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K Sugimura

Publications and source records attributed to K Sugimura.

At least 37 records · Page 2Linked to original sources
PubMed2001

Long-term results of balloon-occluded retrograde transvenous obliteration for the treatment of gastric varices and hepatic encephalopathy.

PURPOSE: To evaluate the long-term results of balloon-occluded retrograde transvenous obliteration (B-RTO) for the treatment of gastric varices (GV) and hepatic encephalopathy. MATERIALS AND METHODS: A total of 43 patients who had undergone B-RTO were evaluated, 32 with GV, two with hepatic encephalopathy, and nine with both. All but one had been consecutively followed up with gastrointestinal endoscopy for more than 1 year (3-60 months; mean, 30.44 months). Collateral veins of gastric varices were graded using balloon-occluded retrograde left adrenal venography. The relation of both worsening of esophageal varices (EV) and improved Child-Pugh score after B-RTO to the grades of collateral vein development was analyzed. The relapse-free survival and the prognostic factors for survival after B-RTO were also assessed. RESULTS: GV disappeared or decreased markedly in size, and hepatic encephalopathy was completely cured in all patients. Improvement in Child-Pugh score was observed in 21 patient (50.0%) 6 months after B-RTO, but in only 11 patients (25.6%) 1 year after B-RTO. Worsening of EV was seen in eight patients and was related to a worsened grade of collateral veins. Cumulative relapse-free survival rate was 90.8% at 1 year and 87.4% at 3 years after B-RTO. The most significant prognostic factor was Child-Pugh classification (relative risk: 4.16) CONCLUSION: B-RTO is a safe and effective treatment for patients with GV and hepatic encephalopathy. The most important prognostic factors are the extent of Child-Pugh classification.

Balloon Occlusion↗
PubMed2001

Refraction imaging and histologic correlation in excised tissue from a normal human lung: preliminary report.

RATIONALE AND OBJECTIVES: The authors performed this study to evaluate the spatial resolution of refraction imaging performed with synchrotron radiation (SR) on 2-mm-thick sections of excised normal human lung. MATERIALS AND METHODS: Refraction images of specimens from a normal human lung were obtained with 19 keV, a 5-second exposure time, and a 2.4 x 2.4-cm field of view. The specimen-detector distance was 83 cm. RESULTS: Structures of secondary pulmonary lobule consisting of pulmonary arteriole, terminal bronchiole, air sac, and venules in the interlobular septum in normal lung were clearly illustrated on refraction images obtained with SR. The imaging findings showed good correlation with those from histologic examination. The spatial resolution of the refraction images was approximately 10-30 microm, as measured with light microscopic analysis of specimens stained with hematoxylin-eosin. CONCLUSION: With refinement, this technique may have some practical purpose for diagnosing lung disease in vivo.

Aged↗
PubMed2001

A close relationship of triplet repeat polymorphism in MHC class I chain-related gene A (MICA) to the disease susceptibility and behavior in ulcerative colitis.

Major histocompatibility complex (MHC) class I chain-related gene A (MICA) has been found near the HLA-B gene. The MICA molecule is exclusively expressed on gastrointestinal epithelium and recognized by intestinal epithelial gamma delta T cells, where it exhibits a triplet repeat polymorphism in the transmembrane region. We investigated the possible correlation between MICA genetic polymorphism and ulcerative colitis (UC). Eighty-three patients with UC and 132 unrelated controls were included in this study. All subjects were Japanese. A triplet repeat polymorphism in the transmembrane region of the MICA was determined by direct sequencing procedures after amplification by a polymerase chain reaction. A significantly higher allele and phenotype frequencies of MICA A6 allele were observed in patients with UC than controls (allele frequency: P(c)=0.000011, phenotype frequency: P(c)=0.0049 odds ratio=2.62). A6 homozygous patients with UC showed significantly earlier onset of UC than patients without the A6 allele ((P)c=0.0042). Phenotypes of MICA A6 allele in Japanese are closely related to the disease susceptibility and behavior in UC. Examinations of MICA polymorphism in other ethnic groups may provide important information about the locus of primary responsible gene for UC.

Adolescent↗
PubMed2001

Stratification analysis of MICA triplet repeat polymorphisms and HLA antigens associated with ulcerative colitis in Japanese.

