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Biomedical subjects

M Tanoue

Publications and source records attributed to M Tanoue.

At least 19 recordsLinked to original sources

[Effectiveness of home help service for psychiatric patients. The results of a model project in S city].

PURPOSE: The purpose of this study was to evaluate the effectiveness of a home help service project for psychiatric patients in S city. METHODS: To assess the effectiveness of the home help service, home help service providers at S city in 1997 were invited to hearings and the transcripts were examined qualitatively. Based on the results, interview questions were developed. We then interviewed 28 home help providers who were providing or had completed the service project, as well as care managers as of July 1998. Home help providers divided their patient stories retrospectively into three time frames: before starting home care, one month after starting providing care and at the present. Amount of care provided and patients' self care level were scored and averages ere compared for the three time frames. RESULTS: The analysis of the hearing data revealed parameters for the effectiveness of home help service for psychiatric patients to be as follows: 1) enhanced ability of daily living, such as taking meals, maintaining hygiene and shopping, (primary effectiveness: 5 items); and 2) developing social function, such as being motivated, maintaining personal relationship, extending social life, and decreasing family burden, (secondary effectiveness: 9 items). The amount of care needed was found to be significantly decreased and social function was significantly enhanced on comparisons between before starting home care and one month later, as well as between before starting home care and the present. DISCUSSION: Home help service for psychiatric patients is not only useful for enhancing patients' ability to succeed in daily living tasks, but also for developing their social functioning. Effectiveness was also identified in the level of patients' behavior. The results provide reasonable grounds for extended use of the home help service.

Home Care Services↗

Reduced ischemia-reperfusion injury in muscle. Experiments in rats with EPC-K1, a new radical scavenger.

L-ascorbic acid 2-[3,4-dihydro-2,5,7,8-tetramethyl- 2-(4,8,12-trimethyltridecyl)-2H-1-benzopyran-6-yl hydrogen phosphate] potassium salt (EPC-K1), a phosphate diester of alpha-tocopherol and ascorbic acid, is a potent antioxidant. We examined the effects of EPC-K1 on ischemia-reperfusion injury in the skeletal muscle of rats, using an ischemic revascularized hind limb model. Warm ischemia (25 degrees C), produced by vascular pedicle clamping, was sustained for 4 hours. After 24 hours of reperfusion, skeletal muscle injury was evaluated in 2 groups: one group treated by intravenous injection of EPC-K1 (10 mg/kg) prior to ischemia, and a group of controls. The EPC-K1-treated group showed a statistically significant amelioration in the reduction of the isometric muscle contraction, inhibition of the elevation of the muscle wet- to dry-weight ratio, limitation of the muscle level of thiobarbituric acid reactive substances and the serum levels of creatine phosphokinase, lactate dehydrogenase and mitochondrial glutamic oxaloacetic transaminase, and reduction of the extent of muscle injury according to the histological findings. These observations indicate that EPC-K1 acted effectively on ischemia-reperfusion injury in the rat skeletal muscle and thereby improved muscle function.

Animals↗

Cathepsin B in gingival crevicular fluid of adult periodontitis patients: identification by immunological and enzymological methods.

Cathepsin B (EC 3.4.22.1), a typical lysosomal cysteine proteinase was identified immunologically with anti-human cathepsin B antibody in inflammatory exudate, gingival crevicular fluid (GCF) of adult periodontitis patients. The sensitive enzyme immunoassay (EIA) system initially developed, was rarely influenced by the presence of endogenous cysteine proteinase inhibitors, cystatin(s), indicating that it is possible to quantify the gross amount of cathepsin B including free enzyme forms and enzyme-inhibitor complex forms using this EIA system. The cathepsin B levels in GCF as determined by EIA and the activity measured with Z-Arg-Arg-MCA showed positive and significant correlation with various clinical parameters. Immunoblotting analysis revealed that the molecular form was a 29 kDa mature enzyme. More than 95% of Z-Arg-Arg-MCA hydrolytic activity in each GCF sample was inhibited by CA-074, specific inhibitor of cathepsin B. These results strongly suggested that the gross amount of cathepsin B in GCF as well as its activity level is closely associated with the severity of the disease and that cathepsins B play an important role in the pathogenesis of periodontitis.

Blotting, Western↗

Acute stretching of peripheral nerves inhibits retrograde axonal transport.

The conjugation of horseradish peroxidase with wheat germ agglutinin was used to identify the effect on retrograde axonal transport of stretching the rat sciatic nerve indirectly by 10% and 20% femoral lengthening with a unilateral external fixator. To investigate the relationship between retrograde axonal transport and blood flow in the stretched nerve, nerve blood flow in the sciatic nerve was measured by a hydrogen washout technique. At 11% strain (20% femoral lengthening), the numbers of horseradish peroxidase-labelled motor neuron cells and nerve blood flow had decreased by 43% and 50%, respectively. Histological examination demonstrated ischaemic changes, but not mechanical damage. However, at 6% strain (10% femoral lengthening) there were no significant abnormalities. These findings suggest that the inhibition of retrograde axonal transport can be induced by acute stretching of the peripheral nerve and that circulatory disturbance is the main cause of the inhibition of retrograde axonal transport at the low strain.

