all patients transient falls in APP levels occurred on the first day. Values appeared to return rapidly toward preoperative values by 3 or 5 days after HTX but failed to show any significant increase compared to preoperative values. In contrast to APP, prolonged decreases in NAPP levels occurred after HTX. Values declined to a nadir on the first or third day after HTX and remained suppressed for 14 days. These results suggest that the production of APP is activated at an early stage of liver regeneration after partial hepatectomy.

Acute-Phase Proteins↗

PubMed1993

Assessment of lymphokine-activated killer activity and gamma-interferon production in patients with small hepatocellular carcinomas.

We have previously reported depressed gamma-interferon production and depressed lymphokine-activated killer and natural killer activity in patients with relatively large hepatocellular carcinomas. These parameters were normal in cirrhosis. Some evidence had suggested a gamma-interferon production defect as the main cause of depressed lymphokine-activated killer activity in hepatocellular carcinoma, (i.e., gamma-interferon enhances lymphokine-activated killer and natural killer activity and gamma-interferon antibody inhibits lymphokine-activated killer induction). However, we were unable to clinically define the precise mechanism operating here because gamma-interferon production and lymphokine-activated killer activity were both defective in advanced hepatocellular carcinoma. In recent years, it has become possible to detect even small hepatocellular carcinomas on ultrasonography and to confirm them by fine-needle biopsy. In this study, we assessed those immune parameters in 48 patients with hepatocellular carcinomas less than 2 cm in diameter to confirm depressed immune function and to clarify the mechanism of these defects. Lymphokine-activated killer activity was defective in 31 patients (64.6%), whereas gamma-interferon production was defective in only 1 of these patients (2.1%). This observation argues against the hypothesis that defective gamma-interferon production is the primary defect and provides new insight into the mechanism of progression of defective immune function in hepatocellular carcinoma. Thirty-one of the 48 hepatocellular carcinoma patients were treated surgically, and these immune parameters were followed for 6 mo. The recovery of lymphokine-activated killer activity in all hepatocellular carcinoma patients with low lymphokine-activated killer activity suggests the tumor burden as the cause of defective lymphokine-activated killer activity.

Adult↗

PubMed1993

Depressed immune function in patients with cirrhosis before emergence of hepatocellular carcinoma.

Hepatocellular carcinomas 1 cm in diameter with high or low echogenicity can be detected on ultrasonography and confirmed on fine-needle biopsy, but it is still very difficult to detect small hepatocellular carcinomas with isoechogenicity. In this study, we assessed lymphokine-activated killer cell activity and interferon-gamma production prospectively every 1 to 3 mo for 23 +/- 4 mo (mean +/- 1 S.D.) in 227 patients with cirrhosis. Transient depression of lymphokine-activated killer activity was detected in 43 patients (defective lymphokine-activated killer group), and hepatocellular carcinoma was detected in 24 cases before the end of the 18-mo follow-up. Twenty-one (87.5%) of the 24 hepatocellular carcinoma patients were included in the defective lymphokine-activated killer group. Defective lymphokine-activated killer activity was detected more than 6 mo before detection of a space occupying lesion in the liver or elevation of alpha-fetoprotein level above 400 ng/ml. Serum alpha-fetoprotein level was elevated above 400 ng/ml in only five cases in which hepatocellular carcinoma was detected as a space-occupying lesion. Our results indicate that sequential assessment of lymphokine-activated killer activity may be a predictor of hepatocellular carcinoma and that the depression of immune function in cirrhotic patients is a serious risk factor for hepatocellular carcinoma emergence.

Adult↗

PubMed1993

[Pathophysiology of carbohydrate-deficient glycoprotein syndrome--neuroradiological and neurophysiological study].

Neuroradiological and neurophysiological studies were done in two male siblings with carbohydrate-deficient glycoprotein syndrome (CDGS) (case 1 and 2) and one male second cousin presumed with CDGS (case 3). Case 1 and 2 had abnormality of epileptic discharge in EEG. Case 1 had MCV in the lowest normal range, giant SEP was observed in SSEP in case 1 and low voltage of P 14 in case 3. Case 1 had low voltage of wave V in ABR and case 3 had low voltage of wave V on one side and no response on the other side. The all cases showed the normal pattern for VEP and MEP. All showed cerebellar hypoplasia and various degree of pontine hypoplasia on MRI. SPECT showed hypoperfusion in cerebellum, brainstem and left centroparietal region in case 1. In CDGS we found the hypoplasia of cerebellum and pons in common, but it was suggested that CDGS might have the heterogeneity of pathophysiology on the basis of various neurological abnormalities.

Adolescent↗

PubMed1993

[Long-term prognosis of idiopathic thrombocytopenic purpura treated by partial splenic embolization].

