Biomedical subjects
Publications and source records attributed to M Sakai.
The activated c-Ha-ras oncogene induced AP1-site DNA-binding activity in F9 cells. This induction appeared to be due, at least in part, to the induction of c-jun transcription. Both activated c-Ha-ras and c-jun induced the differentiation of F9 cells to endoderm-like cells. Thus, AP1 appears to play a key role in the initial stage of F9 cell differentiation.
Island flaps supplied by the intermuscular cutaneous perforator (IMCP) from a deep vessel, such as the peroneal flap pedicled by IMCP from the peroneal vessel or the anterior tibial flap supplied by IMCP from the anterior tibial vessel, are reported to be useful in reconstructive procedures for soft-tissue defects of the lower leg. However, the posterior tibial flap, pedicled by IMCP from the posterior tibial vessel, has not yet been fully described. The posterior tibial flap can be used either as a normal-flow or as a reverse-flow flap. It is particularly versatile as a reverse-flow flap for reconstruction of soft-tissue defects of the heel and foot. Three reverse-flow posterior tibial flaps were clinically applied, without venous anastomosis, to reconstruct heel and foot defects, and all three survived completely. The operative procedure and its characteristics are described.
Though the rubella vaccination programme for adolescent girls was introduced in Japan in 1977, rubella epidemics have occurred repeatedly. Also in Sasebo, Japan in 1987, we experienced various complications as follows: encephalitis (five cases), meningitis (three), thrombocytopenic purpura (four), vascular purpura (four), hemolytic anemia (two), pneumonia (eight), protein-losing gastroenteropathy (one), multiple organ disorder with encephalitis, purpura, myocarditis, hepatic and renal dysfunction (one), and congenital rubella syndrome (CRS: three). Disorders ranging over multiple organs seem to occur in acquired as well as congenital rubella infection. The incidence of encephalitis was estimated to be 1:1600 cases of rubella and two of five cases were apparently serious. Though the strategy for preventing rubella has been directed only against CRS, we should note the various and severe complications with acquired rubella infection, and should adopt two-stepped protection: vaccination of young children of both sexes and of adolescent girls.
In January 1983, a number of premature infants under management in the premature infants' unit of our hospital were found to have bacteremia due to Staphylococcus aureus. By the end of February of the same year, 4 of these infants, who had been treated in the same unit, developed impetigo. The S. aureus responsible for this condition was classified as type IV by a coagulase typing. In a subsequent antimicrobial susceptibility test using the disk diffusion method, this microorganism was found to be resistant to methicillin, erythromycin and lincomycin, and to be susceptible to tetracycline, chloramphenicol and cefmetazole, indicating that it was a methicillin resistant S. aureus (MRSA). Because the result from the coagulase typing agreed with the antimicrobial susceptibility pattern in all cases, we concluded that these cases represented nosocomial infection with MRSA. The source and route of the infection were investigated, and measures taken to prevent bacterial spread from carriers and to keep instruments and environments clean. Although the source of infection was not identified. Then, we tried wiping the body surface of the premature infants with an Isodine solution (10% PVP-I, 1:100 dilution) in order to prevent colonization of the microorganism on the body surface. With this application+, MRSA was no longer detected from the body surface of the premature infants, and no additional MRSA infection occurred in the premature infants' unit. Data collected for premature infants' managed at our hospital in the subsequent 6 years allows us to conclude that MRSA infection can be almost completely controlled by frequent surveys of carriers and appropriate body surface wiping with Isodine solution.(ABSTRACT TRUNCATED AT 250 WORDS)
To examine the functional relationship between distinct cis-active elements within the distal enhancer region of the rat PRL gene, we have used deletional and mutational analysis of that region in transient transfection studies in GH3 pituitary tumor cells. Results from these studies demonstrate that the region of the PRL distal enhancer containing the Pit-1-binding sites is critical not only for enhancer activity and the response to cAMP, but also for the response to estradiol. An interaction of the estrogen receptor with factors conferring basal enhancer activity is suggested by studies with a mutant distal enhancer region in which the PRL estrogen response element was converted to a palindromic estrogen response element. To directly examine potential interactions, cotransfection studies using PRL distal enhancer reporter gene constructs and expression vectors for Pit-1 and rat estrogen receptor were performed in two heterologous cell lines. The activity of the reporter gene under the control of the PRL distal enhancer linked to either the thymidine kinase promoter or the PRL proximal promoter was not significantly altered by cotransfection with the Pit-1 expression vector in COS-1 or RAT-1 cells. Coexpression of these reporter constructs and an expression vector for estrogen receptor resulted in only a slight response to estradiol. However, when both Pit-1 and estrogen receptor were cotransfected with the distal enhancer reporter gene, a marked induction was observed in response to estradiol, and this activity was dependent upon the concentration of the Pit-1 expression vector.(ABSTRACT TRUNCATED AT 250 WORDS)
We examined the effect of rehabilitation on the prognosis of aged patients with a first episode of acute myocardial infarction. The mean age of patients was 77 years old. We divided them into two groups, one group consisted of 53 patients for whom a rehabilitation program was available, another group consisted of 84 patients for whom a rehabilitation program was not available. Of the patients with rehabilitation available, there were 20 who were unable to receive rehabilitation, 15 who were able to participate in only light rehabilitation, 27 who were able to walk and 22 who finished rehabilitation. During 3.5 years of follow-up after initial myocardial infarction, the rates of cardiac death were 51% in the group without rehabilitation and 41% in the group with rehabilitation. For 26 patients who died of cardiac events and who had received rehabilitation, there was a positive correlation (r = 0.53) between the level of rehabilitation reached and the survival in years. The incidence of angina pectoris after myocardial infarction was more frequent in the group with rehabilitation. However the exercise activity level was higher and the prognosis was better in the group with rehabilitation, although statistical significance was not found.
