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Biomedical subjects

S Uehara

Publications and source records attributed to S Uehara.

At least 163 records · Page 9Linked to original sources

Structure and expression of the human angiotensinogen gene. Identification of a unique and highly active promoter.

We have isolated the human angiotensinogen gene from a genomic library and determined the exon-intron junction sequences. The gene is 12 kilobases long and consists of five exons interrupted by four introns, as a single copy in the human genome. Of particular interest are the positions of the introns in the human angiotensinogen gene which are identical to those in the highly homologous human alpha 1-antitrypsin and alpha 1-antichymotrypsin genes, as well as rat and mouse angiotensinogen genes. Northern blot analysis showed that human hepatoma cells (HepG2) produce a large amount of angiotensinogen mRNA but not human glioma cells (T98G). To assay the promoter activity, the 1.3-kilobase genomic fragment containing the 5'-flanking region, first exon, and a part of first intron at positions -1222 to +44 was fused upstream to the chloramphenicol acetyltransferase gene, then transfected into HepG2 and T98G cells. The gene sequence was active only in HepG2 cells, suggesting the presence of a functional promoter. Analysis of deletion mutants demonstrated that the 76-base pairs region from -32 to +44 containing the TATA box and first exon is the minimal promoter, whose activity is as high as that of the SV40 enhancer-promoter. Since the basal expression of the human angiotensinogen gene is much higher in HepG2 than T98G cells, these results may reflect cell-specific differences in the gene transcription.

Amino Acid Sequence↗

[A case of penicillin-resistant pneumococcal meningitis and antibiotic susceptibility of Streptococcus pneumoniae isolated from children].

Recently, isolation of penicillin-resistant S. pneumoniae has been increasing. The first Japanese case of penicillin-resistant pneumococcal meningitis was reported in 1988. We experienced a case of a one-year-old boy with penicillin-resistant pneumococcal meningitis who dead on arrival on his third day of illness. Minimal inhibitory concentration (MIC) of penicillin G or S. pneumoniae isolated from cerebrospinal fluid and blood was 0.6 micrograms/ml. We evaluated the antibiotic susceptibility of 163 strains of S. pneumoniae isolated from children from 1985 to 1988. Penicillin G (PCG), ampicillin (ABPC), cefotaxime (CTX), imipenem (IPM), and vancomycin (VCM) had good susceptibilities to S. pneumoniae. Twelve of the 163 isolates (7.3%) were penicillin-resistant strains whose MIC of PCG were more than 0.1 microgram/ml, and all of them were intermediately resistant. The annual penicillin-resistant rates were 12.5% in 1985, 1.3% in 1986, 0% in 1986, and 19.0% in 1988. We also evaluated the MIC distribution and MIC90 of antibiotics available for meningitis against penicillin-sensitive and -resistant S. pneumoniae. MIC90 of PCG and ABPC against penicillin-resistant strains was 1.56 micrograms/ml, and it might be dangerous to use PCG or ABPC for central nervous system pneumococcal infections. MIC90 of IPM against penicillin-resistant strains was 0.1 microgram/ml, and that of VCM was 0.4 micrograms/ml. There was little fall of susceptibilities of resistant strains in IPM and VCM. We evaluated the MIC distribution and MIC70 of antibiotics for oral usage against penicillin-sensitive and -resistant S. pneumoniae. Although there were falls of susceptibilities of resistant strains in PCG and ABPC, these two antibiotics had the best susceptibilities among the oral antibiotics.

Anti-Bacterial Agents↗

[Radiotherapy of aged cancer patients].

Although it is not a categorized modality, cancers of aged patients, generally characterized by a slow growth, histologically high differentiation and low radiosensitivity due to co-existing chronic anemia, should have more individualized treatment because there is a wide spectrum of differences in functional reservoir and tolerance dose of each organs and individuals. In aged cervical cancer of the uterus, we decrease the fractionated and total irradiation dose of a whole pelvic cavity by 10%. For patients more than 80 years old, we principally abandon external beam and singularly chose an intracavitary treatment. In our protocol, there could find no significant difference in 5 year survival between 51-70 y.o. 51.9% (120/231) and 71-80 y.o. 57% (61/107), but in the over 80 y.o. group, it was decreased to 13.6% (3/22) by increased death of other diseases 61.9% (13/21) compared with 18.4% (36/195) in 51-80 y.o. In radiotherapy of advanced lung cancer in aged, we decreased fractionated and total dose by 10 to 20% with minimum irradiation field. In non-small cell carcinoma, a median survival time was 11.5 months in both over and under 70 y.o., although the response rate (CR + PR) was resulted relatively low in aged, 33.3% (N = 45), compared with under 70 y.o., 38.4 (N = 146). The degrees of impairment in respiratory and bone marrow function were similar in both groups. Accordingly, we convinced the efficacy and the necessity of individualized radiotherapy for aged cancer patients.