We previously reported a conserved haplotype of HLA B52-DR2 and a significantly high frequency of the major histocompatibility complex (MHC) class I chain-related gene A (MICA) transmembrane-short tandem repeat (TM-STR) 6 allele in Japanese patients with ulcerative colitis (UC). To examine the predominance of the MICA TM-STR 6 allele as a marker of the susceptibility to UC within the susceptible haplotype, the association of each allele with UC was estimated following stratification of the patients to control for any possible confounding effects of other alleles positively associated with UC. Sixty-four patients with UC and 236 unrelated healthy controls were included in this study. All subjects were Japanese. HLA-A, -B, -C, and -DR antigens were determined serologically. A triplet repeat polymorphism of the MICA was determined by direct sequencing. To control for the effect of linkage disequilibrium, Mantel-Haenszel weighed odds ratios were calculated. Significantly higher phenotype frequencies of B52, MICA TM-STR 6, and DR2 were observed in patients with UC. Linkage disequilibria among alleles associated with UC revealed that a B52 - MICA TM-STR 6 - DR2 haplotype was conserved in patients with UC, as in controls. When the association of HLA-B52 was estimated after patient stratification for the possible confounding effect of MICA TM-STR 6 or DR2, a strong significant association of B52 with UC was still observed. In contrast, no association with UC was observed for MICA TM-STR 6 or DR2, after stratification of the possible confounding effect of HLA-B52. These results imply that the significant increase in MICA TM-STR 6 in Japanese patients with UC is attributable to linkage disequilibrium with HLA-B52.

Colitis, Ulcerative↗
PubMed2001

Microscopic hematuria as a screening marker for urinary tract malignancies.

BACKGROUND: Although a mass screening urinalysis is a widely accepted procedure, it has not yet been shown if microhematuria is an appropriate and useful screening marker for urologic malignancies. METHODS: (1) The incidence of hematuria was studied in 113 patients with renal cell carcinoma (RCC), 185 with bladder carcinoma and 51 with renal pelvic or ureteral carcinoma. The association of the T stage with the intensity of hematuria in each malignancy was also examined. (2) In 823 asymptomatic adults with microhematuria, the prevalence of these malignancies was studied retrospectively to find the positive predictive value (PPV). RESULTS: (1) The incidence of hematuria was 35% for RCC, including gross and microhematuria. Advanced RCC (T3 and T4) were diagnosed more frequently in the gross hematuria group than in the microhematuria and no hematuria groups. In contrast, the incidence of hematuria was 94% for urothelial carcinomas either in the upper urinary tract or in the bladder. There was no significant difference in the T stage nor grade between the gross hematuria group and the microhematuria group. (2) Regarding asymptomatic microhematuria, the PPV was 1.7% (14 cases) for bladder carcinoma, 0.4% (3 cases) for ureteral/renal pelvic carcinoma and 0.2% (2 cases) for RCC. In men aged 50 years or older, PPV was 6.2% for urothelial carcinomas. In 14 cases of bladder carcinoma, 3 cases showed muscle invasion. CONCLUSIONS: Microhematuria is an appropriate screening marker for urothelial carcinomas, particularly in elderly men, but not for RCC. However, it is unlikely that a mass screening urinalysis using a single voided urine sample would contribute to earlier detection of bladder carcinoma.

Adult↗
PubMed2001

Activated platelets in ulcerative colitis enhance the production of reactive oxygen species by polymorphonuclear leukocytes.

BACKGROUND: Although the number of activated platelets increases in the peripheral blood of patients with inflammatory bowel disease (IBD), the role of activated platelets in the polymorphonuclear leukocytes (PMN)-mediated mucosal injury in IBD remains unclear. In the present study, we used luminol-enhanced chemiluminescence (LCL) to examine the influence of platelets from patients with ulcerative colitis (UC) on the production of reactive oxygen species (ROS) by circulating PMN. METHODS: The proportion of P-selectin-positive activated platelets was determined using flow cytometry. PMN from patients with UC and normal controls were stimulated using phorbol 12-myristate 13-acetate with or without autologous platelets, anti-P-selectin monoclonal antibody and thrombin. Indicator PMN from a normal volunteer were stimulated using heterologous platelets from UC patients and normal controls, and LCL signals were registered every 60 sec for 240 min. RESULTS: The proportion of activated platelets was significantly increased in IBD patients. The level of ROS production by PMN did not significantly differ between UC patients and normal controls in the absence of a platelet-PMN interaction. Platelets from UC patients enhanced the amount of ROS produced by indicator PMN significantly more than those from normal controls. This effect was partly diminished by anti-P-selectin monoclonal antibody. CONCLUSIONS: Platelet activation in UC might be responsible for the secondary activation of PMN, which could account for the increase in PMN-mediated tissue injury associated with UC.

