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Biomedical subjects

T Nishiyama

Publications and source records attributed to T Nishiyama.

At least 19 recordsLinked to original sources

Post-translational processing of rac p21s is important both for their interaction with the GDP/GTP exchange proteins and for their activation of NADPH oxidase.

rac1 and rac2 p21s are ras p21-like small GTP-binding proteins which are implicated in the NADPH oxidase-catalyzed superoxide generation in phagocytes. rac1 and rac2 p21s have a Cys-A-A-Leu (A = aliphatic amino acid) structure in their C-terminal region which may undergo post-translational processing including prenylation, proteolysis, and carboxyl methylation. We studied the function of this post-translational processing of rac p21s in their interaction with the stimulatory and inhibitory GDP/GTP exchange proteins for rac p21s, named smg GDS and rho GDI, and in their NADPH oxidase activation. We produced human recombinant rac1 and rac2 p21s in insect cells and purified them from the membrane and soluble fractions as the post-translationally processed and unprocessed forms, respectively. Post-translationally processed rac1 and rac2 p21s were sensitive to both smg GDS and rho GDI, but post-translationally unprocessed rac1 and rac2 p21s were insensitive to them. The GTP gamma S (guanosine 5'-(3-O-thio)triphosphate)-bound form of post-translationally processed rac1 and rac2 p21s stimulated the NADPH oxidase activity, but post-translationally unprocessed rac1 and rac2 p21s were far less effective. These results indicate that both rac1 and rac2 p21s stimulate the NADPH oxidase activity and that their post-translational processing is important not only for their interaction with smg GDS and rho GDI but also for their NADPH oxidase activation.

Amino Acid Sequence

Identification of two enhancer elements in the gene encoding the type 1 glucose transporter from the mouse which are responsive to serum, growth factor, and oncogenes.

The type 1 glucose transporter (GLUT1) gene encodes an integral membrane glycoprotein responsible for facilitating transfer of glucose across plasma membrane and is rapidly activated by serum, growth factors, and by oncogenic transformation. To elucidate the molecular mechanisms of regulation of GLUT1 gene expression, we isolated and characterized the mouse GLUT1 gene. DNA elements regulating transcription of the gene were analyzed in transient expression assays after transfection of NIH/3T3 cells with a low background chloramphenicol acetyltransferase (CAT) vector system pSVOOCAT. We identified two enhancer elements; the first one is located 2.7 kilobases upstream of the cap site of the gene which contains the homologous sequences with two 12-O-tetradecanoylphorbol-13-acetate-responsive elements (TREs), a serum response element, a cyclic AMP-responsive element (CRE) and three GC boxes, and the second one is located in the second intron of the gene which contains the homologous sequences with two TREs and one CRE. With the promoter alone the transcription of the gene is activated by src, only slightly activated by ras and is not activated by serum and platelet-derived growth factor. When the gene is accompanied by one of these enhancers, the transcription is activated by all these stimuli.

3T3 Cells

Interferon gamma but not tumor necrosis factor alpha decreases susceptibility of human renal cell cancer cell lines to lymphokine-activated killer cells.

Human renal cell cancer (RCC) cell lines, ACHN and KRC/Y, with or without exposure to cytokines, were examined for their susceptibility to lymphokine-activated killer (LAK) cells. Flow-cytometric analysis demonstrated constitutional expression of class I antigen on both cell lines, which was enhanced by interferon alpha (IFN alpha), IFN gamma and tumor necrosis factor alpha (TNF alpha). A 4-h 51Cr-release cytotoxicity assay demonstrated that pretreatment of both cell lines with IFN gamma or IFN alpha, but not with TNF alpha, decreased their susceptibility to LAK cells. IFN gamma also decreased susceptibility to natural killer cells in a 16-h 51Cr-release cytotoxicity assay. IFN gamma treatment decreased the susceptibility of ACHN cells in a dose-dependent manner. "Cold"-target competition assay clearly showed that IFN gamma- but not TNF alpha-pretreated cells compete less effectively than do untreated target cells. Pretreatment with IFN gamma, however, increased expression of intercellular adhesion molecule-1 (ICAM-1) to a degree comparable to that with TNF alpha. Northern blot analyses using a 520-base-pair ICAM-1 cDNA as a probe demonstrated that more 3.3-kb mRNA is expressed in IFN gamma- and TNF alpha-pretreated cells. These results suggest that IFN gamma-treated RCC cell lines may reduce their ability to be recognized by LAK cells, and that IFN-induced protection of RCC cell lines against LAK cells may depend upon a mechanism independent of the expression of class I antigens or ICAM-1 on tumor cells.

