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Biomedical subjects

M Tsushima

Publications and source records attributed to M Tsushima.

At least 55 records · Page 3Linked to original sources

Common mutations in the low-density-lipoprotein-receptor gene causing familial hypercholesterolemia in the Japanese population.

Familial hypercholesterolemia (FH) is a common genetic disorder caused by mutations of the LDL-receptor gene. In the present study, we investigated four Japanese FH homozygotes and identified five point mutations: a splice site mutation in intron 12 (the 1845 + 2 T-->C mutation), a missense mutation in exon 7 (the C317S mutation), a nonsense mutation in exon 17 (the K790X mutation), a missense mutation in exon 14 (the P664L mutation), and a missense mutation in exon 4 (the E119K mutation). We developed simple methods for detecting these mutations. When we examined the presence of these mutations in 24 unrelated FH homozygotes, the 1845 + 2 T-->C mutation was found in 7 of them, and the other four mutations were unique for each proband. We also screened 120 unrelated FH heterozygotes for these mutations and found that the frequencies of the 1845 + 2 T-->C, C317S, K790X, P664L, and E119K mutations were 13.3% (16/120), 6.7% (8/120), 6.7% (8/120), 3.3% (4/120), and 1.7% (2/120), respectively. These mutations were found in more than 30% of unrelated Japanese FH patients. By using the detection methods developed in this study, the diagnosis of more than 30% of the genetic bases of Japanese FH heterozygotes is expected.

Adult↗

Tissue factor pathway inhibitor activity in human plasma. Measurement of lipoprotein-associated and free forms in hyperlipidemia.

Tissue factor pathway inhibitor (TFPI), a protease inhibitor that is present in free and lipoprotein-associated forms in plasma and that also occurs as an endothelial cell-associated form, can inhibit the initial reactions of the tissue factor-mediated coagulation pathway. Although a positive correlation between plasma TFPI activity and cholesterol concentration in human plasma has been demonstrated, levels of the various forms of TFPI, ie, the LDL/VLDL-associated form, the HDL-associated form, and the free form, have not yet been completely determined in hyperlipidemia. We therefore established a method for the measurement of each of these forms of TFPI in plasma by gel filtration of plasma in buffer containing 1 mol/L NaCl. The recovery of TFPI activity in the free form was markedly greater as assessed by the new method than the recovery reported when other methods have been used. We employed the new method to analyze TFPI activity in 19 hyperlipidemic patients and compared the results with those for normal control subjects. The level of LDL/VLDL-associated TFPI in hyperlipidemic patients was significantly increased compared with control subjects' levels (0.383 +/- 0.112 versus 0.237 +/- 0.077 U/mL), whereas the level of the free form of TFPI in hyperlipidemic patients was significantly decreased (0.381 +/- 0.132 versus 0.495 +/- 0.106 U/mL), the former being positively correlated with cholesterol level, while the latter was negatively correlated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Inhibitory effect of natural carotenoids on Epstein-Barr virus activation activity of a tumor promoter in Raji cells. A screening study for anti-tumor promoters.

As a screening study for anti-tumor promoters, 51 carotenoids with diverse structures were examined for their inhibitory effects on the Epstein-Barr virus activation activity of 12-O-tetradecanoylphorbol-13-acetate (TPA) in Raji cells. The results showed that most of the carotenoids exhibited inhibitory activity, and in general, no cytotoxicity on Raji cells was observed in the assay. Among the carotenoids, beta-cryptoxanthin, lutein, and lactucaxanthin showed the strongest inhibitory activity, superior to the well known anti-tumor promoter, beta-carotene. Heteroxanthin, peridinin, and halocynthiaxanthin showed cytotoxicity at the high concentration (1000 molar ratio per TPA), but indicated a strong inhibitory effect at the lower concentrations, which were only weakly toxic (500 and 100 molar ratios). Based on these results, the essential moiety for the activity of carotenoids was considered to be the 3-hydroxy-epsilon-end group.

Antineoplastic Agents, Phytogenic↗

[Alcohol-induced hypertriglyceridemia in subjects with decreased lipoprotein lipase--improvement after cessation of alcohol intake].

