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Biomedical subjects

M Ueno

Publications and source records attributed to M Ueno.

At least 109 records · Page 6Linked to original sources
PubMed2000

Long-term changes of hemodynamics and metabolism after carotid artery occlusion.

OBJECTIVE: To investigate whether in selected patients with internal carotid artery (ICA) occlusion and initially normal oxygen extraction fraction (OEF) measured with PET, subsequent changes of cerebral hemodynamics and metabolism occur during long-term follow-up and, if so, whether the changes are associated with atrophy of the corpus callosum or subsequent ischemic strokes. BACKGROUND: The course of the changes in cerebral hemodynamics and metabolism after ICA occlusion remain unclear. After ICA occlusion, an increase in OEF may increase the risk of cerebral ischemia, and an increase in cortical ischemia would cause progression of callosal atrophy. METHODS: The authors used PET and MRI to examine twice seven medically treated patients with unilateral ICA occlusion and initially normal OEF at intervals ranging from 24 to 64 (mean +/- SD, 42 +/- 17) months. No intervening ischemic attacks occurred between the two examinations. RESULTS: In the hemisphere with ICA occlusion, OEF increased and blood flow decreased during follow-up. At the follow-up evaluation, abnormally increased OEF values were found in three patients, in whom ipsilateral ischemic strokes occurred during subsequent follow-up (18 +/- 6 months). A decrease in oxygen metabolism also occurred and was significantly correlated with the decrease of callosal size. CONCLUSIONS: These preliminary findings in a small, selected patient sample suggest that in patients with ICA occlusion and initially normal OEF, deteriorations of cerebral hemodynamics and metabolism during long-term follow-up may be associated with callosal atrophy or subsequent ischemic strokes.

Aged↗
PubMed2000

Glycoprotein Ibalpha-bound thrombin functions as a serine protease to produce macromolecular activators of phagocytosis from platelets.

Production of macromolecular activators of phagocytosis from platelets (MAPPs) was observed when the lysate of fresh platelets was incubated with MAPP precursors and thrombin. An 800-Da MAPP activator (PMA-II) was obtained by Superdex peptide gel filtration of the lysate after thrombin treatment. The necessity of thrombin in MAPP production in fresh platelets was confirmed by the action of anti-thrombin monoclonal antibody or anti-thrombin III and heparin. To specify the thrombin receptor on which the thrombin forming PMA-II binds, the effects of thrombin-receptor-derived peptides and anti-thrombin receptor antibodies on MAPP production by stored platelets which have lost their thrombin content were investigated. DYYPEEDTEGD involved in glycoprotein Ibalpha and anti-glycoprotein Ibalpha antibody prevented stored platelets from producing MAPP. These observations suggest that thrombin bound to glycoprotein Ibalpha functions as a serine protease in MAPP formation.

Amino Acid Sequence↗
PubMed2000

Lateral ligament: its anatomy and clinical importance.

Since Miles proposed abdominoperineal excision as a radical surgery for rectal cancer in 1908, surgeons have recognized the lateral ligament in the pararectal space of their patients and attached clinical importance to it, although anatomists did not describe any such configuration in cadavers. By analyzing an experience of 421 lower rectal cancer cases at the Cancer Institute Hospital in Tokyo, discussion of the lateral ligament was focused on its relationship to the fascial arrangements in the pelvis, the pelvic autonomic nervous system, and the lymphatic drainage of the rectum. The lateral ligament is not an anatomical term, but a clinical or surgical one. It exists in a living pelvis as a condensation of connective tissue around the middle rectal artery and is divided into two segments by the inferior hypogastric nerve plexus inside it and the visceral endopelvic fascia around it. The lateral ligament is a pathway of blood vessels and nerve fibers toward the rectum and lymphatic vessels from the lower rectum toward the iliac lymph nodes. Therefore, the lateral ligament plays a critical role in surgery for lower rectal cancer in two respects: the anatomic extent of resection for curing rectal cancer, and the preservation of sexual function.

