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Biomedical subjects

T Iwata

Publications and source records attributed to T Iwata.

At least 163 records · Page 9Linked to original sources
PubMed1996

Effect of alacepril on 24-hour blood pressure in elderly hypertensive patients.

The effect of administration of an angiotensin-converting enzyme inhibitor, alacepril, on 24-hour blood pressure in the elderly hypertensive patients was investigated. Thirteen elderly hypertensive patients (mean age 71 +/- 5; 6 male and 7 female) participated in the present study. After 2 weeks of control period alacepril was administered 25-50 mg/day for 8 weeks. Ambulatory blood pressure monitoring with cuff-oscillometric method was performed at the end of both control and treatment periods. Alacepril administration for 8 weeks significantly decreased 24-hour blood pressure while it had little effect on heart rate. Daytime blood pressure was significantly decreased from 154 +/- 10/91 +/- 5 mmHg to 145 +/- 8/85 +/- 5 mmHg, while the change in nocturnal blood pressure was not significant: from 137 +/- 17/79 +/- 7 mmHg to 130 +/- 15/75 +/- 9 mmHg. Hyperbaric area of systolic blood pressure was also significantly decreased (from 295 +/- 185 mmHg x hour/day to 172 +/- 111 mmHg x hour/day), indicating that pressure load to the heart was effectively reduced. Administration of alacepril did not cause tachycardia in response to the decrease in blood pressure. Acrophase of both blood pressure and heart rate was changed to 11:00 a.m. These findings indicate that blockade of the renin-angiotensin system in the elderly hypertensive patients decreased blood pressure effectively without causing tachycardia or deterioration of diurnal variations of blood pressure. These hemodynamic changes produced by alacepril administration are favorable for the treatment of the elderly patients with cardiovascular disease.

Aged↗
PubMed1996

[Repair of the gastric tube-right main bronchus fistula after operation for esophageal cancer--treatment by transposition of pedicled pectoralis major muscle flap].

We have experienced a case who showed the gastric tube-right main bronchus fistula. A 51-year-old male complained cough and vomiting suddenly. He underwent esophagectomy and radio-chemotherapy for advanced esophageal cancer 19 months ago. Chest X-ray showed severe pneumonia, and gastroscopy, bronchoscopy and CT scan showed the fistula between the whole stomach esophageal substitute and right main bronchus. After recovery from the pneumonia with the treatment by continuous suction through the naso-gastric tube, operation was performed. The fistula was repaired with transposition of a pedicled pectralis major muscle successfully. After the operation, respiration was performed independently with two ventilators for right and left lung to avoid increasing air way pressure. His postoperative course was uneventful, and he discharged on the 66th postoperative day. The cause of the fistula was considered to be a peptic ulcer due to residual secretion of gastric acid.

Bronchial Fistula↗
PubMed1996

[Usefulness of "Biotrack Theophylline kit" for measuring serum theophylline concentration in patients with chronic asthma].

Patients with chronic asthma are often treated with sustained-release theophylline preparations. Clearance of theophylline is variable between individuals and grossly dependent on the age of the patient. It is important to measure the theophylline concentration in serum before giving a bolus shot of intravenous aminophylline for the patients taking oral theophylline. "Biotrack Theophylline kit" is a device to detect serum theophylline levels, applying whole blood and using the method of latex agglutination inhibition. It is as accurate as HPLC (high performance liquid chromatography), which is the standard method for measuring serum theophylline levels. Good correlation between the two methods was achieved (r = 0.973, in N = 108). We measured serum theophylline levels using this kit in ten patients who were on round-the-clock treatment but developed acute asthma attacks. The usefulness of this device was shown because of its accuracy and the rapid and easy maneuver.

Age Factors↗
PubMed1996

Hepatic embolization through extrahepatic collateral pathways after hepatic arterial embolization for the hepatocellular carcinoma.

