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Biomedical subjects

N Iwao

Publications and source records attributed to N Iwao.

At least 19 recordsLinked to original sources
PubMed2006

Analysis of donor-type chimerism in lineage-specific cell populations after allogeneic myeloablative and non-myeloablative stem cell transplantation.

We analyzed donor-type chimerism in CD3+, CD14.15+ and CD56+ cells from 36 patients who had undergone conventional-intensity allogeneic stem cell transplantation (CST) and 34 patients who had undergone non-myeloablative allogeneic stem cell transplantation (NST) for hematological malignancies. On day 28 after transplantation, all fractions in NST patients and CD3+ cells in CST patients who received a non-total body irradiation (TBI) regimen showed more frequent mixed chimerism (<90% donor cells) than those in patients who had received TBI. NST patients with acute graft-versus-host disease (grade II-IV) frequently showed more than 50% donor-type chimerism in CD3+ cells on day 14 (P=0.029). NST patients with <50% donor-type chimerism on day 14 and with <90% donor-type chimerism on day 28 in CD56+ cells had significantly poor 1-year overall survival (0 vs 91%, P<0.001 and 20 vs 74%, P=0.002, respectively). Both NST and CST patients with <90% donor-type chimerism in CD14.15+ cells on day 28 had significantly poor 1-year overall survival (14 vs 70%, P=0.005 and 0 vs 66%, P=0.002, respectively). Our data show that the extent of donor-type chimerism in lineage-specific cells appears to have an impact on outcome after allogeneic stem cell transplantation.

Adolescent↗
PubMed2005

Differences in the relationship between lipid CHD risk factors and body composition in Caucasians and Japanese.

OBJECTIVES: To examine differences in the relationship between fat distribution and lipid coronary risk factors in Caucasian and Japanese population and further to determine whether the cut-points for body mass index (BMI) and waist circumference (WC) proposed by WHO and NHLBI are applicable to Japanese population as a predictor of a lipid risk factor abnormality or not. RESEARCH METHODS AND PROCEDURES: Subjects were 895 participants of the Baltimore Longitudinal Study of Aging in the US (BLSA) and 1705 participants of the Longitudinal Study of Aging by the National Institutes for Longevity Science in Japan (NILS-LSA). Subjects were divided into four demographic groups as younger (age<65 y) men and women, and older (age> or =65 y) men and women. Blood total cholesterol, triglycerides, LDL- and HDL-cholesterol and anthropometry were measured. Regression coefficients of BMI and WC on risk factors, sensitivity and specificity of the BMI and WC cut-points for blood lipid abnormality, and mean values of blood lipids at BMI or WC cut-points were computed in both populations. RESULTS: Height, weight, WC and BMI were significantly greater in the BLSA than those in the NILS-LSA subjects. Total cholesterol, HDL- and LDL-cholesterol were significantly greater in the NILS-LSA than in the BLSA subjects. Sensitivities of BMI and WC cut-points were much lower in the NILS-LSA than in the BLSA subjects. Specificities of BMI and WC cut-points were higher in the NILS-LSA than in the BLSA subjects. Mean values of triglycerides, total cholesterol, HDL- and LDL-cholesterol at BMI=25 were significantly greater in the NILS-LSA than in the BLSA subjects. At the WC cut-point (94 cm for men, 80 cm for women), mean values of all lipids were significantly greater in the NILS-LSA than in the BLSA subjects with the exception of triglycerides in younger women. CONCLUSIONS: The Japanese subjects have smaller BMI and WC, worse total and LDL-cholesterol levels and better HDL-cholesterol levels compared to Caucasians. Sensitivities of BMI and WC for predicting lipid risk factor abnormality are much lower in Japanese. The cut-points for BMI and WC proposed by WHO and NHLBI may be too high for predicting an abnormality in triglycerides, total and LDL-cholesterol in Japanese. For detecting an abnormal HDL-cholesterol level, the BMI and WC cut-points may not be as beneficial for the Japanese population as for Caucasians.

Adult↗
PubMed2001

Does waist circumference add to the predictive power of the body mass index for coronary risk?

