Biomedical subjects

T Noguchi

Publications and source records attributed to T Noguchi.

At least 541 records · Page 30Linked to original sources

PubMed1993

[Interleukin-6 and glucocorticosteroid responses to cardiopulmonary bypass].

The responses of interleukin-6 (IL-6), ACTH, cortisol, WBC, CRP to cardiopulmonary bypass (CPB) were studied in 5 patients who underwent elective CABG (N = 4) and AVR (N = 1). IL-6 started to increase from 3 h after the beginning of the operation at which aortic clamp was removed and reached a peak after 4 h at which CPB was withdrawn. ACTH also reached a peak after 4 h. The increase of cortisol started from 2 h when aorta was clamped, which was earlier than that of IL-6. IL-6 and ACTH fell sharply to pre-CPB levels before first postoperative day (1 POD) while cortisol remained high postoperatively. CRP level and WBC counts were maximum at 2 POD. The results suggest that the cortisol response to CPB is not only caused by IL-6, but also by other factors, such as IL-1 and TNF.

Adrenocorticotropic Hormone↗

PubMed1993

[Clinical experience of VA-bypass as a cardiac assist system using centrifugal pump with membranous oxygenator in patients with profound ventricular failure after cardiac surgery].

Twelve patients including 6 ischemic heart diseases, 5 valvular diseases, and one adult atrial septal defect combined with mitral and tricuspid valve insufficiency were treated with circulatory assist system for postoperative severe low-cardiac output syndrome. Intra-aortic balloon pumping (IABP) was used in all cases. In early 7 cases, left heart bypass system was employed including one roller pump, one left ventricular assist device (LVAD), and 5 centrifugal pump. Only one LVAD case could be weaned but died of sustained ventricular arrhythmias 5 days postoperatively. In recent 5 cases, veno-arterial bypass (VA-bypass) was employed using centrifugal pump with membranous oxygenator. Venous blood was drained from the right atrium and oxygenated blood was returned to the right axillary artery. Real time reinfusion of drained blood from intrapericardial and mediastinal tube to the central vein served efficiently to maintain hemodynamics and to save homologous blood transfusion. Three of 5 cases who were treated with Va-bypass survived and are doing well. We conclude that VA-bypass consisting with centrifugal pump and oxygenator returning oxygenated blood to the right axillary artery combined with IABP were useful strategies as biventricular support for profound cardiac failure following surgery.

Aged↗

PubMed1993

Overexpression of HLA class I antigen reduces insulin secretion in pancreatic beta cells (RINM5F): evidence for a non-immune mechanism.

Our recent observation indicated that overexpression of HLA-class I antigen on pancreatic beta cells is one of the features of insulin-dependent diabetes mellitus (IDDM). To analyze the effect of class I antigen overexpression, we have introduced human HLA class I (HLA-Cw3) gene into rat pancreatic beta cell lines, RINm5F. Several stable transformants with various levels of surface expression of class I antigens have been cloned. The insulin secretion of these transfectants was analyzed to evaluate the functions of beta cells. Highly negative correlation between the level of insulin secretion and that of class I expression (correlation coefficiency: r = 0.89) has been observed. These data suggest that the overexpression of HLA class I antigen itself may impair pancreatic beta cells through a nonimmune mechanism.

Animals↗

PubMed1993

[Clinical significance of plasma levels of clomipramine and its desmethylated and hydroxylated metabolites].

Concentrations of clomipramine and its metabolites, N-desmethylclomipramine (DC), 8-hydroxy-N-desmethylclomipramine (HDC) and 8-hydroxyclomipramine (HC), in plasma were determined in 99 patients treated with clomipramine hydrochloride. Doses patients received were not fixed but titrated according to their clinical severity and response to the treatment. Large interindividual variations were present in the concentrations of parent or each metabolic compounds in plasma, however, strong correlations existed between these drug concentrations and daily doses of clomipramine (0.40-5.10 mg/kg of body weight) (r = 0.62-0.80). Metabolic ratios for desmethylation and those for hydroxylation were calculated from these data, and revealed very large inter-individual variations of 30-36 fold and 10-96 fold, respectively. Pharmacological data from 65 of these patients with DSM-III-R mood disorders were analyzed by discriminant analysis using the scores of Global Assessment of Functioning. The overall prediction value for responder or nonresponder was calculated as 70% 2 wk after the initiation of pharmacotherapy. Concentrations of hydroxylated metabolites in plasma does contribute as much to the prediction of clinical response to clomipramine as desmethylated metabolites.