We systematically investigated the effect of lipoprotein lipase (LPL) and alcohol intake on the development of primary type IV hyperlipoproteinemia which is manifested as a moderate increase in serum triglycerides as a consequence of an elevated very low density lipoprotein concentration and a normal level of serum cholesterol. Twenty six type IV hyperlipoproteinemic and 28 normolipidemic males underwent measurement of the immunoreactive LPL mass in postheparin plasma (30 unit of heparin/kg of body weight) and were interviewed as to their alcohol consumption. They were divided into 4 groups, with a LPL mass of 150ng/ml (20 percentile of the normal range) and an alcohol intake of 33g/day as the borderlines. All subjects with LPL mass less than 150ng/ml and alcohol intake of more than 33g/day were prone to manifest type IV hyperlipoproteinemia. One of the subjects in this group showed a recovery to normolipidemic state after cessation of alcohol intake. Subject whose LPL mass value was more than 180ng/ml (50 percentile of the normal range) were not susceptible to type IV hyperlipoproteinemia even though they drank alcohol more than 33g/day.

Alcohol Drinking↗

Acute effect of low-calorie and low-carbohydrate diet on serum triiodothyronine-response to glucose ingestion and its relation to glucose tolerance.

This study was conducted to elucidate the mechanism of glucose intolerance due to carbohydrate restriction. 15 non-diabetic patients, aged 51 +/- 3 yr, were placed under dietary condition-I (2,012 kcal/day; carbohydrate 299 g) for more than 3 days after admission and then condition-I was substituted by condition-II (1,156 kcal/day; carbohydrate 139 g) for 2 weeks. At the end of condition-I and -II, 75 g OGTT was performed. After the comparison between condition-I and -II, patients were subdivided into two groups, namely, glucose tolerance-improved (n = 8) and -impaired (n = 7) groups. In the former, sigma glucose (mg/dl) during OGTT decreased from 898.1 +/- 28.0 to 738.5 +/- 36.0 (p < 0.05) and sigma IRI (microU/ml) decreased from 418.8 +/- 60.1 to 300.7 +/- 33.5 (p < 0.05) but sigma dT3 (ng/dl) increased from 11.3 +/- 14.7 to 70.3 +/- 15.1 (p < 0.05). In the latter, sigma glucose (mg/dl) increased from 774.6 +/- 46.6 to 867.1 +/- 50.1 (p < 0.05) and sigma IRI (microU/ml) increased from 323.4 +/- 47.8 to 400.8 +/- 47.8 (p < 0.05) but sigma dT3 (ng/dl) decreased from 45.3 +/- 7.1 to 20.0 +/- 14.7 although it did not reach a level of statistical significance. These results suggest that blunted serum T3-response to glucose ingestion is linked to the mechanism of glucose intolerance due to carbohydrate restriction.

Blood Glucose↗

Noninvasive quantitative evaluation of early atherosclerosis and the effect of monatepil, a new antihypertensive agent. An interim report.

In two studies on the same group of patients we evaluated noninvasive methods of assessing atherosclerosis and determined the effect of the new calcium channel-blocking agent monatepil on the progression of early atherosclerosis in humans. Computed tomography (CT) of the lower abdominal aorta and ultrasonography of the carotid arteries were used as noninvasive methods to determine the extent of atherosclerosis. To evaluate the CT images, we developed a new medical image analysis program. This enabled aortic calcification volume (ACV) to be quantified using plain CT images, and aortic wall volume (AWV) and aortic wall and calcification volume (AWCV) to be quantified from contrast CT images. Interobserver coefficients of variation of ACV, AWV, and AWCV (n = 8) were 4.7, 2.4, and 5.0%, respectively. In the monatepil study, the effect of the drug on serum lipid profiles was evaluated. Preliminary results show that shortly after monatepil administration, total serum cholesterol levels decreased significantly from 253.8 +/- 35.6 to 244.8 +/- 38.6 mg/dL (P < .009) and triglyceride levels tended to decrease. A positive correlation between the change in total cholesterol and changes in mean platelet volume was found (P = .028). Fasting immunoreactive insulin levels decreased in the four patients in which they were determined. Although this is a preliminary study, results indicate that CT of the lower abdominal aorta in combination with our new analysis program may be a precise, reproducible means of assessing early atherosclerosis. We have also shown that monatepil significantly decreases total cholesterol levels. However, the long-term effects of monatepil on the progression of atherosclerosis remain to be determined.

Aged↗

[Minimum required number of anesthetists for general hospitals (41-1300 beds) in Japan--analysis of questionnaire, 1992].

