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Biomedical subjects

T Wada

Publications and source records attributed to T Wada.

At least 505 records · Page 28Linked to original sources

Methotrexate for steroid-resistant systemic lupus erythematosus.

We here report two patients with steroid-resistant systemic lupus erythematosus (SLE) who were successfully treated with methotrexate (MTX). In both cases, a steroid resistant high fever, associated with mild myositis and pancytopenia were the main common findings, and all these symptoms were alleviated within a few days either by 7.5 mg or 5 mg MTX per week. The number of CD4+ cells increased along with the clinical improvement, whereas the number of CD20+ cells and HLA-DR expressing cells also decreased. Taking into account the side effects of high dose corticosteroids and cyclophosphamides, treatment with a weekly low dose of MTX is known to contribute to an improvement in the long-term prognosis for patients with refractory SLE.

Adult↗

Chronic recurrent multifocal osteomyelitis involving the mandible.

A patient with chronic recurrent multifocal osteomyelitis is presented for the first time in the dental literature. On the basis of the initial diagnosis of diffuse sclerosing osteomyelitis of the mandible, the clinical course was protracted and refractory to surgical and antibiotic therapies. The literature is reviewed to evaluate the relationship between chronic recurrent multifocal osteomyelitis and diffuse sclerosing osteomyelitis. Distinguishing features between the two entities could not be found. It is recommended that a skeletal survey be performed when the diagnosis of diffuse sclerosing osteomyelitis is established.

Adult↗

Formation of double contour in the human mandibular condyle. A case report.

This is the first report of double contour formation in the human mandibular condyle that includes both radiographic and histologic confirmation. Panoramic radiographs showed an additional cortical layer formation on the posterior of the condyle during follow-up after displacement of the condyle. Two cortical layers on the posterior portion of the condyle were demonstrated on the histologic specimen. The outer layer consisted of a few lamellated bone layers and included many osteocytes. However, minimal fibroconnective tissue was seen, and there was no cartilage layer. We concluded that the double contour formation was not caused by endochondral ossification but by periosteal bone formation.

Bone Remodeling↗

Simple bone cyst. Evaluation of contents with conventional radiography and computed tomography.

To evaluate whether gas is present in the cavity of simple bone cysts, the clinical and histologic findings of 53 patients with simple bone cysts were examined and compared with an experimental model. The model consisted of a dry mandible with the medullary bone removed and the resulting cavity injected with water. Although an air-liquid level was observed on all radiographs for the experimental model, none was observed in the clinical cases of simple bone cysts. When the experimental cavity was completely filled with water, the density in the cavity was similar to that of the surrounding water on computed tomography, but when it was filled with air, the density was lower than that of the surrounding water. In contrast, in simple bone cysts said to contain air at surgery, the cavity contents were not consistent with the density for gas on computed tomography. These results indicate that the operative finding of air in the cavity of simple bone cysts may have been in error at least in some cases.

Adolescent↗

Dose-reducing effect of Lipowitz metal-embedded spacers in interstitial brachytherapy for carcinoma of the mobile tongue.

Dose-reducing effects of spacers with and without a Lipowitz metal plate for the purpose of decreasing osteoradionecrosis after interstitial brachytherapy for tongue cancers were examined experimentally and clinically. The thicker the sample or spacer and the thicker the metal plate, the greater was the dose reduction achieved. A more marked dose reduction was achieved with iridium than with radium because of lower gamma ray energy of iridium. Iridium has been used widely as a radioactive source for interstitial brachytherapy. It was concluded therefore that a metal plate should be used as a shield into the spacer in interstitial brachytherapy both to reduce the radiation dose to surrounding normal tissues and to help prevent osteoradionecrosis.

Alloys↗

Restenosis after successful emergency coronary angioplasty for acute myocardial infarction: comparison with elective angioplasty.

We investigated the initial and late restenosis rate after successful emergency coronary angioplasty in 64 patients with acute myocardial infarction, and compared these results with those of 100 patients (110 lesions) who had successful angioplasty on an elective basis. The majority of the baseline clinical and angiographic variables were similar in the myocardial infarction and elective groups. The restenosis rate at 1 month was high in patients undergoing emergency angioplasty for acute myocardial infarction (23 vs. 12%). At 3-6 months, the angiographic restenosis rate was low for the infarction group (26 vs. 37%). The overall restenosis rate was similar in the infarction and elective groups (39 vs. 40%). Lesion regression after coronary angioplasty was more frequent in the infarction than in the elective angioplasty group (27 vs. 14%, P < 0.05). These findings suggest that considering the high restenosis rate at 1 month and the lower, but still 20% or more, rate at 3-6 months, a follow-up angiography should be performed both prior to discharge and at 3-6 months after the procedure, in patients with acute myocardial infarction.

