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Biomedical subjects

Toru Watanabe

Publications and source records attributed to Toru Watanabe.

At least 91 records · Page 5Linked to original sources
PubMed2003

Vitamin K deficiency in severely disabled children.

Vitamin K status was examined in 21 severely disabled children in our hospital from September 2001 to August 2002, and 9 children were found to have a vitamin K deficiency. The 21 patients were divided into two groups: group A, 9 patients with vitamin K deficiency, and group B, 12 patients without vitamin K deficiency. The laboratory data and background factors in the two groups were compared statistically. In group A, all patients received enteral nutrition and anticonvulsants. The protein induced by vitamin K absence-II values were elevated in eight patients. Seven exhibited a bleeding tendency. Six developed vitamin K deficiency in association with infection and four were treated with antibiotics. All showed a good response to the administration of vitamin K. The patients in group A had factors such as use of antibiotics, infection, and elemental nutrition at significantly higher rates than those in group B. Data indicating nutrition factors such as body weight, caloric intake, total protein level, and hemoglobin level were not significantly different between the two groups. Severely disabled children suffer from deficiencies of various nutritional elements. However, vitamin K deficiency in severely disabled children has not been fully investigated. Infection, use of antibiotics, and elemental nutrition are risk factors for vitamin K deficiency in severely disabled children. In severely disabled children, there might be marginal vitamin K intake via enteral nutrition, so more vitamin K supplementation is necessary, especially with infection and use of antibiotics.

Adolescent↗
PubMed2003

Effects of atorvastatin and pravastatin on malondialdehyde-modified LDL in hypercholesterolemic patients.

The aim of the present study was to compare the effects of atorvastatin and pravastatin on lipid parameters and the concentration of malondialdehyde-modified low-density lipoprotein (MDA-LDL) in hypercholesterolemic patients. A total of 17 patients (10 men, 7 women; mean age, 68+/-9 years) who were indicated for drug therapy based on the National Cholesterol Education Program II underwent an 8-week regimen of atorvastatin (10 mg/day) or pravastatin (10 mg/day) with a 4-week washout period between drugs. After an overnight fast, lipid parameters and MDA-LDL concentration were measured before and after the 8-week treatment with each drug. Both atorvastatin and pravastatin produced significant reductions in low-density lipoprotein (LDL) cholesterol and MDA-LDL concentrations, with a significant increase in high-density lipoprotein cholesterol concentration. The percent reductions in LDL cholesterol and MDA-LDL concentration were significantly greater with atorvastatin than pravastatin (46 +/-6% vs 24+/-10%, p<0.0001, and 44+/-10% vs 14+/-13%, p<0.0001, respectively). The ratios of percent reductions in MDA-LDL concentrations and percent reductions in LDL cholesterol concentrations were significantly greater for atorvastatin than pravastatin (0.96+/-0.19 vs 0.59+/-0.55, p<0.0001). In conclusion, atorvastatin reduced serum concentrations of LDL cholesterol and MDA-LDL to a greater degree than pravastatin, indicating that atorvastatin not only has stronger lipid-lowering effects, but also stronger antioxidative effects than pravastatin.

Aged↗
PubMed2003

[A case of spermatic cord tuberculosis].

A 47-year-old man visited our hospital with a complaint of a right intrascrotal mass. The results of a laboratory examination were unremarkable. An ultrasonographic examination of the right scrotum demonstrated a low echoic legion, 2.5 x 1.3 x 0.7 cm in diameter. A right spermatic cord tumor was diagnosed. Right high orchiectomy was performed. Microscopic examination showed a granulomatous lesion with Langhans large cells. Tuberculin skin test was strongly positive. From these findings we diagnosed the patient with tuberculosis in the spermatic cord.

Genital Diseases, Male↗
PubMed2002

Pneumothorax and transient pseudohypoaldosteronism in an infant with hydronephrosis.

Pneumothorax and transient pseudohypoaldosteronism have been noted as complications of obstructive uropathy in infancy. However, they are rare complications, and there have been no reports of a patient with both pneumothorax and pseudohypoaldosteronism in obstructive uropathy. Here we describe a case of pneumothorax and transient pseudohypoaldosteronism in an infant with bilateral hydronephrosis due to ureteropelvic junction obstruction. Nephrostomy improved the patient's condition and laboratory findings rapidly. While the exact pathogenic mechanism of pneumothorax in patients with obstructive uropathy is unclear, some biochemical defects due to obstructive uropathy might impair fetal lung maturation, which results in pneumothorax.

Female↗
PubMed2002

Transient hyporeninemic hypoaldosteronism in acute glomerulonephritis.

While hyporeninemic hypoaldosteronism (HH) has been well described in relation to chronic renal diseases, transient HH has rarely been reported. Here we present a 9-year-old boy with acute glomerulonephritis who developed hyperkalemia, which persisted for a period of 3 weeks despite normal values of creatinine clearance and an absence of acidosis. He was diagnosed as having HH because of low basal plasma renin activity and serum aldosterone level. Renal biopsy showed diffuse endocapillary proliferative glomerulonephritis. There were no apparent pathological changes in the juxtaglomerular apparatus (JGA). Rapid adrenocorticotropic hormone administration increased adequately both serum aldosterone and cortisol levels. Responses of both plasma renin activity and serum aldosterone level following the furosemide upright provocation were blunted in the hyperkalemic acute phase, but recovered in the normokalemic convalescent phase. Serum levels of human atrial natriuretic peptide were within normal range, both in the hyperkalemic and normokalemic phases. These results suggested that a transient dysfunction of the JGA, without volume expansion or structural damage of the JGA, caused HH in this patient.

