Biomedical subjects

T Wada

Publications and source records attributed to T Wada.

At least 37 records · Page 2Linked to original sources

PubMed1997

Glomerular ICAM-1 expression related to circulating TNF-alpha in human glomerulonephritis.

To clarify the in vivo involvement of cellular adhesion molecules and cytokines in human glomerulonephritis, we have investigated the glomerular and interstitial expression of intercellular adhesion molecule 1 (ICAM-1) in 69 kidney biopsy specimens by immunohistochemical methods and its correlation with serum bioactive tumor necrosis factor alpha (TNF-alpha) and soluble ICAM-1 (sICAM-1) levels in 43 cases. In normal controls, glomerular ICAM-1 expression and serum TNF-alpha and sICAM-1 levels showed a mean score of 1.0 (n = 7) and were 12.1 +/- 1.5 and 187 +/- 5 ng/ml (mean +/- SEM, n = 25), respectively. ICAM-1 was positive in 68 kidneys except in 1 patient with membranous nephropathy at various degrees in glomeruli and in 72% of peritubular capillaries or venules in the interstitium. Serum-bioactive TNF-alpha levels increased in the patients with IgA nephropathy, purpura nephritis, and lupus nephritis (LN) (18.9 +/- 4.1, 32.6 +/- 13.3, and 20.9 +/- 3.5 pg/ml) and were positively correlated with the grade of glomerular ICAM-1 expression (n = 43, r = 0.57, p < 0.001), endocapillary proliferation with exudative lesions (r = 0.72, p < 0.001) and hematuria (r = 0.62, p < 0.001). Serum sICAM-1 levels were elevated in patients with LN and purpura nephritis and decreased from 312 +/- 40 to 226 +/- 21 ng/ml after methylprednisolone pulse therapy in LN (n = 9, p = 0.0285). sICAM-1 levels were positively correlated with the grade of interstitial ICAM-1 expression (r = 0.46, p < 0.05), and sICAM-1 levels (>210 ng/ml) showed high odds ratios in the interstitial ICAM-1-positive cases and systemic vasculitides such as purpura nephritis and LN (6.00, p = 0.0355; 6.50, p = 0.0216, respectively). These results suggest that bioactive TNF-alpha might relate to glomerular ICAM-1 expression associated with endocapillary lesions in human glomerulonephritis and that sICAM-1 levels may be used as a clinical marker to assess interstitial lesions in human nephritis and systemic vasculitides.

Adolescent↗

PubMed1997

Postural dysregulation in systolic blood pressure is associated with worsened scoring on neurobehavioral function tests and leukoaraiosis in the older elderly living in a community.

BACKGROUND AND PURPOSE: Postural hypotension, which occurs frequently in community-living, apparently healthy elderly adults, is usually asymptomatic. However, the relation between postural changes in blood pressure and quantitative higher cerebral function or silent brain lesions remains unclear. We examined the association of exaggerated postural changes in systolic blood pressure with cognitive and quantitative neurobehavioral functions and with brain lesions on MRI in the community-dwelling older elderly. METHODS: The study population consisted of 334 community-dwelling elderly adults, aged 75 years or older (mean age, 80 years). Postural changes in systolic blood pressure (SBP) were assessed using an autosphygmomanometer (BP-203 I). By the difference between the mean of two measurements of SBP at standing and at supine position (dSBP = SBP at upright-SBP at supine position), we divided the subjects into three groups: (1) 20 subjects with postural hypotension (d-SBP < or = -20 mm Hg), (2) 29 subjects with postural hypertension (dSBP > or = 20 mm Hg), and (3) 285 subjects with postural normotension (20 < dSBP < 20 mm Hg). We defined the former two groups as the postural dysregulation group. Scores in four neurobehavioral function tests (Mini-Mental State Exam. Hasegawa Dementia Scale Revised, computer-assisted visuospatial cognitive performance score, and the Up and Go Test) and activities of daily living were compared among the three groups. Brain lesions on MRI, including number of lacunes and periventricular hyperintense lesions, were compared among 15 age- and sex-matched control subjects with postural hypotension, 15 with postural hypertension, and 30 with postural normotension. RESULTS: Twenty subjects (6.0%) exhibited postural hypotension and 29 (8.7%) postural hypertension. Scores in neurobehavioral functions and activities of daily living were significantly lower in the postural dysregulation group (both postural hypotension and hypertension groups) than in the postural normotension group. The postural dysregulation group exhibited significantly more advanced periventricular hyperintensities than the normotension group. CONCLUSIONS: Asymptomatic community dwelling elderly individuals with postural hypotension as well as those with postural hypertension had poorer scores on neurobehavioral function tests and more advanced leukoaraiosis demonstrated on MRI than those without exaggerated postural changes in SBP.