OBJECTIVES: To examine the power of the combined measurements of body mass index (BMI) and waist circumference (WC) for the prediction of abnormality in coronary heart disease risk factors and to determine whether the additional measurement of WC is predictive in older men and women. RESEARCH METHODS AND PROCEDURES: 1190 men and 751 women of the Baltimore Longitudinal Study of Aging were dichotomized into younger (<65 years) and older (65+ years) age groups. Coronary risk factors in the realms of glucose/insulin metabolism, blood pressure, and plasma lipids were assessed. The relationship of BMI and WC, singly and combined, to 10 risk factors for coronary heart disease was examined. RESULTS: In younger and older men and women, BMI and WC are highly correlated (0.84 to 0.88). BMI and WC are also significantly correlated to all 10 coronary risk factors in younger men and women and to 8 of the 10 in the older men and women. Both partial correlation and logistic regression analyses revealed a modest but significant improvement in the prediction of coronary risk in younger men and women by WC after controlling for the level of BMI. There was no improvement in the older subjects. DISCUSSION: WC adds only modestly to the prediction of coronary risk in younger subjects once BMI is known, and adds nothing to the production of risk in older subjects.

Adolescent↗
PubMed2000

A test of recently proposed BMI standards with respect to old age.

The purpose of this study was to investigate the effects of age on the relationship between BMI and multiple coronary risk factors, and to determine whether the BMI classification by NHLBI and WHO is applicable as a predictor of coronary risk factors in older (>65 years) as well as in younger (<65 years) men and women. Effects of age on ten coronary risk factors were examined. Sex differences in the slopes of BMI on risk factors were compared between younger and older subjects in order to examine the effects of age on these relationships. The frequency of risk factor abnormality in individual BMI groups (18.5-24.9, 25.0-29.9, 30.0+) was examined for four age-sex groups. The significance of an age group-BMI interaction term was tested by the logistic regression model to see whether there is a significant difference in the relationship between BMI and the individual risk factor abnormalities between younger and older subjects. Older subjects had significantly higher values for most risk factors than younger subjects. The slopes of BMI on risk factors were different between younger and older subjects for fasting glucose, total, HDL- and LDL-cholesterol in men, and for diastolic blood pressure, total and LDL-cholesterol in women. The proportion of subjects with abnormal risk factor levels in each of the three BMI groups was higher in older than in younger subjects for most risk factors. There was generally a progressive worsening of the risk factor levels with increasing BMI in both age groups. There was no consistent age difference in the relationship between BMI groups and the frequency of risk factor abnormality. We conclude that, although age increases the frequency of most cardiovascular risk factor abnormalities, in general, it does not affect the trend of the relationship between the risk factors and the normal, overweight and obese BMI groups defined by NHLBI and WHO. Therefore, these BMI categories are applicable as predictors of risk factor levels in older as well as in younger men and women.

Adult↗
PubMed2000

Effect of aging on the relationship between multiple risk factors and waist circumference.

OBJECTIVE: To examine the relationship between various coronary risk factors and the different levels of fat distribution in younger (<65 years) and older (> or = 65 years) men and women, using the classifications proposed by the National Heart, Lung and Blood Institute (NHLBI) and the World Health Organization (WHO). DESIGN: Cross-sectional study of subjects enrolled in the Baltimore Longitudinal Study of Aging. MEASUREMENTS: Systolic blood pressure, diastolic blood pressure, fasting glucose, 2-hour glucose, fasting insulin, homeostasis model assessment insulin resistance (HOMAIR), triglyceride, total cholesterol, high-density lipoprotein (HDL)-cholesterol, and low-density lipoprotein (LDL)-cholesterol were measured as risk factors. The proportion of subjects with abnormal risk factor levels by waist circumference classifications was determined in the age and gender subgroups. RESULTS: There were significant adverse effects of age per se on all risk factors with the exception of fasting insulin and HOMAIR in both men and women, total cholesterol in men, and diastolic blood pressure in women. HDL-cholesterol was higher in older subjects. There were significant correlations between waist circumference and all of the risk factors in the younger group. Waist circumference did not have a significant correlation with total cholesterol in older men, or with total cholesterol and LDL-cholesterol in older women. The proportion of subjects with an abnormal risk factor level increased with increasing waist circumference for most risk factors in both younger and older subjects, but proportions of subjects in each individual waist group were higher in older than in younger groups for systolic blood pressure, diastolic blood pressure, fasting glucose, and 2-hour glucose in men, and for systolic blood pressure, fasting glucose, 2-hour glucose, total and LDL-cholesterol, and triglyceride in women. CONCLUSIONS: Our data indicate that the waist circumference cutpoints proposed by NHLBI and WHO standards are useful for the prediction of cardiovascular disease risk factors in older as well as in younger men and women.

Adolescent↗
PubMed1998

Effect of insulin on intramuscular 3-hydroxybutyrate levels in diabetic rats.

