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Biomedical subjects

T Mochizuki

Publications and source records attributed to T Mochizuki.

At least 163 records · Page 9Linked to original sources

A translation frameshift mutation induced by a cytosine insertion in the polycystic kidney disease 2 gene (PDK2).

Mutations in the PKD2 gene on the long arm of chromosome 4 are responsible for approximately 15% of cases of polycystic kidney disease. Perhaps the only difference from the more common ADPKD1 cases is the rate of progression of cystic changes, and the age of onset, which is 10-15 years later for the ADPKD2 form. In Cyprus there are at least three large families, documented by molecular linkage analysis, that map to the PKD2 locus. For two of them the defects were recently shown to be nonsense mutations at positions arginine 742 and glutamine 405. In this report, we describe the mutation in the third family, CY1602. For this, the entire coding sequence was systematically screened by single strand conformation analysis and heteroduplex formation. A novel mutation was identified in exon 2 where a new cytosine residue was inserted immediately after codon 231 (231insC). It causes a translation frameshift and is expected to lead to the introduction of 37 novel amino acids before the translation reaches a new STOP codon. It is the most amino terminal mutation reported to date, and based on the protein's modeled structure, is predicted to be within the first transmembrane domain. It is the fourth PKD2 mutation reported thus far, and the first which is not a nonsense mutation.

Cytosine↗

Predicting and treating coagulopathies after cardiopulmonary bypass in children.

UNLABELLED: Coagulopathies in children after cardiopulmonary bypass (CPB) are complex. There are very limited data correlating coagulation tests with postoperative bleeding. We evaluated coagulation changes after CPB and after the administration of coagulation products to 75 children. Baseline coagulation tests were obtained and repeated after protamine administration, after transfusion of individual coagulation products, and on arrival in the intensive care unit (ICU). Regression analysis demonstrated no baseline coagulation test to predict postoperative chest tube drainage. Weight and duration of CPB were determined to be the only predictors of bleeding. Further analyses demonstrated that children <8 kg had more bleeding and required more coagulation products than children >8 kg. Postprotamine platelet count and fibrinogen level correlated independently with 24-h chest tube drainage in children <8 kg, whereas postprotamine platelet count and thrombelastographic values did so in patients weighing >8 kg. Platelet administration alone was found to restore effective hemostasis in many patients. With ongoing bleeding, cryoprecipitate improved coagulation parameters and limited blood loss. Fresh-frozen plasma administration after platelets worsened coagulation parameters and was associated with greater chest tube drainage and more coagulation product transfusions in the ICU. Objective data to guide post-CPB component therapy transfusion in children are suggested. IMPLICATIONS: Children <8 kg can be expected to have more severe coagulopathies, require more coagulation product transfusions, and bleed more after cardiopulmonary bypass. Correlations between coagulation tests and postoperative chest tube drainage are defined. Platelets and, if necessary, cryoprecipitate optimally restore hemostasis. Fresh-frozen plasma offers no benefits in correcting postcardiopulmonary bypass coagulopathies in children.

Anticoagulants↗

Incidence and clinical significance of linear defects ascribed to interrenuncular septa on 99Tcm-DMSA SPET.

99Tcm-dimercaptosuccinic acid (99Tcm-DMSA) planar and single photon emission tomographic images from 100 children were reviewed to analyse whether linear defects corresponding to anatomical characteristics of interrenuncular septum (IRS) could be seen. Thirty sites in 30 kidneys (20 right, 10 left) from 27 patients were determined as showing IRS. They were seen less frequently in patients less than 7 years of age. The prevalence of IRS in the patients with vesico-ureteric reflux (VUR) was not significantly different from that in the patients without VUR. The interrenuncular septum was never seen on planar images and was most clearly demonstrated on conventional coronal tomographic images. The linear defects ascribed to IRS on 99Tcm-DMSA scintigrams were of a similar incidence to that reported previously. However, IRS is still an unestablished structure, and there is no evidence that these linear defects actually correspond to the structure described as the interrenuncular septum.

