Biomedical subjects

K Marumo

Publications and source records attributed to K Marumo.

At least 19 recordsLinked to original sources

PubMed2006

Contaminated oral intubation equipment associated with an outbreak of carbapenem-resistant Pseudomonas in an intensive care unit.

Twenty intensive care patients were diagnosed as infected or colonized by Pseudomonas aeruginosa within a one-month period; a rate three to four times higher than the typical background frequency of this infection in the intensive care unit (ICU). Patients with positive respiratory specimens were mechanically ventilated, which included re-used disinfected bite blocks during intubation. Fourteen specimens from 20 positive patients originated in the respiratory tract. Seven clonal variants were isolated and identified as originating from the same strain by pulsed-field analysis. These isolates were also matched to the strain detected on the re-used bite blocks, which had been disinfected with 140ppm sodium hydrochloride. Notably, Staphylococcus aureus was also detected on bite blocks sterilized with ethylene dioxide, indicating incomplete disinfection. In immunocompromised patients, re-use of bite blocks during intubation must be prohibited. Single-use kits or intubation without the use of bite blocks is recommended.

Carbapenems↗

PubMed2006

Role of collagen enzymatic and glycation induced cross-links as a determinant of bone quality in spontaneously diabetic WBN/Kob rats.

INTRODUCTION: Diabetes is associated with an increased risk of fracture, although type 2 diabetes is often characterized by normal bone mineral density (BMD). Enzymatic and glycation-induced non-enzymatic cross-links play important roles in the expression of bone strength. The serum vitamin B6 concentration is lower in patients with diabetes than in healthy controls. The aim our study was to see if spontaneously diabetic WBN/Kob rats in the pre- and post-onset of diabetes would serve as a suitable model for studying the pathogenesis of the susceptibility to fracture in diabetes without the reduction of bone mineral density. Seventy male WBN/Kob rats were obtained at the ages of 1 to 18 months. METHODS: Seventy normal male Wistar rats were used as the non-diabetic, age-matched control. The contents of enzymatic cross-links (dihydroxylysinonorleucine, hydroxylysinonorleucine, lysinonorleucine, pyridinoline and deoxypyridinoline) and non-enzymatic cross-links (pentosidine) were determined in femoral bone. We also analyzed the serum concentration of vitamin B6 (pyridoxal and pyridoxamine), femoral BMD and a three-point bending test of the femur. RESULTS: A low level of serum vitamin B6 was associated with a decrease in enzymatic crosslinking in bone during the subclinical diabetes stage. After the onset of diabetes, there was a steady decrease in enzymatic cross-links and a steep increase in pentosidine. Furthermore, impaired bone mechanical properties in the WBN/Kob rats despite the lack of reduction in BMD coincided with impaired enzymatic cross-link formation and increases in glycation-induced pentosidine. CONCLUSIONS: These results indicate that the alteration of enzymatic and non-enzymatic crosslinking in bone could be important for explaining the variation of fracture susceptibility in diabetes.

Animals↗

PubMed2005

Akt activation in renal cell carcinoma: contribution of a decreased PTEN expression and the induction of apoptosis by an Akt inhibitor.

BACKGROUND: Akt has been implicated in the oncogenesis of human malignant tumors, because Akt regulates many key effector molecules involved in cell survival. PTEN (phosphatase and tensin homolog deleted on chromosome 10) negatively regulates Akt activation. MATERIALS AND METHODS: The expression of phosphorylated Akt (p-Akt), total Akt and PTEN was analyzed by Western blotting in 45 renal cell carcinoma (RCC) patients. The Bad and phosphorylated Bad (p-Bad) statuses were analyzed in 20 RCC patients. A phosphatidylinositol ether analog was used as an Akt inhibitor to treat four RCC cell lines, namely Caki-1, KU19-20, SW839 and Caki-2. RESULTS: The PTEN expression in RCC was observed to decrease and p-Akt expression to increase significantly in comparison with that in the corresponding normal kidney tissue. The PTEN expression inversely correlated with the p-Akt expression. These alterations were specific for clear cell type RCC, but not for papillary or chromophobe type RCC. Alterations in Bad phosphorylation were also specifically observed in clear cell type. The Akt inhibitor induced apoptosis in KU19-20 and Caki-2 cells with a high Akt activity. CONCLUSIONS: A decreased expression of PTEN may be an underlying mechanism for Akt activation. An Akt inhibitor may be a therapeutic option for a subset of RCC with an elevated Akt activity.

