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Biomedical subjects

M Hotta

Publications and source records attributed to M Hotta.

At least 37 records · Page 2Linked to original sources

[Anesthetic management of a patient with hypohidrotic ectodermal dysplasia].

We anesthetized a 10-year-old girl with hypohidrotic ectodermal dysplasia for an ophthalmic surgery. Ectodermal dysplasia involves the abnormalities of ectodermal tissues and has a triad; hypohidrosis, a lack of teeth, and the scarcity of hair. Hyperthermia may occur due to the defect of sweat glands. Therefore, the body temperature must be monitored continuously. Respiratory tract infection occurs frequently due to the absence of seromucosal glands. We recommend humidifying the inspired gases during the operation. Tracheal intubation may be difficult because of maxillary and/or mandibular abnormalities. We conclude that the particular care should be taken such as the management of the body temperature, preparation for the difficult airway and the humidification of respiratory tract.

Anesthesia, General↗

Corticotropin-releasing factor receptor type 1 mediates emotional stress-induced inhibition of food intake and behavioral changes in rats.

We investigated whether corticotropin-releasing factor (CRF) receptor type 1 (CRFR1) is involved in emotional stress-induced inhibition of food intake and behavioral changes in rats. The inhibition of food intake and increase in locomotor activity induced by emotional stress using a communication box were reversed by both intracerebroventricular injection of alpha-helical CRF (9-41), a non-selective CRF receptor antagonist, and intraperitoneal injection of a selective non-peptidic CRFR1 antagonist. These results suggest that CRFR1 mediates at least in part the emotional stress-induced inhibition of feeding behavior and increase in locomotor activity.

Animals↗

Breast-feeding in Bangkok, Thailand: current status, maternal knowledge, attitude and social support.

BACKGROUND: The promotion of breast-feeding is one of the essential interventions for reduction of infant mortality and improving infant development worldwide. The aim of the present study was to examine the current status of infant feeding and the influences of suspected family sociodemographic characteristics and social support as well as maternal knowledge, attitudes and behaviours in infant feeding since the Baby-Friendly Hospital Initiative was launched in Thailand. METHODS: A total of 221 mother-infant pairs were randomly drawn from six health care centers in Bangkok from 20 April to 1 May 1998. Health care staff, using a structured questionnaire, interviewed the mothers in the health care centers. RESULTS: Most sampled mothers believed that breast milk was the best food for their infants and knew that breast milk had many advantages for infants, mothers and families. Ninety-five percent of mothers breast-fed their infants up to 3 months postpartum, but the prevalence of exclusive breast-feeding was relatively low (62.4%). Multiple logistic regression analyses revealed that the following factors independently increased the risk of mixed or formula feeding during the first 3 months of life: (i) mothers with a full-time job; (ii) grandmothers and other people as the main child caretakers; (iii) mothers who did not have an antenatal plan of exclusive breast-feeding; and (iv) newborns' non-exclusive breast-feeding in hospitals after birth. However, the mother being a housewife, mother as the main child caretaker, an antenatal plan of exclusive breast-feeding and exclusive breast-feeding in hospital were more likely to improve exclusive breast-feeding. CONCLUSION: The prevalence of exclusive breast-feeding was relatively low. Antenatal plans for exclusive breast-feeding and newborn feeding type in hospital after birth may play key roles in the duration of exclusive breast-feeding. These findings suggest the importance of strengthening implementation of the Baby-Friendly Hospital policy and prenatal health education regarding breast-feeding.

Adolescent↗

Decreased serum levels of acid-labile subunit in patients with anorexia nervosa.