Adult↗
PubMed2001

Value of magnetic resonance imaging in predicting efficacy of GnRH analogue treatment for uterine leiomyoma.

BACKGROUND: Estimating pharmacological efficacy is important when selecting conservative treatment of uterine leiomyoma. Hence, the ability of magnetic resonance (MR) imaging to predict gonadotrophin-releasing hormone (GnRH) analogue efficacy was investigated. METHODS: A total of 85 lesions was studied in 40 patients who were clinically diagnosed as having uterine leiomyoma and treated with GnRH analogue for 24 weeks. To evaluate changes in lesion size, T2-weighted and gadopentetate-dimeglumine (Gd-DTPA)-enhanced, T1-weighted MR images were obtained within 2 weeks before, and immediately after termination of, GnRH analogue treatment. RESULTS: An average 46.3% size reduction was observed in 45 lesions (52.9%); these were seen as low signal intensity on T2-weighted images and enhanced by Gd-DTPA. Also, an average 44.7% size reduction was observed in lesions enhanced by Gd-DTPA, irrespective of signal intensity findings on T2-weighted images. The average size reduction of unenhanced lesions was only 17.8%, and significantly different from enhanced lesions (P < 0.001). The prediction of efficacy was difficult in those lesions not enhanced. CONCLUSIONS: It is considered that evaluation of MR signal intensities, and the presence or absence of Gd-DTPA enhancement, would predict treatment efficacy before GnRH analogue administration.

Adult↗
PubMed2001

Pilot study of local radiotherapy for portal vein tumor thrombus in patients with unresectable hepatocellular carcinoma.

BACKGROUND: Patients suffering from hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) generally have a poor prognosis. We therefore conducted a prospective pilot trial of combined transcatheter arterial chemoembolization (TACE) and local radiotherapy (RT) for PVTT in unresectable HCC. The aim of the study was to investigate the efficacy and toxicity of this preliminary trial regime and to explore RT guidelines for cirrhosis. METHODS: Eight patients with unresectable HCC accompanied by first branch PVTT were entered into the study from February 1998 to December 1999. TACE was performed using Lipiodol, epirubicin hydrochloride and mytomycin followed by gelatin sponge cubes. RT was started 10-14 days following TACE. A total delivered dose of 60 Gy was given as daily 2 Gy fractions, with the clinical target volume defined as PVTT only. We observed a relationship between deterioration of liver function and the percent volume of the total liver receiving a dose exceeding 30 Gy (V30). RESULTS: An objective response was observed in three of the eight patients. However, on follow-up angiograms the protrusion of PVTT into the main portal trunk was decreased in all cases. Deterioration of liver function was observed in all patients with V30 >40%. CONCLUSION: It is possible that this combined therapy prevents PVTT from spreading to the main trunk and that indicates a further benefit of TACE. Our results indicate that V30 constitutes a predictive test for the development of liver failure. More detailed evaluations of liver function and determination of the safe irradiation volume are necessary.

Aged↗
PubMed2001

Peptide mimics of monocyte chemoattractant protein-1 (MCP-1) with an antagonistic activity.

In this study, we attempted to analyze the peptide motifs recognized by 24822.111 and F9, monoclonal antibodies (mAbs) that inhibit the chemotactic activity of monocyte chemoattractant protein-1 (MCP-1), a member of the CC subfamily of chemokines. We isolated phage clones from a phage display library and identified six peptide motifs. One of these clones, C27, was strongly and specifically recognized by 24822.111 mAb, while another, G25, was similarly recognized by F9 mAb. Both the C27 motif and the G25 motif contain two cysteines in their sequences and have little homology to the primary amino acid sequence of MCP-1. These clones, however, bound to THP-1 cells, and the binding was competitively inhibited by MCP-1. The clones strongly inhibited the MCP-1-induced chemotaxis of human monocytes. The synthetic and intramolecularly disulfide-linked peptides of C27 and G25 (sC27 and sG25) also inhibited the chemotaxis induced by MCP-1, while their derivatives with serine in place of cysteine did not, suggesting the importance of the loop structure for the inhibition. These results suggest that sC27 and sG25 may mimic the MCP-1-binding domain to the MCP-1 receptor.

