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Biomedical subjects

K Kitamura

Publications and source records attributed to K Kitamura.

At least 1,657 records · Page 92Linked to original sources

Effect of intraocular irrigating solution on flicker electroretinogram during cataract surgery in human eye.

The effects of two commercially available intraocular irrigating solutions, Opeguard MA and BSS Plus, were studied during extracapsular cataract surgery in 45 eyes of 35 patients. After irrigation and aspiration of the residual cortex with Opeguard MA or BSS-Plus, the ERG amplitude increased, respectively, to 111.2+/-5.8% and 109.5+/-5.3% of the preirrigation amplitudes. The increases reached significance (116.9+/-7.0% and 115.7+/-6.5%; both P < .05) at the end of surgery compared with pre-irrigation ERG amplitudes. After irrigation with Opeguard MA or BSS-Plus, the ERG peak times were significantly prolonged to 103.9+/-0.8% and 104.2+/-1.2%, respectively, of the preirrigation peak times (both P < .01). The ERG peak times significantly shortened to 101.5+/-0.9% and 101.3+/-1.22%, respectively, at the end of surgery (P < .001 and P < .05) compared with just after irrigation. Although we have previously shown that Opeguard MA maintained amplitude and implicit time of 30 Hz flicker ERG during vitrectomy better than BSS-Plus, there were no statistically significant differences between the changes in amplitude and peak time with Opeguard MA and BSS-Plus during cataract surgery. We speculate that a drop in the retinal temperature during irrigation and aspiration in the anterior chamber and an increase in the photopic ERG amplitude during light adaptation with the operating microscope caused these ERG changes.

Aged↗

Preparation and properties of the immunoconjugate composed of anti-human colon cancer monoclonal antibody and mitomycin C-dextran conjugate.

Monoclonal antibody (mAb) A7, produced against human colon cancer, was conjugated with a polymeric prodrug of mitomycin C (MMC), the MMC-dextran conjugate with an anionic charge (MMCDan) and a molecular weight of 70,000. The amino groups were introduced into the MMCDan by reacting ethylenediamine with the carboxyl group in the spacer arm of the dextran bridge by a carbodiimide-catalyzed reaction. The coupling to mAb A7 was performed using SPDP. A 15 M excess of ethylenediamine produced an optimal MMCDan with amino groups, which resulted in a homogenous conjugate (A7-MMCD) with minimal formation of high-molecular-weight aggregates in about a 30% yield of both IgG and MMC. The molar binding ratio of IgG:dextran:MMC in A7-MMCD was estimated to be 1:1.2:40. A7-MMCD, having MMC prodrug properties, released active MMC with a half-life of 29.1 h and had an almost neutral electric charge under physiological conditions. A competitive binding assay using 125I-labeled A7 revealed that the A7-MMCD almost fully retained its antibody-binding activity. The cytotoxicity of A7-MMCD was assayed by determining the degree of inhibition of [3H]-thymidine in corporation in two different ways using the human colon cancer cell line SW1116. A 48-h continuous exposure test revealed that the pharmacological activity of MMC in A7-MMCD was completely preserved. In addition, A7-MMCD exhibited about a 14-fold greater cytotoxicity than MMCDan when the IC50 values determined using a 2-h pretreatment exposure system were compared. These results suggest that A7-MMCD could be useful in immunotargeting chemotherapy for colorectal cancer.

Antibodies, Monoclonal↗

Abrogation of oral tolerance by contrasuppressor T cells suggests the presence of regulatory T-cell networks in the mucosal immune system.

Continuous ingestion of a thymus-dependent (TD) antigen differentially affects two compartments of the immune system. A secretory IgA antibody response is induced in mucosal tissues, concurrent with a state of antigen-specific systemic unresponsiveness to parenteral challenge, termed oral tolerance. The precise mechanisms whereby gut antigenic exposure induces oral tolerance are unknown, although T-suppressor cells, anti-idiotypic networks and immune complex formation have all been proposed. Here we show that the systemic unresponsiveness of mice made orally tolerant to the TD antigen sheep red blood cells (SRBC) is reversed by the adoptive transfer of Lyt-1+,2-, Vicia villosa lectin-adherent and I-J+ T cells derived from mice which are genetically resistant to the induction of oral tolerance to SRBC. This T-cell subpopulation has the characteristics of contrasuppressor effector T cells (Tcs). Small numbers of these Tcs cells reverse SRBC-specific tolerance both in vivo and in vitro. This finding offers new insight into the mechanisms of oral tolerance induction and maintenance, and suggests that a network of T cells are involved in the regulation of host responses to ingested antigens.