One of the observations in malnutrition is that serum insulin-like growth factor (IGF)-I levels are decreased, and this decrease is associated with an altered profile of IGF binding proteins (IGFBPs). In human circulation, IGFs are mostly present as an approximately 150-kDa ternary protein complex consisting of IGFs, IGFBP-3, and acid-labile subunit (ALS). In the present study, to clarify the effect of nutrition on serum ALS levels, we investigated 33 patients with anorexia nervosa. Serum levels of ALS were measured by RIA. Furthermore, we measured serum IGF-I, IGF-II, IGFBP-2, and IGFBP-3 levels in the patients. From these data, we investigated which was the best predictor of body mass index (BMI) as a nutritional status marker. In the patients with anorexia nervosa, the serum ALS levels ranged from 0.7-16.9, with a mean of 10.6 +/- 0.7 mg/L, and the levels were significantly lower than those of normal subjects (13.8 +/- 0.8 mg/L, P < 0.05). Serum ALS levels positively correlated with BMI (r = 0.41, P < 0.05), and the levels increased during treatment. The serum IGFBP-2 levels in the patients were increased (871 +/- 91 microg/L), and the levels inversely correlated with BMI (r = -0.52, P < 0.01). The serum IGF-I and IGFBP-3 levels were low (152 +/- 14 microg/L and 2.56 +/- 0.12 mg/L, respectively), and the levels positively correlated with BMI (r = 0.46, P < 0.01; and r = 0.39, P < 0.05, respectively). The serum IGFBP-2, IGF-I, and IGFBP-3 levels returned toward normal ranges as BMI in the patients improved during treatment. Serum IGF-II levels did not correlate with BMI (r = 0.24, P = 0.17). Stepwise regression analysis revealed that serum IGFBP-2 was the best marker of BMI among these variables. The present study suggested that ALS was regulated by nutritional status, the same as IGF-I, IGFBP-2 and IGFBP-3; but the serum IGFBP-2 was the best predictor of BMI as nutritional status marker among the parameters in patients with anorexia nervosa.

Adult↗

Pancreatic beta cell-specific expression of thioredoxin, an antioxidative and antiapoptotic protein, prevents autoimmune and streptozotocin-induced diabetes.

The cytotoxicity of reactive oxygen intermediates (ROIs) has been implicated in the destruction of pancreatic beta cells in insulin-dependent diabetes mellitus (IDDM). Thioredoxin (TRX), a redox (reduction/oxidation)-active protein, has recently been shown to protect cells from oxidative stress and apoptosis. To elucidate the roles of oxidative stress in the development of autoimmune diabetes in vivo, we produced nonobese diabetic transgenic mice that overexpress TRX in their pancreatic beta cells. In these transgenic mice, the incidence of diabetes was markedly reduced, whereas the development of insulitis was not prevented. Moreover, induction of diabetes by streptozotocin, an ROI-generating agent, was also attenuated by TRX overexpression in beta cells. This is the first direct demonstration that an antioxidative and antiapoptotic protein protects beta cells in vivo against both autoimmune and drug-induced diabetes. Our results strongly suggest that oxidative stress plays an essential role in the destruction of beta cells by infiltrating inflammatory cells in IDDM.

Animals↗

Brain vasopressin is involved in stress-induced suppression of immune function in the rat.

The possibility that vasopressin (VP) is involved in stress-induced suppression of immune function was examined in rats. Intermittent electrical footshock for 60 min suppressed the proliferative response of splenic T cells to the mitogen concanavalin A as well as natural killer (NK) cytotoxicity, and the former change was partially, and the latter was completely, blocked by intracerebroventricular (i.c.v.) preadministration of a V1 receptor antagonist. The footshock-induced suppression of the T cell proliferative response was completely abolished by coadministration of a corticotropin-releasing hormone (CRH) receptor antagonist and the V1 receptor antagonist. The i.c.v. administration of VP suppressed the proliferative response of splenic T cells and NK cytotoxicity in an adrenal-independent manner. These effects were completely reversed by i.c.v. preadministration of the V1 receptor antagonist. These results suggest that brain VP, in conjunction with CRH, suppresses immune function through the V1 receptor in rats under stress.

Adrenalectomy↗

Structure and hair follicle-specific expression of genes encoding the rat high sulfur protein B2 family.

High sulfur proteins are cysteine-rich proteins synthesized during the differentiation of hair matrix cells, and form hair fibers in association with hair keratin intermediate filaments. Rat high sulfur protein B2 genes were isolated after screening of a rat genomic library using the cDNA as a probe. Sequence analysis of a 4 kb fragment revealed two high sulfur protein genes, B2E and B2F. Both genes lacked introns, with B2F being located at 2 kb downstream of B2E. The 5' flanking regions of both genes had TATA and CAAT boxes, and consensus sequences of B2 genes. The upstream region of B2F had possible AP-1 and Sp-1 binding elements. The high sulfur protein B2E and B2F, which have putative 188 and 122 amino acids, respectively, comprised four distinct domains with a characteristic repetitive sequence. In situ hybridization indicated that the mRNA of high sulfur protein B2 was specifically localized in the cortex of the hair shaft, and northern blot analysis indicated that the expression of B2 increased in anagen and decreased in telogen, suggesting that high sulfur protein B2 synthesized in cortical cells during anagen contributes to the production of hair fibers.

