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Biomedical subjects

M Kakuta

Publications and source records attributed to M Kakuta.

At least 19 recordsLinked to original sources
PubMed2003

The expression of nectin-1alpha in normal human skin and various skin tumours.

BACKGROUND: A novel cell-cell adhesion system that consists of nectin and afadin has been identified at cadherin-based cell-cell adherens junctions. Nectin is a Ca2+-independent homophilic and heterophilic cell adhesion molecule that belongs to the immunoglobulin superfamily. Nectin has recently been shown to serve as an alpha-herpesvirus entry and cell-cell spread mediator. In spite of the ubiquitous expression of nectin-1alpha, its detailed localization in human skin has not been examined so far. OBJECTIVES: To investigate the localization of nectin-1alpha in normal human skin and the alteration of its expression in malignant skin tumours. METHODS: Immunohistochemistry was employed to determine the expression of nectin-1alpha and other adhesion molecules. RESULTS: We detected nectin-1alpha in normal human epidermis, follicles and eccrine ducts. Nectin-1alpha was colocalized with E-cadherin at cell-cell adherens junctions of the epidermis. The concentration of the nectin-afadin system at cell-cell adherens junctions was reduced in the early stage of malignant transformation of keratinocytes, such as in basal cell carcinomas and squamous cell carcinomas, where the cadherin-catenin system was preserved. Nectin-1alpha at cell-cell adherens junctions was reduced in human epithelial cancer cells located at the advancing border of the tumour. CONCLUSIONS: Our results showed that nectin-1alpha is located at cell-cell adherens junctions in human skin and that reduction of nectin-1alpha at cell-cell adherens junctions may be involved in the invasion of squamous cell tumours.

Aged↗
PubMed2001

Microfabricated devices for fluid mixing and their application for chemical synthesis.

Over the last few decades, the processes of miniaturization, integration, and automation have revolutionized the world of science and industry. Within a chemical reaction process the unit operations, mixing, heating, and cooling, can be regarded as key steps. In microreactors, enhanced heat and mass transport, due to small characteristic dimensions together with large surface to volume ratios, are expected to open up a whole range of new possibilities. Increase in reaction yield, reduction of reaction time as well as byproduct formation, inherent process safety, and even completely new process routes are some of the advantages associated with microTAS (micro Total Analysis Systems) or microSYNTAS (micro SYNthesis Total Analysis Systems). This article aims to describe the development of microfabricated devices for fluid mixing, so-called micromixers, and their application for chemical synthesis.

Journal Article↗
PubMed2001

[Examination of the power of families taking care of patients at home at peace].

OBJECTIVE: We examined the power of families who take care of a patient at home. We wanted to know how much caring power patients needed to stay at home at peace. PATIENTS AND METHODS: The subjects were 150 patients who visit the hospital for day care or are taken care of at home under our management. We examined their age, sex, main disease, the points of their families power for their care, the assessment of how peaceful at home, use of care services, and special things. RESULTS: Most of the patients were in their 80's or 70's. Stroke was the main disease. The most care grade are second grade. Higher care grade are smaller number. About 50% of the families paid for care services. The assessment of low care grade patients did not depend on the power of the families. But the assessment of high care grade patients did depend on that. We concluded that it is difficult to take care at home of high care grade patients who does not have some powers on families for his care. If the patient and his/her family want to use care services, they have to pay 10% charge. It is difficult to alleviate the burden they pose on their family.

Aged↗
PubMed2001

[How to support the death at home].

Forty-three patients who were taken care of at home were divided into three groups according to the place of their death to examine the cause of death at home and to improve the home care service, especially for supporting the death at home. Group A included 15 patients who died at home, group B included 22 patients who died at the hospital and group C included 6 patients who were transferred to our hospital by ambulance to confirm they were dead. In group A, 8 patients died from cancer, 5 from old age, 1 from chronic heart failure and 1 from Wernicke's encephalopathy. In group B, 8 patients died from pneumonia, 3 from other acute diseases, 4 from cancer, 4 from other chronic diseases. In group C, 5 patients died from old age and 1 from cancer. After the home care service was changed to 24-hour support, the number of patients who died at home increased from 1 to 14, and the emergency transfer by ambulance decreased from 5 to 1. The patients with chronic and gradually deteriorating conditions, such as cancer and aging itself, tend to die at home and this is effectively supported by the 24-hour home medical care service.

