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Biomedical subjects

T Kawamura

Publications and source records attributed to T Kawamura.

At least 145 records · Page 8Linked to original sources
PubMed2000

Prostaglandin E1 reduces myocardial reperfusion injury by inhibiting proinflammatory cytokines production during cardiac surgery.

OBJECTIVE: To determine the influence of prostaglandin E1 (PGE1) on the cytokine balance and myocardial protection during cardiac surgery. DESIGN: Prospective, randomized, nonblinded study. SETTING: University hospital. PATIENTS: A total of 19 patients on cardiopulmonary bypass undergoing cardiac surgery. INTERVENTIONS: According to randomized sequence, the patients received PGE1 (0.02 approximately 0.05 microg x kg(-1) x min(-1)) from the beginning of surgery to the end of study (PGE1 group, n = 11) or nothing (control group, n = 8). MEASUREMENTS AND MAIN RESULTS: Interleukin (IL)-6, IL-8, IL-10, IL-1 receptor antagonist (IL-1ra), soluble tumor necrosis factor receptor I (sTNF RI), and soluble tumor necrosis factor receptor II (sTNF RII) were measured by enzyme-linked immunosorbent assays. Troponin-T and isoenzyme of creatine kinase with muscle and brain subunits (CK-MB) were measured by enzyme immunoassay and ultraviolet absorption spectrophotometry method, respectively. Serum IL-6 and IL-8 concentrations in both groups increased significantly from 60 mins after declamping the aorta compared with preoperative value (p < .001), However, the increases were greater in the control group than in the PGE1 group (p < .01). Serum IL-10, IL-1ra, sTNF RI, and sTNF RII concentrations increased significantly from 60 mins after declamping the aorta compared with preoperative values in two groups (p < .001, respectively). There were no differences between the two groups. Serum troponin T and CK-MB concentrations increased significantly in the two groups from 60 mins after declamping the aorta (p < .001), but these increases were greater in the control group than in the PGE1 group (p < .01). IL-6 and IL-8 levels correlated with CK-MB concentration (r2 = 0.49, r2 = 0.36; p > .001 respectively). CONCLUSIONS: PGE1 suppressed the production of IL-6 and IL-8 but not IL-10, IL-1ra, sTNF RI, or sTNF RII. The change in the balance between pro-and anti-inflammatory cytokines may be one of the most important cytoprotective mechanisms of PGE1.

Aged↗
PubMed2000

[A case report of lung abscess caused by Capnocytophaga gingivalis infection].

A 48-year-old male was admitted to our hospital because of fever, cough and of loss appetite. Chest X-P revealed an abnormal shadow in the left upper lobe. Bronchoscopy was performed and Capnocytophaga gingivalis was cultured from the bronchial lavage and bronchial curreting fluid. Ceftizoxime sodium and Clindamycin phosphate was administered intravenously. He was discharged after 30 days. He did not have any immunosuppressive underlying disease including HIV infection and diabetes mellitus which cause these lesions.

Capnocytophaga↗
PubMed2000

Serum group II phospholipase A(2) levels during menstrual cycle and pregnancy.

The purpose of this study was to evaluate the circulating group II phospholipase A(2) (PLA(2)-II) levels during normal menstrual cycle and to assess alterations in maternal circulating PLA(2)-II concentrations during pregnancy and at puerperium. Circulating serum PLA(2)-II concentrations were compared between 38 nonpregnant women with normal menstrual cycle (15 at menstrual phase, 11 at follicular phase, and 12 at luteal phase), 61 normal pregnant women (13 in the first trimester, 12 in the second trimester, and 36 in the third trimester), and 14 normal postpartum women at 5th puerperal day. Serum PLA(2)-II concentrations were also measured in 11 patients with threatened premature labor. Maternal and fetal serum PLA(2)-II levels before and after delivery were made to determine differences in 11 neonates delivered vaginally and 11 neonates delivered by elective cesarean section. Serum PLA(2)-II level was measured with an immunoradiometric assay. Serum PLA(2)-II concentrations at luteal phase were significantly lower than those at menstrual or follicular phase (p< 0.05). There was no significant difference for PLA(2)-II levels between first trimester and menstrual phase or follicular phase. There were no significant differences among three trimesters during pregnancy. There was no significant difference in serum PLA(2)-II levels between normal pregnant women and patients with threatened premature labor. Labor stress did not affect both maternal and fetal serum PLA(2)-II concentrations. There was also no significant difference for circulating PLA(2)-II levels between maternal and fetal serum. Interestingly, serum PLA(2)-II concentrations in postpartum women were significantly higher than those in normal pregnant women (p<0.05). These results suggest that a regulatory mechanism of PLA(2)-II may exist during the normal menstrual cycle and at puerperium.