Aged↗

Primary intraosseous carcinoma: review of the literature and diagnostic criteria.

Twenty-four reports describing 39 cases of primary intraosseous carcinoma (PIOC) were reviewed and the clinicopathologic features were summarized. The mean age of the patients at the time of diagnosis was 51.0 years, and the male: female ratio was 2:3. The posterior mandible was the predominant site; in no patient was a lesion observed in the posterior maxilla. Twenty-five of 31 patients (80.6%) showed swelling of the oral mucosa. However, ulcer formation was observed in only 3 of 36 patients. Pain, sensory disturbances, and metastasis to regional lymph nodes were observed in 25 of 34 patients (73.5%), 9 of 15 patients (60%), and 13 of 33 patients (39.4%), respectively. Radiographically, most lesions produced bone resorption with ill-defined margins (51.6%) or with well-defined margins (19.4%). The diagnostic criteria proposed for PIOC are absence of ulcer formation, except when caused by other factors; histologic evidence of squamous cell carcinoma without a cystic component or other odontogenic tumor cells; and absence of another primary tumor on chest radiographs obtained at the time of diagnosis and during a follow-up period of more than 6 months.

Adolescent↗

Radiographic evaluation of bone invasion of adenoid cystic carcinoma in the oral and maxillofacial region.

PURPOSE: To investigate the relationship between clinicopathologic features and bone invasion in adenoid cystic carcinoma. PATIENTS AND METHODS: Thirty-two patients with adenoid cystic carcinoma were included. Of 17 patients with suspected bone invasion based on clinical and/or radiographic findings, 13 also underwent histologic evaluation. RESULTS: Bone invasion was detected in nine patients. Bone involvement was radiographically classified as erosive, diffuse invasive, or minimal change. No tumor infiltration into the surrounding bone marrow spaces was observed in the erosive-type tumors. However, tumor invasion through the resorbed cortex was observed with the diffuse invasive tumors and through the bone defects in the minimal change tumors. CONCLUSION: Histologically, diffuse invasive radiographic change was observed with solid lesions. However, minimal bone resorption was observed on radiographs of the glandular lesions, even when the tumor cells had infiltrated extensively into the bone marrow spaces. In the tumors of the tubular type, all three radiographic types were observed.

Bone Marrow↗

Risk factors for infection and immunoglobulin replacement therapy in adult nephrotic syndrome.

Infection has been recognized as an important cause of morbidity and mortality in children with nephrotic syndrome. However, the incidence and severity of infection and the mechanisms responsible for the increased susceptibility to infection are still unclear in adults. We studied 86 consecutive adult patients with nephrotic syndrome but no diabetic nephropathy. Risk factors for infection were evaluated by logistic regression analysis. Infections were found in 16 patients (19%), of whom six died of infection and two developed end-stage renal failure associated with infection. The relative risk for bacterial infection among patients with serum immunoglobulin G (IgG) levels below 600 mg/dL was 6.74 compared with that for patients with serum IgG levels over 600 mg/dL (95% confidence interval, 1.22 to 36.32; P = 0.029). In patients with serum creatinine levels over 2.0 mg/dL, the relative risk of bacterial infection was 5.31 compared with patients with serum creatinine levels below 2.0 mg/dL (95% confidence interval, 1.08 to 26.09; P = 0.040). Intravenous immunoglobulin (10 to 15 g) was administered prospectively every 4 weeks to 18 patients with serum IgG levels below 600 mg/dL until serum IgG levels increased to over 600 mg/dL. Administration of immunoglobulin resulted in a decreased rate of bacterial infections to a level equal to that in patients with endogenous levels over 600 mg/dL. These data indicate that hypogammaglobulinemia and renal insufficiency are independent risk factors for bacterial infection in adult patients with nephrotic syndrome. The effects of intravenous immunoglobulin suggest that maintenance of serum IgG levels over 600 mg/dL may reduce the risk of infection.

Adult↗

Detection of urinary interleukin-8 in glomerular diseases.