Aged↗

PubMed1997

Relationship between ultrasound assessment of arterial wall properties and blood pressure.

Physical properties of an artery can be described in terms of stiffness, distensibility, and compliance. Changes in these properties can predict atherosclerosis disease, but it is necessary to identify an index that is independent of changes in blood pressure. We measured common carotid artery diameter and pulsatile change with an ultrasonic phase-locked, echo-tracking system in 7 subjects whose mean brachial blood pressure had varied 15 mm Hg or more within a month. Patients taking antihypertensive agents were excluded from the study. We measured changes in arterial diameter (n = 41) at least four times during the study period and calculated the pressure-strain elastic modulus (Ep), distensibility coefficient (DC), cross-sectional compliance (CC) and stiffness parameter (beta) from inner diameter, its pulsatile change, and blood pressure. The correlation coefficients of mean blood pressure with each index are as follows: Ep, 0.53; DC, 0.58; CC, 0.63; beta, 0.21. When mean blood pressure increased 1 mm Hg, the change in each index at 100 mm Hg was as follows: Ep, 1.48 +/- 1.30%; DC, -1.05 +/- 0.97%; CC, -0.69 +/- 0.90%; beta, 0.45 +/- 1.11%. Among the four indices that measure the properties of the arterial walls, stiffness parameter beta was the least dependent on blood pressure. Thus, it appears to have usefulness as an index of arterial wall sclerosis.

Aged↗

PubMed1997

Regional hemodynamic effects of candesartan cilexetil (TCV-116), an angiotensin II AT1-receptor antagonist, in conscious spontaneously hypertensive rats.

The regional hemodynamic effects of candesartan cilexetil (TCV-116), a selective angiotensin II AT1-receptor antagonist, and enalapril, an angiotensin-converting enzyme inhibitor, were compared in conscious spontaneously hypertensive rats (SHR). A 7-day repeated administration study was carried out. TCV-116 (1 mg/kg, p.o.) and enalapril (10 mg/kg, p.o.) reduced blood pressure to the same extent 5 hr after administration on the 1st and the 7th day. At these points, the cardiac index and organ or tissue blood flow were measured by the non-radioactive colored dye-extraction microsphere technique. Repeated administration of TCV-116, and single and repeated administration of enalapril significantly increased renal blood flow without any changes in the cardiac index. TCV-116 and enalapril also tended to increase splanchnic blood flow following the 1st dose but not the 7th dose. No significant changes in blood flow were observed in the brain, heart, adrenal, skin and skeletal muscle. These results suggest that the antihypertensive effects of TCV-116 and enalapril are attributable to the systemic reduction of vascular resistance caused by the dilatation of blood vessels. These hemodynamic effects of TCV-116, like those of enalapril, may be beneficial in the treatment of hypertension.

Administration, Oral↗

PubMed1997

Suppression of glucose absorption by some fractions extracted from Gymnema sylvestre leaves.

Extracts containing gymnemic acids, which were extracted from the leaves of Gymnema sylvestre (GS) as nine fractions, were evaluated for their effects on a high K(+)-induced contraction of guinea-pig ileal longitudinal muscles, on glucose transport mediated by the difference of glucose-evoked transmural potential difference (delta PD) in the inverted intestine of guinea-pig and rat, and on blood glucose in rat. Among nine fractions obtained by high performance liquid chromatography from the extract, f-2 and f-4 strongly suppressed the high K(+)-induced contraction of the ileal muscle, f-3 and f-5 did so moderately, and f-8 and f-9 did so weakly, whereas the other fractions did not affect it. The degree of suppression of high K(+)-induced contraction by f-2 at 74% was almost the same as that of f-4 at 67%, at concentrations of 0.1 mg/ml. The suppressed contraction by f-2 or f-4 was recovered by adding 5.5 mM pyruvate. The delta PD increased by 5.5 mM glucose in the inverted intestines of guinea-pig and rat were equally suppressed by 0.1 mg/ml of f-2 or f-4 to 40%. In a rat sucrose tolerance test, f-2 and f-4 suppressed the elevation of blood glucose level. Both f-2 and f-4 suppressed the contraction of guinea-pig ileal longitudinal muscle, interfered with the increase in delta PD induced by glucose in the inverted intestines of guinea-pig and rat, and inhibited the elevation of blood glucose level. In conclusion, it is suggested that some of the extracts containing gymnemic acids from GS leaves suppress the elevation of blood glucose level by inhibiting glucose uptake in the intestine.

