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Biomedical subjects

M Nagai

Publications and source records attributed to M Nagai.

At least 199 records · Page 11Linked to original sources
PubMed1997

Significance of pupillary reactivity in poor-grade aneurysm patients as a prognostic factor and an indication for active treatment.

Sixty-eight patients with subarachnoid haemorrhage (SAH) who were admitted in a comatose state were studied to determine the factors influencing mortality and to seek criteria for case management. Overall, the functional recovery (good recovery or moderate disability) rate was 33%, with a mortality rate of 50%. Bilaterally unreactive pupils on admission was a powerful predictor of death (p < 0.0001): outcome of these patients was poor regardless of any treatment modalities with a mortality rate of 91% (20/22). Initial poor motor response (abnormal flexion, extension, or nil) was also significantly related with death (p < 0.05). However, motor response was a less powerful predictor than pupillary reactivity. Motor response often altered spontaneously during the 12 h after admission, whereas pupillary reactivity tended to be stable. Initial reactive pupils were shown to be an indicator of spontaneous improvement of motor response. These findings indicate that pupillary reactivity may be a reliable predictor of outcome in poor-grade SAH patients.

Adult↗
PubMed1997

Are left-sided gallbladders really located on the left side?

OBJECTIVE: The aim of this investigation was to establish the association between left-sided gallbladders and right-sided round ligaments. SUMMARY BACKGROUND DATA: The left-sided gallbladder is a rare anomaly and has been classified into two types: 1) gallbladder migration to the left side and 2) development of a second gallbladder with atrophy of the original one. Recently, left-sided gallbladders were reported to be associated with right-sided round ligaments. METHODS: The authors reviewed 3 patients treated in their departments and 15 patients reported in the literature diagnosed as having left-sided gallbladders accompanied by right-sided round ligaments. RESULTS: Although the gallbladders of all 18 patients were located at the normal site, they were diagnosed as being left sided because of the right-sided round ligaments. This anomaly was accompanied by abnormal intrahepatic portal venous branching, which could be classified into two types. In eight patients, the first branch of the portal vein ran to the posterior segment and then the portal vein formed a trunk of the left and right anterior portal veins. The latter portal vein formed the umbilical portion and finally joined the right-sided round ligament (trifurcation type). In five, the portal vein diverged normally to form the left and right portal veins, then the latter branched to form the anterior and posterior segments, and finally the anterior branch joined the round ligament (bifurcation type). In the other five, the branching type could not be determined. CONCLUSIONS: A right-sided round ligament causes a gallbladder at the normal site to be located on the left side. This anomaly should not be diagnosed as a left-sided gallbladder but as a right-sided round ligament. Recognition of this anomaly clinically is important when performing hepatectomy, because it is always associated with abnormal intrahepatic portal venous branching.

Adult↗
PubMed1997

A simple stenting method for management of hepatic ductal injury secondary to blunt abdominal trauma: two case reports.

We report two cases of liver injury with hepatic ductal disruption after blunt abdominal trauma. The first case involves a 23-year-old male. Because the bifurcation of the hepatic duct was longitudinally torn, two stenting catheters were inserted toward the right and left hepatic ducts without suture closure of the tear. The patient is well 10 years after the injury. The second case involves a 22-year-old male who suffered an infarction of the inferior portion of the medial segment of the left hepatic lobe as well as a laceration of the left hepatic duct, a 50% circumferential tear. A stenting catheter was introduced into the left hepatic duct, but the defect was not sutured. The patient is well 1.5 years after the injury. The catheter stenting method without suture repair or defect plasty is a simple and effective way to manage hepatic ductal injury.

Abdominal Injuries↗
PubMed1997

Trigeminal somatosensory evoked potentials before, during and after an inferior alveolar nerve block in normal subjects.

The changes of the trigeminal somatosensory evoked potential (TSEP) before, during and after inferior alveolar nerve block were serially recorded in six healthy subjects (33-43 years of age; mean age 38.0 years). In four subjects in whom successful nerve block was achieved, TSEP showed linear flattening of the wave form. The recovery of TSEP slightly preceded the recovery of threshold of the sensation to electrical stimulation and that of two-point discrimination on the skin. In the remaining two subjects, in whom effective nerve block failed, TSEP showed no change in the wave form but did show slight prolongation of the latencies. We conclude that TSEP can be used as a method to confirm whether conduction anesthesia has been successful or unsuccessful.

