[Pyruvate decarboxylase deficiency].
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Biomarkers↗
Biomedical subjects
Y Kuroda
Publications and source records attributed to Y Kuroda.
Total parenteral nutrition on energy metabolism in children undergoing autologous peripheral blood stem cell transplantation.
The resting energy expenditure (REE) and the respiratory quotient (RQ) were measured longitudinally using indirect calorimetry to examine the effects of total parenteral nutrition (TPN) on energy metabolism in children undergoing autologous peripheral blood stem cell transplantation (PBSCT). There were six children (two males and four females) and the age ranged from five to 13 years (median, eight yrs). The diagnosis included acute lymphocytic leukemia (ALL; 4), neuroblastoma (NBL; 1) and primitive neuroectodermal tumor (PNET; 1). TPN was started after the patients were stabilized following PBSCT (group A; n = 3) or before the initiation of high-dose cytoreductive chemotherapy (HCC) (group B; n = 3). Duration of HCC before PBSCT was identical between the two groups (six to eight days). Average total calorie and protein intake during HCC was significantly higher for group B than for group A. The %REE, the percentage of REE to the predicted basal energy expenditure (BEE), in group A showed 133 +/- 19%, 129 +/- 14% and 146 +/- 11% during three periods of HCC (days -8 to -1 of PBSCT), bone marrow suppression (days 0 to 11 of PBSCT) and bone marrow recovery (days 12 to 22 of PBSCT), respectively. In contrast, those in group B were 10% to 20% lower than those in group A at all periods. Carbohydrate oxidation rates during HCC in group A were significantly lower than those in group B, and those were not different between both groups during post-PBSCT periods. Fat oxidation rates in both groups were similar at all stages of periods. In contrast, protein degradation rates in group A were significantly higher than those in group B at all stages of the period. From these results, we concluded that commencement of TPN administration prior to HCC in the patients undergoing PBSCT provides beneficial effects to maintain better energy metabolic and nutritional status.
Adolescent↗
Management of continuous anastomosis of pancreatic duct and jejunal mucosa after pancreaticoduodenectomy: historical study of 300 patients.
BACKGROUND: Pancreaticojejunostomy is the most problematic anastomosis in the reconstruction after pancreaticoduodenectomy. In the past, much of the morbidity and mortality associated with this operation was related to problems with this anastomosis. Recent data, however, suggest that the use of duct-to-mucosa sutures has led to a marked drop in both morbidity and mortality associated with pancreaticojejunostomy. METHODS: Among the 300 patients who underwent pancreaticoduodenectomy, including pylorus-preserving pancreaticoduodenectomy, 87 patients underwent traditional pancreaticojejunostomy by invagination of the end of the pancreas into the bowel (group B). Recently three-layer anastomosis was created in 213 patients. The outer layer was created between the pancreatic capsule and the serosa of jejunum. The middle layer was created between the pancreatic parenchyma and the seromuscular wall of jejunum. The inner layer was placed between the pancreatic duct and a small opening in the antimesenteric border of the jejunal mucosa. Among the 213 patients, the inner anastomosis was created with interrupted absorbable sutures (group A1) in 93 patients and continuous absorbable sutures (group A2) in 120 patients. RESULTS: The three groups were similar with respect to age, gender, and primary disease. In the anastomosis, the incidence of leakage in group A2 (4.2%) was significantly less than in groups B (17.2%, p < 0.01) and A1 (11.8%, p < 0.05). The operative mortality rates were 3.2% in group A1, 1.7% in group A2, and 5.7% in group B. CONCLUSIONS: We recommend continuous anastomosis of the pancreatic duct and jejunal mucosa as a safe procedure after pancreaticoduodenectomy.
Adolescent↗
[Vitamin B1 dependency].
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3-Methyl-2-Oxobutanoate Dehydrogenase (Lipoamide)↗
[The long-term results of percutaneous isolated hepatic perfusion for patients with advanced hepatocellular carcinoma].
