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Biomedical subjects

S Ihara

Publications and source records attributed to S Ihara.

At least 55 records · Page 3Linked to original sources

Identification of mutation sites of a temperature-sensitive mutant of HCMV DNA polymerase activity.

The human cytomegalovirus (strain Towne) temperature-sensitive mutant ts 256 exhibits a virus specific DNA polymerase-negative phenotype. The position of the mutation of ts 256 was determined by three step marker-rescue assays to be within a 5.1 kb XbaI-BamHI fragment between map unit 0.33 and 0.35 in a HindIII-D fragment located in a long unique region. Nucleotide sequencing showed that the 5.1 kb fragment contained three open reading frames corresponding to those of the genes for UL52, UL53 and UL54 (DNA polymerase gene), respectively, of strain AD169. The functions of UL52 and UL53 are unknown. Comparison of the DNA sequences of the 5.1 kb fragments of the wild-type and ts 256 mutant revealed two base changes within UL53 and UL54, respectively, which result in amino acid substitutions. The mutation in the UL54 gene was located within a distinct conserved region VI common to alpha-like DNA polymerases, suggesting that this base change would be responsible for DNA negative phenotype.

Amino Acid Sequence↗

Pit-1/GH factor-1 involvement in the gene expression of somatolactin.

A presumed pituitary hormone, somatolactin (SL), belonging to the GH/PRL family, is produced in the intermediate lobe of teleost pituitary. The pituitary-specific transcription factor, Pit-1, is indispensable not only for the expression of mammalian GH and PRL genes, but for the development of GH- and PRL-producing cells present in the anterior lobe of the pituitary as well. Thus, in this study, examination was made of the possible involvement of Pit-1 in the intermediate lobe-specific expression of the SL gene. Using antibodies against chum salmon Pit-1, the presence of the 40-kilodalton Pit-1 protein in anterior and neurointermediate lobes of rainbow trout pituitary was demonstrated. By immunohistochemical examination, Pit-1 protein was shown to be located in the nuclei of SL-producing cells in the intermediate lobe. In experiments of cotransfection into HeLa cells, rat Pit-1 enhanced the promoter activity of SL gene, and a 0.5-kilobase upstream region from the transcriptional start site was sufficient for this enhancement. It follows from these results that Pit-1 protein may possibly be involved in SL gene expression as well as the development of SL-producing cells.

Animals↗

[Home oxygen therapy in pulmonary tuberculosis and pulmonary atypical mycobacteriosis during chemotherapy].

During the period of eight years from 1985 to 1992 we had sixteen patients (pulmonary tuberculosis: 6, atypical mycobacteriosis: 10) who had been under the treatment for tuberculosis and on whom home oxygen therapy (HOT) was started. Of sixteen patients twelve had history of antituberculous therapy in the past. There were nine chronic active or persistently sputum positive patients of whom three were pulmonary tuberculosis and six atypical mycobacteriosis. The duration of illness was long in these patients and it was more than ten years in tuberculosis patients. Four cases died, two cases of pulmonary tuberculosis died from hemoptysis, and two cases of atypical mycobacteriosis died from respiratory failure.

Adult↗

[Asymptomatic multiple intracranial tuberculous nodules detected in a case of miliary tuberculosis].

A case of multiple intracranial tuberculous nodule following miliary tuberculosis was reported. The case was a 19-year-old woman visited a general practitioner, because of fever. Chest x-ray film on the first visit showed diffuse granular shadows in her both lungs with pleural effusion in the left side. The case was diagnosed as bacterial pneumonia, and was treated with antibiotics. She had been getting worse, and the doctor finally examined her sputum, and tubercle bacilli were seen in her sputum (Gaffky 4) by the Ziehl Neelsen's staining. She was introduced to our hospital. Chest x-ray film on admission showed diffuse granular shadows in her both lungs and she was diagnosed her as miliary tuberculosis, and anti-tuberculous therapy was quickly started. She didn't complain of any neurological disorders, but her brain CT showed several nodules in the left cerebral cortex enhanced with contrast medium. T1 weighted MRI enhanced by Gd-DTPA revealed abnormal enhancements in the cerebrum, the cerebellum, and the midbrain. She was treated with anti-epileptic drugs, but after 65 days, she started to suffer from epileptic stroke. Six months later, her brain lesions have improved by the use of anti-tuberculosis drugs and anti-epileptic drugs. The incidence of tuberculosis has decreased in Japan, and, many doctors did not show concern on, thus, a doctor's delay is a serious problem in Japan. Advocary should be made to doctors to detect tuberculous patients as early as possible.

Adult↗

[A case of miliary tuberculosis after adrenocorticosteroid medication for tuberculosis of the wrist].