To clarify the mechanism of neutrophil infiltration in glomerulonephritis, both urinary and plasma levels of a potent neutrophil chemotactic cytokine, interleukin-8 (IL-8), were measured in 40 healthy volunteers and 96 patients with various renal diseases. The plasma IL-8 levels were less than 16 pg/ml. The urinary IL-8 levels were elevated in several renal diseases including IgA nephropathy (17 of 43), acute glomerulonephritis (4 of 6), lupus nephritis (11 of 15), purpura nephritis (2 of 4), membranoproliferative glomerulonephritis (1 of 1), and cryoglobulinemia (2 of 2). IL-8 was detected immunohistochemically in diseased glomeruli, suggesting its local production. Elevated urinary IL-8 levels during the acute phase or exacerbations were found to be decreased during spontaneous or steroid pulse therapy-induced convalescence in all patients examined. The urinary IL-8 levels were higher in patients with glomerular leukocyte infiltration than in those without infiltration. Collectively, local production of IL-8 in diseased glomeruli might be involved in the pathogenesis of the glomerular diseases and measurement of IL-8 in the urine might be useful for monitoring the glomerular diseases.

Acute Disease↗

Contribution of renal angiotensin II type I receptor to gene expressions in hypertension-induced renal injury.

Recent evidence indicates that transforming growth factor-beta 1 (TGF-beta 1) plays an important role in renal fibrosis via stimulation of extracellular matrix synthesis. The present study was undertaken to investigate the role of angiotensin II type I receptor (AT1 receptor) in hypertension-induced renal injury. Twenty-two-week-old stroke-prone spontaneously hypertensive rats (SHRSP), which had established hypertension and moderate renal damage, were orally given TCV-116, a selective non-peptide AT1 receptor antagonist (0.1, 1 or 10 mg/kg/day), enalapril (10 mg/kg/day) or vehicle once a day for 10 weeks. At the end point of the treatment, we examined renal function, the gene expressions of TGF-beta 1 and extracellular matrix components in the interstitium [collagen types I (COI) and III (COIII), fibronectin (FN)] and the basement membrane (COIV and laminin), and renal microscopic morphology in rats aged 32 weeks. In vehicle-treated 32 week-old SHRSP with renal dysfunction and nephrosclerosis, renal mRNA levels for TGF-beta 1, COI, COIII, FN, COIV were all several-fold higher than in WKY. Thus, renal TGF-beta 1 gene expression was enhanced in SHRSP, which may contribute to the increased renal expressions of COI, COIII, FN, COIV in SHRSP. Treatment with TCV-116 (0.1 mg/kg/day) in SHRSP, in spite of no reduction of blood pressure, decreased renal mRNA levels for TGF-beta 1, COI, COIII, FN, COIV, being accompanied by the significant decrease in urinary protein and albumin excretion, blood urea nitrogen and plasma creatinine. Treatment with TCV-116 (10 mg/kg/day) in SHRSP decreased mRNAs for TGF-beta 1, COI, COIII, FN and COIV to almost the same levels as WKY, being associated with normalization of urinary protein and albumin excretion and the prevention of nephrosclerosis, as judged by microscopic histological observations. On the other hand, the effects of enalapril (10 mg/kg/day) on the above mentioned mRNA levels, renal function and renal morphology were weaker than those of TCV-116 (10 mg/kg/day) and were as much as TCV-116 (1 mg/kg/day). These results suggest that independently of hypotensive action, AT1 receptor antagonist has a potent renal protective effect by inhibiting the gene expression of renal TGF-beta 1 and extracellular matrix components.

Angiotensin II↗

Cloning and expression of cDNA coding for a new allergen from the house dust mite, Dermatophagoides farinae: homology with human heat shock cognate proteins in the heat shock protein 70 family.

An immunoreactive clone, which shares no homology with the major allergens, Der f I and Der f II, was isolated by screening of a Dermatophagoides farinae cDNA library with rabbit antiserum raised against an extract of the house dust mite and sera from patients with mite allergy. The deduced amino acid sequence of the cDNA of the clone is significantly homologous, up to 65.5%, to the carboxyl-terminal region of the heat shock cognate protein (hsc) 71 in the heat shock protein (hsp) 70 family. A pool of the recombinant protein-specific IgE purified from mite-allergic sera recognized a 67 kDa protein on a blot of ATP-binding components partially purified from the mite body extract, while the antibody did not bind to the major allergens. We conclude that the recombinant protein, one of several important allergens, may be a protein in the heat shock protein 70 family from the house dust mite, D. farinae.

Allergens↗

Cloning and characterization of cDNA coding for a new allergen from the house dust mite, Dermatophagoides farinae.