Adult↗
PubMed1997

Cytotoxic T-lymphocytes recognizing P-glycoprotein in murine multidrug-resistant leukemias.

A multidrug-resistant murine lymphoid leukemia P388/ADR overexpresses P-glycoprotein (P-gp), an active transporter that pumps cytotoxic drugs out of cells and a product of mdr1 gene. Cytotoxic T lymphocytes (CTL) that showed cytotoxicity against P388/ADR were generated from mixed lymphocyte tumor cell culture. CTL do not kill drugsensitive parental P388 (P388/parent) that does not express P-gp. Monoclonal antibody against P-gp inhibited cytotoxic activity. Similar results were obtained in another multidrug-resistant cell line P388/VP-16. Cytotoxic activity was mediated by Thy1+ CD4- CD8+ T-cells. When P388/ADR was treated with murine IL-4, expression of P-gp was downregulated. Monoclonal antibody against interleukin-4 (IL-4) abrogated the IL-4-induced suppression of P-gp. Cytolytic activity of CTL against IL-4-treated P388/ADR was dose dependently inhibited. These results suggest that P-gp is immunogenic and can be a target of CTL in this murine leukemia model.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1997

Comparison of characterization among Bordetella calmodulin-like protein, bovine brain calmodulin and Escherichia coli acyl-carrier protein.

We previously reported that Bordetella calmodulin-like protein (CLP), like bovine brain calmodulin (CaM), enhances adenylate cyclase and phosphodiesterase activities. In this communication, antigenic and biochemical characters were compared between CLP and CaM. It was found that anti-CLP and anti-CaM sera obtained reacted with CaM and CLP, respectively. The amino acid composition of CLP was similar to CaM. The similarity was also found in an Escherichia coli acyl-carrier protein (ACP), a Ca(2+)-binding protein. Though the amino acid sequence of N-terminus region of CLP has no significant homology with CaM, ACP has highly homology in its N-terminus similar to CaM. These results suggest that CLP might act as a Ca(2+)-binding protein, and/or an ACP during the activation of adenylate cyclase and phosphodiesterase.

Acyl Carrier Protein↗
PubMed1997

Inhibitory effect of acyl-CoA and acyl-carnitine compounds on the ischemia-inducing activity of Bordetella heat-labile toxin in guinea pig skin.

The ability of Bordetella heat-labile toxin (HLT) to induce ischemic lesions after intracutaneous injection to guinea pig skin was lost following incubation at 37 degrees C with long-chain saturated acyl-CoA and acyl-carnitine compounds. Short-chain unsaturated acyl-CoA compounds, however, were less potent in inhibiting the induction of HLT activity. Long-chain saturated acyl-CoA and acyl-carnitine compounds, potently inhibited the induction of this activity. On incubation with HLT at 0 degrees C, a long-chain saturated acyl-CoA compound, palmitoyl-CoA, did not inhibit HLT activity. When first mixed with bovine serum albumin or dimethyl-beta-cyclodextrin, palmitoyl-CoA lost the ability to inhibit HLT activity. Binding of 14C-palmitoyl-CoA to HLT was measured by Scatchard analysis. The Bmax values of HLT (2.75 mol/mol of protein) were higher than that of acyl-CoA-binding protein from bovine liver (0.95 mol/mol of protein). Neither acyl-CoA hydrolase nor acyl-CoA ligase was detected in the HLT preparation. These results suggest that the acyl-CoA and acyl-carnitine compounds bind directly to HLT and produce a critical change in conformation required for HLT activity.

Acyl Coenzyme A↗
PubMed1997

Anti-tumor promoting activities of isoflavonoids from Wistaria brachybotrys.

Eight minor isoflavonoids (3-10) isolated from the knot of Wistaria brachybotrys were tested for their inhibitory effects on Epstein-Barr virus (EBV) activation induced by the tumor promoter, 12-O-tetradecanoyl-phorbol-13-acetate (TPA), in Raji cells as a primary screening test for anti-tumor-promoters (cancer chemopreventive agents), and all the tested compounds showed inhibitory activity. Of these compounds, pendulone (3) was further examined on the cell cycle of Raji cells, and indicated strong inhibition on the effect of the cell cycle induced by TPA. In addition, the compound showed potent anti-tumor-promoting activity for an in vivo two-stage carcinogenesis test of mouse skin using 7,12-dimethylbenz[a]-anthracene and TPA. Consequently, it suggests that 3 could be a valuable chemopreventive agent in chemical carcinogenesis.