Extrahepatic collateral pathways developing after repeated transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) make therapeutic arterial embolization for recurrent lesions extremely difficult. TAE was performed through the collateral pathways using a sophisticated micro-catheter with good trackability and pushability and a coaxial system. Twenty-three TAEs were undertaken through the collateral pathways in 13 patients with recurrent HCC who had extrahepatic collateral pathways after the previous hepatic arterial TAE. There were 69 extrahepatic collateral pathways, with partially obstructed hepatic arteries. On the average, three feeding arteries were seen in the liver. The main extrahepatic collateral pathways were the inferior phrenic artery and epicholedocal artery, 18 vessels and 29 vessels, respectively, accounting for about 80% of the total collateral pathways. TAEs were successful in all cases and the number of embolized vessels was 2.1 on average. The average time of the first collateral TAE after the initial conventional hepatic arterial TAE was 2.3 years. Excellent prognosis was observed with a one-year survival rate of 77% and 3-year survival rate of 38% after the collateral TAE. We consider that collateral TAE for recurrent HCC with obstruction of the hepatic artery is the procedure of choice, is technically feasible, and provides better prognosis for the patients.

Adult↗
PubMed1995

Effect of dietary NaCl on tyrosine hydroxylase in the superior cervical ganglia of Dahl rats.

To investigate the involvement of peripheral catecholamines in the development of Dahl-Iwai salt-sensitive (DIS/Eis) hypertension, we performed immunohistochemical staining of tyrosine hydroxylase (TH) in the superior cervical ganglia (SCG) of DIS/Eis rats and Dahl-Iwai salt-resistant (DIR/Eis) rats, and in situ hybridization histochemistry for demonstration of TH mRNA localization in the SCG of these rats. DIS/Eis and DIR/Eis rats were fed on a high (8%) salt diet or on a low (0.3%) salt diet for 4 weeks. Nerve cells in the SCG of DIS/Eis high salt rats exhibited more intense TH-immunoreactivity (P < 0.01) and hybridization signals (P < 0.01) than those of the other experimental groups. These findings suggest that activation of peripheral sympathetic nerves may account for hypertension in DIS/Eis rats on a high salt diet.

Animals↗
PubMed1995

An alternative splicing site modifies the carboxyl-terminal trans-membrane domains of the Na+/Ca2+ exchanger.

The 6-kilobase (kb) cDNA of pTB11 clone and its 5' fragment of 3.7 kb encoding the canine heart Na+/Ca2+ exchanger (Nicoll, D.A., Longoni, S., and Philipson, K.D. (1990) Science 250, 562-565) were transiently expressed in 293 cells to investigate the role of the 3'-"untranslated" region. Both fragments yielded high levels of expressed protein that were well incorporated in the membranes. Cells expressing the 6-kb cDNA produced rearranged transcripts of smaller than expected size. A 120-kDa polypeptide was produced in cells expressing the modified exchanger, and Ca2+ uptake was higher in this type of transfected cells. A constant stretch of nucleotides located at the 3' end of the 6 kb cDNA was found to be connected, by alternative RNA splicing, to four different upstream sequence positions. The deduced hydrophobic sequence of the spliced-in exon could replace the IX or the XI trans-membrane domain of the exchanger protein in two spliced isoforms. The new exon sequence was not completely included in the pTB11 insert, i.e. these two products were artificially truncated. The RNA processing of these two alternative 5'-splicing sites also occurred in tissues, as shown by RNase protection analysis. In a third type of isoform the splicing took place downstream of the originally proposed stop codon, whereas in a fourth type a stop codon was introduced after the V hydrophobic segment in the large intracellular loop.

Alternative Splicing↗
PubMed1995

Structural organization of the human sorbitol dehydrogenase gene (SORD).

