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Biomedical subjects

K Tsutsumi

Publications and source records attributed to K Tsutsumi.

At least 19 recordsLinked to original sources
PubMed2006

Role of diffusion-weighted magnetic resonance imaging in diffuse axonal injury.

PURPOSE: To determine whether the signal changes on magnetic resonance imaging (MRI), including fluid attenuated inversion recovery (FLAIR), T2*-weighted gradient echo (GE) imaging, and diffusion-weighted imaging (DWI) in diffuse axonal injury (DAI) patients correlate with the clinical outcome. MATERIAL AND METHODS: We diagnosed patients with DAI based on the following criteria: 1) a loss of consciousness from the time of injury that persisted beyond 6 h; 2) no apparent hemorrhagic contusion on computed tomography (CT); 3) the presence of white matter injury on MRI. Twenty-one DAI patients were analyzed (19 M, 2 F, mean age 34 years) with MRI (FLAIR, T2*-weighted GE imaging, and DWI). RESULTS: 325 abnormalities were detected by MRI within a week after injury. The T2*-weighted GE imaging was significantly more sensitive than FLAIR and DWI in diagnosing DAI. DWI detected only 32% of all lesions, but could depict additional shearing injuries not visible on either T2*-weighted GE imaging or FLAIR. The mean number of lesions in brainstem detected by DWI in the favorable group (good recovery/moderately disabled) was significantly smaller than in the unfavorable group (severely disabled/vegetative survival/death). This trend was not observed on the T2*-weighted GE imaging and FLAIR findings. CONCLUSION: DWI cannot detect all DAI-related lesions, but is a potentially useful imaging modality for both diagnosing and assessing patients with DAI.

Adolescent↗
PubMed2006

2D Thick-section MR digital subtraction angiography for the assessment of dural arteriovenous fistulas.

BACKGROUND AND PURPOSE: Although dynamic contrast-enhanced MR angiography studies for arteriovenous malformations (AVFs) and brain tumors have shown promising results, no formal attempt has yet been made to similarly evaluate dural AVFs. To assess the practical applicability of 2D thick-section contrast enhanced MR digital subtraction angiography (MRDSA) for the diagnosis and management of dural AVFs, MRDSA and intra-arterial digital subtraction angiography (IADSA) were comparatively evaluated. METHODS: We performed 80 consecutive MRDSA studies for 25 dural AVFs, including 11 cavenous sinuses, 9 sigmoid sinuses, 2 tentorial sinuses, one anterior condylar vein, one craniocervical junction, and one spine. MR images were continuously obtained following the initiation of a bolus injection of gadrinium chelates and subtraction images were constructed. We thereafter evaluated the imaging quality and hemodynamic information from all 46 MRDSA images performed in parallel with IADSA in either perioperative or follow-up studies. RESULTS: Most MRDSA images detected early venous filling, sinus occlusion, leptomeningeal venous drainage, and varices. It was difficult, however, to identify the feeding arteries because of both the partial volume effect and a low spatial resolution. Most important, MRDSA accurately detected aggressive lesions with leptomeningeal venous drainage and varices. CONCLUSION: Our MRDSA technique was found to have limited value for depicting all the anatomic details of dural AVFs, though it was able to identify important hemodynamic abnormalities related to the risk of hemorrhaging. MRDSA is therefore useful as a less invasive, dynamic angiographic tool, not only for perioperative studies but also for follow-up studies.

Adult↗
PubMed2005

Lesions identified on T2*-weighted gradient echo images in two patients with suspected diffuse axonal injury that resolved in less than ten days.

T2*-weighted gradient echo (GE) imaging is useful for detection of intracranial hemorrhage in the patients with diffusion axonal injury (DAI). However, the temporal changes in the DAI-related lesions on T2*-weighted GE images are not clear. We report two very rare cases with DAI in which lesions identified on T2*-weighted GE images resolved in less than ten days.

Adolescent↗
PubMed2005

Bacteriological study of autologous cryoprecipitate-derived fibrin glue as the operative sealant.