Collateral Ligaments↗
PubMed2000

Differential induction of JE/MCP-1 in subclones from a murine macrophage cell line, RAW 264.7: role of kappaB-3 binding protein.

The JE/MCP-1 gene is an immediate-early gene, and its product is a CC chemokine that attracts monocytes, basophils and T lymphocytes. JE/MCP-1 gene expression is induced by various inflammatory stimuli, but its transcriptional mechanism is not fully understood. To address this question, we obtained two subclones from a parental RAW264.7 cell line, one subline with low JE/MCP-1-producing capacity (named RAW.c11) and the other with high JE/MCP-1-producing capacity (named RAW.c25), in response to lipopolysaccharide (LPS). These subclones have no significant differences in CD14 expression, nitric oxide production, or production of other cytokines, including TNF-alpha or IL-1alpha/beta. In electrophoretic mobility shift assays (EMSA), there were no significant differences in DNA binding to the NF-kappaB-consensus sequence and interferon regulatory factor (IRF)-1,2 binding sequences. However, significantly higher binding activity to the NF-kappaB-like sequence (kappaB-3), which is located in the promoter region of the JE/MCP-1 gene, was shown by a high producer subclone than by a low producer subclone. Transient transfection analysis using deletion mutants of a 0.5-kb region from -467 to +59 identified an LPS-responsive region in a kappaB-3 site (from -169 to -132) in the high producer subclone. Mutation of this site markedly reduced sensitivity to LPS in the high producer subclone. These data suggest that a yet undefined nuclear factor may be involved in differential JE/MCP-1 gene transcription.

Animals↗
PubMed2000

Lateral node dissection and total mesorectal excision for rectal cancer.

PURPOSE: Although the existence of lateral lymphatic drainage of the rectum has been verified anatomically, the clinical importance of it has not yet been fully investigated. The lack of a definition of lateral lymphatic flow makes it difficult to analyze and compare data. The aim of this study was to define the concept of lateral lymphatic drainage and explore its relationship to total mesorectal excision and to disclose the incidence and efficacy of dissection of lateral node involvement. METHODS: Review of anatomic and clinical research on lateral lymphatic flow was made to create a definition of lateral lymphatic flow. Based on this review, a three-space dissection was designed and applied. A retrospective analysis was made of 764 patients with rectal cancer treated by a curative three-space dissection operation during 20 years starting in 1975 at Cancer Institute Hospital. RESULTS: Lateral lymphatic flow passes from the lower rectum and through the lateral ligament laterally beyond the mesorectum. It then ascends along the internal iliac artery and, in addition, inside the obturator space. Sixty-six cases proved to have lateral node involvement, which comprised 8.6 percent of all rectal cancer and 16.4 percent of low-lying (lower margin below 5 cm above the dentate line) rectal cancer cases. The five-year survival rate of these 66 cases was 42.4 percent. There were 16 cases that had a solo lateral node involvement. CONCLUSION: Lateral lymphatic flow from low-lying rectal cancer passes outside the boundaries of total mesorectal excision but within the range of curative surgery by three-space dissection.

Humans↗
PubMed2000

A new method to estimate rCBF using IMP and SPECT without any blood sampling.

We developed and evaluated a method to measure rCBF without any blood sampling by using iodine- 123 IMP and SPECT. An integral of arterial input function, the integral taken from the value 0 to T of the variable Ca(t)dt, can be expressed as TC(T)/CO, where TC(T) is radioactivity delivered to the body in T minutes and CO is cardiac output. If T is acceptably small, rCBF can be determined by means of a microsphere model analysis with IMP as Cb(T)/(TC(T)/CO), where Cb(T) is cerebral radioactivity at T minutes. We derived TC(T) and CO from a chest dynamic scan. The method was applied to 45 patients who underwent rCBF studies (58 studies) with arterial blood sampling (ABS). Data from the chest scan were analyzed in comparison with ABS data in the first 28 studies, and equations for correction yielding an accurate TC(T)/CO were derived. The validity of the proposed method was evaluated in the subsequent 30 studies. The method yielded rCBF (rCBF-test) which agreed well with rCBF obtained by a two-compartment model analysis of dynamic SPECT and ABS data (rCBF-ref) with the mean and SD of differences between rCBF-test and rCBF-ref being 1.0 and 2.7 ml/100 g/min, respectively. In eleven subjects who underwent more than two studies, a percentage change in rCBF-test between the studies also closely approximated that of rCBF-ref (y = 1.11 x + 2.63, r = 0.92). The method can be used with acceptable reliability to measure rCBF without any blood sampling.