Seven elderly patients with hypertrophic obstructive cardiomyopathy (HOCM), who had the three following characteristics on echocardiograms 1) extremely thickened septum, 2) systolic anterior motion of the mitral valve, 3) mid systolic semi-closure of the aortic valve, were clinically evaluated. Ages ranged from 73 to 86 years old (average 78.9% yr.) and all were women. None had not a family history of hypertrophic cardiomyopathy but they had mild hypertension. Six patients showed a significant high voltage on the ST-segment and T-wave abnormalities ("strain" pattern). The left ventricular posterior wall as well as the septum was thickened in 5 and the remaining 2 showed asymmetrical septal hypertrophy (ASH) on echocardiograms. The left ventricular cavity was narrowed due to left ventricular hypertrophy and the shape of the left ventricular cavity was ovoid in all patients. The aorto-septal angles in these 7 patients were 80 degrees to 120 degrees. In addition, proximal septal bulge in all and anterior displacement of the mitral posterior leaflet due to the mitral ring calcification (MRC) in some patients contributed to the narrowing of the left ventricular outflow tract, and the mitral valve was pulled up toward the septum because of the good left ventricular systolic function (ejection fraction: 70 to 94% by echocardiography) and blood was ejected at a high velocity through a narrowed outflow tract (Venturi effect). Pressure gradients in the left ventricular outflow tract was 38 to 146 mmHg in 5 examined by cardiac catheterization. Biopsy specimens were obtained from 2 patients, showing hypertrophic myocytes (diameter: 20 to 30 micron) in 2 and mild disarray in 1.(ABSTRACT TRUNCATED AT 250 WORDS)
The antitumor effect of bleomycin (BLM) ointment in combination with lysozyme (LY) ointment was investigated. Nine-week-old male and female WHT/Ht mice were implanted with a graft of WHT squamous cell carcinoma into the subcutis of back, and the skin covering the developed solid tumor was resected 7 days after implantation. Thereafter, the mice were administered twice daily for 7 days with each of the following: 220 mg of 0.25% BLM ointment, 2.5% LY ointment, and a 1:1 mixture of 0.5% BLM ointment plus 5% LY ointment. BLM ointment and the combination of BLM ointment and LY ointment were effective with an inhibition rate of 79.3 and 89.7%, respectively. The inhibition rates of these groups showed a statistically significant increase over that of control group. Further, the rate of the combination group displayed a statistically significant increase over that of the BLM ointment group. Formation of crusta on the solid tumor was markedly inhibited in the groups applied LY ointment and the combination of LY ointment and BLM ointment. LY was ineffective against cultured cells of WHT squamous cell carcinoma and did not potentiate the antitumor activity of BLM in combination. These results suggest that potentiation of the antitumor effect of BLM ointment in combination with LY ointment is due to inhibition of crusta formation by LY resulting in an increased permeation of BLM into tumor tissue.
The clinical usefulness of serum 5'-nucleotide phosphodiesterase isozyme-V (5'-NPD-V) assay as a serological marker for hepatocellular carcinoma was evaluated. Serum levels of 5'-NPD-V were measured by polyacrylamide gel electrophoresis in 536 Japanese patients with various diseases, including 120 patients with hepatocellular carcinoma. Icteric serum was not an indicator for the measurement of this isozyme, because jaundice gave a non-specific false-positive reaction. In 99 cases of hepatocellular carcinoma without jaundice, 73 (74%) had positive 5'-NPD-V and 24 (24%) showed levels greater than (+ +). The diagnostic value of this isozyme for hepatocellular carcinoma was relatively high, especially in patients with low or negative AFP levels. Diagnostic application for serum 5'-NPD-V assay to small liver tumors was limited. 5'-NPD-V showed false-positive results even in certain cases of benign liver diseases such as chronic hepatitis and liver cirrhosis, but cases with positivities stronger than (+ +) were few. Moreover, the test might be useful for the prediction of liver metastasis in cancer patients, since positive rates were significantly higher in cases with liver metastasis than in those in the non-liver metastasis group.