Apoptosis↗

PubMed2005

Inhibition of Wnt signaling downregulates Akt activity and induces chemosensitivity in PTEN-mutated prostate cancer cells.

BACKGROUND: The cross-talk between Wnt signaling and the Akt pathway in prostate cancer (Pca) is still unclear. In the present study, we found that WIF-1 downregulates the Akt pathway and also enhances chemosensitivity in PTEN-null Pca cells. METHODS: Wnt inhibitory factor-1 (WIF-1), an inhibitor of Wnt proteins, was transfected into PC-3 and DU145 Pca cells. RESULTS: Akt was phosphorylated in PTEN-null PC-3 cells but underphosphorylated in PTEN-expressed DU145 cells. The levels of phosphorylated Akt in WIF-1 overexpressing PC-3 cells were lower than those in native or control vector-transfected PC-3 cells. However, WIF-1 showed no additional inhibition of already reduced Akt activity in DU145 cells. Overexpression of WIF-1 resulted in sensitizing PC-3 cells for paclitaxel to induce apoptosis. DU145 cells were more sensitive to paclitaxel but were not affected by WIF-1 transfection. The PI3K inhibitor LY294002 seemed to restore the chemosensitivity of native PC-3 cells like WIF-1 did. CONCLUSIONS: Our results show that Wnt signaling is involved in Akt activation in Pca cells. Our data also indicate the possibility that Wnt and its signaling pathway can be therapeutic targets for PTEN-mutated advanced Pca.

Adaptor Proteins, Signal Transducing↗

PubMed2002

Significant decrease of the International Index of Erectile Function in male renal failure patients treated with hemodialysis.

In order to evaluate the erectile function in male renal failure patients treated with hemodialysis (HD), we investigated the International Index of Erectile Function (IIEF) in patients and healthy controls. The subjects were 174 male patients treated with HD, of whom 43 had diabetes mellitus (DM) and the remaining 131 patients did not have DM. The controls were 1133 healthy males. We evaluated the prevalence of erectile dysfunction (ED) using the erectile function (EF) score, which is one of the five domains of the IIEF, in each age group (upto 39 y old, 40-49 y old, 50-59 y old, 60-69 y old). The severity of ED was classified into five categories using EF in each age group. The univariate logistic regression analysis and multiple variate analysis of IIEF in HD patients were performed. The prevalence of ED in HD patients was significantly higher than that in the controls in each age group. The severity of ED in HD patients was also significantly higher than that in the controls in each age group. In the logistic regression analysis and multiple variate analysis of IIEF in HD patients, DM and age were significant risk factors on sexual dysfunction. ED was more prevalent in male renal failure patients treated with HD than in the controls. In the patient group, ED was more prevalent in older DM patients.

Adult↗

PubMed2001

Age-related prevalence of erectile dysfunction in Japan: assessment by the International Index of Erectile Function.

BACKGROUND: The effects of age and concomitant chronic illness on male sexual function were investigated to obtain insight into the prevention of erectile dysfunction (ED). METHODS: A questionnaire from the International Index of Erectile Function (IIEF) was given to 2311 non-institutionalized men aged 23-79 years along with a survey of health status. The study sample consisted of 1517 men who provided complete responses to the questionnaire. For statistical analysis, ANOVA was conducted to evaluate the effect of aging on the sexual functions and a logistic regression model was used to identify significant independent risk factors for ED. RESULTS: There was a significant correlation between age and the scores for erectile function, orgasmic function, sexual desire and intercourse satisfaction. The prevalence of moderate and severe cases of ED were 1.8% and 0% for ages 23-29; 2.6% and 0% for ages 30-39; 7.6% and 1.0% for ages 40-49; 14.0% and 6.0% for ages 50-59; 25.9% and 15.9% for ages 60-69; and 27.9% and 36.4% for ages 70-79 years, respectively. Hypertension, diabetes mellitus, heart disease, chronic hepatitis, disc herniation and cerebral infarction under treatment with anticoagulants were significant independent risk factors for ED. CONCLUSIONS: The results obtained indicated a significant association between aging and chronic diseases and erectile function. Further epidemiologic research and analysis of individual risk factors are required to allow more effective future strategies for the treatment and prevention of ED.