Amino Acid Sequence↗

Hepatocyte nuclear factor-1alpha gene and non-insulin-dependent diabetes mellitus in the Japanese population.

Recently, hepatocyte nuclear factor-1alpha(HNF-1alpha, which is encoded by the TCF1 gene) mutations were reported in a subset of patients with maturity onset diabetes of the young (MODY3). We studied the contribution of TCF1 to genetic susceptibility to common non-insulin-dependent diabetes mellitus (type 2) in Japanese subjects by investigating allelic association with type 2 diabetes use of three markers. We also studied the frequency of the G191D mutation, the only mutation of TCF1 reported so far in late-onset type 2 diabetes. A total of 356 subjects were studied. There were no significant differences in allele frequency of the three markers between patients with type 2 diabetes and control subjects. A G191D mutation was not found in the subjects studied, giving a frequency of less than 0.4% in common type 2 diabetes. The lack of association of type 2 diabetes with three markers in and near TCF1 suggests that mutations in TCF1 derived from a limited number of founders are not a major cause of common type 2 diabetes even in the genetically homogeneous Japanese population. The data also indicate that the G191D mutation in TCF1 plays little, if any, role in susceptibility to common type 2 diabetes in the Japanese.

Adult↗

Study of the pharmacokinetics of cefpirome sulphate in the elderly.

OBJECTIVE: To determine the appropriate method of administration of the cephem antibiotic cefpirome sulphate in elderly patients. METHOD: We studied cefpirome's pharmacokinetics in patients with urinary tract infections. Patients received cefpirome sulphate 0.5 g by intravenous drip infusion over 30 mins. RESULTS: Patients with a creatinine clearance rate (Ccr) of 80 ml/min had an AUC of 96.7 microg.h/ml and a T1/2 of 2.36 h, whereas those with Ccr of 40-80 ml/min had an AUC of 172.0 microg.h/ml and a T1/2 of 3.45 h and those with Ccr of < 40 ml/min had an AUC of 152 microg.h/ ml and a T1/2 of 4.86 h. CONCLUSION: These results indicate that decreased kidney function can cause increases in the AUC and T1/2 of cefpirome. Thus in elderly patients and perhaps also in other patients with decreased kidney function, cefpirome should be administered at an initial dose of 0.5 g.

Aged↗

Antibacterial temporary filling materials: the effect of adding various ratios of Ag-Zn-Zeolite.

The effect of a new type of antibacterial temporary filling material was evaluated. Ag-Zn-Zeolite (Bactekiller, Kanebo, Japan) and SiO2 filler were incorporated into urethane acrylate monomer paste in amounts of 5/55, 10/50, 20/40 and 30/30 wt%, respectively. The present study was designed to use a dye penetration test to measure direct inhibition of bacterial growth of four oral bacteria (Streptococcus mutans, Streptococcus mitis, Streptococcus salivarius, Streptococcus sanguis). The amounts of silver and zinc ions released from these materials were measured by atomic absorption spectrophotometry. The results indicated that the occurrence of marginal leakage was low in all of these materials. These materials exhibited prominent in-vitro antibacterial activity against S. mutans and S. mitis. The Ag-Zn-Zeolite in these materials was able to release very small but detectable amounts of Ag and Zn even 4 weeks after the immersion started. The larger the amounts of Ag-Zn-Zeolite that were incorporated, the greater the release of silver and zinc. However, it appears that increasing antibacterial activity is not promoted by the higher ratio of Ag-Zn-Zeolite.

Acrylic Resins↗

Effect of primers on bonding agent polymerization.

The aim of the present study was to evaluate the effect of primers on the polymerization of bonding agent. We measured the degree of conversion (radical production) and mechanical properties (surface hardness and direct tensile strength) of various adhesives/primers mixed at different ratios and the effect of varying the visible-light curing time. With and without primer treatment, the tensile bond strength of adhesive resin to micacious glass ceramic and human enamel was measured. After the tensile bond test, using the Image Capture System, the failure patterns of adhesive resin bonded to micacious glass-ceramic were analysed. The results show that the mixtures containing the higher amounts of primer yielded a lower degree of conversion and inferior mechanical properties when compared with the mixtures containing a lower proportion of primer, except in the experimental bonding system. The adhesive/primer mixtures inhibited free radical polymerization. The value for the Knoop hardness number and the direct tensile strength of the adhesive/primer mixtures were significantly decreased compared with those of the adhesive bonding agent alone with no primer added. The tensile bond strength of adhesive resin bonded to micacious glass-ceramic or human enamel without primer treatment was significantly greater than that of adhesive resin with primer treatment in certain cases. Most of the fractures of ceramic surfaces were cohesive (within resins) and/or interface (at the ceramic surface) failure.

