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Biomedical subjects

N Nakashima

Publications and source records attributed to N Nakashima.

At least 163 records · Page 9Linked to original sources
PubMed1993

Clinical remission criteria for epithelial carcinoma of the ovary.

After primary cytoreductive surgery 188 patients with epithelial ovarian cancer were treated with combination chemotherapy between 1986 and 1989 in the Tokai Ovarian Tumor Study Group. Clinical remission criteria were set in this study and patients were examined to determine if they were in remission or not. Forty-seven cases (25%) had no remission and 85.9% of them died within 20 months after primary surgery. Fifty-seven cases (30.3%) had a remission and a subsequent recurrence. Eighty-four cases (44.7%) had no recurrence and all are currently alive. Independent remission factors by multivariate analysis were higher stage (P = 0.018), clear-cell carcinoma (P = 0.0048), larger maximum residual tumor (P = 0.0023), and PVB therapy (P = 0.026). Independent recurrence factors were higher stage (P = 0.0012), serous cystadenocarcinoma (P = 0.0001), clear-cell carcinoma (P = 0.00409), and PVB therapy (P = 0.0499). A significantly high remission rate and low recurrence rate was achieved using PVB therapy. This criteria has value for the treatment of epithelial ovarian carcinoma. The disease-free survival rate after clinical remission was the same as that after a negative second-look laparotomy, which implies that a second-look laparotomy may be unnecessary in the management of epithelial carcinoma of the ovary.

Adenocarcinoma↗
PubMed1993

Unilateral perihilar opacification caused by lightning.

The chest radiographs of two children struck by lightning showed right perihilar opacification. The radiographs were taken 2 h and 5 h after the event respectively. To our knowledge no similar cases have been reported.

Child↗
PubMed1993

Apolipoprotein E polymorphism affects the response to pravastatin on plasma apolipoproteins in diabetic patients.

In the present study, we examined the levels of plasma lipids and apolipoproteins in patients with non-insulin dependent diabetes mellitus (NIDDM) with hypercholesterolemia in different apolipoprotein E (apo E) phenotypes. We also examined the influences of apo E polymorphism on the response to pravastatin. The patients were divided into three groups, E4/E3, E3/E3, and E3/E2. There were no differences in the baseline levels of plasma lipids and apolipoproteins, except that the level of triglycerides in E3/E2 heterozygotes was significantly higher than E3/E3 homozygotes. Three months of pravastatin administration significantly reduced plasma levels of total cholesterol and low-density lipoprotein cholesterol in each group to the same degree. We observed a significant reduction of apo B both in the E4/E3 and E3/E3 groups and apo E in the E3/E3 group. Such reduction was not observed in the E3/E2 group. We conclude that pravastatin is a potent drug to correct lipid abnormalities, particularly in NIDDM patients with apo E4/E3 and E3/E3. In the E3/E2 group, its effectiveness may be diminished.

Adult↗
PubMed1993

Isolation of pseudoprototimosaponin AIII from rhizomes of Anemarrhena asphodeloides and its hypoglycemic activity in streptozotocin-induced diabetic mice.

A hot-H2O extract of rhizomes of Anemarrhena asphodeloides, the Japanese sino-medicine "chimo," lowered the blood glucose level in alloxan-diabetic mice. Hypoglycemic activity-guided fractionation isolated a new glycoside, pseudoprototimosaponin AIII [1], which was compared with chemically known prototimosaponin AIII [2]. These compounds exhibited hypoglycemic effects in a dose-dependent manner in streptozotocin-diabetic mice but showed no effects on glucose uptake and insulin release, suggesting that the hypoglycemic mechanism may be due to inhibition of hepatic gluconeogenesis and/or glycogenolysis.

Animals↗
PubMed1993

A squamous cell carcinoma originated from intracranial dermoid cyst.

A 59-year-old female had been treated for epilepsy over 20 years. She had frequent convulsive seizures in spite of medication and was admitted to our hospital in status epilepticus. CT showed low density cyst with calcified wall at right suprasellar region and irregular ring enhancement in the frontal lobe which was continuous with the cyst. Angiography revealed tumor stain in the venous phase. The frontal mass was removed with evacuation of the cyst. Pathological findings were suggestive of squamous cell carcinoma arising from the epithelial component of the pre-existing dermoid cyst. The patient died six months after the operation with severe hyperglycemia, ketoacidosis and hypotension probably due to chemical meningitis and hydrocephalus.

Brain Neoplasms↗
PubMed1993

Needle tract implantation of thymoma after transthoracic needle biopsy.