The primary structure of human sorbitol dehydrogenase (SORD) was determined by cDNA and genomic cloning. The nucleotide sequence of the mRNA covers 2471 bp including an open reading frame that yields a protein of 356 amino acid residues. The gene structure of SORD spans approximately 30 kb divided into 9 exons and 8 introns. The gene was localized to chromosome 15q21.1 by in situ hybridization. Two transcription initiation sites were detected. Three Sp1 sites and a repetitive sequence (CAAA)5 were observed in the 5' noncoding region; no classical TATAA or CCAAT elements were found. The related alcohol dehydrogenases and zeta-crystallin have the same gene organization split by 8 introns, but no splice points coincide between SORD and these gene types. The deduced amino acid sequence of the SORD structure differs at a few positions from the directly determined protein sequence, suggesting allelic forms of the enzyme. High levels of SORD transcripts were observed in lens and kidney, as judged from Northern blot analysis.

Amino Acid Sequence↗
PubMed1995

Preservation of the lower esophageal sphincter during total gastrectomy for gastric cancer to prevent postoperative reflux esophagitis.

The lower esophageal sphincter (LES) is usually removed during total gastrectomy to successfully perform a curative operation. In this study, the preservation of the LES in curative total gastrectomy was attempted to reduce the reflux. An experimental study using dogs has revealed that the high-pressure zone of the LES can be preserved by making a resection at the gastroesophageal junction, which thus helps to protect the reflux. A previous clinicopathological study revealed that the LES can be preserved without any fear of recurrence at the resection site, if the tumor is located more than 2.0 cm and 3.0 cm from the gastroesophageal junction to the oral margin in node-negative and -positive cases, respectively. Clinically, 8 patients underwent an LES-preserving total gastrectomy [LES(+) gastrectomy] while 19 had an LES(-) gastrectomy in the same period. Of the five LES(+) cases examined, all showed a high pressure zone, whereas none of the four LES(-) cases examined showed such a high-pressure zone after the operation. Endoscopic examination showed that only one of the seven LES(+) cases but six of nine LES(-) cases revealed esophagitis.

Anastomosis, Surgical↗
PubMed1995

Clinical usefulness of an ATP heat sensitivity test using endoscopic biopsy materials from esophageal cancer patients.

The usefulness of a heat sensitivity test which involved performing an ATP assay on endoscopic biopsy materials for predicting the clinical response to hyperthermia was investigated in esophageal cancer patients. Following in vitro heat treatment of FM3A tumor cells, the heat sensitivity detected by ATPA was significantly correlated with that in the colony-forming assay, and the percent inhibition of the ATP level in the tumor cells was correlated with in vivo tumor growth. The heat sensitivity of the biopsy materials evaluated by ATPA correlated well with that of the resected specimens in 18 esophageal cancer patients, while the clinical response to thermal therapy was well predicted by the heat sensitivity of the biopsy materials evaluated by ATPA in seven of the patients. These results indicate that the heat sensitivity test conducted by performing an ATPA on endoscopic biopsy materials could be a useful indicator for predicting the clinical response to thermal therapy.

Adenosine Triphosphate↗
PubMed1995

Hepatic amyloidosis in Japan: histological and morphometric analysis based on amyloid proteins.

To investigate the relationship between the tissue distribution and the types of amyloid proteins, the detailed histopathologic features of the available liver in 284 cases of amyloidosis were examined. We classified hepatic amyloidosis into three types, namely, the vascular pattern, parenchymal pattern, and stromal pattern according to the topographic distribution pattern of amyloid. Of the 152 amyloid A (AA) cases, all but one exhibited the vascular pattern; the single exception had the parenchymal pattern. Among 117 amyloid light chain (AL) cases, 51.3% exhibited the vascular pattern and 43.6% the parenchymal pattern. The stromal pattern was observed in 5.1% of the cases but was found only in AL amyloidosis. The parenchymal and stromal patterns in the liver seemed to be characteristic morphological distributions of AL amyloidosis. Routine histochemical study is useful to distinguish AL from AA, although some ethnic differences were apparent. Morphometric results showed that the walls of the hepatic arteries with amyloid deposition were significantly thicker than walls in arteries from the control group. The arterial walls in AA amyloidosis, especially, were significantly thicker than walls in AL amyloidosis of any pattern.

Amyloid↗
PubMed1995

The 70 kD component of the heart sarcolemmal Na+/Ca(2+)-exchanger preparation is the C-terminal portion of the protein.

