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Biomedical subjects

N Takeuchi

Publications and source records attributed to N Takeuchi.

At least 73 records · Page 4Linked to original sources

Effect of acarbose on blood glucose profiles and plasma 1,5-anhydro-d-glucitol in type 2 diabetes poorly controlled by sulfonylurea therapy.

Sixteen patients with type 2 diabetes poorly controlled by glibenclamide (7.5-10.0 mg/day) were treated with acarbose (100 mg tds) for one week and the effect on the blood glucose profile, 24-hour urinary glucose excretion, plasma fructosamine, and plasma 1,5-anhydro-D-glucitol (1,5-AG) level was determined. The blood glucose profile was more stable and levels were lower during acarbose administration. In some patients, this improvement was maintained after discontinuing acarbose. The M-value, an indicator of blood glucose fluctuations, decreased significantly from 33.2 +/- 3.0 (mean +/- SEM) in the run-in period to 13.4 +/- 2.4 during acarbose therapy (P < 0.001), and rose again to 26.5 +/- 4.4 (P < 0.001) in the follow-up period. The 24-hour urinary glucose excretion and plasma fructosamine decreased similarly (P < 0.001 and P < 0.01, respectively) during and after acarbose therapy. Plasma 1,5-AG levels did not change significantly during acarbose therapy, but increased markedly afterwards (from 19.3 +/- 3.1 mumol 1(-1) to 25.0) +/- 3.1 mumol l-1, P < 0.001). Plasma 1,5-AG levels were significantly correlated with urinary glucose excretion one week earlier (r = 0.513, P < 0.006). These findings suggest that acarbose may improve glycemic control in type 2 diabetic patients poorly controlled by sulfonylurea therapy and that plasma 1,5-AG might be used as a marker of glycemic control cooperating with other markers such as fructosamine and urinary glucose determination for monitoring the short-term response to antidiabetic therapy.

Acarbose↗

Enhancement of CD3-mediated thymocyte apoptosis by the cross-linkage of heat-stable antigen.

Heat-stable antigen (HSA) is a murine differentiating antigen that is expressed on both CD4-CD8- double-negative and CD4+CD8+ double-positive thymocytes but not CD4+ or CD8+ single-positive thymocytes. Effects of anti-HSA monoclonal antibody, R13, on thymocyte apoptosis induced by various stimulations were investigated by a single-cell suspension culture system. Immobilized R13 enhanced the CD3-mediated DNA fragmentation and killing of thymocytes but not the dexamethasone-induced or phorbol myristate acetate-induced killing of thymocytes. Immobilized R13 by itself could not induce thymocyte apoptosis. Soluble R13 enhanced CD3-mediated apoptosis when HSA and T-cell receptor (TCR)/CD3 were co-cross-linked by a cross-reactive secondary antibody. Even without the cross-reactive secondary antibody, soluble R13 enhanced CD3-mediated apoptosis, although a greater than 100-fold increase in the amount of R13 was needed to give a similar enhancement compared with immobilized R13. Neither R13 by itself nor R13 plus secondary antibody induced cytosolic calcium influx, whereas R13 enhanced CD3-mediated cytosolic calcium increase. These results suggest a functional role of HSA in promoting the activation-induced apoptosis of thymocytes and the involvement of HSA in negative selection.

Animals↗

High-resolution CT findings of lung disease in patients with polymyositis and dermatomyositis.

The purpose of this study was to determine the type and distribution of interstitial lung disease seen in patients with polymyositis and dermatomyositis, using high-resolution computed tomography (HRCT). The presence and distribution of high-resolution CT findings were retrospectively evaluated in 25 patients with polymyositis/dermatiomyositis. In 14 patients, a pathological diagnosis of pulmonary disease was obtained. Three lung specimens were also studied. Results showed that 23 patients had abnormal HRCT showing the following abnormalities: ground glass opacities (92%), linear opacities (92%), irregular interfaces (88%), airspace consolidation (52%), parenchymal micronodules (28%), and honeycombing (16%). A relatively high prevalence of airspace consolidation (52%) and a low prevalence of honeycombing (16%) were observed. Two patients with extensive consolidation proved to have diffuse alveolar damage; eight patients with either subpleural band-like opacities (n = 5) and/or airspace consolidation (n = 7) had bronchiolitis obliterans organizing pneumonia; four patients with honeycombing had usual interstitial pneumonitis. We conclude that HRCT findings in patients with polymyositis/dermatomyositis are nonspecific. However, a high prevalence of airspace consolidation and a low prevalence of honeycombing were observed. Predominant HRCT patterns are suggestive of the pathologic processes occurring in polymyositis/dermatomyositis.

