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Biomedical subjects

M Sugiyama

Publications and source records attributed to M Sugiyama.

At least 145 records · Page 8Linked to original sources

Does endoscopic papillary balloon dilation affect gallbladder motility?

BACKGROUND: Endoscopic papillary balloon dilation for treatment of bile duct stones is likely to preserve papillary function. However, endoscopic papillary balloon dilation may affect gallbladder motility. We investigated the effects of endoscopic papillary balloon dilation on gallbladder motility. METHODS: Ten patients with an intact gallbladder (six with and four without gallbladder stones) who underwent endoscopic papillary balloon dilation for choledocholithiasis were studied. Gallbladder motility was examined before and 7 days and 1 month after endoscopic papillary balloon dilation. Gallbladder volume, while fasting and after dried egg yolk ingestion, was determined by ultrasonography. RESULTS: Before endoscopic papillary balloon dilation, particularly in patients with gallbladder stones, the gallbladder showed significantly larger fasting volume and lower yolk-stimulated maximum contraction compared with control subjects. Seven days after endoscopic papillary balloon dilation, fasting volume was decreased and maximum contraction was increased, regardless of the presence of gallbladder stones, with significant differences from the values before endoscopic papillary balloon dilation. One month after endoscopic papillary balloon dilation, these changes were reduced and gallbladder function did not differ significantly from baseline. CONCLUSIONS: After endoscopic papillary balloon dilation, gallbladder motility improves transiently at 7 days but returns to baseline at 1 month. In terms of gallbladder motility, endoscopic papillary balloon dilation does not seem to increase the subsequent risk of acute cholecystitis.

Aged↗

Organogenesis in vitro.

Organogenesis in vitro consists of many aspects such as phytohormone perception, dedifferentiation of differentiated cells to acquire organogenic competence, re-entry of quiescent cells into cell cycle, and organization of cell division to form specific organ primordia and meristems. Some of elementary processes and essential genes involved in this composite phenomenon are being identified largely through genetic analysis with various types of mutants including temperature-sensitive and activation-tagged ones.

Arabidopsis↗

Management of prenatally diagnosed congenital cystic adenomatoid malformation of the lung.

We have treated four prenatally diagnosed cases of extensive congenital cystic adenomatoid malformation (CCAM) of the lung. The first case in 1982 was associated with severe fetal hydrops. After thoracentesis at 31 weeks of gestation abruptio placentae occurred, and a female baby was delivered by cesarean section. She underwent a right lower lobectomy, but soon died. The second baby without hydrops, diagnosed as having CCAM at 26 weeks of gestation, was followed conservatively until full term. After birth, it was necessary to treat the baby boy with extracorporeal membrane oxygenation (ECMO), but he survived. The third baby with fetal hydrops had an indwelling drainage catheter inserted into the CCAM at 27 weeks of gestation. The hydrops subsided and the baby was delivered at 37 weeks of gestation. He was allowed to breathe spontaneously, but was intubated 16 hours after birth. A right lower lobectomy was successfully performed 24 hours after delivery. The fourth baby without fetal hydrops was followed conservatively until delivery. He underwent left lower lobectomy successfully on the 4th day of life. Although management of prenatally diagnosed CCAM varies among patients, insertion of an indwelling catheter into the cyst appears to be the treatment of choice if indicated; the catheter can be maintained for as long as 10 weeks, as shown in Case 3. Cases of CCAM without fetal hydrops should also be treated carefully, because persistent fetal circulation may occur postnatally.

Catheters, Indwelling↗

Differential diagnosis of small polypoid lesions of the gallbladder: the value of endoscopic ultrasonography.