Adult↗

PubMed2001

The prevalence of renal cell carcinoma: a nation-wide survey in Japan in 1997.

BACKGROUND: The present study was conducted to investigate the incidence of renal cell carcinoma by sex, age group and different regions in Japan. METHODS: The survey was conducted from the beginning of January 1997 to the end of December 1997. A total of 1306 Institutions in all 47 prefectures throughout Japan were requested to register cases. RESULTS: There were 6358 persons with renal cell carcinoma, consisting of 4372 men and 1986 women. The age-specific incidence rates showed a peak in the age group of 65-70 years in both men and women. The crude incidence rates per 100 000 population for men and women were 7.1 and 3.1, respectively, and age-standardized incidence rates per 100 000 population for men and women were 4.9 and 1.8, respectively. The incidence rates in the Hokkaido region were significantly higher than in other regions (P < 0.05), among which there was no significant difference in incidence rates. CONCLUSIONS: The present study showed that the incidence rates of renal cell carcinoma in Japan were approximately the same as among Japanese in Los Angeles. The rates were, however, lower than North American and European countries, but higher than China, Central or South American countries and African countries. The reasons for the high incidence of renal cancer in the Hokkaido region are not entirely clear. Further epidemiologic research is required.

Adult↗

PubMed2001

Aging and erectile dysfunction: the role of aging and concomitant chronic illness.

Erectile dysfunction (ED) can have a strong negative effect on the well-being and quality of life of the sufferer. Many factors may contribute to the development of this disorder; age in particular and also concomitant chronic illnesses including neurological, hormonal, arterial and cavernosal factors. An understanding of the prevalence and characteristics of risk factors for ED is required, in order to establish effective therapeutic strategies. However, the prevalence of ED depends on the definitions used and the use of an internationally established scale for the assessment of male sexual function is necessary to facilitate the comparison of data between different countries. Further epidemiologic research and analysis of individual risk factors is required. Such studies will clarify the interactive effects of organic factors and their probable etiology with the general physical, sociocultural and psychologic status of patients. These efforts will make it possible to design more effective future strategies for the treatment and prevention of ED.

Aged↗

PubMed2001

[Evaluation of rapidly growing Mycobacteria isolates in a general hospital: reports from the hospital microbiology laboratory].

Forty isolates of rapidly growing Mycobacteria, Mycobacterium fortuitum group including M. fortuitum and M. peregrinum and M. chelonae group including M. chelonae subsp. chelonae and M. chelonae subsp. abscessus at Showa University Fujigaoka Hospital collected between February 1981 and December 1997 were investigated in this study. These isolates were from the patients who were not infected with HIV. The average age of fourteen patients, from whom M. fortuitum group was isolated, was 58 years, ranging from 17 to 80 years old. One patient (71-year-old) with chronic myelogenous leukemia and another (64-year-old) with chronic diabetes mellitus were diagnosed with skin abscesses of M. fortuitum group, which were located on the right site of the neck and in the scar after injecting insulin (injection abscess), respectively. The average age of twenty-six patients, from whom M. chelonae group was isolated, was 57 years, ranging from 32 to 84 years old. One patient (75-year-old) with articular rheumatism was diagnosed with a lung infection of mixed M. chelonae group and Pseudomonas aeruginosa, and another (74-year-old) with diabetes mellitus and kidney failure was strongly suspected of a lung infection. The isolates of the two mycobacteria from the remaining patients were due to colonization, while these patients had the following underlying diseases contributing to infections: pulmonary emphysema; diabetes mellitus; leukemia; collagen diseases; lung cancer; chronic kidney diseases; systemic lupus erythematosus; carcinomatous pleurisy; bronchiectasis; post-tuberculosis. Most isolates of the two mycobacteria were separated from the specimens of patients' respiratory tracts, but since M. chelonae group was a contaminant in the tap-water for diluting concentrated chlorhexidine, the organism happened to be isolated with the mucous membranes of the 6 patients' colons that were picked up while using the washed fiber-scope. These findings suggest that M. fortuitum and M. chelonae groups, in spite of the fact that they rarely cause infection, have a significant risk of infecting aged patients in general hospitals with various underlying diseases attributable to infections. As only a few colonies were isolated from patients' specimens in the majority of cases, it took time to carry out these clinical examinations, and to improve this "laboratory's delay", it is needed to make faster report to clinicians.