This report is a case study of miliary tuberculosis that was induced when adrenocorticosteroid treatment for tuberculosis of the wrist was given because of a mistaken diagnosis of rheumatoid arthritis. An 85-year-old man was admitted to a hospital with a fever and chest pains. Since an examination of the chest X-ray revealed fine nodules throughout both lungs and a sputum smear tested positive for acid-fast bacilli, he was transferred to our hospital. The patient had a three-year history of pain in his left wrist joint. He had swelling on the dorsal aspect of his left wrist for 1 1/2 years, and had been diagnosed as having rheumatoid arthritis. Prednisolone had been administered in dosages of 5 mg per day for two months and 5 mg every other day for four months prior to admission. Upon admission to the hospital, an X-ray examination of the wrist revealed marked destruction of the left carpal bones. Smears of fluid aspirated from the swelling showed acid-fast bacilli, and cultures grew M. tuberculosis. He was treated with INH, RFP and SM, however, he had complications of tuberculous spondylitis and renal tuberculosis, and died nine months after admission.

Aged↗

[A case of pulmonary eosinophilic granuloma confirmed by transbronchial lung biopsy].

A case of pulmonary eosinophilic granuloma confirmed by transbronchial lung biopsy (TBLB) is reported. A 63-year-old man was admitted to our hospital complaining of productive cough and exertional dyspnea. Chest roentgenogram and computed tomography showed bilateral linear and reticular shadows predominantly in the upper and middle lung fields. TBLB was performed and the specimens showed granulomatous lesions consisting of histiocytes with infiltration of eosinophils. Histiocytes were positive for S-100 protein by immunohistochemistry. He was diagnosed as having pulmonary eosinophilic granuloma. In the diagnosis of pulmonary eosinophilic granuloma, open lung biopsy is useful, but TBLB is also useful for diagnosis in the active or early stage of this disease.

Biopsy↗

Inducible expression of a foreign gene inserted into the human cytomegalovirus genome.

We previously described the insertion of a foreign gene into a non-essential region of human cytomegalovirus (HCMV) by homologous recombination. Here we report insertion of the Escherichia coli lacZ gene downstream of the mouse metallothionein promoter into the HindIII-O region of HCMV by replacement-type recombination. Expression of the lacZ gene in the recombinant was independent of viral growth, but dependent on induction by heavy metals. Of several metals tested for beta-galactosidase induction and also for their toxicity to HEL cells, Zn was found to be the most suitable for use as an inducer. In HEL cells infected with the recombinant in the presence of 50 microsM-Zn, beta-galactosidase activity was maximal 3 days after infection, and reached levels 27 times higher than the value obtained in the absence of Zn.

Cytomegalovirus↗

[Organ transplantation and religious feeling of Japanese people against it].

More than one year and six months have passed since the provisional committee on Brain Death has recognized brain death as the death of a human being, and the possibility of organ transplantation from the dead patient after brain death has been confirmed. However, no operation has been performed since then because of many obstacles. One of them is a cultural resistance which Japanese people have against the organ transplantation from a dead person whose heart is still beating. This resistance is based on religious feelings which have been cultivated through the long history of Japan. For opinion makers working professionally in the medical filed, what are the important points which should be examined in order to promote organ transplantation? In this paper or article, I will try to analyze this cultural and religious resistance against it.

Attitude↗

[The background of foreign patients with pulmonary tuberculosis and investigation of treatment results].

This study focuses on the investigation of 35 foreign patients diagnosed as having pulmonary tuberculosis and treated at National Chiba-Higashi Hospital and the Chiba Anti-Tuberculosis Association between 1987 and 1991. All of the patients had lived in Japan less than five years. A large number of the patients were in their 20s. The chest X-rays of 24 cases (70%) revealed cavitary and sputum smear cultures for Mycobacterium tuberculosis were positive in 27 cases (77%). Many patients were in moderately advanced stages of the disease, becoming ill soon after their arrival in Japan, and being diagnosed symptomatically. Among the 35 cases, eight cases failed to finish treatment. Of those failing to finish, six were female and two were male. The results of sputum smear cultures of the patients failing to complete treatment revealed four cases that tested positive. Among those cases failing to complete treatment, four patients discharged themselves, three patients stopped during out-patient treatment, and one patient had to return to her home country because of a legal problem. A total of 14 patients were illegal immigrants: three of them failed to complete treatment because of their illegal status, and two of them due to unspecified reasons.

Adolescent↗

[A case of Addison's disease caused by adrenal tuberculosis, and revealed acute hypoadrenocorticism].

