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Biomedical subjects

Y Ito

Publications and source records attributed to Y Ito.

At least 343 records · Page 19Linked to original sources

Intimate relationship between TGF-beta/BMP signaling and runt domain transcription factor, PEBP2/CBF.

BACKGROUND: When C2C12 pluripotent mesenchymal precursor cells are treated with transforming growth factor-beta1 (TGF-beta1), terminal differentiation into myotubes is blocked. Treatment with bone morphogenetic protein-2 (BMP-2) not only blocks myogenic differentiation but also induces osteoblastic differentiation. However, the molecular mechanisms governing the ability of TGF-beta and BMP to induce ligand-specific responses and inhibit myogenic differentiation are not known. The objective of our studies was to elucidate the molecular mechanisms that block myoblastic differentiation and induce osteoblastic differentiation in C2C12 cells. METHODS: Induction of RUNX2/PEBP2alphaA/Cbfa1 by TGF-beta and BMP was examined by electrophoretic mobility shift assay (EMSA) and Northern blot analysis. C2C12 cells stably expressing RUNX2 or Smad, or both, were established, and the role of these genes in the process of osteoblastic differentiation was analyzed by examining the expression of osteoblast-specific markers. RESULTS: Treatment of C2C12 with TGF-beta and BMP-induced RUNX2/PEBP2alphaA/Cbfa1, a global regulator of osteogenesis. Cooperation between RUNX2 and BMP-activated Smad induced osteoblastic differentiation. CONCLUSIONS: Both TGF-beta and BMP activate transcription of RUNX2, which is sufficient to inhibit myogenesis. To induce osteogenesis, BMP-induced RUNX2 must cooperate with BMP-activated Smads.

Animals↗

[A case of relapsed small cell lung cancer recognized by simple metastasis to the duodenum].

We describe a case of relapsed small cell lung cancer (SCLC) recognized by a duodenal tumor, its probable metastasis. A 69-year-old man was admitted to Keio University Hospital complaining of persistent sputum production in September, 1996. A diagnosis of SCLC of the left lung invading the mediastinum was based on a transesophageal biopsy. Chemotherapy consisting of CDDP and VP-16 followed by thoracic irradiation at a total dose of 50 Gy was performed from October 1996 to August 1997, resulting in CR (Complete Response) of the tumor. In April of 1999, a mass surrounding the duodenum was found through an abdominal CT survey for tumor relapse, but no other tumors were detected in a series of CT scans or inbone scintigraphy. Subsequent fiberscopy of the upper gastrointestinal tract revealed an ulcerative tumor extensively invading the mucosa of the duodenal bulb. Biopsy specimens obtained from the duodenal tumor showed small-cell carcinoma with features similar to those of SCLC found in 1996, suggesting that SCLC of the left lung metastasized to the duodenal wall. Chemoradiotherapy with 4 cycles of CDDP and VP-16 followed by abdominal irradiation at a dose of 30 Gy was given again from May to September 1999, producing good PR (Partial Response). Although metastasis of SCLC to the duodenum seldom occurs, this report indicates that its early detection and effective treatment may prevent serious symptoms caused by obstruction of the duodenum or the papilla Vater.

Aged↗

Efficacy of cutting balloon angioplasty for in-stent restenosis: an intravascular ultrasound evaluation.

BACKGROUND: The increase in the use of stents has seen the increasing emergence of in-stent restenosis (ISR). Reports suggest that the Cutting Balloon (Interventional Technologies, San Diego, California) may be a useful treatment modality for this new clinical entity. METHODS: In this study, we compared the efficacy of Cutting Balloon angioplasty (CBA) with conventional balloon angioplasty (PTCA) for ISR in 47 patients (47 lesions). Results were evaluated with intravascular ultrasound (IVUS). The CBA group included 25 patients (mean age, 65 +/- 78 years; 7 females) and the PTCA group included 22 patients (mean age, 69 +/- 51 years; 6 females). RESULTS: The procedural success rate was 100% in both groups. IVUS showed that luminal area acute gain was larger in the CBA group (2.5 +/- 0.8 mm2) compared to the PTCA group (1.8 +/- 1.0 mm2), while late loss was smaller in the CBA group (0.5 +/- 0.4 mm2) compared to the PTCA group (1.3 +/- 0.5 mm2). The change in total area was similar in both groups. The increase in area at the stented portion was 0.4 +/- 0.8 mm2 in the CBA group and 1.2 +/- 0.5 mm2 in the PTCA group. The restenosis rate at follow-up (mean follow-up, 5.4 months) was higher in PTCA patients (59%) than in the CBA patients (24%). CONCLUSION: CBA may result in no increase in total vessel area, a constant stent area, a decrease in plaque area, and an increase in lumen area (induced by the decrease in plaque area). Our IVUS findings suggest that compared to PTCA, the dilatation mechanism of CBA may be associated with reduced dilatation of both the total vessel area and the stent area for ISR. The mechanism of this modality may minimize injury to the intimal membrane and may potentially be a primary device for in-stent restenosis in the future.