Adolescent↗

PubMed2000

Isolation of Pseudomonas aeruginosa producing OXA-4 beta-lactamase in a Japanese hospital in 1996.

One-hundred and fifty isolates of Pseudomonas aeruginosa were collected from different patients' specimens at Showa University Fujigaoka Hospital between April and August 1996. The 23 isolates resistant to piperacillin (minimum inhibitory concentration, >or=100 microg/ml) were widely distributed in the hospital wards. Using polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and isoelectric focusing (IEF) methods, we detected OXA-4 beta-lactamase hydrolyzing penams in 4 of the resistant isolates (17%) with O-serotype E. However, no other external beta-lactamase was detected by the IEF method. The hybridization results showed that the OXA-4 genes were located in chromosome, but not in plasmid. Furthermore, the isolation rate was significantly lower than that found between 1992 and 1993 (61%; P < 0.01; chi2-test), suggesting a decreased rate of hospital infection caused by P. aeruginosa producing the OXA-4 enzyme.

Humans↗

PubMed2000

Long-term results of anterior cruciate ligament reconstruction using semitendinosus and gracilis tendons with Kennedy ligament augmentation device compared with patellar tendon autografts.

ACL reconstructions were postoperatively evaluated in 102 patients who underwent surgery using an arthroscopically assisted double-incision technique. Augmentation of the distally based semitendinosus and gracilis tendons was done either with the Kennedy ligament augmentation device (LAD) (Group 1 patients, mean follow-up of 108 months) or bone-patellar-tendon-bone graft (Group 2 patients, mean follow-up of 109 months). At follow-up, serial KT-1000 measurements showed < or = 5 mm side-to-side differences in 70% of Group 1 and 90% of Group 2 patients. No differences were found among patients regarding postreconstruction complications such as loss in motion range, patellofemoral crepitus, osteoarthritis, and muscle disfunction.

Activities of Daily Living↗

PubMed2000

[Epidemiological evaluation of Serratia marcescens isolates in one Japanese hospital during the two years from April 1997 to March 1999].

One hundred fourteen isolates of Serratia marcescens from different patients in Showa University Fujigaoka Hospital during the 2 years from April 1997 to March 1999 were investigated in this study. The isolation frequency(37%, 43 of the isolates) of O-serotype 14(O14) was highest among the 16 different serotypes, and that(24%, 27 of the isolates) of O2 was secondarily highest, while these types were frequently isolated from patients in the surgical ward. O14 with major bacteriocin types 4 and 9(B4 and B9, respectively) showed resistance to piperacillin, the third and fourth generation cephems, new quinolones and aminoglycosides except gentamicin tested. However, O2 with major B1 and B5 showed much greater sensitivity to the antimicrobial agents tested than O14. Furthermore, O2 and O14 were frequently isolated from patients' sputa(41%, 11 of the 27 isolates) and urine(72%, 31 of the 43 isolates), respectively. These findings suggested that S. marcescens O14 with B4 and B9, more resistant to various agents, and O2 with B1 and B5, more sensitive to various agents, show a tendency to inhabit the urinary and respiratory tracts in the hospital patient's body, respectively, having a high risk of hospital infection.

Anti-Bacterial Agents↗

PubMed1999

Surgical management of congenital permanent dislocation of the patella in nail patella syndrome by Stanisavljevic procedure.

