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Biomedical subjects

Y Mizuno

Publications and source records attributed to Y Mizuno.

At least 307 records · Page 17Linked to original sources
PubMed1997

Study of needlestick accidents and hepatitis C virus infection in healthcare workers by molecular evolutionary analysis.

In the five-year period between 1989 and 1993, 87 needlestick accidents occurred among healthcare workers at our hospital. Thirty-seven (43%) of these needlestick accidents involved blood contaminated with hepatitis C virus (HCV), and two of them (5.4%) led to the occurrence of hepatitis C infection. Case 1 was a 43-year-old nurse who was accidentally injured by a needle contaminated with blood from a patient who had cirrhosis and hepatocellular carcinoma due to hepatitis C. Acute hepatitis C occurred after five weeks and HCV RNA was positive after eight weeks. Case 2 was a 33-year-old nurse who was injured by a needle contaminated with blood from a patient who had chronic hepatitis C. Liver function was normal at 11 days after the accident. However, hepatitis C was diagnosed 21 months later after she had successfully given birth to her baby. The nucleotide sequence of the HCV E2/NS1 region was determined in the two patients and the needlestick victims, and phylogenetic trees were constructed by molecular evolutionary analysis. On the basis of these trees, transmission of HCV could be confirmed in both cases. This method of analysis may be useful for confirming the transmission of HCV even long after the event.

Adult↗
PubMed1997

Effects of angiotensin-converting enzyme inhibitor on plasma B-type natriuretic peptide levels in patients with acute myocardial infarction.

BACKGROUND: Plasma levels of B-type natriuretic peptide (BNP) are markedly increased in patients with heart failure and acute myocardial infarction. The changes in plasma BNP levels in the treatment of acute myocardial infarction with angiotensin-converting enzyme inhibitors have not been examined well. This study was designed to examine the effects of early angiotensin-converting enzyme inhibitor therapy on plasma BNP levels in patients with acute myocardial infarction. METHODS AND RESULTS: We measured the plasma levels of B-type natriuretic peptide over the time course for 2 weeks in 30 patients with acute myocardial infarction in whom either imidapril (n = 15) or placebo (n = 15) was given at random immediately after admission. Plasma BNP levels increased and reached a peak of 192 +/- 28 pg/ML 16 hours after administration; thereafter, the levels decreased and then again increased, forming the second peak of 217 +/- 38 pg/ML on the fifth day (biphasic pattern). On the other hand, plasma BNP levels increased and reached a peak level of 190 +/- 22 pg/ML 16 hours after admission and then decreased from 2 days after admission until the second week in the imidapril group (monophasic pattern). Left ventricular ejection fraction measured in the second week was significantly higher in the imidapril group than in the control group (62.2 +/- 1.1% vs 51.2 +/- 3.6%, P < .01). CONCLUSION: It is concluded that plasma BNP levels followed a monophasic pattern after imidapril treatment, whereas a biphasic pattern was followed after placebo, and that plasma BNP levels constitute a marker of ventricular dysfunction in the treatment of acute myocardial infarction with angiotensin-converting enzyme inhibitors.

Adult↗
PubMed1997

Patient with primary tonsillar and gastric syphilis.

A male patient with syphilitic lesions in the tonsil and stomach is presented. The patient was infected while practising oral sex with heterosexual friends. He complained of nausea and snoring; his left tonsil was enlarged. Spirochetes were detected in a smear preparation from the left tonsil. As a gastric lesion, initially believed to be cancer, appeared to result from spirochete ingestion, the case is considered to represent primary syphilis. After antibiotic therapy with ampicillin, the left tonsil returned to normal size and gastric changes were no longer evident endoscopically. Gastroscopy should be considered if syphilis of the tonsil is observed, particularly when gastrointestinal symptoms are present. Both the oral and the gastric lesion can be mistaken for malignant neoplasm.

Adult↗
PubMed1997

Relationships of subunits of type-1 serine/threonine protein phosphatase to morphology and aggregation of B cells.

