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Biomedical subjects

N Tsukamoto

Publications and source records attributed to N Tsukamoto.

At least 19 recordsLinked to original sources

Mutations associated with Sjögren-Larsson syndrome.

Sjögren-Larsson syndrome (SLS), a rare autosomal disorder characterized by ichthyosis, spastic neurological disorders and oligophrenia, is associated with deficiency of fatty aldehyde dehydrogenase encoded by a gene on chromosome 17q11.2. Mutations of the gene (GDB symbol ALDH10) were recently identified in three SLS patients. Another aldehyde dehydrogenase isozyme. ALDH3, also has a high activity for fatty aldehyde oxidation, and is encoded by a gene in chromosome 17q11.2. Abnormality of the ALDH3 gene could also cause a similar syndrome. The examination of the ALDH3 locus of three additional SLS patients showed that two are heterozygous with C-->G at nt 985 (Pro-->Ala at protein position 329). However, the mutation was found to be common (frequency of the atypical allele is about 0.25) in normal subjects, and not related to SLS. Isoelectric focusing analysis indicated that ALDH3 is hardly expressed in normal as well as patients' fibroblast cells, while ALDH10 expressed in the normal cells is diminished in the three patients' cells. The level of ALDH10 mRNA is also low in the patients' cells. The examination of the ALDH10 locus revealed the existence of a 3 base deletion coupled with a 21 base insertion at intron 6/exon 7 junction in one patient. This abnormality is the same as that found in the patient previously reported by other investigators. One patient is associated with a 2 base deletion at nt 1297 and consequent premature chain termination at protein position 434. Another patient is a compound heterozygote for the same 2 base deletion at nt 1297 and a 5 base insertion at nt 1311 and premature chain termination at protein position 457. Unique characteristics of the SLS mutations are pointed out.

Aldehyde Dehydrogenase

6-deoxyerythronolide B synthase 1 is specifically acylated by a diketide intermediate at the beta-ketoacyl-acyl carrier protein synthase domain of module 2.

We have used 6-deoxyerythronolide B synthase (DEBS) as a model system to investigate molecular recognition by a modular polyketide synthase (PKS). DEBS consists of three proteins (DEBS1, -2, and -3) that biosynthesize the polyketide skeleton of the antibiotic erythromycin from propionyl-CoA and methylmalonyl-CoA. Active sites within these multifunctional proteins are organized into biosynthetic "modules", each of which catalyzes a discrete round of polyketide chain elongation and adjusts the appropriate level of beta-ketoacylthioester reduction. Using DEBS1, we demonstrate that there is a substantial degree of molecular recognition in the processing of the natural diketide chain elongation intermediate. Exogenously added (2S,3R)-2-methyl-3-hydroxypentanoic acid N-acetylcysteamine thioester is exclusively recognized by its cognate beta-ketoacyl-acyl carrier protein synthase domain in module 2 (KS2). Labeled diketide specifically acylated DEBS1 in crude protein extracts and limited proteolysis localized the binding to module 2. The precise site of acylation in DEBS1 was established by the finding that a Cys2200 Ala mutant of DEBS1, lacking the KS2 active-site cysteine, did not undergo acylation by the diketide. Pretreatment of the wild-type protein with the beta-ketoacyl-ACP synthase inhibitor cerulenin also blocked acylation. These results indicate that in addition to the purely organizational consequences resulting from the order of active-site domains, the programming of polyketide biosynthesis by modular PKSs involves a substantial level of molecular recognition. This conclusion has important implications for the use of PKSs to rationally design novel polyketides.

3-Oxoacyl-(Acyl-Carrier-Protein) Synthase

Endometrial carcinoma associated with hyperplasia.

