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Biomedical subjects

K Arima

Publications and source records attributed to K Arima.

At least 109 records · Page 6Linked to original sources

Angiographic study of mutant tissue-type plasminogen activator versus urokinase for acute myocardial infarction.

The effects and problems of intravenous thrombolytic therapy with a bolus injection of mutant tissue plasminogen activator (t-PA) were investigated in 34 patients with first acute myocardial infarction (AMI). In contrast, 114 patients were selected from 1,003 patients with AMI for treatment using intravenous infusion urokinase (UK). Angiography of these 148 patients revealed a complete occlusion of infarct-related artery with no clear contraindications to the study treatment. With the exception of thrombolysis in myocardial infarction (TIMI-3) recanalization 60 min after a bolus injection of mutant t-PA, the patients were given intracoronary UK in addition to mutant t-PA. The study comparisons were assessed using the following criteria: (1) 60-min assessment of recanalization rates, mutant t-PA vs UK; (2) time interval from initiation of thrombolysis to recanalization, mutant t-PA vs UK; (3) angiographic reocclusion rates within 1 month, mutant t-PA alone vs UK vs mutant t-PA plus UK; and (4) intracerebral hemorrhage rates, mutant t-PA alone vs UK vs mutant t-PA plus UK. There were no significant differences in the recanalization rates between mutant t-PA and UK, but there was a significant reduction in the time to recanalization with mutant t-PA (31.8 +/- 12.7 min) compared with UK (56.5 +/- 6.3 min). There was a significant difference in the reocclusion rates among the 3 treatment groups (20% mutant t-PA alone vs 4% UK vs 0% mutant t-PA plus UK). On the other hand, no significant differences in intracerebral hemorrhage rates among the 3 treatments were observed. In conclusion, thrombolytic therapy with a bolus injection of mutant t-PA achieved more rapid recanalization, but treatment with mutant t-PA led to a high rate of reocclusion.

Acute Disease↗

Evidence for structural differences between the two highly homologous actin-regulatory proteins, destrin and cofilin.

The amino acid sequences of destrin and cofilin are very similar (84% homology) throughout the entire range of proteins, but they have different functions. In this study, we constructed a new cofilin expression plasmid, which had high expression frequency, and the structures of destrin and cofilin were analyzed by limited proteolysis and circular dichroism (CD). When destrin was digested by trypsin, two fragments of 17.0 kDa and 9.2 kDa were obtained, whereas only one 8.4 kDa fragment was obtained from cofilin. In spite of the overall sequence homology, an N-terminal amino acid sequence analyses of the fragments revealed the cleavage sites on destrin and cofilin to be different. These results suggest that destrin and cofilin differ in their overall tertiary folds. Cofilin showed activity similar to destrin at high pH values, although no pH-dependent structural change in cofilin was confirmed by using limited proteolysis and CD.

Actin Depolymerizing Factors↗

[Abscess of corpus cavernosum: a case report].

A 72-year-old man was admitted to our hospital complaining of a penile mass. The local biopsy indicated an abscess formation in the corpus cavernosum. In spite of antibiotic treatment, the abscess cavity ruptured to the dorsal skin and the urethra. After cystostomy formation, dorso-caverno-urethral fistula was closed by conservative therapies. Although the patient was followed up with antibiotics on an outpatient basis, necrotic changes in the right foot were noticed and he was diagnosed with arteriosclerosis obliterance in the right lower leg. Therefore, he was referred to an orthopedic clinic for amputation of his right lower leg with cystostomy catheter. This is the 7th case reported in Japan.

Abscess↗

An alpha2-macroglobulin-serine proteinase complex from human carcinomatous ascites and pleural effusion: isolation, monoclonal antibody preparation, and immunohistochemical study.

