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Biomedical subjects

H Fusamoto

Publications and source records attributed to H Fusamoto.

At least 163 records · Page 9Linked to original sources

Two-dimensional computer color graphics of gastric mucosal blood distribution in normal subjects and ulcer patients.

The mucosal blood volume in 20 to 24 different regions of stomach was estimated by reflectance spectrophotometry during endoscopy, and an image showing mucosal blood distribution was made by two-dimensional computer color graphics with the aid of a personal computer. In 55 normal controls, the estimated mucosal blood volume (EMBV) was greater in the corpus mucosa than in the antral mucosa, and less in the lesser curvature than in the greater curvature. The volume in the anterior and posterior walls was almost the same. In 15 patients with active gastric ulcers in the angular region, the EMBV was decreased in all regions in the stomach. In 37 patients with healing ulcers, the EMBV increased, resuming the same levels as in normal controls. However, the EMBV around the ulcer increased remarkably at this stage. In 35 patients with ulcers in the scarring stage, the distribution of the EMBV was similar to that in the normal controls. These hemodynamic changes were shown clearly in a color display with the aid of a personal computer. This method could offer new possibilities in endoscopic research.

Adult↗

Renal kinin and kallikrein excretion in cirrhotic patients.

Urinary kinin and urinary kallikrein activity were measured in 33 liver cirrhotics, and the values were correlated with the severity of the liver disease. A significant relationship was observed between urinary kinin excretion and urinary kallikrein excretion (r = 0.53; p less than 0.01). Both urinary kinin and kallikrein excretion were significantly lower in Child's group C than in Child's groups A and B (p less than 0.05) and showed positive correlations with serum albumin (r = 0.47, p less than 0.01 and r = 0.46, p less than 0.01, respectively). Increases in urinary kinin and kallikrein excretion after endoscopic variceal sclerotherapy were observed in 18 patients (p less than 0.01 and p less than 0.05, respectively). These results suggest that the renal kallikrein-kinin system in suppressed in severe liver disease in proportion to the severity of the underlying liver disease. In this study possible activation of this system after sclerotherapy was also demonstrated.

Esophageal and Gastric Varices↗

Obesity and liver disease: evaluation of fatty infiltration of the liver using ultrasonic attenuation.

We developed an in vivo ultrasonic attenuation measurement system with which we attempted to evaluate the degree of fatty infiltration in the liver. In an animal study, fatty liver was induced in rabbits, and ultrasonic radiofrequency waveforms from the liver were obtained using a 10 MHz A mode transducer. Frequency-dependent attenuation of the ultrasound, which was correlated with total lipid content, was calculated using a spectral difference method. In a human study, ultrasonic waveforms were obtained using a 3.5 MHz transducer. Frequency-dependent attenuation also showed a significant correlation with the grading of fatty infiltration of the liver. These results suggested that fatty infiltration of the liver could be evaluated quantitatively and noninvasively using frequency-dependent attenuation of the ultrasound.

Animals↗

Organ assimilation of peptides.

Dipeptides injected intravenously or added to liver perfusion medium were hydrolyzed rapidly to amino acids. The clearance volumes per min of plasma Gly-Phe and Gly-Lys were 63% and 224%, respectively, of the total plasma volume. These values far exceed the blood flow in any single organ, suggesting that several organs must be involved in peptide assimilation. Intravenous administration of peptides increased the levels of their constituent amino acids in organs. Two possible explanations for this were assimilation of the peptides by the organs, and transport into the organs of the amino acids generated by extracellular hydrolysis of the peptides. The former possibility was tested by eliminating plasma lysine by enzymic degradation, so that the amino acid would accumulate only in the organs that assimilate lysine-containing peptides. Results showed that all organs tested, except the brain, had an intrinsic ability to assimilate peptides.

Animals↗

[Detection of hepatitis C virus RNA in serum during treatment of chronic hepatitis C with interferon alpha].