Adult↗
PubMed2000

Blood-brain barrier permeability in the periventricular areas of the normal mouse brain.

The main objective of this study was to assess the blood-brain barrier (BBB) permeability in periventricular areas of the normal mouse brain to test the hypothesis that the fragility of the BBB in periventricular areas may play a role in periventricular white matter lesions. Vascular permeability to intravenously injected horseradish peroxidase (HRP) was examined in the periventricular areas of adult mouse brain using light and electron microscopy. Staining for HRP appeared in the periventricular area adjacent to medial side of the lateral ventricle as well as in BBB-free areas, in the lateral septal nucleus, in the medial portion of the hippocampus and in the dorsal portion of the thalamus. In addition, the staining for HRP appeared in ependymal cell layer located near the choroid plexus and was found early after HRP injection in the wall of some vessels located at medial side of the optic tract. Ultrastructural examination of the vessel wall revealed that staining for HRP in the perfusion-fixed mice after circulation of the tracer for 5 min appeared in the perivascular space, in the basal lamina, in several vesicular profiles of the endothelial cell cytoplasm including abluminal pits, in vesicular profiles of perivascular cells and in the adjacent extracellular space. In the mice perfusion-fixed after HRP circulation for 90 min, staining for HRP in the vessels at medial side of the optic tract appeared in the cytoplasm of the perivascular cells, in vesicular structures of the endothelial cell cytoplasm such as plasmalemmal vesicles, endosomes and multivesicular bodies and occasionally in the vascular basal lamina. No clear staining reaction for HRP was found in the periventricular areas adjacent to lateral side of the lateral ventricles. These findings indicate that the BBB in the periventricular area adjacent to medial side of the lateral ventricle near the root of the choroid plexus is not so tight as it is in the cortex or in the lateral periventricular areas, and suggest that the perivascular cells play a scavenger role in the periventricular area as a component of the BBB. In addition, they indicate that blood-borne macromolecules can also invade the areas adjacent to the ventricles such as the lateral septal nucleus, the medial portion of the hippocampus and the dorsal portion of the thalamus.

Animals↗
PubMed2000

Pulmonary thromboembolism after surgery for esophageal cancer: its features and prophylaxis.

We attempt to clarify the problems of pulmonary thromboembolism (PTE), which occurs less frequently in Japan than in the West, regarding its special perioperative management and prophylaxis for PTE after esophagectomy. We studied 26 patients with PTE following esophagectomy among 1023 patients with esophageal cancer between 1984 and 1997. The presence of embolism was confirmed by pulmonary perfusion scintigraphy. The incidence, diagnosis, and other issues of PTE were all reviewed. The incidence of PTE was 2.5%, with patients showing a biphasic early and late onset. The main symptoms were dyspnea in 19 patients and tachycardia in 17. Scintigraphy demonstrated 154 lesions, 35.7% of which were located in the left lower lobe and 25.3% in the right lower lobe. Treatment mainly consisted of the administration of heparin and urokinase. Four of the 26 patients died. Intermittent pneumatic compression (IPC) with the administration of heparin has been used in our department since 1994 to prevent PTE and this has also helped to decrease the incidence from 3.2% to 0.7%. Because the incidence of PTE following esophagectomy is higher than expected, PTE should be considered whenever hypoxemia of some unknown cause is found. Both early diagnosis and treatment are essential. It is also important to prevent PTE by the use of IPC.

Esophageal Neoplasms↗
PubMed2000

Ultrastructural characteristics of diabetic nephropathy.