Amino Acid Sequence↗
PubMed2001

Endocrine-disrupting chemicals in CAPD dialysate and effluent.

Environmental contamination by endocrine-disrupting chemicals (EDC) has been a major focus of recent research and policy discussions. EDC-suspected man-made chemicals used as raw materials or plasticizers have been shown to elute from plastic products. To examine whether the dialysate for continuous ambulatory peritoneal dialysis (CAPD) is contaminated with EDC, we determined bisphenol A (BPA), nonylphenol (NP), di-(2-ethylhexyl)phthalate (DEHP) and di-n-butyl phthalate (DBP) in the pre-used dialysate and in the peritoneal effluent from renal failure patients by gas chromatography/mass spectrometry. Concentrations of BPA, NP, DEHP and DBP were 0.02-0.23 ppb (microg/l), 0.09-0.22, 1.1-3.7, and <0.1-2.1 ppb, respectively, in the pre-used dialysate, and <0.01-0.07, <0.1-0.45, 0.35-1.23, and 0.42-1.76 ppb, respectively, in the effluent, from which the maximal daily contamination of BPA and NP by CAPD was estimated at the microgram level and that of phthalate esters at the 10-microg level. These concentrations are far less than the toxic dosage reported so far, so that CAPD is unlikely to contaminate patients seriously.

Adult↗
PubMed2001

Influence of interleukin-10 on the interleukin-1 receptor antagonist/interleukin-1 beta ratio in the colonic mucosa of ulcerative colitis.

A decrease in the ratio of IL-1ra/IL-1 beta produced regionally by the colonic mucosa of patients with ulcerative colitis (UC) is believed to play a role in the pathogenesis of UC. To investigate factors influencing intramucosal IL-1ra/IL-1 beta ratios, we evaluated polymorphism of the IL-1ra gene and the production of mucosal cytokines in Japanese patients with UC. Colonic biopsy specimens of mucosal tissue were placed in organ cultures for 24 h. Then, the supernatant concentrations of IL-1 beta, IL-1ra, IL-8, IL-4, IL-10, and TGF-beta were assayed by ELISA. Genomic DNA was extracted from patient peripheral blood samples, then IL-1ra gene polymorphism was determined using PCR amplification. The mucosa from patients with active stage UC showed a tendency toward a decreased IL-1ra/IL-1 beta ratio. In the resolving stage, IL-1ra/IL-1 beta ratios increased with increasing IL-10 and TGF-beta concentrations. The addition of human recombinant IL-10 to the culture supernatants produced concentration-dependent inhibition of IL-1 beta. In Japanese patients with UC, the IL-1ra allele gene 2 phenotype had no effect on the IL-1ra/IL-1 beta ratio. Our findings suggest that a relative deficiency of IL-10 in patients with UC may contribute to persistent inflammatory changes.

Adult↗
PubMed2001

Oxygen-enhanced MR ventilation imaging of the lung: preliminary clinical experience in 25 subjects.

OBJECTIVE: The purpose of this study was to show the feasibility of oxygen-enhanced MR ventilation imaging in a clinical setting with correlation to standard pulmonary function tests, high-resolution CT, and (81m)Kr ventilation scintigraphy. SUBJECTS AND METHODS: Seven healthy volunteers, 10 lung cancer patients, and eight lung cancer patients with pulmonary emphysema were studied. A respiratory synchronized inversion-recovery single-shot turbo-spin-echo sequence (TE, 16; inversion time, 720 msec; interecho spacing, 4 msec) was used for data acquisition. The following paradigm of oxygen inhalation was used: 21% oxygen (room air), 100% oxygen, 21% oxygen. MR imaging data including maximum mean relative enhancement ratio and mean slope of relative enhancement were correlated with forced expiratory volume in 1 sec, diffusing lung capacity, high-resolution CT emphysema score, and mean distribution ratio of (81m)Kr ventilation scintigraphy. RESULTS: Oxygen-enhanced MR ventilation images were obtained in all subjects. Maximum mean relative enhancement ratio and mean slope of relative enhancement of lung cancer patients were significantly decreased compared with those of the healthy volunteers (p < 0.0001, p < 0.0001). The mean slope of relative enhancement in lung cancer patients with pulmonary emphysema was significantly lower than that of lung cancer patients without pulmonary emphysema (p < 0.0001). Maximum mean relative enhancement ratio (r(2) = 0.81) was excellently correlated with diffusing lung capacity. Mean slope of relative enhancement (r(2) = 0.74) was strongly correlated with forced expiratory volume in 1 sec. Maximum mean relative enhancement had good correlation with the high-resolution CT emphysema score (r(2) = 0.38). The maximum mean relative enhancement had a strong correlation with the distribution ratio (r(2) = 0.77). CONCLUSION: Oxygen-enhanced MR ventilation imaging in human subjects showed regional changes in ventilation, thus reflecting regional lung function.