The aim of this study was to clarify the relationship of endometrial hyperplasia to endometrial carcinoma. From 1979 through 1990, 115 cases of stage I-IV endometrial carcinomas treated initially by hysterectomy were reviewed histologically. Forty-two of 115 (36.3%) patients had hyperplasia in the endometrium adjacent to the carcinoma. Women with both endometrial carcinoma and hyperplasia were significantly younger than those with carcinoma without hyperplasia (P < 0.05). In a comparison of patients with carcinoma without hyperplasia, those with hyperplasia were better differentiated (P = 0.0072), and lacked deep myometrial invasion (P < 0.0001), cervical involvement (P = 0.0192), lymph-vascular space invasion (P = 0.0102), and para-aortic lymph node metastases (P = 0.0434). The presence of endometrial metaplasia (P = 0.0001). The estimated 5-year survival rates for patients with carcinoma with hyperplasia and those with carcinoma without hyperplasia were 96.55 and 73.33%, respectively (P = 0.0016). In endometrial carcinomas, the presence of endometrial hyperplasia may demonstrate a more favorable prognosis.

Adult

The majority of T lymphocytes are polyclonal during the chronic phase of chronic myelogenous leukemia.

To clarify the extent of cell lineage involvement in chronic myelogenous leukemia (CML), we investigated the bcr gene rearrangement and clonality using the X-chromosome-linked restriction fragment length polymorphism (RFLP) methylation method in T lymphocytes and granulocytes. We examined the granulocyte and T-cell fractions from the peripheral blood of seven female patients with CML during the chronic phase; patients were heterozygous for RFLPs at the phosphoglycerate kinase (PGK) or the hypoxanthine phosphoribosyltransferase (HPRT) gene. RFLP-methylation analysis of granulocytes demonstrated a monoclonal pattern in six of the seven patients and a rearranged bcr gene in all seven patients. In contrast, T lymphocytes exhibited a polyclonal pattern in six cases; in one case, a faint band was observed following methyl-sensitive enzyme cleavage. The bcr gene analysis in T lymphocytes showed the germline in every case. Our results indicate that the majority of T lymphocytes are polyclonal during the chronic phase of CML and confirm previous reports based on glucose-6-phosphate dehydrogenase, cytogenetic, and bcr rearrangement analyses.

Adult

Detection of c-myc oncogene amplification in a CML blastic phase patient with double minute chromosomes.

Double minute chromosomes (dmin) are relatively rare in leukemias. Cytogenetic analysis of blood cells from a woman with blastic phase chronic myelogenous leukemia (BC-CML) showed numerous dmin chromosomes and complex abnormalities including a Philadelphia (ph(1))-chromosome. Oncogene amplification in hematopoietic malignancies is also rare. Using PCR, we retrospectively investigated the extent of c-myc gene amplification in DNA extracted from stored blood smears from the patient. To qualify the PCR products, the beta-globin gene was used as the internal reference gene and it was co-amplified with the c-myc gene. The extent of amplified c-myc was about 6.8-fold. This finding suggests that the c-myc gene was amplified in dmin and that the gene amplification contributes to the progression to acute leukemia or rapid growth of leukemic cells.

Base Sequence

Convulsions associated with epidural analgesia during sevoflurane anaesthesia.

A three-year-old girl who underwent an operation for adrenal neuroblastoma was anaesthetized with sevoflurane and epidural analgesia. In the immediate recovery period she had convulsions. The convulsions were successfully treated with thiopentone and sevoflurane, there were no neurological sequelae. The convulsions were considered to be a manifestation of mepivacaine toxicity because of a high plasma mepivacaine concentration. Complications of paediatric regional analgesia and manifestations of mepivacaine toxicity under sevoflurane anaesthesia are discussed.

Analgesia, Epidural

The effects of sevoflurane and isoflurane anesthesia on renal tubular function in patients with moderately impaired renal function.

