Biomedical subjects

T Takemura

Publications and source records attributed to T Takemura.

At least 55 records · Page 3Linked to original sources

PubMed2001

Significantly rapid relief from steroid-resistant nephrotic syndrome by LDL apheresis compared with steroid monotherapy.

Rapid amelioration of hypercholesterolemia by LDL apheresis (LDL-A) was performed for long-standing nephrotic syndrome (NS) with hyperlipidemia due to focal segmental glomerulosclerosis (FGS) and the clinical data and prognosis were compared between LDL-A-treated and nontreated groups. Seventeen steroid-resistant NS patients treated with LDL-A (LDL-A group) and 10 NS patients treated with steroids only (steroid-monotherapy (SM) group) were compared. Serum cholesterol and phospholipid levels were significantly lowered only in the LDL-A group (p < 0.01, respectively). The LDL-A group showed a significant decrease of urinary protein (UP, p < 0.01) and increase of serum albumin (p < 0.05). Average time needed to achieve a decrease of UP to less than nephrotic range (< 3.5 g/day) was significantly shorter in the LDL-A group than in the SM group (p < 0.01). Although this is not a prospective study, it is highly expected that a rapid improvement of hypercholesterolemia by LDL-A in steroid-resistant NS will provide more rapid relief from NS than steroid therapy alone.

Adolescent↗

PubMed2001

[A case of sarcoidosis acutely aggravated with high fever and diffuse interstitial pulmonary infiltrates].

We present a case of sarcoidosis acutely aggravated with high fever and diffuse interstitial pulmonary infiltrates in a female patient at the age of 64. Sarcoidosis was diagnosed in another hospital as a result of iritis, chest radiography findings, and a negative reaction in a tuberculin skin test. She was admitted to our hospital because of dyspnea and a high temperature of 39 degrees C in February 1994. A marked hypoxemia (PaO2 46.5 torr) was found in arterial blood gas analysis. Chest radiography revealed a bilateral diffuse reticulo-nodular shadows, and chest CT showed ground glass opacity predominant posteriorly. Analysis of bronchoalveolar lavage fluid revealed an increase in lymphocytes and an increased ratio of CD4 to CD8 T lymphocyte. Transbronchial lung biopsy revealed lymphocytic alveolitis and proliferation of epithelioid cell granulomas in the alveolar septa and intraalveolar spaces. The patient was treated for deterioration of sarcoidosis with 40 mg of prednisolone and her respiratory status and the radiographic findings improved rapidly. With dose tapering of prednisolone, dyspnea and deterioration of the radiographic findings occurred, but with addition of a weekly low dose of methotrexate, dose reduction of prednisolone was achieved.

Acute-Phase Reaction↗

PubMed2001

Intravenous nedaplatin and intraarterial cisplatin with transcatheter arterial embolization for patients with locally advanced uterine cervical cancer.

Nedaplatin is a platinum analog that has less renal toxicity and higher efficacy for uterine cervical cancer than cisplatin. Intraarterial cisplatin has been shown to be more effective than intravenous cisplatin in the treatment of cervical cancer. To improve the prognosis of cervical cancer, we studied combination chemotherapy of intravenous nedaplatin and intraarticular cisplatin with transcatheter arterial embolization (TAE). The criteria for selecting patients for this study were as follows: age 16-75 years, stage Ib2-IV according to the classification of the International Federation of Gynecology and Obstetrics (FIGO), performance status between 0 and 2, a creatinine clearance of >40 ml/min, adequate bone marrow and adequate renal and hepatic function. Thirty-two patients, aged 29-72 years (median: 55) were treated. FIGO stage was Ib2 in seven patients, IIa in seven patients, IIb in four, IIIa in one, IIIb in seven and IVa in six. Twenty-four patients had squamous cell carcinoma, three had adenocarcinoma and five had adenosquamous carcinoma. Written informed consent was obtained from all patients. Nedaplatin (30-70 mg/m2) was administered intravenously on day 1 and cisplatin (70 mg/m2) was administered intraarticularly via both uterine arteries on day 3 using the Seldinger method. TAE was then performed. This course of treatment was repeated every 3 weeks for 2-3 cycles. Response to the therapy was defined by magnetic resonance imaging. Partial response was found in 59% patients (19/32) and complete response in 34% (11/32), with an overall response rate of 94% (30/32). Myelosuppression was manageable. No grade 2 neurotoxicity was observed. The median follow-up was 32 months (6-53 months), with 84% of patients showing an overall survival of 1 year and 77% showing an overall survival of 2 years. These results show that this combination chemotherapy effected a high response rate. However, its influence on long-term survival remains to be determined.

