Transhepatic portosystemic shunts: CT appearance and anatomic correlation.
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Aged↗
Biomedical subjects
Y Inoue
Publications and source records attributed to Y Inoue.
Growth inhibitory effects of ATP and its derivatives on human fibroblasts immortalized with 60Co-gamma rays.
In our previous study (Katayama B et al, Int J Mol Med 2: 603-606, 1998), cell growth inhibition caused by ATP added to cultures was found to be greater in immortalized human fibroblasts than in the normal human fibroblasts. Since it has been reported that ATP affects cells via P2-purinergic receptors, growth inhibitory effects of ATP and its derivatives on immortalized human fibroblasts were investigated in the present study in order to learn what type of receptors are involved in ATP cytotoxicity. The ATP derivatives used in this study were: ATP, ADP, beta, gamma-methyleneadenosine 5'-triphosphate (MeATP), 2' & 3'-o-(4-benzoylbenzoyl) adenosine, triethylammonium salt (BzATP), adenosine 5'-o-(3-thiotriphosphate) (ATPgammaS), 2-methylthioadenosine 5'-triphosphate (2-MeSATP) and UTP. The extent of cytotoxicity induced by these drugs was found to be in the order of: ATP=ADP>ATPgammaS>MeATP=BzATP. On the other hand, neither 2-MeSATP nor UTP showed any cytotoxicity. These findings indicate that ATP may exert the cell growth inhibition by certain kinds of signal transduction via P2x or P2y purinergic receptors which affect intrinsic channels/pores of cell membrane and/or G protein activation. As a result, intracellular elevation in the concentrations of ions such as calcium and potassium, membrane depolarization, loss of endogenous ions/metabolites, and activation of inositol phospholipid-specific phospholipase C may occur. Actually, a dihydropyridine calcium channel blocker, nifedipine, and an ATP-sensitive K+-channel blocker, glybenclamide, reduced the growth inhibitory effects of ATP on the cells to some extent. The growth inhibition caused by ATP was not due to apoptosis or induction of a cyclin/CDK kinase inhibitor, P21.
Adenosine Triphosphate↗
Different expression of positive and negative regulators of hepatocyte growth in growing and shrinking hepatic lobes after portal vein branch ligation in rats.
Portal vein branch embolization is often performed before hepatectomy to prevent postoperative liver failure. It is, however, still not clear how the embolized lobe shrinks and the non-embolized lobe proliferates in counterbalance. We investigated the expression of positive and negative regulators of hepatocyte growth to clarify the mechanisms of liver growth and atrophy in a rat portal vein ligation (PVL) model compared with partial hepatectomy (PH). A significant increase in DNA synthesis within the non-ligated lobe reached a peak at 36 h, a delay of 12 h as compared with PH, while no increase occurred in the ligated lobe. Expression of hepatocyte growth factor mRNA remarkably increased in the non-ligated growing lobe between 6 and 24 h, but was only slightly elevated in the ligated shrinking lobe. Contrarily, negative regulators of hepatocyte proliferation, such as TGF-beta1 and IL-1beta, were strongly expressed in the ligated shrinking lobe. Thus, the changes of portal venous flow and/or pressure caused by PVL may contribute to induction of different kinds of growth factors between the ischemic and non-ischemic lobes; these factors possibly regulate liver regeneration and atrophy after PVL.
Animals↗
Expression of the SART1 tumor-rejection antigen in human osteosarcomas.
We recently reported a tumor-rejection antigen, SART1259, possessing tumor epitopes capable of inducing cytotoxic T lymphocytes (CTLs). This study investigated the expression of SART1259 antigen in osteosarcoma and other skeletal malignant tumors to explore for a potential molecule for use in specific immunotherapy. The SART1259 antigen was detected in the cytosol fraction of 13 of 21 (62%) osteosarcoma cell lines and 3 of 8 (38%) osteosarcoma tissues, and 3 of 10 (30%) malignant fibrous histiocytoma (MFH) tissues. The HLA-A24+ and SART1259+ osteosarcoma cells were recognized by the HLA-A24 restricted and SART1 specific CTLs. These results raise a possibility that the SART1259 would be an appropriate molecule for use in specific immunotherapy of approximately one-third of HLA-A24+ patients with osteosarcoma and MFH.
Antigens, Neoplasm↗
Genotypic analysis of hepatitis C virus in blood donors in Indonesia.