Administration, Oral↗

PubMed1997

Comparison of nasopharyngeal growth between patients with clefts and noncleft controls.

OBJECTIVE: This study was a comparison of the cephalometric growth characteristics of the nasopharyngeal structures between UCLP and noncleft controls. METHOD: Eighty patients with complete unilateral cleft lip and palate (UCLP group) and 82 noncleft controls (NCC group) were assigned to four developmental stages (i.e., stage 1, at 4 years; stage 2, at 8 years; stage 3, at 12 years; and stage 4, at 17 years of age). Measurements on the anteroposterior and the vertical dimensions were derived from reference lines and points of nasopharyngeal structures on the lateral cephalograms. RESULTS: The results showed that there were no growth differences between the two groups at any stages in the regions of cranial base and cervical vertebrae, and that growth of the posterior maxilla in the UCLP group was significantly less at any stage in both A-P and vertical dimensions than in the NCC groups. As well, the nasopharyngeal triangle (Ho-At-PMP) in the groups showed almost parallel increase with stage, though with short vertical dimension in the UCLP group, and the soft palate length in the UCLP group was significantly less at stages 2, 3, and 4 compared to that in the NCC group. The adequate ratio (soft palate length/pharyngeal depth) in the UCLP group tended to decrease and was significantly less at stage 4 compared to that in the NCC group. CONCLUSIONS: These results indicate that the growth of the cranial base and the upper cervical vertebrae is independent of the effect of clefts or of surgeries on clefts, and that the growth inhibition at the posterior maxilla results in morphologic disharmony of upper nasopharyngeal structures. This could be a potential factor for the reappearance of velopharyngeal incompetence at a later age.

Adolescent↗

PubMed1997

Effect of temporary closure of oronasal fistulae on levator veli palatini muscle activity.

OBJECTIVE: The objective of this study was to clarify electromyographically the effects of closing an oronasal fistula on levator muscle activity and oral air pressure in patients with velopharyngeal incompetence and in those with adequate velopharyngeal function. SUBJECTS: Five patients with adequate velopharyngeal function and six patients with velopharyngeal incompetence were studied. All subjects had an oronasal fistula at the anterior third portion of the hard palate in spite of primary palatal closure using palatal push-back operation. OUTCOME MEASURES: The smoothed electromyographic activity of the levator veli palatini muscle was measured with the fistula closed with a cotton swab dipped in saline and with the fistula left open. RESULTS: Under the closed fistula condition, oral air pressure was greater than that observed under the open fistula condition irrespective of velopharyngeal function. Levator veli palatini muscle activity was significantly lower in magnitude under the condition of closure than under the open condition in the patients with adequate velopharyngeal function, whereas in those with velopharyngeal incompetence, it was not significantly changed. CONCLUSIONS: The results suggest that velopharyngeal function is affected by temporary closure of an oronasal fistula, and that the magnitude of the effect is greater for subjects with adequate velopharyngeal function than for subjects with velopharyngeal incompetence.

Adolescent↗

PubMed1997

Apheresis therapy for prolonged red cell aplasia after major ABO-mismatched bone marrow transplantation.

Two cases of leukemia were treated successfully with apheresis for delayed recovery of erythropoiesis due to antibody-mediated red cell aplasia after ABO-mismatched bone marrow transplantation (BMT). A 25-year-old female (ABO group O) underwent BMT from her brother (group A). Immunoadsorption using Biosynsorb A performed on day 146 after BMT followed by double filtration plasma pheresis (DFPP) reduced anti-A antibody titers from 1:32 to 1:2. Anemia improved dramatically within 2 weeks. A 49-year-old female (group O) underwent BMT from her mother (group A). She was treated with DFPP on day 131 after BMT. Anti-A antibody titers dropped from 1:16 to 1:1 and anemia improved gradually.