We estimated HCV RNA in serum of 20 patients with chronic hepatitis C during interferon therapy using a combination assay of reverse transcription and polymerase chain reaction (RT-PCR). RNA was extracted from 200 microliters of serum. The primers were chosen from the NS3 region of prototype HCV RNA sequence. After 40 cycles of PCR, the products were analyzed by Southern hybridization. HCV RNA was detected in 18 of 20 (90%) patients before therapy. In cases with improvement of serum GPT level, HCV RNA became undetectable at 4 weeks of the therapy. However, HCV RNA reappeared within 4 weeks after the therapy in cases with relapse. In the no response group, HCV RNA did not disappear during the therapy. Interferon therapy is beneficial in improvement of viremia of HCV, and the detection of HCV RNA in serum is useful to evaluate the antiviral effect of interferon.

Adult↗

Cepstral analysis of ultrasound in chronic liver disease--a preliminary study in the non-invasive evaluation of structural change.

To evaluate the morphological changes in chronic liver disease non-invasively we used the frequency-domain analysis of ultrasound. We assumed that liver tissue is a collection of semi-regularly arrayed small scatterers of ultrasound. We applied cepstral analysis to ultrasonic waveforms and evaluated the periodicity of scalloping of the power spectrum, caused by an interference effect among liver scatterers of a given spacing. In a phantom experiment, we could correctly measure the space among scatterers of a phantom consisting of a regularly spaced distribution of nylon filaments. In an experiment involving a freshly excised porcine liver, the distribution of the space among scatterers (SAS) determined on cepstral analysis reflected the size distribution of the hepatic lobules. In a human study, two statistical parameters, mode and kurtosis, were determined from the distribution of the SAS for each patient. In a previous study, we collected ultrasonic data during peritoneoscopy with a 10 MHz transducer directly contacting the liver and showed that we could evaluate morphological changes in chronic liver disease using cepstral analysis. In the present study, we obtained data in two ways: with a 3.5 MHz transducer through the abdominal wall and with a 10 MHz transducer directly contacting the liver during peritoneoscopy. The mode and kurtosis of the SAS obtained with the 3.5 MHz transducer were both well correlated with the mode and kurtosis of the SAS obtained with the 10 MHz transducer. These results suggest that we can evaluate morphological changes in chronic liver disease non-invasively.

Animals↗

Expression of X protein and hepatitis B virus replication in chronic hepatitis.

The X protein can act on the enhancer of hepatitis B virus in an in vitro system and elevate the transcriptional level of hepatitis B virus. However, because no relationship had been reported between X protein expression and hepatitis B virus replication in patients with chronic hepatitis B, we focused on its expression in the liver in comparison with markers of hepatitis B virus replication. Liver biopsy samples and sera from 59 carriers with HBsAg were examined immunohistochemically for X protein using rabbit IgG against recombinant X protein. There was a significant difference in the serum hepatitis B virus DNA level between X protein-positive and -negative patients (p less than 0.001). Serum pre-S1 and pre-S2 antigens were also measured quantitatively by enzyme immunoassay using monoclonal antibodies specific against each antigen. The titers of pre-S1 antigen in patients positive for X protein were significantly higher (p less than 0.001) than those of the X protein-negative patients (3.02 +/- 0.99 vs. 2.00 +/- 0.59, respectively). Similarly, the titers of pre-S2 antigen were 2.98 +/- 0.91 vs. 1.94 +/- 0.54, respectively (p less than 0.001). The rate of positivity of the X protein was higher (38 of 49; 77.6%) in the replicative group (serum HBeAg, serum hepatitis B virus DNA or HBcAg in liver positive) compared with that observed in the nonreplicative group (3 of 10; 30%--serum HBeAg, serum hepatitis B virus DNA and HBcAg in liver negative) (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A clinical study of acute gastrointestinal hemorrhage associated with various shock states.