Aged↗

Low-dose dobutamine electrocardiograph-gated myocardial SPECT for identifying viable myocardium: comparison with dobutamine stress echocardiography and PET.

UNLABELLED: The identification of severely dysfunctional but viable myocardium is of particular importance for the selection of patients with depressed left ventricular function who will benefit from coronary revascularization. Assessment of inotropic reserve with dobutamine has recently been used for this purpose. This study compared the accuracy of low-dose dobutamine stress gated myocardial SPECT (DS SPECT) with the accuracy of dobutamine stress echocardiography (DSE) and resting perfusion SPECT for the identification of viable myocardium in patients with previous myocardial infarction. METHODS: Resting and low-dose dobutamine (7.5 microg/kg/min) gated (99m)Tc-tetrofosmin SPECT and echocardiography and resting (18)F-FDG PET were prospectively studied in 23 patients with previous myocardial infarction and severely depressed regional function. Twenty-one of them were successfully studied with each technique. The left ventricular wall was divided into 14 segments to assess wall motion using a 5-point scale. PET viability was defined as FDG uptake >/= 50% of the maximum uptake in a region with normal wall motion. For DS SPECT and DSE studies, viable myocardium was defined as hypokinetic areas with > or = 1 point improvement in wall motion. For resting perfusion SPECT, viable myocardium was defined as hypokinetic areas with a relative uptake > or = 50% of the maximum uptake. RESULTS: Of a total of 294 segments, 55 had severe resting dyskinesis. Thirty-four segments were identified as viable on FDG PET, and 21 segments were identified as nonviable. Eleven segments were inadequately visualized with DSE, including 5 segments in the apex. Sensitivities (78% vs. 76%) and specificities (94% vs. 100%) were similar for DSE and DS SPECT, with a concordance of 86% (kappa = 0.72). DS SPECT and perfusion SPECT did not significantly differ with respect to sensitivities (76% vs. 85%, respectively). However, specificity was significantly higher for DS SPECT than for perfusion SPECT (100% vs. 52%, respectively, P < 0.05). CONCLUSION: This study indicated that DS SPECT correlates well with DSE in the assessment of viability. In addition, gated SPECT can evaluate regional wall motion, even in areas inadequately assessed by echocardiography. DS SPECT may also provide additional information for identifying viable myocardium, which is often overestimated by routine perfusion scans.

Aged↗

Effect of prolonged low-dose methylprednisolone therapy in acute exacerbation of idiopathic pulmonary fibrosis.

We report on a 74-year-old man with an acute exacerbation of idiopathic pulmonary fibrosis (IPF) who was successfully treated with prolonged low-dose methylprednisolone, initiated at a loading dose of 2 mg/kg, followed by 2 mg/kg per day for 14 days. The dose was then tapered. The exacerbation observed on the chest radiograph and high-resolution computed tomography was found to have abated after the treatment. This successful case suggests the feasibility of this methylprednisolone treatment protocol for patients with IPF accompanied by accelerated deterioration. Furthermore, this case suggests possible similarities between acute exacerbation of IPF and late acute respiratory distress syndrome, as the same treatment protocol was previously proved to be beneficial for patients with late acute respiratory distress syndrome.

Acute Disease↗

[CD56- and CD4-positive non-Hodgkin's lymphoma of probable T-cell origin].