ABO Blood-Group System↗

PubMed1997

Trochlear and abducens nerve neurinomas accompanied by a cerebellopontine angle meningioma--case report.

A 66-year-old male presented with cerebellovestibular symptoms and hypesthesia of the V2 area of his face. Neuroimaging only detected a cerebellopontine angle (CPA) meningioma. The CPA meningioma was removed using the lateral suboccipital approach, which exposed small neurinomas arising from the trochlear and abducens nerves. Both neurinomas were removed intracapsularly. Postoperatively hypesthesia resolved, but other symptoms were unchanged. A karyotypic analysis of chromosome 22 and estrogen receptor analysis suggested absence of neurofibromatosis II, but the cause(s) of the genesis of the multiple diverse tumors was not determined. This extremely rare combination of neurinomas and meningioma was probably incidental, as there are no reports of any case which a combination of the trochlear and the abducens nerve neurinomas, much less one accompanied by a meningioma.

Abducens Nerve↗

PubMed1997

Protective effects of candesartan cilexetil (TCV-116) against stroke, kidney dysfunction and cardiac hypertrophy in stroke-prone spontaneously hypertensive rats.

The effects of chronic treatment with an angiotensin II receptor antagonist, candesartan cilexetil (TCV-116, 0.1, 1, 10 mg/kg), and an angiotensin converting enzyme inhibitor, enalapril maleate (enalapril, 10 mg/kg), on the development of end-organ damage were examined in stroke-prone spontaneously hypertensive rats (SHRSP). The control SHRSP developed severe hypertension with stroke signs and increased urinary protein excretion. TCV-116 (0.1 mg/kg) reduced the stroke incidence and urinary protein excretion without affecting the blood pressure. TCV-116 (1 and 10 mg/kg) and enalapril reduced blood pressure, the stroke incidence, the urinary indices and left ventricular weight. Circulating renin-angiotensin system (RAS) and renal renin mRNA expression were significantly accelerated or tended to be accelerated in the control SHRSP with end-organ damages. A low dose of TCV-116 tended to reduce the RAS indices in plasma by improving the damages, whereas a high dose (10 mg/kg) increased them by the reflexes with blocking RAS. The present results indicate that chronic All blockade reduces the increase in blood pressure, end-organ damages and RAS related to the damages in SHRSP.

Angiotensin Receptor Antagonists↗

PubMed1997

Genotypes of Japanese encephalitis virus isolated in three states in Malaysia.

Two hundred forty nucleotides from the pre-membrane gene region of 12 Japanese encephalitis virus (JEV) strains isolated from three different regions of Malaysia from 1993 to 1994 were sequenced and compared with each other and with the JEV strains from different geographic areas in Asia. These 12 Malaysian isolates were classified into two genotypes. The four JEV strains isolated from Sarawak in 1994 and the four JEV strains isolated from Sepang, Selangor in 1993 were classified into one genotype that included earlier isolated strains from Malaysia (JE-827 from Sarawak in 1968 and WTP/70/22 from Kuala Lumpur in 1970). The four JEV strains from Ipoh, Perak in 1994 were classified into another genotype that included JEV strains isolated from northern Thailand and Cambodia. In an earlier report, 10 JEV strains from Sabak Bernam, Selangor in 1992 were classified into the largest genotype that included strains isolated in temperate regions such as Japan, China, and Taiwan. The data indicate that at least three genotypes of JEV have been circulating in Malaysia.

Amino Acid Sequence↗

PubMed1997

[Prostatic involvement of bladder carcinoma].