Adrenal Cortex Hormones↗

Dynamic range control processing of digital chest images. A clinical evaluation.

PURPOSE: The clinical usefulness of an advanced image-processing system called "dynamic range control processing" was investigated, with which selected parts of the dynamic range of digital chest images could be controlled. MATERIAL AND METHODS: A comparative study of 3 different post-processed formats of storage phosphor (SR) images was performed in 35 patients with abnormalities in the chest. The 3 formats were SR images with standard mode (SR-standard), SR images with strong edge-enhancement (SR-enhanced), and dynamic range controlled SR images (SR-controlled). RESULTS: For lung abnormalities, there was no difference among the 3 SR image formats. For normal mediastinal structures and lung abnormalities covered by the heart or diaphragm, SR-controlled and SR-enhanced images were significantly superior to SR-standard images, while no difference was found between SR-controlled and SR-enhanced images except for the trachea and bony structures. CONCLUSION: Dynamic range control processing appears to be a useful method for displaying SR chest images with an extremely wide dynamic range.

Adolescent↗

Influence of cholesterol feeding on bile acid metabolism in young and aged germ-free rats.

The effects of cholesterol feeding on serum and liver cholesterol levels, fecal and biliary bile acid levels, bile acid pool size and bile acid composition were examined in 2-, 12- and 24-month-old male germ-free rats. The major bile acids in these animals were cholic and beta-muricholic acids. Cholesterol feeding increased synthesis of bile acids by 3- to 4-fold, especially that of chenodeoxycholic acid (mainly beta-muricholic acid in the rat), decreasing the cholic acid/chenodeoxycholic acid (CA/CDCA) ratio in all rats regardless of age, even though the CA/CDCA ratio increased as a linear function of age in both diet groups. Cholesterol feeding increased the serum cholesterol level markedly in aged rats. This hypercholesterolemia may be produced by the increase in CA/CDCA ratio in aged rats.

Aging↗

Detection of subtle interstitial abnormalities of the lungs on digitized chest radiographs: acceptable data compression ratios.

OBJECTIVE: To determine acceptable compression ratios for digital radiography, we evaluated the effect of data compression on the detection of subtle interstitial lung abnormalities using digitized chest radiographs. MATERIALS AND METHODS: Screen-film chest radiographs of 38 patients with subtle interstitial lung abnormalities and 40 patients with normal lung parenchyma were digitized (spatial resolution, 0.175 mm; 2000 x 2000 pixels; 10 bits per pixel) and compressed with the discrete cosine transform method at ratios of 10:1, 20:1, and 30:1. Five chest radiologists and five radiology residents examined the uncompressed and compressed digital images and rates the presence of interstitial lung abnormalities with a five-level scale of confidence. Results were analyzed by receiver operating characteristic methods. RESULTS: Overall, the interpretation of images with a compression ratio of 30:1 was significantly less accurate than that of uncompressed images (p < .05). For the five chest radiologists, interpretation of images with a compression ratio of 20:1 or 30:1 was significantly less accurate than that of uncompressed images (p < .05). However, for the five residents, no significant difference between interpretations of compressed and uncompressed images was noted (p > or = .05). CONCLUSION: These results suggest that a 10:1 data compression ratio does not influence the detection of subtle interstitial lung abnormalities. However, information that is lost with a 20:1 data compression ratio might be essential for interpretation by experienced chest radiologists.

Adult↗

An importance of carbohydrate ingestion for the expression of the effect of alpha-glucosidase inhibitor in NIDDM.