A protein with the apparent molecular mass of 720 kDa which hydrolyzes anilide substrates of p-guanidino-L-phenylalanine was purified from ascites and pleural effusion of patients with pulmonary, breast, gastric, and ovarian cancers by chromatographic techniques. When this protein was separated on SDS-PAGE on nonreducing conditions, two bands corresponding to 720 and 360 kDa were seen to have gelatin-digestive activity in zymography assay. Moreover, when it separated by SDS-PAGE on reducing conditions, it migrated as several bands up to 180 kDa. The N-terminal amino acid sequence and immunoreactivity of anti-alpha2-macroglobulin polyclonal antibody revealed that the 180-kDa band was intact alpha2-macroglobulin. The hydrolytic activity of this complex was completely inhibited by diisopropyl fluorophosphate (DFP) and p-amidinophenylmethanesulfonyl fluoride. In addition, the 65-kDa protein observed under reducing conditions bound 3H-labeled DFP. These results suggest that the purified protein is a complex of the plasma proteinase inhibitor alpha2-macroglobulin and a serine proteinase. Several monoclonal antibodies were obtained when the purified complex was used as an antigen. One of these antibodies, which was immunoreactive to this complex but not to alpha2-macroglobulin, gave a positive band corresponding to 65 kDa on SDS-PAGE under reducing conditions. Use of this antibody in immunohistochemical studies revealed immunoreactivities in numerous neoplastic tissues with strong activity in advanced gastric cancers (e.g., poorly differentiated adenocarcinoma). In addition, strong cross-reactivity was detected in glandular cells of the fetus intestine.

Adenocarcinoma↗

[Percutaneous sclerotherapy for chyluria with leg edema: a case report].

A 45-year-old woman with left leg edema was admitted to our hospital because of chyluria from the previous year. Her left leg edema appeared after Caesarean section for her first delivery and hysterectomy at the age of 31. Because microfilaria was not detected, she was diagnosed with postoperative lymphangiomatosis. The instillation of 0.1-0.5% silver nitrate into the renal pelvis was not effective. We however, after percutaneous sclerotherapy to the left inguinal lymph nodes with doxycycline, the chyluria disappeared and her left leg edema improved. Then, the surplus skin of her left lower leg was resected. We considered percutaneous sclerotherapy to be a good procedure for chyluria due to postoperative lymphangiomatosis.

Anti-Bacterial Agents↗

[A case of metastatic ureteral tumor from rectal cancer].

A 67-year-old man was referred for further examination of left hydronephrosis. He had undergone anterior resection for rectal cancer 2 years previously and also right lobectomy for a solitary hepatic metastasis one year postoperatively. Antegrade pyelography demonstrated a filling defect in middle portion of the left ureter. Cytology of the aspirated urine was class V. Left nephrourete-rectomy was performed. Histologically metastatic adenocarcinoma with intact ureteral mucosa was demonstrated.

Adenocarcinoma↗

[Estimated prevalence rate of HTLV-I uveitis in Chikugo].

To estimate the prevalence rate of human T-cell lymphotropic virus type 1 (HTLV-I) uveitis, an epidemiological survey was carried out in the Chikugo District of Fukuoka Prefecture between 1 September and 31 October 1995. The survey was done by sending questionnaires on uveitis patients to all ophthalmological institutes in the district and measuring the serum antibody to HTLV-I. The recovery rate of the survey was 39 of 48 institutes (81.3%). A total of 357 patients with uveitis were reported in the survey, of whom 317 (88.8%) were tested for their seropositivity to HTLV-I. Among them, 18 patients were counted as having HTLV-I uveitis (HU) on 1 October 1995. Based on these data together with the age- and sex-specific population of HTLV-I carriers in the Chikugo District, it was estimated that the crude prevalence rates of HU per 100,000 HTLV-I carrier population were 58.6 in males, 152.0 in females, and 112.2 in both sexes. The prevalence rate of HU was slightly higher than that of HTLV-I associated myelopathy.

Adult↗

[A case of renal cell carcinoma with metastasis in clivus presenting as diplopia].