Adenocarcinoma↗

PubMed2000

In vitro selection of DNA aptamers which bind to cholic acid.

DNA aptamers which bind to cholic acid have been identified by in vitro selection from a pool of approximately 9x10(14) DNA molecules. After 13 rounds of selection, 19 clones with 95-100 nucleotide length were sequenced. Deletion-mutant experiments and computational sequence analysis suggested that all clones contained cholic acid binding sequences which could fold into three-way junction structures. By comparing the sequences involved in the predicted three-way junction structure of these 19 clones, it was determined that the nucleotide sequences and lengths of three stem and loop regions have no similarity. The most conserved structure seems to have three base pairs flanking the junction of the three stems and they may form a hydrophobic cavity in which they interact with cholic acid.

Base Sequence↗

PubMed2000

Hemopexin as a carrier protein of tumor-localizing Ga-metalloporphyrin-ATN-2.

During size exclusion HPLC, ATN-2 binding protein separated from human and mouse sera, SCCVII and colon 26 tumor tissues were found in fraction 13 (A: estimated molecular weight 70,000). Fraction 13(A) of human sera was exclusively reactive to the human hemopexin antibody. During two-dimensional electrophoresis and amino acid sequence analysis, Fraction 13(A) of C3H/He mouse sera was found to have partial homology with the mouse hemopexin precursor. Glycoprotein with the same domain structure of hemopexin has been proposed to be an important carrier protein that forms the tumor-localizing activity of water-soluble porphyrin.

Animals↗

PubMed2000

Molecular cloning, expression, and chromosomal localization of a human tubulointerstitial nephritis antigen.

Tubulointerstitial nephritis antigen (TIN-ag) is an extracellular matrix basement protein which was originally identified as a target antigen involved in anti-tubular basement membrane (TBM) antibody-mediated interstitial nephritis (TIN). Further investigations elucidated that TIN-ag plays a role in renal tubulogenesis and that TIN-ag is defected in hereditary tubulointerstitial disorder such as juvenile nephronophthisis. We previously isolated and characterized 54 kDa glycoprotein as TIN-ag. cDNA encoding rabbit and mouse TIN-ag has recently been identified. In the present study, the cDNA of the human homologue of TIN-ag was cloned and its nucleotide sequence was determined (Accession No. AB022277; the DDBJ nucleotide sequence database). Deduced amino acid sequence (476 aa) exhibited the presence of a signal peptide (1-18 aa), cysteine residues termed follistatin module, six potential glycosylation sites, and an ATP/GTP-binding site. Homology search revealed approximately 85% homology with both rabbit and mouse TIN-ag, and also some ( approximately 40%) similarity with C. elegans. Human TIN-ag contained a sequence similar to several classes of extracellular matrix molecules in amino terminal region and to cathepsin family of cysteine proteinases in the carboxyl terminal region. Northern blot analysis revealed exclusive expression of this molecule in human adult and fetal kidney tissues. Using a monoclonal antibody recognizing human TIN-ag, protein expression ( approximately 50 kDa) was identified in cultured COS-1 cells transfected with human TIN-ag cDNA. The human TIN-ag was mapped to chromosome 6p11.2-12 by fluorescence in situ hybridization. These results may provide further evidence for understanding TIN-ag molecule and clues for gene analysis of juvenile nephronophthisis.

Adult↗

PubMed2000

Overexpression of bcl-2 in transient abnormal myelopoiesis associated with Down syndrome.

Transient abnormal myelopoiesis (TAM) is a haematological complication found in Down syndrome. To determine the mechanisms of sustained proliferation of TAM cells, we studied the expression of apoptosis-related proteins, such as bcl-2, Fas (APO-1/CD95) and p-53, in peripheral blood cells from a new-born infant with Down syndrome and TAM. Using flow cytometry, peripheral blood mononuclear cells (PBMCs), consisting mostly of blast cells, showed marked expression of bcl-2 protein but not of Fas or p-53 products. DNA gel electrophoresis of PBMCs, cultured in the absence of serum factors, revealed no marked fragmentation. Our findings suggest that bcl-2 overexpression may be associated with prolonged cell survival of TAM cells.

Down Syndrome↗

PubMed2000

Clinical and radiological features in four adolescents with nutcracker syndrome.