A 73 year old woman was admitted to hospital because of an anterior mediastinal mass. For definite diagnosis, needle biopsy was performed under fluoroscopic observation. The histopathological diagnosis was thymoma and combination chemotherapy was given. The tumour almost completely disappeared and the patient was discharged. But the tumour recurred in the left anterior chest wall four months later. It is suggested that the thymoma tissue had been implanted in the needle tract.

Aged↗
PubMed1993

Point mutation in a family with hyperproinsulinemia detected by single stranded conformational polymorphism.

We previously described a case of familial hyperproinsulinemia, the fifth to be reported. In the present study we characterized the genetic defect carried by this family and demonstrated that it could be detected by polymerase chain reaction-single stranded conformational polymorphism. Since the serum proinsulin molecule from the propositus, a 63-yr-old Japanese man, was eluted on the same fraction of human proinsulin intermediate cleaved only at the B-C junction, we sequenced exon 3 of his insulin gene, including the C-A junction. A point mutation was discovered that changed codon 65 from arginine (CGT) to histidine (CAT) in one allele. This was the same point mutation as that described previously in three unrelated kindreds representing two races, consistent with the hypothesis that the dinucleotide sequence CpG may be a "hot spot" for mutations. Recently, developed polymerase chain reaction-single stranded conformational polymorphism proved useful in detecting this mutation in the family members. The daughter of the propositus and one of his two grandsons were also demonstrated to be heterozygous for this point mutation by this method.

Base Sequence↗
PubMed1993

Postoperative pneumonia in elderly patients: incidence and mortality in comparison with younger patients.

To determine whether elderly patients have an increased incidence of postoperative pneumonia and/or an increased mortality, we conducted a retrospective study of 4,380 patients who underwent thoracic, abdominal or neurosurgery under general anesthesia. Thirty of these patients developed postoperative pneumonia (incidence, 0.68%). The elderly patients aged 65 years or older who underwent thoracic surgery had the highest incidence of pneumonia. Nine of the 30 patients with pneumonia died (mortality, 30%). Elderly patients did not show a higher mortality than the younger patients. The extent of pulmonary infiltrates on chest roentgenogram and the serum bilirubin level, both of which were determined at the onset of pneumonia, independently had a significant association with mortality. Our study suggests that advanced age is a risk factor for postoperative pneumonia in patients who undergo thoracic surgery.

Adult↗
PubMed1993

CT visualization of the major pulmonary fissures: value of 25 degrees cranially tilted axial scans.

OBJECTIVE: CT visualization of the major (oblique) pulmonary fissures is often hampered by partial volume effects of adjacent lung parenchyma. We attempted to improve visualization of the fissures by using 25 degrees cranially tilted axial scans. An initial in vitro study also was performed. MATERIALS AND METHODS: Both conventional and 25 degrees tilted axial CT scans were obtained in 40 adult patients. After scans with 2-mm collimation were obtained at 1 cm and 6 cm below the carina, the gantry was tilted 25 degrees cranially to be perpendicular to the plane of the major fissures, and scans with 2-, 5-, and 10-mm collimation were obtained at the same two levels. The appearance of the fissures was classified as linear opacity, band-like opacity, or avascular area for each lung at each level. RESULTS: On 2-mm conventional axial scans, the major fissures were seen as linear opacities in three to 23 patients (8-58%), as band-like opacities in 13-31 (32-78%), and as avascular areas in one to seven (2-18%). (Ranges indicate lowest and highest values when data for the two levels in the two lungs are grouped separately.) On 2-mm tilted scans, the ranges were 32-38 patients (80-95%), one to eight (2-20%), and zero to one (0-2%), respectively. The 2-mm tilted scans were significantly superior to the 2-mm conventional axial scans for showing the fissures (p < .01). Direct visualization as linear or band-like opacities was possible even on 10-mm tilted scans in 15-32 cases (38-80%). CONCLUSION: Our results show that visualization of the major fissure is improved when tilted CT scans rather than conventional axial scans are used.

Adult↗
PubMed1993

Incidence of antibodies to hepatitis C virus in patients undergoing chronic dialysis and CAPD.

We measured antibodies to hepatitis C virus (anti-HCV) in patients who were receiving hemodialysis or continuous ambulatory peritoneal dialysis (CAPD). Sixty seven patients (28%) were anti-HCV positive. The anti-HCV positive frequency increased with the time of treatment with dialysis, the frequency being 50% with a dialysis period > or = 10 years. The frequency of anti-HCV positivity was similar in patients with a history of blood transfusion (48/152, 32%) and in those without this history (19/89, 21%, p > 0.05). Therefore, in addition to blood transfusion, there may be other routes of HCV infection associated with long-term dialysis. Chronic liver disease was observed in 31% (21/67) of the patients positive for anti-HCV but in only 6% (11/174) of the negative patients (p < 0.01). HCV seems to be important as a cause of chronic liver disease in dialysis patients.

