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Biomedical subjects

T Wada

Publications and source records attributed to T Wada.

At least 361 records · Page 20Linked to original sources

Candesartan (CV-11974) dissociates slowly from the angiotensin AT1 receptor.

The mechanisms of the insurmountable antagonism of 2-ethoxy-1-[[2'-(1H-tetrazol-5-yl)biphenyl-4-yl]methyl]1H-benzimid azole -7-carboxylic acid, candesartan (CV-11974), an angiotensin AT1 receptor antagonist, on angiotensin II-induced rabbit aortic contraction were examined in contraction and binding studies. Preincubation of the rabbit aorta with CV-11974 (0.1 nM) for 30 min reduced the maximal contractile response to angiostensin II by approximately 50%. This insurmountable antagonism of CV-11974 was reversed in the presence of losartan (1 microM), a surmountable angiotensin AT1 receptor antagonist. The inhibitory effect of CV-11974 on angiotensin II-induced contraction persisted longer after washing than did that of losartan but was irreversible. Scatchard analysis of [3H]CV-11974 binding in bovine adrenal cortical membranes indicated the existence of a single class of binding sites (Kd = 7.4 nM). Competition binding studies using angiotensin II receptor agonists and antagonists have demonstrated that [3H[CV-11974 binding sites may be identical to angiotensin AT1 receptors. The dissociation rate of [3H]CV-11974 binding (t1/2 = 66 min) was 5 times slower than that of [125I]angiotensin II binding (t1/2 = 12 min). These results suggest that the insurmountable antagonism by CV-11974 is due to its slow dissociation from angiotensin AT1 receptors.

Adrenal Cortex↗

Mixed connective tissue disease associated with idiopathic portal hypertension and chronic thyroiditis.

We report a patient with mixed connective tissue disease (MCTD) associated with idiopathic portal hypertension (IPH) and chronic thyroiditis. The patient was a 68-year-old Japanese woman who was admitted to our hospital for treatment of bleeding esophageal varices. She had previously exhibited Raynaud's phenomenon and had had arthritis for about 30 years. She also had had high titers anti-U1 of ribonucleoprotein (RNP) anti-single strand-DNA autoantibodies for 2 years, and had been diagnosed with MCTD 1 year previously. The bleeding from esophageal varices was successfully stopped by endoscopic injection sclerotherapy. Results of laboratory examinations, imaging examinations, and laparoscopy, including liver biopsy, indicated that the esophageal varices were caused by portal hypertension due to IPH. The patient also had a diffusely firm and enlarged goiter and hypothyroidism, and she exhibited anti-thyroid microsomal antibodies and anti-thyroglobulin antibodies, she was diagnosed as having a complication of chronic thyroiditis. This association of MCTD, IPH, and chronic thyroiditis is quite rare and provides a unique opportunity to observe immunological involvement in the pathogenesis of IPH.

Aged↗

Closed rupture of a finger extensor following the Sauvé-Kapandji procedure: a case report.

A case of closed rupture of the ring extensor digitorum tendon following performance of the Sauvé-Kapandji procedure is presented. This complication is not rare following performance of the Darrach procedure. The operative findings indicated that the rupture was caused by an impingement of the tendon between the proximal stump of the ulna and the extensor retinaculum. The patient was successfully treated with shortening of the proximal ulnar stump and tendon transfer.

Adult↗

Systemic autoimmune nephritogenic components induce CSF-1 and TNF-alpha in MRL kidneys.