A study was conducted to describe the genetic diversity of hepatitis C virus (HCV) in a population of positive blood donors from throughout Indonesia. Repeat analysis by reverse transcription-polymerase chain reaction (RT-PCR) of 102 anti-HCV positive samples showed that 67 gave HCV-specific positive signals by the PCR for the 5'-untranslated genomic region of HCV. Further genotypic analysis on 64 HCV RNA-positive samples indicated that 57 belonged to the following individual genotypes: 1a, 1b, 2a, 2b, and 3b. The predominant HCV genotypes in this donor population were 1b (57.8%), 2a (17.2%), and 3b (10.9%). The core sequences of the 4 indeterminate samples when aligned with published sequences of various HCV genotypes showed a range of homology from 16.16% to 78.67%. Comparative analysis of genotypic representation from other anti-HCV-positive study populations, including polytransfused pediatric and adult renal dialysis groups, is now being carried out to determine the potential genotypic association with mechanistic HCV spread.
5' Untranslated Regions↗
[Evaluation of extraocular muscle enlargement in dysthyroid ophthalmopathy].
PURPOSE: To evaluate the extraocular muscle enlargement in dysthyroid opthalmopathy. METHOD: Extraocular muscle enlargement was assessed by orbital computed tomography (CT) in 573 patients with dysthyroid ophthalmopathy in order to investigate the frequency and exact location of extraocular muscle enlargement and the clinical features of related ocular symptoms in patients with dysthyroid ophthalmopathy. RESULTS AND CONCLUSION: 187 patients (38% of the total) showed evidence of extraocular muscle enlargement on CT images, and this disorder were more frequent in male patients than in female patients. Extraocular muscle enlargement was also more frequently seen in older patients than in younger patients. Enlargement of a single muscle was found in 55% of the 187 patients, with the most frequently affected muscle being the inferior rectus muscle. When multiple muscles were enlarged, the inferior rectus muscle was the most frequently affected, followed by the medial rectus muscle. Of the clinical findings specific to dysthyroid ophthalmopathy examined in the present study, the incidence of exophthaomos, upper lid swelling, superior limbic keratoconjunctivitis, keratitis, diplopia, and dysthyroid optic neuropathy were significantly increased in patients with dysthyroid ophthalmopathy, indicating a close relationship between these findings and the underlying disease, but the incidence of upper lid retraction was not significantly increased.
Adolescent↗
[A case of advanced hepatocellular carcinoma with lung and bone metastases effectively treated by orally administered UFT].
A 52-year-old male underwent hepatic subsegmentectomy for hepatocellular carcinoma (HCC). Five months later, a recurrent tumor was found in the liver and transcatheter arterial embolization (TAE) was performed. However, recurrent tumors were growing rapidly with multiple lung and bone metastases. The titer of serum AFP was elevated to 896,095 ng/ml and the titer of serum PIVKA-II was elevated to 1294.5 AU/ml. The patient was treated by oral administration of UFT (600 mg/day). Two weeks later, his general condition was improved, and several months later, the liver tumor, multiple lung metastases and multiple bone metastases had almost disappeared. The titers of serum AFP and PIVKA-II were reduced to the normal range. He has maintained a good state of health for about four years now. This case suggests the clinical usefulness of UFT for advanced HCC.
Administration, Oral↗
[A cost-effectiveness analysis of a pre-visit testing system for new outpatients in primary care medicine].
We evaluated cost-effectiveness parameters of common diagnostic test panels advocated by the Japan Society of Clinical Pathology in order to determine the validity of pre-visit testing of these test panels for new outpatients with some defined symptoms. The "Essential Laboratory Tests(ELT) (2)" panel was universally applied to 540 new outpatients who visited the Comprehensive Medicine Clinics in the National Defense Medical College and its affiliated hospital. A "useful result(UR)", the unit of usefulness of the ELT, was assigned by assessing the impact of its results on physician's diagnosis- or decision-making. Patients were classified into 7 major symptom groups according to their chief complaint, and clinical effectiveness(UR/patient), economic efficiency(cost/UR) and cost-effectiveness(delta cost/delta UR) were analyzed in each patient group. Clinical effectiveness ranged from 1.38(renal/urinary tract symptoms) to 0.27 UR/patient(neurological symptoms) with a cost disparity from yen 1,222 to yen 5,946/UR between these patient groups. Substantial decreases in clinical effectiveness were demonstrated in all patient groups with the ELT(1)-testing alone in a simulation study; however, cost-effectiveness parameters still remain in excellent values in the renal/urinary tract symptom and infection/inflammation-related symptom groups(1.13 and 0.77 UR/patient at a cost of yen 836 and yen 1,181/UR, respectively). The addition of some ELT(2)-specific test items such as AST, ALT to the ELT(1) baseline panel improved clinical effectiveness of the ELT(1) in lassitude/exhaustive symptom group at a minimal cost increment. This study verified the validity of the ELT(1) as a panel for pre-visit testing in patients with renal/urinary tract symptoms and infection/inflammation-related symptoms, but not in those with other symptoms.