We report a rare case of renal cell carcinoma presenting as diplopia which was caused by a metastasis to the clivus. A 58-year-old man was admitted to our hospital with the chief complaint of diplopia. Head magnetic resonance imaging showed a mass in the clivus accompanied by bone destruction. Metastatic tumor to the skull base was suspected. Further examinations for the primary lesion revealed left renal cell carcinoma. He was relieved of diplopia by radiotherapy to the clivus and subsequently underwent left radical nephrectomy.

Carcinoma, Renal Cell↗

[Laparoscopic fenestration of lymphocele after renal transplantation: report of two cases].

Lymphocele after renal transplantation is a complication that often requires surgical treatment. We performed laparoscopic drainage for the postoperative lymphocele in two renal transplantation patients. The patients were suffering from perineal discomfort and urinary frequency due to the lymphocele after the renal transplantation. Percutaneous catheter drainages and injections of tissue sclerosing agents such as povidone-iodine solution and tetracycline were not effective. Then fenestration of the lymphocele by laparoscopic technique was done. This procedure made the lymphatic fluid free from the lymphocele in the retroperitoneal space to the peritoneal cavity following creation of a peritoneal window. There were no apparent complications. The patients were free from symptoms and had no relapse 10 months after the operation. We report the procedure and the results of the laparoscopic fenestration.

Adult↗

[An autopsy case of rhino-orbito-cerebral mucormycosis associated with multiple cranial nerve palsy and subsequent subarachnoid hemorrhage].

We report an autopsy case of 53-year-old male with poor controlled diabetes mellitus and hepatocellular carcinoma who developed rhino-orbito-cerebral mucormycosis. Initial complaints were epistaxis and headache followed by a sudden blindness, the 2nd through 7th cranial nerve palsy and diabetes inspidus. Laboratory data revealed that he had liver cirrhosis due to hepatitis C virus infection and diabetes mellitus. Head CT and MRI showed no significant findings. Eleven days after the onset, he died of subarachnoid hemorrhage. The postmortem examination revealed severe infiltration of numerous mucors in the sphenoid sinus, cavernous sinus and bilateral internal carotid arteries. Severe granulomatous vasculitis was seen in the cavernous portion of the bilateral internal carotid arteries. Thus, we considered that this case had been caused by the infiltration of mucors to the cavernous sinus, resulting in the obstruction of ophthalmic arteries. Rupture of the right internal carotid artery was seen at the branching portion of the ophthalmic artery, demonstrating the cause of his death. We would like to emphasize that rhino-orbito-cerebral mucormycosis should be ruled out if we examine a nondiagnostic case of diabetes mellitus or immunosuppressed disease associated with rapid multiple cranial nerve palsy following the orbital symptoms.

Abducens Nerve↗

[Extracorporeal shock wave lithotripsy in patients with coagulopathies: report of three cases].

We describe our experience with extracorporeal shock wave lithotripsy (ESWL) in three patients with coagulation disorders (one case of hemophilia A, and two cases of thromboasthenia). We successfully performed ESWL using factor VIII or transfusion of platelets without any severe hemorrhagic complications, such as perirenal and subcapsural hematomas. We consider that adequate supplement of coagulation factor or platelets may lower the risk of hemorrhagic complications in coagulopathic patients who undergo ESWL.

Adult↗

Improvement of systemic lupus erythematosus activity by the association of delayed onset Cushing's syndrome.

We describe a 43-year-old woman with systemic lupus erythematosus (SLE) who had complete resolution of all SLE symptoms as a result of hypercortisolemia induced by a glucocorticoid-producing adenoma of the left adrenal gland. After an adrenalectomy, she developed an SLE exacerbation, characterized by photosensitivity, polyarthralgia, and hemolytic anemia, which required intensive steroid therapy. This is the first report of a patient with SLE entering apparent remission due to excessive adrenal secretion of glucocorticoids.

Adult↗

Detection of Borna disease virus genome in normal human brain tissue.