We report a patient with nail patella syndrome associated with congenital permanent dislocation of the patella successfully operated on using a modified Stanisavljevic method. The patient, a 26-year-old woman, complained of inability to completely extend her right knee joint. She had occasionally experienced the "giving way" phenomenon since childhood, but she had not received any treatment since birth. Physical examination showed that all fingernails were deformed, with longitudinal striations, while the lunules were of an abnormal triangular shape or were missing. Both patellae were palpably hypoplastic, with the right patella dislocated laterally, and the knee had an extension lag of 90 degrees. Thigh and leg muscle were slightly underdeveloped, but quadriceps muscle contraction was good. Several radiographs were taken and they showed bilateral iliac horns and hypoplasia of the bilateral humero-radial joints and of both patellae, and complete dislocation of the right patella. We employed the Stanisavljevic procedure for the reduction of the patella, with Z-lengthening of the rectus femoris and medial translocation of the tibial tuberosity. Four years after the operation, a 30-degree extension lag still exists in the right knee, but the treatment resulted in stable alignment of the quadriceps mechanism, and notably improved gait appearance.

Adult↗

PubMed1999

Interferon-alpha and 5-fluorouracil therapy in patients with metastatic renal cell cancer: an open multicenter trial. The Japanese Study Group Against Renal Cancer.

OBJECTIVES: Recent clinical trials have implied the cytotoxic and antiproliferative effects of combining 5-fluorouracil and interferon-alpha in the treatment of metastatic renal cell cancer. We therefore conducted an open multicenter trial to test the efficacy of such a combination on this cancer. METHODS: Human lymphoblastoid interferon (3 MIU per patient) was administered subcutaneously three times weekly for 12 weeks, while 5-fluorouracil was administered (600 mg/m2/day) as a continuous infusion for the first 5 days, followed by an intravenous bolus infusion of 600 mg/m2 once a week from the 3rd week until the 12th week. RESULTS: Of the 63 patients entered into the trial, 55 were eligible and evaluable for systemic toxicities, and 53 were evaluable for their response. All patients had undergone a prior nephrectomy, and their European Cooperative Oncology Group (ECOG) performance status ranged from 0 to 3 (median 0). Three complete and eight partial responses were induced, with an overall response rate of 20.0%. The median time to progression and the median survival time were 11 and 33 months, respectively. World Health Organization grade 3 toxicities were observed in 8 patients; however, no grade 4 toxicities or toxicity-related deaths were noted. CONCLUSIONS: Combination therapy of interferon-alpha plus 5-fluorouracil at the above-described dosage and schedule produced no better responses than interferon monotherapies. Prolongation of survival could be attributable to the fair performance status of the patients. This regimen has limited value for the treatment of patients with advanced renal cell cancer.

Adult↗

PubMed1999

Erectile function and nocturnal penile tumescence in patients with prostate cancer undergoing luteinizing hormone-releasing hormone agonist therapy.

BACKGROUND: Luteinizing hormone-releasing hormone (LHRH) agonists have been widely used as effective agents in endocrine therapy for prostate cancer. Continuous administration of the drug results in profound suppression of testicular androgen production. However, the side effects on erectile function have not been fully investigated. METHODS: We studied the influences of testosterone suppression on male sexual function and nocturnal penile tumescence in nine sexually active patients with prostate cancer who were treated with an LHRH agonist. RESULTS: Following reduction of serum testosterone concentrations to a castration level by the administration of the LHRH agonist, sexual desire, sexual interest and sexual intercourse were totally annulled, with significant changes in frequency, magnitude, duration and rigidity of nocturnal erections observed in all patients. CONCLUSIONS: These results demonstrate that the LHRH agonist strongly suppresses erectile function and sexual activity. Taking into account the quality of sexual function for relatively young and sexually active patients and their partners, it is necessary to establish effective modalities that minimize the adverse effects on sexual function for the treatment of patients with prostate cancer.

Aged↗

PubMed1999

Detection of OXA-4 beta-lactamase in Pseudomonas aeruginosa isolates by genetic methods.