Fibrin glue (FG) is frequently used to seal and cover the anastomoses in many operations such as cardiovascular surgery or orthopaedic surgery. However, in case of gastrointestinal surgery, anastomoses are potentially contaminated, and FG may promote bacterial growth, increasing the risk of leakage. The purpose of this study was to examine the effect of cryoprecipitate-derived FG (CryoFG) on bacterial growth. Bacterial growth on the CryoFG and on the commercial FG (Beriplast P) was evaluated and compared with that on control medium. In addition, the complement activities were evaluated by heat inactivation or addition of guinea-pig complement to the experimental settings. The CryoFG inhibited the growth of Escherichia coli, whereas the commercial FG had no effect. Heat inactivation of the CryoFG inhibited the bactericidal effect of CryoFG. Addition of guinea-pig complement to the heat-inactivated CryoFG could almost restore the bactericidal activity, suggesting the important role of complement. This study showed that the CryoFG preserved the complement activity, which inhibited the in vitro growth of E. coli. Therefore, we concluded that the application of the CryoFG for gastrointestinal surgical anastomoses not only would be safe but also has the advantage of reducing bacterial infection.

Bacteria↗
PubMed2005

[Successful removal of T4 lung cancer with left atrial invasion after induction chemotherapy].

A 53-year-old man presented with cough, sputa and chest pain. The chest X-ray revealed a large mass shadow in the right lower lobe. Massive tumor extending into the left atrium was diagnosed by computed tomography (CT). The brushing cytology by broncoscopy was squamous cell carcinoma and its stage was IIIB. Chemothrapy using cisplatin, paclitaxel and gemcitabine hydrochloride was performed 8 courses during 6 months. The effect of the chemotherapy was complete response, enabling the surgical treatment. The right pneumonectomy with partial resection of the left atrium was performed by using vascular clamp. The defect of the left atrium could be sutured directly. Wide-spread necrotic change with very small amount of cancer cells in the atrial wall was confirmed by pathology. The patient has been well for 3 years and 6 months after surgery.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Overexpression of lipoprotein lipase improves insulin resistance induced by a high-fat diet in transgenic rabbits.

AIMS/HYPOTHESIS: Dysfunctions of lipoprotein lipase (LPL) have been found to be associated with dyslipidaemias, atherosclerosis, obesity and insulin resistance. There are two conflicting hypotheses regarding the roles of LPL in glucose metabolism and insulin resistance. Whether systemically increased LPL activity would be beneficial or detrimental to insulin sensitivity is yet to be resolved. To address this issue, we studied transgenic rabbits overexpressing human LPL transgene. METHODS: LPL transgenic and control rabbits were fed a 10% high-fat diet (HFD) for 16 weeks. To evaluate glucose metabolism, we compared plasma levels of glucose and insulin in transgenic rabbits with control rabbits and performed an intravenous glucose tolerance test. In addition, we measured adipose tissue accumulation in HFD-fed rabbits. RESULTS: Increased LPL activity in transgenic rabbits resulted in a significant reduction of plasma triglycerides and non-esterified fatty acids, but not in basal levels of glucose and insulin. HFD feeding induced an elevation of plasma glucose levels accompanied by hyperinsulinaemia in control rabbits, but was significantly inhibited in transgenic rabbits. The intravenous glucose tolerance test showed that transgenic rabbits had faster glucose clearance associated with lower levels of insulin secretion than control rabbits. In addition, there was a significant reduction of body adipose tissue in transgenic rabbits compared with in control rabbits fed an HFD. Scanning electron microscopic examination revealed that adipocytes in transgenic rabbits were predominately small cells. CONCLUSIONS/INTERPRETATION: Our results showed that systemically increased LPL activity improves insulin resistance and reduces adipose accumulation in transgenic rabbits, indicating that systemic elevation of LPL may have potential benefits for the treatment of insulin resistance and obesity.

Adipocytes↗
PubMed2004

Induction of calcification in MC3T3-E1 cells by inorganic polyphosphate.

Relatively large amounts of inorganic polyphosphate [poly(P)] (400 microM) have been found in normal osteoblasts. The effect of poly(P) with an average chain length of 65 phosphate residues on cell calcification was therefore investigated with the use of MC3T3-E1 cells. Expression of both osteopontin and osteocalcin was induced by poly(P) (0.1 approximately 1 mM), and cells treated with poly(P) were strongly stained by alizarin red. In addition, the level of alkaline phosphatase activity induced in poly(P)-treated cells was two-fold higher than that in either orthophosphate-treated or control cells but not higher than that in cells treated with beta-glycerophosphate and ascorbic acid. In contrast, however, polyphosphatase activities were activated by poly(P) treatment to levels up to six-fold greater than that in controls. MC3T3-E1 cells may utilize poly(P) as a phosphate source for calcification rather than phosphate sources that are mainly produced by ALPase. Poly(P)-dependent induction of polyphosphatase activities may therefore promote calcification in MC3T3-E1 cells.

