Search PubMed⌕ Search

Biomedical subjects

T Kawamoto

Publications and source records attributed to T Kawamoto.

At least 55 records · Page 3Linked to original sources
PubMed2001

[Chemoradiotherapy and salvage surgery in a patient with advanced esophageal cancer].

We report a case of advanced esophageal cancer, which was treated by chemoradiotherapy combined with surgical treatment. Moreover, 14 advanced esophageal cancer patients treated by chemoradiotherapy are discussed. The chemoradiotherapy showed beneficial control of the tumor; however, it sometimes leads to esophageal stenosis and ulcer. We conclude that additional salvage surgery is needed for such complications.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2001

Dynamic viewer of medical events in electronic medical record.

Medical record should enable doctors to comprehend the patient's history and select suitable medical treatment. In paper based medical records, medical events (examination, treatment etc.) are recorded successively, and problem oriented recording is difficult to be applied to patients with much information and a long history. Consequently it is not easy to understand the patient's history from paper based medical records. In order to solve this problem, we developed the flow sheet system in our electronic medical record (EMR). To make a flow sheet, we analyzed the structure of the medical event data. In this paper we introduced the medical event information model for our EMR. Furthermore, we clarified the specification of the data presentation on the flow sheet. We developed the flow sheet on the basis of these analyses. Because there are 3 layers in the vertical axis of the flow sheet, many items of the medical event can be displayed on the screen. When user clicks the cell, the corresponding detail data including images are shown. This system functions to link medical event items with a problem, and shows the bundled items on the flow sheet when the user selects the problem. We implemented this system in Osaka University Hospital. The number of the types of medical events and those of detail events in inpatients are 5.0+1.7 (mean+SD) and 60+47, respectively. The medical doctors in Osaka University Hospital evaluated this system, and concludes that the flow sheet data presentation makes comprehension of the patient's history easier than paper based records. As to the function of bundling the items relevant to the problem, they feel it is especially useful for patients with chronic disease. Thus the flow sheet data presentation in EMR is useful for medical practice.

Chronic Disease↗
PubMed2001

Two-dimensional changes in soft tissue profile following surgical mandibular advancement in Japanese retrognathic adults.

The purpose of this study was to evaluate changes in the hard and soft tissues and to test a preliminary method for predicting the soft tissue profile changes in 14 Japanese retrognathic patients who underwent surgical mandibular advancement. A pair of pre- and postoperative lateral cephalograms was taken for each subject. A paired t test identified significant hard and soft tissue changes following surgery. A Pearson correlation analysis was used to identify soft tissue changes for hard tissue changes in the horizontal and vertical dimensions. Multiple regression models were generated to predict postoperative variables based on preoperative variables. Significant changes in the hard and soft tissues were found in the area inferior to the point Stomion in both the horizontal and vertical dimensions. The soft tissue changes demonstrated a significant correlation not only with the corresponding hard tissue, but also with noncorresponding anatomical points. Moreover, the tendency of changes in the soft tissue was different in the lower lip area from the chin area in both the horizontal and vertical dimensions. Significant R2 and higher contribution ratio were obtained from the multiple regression analysis for the chin area compared to the lower lip area.

Adult↗
PubMed2000

Archaeal adaptation to higher temperatures revealed by genomic sequence of Thermoplasma volcanium.

The complete genomic sequence of the archaeon Thermoplasma volcanium, possessing optimum growth temperature (OGT) of 60 degrees C, is reported. By systematically comparing this genomic sequence with the other known genomic sequences of archaea, all possessing higher OGT, a number of strong correlations have been identified between characteristics of genomic organization and the OGT. With increasing OGT, in the genomic DNA, frequency of clustering purines and pyrimidines into separate dinucleotides rises (e.g., by often forming AA and TT, whereas avoiding TA and AT). Proteins coded in a genome are divided into two distinct subpopulations possessing isoelectric points in different ranges (i.e., acidic and basic), and with increasing OGT the size of the basic subpopulation becomes larger. At the metabolic level, genes coding for enzymes mediating pathways for synthesizing some coenzymes, such as heme, start missing. These findings provide insights into the design of individual genomic components, as well as principles for coordinating changes in these designs for the adaptation to new environments.

Adaptation, Physiological↗
PubMed2000

Junctional adhesion molecule (JAM) is phosphorylated by protein kinase C upon platelet activation.