Adhesiveness↗

Somatosensory-evoked blink response: investigation of the physiological mechanisms.

The somatosensory-evoked blink response (SBR) is a newly identified blink reflex elicited by electrical stimulation of peripheral nerves. The present study was performed to investigate the physiological mechanism underlying the SBR elicited by median nerve stimulation in normal subjects. The peripheral afferents responsible for the SBR included low-threshold cutaneous fibres. In the SBR-positive subjects, the late (R2) component of the blink reflex elicited by supraorbital nerve stimulation and the SBR facilitated each other when both responses were induced at the same time, but they each caused long-lasting inhibition in the other when one stimulus was given as a conditioning stimulus. The extent of inhibition was correlated with the size of the preceding SBR. In the SBR-negative subjects, simultaneous inhibition of R2 was observed when median nerve stimulation was applied as a conditioning stimulus. Brainstem excitability, as evaluated by blink-reflex recovery studies, did not differ between SBR-positive and SBR-negative subjects. Therefore, based on anatomical and physiological findings, it appears that the reflex pathways of the SBR and R2 converge within the brainstem and compete with each other, presumably by presynaptic inhibition at the premotor level, before entering the common blink-reflex pathway. The influence of median nerve stimulation upon tonic contraction of the orbicularis oculi muscle was studied to detect the latent SBR. There was not only a facilitatory period corresponding to the SBR but also an active inhibitory period (exteroceptive suppression), suggesting that the mechanism generating the SBR is not only influenced by blink-reflex volleys but also by active exteroceptive suppression. Thus, the SBR may appear as a result of integration of facilitatory and inhibitory mechanisms within the brainstem.

Adult↗

[Inflammatory reactions and microorganisms cultured from sputum and blood in association with terminal stage infection of patients with lung cancer].

We reviewed our experience with terminal stage infections in patients with lung cancer over an 11 year period at Kurume University Hospital. In patients with end-stage lung cancer, the infection is common and a mortal disease. We examined the clinical features and significance of pathogenic microbes isolated from sputum and blood in patients with lung cancer during their last month. Bacteriological examinations from blood done frequently in patients with episodes of fever revealed that bacteremia was one of the most important disease in terminal stage infection. In the blood cultures from the 22 patients various species of pathogenic microbes were recovered, and nine of which were fungi; five Candida albicans, three Candida tropicalis and one Candida parapsilosis. The major species of bacteria isolated from sputum were Staphylococcus aureus, including methicillin-resistant strain, and Gram-negative bacilli; P. aeruginasa, A. calcoaceticus, K. pneumoniae and E. cloacae, which are known to be frequently involved in hospital-acquired infections. However, S. pneumoniae and H. influenzae which were well known to be microbes of respiratory infections were rare. We concluded that we had to reveal the feature of terminal stage infection in order to reduce the fee for medical treatment and improve the QOL of patients with terminal stage lung cancer.

Bacteremia↗

Interleukin-1beta administered intracerebroventricularly stimulates the release of noradrenaline in the hypothalamic paraventricular nucleus via prostaglandin in the rat.

We evaluated the effect of intracerebroventricular (i.c.v.) administration of interleukin (IL)-1beta on the rectal temperature and the release of noradrenaline (NA) in the hypothalamic paraventricular nucleus (PVN) of the rat. IL-1beta increased rectal temperature at doses ranging from 300 pg to 300 ng, whereas it, at doses ranging from 3 ng to 300 ng, significantly stimulated the release of NA in the PVN measured by intracerebral microdialysis. The stimulatory effect of IL-1beta on the release of NA was blocked by the subcutaneous injection of indomethacin. These findings suggest that IL-1beta stimulates the release of NA in the PVN via prostaglandin, and that the release of NA in the PVN is not necessarily related to the increase in body temperature.