BACKGROUND: We have elucidated the deficit of anesthetists in general hospitals excluding university hospitals by assessing the results of questionnaires from 204 institutions in Japan. METHODS: Answers to the questionnaire were computed in average, maximum, and minimum values, using MS-Excel soft ware for statistical analysis. RESULTS: The 204 hospitals were classified into 4 groups; G-1(46)-more than 640 beds, G-2(53)-more than 500 beds, G-3(53)-more than 360 beds, and G-4(52)-less than 359 beds, respectively (parenthesis indicate hospital numbers). The number of cases of anesthesia performed by anesthesiologists were 2055(G-1), 1516(G-2), 1177(G-3) and 959(G-4), respectively. The number of anesthetists per operating table were as follows; 0.62(G-1), 0.62(G-2), 0.58(G-3) and 0.74(G-4), but remarkably low compared to the number of operating theater nurses: 5.49(G-1), 2.96(G-2), 2.82(G-3) and 3.07(G-4). Moreover, the number of emergency cases were as follows; 235(G-1), 187(G-2), 134(G-3) and 125(G-4), respectively. In prolonged surgery over 6 hours, patients were anesthetized with an exchange system or two anesthetists system in 74% of the institutions in G-1. Also, 28-50% of anesthetists in the 4 groups were concerned with intensive care medicine and 0.94-1.54 anesthetists worked in pain clinics with combined operation-theater tasks 1.37-2.49 days per week. In G-1-G-4 institutions, we found that anesthesia cases per year were equivalent to 5 times their bed numbers. CONCLUSION: We concluded that the number of anesthetists should be at least 50% of that of operation-theater nurses. Without increasing anesthesiologists, we cannot expect sophisticated medical care in the 21st century.

Anesthesiology↗

[Quantitative and qualitative alterations of plasma lipoproteins in obesity].

In order to clarify lipoprotein abnormality in mild to moderate obesity (BMI > or = 25), plasma was separated by table top ultracentrifugation into VLDL (chylomicron), IDL, LDL and HDL. Chol, TG and ApoB were determined in each fraction by enzymatic and sensitive Latex method. The data were analysed according to glucose intolerance and hyperinsulinemia (HI). In obese subjects, irrespective of glucose intolerance, Chol, TG & ApoB levels were high in plasma, and an increase in VLDL (Chol, TG & ApoB), IDL (Chol & ApoB), LDL (Chol & ApoB), and a decrease in HDL-Chol were observed. These levels were also abnormal in nonDM particularly with HI. In DM, HI did not seem to affect hyperlipidemia. Correlation between Chol, TG and ApoB in three ApoB containing lipoprotein subfractions was noted in obesity. The ratio of Chol/ApoB and TG/ApoB in LDL was significantly lower in obesity implying that LDL particles were smaller in size. Half of nonDM patients had HI, and only 29% of DM patients had HI, and both groups had almost the same lipoprotein abnormality. Hyperlipidemia was severe in nonDMHI(+) compared to nonDMHI(-). Therefore, in hyperlipidemia of obesity, hyperinsulinemia plays a role in nonDM and hyperglycemia in DM. Insulin resistance seems to be an important factor in DM. Although the mechanism may be different, the consequence of hyperlipidemia is similar. Increased numbers of ApoB containing lipoproteins and smaller size of LDL are the characteristic features of hyperlipidemia in mild to moderate obesity. Because these quantitative and qualitative changes appear to be linked to an increased risk for premature arteriosclerosis, intensive therapy should be recommended even in mild to moderate obesity.

Apolipoproteins B↗

A sensitive peroxidase staining immunoblotting method for measuring total protein S in human plasma.

In plasma, protein S is found in its free form and as a complex with C4b-binding protein. After 125I-protein S was added to normal human plasma and applied to SDS-8% polyacrylamide gel electrophoresis, the autoradiogram of the gel showed only one single band at free protein S position. Applying this evidence, we have developed a peroxidase staining Western Blotting method to quantitate total protein S in human plasma which consists of sodium dodecyl sulfate polyacrylamide gel electrophoresis followed by blotting to nitrocellulose membrane and a sensitive avidin-biotinylated peroxidase staining method (ABC technique). The measurement of protein S by the immunoblotting was reproducible and the coefficient of variation was 7%. As little as 1 ng of protein S could be detected. C4b-binding protein did not affect the measurement of protein S. Compared to other immunoassays, this peroxidase staining immunoblotting method has the advantage of directly estimating the apparent molecular weight of protein of interest, eliminating nonspecific stain and having high sensitivity without using radioisotope.

Avidin↗

Effect of reduced alcohol consumption on blood pressure in untreated hypertensive men.