3T3 Cells↗
PubMed2004

NO-1886 decreases ectopic lipid deposition and protects pancreatic beta cells in diet-induced diabetic swine.

The synthetic compound NO-1886 (ibrolipim) is a lipoprotein lipase activator that has been proven to be highly effective in lowering plasma triglycerides. Recently, we found that NO-1886 also reduced plasma free fatty acids and glucose in high-fat/high-sucrose diet-induced diabetic rabbits. In the current study, we investigated the effects of NO-1886 treatment on ectopic lipid deposition and the islet pathology in miniature swine fed a high-fat/high-sucrose diet. Our results showed that feeding this diet to miniature swine caused insulin resistance, increased lipid deposition in non-adipose tissue, such as in the heart, skeletal muscle, liver and pancreas, and also caused pancreatic beta cell damage. However, supplementing 1% NO-1886 (200 mg/kg per day) into the high-fat/high-sucrose diet decreased ectopic lipid deposition, improved insulin resistance, and alleviated the beta cell damage. These results suggest that improvement of lipid disorder, non-adipose tissue steatosis and insulin resistance may be very important for the protection of beta cell damage. Therefore, NO-1886 is potentially beneficial for the treatment of insulin-resistance syndrome.

Animals↗
PubMed2003

Esophageal carcinoma with tracheal stenosis due to tumor invasion and long survival after chemoradiotherapy.

For patients who have esophageal carcinoma with tracheal invasion surgery is usually not indicated because operative complications are considerable and the prognosis is poor. We experienced complete regression of a large esophageal carcinoma with tracheal stenosis due to tumor invasion without tracheo-esophageal fistula. Irradiation of 68 Gy was delivered to a long T field from the neck to the lower thoracic esophagus, and was combined with chemotherapy using cisplatin and 5-fluorouracil. The tumor decreased markedly in size and the tracheal stenosis resolved. The patient has survived for 4 years, although second primary early esophageal carcinoma and hypopharyngeal carcinoma were detected 2 years after his initial chemoradiotherapy. Although the prognosis of advanced esophageal carcinoma with invasion of other organs is usually poor, the effect of chemoradiotherapy can sometimes be dramatic and a good result can be achieved in such patients.

Combined Modality Therapy↗
PubMed2003

Lipoprotein lipase and atherosclerosis.

Lipoprotein lipase (LPL) is a rate-limiting enzyme that hydrolyzes circulating triglyceride-rich lipoprotein such as very low density lipoproteins and chylomicrons. A decrease in LPL activity is associated with an increase in plasma triglycerides (TG) and decrease in high density lipoprotein (HDL) cholesterol. The increase in plasma TG and decrease in HDL cholesterol are risk factors of coronary heart disease. However, whether LPL directly or indirectly promotes or protects against atherosclerosis remains unclear as two contrary views exist in this regard: one where LPL promotes atherosclerosis and one where LPL protects against atherosclerosis. Many studies have been carried out to investigate whether LPL is an anti-atherogenic or atherogenic enzyme by using animals with genetic defects or with an excess of this enzyme. From these studies, much evidence has been acquired showing that LPL is an anti-atherogenic enzyme. We hypothesized that elevating LPL activity would cause a reduction of plasma TG and increase in HDL cholesterol, resulting in protection against the development of atherosclerosis. To test this hypothesis, we studied the effects of the LPL activator NO-1886 in animals. NO-1886 has been shown to increase LPL mRNA in adipose tissue and myocardium, and increase LPL activity in adipose tissue, myocardium and skeletal muscle, resulting in an elevation of postheparin plasma LPL activity and LPL mass in rats. NO-1886 has also been shown to decrease plasma TG levels accompanied by a concomitant rise in HDL cholesterol. Long-term administration of NO-1886 to rats and rabbits with experimental atherosclerosis inhibited the development of atherosclerotic lesions in coronary arteries and aortae. The results of multiple regression analysis in these studies suggest that the increase in plasma HDL cholesterol and the decrease in TG protect against atherosclerosis. We have determined in our studies that the atherogenic lipid profile is changed to an anti-atherogenic lipid profile by increasing LPL activity, resulting in protection against the development of atherosclerosis. Therefore, we believe that high activity of LPL is anti-atherogenic, whereas a low activity of LPL is atherogenic.

Animals↗
PubMed2001

Discovery of novel mesangial cell proliferation inhibitors using a three-dimensional database searching method.