Diabetic nephropathy is a major cause of chronic renal failure in Japan, and the prevalence rate has markedly increased during the past decade. Diabetic nephropathy shows various specific histological changes not only in glomeruli but also in the interstitial region. Nodular, diffuse, and exudative lesions, so-called diabetic glomerulosclerosis, are well known as glomerular lesions. At first, they were historically evaluated only by light microscopy, and thus which components of the glomeruli were modified was not sufficiently clear. Subsequent electron microscopic studies clarified that the expansion of the mesangial matrix was the true form of nodular and diffuse lesions, and that insudated serum substance was the real appearance of an exudative lesion. Interstitial lesions also exhibit specific features in diabetic nephropathy. In electron microscopic studies, it was proved that the size of mitochondria and thickness of the tubular basement membrane were increased in diabetic nephropathy. In this review, we introduce typical electron microscopic findings in diabetic nephropathy and recent opinions on the progression of diabetic nephropathy.

Diabetic Nephropathies↗
PubMed2000

A new, safe, and easy technique of atrial septal defect creation.

We created an atrial septal defect (ASD) using a Ferris-Smith-Kerrison bone punch under transesophageal echocardiographic monitoring for infants with complex congenital heart diseases, eg, transposition of the great arteries. We describe a safe and easy technique of ASD creation instead of Blalock-Hanlon operation.

Echocardiography, Transesophageal↗
PubMed2000

Asymmetric sweating in a child with multiple sclerosis.

A 10-year-old male with multiple sclerosis complained of excessive sweating on the right side of the forehead and shoulder on relapse 3 months after the onset of multiple sclerosis. Because the neurologic evaluation revealed no abnormalities in the sudomotor function, it is likely that the hyperhidrosis resulted from a lesion in the central or preganglionic sympathetic nervous system. Magnetic resonance imaging demonstrated a high-intensity lesion involving the left hypothalamus on T(2)-weighted imaging. Thus hypothalamic involvement might be the reason for the hyperhidrosis in this patient.

Abducens Nerve Diseases↗
PubMed2000

Adenoviral-mediated transfer of Escherichia coli uracil phosphoribosyltransferase (UPRT) gene to modulate the sensitivity of the human colon cancer cells to 5-fluorouracil.

5-Fluorouracil (5-FU) has been used as a chemotherapeutic drug for colorectal cancer. Escherichia coli uracil phosphoribosyltransferase (UPRT), a pyrimidine salvage enzyme, converts 5-FU into 5-fluorouridine monophosphate (5-FUMP) at the initial step of 5-FU activation. We investigated the effects of adenoviral-mediated transfer of the E. coli UPRT gene into human colon cancer cells on 5-FU metabolism and 5-FU chemosensitivity. Three cell lines were used (HT29, KM12 and SW1116). The intracellular levels of 5-fluorodeoxyuridine monophosphate (5-FdUMP) and 5-FU incorporated into RNA after 5-FU treatment in cells infected with adenovirus containing the UPRT gene (AdCA-UPRT) were significantly higher than those of non-infected cells. This was accompanied by marked inhibition of thymidylate synthase (TS) in all cell lines. Furthermore, HT29, KM12 and SW1116 infected with AdCA-UPRT were, respectively, 13.1-, 30.2- and 70.5-fold more sensitive to 5-FU than non-infected cells. Most importantly, treatment with AdCA-UPRT and 5-FU effectively inhibited the growth of HT29-xenografted subcutaneous tumours in nude mice. Therefore, AdCA-UPRT/5-FU treatment had the potential to enhance the actions of 5-FU at both the DNA and RNA levels. Treatment augmented the sensitivity of human colon cancer cells to 5-FU both in vitro and in vivo. We conclude that adenoviral-mediated transfer of the E. coli UPRT gene into colon cancer cells can achieve biochemical modulation of 5-FU and this provides a new approach in the treatment of colorectal cancer.

Adenoviridae↗
PubMed2000

Immunohistochemical adrenomedullin expression is decreased in the placenta from pregnancies with pre-eclampsia.