Increasing evidence indicates that sevoflurane anesthesia does not impair renal function in healthy patients despite higher concentrations of plasma inorganic fluoride. However, whether sevoflurane further affects renal tubular function in patients with impaired renal function is not known. We compared the effect of sevoflurane anesthesia with that of isoflurane anesthesia on renal tubular function in patients with moderately impaired renal function. Fourteen patients with creatinine clearance between 10 and 55 mL/min were anesthetized with either sevoflurane or isoflurane using a semiclosed circuit system. Plasma inorganic fluoride concentrations and urine N-acetyl-beta-D-glucosaminidase (NAG), gamma-glutamyltranspeptidase (gamma-GTP), and beta 2-microglobulin (beta 2MG) excretions were measured up to post-anesthetic day 14. Although both the peak plasma inorganic fluoride concentrations and the areas under the curve of plasma inorganic fluoride concentration versus time were significantly greater in the sevoflurane group than in the isoflurane group, urine NAG, gamma-GTP, and beta 2MG excretions per day did not differ between the two groups. These results indicate that sevoflurane and isoflurane may have similar effects on the renal tubules in patients with moderately impaired renal function.

Acetylglucosaminidase

[Palliation of brain metastases: factors associated with survival].

One hundred ten patients with brain metastases (76 lung cancer, 11 breast cancer, 7 colorectal cancer and others) were treated with radiotherapy, and the results were retrospectively evaluated. Neurologic symptoms were improved in 66% of patients. The relationship between improvement of neurologic symptoms and several factors, including irradiation dose, primary lesion, histology, term between first treatment and recurrence, clinical symptoms and CT findings, was analyzed. There was no significant correlation between symptom relief and these factors except for the number of metastatic lesions. Four of 110 patients could survive more than 2 years after radiotherapy: one with lung cancer, one with breast cancer, one with rectum cancer and one with uterine cancer. The factors that were analyzed for symptom relief were also studied to determine their effect on the survival of lung cancer patients with brain metastases. The patients who had higher dose irradiation (50 Gy) of improvement of neurological symptoms after radiotherapy survived significantly longer than those who had 30 Gy of irradiation or no symptom relief. Multivariate analysis of these factors showed that improvement of symptoms and irradiation dose were similarly important prognostic factors, whereas the others were not correlated with survival.

Brain Neoplasms

Endometrial carcinoma in women 65 years of age or older: a clinicopathologic study.

The purpose of this study is to clarify the clinical and pathologic features of endometrial carcinomas in women 65 years of age or older in Japan where the incidence of endometrial carcinoma is still low. Between 1979 and 1990, 24 of 164 patients with endometrial carcinoma were 65 years old or over. In addition, 41 patients 50 years of age or younger were also analyzed, comparing clinicopathologic features with those of older age group. Seventeen of 24 (71%) showed deep myometrial invasion (more than a half of the myometrium). Endometrial carcinomas in older age groups have deeper myometrial invasion, and higher histologic grade than those of younger age groups. The adjacent endometrium is usually atrophic and the presence of hyperplasia and/or metaplasia was significantly less frequent in the older group as compared with that in the younger group. Nine of these 24 patients died of disease in a relatively short follow-up period. The prognosis for the older group (expected 5-year survival 69.2%) is significantly worse than for the younger group (expected 5-year survival 94.3%) (P = 0.006). Endometrial carcinomas in patients over 65 years of age are usually of high histologic grade, and have deep myometrial invasion and an unfavorable prognosis.

Age Distribution

The human aldehyde dehydrogenase 3 gene (ALDH3): identification of a new exon and diverse mRNA isoforms, and functional analysis of the promoter.

Expression of the human ALDH3 gene is regulated in a tissue-dependent constitutive as well as drug-inducible manner. We identified a new 5'-noncoding exon (exon 1) existing at about 3 kilobase pairs (kb) upstream from the first coding exon (exon 2) of the human ALDH3 gene. Analysis of ALDH3 mRNA revealed the existence of several isoforms with different 5' regions resulting from i) usage of multiple transcriptional initiation sites of the new exon 1, ii) usage of alternative splice acceptor sites at the 3' end of the new intron 1, and iii) alternative splicing out of exon 2. Usage of alternative splice acceptor sites was only found in tissues expressing ALDH3 constitutively, but not in Hep G2 induced by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Nucleotide sequence analysis and chloramphenicol acetyltransferase (CAT) expression studies showed that a strong promoter region exists at nucleotide (nt) positions -216 to +54 of the gene. Repression activities were found upstream of the -216/+54 region. Several putative drug-inducible elements exist in the regulatory region. A possible regulatory mechanism for tissue-specific constitutive and inducible expression of the human ALDH3 gene is discussed.