A three-dimensional pharmacophore model of mesangial cell (MC) proliferation inhibitors was generated from a training set of 4-(diethoxyphosphoryl)methyl-N-(3-phenyl-[1,2,4]thiadiazol-5-yl)benzamide, 2, and its derivatives using the Catalyst/HIPHOP software program. On the basis of the in vitro MC proliferation inhibitory activity, a pharmacophore model was generated as seven features consisting of two hydrophobic regions, two hydrophobic aromatic regions, and three hydrogen bond acceptors. Using this model as a three-dimensional query to search the Maybridge database, structurally novel 41 compounds were identified. The evaluation of MC proliferation inhibitory activity using available samples from the 41 identified compounds exhibited over 50% inhibitory activity at the 100 nM range. Interestingly, the newly identified compounds by the 3D database searching method exhibited the reduced inhibition of normal proximal tubular epithelial cell proliferation compared to a training set of compounds.

Benzamides↗
PubMed2001

Carbon-carbon bond formation by electrophilic addition at the central carbon of the mu-eta(3)-allenyl/propargyl ligand on the Pd-Pd bond.

The mu-eta(3)-allenyl/propargyldipalladium complexes were synthesized by the reaction of the corresponding eta(1)-allenyl- or eta(1)-propargylpalladium complexes with Pd(2)(dba)(3). The X-ray diffraction analysis indicates that the dinuclear complex has a unique structure, in which two palladium, three carbon, two phosphorus, and one halogen atoms are in the same plane. These dinuclear complexes react with electrophiles, such as HCl or AcCl, at the central carbon of the mu-eta(3)-allenyl/propargyl ligand to give the mu-eta(3)-vinylcarbenedipalladium complexes. Intramolecular reaction proceeded smoothly to give cyclization products quantitatively. Addition of a catalytic amount of a palladium(0) complex dramatically accelerated the carbon-carbon bond formation. The MO calculations on the mu-eta(3)-allenyl/propargyl complexes indicated that the reaction proceeds via orbital control.

Journal Article↗
PubMed2001

A novel growth-related nuclear protein binds and inhibits rat aldolase B gene promoter.

The promoter of the rat aldolase B (AldB) gene that confers liver-specific transcription has an additional role. It functions in vivo as an origin region of DNA replication in the cells in which the gene is repressed (Zhao, Y., Tsutsumi, R., Yamaki, M., Nagatsuka, N., Ejiri, S., Tsutsumi, K., 1994. Initiation zone of DNA replication at the rat aldolase B locus encompasses transcription promoter region. Nucleic Acids Res. 22, 5385-5390). This promoter/origin region has multiple protein-binding sites and, thus, binding of a particular set of protein factors in AldB-expressing or non-expressing cells seems to correlate with functional switch of this promoter/origin region. In the present study, we characterized two closely related proteins, termed AlF-C1 and AlF-C2, which are assumed to be involved in repression of the AldB gene. These two proteins share an identical amino acid sequence except for a 47-residue-insertion in AlF-C1, and are members of a gene family including heterogeneous nuclear ribonucleoprotein (hnRNP) and CCAAT-binding factor subunit A (CBF-A) genes. Bacterially expressed AlF-C1 can bind sequence-specifically to the AldB gene promoter, whereas AlF-C2 can only weakly. Transfection experiments using mammalian expression vectors showed that AlF-C1 down-regulates the AldB gene promoter in rat hepatoma cells, while AlF-C2 had no or little effect. Expressions of mRNAs encoding these two proteins are enriched in fetal livers and in regenerating livers. These results implied that AlF-C1 and/or C2 is involved in growth-regulated repression of the AldB gene.

Amino Acid Sequence↗
PubMed2001

Surgical treatment for a ruptured thoracic aortic aneurysm.

