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Biomedical subjects

Y Katayama

Publications and source records attributed to Y Katayama.

At least 379 records · Page 21Linked to original sources

Inhibition of the high-affinity glutamate uptake system facilitates the massive potassium flux during cerebral ischaemia in vivo.

During cerebral ischaemia, the extracellular concentration of K+ ([K+]e) increases abruptly to 50-60 mM following an initial slow increase to 6-10 mM. We have recently shown that the increase in [K+]e is significantly delayed by in situ administration of kynurenic acid, a broad spectrum antagonist of excitatory amino acids, suggesting that the catastrophic ionic fluxes occurring during ischaemia are initially mediated by EAA-coupled ion channels. In order to confirm further the role of EAAs, the changes in extracellular K+ ([K+]e) and glutamate ([Glu]e) during cerebral ischaemia were determined in the rat hippocampus by microdialysis in vivo, and the effect of dihydrokainate (DHKA), an inhibitor of the high-affinity uptake system of EAAs, was examined by in situ administration through the dialysis probe. DHKA induced a significant increase in baseline [Glu]e and facilitated the abrupt increase in [K+]e during cerebral ischaemia. These findings support the hypothesis that EAAs play a vital role in producing the rapid ionic shifts earlier during cerebral ischaemia.

Animals↗

Detection of measles virus nucleoprotein mRNA in autopsied brain tissues.

By means of RT-PCR, a portion of measles virus (MV) mRNA encoding nucleoprotein (NP) could be detected in 11 (18%) of 61 brain tissue samples obtained from administrative autopsy cases, who apparently had not suffered from subacute sclerosing panencephalitis (SSPE)-like central nervous system disorders. Most of the brain-derived NP sequences showed significant asynonymous nucleotide substitutions when compared with wild-type MV isolates and SSPE virus. Our present results suggest that MV commonly persists in the human brain without causing apparent clinical symptoms, probably due to decreased virus replication.

Adolescent↗

Age-related morphometrical changes of arteries of uterine wall in mares.

To investigate the morphological changes of uterine wall arteries associated with the progression of age in Thoroughbred broodmares, uterine wall arteries from 13 mares, aged 2 to 31 years, were studied by routine histomorphometry. The ratio of intimal thickness to external diameter increased due to hyperplasia of elastic fibers and was significantly correlated with age (r = 0.95, P < 0.001). The ratio of medial thickness to external diameter decreased and was also significantly correlated with age (r = -0.84, P < 0.001). Using electron microscopy, it was determined that the cross-sectional area of the tunica media occupied by smooth muscle cells gradually decreased with increasing age. These results demonstrate that in arteries of the uterine wall in mares, hyperplasia of intimal elastic fiber and thinning of the medial smooth muscular layer is associated with aging, suggesting that aging may influence endometrial pathology.

Aging↗

Expression of vascular permeability factor (VPF/VEGF) messenger RNA by plasma cells: possible involvement in the development of edema in chronic inflammation.

Edema occurs in some types of chronic inflammation such as nasal polyps, uterine cervical polyps and gastric hyperplastic polyps. However, the factors or cellular components involved in the development of edema in chronic inflammation remain to be clarified. Recently, the gene encoding vascular permeability factor (VPF) or vascular endothelial growth factor (VEGF) and the genes encoding its receptors (kinase insert domain-containing receptor (KDR) and fms-like tyrosine kinase-1 [fit-1]) have been cloned. VPF/VEGF induces vascular hyperpermeability and vascular endothelial proliferation through KDR or fit-1 receptors. As there is a possibility that VPF/VEGF may play a role in the development of edema in chronic inflammation, we examined the messenger (m) RNA expression of VPF/VEGF and its receptors in nasal polyp tissues, which is an example of chronic inflammation with remarkable edema. Using northern blotting, all nasal polyp tissues examined expressed mRNA of VPF/VEGF and KDR. In situ hybridization revealed that VPF/VEGF mRNA-expressing cells were scattered in the edematous stroma of nasal polyps. In the adjacent sections, these cells showed the morphological features of plasma cells and expressed mRNA of immunoglobulin light chains. Human B cell leukemia and plasmacytoma cell lines expressed VPF/VEGF mRNA but human mast-cell leukemia and T cell leukemia cell lines did not. The alternatively spliced pattern of VPF/VEGF transcripts observed in nasal polyp tissues was consistent with that in plasmacytoma cell lines. Taken together, the VPF/VEGF mRNA-expressing cells in nasal polyps appeared to be plasma cells, suggesting that plasma cells may play an important role in the development of edema in chronic inflammation through the production of VPF/VEGF.