Animals↗
PubMed1997

Bone resorption inhibitors from hop extract.

We searched hop extract for active component(s) that inhibited bone resorption in the pit formation assay, and isolated xanthohumol and humulone as active ingredients. Especially humulone had extraordinarily strong inhibitory activity and the IC50 (concentration of 50% inhibition) value was 5.9 x 10(-9)M.

Bone Resorption↗
PubMed1997

Early fatal rebleeding from a cerebellar cavernous malformation--case report.

A 25-year-old female patient presented with hemorrhage from a cerebellar cavernous malformation manifesting as headache and vomiting. She died of massive rebleeding within 1 week of the previous hemorrhage. The natural history of cavernous malformations was considered relatively benign, with significant hemorrhage being uncommon. The present case suggests that emergency surgery should be performed for patients with unstable clinical conditions and/or those with a significant mass effect in the cerebellum or the brainstem.

Adult↗
PubMed1997

[Survey of patients with intractable diseases. Analyses of patients receiving financial aid for treatment].

The Research Committee of Epidemiology of Intractable Disease (Ministry of Health and Welfare, Japan) conducted a Nationwide survey of 34 intractable diseases with each of the 47 prefectural governments reporting information on all patients having any of 34 intractable diseases, and who received financial aid for the disease from April 1992 to March 1993. Information collected about each patient was the identification number, which included the disease code, sex, age, the code of the municipality where the patient lived, the medical institution which treated the patient, and the department where the patient was treated. The results can be summarized as follows: 1) The total number of patients who received financial aid for disease was 247,726 (Male 93,251 Female 154,274) for a sex ratio of 0.60, and 61.7% of patients were between 40 and 69 years of age. Of 109,387 patients whose status could be confirmed regarding either outpatient or inpatient, 13.5 percent were inpatients. Of the patients, 47,222 (53.0%) were treated in departments of internal medicine. 2) Of all 34 intractable diseases, the greatest number receiving aid were patients with systemic lupus erythematosus with 35,690 receiving aid between April 1992 and March 1993. Of new patients commencing financial aid between April 1992 and March 1993, the largest group was patients with ulcerative colitis with 5,361. 3) The numbers of patients and those who started receiving the aid in the observed one year was larger than those in 1984 and 1988. The increase in numbers between 25 and 34 years of age was remarkable. By age group, the largest number of patients became older within the 8 years from 1984 to 1992.

Adult↗
PubMed1997

[Intakes and health effects of aluminum. "Is aluminum a risk factor for Alzheimer's disease?"].

Alzheimer's disease will be one of the main health problems in Japan in the near future, where the proportion of elderly people is showing rapid increase. The causes of the disease have been obscure, but some reports in recent years indicate the intake of aluminum is a risk factor. The reported knowledge concerning the function aluminum, the intake of aluminum and the relationship of aluminum to Alzheimer's disease needs to be summarized. The intestinal absorption of aluminum differs according to its chemical structures, coexistent substances such as maltose, citric acid, silicon and hydrogen ion concentration exponent. Aluminum absorbed from the intestine may be possibly accumulated in the brain tissue. There are some reports which indicate that the aluminum in the brain are toxic to nerve cells and produce Alzheimer's disease-like pathological or biochemical changes in animal brain. While there are a number of epidemiological reports which show that the presence of aluminum in the water supply relates to the disease incidence, it is not well recognized that a large amount of aluminum is contained and can be consumed through commonly used confectioneries and medications. At the present time while the amount of information is not sufficient to make some proposals about the aluminum consumption through foods and medicines, it is sufficient to merit informing people of their intake of the metal so as to be able to make their own decision. For further recommendations, more studies on this problem are necessary.

Aluminum↗
PubMed1997

[Development of index of social activities for the elderly].