In Pseudomonas aeruginosa, resistance to cefclidin is usually associated with resistance to another third-generation cephalosporin, ceftazidime. In this study we analysed 22 isolates of P. aeruginosa, collected at Showa University Fujigaoka Hospital between 1992 and 1993, which were resistant to cefclidin but susceptible to ceftazidime. All polymerase chain reaction (PCR) products amplified by a primer pair covering the full-length gene of OXA-4 (also OXA-1) precursor beta-lactamase were 0.84 kb in length. The isoelectric points of the beta-lactamases produced by these isolates were typical of the OXA-4 type of beta-lactamase (pl 7.5) rather than the OXA-1 type (pl 7.4). All PCR products at 216 bp were amplified by the primer pair covering the A928-->T point mutation, which corresponds to the Asp48-->Val amino acid substitution of OXA-1 beta-lactamase to form OXA-4 beta-lactamase. These single-strand conformation polymorphism (SSCP) patterns are typical of the OXA-4 gene, rather than the OXA-1 gene, demonstrating that these enzymes can be classified by SSCP analyses based on the PCR method. Although OXA-4 beta-lactamase is generally plasmid-mediated, the chromosomal DNA of these isolates, but not their plasmids, hybridized with the OXA-4 gene amplified by the PCR method. Based on these results, we suspected that the plasmids encoding OXA-4 beta-lactamase had been spontaneously cured, or that the gene had been deleted from the plasmid. The distribution of P. aeruginosa producing OXA-4 beta-lactamase amongst hospital wards and clinical specimens demonstrated that the OXA-4 enzyme in this collection period was representative of hospital P. aeruginosa.

Amino Acid Sequence↗

PubMed1999

Antitumor effects of an interferon-loaded silicone formulation in human renal cell carcinoma in nude mice.

Conventional therapy for renal cell carcinoma using interferon (IFN) has shown limited antitumor action. The IFN-loaded silicone formulation (IFN-SF) is a sustained-release formulation of human lymphoblastoid IFN, with a medical grade silicone elastomer used as the carrier material. We evaluated the antitumor effect of IFN-SF on human renal cell carcinoma cell line (KU-2) transplanted to nude mice. The treatment was started when the tumor nodules had grown 6 to 8 mm in diameter. IFN-SF, on an aqueous solution of IFN, was given by subcutaneous or peritumoral injection. Antitumor effects were evaluated according to tumor weights calculated as (long diameter) x (short diameter)2/2 in 7 groups consisting of 6 mice each. Serum IFN levels remained detectable up to 30 days after subcutaneous injection of IFN-SF. IFN-SF administered by the subcutaneous and peritumor route significantly inhibited growth of the tumor when compared with tumor growth in the untreated mice and mice treated with aqueous IFN solution. IFN-SF had equivalent inhibitory effects on tumor growth by peritumor and subcutaneous injection. Results indicated that the use of IFN-SF could reduce the frequency of injections and provide better treatment of patients with renal cell carcinoma because of its long-acting effect when it is used systemically.

Animals↗

PubMed1999

[Effect of aging and diseases on male sexual function assessed by the International Index of Erectile Function].

PURPOSE: Many epidemiological factors contribute to erectile dysfunction (ED). The objective of the present research was to investigate the risk factors of ED and the influence of aging on male sexual function, to obtain some insight into prevention of ED. METHODS: The study sample consisted of employees, aged from 22 to 59 years old of ten companies in Japan, who responded to the International Index of Erectile Function (IIEF) questionnaire and a survey of health status and related variables. The IIEF sexual activity questionnaire includes 15 items related to male sexual activity organized into five domains (that is erectile function, orgasmic function, sexual desire, intercourse satisfaction, overall satisfaction) to which 967 of the 1,020 subjects (94.8%) provided complete responses. These 967 men constitute the present study sample. For statistical analysis, ANOVA with Scheffe's (post hoc) test was conducted, and statistical significance was set at p < 0.05. RESULTS: Presence of hypertension, heart disease, diabetes and hyperlipidemia was associated with a significantly decreased score for erectile function in subjects in their fifties (p < 0.05), however, it was not significant in the other age groups. In subjects, who were free from risk factors for sexual function, there was significant correlation between age and the scores for erectile function, orgasmic function, sexual desire and intercourse satisfaction. CONCLUSIONS: Aging and chronic disorders that have been considered to be putative risk factors for ED, therefore affect male sexual function in the elderly. The IIEF was suggested to be suited for use in studies assessing epidemiology of ED.

Adult↗