OBJECTIVE: To evaluate the accuracy of endoscopic ultrasonography (EUS) in making a differential diagnosis of small (< or =20 mm) polypoid lesions of the gallbladder. SUMMARY BACKGROUND DATA: Differential diagnosis of these lesions is often difficult using conventional imaging modalities. METHODS: The findings of EUS and transabdominal ultrasonography were retrospectively analyzed in 65 surgical cases of small polypoid lesions (cholesterol polyp in 40, adenomyomatosis in 9, adenoma in 4, and adenocarcinoma in 12). RESULTS: Polypoid lesions exceeding 10 mm suggested malignancy. EUS showed a tiny echogenic spot or an aggregation of echogenic spots with or without echopenic areas in 95% of patients with cholesterol polyps. EUS showed multiple microcysts or comet tail artifact in all adenomyomatosis cases. Adenomas and adenocarcinomas were not associated with the echogenic spots, microcysts, or artifacts. Among adenomas and adenocarcinomas, all sessile lesions were adenocarcinomas. EUS differentiated among polypoid lesions more precisely than ultrasonography (97% vs. 71%). CONCLUSIONS: A tiny echogenic spot or an aggregation of echogenic spots and multiple microcysts or comet tail artifact is pathognomonic for cholesterol polyp and adenomyomatosis, respectively. Polypoid lesions without these findings indicate adenoma or adenocarcinoma on EUS. Routine use of EUS is recommended for differential diagnosis of polypoid gallbladder lesions when ultrasonography shows no signs indicative of either cholesterol polyp or adenomyomatosis.

Adult↗

Immunohistochemical localization of beta-1,4-galactosyltransferase in human pancreatic tissues.

beta-1,4-Galactosyltransferase (GalTase) is the glycosyltransferase in the Golgi apparatus that transfers galactose from UDP-galactose to terminal N-acetylglucosamine residues in glycoconjugates with formation of a beta-1,4 linkage. Neoplasms undergo various changes in the carbohydrate moieties of their glycoconjugates. This process also indicates the possibility of changes in glycosyltransferases themselves. Therefore, we compared the binding pattern of a monoclonal antibody (MAb8628) against GalTase in both normal and neoplastic exocrine pancreatic tissues. Ten normal and 11 neoplastic human exocrine pancreatic tissues obtained from surgery were used. Frozen sections were incubated with this antibody. Supranuclear regions and terminal bars of normal duct cells and acinar cells revealed positive staining for GalTase at the light microscopic level. Centroacinar cells revealed positive staining in their perinuclear region. Neoplastic cells were also stained in their supranuclear regions and terminal bars. Supranuclear regions were well developed in neoplastic cells and intensely stained compared with those in normal cells. The supranuclear regions and the terminal bars corresponded to the trans cisternae of the Golgi apparatus and the junctional complex (i.e., tight junction and adherens junction), respectively, seen at the electron microscopic level. Pancreatic neoplastic changes thus led to an increase in the expression of GalTase in the Golgi apparatus, the increase of which may have an important effect on the intercellular adhesion and communication among pancreatic epithelial cells. Measurement of this enzyme is useful for diagnosis of exocrine pancreatic neoplastic changes from normal tissues.

Adenocarcinoma↗

Crystallization and preliminary X-ray diffraction studies of bleomycin-binding protein encoded on the transposon Tn5.

A bleomycin-binding protein, designated BLMT, encoded on the transposon Tn5 was crystallized using the vapour-diffusion method in a form suitable for X-ray diffraction analysis. Crystals were grown at pH 6.5 in 0.1 M sodium cacodylate and 0.2 M calcium acetate, using 25% PEG 6000 as a precipitant. They belong to the orthorhombic system, space group C2221, with unit-cell dimensions a = 81.56, b = 85.25, c = 78.91 A and one dimer in the asymmetric unit. The diffraction intensity data were collected on beamline 18B of the Photon Factory to 2.0 A resolution with a merging R value of 0.052. The diffraction data set is 91% complete.

Acetyltransferases↗

Molecular epidemiology of rabies in Thailand.