Carcinoma, Renal Cell

Differential diagnosis of adrenal tumour and upper pole renal tumour by I-131 cholesterol adrenocortical scintigraphy.

A 27-year-old housewife with right hypochondralgia was admitted for treatment of a huge right adrenal or upper pole renal tumour. The tumour measured 10 x 8 x 8 cm and was hypovascular. The main blood supply derived from the right adrenal artery which originated from the abdominal aorta just proximal to the right renal artery. Although several diagnostic imaging studies suggested that the tumour arose from the right adrenal gland, the bilateral adrenal glands were equally visualized on I-131 cholesterol adrenocortical scintigraphy. After surgery and pathological examination, the tumour proved to be a renal cell cancer, while the right adrenal gland was intact. This case demonstrates that adrenocortical scintigraphy is useful in the differentiation of adrenal and renal tumours when a large tumour occupies the upper pole of the kidney or adrenal gland.

Adrenal Gland Neoplasms

A vascularised rib strut technique for funnel chest correction.

We have refined the Ravitch technique of sternal elevation for surgical correction of funnel chest. Our major modification is introducing a living rib strut for supporting the elevated sternum. The left 5th rib with a vascular pedicle from the internal thoracic artery is turned 180 degrees beneath the sternum. We have used this method in 10 cases. The results have all been satisfactory.

Adolescent

Primary localized amyloidosis of the bladder: a case of AL (lambda) amyloid protein and combination therapy using dimethyl sulfoxide and cepharanthin.

We report a case of primary localized amyloidosis of the bladder with amyloid deposits which was characterized as being of immunoglobulin light chain origin (AL) including lambda type (A lambda) and P component (AP) using the KMnO4 pretreatment method and immunohistochemical procedures. The patient was treated successfully with intravesical dimethyl sulfoxide instillation and oral administration of high-dose cepharanthin after transurethral resection. Combination therapy with dimethyl sulfoxide and cepharanthin was shown to be useful for primary localized amyloidosis of the bladder.

Aged

Gynecomastia and ectopic human chorionic gonadotropin production by transitional cell carcinoma of the bladder.

We report a patient with gynecomastia and ectopic production of human chorionic gonadotropin (HCG) by a transitional cell carcinoma of the bladder. In the present case, serum HCG levels and gynecomastia paralleled the clinical course. On admission, the patient was suffering from invasive transitional cell carcinoma (grade 3) of the bladder with metastasis to the left inguinal lymph nodes, together with gynecomastia. The serum HCG level was also elevated. After anticancer chemotherapy, the apparent bladder lesion and gynecomastia disappeared, and the serum HCG level declined to within normal limits. About 2 months after discharge, when the patient suffered from recurrent invasive tumors of the bladder, gynecomastia reappeared and the serum HCG level again became elevated. beta-HCG was demonstrated in biopsy tissue using the immunoperoxidase technique. The presence of beta-HCG was always focally demonstrated and was shown to be localized in the cytoplasm of the tumor cells.

Carcinoma, Transitional Cell

Partial anomalous pulmonary venous return showing anomalous venous return to the azygos vein.

Partial anomalous pulmonary venous return (PAPVR) is a congenital heart disease with a reported incidence of autopsied case. The location of the anomalous pulmonary venous return is usually the right atrium, superior vena cava (SVC), and sometimes the brachiocephalic vein, inferior vena cava (IVC) or coronary venous sinus. Recently we experienced a rare case of PAPVR showing anomalous right total pulmonary venous return to the azygos vein. Furthermore, downward translocation of the right upper lobe bronchus was evident. This rare case is reported along with a review of the related literature.

Azygos Vein

Effect of hyaluronate on physicochemical and biological properties of collagen solution which could be used as collagen filler.

The effect of hyaluronate (HA) on the physiochemical and biological properties of collagen solution was examined for two preparations of collagen with different rates of fibril formation. The addition of HA to the collagen preparation with the slower rate of fibril formation caused a prominent acceleration of fibril formation. A differential scanning calorimetric measurement of the collagen preparation demonstrated a stabilizing effect of HA on collagen solution after incubation at 37 degrees C. Histochemical examination of rat dermis after injection of the collagen solution into the tissue revealed the migration of fibroblast-like cells into the region occupied by the injected collagen. The addition of HA to collagen preparation S (slower rate of fibril formation) shortened the time-to-appearance of fibroblast-like cells to a similar value to that observed when collagen preparation F (faster rate of fibril formation) was used. The timing of cell appearance was in accord with the rate of fibril formation in vitro. Fibrils newly formed by injected collagen might provide sites for cell attachment, migration and proliferation.