Adolescent↗
Attenuation correction in evaluating renal function in children and adults by a camera-based method.
UNLABELLED: Correction for soft-tissue attenuation is required to evaluate absolute renal function by a camera-based method, and an estimate of renal depth and an attenuation coefficient are commonly used for attenuation correction. The first goal of this study was to develop formulas for the calculation of renal depth in both children and adults. The second goal was to optimize the attenuation coefficient for the estimation of renal accumulation of a 99mTc-labeled agent. METHODS: Renal depth was measured by CT in 74 children and 232 adults and compared with the depth calculated using previously published equations. Multiple stepwise linear regression analysis was conducted using data from children and adults together, and new formulas to calculate renal depth were derived. Using the resulting equations, percentage renal uptake at 2-2.5 min was computed from 99mTc-diethylenetriamine pentaacetic acid (DTPA) renography in 40 children and 92 adults. Percentage renal uptake was assessed using various values of an attenuation coefficient, and an optimized attenuation coefficient was determined to maximize the correlation coefficient between percentage renal uptake and glomerular filtration rate (GFR) measured from 2 blood samples. RESULTS: Although the previously published equations appeared to be acceptable in predicting adult renal depth, they substantially underestimated pediatric renal depth. Renal depth (D, cm) was shown by stepwise regression analysis to depend on the ratio of body weight (W, kg) to body height (H, cm) and was successfully calculated in both children and adults using the derived equations (right: D = 16.778 x W/H + 0.752; left: D = 16.825 x W/H + 0.397). The correlation coefficient between percentage renal uptake of 99mTc-DTPA and measured GFR varied substantially according to the attenuation coefficient used and was the highest (0.947) with an attenuation coefficient of 0.087/cm. CONCLUSION: The equations presented here enabled estimation of renal depth irrespective of the patient's age. Attenuation correction using these equations and the optimized attenuation coefficient appears to aid in evaluating renal accumulation and, consequently, renal function in both children and adults.
Adolescent↗
Opportunistic discovery of occult disease by use of test panels in new, symptomatic primary care outpatients: yield and cost of case finding.
BACKGROUND: Diagnostic test panels have been advocated by the Japan Society of Clinical Pathology for evaluation of presenting complaints of new outpatients in primary care medicine. The tests have additional potential utility for opportunistic finding of asymptomatic diseases, but data are lacking on the number of new conditions identified by the test panels and on the cost per identified case. METHODS: We studied 540 new, symptomatic patients at the Comprehensive Medicine Clinics of National Defense Medical College during 1991-1997. All underwent testing with the "Essential Laboratory Tests" panel (2) [ELT(2) panel]. This panel includes hematologic tests, urinalysis, total protein, C-reactive protein, albumin, cholesterol, triglycerides, glucose, urea nitrogen, creatinine, uric acid, serum protein fractionation, six enzymes, and optional tests, including x-rays, electrocardiogram, and fecal occult blood. RESULTS: The ELT(2) panel uncovered 276 additional diagnoses of asymptomatic disease or abnormal health status. The most frequent occult condition was hyperlipidemia (100 cases) followed by liver dysfunction (53 cases). Clinical efficiency of the panel (occult diseases/patient) varied depending on the category of tentative initial diagnosis, with the highest efficiency in patients with cardiovascular disease. We created smaller panels by combining 11 basic tests [called the ELT(1) baseline panel] with one or more additional tests from the ELT(2) and analyzed their cost-effectiveness. Addition of four tests (total cholesterol, alanine aminotransferase, glucose, and uric acid) improved both clinical efficiency (0.41 occult disease/patient) and economic efficiency [ 2372 yen (approximately $22.50 US)/occult disease] at a cost-effectiveness of 177 yen per incremental case of occult disease. Addition of further tests decreased cost-effectiveness. CONCLUSIONS: Although the ELT(2) panel has supplemental utility for opportunistic screening of some significant, occult diseases and conditions, universal utilization of the full panel is not supported by the cost-effectiveness found in this study.