MRL-Faslpr mice are an appealing strain to understand the importance of cytokines in the pathogenesis of autoimmune renal destruction, since injury is rapid and predictable. Colony stimulating factor 1 (CSF-1) and tumor necrosis factor alpha (TNF-alpha) are detected in the kidney and circulation prior to renal injury and continue to increase with progressive renal damage in MRL-Faslpr, Fas deficient mice, but not the congenic Fas intact MRL-(++) strain. Delivery of CSF-1, but not TNF-alpha, into the kidney via gene transfer incites local renal injury. By comparison, dual gene transfer of CSF-1 and TNF-alpha incites autoimmune renal injury that is far more severe than CSF-1 alone. The purpose of this study was to establish whether CSF-1 and TNF-alpha incites autoimmune renal injury that is far more severe than CSF-1 alone. The purpose of this study was to establish whether CSF-1 and TNF-alpha expression in the kidney of MRL-Faslpr mice induced by a circulating stimulant resulted from a primary defect in the kidney. Therefore, we transplanted (Tx) a MRL-(++) kidney without CSF-1, TNF-alpha and renal injury into an MRL-Faslpr recipient after removing nephritic kidney expressing CSF-1 and TNF-alpha. The Tx kidneys were examined after 2, 4, 5, 6, and 12 weeks. CSF-1 and TNF-alpha were rapidly induced in the MRL-(++) Tx kidney. CSF-1 and TNF-alpha were evident by two weeks and continually increased for 12 weeks post-transplantation. Within several weeks, the rapid expansion of M phi and T cells and induction of glomerulonephritis and interstitial nephritis in the MRL-(++) Tx kidney was similar to the age-matched native MRL-Faslpr kidney. In conclusion, we have constructed an experimental transplantation system that can explore whether cytokine expression in the kidney induced by a circulating stimulant is a result of a primary defect in the kidney. Using this approach, we established that the MRL-Faslpr kidney is not defective, but rather a circulating stimulant in the MRL-Faslpr mouse can induce CSF-1, TNF-alpha and renal injury in a normal MRL-(++) kidney. Thus, we exclude an intrinsic defect in the MRL-Faslpr kidney as the pathogenic mechanism responsible for tissue damage. We suggest purging the circulation of molecules that induce CSF-1 and TNF-alpha as a therapeutic strategy for autoimmune renal injury.

Animals↗

In situ expression and soluble form of P-selectin in human glomerulonephritis.

To clarify the early involvement of cellular adhesion molecules in human glomerulonephritis, we investigated P-selectin and high endothelial venules' (HEVs) marker MECA-79 expression in kidney specimens by immunohistochemical and in situ hybridization analyses, and measured serum and urinary soluble P-selectin levels by enzyme-linked immunosorbent assay. In normal controls, P-selectin and MECA-79 expression were negative in glomeruli (N = 4), and serum soluble P-selectin levels were 114.3 +/- 36.8 ng/ml (mean +/- SEM, N = 12). Soluble P-selectin was not detectable in urine of all cases. In proliferative glomerulonephritis involving rapidly progressive glomerulonephritis (N = 6), IgA nephropathy (N = 26), lupus nephritis (N = 7) and acute glomerulonephritis (N = 2), both glomerular and interstitial P-selectin expression were up-regulated. Glomerular P-selectin expression correlated positively with local cellular accumulation, endocapillary proliferation and CD41b (platelet) staining. Interstitial P-selectin expression showed a positive correlation with the grade of local cellular infiltrates. P-selectin mRNA signals detected by in situ hybridization were only observed on capillary or venous endothelium in the interstitium, but not in glomeruli. In addition, MECA-79 was expressed on the plump endothelial cells at the cortico-medullary junction (outer medulla). Serum soluble P-selectin levels were significantly higher in patients with proliferative glomerulonephritis, especially in glomerular and interstitial P-selectin positive staining, and correlated with glomerular endocapillary proliferation. These observations suggested that P-selectin was associated with both glomerular and interstitial leukocyte accumulation in human glomerulonephritis, and might be expressed by two distinct mechanisms that are the activated platelets in glomeruli and the de novo expression in the interstitial lesions that correlated with MECA-79 expression as HEVs like vessels, and serum soluble P-selectin may be a useful marker for predicting in situ P-selectin expression associated with glomerular endocapillary proliferation in nephritis.