OBJECTIVE: To examine the usefulness of alpha-glucosidase inhibitors in glycemic control of patients with NIDDM. The involvement of carbohydrate ingestion in manifestation of the effects of alpha-glucosidase inhibitors was also investigated. RESEARCH DESIGN AND METHODS: A total of 41 patients hospitalized with NIDDM (22 patients receiving sulfonylurea and 19 receiving insulin therapy) were given alpha-glucosidase inhibitors during the period when their blood glucose levels were well controlled. They were followed for 3 weeks as inpatients and for an additional 6 months as outpatients. They were retrospectively divided into two groups according to the percentage of carbohydrates in all sources of calories during outpatient management: the < 50% group and the > 50% group. Between these two groups, we compared circadian variation in blood glucose levels, HbA1c, and urine C-peptide. RESULTS: Treatment with alpha-glucosidase inhibitors during the hospital stay markedly improved circadian variation in blood glucose levels and HbA1c and decreased urine C-peptide in both groups. While HbA1c returned to its pretreatment level at 6 months after the treatment in the < 50% group, HbA1c had further improved in the > 50% group at 6 months. CONCLUSIONS: alpha-Glucosidase inhibitors are useful for glycemic control in patients with NIDDM and the percentage of carbohydrate in all calorie sources is an important factor for the expression of their effects.

Biomarkers↗

Lipase activities in post-heparin plasma and tissues, and susceptibilities of lipoproteins in experimental diabetic rats.

Heparin administration to diabetic rats caused no change in VLDL, an increase in IDL and a decrease in LDL on electrophoretic analysis of plasma lipoproteins, while the administration to control rats markedly decreased VLDL and increased IDL and LDL. Both hepatic triglyceride lipase (HTGL) and lipoprotein lipase (LPL) activities in the postheparin plasma were lower in the diabetic rats than in the controls, and the reduction of HTGL activity was greater than that of LPL activity in the diabetic rats. The LPL activity in the adipose tissue was lower in the diabetic rats than in the controls, but the activities in the cardiac and skeletal muscles were similar in the two rats. The HTGL-catalyzed fatty acid (FA) releases from the diabetic VLDL and IDL were lower than those from the normal rat VLDL and IDL, while the LPL-catalyzed FA release in the diabetic rats was not different from those in the controls. The decreases in LPL and HTGL activities and the markedly impaired susceptibility of IDL to HTGL coincide well with the postheparin changes in plasma lipoproteins in diabetic rats, an increase in IDL and a decrease in LDL.

Adipose Tissue↗

Altered bile acid metabolism related to atherosclerosis in alloxan diabetic rats.

Normal and alloxan diabetic rats were kept on a 0.25% cholesterol diet for 12 months and the changes in serum cholesterol levels, and fecal excretion of sterols and bile acids were examined to elucidate the influence of changes in bile acid metabolism on manifestations of hypercholesterolemia and development of atheromatous lesions. Diabetic rats fed the cholesterol diet showed increases in bile acid synthesis and in the cholic acid group/chenodeoxycholic acid group (CA/CDCA) ratio, and developed significant hypercholesterolemia and atheromatous lesions. In contrast, normal rats showed increased bile acids synthesis but a decreased CA/CDCA ratio after feeding with the cholesterol diet, and developed neither hypercholesterolemia nor atheromatous lesions. Fecal sterol excretion and the cholesterol/sitosterol ratio decreased in diabetic rats. Positive correlations were found between the cumulative serum cholesterol level and the atheromatous lesion area, and between the fecal CA/CDCA ratio and the serum cholesterol level, in the latter of which the correlation was higher in rats on the cholesterol diet than in those on the standard diet. These findings suggest that alteration of bile acid metabolism with increases in cholic acid synthesis and CA/CDCA ratio in diabetic rats enhances cholesterol absorption to produce significant hypercholesterolemia, which in turn leads to development of atheromatous lesions.

Alloxan↗

Improved production of phenomycin by a genetically engineered Escherichia coli.

We established an improved production of an antitumor polypeptide anti biotic, phenomycin (PHM), by using a genetically engineered Escherichia coli. Phenomycin consists of 89 natural amino acids without intramolecular disulfide bridge. PHM gene was synthesized as a fusion gene in which PHM at the C-terminus and the residues 1 approximately 20 of Hirudin variant 1 (HV1) at the N-terminus connected by a factor Xa recognition sequence (Ile-Glu-Gly-Arg). E coli JM 109 transformed with a plasmid containing the synthesized gene expressed a fusion protein and the trypsinization of the fusion protein purified by ultrafiltration and ion-exchange chromatography gave efficiently recombinant PHM at a final yield of 50 mg/liter of culture. This PHM yield was six times higher than that obtained by a natural PHM producing strain of Streptoverticillium baldacci. Recombinant PHM was not distinguishable from natural PHM in all aspects observed.