To elucidate the roles of serine/threonine protein phosphatases PP1 and PP2A in the morphological changes of B-lymphocytes during development and in immune responses, we investigated alterations of protein levels of catalytic subunits of PP1 and PP2A and regulatory subunits of PP1 including M130/M133, inhibitor-1 (I-1) and inhibitor-2 (I-2) in B-cell lines at different maturational stages and during their aggregation induced by phorbol myristate acetate (PMA). The protein levels of PP1delta and/or M130/M133 were significantly lower in B-cell lines without pseudopods, WEHI-231, BAL-17, Daudi, and CESS, than in those with pseudopods, Bcl.1, A20, M12, and SKW6.4, whereas the amounts of PP1alpha and PP2A were similar among them. During aggregation of A20 and CESS cells induced by PMA, an activator of PKC, the amount of PP1delta was progressively decreased, and this decrease was blocked by H7, an inhibitor of PKC. The amount of PP1alpha was constant under these conditions. Okadaic acid, an inhibitor of PP1 and PP2A, also induced aggregation of A20 cells at concentrations sufficient to inhibit PP1, but not at lower concentrations that inhibit PP2A alone. These results suggest that myosin light chain phosphatase composed of PP1delta and M130/M133 is involved in the maintenance and regulation of cytoskeletal structures in B-lymphocytes.

Animals↗
PubMed1997

Alterations in type-1 serine/threonine protein phosphatase PP1alpha in response to B-cell receptor stimulation.

In response to stimulation of B-cells through cell surface IgM, the activity of the serine/threonine protein phosphatase PP1, but not PP2A, was transiently decreased and reached a minimum 10-20 min after the stimulation. The decrease was more profound in the immature B-cell line WEHI-231, than in the mature B-cell line BAL-17. Under these conditions, PP1alpha, an isoform of PP1, showed unique alterations in the patterns of several spots with distinct isoelectic points in the Western blot after two-dimensional electrophoresis, whereas another isoform, PP1delta, did not show any alteration. PP1gamma1 and PP1gamma2 were not detected in B-cells. Similar alterations in these spots were observed in B-cells stimulated by PMA. When partially purified PP1 consisting of PP1alpha and PP1delta was incubated with [gamma-32P]ATP and PKC, radioactive spots of PP1alpha could be detected, but no spot of PP1delta was detected. Because differences in sequence among PP1 isoforms are mostly restricted to their C-terminals, phosphorylation rates of the C-terminal peptides containing the PKC-phosphorylation motif were compared. The C-terminal peptide of PP1alpha is a better substrate for PKC than those of PP1gamma1 and PP1gamma2, and is phosphorylated at the serine residue corresponding to Ser-325 of PP1alpha. The corresponding C-terminal region of PP1delta does not contain the phosphorylation site. On the other hand, there was a large difference in subcellular distribution of PP1delta, but not PP1alpha, between immature and mature B-cells. From these results, it was strongly suggested that PP1alpha is involved, via phosphorylation by PKC, in the regulation of signal transduction in response to the stimulation of B-cells through cell surface IgM.

Amino Acid Sequence↗
PubMed1997

Resources, stigma, and patterns of disclosure in rural women with HIV infection.

A growing number of cases of HIV infection are being diagnosed in rural communities especially among women. Although HIV-specific education and care delivery programs have been focused on rural areas in recent years, limited data are available on the impact of such initiatives on the lives of women with HIV infection. The purpose of this study was to examine characteristics of women with HIV disease living in rural communities. The study used a cross-sectional sample of rural women in Georgia. Data analysis indicated that although a majority of the women reported adequate resources, there was a group of women for whom resources for basic needs were not always adequate. Additionally, women with HIV who had not progressed to AIDS had greater difficulty in obtaining a number of resources. Almost half of the women felt stigmatized due to having HIV. Yet, a high percentage of these women had disclosed their HIV status to health care workers, sexual partners, and family. Study results provide insight into the needs of HIV-infected rural women from their perspective. This information can be important to nurses working in public health and community settings as they face the challenge of developing effective health care services for this population.

Adolescent↗
PubMed1997

[The basics for establishing a needlestick injury prevention program in hospitals].