Base Sequence↗

Role of excitatory amino acid-mediated ionic fluxes in traumatic brain injury.

One major event taking place at the moment of traumatic brain injury in neuronal cells is the occurrence of massive ionic fluxes across the plasma membrane, which can be referred to as traumatic depolarization (TD). Unlike spreading depression, TD can occur over wide brain areas simultaneously. Furthermore, recovery from TD often takes far longer than recovery from ionic perturbation elicited by the passage of a single wave of spreading depression. Neuronal cell damage caused by ischemic brain injury is also initiated by massive ionic fluxes, termed anoxic depolarization. The occurrence of similar ionic events in these two forms of brain injury may account for the genesis of diffuse ischemia-like damage without actual episodes of hypoxia or ischemia in traumatic brain injury. We review the data indicating that excitatory amino acids (EAA) may play a vital role in producing TD, and that such EAA-mediated ionic perturbation is responsible for a number of posttraumatic events including subcellular metabolic dysfunction and cellular responses such as microglial activation and astrocytic transformation. TD may represent one of the most important mechanisms of diffuse neuronal cell dysfunction and damage associated with traumatic brain injury.

Animals↗

Suppression of plasma-activated factor VII levels by warfarin therapy.

To investigate the effect of warfarin treatment on the early phase of tissue factor-induced coagulation, we measured plasma-activated factor VII (factor VIIa) levels by a direct fluorogenic assay in 74 cardiovascular disease patients on long-term oral anticoagulation. We divided the patients into three groups based on the international normalized ratio (INR). In the patients with INR ranges of < 1.7 and 1.7 to 2.5, factor VIIa levels were 42% and 61% lower, respectively, than in age- and sex-matched controls. Factor VII coagulant activity (factor VIIc), factor VII antigen (factor VIIag), protein C, and factor X levels were also reduced to a similar extent in both groups. However, in patients with an INR > 2.5, the factor VIIa level was not decreased compared with that at an INR of 1.7 to 2.5, although the factor VIIc, factor VIIag, factor X, and protein C levels were all decreased further. Although the precise relation between the reduction of factor VIIa levels and the increase of INR requires appropriately designed long-term clinical trials, our data suggest that an INR range of 1.7 to 2.5 is sufficient for the suppression of factor VIIa. During the long-term follow-up of three patients with congenital antithrombin III or protein C deficiency, the factor VIIa level was more responsive to changes in the warfarin dose than the INR, and there were generally no corresponding changes of the thrombin-antithrombin III complex (TAT) level. However, one patient showed a transient marked increase of factor VIIa during the discontinuation of warfarin that was accompanied by an increase in TAT. Based on these findings, factor VIIa could be useful for monitoring both hypercoagulable and hypocoagulable states.

Adult↗

A new pharmacokinetic model including in vivo dissolution and gastrointestinal transit parameters.