Aged↗
PubMed2001

[The care insurance and the patients of at home care].

Thirty-one patients used the at-home nursing care service provided by our hospital. However, they were also taken care of by old family members, mostly 60 years old or more, thus only 23.8% of the maximum Care Insurance was used. The average insurance, for the service is 6,312 yen, which does not increase according to the level of care the patient required. Especially, the expenses regarding the home bathing service, which is the most used, have doubled since the Care Insurance started. The family of most patients may not be able to pay more than 10,000 yen every month for the care of old and handicapped people. The increased expenses can become an obstacle regarding the promotion of at-home care.

Home Care Services↗
PubMed2000

Renal amyloidosis in recessive dystrophic epidermolysis bullosa.

BACKGROUND: Although it is known that renal amyloidosis may complicate several dermatoses, recessive dystrophic epidermolysis bullosa (RDEB) complicated by nephropathy has been thought to be rare. We, however, had seen a young adult with RDEB who died of renal failure due to systemic amyloidosis. OBJECTIVE: A retrospective study was performed in order to investigate the incidence and etiology of renal amyloidosis in RDEB. METHODS: Routine urinalysis, serum amyloid A protein (SAA) and creatinine levels were repeatedly determined in 11 patients with RDEB (mean age 17.7 years, range 5-28, 7 males, 4 females). Nephropathy was defined as the presence of both proteinuria and hematuria with red blood cell casts. RESULTS: Seven out of 9 generalized RDEB patients had nephropathy including 3 cases with end-stage renal disease (2 died within 2 years from the onset of nephropathy), while 2 patients with localized RDEB did not. Levels of SAA were significantly higher in patients with nephropathy than those in patients without nephropathy (p<0.05). CONCLUSION: Nephropathy is a common and serious complication of RDEB. Renal amyloidosis may play an important role in its etiology. We recommend that patients with RDEB should be periodically screened for nephropathy due to amyloidosis by urinalysis and measuring SAA levels.

Adolescent↗
PubMed2000

[Terminal care at home and the burden on the family].

OBJECT: To assess the burden on families who care for a patients in the terminal stage of cancer at home. PATIENTS AND METHODS: Family members caring for three terminal patients at home completed the Burden Index every ten days and compared it with the patient's physical condition and the care provided by the family. The Index was used by the family to indicate the percent of the present burden against 100%, the imagined maximum. RESULTS: The Burden Index decreased at first as the family became accustomed to daily activities, then increased within 30 days due to the deterioration of patients' condition and increased caring chores and anxiety of the family. Factors affecting the Burden Index were complicated by caring factors such as habituation, anxiety, caring chores, cooperation of other family members, and factors of patients' conditions such as pain, consciousness level, and fever. CONCLUSION: Monitoring the burden of the family was useful in evaluating the patients' environment at home, and in reconsidering the management of the terminal care at home.

Aged↗
PubMed1999

[Combination effect of teicoplanin and panipenem on highly resistant strains of MRSA].

We investigated the in vitro combination effect of teicoplanin (TEIC) and panipenem (PAPM) on highly oxacillin-resistant strains of Staphylococcus aureus (MRSA) isolated from various clinical specimens. Combination of TEIC and PAPM using checkerboard titration technique by agar dilution exhibited an excellent effect with mean fractional inhibitory concentration index of 0.18 +/- 0.07 on 47 MRSA strains, and the effects were judged as synergistic against all of the strains tested. In the combination of TEIC and PAPM at 1/4 MIC each against exponentially growing cells of MRSA, good bactericidal activity was found when TEIC and PAPM were added simultaneously, and PAPM was added at 1 or 2 hours prior to addition of TEIC, although the bactericidal activity was scarcely demonstrated when TEIC was added at 1 or 2 hours prior to addition of PAPM. Bactericidal activity against MRSA was enhanced in the combination of TEIC and PAPM at 1/4 MIC each for MRSA than the bactericidal activity of TEIC at 1 MIC alone. TEIC alone showed no bactericidal activity against P. aeruginosa in the mixed cultures with MRSA, while strong bactericidal activity against P. aeruginosa was induced by PAPM. In vitro bactericidal activities against mixed cultures of MRSA with P. aeruginosa were evaluated under conditions of concentrations of TEIC and PAPM, alone and in combination, whose plasma concentrations in human were simulated by a pharmacokinetic simulation model. Bactericidal activity against MRSA was enhanced by the combination of TEIC at 200 mg twice or once daily with PAPM at 500 mg twice daily in comparison with the bactericidal activity of each antibiotic alone, and P. aeruginosa was killed by the antibacterial activity of PAPM.