We studied the long-term outcome of percutaneous isolated hepatic perfusion (PIHP) for patients with hepatocellular carcinoma. This study included 31 patients with Stage IVA and 5 with IVB disease treated by PIHP until December, 1997. The mean age and tumor diameter were 55 and 7.7 cm, respectively. Twenty-two had portal vein invasion, 13 had hepatic vein invasion, and all patients had multiple intrahepatic metastases of more than 5 tumor foci. The PIHP with adriamycin or cisplatin was undertaken in a total of 50 treatments in these 36 patients. CR was observed in 6 and PR in 13 with an overall response rate of 59%, excluding 4 patients who were not evaluable. Five of 6 patients with CR remain free of disease at 7 to 54 months after the first treatment. The overall survival rate was 67% at 1 year and 32% at 5 years. The survival rates of Stage IVA patients (1-year = 71%, 5-year = 36%) were higher than Stage IVB patients (1-year = 20%, 5-year = 0%). The 5-year survival rates of patients with vascular invasion (Vp1-3 = 23%, Vv1-3 = 8%) were lower than those without it (Vp0 = 47%, Vv0 = 51%). These results indicated that PIHP achieved a 5-year survival rate of approximately 40% in patients with multiple advanced hepatocellular carcinoma in the absence of distant organ metastases and marked vascular invasion, and yielded complete long-term remission in some of these patients.
Antibiotics, Antineoplastic↗
[Experimental study on TNF-alpha linked percutaneous isolated hepatic chemoperfusion (PIHP)].
Recently, isolated hepatic perfusion (IHP) with high-dose TNF-alpha for hepatic malignancies has again attracted attention as a locoregional chemotherapy. A novel system of hepatic venous isolation and charcoal hemoperfusion (HVI.CHP) is a minimal invasive surgery for high-dose chemotherapy of the liver. This study was undertaken to determine whether this novel system could limit systemic exposure to TNF-alpha following hepatic arterial infusion (HAI) when combined with anti TNF-alpha antibody. Beagles were allocated into two groups; group I (n = 4), TNF-alpha + anti TNF-alpha antibody and group II (n = 5), TNF-alpha only (control). All animals received HAI of 50 micrograms/kg of recombinant human TNF-alpha over 20 min with complete hepatic venous isolation. In group I, 250 micrograms/kg of antibody was administered into the hepatic venous outflow line over 30 min after the initiation of HAI. The Cmax (ng/ml) of systemic TNF level was significantly lower in group I (125 +/- 57) than in group II (825 +/- 283) (p < 0.05). The AUC (mg.min/ml) of the systemic TNF level was significantly lower in group I (2.0 +/- 1.0) than in group II (34.5 +/- 9.5) (p < 0.01). By use of anti TNF antibody, systemic exposure to TNF was reduced efficiently. These results indicated that HVI.CHP may be applicable to the TNF-alpha linked chemoperfusion to the liver in combination with anti TNF-alpha antibody.
Animals↗
[Pharmacokinetic comparison between cisplatin and nedaplatin in hepatic arterial chemotherapy using complete hepatic venous isolation and charcoal hemoperfusion].
We undertook a pharmacokinetic comparison between cisplatin and nedaplatin in hepatic arterial chemotherapy using complete hepatic venous isolation and charcoal hemoperfusion (HVI.CHP). Dogs received a 20-min hepatic arterial infusion of either 4 mg/kg cisplatin (Group I, n = 5) or 4 mg/kg nedaplatin (Group II, n = 5) under HVI.CHP. The CHP filter adsorption ratios did not differ significantly between the two groups. Drug clearance fractions by HVI.CHP in group II (free pt 45.9%, total pt 55.1%) were significantly higher than those in group I (free pt 23.4%, total pt 27.5%) (p < 0.05). In contrast, hepatic extraction ratios in group I tended to be higher than those in group II. These results indicated that extrahepatic distribution of cisplatin became lower than that of nedaplatin, when given via the hepatic artery, and that the pharmacokinetic advantage of HVI.CHP would be greater when a drug like nedaplatin with a relatively low hepatic extraction ratio is used. Thus, we concluded that nedaplatin is a more suitable drug than cisplatin.
Animals↗
Peripheral blood stem cell mobilization with granulocyte colony-stimulating factor and a harvesting procedure in pediatric donors.
The safety of injecting healthy donors with granulocyte colony-stimulating factor (G-CSF) has not been established. To evaluate PBSC mobilization and harvesting efficacy in the pediatric population, we compared it with those in adult donors. In this study, we conclude that PBSC mobilization and harvesting protocol in normal pediatric donors can be performed safely and effectively. Considering the lower frequency of side-effects and WBC counts, and G-CSF kinetics, higher dose of G-CSF would be recommended when small children become donors for adult patients.