Junctional adhesion molecule (JAM) is a member of the immunoglobulin superfamily (IgSF) expressed in tight junctions of epithelial cells and endothelial cells, and implicated in transendothelial migration of leukocytes. Recently, JAM is reported to be constitutively expressed on circulating monocytes, neutrophils, lymphocytes subsets, and platelets. However, the role of JAM is not known. Here, we examined how phosphorylaton of JAM is regulated upon platelet activation. Phosphorylation of JAM was induced by thrombin, collagen, but not by ADP. The phosphorylated amino acids were shown to be serine residues by phosphoamino acid analysis. Inhibition of JAM's phosphorylation by PKC inhibitors and Ca(++) chelator suggests the involvement of conventional types of PKCs. By in vitro kinase assays, we demonstrated that JAM could be directly phosphorylated by cPKCs. We also demonstrated phosphorylation of Ser 284, a putative PKC phosphorylation site, by immunoblotting with anti-phosphoserine-JAM antibody in thrombin-stimulated platelets. In addition to the phosphorylation, JAM seemed to form clusters at several sites of cell-cell contact in aggregated platelets by immunoelectron microscopic study. We speculate that JAM may be directly phosphorylated by cPKC(s)upon platelet activation and that the phosphorylationmight be involved in platelet activation.

Adenosine Diphosphate↗
PubMed2000

Smoking and oxidant stress: assay of isoprostane in human urine by gas chromatography-mass spectrometry.

Isoprostane (8-epi-prostaglandin F2alpha) is synthesized non-enzymatically from arachidonate and active oxygen. We examined the relationship of smoking and excretion of isoprostane in urine with gas chromatography-mass spectrometry selected ion monitoring assay and the stable isotope dilution method. Urine isoprostane concentrations were significantly higher in smokers (n=81, 605.24+/-59.01 ng/mg creatinine) than in non-smokers (n=39, 424.07+/-70.37 ng/mg creatinine), but concentrations in ex-smokers (n=21, 487.27+/-98.48 ng/mg creatinine) did not differ significantly from those in the other groups. In smokers, age, the duration of smoking, and the number of cigarettes per day were not correlated with urine isoprostane concentrations. However, urine isoprostane concentrations were negatively correlated with time since quitting in ex-smokers and with age in non-smokers. These results indicate that smoking increases isoprostane concentration in urine and suggest that smoking causes lipid peroxidation by oxidant stress.

Adult↗
PubMed2000

Aldehyde dehydrogenase (ALDH) 2 associates with oxidation of methoxyacetaldehyde; in vitro analysis with liver subcellular fraction derived from human and Aldh2 gene targeting mouse.

A principal pathway of 2-methoxyethanol (ME) metabolism is to the toxic oxidative product, methoxyacetaldehyde (MALD). To assess the role of aldehyde dehydrogenase (ALDH) in MALD metabolism, in vitro MALD oxidation was examined with liver subcellular fractions from Japanese subjects who carried three different ALDH2 genotypes and Aldh2 knockout mice, which were generated in this study. The activity was distributed in mitochondrial fractions of ALDH2*1/*1 and wild type (Aldh2+/+) mice but not ALDH2*1/*2, *2/*2 subjects or Aldh2 homozygous mutant (Aldh2-/-) mice. These data suggest that ALDH2 is a key enzyme for MALD oxidation and ME susceptibility may be influenced by the ALDH2 genotype.

Acetaldehyde↗
PubMed2000

Regio- and endo-selective

Irradiation of various meta- and para-substituted homobenzoquinones with ethyl vinyl ether gave the [2 + 2] photoadducts, tricyclic diones, regio- and endo-selectively and in good yields. The tricyclic skeleton has an anti-form built by the addition of ethyl vinyl ether from the less hindered side of homoquinones. All of the CH(3), Cl, Br, and CH(3)O substituents at the reacting C=C double bond afforded head-to-head (HH) addition predominantly. In the case of CH(3), Cl, and Br, the ethoxy group was oriented in the endo-position, while the CH(3)O substituent led to a 1/5 mixture with the exo-isomer. It was also found that the Br-substituted [2 + 2] adducts undergo a facile skeletal rearrangement, being converted into dihydro-o-benzoquinone monomethide derivatives for para-substitution and dihydrobenzofuran derivatives for meta-substitution, probably under the influence of the in situ generated HBr. Intramolecular [2 + 2] photocycloaddition of an alkenylhomobenzoquinone afforded a tetracyclic dione.