Anti-Bacterial Agents↗
PubMed1999

[In vitro and in vivo activities of cefpodoxime proxetil against penicillin-resistant Streptococcus pneumoniae].

We evaluated in vitro and in vivo activities of cefpodoxime proxetil (CPDX-PR) in comparison with other oral beta-lactams, cefdinir (CFDN), cefditoren pivoxil (CDTR-PI), and faropenem (FRPM), against penicillin-susceptible and -resistant Streptococcus pneumoniae. In vitro activities (MICs) of CPDX, CFDN, CDTR, and FRPM against clinical isolates, penicillin-susceptible S. pneumoniae (PSSP: MIC of penicillin G, < or = 0.063 microgram/ml), penicillin-intermediate S. pneumoniae (PISP: MIC of penicillin G, 0.125-1 microgram/ml), and penicillin-resistant S. pneumoniae (PRSP: MIC of penicillin G, > or = 2 micrograms/ml), were tested by an agar dilution method. The MIC80s of CPDX against 27 PSSP strains, 23 PISP strains, and 23 PRSP strains were 0.032, 1, and 8 micrograms/ml, respectively, which were superior to or equal to those of CFDN (0.063, 4, and 8 micrograms/ml) and were inferior to those of CDTR (0.016, 0.5, and 1 microgram/ml) and FRPM (< or = 0.008, 0.25, and 1 microgram/ml). Infection was induced in mice by inoculating with a PRSP clinical isolate, 9605 or 9601 (serotype 6), or 10692 (serotype 19), through the nares of male ddY mice into the lungs. The mice were treated with drugs with doses of 2-50 mg/kg at 18, 26, 42, and 50 hours after the infection. Viable cell numbers in the lungs and blood were assayed at 66 hours after the infection. The efficacy of each drug was dose-dependent. CPDX-PR showed the most potent in vivo efficacy among the drugs tested against the infections caused by the PRSP strains. MICs of the drugs against PRSP 9605, 9601, and 10692 were as follows: CPDX, 4, 4 and 2 micrograms/ml; CFDN, 16, 16, and 4 micrograms/ml; CDTR, 1, 1, and 0.5 microgram/ml; and FRPM, 1, 0.5, and 0.5 microgram/ml, respectively. Thus, CPDX-PR showed a stronger in vivo activity than that expected from the MICs of CPDX. This was probably caused by the pharmacokinetic advantage of CPDX over the other drugs used in this study.

Animals↗
PubMed1997

Purification and characterization of the alpha-1,3-mannosylmannose-recognizing lectin of Crocus vernus bulbs.

A unique mannose-binding lectin, highly specific for terminal Man(alpha1,3)Man groups, was isolated from bulbs of crocus (Crocus vernus All.). The lectin failed to bind to a mannose affinity column and was purified by simple gel permeation chromatography (Sephacryl S200). The purified lectin, obtained in crystalline form, had a molecular mass of 44 kDa on gel filtration and showed a single peptide band with a molecular mass of 11 kDa on SDS-polyacrylamide gel electrophoresis, indicating it to be a tetrameric protein composed of four identical subunits. The N-terminal amino acid sequence analysis of the crocus lectin showed essentially no homology with that of other mannose-binding bulb lectins. The crocus lectin selectively interacted with the wild type Saccharomyces cerevisiae and other mannans carrying terminal Man(alpha1,3)Man but not with those lacking this disaccharide unit. In hapten inhibition studies, methyl alpha-mannopyranoside did not inhibit the mannan-lectin interaction. Of various alpha-mannooligosaccharides, those having the Man(alpha1,3)Man sequence showed the highest inhibitory potency, confirming the strict requirement of lectin for terminal alpha1,3-linked mannosylmannose units. An affinity column of immobilized lectin enabled the complete resolution of yeast mannan and glycogen. The immobilized lectin may provide a useful tool for purification and analysis of biologically important polysaccharides and glycoproteins.