Child↗

Spectral analysis applied to hepatobiliary dynamic scintigraphy with 99Tcm-N-pyridoxyl-5-methyltryptophan.

This study was performed to evaluate the application of spectral analysis (SA) to hepatobiliary dynamic scintigraphy with 99Tcm-N-pyridoxyl-5-methyltryptophan (99Tcm-PMT) in 82 patients with a wide range of liver function, and to compare it with compartment analysis (CA) and deconvolution analysis (DA). The rate of uptake of PMT by the liver from the blood (k1) obtained by SA (y, min-1) agreed well with the k1 value obtained using CA (x, min-1) (y = 1.079x + 0.000, r = 0.993, standard error of the estimate (S.E.E.) = 0.042 min-1). The mean residence time (MRT) of PMT in the liver obtained by SA (y, min) also agreed well with the MRT value obtained by DA (x, min) (y = 1.036x - 0.759, r = 0.967, S.E.E.-1.014 min) and that obtained by CA (x, min) (y = 0.859x + 1.006, r = 0.931, S.E.E. = 1.428 min). The fraction of the measured blood activity superimposed on the true liver activity (f) obtained by SA (y) correlated well with the f value obtained by CA (x) (y = 1.168x - 0.004, r = 0.924, S.E.E. = 0.043). We conclude that the application of SA to hepatobiliary dynamic scintigraphy with PMT appears to be useful in evaluating the functional status of the liver, since it facilitates the interpretation of the kinetic behaviour of PMT in the liver and allows us to extract quantitative parameters corresponding to those obtained by CA or DA.

Biliary Tract↗

Adrenocorticotropic hormone-releasing activity of urotensin I and its fragments in vitro.

Adrenocorticotropic hormone (ACTH)-releasing activity of synthetic carp Urotensin I (UI) and its ten synthetic fragments were examined using cultured rat pituitary cells. Both UI(1-41) and rat CRF (rCRF) increased ACTH release in a similar fashion at a concentration range from 10 pM to 100 nM. The potency of UI(1-41) was about one seventh that of rCRF on a molar basis. Four of ten UI fragments, UI(1-36), UI(4-36), UI(6-36) and UI(1-19) showed relatively strong ACTH-releasing activity, whereas both UI(9-36) and UI(17-36) showed extremely weak ACTH-releasing activity. However, all these fragments showed the activity in a dose-dependent manner parallel with that of UI(1-41). The activity of UI(1-36) was weaker than UI(1-41), suggesting that the C-terminal 37-41 sequence is required to express the full ACTH-release activity, although each of four C-terminal fragments, UI(24-36), UI(24-41), UI(29-36) and UI(29-41), exhibited no activity. In summary, the 4-19 amino acid sequence of UI(is important to exhibit ACTH-releasing activity and the C-terminal 37-41 sequence will be necessary to express the full activity.

Adrenocorticotropic Hormone↗

Random amplification of polymorphic DNA is useful for the differentiation of several anthropophilic dermatophytes.

The efficacy of random amplification of polymorphic DNA (RAPD) analysis, a polymerase chain reaction (PCR)-based technology, as a tool for differentiation of several anthropophilic dermatophytes, that is, Trichophyton mentagrophytes var. interdigitale, T. rubrum and Epidermophyton floccosum, was examined. Total cellular DNA extracted by a mini-preparation method were used as template DNAs and PCRs were performed using five primers, all of which were synthesized 10-mers. All of the primers generated PCR products and their electrophoresed profiles were characteristic for each of the species. Since these anthropophilic dermatophyte species could be differentiated clearly by the RAPD analysis, this method may be useful for identification of these species. Minimal intraspecies polymorphisms were observed between the isolates of T. mentagrophytes var. interdigitale. The banding patterns were reproducible using template DNAs prepared at different times from each of stock cultures.

Arthrodermataceae↗

A functional role for death proteases in s-Myc- and c-Myc-mediated apoptosis.