Cesarean Section↗
PubMed2000

Some molecular and inhibitory specifications of a dipeptidyl carboxypeptidase from the polychaete Neanthes virens resembling angiotensin I converting enzyme.

Dipeptidyl carboxypeptidase (DCP) from the polychaete Neanthes virens, resembling mammalian angiotensin I converting enzyme (ACE), was studied to discover some of its molecular and inhibitory properties, as the first evidence of these in a marine invertebrate. Amino acid and carbohydrate contents were analyzed. The N-terminal amino acid sequence of N. virens DCP was (NH2)D-E-E-A-G-R-Q-W-L-A-E-Y-D-L-R-N-Q-T-V-L-. Peptide maps of N. virens DCP from lysyl endopeptidase digestion were different from rabbit p-ACE. The far-ultraviolet circular dichroic spectra of N. virens DCP indicated that the secondary structure of this enzyme seemed to be an alpha-helical structure and was similar to that of rabbit p-ACE, but the near-ultraviolet circular dichroic spectra of N. virens DCP indicated that the aromatic amino acid residue circumambience of this enzyme was different from rabbit p-ACE. The effects of several reagents for chemical modification of amino acids on the activity of N. virens DCP were tested. Arg, Tyr, Glu, and/or Asp, His, Trp, and Met caused loss of the activity. In addition, the IC50 and Ki values for a well-known ACE inhibitor, Val-Tyr, which was a competitive inhibitor of N. virens DCP, were 263 and 20 microM, respectively. These results suggested that N. virens DCP is different from mammalian ACE in the molecular and inhibitory properties, although the same substrate specificity was demonstrated in a previous paper.

Amino Acid Sequence↗
PubMed2000

DiGeorge syndrome with Graves' disease: A case report.

DiGeorge syndrome (DGS) is characterized by aplasia or hypoplasia of the thymus and parathyroid glands, cardiac defects and anomaly face. This syndrome is usually associated with hypocalcemia resulting from hypoparathyroidism. In most cases the initial symptom is tetany caused by hypocalcemia within 24-48 hours after birth, with symptoms by immune abnormality appearing later. We report a woman who passed with no symptoms before age 18 and was diagnosed DiGeorge syndrome by tetany with developing auto-immune thyroid disease (Graves' disease). She had surgery for intraventricular septal defect at age 3, hypoparathyroidism, decrease of T cells in peripheral blood and the deletion of the 22nd chromosome long arm (22q11.2). It is supposed that abnormalities of immune function of this case are not complete as indicated by complicating of Graves' disease, and contributing to her long-term survival.

Adolescent↗
PubMed2000

Depressive mood and suicide among middle-aged workers: findings from a prospective cohort study in Nagoya, Japan.

BACKGROUND: In Japan, mortality from suicide has peaked around 50 years old among men, with increasing trend after 65 years old, and this peak became more apparent in recent years. Beside this, "psychological autopsy" has revealed depression as one of the most important risk factors for suicide. There is, however, no cohort study which examined the relationship between depressive mood measured by simple method and suicide in middle-aged general population. METHODS: In 1989, baseline information was collected by a self-administered questionnaire, and 18,450 workers were followed up to March 31, 1995. All deaths observed during active service were identified, and when retired, its date was recorded. Among 5,352 male workers aged between 40 to 54, 11 committed suicide during follow-up period of 5 years. Analysis were carried out by Cox's proportional hazard model, controlling for age. RESULTS: Those who slept 9 hours or more per night demonstrated 12.14-fold risk of suicide compared with those who slept less than 9 hours. Smokers were more likely to commit suicide than non-smokers. Those who answered affirmatively to more than 7 out of 12 questions, which were derived from Zung self-rating depression scale, experienced an increased risk of suicide (RR 9.95; 95%CI: 1.89-52.44), even after adjusting for other confounding factors. CONCLUSION: We found an association between depressive mood and subsequent suicide in a middle-aged workers. Detailed observation and follow-up of those with depressive mood should be systematically organized with due attention and caution.