Adolescent↗
[A case of familial myoclonus showing extremely benign clinical course].
We report a patient with familial myoclonus showing an extremely benign clinical course. The patient was a 70-year-old woman, who first noticed shaking of hands at age of 25. The symptom did not worsen for more than 40 years. She visited our hospital at the age of 70 because of disturbance in chores because of worsening of her hand shaking in the past one year. A family history showed that 4 members had similar symptoms and that the two were afflicted with fits of loss of consciousness. On neurologic examination, rhythmic myoclonic jerks were noted in all the extremities, more in the upper limbs, both at rest and during action. Tandem gait was mildly disturbed. The remainings of neurologic examination were normal. SEP and jerk-locked back averaging provided evidence of cortical myoclonus. EEG showed multifocal polyspike discharges. Gene analysis for DRPLA, pyruvate and lactate levels in serum and the cerebrospinal fluid, serum amino acid levels, and CSF HVA and 5-HIAA levels were all normal. No brain atrophy was noted in cranial MRI. Myoclonus was markedly reduced after administration of clonazepam. The clinical features and electrophysiological data of our patient are consistent with the clinical diagnosis of familial essential myoclonus and epilepsy/benign adult familial myoclonic epilepsy.
Aged↗
L-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol stimulates ganglioside biosynthesis, neurite outgrowth and synapse formation in cultured cortical neurons, and ameliorates memory deficits in ischemic rats.
To address the role of brain gangliosides in synaptic plasticity, the synthetic ceramide analog, 1-phenyl-2-decanoylamino-3-morpholino-1-propanol (PDMP) was used to manipulate the biosynthesis of gangliosides in cultured cortical neurons. Spontaneous synchronized oscillatory activity of intracellular Ca2+ between the neurons, which represents synapse formation, was suppressed by the depletion of endogenous gangliosides by D-threo-PDMP, an inhibitor of glucosylceramide synthase. The decreased functional synapse formation was normalized by supplementation of GQ1b but not by the other gangliosides, suggesting that de novo synthesis of ganglioside GQ1b is essential for the synaptic activity (Mizutani A. et al., Biochem. Biophys. Res. Commun. 222, 494-498, 1996). On the other hand, the enantiomer of the inhibitor, L-threo-PDMP, could elevate cellular levels of glycosphingolipids including gangliosides. This paper presents our recent findings on the neurotrophic actions of L-threo-PDMP in vitro and in vivo. We found that L-PDMP could up-regulate neurite outgrowth, functional synapse formation and ganglioside biosynthesis through activating GM3, GD3 and GQ1b synthases. Simultaneously, the activity of p42 mitogen-activated protein kinase was also facilitated by L-PDMP. To evaluate the efficacy of this drug on long term memory, rats were trained for 2 weeks using an 8-arm radial maze task, and then forebrain ischemia was induced by 4-vessel occlusion (for 10 min x 2 with a 60 min interval). Repeated treatment of L-threo-PDMP (40 mg/kg, i.p. for 6 days, twice a day) starting 24 h after the ischemia, improved the deficit of the well-learned spatial memory, demonstrating the potential therapeutic use of the ceramide analog for treatment of neurodegenerative disorders.
Animals↗
Pathological changes in glandular stomach of Helicobacter pylori-infected Mongolian gerbil model.
We have established a Helicobacter pylori-infected Mongolian gerbil model, following Hirayama's method, to clarify gastric diseases associated with H. pylori infection. We administered the culture broth of H. pylori ATCC 43504 orally to 8-week-old male Mongolian gerbils. After H. pylori inoculation, the gerbils were fed in a vinyl isolator. Subsequently, over the course of 48 weeks, they were killed for histopathological examination, H. pylori culture, and serum antibody measurement. H. pylori colonization in the glandular stomach was seen in all the infected gerbils, but only a few H. pylori were detected histologically. The serum antibody titer in the H. pylori-inoculated group increased gradually in comparison with controls. Acute inflammation, immature epithelium, and erosion were observed 2 weeks after H. pylori infection. Chronic inflammation was noted from 4 weeks after H. pylori infection. We also found intestinal metaplasia and gastric ulcers from 12 and 24 weeks after inoculation, respectively. Some histological findings were similar to those in humans, but the chronic inflammation in the gerbils was present mainly in the deep mucosa and submucosa. This appears to be a good animal model for H. pylori-associated gastric diseases and it may be useful for investigating the pathogenesis of H. pylori infection.