Journal Article↗
PubMed2000

Relation of phasic coronary flow velocity characteristics with TIMI perfusion grade and myocardial recovery after primary percutaneous transluminal coronary angioplasty and rescue stenting.

BACKGROUND: A residual stenosis and/or microvascular damage have been proposed as mechanisms of TIMI 2 flow for acute myocardial infarction. Coronary flow dynamics were assessed in patients with TIMI 2 flow to predict whether additional intervention would improve TIMI grade. METHODS AND RESULTS: In 35 patients who had a successfully recanalized anterior acute myocardial infarction using angioplasty or rescue stenting, coronary flow patterns were compared with corresponding TIMI grade and regional left ventricular wall motion (LVWM) 1 month after the intervention. After angioplasty, the time-averaged peak velocity (APV) was lower in patients with TIMI 2 flow (n=22) than in those with TIMI 3 flow (n=13; 7.9+/-3.9 versus 20.6+/-5.1 cm/s; P<0.001). Two different flow patterns were recorded in patients with TIMI 2 flow (versus TIMI 3, P<0.001); patients with type 1 TIMI 2 flow (n=15) had a reduced diastolic APV (8.3+/-4.8 versus 24.2+/-7.4 cm/s), prolonged diastolic deceleration time (1176+/-455 versus 728+/-205 ms), and a small diastolic/systolic APV ratio (1.3+/-0.6 versus 2.1+/-0.7); patients with type 2 TIMI 2 flow (n=7) had systolic flow reversal (systolic APV, -7.9+/-4.6 versus 11. 7+/-4.5 cm/s), a rapid diastolic deceleration time (221+/-84 versus 728+/-205 ms), and a negative diastolic/systolic APV ratio (-2.1+/-1. 4 versus 2.1+/-0.7). A significantly lower mean chord LVWM (-3.0+/-0. 2 versus -1.9+/-0.8; P<0.001) and a greater number of chords <-2SD (50+/-2 versus 28+/-18; P<0.001) were present in patients with type 2 versus type 1 TIMI 2 flow. Stenting increased TIMI 2 flow to TIMI 3 flow more in patients with type 1 than type 2 flow (67% versus 0%; P=0.003). Patients with TIMI 2 flow after stenting continued to demonstrate a type 2 pattern, and they had poor LVWM recovery. CONCLUSIONS: The differentiation between 2 types of TIMI 2 flow can predict the improvement of TIMI grade and LVWM recovery after additional stenting.

Aged↗
PubMed2000

Compensatory enlargement of the coronary artery in acute myocardial infarction.

Compensatory enlargement occurred in 71% of lesions in patients with acute myocardial infarction and was more common in these patients than in patients with stable effort angina pectoris. These results suggest that compensatory enlargement may be associated with plaque rupture and subsequent acute myocardial infarction.

Aged↗
PubMed2000

High expression of Survivin, mapped to 17q25, is significantly associated with poor prognostic factors and promotes cell survival in human neuroblastoma.

Survivin (SVV) is a family member of inhibitor of apoptosis proteins (IAPs) and its expression is cell cycle regulated. The gene is mapped to chromosome 17q25, the region of which is frequently gained in advanced stages of neuroblastoma (NBL). However, the role of SVV in NBL is poorly understood. Here we studied the clinical and biological role of SVV in NBL. A 1.9 kb SVV transcript was expressed in all of 9 NBL cell lines at higher levels than those in adult cancer cell lines. In 34 primary NBLs, high levels of SVV expression was significantly associated with age greater than 12 months (two sample t-test: P= 0.0003), advanced stages (P = 0.0136), sporadic tumors (P= 0.0027) and low levels of TrkA expression (P = 0.0030). In NBL cell lines, SVV mRNA expression was dramatically down-regulated in CHP134 and IMR32 cells undergoing apoptosis after treatment with all-trans retinoic acid (RA) or serum deprivation. It was only moderately decreased in cells (SH-SY5Y and CHP901) undergoing RA-induced differentiation. On the other hand, in proliferating NBL cells or RA-treated SK-N-AS line which is refractory to RA, the SVV mRNA remained at steady state levels or rather up-regulated. Furthermore, transfection of SVV into CHP134 cells induced remarkable inhibition of the RA-induced apoptosis. Collectively, our results suggest that high expression of SVV is a strong prognostic indicator for the advanced stage neuroblastomas, and that it could be one of the candidate genes for the 17q gain.

Apoptosis↗
PubMed2000

Benefits of adjuvant radiotherapy after radical resection of locally advanced main hepatic duct carcinoma.