The therapeutic effect of partial splenic embolization (PSE) was evaluated in 13 patients with idiopathic thrombocytopenic purpura (ITP). Eight patients were treated by PSE and followed up over 6 months after the treatment. Two patients were treated by splenectomy following PSE. (1) PSE achieved complete remission in one case, partial response in 3 cases, minimal response in one case and no change in 3 cases. PSE resulted in 62.5% of the effective rate. (2) The effect of PSE did not depend on age, sex, the duration of disease, platelet count and PA-IgG level before the treatment and the splenic infarcted rate. The platelet count after PSE increased more remarkably in the effective cases than in the non-effective ones (p < 0.01), which could predict the prognosis after PSE. (3) One patient whose platelet count increased enough after PSE had splenectomy later and resulted in complete remission. However another patient whose platelet count did not increase enough after PSE revealed no effect by splenectomy. PSE for the treatment of ITP could prevent some patients from non-effective splenectomy and achieve the same effective rate as splenectomy. Therefore, PSE could be an alternative therapy of splenectomy because of the less invasive one.

Adolescent↗

PubMed1993

[Type IV collagenase activities in human colorectal cancers and its role in cancer invasion and metastasis].

In 36 patients with colorectal cancers, type IV collagenase activities were measured in cancer and non-cancer tissues for evaluating its role in the process of cancer invasion and metastasis. The colorectal cancer tissues revealed remarkably higher activities than the distant normal and tumor-neighboring mucosa (p < 0.001). The activities in the colorectal cancer tissues with high-grade histological venous invasion were higher than those with low-grade histological venous invasion (p < 0.005). But no differences of the activities were found between patients with and without hepatic metastasis. These results suggest that the type IV collagenase plays an important role in the cancer invasion to the blood vessels around the primary site in colorectal cancers.

Adult↗

PubMed1993

[Continuous intra-hepatic-arterial infusion of low dose 5-fluorouracil for colorectal cancer patients with unresectable liver metastases].

Five cases of colorectal cancer with unresectable liver metastases treated from April 1992 to April 1993 in Osaka National Hospital were summarized in this paper. A silicone catheter was placed in the hepatic artery through the gastroduodenal artery by operative procedure and connected to a subcutaneously implanted reservoir. 5-FU was administered ambulatorily using Baxter Infusor (multi day type) according to a regimen of 5-day continuous infusion and subsequent 2-day rest. The patients were 4 men and 1 woman, and from 51 to 65 years old (average: 62.4 y.o.). According to criteria for antitumor effectiveness by CT scan, one patient was judged CR, two were PR, and one was PD. One case could not be estimated because of catheter obstruction. The total efficacy rate was 75%. The serum CEA level was reduced in 3 patients. As for complication, obstruction of catheter, damage to reservoir and segmental necrosis of liver were observed in 3 patients. In conclusion, our ambulatory therapy for colorectal cancer patients with liver metastases was considered to have a high potential of not only effectiveness for cancer lesion but also the improvement of patients' quality of life.

Aged↗

PubMed1993

[Intra-arterial infusion chemotherapy for recurrent breast cancer via an implantable system].

Intra-arterial infusion chemotherapy via implantable port catheter has been applied in 14 patients suffering from recurrent breast cancer. The regimen consisted of at least 2 cycles of epirubicin (1 cycle: 150 mg) and subsequent maintenance infusion (30 mg/2 weeks). The results were as follows: 1) The response rate (CR+PR) was 50%: 42.9% CR, 7.1% PR, 14.3% MR, and the median duration of response was 6 months. 2) Intractable pain, severe lymphedema and infection were reduced in 42.9% (6/14). 3) Leucopenia was the dose-limiting factor, and it appeared with an incidence of 78.8%. Catheter or portal trouble was observed in 28.6% of the patients. Despite the existence of several unanswered questions, intra-arterial infusion chemotherapy via implantable system is promising with regard to therapeutic effect and quality of life.

Adult↗

PubMed1993

Influence of argon laser curing on resin bond strength.

Light cured resin composites are usually cured with halogen lamps whose light output decreases with time and distance to the resin surface. This study compared bond strengths of resins to tooth structure cured with either an argon laser or a conventional halogen light. The enamel and dentin of bovine incisors were ground on the buccal surface with wet #600 grit SiC paper. A 4 x 2 mm mold was placed on the tooth surface and Scotchbond 2/Silux and Clearfil Photobond/Photo Clearfil A were placed into the molds and cured using a Quick Light or an argon laser for exposure times of 10, 20, and 30 seconds, and distances of 0.0, 0.5, 1.0, and 1.5 mm from the resin surface. The intensity of the Quick Light was measured as 510 mW/cm2 at 470 +/- 15 nm and the intensity of the argon laser was adjusted to 510 mW/cm2 before curing. Shear bond tests at a crosshead speed of 1.0 mm/min were performed after 24 hours of storage in water. The bond strengths obtained with the halogen lamp and the laser were not significantly different at the same exposure times and at 0.0 or 0.5 mm from the resin surface. The laser cured bond strengths did not decrease with increasing distance whereas there was a significant decrease in halogen bond strengths at distances greater than 0.5 mm for both resins. The use of the laser might provide a clinical advantage in cases where the curing light source cannot be brought into proximity to the surface of the resin.