The purpose of the present study was to investigate whether placental immunohistochemical adrenomedullin expression in normal normotensive pregnancies is different from that in pregnancies with pre-eclampsia. Placental tissues were obtained from seven normal normotensive pregnancies and 12 pregnancies with pre-eclampsia. The intensity of adrenomedullin staining in syncytiotrophoblasts was evaluated by means of immunohistochemistry and the ratio of the number of intact tertiary villi to that of total tertiary villi (intact/total villi ratio) was determined. The intensity of adrenomedullin expression in the placenta obtained from pregnancies with pre-eclampsia was significantly decreased compared with expression in placentas from uncomplicated normotensive pregnancies (P < 0.005). The intact/total villi ratio in placentas obtained from pregnancies with pre-eclampsia was significantly lower than that in placentas from normal normotensive pregnancies (P < 0.0001). In the amnion and extravillous trophoblast cells in both groups, no difference for the intensity of adrenomedullin expression was noted. These results suggest that adrenomedullin synthesis in the villous syncytiotrophoblasts is decreased in pregnancies with pre-eclampsia.

Adrenomedullin↗
PubMed2000

Simultaneous production of granulocyte colony-stimulating factor and parathyroid hormone-related protein in bladder cancer.

A case of bladder cancer with simultaneous production of granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP) is reported. An 81-year-old male patient was admitted to the Saitama Medical School for treatment of gross hematuria, leukocytosis and hypercalcemia and diagnosed as having advanced bladder cancer. Immediately after a cystectomy was carried out, his white cell count and serum calcium levels returned to normal. However, the tumors recurred locally and the recurrence was accompanied by an increase in the serum G-CSF and PTHrP levels with a recurrent elevation of white cell count and the serum calcium level. The production of G-CSF and PTHrP in the tumor cells was confirmed by immunohistochemistry.

Aged↗
PubMed2000

Hypercalcemia in a patient with renal cell carcinoma producing parathyroid hormone-related protein and interleukin-6.

A patient with renal cell carcinoma who developed humoral hypercalcemia of malignancy is reported. A 52-year-old male patient was diagnosed with renal cell carcinoma and multiple lung metastases. A cell line isolated from the surgical specimen exhibited continuous production of parathyroid hormone-related protein (PTHrP) in vitro. The production of PTHrP from the cancer cells was confirmed by RT-PCR and immunoradiometric assay. The serum calcium level was not enhanced, whereas the lung lesion was developing and producing interleukin-6, a possible modulator of osteoclastic resorption. Hypercalcemia was induced when the PTHrP concentration increased up to 3.3 pmol/L.

Carcinoma, Renal Cell↗
PubMed2000

Usefulness of autologous blood transfusion for avoiding allogenic transfusion and infectious complications after esophageal cancer resection.

BACKGROUND: A retrospective investigation was conducted to determine whether autologous blood collection could reduce allogenic transfusion after resection of esophageal cancer and whether allogenic transfusion influenced postoperative infection. METHODS: Patients (n = 100) who met the criteria for hemoglobin, age, body weight, and serum protein donated 800 mL of autologous blood from May 1994 to December 1997. The control group (n = 248) was selected from patients who met the same criteria and did not donate autologous blood over the 10 years before the start of autologous blood collection. RESULTS: Only three patients (3%) from the autologous group required allogenic transfusion versus 84 patients (33.7%) from the control group. Sixteen of the 26 patients who received more than 4 units of allogenic blood contracted postoperative infections compared with 25 of 165 patients who did not (P < .0001). Autologous blood transfusion significantly increased the probability of avoiding allogenic transfusion (odds ratio, 27.58), and allogenic transfusion was significantly related to postoperative infection (odds ratio, 1.19), according to logistic regression analysis. CONCLUSIONS: Autologous blood collection reduces the need for allogenic transfusion in patients undergoing resection of esophageal cancer, and avoidance of allogenic transfusion may reduce the risk of postoperative infection.

Bacterial Infections↗