We describe four adolescents with the nutcracker syndrome. In three patients, the nutcracker syndrome was detected through mass urinary screening; the other patient was diagnosed after a sudden onset of dark urine. All patients underwent magnetic resonance angiography (MRA) for diagnosis of the nutcracker syndrome, which revealed dilatation of the left renal vein ranging between 7.4 and 13 mm at the hilar portion. A renal biopsy, performed in three patients, showed no remarkable abnormalities in the glomerulus or tubulointerstitial tissue. The patients complained of physical discomfort, including headache, abdominal pain, fainting, and tachycardia mimicking clinical symptoms of an orthostatic disturbance. However, no chronic systemic diseases were detected in any of the patients after repeated laboratory examinations. An orthostatic disturbance preceded diagnosis in three patients. This report indicates that the nutcracker syndrome may cause serious physical ailments that clinically mimic an orthostatic disturbance. It may be important to identify the nutcracker syndrome among children who manifest non-specific physical complaints. MRA could be a safe and reliable method for diagnosing the nutcracker syndrome.

Abdominal Pain↗

PubMed2000

Complete resection of cardiac leiomyosarcoma extending into the pulmonary trunk and right pulmonary artery.

A cardiac leimyosarcoma is an extremely rare tumor. We report a case of complete resection of a cardiac leiomyosarcoma extending into the pulmonary trunk and the right pulmonary artery using the Freestyle bioprosthesis (Medtronic, Inc, Minneapolis, MN) and Xenomedica graft (Baxter Healthcare Corp, Horw, Switzerland). Extensive resection and reconstructive surgery with the addition of radiotherapy prolonged the patient's life.

Adult↗

PubMed2000

Effects of probucol on cholesterol metabolism in mouse peritoneal macrophages: inhibition of HDL-mediated cholesterol efflux.

Macrophage-derived foam cells are known to play an essential role in the development and progression of atherosclerotic lesions. Probucol prevents oxidative modification of low-density lipoprotein (LDL) and lowers plasma contents of LDL and high-density lipoprotein (HDL). A recent report using apoE -/- mice demonstrated that probucol treatment enhanced atherosclerosis in apoE -/- mice more rapidly than that in untreated apoE -/- mice, and a reduction in plasma cholesterol by probucol was not the cause of enhancement of atherosclerotic lesions in probucol-treated apoE -/- mice. Moreover, probucol was reported to inhibit apoA-I mediated cholesterol efflux from mouse macrophages. These reports suggested that probucol might directly affect cholesterol metabolism in mouse macrophages. Thus, we investigated the effects of probucol on cholesterol metabolism in mouse resident peritoneal macrophages. Probucol did not affect degradation of acetylated LDL (Ac-LDL), degradation of LDL and endogenous cholesterol synthesis in mouse macrophages. However, it significantly inhibited HDL-mediated cholesterol efflux. Moreover, probucol partially (30%) inhibited the binding of HDL to mouse macrophages, and significantly activated acyl-coenzyme A:cholesterol acyltransferase (ACAT). Our results suggested that probucol inhibited HDL-mediated cholesterol efflux by inhibiting the binding of HDL to mouse macrophages and reducing HDL-accessible free cholesterol content by ACAT activation, thereby worsening atherosclerotic lesions in apoE -/- mice. However, it remains unclear whether probucol inhibits HDL-mediated cholesterol efflux from human macrophages.

Animals↗

PubMed2000

Telomerase activity significantly correlates with chromosome alterations, cell differentiation, and proliferation in lung adenocarcinomas.

Telomerase activity was examined by the telomeric repeat amplification protocol assay in 25 cases of lung adenocarcinoma, in relation to cancer cell differentiation, proliferation, and chromosome alterations. Telomerase activity, chromosome alterations, and cell proliferation assessed by Ki-67 labeling were significantly lower (P < .001 to .05) in well-differentiated (10 cases) than in moderately differentiated (8 cases) or poorly differentiated (7 cases) lesions. Telomerase activity by semiquantitative analysis with scoring of 0 to 3 was significantly correlated with similarly graded chromosome alterations (P < .05) and Ki-67 labeling indices (P < .002). Telomerase activity and chromosome alteration (T-C) indices generated by multiplication of telomerase activity and chromosome alteration scores also showed a significant correlation with cell differentiation. The Clara cell subtype, confirmed by electron microscopic analysis, significantly predominated in the well-differentiated group, showing a low grade of telomerase activity and chromosome alterations and low Ki-67 labeling indices, suggesting clinical relevance. No significant association of telomerase activity was found with p53 protein accumulation or Bcl-2 protein expression. The good correlation of telomerase activity with chromosome alterations, cell differentiation, and Ki-67 labeling indices suggests that this parameter might have potential application in estimation of prognosis.