When dissolution is the rate-limiting step in absorption of a drug, both it and gastrointestinal transit can play dominant roles in determining absorption. Therefore, a pharmacokinetic model including the process of dissolution, gastrointestinal transit rate and gastrointestinal pH profile was proposed to explain the behavior of drug formulations in vivo. Clarithromycin (CAM), which exhibits pH-dependent solubility and has high partition coefficients, was used as a drug to test the model, and the effect of a meal on serum concentrations of CAM after a single oral administration to healthy volunteers was evaluated. The results of pharmacokinetic analyses of serum concentration-time data for a single oral administration of CAM to humans in the fasting and postprandial states were well fitted by the new pharmacokinetic model. By substituting the pharmacokinetic parameters obtained into the model equations, the in vivo rate of dissolution could be determined. Pharmacokinetic parameters affecting drug bioavailability were also examined using the model. Factors influencing the behavior of a drug formulation in the gastrointestinal tract were determined. These findings indicate that the model we have proposed can be used to evaluate the behavior of drug formulations in vivo.

Clarithromycin↗

In vitro dissolution tests corresponding to the in vivo dissolution of clarithromycin tablets in the stomach and intestine.

The correlation between in vivo and in vitro dissolution of clarithromycin (CAM) tablets was examined. In vivo dissolution rate constants in the stomach and the intestine were obtained from analysis of the urinary excretion data of CAM following oral administration to humans in the fasting or postprandial state using a pharmacokinetic model including gastrointestinal transit. In the present study, the flow-through cell method with moderate agitation was used, as the in vitro dissolution test related to the in vivo dissolution rate constants. Both the effects of pH of the dissolution medium and the volumetric solvent flow rate on the dissolution rate in the flow-through cell method were examined. The pH of the dissolution medium and the flow rate were related to the in vitro dissolution rate. Therefore, the conditions of the flow-through cell method in correlation with the in vivo dissolution rates in the stomach and intestine were determined by controlling the flow rate at pH 3.0 and 6.8 dissolution medium. The urinary excretion of CAM, simulated by substituting the in vitro dissolution rate constants into the equation, were consistent with the in vivo data. The in vitro tests corresponding to the in vivo dissolution in the stomach and intestine following a single oral administration in the fasting or postprandial state for a CAM tablet were established.

Administration, Oral↗

Temporal thresholds of reperfusion in the middle cerebral artery occlusion model in rats.

In this study, the middle cerebral artery (MCA) of adult male Sprague-Dawley rats was occluded by the modified Koizumi method to determine the temporal thresholds of reperfusion for the treatment of cerebral embolism. Regional cerebral blood flow (rCBF) and pathological findings were measured at 1 and 2 h of ischemia and after 24 h and 7 days of reperfusion following 1 or 2 h of ischemia. rCBF was decreased the most (less than 10% of control CBF) in the parietal cortex (Pcor) and the lateral caudoputamen (Lcp) at both 1 and 2 h of ischemia. There was no significant difference in rCBF in these areas between the 2 ischemic groups. The 2 h ischemia group clearly showed infarction in the area perfused by the middle cerebral artery (including the Pcor and Lcp) after 24 h and 7 days of reperfusion, while the 1 h ischemia group showed only slight infarction. These findings suggest that temporal thresholds of reperfusion in this model exist between 1 and 2 h of ischemia, and that rCBF levels during ischemia and the duration of ischemia are the most important factors in producing brain infarction.

Animals↗

Non-cushingoid Cushing's syndrome due to adrenocorticotropic hormone-independent bilateral adrenocortical macronodular hyperplasia.

This case report describes a 68-year-old man with Cushing's syndrome due to adrenocorticotropic hormone (ACTH)-independent bilateral adrenocortical macronodular hyperplasia (AIMAH). He was referred to our hospital for evaluation of bilateral enlargement of the adrenal glands found incidentally by computed tomography (CT). He had a ten-year history of hypertension. Although he was normokalemic and did not show Cushingoid features, the diagnosis of ACTH-independent Cushing's syndrome was established by endocrinological examinations. His plasma cortisol showed no diurnal rhythm and was unsuppressible by high-dose (8 mg/day) dexamethasone. Plasma ACTH was undetectable and did not respond to corticotropin-releasing hormone. Excised adrenal glands were markedly enlarged (right 28 g and left 64 g). Macroscopic appearance of the glands showed multiple yellowish nodules typical for AIMAH; microscopic findings were also compatible with AIMAH. The present case indicates that patients with AIMAH sometimes do not show typical Cushingoid features and therefore AIMAH can be found incidentally from ultrasound or CT examination of the abdomen.