Aldehyde Dehydrogenase

Leukemic transformation in three patients with polycythemia vera. Analysis of the clinicopathological features and N-ras gene mutation.

Thirty-three patients were diagnosed as having polycythemia vera (PV) from 1973 to 1993 in our institution. Of these patients, three who had been treated with alkylating agents, progressed to acute non-lymphocytic leukemia (ANLL). Their physical findings and the laboratory data were similar to those patients who did not become leukemic. To investigate the association with leukemic evolution, we examined N-ras oncogene activation in those patients who progressed to acute leukemia. Point mutations in codons 12 and 13 were not always detected, suggesting that the N-ras gene did not influence occurrence of ANLL in our patients.

Adult

The prognostic significance of lymphovascular space invasion in endometrial cancer when conventional hemotoxylin and eosin staining is compared to immunohistochemical staining.

The current study was undertaken to compare the usefulness of hemotoxylin and eosin (H&E) staining and immunohistochemical staining to identify lymphovascular space invasion (LVSI) in endometrial cancer and to evaluate the presence of LVSI detected by either technique as an independent prognostic factor. Histologic sections from 92 patients with clinical stage I-II endometrial cancer were reviewed, and representative sections were stained immunohistochemically with antibodies for von Willebrand factor and blood group isoantigens. To compare the prognostic significance of LVSI detected by H&E staining with that detected by immunohistochemical staining, univariate and multivariate analyses were performed. Thirty (32.6%) of the 92 cases showed LVSI in H&E staining. In 8 of the 30 cases, LVSI was negative by immunohistochemical staining, while LVSI was positive by immunohistochemical stainings in 2 of 62 cases showing negative LVSI in H&E staining. In univariate analysis, LVSI detected by H&E and immunohistochemical staining was proved to be significant as a prognostic factor. In multivariate analysis by Cox's proportional hazards model, LVSI identified by H&E staining was selected as one of significant prognostic factors, but LVSI identified by immunohistochemical staining not selected. The results of this study indicate that LVSI is one of the independent prognostic factors in endometrial cancer, and that LVSI as detected by H&E is more prognostic of survival than immunohistochemical detection.

Adult

Primary jejunal adenocarcinoma masquerading as a primary ovarian malignancy.

Primary adenocarcinoma of the jejunum which accounts for only approximately 3% of all gastrointestinal tract malignancies, is distinctly unusual. Ovarian metastasis from a jejunal cancer is extremely rare. It has significant therapeutic and prognostic implications to differentiate primary ovarian carcinoma from metastatic disease to the ovary. A 49-year-old Japanese woman presented with intermittent nausea, vomiting, and palpable abdominal mass. Pelvic examination and imaging studies revealed a huge ovarian tumor, suspicious for malignancy. Upper GI series and barium enema were unremarkable. Exploratory laparotomy was done for presumed primary ovarian malignancy. Mucinous adenocarcinoma of the right ovary, measuring 25 x 18 x 12 cm, without other intraabdominal dissemination was found. Exploration of the upper abdomen revealed an annular constriction of the jejunum 30 cm distal to the ligament of Treitz. Partial jejunectomy with end-to-end anastomosis was done. Metastatic ovarian cancer from the primary jejunal adenocarcinoma was confirmed microscopically. Although small bowel malignancy is uncommon, small bowel follow-through examination or enteroclysis may be indicated in patients with positive stool for occult blood who have no abnormality in the upper gastrointestinal series and barium enema. In addition to the imaging studies, thorough exploration of the entire abdominal cavity is necessary at ceiliotomy in patients with ovarian malignancy to distinguish primary ovarian cancer from metastatic disease to the ovary.