The epithelial neoplasms were observed on the mouth of the cultured coho salmon, Oncorhynchus kisutch. Histopathologically, the tumors were formed to be proliferative epithelial cells, but no change was observed in other organs. The virus from this tumor was isolated in RTG-2 and CHSE-214 cells and developed the cytopathic effect which characterized to be the formation of syncytia and the migration of chromatin. This virus was neutralized with anti-Oncorhynchus masou virus (OMV) rabbit serum.
We evaluated 12% Au-Ag-Pd alloy cast lower denture plates prepared by dental students in laboratory exercises for casting defects. First, we determined the most suitable exposure conditions for nondestructive radiographic test of 12% Au-Ag-Pd alloy. Subsequently, 130 plates were nondestructively evaluated by radiography under the most suitable exposure conditions. In radiographic testing using X-Omat RP films (Eastman Kodak Co.) and X-Omatic Fine Screen (Eastman Kodak Co.), the most suitable exposure conditions involved a target-to-film distance of 1.9 m, tube voltage of 148 Kvp, tube current of 10 mA, and exposure time of 1.5 sec. Preliminary radiographic examination of artificial casting defects revealed semispherical defects in the diameter of 0.25 mm in 1.6 mm-thick 12% Au-Ag-Pd alloy plates and detects of 0.26 mm in 2.4 mm thick plates. In the 130 cast plates, 56 casting defects were detected. These defects were found at the left webbing part in 40 (30.8%), right webbing part in 36 (27.7%), lingual bar in 7 (5.4%), I-bar in 4 (3.0%), and at other regions of the metal frames in 3 (2.3%) cases. These results indicate that nondestructive radiographic testing is as effective in detection of casting defects in 12% Au-Ag-Pd alloy cast plates as it is in Co-Cr and Ni-Cr alloy plates. This method was also found to be effective in evaluation of the practice metal frames constructed by dental students.
Pure titanium produced by a commercial pure titanium casting system was studied for use as a cast plate for clinical application. The mechanical properties, elemental analysis, castability, adaptability of pure titanium and adhesion to denture base resin were investigated. The interfacial zone of the pure titanium castings was composed of a layered structure obtained by reaction with phosphate bonded Al2O3/SiO2 investment material. Vicher's hardness at 100 microns thick from the surface was higher than that in the inner part by oxidation. Cast pure titanium showed tensile strength, elongation and hardness close to those of the type III or IV dental gold alloy. The castability of pure titanium was lower than that of Co-Cr alloy and pure titanium castings also had large casting defects. Adaptability between pure titanium cast plate and the working model was satisfactory when reversible hydrocolloid impression material was used with heating-bath treatment in the refractory model. The tensile and compressive shear bonding strength of pure titanium to heat-curing or self-curing resin were similar to that of the Co-Cr alloy, and surface treatment using a solution containing 2-vol% 3-methacryloxypropyltrimethoxysilane produced a higher bonding strength than non-treatment, MKV treatment and 4-META treatment. These findings suggest that pure titanium castings produced by this system have suitable mechanical properties, adaptability and adhesion to denture base resin, and is available for cast plate in clinical application.
Adults with untreated malocclusions suffer from more periodontal disease than if their malocclusion had been corrected orthodontically. What orthodontists can offer in the management of patients with periodontal disease, how they can help the periodontists and the patients, and how the periodontists can help the orthodontist make treatment safe and purposefully are widely discussed. The purpose of this study is, therefore, to discuss how orthodontic patients with severe periodontitis could be treated and what we should do for these patients during the treatment as well as at their initial visit. One case is presented as an example of treatment for malocclusion with sever periodontitis: The patient was a 23 years 8 months female with a chief complaint of protrusion of upper incisors. Since clinical examination revealed severe periodontitis, periodontal treatment was undertaken for one year prior to orthodontic treatment. From these observations, we are conviced of the importance again of the global approach and the team treatment method in treating malocclusions with periodontitis.