Adrenal Glands↗

Control of persistent hemiballismus by chronic thalamic stimulation. Report of two cases.

Persistent hemiballismus after stroke is often difficult to treat. The ballistic movement is sometimes so violent that progressive exhaustion results. The authors report two such cases, which were successfully treated by chronic thalamic stimulation. The lesions responsible for the ballistic movement in these patients were located near the subthalamic nucleus and in the putamen, respectively. The thalamic nucleus ventrolateralis and nucleus ventralis intermedius were stimulated with 0.2 to 0.3 msec pulses at 50 to 150 Hz and 4 to 7 V continuously during the day. Several weeks later, complete control of the hemiballismus was achieved during stimulation. The improvement was clearly not attributable to spontaneous recovery, because ballistic movement reappeared after termination of the stimulation. The stimulation has remained effective for more than 16 months in both cases without any serious complications. Chronic thalamic stimulation appears to be useful for controlling persistent hemiballismus, as it is for other involuntary movement disorders.

Electric Stimulation Therapy↗

Ectopic pituitary adenoma occurring in the interpeduncular cistern. Case report.

Intracranial ectopic pituitary adenoma occurs most frequently in the suprasellar cistern, usually in continuity with the pituitary stalk. Such tumors probably originate from cells of the pars tuberalis located above the diaphragma sellae or from aberrant anterior pituitary cells of the pituitary stalk. The authors report the case of a 37-year-old woman with Cushing's syndrome caused by an ectopic pituitary adenoma of unique location: the tumor was separate form the pituitary stalk and confined within the interpeduncular cistern. After surgical removal of the tumor, continued improvement in the patient's laboratory results and disappearance of her endocrine symptoms strongly indicated the absence of adenoma cells in the pituitary gland or stalk. The tumor in the present case appears to have arisen from aberrant pituitary cells that were present in the leptomeninges of the basal surface of the hypothalamus.

Adenoma↗

[Quality control of fine needle aspiration cytology of breast lesions].

From 1988 to 1993 we treated 1,310 cases of fine needle aspiration cytology of breast lesions. The results were positive for malignancy in 218, suspicious in 134, negative in 857, and inadequate specimen in 101. Histological examinations were performed in 461 cases; 243 malignancies and 218 benign lesions. The cytological diagnosis of these cases was positive in 211, suspicious in 91, negative in 142 and inadequate specimen in 17. The cytologic diagnosis of the cases of histological malignancy was positive in 198, suspicious in 24, negative in 17 and inadequate specimen in 4. Therefore we have 17 false negative cases. The histological diagnoses in these cases were scirrhous carcinoma (7), papillotubular carcinoma (6), invasive lobular carcinoma (2), mucinous carcinoma (1) and angiosarcoma (1). There were 13 cases of cytologically false positive cases; the histological diagnoses were fibroadenoma (4), mastopathy (4), papilloma (3), adenosis (1) and xanthogranuloma (1). For over six years, we have used a computer system incorporating both cytologic and histologic records. This system is very useful in quickly review the correlations of cytologic-histologic diagnoses. In addition to this system, a close relationship between clinical to pathological department is necessary in the quality control of diagnostic cytology.

Biopsy, Needle↗

[Influence of genetic factors on family history of upper urinary stones].