BACKGROUND: The histological pattern of prostatic involvement by transitional cell carcinoma is still unclear. The present study was carried out in bladder carcinoma with prostatic involvement to clarify the histological invasion pattern and its association with primary lesions. METHODS: In the past 10 years, 83 cases of total cystectomy including prostatectomy underwent pathological diagnosis in our department. This study included 81 cases of transitional cell carcinoma (TCC), of which 11 showed prostatic involvement of bladder carcinoma. In these cases, the histological patterns of invasion were classified in relation to prostatic urethra, prostatic duct, stroma, lymphatic duct, capsule, vein and perineural invasion. Seventy cases without prostatic involvement were controls. The location, pathological grade, stage and lymphatic involvement of primary bladder carcinoma were compared in terms of prostatic involvement cases with control cases. RESULTS: Among those 11 cases, there were 3 cases in which only the prostatic duct was involved, 2 cases with invasion to only lymphatic duct, and involvement of both in 6 cases. One case of the prostatic duct involvement showed non-continuous invasion in the prostatic duct without prostatic urethra invasion, suggesting the possibility that non-continuous invasion could occur as a type of multicentric growth of TCC. CONCLUSIONS: Suspected routes of invasion of bladder carcinoma into the prostate were; 1 continuous transductal, 2 trans-lymphatic ductal, 3a combination of the two. It appears necessary to consider the possibility of TCC occurring in the prostate simultaneously with bladder carcinoma as a part of multicentric growth. There was a tendency of prostatic involvement cases include the bladder neck and trigone, and show lymphatic duct involvement more than non-prostatic involvement cases.

Carcinoma, Transitional Cell↗

PubMed1997

[Identification of predictive factors associated with recurrent restenosis after second percutaneous transluminal coronary angioplasty].

The predictive factors of a second restenosis after repeated percutaneous transluminal coronary angioplasty (PTCA) were investigated by review of the records of 100 consecutive patients who underwent second angioplasty for restenosis of the same site. PTCA was successful in 97 (97%) of these patients, but 38 patients (39%) developed a second restenosis (recurrent restenosis group) and 59 did not (no recurrent restenosis group). The clinical, angiographic and procedural factors at the second PTCA of the two groups of patients were compared. The major risk factors (hypertension, diabetes mellitus, hyperlipidemia) and type and morphology of the lesion (eccentricity, calcification, length, bend) at repeat PTCA did not differ significantly between the recurrent restenosis and no recurrent restenosis groups. The mean intervals from the initial to the second PTCA were significantly shorter in the recurrent stenosis group than in the no recurrent restenosis group (2.1 +/- 1.1 vs 3.4 +/- 1.3 months, p < 0.001). Sixteen (76%) of 21 patients had a second restenosis at an interval between the two PTCAs of < 3 months, compared with 22 (29%) of 76 patients with an interval of > or = 3 months (p < 0.001). Patients who undergo a second angioplasty procedure within 3 months from the previous procedure at the same site have a much higher risk of recurrent restenosis and these patients may benefit from an alternative therapeutic approach.

Aged↗

PubMed1997

p16 (CDKN2/MTS1) gene deletions are rare in prostatic carcinomas in the United States and Japan.

PURPOSE: The incidence of clinically apparent prostatic carcinoma is much higher in the United States than in Japan. Alterations in the p16 tumor suppressor gene have been identified in various tumor types, including cultured prostatic carcinoma cell lines. We studied the possible deletions of either exon 2 or 3 of this gene in primary clinical prostatic carcinomas from Japan and the United States. MATERIALS AND METHODS: Genomic DNA was extracted from 36 formalin-fixed, paraffin-embedded clinical prostatic carcinomas from Japan and 27 carcinomas from the United States. Exons 2 and 3 of the p16 gene were amplified using comparative multiplex polymerase chain reactions (PCR) and then analyzed for possible deletions of either exon. RESULTS: Two out of 36 (5.6%) carcinomas from Japan clearly demonstrated deletion of p16 exon 2, but this deletion was not detected in any of the 27 carcinomas from the United States. CONCLUSIONS: Although slightly higher in Japan than in the United States, the frequency of p16 exon deletions in clinical prostatic carcinomas is very low, and probably is not important in the development of this neoplasm.

Carrier Proteins↗

PubMed1997

[Evaluation of expected AUC of carboplatin (CBDCA) predicted by Chatelut's formula in comparison with Calvert's].