Animals↗

T-cell epitope of the autoantigen myelin basic protein that induces encephalomyelitis.

Chronic relapsing paralysis and demyelination within the central nervous system (CNS), features associated with the human disease multiple sclerosis (MS), develop in mice after injection of murine T-cell clones specific for the autoantigen myelin basic protein (MBP). We examined the fine specificity of three independently derived encephalitogenic T-cell clones using synthetic polypeptides derived from portions of the N-terminal sequence of MBP. These clones appear functionally identical; they all respond to an epitope in the N-terminal nine amino acid residues in association with the same class II (I-A) molecules of the major histocompatibility complex (MHC). Both the N-terminal acetyl moiety and the first residue (Ala) are necessary for recognition. Only N-terminal MBP peptides recognized by these clones were found to cause encephalomyelitis (EAE) in vivo. These results show that the N-terminal MBP-specific T lymphocytes that mediate autoimmune encephalomyelitis are a small population with a limited repertoire; they all recognise the same combination of MHC and target.

Animals↗

Biological and clinical roles of adrenomedullin in circulation control and cardiovascular diseases.

1. Adrenomedullin (AM) is found ubiquitously in tissues and organs, especially in cardiovascular tissues and in the kidney, lung and endocrine glands. It has multifunctional biological properties, of which, its effects on the control of circulation and body fluid volume regulation seem to be the most outstanding and characteristic. 2. Acute administration of a high dose of AM induces a vasodilator depressor response, cardiac inotropic effects, diuresis and suppression of aldosterone secretion in experimental animals. 3. Long-term continuous administration of a very low dose of AM causes vasodilation in sheep (0.5 microgram/kg per h) and hypotension in rats (0.8 microgram/kg per h). 4. The plasma concentration of AM increases under pathological conditions such as congestive heart failure, myocardial infarction and hypertensive and renal diseases. Under these disease conditions, AM may be produced in vascular endothelial and smooth muscle cells and in cardiac myocytes in response to volume expansion, hypertension and activated humoral factors, such as catecholamine and the renin-angiotensin system. 5. Increased AM in the circulating blood and cardiovascular tissues may counteract pathological deviation in the system that controls circulation and body fluid volume, acting against cardiovascular damage and disease. 6. Because of these beneficial properties in the cardiovascular system, AM and its pharmaceutical ligands should prove useful in the treatment of cardiovascular diseases.

Adrenomedullin↗

Assessment of left ventricular volume by an ambulatory radionuclide monitoring system during head-up tilt in patients with unexplained syncope: relation to autonomic activity assessed by heart rate variability.

BACKGROUND: Decreased left ventricular volume during head-up tilt plays an important role in triggering syncope in patients with neurally mediated syncope. However, precise changes in left ventricular volume during head-up tilt have not been well investigated. This study was conducted to test the hypothesis that the decline in left ventricular volume during tilt could trigger ventricular mechanoreceptor activation. METHODS AND RESULTS: To investigate the mechanisms of tilt-induced syncope, we measured the temporal changes in left ventricular volume, ejection fraction, cardiac output, and heart rate variability indices during head-up tilt in 25 patients with syncope of undetermined etiology. Eleven patients had a cardioinhibitory response (CI group), 7 patients showed a vasodepressor response (VD group), and 7 patients demonstrated a negative response (NG group). Before syncope, ejection fraction increased most in the CI group, the left ventricular end-diastolic volume declined most in the VD group (VD group, -11.0% +/- 3.3%; CI group, -2.8% +/- 4.8%; NG group, -3.4% +/- 2.2%; P <.005), and the high-frequency spectra increased most in the CI group (CI group, 25.0% +/- 21.0%; VD group, -4.1% +/- 11.7%; NG group, -5.3% +/- 12.7%; P <.01). The vasodepressor response was dependent on left ventricular volume, whereas the cardioinhibitory response was related to the vagal activity reflected by high-frequency spectra. CONCLUSIONS: The precise evaluation of left ventricular volume by an ambulatory radionuclide monitoring system combined with a heart rate variability analysis is considered useful for clarifying the pathophysiology of neurally mediated syncope.