Although the risk of occupationally acquired infection is a matter of considerable concern for health care workers, the problem of needlestick injuries has yet to be fully understood in Japan. We investigated 257 cases of needlestick injuries in five Nagoya Municipal Hospitals from 1989 to 1994 using the Japan EPInet. The number of needlestick injuries increased each year of the study. In one of these hospitals, the Higashi Municipal Hospital, a specialist committee began activities in April, 1993, and protective equipment and devices were also introduced during 1994. HCV contamination injuries accounted for 70%-80% of the total number of injuries reported during the 1991-1994 period at the four hospitals and during 1991-1992 period at the Higashi Municipal Hospital. At the Higashi Municipal Hospital, HCV contamination injuries decreased from 22 cases (48%) in 1993, to 15 cases (25%) in 1994. The use of the Japanese EPINet for analytical purposes enabled us to clearly identify the causes and status of needlestick injuries, resulting in the establishment of an effective prevention program.

Female↗
PubMed1997

Nine-year follow-up study of bromocriptine monotherapy for Parkinson's disease.

A 9-year nationwide study of bromocriptine monotherapy and combination therapy with bromocriptine and levodopa in Parkinson's disease is reported. Eleven patients were on bromocriptine monotherapy, 35 patients were on combined treatment of bromocriptine and levodopa for a certain time during a 9-year period. Maintenance doses of bromocriptine at the end of the 9th year in the two groups were 11.1 mg/day in the monotherapy and 12.7 mg/day in the combination therapy group with levodopa. Changes in Hoehn and Yahr's grading between the time of trial start and the end of 108 months' treatment revealed that 5 of 11 cases in the monotherapy group remained in the same stages, the other 2 cases improved in condition from stage II to I, and another 4 deteriorated compared with pretreatment grade. On the other hand, 20 of 35 cases in the combination-therapy group reached more advanced stages, 3 patients moving to stage V. Four of them, however, improved, and 11 did not change at the end of 9 years of treatment. Although it is difficult to prove the neuroprotective effect of a dopamine receptor agonist, our long-term nation-wide collaborative studies will help us to answer the question of how bromocriptine works in pharmacokinetic aspects.

Aged↗
PubMed1997

Nationwide multicenter prospective study on the long-term effects of bromocriptine for Parkinson's disease. Final report of a ten-year follow-up.

A 10-year nationwide multicenter prospective study on the long-term efficacy of bromocriptine for Parkinson's disease is reported. Six patients remained on bromocriptine monotherapy for 10 years, while 22 patients achieved good disease control with bromocriptine plus levodopa (added during the course of the study). In the 6 patients on bromocriptine alone, the disease remained in Hoehn and Yahr stage I or II for 10 years. In the other 22 patients on bromocriptine plus levodopa therapy, disease progression was very slow for 7-8 years. None of the 6 patients remaining on bromocriptine monotherapy experienced adverse reactions like the wearing-off phenomenon, dyskinesia, or the on-off phenomenon. Among the 22 patients who started levodopa therapy during the course of the study, these adverse reactions to levodopa were infrequent (10, 3, and 3 patients, respectively). Thus, early introduction and long continuation of bromocriptine therapy with restricted concomitant use of levodopa may have led to very slow disease progression and the suppression of adverse reactions. Although the patients who could be maintained long-term on bromocriptine monotherapy might represent a population who have very slowly progressive disease, their adequate disease control and the low incidence of adverse reactions in the patients who later started concomitant levodopa suggest that the unwanted effects of levodopa may be reduced by early and sustained treatment with bromocriptine. Introduction of bromocriptine monotherapy at an early stage of Parkinson's disease or with restricted use of additional levodopa therapy to bromocriptine when necessary may be a useful strategy for achieving adequate and sustained disease control.

Aged↗
PubMed1997

Mn SOD activity and protein in a patient with chromosome 6-linked autosomal recessive parkinsonism in comparison with Parkinson's disease and control.

We report Mn superoxide dismutase (SOD) protein and activity in a patient with familial autosomal recessive Lewy body-negative parkinsonism in comparison with patients with sporadic Parkinson's disease (PD) and controls. We recently proved linkage of this family with markers of chromosome 6 at 6q25.2-27, which included the Mn SOD gene. We used a novel polymorphic mutation at -9 position of the signal peptide of the Mn SOD precursor protein, which caused valine to alanine substitution. All the affected members of this family showed homozygosity for alanine, whereas nonaffected members, sporadic PD patients, and the control subjects studied showed either heterozygosity of alanine and valine or homozygosity of valine. The Mn SOD activity of this familial patient was the highest among the PD patients and the control subjects studied, and an abundant expression of Mn SOD was found in the substantia nigra. The molecular weight of Mn SOD protein by Western blotting of this patient was essentially similar to that of PD patients and the control subjects. High Mn SOD activity may constitute a genetic risk factor in this familial patient. The difference in the signal peptide sequence may affect the expression of Mn SOD within mitochondria; however, it is unlikely that loss of function type Mn SOD mutation is the cause of this familial parkinsonism. Mn SOD in sporadic PD patients was similar to that in controls.