Borna disease virus (BDV), a neurotropic virus naturally infecting horses and sheep, has been suggested to be associated with human psychiatric disorders. Thus far no extensive studies have been done, providing the evidence of BDV genome in normal human brain tissue. We therefore examined four brain regions of 30 normal autopsy brains for BDV p24 genome. By highly sensitive nested reverse transcriptase (RT)-mediated PCR analysis, we found positive PCR products in two brains: one in frontal and temporal cortices and hippocampus and another in frontal cortex and olfactory bulb. Our results suggest that BDV can infect human brain tissue latently, without causing an apparent neuropsychiatric disorder.

Adult↗

Analysis of Cdc2 and Cyclin D1 Expression in Breast Cancer by Immunoblotting.

Cyclins and cyclin-dependent kinases may reflect the status of cell proliferation in cancer tissues. The authors sought to determine whether cdc2 and cyclin D1 are expressed in breast cancer and are useful as prognostic factors. Accumulation of cdc2 and cyclin D1 proteins was examined in 88 cases of breast cancer using immunoblotting techniques and correlations with clinicopathological factors and prognoses were investigated. Cdc2 and cyclin D1 proteins were observed in 27.3 % and 75.0 % of breast cancers studied, respectively. The incidence of lymph node metastasis was significantly high in cdc2/cyclin D1-double positive group and low in double negative group. On the other hand, the incidence of estrogen receptor (ER) negative cases was significantly higher in the cdc2-positive/cyclin D1-negative group. Relapse-free survival times of cdc2-positive cases were significantly shorter than those of Cdc2-negative cases. The relapse-free survival times of cyclin D1-positive cases also tended to be poorer than those of cyclin D1-negative cases. Multivariate analyses revealed cdc2 as the second most significant of the prognostic variables, following lymph node status. The three-year relapse-free survival rate of cdc2/cyclin D1-double positive cases was 58.9%, whereas that of cdc2/cyclin D1-doublue negative cases was 100%. Cdc2 and cyclin D1 represent the status of cell proliferation in breast cancer, and may be useful in breast cancer assessment.

Journal Article↗

Ultrastructure of astrocytes associated with selective neuronal death of cerebral cortex after repeated ischemia.

Astrocytic swelling after ischemic insult has been considered a sign of parturbed cell viability. Investigations using cultured astrocytes and C6 glioma cells have revealed that viable astrocytes swell, spatially buffering various metabolites which are increased by the metabolic turmoil following ischemic insults. In the present study, we have studied the temporal profile of ultrastructural changes of astrocytes in the cerebral cortex associated with progressive selective neuronal, death where infarction is not induced. We occluded the left carotid artery of the Mongolian gerbil twice for 10 minutes at a 5 hr interval. In this model, following reperfusion, selective neuronal death progresses in the coronal section cut at the infundibular level. The whole brains of the sham operated control and postischemic animals were fixed by transcardiac perfusion of glutaraldehyde fixatives, at 15 min, 5 and 12 hr after the 2nd 10 min ischemia. Ultrathin sections including the 3rd and 5th cortical layers were prepared from the cut surface at the level of infundibulum. Mild swelling of astrocytic processes and perivascular end-feet was observed in the 15 min group. Glycogen granules were not prominent. In the 5 hr group, we found a few necrotic neurons disseminated in the cortex. All astrocytic cell processes were swollen with increased number of glycogen granules, especially marked in the perivascular end-feet. In the 12 hr group, necrotic neurons increased in number, astrocytic swelling was more extensive, and glycogen granules were evident in astrocytes. No cellular destruction was observed. We conclude: 1. Swelling progresses in astrocytes which however still remain viable and this process is associated with selective progression of neuronal death. 2. Glycogen granules increase in the swollen yet viable astrocytic cell processes.

Animals↗

Ultrastructural characterization of the tau-immunoreactive tubules in the oligodendroglial perikarya and their inner loop processes in progressive supranuclear palsy.