Adult↗

Hereditary sensorineural hearing loss of unknown cause involving mitochondrial DNA 1555 mutation.

We report on a family with maternally inherited sensorineural hearing loss, in which no history of aminoglycoside injection and no other specific etiology could be identified in any member. A 1555 A-to-G mutation of mitochondrial DNA was found in all members demonstrating hearing loss. The hearing in the propositus and his sister was severely impaired at a younger age than that in the mother. This case suggests that the 1555 point mutation of mitochondrial DNA has potential to promote inherited nonsyndromic hearing loss without any known etiology.

Audiometry↗

Role of computerized transverse axial tomography on stereotactic surgery of the diencephalon. A preliminary report of 67 cases.

67 cases of various functional disorders of the diencephalon were examined by EMI scanner. The patients were composed of 38 cases of parkinsonism, 7 cases of thalamic syndrome, 6 cases of choreoathetoid movement, 2 cases of dystonia, 11 cases of involuntary movement of unknown etiology and 1 case of torticollis, tic, and ballismus, respectively. In parkinsonism, 79% showed diffuse cerebral atrophy, 5% had focal low density in the substantia nigra and the thalamus, whereas 16% remained normal. Pre- and postoperative assessment with CT scan was briefly discussed with reference to stereotactic surgery of the diencephalon.

Adult↗

Efficacy and safety of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor fluvastatin in hyperlipidemic patients treated with probucol.

The objective of this open trial was to investigate the efficacy and safety of the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor fluvastatin in hypercholesterolemic patients already receiving probucol. All of the participants had hypercholesterolemia. i.e. serum total cholesterol > or = 220 mg/dl, despite administration of probucol, 500 mg/day, for more than 4 weeks. After this, fluvastatin, 30 mg/day, was added to probucol treatment for 12 weeks. Twenty-seven patients were recruited into this study; all were evaluated for safety, and 22 were evaluated for efficacy. The addition of fluvastatin to the probucol regimen produced a significant further reduction in serum total and low-density lipoprotein cholesterol concentrations (of 18 and 20%, respectively; p < 0.001); these effects were fully established within 4 weeks of treatment and were maintained throughout the treatment. Fluvastatin did not affect the serum high-density lipoprotein cholesterol concentration. Fluvastatin treatment decreased serum triglyceride concentrations slightly in all patients (not significant); in patients with hypertriglyceridemia, triglyceride levels were decreased significantly by 34% (p < 0.01; serum triglycerides > or = 150 mg/dl). In addition, fluvastatin significantly decreased serum apolipoprotein B, C-II, C-III and E levels, whereas serum apolipoprotein A-I and A-II levels were unaffected. One patient complained of slight abdominal discomfort during fluvastatin administration, but relationship to fluvastatin remains unclear. One patient had slight elevation of the serum alanine aminotransferase level, and another patient had an elevated gamma-glutamyl transferase level. The addition of fluvastatin to probucol treatment can be considered to be an effective and well tolerated treatment in hypercholesterolemic patients.

Adult↗

Congenital cholesteatoma of the petrous pyramid.

A congenital cholesteatoma arising from the petrous pyramid is rarely encountered, and we report a case of such a cholesteatoma in a 23-year-old male. This cholesteatoma was successfully removed by a middle cranial fossa approach. The cholesteatoma showed a unique mode of spread, that is, it originated from the pyramidal apex and extended in two directions: through the facial canal to the tympanic sinus, and along the tympanic tegmen to the mastoid antrum. We discuss the importance of CT and MRI for achieving a diagnosis, as well as the merits of using a middle cranial fossa approach for the surgical excision of this cholesteatoma.

Adult↗

Spontaneous nystagmus in normal subjects.