Adenocarcinoma↗

PubMed2000

Mosaic-like distribution of endothelial cell antigens in capillaries and juxta-alveolar microvessels in the normal human lung.

The distribution patterns of endothelial cell antigens, including thrombomodulin and von Willebrand factor (vWf), were studied in normal lung tissues obtained from distant areas of solitary nodules (seven adenocarcinomas and four hamartomas). By single immunoalkaline phosphatase and dual immunofluorescence stainings, the plasma membranes of alveolar capillary endothelium showed linear distribution of thrombomodulin, but their cytoplasm was rarely reactive for vWf (thrombomodulin-dominant pattern). Microvessels with a diameter larger than 10 microm located in the connective tissue zones demonstrated band-like reaction for vWf in their cytoplasm, and their plasma membranes often lacked reactivity for thrombomodulin (vWf-dominant pattern). The juxta-alveolar microvessels located along the borders between the alveolar- and connective-tissue zones showed mosaic-like pattern of distribution for these antigens. The pulmonary venules and peribronchial microvessels measuring up to 40 microm in diameter, demonstrated the expression of thrombomodulin along the plasma membrane, and that of vWf in the cytoplasm. Capillaries of the bronchial circulation were also characterized by mosaic-like pattern of distribution. Both antigens were often expressed in a single cytoplasmic segment. The heterogeneous distribution pattern of these antigens suggests topographic difference in endothelial cell function to maintain coagulatory and anticoagulatory balance in the normal human lung.

Adult↗

PubMed2000

Pulmonary tuberculosis with unusual cystic change in an immunocompromised host.

We present a rare case of upper zone cystic change of the lung with disseminated tuberculosis of a non-smoking 30-year-old immunocompromised male. He suffered from repeated pneumothorax. The basic pathological feature of video-assisted thoracoscopic lung biopsy revealed granulomatous involvement in the respiratory bronchioles with poorly developed epithelioid cells and disruption of elastic fibers. Electron microscopy demonstrated a decrease in elastic fibers and disruption of the epithelial basement membrane of the respiratory bronchiole and no Langerhans cells in the lesion. Autopsy of the lung revealed centroacinar distribution of multiple cystic lesions in the bilateral upper lobe. Almost all cystic walls showed loss of elastic fibers and cysts frequently involved the respiratory and terminal bronchioles, alveolar ducts and, occasionally, alveoli. Some larger cystic lesions revealed communication to the bronchi. The cystic changes in this case of pulmonary tuberculosis may be caused by a check-valve mechanism due to granulomatous involvement of the bronchioles and also by excavation of caseous necrotic material by draining bronchi.

Adult↗

PubMed2000

Lymphoid hyperplasia of the large intestine: a case report with immunohistochemical and gene analysis.

A case of lymphoid hyperplasia arising in the large intestine of a 54-year-old woman is described. Barium enema X-ray and colonoscopic examination revealed multiple small polyps in the right side of the colon. Pathological findings from forceps biopsy revealed similar features to a mucosa-associated lymphoid tissue (MALT) lymphoma. A right hemicolectomy with mesenteric lymph node dissection was carried out. Histological sectioning demonstrated hypertrophic lymphoid follicles with well-formed germinal centers. Occasionally, lymphocytes infiltrated the crypts, in a way similar to that found in lymphoepithelial lesions, which was suggestive of a MALT lymphoma diagnosis. Cryptitis was also observed in the lamina propria. Immunohistochemically, proliferating lymphocytes were positive for CD20 (L26) and negative for CD45RO (UCHL-1). Analyses of immunoglobulin gene (IgHJH) rearrangement could not detect any monoclonality in these cells. These findings suggested that the present case should be categorized as lymphoid hyperplasia rather than lymphoma.

Antigens, CD20↗

PubMed2000

Heterogeneous distribution of thrombomodulin and von Willebrand factor in endothelial cells in the human pulmonary microvessels.