Animals↗

The relationship between lipoprotein(a) and low density lipoprotein receptors during the treatment of hyperthyroidism.

To determine whether the low density lipoprotein (LDL) receptor pathway is involved in the catabolism of plasma lipoprotein (a) [Lp(a)], serum lipids, Lp(a), and LDL receptor activity were measured in seven patients with hyperthyroidism before and after methimazole treatment given hyperthyroidism is associated with enhanced LDL receptor activity. LDL receptor activity in patients was estimated by the equation using the serum concentrations of apolipoprotein (apo) B and C-II. When euthyroidism was achieved after treatment, not only did serum total cholesterol, high density lipoprotein-cholesterol, apo B, and LDL-cholesterol (LDL-Ch) levels rise, but Lp(a) significantly increased and calculated LDL receptor activity significantly decreased. The changes in LDL receptor activity were significantly correlated with the changes in LDL-Ch as expected, but not with changes in Lp(a). These results suggest that the serum concentration of Lp(a) is lowered in hyperthyroidism, probably by a mechanism other than the enhanced activity of the LDL receptor, and that the LDL receptor pathway is involved in the catabolism of Lp(a) to a limited extent.

Apolipoproteins↗

The role of complement-derived chemotactic factors in lung injury induced by preformed immune complexes.

Our previous studies have suggested a role for complement fragments presumably activated by immune complexes in patients with hypersensitivity pneumonitis. The present study has shown that circulating complement depletion by cobra venom factor resulted in the reduction in severity of immune-complex-mediated pulmonary inflammation. The activity of chemotactic factors for neutrophils generated in bronchoalveolar lavage fluids in complement-depleted animals was significantly diminished to 61.2% compared to the undepleted animals. In addition, reduced activity of chemotactic factors resulted in a marked reduction of accumulation of neutrophils in bronchoalveolar lavage fluids indicating that chemotactic factors play an important role in the sequestration of neutrophils on the alveolar side of the lung. In conclusion, chemotactic factors in bronchoalveolar lavage fluids which preceded the accumulation of polymorphonuclear cells are partially derived from complement.

Alveolitis, Extrinsic Allergic↗

[A case of yellow nail syndrome presenting as recurrent pneumonia].

We report a case of yellow nail syndrome (YNS) associated with recurrent episodes of pneumonia. The patient, a 31-year-old female, presented with yellow nails, chronic bronchitis and pleural effusion. The etiology of YNS remains unknown although it has been postulated to be associated with lymphatic abnormalities. YNS is a rare disease with only 22 cases reported in Japan. However, YNS is often associated with respiratory infections, and should thus be borne in mind.

Adult↗

Sequential changes in lung injury induced by preformed immune complexes.

Immune complexes formed in the airside may be involved in the early parenchymal changes in hypersensitivity pneumonitis. The present study was undertaken to compare the responses of animals after an intratracheal injection with preformed immune complexes to those of patients with acute hypersensitivity pneumonitis, with special emphasis on sequential bronchoalveolar lavage findings and the possible role of chemotactic factors in the immune complex-induced lung injury. An increased number and percentage of polymorphonuclear cells could be detected in bronchoalveolar lavage fluids of guinea pigs within 48 hr following an intratracheal injection of preformed immune complexes. Chemotactic factor activity preceded the observed increase of polymorphonuclear cells in bronchoalveolar lavage fluids, suggesting a role for chemotactic factors in the sequestration of these cells in the lung. In addition, this study confirmed the usefulness of bronchoalveolar lavage in evaluating the pulmonary findings because the changes in bronchoalveolar lavage cell populations correlated with sequential histological findings. The sequential characteristics of the involved areas were noted to be of a peribronchial or bronchiolar infiltration with polymorphonuclear cells at early stages, then alveolar sac infiltration, followed by mild infiltration of mononuclear cells into the alveolar walls. The findings suggest a possible role for chemotactic factors in the accumulation of polymorphonuclear cells, and the sequential changes of bronchoalveolar lavage and histological findings in animals are comparable to those in patients with acute hypersensitivity pneumonitis.

Alveolitis, Extrinsic Allergic↗

[Serial changes in lung injury produced by preformed immune complexes].