Administration, Oral↗

PubMed1993

Evaluation of chimerism after bone marrow transplantation with single locus minisatellite DNA probes.

The origin of cells in almost all allogeneic donor-recipient pairs can be determined through the use of highly polymorphic minisatellite DNA probes. Single-locus probes were cloned from hypervariable fragments in a human DNA fingerprint detected with a multi-locus probe. While each probe is highly polymorphic and locus specific, they all contain repetitive sequences. The properties of single-locus probes have improved the sensitivity of detecting mixed chimerism in comparison with multi-locus probes. The use of single-locus probes permitted detection of mixed chimerism (MC) at levels as low as 0.625%, approaching that obtained by PCR methods. In the present study, five patients who received allogeneic BMT for hematologic malignancies were analyzed. Two patients exhibited MC after BMT. One developed acute GVHD and chronic GVHD and remained in CR while the second patient who had no signs of GVHD suffered a relapse.

Adult↗

PubMed1993

[Relationship among aromatase activity, estrogen receptor and progesterone receptor in ovarian tumors from postmenopausal women].

Aromatase activity, as well as steroid receptors, has been demonstrated in ovarian tumors. Aromatase activity was detected in 35 tumors (81%), PR in 21 tumors (49%) and ER in 13 tumors (30%) out of 43 ovarian tumors (27 benign, 14 malignant and 2 granulosa cell tumors). Moreover, immunohistochemical study demonstrated aromatase cytochrome P-450 (P-450arom) in the tumor tissues. Aromatase activity was significantly greater in PR-positive tumors than in PR-negative tumors (p < 0.002). There was a positive correlation between aromatase activity and the PR level (rs = 0.490, p < 0.001). Thirteen of 14 (93%) malignant tumors showed negative PR with low aromatase activity. However, the presence of ER was not correlated with aromatase activity or the presence of PR. There was a positive correlation among serum levels of estradiol, estrone, androstenedione and testosterone, whereas the serum steroid levels were not correlated with aromatase activity, the PR or ER of ovarian tumors. These results suggest that aromatase activity is correlated with PR in ovarian tumors of postmenopausal women.

Adult↗

PubMed1993

Tertiary structural analysis of Escherichia coli lysine tRNA.

It has been suggested that Escherichia coli lysine tRNA (E. coli tRNA(Lys)) has an unusual anticodon loop structure, judging from the abnormal CD pattern derived from 5-methylaminomethyl-2-thiouridine (mnm5s2U) located at the first position of the anticodon of the tRNA. Here, the structure of E. coli tRNA(Lys) was analysed by chemical modification and nuclear magnetic resonance (NMR) of the imino protons. The chemical probing approach showed that the anticodon arm region forms the ordinary stem-and-loop structure as expected from the standard clover-leaf structure, because N7 of G30, N3 of C40, N7 of A41 and N7 of A42 were protected under a native condition. By using the heteronuclear 15N-1H single quantum coherence (HSQC) spectra of 15N-labeled E.coli tRNA(Lys) and the analyses of the nuclear Overhauser effects (NOE) between the imino protons of non labeled E.coli tRNA(Lys), the imino protons in the acceptor stem was assigned, which indicates that the acceptor stem exists in an usual form. The tertiary base-base interactions was also detected. Thus, E.coli tRNA(Lys) seems to maintain a similar structure to the ordinary L-shaped tertiary structure, as a whole. The fine structure of the anticodon loop is now being analyzed.

Anticodon↗

PubMed1993

[A case of clear cell adenocarcinoma of the female urethra].