It has been shown that inhibition of lipolysis and ketogenesis by insulin is more sensitive than suppression of hepatic glucose production and stimulation of tissue glucose uptake. Clinically, on the other hand, blood glucose concentrations fall much more quickly than blood ketone concentrations. Therefore, during continuous insulin infusion at a rate of 3.0 mU/kg B.W./min over a period of 150 min we monitored blood glucose and 3-hydroxybutyrate (3-OHBA) concentrations and muscle 3-OHBA levels using the microdialysis technique in streptozotocin-induced diabetic rats. Blood glucose concentrations decreased rapidly after insulin infusion. However, significant reduction in blood-3-OHBA concentration was found for the last 30 min. In muscle dialysate 3-OHBA concentrations and muscle local blood flow there was no significant change throughout the study. These results suggest that one possible mechanism of delayed improvement in ketonemia is a reduction in muscle removal capacity.

3-Hydroxybutyric Acid↗
PubMed1998

Secondary aortoduodenal fistula complicating aortic grafting, as a cause of intermittent chronic intestinal bleeding.

Intermittent intestinal bleeding persisted in a 77-year-old male, who had undergone grafting for abdominal aortic aneurysm. Each attack lasted for a few weeks and spontaneously resolved. Only a minute abnormality was found in the third portion of the duodenum; barium studies showed a segmental narrowing, but endoscopy disclosed only a small erosion in that portion. Massive and fatal gastrointestinal hemorrhage broke out 6 months after the onset of bleeding. Autopsy revealed an adhesion area with a small fistula formation between the duodenum and aorta. Even slight endoscopic findings should be considered suggestive of aortoenteric fistula in patients after aortic surgery.

Aged↗
PubMed1998

[Syndrome of inappropriate secretion of antidiuretic hormone and neurotoxicity induced by vincristine and alkylating agents during chemotherapy for malignant lymphoma of thyroid gland].

We report a syndrome of inappropriate secretion of antidiuretic hormone (SIADH), neurotoxicity and facial erythema induced by several anti-cancer drugs in a case of malignant lymphoma of thyroid gland. A 68-year-old male was admitted, complaining of neck tumor and dyspnea. On admission, he was treated with vincristine (VCR) for bronchostenosis due to malignant lymphoma. Neck tumor and mediastinal lymph node swelling reduced. On the ninth day after chemotherapy of VCR, a consciousness disturbance was found and he was diagnosed as having SIADH. Following chemotherapy of cyclophosphamide, SIADH was also induced so he was treated with irradiation for neck and mediastinal field, instead of chemotherapy. During irradiation, however, enlargement of systemic lymph nodes appeared, and the chemotherapy was resumed. He achieved partial remission, but somnolence after ifosfamide and facial erythema after ranimustine were observed. In spite of the difference in the chemical structure of these anti-cancer drugs, several side effects occurred. It is suggested that the direct effects of drugs on the nervous system were SIADH and neurotoxicity.

Aged↗
PubMed1997

Regional difference in lipolysis caused by a beta-adrenergic agonist as determined by the microdialysis technique.

We have investigated the difference in lipolysis caused by a beta-adrenergic agent between visceral and abdominal subcutaneous adipose tissues in vivo. Glycerol levels (lipolysis index) were continuously monitored in mesenteric and abdominal subcutaneous adipose tissues of anaesthetized Wistar rats using the microdialysis technique. During microdialysis, increasing concentrations of the lipolytic agent, isoproterenol (10(-8), 10(-7), 10(-6), 10(-5) mol L-1), were added to the perfusion. Glycerol concentrations in dialysate at each isoproterenol concentration, blood glucose concentrations during the experiment, and plasma insulin concentrations before and immediately after the experiment were measured. The effect of isoproterenol on local blood flow was investigated using the ethanol technique. The clearance rate of ethanol from the perfusion medium was used as the index of local blood flow. There was no significant change in blood glucose or plasma insulin concentrations during the study. Glycerol levels in dialysate were significantly higher in mesenteric than in abdominal subcutaneous adipose tissues at all isoproterenol concentrations. The percentage change of baseline ethanol ratio was not altered by increasing isoproterenol concentrations in both mesenteric and subcutaneous adipose tissues. There was also no significant difference in percentage change of the baseline ethanol ratio between mesenteric and abdominal subcutaneous adipose tissues. These results suggest that mesenteric adipose tissue is characterized by an even higher beta-adrenergic agonist-induced lipolysis than abdominal subcutaneous adipose tissue.

Abdomen↗
PubMed1997

Follow-up after the Hanshin-Awaji earthquake: diverse influences on pneumonia, bronchial asthma, peptic ulcer and diabetes mellitus.

