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Biomedical subjects

K Katada

Publications and source records attributed to K Katada.

At least 19 recordsLinked to original sources

Interleukin-8 production via protease-activated receptor 2 in human esophageal epithelial cells.

Interaction between proteases and protease-activated receptor (PAR) 2 has been proposed to mediate inflammatory and immune response in the gastrointestinal tract. Recently, increase in interleukin (IL)-8 in the esophageal mucosa has been associated with the pathogenesis of esophagitis induced by reflux of gastric acids, bile acids or trypsin. The aims of the present study were to determine PAR2 expression in normal human esophageal epithelial cells (HEEC) and to evaluate the mediation of IL-8 production by trypsin-PAR2 interaction in HEEC. Reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis revealed that PAR2 mRNA and protein were constitutively expressed in HEEC without upregulation by the stimulation with tumor necrosis factor alpha or trypsin. IL-8 was produced in a dose-dependent fashion when cells were stimulated with a PAR2 agonist such as trypsin or SLIGKV-amide. Blocking antibody to PAR2, camostat mesilate (a trypsin inhibitor), p-38 mitogen-activated protein kinase (MAPK) inhibitors or ERK1/2 inhibitors reduced IL-8 production from trypsin-stimulated HEEC. Mutation of the NFkappaB-, AP-1- and NF-IL-6-binding site on the IL-8 gene promoter abrogated the induction of luciferase activities stimulated with trypsin by 100, 80 and 50%, respectively. These results indicate that PAR2 activation in HEEC by trypsin induces NFkappaB- and AP-1-dependent IL-8 production in association with activation of p38 MAPK and ERK1/2, suggesting that esophageal inflammation may be induced by PAR2 activation via reflux of trypsin.

Antibodies↗

Heme oxygenase-1 (Hsp32) is involved in the protection of small intestine by whole body mild hyperthermia from ischemia/reperfusion injury in rat.

AIM: The aim of the present study was to explore whether heme oxygenase-1 (HO-1) is involved in the hyperthermia-provided protection of the small intestine from ischemia/reperfusion injury in rats. METHODS: Intestinal damage was induced in male Sprague-Dawley rats by clamping both the superior mesenteric artery and the celiac trunk for 30 min, followed by reperfusion. Whole-body hyperthermia was induced in anesthetized rats by placement in a temperature-controlled water bath. Whole-body hyperthermia to a core temperature of 42-43 degrees C for 15 min was followed by passive cooling. We started the hyperthermic treatment 6 h before the vascular clamping. The severity of the mucosal injury was evaluated by several biochemical markers and histological findings. Hyperthermia-induced heat-shock proteins were detected by Western blotting. We also investigated the effect of zinc protoporphyrin IX (an HO-1 inhibitor) on the protective effect of hyperthermia. RESULTS: The rats, which were killed after ischemia/reperfusion, had severe intestinal inflammation. Hyperthermia significantly induced the production of Hsp70 and HO-1 in intestinal mucosa and significantly reduced ischemia/reperfusion-induced mucosal injury. The combination of zinc protoporphyrin IX with hyperthermia extinguished the protective effects of hyperthermia on ischemia/reperfusion injury. CONCLUSION: Hyperthermia protects against ischemia/reperfusion injury in rat small intestine through the expression of heat-shock proteins, especially HO-1.

Animals↗

An orally active matrix metalloproteinase inhibitor, ONO-4817, reduces dextran sulfate sodium-induced colitis in mice.

OBJECTIVE: Over-expression of matrix metalloproteinases (MMPs) can accelerate tissue destruction and disrupt subsequent tissue repair. A dextran sulfate sodium (DSS) colitis model was established to examine the effects of MMP inhibition, by an orally active MMP inhibitor ONO-4847, on colonic inflammation. MATERIALS AND METHODS: Acute colitis was induced in female BALB/c mice by giving 8% DSS orally in drinking water for 7 days. The animals were randomized into groups receiving different concentrations of ONO-4847 or vehicle by oral gavage every day. mRNA levels of 4 MMPs and a tissue inhibitor of MMP (TIMP-1) were measured by RT-PCR in intestinal tissue isolated from mice after DSS administration. Colonic mucosal injury and inflammation were evaluated clinically, biochemically, and histologically. The clinical disease activity index (DAI), including body weight loss, stool consistency, and blood in feces, was examined. Moreover, mucosal tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma were determined by immunoassay. RESULTS: The intestinal expression of MMP-3, -7, 9, and -12 and TIMP-1 mRNA was upregulated after DSS administration. Shortening of the colon was significantly reversed by ONO-4847 at a dose of 30 mg/kg. DAI in DSS-treated mice was significantly lower in the ONO-4847-treated mice compared with the control mice. Histological study also showed a reduced infiltration of inflammatory cells, especially neutrophils, and reducedmucosal cell disruption in ONO-4847-treated mice compared with the control mice. The increases in tissue-associated myeloperoxidase activity and thiobarbituric acid-reactive substances after DSS administration were both significantly inhibited by co-administration with ONO-4847. ONO-4847 also inhibited increases in the mucosal TNF-alpha and IFN-gamma content after DSS administration. CONCLUSION: Improvements in DSS colitis in response to ONO-4847 suggest that activation of MMPs contributes to the initiation/amplification of colonic inflammatory injury by mechanisms including oxidative damage as well as enhancement of inflammatory cytokine release.