A 49-year-old female visited our hospital because of bloody discharge from the urethra. On examination, an elastic-soft mass was palpable beneath the anterior vaginal wall. The vaginal mucosa was intact. Cystourethroscopy demonstrated neither tumor nor diverticular orifice. Pathological specimen obtained by needle biopsy revealed clear cell adenocarcinoma. The patient underwent anterior pelvic exenteration and modified Kock pouch urinary diversion. The microscopic appearance suggested that the tumor arose from the paraurethral duct. Stains for prostatic specific antigen and prostate specific acid phosphatase were negative. Forty cases of clear cell adenocarcinoma of the female urethra reported in the literature were reviewed.

Adenocarcinoma, Clear Cell↗

PubMed1993

[A case of interstitial pneumonia of polymyositis-dermatomyositis with various pathological findings in open lung biopsy].

A 60-year-old woman was admitted to our hospital with a two month history of dry cough and dyspnea on exertion. A chest roentgenogram revealed diffuse interstitial shadows with a reduction of lower lung volume. Laboratory examinations revealed an increase in CPK and aldolase. There was decreased proximal muscle power, and the findings of a biopsy of the right deltoid were compatible with polymyositis. Myositic symptoms were stable, but the respiratory symptoms worsened, and an open lung biopsy was performed for diagnosis and to determine the best treatment. The histological findings of biopsy materials demonstrated active interstitial pneumonia complicated by cellular interstitial pneumonia, bronchiolitis obliterans organizing pneumonia, usual interstitial pneumonia and lymphoid hyperplasia. The patient responded well to adrenocorticosteroid and immunosuppressive therapy, and is now attending as an out patient. It is well known that PM-DM can be associated with interstitial pneumonia, and this complication is an important prognostic factor clinically. The pathological patterns of interstitial pneumonia in PM-DM may be divided into usual interstitial pneumonia and bronchiolitis obliterans organizing pneumonia. Furthermore, it is well documented that these patterns are concurrent with the response to adrenocorticosteroid and prognostic factors. However, our case of PM-DM, in which various patterns such as rheumatoid arthritis (RA) were pathologically revealed, cannot be considered as having uniform pathological pattern. We consider that pulmonary pathological patterns of PM-DM are very varied, as with RA. It is a very important to evaluate the nature of these patterns and the subsequent clinical course in PM-DM with interstitial pneumonia.

Biopsy↗

PubMed1993

Interindividual variations of desmethylation and hydroxylation of clomipramine in an Oriental psychiatric population.

We measured the concentrations of clomipramine and its metabolites, N-desmethylclomipramine, 8-hydroxy-N-desmethylclomipramine, and 8-hydroxyclomipramine in plasma in 92 Japanese psychiatric patients receiving clomipramine hydrochloride (Anafranil, Ciba-Geigy Japan Limited, Takarazuka, Japan) by high-performance liquid chromatography. Although there were large interindividual variations of total drug concentrations and concentrations of parent or intermediate metabolic compounds in plasma, significant positive correlations were observed between these drug concentrations and daily doses of clomipramine hydrochloride (milligrams per kilogram of body weight). The metabolic ratios for both desmethylation and hydroxylation varied substantially with 30- to 90-fold interindividual variations. Frequency distribution histograms and probit analyses of these parameters identified only one possible poor hydroxylator but no poor desmethylator of clomipramine. These results suggest that there are large interindividual variations of capacities for hydroxylation and desmethylation of clomipramine in the Oriental population and that therapeutic drug monitoring is essential in clinical practice to reduce the adverse effects of clomipramine and to prevent poor response to clomipramine.

Adolescent↗

PubMed1993

A case of radical resection for solid cystic tumor of the pancreas with widespread metastases in the liver and greater omentum.

Solid cystic tumor (SCT) of the pancreas is known to be a low-grade malignant tumor and distant metastasis is very rare. A 50-year-old Japanese female was hospitalized because of a large mass in the upper abdomen. Computerized tomography revealed a large calcified tumor in the body-tail of the pancreas, and multiple liver tumors. Abdominal angiography demonstrated the pancreatic tumor and multiple hepatic tumors as a hypervascular mass, and disclosed a small tumor stain in the branch of the right gastroepiploic artery. The patient underwent a distal pancreatectomy with splenectomy, extended right hepatic lobectomy, and removal of the omental metastases. Histopathological and electron microscopic studies made a definitive diagnosis of SCT. She is well without any signs of tumor recurrence 1 yr and 2 months after the operation. This may be the first patient receiving simultaneous radical resection for both the main tumor and widespread distant metastases.