We reported a case of Addison's disease, caused by adrenal tuberculosis. The patient was female, seventy four years old. She complained cough and body weight loss. She complained cough from June, 1989, but her home doctor didn't take care of her symptoms. September 1989, she felt appetite loss, and easy fatigue, so her home doctor suspected her disease as pulmonary tuberculosis, so he introduced our hospital, and she admitted. When she admitted, her chest roentogenogram revealed bIII2. Sputum smear examinations were negative. Laboratory data on admission, we observed slightly eosinophilia, severe iron deficiency anemia, and accenturation of blood sedimentation rate. Immediately after admission, she complained nausea, vomiting, coldness, and powerless. On 25 days after admission, she lost her senses suddenly, and her blood pressure fell 5 days after, she fell in shock state, too. We found out her blood sugar data was 29. After blood examinations, we found out that ACTH was high, cortisole, 17-KS, 17-OHCS were low. So we thought she got acute hypoadrenocorticism. We found her abdominal CT revealed calcification in her right adrenal gland. We diagnosed her disease as Addison's disease caused by adrenal tuberculosis so we began to give prednisolone, 7.5 mg per day. After giving, her state made better. We thought her disease as Addison's disease caused by adrenal tuberculosis, revealed acute hypoadrenocorticism.

Addison Disease↗

[Investigation of tracheo-bronchial tuberculosis cases].

A total of 1397 patients were admitted to our hospital between 1986 and 1992. Of those patients, 68 were diagnosed as having tracheo-bronchial tuberculosis, when examined using a bronchofiberscope. We investigated the cases of 50 patients who were examined during the early stages of the diagnosed them as having pulmonary tuberculosis. The number of women in the group was larger than men, and young patients made up 30% of the group. Upon admission to the hospital, all of the patient's sputum examinations were tested positive, but their chest roentgenograms did not show a progressive stage. After treatment, patient roentgenograms showed improvement, however there was no improvement in tracheo or bronchial conditions. It was therefore believed that therapy was impeded by tracheobronchial tuberculosis, but only one patient was treated surgically. It was deemed that the delay of patients seeking treatment was not long, however, the delay for doctors in beginning therapy was very long. Many of the patients with tracheo-bronchial tuberculosis complained of coughing and sputum, therefore diagnosis and therapy should be performed as soon as possible.

Adolescent↗

[A case of local reactivation of tuberculous peritonitis with suspected gastric submucosal tumors after laparotomy].

After complaining of right hypochondrial pain, a 36-year old man was diagnosed as having a gastric submucosal tumor at a nearby hospital and admitted to Chiba Cancer Center Hospital. On admission, a hard and immobile mass was palpable on the right upper quadrant. Laboratory findings were within normal limits. A chest X-ray revealed bilateral pleural adhesions and streaking shadows in the bilateral lung area. These findings were assumed to be due to a prior tuberculous infection. Upper gastrointestinal series and endoscopic examination showed a protruding lesion on the stomach body. An abdominal CT showed another lesion adjacent to the stomach antrum. A resection was carried out under the presumptive diagnosis of multiple gastric submucosal tumors. Exploration of the abdomen revealed widespread fibrous adhesion suspected to be due to prior old tuberculous peritonitis. Two tumors were located here. One was adjacent to the stomach body, and the other was adjacent to the liver and abdominal wall. Pathologically, both were caseated necrotizing granulomas composed of mature epithelioid cells and Langhans giant cells. A close examination revealed that one originated from the serosa of the stomach and the other from the peritoneum. Both were believed to be relatively new lesions. Pus obtained from the tumors tested positive for acid-fast bacilli. A post-operative tuberculin skin test was given and checked highly positive. From these findings, this case was diagnosed as local reactivation of old tuberculous peritonitis. After antituberculous chemotherapy at our hospital, the patient was discharged and sent home without any symptoms. The reason for the local reactivation was unknown.

Adult↗

[Investigation of self-discharged patients of pulmonary tuberculosis].

This study investigates 27 cases in which the patients left hospital care without permission for personal reasons. These patients were classified as "self-discharged patients". Each of the patients had been diagnosed as having pulmonary tuberculosis, and were receiving treatment at the National Chiba Higashi Hospital during the period from January 1988 to July 1991. Disease was in an advanced stage in each of the patients when admitted: all sputum examinations were positive and chest roentgenograms revealed cavities in 26 patients. In addition to pulmonary tuberculosis, the patients were also diagnosed has having a variety of other medical complications such as diabetes mellitus, gastric ulcers and liver disease. Many of them were unemployed or were day labors. Reasons attributed to patients self-discharge from the hospital included repetition of alcohol drinking and unauthorized outings. At the time patients chose to leave hospitalization 11 cases checked positive for sputum examinations, and 16 cases never returned to complete therapy. Many of them were rated as high risk patients for pulmonary tuberculosis because they had no immediate family, did not own a residence or have regular employment thus economic and psychological conditions were very low. There is a high possibility that these individuals will suffer pulmonary tuberculosis relapse and become infectious bacteria carriers. It is important that such patients be hospitalized long enough to receive adequate treatment to prevent then from becoming infectious carriers and spreading disease.

Adolescent↗