We evaluated the influence of the Hanshin-Awaji earthquake on the patients in our internal medicine department. After the initial rush of patients with injury, the number of respiratory diseases, largely pneumonia, increased within one month. This same event, however, seemed to decrease attacks among asthma patients. During the following three months, the number of peptic ulcer patients increased: 39.5% had a giant gastric ulcer and 34.8% had bleeding complications. Diabetic control of outpatients became worse after the earthquake. It is important to recognize that various disorders involving physical and psychological problems develop at different stages after a large-scale disaster.

Asthma↗
PubMed1995

Combination chemotherapy of carboplatin and cytosine arabinoside for high-risk leukemia: a pilot study.

Fourteen patients with high-risk leukemia (six with relapsed AML, three with relapsed ALL, one with AML-M0, four with CML in myeloid blastic crisis) were treated with a combination chemotherapy of carboplatin (200-300 mg/m2/day) and cytosine arabinoside (100 mg/m2/day) by 24 h continuous infusion for 5-7 days. Five patients (35.7%) achieved complete remission including two patients complicated with myelofibrosis (one with AML-M0 and one with CML in myelo-megakaryocytic crisis). Thirteen patients had nausea and vomiting, five patients had severe, prolonged neutropenia for which it was necessary to administer granulocyte colony-stimulating factor and six patients had severe thrombocytopenia. We concluded that this regimen is effective for the treatment of high-risk leukemia.

Adolescent↗
PubMed1995

Acute graft-versus-host disease of the gut.

A 28-year-old man with acute promyelocytic leukemia at first early relapse received HLA-matched allogenic bone marrow transplantation (BMT) at first early relapse. Cyclosporin A and methotrexate were administered at conventional doses as a prophylaxis for graft-versus-host disease (GVHD). He presented with severe bloody diarrhea on day 87 after BMT. Examination of the lower gastrointestinal tract revealed diffuse mucosal change of inflammation. A diagnosis of late onset of acute gut GVHD was made, in the absence of other manifestations such as skin and liver involvement. A further survey is needed to clarify the incidence and the pathogenesis of atypical gut GVHD.

Acute Disease↗
PubMed1994

Extracellular ATP promotes cellular growth of glomerular mesangial cells mediated via phospholipase C.

The present study was undertaken to determine whether extracellular ATP promotes cellular growth of glomerular mesangial cells. ATP increased inositol 1,4,5-trisphosphate (IP3) production and cellular free calcium concentration ([Ca2+]i) in a dose-dependent manner. None of ADP, AMP or adenosine caused an increase in IP3 production or [Ca2+]i mobilization. Also, ATP activated mitogen-activated protein (MAP) kinase and 3H-thymidine incorporation and increased the absorbance by colorimetric assay in a dose-dependent manner. Again, either of ADP, AMP or adenosine had no effect. These results indicate that extracellular ATP binds to P2 purinergic receptors and activates phospholipase C in glomerular mesangial cells. Such a signal transduction promotes cellular growth of mesangium.

Adenosine↗
PubMed1991

[Clinical evaluation of the combination of carumonam and cefotiam in the treatment of complicated urinary tract infection].

The combination of carumonam (CRMN) and cefotiam (CTM), expected to have a broader spectrum of coverage in connection with urinary tract infections, was evaluated for its effectiveness and safety at the Department of Urology, Osaka University Hospital and 17 affiliated hospitals. CRMN and CTM were given together to 109 patients with complicated urinary tract infections (UTI), of whom 65 cases satisfied the "Criteria of UTI Committee for the Evaluation of Drug Efficacy in the UTI (3rd Ed.)", which was modified by adopting the midstream urine data for women. CRMN and CTM were administered by drip or one-shot infusion at a total daily dose of 4 g (equally mixed 1 g plus 1 g each, twice a day) for 5 consecutive days or longer. The overall clinical efficacy rate in the 65 cases of complicated UTI was 72%, estimated by the criteria cited above. The efficacy rate according to the infection type groupings was 72% for the 29 patients in the 1st group, 100% for the 1 patient in the 2nd group, 100% for the 7 patients in the 3rd group, 83% for the 6 patients in the 4th group, 50% for the 14 patients in the 5th group and 75% for the 8 patients in the 6th group. The disappearance rate of both urinary Gram positive cocci and Gram negative bacilli was 83.3%. Fifteen strains appeared after the treatment, only 4 of which were Gram positive cocci. Among the 109 patients treated with CRMN+CTM, no subjective side effects were recorded and the abnormalized laboratory findings observed were: eosinophilia in one patient, increases in both GPT and GOT in one patient, and lowered creatinine clearance in one patient. With a broader spectrum and safe regimen, the combination of CRMN/CTM is recommended as the first choice against complicated UTI.

Adult↗