A previous study demonstrated increased levels of C5a des Arg and increased numbers of polymorphonuclear cells (PMNs) in bronchoalveolar lavage (BAL) fluids of acutely ill patients with summer type hypersensitivity pneumonitis (HP), suggesting the role of immune complexes (IC) in the early stage of HP. The present study was undertaken to compare the BAL findings in patients with acute HP and in animals which were injected intratracheally with preformed IC and to determine the correlation between the sequential BAL findings and the serial histology in animals. The results indicated that total cells recovered by BAL increased up to 24 hours. However, the most striking observation was that the increased number and percentage of PMNs in BAL cells shortly after the intratracheal injection, which the number of macrophages in BAL cells tended to be high, the increase was not statistically significant. Histological examinations revealed peribronchial and intraalveolar infiltration with PMNs at the early stage when intraalveolar infiltration were predominant, and the latest lesions consisted of infiltration with mononuclear cells in the alveolar walls. Furthermore, the cellular findings of BAL cells reflected the histological findings in involved lungs. The present study demonstrated that the sequential BAL changes of acutely ill patients with HP were similar to those of IC-injected animals, suggesting the possibility that IC formed in the airways is involved in the early stage of HP.

Alveolitis, Extrinsic Allergic↗

[Neutrophil chemotactic factor in lung injury produced by immune complexes].

Our previous study demonstrated increased levels of C5a des Arg and increased numbers of neutrophils in bronchoalveolar lavage (BAL) fluids of patients acutely ill with hypersensitivity pneumonitis (HP), suggesting that complement fragments activated by immune complexes (IC) play a role in the early stage of disease. The present study was undertaken to clarify the mechanisms involved in lung injury produced by IC formed in the airway. Sequential changes of neutrophils and neutrophil chemotactic activities (NCF) in BAL fluids were evaluated in guinea-pigs injected intratracheally with preformed IC. Our results were as follows: 1) There was an increased number of neutrophils in BAL cells within 48 hours of the intratracheal injection with preformed IC reaching a peak at 24 hours postinjection. 2) NCF in BAL fluids were potent at 2-6 hours postinjection and preceded an increase of neutrophils in BAL cells, indicating that NCF play a role in the accumulation of neutrophils in the lung. 3) A consequent increase of alveolar macrophages and macrophage chemotactic activities (MCF) in BAL fluids was observed but to a lesser extent. 4) Pretreatment with cobra venom factor of guinea-pigs reduced the increase of BAL cells, especially neutrophils and NCF to approximately 60% of comparable results, suggesting that complement fragments play a role in IC mediated lung injury.

Alveolitis, Extrinsic Allergic↗

Chemotactic factors present in the supernatants of cultured sarcoid granulomas.

The present study was undertaken to test whether cultured lymphocytes and epithelioid cells from sarcoid granulomas obtained from patients with active stage 2 sarcoidosis produced chemotactic factors (CF) for leukocytes as assessed by modified Boyden's method. The results indicate that: (1) CF for mononuclear cells and for neutrophils were detected in supernatants from cultured sarcoid granulomas; (2) similar activity was detected in culture supernatants from both lymphocytes and epithelioid cells; (3) CF present in the supernatants of cultured epithelioid cells were similar physically to those which other investigators have disclosed to be released by alveolar macrophages, (4) CF in the supernatants of cultured lymphocytes were similar to the lymphokines based on an estimation of molecular size; (5) neutrophils from patients with sarcoidosis were less responsive to zymosan-activated sera and did not respond well to CF derived from their own granuloma, whereas mononuclear cells from sarcoid patients responded well to CF. In conclusion, CF are present in the supernatants of cultured sarcoid granulomas and they appear to preferentially attract mononuclear cells from sarcoid patients.

Cells, Cultured↗

Analysis of bronchoalveolar lavage cells and fluids in patients with hypersensitivity pneumonitis: possible role of chemotactic factors in the pathogenesis of disease.

The current study concerns immunological mechanisms involved in the pathogenesis of hypersensitivity pneumonitis (HP) by an analysis of the cells and chemotactic factors (CF) obtained by bronchoalveolar lavage (BAL). Nine patients at an acute stage (HP acute, 8 summer type and 1 pigeon breeder's lung) and 4 patients at a quiescent stage (HP quiescent, 3 summer type and 1 pigeon breeder's lung) were included. The results indicate that: CF for polymorphonuclear cells (PMN) in HP acute were significantly more potent than in HP quiescent; CF for mononuclear cells were not significantly different in the groups; the percentage of lymphocytes in HP acute was significantly greater even though HP quiescent revealed greater percentages of lymphocytes as compared to normal controls; determination of T cell subsets employing OKT antibodies revealed the ratio of OKT8+ cells to OKT4+ cells in HP acute was significantly higher than in HP quiescent, and chemotaxis for PMN was marginally correlated with the percentage of OKT8+ cells at the acute stage of disease.

Albumins↗