Upon activation, cell surface death receptors, Fas/APO-1/CD95 and tumor necrosis factor receptor-1 (TNFR-1), are attached to cytosolic adaptor proteins, which in turn recruit caspase-8 (MACH/FLICE/Mch5) to activate the interleukin-1 beta-converting enzyme (ICE)/CED-3 family protease (caspase) cascade. However, it remains unknown whether these apoptotic proteases are generally involved in apoptosis triggered by other stimuli such as Myc and p53. In this study, we provide lines of evidence that a death protease cascade consisting of caspases and serine proteases plays an essential role in Myc-mediated apoptosis. When Rat-1 fibroblasts stably expressing either s-Myc or c-Myc were induced to undergo apoptosis by serum deprivation, a caspase-3 (CPP32)-like protease activity that cleaves a specific peptide substrate, Ac-DEVD-MCA, appeared in the cell lysates. Induction of s-Myc- and c-Myc-mediated apoptotic cell death was effectively prevented by caspase inhibitors such as Z-Asp-CH2-DCB and Ac-DEVD-CHO. Furthermore, exposing the cells to a serine protease inhibitor, 4-(2-aminoethyl)benzenesulfonyl fluoride (AEBSF), also significantly inhibited s-Myc- and c-Myc-mediated apoptosis and the appearance of the caspase-3-like protease activity in vivo. However, AEBSF did not directly inhibit caspase-3-like protease activity in the apoptotic cell lysates in vitro. Together, these results indicate that caspase-3-like proteases play a critical role in both s-Myc- and c-Myc-mediated apoptosis and that caspase-3-like proteases function downstream of the AEBSF-sensitive step in the signaling pathway of Myc-mediated apoptosis.

Animals↗

Real-time processable three-dimensional US in obstetrics.

Results with real-time processable three-dimensional ultrasound (US) were assessed in 57 normal fetuses and two fetuses with hydramnios. Volume scanning time was 4 seconds, and a complete three-dimensional fetal image was displayed at the end of scanning. Although this method was limited in some respects, such as viewing direction, it was very useful when performed in conjunction with conventional tomographic US because of its speed and because some components were depicted more clearly.

Female↗

Evaluation of emphysema in patients with reversible airway obstruction using high-resolution CT.

OBJECTIVE: This study was carried out to determine whether asthma affects the development of emphysema. METHODS: We studied 62 patients with reversible airway obstruction during remission, and evaluated the presence and severity of emphysema using high-resolution CT. The emphysema score (ES) was evaluated with the visual scoring method on CT scans. RESULTS: Of the 62 patients, 14 were judged to have emphysema. Patients with emphysema were significantly older and more likely to be male than those without emphysema. All patients with emphysema were smokers. There was no significant difference in the duration or severity of asthma between patients with and without emphysema. The 62 patients were divided into three groups according to the ES: 48 patients without emphysema (ES = 0%), 8 patients with mild emphysema (0% < ES < 15%), and 6 patients with more severe emphysema (ES > or = 15%). Highly significant differences between patients without emphysema and those with more severe emphysema were found in FEV1 (p<0.01), FEV1/FVC (p<0.001), diffusing capacity for carbon monoxide (DCO) (p<0.01), and DCO/alveolar volume (p<0.0001). CONCLUSION: Neither the duration nor the severity of asthma was correlated with the presence of emphysema, while smoking history, sex, and age were strongly correlated. No patients with emphysema were found among the nonsmokers, including those with severe asthma or asthma of long duration. These results suggest that asthma does not lead to emphysema.

Adult↗

[Magnetic resonance imaging of a case of central nervous system tuberculosis with tuberculous arachnoiditis and multiple tuberculomas].