We investigated the effect of exogenously applied 3-deoxyglucosone, a major carbonyl intermediate, on the Maillard reaction. The fluorescence intensity of the product of the reaction of bovine serum albumin with 3-deoxyglucosone was higher than that with an equivalent amount of glucose. Similarly the rate of polymerization of lysozyme in the presence of 3-deoxyglucosone was also greater than with glucose, and collagen incubated with 3-deoxyglucosone was less digestible than collagen incubated with glucose. By contrast, aminoguanidine inhibited an increase in fluorescence of the Maillard compounds and the polymerization of protein, both of which were stimulated by 3-deoxyglucosone. These results suggest that 3-deoxyglucosone accelerates the advanced stage of the Maillard reaction and that aminoguanidine acts on 3-deoxyglucosone to inhibit its action in the advanced stage of the Maillard reaction.
A 31-year-old male patient with type Ia glycogen storage disease was admitted to our department complaining of general fatigue and right hypochondriac pain. He exhibited massive hepatomegaly with systemic hypoglycemia, lactic acidosis, hyperuricemia, hyperpyruvatemia and hyperlipemia. The failure of blood glucose levels to increase after a glucagon loading test, and a reduced lactate level on glucose tolerance test were also observed. Various imaging techniques suggested hepatic adenoma with hemorrhage in the tumor, which was confirmed histologically. There was a complete absence of glucose 6-phosphatase activity, as determined by an enzyme assay on resected liver specimens, which proved the case to be type Ia glycogen storage disease. We also reviewed all previously reported cases of hepatic tumor and glycogen storage diseases. We conclude that, since hepatic adenoma is not rare in this disease, and is complicated by hemorrhage, rupture and malignancy, careful follow-ups are necessary.
A male case of Swyer-James syndrome, who had been followed for bronchiectasis for a long time, detected at age 70 and diagnosed by radiological studies was reported. The movement of his left diaphragm was impaired. Arterial oxygen tension was 68 torr while breathing room air. Pulmonary function tests showed mixed ventilatory impairment, increase of residual volume, and uneven gas distribution, but diffusing capacity was normal with the single breath method. Chest radiograph revealed hyperlucency of the left lung and the right middle lung field. In these areas, pulmonary angiography showed marked hypovascularity and diffuse vascular atrophy, and perfusion and inhalation scans also showed marked decreased perfusion and ventilation. Pulmonary hypertension was not detected by right heart catheterization. Fiberoptic bronchoscopy was performed and showed no abnormality of the left bronchial tree, and bronchography demonstrated diffuse cylindrical bronchiectasis of the left lung with no alveolar filling. He had suffered from chronic sinusitis for a long time, which might suggest that he had sinobronchitis due to congenital abnormality of the airway and this caused continuous respiratory infection, which could cause this syndrome. Including our own case, about 80 cases of Swyer-James' syndrome have been reported in Japan. But only 4 cases were above 70 years of age and all of them were male, and there has been no female cases above age 50. Males predominate over females, and in both sexes the left lung was more commonly affected than the right.
We report two patients whose intra-aortic balloons exhibited delayed perforation caused by prolonged contact of the balloon against calcific atheromatous plaque. Perforation was diagnosed by the presence of blood in the tube connecting the balloon. Leak detection systems were useless to diagnose this complication. We believe that the balloon immediately should be removed at the presence of blood in the tube.
An autopsy case of primary cerebral malignant lymphoma with choreoathetosis as initial and main symptom was reported. A 57-year-old woman showed choreoathetosis in right upper and lower extremities, and mental aberration. Cranial CT scan showed high density areas in bilateral frontal lobes, right caudate nucleus and putamen, right vermis of cerebellum, left corpus callosum, all of which revealed increased high density by enhancement. The diagnosis of malignant lymphoma was confirmed by the findings of CT scan-guided stereotaxic biopsy. Although the consciousness became gradually drowsy, neurological signs and symptoms and cranial CT scan's findings were improved by radiation therapy. Subsequently, she developed paresis of left upper and bilateral lower extremities and died of sepsis and disseminated intravascular coagulation 8 months after the onset. Neuropathological examination revealed macroscopically atrophy and brawnish discoloration in bilateral caudate nuclei and right globus pallidus. Microscopically, there were invasions of tumor cells in the subependymal perivascular space of ventricles and subarachnoidal spaces of cerebellum and brainstem. The bilateral heads of caudate nuclei revealed severe atrophy, neuronal loss and astrocytic proliferation induced by tumor cell invasion into the head of caudate nuclei, of which body and tail were well preserved. The globus pallidus and putamen did not show any abnormalities on left side, but the right globus pallidus was atrophic, and middle part of putamen and globus pallidus showed tissue rarefaction, loss of myelin, and astrocytic proliferation. However, neuronal cells were relatively preserved. In the spinal cord, the tumor cells invaded to the subarachnoidal and perivascular spaces and necrosis of spinal parenchyma were noted from lower cervical to upper thoracic cord.(ABSTRACT TRUNCATED AT 250 WORDS)