Laser scanning confocal fluorescence microscopy techniques were used to study the localization of von Willebrand factor (vWf; Factor VIII-related antigen) and thrombomodulin (transmembrane receptor for thrombin) in the microvascular endothelial cells in the normal human lung. Tissues were obtained from lobectomy specimens resected for solitary nodules (7 adenocarcinomas and 4 hamartomas) from 11 patients. The plasma membranes of the capillary endothelial cells in the alveolar zones (A-zones) showed red linear fluorescence for thrombomodulin. However, their cytoplasm was mostly unreactive for vWf. The microvessels which were located in the connective tissue (C-zones), including peribronchial, and subpleural areas and large vascular walls, consistently demonstrated band-like green fluorescence for vWf in their cytoplasm, and their plasma membranes usually lacked reactivity for thrombomodulin. Only a limited number of peribronchial capillaries measuring <10 microm in diameter showed a mosaic-like appearance, in which red fluorescence along the plasma membranes was found together with green fluorescence in the subjacent cytoplasm. In the juxtaalveolar (J-zones) microvessels located along the borders between A- and C-zones, and measuring up to 40 microm in diameter, the endothelial cells showed a mosaic-like pattern of distribution of the two antigens. However, the localization of thrombomodulin in the J-zone microvessels was separate and independent from that of vWf. The thrombomodulin-reactive cells were directly connected to the alveolar capillary endothelial cells. Heterogeneous patterns of distribution of thrombomodulin and vWf suggest that topographic differences of endothelial function occur to maintain a balance of coagulation and anticoagulation in the normal human lung.

Adult↗

PubMed2000

Clinicopathological analysis of premature infants treated with artificial surfactant.

OBJECTIVE: Our aim was to obtain new information about the relationship between infant responses to surfactant replacement therapy and histopathological changes in vital organs. STUDY DESIGN: To accomplish this, the autopsy findings and clinical backgrounds of 41 very low birth weight infants (gestational week 25.6 +/- 2.3; birth weight 806.4 +/- 251.6g) who had died after receiving surfactant replacement therapy were reviewed, and those who responded to therapy were compared with those who did not. Responders were infants in whom the required FiO(2) declined by > 20% or mean airway pressure declined by > 20% within six hours of instilling surfactant (n=18); non-responders were infants who did not meet those criteria (n=23). RESULT: Gestational age, birth weight and time at treatment were similar in responders and non-responders, but survival was significantly longer in responders. The incidences of hyaline membrane disease, pulmonary interstitial emphysema, hemorrhagic necrosis and parenchymal degeneration of the liver and kidney were all higher in non-responders, whereas the incidences of bronchopulmonary dysplasia and pneumonia were higher in responders. Prior to treatment, acidosis and hypothermia were significantly more severe in non-responders, and perinatal complications, such as fetal distress and intrauterine infection, were observed more often in non-responders. Substantial degradation of vital organs had already occurred during the early post-natal or intrauterine life of the non-responders, which would be expected to interfere with the clinical response to instilled surfactant. CONCLUSION: It is anticipated that in the future improved monitoring of immature fetuses will be indispensable to improve intrauterine fetal management and to achieve better control over the timing and mode of delivery.

Gestational Age↗

PubMed2000

A diabetic patient with scrotal subcutaneous abscess.

A 51-year-old type 2 diabetic patient with a scrotal subcutaneous abscess is reported. He was diagnosed as having diabetes mellitus five years earlier. He had left scrotal swelling and pain with granulocytosis, elevated C-reactive protein and hyperglycemia. He was successfully treated with incision and drainage (Streptococcus agalactiae was identified in the pus), debridement, antibiotics, immunoglobulin and insulin. This case resembled Fournier's gangrene, an infective necrotizing fasciitis of the perineal, genital or perianal regions. Diabetes mellitus is a basic disorder often associated with Fournier's gangrene. Scrotal subcutaneous abscess should be prevented from progressing to Fournier's gangrene with early and appropriate treatment.

Abscess↗

PubMed2000

[The quality of life after radical prostatectomy measured by general health questionnaire and visual analogue scales].

OBJECTIVES: The impact of radical prostatectomy on the quality of life (QOL) of patients were evaluated. MATERIALS AND METHODS: A total of 22 patients who underwent radical prostatectomy for clinically localized prostate cancer entered this study. Patients were asked to complete a questionnaire containing the general health questionnaire (GHQ) and a series of questions evaluating voiding function, incontinence and sexual dysfunction before and after the operation. In addition, the visual analogue scaled (VAS) questionnaire containing incontinence and sexual dysfunction was applied. RESULTS: No significant differences in GHQ were found between pre- and post operative status, but disease-targeted QOL such as sexual function was affected after the radical prostatectomy. In the points of incontinence and sexual dysfunction, VAS questionnaire significantly correlated with those of categorical questionnaires. CONCLUSIONS: There results suggest that GHQ is not affected, but disease-targeted QOL in some categories of sexual function is affected by radical prostatectomy, and that VAS questionnaires are not only useful for assessing the disease-targeted QOL but also easy to quantify QOL of the patients.

Aged↗