Administration, Oral↗

Multi-slice 3D-CTA - an improvement over single slice helical CTA for cerebral aneurysms.

BACKGROUND AND OBJECTIVE: The aim of this study was to demonstrate the utility of volume rendered multi-slice helical three-dimensional CT angiography in patients with cerebral aneurysm when compared with single slice CT angiography and formal digital subtraction angiography. METHODS: A prototype Toshiba Aquilon multi-slice CT scanner was employed with the following scan conditions: voltage 135 kV; current 300 mA; slice thickness 0.8 mm; scan speed 0.75 sec/cycle; couch speed 1 mm/sec; range 50 mm from foramen magnum; scan pitch 3; three dimensional images were reconstructed using multiple image projections and integral volume rendering algorithms on a Xlink/Xtension workstation. 80 cases of multi-slice CTA for cerebral aneurysm carried out at Fujita University from January 1999 to January 2001 were reviewed. RESULTS: The advantages of multi-slice imaging are illustrated with representative cases of cerebral aneurysm - good demonstration of three dimensional anatomy, appreciation of perforators down to 1 mm in size, delineation of the vessels around the aneurysm complex, relationship between the aneurysm and skull base, information on calcification, thrombus and blebs in the wall and eleven routine views for perusal. CONCLUSION: Multi-slice CTA is a significant improvement over single slice CTA for cerebral aneurysms. It is our experience the superior and precise images produced by multi-slice technology displays anatomical information not readily available from standard DSA. Multislice 3D-CTA is relatively non-invasive and provides better and adequate detail for surgical planning. The basis of multi-slice CT angiography is described. Multi slice CTA is changing the way cerebral aneurysms are being managed nowadays. New advances in the technology of multi-slice CTA resulting in increased image resolution are outlined.

Angiography, Digital Subtraction↗

Simple and low-cost tele-nuclear medicine conference system with the e-mail protocol.

PURPOSE: Because of the recent innovative growth in computer technology, digital imaging, and the Internet, we can take advantage of these facilities for education and clinical work in nuclear medicine. We developed a tele-nuclear medicine conference system with electronic mail (e-mail) on the Internet. METHODS: Twenty-one physicians (20 radiologists, 1 neurologist), 6 technologists and 2 medical students in six university hospitals (Japan 5, Canada 1), 5 local hospitals in Japan participated in this project. We used digital still cameras (330 k pixels) equipped with a floppy disk drive and 10 x optical zoom to digitize images with JPEG compression (640 x 480 matrix). The images were attached to e-mail messages (containing a brief description of each case). The mail was sent simultaneously to all members on the mailing list. Scintigram and SPECT images as well as other radiological images were sent by e-mail. Reply mails about each case were sent to all members via the mailing list. RESULTS: During a period of 6 months, 18 cases (tumor/infection: 7, bone: 6, cardiovascular: 1, neurology; 3, endocrine: 1) with 144 e-mails (average 5.6/case) were submitted to the conference. The average period of discussion was 15.6 days. The number of attached images was 1 to 9 (average, 4.2/e-mails). JPEG compression rate was 1/10 to 1/20. The quality of the images was good enough for discussion. Some cases required additional images for further discussion. CONCLUSION: Our tele-nuclear medicine conference with an electronic mailing list and digital camera was simple and low-cost. The conference system was useful for education and clinical work.

Canada↗

Phytochrome A-mediated inhibition of seed germination in tomato.