A 65-year-old man was admitted with swelling of the right neck and bilateral inguinal lymph nodes. Endoscopic examination revealed no nasal infiltration. Pathological examination of a neck lymph node biopsy specimen revealed peripheral T-cell lymphoma according to the Revised European-American Classification of Lymphoid Neoplasms (REAL). The phenotype of the lymphoma cells was CD56+, CD16-, CD2+, surface CD3-, cytoplasmic CD3+, CD4+, CD8-, CD5+, CD7- and CD45RO+. May-Giemsa staining demonstrated no azurophilic granules in the lymphoma cells. Immunohistopathologic examination showed negativity for TIA-1 and granzyme B, and rearrangement of the TCR C beta 1 gene was also noted. These findings strongly suggested that this was a T-cell lymphoma. The patient received 8 courses of CHOP chemotherapy plus sobuzoxane. This led to a marked decrease of lymph node swelling, and currently the patient is still in remission. According to the REAL classification, T/NK-cell lymphomas are included among the peripheral T cell tumours, and seem to constitute a heterogeneous group of neoplasms. Although some cases of CD4+ CD56+ lymphoma have been reported, the present case appears to be the first example to show TCR gene rearrangement and negativity for TIA-1 and granzyme B. Since the classification of T/NK-cell lymphoma is still controversial, accumulation of such cases may help to better define T/NK-cell neoplasms.

Aged↗

[Aortitis syndrome associated with ulcerative colitis, preceded by pulmonary infarction involvement].

A 21-year-old woman with a 6-year history of ulcerative colitis admitted to our hospital with chest pain, cough and fever of unknown origin in August 1998. On admission, laboratory data showed positive inflammatory signs. A chest radiograph and chest computed tomogram (CT) revealed nodular shadows in the right upper lung field. Fifty days after admission, hypertension developed and a bruit was audible in the neck and the upper abdomen. Digital subtraction angiography showed stenosis in carotid, renal and right upper pulmonary arteries. On the basis of these results, a diagnosis of aortitis syndrome was made. Moreover, these findings indicated pulmonary infarction in the right upper lobe due to aortitis syndrome. Aortitis syndrome preceded by pulmonary infarction involvement is very rare. Autoimmune disorders may have been involved in this case because of the association with ulcerative colitis.

Adult↗

[Primary adenocarcinoma of the renal pelvis with a pyeloduodenal fistula: a case report].

A 62-year-old woman visited our hospital complaining of fever and right flank pain. On excretory pyelography the right kidney containing three renal stones was not visualized. Retrograde pyelography revealed an irregular filling defect in the right renal pelvis. Computed tomography revealed renal stones and a tumor mass in the right renal pelvis. From these findings, the pelvic tumor of the right kidney complicated by renal stones was diagnosed. Right nephrectomy was performed. Because a fistula between the renal pelvis and the second portion of the duodenum was found in the operation, partial resection of the duodenum was also performed. Pathological diagnosis was adenocarcinoma of the renal pelvis and pyeloduodenal fistula due to chronic pyelonephritis. Postoperative chemotherapy was not given. This is the first case report of adinocarcinoma of the renal pelvis coexisting with a pyeloduodenal fistula.

Adenocarcinoma↗

Clinical outcome of stent implantation in small coronary arteries using different types of coronary stents.

PURPOSE: We evaluated the results of stent placement in small coronary arteries. SUBJECTS: The subjects were divided into 2 groups: the first contained 911 lesions treated with stenting in the coronary arteries (stent group), and the second contained 1,203 background- and patient-matched lesions treated with balloon angioplasty (POBA group). There was no significant difference in the background of patients or lesions between the groups. A "small coronary artery" was defined as a coronary artery with a reference vessel diameter < 3.0 mm. RESULTS: There was no significant difference in incidence of acute myocardial infarction (AMI), coronary artery bypass grafting, or death between the groups. In the stent group, acute occlusion (0.8%) and subacute thrombosis (2.1%) occurred. The restenosis rate of 29.8% in the stent group was significantly lower than in the POBA group (38.2%; p < 0.01). The restenosis rate of 19.4% in stented vessels 3.0 mm diameter was significantly lower than in vessels < 3.0 mm diameter (29.8%; p < 0.01). The rate of restenosis was 22.9% for the Multi-Link stent, 24.4% for the NIR stent, 34.1% for the GFX stent, and 35.3% for the PS stent. The restenosis rate of 23.8% in stented vessels > 2.5 mm diameter and < or = 20 mm length was significantly lower than in vessels , < or = 2.5 mm diameter and > 20 mm length (32.7%; p < 0.01). Factors associated with restenosis, analyzed using a stepwise multivariate logistic regression model, included ostial lesions and post-procedural minimum lumen diameter. CONCLUSIONS: Stent implantation in vessels < 3.0 mm diameter using a newly designed coronary stent yielded favorable clinical results, while there was a high prevalence of restenosis, leading to diffused stenotic lesions, in vessels < 2.5 mm diameter.