OBJECTIVE: The treatment for a ruptured thoracic aortic aneurysm remains controversial. This study was undertaken to assess the outcome from surgery. METHODS: Between 1993 and 1998, we have performed 19 operations for a ruptured thoracic aortic aneurysm. Patients with an impending rupture or a chronic false aneurysm were excluded. There were 11 men and 8 women, with a mean age of 70.5 +/- 6.7 years. The aneurysm was caused by dissection in 8 patients. Of these, 7 were acute (Stanford type A, 6; type B, 1), and the other one was chronic (type B). Aortic rupture occurred into the pericardial cavity (n = 7), into the left lung (n = 6), the mediastinum (n = 3), the pleural cavity (n = 2), or into the esophagus (n = 1). Severely unstable hemodynamics were noted in 12 patients with a rupture into the pericardium, mediastinum, or pleural cavity (Group A). Inotropic support was required in each of these patients. Metabolic acidosis developed all but 1 patient. The 7 patients with a rupture into the lung or esophagus coughed or vomited blood (Group B). The operative approach was anterior (n = 17) or lateral (n = 2). Grafts were placed in the ascending aorta (n = 4), ascending and transverse arch aorta (n = 7), transverse arch aorta (n = 3), or in the descending thoracic aorta (n = 5). Selective cerebral perfusion was used in 13 patients. RESULTS: There were 5 hospital deaths (26.3%). The postoperative complications included central nervous system dysfunction (n = 3), low cardiac output syndrome or cardiac arrhythmias (n = 3), respiratory failure (n = 4), acute renal failure (n = 1), and local or systemic infections (n = 4). The perioperative event-free rate was 36.8% overall, 25% in Group A, and 57.1% in Group B. CONCLUSIONS: Patients with unstable hemodynamics require prompt operative intervention. Rupture into the esophagus is associated with a high mortality rate. Rupture in a thoracic aortic aneurysm can be successfully treated with emergency surgery.

Aged↗
PubMed2001

Detection and management of concomitant coronary artery disease in patients undergoing thoracic aortic surgery.

OBJECTIVES: No method has been established to detect and manage coronary artery disease in patients undergoing thoracic aortic surgery. METHODS: Subjects were 192 patients scheduled for elective thoracic aortic surgery. Selection criteria for coronary angiography included a history of coronary artery disease or a positive dipyridamole myocardial perfusion imaging test. RESULTS: Four patients were inoperable due to complications associated with coronary angiography or aneurysm rupture following coronary revascularization. A total of 55 patients with coronary angiography (group A) underwent 57 thoracic aortic operations and 133 patients without coronary angiography (group B) underwent 143 similar operations. Of 13 group A patients with significant coronary stenosis, 9 underwent either preoperative percutaneous transluminal coronary angioplasty (n = 3) or concomitant coronary artery bypass (n = 6). Perioperative myocardial infarction occurred in 3 group A patients (5%) and in 4 group B patients (1%, ns). The incidence of cardiac events--perioperative myocardial infarction or cardiac death--in group A (11%, 6/57) was higher than that in group B (3%, 4/143; p < 0.05). Multivariate analysis demonstrated incomplete revascularization of major coronary arteries with significant stenosis as a risk factor for cardiac events (p = 0.0106). CONCLUSIONS: Although dipyridamole myocardial perfusion imaging was useful, additional selection criteria for coronary angiography is needed. Complete revascularization of major coronary arteries with significant stenosis is essential to reduce postoperative cardiac events.

Adolescent↗
PubMed2001

Gender- or age-related binding characteristics of valproic acid to serum proteins in adult patients with epilepsy.

The aim of the present study was to determine the gender- or age-related binding characteristics of valproic acid (VPA) to serum proteins in the adult population. Serum samples examined in the study were obtained from 70 adult patients (36 males, 34 females) with epilepsy on VPA monotherapy. Their age ranged from 16 to 68 years (mean age with (SD), 37.7 (15.7) years; <45 years, n=44; >/=45 years, n=26). The in vivo population binding parameters of VPA to serum proteins and theoretical minimal unbound serum VPA fraction (Fu) were determined using an equation derived from the Scatchard equation in: (1), all; (2), male and female subgroups; and (3), younger (<45 years) and older (>/=45 years) subgroups. There was a significant difference in serum concentration of unbound VPA between male and female patients. The mean association constant (K) was 0.010 microM(-1) in all, male, and female patients. The mean total concentration of binding sites (n(Pt)) was 1453 microM for all patients, and 1561 and 1394 microM for male and female patients, respectively. The Fu was 0.064 for all patients, and 0.060 and 0.067 for male and female patients, respectively. There were no significant differences in the binding characteristics of VPA to serum proteins between the male and female groups. On the other hand, there were significant differences in the serum albumin concentration and molar concentration ratio of free fatty acids to albumin in serum between the younger and older patients. The mean value of K was 0.016 microM(-1) for the younger patients and 0.007 microM (-1) for the older patients. The mean n(Pt) was 1157 microM for the younger patients and 1703 microM for the older patients. The Fu was 0.051 for the younger patients and 0.077 for the older patients. Thus, significant differences were observed in the binding characteristics of VPA to serum proteins between the younger and older groups. Our results show that age, but not gender, has significant influences on the binding characteristics of VPA to serum proteins in our patient population.

Adolescent↗