A 62-year-old woman developed headache, vomiting and fever. On admission to hospital, she showed an imparied level of consciousness, diplopia on left lateral gaze, bilateral hearing loss and left hemiparesis. Cranial contrast computed tomography (CT) revealed basal meningeal enhancement. Lumbar cerebrospinal fluid (CSF) showed an increase in cell count (80/mm3) and total protein (3000 mg/dl), and a decrease in glucose (65 mg/dl) in comparison with blood sugar (173 mg/dl). Polymerase chain reaction was positive for Mycobacterium tuberculosis in the CSF. She was diagnosed as having tuberculous meningitis and was treated with anti-tuberculous chemotherapy. Her level of consciousness recovered and other clinical signs improved gradually the first month after admission. However, in spite of the combination of anti-tuberculous chemotherapy and steroid therapy, her combination of anti-tuberculous chemotherapy and steroid therapy, her consciousness level worsened again in association with paraplegia at the sixth week after admission and magnetic resonance imaging (MRI) revealed multiple tuberculomas, spinal arachnoiditis and spinal cord infarction. On T2-weighted imaging some of the tuberculomas showed a central hyperintense area (a central bright core) with an isointense periphery, which was surrounded by a hyperintense area. The lesion appeared hypointense with an isointense rim on T1-weighted imaging, showing a ring enhancement on post-contrast T1W imaging. The spinal cord infarction was situated at the third thoracic cord, which corresponded to the borderline of spinal artery perfusion. This is a rare case of progression of spinal arachnoiditis and spinal cord infarction during anti-tuberculous chemotherapy, and who had tuberculoma with a central bright core on MRI.

Arachnoiditis↗

[Examination of low palatal arch with long low hanging soft palate in obstructive sleep apnea syndrome and cephalometry].

In order to clarify morphological abnormalities of the upper airway in patients with obstructive sleep apnea syndrome (OSAS), and to predict the severity as well as the effect of surgery, we statistically examined the relationship between the degree of low palatal arch and the result of cephalometry in 45 adult male patients with OSAS who underwent uvulopalatopharyngoplasty. The patients were divided into 3 types, A, B and C, according to the degree of low palatal arch on inspection, and type C was regarded as having a low palatal arch with a long low-hanging soft palate. It was found that (1) type C patients showed a higher preoperative apnea index and lower minimal blood oxygen saturation, suggesting a serious condition. (2) In type C patients, the long axis (PNS-H) of the airway was larger, and the oral area was smaller. The area of the entire tongue, especially the upper half of the tongue, was larger than that in patients of other types. Type C patients were further divided into 3 subtypes: (1) those with a substantially long low-hanging soft palate; (2) those with a long low-hanging soft palate and large tongue; and (3) those in whom the large tongue is the main factor for the apparent low-hanging soft palate. These subtypes should be confirmed by cephalography before treatment for effective surgical results.

Adult↗

Assessment of left ventricular volume using ECG-gated SPECT with technetium-99m-MIBI and technetium-99m-tetrofosmin.

UNLABELLED: We evaluated ECG-gated SPECT (g-SPECT) in the measurement of absolute left ventricular (LV) volume by comparing it with left ventriculography (LVG) and with cine-MRI. METHODS: Projection data from 31 patients were acquired with a three-headed SPECT system in 12 min using a 64 x 64 matrix with 1.5 zoom (1 pixel = 4.27 mm). The R-R interval from simultaneously acquired ECG was divided into eight frames. The end-diastolic and end-systolic volumes (EDV; ESV) and LV mass were assessed by an area-length method with manual delineation of the epi- and endocardial LV borders using midventricular vertical and horizontal long-axis images. The stroke volume, LVEF and cardiac output (CO) were generated from the EDV, ESV and heart rate during the study. The g-SPECT LV values were compared with those of LVG (25 patients) and cine-MRI (18 patients). RESULTS: The g-SPECT values correlated well with those from LVG (r = 0.83 to 0.92; p < 0.001) and cine-MRI (r = 0.76 to 0.99; p < 0.001). The g-SPECT technique provides an assessment of LV volumes (EDV, ESV, stroke volume, LVEF, CO, LV mass). CONCLUSION: Despite potential problems that may cause inaccuracy and require improvements such as an accurate and reproducible automatic edge detection algorithm, g-SPECT has clinical utility in assessing global LV volumes and function.