The cardiac sarcolemmal Na+/Ca(2+)-exchanger was expressed in COS-7 cells by the vaccinia virus system as a fusion protein with a poly-His tag at its C-terminus. Extracts of cells expressing the exchanger construct without the His-tag reacted with an antiserum against the C-terminal portion of the main intracellular loop of the exchanger: in agreement with the finding routinely made on heart sarcolemma and on plasma membrane of cells expressing the cardiac exchanger gene, three bands of about 160, 120, and 70 kD were detected in Western blots. All three bands shifted to higher molecular masses when the construct with the His-tag was expressed, indicating that the three proteins had the same C-terminus. Thus, the 70 kD protein, whose nature has always been obscure, appears to be a degradation product of one of the two larger proteins. N-terminal sequencing of partially purified exchanger preparations has identified the cleavage site(s) producing the 70 kD protein in the 257-269 residue region of the exchanger molecule.

Amino Acid Sequence↗
PubMed1995

Serial changes of cystic air spaces in fibrosing alveolitis: a CT-pathological study.

In patients with cryptogenic fibrosing alveolitis (CFA), subpleural large cysts are sometimes seen within honeycombing on computed tomography (CT). These cysts may be interpreted as bullae and the coexistence of emphysema with CFA might be assumed. We evaluated whether cystic spaces in honeycombing become larger in patients with CFA on serial CT scans. CT scans were obtained in 16 patients with CFA, who had undergone two CT examinations (6 to 43 months, mean 25.1 months apart), were reviewed focusing on the changes in size of the cystic spaces in honeycombing. The mechanism of enlargement of cystic spaces was investigated using microscopic serial sections of autopsied specimens. In 15 of 16 patients, the cystic spaces in honeycombing were larger on the second examination. Histologically, stenosis of bronchioles and slit-like structures between cysts and bronchioles were detected in addition to alveolar septal dissolution and bronchiolectasis. Both the bronchiolar stenosis and the slit-like gaps have the potential to work as check-valves and increase the volume of cystic spaces. Therefore, in the evaluation of CFA, large cysts should be interpreted with caution to avoid misinterpretation of the cysts as bullae associated with emphysema. From the results of this correlative study, we suggest that a check-valve effect is an important mechanism in the formation of large cysts in honeycomb lung.

Aged↗
PubMed1995

Angiomyxoid tumour in the renal peripelvic tissues with features of aggressive angiomyxoma.

A case of angiomyxoid tumour in the renal peripelvic soft tissue of a 45 year old woman is reported. The encapsulated tumour, measuring 12 x 9 x 6 cm, was solid and firm. The cut surface revealed a yellowish-white, gelatinous, and glistening tumour. Histologically, the tumour was composed of loosely textured spindle and stellate cells with prominent blood vessels of variable calibre. The tumour cells stained strongly for vimentin. These findings strongly resemble those associated with aggressive angiomyxoma in the vulva and perineum.

Female↗
PubMed1995

Complete remission in a patient with hypoplastic acute lymphoblastic leukemia induced by granulocyte-colony-stimulating factor.

We report here a case of hypoplastic leukemia with T cell markers in whom complete remission was obtained with granulocyte-colony-stimulating factor (G-CSF) alone. A 23-year-old male was diagnosed with hypoplastic leukemia: Hb 2.6 g/dl, platelet count 29.0 x 10(9)/l after transfusion, WBC 2.9 x 10(9)/l, hypocellular bone marrow with 70.7% blasts. He was given G-CSF 300 micrograms/day by intravenous drip infusion without antileukemic agents for severe pneumonia. After the administration of G-CSF for 15 days, hematological examination and bone marrow findings had improved to normal, and complete remission was obtained. However, the patient relapsed 45 days after discontinuation of G-CSF. The characteristics of the relapsed leukemia cells were similar to those on admission: negative for myeloperoxidase and positive for T cell markers (CD2 and CD7). The possibilities for the differentiation of leukemic cells and the recovery of normal hematopoiesis with G-CSF are discussed.

Adult↗