Adult↗
PubMed2001

Clinical efficacy of fidarestat, a novel aldose reductase inhibitor, for diabetic peripheral neuropathy: a 52-week multicenter placebo-controlled double-blind parallel group study.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of fidarestat, a novel aldose reductase (AR) inhibitor, in a double-blind placebo controlled study in patients with type 1 and type 2 diabetes and associated peripheral neuropathy. RESEARCH DESIGN AND METHODS: A total of 279 patients with diabetic neuropathy were treated with placebo or fidarestat at a daily dose of 1 mg for 52 weeks. The efficacy evaluation was based on change in electrophysiological measurements of median and tibial motor nerve conduction velocity, F-wave minimum latency, F-wave conduction velocity (FCV), and median sensory nerve conduction velocity (forearm and distal), as well as an assessment of subjective symptoms. RESULTS: Over the course of the study, five of the eight electrophysiological measures assessed showed significant improvement from baseline in the fidarestat-treated group, whereas no measure showed significant deterioration. In contrast, in the placebo group, no electrophysiological measure was improved, and one measure significantly deteriorated (i.e., median nerve FCV). At the study conclusion, the fidarestat-treated group was significantly improved compared with the placebo group in two electrophysiological measures (i.e., median nerve FCV and minimal latency). Subjective symptoms (including numbness, spontaneous pain, sensation of rigidity, paresthesia in the sole upon walking, heaviness in the foot, and hypesthesia) benefited from fidarestat treatment, and all were significantly improved in the treated versus placebo group at the study conclusion. At the dose used, fidarestat was well tolerated, with an adverse event profile that did not significantly differ from that seen in the placebo group. CONCLUSIONS: The effects of fidarestat-treatment on nerve conduction and the subjective symptoms of diabetic neuropathy provide evidence that this treatment alters the progression of diabetic neuropathy.

Aldehyde Reductase↗
PubMed2001

A preliminary study of proposed levels of relatedness in identity exploration among female late adolescents in Japan.

This study examined features of identity exploration among late adolescent Japanese girls from the viewpoint of relatedness. The expanded Ego Identity Interview was administered to 33 female university students. Five levels of relatedness were formulated in a sequence from exploration without relatedness to exploration with disagreements between one's own and others' perspectives. The results support the current view of researchers emphasizing relational aspects of identity and provide detailed features of the identity formation process from the viewpoint of relatedness among late adolescent girls in Japan.

Adolescent↗
PubMed2001

[Diagnostic imaging in male pelvic disorders].

This article reviews the imaging findings of male pelvic disorders, especially those of prostate disease. Magnetic resonance imaging (MRI) provides excellent anatomical detail, and is useful to stage prostate cancer and to understand the process of anomaly. However, failure to detect capsular invasion remains a significant weakness in prostate cancer. It is important to understand the limits and contributions of MRI to the staging of prostate cancer, and to perform the appropriate examination.

Humans↗
PubMed2001

[Temporary placement of inferior vena cava filter prior to transcatheter arterial embolization (TAE) for hepatocellular carcinoma with IVC tumor thrombus--prevention of pulmonary tumor emboli after TAE].

A 66-year-old-man with a right huge hepatocellular carcinoma (HCC) extending into both the right portal vein and the right atrium underwent transcatheter arterial embolization (TAE) via the right hepatic artery. Prior to the TAE, a temporary inferior vena cava (IVC) filter was placed suprarenally for prevention of pulmonary tumor emboli. When we replaced the temporary IVC filter with a new one 7 days after the TAE, the filter which was pulled out of the IVC captured a fragment of the tumor thrombus. A histopathological specimen demonstrated only ghost cells. The patient has been followed at our outpatient clinic without any tumor thrombus or pulmonary infarction for 13 months after this procedure.

Aged↗