In order to develop indices of social activities for the elderly, two surveys with 2 year intervals were conducted on the same 5,201 elderly subjects in four areas in Japan using a self-administered questionnaire. Social activities were defined as "activities which required contact with society" and were measured by 4 major facets of social activities, which were based on 21 questions relating to job activity, socially-plated activities, learning activities, and personal activities. The results were as follows; 1. The Wilcoxon scores in indices for 4 facets were given in sex and age groups. 2. Means of scores of indices increased with the degree of social activities from a subjective judgment. 3. Rank correlation coefficients between indices in two surveys were 0.60-0.71 for the persons whose answers were "no" to the question "did degrees of your activities change over the two years?" 4. Differences between indices in two surveys were higher in the persons with answers of "increase" to the above question than those with answers of "no", and were lower in those with answers of "decrease". These findings suggest that indices are available for assessing social activities as indicated by the reproducibility, validity and responsiveness found in this study.

Activities of Daily Living↗
PubMed1997

[A case of multiple intracranial tuberculoma diagnosed by open brain biopsy].

To provide histological diagnoses of brain diseases, CT-guided stereotactic brain biopsy (CT-SBB) has been widely used because of its less invasive technique compared with open brain biopsy (OBB). However, CT-SBB is not always diagnostic. We report a case of multiple intracranial tuberculoma whose diagnosis was not made by CT-SBB but by OBB. The patient is a 46-year-old man with insulin-dependent diabetes mellitus who had been receiving immunosuppressive agents (azathioprine, cyclosporin, and prednisolone) after renal transplantation for diabetic renal failure for 9 years. He gradually developed febrile, headache and unsteady gait. Brain MRI demonstrated multiple intracranial lesions involving left fronto-temporal and right parietal lobes, left cerebellar hemisphere, and the fourth ventricle. Although the MRI findings were consistent with those of previously reported cases of intracranial tuberculoma, other conditions, such as malignant lymphoma and toxoplasmosis, were not ruled out. Therefore, CT-SBB targeting the left temporal lobe lesion was done for definitive diagnosis, but it revealed only mild perivascular infiltration of mononuclear cells and hemorrhage. He was transferred to our clinic for further evaluation. On examination, mild truncal and limb ataxia on the left were noted in addition to the neurological findings corresponding to diabetic retinopathy and neuropathy. Despite vigorous laboratory examinations, including repeated bacterial cultures and PCR of cerebrospinal fluid, no evidence of tuberculous infection was obtained. A tentative diagnosis of multiple intracranial tuberculoma was made, and anti-tuberculous drugs (isoniazid 400 mg, ethambutol 750 mg, and pyrazinamide 1.5 g) were administered. Since his symptoms deteriorated because of ventricular dilatation resulting from the enlarged lesion in the fourth ventricle after a temporary clinical improvement, VP-shunting and OBB from the left temporal lobe lesion were done. The excised lesion was firmly encapsulated and the histological examination revealed typical pathology of tuberculoma. Ziehl-Neelsen staining and PCR for Mycobacterium tuberculosis of the biopsied specimen were also positive. Further administration of increased doses of anti-tuberculous drugs (isoniazid 600 mg, ethambutol 500 mg, pyrazinamide 2.0 g and intramuscular injection of streptomycin 0.3 g twice a week) eventually ameliorated the symptoms and shrank the lesions. In case of intracranial tuberculoma, the needle of CT-SBB may not penetrate the firm capsule of tuberculoma and only the surrounding brain tissue may be obtained as in the present case. Therefore, it is recommended to consider OBB from the beginning for definitive diagnosis of intracranial tuberculoma. Paradoxical worsening of the clinical and laboratory findings of tuberculosis in spite of appropriate anti-tuberculous therapy as seen in the present case has been described in both pulmonary and extra-pulmonary tuberculosis. The phenomenon, called transient worsening, could happen and we have to keep it in mind during the treatment of intracerebral tuberculoma.

Antitubercular Agents↗
PubMed1996

A variant CD30 protein lacking extracellular and transmembrane domains is induced in HL-60 by tetradecanoylphorbol acetate and is expressed in alveolar macrophages.