Adolescent↗
Rapid detection of M1S1 mutations by the protein truncation test.
PURPOSE: To determine a method of rapid detection of M1S1 gene mutations in patients with gelatinous droplike corneal dystrophy. METHODS: Forty-one patients from 35 families with gelatinous drop-like corneal dystrophy were studied. The entire coding region of the M1S1 gene was screened using the protein truncation test (PYT), with a polymerase chain reaction fragment amplified from genomic DNA serving as a template of in vitro translation. RESULTS: Homozygous or compound heterozygous mutations were detected in all patients by a single reaction of the PTT. This result matched those obtained using the polymerase chain reaction-restriction fragment length polymorphism and direct sequence analyses. The Q118X mutation was present in 63 of the 70 alleles, accounting for 90% of the disease-associated chromosomes in Japanese patients. CONCLUSIONS: The PTT is useful for detecting mutations in the M1S1 gene. This technique showed that the Q118X mutation is a founder mutation in Japanese patients with gelatinous droplike corneal dystrophy, and it reflects the linkage disequilibrium reported previously.
Antigens, Neoplasm↗
[A case of myasthenia gravis, who developed minimal change nephrotic syndrome during immunosuppressive therapy after thymectomy].
Myasthenia gravis is caused by antibodies against acetylcholine receptors and is treated with inhibition or elimination of antibody production. We report a 58-year-old woman who had been suffering from myasthenia gravis and underwent thymectomy in July 1995. Her myasthenic symptoms improved with immunosuppressive treatment using corticosteroid(100 mg/day) and azathioprine(100 mg/day). However she presented edema with massive proteinuria(7.54 g/day) and was admitted to our hospital on July 1997. She was diagnosed as having nephrotic syndrome and a renal biopsy was performed. The histological findings showed minimal change nephrotic syndrome. After pulse therapy with methylprednisolone(1 g/day x 3 days) following oral administration of prednisolone(60 mg/day), proteinuria disappeared after one month. Nephrotic syndrome is a rare complication in patients with myasthenia gravis. The increase in lymphokine production caused by thymectomy may be closely associated with the occurrence of nephrotic syndrome in spite of intensive immunosuppressive treatment in the present case. In this report, we also summarized reported cases of minimal change nephrotic syndrome with thymoma and myasthenia gravis.
Azathioprine↗
Mutations in the 11-cis retinol dehydrogenase gene in Japanese patients with Fundus albipunctatus.
PURPOSE: To detect mutations in the RDH5 gene encoding 11-cis retinol dehydrogenase in patients from Japan with fundus albipunctatus. METHODS: Polymerase chain reaction and direct genomic sequencing techniques were used to detect mutations of the RDH5 coding exons (exons 2-5) in two unrelated patients with fundus albipunctatus. Selected alleles that altered the coding region or intron splice sites were evaluated further through segregation analysis in the families of the index cases. RESULTS: Two novel RDH5 mutations were identified. One of these was a missense mutation Val264Gly in exon 5, and the other was an in-frame insertion of 3 bp in exon 5. CONCLUSIONS: The data indicate that mutations in RDH5 are the primary cause of fundus albipunctatus.
Alcohol Oxidoreductases↗
[A case report of intra-thoracic biliary fistula after percutaneous microwave coagulation therapy].
Among the locoregional therapies for hepatic malignant tumor, percutaneous microwave coagulation therapy (PMCT) has spread widely as a minimally invasive therapy. We performed PMCT on 40 patients under hepatic blood flow interruption with the aim of improving the radical treatment and expanding the coagulation area by single microwave delivery. A patient with a 2.5 cm lesion in S5 of the liver under PMCT transdiaphragmatically, but he developed a postoperative biliary fistula with consequent development of an intra-thoracic abscess through the diaphragm. Biliary fisture and liver abscess disappeared with open drainage under thoracotomy and laparotomy. Liver abscess has occasionally been reported as a PMCT complication, whereas there have been no reports, to the authors' knowledge, about intra-thoracic abscess as a PMCT complication, as in our case. It should be kept in mind that the penetration of the diaphragm as a route for PMCT may result in a biliary fistula flowing into the thorax, leading to a very serious condition.
Abscess↗
[A case report of successful transcatheter arterial embolization therapy for osseous metastasis of hepatocellular carcinoma].