Anti-Bacterial Agents↗

[Measurement of serum catalase activity and its clinical significance].

Catalase (CAT) is an enzyme to scavenge H2O2 and to protect peroxidation of cell wall lipid and lipoproteins. The increase in its activity has been observed in several diseases as an compensating reaction. The decrease in its activity may be related to some pathophysiologies of diseases. However, there has been few reports on the measurement of serum CAT activity. We formerly reported the method to measure CAT accurately with an automated analyzer. In the present experiment, we measured CAT in various kinds of diseases and healthy controls by this method. By an analysis of serum samples which were obtained from randomly selected 1,051 patients at Chibune Hospital for 12 months (from January to December, 1993), we obtained following results. The CAT of neuromuscular, cardiovascular and metabolic diseases were significantly high (p < 0.01). The CAT of psychiatric and otorhinopharyngologic diseases were significantly low (p < 0.01). There was significant relationship between CAT and some biochemical markers. CAT is thought as a protector against tissue injuries or circulatory insufficiencies. These results indicate that CAT increases in some kinds of diseases as a protection reaction to the injury, and that the decrease of CAT may cause some kinds of diseases.

Cardiovascular Diseases↗

[Laparoscopic pelvic lymphadenectomy for localized prostate cancer].

We report the clinical results and efficacy of laparoscopic pelvic lymphadenectomy for localized prostate cancer. This procedure was followed by radical prostatectomy, when metastasis was not found in the frozen section, and by optional treatment, such as transurethral resection (TUR) or castration, other than radical prostatectomy when metastasized nodes were found. We performed transperitoneal laparoscopic lymphadenectomy on 30 patients and extraperitoneal approach on 20 between April, 1992 and September, 1995. The patients were between 52 and 78 years old. Nineteen, patients had stage B1, 17 stage B2 and 14 stage C cancer. Bilateral obturator nodes were dissected. We could not perform laparoscopic lymphadenectomy on two patients because of adhesion. The average operation time and blood loss were 166 minutes and 151 ml, respectively, in the transperitoneal group, while 142 minutes and 126 ml in the extraperitoneal group. The average number of removed nodes was 12 in the transperitoneal group and 10 in the extraperitoneal group. The extraperitoneal approach is a safer and useful procedure. Nodal metastasis were found in 12 patients by frozen section. Additional positive nodes were found in 7 patients by a further study. Two were not harvested laparoscopically and 5 were ascertained only by permanent section. Therefore, the two-staged operation might be preferable. Nodal metastasis was likely to be found in localized prostate cancer patients with clinical stage C, poorly differentiated cancer, or prostatic specific antigen density (PSAD) over 0.5 ng/ml/ml. Laparoscopic pelvic lymphadenectomy might be indicated for these cases.

Aged↗

Compositions of very low density lipoprotein subfractions from patients with polydisperse low density lipoproteins.

In some hyperlipidemic patients, low density lipoprotein (LDL) shows several peaks (polydisperse) on polyacrylamide gel disc electrophoreses, though LDL usually shows a single peak (monodisperse). In order to clarify the relationship between the LDL polydispersion and VLDL heterogeneity, LDL and VLDL were prepared from hyperlipidemic patients sera with mono- and polydisperse LDL by sequential ultracentrifugation and fractionated by gradient ultracentrifugation and their compositions were analyzed. Polydisperse LDL was rich in triacylglycerol (TG) and poor in esterified cholesterol (CE) as compared with monodisperse LDL and consisted of the lowest and the medium density subfractions when the LDL was separated into six subfractions. The monodisperse LDL was composed of a single major subfraction of a medium density. VLDL from the patients with polydisperse LDL was relatively rich in the dense and poor in the buoyant subfractions as compared with that from the patients with monodisperse LDL. The subfractions in the former contained more CE and less TG than the corresponding subfractions in the latter. There were no significant differences in the apolipoprotein compositions between those VLDLs. The results suggest that polydisperse LDL might be originated from VLDL that differs in particle sizes, densities and compositions from ordinary VLDL.

Adult↗