Animals

[Successful local adoptive immunotherapy for pleuritis carcinomatosa due to renal cell cancer. A case report].

A 54-year-old woman who had undergone radical nephrectomy for renal cell cancer nine months before was admitted to our hospital because of difficulty in breathing. X-ray films of the chest showed massive pleural effusion on the left side and cytological examination of the effusion revealed malignant cells which may have originated from renal cell cancer. Intrapleural instillations of interleukin-2 and of tumor infiltrating lymphocytes isolated from the pleural effusion were performed. After the initiation of the treatment, the pleural effusion decreased and malignant cells disappeared from the pleural fluid. Partial response defined by the criteria provided by the Japan Lung Cancer Society was achieved. No serious side effects were observed. This would be a useful treatment for pleuritis carcinomatosa by renal cell cancer.

Carcinoma, Renal Cell

[MRI of pheochromocytoma--comparison with CT, 131I-MIBG, urinary catecholamine level and operative findings].

16 patients (7 male, 9 female) ranging in age from 13 to 71 (44.1 +/- 18.4) years old with clinically diagnosed pheochromocytoma were prospectively evaluated with CT (N = 16), MRI (N = 16), 131I-MIBG (N = 10) and operative findings in order to evaluate their diagnostic efficacy. 1. Normal adrenal glands appeared less intense than the liver on T1-weighted image (T1WI), less intense than or isointense with the liver on both proton density image (PDI) and T2-weighted image (T2WI). 2. Pheochromocytomas with high urinary noradrenaline level appeared less intense than the liver on T1WI, more intense on T2W1 and showed accumulation of radioisotope on 131I-MIBG scintigraphy. In cases with normal urinary noradrenaline level, they appeared less intense than or isointense with the liver on all pulse sequences (T1WI, PDI and T2WI). 3. Although diagnostic accuracy of localization was 81.3% (13/16) by CT, 93.8% (15/16) by MRI and 90% (9/10) by 131I-MIBG scintigraphy, MIBG scintigraphy showed higher diagnostic ability in cases with multiple lesions or recurrent tumors.

3-Iodobenzylguanidine

[Sequential methotrexate and 5-fluorouracil, doxorubicin, and cisplatin for advanced urothelial cancer].

Twenty cases (fourteen males, six females, mean age 66.0) with locally advanced (T2-4 N0, M0, n = 9) or metastatic (N2-3 or M1, n = 11) urothelial cancer were treated sequentially with methotrexate (MTX) and 5-fluorouracil (5-FU), Doxorubicin (ADM), and cisplatin (CDDP) since August, 1988. Primary tumors were in the bladder in fifteen patients and in the renal pelvis or ureter in five cases. Histological findings were adenocarcinoma in one and transitional cell carcinoma in the other cases. Histological grades were grade 2 in four, grade 3 in fifteen, poorly differentiated adenocarcinoma in one. Seven patients were treated by neoadjuvant chemotherapy. Three were treated for recurrent lesions. Ten were treated for the unresectable disease. The patients received one to four cycles of this regimen (average: 2.8 cycles). Complete clinical response was observed in seven of twenty patients (35%) with measurable indicator lesions. Seven patients (35%) had a partial clinical response. Significant tumor regression was noted in fourteen of twenty patients (70%) in total, in eight of ten (80%) treated with full dose chemotherapy. The group of full dose chemotherapy showed an improved trend in survival rate as compared with the group treated by 80% and less dose chemotherapy. Toxicity was relatively mild, with anemia, leukopenia, thrombocytopenia, and no drug related death. The results suggest that the combined chemotherapy with sequential MTX and 5-FU, ADM, and CDDP is remarkably effective on advanced urothelial cancer.

Adenocarcinoma

[Supralevator pelvic exenteration with simultaneous bowel and urinary reconstruction. Two case reports].

Two male patients underwent supralevator pelvic exenteration, preserving their normal voiding and evacuating function. Case 1 was a 19-year-old man with pineal region tumor, and a metastatic lesion in the bottom of the rectovesical pouch, possibly through the ventriculo-peritoneal shunt. Following supralevator pelvic exenteration, the construction of double pouches, a colonic J pouch and Mainz pouch to the urethra, were performed. Case 2 was a 39-year-old man with bulky retrovesical tumor. He underwent supralevator pelvic exenteration by sigmoid colo-proctostomy and U-pouch to the urethra. Both patients achieved continent except for urinary leakage at night and were able to defecate and urinate voluntarily. Urodynamic study revealed that the pressure in their urinary pouches was low.