Adult↗

Trabecular bone pattern of the mandible. Comparison of panoramic radiography with computed tomography.

OBJECTIVES: To analyse the possible correlation between the trabecular bone pattern of the edentulous mandible visualized by panoramic radiography and the bone mineral density (BMD) measured by computed tomography (CT). METHODS: Panoramic radiography and CT were performed on 28 patients with edentulous mandibles. The trabecular bone pattern of 47 regions on the panoramic radiographs was classified into one of five grades. BMD was measured within circular regions of interest on the axial CT images in the corresponding trabecular area. The gradings were correlated with the CT values using one-way analysis of variance. RESULTS: There was a significant correlation between the grade of the trabecular bone pattern and the BMD (P < 0.0001). CONCLUSION: The proposed classification for the trabecular bone pattern on panoramic radiographs might be a useful aid for the evaluation of the edentulous mandible prior to implant placement.

Adult↗

Observer agreement in the assessment of mandibular trabecular bone pattern from panoramic radiographs.

OBJECTIVES: To study the observer agreement in the assessment of trabecular pattern of the mandible from panoramic radiographs. METHODS: Seven observers were asked to classify the trabecular pattern of 100 edentulous regions of the mandible in 80 randomly selected panoramic radiographs into one of five grades with the aid of a written description and reference images. Intra- and interobserver agreement was calculated as overall agreement and Kappa index. RESULTS: The intra-observer agreement varied between 65% and 79%. The Kappa index for intra-observer agreement was moderate for three observers and substantial for four. For all seven observers, it varied according to the grade of trabecular bone pattern, but the majority deviated from each other by only one grade. CONCLUSION: The relatively high rates of observer agreement indicate that panoramic radiography can be used for the clinical assessment of the trabecular pattern of the mandible.

Adult↗

A radiographic study of recurrent unicystic ameloblastoma following marsupialization. Report of three cases.

OBJECTIVES: To study the radiographic sequence in the recurrence of unicystic ameloblastoma following marsupialization. MATERIALS AND METHODS: Retrospective analysis of three cases of uncystic ameloblastoma. RESULTS: Six distinct stages were identified in all three cases: bone regeneration starting at the periphery of the cavity; appearance of a diffusely sclerotic band; appearance of scalloping; expansion of scalloping; formation of a multilocular pattern; and enlargement of the cystic lesion. CONCLUSION: The first radiographic sign of recurrence is scalloping of the sclerotic margin of the regenerated bone.

Adult↗

Vector autoregressive modeling for analyzing feedback regulation between heart rate and blood pressure.

We present a noninvasive technique for analyzing the feedback relationship between short-term fluctuations in blood pressure (BP) and heart rate (HR) in humans. Beat-to-beat BP was monitored for several minutes with a noninvasive BP measuring device, i.e., arterial tonometry, in 16 healthy subjects and 15 patients on hemodialysis (HD), and the recorded systolic BP (SBP) and the pulse wave interval (R-R interval) were fitted to vector autoregressive models according to Akaike's method. The impulse-response function was then simulated to determine the contribution of changes in R-R interval or SBP to the fluctuation of SBP or R-R interval along a time scale. In healthy subjects, when a simulated 1-mmHg impulse was applied to SBP, the R-R interval increased to approximately 3.5 ms with a delay of several beats. In HD patients the same impulse caused essentially no response in the R-R interval. A 1-ms impulse applied to the R-R interval decreased SBP, and the response was not different in healthy subjects and HD patients. In the R-R interval-to-R-R interval response and the SBP-to-SBP response, the exponential-like decay after the initial jump was more rapid in the HD patients than in the healthy subjects. The results demonstrated that this technique can provide information on the feedback regulation between fluctuations in BP and HR in patients with or without autonomic nervous system dysfunction. This technique provides a simple and practical way to estimate autonomic function in clinical medicine.

Adult↗

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↗

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↗

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↗

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↗

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↗