Adult↗
PubMed2000

Prevalence of idiopathic hypoparathyroidism and pseudohypoparathyroidism in Japan.

A nationwide epidemiologic survey of idiopathic hypoparathyroidism and pseudohypoparathyroidism was conducted in 1998 to clarify the prevalence of the two disorders in Japan. From a total of 14,100 departments of pediatrics, internal medicine, neurology, and endocrinology in whole Japan, 2952 (20.9%) study departments were selected at random. Of these departments receiving the first questionnaire, 1855 (62.8%) responded. From these departments 390 patients with idiopathic hypoparathyroidism and 203 with pseudohypoparathyroidism who visited the hospitals in 1997 were reported. The total numbers of patients were estimated to be 900 (690-1100) for idiopathic hypoparathyroidism and 430 (330-520) for pseudohypoparathyroidism (95% confidence intervals in parentheses). Using these data, the period prevalence of the diseases were 7.2 (5.5-8.8) per million population in idiopathic hypoparathyroidism, and 3.4 (2.6-4.2) in pseudohypoparathyroidism (95% confidence intervals in parentheses).

Adolescent↗
PubMed2000

Maternal active and passive smoking and fetal growth: A prospective study in Nagoya, Japan.

In order to examine the effect of maternal active and passive smoking on fetal growth, we carried out a population-based cohort study. A self-administered questionnaire was distributed to 15,207 women who notified their pregnancy from April, 1989 to March, 1991. A total of 7,411 mother-singleton infant pairs were analyzed in this study. Paternal smoking status and maternal hours exposed to environmental tobacco smoke (ETS) were used as indicators of passive smoking. Infants born to active smoking mothers were 96 g lighter, on an average, at birth than those born to non-smokers, and the relative risk for intrauterine growth retardation was 1.79 (95% confidence interval (CI) = 1.05-3.04) among active smoking mothers. Infants with smoking fathers weighted 11 g lighter, on an average, than those with non-smoking fathers, and mean birth weight of infants was reduced by 19 g among mothers exposed to ETS. The relative risk for intrauterine growth retardation in non-smoking pregnants with a smoking husband and those exposed to ETS was 0.95 (95% CI = 0.72-1.26) and 0.95 (95% CI = 0.71-1.26), respectively. Our findings indicated an adverse effect of maternal active smoking on fetal growth in Japanese pregnant population, but with small influence of maternal passive smoking.

Analysis of Variance↗
PubMed2000

Sleep patterns and total mortality: a 12-year follow-up study in Japan.

A population-based cohort study was conducted to assess the relationship between total mortality and self-reported sleep patterns as regards not only to sleep duration but also subjective sleep quality. A total of 5,322 inhabitants in Gifu Prefecture, Japan, completed a self-administered questionnaire on health status and lifestyles including habitual sleep patterns, and were followed-up for an average of 11.9 years. Relative risks were computed by using Cox proportional hazards models. Both longer and shorter sleep, compared to 7-8 hour-sleep, was related to significantly increased risk of total mortality in males (relative risk [RR] for > or = 10 hours = 1.94, and RR for < 7 hour = 1.90), but not in females. Females complaining of poor awakening state experienced a higher mortality risk compared to those who woke up normally (RR: 1.97). Males who usually fell asleep easily showed a marginally lower mortality risk compared to those who fell asleep normally (RR: 0.70). Female users of sleeping pills were at an elevated risk (RR: 1.89). These findings were almost unchanged after adjustment for sleep duration and other confounders. Poor self-reported quality of sleep seemed to be associated with an increased risk of mortality independently of sleep duration.

Adult↗
PubMed2000

[Dose the serum brain natriuretic peptide (BNP) level after open heart surgery reflect myocardial protection?].