Animals↗
Effect of pancreatic warm ischemia on islet yield and viability in dogs.
BACKGROUND: Defining tolerable warm ischemia (WI) is mandatory before nonheartbeating cadavers can be used to enlarge the donor pool. No studies to date have precisely evaluated the effect of pancreatic WI on islet yield and viability in a large animal model. METHODS: We used mongrel dogs in our study at the University of Minnesota. Excised pancreases were left in situ for a designated period (0, 30, 45, and 60 min in groups 1 to 4, respectively) of WI. Then, they were digested by the automated collagenase digestion method of Ricordi, purified on Euro-Ficoll discontinuous gradients with the COBE cell processor, and autotransplanted into the liver via a mesenteric vein. We compared the four groups in terms of islet yield, expressed as islet equivalents (IE; diameter standardizing to 150 microm) per pancreas weight (IE/g pancreas), and viability, assessed by functional success (maintenance of normoglycemia for 2 weeks) after transplant. RESULTS: Mean islet yield (+/- SD) and the functional success rate after transplant were as follows: 6200+/-1800 IE/g pancreas and 4 of 4 (100%) in group 1; 6300+/-4400 and 4 of 4 (100%) in group 2; 3800+/-2600 and 2 of 4 (50%) in group 3; and 1400+/-1300 and 0 of 4 (0%) in group 4 (P=0.01 vs. group 1). CONCLUSIONS: With 30 min or less of WI, there are no deleterious effects on islet yield and viability. However, with periods of WI longer than 30 min, the loss in islet yield is severe, resulting in functional failure after autotransplantation. The limit of WI that is tolerable for islets is shorter than for a whole pancreas.
Animals↗
Correlation between permeability-related glycoprotein expression and susceptibilty to oxygen radicals in vincristine-resistant hematologic cell lines.
This study was designed to test the correlation between the expression of permeability-related glycoprotein (P-GP) and susceptibility to oxygen radicals derived from the reaction of hypoxanthine (HX)-xanthine oxidase (XO) in wild type and vincristine (VCR)-resistant hematologic cell lines. A marked correlation between P-GP expression and susceptibility to oxygen radicals was found in VCR-resistant cells, while it was weak in wild cell lines. In contrast, there was neither correlation between sensitivity to VCR and oxygen radicals nor between sensitivity to VCR and P-GP expression in both wild type and VCR-resistant cells. No correlation between sensitivity to adriamycin or oxygen radicals and P-GP expression were observed in both cells tested. These results may suggest a new mechanism of drug resistance in cells expressing P-GP.
ATP Binding Cassette Transporter, Subfamily B, Mem↗
Serum thrombopoietin levels in patients receiving high-dose chemotherapy with support of purified peripheral blood CD34+ cells.
In a case control study, serum levels of thrombopoietin (TPO) were determined by a sandwich ELISA in 20 patients (median age, 7 years; range, 2-56 years) with various malignancies who received high-dose chemotherapy and a stem cell rescue operation. The patients received two different transplant modalities: (a) 12 patients received purified autologous peripheral blood CD34+ cells; and (b) 8 patients received cells in the CD34(-) fraction, which still contains many CD34+ cells. No significant differences were observed between the two groups with regard to the duration required to achieve an absolute granulocyte count of >0.5 x 10(9)/liter, the duration of dependence on platelet transfusion, or the number of platelet transfusions. In both groups, the serum TPO levels were inversely correlated with the circulating platelet count. Multivariate analysis demonstrated that significant determinants of the serum TPO level included the circulating platelet count (standardized regression coefficient = -0.5179), transplantation with cells in the CD34(-) fraction (0.2414), solid tumor (0.1420), and the age of the patient (-0.1236; r2 = 0.3021; P < 0.0001). These results suggest that the mode of stem cell support (ie., the presence of accessory cells in the inoculum), age, or the type of preceding chemotherapy affects serum TPO levels after transplantation.
Adolescent↗
Protection of canine pancreatic microvascular endothelium against cold ischemic injury during preservation by the two-layer method.