A cDNA clone encoding a new allergen from the Dermatophagoides farinae cDNA lambda gt11 library was isolated and sequenced. There was no amino acid sequence homology with other known allergens. The gene product, beta-galactosidase fusion protein, of the truncated cDNA on blot reacted with IgE in 13 of 43 sera from patients allergic to mites. The affinity-purified fusion protein had a potent ability to release histamine from washed blood cells of the mite-allergic patients. Human specific IgE eluted from the fusion protein band on blots recognized a 39-kD component on blots of a mite body extract.

Allergens↗

Structure of IgE epitopes on a new 39-kD allergen molecule from the house dust mite, Dermatophagoides farinae.

Two IgE epitope sequences comprising Ser56-Pro-Val-Thr-Lys-Arg-Ala-Ser-Leu-Lys-Ile-Asp-Ser-Lys-Lys70 and Asp104-Val-Glu-Leu-Ser-Leu-Arg-Ser-Ser-Asp-Ile-Ala115 were identified by deletion analysis of the cDNA encoding a new 39-kD protein of mite allergen. A synthetic dodecapeptide corresponding to the latter epitope sequence functioned as a monovalent and mite-specific hapten. Replacement of each of the 12 amino acid residues with Gly, using site-directed mutagenesis, indicated that Arg110 may play a central role in IgE binding. However, the 8 allergic sera tested exhibited a wide variation in their amino acid residues required for reactivity to IgE in allergic sera.

Allergens↗

Correlation of ultrasound-measured common carotid artery stiffness with pathological findings.

To quantitatively and noninvasively evaluate common carotid atherosclerosis in a series of patients, we measured the stiffness parameter beta, which represents the mechanical properties of the vessel. beta was calculated from the relationship between blood pressure and the diameter of the artery as measured by an ultrasonic, phase-locked, echotracking system. Increases in the severity grade of atherosclerosis as subsequently determined at autopsy were correlated with increased beta values in 60 common carotid arteries (r = .68). Patients with beta values greater than 13 had a pathological diagnosis of atherosclerosis in the common carotid artery. The sensitivity of this discrimination ratio was 80%, and the specificity was 80% as well. Thus, beta shows promise as a useful diagnostic indicator for detecting asymptomatic common carotid atherosclerosis.

Adult↗

Role of angiotensin II in renal injury of deoxycorticosterone acetate-salt hypertensive rats.

To investigate the role of angiotensin II (Ang II) in hypertension-induced tissue injury, we gave TCV-116 (1 mg/kg per day PO), a nonpeptide Ang II type I receptor antagonist, or enalapril (10 mg/kg per day PO) to deoxycorticosterone acetate (DOCA)-salt hypertensive rats for 3 weeks and examined the effects on tissue mRNA levels for transforming growth factor-beta 1 (TGF-beta 1) and extracellular matrix components. Tissue mRNA levels were measured by Northern blot analysis. Renal mRNA levels for TGF-beta 1; types I, III, and IV collagen; and fibronectin in DOCA-salt hypertensive rats were increased by severalfold (P < .01) compared with sham-operated rats. In the aorta of DOCA-salt hypertensive rats, TGF-beta 1 and fibronectin mRNA levels were increased, but types I, III, and IV collagen mRNAs did not increase. In the heart, increased mRNA was found only for fibronectin. Thus, these gene expressions are regulated in a tissue-specific manner. TCV-116 or enalapril did not lower blood pressure in DOCA-salt hypertensive rats. However, the increase in renal mRNAs for TGF-beta 1 and extracellular matrix components in DOCA-salt hypertensive rats was significantly inhibited by treatment with TCV-116 or enalapril, which was associated with a significant decrease in urinary protein and albumin excretions and histological improvement of renal lesions. In contrast, in the aorta and heart these gene expressions were not affected by TCV-116 or enalapril. Thus, local Ang II may contribute to renal injury of DOCA-salt hypertension by stimulating the gene expression of TGF-beta 1 and extracellular matrix components.

Angiotensin II↗

Preparation of DNA-carrying affinity latex and purification of transcription factors with the latex.

We have developed DNA-carrying latex particles for the separation and purification of transcription factors. These particles consist of styrene (St), glycidyl methacrylate (GMA) and divinylbenzene (DVB). It was confirmed that the ethanolamine-treated surface of these particles suffered no nonspecific adsorption of proteins. To the latex particles sequence-specific DNA oligomers were immobilized via covalent coupling. A transcription factor, E4TF3, was efficiently purified to homogeneity using the latext particles. In contrast, the purification using DNA-carrying Sepharose gel yielded poor results. Compared to DNA-carrying Sepharose gel, the latex particles exhibited several times higher efficiency in the purification of E4TF3 from the crude nuclear extract.

Adsorption↗