Adult

[The effect of intra-urethral catheter for prostatic hypertrophy patients who are unfit for operation and suffer from urinary retention].

The effect of double Malecot type polyurethane intraurethral catheter (IUC) was examined in 17 benign prostatic hypertrophy patients who were unfit for operation and suffered from urinary retention. Patients were aged 68 to 90 (mean 80.5) years old and the causes of IUC insertion were cardiac, cerebrovascular, respiratory and gastrointestinal diseases, diabetes mellitus and aging. IUC was selected among three types (55, 60, 65 mm) according to the length of prostatic urethra. Insertion of IUC was carried out easily under fluoroscopic guidance without endoscopy. All patients could void by themselves just after insertion of IUC and the longest indwelling period was 10 months. The length of IUC need not be longer than that of prostatic urethra and patients with normal or hypertonic bladder could void better than those with atonic bladder. Urinary tract infection did not get worse in any patients with indwelling IUC. Double Malecot type polyurethane IUC is a safe and an effective alternative method in place of urethral balloon catheter for inoperable prostatic hypertrophy patients in urinary retention.

Aged

[A case of advanced ureteral squamous cell carcinoma showing complete response to combination chemotherapy with cisplatinum, vindesine, and bleomycin].

A 56-year-old Japanese female was diagnosed as advanced squamous cell carcinoma of the left ureter, stage IV (T4N0M0), and treated with anti-cancer drugs using cis-platinum, vindesine, and bleomycin. The tumor vanished after the treatment. The specimen after left total nephroureterectomy and hysterectomy showed only granulomatous change with necrosis and foreign giant cells but not cancer cells.

Antineoplastic Combined Chemotherapy Protocols

[Interaction of nicardipine and inhalational anesthetics--comparison between enflurane and isoflurane].

The effects of nicardipine 1 mg bolus injection under enflurane anesthesia were compared with those under isoflurane anesthesia. Twelve neurosurgical patients were divided into 2 groups, enflurane group (n = 6) and isoflurane group (n = 6). In all patients anesthesia was induced with midazolam, thiamylal, fentanyl and vecuronium. Anesthesia was maintained with fentanyl, nitrous oxide, pancuronium plus enflurane (enflurane group) or plus isoflurane (isoflurane group). After incision of dura mater, nicardipine 1 mg was given through forearm venous line. For about 30 minutes before and after nicardipine injection, concentration of inhalational anesthetics was kept constant and no drugs were given. Blood pressure (BP), heart rate (HR), rate pressure product (RPP), and serum concentrations of catecholamine and nicardipine were monitored for 30 minutes after nicardipine injection. In isoflurane group, BP decreased more and longer, and increases of HR and serum concentration of catecholamine continued longer compared with enflurane group. Elimination half life of nicardipine was shorter, area under the curve (AUC) was smaller and clearance of nicardipine was larger in isoflurane group than in enflurane group. It was concluded that isoflurane increased the effects of nicardipine, which were BP depression and reflex sympathetic stimulation, than enflurane and that metabolism and elimination of nicardipine were accelerated more by isoflurane than by enflurane.

Anesthesia, Inhalation

[Epidural midazolam with bupivacaine--optimal dose for postoperative pain relief].

Optimal dose of epidural midazolam with bupivacaine for postoperative pain relief was investigated. Forty seven patients for upper abdominal surgery were divided into 5 groups. Each group had either 0.25% bupivacaine 6 ml (control group), 0.25% bupivacaine 6 ml + midazolam 0.025 mg.kg-1 (0.025 group), 0.05 mg.kg-1 (0.05 group), 0.075 mg.kg-1 (0.075 group), or 0.1 mg.kg-1 (0.1 group) administered epidurally for complaint of first postoperative pain. Blood pressure (BP), heart rate (HR), respiratory rate (RR) and sedation score (SS) were monitored for 120 minutes, and the time interval for next analgesics (TNA) was checked. In each group, BP fell down 10 minutes after injection, HR was unchanged, and RR (except for 0.1 group) decreased, compared with the preinjection level. There was no difference between control group and others in BP, HR and RR. But 3 cases in 0.075 group and 4 cases in 0.1 group needed chin lift with a pillow under the shoulder for slight airway obstruction. The most optimal SS was obtained in 0.05 group. TNA was significantly longer in 0.025 and 0.05 groups than in the control group. It was concluded that the optimal dose of epidural midazolam with 0.25% bupivacaine 6 ml was 0.05 mg.kg-1 for postoperative pain relief after an upper abdominal surgery.

Abdomen