Adult↗
PubMed1993

[Myocardial metabolism during dynamic exercise].

The development of Webster catheterization has enabled us to make clinical measurement of coronary sinus blood flow and to estimate the kinetics in myocardial substrate uptake. In this study, exercise tolerance test using supine multistage bicycle ergometer test was performed and exercise-induced hemodynamic alteration was evaluated in 18 patients with ischemic heart disease (16 males and 2 females, average age 56.3 years). The change in substrate kinetics in myocardial metabolism was also examined in terms of two indexes; myocardial uptake rate and myocardial uptake. The following results were obtained. 1) The myocardial uptake rates of glutamate and free fatty acid were significantly decreased by exercise, while those of glucose and lactate showed no significant change. 2) The myocardial uptakes of glutamate, glucose and lactate were significantly increased by exercise, but that of free fatty acid did not change significantly. 3) A significant negative correlation (r = -0.52, p < 0.05) was observed between the change in myocardial glutamate uptake and the change in pulmonary artery wedge pressure induced by exercise, suggesting that patients with ischemic heart disease might fail in glutamate uptake induced by exercise. The difference in the kinetics of myocardial uptake rate and myocardial uptake for glutamate, alanine, glucose, free fatty acid and lactate is observed. This difference occurs from the decrease in uptake rate due to the increase in coronary sinus blood flow. Myocardial uptake, which directly reflects myocardial energy metabolism is regarded as a more useful index of myocardial metabolism than myocardial uptake rate.

Energy Metabolism↗
PubMed1992

Yolk vitronectin. Purification and differences from its blood homologue in molecular size, heparin binding, collagen binding, and bound carbohydrate.

This is the first report on a unique vitronectin molecule, yolk vitronectin, which is similar to its blood homologue in cell spreading activity but different in molecular size, bound carbohydrate, and heparin and collagen binding activity. Yolk vitronectin was purified 2,500-fold from chick egg yolk by a combination of hydroxylapatite, DEAE-cellulose, and anti-vitronectin-Sepharose column chromatographies. In SDS-polyacrylamide gel electrophoresis under reducing conditions, yolk vitronectin was separated into 54- and 45-kDa bands, which are 16 and 25 kDa smaller, respectively, than the 70-kDa major band of chick blood vitronectin. The 54-kDa band shares the same NH2-terminal sequence as chick blood vitronectin. In contrast, the NH2-terminal sequence of the 45-kDa band is somewhat homologous with the internal sequences of mammalian vitronectins beginning at the 50th amino acid from the NH2 terminus. The bound carbohydrate of the 54- and 45-kDa species of yolk vitronectin is similar to, but distinct from, that of blood vitronectin. Unlike blood vitronectin, yolk vitronectin cannot bind to either heparin or collagen.

Amino Acid Sequence↗
PubMed1992

Vitronectin diversity in evolution but uniformity in ligand binding and size of the core polypeptide.

We isolated vitronectins from the plasma or sera of 14 animal species including mouse and rat by heparin affinity chromatography. They cross-reacted with anti-vitronectin antibody and their amino terminal sequences showed strong homology. They also promoted spreading of BHK cells and were bound to heparin and collagen in the same way. Therefore, these properties appear to be essential for vitronectin function. However, the apparent molecular weights of these vitronectins varied considerable from 59 to 78 kDa in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). In addition, the number of bands also varied from 1 to 3. To search for the uniformity of vitronectin polypeptide, vitronectins were deglycosylated and examined by Ferguson plot analysis. The size of the polypeptide portion of vitronectins was estimated to range from 40 to 57 kDa which was 19-26 kDa smaller than original values. Supposing a possible cleavage site at 5-13 kDa far from the carboxyl terminus, all vitronectin polypeptides were speculated to be synthesized de novo in the size range of 50-57 kDa. Proteins reacting with anti-vitronectin antibody were also detected on the immunoblot of 13 more species including Drosophila and Physarum. Almost all of these vitronectin-like proteins showed marked species-specific variations in their apparent molecular weights from 51 to 96 kDa in SDS-PAGE.

Amino Acid Sequence↗
PubMed1992

Testicular sex cord-stromal lesions: immunohistochemical analysis of cytokeratin, vimentin and steroidogenic enzymes.