Several studies have shown that carboplatin AUC seems to correlate with therapeutic outcome and hematologic toxicity. Calvert's formula predicts carboplatin AUC using GFR estimated by the 51Cr-EDTA method. It is very complicated to manage radioactive agents, so we use 24-hour creatinine clearance before carboplatin administration as GFR in Calvert's. Recently, Chatelut reported a formula to predict carboplatin AUC using serum creatinine as a variable parameter of renal function as well as age, sex and body weight. We measured the AUC of free Pt by serial sampling in 14 ovarian cancer patients who received carboplatin by one-hour infusion in the initial treatment course. We evaluated the two predictive formulas with measured AUC. Calvert's predicted AUC showed a linear correlation with actual AUC (r = 0.768, p = 0.0013). But using Chatelut's formula, the predicted AUC had a better correlation with actual AUC (r = 0.833, p = 0.0002). Actual AUC correlated inversely with nadir PLT counts (r = -0.707, p = 0.0047). In conclusion, Chatelut's prediction had a better correlation with the actual AUC of carboplatin and nadir of thrombocyte count than Calvert's. Chatelut's formula was thus more useful to predict the carboplatin AUC than Calvert's when 24-hour creatinine clearance was used as GFR.

Adult↗

PubMed1997

Distal posterior interosseous nerve syndrome.

Five patients presenting with chronic dorsal wrist pain and diagnosed as distal posterior interosseous nerve syndrome are reported. Clinical examination revealed point tenderness of the fourth extensor compartment. The symptoms were reproduced by extreme wrist extension in all patients and by extreme flexion in three of the patients. The pain was relieved in all patients by a selective lidocaine block of the terminal branch of the posterior interosseous nerve at the wrist joint. All the patients failed to respond to nonoperative treatment and underwent surgical exploration of the nerve. The operative findings were an enlarged nerve in three patients and adhesion of the nerve to the joint capsule in five patients. A 2 cm section of the nerve proximal to the extensor retinaculum was resected. Four of the five patients had excellent pain relief and returned to full asymptomatic activity. One patient had improvement in pain and was satisfied with the outcome. A diagnosis of distal posterior interosseous nerve syndrome should be considered if the usual sources of dorsal wrist pain are eliminated.

Adolescent↗

PubMed1997

[A case of idiopathic spinal epidural hematoma with a fructuation of the symptoms].

We reported a 9-year-old girl with idiopathic spinal epidural hematoma. She complained of her back and neck pain only during night for a few days, followed by days with no symptoms (a few days remission of her symptoms). This episode repeated, and she was suspected to have a psychogenic reaction. However, 28 days later after the first symptoms appeared, paralysis of lower extremities, anesthesia and urinary bladder dysfunction (neurogenic bladder) appeared. Spinal MRI showed a spinal epidural hematoma at the C 5-Th 2 level. An emergency operation of laminectomy and evacuation of the hematoma was done, and she has recovered gradually. We diagnosed her as having idiopathic spinal epidural hematoma. Excerbations of symptoms during nights were thought to be due to an elevation of venous pressure by lying, and transient remissions were due to intermittent small hemorrhages.

Child↗

PubMed1997

Clinical, morphologic, and biochemical characteristics of Chediak-Higashi syndrome in fifty-six Japanese black cattle.

OBJECTIVE: To characterize Chediak-Higashi syndrome (C-HS) in Japanese Black cattle. ANIMALS: 56 of 200 cattle with a bleeding disorder and giant granules in leukocytes. PROCEDURE: Clinical observation, CBC, hemostatic screening test, platelet aggregometry, electron microscopy, platelet constituent analysis, and ophthalmoscopic examination were done. RESULTS: Affected Japanese Black cattle had increased bleeding tendency and abnormal granules in their leukocytes. Susceptibility to infection was not increased. Cutaneous albinism was evident in 6 new-born calves, but not in most affected cattle. In all affected cattle, the tapetal fundus was pale and the nontapetal fundus was almost devoid of pigment. By electron microscopy, a remarkable decrease in the number of dense granules in platelets was observed. Functionally, collagen-induced platelet aggregation was markedly reduced. CONCLUSIONS: This bleeding disorder was diagnosed as C-HS. With regard to susceptibility to infection, albinism, and mortality, clinical manifestations of C-HS in Japanese Black cattle were moderate, compared with C-HS in human beings and Hereford cattle. CLINICAL RELEVANCE: Because an autosomal recessive mode of inheritance was documented and recessive homozygotes could be easily detected, C-HS in Japanese Black cattle can be controlled.

Adenosine Diphosphate↗