BACKGROUND: Ischemic injury of the microvascular endothelium during cold preservation causes a disturbance of vascular microcirculation after reperfusion and results in graft failure. Recently we have shown that oxygenation of the canine pancreas during preservation by the two-layer method extends the period of preserved pancreatic viability. The aim of this study was to clarify the role of the oxygenation of the pancreas graft by the two-layer method in the viability of the microvascular endothelium during preservation. METHODS: After preservation of the canine pancreas by simple cold storage in Euro-Collins solution (EC) (group 1) or by the two-layer method using EC (group 2) for 48 hr, the viability of vascular endothelial cells was judged from nuclear trypan blue uptake. Pancreatic tissue perfusions were measured with a hydrogen gas clearance technique, and graft survival rates were examined after autotransplantation. In the control group, the grafts were autotransplanted without preservation (group 3). RESULTS: Graft survival rates were 0 of 5 (0%), 5 of 5 (100%), and 5 of 5 (100%) in groups 1, 2, and 3, respectively. The percentage of trypan blue-positive vascular endothelium in group 1 was significantly higher compared with group 3 (control) (26.4+/-1.7 vs. 7.4+/-4.3%, P<0.01). The two-layer method (group 2) decreased trypan blue uptake (11.3+/-3.7 vs. 26.4+/-1.7%, P<0.01). Pancreatic tissue perfusions after 2 hr of reperfusion were in inverse proportion to trypan blue uptake. Namely, pancreatic tissue perfusions in group 1 were significantly lower than group 3 (control) (45.6+/-12.8 vs. 64.5+/-20.6 ml/min/100 g, P<0.01). The two-layer method (group 2) improved pancreatic tissue perfusions (68.8+/-8.6 vs. 45.6+/-12.8 ml/min/100 g, P<0.01). CONCLUSION: We conclude that oxygenation of the pancreas during preservation by the two-layer method protects the microvascular endothelium from cold ischemic injury. Consequently, pancreatic microcirculation can be maintained after reperfusion, thus extending the period of preserved pancreatic viability.
Animals↗
Up-regulation of ganglioside biosynthesis, functional synapse formation, and memory retention by a synthetic ceramide analog (L-PDMP).
To address the role of brain gangliosides in synaptic activity, the ceramide analogs, D-threo-1-phenyl-2-decanoylamino-3-morpholino-1-propanol (D-PDMP) and its enantiomer, L-PDMP, were used to inhibit and stimulate ganglioside biosynthesis in cultured cortical neurons. Prolonged treatment with both PDMP isomers exhibited opposite effects on functional synapse formation measured by spontaneous synchronized oscillatory activity of intracellular Ca2+ between the neurons: suppression by D-PDMP and facilitation by L-PDMP. Up-regulation of synaptic activity by L-PDMP could be correlated with the slow but robust stimulation of ganglioside biosynthesis through activating GM3, GD3 and GQ1b synthases. In a similar time course, the activity of p42 mitogen-activated protein kinase was also enhanced by L-PDMP. To evaluate the efficacy of this drug in long-term memory, rats were trained for 2 weeks using an 8-arm radial maze task, and then forebrain ischemia was induced by 4-vessel occlusion. Treatment with L-PDMP starting 24 hours after the transient ischemia ameliorated the deficit of a well-learned spatial memory, demonstrating the potential therapeutic intervention of the ceramide analog for neurodegenerative disorders.
Animals↗
8-cyclopentyltheophylline, an adenosine A1 receptor antagonist, inhibits the reversal of long-term potentiation in hippocampal CA1 neurons.
The effects of an adenosine A1 receptor antagonist, 8-cyclopentyltheophylline (8-CPT, 1 microM), on the reduction of long-term potentiation were studied in CA1 neurons of guinea pig hippocampal slices. Reduction of long-term potentiation (depotentiation) was achieved by delivering a train of low-frequency afferent stimuli (low-frequency stimulation, 1000 pulses, 1 Hz) 20 min after the tetanus (100 Hz, 100 pulses). In control experiments, low-frequency stimulation reduced the potentiated component of the slope of the field EPSP and the amplitude of the population spike by 68.5 +/- 14.4% and 80.1 +/- 8.8%, respectively (n = 6); these values were significantly reduced to 13.4 +/- 9.7% and 9.0 +/- 10.9% (n = 7) when the low-frequency stimulation was applied during the perfusion with 8-CPT (1 microM). These results indicate that activation of adenosine A1 receptors enhances the depotentiation of long-term potentiation.
Animals↗