Far-red light (FR) inhibition of seed germination of tomato (Solanum lycopersicum L.) was studied with the phytochrome (phy)-hypersensitive mutants, hp-1w, hp-1w,fri1, a phyA-deficient double mutant, and hp-1w,tri1, a phyB1-deficient double mutant. Seeds of all mutants germinated readily in the dark at 25 degrees C, and the germination was retarded by a single 100-s FR pulse given 1-3 h after sowing. The effect of an FR pulse was red-light reversible in all mutants used. After 24 h where a single FR pulse was no longer effective, prolonged FR exposure or hourly FR pulses suppressed germination in hp-1w and hp-1w,tri1, whereas in hp-1w,fri1 the suppressive effect of FR was almost absent. The effect of the prolonged FR was greater than that of the hourly 3-min FR pulses having equal photon fluence, and was fluencerate dependent. Thus we conclude that the germination inhibition by FR in tomato seed consists of a low-fluence response and a high irradiance response (HIR); the latter is controlled by phyA, but not phyB1. This is the first indication of phyA being involved in the HIR of seed germination inhibition.

Apoproteins↗

Can 3D-CTA surpass DSA in diagnosis of cerebral aneurysm?

After introducing of Helical scanning CT (HCT) and 3D-CTA (three-dimensional CT angiography), various improvements to these methods have been made every year to achieve better imaging quality. The current resolution permits visualisation of the internal structure of tumors, although as yet insufficiently clearly. We suggest that these improvements can be more efficient than conventional cerebral aneurysms angiography. In this study, we compared HCT and 3D-CTA with conventional cerebral angiography in patients with cerebral aneurysms at our facility. We also examined whether 3D-CTA has the possibility of independent clinical application and can surpass conventional DSA in diagnostic efficacy. In this paper, we found this information insufficient in clipping operations using 3D-CTA only when 1) It was difficult to distinguish a crooked infundibular dilation from an aneurysm, 2) Imaging threshold influenced the measured value of the vascular diameter and 3) It was also difficult to confirm whether the peripheral vessels adhere to the aneurysm. In conclusion, from the result of the comparison between 3D-CTA and DSA in this study, it was concluded that 3D-CTA is a reliable alternative method to conventional angiography in the diagnosis of anterior circulation and most aneurysms of regular size. In such cases it may be possible to obtain the same quality of preoperative information, but it is less invasive.

Adult↗

Mechanism and prevention of enlargement or new development of aneurysm following treatment by clipping or coiling.

The mechanisms of cerebral aneurysm recurrence and enlargement were investigated in 11 patients: two with dissecting aneurysms, six with fully grown aneurysms after neck clipping, one with enlarged aneurysm after dome clipping, and two with enlarged aneurysm due to recanalization after GDC coil embolization. We concluded that it is fundamentally important to ensure complete attachment of the internal elastic lamina around the aneurysm neck by precise neck clipping and effective embolization, with accurate positioning of remaining internal elastic lamina.

Endothelium, Vascular↗

Scleroderma associated with anemia and thrombocytopenia that responded well to cyclosporin.

A 55-year-old woman came to our hospital because of cutaneous sclerosis of the limbs in September 1996, and was diagnosed with scleroderma based on a skin biopsy. In August 1997, the cutaneous sclerosis became progressive (hemoglobin level, 4.3 g/dl; platelet count, 7 x 10(9)/l). The laboratory results were positive for the direct Coombs test, bone marrow aspiration showed a dry tap, and the bone marrow biopsy showed marked fatty marrow. Indium-111 bone marrow scintigraphy showed a markedly decreasing uptake. These findings indicated bone marrow hypoplasia associated with hemolytic anemia. After prednisolone therapy (60 mg) was initiated, the direct Coombs test became negative but the blood cell count did not increase. Then, 300 mg of cyclosporin was initiated and anemia and thrombocytopenia improved. The cyclosporin dosage was gradually decreased and the patient's hematological condition was good, although the cutaneous sclerosis changed only a little. This is a rare and interesting case of a patient with scleroderma associated with bone marrow insufficiency and hemolysis who responded well to cyclosporin.

Anemia, Hemolytic↗

Application of three-dimensional CT angiography (3D-CTA) to cerebral aneurysms.