Adult↗
PubMed1997

Cerebellin and cerebellin mRNA in the human brain, adrenal glands and the tumour tissues of adrenal tumour, ganglioneuroblastoma and neuroblastoma.

The expression of cerebellin and cerebellin mRNA was studied by radioimmunoassay and Northern blot analysis in the human brain, adrenal gland and the tumour tissues of adrenal tumour, ganglioneuroblastoma and neuroblastoma. Immunoreactive cerebellin was detected in every region of brain studied, with the highest concentrations found in the hemisphere of the cerebellum (424.2 +/- 12.6 pmol/g wet weight, n = 6, mean +/- S.E.M.) and the vermis of the cerebellum (256.8 +/- 30.5 pmol/g wet weight). Immunoreactive cerebellin was also detected in the pituitary (8.2 +/- 1.8 pmol/g wet weight), the spinal cord (3.3 +/- 0.3 pmol/g wet weight) and the normal parts of adrenal glands (2.98 +/- 0.37 pmol/g wet weight, n = 9) and some tumour tissues, such as phaeochromocytomas, cortisol-producing adrenocortical adenomas, ganglioneuroblastomas and neuroblastomas. Northern blot analysis showed that cerebellin mRNA was highly expressed in the hemisphere and vermis of the cerebellum. Cerebellin mRNA was also expressed in other regions of the brain and the tumour tissues of phaeochromocytoma, cortisol-producing adrenocortical adenoma, ganglioneuroblastoma and neuroblastoma. Immunocytochemistry of the normal adrenal gland showed that immunoreactive cerebellin was localized in the adrenal medulla. The present study has shown the expression of cerebellin and cerebellin mRNA, not only in the cerebellum but also in other regions of the brain and some tumours, such as cortisol-producing adrenocortical adenoma, phaeochromocytoma and neuroblastoma. These findings suggest possible pathophysiological roles of cerebellin peptides, not only in the cerebellum, but also in the extra-cerebellar tissues.

Adenoma↗
PubMed1997

Mortality associated with selegiline in Parkinson's disease. What do the available data mean?

A recent study by the Parkinson's Disease Research Group of the United Kingdom revealed higher mortality in patients with Parkinson's disease who were treated with selegiline (deprenyl) compared with those who were not. In this article, the methodological limitations of the UK study are discussed. Although several problems exist with this study, the mortality rate was correct, since the data were obtained from a verifiable source. The question then is whether or not the higher mortality rate can be ascribed to selegiline. It is difficult to find answers to this question in the study data, and we will have to wait for the study authors' final report. No other studies have reported higher mortality with selegiline. However, when prescribing selegiline in patients with early-stage Parkinson's disease, it is important to provide them with all the available information so that treatment decisions can be made jointly. Meanwhile, the best indication for selegiline appears to be motor fluctuations in patients with moderately advanced Parkinson's disease.

Antiparkinson Agents↗
PubMed1997

[Randomized prospective trial of gentian violet with dibutyryl cAMP and povidone-iodine with sugar as treatment for pressure sores infected with methicillin-resistant Staphylococcus aureus in elderly patients].

A randomized prospective study was done to evaluate the two treatments for pressure sores infected with methicillin-resistant Staphylococcus aureus in elderly patients: Gentian violet plus dibutyryl cAMP (GVcAMP, n = 8) and povidone-iodine plus sugar (IS, n = 11). Age, underlying diseases, and nutritional status did not differ between the two groups. Specimens were obtained biweekly from the pressure sores and were cultured. The percentage of culture dishes with no methicillin-resistant S. aureus was 93% for the patients given GVcAMP, but only 74% for those given IS (p < 0.01). By the 14th week after the start of treatment, the mean area of the pressure sores in the GVcAMP group had decreased to 45% of the area at the start of treatment. In the IS group, the decrease was smaller to 56% of the area before treatment. No local or systemic adverse effects occurred in either group. GVcAMP is useful to treat pressure sores infected with methicillin-resistant S. aureus.