Aged↗

[Risk factors relating to coronary artery disease in the elderly].

A total of 224 patients with coronary artery disease (CAD) and 167 healthy control beings (C) were evaluated for coronary risk factors. Analysis of low age subset (age less than 55) disclosed hypertension and hypercholesterolemia were more common findings in CAD compared with C. Significantly elevated plasma triglyceride (TG) and low density lipoprotein cholesterol (LDL-C), and reduced high density lipoprotein cholesterol (HDL-C) concentrations were found in CAD, accompanied by significant increase of atherogenic index (AI). In CAD, a decreased number of males and smokers was noted in high age subset (age over 65). Significantly reduced plasma TG and elevated HDL-C were observed in the elderly compared with the young. AI was also significantly higher in this group. Therefore, in CAD, the level of coronary risk factors seemed to be attenuated in the hig age subset compared with the low age group, which was different from the findings in C in whom significantly increased AI was noted in the elderly. In 61 CAD cases, lipid profiles were monitored for 5 years in average. Significant changes recognized during this period were the reduction of TG, LDL-C and AI along with the elevation of HDL-C, suggesting their risk to be improved. To examine the metabolic effects of diuretics, 52 patients with essential hypertension on trichlormethiazide for long periods were subjected to the substitution of this drug by the inhibitor of angiotensin converting enzyme, enalapril, for more than 3 months. At the end of each treatment, measurements of blood sugar (BS) and insulin (IRI) were made together with lipid analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

Role of the kallikrein-kinin system in human pancreatitis.

Various factors in the kallikrein-kinin system were evaluated in acute and chronic pancreatitis. It was noted in particular that plasma trypsin and glandular kallikrein increased markedly in acute phase of pancreatitis and its correlation with amylase was observed. Plasma prekallikrein (PPK) decreased in acute pancreatitis, but increased in chronic pancreatitis. A negative correlation was noted between PPK and kallikrein like activity. Both HMW and LMW kininogen decreased in acute pancreatitis. It was presumed from these findings that the increase in kinin and its activation at the acute phase of pancreatitis might be due to kallikrein or trypsin originating from the pancreas.

Acute Disease↗

A novel kinin, Met-Ile-Ser-bradykinin (Met-T-kinin) is released from T-kininogen by an acid proteinase of granulomatous tissues in rats.

Acid proteinase of granulomatous tissues in rats with carrageenin-induced inflammation released two types of kinin from T-kininogen. The kinin was identified as Ile-Ser-bradykinin (T-kinin) and a novel kinin, Met-Ile-Ser-bradykinin (Met-T-kinin), from determination of its amino acid composition and its immunoreactivity toward anti-bradykinin antiserum. The release of T-kinin and Met-T-kinin from T-kininogen were found to occur by consecutive cleavage by cathepsin D and 72 kDa protease.

Amino Acids↗

[Studies on 145 cases of septicemia in infancy and childhood--especially on septicemic patients with malignant and hematological diseases].

Clinical and bacteriological data of 145 inpatients with septicemia, treated at the hospital of Chiba University School of Medicine from 1972 to 1987, were reviewed by dividing them into three stages. (stages I: 1972-76, stage II: 1978-82, stage III: 1983-87) Patients with underlying diseases have been increasing: 91.8% of the total patients in stage III. Among the patients with underlying diseases, malignant and hematological diseases occupied about 60%, and in the other diseases, congenital heart diseases have been increasing in number. As to the organisms isolated, gram positive bacteria have increased, while gram negative bacteria have decreased. In stage III, the rate of gram positive organisms and gram negative ones accounted for 43.1% and 41.2% of all the isolates from the septic patients with malignant & hematological diseases, respectively. In patients with malignant & hematological diseases, alpha-streptococcus, coagulase-negative staphylococcus, and Fusobacterium sp. have been increasing, whereas, Escherichia coli, Enterobacter sp., Klebsiella sp., and Pseudomonas aeruginosa decreasing. In patients with other underlying diseases, S. aureus, CNS, and non Fermenters have been increasing. Among the patients without underlying diseases, gram positive bacteria accounted for the major part. The decrease of gram negative organisms in patients with malignant and hematological diseases may partially depend on the introduction of polymixin B as the drug of gut decontamination. The outcome of septicemia in the patients with malignant & hematological diseases has been markedly improving through all the three stages. During stage III, episode mortality and case mortality rate proved to be 23% and 31%, respectively. The introduction of the third generation cephems has decreased the mortality rate for gram negative organisms and contributed to the improvement of the total prognosis. The prognosis was worst in the case of P. aeruginosa, showing a mortality rate of 50% during stage III. Coincidence rate of blood and other cultures have been largest in the case of P. aeruginosa, so, the drug sensitivity of the strain cultured from other sites is sometimes useful in the choice of antibiotics.