For the purpose of making clear the dynamics of rabies viruses that are prevalent among dogs in Asia, especially Thailand, nucleoprotein (N) genes of isolates derived from Thailand were partially sequenced, and a phylogenetic analysis was performed on the basis of the sequencing data. Firstly, all 27 isolates from Thailand belonged to one group that was distantly related to an isolate from China and was separated into at least six lineages. On the other hand, the isolate from Japan was related to viruses from the Arctic. Secondly, in order to analyze the diversity of the N gene more conveniently, restriction fragment length polymorphism (RFLP) analysis was performed on the N gene of 27 isolates from Thailand. The RFLP analysis could distinguish the lineages of each isolate, and the lineages of additional 34 isolates were deduced by this method. On examination of the geographical distribution of the six lineages, based on the results of phylogenetic and RFLP analyses, it was clear that infection cycles of the rabies virus in Thailand have tended to be maintained endemically.

Animals↗

Does endoscopic sphincterotomy cause prolonged pancreatobiliary reflux?

OBJECTIVE: Endoscopic sphincterotomy (ES) reduces sphincter function, which may allow reflux of pancreatic juice and intestinal contents into the common bile duct. The reflux, if present, may cause development of biliary tract carcinomas, as may anomalous pancreaticobiliary junction. We prospectively investigated pancreatobiliary and duodenobiliary reflux after ES. METHODS: In 15 patients with choledocholithiasis, ductal bile was sampled for amylase concentration and bacterial culture during endoscopic retrograde cholangiopancreatography, before and at 7 days to 5 yr after ES. To provide comparative data, ductal bile was sampled in 11 patients with gallbladder cholesterol polyps or anomalous pancreaticobiliary junction who did not undergo ES. RESULTS: Amylase concentration of ductal bile in patients with choledocholithiasis before ES was not different from that in patients with gallbladder polyps. Its concentration was increased 7 days after ES compared with that before ES, reaching the level of that in patients with anomalous pancreaticobiliary junction. Thereafter, amylase concentration gradually decreased, returning to that before ES by 1 yr. After ES, bactobilia occurred in 60-80% of patients, although none developed acute cholangitis. CONCLUSIONS: Although ES causes transient pancreatobiliary reflux, the reflux is abolished by 1 yr after ES. ES is unlikely to increase the risk for development of biliary tract carcinoma as long as cholangitis or bile duct stones do not recur.

Adult↗

Extrapancreatic neoplasms occur with unusual frequency in patients with intraductal papillary mucinous tumors of the pancreas.

OBJECTIVE: Intraductal papillary mucinous tumor (IPMT) of the pancreas has a favorable prognosis. Non-pancreatic primary neoplasms have potential prognostic significance in patients with IPMT. This study focused on the incidence and characteristics of nonpancreatic neoplasms in IPMT patients. METHODS: Forty-two patients (mean age, 64 yr) with IPMT underwent surgery; 16 had adenoma and 26 adenocarcinoma. Preoperative and postoperative, nonpancreatic neoplasms were investigated. The mean postoperative follow-up period was 4.2 yr (range, 0.2-13 yr). Furthermore, 46 patients with pancreatic ductal adenocarcinoma were analyzed for nonpancreatic neoplasms. RESULTS: Five-year survival rates were 100% for benign and 82% for malignant IPMT. Twenty patients (48%) had nonpancreatic neoplasms, before (n = 11), at (n = 4), and after (n = 10) surgery for IPMT. Fifteen patients (32%) had nonpancreatic malignancies. Nonpancreatic neoplasms included colorectal adenomas (21%) and adenocarcinomas (12%), and gastric carcinomas (10%). One patient died of subsequent bile duct carcinoma. Development of nonpancreatic neoplasms was related to age but not to gender, family history, adjuvant chemotherapy, or IPMT pathology. The incidences of nonpancreatic neoplasms and malignancies were significantly higher in patients with IPMT than in those with pancreatic ductal adenocarcinoma (11% and 7%, respectively). CONCLUSIONS: IPMT is associated with a high incidence of nonpancreatic neoplasms, particularly colorectal neoplasms. In IPMT patients, systemic surveillance may allow early detection of second tumors. In preoperative screening and postoperative follow-up of patients with nonpancreatic neoplasms, the possibility of IPMT should be considered.