We have studied immunolocalization of all steroidogenic enzyme involved in sex steroids biosynthesis, P-450 side chain cleavage (P-450scc), 3 beta hydroxy steroid dehydrogenase (3 beta-HSD), P-450 17 alpha hydroxylase (P-450(17 alpha)) and P-450 aromatase (P-450arom) and that of vimentin and cytokeratin in 14 cases of testicular sex cord-stromal tumours (6 Leydig cell tumours, 5 Sertoli cell tumours, 2 fibromas and 1 granulosa cell tumour) as well as 4 cases of hyperplasia (2 Leydig and 2 Sertoli). Leydig cell tumour expressed all four steroidogenic enzymes examined, indicating that this tumour can synthesize oestrogen from cholesterol. In 2 cases of Sertoli cell tumour, the tumour cells with clear cytoplasm and without Reinke's crystals expressed P-450ssc, 3 beta-HSD and P-450(17 alpha), suggesting the capability of androgen production in these tumour cells. Fibromas and granulosa cell tumour were negative for the enzymes examined. In immunohistochemistry of intermediate filaments, Leydig cell tumours demonstrated only vimentin. Sertoli cells in hyperplasia and non-neoplastic testis expressed only vimentin but Sertoli cell tumours expressed both cytokeratin and vimentin. Cytokeratin immunoreactivity was correlated with morphological epithelial differentiation in Sertoli cell tumour. These findings in testicular Sertoli cell tumour are considered to represent the multiple differentiation capacity of this neoplasm. Immunohistochemical study of steroidogenic enzymes and intermediate filaments provided new insight into neoplastic steroidogenesis and the differentiation capacity of testicular sex cord-stromal neoplasms.

3-Hydroxysteroid Dehydrogenases↗
PubMed1992

Seven tumor markers in benign and malignant germ cell tumors of the ovary.

Seven tumor markers were analyzed clinically in 135 patients with germ cell tumors of the ovary who were treated in Tokai Ovarian Tumor Study Group, an association comprising Nagoya University and its affiliated hospitals, between January 1979 and September 1990. Positive rate of AFP was 100% (36/36) in yolk sac tumor, 61.9% (13/21) in immature teratoma, and 11.8% (2/17) in dysgerminoma, but there were no positive cases of mature cystic teratoma with malignant transformation (0/7) and mature cystic teratoma (0/31). Positive rate of CA125 was over 50% in all tumor types except mature cystic teratoma, which showed a positive rate of 23.7%. CA125 was useful for the screening of malignant germ cell tumors. CA19-9 showed a high positive rate in teratomatous tumors, which were immature teratoma, mature cystic teratoma with malignant transformation, and mature cystic teratoma. Dysgerminoma and yolk sac tumor, especially dysgerminoma, had a high positive rate of LDH. TPA and CEA were not considered useful tumor markers for germ cell tumors of the ovary.

Biomarkers, Tumor↗
PubMed1992

Effects of vitamin D-binding proteins on HL-60 cell differentiation induced by 26,26,26,27,27,27-hexafluoro-1 alpha,25-dihydroxyvitamin D.

Monocytic differentiation-inducing activity of 26,26,26,27,27,27-hexafluoro-1 alpha,25-dihydroxyvitamin D3 [26,27-F6-1 alpha,25-(OH)2D3] was re-evaluated in human promyelocytic leukemia (HL-60) cells in serum-supplemented or serum-free culture. The order of in vitro potency for reducing nitroblue tetrazolium (NBT) was 26,27-F6-1 alpha,25-(OH)2D3 greater than 1 alpha, 25-dihydroxyvitamin D3 [1 alpha,25-(OH)2D3] = 26,26,26,27,27,27-F6-1 alpha,23(S), 25-trihydroxyvitamin D3 [26,27-F6-1 alpha,23(S), 25-(OH)3D3] under serum-supplemented culture conditions, whereas the order was 1 alpha, 25-(OH)2D3 = 26,27-F6-1 alpha,25-(OH)2D3 greater than 26,27-F6-1 alpha,23(S), 25-(OH)3D3 under serum-free culture conditions. This rank order for differentiation-inducing activity under serum-free culture conditions correlated well with the binding affinity of these analogs for vitamin D3 receptor of HL-60 cells. The order of relative % binding affinity for the vitamin D-binding protein in fetal calf serum was 1 alpha,25-(OH)2D3 (100%) much greater than 26,27-F6-1 alpha,25-(OH)2D3 (5.1%) greater than 26,27-F6-1 alpha,23(S), 25-(OH)3D3 (less than 1%). These results suggest that serum vitamin D-binding proteins apparently modulate monocytic differentiation of HL-60 cells by 26,27-F6-1 alpha,25-(OH)2D3 under serum-supplemented culture conditions.

Binding, Competitive↗