We identified and cloned cDNAs for two novel CD30 mRNAs of 2.3 kb that are induced by 12-O-tetradecanoylphorbol 13-acetate (TPA) in the human myeloid leukemia cell line HL-60. These transcripts were transcribed from the intronic region just upstream of the exon coding for the transmembrane domain of the CD30 protein. The shorter cDNA had a deletion of 54 nucleotides corresponding to the 3' region of the transmembrane domain of the CD30 and which was probably caused by alternative splicing. Translation of these transcripts appeared to start from the internal methionine codon at nucleotide position 289 that corresponds to that of 1612 in the CD30 cDNA, and encode a protein of 132 amino acid residues which corresponds exactly to the C-terminal cytoplasmic domain of CD30 protein. The calculated molecular mass of this variant CD30 (CD30v) protein was 14,087. Thus, the predicted CD30v protein retains most of the cytoplasmic region, but lacks the extracellular and transmembrane domains. Northern blots detected the expression of CD30v transcripts only in the lung and the TPA-stimulated HL-60 cell line. Translation of this mRNA in vitro produced a protein of 25 kD. Immunoblotting analysis with HCD30C1, a rabbit polyclonal antibody raised against the cytoplasmic domain of CD30 protein, detected proteins with an apparent Mr 25 kD expressed in TPA-stimulated HL-60 and COS-7 cells that were transfected with both types of CD30v cDNAs. Constitutive phosphorylation of the CD30v protein was demonstrated by in vitro labeling with [32P]. Immunohistochemical studies demonstrated CD30v protein was in alveolar macrophages. Cotransfection experiments using a kappa B-site-dependent reporter construct showed that CD30v can transactivate gene expression through activation of NF kappa B, as was noted on the authentic CD30 protein. Overexpression of the CD30v induced differentiation of HL-60 cells as evidenced by an increased NBT reduction activity. These observations provided new insights into the molecular heterogeneity and biological function of CD30 in myeloid cells.

Animals↗
PubMed1996

A higher proinsulin response to glucose loading predicts deteriorating fasting plasma glucose and worsening to diabetes in subjects with impaired glucose tolerance.

To evaluate the clinical significance of proinsulin determination, we measured glucose, insulin, C-peptide and proinsulin during 75-g oral glucose loading in 59 patients. In a 2.5-year follow-up study of 37 subjects with impaired glucose tolerance (IGT) at the initial test, 11 patients changed from IGT to a normal state and 5 patients showed worsening to overt Type 2 diabetes with elevation of fasting plasma glucose; 21 patients remained unchanged. Although our data showed that both fasting (IGT: p = 0.4523) and 120-min plasma glucose (IGT: p = 0.8168) values at the initial test were not significantly correlated with increased fasting plasma glucose levels in a 2.5-year follow-up study, subjects with a higher 120-min proinsulin response to glucose during the initial OGTT showed a significant correlation (IGT: p < 0.0001) with increased fasting plasma glucose levels after follow-up period and developed Type 2 diabetes. The present findings suggest that the proinsulin response to glucose loading might be a useful indicator for predicting worsening to diabetes in subjects with impaired glucose tolerance.

Administration, Oral↗
PubMed1996

Cerebral aneurysms unrelated to arterial bifurcations.

The majority of saccular cerebral aneurysms arise at arterial branchings; those arising elsewhere are rare. Among 557 saccular cerebral aneurysms surgically treated between 1983 and 1994, 29 (5.2%) were unrelated to arterial divisions. These cases were retrospectively analysed. The ages of the subjects ranged from 6 to 80 years (mean 57); 17 (59%) were female, and 12 (41%) male. Twenty-four (83%) presented with subarachnoid haemorrhage. Seventeen (59%) had a history of hypertension, and ten (34%) had multiple cerebral aneurysms. The most common site was the internal carotid artery (45%), followed by the middle cerebral artery (28%), the vertebrobasilar arteries (17%), and the anterior cerebral artery (10%). The aneurysms were classified in relation to arterial curvature into three groups: dorsal curvature (41%), ventral curvature (10%) and non-curvature (49%). During surgery, sclerotic changes were noted in the arterial wall adjacent to the aneurysms in 14 patients (48%). Five cases (17%) had small thin walled (blister-like) aneurysms, four of which ruptured during surgery resulting in poor clinical outcomes. We suggest that arteriosclerotic changes in the arterial wall, carotid siphon, and/or local haemodynamic forces are important factors in the development of this type of aneurysms. At surgery, one should bear in mind the possibility of sclerotic or blister-like aneurysms which require special attention to deal with them.

Adult↗