Adenocarcinoma, Mucinous↗

Synthesis of 2-phenylbenzofuran derivatives as testosterone 5 alpha-reductase inhibitor.

A series of 2-phenylbenzofuran derivatives with a carbamoyl, alkylamino, or alkyloxy group at the 5 or 6 position of the benzofuran ring were synthesized and evaluated for rat and human testosterone 5 alpha-reductase inhibitory activities in vitro. Against rat enzyme, the carbamoyl derivatives had more potent inhibitory activities than the alkylamino or alkyloxy derivatives, and the 6-carbamoyl derivatives tended to be more potent than the 5-carbamoyl derivatives. Against human enzyme, the 6-substituted derivatives had more potent inhibitory activities than the 5-substituted derivatives. The 6-carbamoyl and 6-alkylamino derivatives tended to show stronger inhibitory activities against human type 1 enzyme than against type 2 enzyme, but they were not largely selective.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

Structural characterization of the 16-kDa allergen, RA17, in rice seeds. Prediction of the secondary structure and identification of intramolecular disulfide bridges.

The 16-kDa rice allergen, RA17, belonging to the alpha-amylase/trypsin inhibitor family was isolated from rice seed and structurally characterized by identifying cystine-containing peptides and predicting the secondary structure and hydrophobic regions. Eight peptides, which constitute three sets of cystine-containing peptides, were purified by HPLC from a thermolytic digest of RA17 and identified by their amino acid sequence and composition, indicating five intramolecular disulfide bridges: Cys34-Cys94, Cys26-(Cys50 or Cys51)-Cys110 and Cys12-(Cys62 or Cys64)-Cys122. Analyses of the CD spectrum and the Chou-Fasman prediction suggested that RA17 had some helical- and sheet-structure regions. Based on these experimental and predicted data, RA17 is proposed to be a globular molecule with a small hydrophobic core having folding restricted by five intramolecular disulfide bridges.

Allergens↗

Nasal nocardiosis in a calf.

Nasal nocardiosis was found in a female Japanese Black calf, 11 months of age. Macroscopically, the posterior half of the left nasal passage was completely obstructed by yellowish brown caseous substance and the mucosa was irregularly thickened. In the brain, a few soft brown foci were present in the olfactory bulb and frontal lobe. Microscopically, there were closely packed granulomas in the nasal cavity and brain. The lesions were characterized by a center of cellular debris surrounded by epithelioid macrophages, neutrophils, lymphocytes and multinucleated giant cells of the Langhans type. Special stains revealed the presence of a large number of filamentous branching gram-positive, partially acid-fast organisms in these epithelioid cells and giant cells, and in cellular debris.

Animals↗

Observation of marking-like behavior, marking behavior, and growth of the scent gland in young Mongolian gerbils (Meriones unguiculatus) of an inbred strain.

A marking-like behavior (defined by authors), a marking behavior, and growth of the scent glands were observed in young Mongolian gerbils of an inbred strain. In males and females, a marking-like behavior, in which animals rub their abdominal scent glands on the floor, began to be seen at the age of 19 days and could be seen in almost all the gerbils at 22 days of age during the suckling period. The frequency of this behavior was highest at 60 days of age (males: 17.9/10 min, females: 15.4/10 min) and there was no sex difference. Marking behavior, in which animals rub their abdominal scent glands on small protruding objects, began to be seen at the age of 40 days in males and 50 days in females. The frequency of this behavior tended to increase until 90 days of age in males (13.7/10 min), but the levels were low (2.5-5.0/10 min) in females. The values in the male group therefore tended to be higher than that in the female group. Macroscopic scent gland pads were clearly observed at the age of 30 days in males, but not until 45 days of age in females. At the age of 45-90 days, the length of the scent gland pad in males and females was 2.1-2.8 and 1.6-1.7 cm, respectively and the width was 0.3-0.5 in males and 0.2-0.3 cm in females. During this period, the length and depth of the pads in males were significantly greater than those in females (p < 0.05). Histological examination of the structure of the scent glands after the age of 45 days showed that the development of clusters of acinar cells in females occurred much later than that in males, but the basic structure of these glands was similar in both sexes. These results suggest that the marking-like behavior was manifested although during the period when the scent glands had not yet developed, whereas true marking behavior first occurred when the glands were moderately well developed.