Cysts↗

PubMed1993

[Cortisol responses to rapid ACTH test in patients with multiple organ failure].

Cortisol concentrations are usually elevated in sepsis, during major surgery and in burns. Adrenocortical response to stress seems to be essential for survival. To investigate the endogenous adrenocortical response to multiple organ failure, rapid ACTH stimulation tests were used in 15 patients. Patients were divided to nonsurvival group and survival group. Patients in both groups appeared to have increased adrenocortical activity, because basal cortisol concentrations were above normal (non-survival group: 33.8 +/- 13.7 micrograms.dl-1, survival group: 19.1 +/- 3.8). There are no significant differences between the two groups. We could not find absolutely adrenal insufficient patient. Plasma cortisol concentrations increased significantly in patients of both groups following ACTH stimulation. We found poor response to ACTH in two patients in non-survival group with very high basal cortisol concentrations. But there is no significant difference of cortisol response between the two groups. We could not determine whether the high mortality is associated with poor response to ACTH or not.

Adrenal Cortex↗

PubMed1993

An alternate nonisotopic technique of PCR-mediated allele-specific oligonucleotide analysis for the detection of a point mutation.

We report a simple protocol for the allele analysis of a point mutation using polymerase chain reaction. Conditions have been determined to use probes prepared for the conventional allele-specific oligonucleotide hybridization method directly. After amplification of the genomic region containing the mutation site, the nested polymerase chain reaction was performed using an allele-specific oligonucleotide probe as one side of the primer. Specificity of the amplification was achieved by decreasing the primer concentration in a two segment thermal cycling pattern. This protocol does not require additional special primers and an allelic mutation can be determined non-isotopically.

Alleles↗

PubMed1993

[Evaluation of blood purification in perioperative acute renal failure].

The technical aspects of blood purification have made a great progress during 1980's. We reviewed our experiences of blood purification for the past six years. Between 1986 to 1991, we treated 48 perioperative patients with acute renal failure (ARF). Four were intraoperative cases and 46 were postoperative cases. Three of four intraoperative patients received major cardiovascular surgery, and hemodialysis was connected directly to ECC in these three cases, and in other one case, ARF was treated with continuous hemofiltration (CHF). There was no intraoperative complication. One patient died of septic multiple organ failure (MOF), but other three patients were discharged uneventfully. Thirty five postoperative ARF patients showed oliguric ARF, and their major causes were LOS (65%) and septic shock (29%). We treated these ARF patients with CHF combined with HD (63%), CHF only (28%) and HD only (9%). There were 21 deaths (60%) in this group and most common cause of death was septic MOF. Eleven postoperative ARF patients showed non-oliguric renal failure, and major cause of this type of ARF was thought to be aortic dissection and relative hypotension (45%). We treated these non-oliguric ARF patient with HD only (73%) and HD combined with CHF (27%). One of these non-oliguric ARF patients died from ARDS.

Acute Kidney Injury↗

PubMed1993

Donor hepatectomy for living related partial liver transplantation.

BACKGROUND: An essential prerequisite for living related partial liver transplantation is to perform donor hepatectomy with minimal risk while preserving graft viability. This article describes a safe method of donor hepatectomy that was used for five patients who underwent living related liver transplantation. METHODS: Liver parenchymal transection was performed by the selective vascular occlusion technique in four patients, and interruption of the blood supply to the left medial segment was carried out along the right side of the umbilical portion before parenchymal division in the other patient. RESULTS: These procedures resulted in insignificant intraoperative blood loss, for which no banked blood or blood derivatives were transfused. The postoperative course for each of the five donors was uneventful, and excellent graft viability was verified by the fact that the five recipients showed a good immediate postoperative course without marked increases in the serum activities of liver enzymes. CONCLUSIONS: We believe that the operative risk of living related donor hepatectomy is minimal if it is performed by experienced liver surgeons with the present procedures.

Adult↗

PubMed1993

[A new technique for evaluating the respiratory tract--digital subtraction bronchography (DSBG)].