BACKGROUND: 3D CT angiography (3D-CTA) is a noninvasive imaging modality for cerebral aneurysms. 3D-CTA is helpful in the evaluation of the configuration of the aneurysm, the surrounding vessels, and the inside of the aneurysm dome. Clinical application of this technique in complicated large cerebral aneurysms showed that with 3D-CT endoscopic imaging, anatomical details of cerebral aneurysms such as the orifice of the aneurysm, intraluminal thrombus, and calcification of the wall could be clearly demonstrated. Using the 3D-imaging method with helical CT, virtual views of various surgical approaches can be compared preoperatively. This information was found to be very useful for determining difficult aneurysms for coil embolization or direct surgery including complicated and broad-based aneurysms. METHODS: Helical CT scanners (TOSHIBA X-vigor) are used for intracranial vascular lesions. At present, nearly stereoscopic images at a pixel size of 0.35 x 0.35 x 0.4 mm are obtained by reconstruction under the following conditions: slice thickness, 0.8 mm; couch top speed, 1.0 mm/ sec.; 130 kV; 220 mA; visual field, 18 cm in diameter (11 cm after extension); pitch, 0.4 mm; and opposed beam interpolation. RESULTS AND CLINICAL APPLICATION: By virtual vascular 3D-CT endoscopy, the lumen of the cerebral aneurysm is displayed by the surface rendering method. Its clinical applications include 1) Demonstration of three-dimensional aneurysm morphology, including the dome and the neck region; 2) Preoperative simulation; 3) Confirmation of parent blood vessels flowing into and out of aneurysms and visualization of aneurysmal lumen calcification. Coronal and sagittal sections can demonstrate whether the branches arise from the aneurysm or aneurysmal neck. The limitation of 3D-CTA is in delineating perforating arteries that are less than 1.2 mm in diameter. The problem with virtual vascular 3D-CT endoscopic images is that endoscopic findings in the vascular wall are incomplete because of the partial volume effect and pulsation of the aneurysm and vascular wall. CONCLUSIONS: Helical Scanning-CT (HES-CT) is an excellent noninvasive diagnostic modality for cerebral aneurysm detection. 3D-CT angiography has distinct advantages in evaluating aneurysms and selecting the most appropriate therapeutic modality.

Cerebral Angiography↗

Intracranial aneurysms: detection with three-dimensional CT angiography with volume rendering--comparison with conventional angiographic and surgical findings.

PURPOSE: To assess the diagnostic accuracy of three-dimensional (3D) computed tomographic (CT) angiography for intracranial aneurysms. MATERIALS AND METHODS: The 3D CT angiograms obtained in 49 patients with or without intracranial aneurysms were evaluated by four blinded observers. Results were compared with findings at conventional angiography or surgery. A volume-rendering method was used, and 13 images obtained in different directions were reviewed in each study. The diameter of aneurysms was divided into four sizes: large, greater than 13 mm; medium, 5-12 mm; small, 3-4 mm; and very small, less than 3 mm. Results were also evaluated by means of receiver operating characteristic analysis. RESULTS: At conventional angiography, 47 aneurysms, including 14 less than 3 mm, were depicted in 35 patients. The mean sensitivity of CT angiography for very small aneurysms was 64%; small, 83%; medium, 95%; and large, 100%. Some very small aneurysms that were not depicted at conventional angiography were depicted at CT angiography, and one was proved at surgery. CONCLUSION: CT angiography has good sensitivity for depiction of intracranial aneurysms 3 mm or larger and relatively good sensitivity for aneurysms less than 3 mm. CT angiography may be a noninvasive technique for detection of asymptomatic unruptured or ruptured aneurysms.

Adult↗

Virtualized angioscopy of the thoracic aorta in a rabbit model of atherosclerosis.

The purpose of this study was to apply virtual reality technology to spiral computed tomographic (CT) angiogram images in a rabbit model of atherosclerosis and to correlate the images with histopathologic evaluation of the aorta. Image data were transferred to the virtual endoscope system in a graphics workstation. "Virtualized angioscopy" includes an interactive graphic user interface, which controls the viewpoint, the direction of the observation, and rendering and navigation functions. The virtual angioscopy system demonstrated irregularities of the luminal surface of the ascending aorta and a smooth luminal surface in the descending aorta. These observations were correlated with histopathologic findings. The results of this study indicate that the potential and real benefits of virtualized angioscopy far outweigh several technical limitations.

Angioscopy↗

Successful resection of arteriovenous malformations in eloquent areas diagnosed by surface anatomy scanning and motor evoked potential.

Successful resection of cerebral arteriovenous malformations (AVMs) involving the sensorimotor cortex was achieved in 17 cases. The theoretical basis for performing resection of AVMs in eloquent areas is the fact that the brain in and around the nidus about 1 mm in thickness is considered not to be functioning. It is also considered that any center of important function, when an AVM is involved, shifts to the near-by cortex from the original site. Nevertheless, it is critically important to recognize the cortex functioning as sensorimotor centers before and during operation. For this purpose, we have used surface anatomy scanning (SAS) in combination with magnetic resonance angiography. SAS is found to be very useful for the recognition of the topographical relationship between the surface anatomy and AVM. During operation, the motor cortex is identified with motor evoked potential. We have found that, in some cases, the motor center has shifted to the accessory motor cortex. With these information, it is possible to start resection of the lesion from dissection of the main feeders and dissection of the nidus from a silent cortex toward the critical area. Apparent neurological improvements were achieved in 15 of 17 patients treated surgically (88%). With this result, we think that AVMs in eloquent areas can be treated successfully when the surgery is well-designed and well-oriented with the combined use of diagnostic imaging and monitoring. As for control of intraoperative bleeding, careful attention to small but important surgical techniques avoids troublesome bleeding during AVM surgery.