Carbohydrate Sequence↗
PubMed1997

An optical method for evaluating ion selectivity for calcium signaling pathways in the cell.

A method for evaluating a physiologically relevant ion selectivity of Ca2+ signaling pathways in biological cells based on a Ca(2+)-dependent on/off switch for cellular processes via calmodulin (CaM) chemistry is described. CaM serves as a primary ion receptor for Ca2+ and a given CaM-binding peptide as a target for a CaM-Ca2+ complex. Upon accommodating four Ca2+ ions in its binding sites, CaM undergoes a conformational change to form a CaM-Ca(2+)-target peptide ternary complex. This Ca(2+)-induced selective binding of the Ca(2+)-CaM complex to the target peptide was monitored by a surface plasmon resonance (SPR) technique. As a target peptide, a 26-amino acid residue of M13 derived from skeletal muscle myosin light-chain kinase was used. The target peptide was covalently immobilized in the dextran matrix on top of gold, over which sample solutions containing Ca2+ and CaM were injected in a flow system. Ca(2+)-dependent SPR signals were observed for Ca2+ concentrations from 3.2 x 10(-8) to 1.1 x 10(-5) M and it leveled off. The observed SPR signals were explained as due to an increase in the refractive indexes caused by a Ca2+ ion-switched protein/ peptide interaction, i.e., Ca2+ ion to CaM and subsequent additional binding of the thus formed complex with immobilized M13. No SPR signals were however, induced by Mg2+, K+, and Li+ at concentrations as high as 1.0 x 10(-1) M; these results and previous spectroscopic data taken together conclude that these ions do not induce CaM/peptide interaction. Large changes in SPR signals were observed with a Sr2+ ion concentration over 5.1 x 10(-4) M; Sr2+ ion behaved in this case as a strong agonist toward the Ca(2+)-dependent on/off switch of CaM. The present system thus exhibited "physiologically more relevant" ion selectivity in that relevant metal ions could switch on the CaM/peptide or -protein interaction rather than merely be bound to CaM causing no further signal transduction. The potential use of this finding for more widely evaluating cation selectivity toward the Ca2+ signaling process was discussed.

Amino Acid Sequence↗
PubMed1997

X-ray study of beijeran sodium salts, a new galacturonic acid-containing exo-polysaccharide.

X-Ray fiber diffraction patterns were obtained from oriented films of sodium salts of a new uronic acid-containing polysaccharide (beijeran) both in its native, poly [-->3)-alpha-D-GalA-(1-->3)-beta-L-Rha-(1-->3)-alpha-D-Glc-O6Ac-(1 -->], and deacetylated forms. Initially the stretched films of both polysaccharides were amorphous, but the crystallinity was much improved by annealing at high temperature. The deacetylated specimen had higher crystallinity than the native. Both films showed similar X-ray fiber patterns indicating that these polysaccharides had similar unit cell dimensions and that the O-acetyl groups in the native beijeran chain did not disturb the regular array in the crystal having space group P21. All the visible reflections could be indexed in terms of a monoclinic unit cell with dimensions a = 1.277, b = 1.611, c (fiber axis) = 2.437 nm, and gamma = 96.79 degrees. The fiber axis length and the presence of (002) and (006) reflections indicated that the conformation was made up of two trisaccharide residues, in an extended two-fold helix.

Carbohydrate Conformation↗
PubMed1997

In vitro and in vivo antibacterial activities of CS-834, a novel oral carbapenem.