Adolescent↗

Effects on the urinary level of gamma-carboxyglutamic acid caused by the administration of antibiotics with N-methyl thiotetrazole side chains to patients with infectious diseases.

A comparative study was conducted of the urinary level of gamma-carboxyglutamic acid (gamma-Gla) in patients with infectious diseases to investigate the mechanism of hemorrhagic diathesis occurrence resulting in post-administrative side effects of cephem-group antibiotics. The results showed that the group of administered antibiotics with N-methyl thiotetrazole (NMTT) side chains exhibited decreases in the urinary level of gamma-Gla. Especially, in the aged group of patients (over 65) with non-carcinoma infectious diseases, significant decreases in the urinary level of gamma-Gla were observed. From the above, it is considered that the administration of antibiotics with NMTT side chains has an effect of prohibiting the vitamin K function.

1-Carboxyglutamic Acid↗

Effects of cilostazol on platelet function.

The antiplatelet effect of cilostazol (OPC-13013) was investigated by means of both in vitro and in vivo examinations. With the in vitro tests, cilostazol showed an inhibitive effect approximately 10 times greater than trapidil as a result of comparative examinations of the platelet aggregation inhibitive effect using trapidil as the control. In the in vivo tests, which were conducted to observe the platelet aggregation inhibitive effect as a result of oral administration of cilostazol at 100 mg/d for 4 weeks to patients with stable cerebral vascular diseases, a significant decrease in aggregation was recognized.

Adult↗

[A case of cholangiocarcinoma with marked reduction of tumor after oral administration of UFT].

A 54-year-old male complaining mainly of pain in the right terminal rib area was admitted to hospital for hepatic tumor examination. Cholangiocarcinoma was diagnosed by various imaging techniques, and the patient was started on a program of daily oral administrations of 600 mg of UFT after abdominal arterial injection of 30 mmg of MMC. The tumor continued to decrease in size on CT image during two years of UFT administration. The patient continues to be monitored as an outpatient. A marked reduction in the size of a cholangiocarcinoma was observed in the case, and administration of UFT has proved effective in prolonging life for over two years.

Adenoma, Bile Duct↗

[Interstitial radiotherapy of carcinoma of the tongue-comparison between Jacobson-Yamamoto grading and prognosis].

One hundred and one patients of less than seventy years old with T1, T2 and N0 carcinoma of the tongue were graded according to the Jacobson-Yamamoto's grading (1-4 D). All patients were also classified into two groups such as less than fifty years old group and fifty to seventy years old group. Patients with grade 3, 4 C and 4 D carcinoma had more metastases to the cervical lymph nodes than grade 1, 2. Patients with T2N0 carcinoma showed approximately same five year cervical lymph node metastases free survival rate. However, the five year survival rate of less than fifty years old group was significantly lower than that of fifty to seventy years old group. In T2N0, grade 3-4 D carcinoma cases, more dead cases were found in less than fifty years old group than in fifty to seventy years old group.

Adult↗

Deep local and regional hyperthermia with annular phased array.

33 refractory tumors mainly located in the pelvic cavity after definitive treatment were treated by loco-regional hyperthermia alone (n = 11) or by heat in combination with radiotherapy (n = 22) by annular phased array (APA) manufactured by BSD Corp. Tumors were heated up to more than 42 degrees C in 78% of 347 total heat sessions with induction time 22 +/- 1 (S.D.) minutes during which those of intra-pelvic organs were elevated up to between 41 and 42 degrees C. Tumor response was CR 18%, PR 50% by heat (11.2 +/- 1.5 S.D. fractions) combined with radiotherapy (43.8 +/- 12.5 S.D. Gy) and by heat alone (8.6 +/- 1.3 S.D. fractions) CR 18%, PR 9%. In all heat sessions superficial pain 36%, skin burn (grade 1-2) 12% inside annular array and slight to moderate systemic heat stress 100% were the main adverse reactions we experienced.

Adult↗

Modification of annular phased array heating pattern.

By attaching 8 pairs of opposing Al-flaps, which have an angle of 30 degrees or 60 degrees with E-field direction in annular phased array (APA), on both sides of APA we could enhance the E-field in the pelvic heating center by a factor of 2 to 3 and also could decrease the E-field ratio of neck/pelvic center and ankle/pelvic center more than 50% compared with conventional use without Al-flaps between RF range of 50 and 90 MHz except 70 MHz. But that of pelvic surface/pelvic center was suppressed 30% only when 30 degrees angled 8 Al-flaps used.

Humans↗