The family history between patients with upper urinary tract stones and healthy subjects was compared to evaluate the possible involvement of genetic factors in obtaining information through a questionnaire. The patients showed a significantly more marked history than the healthy subjects (p < 0.001). In particular, recurrent stone formers showed a significantly more marked history than single stone formers (p < 0.05). Compared with the healthy subjects, a more marked family history was observed in the parents, brothers and sisters, and children, but not in the spouse (p < 0.05-0.005). However, the family history was not affected by consanguineous marriage. A more marked family history was observed in patients with upper urinary tract stones, suggesting the involvement of genetic factors in the development of upper urinary tract stones. In particular, genetic factors seem to be more closely involved in recurrent stone formers.

Adult↗

[Mitral obstruction due to infective endocarditis: a case report].

Acute valvular obstruction caused by vegetation is a rare complication infective endocarditis. To our knowledge, only 9 cases and an autopsy case by Roberts have been reported since 1967. A 46-year-old man admitted with a chief complaint of pyrexia for 2 months duration. Within 24 hours of admission, the patient noticed of increased shortness of breath. Physical examination and the chest X-ray confirmed the pulmonary edema. An echocardiogram revealed a huge echogenic mass that was adherent to the mitral leaflet and obstructed the orifice completely. Soon after the patient fell into cardiogenic shock, an emergency mitral valve replacement was undertaken. At operation, multiple verrucae arising from the entire mitral leaflet was seen to occlude the orifice. The vegetation was excised and replaced with a # 25 Omnicarbon prosthesis. Postoperatively, the patient developed multiple organ failure caused by cardiogenic and septic shock which responded well to intensive medical treatment consisting of hemodialysis and continuous arteriovenous hemofiltration. Angiographically, a mycotic aneurysm in the left radial artery was found on the 18th postoperative day. After extirpation of the infective focuses, the postoperative course had stabilized. Mitral obstruction due to infective endocarditis is a fatal disease. Prompt diagnosis with echocardiogram and an emergency surgery should be undertaken to save the patient.

Endocarditis, Bacterial↗

[Recent progress in evaluation of glycemic control by glycated protein and 1,5-AG].

The aim of treatment of diabetes is to prevent the progress of diabetic complications. A recent report by the DCCT (Diabetes Control and Complications Trial) clearly shows the importance of strict glycemic control for prevention of diabetic complications. For this purpose, some markers for long-term glycemic control other than glucose concentration will be helpful, because glucose levels fluctuate too severely to assess whether they are precise. HbA1c is the longest established marker for glycemic control but still large interlaboratory variation is present. The standardized procedure for measurement of HbA1c was just proposed by the Japan Diabetes Society. Fructosamine is measured by a simpler procedure but many deoxidizing materials in serum especially superoxide may interfere with the reaction. Glycated albumin should be more reliable than fructosamine but a standard method of measurement has not been established yet. Future measurement of advanced glycation end product (AGE) should prove to be good marker for not only glycemic control but also diabetic complications or diagnosis of diabetes. The decrease in serum 1,5-anhydro-D-glucitol(1,5-AG) is very sensitive to urinary glucose excretion and may be useful as a marker of glycemic control and diagnosis of diabetes.

Biomarkers↗

[Early diagnosis and detection of successful reperfusion by mitochondrial-AST/soluble-AST ratio after acute myocardial infarction].

The change of mitochondria aspartate aminotransferase (m-AST)/soluble-AST (s-AST) ratio was examined in 22 cases of acute myocardial infarction (AMI). The m-AST/s-AST was 40.8 +/- 18.9% at admission to a hospital (2.9 +/- 1.6h). The m-AST/s-AST decreased to normal value rapidly after peak and then increased again gradually. The decrease ratio of m-AST/s-AST per minute at early stage of 8 cases, who were succeeded to reperfusion, was 0.28 +/- 0.20%, and that was significantly higher than of conventionally treated 7 cases and non-reperfused 7 cases (0.11 +/- 0.07%). These results indicated that (1) m-AST/s-AST may be an excellent indicator for AMI in early stage. (2) The decrease ratio of m-AST/s-AST would predict whether reperfusion is successful or not at an earlier stage of AMI.

Aged↗