Animals↗

PubMed1993

[Role and movement of the toes during walking].

In order to understand the function of toes during free walking, movements of the toes of 30 normal adults were measured with the electrogoniometers. The angular changes of the interphalangeal (IP) joint of the 1st toe and the distal interphalangeal (DIP) joints of the 2nd to 4th toes, the ground reaction force, foot switch signal and the pressure changes in the forefoot were recorded simultaneously. The relationships between these measurements were then investigated. During the foot-flat phase, the IP joint of the 1st toe stayed at a flexed position, while the DIP joints of the 2nd to 4th toes remained at a slightly extended or neutral position but there was scarcely any pressure on the toe tips (0-0.3 kg/cm3). After the heel-off, the pressure on the 1st toe tip gained with increasing flexion of the IP joint of the 1st toe. The mean of the maximum angles was 13 +/- 5 (mean +/- SD) degrees. After the heel-off, the DIP joints of the 2nd and 3rd toes remained in the extended position in 16 cases (6.6 +/- 3.1 and 6.3 +/- 3.4 degrees) and appeared to stay at a flexed position in 14 cases (10.0 +/- 7.8 and 8.0 +/- 5.3 degrees). The DIP joint of the 4th toe remained in the extended position in all cases (9.2 +/- 8.5 degrees). The pressure of the toe tips increased. The magnitude of the pressure of the extended toe tips was higher than that in the flexed toe tips. The pressure of the toe tips of the 1st to 4th toes reached the maximum much earlier than that of the toe-off. From these observations, we conclude that the function of the toes during free walking seems to stabilize the foot by extending a contact area with floor mainly after the heel-off.

Adult↗

PubMed1993

Hepatic inflammatory lesions manifested as a pseudotumor. Report of two cases with different characteristics.

We report two surgical cases of inflammatory conditions of the liver that, on imaging studies, closely resembled a neoplasm. Under the diagnoses of hepatic malignant neoplasms, both patients underwent hepatic resections. Histologically, one case was found to be a hepatic xanthogranuloma (an inflammatory pseudotumor) that consisted of foamy histiocytes, plasma cells, lymphocytes, and fibroblasts, while the other case was found to be an epithelioid cell granuloma with a central area of coagulative necrosis. Although their exact pathogenesis remained obscure, cholangitis in the former case and tuberculosis in the latter were assumed to be possible causal factors. Special attention should be paid to these unusual conditions in terms of the differential diagnosis of hepatic mass lesions.

Aged↗

PubMed1993

[A new sequential chemotherapy of methotrexate with 5-fluorouracil against advanced colo-rectal cancer].

A new sequential chemotherapy consisting of intravenous (IV) administration of methotrexate (MTX) 50 mg/m2 followed by 3 equal IV doses of 5-fluorouracil (5-FU) 500 mg/m2 at 1.4 and 21 hrs. and a leucovorin rescue (15 mg/body/8 hr) from 24 hrs. after MTX for 3 days was applied every two weeks for the patients with advanced colo-rectal cancer. The effectiveness of this MTX/3-dose 5-FU regimen was compared retrospectively with that of the standard sequential regimen consisting of the IV administration of MTX 100 mg/m2 followed by a single IV dose of 5-FU 800 mg/m2 one hr. later and a leucovorin rescue (21 mg/body/6 hr) 24 hrs. later given every week, namely MTX/1-dose 5-FU regimen. Partial response was achieved in 7 (46.7%) of 15 evaluable patients with the MTX/3-dose 5-FU regimen and in 3 (13.6%) of 22 evaluable patients with the MTX/1-dose 5-FU regimen (p < 0.05). The median survival times were 13 and 9 months, respectively. There were no significant difference in the patient characteristics between the two groups, and the toxic effects were much lower in the MTX/3-dose 5-FU than in the MTX/1-dose 5-FU regimen. It is therefore, concluded that the MTX/3-dose 5-FU regimen is superior to the standard MTX/1-dose 5-FU regimen.

Adult↗

PubMed1992

Activation of human multidrug resistance-1 gene promoter in response to heat shock stress.