We investigated the incidence of spontaneous nystagmus in 30 normal volunteers using electronystagmography (ENG). In all subjects, ENG was performed with the eyes open in the primary position, with the eyes closed, and with the eyes open in total darkness. Spontaneous nystagmus was detected in 5 (16.7%) of 30 subjects. In 15 subjects who underwent 2 ENG examinations, 4 subjects (26.7%) exhibited spontaneous nystagmus. Caloric testing was performed in 26 of 30 subjects. Spontaneous nystagmus was detected in 3 subjects who had a right-left difference in caloric response of over 40%, and in 2 of 23 subjects who had a difference of less than 40%. Our results showed that spontaneous nystagmus was detected in more subjects when the ENG examinations were repeated. Thus, a single ENG examination cannot exclude the possibility of spontaneous nystagmus.

Adult↗

Nationwide co-operative study of intracranial aneurysm surgery in Japan.

A cooperative study was made of 4750 intracranial aneurysm cases collected from 133 neurosurgical clinics in Japan by letter inquiry for the period of 2 years from January 1974 to December 1975. Among them, 4124 cases (87%) had a single aneurysm, and 626 cases (13%) had multiple ones. Direct radical surgery was done in 78% of all cases, carotid ligation in 2% and non-surgical treatment in 17%. Direct surgery in a mortality rate of 15% for ruptured aneurysm cases and 7% for nonruptured cases. Radical surgery within 24 hours after rupture had a mortality of 51%, while those within 1 week and 2 weeks were 39% and 30% respectively; grade I or II patients, however, showed much better surgical results even in early operations. The neurosurgical clinics included in this study were spread throughout most of Japan. Micro-surgical technic was already in use of aneurysm surgery at the time of this study in Japan.

Adolescent↗

Temporal bone histopathology associated with occlusion of vertebrobasilar arteries.

We have presented the histological findings in the inner ear of a patient who experienced occlusion of the vertebral and basilar arteries 17 days before death. A large infarction was observed in the medulla and pons on the right side. There was severe degenerative change in the right membranous labyrinth as well as in the right cochlear and vestibular nerves, which was presumably caused by ischemia from occlusion of the right labyrinthine artery. The organ of Corti and sensory epithelia of the vestibular labyrinth showed the most advanced state of degeneration. The histopathological appearance was similar to that observed in the subacute stage following obstruction of the labyrinthine arteries in animal experiments.

Aged↗

A novel enzymatic assay for the quantification of skin surface lipids.

The applicability of a novel enzymatic assay for quantifying skin surface lipids was investigated experimentally. The standard curves for the assays of glycerol esters, free fatty acids, and cholesterol and its esters were linear over a wide range of lipid concentrations, which ensures the accuracy of measurements. The assay system also showed good simultaneous reproducibility. There were significant positive correlations (P < 0.001) between the quantities of glycerol esters, free fatty acids, and cholesterol and its esters sampled from the skin surface of women when measured by the enzymatic assay compared with the gas chromatographic method. The enzymatic assay was applied to studies of the relationships between age, acne and menstrual cycle, and skin surface lipids in women. The quantities of glycerol esters and free fatty acids reached peaks in females in their twenties and thirties. Increased quantities of glycerol esters, free fatty acids, and cholesterol and its esters were observed in women with acne compared with women without acne. Among the women with acne, those in the premenstrual phase of the menstrual cycle showed increased levels of glycerol esters, free fatty acids, and cholesterol and its esters compared with those in the menstrual phase. The results suggest that the enzymatic method is a satisfactory new technique for the quantification of skin surface lipids.

Acne Vulgaris↗

Short-term effects of iontophoresis on the structure of the guinea pig tympanic membrane.

Guinea pig tympanic membrane was anesthetized iontophoretically. The animals were sacrificed between 2 h and 4 days after the anesthesia and the tympanic membrane was studied histologically by light microscopy and transmission electron microscopy. Edema in the subepidermal connective tissue layer and detachment of the basement membrane from the basal cell layer were observed 2 h after iontophoresis. Eight and 12 h later, the epidermal layer between the handle of the malleus and the bony annulus peeled and retracted towards the bony annulus, leaving only hornified outer epidermis on the fibrous layer. Four days after iontophoresis, the retracted margin of the epidermal layer became greatly thickened and evidence of hyperplasia and migration was observed. This study has demonstrated that iontophoresis of the tympanic membrane produces remarkable histological changes. However, no perforation was observed.

Anesthesia, Local↗