Arteriovenous Malformations↗

Treatment and results of partially thrombosed giant aneurysms.

Partially thrombosed giant aneurysms are one of the most difficult diseases in the neurosurgical field. We have had 18 of these cases namely, three in vertebral artery, four in basilar artery, four in internal carotid artery, five in middle cerebral artery, and two in anterior communicating artery. Nine aneurysms were clipped, two aneurysms were removed with anastomosis, two cases were treated interventionally, and five cases were treated conservatively because of serpentine and fusiform types of aneurysms in internal carotid artery bifurcation. These conservatively treated patients died due to infarction. When surgery is selected in the thrombosed giant aneurysms, the approach is the most important to secure the neck. Three-dimensional computed tomography angiography was useful to plan the strategy for surgery. If the neck is big enough for placement of a clip, arterial reconstruction is the choice. The reconstruction must be done including an adequate size of the artery because of the thick wall. If the aneurysm neck is too small to reconstruct, aneurysmectomy with anastomosis is one of the choices.

Adult↗

Normal perfusion pressure breakthrough syndrome in giant arteriovenous malformations.

The treatment of large, high-flow cerebral arteriovenous malformations is one of the most difficult operations which neurosurgeons encounter because of the complex surgery and the post-operative effects on the brain. We have evaluated 10 patients with large, high-flow AVMs who underwent surgical resection. Patients were investigated with contrast-enhanced computed tomography and magnetic resonance imaging, 1231-IMP single photon emission computed tomography (SPECT) studies of cerebral flow and cerebral vasodilatory function, intraoperative Laser Doppler flowmetry (4 or 10 patients), and conventional angiography. The volume of the arteriovenous malformation nidi ranged from 32.8 to 210.5 cc. SPECT imaging performed on the first post-operative day showed marked hyperperfusion in the brain tissue surrounding the resected nidus, and these regions were normal on images on the 7th post-operative day. Laser Doppler flowmetry showed sudden, and marked increase in CBF immediately following placement of temporary clips on the main feeding artery. Angiograms done on 7-14 days following surgery showed a stagnating artery, fragile vessel, and a prolonged circulation time. Our results indicate that pre- and post-operative SPECT study, especially a dynamic SPECT study done on the first post-operative day, was the most useful examination for ascertaining the post-operative normal perfusion pressure breakthrough.

Adolescent↗

Early experience with real-time CT-fluoroscopy for an intracranial lesion.

We have developed a real-time CT-fluoroscopy (CTF) system of which the initial trial was reported in 1993. This paper deals with the early clinical experience with this system. A third-generation scanner equipped with a slip-ring (Toshiba) was used. Images were reconstructed and displayed at a rate of 6/s with a 0.83-second delay time using a newly designed array processor. CTF was carried out in 12 cases (10 brain hemorrhages, 2 tumors). Good-quality fluoroscopic images were obtained in all cases. Real-time monitoring with CTF of needle placement and advancement was useful for accurate puncture needle biopsy and evacuation of the lesions. No serious complication was experienced in this series.

Biopsy, Needle↗

Synthesized surface anatomy scanning (SSAS) for surgical planning of brain metastasis at the sensorimotor region: initial experience with 5 patients.

Surface anatomy scanning (SAS) is a powerful technique that uses T2-weighted magnetic resonance images (MRI) to visualize brain surface structures, and to precisely localize subcortical lesions. To overcome technical limitations of this method, synthesized SAS (SSAS) superimposes MR angiography (MRA) data on the SAS images. We describe our initial experience with surgical planning for the resection of metastases at the sensorimotor region in 5 patients using SSAS. Neurological deficits were assessed before and after surgical resection. Although 4 of 5 patients had mild to severe neurological deficits before surgery, three became symptom-free and no patient had an increased deficit after surgery. Our results undoubtedly provide palliative surgery for sensorimotor metastases. As SSAS is non-invasive and requires a short scanning time, this method could become a useful technique for the routine pre-operative simulation for surgery on brain surface lesions such as sensorimotor metastases.

Adenocarcinoma↗