Coiled bodies and interfascicular threads are conspicuous white matter abnormalities of brains of patients with progressive supranuclear palsy (PSP). Both structures are argyrophilic and immunoreactive for the microtubule-binding protein tau. This report concerns the ultrastructural localization of interfascicular threads and their relationship to coiled bodies in five PSP patients. We showed for the first time that abnormal tubules with a 13- to 15-nm diameter and fuzzy outer contours were the common structures of coiled bodies in the oligodendroglial perikarya and of interfascicular threads. Moreover, the tubules were immunolabeled by anti-tau antibodies. The abnormal tau-positive tubules of interfascicular threads were located in the inner loop of the myelin sheath. Our study further indicated that the thread-like structures in the white matter comprised, at least in part, oligodendroglial processes, and that they were also present in gray matter. We consider that the formation of coiled bodies in the perikarya and of interfascicular threads represents a common cytoskeletal abnormality of the oligodendroglia of PSP patients. Moreover, even though the white matter alterations of PSP resemble those of corticobasal degeneration, there are certain ultrastructural differences in the abnormal oligodendroglial tubules of the two diseases.

Aged↗

Frequency and significance of antibodies to P450IID6 protein in Japanese patients with chronic hepatitis C.

BACKGROUND/AIMS: The aims of the current study were to assess the frequency and the significance of antibodies to cytochrome P450IID6 protein (anti-P450IID6) in various diseases among Japanese patients. METHODS: Sera from 541 patients were tested by indirect immunofluorescence, and the specificity of anti-P450IID6 was ascertained by either enzyme immunoassay (ELISA) or Western blot using recombinant antigen or rat liver microsomes. RESULTS: Anti-P450IID6 was found in only 6 of 235 patients (2.6%) with chronic active hepatitis (CAH) positive for hepatitis C virus (HCV) antibody and quantitative HCV-RNA with genotypes II and IV. The predominant epitopes on immunoblots were 66 and 50KD, a 10KD band being the newly underfined microsomal antigen. Even in the patients negative for autoantibodies to nuclear antigens (ANA) by routine indirect immunofluorescence test, various ANA were detected by the newly developed recombinant ELISA. These patients were younger, with lower gamma-globulin and IgG levels than patients with autoimmune hepatitis. Three of five patients with anti-P450IID6 responded well to interferon therapy and one received prednisone when interferon was ineffective. Interestingly, only this patient was diagnosed as definite autoimmune hepatitis according to the criteria proposed by the International Autoimmune Hepatitis Group (IAHG). The other five patients who did not satisfy the IAHG criteria might be considered as CAH-C with autoimmune features. No autoimmune hepatitis patients positive for anti-P450IID6 were identified in the current study, indicating that the variant is very rare in Japan. CONCLUSIONS: Anti-P450IID6 in CAH-C patients in Japan is not as rare as expected. Anti-P450IID6 among Japanese patients has uncertain significance and precludes further characterization of CAH-C with autoimmune features, which might require interferon therapy.

Adult↗

Two forms of hemitonic seizure in patients with infantile hemiplegia and epilepsy.

Two forms of unilateral tonic (hemitonic) seizure were observed in two adult epileptic patients with infantile hemiplegia. Their ictal EEGs showed diffuse bilaterally synchronous spike bursts without focal features. In one case, a 31-year-old male, the VTR/EEG recording clearly demonstrated hemitonic seizure which simultaneously involved his paretic limbs and body and were associated with loss of consciousness and autonomic signs. In the other case, a 33-year-old male, partial seizures with secondary unilateral generalization were demonstrated by VTR/EEG recording. The reason why these cases do not exhibit motor seizure activity on the unaffected side despite diffuse bilateral EEG changes, a lower motor threshold in the paretic limbs and inhibitory effect in the brain-stem on undamaged side are postulated. These two cases suggest that hemitonic seizures include heterogeneous characteristics of partial and generalized epilepsy. In patients with diffuse brain damage, such as those with infantile hemiplegia, seizures appear to exhibit complicated patterns, with characteristics of partial and generalized seizures. There is a gradiation of expression of unilateral seizure, range from clearly partial seizures to those with mostly features of generalized seizures, except for an asymmetry of motor expression.

Adult↗