Adenocarcinoma

Molecular cloning of a novel mitogen-inducible nuclear protein with a Ran GTPase-activating domain that affects cell cycle progression.

We have cloned a novel cDNA (Spa-1) which is little expressed in the quiescent state but induced in the interleukin 2-stimulated cycling state of an interleukin 2-responsive murine lymphoid cell line by differential hybridization. Spa-1 mRNA (3.5 kb) was induced in normal lymphocytes following various types of mitogenic stimulation. In normal organs it is preferentially expressed in both fetal and adult lymphohematopoietic tissues. A Spa-1-encoded protein of 68 kDa is localized mostly in the nucleus. Its N-terminal domain is highly homologous to a human Rap1 GTPase-activating protein (GAP), and a fusion protein of this domain (SpanN) indeed exhibited GAP activity for Rap1/Rsr1 but not for Ras or Rho in vitro. Unlike the human Rap1 GAP, however, SpanN also exhibited GAP activity for Ran, so far the only known Ras-related GTPase in the nucleus. In the presence of serum, stable Spa-1 cDNA transfectants of NIH 3T3 cells (NIH/Spa-1) hardly overexpressed Spa-1 (p68), and they grew as normally as did the parental cells. When NIH/Spa-1 cells were serum starved to be arrested in the G1/G0 phase of the cell cycle, however, they, unlike the control cells, exhibited progressive Spa-1 p68 accumulation, and following the addition of serum they showed cell death resembling mitotic catastrophes of the S phase during cell cycle progression. The results indicate that the novel nuclear protein Spa-1, with a potentially active Ran GAP domain, severely hampers the mitogen-induced cell cycle progression when abnormally and/or prematurely expressed. Functions of the Spa-1 protein and its regulation are discussed in the context of its possible interaction with the Ran/RCC-1 system, which is involved in the coordinated nuclear functions, including cell division.

3T3 Cells

[Palliative radiotherapy for symptomatic osseous metastases].

Bone metastases are one of the most common and serious conditions requiring radiotherapy, but there is still a considerable lack of agreement on optimal radiation schedule. We analyzed patients with symptomatic osseous metastases from lung (72 patients) and breast (63 patients) carcinoma treated by palliative radiotherapy between 1983 and 1992. In this series, the incidences of symptomatic bone metastases appearing within 2 years after the first diagnosis of the primary lesion were 96% and 36% for lung and breast carcinomas, respectively. Thirty percent of bone metastases from breast carcinoma were diagnosed more than 5 years after the first diagnosis. Thus careful follow-up must be carried out for a prolonged period. Pain relief was achieved at almost the same rate for bone metastases from lung and breast carcinomas (81% and 85%, respectively), an the rapid onset of pain relief (15 Gy or less) was obtained in about half the patients for both diseases. The rapid onset of pain relief and the lack of association between the onset of pain relief and primary tumor argued against the conventional theory that tumor shrinkage is a component of the initial response. In contrast to the fact that almost all lung carcinoma patients had very poor prognoses, one third of the breast carcinoma patients were alive more than 2 years after palliative radiotherapy. Thus, the late effects of radiation, such as radiation myelopathy, must be always considered especially in breast carcinoma patients even when it is 'just' palliative radiotherapy for bone metastases.

Adult

[Lumbar epidurography with iohexol: the effect of aging on the leakage of contrast media from the intervertebral foramina].

The lateral and longitudinal spread of contrast media was investigated by lumbar epidurography with 8 ml of iohexol in 47 patients aged 25 yr to 86 yr. Iohexol was injected through the epidural catheter epidurally advanced by 5 cm cephalad from the L 1-4 interspace. A significant correlation was found between the longitudinal spread of iohexol and aging. No correlation was found between the leakage of iohexol from the intervertebral foramina and aging. This finding may deny the hypothesis that in elderly patients, the more extensive longitudinal spread of local anesthetics in the epidural space may be caused by its smaller leakage from the intervertebral foramina.

Adult

[Dose-volume histogram comparison among techniques of linac stereotactic radiosurgery].