Bronchography is essential for evaluation of morphological changes in the bronchial tree. However, conventional bronchography using Propyliodone (Dionosil) is extremely invasive, especially to those with pulmonary infections. In the present study, we developed a new less invasive method of bronchography with the aid of digital subtraction technique (DSBG), and evaluated its clinical benefits. Bronchography was performed by injecting contrast medium (Iopamidol: Iopamiron 300) via the lumen of the bronchoscope (Olympus Type 20), and image processing of the respiratory tract was performed using digital subtraction technique. From 1991 to 1992, DSBG was performed in 15 cases (8 bronchiectasis, 1 diffuse panbronchiolitis, 1 lung cancer, 1 pulmonary emphysema, and 4 others). DSBG clearly demonstrated the morphological changes of large and segmental bronchial lesions in cases of bronchiectasis and lung cancer, as well as conventional bronchography using Dionosil. In addition, it was possible to image the morphological changes of bronchiolar lesions in diffuse panbronchiolitis and pulmonary emphysema to the same detail as obtained using classical selective alveolo-bronchography (SAB). Since DSBG can provide enhanced images the bronchial tree without being affected by cardiac and respiratory movements, we could obtain detailed information on bronchial and/or bronchiolar lesions. With respect to side effects, Iopamiron was quickly drained and/or absorbed within 2 hours after injection. Pulmonary infection and bronchial bleeding, which are well known primary complications of classical bronchography using Dionosil, were not observed. We conclude that 1) DSBG is useful new technique for examining morphological changes of the respiratory tract, and 2) DSBG is less invasive than conventional bronchography.

Adult↗

PubMed1993

[Clinical significance of micromegakaryocytes in de novo AML].

Bone marrow specimens obtained from 54 patients with de novo AML and 7 patients with AML evolving from MDS were retrospectively examined for the presence of micromegakaryocytes defined as cells of less than 30 microns in diameter with one or two nuclei. At least 25 megakaryocytes were counted in each patient. Micromegakaryocytes were found in 17 cases (31%), M1:1/11, M2:5/18, M3:0/4, M4:5/12, M5:1/4, M6:4/4, M7:1/1. The median age of the patients was higher in de novo AML with micromegakaryocytes (57 years) than in de novo AML without micromegakaryocytes (41 years) (p = 0.014). Chromosomal analysis revealed that deletion of 5 or 5q-, 7 or 7q- was recognized only in the group of de novo AML with micromegakaryocytes and that t(15;17), t(8:21) and inv (16) were not recognized in this group. Micromegakaryocytes were identified in each bone marrow specimen obtained from 9 of 10 patients with de novo AML with trilineage myelodysplasia. The complete remission rate was significantly lower in de novo AML with micromegakaryocytes (33%) than in de novo AML without micromegakaryocytes (86%) (p = 0.001). The duration of survival of the patients with de novo AML with micromegakaryocytes was shown to be shorter than that of the patients with de novo AML without micromegakaryocytes (p = 0.017). Micromegakaryocytes were recognized in all of 7 patients with AML evolving from MDS. The presence of micromegakaryocytes in bone marrow of the patients with AML indicates a subset of AML with poor prognosis that may be closely associated with myelodysplastic syndrome.

Adolescent↗

PubMed1992

Molecular cloning of hippocalcin, a novel calcium-binding protein of the recoverin family exclusively expressed in hippocampus.

We have isolated a cDNA clone encoding a novel calcium-binding protein of the recoverin family from rat brain cDNA library. This clone (PCB11) has 588 nucleotides in the open reading frame including the termination codon, 174 nucleotides of the 5' leader and 800 nucleotides of the 3' noncoding region. The complete amino acid sequence deduced from the cDNA is composed of 195 residues, has a calculated molecular mass of 22,574 Daltons, and contains three putative calcium-binding domains of the EF-hand structure. The deduced amino acid sequence has a striking sequence homology to those of the retinal recoverin family (recoverin, visinin, P26, 23kD protein, S-modulin) and the brain-derived recoverin family (P23k, 21-kDa CaBP and neurocalcin). Northern blot, in situ hybridization, immunoblot and immunohistochemical analyses revealed that the protein is exclusively expressed in pyramidal layer of the hippocampus. The protein was therefore designated hippocalcin.

Amino Acid Sequence↗