PURPOSE: The objective of this study was to determine the benefits of adjuvant radiotherapy after radical resection of locally advanced main hepatic duct carcinoma (Klatskin tumor). METHODS AND MATERIALS: We conducted a retrospective review of 63 patients who underwent surgical resection of Stage IVA Klatskin tumor. Of the 63 patients, 47 had microscopic tumor residue (RT1). Twenty-eight of the 47 patients with RT1 were treated by adjuvant radiotherapy and the remaining 19 patients were treated exclusively by surgical resection. Seventeen of the 28 patients with RT1 were treated by both intraoperative radiotherapy (IORT) and postoperative radiotherapy (PORT); of the remaining 11 patients with RT1, 6 underwent resection and IORT, and 5 underwent resection and PORT. RESULTS: The major complication and 30-day operative death rates were significantly lower in the radiation group (9.5% and 0.0%, respectively) than in the resection alone group (28.5% and 9.5%, respectively). Of the eight 5-year survivors with RT1, 6 had adjuvant radiotherapy and the remaining 2 had resection alone. Adjuvant radiotherapy for patients with RT1 yielded significantly (p = 0.0141) higher 5-year survival rates (33.9%) than in the resection alone group (13.5 %). The best 5-year survival rate (39.2 %) was found in patients who underwent a combination of IORT and PORT after resection. The local-regional control rate was significantly higher in the adjuvant radiation group than in the resection alone group (79.2% vs. 31.2%). CONCLUSION: Our data clearly suggest the improved prognosis of patients with locally advanced Klatskin tumor by integrated adjuvant radiotherapy with IORT and PORT to complete gross tumor resection with acceptable treatment mortality and morbidity.

Adult↗
PubMed2000

Inherited polymorphism in the N-acetyltransferase 1 (NAT1) and 2 (NAT2) genes and susceptibility to gastric and colorectal adenocarcinoma.

The polymorphic arylamine N-acetyltransferases (NAT1 and NAT2) have been implicated in increased susceptibility to certain malignancies. We analyzed genetic polymorphisms in both the NAT1 and NAT2 genes among 140 gastric adenocarcinoma patients, 103 colorectal adenocarcinoma patients and 122 healthy controls from Japan. The frequency of the specific genotype NAT1*10 allele, which contains a variant polyadenylation signal, was higher among all gastric adenocarcinoma cases, but this increase did not reach statistical significance. After grouping according to tumor differentiation of gastric adenocarcinoma patients, NAT1 polymorphism was a risk factor among the well-differentiated type of tumors (OR = 3.03, 95% CI 1. 08-8.46). Stratifying by smoking status, we found that the OR for heavy smokers with the NAT1*10 allele was 2.97 (95% CI 1.23-7.14). When the combined risk of NAT1*10 allele from smoking and tumor differentiation was calculated, we found that the risk of the NAT1*10 allele with heavy smoking was increased among the well - differentiated type of gastric adenocarcinoma (OR = 4.24, 95% CI 0. 87-20.6). The NAT1*10 genotype was not a significant risk factor in colorectal adenocarcinoma. No statistically significant differences were observed in the frequency of NAT2 rapid acetylation genotype in gastric (91.4%) or colorectal (95.2%) adenocarcinoma patients when compared with the control population (94.3%). Our results suggest the NAT1*10 allele may be an important genetic determinant of the well-differentiated type of gastric adenocarcinoma, which may be induced by smoking.

Acetyltransferases↗
PubMed2000

Hunting the subset-specific genes of neuroblastoma: expression profiling and differential screening of the full-length-enriched oligo-capping cDNA libraries.

BACKGROUND: Neuroblastoma (NBL) has a distinct nature in different prognostic subgroups. PROCEDURE: To understand the molecular mechanism of NBL's genesis and biology as well as that of the neural crest development, we constructed full-length-enriched cDNA libraries by an oligo-capping method from two different subsets of primary NBL, one with favorable biology and the other with MYCN amplification. RESULTS: Sequencing analysis of these libraries revealed that the expression profile was markedly different between both subsets. To identify the genes differentially expressed between the subsets, semi-quantitative RT-PCR analyses are proceeding. CONCLUSION: So far, 54 transcripts have been found to be expressed at high levels in favorable NBLs, and significantly at low levels in unfavorable NBLs.