The aim of this study was to analyze the three-dimensional dose distributions produced by various techniques used in current radiosurgery treatments by means of dose-volume histograms (DVH). Off-center ratio and tissue-peak ratio from 6-MV X-rays through additional cylindrical collimators were measured in advance for dose calculation. The use of the diamond detector and beam profile film dosimetry in small fields were certified. The impact of arc number, arc geometry, and field size on the dose distribution in a spherical phantom was evaluated through the use of DVH. These were calculated for a) four arc irradiations with collimator sizes of 5, 10, 20 and 30 mm in diameter, and b) for single-plane rotation, four or eleven multiple non-coplanar convergent arcs, dynamic rotation and precessional converging radio-therapy (PCR) with a field size of 20 mm. PCR is performed in the sitting position with the patient seated on a special treatment chair, which is rotating continuously while the gantry moves from the top to the center of the chair rotation. Most of the differences between techniques were found in a range of less than 40% of the maximum dose. Multiple non-coplanar convergent arcs with four or eleven arcs and PCR performed similar result in DVH, while single-plane rotation revealed almost unacceptably shallow dose falloffs. The DVH of dynamic rotation was between that of single-plane rotation and the other three methods.

Humans

Evaluation of bi-level image converting methods for nuclear medicine image database stored in the IS&C magneto-optical disk.

1. INTRODUCTION. We have developed a report and imaging management system for nuclear medicine. The report and image data are stored in the IS&C magneto-optical disk (IS&C MOD). Nuclear medicine image data are relatively small, but they are large enough to create problems when being transported over a low-speed Hospital Information System (HIS) network. Moreover, gray scale image output devices (i.e., high-resolution displays, sonoprinters) are expensive. If high quality bi-level (black and white) images were available, images could be transferred through low-speed network with inexpensive bi-level terminals or conventional page-printers. We examined images using several bi-level image conversion techniques [1, 2] in order to determine how useful the bi-level images are and to assess their suitability for use in nuclear medicine. The images were compared with original film images by ROC analysis. The modified minimized average error method was found to be superior to other methods in bone and gallium images. Its A-values are 0.83 in gallium scan and 0.85 in bone scan. 2. MATERIALS AND METHODS. Our system consists of three digital gamma cameras, a nuclear medicine data processing unit, two UNIX stations, and two personal computers. The computers and the data processing unit are connected via Ethernet and each computer has an IS&C MOD unit. Image and report data are stored in the IS&C MOD. The computers are also connected off-line through the IS&C MOD. To evaluate image quality, bone scan images and gallium scan images (1024x512, 2048x1024 pixels and 16 bits depth) were converted to bi-level images (same pixels and one bit depth) using four methods: dither method, minimized average error method (MAE)[1], modified regional adaptation method, and constrained average method. For the dither methods, three sets of dither matrix (Fatting's, Bayer's and our original matrix) were employed. The computer images were compared with original film images by ROC analysis. 3. RESULTS. The converted bi-level images were 1/16 the size of the originals. They were transferred via Ethernet, displayed on the monochrome display, and printed using a conventional page-printer (240 dpi or 300 dpi). The A-values of the original gallium and bone images on the films were 0.89 and 0.94. Modified MAE method gave better results than other methods tested, with the gallium image using this technique reading 0.83 on the A-scale; and the bone images were 0.85. 4. DISCUSSION. Generally, nuclear medicine images require lower spatial and gray level resolution than other computer imaging techniques. We compared four bi-level image conversion methods in order to know which methods are suitable to nuclear medicine images. The ROC analysis was employed to evaluate these image qualities. The MAE methods made particular texture pattern as artifacts in the intermediate gray level area. But it can express homogeneity the neutral level. The dither method images are coarse texture. It affects detectabilities of subtle abnormal findings. 5. CONCLUSIONS. The A-z values of the modified MAE images were comparable to those of original film images. Although bone images give slightly lower values, many abnormal findings can be ascertained on bi-level images. High quality bi-level image techniques are considered to be useful for nuclear medicine image database systems.

Japan