Aging↗

A mammalian vector carrying the bleomycin N-acetyltransferase gene from bleomycin-producing Streptomyces verticillus as a selective marker.

A gene, blmB, encodes a bleomycin (Bm) N-acetyltransferase, designated BAT, from Bm-producing Streptomyces verticillus and confers resistance to Bm in Streptomyces and Escherichia coli. COS-1 cells transfected with a plasmid designated pEF-BOS/blmB, in which blmB is under the control of a strong promoter from the human polypeptide chain elongation factor 1alpha, transiently produced BAT. Immuno-cytochemical analysis using an anti-BAT monoclonal antibody revealed that BAT was localized in the nucleus of the blmB-carrying COS-1 cells. NIH/3T3 cells, transfected with pEF-BOS/blmB, stably expressed BAT at least for one month. The stable transformants of blmB showed specific resistance to the Bm family of antibiotics, suggesting that blmB has potential as a selective marker in gene transfer studies with mammalian cells.

Acetyltransferases↗

Reappraisal of intraoperative ultrasonography for pancreatobiliary carcinomas: assessment of malignant portal venous invasion.

BACKGROUND: Conventional preoperative imaging modalities are unreliable for assessing portal venous invasion by pancreatobiliary carcinoma. We evaluated the usefulness of intraoperative ultrasonography for detecting pancreatobiliary carcinoma and assessing portal venous invasion, compared with other imaging modalities. METHODS: Ninety-one patients with pancreatic carcinoma (n = 66) or bile duct carcinoma (n = 25) underwent ultrasonography, computed tomography, angiography, and endoscopic ultrasonography preoperatively. All these patients underwent tumor resection, with (n = 23) or without (n = 68) portal vein resection, after intraoperative ultrasonography. Portal venous invasion was histologically examined in all patients. RESULTS: Intraoperative ultrasonography was significantly more sensitive (100%) than ultrasonography (79%), computed tomography (81%), and angiography (54%) for detecting carcinomas, especially bile duct carcinomas and small (< or = 2.0 cm) tumors. Portal venous invasion was confirmed histopathologically in 25 patients. For diagnosing portal venous invasion, intraoperative ultrasonography was more sensitive (92%) and specific (92%) than ultrasonography (56% and 73%), computed tomography (64% and 79%), and angiography (76% and 83%), respectively. Endoscopic ultrasonography showed a 95% detectability for carcinomas and a 92% accuracy for assessing portal venous invasion. CONCLUSIONS: Intraoperative ultrasonography is a simple and accurate procedure for detection of pancreatobiliary carcinomas and assessment of portal venous invasion.

Adult↗

[Clinical outcome of emergency coronary artery bypass grafting for acute myocardial infarction with cardiogenic shock].

From January 1993 through December 1998, Emergency Coronary Artery Bypass Grafting was Performed within 24 Hours after the Onset of Acute Myocardial Infarction (AMI) with Cardiogenic Shock in 22 Patients (17 men and 5 women; aged, 52-81 years). The incidence of AMI involving the left main coronary artery was 50%. The incidence of interventional therapy was 40.9% (PTCA 31.8%; PTCR 9.1%). The condition in 95.5% of the patients could be stabilized hemodynamically by preoperative intraaortic balloon pumping; 4 of the 5 patients suffered from cardiopulmonary arrest required percutaneous cardiopulmonary support. There were 4 (18.2%) deaths overall. Operative mortality was related to the intervals between AMI and operation (less than 6 hours, 25%; 6 to 24 hours, 10%). Three of the 4 patients who received cardiopulmonary support survived. We conclude that early revascularization and minimal reperfusion injury caused by mechanical devices are important determinants of survival in patients who have AMI with cardiogenic shock.

Aged↗