This clinical study was conducted to determine whether the serum BNP level after open heart surgery reflects myocardial protection. The levels of BNP and CPK-MB were measured before and after 12 hours of cardiopulmonary bypass, then 1, 3, and 6 days after open heart surgery, and the relationship between the maximum levels of BNP and the CPK-MB after open heart surgery was examined. The patients were divided into two groups according to whether or not the maximum CPK MB was more than 100 IU/l after open heart surgery. A significant relationship between the maximum BNP and the maximum CPK-MB after open heart surgery was observed (p = 0.013). Moreover, the BNP was significantly increased in the group of patients with a maximum CPK-MB > or = 100 IU/l, compared to that in those with a maximum CPK-MB < 100 IU/l, 12 hours 1 day, and 6 days after open heart surgery (p < 0.01). These findings indicate that the serum level of BNP after open heart surgery can reflect myocardial protection.

Adult↗
PubMed2000

[Could apoptosis be contributed to the occurrence of aortic dissection?].

This clinical study was conducted to determine whether apoptosis is contributed to the occurrence of aortic dissection. The subjects comprised 11 patients who underwent Stanford type A aortic dissection and 4 autopsy cases, being the control group. The occurrence of apoptosis was determined by the TUNEL assay using an aortic wall specimen, and the distribution of macrophages and h-MMP-9 was examined by immunohistological staining. Apoptotic cells were observed in the aortic specimens for all of the 11 patients who underwent Standford type A aortic dissection, but not in any of the 4 autopsy cases. Moreover, apoptotic cells were present in large numbers on the surface of the false lumen strongly in 8 patients who underwent surgery within 1 month after aortic dissection, but not in 3 who underwent treatment after than 1 month. Those phenomena were also observed in the immunohistological staining of CD 68 and h-MMP-9. These findings indicate that apoptosis could be contributed to the occurrence of aortic dissection.

Aged↗
PubMed2000

[Usefulness of ultrasonography in a case of spontaneous carotid-cavernous fistula: a case report].

Since spontaneous carotid-cavernous fistula (CCF) is a dural arterio-venous fistula at the cavernous sinus, which is different from traumatic CCF and CCF associated with a ruptured aneurysm at the cavernous internal carotid artery, cerebral angiography is required in order to differentiate these condition. We here report a case of spontaneous CCF, in which a result of ultrasonographic evaluation of cervical arteries well corresponded with that of cerebral angiography. Ultrasonography showed increased blood flow and decreased pulsatility index in the ipsilateral external carotid artery, contralateral internal and external arteries, and these values in all arteries resolved within normal range after the interventional embolization. Ultrasonography is less invasive examination and can be easily performed even in outpatients for observation of spontaneous CCF.

Blood Flow Velocity↗
PubMed2000

Measurement of serum IgA and C3 may predict the diagnosis of patients with IgA nephropathy prior to renal biopsy.

The levels of serum IgA and C3 in patients with IgA nephropathy were determined using international standard serum (IFCC/CRM470) in a multicenter trial in Japan. The ratio of serum IgA to C3 (serum IgA/C3 ratio) without any information from renal biopsy was used for the diagnosis of IgA nephropathy. Three hundred and six patients with IgA nephropathy and other glomerular diseases, and 418 healthy adults were examined. The new diagnostic standardized criterion in patients with IgA nephropathy, obtained by nephelometric immune assay based on the international reference preparation CRM470, was 315 mg/dl. The serum IgA/C3 ratio was a more useful marker for distinguishing IgA nephropathy from non-IgA nephropathy together with serum IgA levels. This suggests that the measurement of serum IgA and C3 may predict the diagnosis of patients with IgA nephropathy prior to renal biopsy.

Adult↗
PubMed2000

[Serrapeptase-induced lung injury manifesting as acute eosiniphilic pneumonia].

An 84-year-old man was referred to our hospital because of fever, cough, and hemoptysis. The patient had acute respiratory failure (PaO2 < 40 mmHg) on admission, with diffuse interstitial infiltration and bilateral pleural effusion. The bronchoalveolar lavage fluid was bloody, and contained a high percentage of eosinophils (32%). A diagnosis of acute eosinophilic pneumonia was established, and the patient made a rapid recovery after corticosteroids were administered. When the DLST (drug lymphocyte stimulation test) was performed after the corticosteroid therapy was stopped, it was positive for serrapeptase, which had been prescribed for chronic cystitis for 3 months before the onset of the pneumonia. This was a case of drug (serrapeptase)-induced pneumonitis manifesting as acute eosinophilic pneumonia.