Gene Expression Regulation, Neoplastic↗
PubMed2000

Association between favorable neuroblastoma and high expression of the novel metalloproteinase gene, nbla3145/XCE, cloned by differential screening of the full-length-enriched oligo-capping neuroblastoma cDNA libraries.

BACKGROUND: The biology of neuroblastoma (NBL) is at least partly regulated by neurotrophic factors and their receptors. PROCEDURE: To identify novel NBL-related genes that affect growth, differentiation, and programmed cell death of the tumor, we constructed full-length-enriched cDNA libraries by oligo-capping method. RESULTS: Semi-quantitative and quantitative real-time RT-PCR showed that the nbla3145 gene was significantly highly expressed in favorable subset of NBL. The nucleo-tide sequence of nbla3145 revealed that it was a novel member of metalloproteinase, endothelin-converting enzyme, and was the same gene recently reported as XCE. We also cloned nbla3145beta which was a novel truncated form of nbla3145 (or nbla3145alpha). CONCLUSIONS: Our results suggested that nbla3145/XCE plays an important role in regulating growth and differentiation of NBL.

Gene Expression Regulation, Neoplastic↗
PubMed2000

A method for preparing 2- to 50-micron-thick fresh-frozen sections of large samples and undecalcified hard tissues.

This article describes a method for preparing 2- to 50-micron-thick fresh-frozen sections from large samples and completely calcified tissue samples. In order to perform the more routine work involved, a tungsten carbide disposable blade was installed to a heavy-duty sledge cryomicrotome. An entire 10-day-old rat and bone and tooth samples from a 7-month-old rat were rapidly frozen. The frozen samples were attached to the cryomicrotome stage. The cutting surface of the samples was covered with a polyvinylidene chloride film coated with synthetic rubber cement and cut at -25 degrees C. The soft tissues and the hard tissues were satisfactorily preserved and all tissue cells were easily identifiable. Enzymatic activity in the fresh sections was much stronger than that in chemically fixed and/or decalcified sections. The sections permitted histological and histochemical studies without trouble. In addition, the sections can be used for multiple experiments such as immunohistochemistry, in situ hybridization, and electron microprobe X-ray micro-analysis. This method can be used with conventional cryomicrotome equipment.

Alkaline Phosphatase↗
PubMed2000

Hyperinsulinemia during oral glucose tolerance test is associated with increased neointimal tissue proliferation after coronary stent implantation in nondiabetic patients: a serial intravascular ultrasound study.

OBJECTIVES: The purpose of this study was to determine whether hyperinsulinemia during the oral glucose tolerance test is associated with increased neointimal tissue proliferation after coronary stent implantation in nondiabetic patients. BACKGROUND: Although hyperinsulinemia induces increased vascular smooth muscle cell proliferation in experimental models, it has not been determined whether hyperinsulinemia is associated with increased neointimal tissue proliferation after coronary stent implantation. METHODS: Serial (postintervention and six-month follow-up) intravascular ultrasound (IVUS) was used to study 67 lesions treated with Palmaz-Schatz stents in 55 nondiabetic patients. Cross-sectional images within stents were taken at every 1 mm, using an automatic pullback, and a neointimal index was calculated as the ratio between the averaged neointimal area and averaged stent area. All patients underwent a 75-g oral glucose tolerance test. Plasma glucose (PG) and immunoreactive insulin (IRI) levels were measured at baseline and 1 and 2 h after the glucose load. The sum of PGs (sigmaPG) and the sum of IRIs (sigmaIRI) were calculated. Body mass index (BMI), lipid levels, and glycosylated hemoglobin levels were measured. RESULTS: There were 27 patients with normal glucose tolerance, and 28 patients with impaired glucose tolerance (IGT). The neointimal index in patients with IGT was greater than that in patients with normal glucose tolerance (42.9 +/- 14% vs. 24.9 +/- 8.3%, respectively, p < 0.0001). Linear regression analysis showed that the neointimal index at follow-up correlated well with sigmaPG (p < 0.0001), fasting IRI (p < 0.0001), sigmaIRI (p < 0.0001), triglyceride level (p = 0.018), and BMI (p < 0.0001). Multiple regression analysis revealed that sigmaIRI (p = 0.0002) and sigmaPG (p = 0.0034) were the best predictors of the greater neointimal index at follow-up. CONCLUSIONS: Serial IVUS assessment shows that hyperinsulinemia during an oral glucose tolerance test is associated with increased neointimal tissue proliferation after coronary stent implantation in nondiabetic patients.

Aged↗