CS-834 is a novel oral carbapenem antibiotic. This compound is an ester-type prodrug of the active metabolite R-95867. The antibacterial activity of R-95867 was tested against 1,323 clinical isolates of 35 species and was compared with those of oral cephems, i.e., cefteram, cefpodoxime, cefdinir, and cefditoren, and that of a parenteral carbapenem, imipenem. R-95867 exhibited a broad spectrum of activity covering both gram-positive and -negative aerobes and anaerobes. Its activity was superior to those of the other compounds tested against most of the bacterial species tested. R-95867 showed potent antibacterial activity against clinically significant pathogens: methicillin-susceptible Staphylococcus aureus including ofloxacin-resistant strains, Streptococcus pneumoniae including penicillin-resistant strains, Clostridium perfringens, Neisseria spp., Moraxella catarrhalis, most members of the family Enterobacteriaceae, and Haemophilus influenzae (MIC at which 90% of strains are inhibited, < or =0.006 to 0.78 microg/ml). R-95867 was quite stable to hydrolysis by most of the beta-lactamases tested except the metallo-beta-lactamases from Stenotrophomonas maltophilia and Bacteroides fragilis. R-95867 showed potent bactericidal activity against S. aureus and Escherichia coli. Penicillin-binding proteins 1 and 4 of S. aureus and 1Bs, 2, 3, and 4 of E. coli had high affinities for R-95867. The in vivo efficacy of CS-834 was evaluated in murine systemic infections caused by 16 strains of gram-positive and -negative pathogens. The efficacy of CS-834 was in many cases superior to those of cefteram pivoxil, cefpodoxime proxetil, cefdinir, and cefditoren pivoxil, especially against infections caused by S. aureus, penicillin-resistant S. pneumoniae, E. coli, Citrobacter freundii, and Proteus vulgaris. Among the drugs tested, CS-834 showed the highest efficacy against experimental pneumonia in mice caused by penicillin-resistant S. pneumoniae.

Administration, Oral↗
PubMed1997

Transepidermal elimination of lepromatous granuloma: a mechanism for mass transport of viable bacilli.

A 35-year-old male with lepromatous leprosy showed significant progression of the disease on initial examination. Along with typical lepromatous skin lesions, many scar-forming lesions were present, mainly on his extremities. Some lesions showed erosive surfaces. From clinicopathological findings, these lesions were suspected to be due to the partial excretion of intradermal lepromatous granulomata by 'transepidermal elimination'. Increased local volume, which might be due mainly to rapidly growing lepromatous infiltration before chemotherapy, is suspected of triggering this phenomenon. There is no doubt that many fresh Mycobacterium leprae were included in these excretions. After the initiation of chemotherapy, no new scar-forming lesions were observed.

Adult↗
PubMed1997

[Combination effect between panipenem and vancomycin on highly methicillin-resistant Staphylococcus aureus].

We investigated the in vitro and in vivo combination effects between panipenem (PAPM) and vancomycin (VCM) on highly methicillin-resistant strains of Staphylococcus aureus (MRSA) isolated from various clinical specimens. Examination of combination between panipenem and vancomycin using checkerboard titration showed a good effect with mean fractional inhibitory index of 0.32 +/- 0.12 on 40 MRSA strains, and the effects were judged as synergistic against 33 strains (83%) and additive against 7 strains (17%). In the combination of PAPM and VCM at 1/4 MIC each against exponentially growing MRSA, bactericidal activity was found when PAPM was added at 1 hour or 2 hours prior to VCM-addition, and PAPM with VCM was added simultaneously, although bactericidal activity was scarcely demonstrated when VCM was added at 1 hour or 2 hours prior to PAPM-addition. Bactericidal activity was enhanced against MRSA in the combination of PAPM and VCM at 1/4 MIC each for MRSA than the bactericidal activity of VCM at 1 MIC alone, and the combination showed a strong bactericidal activity against P. aeruginosa. VCM alone, however, had no bactericidal activity in the in vitro mixed cultures of the two bacteria. Furthermore, the combination of PAPM and VCM induced a marked damage to cell surface and bacteriolysis against MRSA and P. aeruginosa in the mixed cultures, although VCM alone induced only slight morphological alterations. Penicillin-binding proteins (PBPs) including MRSA-specific PBP 2' were decreased greatly in the amounts in MRSA-cells with the increase of VCM-treated concentration. The combination therapy of PAPM and VCM showed a greater efficacy than the therapeutic efficacy of each antibiotic alone against mixed infection in burned mice caused by MRSA and P. aeruginosa, and the activity was judged as synergistic based on the FED index smaller than 0.34.

Animals↗
PubMed1996

Giant mixed tumor of the face.

A 35-year-old Japanese man consulted our clinic with an eight year history of a 6 cm diameter subcutaneous tumor on the left cheek. Hematoxylin and eosin staining of the resected section showed histology corresponding to a benign chondroid syringoma. Keratin was positive in most of the constituent cells, and S-100 protein was positive in the cells distant from the lumens and in myxomatous cells. A benign chondroid syringoma of this size has only been very rarely reported in the literature.

Adenoma, Pleomorphic↗