Aged↗
PubMed2000

[Relationship between cardiac natriuretic peptide (ANP/BNP) and fluid intake in patients with subarachnoid hemorrhage].

Several authors described elevated natriuretic peptides, atrial natriuretic peptide(ANP) and brain natriuretic peptide (BNP), in patients with subarachnoid hemorrhage(SAH), which were account for inappropriate antidiuretic hormone(SIADH) or cerebral salt wasting syndrome(CSW). Although the secretion of natriuretic peptide depends on the total blood volume, central venous pressure, and cardiac output volume, the volume of fluid intake in patients with SAH had not been taken in consideration in previous report. We here examined the relationship between fluid intake and the natriuretic peptides in two cases without cardiac failure. ANP elevated 2 or 3 days after SAH and remained in normal range for 2 weeks. BNP elevated when the volume of fluid intake was increased, and BNP did not elevate during the periods with lower fluid intake. Several authors proposed the possibility of iatrogenic factor in natriuresis after SAH and these results supported this opinion.

Adult↗
PubMed1999

Phosphorylation of the invariant chain by protein kinase C regulates MHC class II trafficking to antigen-processing compartments.

The invariant chain (Ii) plays a critical role in the transport of newly synthesized class II molecules to endosomal Ag-processing compartments. Of the two major isoforms of human Ii, only Ii-p35 is phosphorylated in vivo, and inhibiting Ii phosphorylation inhibits the trafficking of newly synthesized class II molecules to Ag-processing compartments. We now report that a member of the protein kinase C family of serine/threonine kinases is responsible for the constitutive phosphorylation of 50% of the total cellular pool of Ii-p35 in a wide variety of APCs, including B lymphocytes, PBMC, immature dendritic cells, and mature dendritic cells. Stimulation of protein kinase C activity in APCs significantly enhanced the kinetics of degradation of class II-associated Ii in Ag-processing compartments and the binding of antigenic peptides to these class II molecules. In cells expressing an Ii-phosphorylation mutant, trafficking of class II molecules to endosomes was impaired and Ii proteolysis was inhibited, demonstrating a direct effect of Ii phosphorylation on MHC class II trafficking. These results demonstrate that phosphorylation of Ii in APCs alters the kinetics of trafficking of newly synthesized class II molecules to lysosomal Ag-processing compartments.

Antigen Presentation↗
PubMed1999

Prophylaxis of antibody-induced acute glomerulonephritis with genetically modified bone marrow-derived vehicle cells.

Glomerulonephritis is an inflammatory disease of the renal glomerulus, which often progresses either slowly or rapidly, ending in renal death despite the availability of various antiinflammatory drugs. Gene therapy may be a promising method of suppressing the progression of glomerulonephritis through the blockage of key inflammatory molecule(s). However, the difficulty of local gene delivery into the glomerulus has made the clinical use of gene therapy difficult. As a solution to this issue, we applied a novel ex vivo technique that may allow site-specific gene delivery into the inflamed site and thus suppress local inflammation in the glomerulus, and examined the feasibility of this system as a prophylaxis of glomerulonephritis. The gene encoding the antiinflammatory cytokine interleukin 1 receptor antagonist (IL-1ra) was delivered into animal models of inflamed glomeruli evoked by anti-glomerular basement membrane antibody; this animal model is an analog of the human Goodpasture syndrome. Vehicle cells did indeed accumulate in the glomeruli on the induction of nephritis and were confirmed to secrete recombinant IL-1ra. Renal functions as well as morphology were preserved by this intervention for up to 14 days after IL-1ra introduction. These data demonstrate the possible application of gene therapy for acute glomerulonephritis. A gene encoding an antiinflammatory molecule, IL-1 receptor antagonist, was delivered into inflamed glomeruli, using a technique that may allow site-specific gene delivery into inflamed tissues. The progression of experimental acute glomerulonephritis was effectively suppressed by this intervention for at least 14 days after gene introduction. This success may strengthen the rationale for gene therapy in the treatment of inflammatory diseases such as glomerulonephritis.

Acute Disease↗