A 74-year-old man was admitted to our hospital with a chief complaint of severe local pain of the hip joint. Radiological findings showed a metastasized lesion on the left side of the pelvic wall originated from hepatocellular carcinoma (HCC) in the anterior segment of the liver. Transcatheter arterial embolization (TAE) therapy using epirubicin, Lipiodol and Spongel was successfully performed twice for primary HCC, and four times for osseous metastasis of HCC. After TAE therapy, the size of the metastasized lesion decreased with relief of pain, and an improvement in performance status of 4 to 2 was achieved. In conclusion, TAE therapy is thought to be very useful in the treatment of osseous metastasis of HCC with severe local pain.
Aged↗
Classification of neocortical epilepsies.
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Epilepsy↗
Preventive effect of local plasmid DNA vaccine encoding gD or gD-IL-2 on herpetic keratitis.
PURPOSE: The goal of this study was to evaluate the effectiveness of a local plasmid DNA vaccine encoding herpes simplex virus (HSV) type 1 glycoprotein D (gD) or gD-interleukin (IL)-2 (chimeric gene of gD and human IL-2) in preventing murine herpetic keratitis. METHODS: Plasmids containing gD (pHSDneo1), gD-IL-2 (pHDLneo1), or vaccine vector (pHSGneo) were injected subconjunctivally with BALB/c mice on days 0 and 7 (90 microgram x 2). Immunization was indicated by positive virus-neutralizing antibody titer, swollen pinna (due to delayed-type hypersensitivity [DTH] reaction), and release of (51)Cr from splenic and/or local cytotoxic effector cells on day 28. In another group of the immunized mice, corneas were challenged with HSV-1 (CHR3 strain, 10 microliter of 3 x 10(6) plaque-forming units [PFU]/ml). Mice were evaluated for clinical signs of epithelial or stromal keratitis on days 1 through 8 and days 10 and 14 or measured on days 2, 4, or 6 for viral titers in the eyes, trigeminal ganglia, and brain. RESULTS: All gD-DNA-injected mice obtained specific immunity. Furthermore, gD-IL-2-DNA elicited a higher DTH reaction and more vigorous cytotoxic effector cell activity. Stromal keratitis scores were lower for all immunized mice compared with control mice, although the difference in epithelial keratitis scores was not statistically significant. Viral titers in eyes, trigeminal ganglia, and brains were suppressed in all immunized mice. CONCLUSIONS: Local immunization with plasmid DNA encoding gD or gD-IL-2 induces humoral and cellular immunity against HSV-1 and inhibits development of stromal keratitis. gD-IL-2 DNA induces greater cell-mediated immunity than gD DNA alone. A plasmid encoding gD-IL-2 is therefore a promising candidate for a vaccine against HSV-1.
Animals↗
Evaluation of renal function with 99mTc-MAG3 using semiautomated regions of interest.
UNLABELLED: The need to draw regions of interest (ROIs) manually may reduce the convenience and reliability of estimating renal function from renal scintigraphy. We developed a semiautomated method to define ROIs for renal scintigraphy with 99mTc-mercaptoacetyltriglycine (MAG3) and evaluated the clinical applicability of the method to the estimation of renal function by camera-based methods. METHODS: Dynamic renal scintigraphy with 99mTc-MAG3 was performed on 21 patients. An operator placed a large rectangular ROI over each kidney, a circular ROI within the liver, and a rectangular ROI between the kidneys. Using these ROIs, semiautomated renal ROIs were determined on the basis of the temporal changes in counts, in addition to the absolute counts, and a subrenal background ROI was automatically assigned for each renal ROI. Background-subtracted renograms were generated using these renal and subrenal ROIs, and renogram parameters were derived from the slope of the renogram and the area under the renogram. Clearance was calculated using the renogram parameters and equations determined previously with manual ROIs and correlated with clearance measured by a single-sample method. The relative function of the right kidney determined by the semiautomated method was compared with that determined by the manual method. Data processing was performed independently by another operator to assess interoperator reproducibility. RESULTS: ROIs defined by the semiautomated method were visually judged to be acceptable for clinical use in all patients with a wide range of renal function. Clearance was successfully predicted with the semiautomated ROIs (r = 0.968 using the slope of the renogram; r = 0.934 using the area under the renogram), and relative function calculated with the semiautomated ROIs was almost identical to that calculated with manual ROIs. There was almost complete concordance in absolute and relative function between the two operators. CONCLUSION: The semiautomated method can define ROIs for 99mTc-MAG3 renal scintigraphy with limited operator intervention. Camera-based methods using the semiautomated ROIs allow estimation of renal function with high accuracy and little interoperator variability and are suggested to be suitable for clinical use.
Adult↗