Fifty-four untreated, mildly hypertensive men whose daily alcohol consumption was > or = 28 ml ethanol and who drank at least 4 times per week took part in a randomized, controlled crossover trial. The purpose of the trial was to test the effects of alcohol reduction on blood pressure. After a 2-week familiarization period, the participants were assigned to either a reduced alcohol drinking group or a usual drinking group for 3 weeks (experimental period 1). The situation was then reversed for the next 3 weeks (experimental period 2). The participants were requested to limit their daily alcohol consumption to zero or reduce it as much as possible for the reduced alcohol consumption period. The self-reported alcohol consumption was 56.1 +/- 3.6 (SEM) ml/day during the usual alcohol drinking period and 26.1 +/- 3.0 ml/day during the period of reduced alcohol consumption. Systolic and diastolic blood pressures in the intervention group were found by analysis of variance to be significantly lower (2.6-4.8 and 2.2-3.0 mm Hg, respectively) than those in the control group during experimental period 2 for systolic blood pressure and experimental period 1 for diastolic blood pressure. Significant (3.6 mm Hg) and nonsignificant (1.9 mm Hg) decreases in systolic and diastolic blood pressure, respectively, were observed. The method of Hills and Armitage was used, reducing ethanol in daily alcohol consumption by 28 ml. The lowering effect of reduced alcohol consumption on blood pressure was independent of changes in salt consumption, which were estimated by 24-hour urine collection and body weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Progress in diagnosis of arteriosclerosis in humans--review].

Most of cerebrovascular diseases or ischemic heart diseases, the major causes of death in Japan, occur as terminal symptoms of atherosclerosis. Much effort has been made to prevent these diseases and also to assess premature atherosclerosis. Recently, new models of tools for diagnosis has been developed. There are several ways to determine the existence of atherosclerosis, namely (1) to find the major risk factors of atherosclerosis such as hyperlipoproteinemia, hypertension, diabetes mellitus and/or smoking, and also (2) for apparent cardiovascular patients, to examine the pathogenesis of the disease by using invasive methods such as selective arteriography, intravasculoscopy, and intravascular ultrasonic examination, if necessary, and (3) for asymptomatic people, to apply hypoinvasive examinations such as the ultrasonic examination, the computed tomography and magnetic resonance angiography. As a non-invasive diagnostic method, we have been trying to assess the progression of atherosclerosis clinically by computed tomography (CT) of the abdominal aorta. Recently we developed a new computer program to define the wall thickening and calcification of aorta on personal computer. In the near future, progression and regression collaboration studies in Japan may be achieved.

Arteriosclerosis↗

Anti-neoplastic effect of halocynthiaxanthin, a metabolite of fucoxanthin.

We have reported that fucoxanthin, a natural carotenoid, inhibited the growth of human neuroblastoma GOTO cells. In the present study, we show that a metabolite of fucoxanthin, halocynthiaxanthin, which is isolated from sea squirt Halocynthia roretzi, has a more potent inhibitory effect. Halocynthiaxanthin (5 micrograms/ml) caused complete suppression of GOTO cell proliferation, whereas fucoxanthin reduced the growth rate by only 88.8% compared with the control, at day 2 after the drug treatment. Furthermore, halocynthiaxanthin also inhibited the growth of other human malignant tumor cells. Thus halocynthiaxanthin seems to be a promising anti-neoplastic agent.

Antineoplastic Agents↗

Siblings with normal LDL receptor activity and severe hypercholesterolemia.

We report about a brother and sister having clinical symptoms similar to those of homozygous familial hypercholesterolemia (FH) but surprisingly who have normal low density lipoprotein (LDL) receptor activities (M. Harada-Shiba et al, J Jpn Atheroscler Soc 1991; 19:227-242). The LDL receptor activities in the cultured fibroblasts of the patients were compared with those of FH heterozygotes and homozygotes for the LDL receptor mutation. The LDL receptor activities in the cultured fibroblasts of the patients were in the normal range, but their plasma cholesterol concentrations were similar to patients with homozygous FH. After the plasma LDL was removed by plasmapheresis in both patients, plasma cholesterol levels started to increase. The "rebound" of plasma cholesterol was compared with those for heterozygous and homozygous FH. The plasma cholesterol levels of the patients, which were greater than 410 mg/dl 2 weeks after plasmapheresis, were much higher than those of FH heterozygotes (232-311 mg/dl) but similar to those of FH homozygotes (345-464 mg/dl). The urinary mevalonate excretion rate, which reflects the rate of whole-body cholesterol synthesis, was higher for the brother (patient 1, 32.6 nmol/kg.day-1) than for the normal subjects (17.7 +/- 4.1 nmol/kg.day-1) but was similar to those of FH homozygotes (31.2 +/- 4.3 nmol/kg.day-1) and heterozygotes (29.8 +/- 10.9 nmol/kg.day-1). To estimate the catabolic and production rates of cholesterol in the brother, the time course for the increment in the total cholesterol level after plasmapheresis was analyzed by the two-compartment model.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Changes in coagulation factors by passage through a dextran sulfate cellulose column during low-density lipoprotein apheresis.