Aged↗

[Evaluation of MRSA identification with latex agglutination kit for the detection of penicillin-binding protein 2].

MRSA is one of the major nosocomial pathogens, and methicillin-resistance is associated with acquisition of the mecA gene coding for the penicillin-binding protein 2' (PBP2'). MRSA-screen test (Denka Seiken Co., Ltd., Tokyo, Japan) is a slide latex agglutination kit which can detect PBP2' within 15 min. MRSA-screen test was compared with PCR for detection of the mecA gene in order to detect MRSA. S. aureus strains isolated from April to October in 1999 in Gifu Red Cross Hospital were identified as 25 MRSA and 19 MSSA by susceptibility testing to oxacillin by the agar dilution method according to the recommendation of the National Comittee for the Clinical Laboratory Standards. The MRSA screen test and PCR for the mecA gene showed sensitivites of 92.0 and 96.0% and specificities of 89.5 and 94.7%, respectively. It is considered that MRSA-screen is a rapid and reliable test for discrimination of MRSA from MSSA colonies on agar plates.

Bacterial Proteins↗

Correction of early subnormal superior hemiretinal DeltaPO(2) predicts therapeutic efficacy in experimental diabetic retinopathy.

PURPOSE: To test the hypothesis that regional retinal oxygenation responses to a hyperoxic inhalation challenge are associated with reported retinopathy outcomes after different therapies in rat models of diabetic retinopathy. METHODS: Six groups of rats were maintained for 3 months: controls (n = 8), untreated diabetic (n = 8), aminoguanidine (AMG)-treated diabetic (2.5 g/kg of diet; n = 6), untreated galactosemic (n = 7), AMG-treated galactosemic (n = 10), and WAY-509-treated (25 mg/kg body weight per day) galactosemic (n = 7). After 3 months, the change in oxygen tension was measured noninvasively from the superior to the inferior ora serrata, using a novel functional magnetic resonance imaging (fMRI) technique and a carbogen (a gas mixture of 5% carbon dioxide and 95% oxygen that has been used clinically, instead of 100% oxygen, to minimize the vasoconstrictive effects of pure O(2) on retinal blood flow and oxygenation) inhalation challenge. Retinal morphometric measurements were also obtained. RESULTS: Retinal lesions (acellular capillaries and pericyte ghosts) were not significantly (P > 0.05) present at 3 months in any experimental groups compared with the control group. Superior but not inferior hemiretinal change in partial pressure of oxygen (DeltaPO(2)) became significantly subnormal (P < 0.05) at 3 months of diabetes or galactosemia. Aminoguanidine, which has been found to inhibit the development of retinopathy in diabetic but not galactosemic rats, inhibited the development of a subnormal DeltaPO(2) in diabetes but not in galactosemia. WAY-509, which has been reported to inhibit retinopathy in galactosemic rats, inhibited the DeltaPO(2) defect in galactosemic rats. CONCLUSIONS: An early subnormal superior hemiretinal DeltaPO(2) after treatment appears to be a good predictor of the risk of development of retinopathy, as well as for assessing therapeutic efficacy in experimental diabetic retinopathy.

Aldehyde Reductase↗

Age-dependent chemosensitive pontine inhibition of medullary respiratory rhythm generation in the isolated brainstem of the neonatal rat.

Age-dependence and chemosensitivity of the pontine inhibitory effect on medullary respiratory rhythm generation were examined in the isolated brainstem-spinal cord of the neonatal rat. In early preparations (days 1-2), the increase in RR (Delta RR) induced by the pons resection was larger in 8% CO(2) (pH 7.2) than in 2% CO(2) (pH 7.8). That difference was not found in late preparations (days 3-4). Under a given pH, the Delta RR was larger in early preparations than in late preparations.

Aging↗