Adult↗

Malignant fibrous histiocytoma of the temporal bone with endocranial extension.

Cranial malignant fibrous histiocytomas are rare tumors. Most are hypervascular, destructive masses that are similar to other malignant lesions and to malignant fibrous histiocytomas found elsewhere in the body. We describe a myxoid malignant fibrous histiocytoma of the temporal bone, possibly of dural origin, with features that more closely resembled a meningioma at CT, MR imaging, and angiography.

Adult↗

[Successful surgical treatment of double-outlet right ventricle with intramural coronary artery, using the modified Aubert procedure--a case report].

The modified Aubert procedure and left ventricular outflow tract reconstruction were performed successfully for double-outleft right ventricle with subpulmonary ventricular septal defect, which showed an unusual Shaher type 5a coronary artery pattern. This pattern was characterized by two coronary ostia arising from the right septal sinus and intramural segment in a left trunk of the coronary artery. In this case, the neo-pulmonary artery was reconstructed without prosthetic materials. However, postoperative echocardiography showed no evident supravalvar pulmonary stenosis. The modified Aubert procedure without prosthetic marerids can be used for double-outlet right ventricle and transposition of the great arteries which show dilated prelimonary artery.

Double Outlet Right Ventricle↗

[A case of transient cortical blindness due to reversible ischemic neurological deficit (RIND) after caesarean section under lumbar anesthesia].

We report a case of 31-year-old woman with pregnant toxicosis, who developed transient blindness after caesarean section under lumbar anesthesia. The patient was hypoxic due to atelectasis when she developed blindness, but she had no ophthalmologic abnormalities. MRI depicted abnormal high intensity areas (HIA) with T 2-weighted images (T 2 WI) in the occipital lobes and the basal ganglia. CT could not detect any of these MRI findings. The patient regained her vision four days after the onset. The HIA disappeared in a follow up MRI (T 2 WI) two weeks after the onset. The patient was diagnosed as cortical blindness due to RIND. Although most of the transient cortical blindness are accompanied with pregnant toxicosis with hypertension, there are some cases without pregnant toxicosis. We stress the importance of maintaining the blood pressure within the normal range in patients with hypertension who undergo surgery under spinal anesthesia.

Adult↗

[CT-ventriculography: a new application of the helical CT].

The authors proposed a new application of helical CT, namely, CT-ventriculography that can obtain 2D and 3D images of different cardiac phases. CT-ventriculography could assess wall motion, systolic thickening and chamber volume. From a single breath hold helical CT 50-rotation), about 500 transaxial slices were obtained by applying overlapping reconstruction (0.1 pitch, 0.08 sec = 0.2 mm interval). All transaxial slices were recordered to separate different cardiac phases. Then, long and short axial 2D tomograms and 3D images in different cardiac phases were reformatted. CT-ventriculography is a promising new application for the assessment of heart function.

Angina Pectoris↗

[Anomalous origin of the right pulmonary artery from the ascending aorta--a report of three operative cases].

Three patients with anomalous origin of the right pulmonary artery from the ascending aorta were reported. Case 1: A 33-day-old premature infant (body weight 984 g) with the right pulmonary artery arising from the ascending aorta (RAPAA) and the patent ductus arteriosus (PDA). Banding of the right pulmonary artery (RPAB) and ligation of PDA were performed as a palliative operation. AT 3-month-old (BW 2,200 g), division and direct anastomosis of the anomalous vessel to the main pulmonary trunk was done as a radical operation under hypothermic cardiopulmonary bypass (CPB). Case 2: A 16-day-old infant with RAPAA and PDA. Division and direct anastomosis of the anomalous vessel to the main pulmonary trunk and ligation of PDA were performed as a radical operation under hypothermic CPB. Case 3: A 74-day-old infant with RAPAA and Ebstein's anomaly. RPAB was performed as a first palliative operation and left Blalock-Taussig shunt as a second operation. Glenn operation is scheduled as third operation prior to Fontan type operation.

Aorta↗