To determine the extent of adsorption of coagulation factors by a dextran sulfate cellulose column used for selective removal of low-density lipoprotein (LDL), various coagulation factors were measured before and after application to the column during LDL apheresis. The column almost completely adsorbed many coagulation factors. Although the bradykinin concentration was markedly increased by passing the plasma through the column, this increment was suppressed by nafamostat mesilate which inhibits the initial contact phase of the intrinsic coagulation pathway. The von Willebrand factor, which forms a complex with factor VIII in plasma, is reduced in apheresis with nafamostat mesilate to the same extent as in apheresis without nafamostat mesilate. Thus, coagulation factors seem to be adsorbed by different mechanisms which include activation of the initial contact phase by the negative charges of dextran sulfate and concomitant adsorption with the phospholipid portion of lipoproteins containing apolipoprotein B or with von Willebrand factor.

Adolescent↗

A case of diabetic non-ketotic hyperosmolar coma with an increase with plasma 3-hydroxybutyrate.

We have seen a case of "diabetic non-ketotic hyperosmolar coma" with ketosis. An 84-year-old man was brought into the hospital in a deeply comatous and dehydrated state. The initial blood glucose level was 1252 mg/dl with plasma osmolarity of 435 mOsm/l, but no ketonuria was detected by the nitroprusside method (Ketostix). However, the plasma 3-hydroxybutyrate (3-OHBA) level was 5 mM in a newly developed bedside film test. The serum ketone bodies were later found to be 5.56 and 0.82 mmol/l for 3-OHBA and acetoacetate (AcAc), respectively. A marked increase in glucagon, cortisol and ADH with renal dysfunction (creatinine 5.0 mg/dl) were noted. An abnormal electrocardiogram, occular convergence and chorea like movement disappeared after correction of metabolic disturbances. The moderate level of IRI (14 microU/ml) on admission and a good response to glucagon 2 months after admission also indicate that the present case is a typical hyperosmolar non-ketotic coma. Because of a preferential increase in 3-OHBA, ketonuria seemed to be absent in the regular nitroprusside test. Marked dehydration is thought to cause renal dysfunction, and the increase in ADH may have helped to prevent further aggravation of ketoacidosis. We propose to change the term hyperosmolar non-ketotic coma (HNC) to diabetic hyperosmolar coma (DHC), because sometimes patients with hyperosmolar non-ketotic diabetic coma are ketotic, as seen in the present case. Determination of 3-OHBA or individual ketone bodies in blood is important and essential for the differential diagnosis of diabetic coma. The diagnosis of either ketoacidotic or hyperosmolar coma should be made depending on the major expression of ketoacidosis or hyperglycemic hyperosmolarity.

3-Hydroxybutyric Acid↗

Diurnal changes in serum melatonin concentrations under indoor and outdoor environments and light suppression of nighttime melatonin secretion in the female Japanese monkey.

To examine whether artificial light with the intensity commonly used for animal experimentation can mimic natural sunlight with respect to diurnal changes in serum melatonin, and to determine the minimum light intensity required to suppress nocturnal melatonin, serum melatonin profiles were examined in groups of female Japanese monkeys (Macaca fuscata fuscata). Under outdoor environment, light intensities at the level of the monkey's eyes varied during daytime (0900-1500 h) depending on weather conditions (minimum and maximum on particular experimental days: 170 lux at 0900 h on a rainy day and 9500 lux at 0900 h on a slightly cloudy day); under indoor environment, light was provided by ordinary fluorescent bulbs that resulted in intensities of 400-500 lux at the level of monkey's eyes. No difference was found in diurnal changes in serum melatonin concentrations regardless of weather or housing conditions: Serum melatonin remained low during daytime and increased during nighttime. Following exposure to light, irradiances of 10,000, 400-500, 100-140, 50-100, and 10-30 lux at midnight resulted in a rapid decrease in serum melatonin to daytime levels within 1 to 2 h. After the onset of dark, serum melatonin reverted to previous nighttime levels within 2 h. Exposure to a light irradiance of 2-5 lux, however, did not suppress nocturnal melatonin secretion. It is concluded that artificial light can mimic natural sunlight with respect to melatonin secretion in the female Japanese monkey, and that light of 10-30 lux irradiance was sufficient to suppress serum melatonin to near daytime levels.

Animals↗