Animals↗

Hypercalcemia in an euthyroid patient with secondary hypoadrenalism and diabetes insipidus due to hypothalamic tumor.

A 20-year-old Japanese man with a hypothalamic tumor (most likely germ-cell tumor) which caused secondary hypoadrenalism, hypogonadism and diabetes insipidus developed hypercalcemia and acute renal failure. The serum levels of intact PTH (iPTH), PTH-related protein (PTH-rP), 1,25-dihydroxy vitamin D (1,25- (OH)2 D), ACTH, cortisol, gonadotropins and testosterone were decreased, but his serum levels of triiodothyronine (T3) and thyroxine (T4) were within the normal range at admission, with depressed TSH and slightly increased thyroglobulin. The hypercalcemia was refractory to extensive hydration and calcitonin, but was ameliorated by pamidronate. After irradiation of the hypothalamic tumor, panhypopituitarism gradually developed. The patient has been normocalcemic for the last 2 years and is doing well under replacement therapy with glucocorticoid, L-thyroxine, methyltestosterone and 1-desamino D arginine vasopressin (dDAVP). As to the mechanism of euthyroidism at admission, transient destructive thyroiditis associated with hypopituitarism or delayed development of hypothyroidism following the hypoadrenalism was suggested. This is the first reported case of hypercalcemia in secondary hypoadrenalism due to hypothalamic tumor. Hypercalcemia was most likely induced by increased bone resorption, which was probably elicited by the combined effects of deficient glucocorticoid and sufficient thyroid hormones in addition to hypovolemia and reduced renal calcium excretion. Furthermore, severe dehydration due to diabetes insipidus and disturbance of thirst sensation caused by the hypothalamic tumor aggravated the hypercalcemia, leading to acute renal failure.

Acute Kidney Injury↗

The importance of body weight history in the occurrence and recovery of osteoporosis in patients with anorexia nervosa: evaluation by dual X-ray absorptiometry and bone metabolic markers.

In order to investigate the risk factors, pathogenesis and natural course of the osteoporosis frequently seen in anorexia nervosa, we measured the bone mineral density (BMD) of the lumbar spine using dual X-ray absorptiometry in 51 Japanese female patients with anorexia nervosa, and followed the change in BMD of 29 patients for 11 to 46 months. We also evaluated the serum osteocalcin and the urinary CrossLaps, degradation products of collagen I, in 103 samples obtained from 51 patients. There was a significant correlation between the spinal BMD and the duration of emaciation below a body mass index (BMI) of 15kg/m2 (r= -0.652, P<0.0001) and 16kg/m2 (r= -0.647, P<0.0001). The increase in BMD per year in the 29 patients significantly correlated with the BMI at the time of entry of each follow-up period (r= 0. 712, P<0.0001). The critical BMI for a positive increase in BMD was 16.4+/-0.3 kg/m2 (mean+/-S.E.M.). The serum osteocalcin declined, while the urinary CrossLaps increased in proportion to a decrease in BMI. Both markers were normalized in patients whose BMI was between 16.4 and 18.5 kg/m2. The ratio of urinary CrossLaps to serum osteocalcin correlated with BMI (r= -0.664, P<0.0001). We conclude that the body weight history is the most important predictor of the presence of osteoporosis as well as of recovery The BMD of patients does not increase to the normal range even several years after the recovery from this disorder, and they remain a high-risk group for osteoporosis in the future.

Absorptiometry, Photon↗

[A case of hepatic metastasis of rectal cancer with familial adenomatous polyposis treated by transarterial administration of low-dose leucovorin and 5-FU].

A 37-year-old man was diagnosed as having a rectal cancer with familial adenomatous polyposis, with the mutation of APC gene, and gastric polyposis, hypertrophy of the retinal pigment epithelium and a lipoma of the left arm. The patient underwent a total colectomy for the rectal cancer and a partial resection of the liver for metastasis (S3) which was detected on laparotomy, followed by cannulation in the hepatic artery. After the operation, 5-FU alone and low doses of CDDP and 5-FU were administered, but the level of serum CEA elevated and CT scanning showed multiple liver metastases. Then, low doses of leucovorin (30 mg/body bolus) and 5-FU (500 mg/body/h) were injected through an injection port every week. After 6 months, the level of serum CEA reduced and CT scanning showed minor response (about 30% on the decrease rate), without side effects, including diarrhea, stomatitis and bone marrow suppression.

Adenomatous Polyposis Coli↗