Aged↗
PubMed1997

Diagnostic Brachial Coronary Arteriography Using a Power-Assisted Injector and 4 French Catheters with New Shapes.

BACKGROUND: Right brachial access in diagnostic coronary arteriography (CAG) has demonstrated advantages over femoral approaches, including earlier ambulation and more predictable hemostasis, particularly when small diameter catheters were used. Poor results from some earlier reports of brachial CAG have been due partially to the need to use large diameter catheters for positional control. Technical advances in catheters and contrast injection may increase the utility of brachial access CAG. PURPOSE AND STUDY DESIGN: We evaluated three 4 French (Fr) catheters with new shapes and with a large internal to external diameter ratio that were designed to overcome previous limitations to brachial CAG. Contrast agent was delivered with a novel power injector (CAG-20) intended for arteriography using small catheters. Routine right brachial access CAG and left ventriculography (LVG) were evaluated in 2663 (69%) of 3880 consecutive patients admitted for examination from 1991 to 1995. The study population included 128 patients (5%) with left main trunk disease, 819 (21%) with old myocardial infarctions and 1747 (66%) with more than one vessel disease. For this trial, 1217 patients with valvular disease, ischemia associated with aortic or peripheral vascular disease, congenital cardiac disease and post-surgical and emergency catheterization were excluded because femoral access or a larger catheter (> 4 Fr) were required in those cases. RESULTS: A total of 2573 (97%) diagnostic quality CAG (> grade 3/5) were obtained solely with 4 Fr catheters placed via the right brachial artery. Of the other 66 examinations, 50 were completed through the brachial route but with alternate size or shape catheters and 16 cases required the femoral JudkinÕs technique. Useful LVG (> grade 2/4) were obtained from 2604 patients (98%). Overall, 2536 (95%) of cases provided clinically valuable images for both CAG and LVG from brachial access. We experienced one semi-emergency bypass operation and one emergency stent implantation caused by coronary dissection. There were no deaths, acute myocardial infarctions, loss of pulse or nerve injuries. CONCLUSION: Power-injector assisted, brachial 4 Fr CAG and LVG proved to be safe and cost-effective. Brachial access has the potential to become a routine method for out-patient cardiac opacification.

Journal Article↗
PubMed1997

[Thoracoscopic surgery for pneumothorax with bullous emphysema in an elderly patient: a case report].

Recent advances in optical and endoscopic operating instruments have made thoracoscopic surgery easier. The authors report the case of an 83-year-old patient who was referred to our hospital for right spontaneous pneumothorax associated with severe bullous emphysema. Chest X-ray films showed 40% collapse of right lung and the right spontaneous pneumothorax was treated by chest tube drainage for 3 weeks. However air leak was not decreased and subcutaneous emphysema appeared. Chest computerized tomography revealed multiple bullae. Thoracoscopic surgery was performed because of preservation of the respiratory function. The ruptured bulla was resected by using ENDO GIA and the other multiple bullae were resected similarly in order to improve the pulmonary function. A surgical drain was removed on the 14th postoperative day because of a little air leak continuing. His postoperative course was uneventful after removal of the chest drain. He was discharged on 27th postoperative day and had no shortness of breath in daily life. From our experience, thoracoscopic surgery appears to be much better than thoracotomy for spontaneous pneumothorax because of much less postoperative disability and preservation of respiratory function.

Aged↗
PubMed1997

[Concept and diagnostic criteria of Parkinson's disease and parkinsonism].

Parkinson's disease (PD) is defined as a neurodegenerative disorder characterized pathologically by degeneration of substantia nigra and locus coeruleus with Lewy bodies in the remaining neurons and clinically by resting tremor, cogwheel rigidity, bradykinesia and loss of postural reflex. Parkinsonism may be defined as those who show at lest two of the major four features characterizing PD. We propose the following diagnostic criteria for PD, i.e., clinical criteria (resting tremor or at least two of the remaining cardinal features of PD), treatment criteria (good response to anti-parkinson drugs), image criteria (essentially normal cerebral MRI), and exclusion criteria (no history of encephalitis or exposure to parkinsonism-inducing substances or drugs). Patients must fulfil all four criteria for the diagnosis.

Humans↗