Gastrointestinal hemorrhage from stress ulceration is a life-threatening complication in a critically ill patient. We retrospectively studied 471 patients admitted to the Department of Traumatology of our hospital who developed shock in their clinical course. Forty-two patients (8.9%) developed gastrointestinal hemorrhage, most within 1 wk (76.2%). The hemorrhage lesion usually was located in the corpus of the stomach. The mortality rate of the shock patients with gastrointestinal hemorrhage was 33.3% (14 of 42). Comparison of different types of shock showed that the incidence, severity, and mortality rates of gastrointestinal hemorrhage were significantly higher in septic shock patients than in hemorrhagic shock patients. These findings show the importance of preventive therapy against progression of early mucosal damage and development of gastrointestinal hemorrhage in shock patients, especially those with sepsis.

Acute Disease↗

Quantitative analysis of pre-S1 and pre-S2 in relation to HBsAg expression.

Sera from four patients with acute hepatitis B and 87 patients with chronic hepatitis B were examined quantitatively for pre-S1 and pre-S2 antigens by solid-phase enzyme immunoassays. Pre-S1 and pre-S2 antigens were detected in HBsAg-positive sera irrespective of the presence of viral replicative markers, and their titers correlated with those of HBsAg (r = 0.74, p less than 0.01; r = 0.74, p less than 0.01, respectively). Sera positive for HBeAg showed higher titers of pre-S1 (p less than 0.01) and pre-S2 (p less than 0.01) antigens than sera negative for HBeAg. The titers of pre-S1 and pre-S2 antigens also correlated with the levels of HBV-associated DNA polymerase activity (r = 0.51, p less than 0.01; r = 0.59, p less than 0.01, respectively) and HBV-DNA (r = 0.50, p less than 0.01; r = 0.46, p less than 0.01, respectively). However, the ratios between the titers of pre-S antigens and HBsAg had no significant relationships with those viral replicative markers. These findings suggest that the expression of pre-S antigens is intimately related to the expression of HBsAg and that they are not useful as markers of viral replication. The ratios between the titers of pre-S antigens and HBsAg tended to be high in patients with chronic active hepatitis and high aminotransferase levels. This finding may have been due to the hepatic release of pre-S antigens, over-production of which may have some relationship to liver injury.

Acute Disease↗

Detection of antibodies against the polymerase gene product in hepatitis B virus infection.

We have studied antibodies (anti-pol antibody) against the polymerase gene product of hepatitis B virus by solid-phase enzyme immunoassay using synthetic peptides coded for by this gene. Sera from six patients with acute hepatitis B, 112 chronic hepatitis B virus carriers and six healthy individuals with naturally acquired immunity to hepatitis B virus were tested for anti-pol antibody. In acute hepatitis B virus infection, anti-pol antibody was detected in three of six patients. In chronic hepatitis B virus infection, anti-pol antibody was detected in 17 of 29 (59%), in 23 of 33 (70%) of cirrhotic patients and in 18 of 24 (75%) patients with cirrhosis complicated by hepatocellular carcinoma, compared with 4 of 19 (21%) asymptomatic carriers and 2 of 7 (29%) patients with chronic persistent hepatitis. Titers of anti-pol antibody were higher in cirrhotic patients with and without hepatocellular carcinoma than in patients with chronic active hepatitis. The presence of anti-pol antibody, however, had no relationship with hepatitis B virus-associated DNA polymerase activities and other viral replicative markers. As for sera from six healthy individuals with naturally acquired immunity to hepatitis B virus, two (33%) were positive for anti-pol antibody. These results indicate that the immune response toward the polymerase gene product is induced during acute and chronic hepatitis B virus infection. In chronic hepatitis B virus infection, anti-pol antibody may serve as a new marker indicative of a long period of hepatitis B virus-induced hepatitis.

Acute Disease↗

Effects of endoscopic variceal sclerotherapy using GT XIII on blood coagulation tests and the renal kallikrein-kinin system.