The multidrug resistance (MDR1) gene encodes a P-glycoprotein, which catalyzes the energy-dependent efflux of anticancer agents. Various environmental stresses including heat shock can induce the expression of endogenous MDR1 genes. In order to study the regulatory mechanisms of MDR1 gene expression, we have established human cancer KB cell lines which could stably integrate bacterial chloramphenicol acetyltransferase (CAT) gene driven by various lengths of the MDR1 promoter. Kst-6 has an integrated plasmid, pMDRCAT1, containing the human MDR1 promoter of -2 kilobases. The MDR1 gene promoter contains a typical heat shock element (HSE) motif located -152 bp to -178 bp from the initiation site. Heat shock at 45 degrees C for 90 min significantly induced CAT activity in Kst-6 cells. Northern blot analysis showed a 4-5 fold increase in CAT mRNA levels in Kst-6 cells. Deletion analysis of the MDR1 promoter demonstrated that the induction of CAT activity was observed in Kxh-14 cells containing a HSE-deleted MDR1 promoter construct, pMDRCAT7. However, further deletion analysis showed that heat shock could not induce CAT activity in Khp-1 cells containing -76 approximately +121 base sequence of the promoter, suggesting that a new heat shock responsible element was located at between -136 and -76. Gel shift assay showed that the heat shock factor (HSF) could bind to the HSE motif located at -152 bp to -178 bp in the MDR1 promoter. We also found that one distinct DNA-protein complex formed specifically within the MDR1 promoter region -99 to -66 was not significantly increased, but relatively more stabilized under mild denaturing condition in the nuclear extract of heat-shocked cells. In our present assay system, activation of the MDR1 promoter in response to heat shock appears to be mediated through both a new heat shock responsive element and MDR1 specific transcription factor.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed1992

Rapid analysis of human serum albumin by high-performance liquid chromatography.

High-performance liquid chromatographic analysis of human serum albumin, using a column containing quaternized dimethyl-aminomethylstyrene-ethylene glycol dimethacrylate, was performed by isocratic elution. This column afforded resolution of albumin components, such as human mercaptalbumin and human nonmercaptalbumin. The method is an alternative to gradient chromatography, and allows rapid determination of the albumin components.

Chromatography, High Pressure Liquid↗

PubMed1992

Biliary cystadenocarcinoma of the liver. A clinicopathologic and histochemical evaluation of nine cases.

Nine cases of biliary cystadenocarcinoma of the liver were studied, with emphasis on its clinicopathologic features, mucin profiles, and immunohistochemical characteristics. In general, the cystic tumors had protrusions that consisted of well-differentiated papillary adenocarcinoma cells with or without benign-appearing epithelial elements. In invading or metastatic foci, the carcinoma cells tended to show distinctive anaplastic changes. Tumor growth was confined to the cystic lesions in five cases (noninvasive type), whereas in four cases it extended to the hepatic parenchyma or neighboring organs (invasive type). There was a considerable difference between the two groups in terms of prognosis. In fact, the patients included in the group with the noninvasive type had no sign of tumor recurrence after an appropriate surgical procedure. With mucin histochemical and immunohistochemical approaches, positive reactions with carcinoembryonic antigen, tissue polypeptide antigen, carbohydrate 19-9, and Dupan-2 and the predominance of sialomucin were observed in most cases of biliary cystadenocarcinoma, indicating a similar cellular nature of cholangiocarcinoma.

Adenoma, Bile Duct↗

PubMed1992

The human multidrug resistance 1 promoter has an element that responds to serum starvation.

We have previously demonstrated in transient expression assay systems that a human multidrug resistance 1 (MDR1) promoter can be directly activated by cytotoxic anticancer agents. In this study, we examined whether the MDR1 promoter could be regulated in response to growth arrest induced by serum starvation. We have established human and rodent cell lines which stably expressed the chloramphenicol acetyltransferase (CAT) gene driven by various lengths of the MDR1, the viral thymidine kinase (TK) and the simian virus 40 (SV40) promoters. Serum starvation caused enhanced expression of CAT gene with MDR1 promoter, but not with two viral gene promoters in human cancer KB cells. Hydroxyurea activated the MDR1 promoter, but not TK and SV40 promoters. By contrast, the DNA topoisomerase II inhibitor, etoposide, equally activated the MDR1, TK and SV 40 promoters. Increased CAT gene expression by serum starvation was also specifically observed in stable transfectants of human adrenal SW-13 cell lines, but not in stable transfectants of mouse fibroblast NIH3T3 and adrenal Y-1 cell lines when the human MDR1 promoter-CAT was introduced. Etoposide, however, effectively induced CAT activity in both human and rodent cells. Assays with deletion constructs of the MDR1 promoter showed that serum starvation activated the MDR1 promoter carrying -258 approximately +121 base sequence of the promoter, but not -198 approximately +121 of the promoter. These results suggest that the expression of the MDR1 gene induced by serum starvation is regulated at the transcriptional level in a promoter sequence-specific manner in human cells.

Animals↗