Forty-six sclerotherapy sessions were performed on liver cirrhotics with high-risk esophageal varices using GT XIII, a sclerosant composed of gelatin, thrombin and coagulation factor XIII. GT XIII was effective for the prevention of temporary symptoms and transient hypotension observed in 55 sclerotherapy sessions using thrombin. In 42 (91%) sessions, patients underwent sclerotherapy with no symptoms, and in the other four (9%) sessions, only slight symptoms of general fatigue and headache were observed. Changes in the mean arterial pressure were significantly smaller in sessions using GT XIII than in those using thrombin (-12.3 +/- 13.6 vs. -26.8 +/- 20.7 mmHg, P less than 0.01). Changes in coagulation tests, similar to those of disseminated intravascular coagulation (DIC), were also reduced in sessions using GT XIII. Urinary kallikrein and kinin excretion significantly increased after the procedure (P less than 0.01), indicating activation of the renal kallikrein-kinin system. Increases in urinary kallikrein and kinin excretion showed a significant relationship with the consumed plasma fibrinogen levels (r = -0.51, P less than 0.01 and r = -0.58, P less than 0.01, respectively), and it was suggested that activation of the glandular kallikrein-kinin system caused by abrupt DIC-like changes in the hemostatic system might play a role in manifestations of temporary complications occurring with the use of hemostatic agents containing thrombin.

Blood Coagulation↗

Sequential protooncogene expression during regeneration in rat stomach.

Cellular protooncogenes such as c-myc and c-Ha-ras may play important roles in the control of regeneration of the stomach. In this study, in situ hybridization histochemistry and immunohistochemistry were used to determine how these protooncogenes and the corresponding oncoproteins are expressed at the cellular level during gastric regeneration after mucosal injuries caused by indomethacin. In addition, cells in the S-phase were immunohistochemically detected by means of 5-bromo-2'-deoxyuridine incorporation. Expression of the c-myc gene was localized to nuclei and reached a maximum at 3 h, and that of the c-Ha-ras gene was localized to cytoplasm with a peak at 6-12 h after treatment on the mucous neck, parietal, chief, and enterochromaffinlike cells around the lesions. The distribution of cells in the S-phase roughly coincided with that of cells in which expression of the protooncogenes was detected. In conclusion, various types of gastric mucosal cells participated in the sequential regulated expression of cellular protooncogenes during regeneration of the rat stomach.

Animals↗

[Expression of hepatitis B virus (HBV) markers in chronic liver disease positive for antibody to hepatitis C virus (HCV)].

We investigated expression of HBV markers in chronic liver disease positive for antibody to HCV (anti-HCV). Sera from 107 patients with chronic non-A, non-B liver disease, 65 HBs antigen carriers with chronic liver disease and 14 asymptomatic HBV carriers were tested for the presence of anti-HCV. Anti-HCV was detected in 83 (78%) patients with chronic non-A, non-B liver disease, irrespective of the past history of blood transfusion, and anti-HCV prevalence was similar in each category of chronic liver disease. Fifty-three (64%) out of these 83 sera positive for anti-HCV has also antibodies to HBV. Anti-HBc antibody was detected frequently in liver cirrhotics with hepatocellular carcinoma than in chronic persistent hepatitis, chronic active hepatitis and cirrhotics without hepatocellular carcinoma. In addition, titers of anti-HBc antibody were significantly higher in cirrhotics with hepatocellular carcinoma than in the other groups. On the other hand, anti-HCV was detected in 7 out of 65 patients with HBV-related liver disease. Four out of these 7 were patients with HBV-related hepatocellular carcinoma. Anti-HCV was detected in none of asymptomatic HBV carriers. These findings suggest that infection with both HBV and HCV is likely to cause more serious liver disease than infection with a single agent.

Adult↗

Heterogeneous activation of protein kinase C during rat liver regeneration induced by carbon tetrachloride administration.

During rat liver regeneration induced by carbon tetrachloride administration, the protein kinase C alpha subspecies was activated in a heterogeneous fashion, a higher number of hepatocytes expressing the protein kinase C alpha subspecies being detected in the pericentral zone than in the periportal zone. This zonal heterogeneity became maximal at 24 h after the treatment. The distribution of hepatocytes expressing the protein kinase C alpha subspecies was roughly coincident with that of hepatocytes exhibiting DNA synthesis. These results suggest that protein kinase C may play a crucial role in liver regeneration.

Animals↗