Acute Disease↗
PubMed2002

Expression of estrogen receptor (ER) (beta)cx protein in ER(alpha)-positive breast cancer: specific correlation with progesterone receptor.

Estrogen receptor (ER) (beta)cx, a splice variant of ERbeta, is a dominant repressor of ER(alpha) function. In this study we investigated the possibility that because the progesterone receptor (PR) gene is a downstream target of activated ER(alpha), in ER(alpha)-positive breast cancers, expression of ER(beta)cx would result in repression of PR. In ER(alpha)-positive MCF-7 cells, stable transfection of an ER(beta)cx expression vector resulted in reduced expression of PR without affecting ER(alpha) expression. In breast cancers, immunohistochemical evaluation of ER(alpha)-positive foci for the expression of PR and ER(beta)cx revealed a significant correlation between a PR-negative phenotype and the presence of ER(beta)cx within the foci. However, when entire lesions were evaluated by Allred scoring in 115 ER(alpha)-positive breast cancer specimens, the presence of two distinct groups of patients could be discerned. One group expressed ER(beta)cx and had very reduced levels of PR expression, as expected. The second group showed both ER(beta)cx and high levels of PR. To evaluate the role of ER(beta)cx in sensitivity to tamoxifen, 18 core needle biopsies, obtained before preoperative treatment with tamoxifen, were investigated. The results show that expression of ER(beta)cx in primary lesions correlated with a poor response to tamoxifen, especially in cancers with a low PR expression in Allred score. This is the first evidence that evaluation of ER(beta)cx along with PR may contribute to a better characterization of ER(alpha)-positive breast cancers.

Amino Acid Sequence↗
PubMed2002

Reflux nephropathy in a patient with crossed renal ectopia with fusion.

Crossed renal ectopia with fusion is a rare congenital anomaly of the urinary tract. While vesicoureteral reflux has been noted frequently, reflux nephropathy has rarely been reported with this anomaly. I describe here a case of reflux nephropathy in a patient with crossed renal ectopia with fusion. A 14-year-old boy was referred to our hospital for further examination of proteinuria, detected by the school's annual urinary screening program. Laboratory study revealed proteinuria and renal insufficiency. Abdominal computed tomography and voiding cystography disclosed crossed renal ectopia with fusion and vesicoureteral reflux in each moiety. Renal biopsy of the orthotopic kidney showed diffuse interstitial fibrosis and mononuclear cell infiltration, periglomerular fibrosis, glomerular hypertrophy, and focal and global glomerulosclerosis, which were compatible with reflux nephropathy. A low-protein diet and an administration of angiotensin converting enzyme inhibitor decreased the urinary excretion of protein.

Adolescent↗
PubMed2002

Concordance in pathological response to neoadjuvant chemotherapy between invasive and noninvasive components of primary breast carcinomas.

BACKGROUND: Invasive breast carcinomas are composed of invasive and noninvasive components in varying proportions and sometimes the two components show different histopathological responses to chemotherapy, however there has been no study as yet comparing the pathological response to chemotherapy of invasive and noninvasive components. PATIENTS AND METHODS: A consecutive series of 100 women neoadjuvant chemotherapy with doxorubicin and docetaxel every three weeks before surgery. After the chemotherapy, surgically resected specimens were studied histologically according to the criteria of the Japanese Breast Cancer Society. RESULTS: Five cases (5/100; 5%) were determined to show Grade 3 pathological response, and 28 cases (28/100; 28%) showed Grade 2 response. There were 6 Grade 3 (6/96; 6%) and 18 Grade 2 (18/96; 19%) invasive component cases. There were 7 Grade 3 (7/82; 9%) and 18 Grade 2 (18/82; 22%) cases showing pathological response in the noninvasive component. With regard to pathological response, there was a strong correlation between the invasive and noninvasive components (p<0.001). There was also a correlation in pathological response between the invasive component and axillary lymph nodes in individual cases (p=0.02). There was no correlation between the response of the noninvasive component and axillary lymph nodes. By multivariate analysis, the overall primary tumor response was reflected by the histological response of the invasive component in the primary breast carcinoma. CONCLUSION: We suggest that the pathological response of the invasive component of breast carcinoma should be evaluated, which might provide more accurate information for prognosis and treatment decisions.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

Clinical impact of assay of estrogen receptor beta cx in breast cancer.

Since 1996 when estrogen receptor beta(ER beta) was discovered, much effort has been devoted to the question of the value of ER beta as a prognostic and/or predictive factor in breast cancer and its potential as a novel target for pharmacological intervention. When estrogen receptors are applied on sucrose gradients and quantified by ligand binding, we found that in contrast to ER alpha, which has a narrow tissue distribution, ER beta is expressed in many tissues including both normal and malignant breast tissue. Receptor protein levels in tissues can also be measured from the intensities of bands after Western blotting and can be quantified when purified and quantified receptor is used as a standard. With this technique, we found that there were some tumors which had over 600 fmol/mg of ER beta protein but no detectable estradiol binding. In such tumors, RT-PCR analysis revealed that ER beta cx is the only ER beta isoform present. ER beta cx is a splice variant which utilizes an alternative exon 8. This change in the C-terminus results in very poor binding to estradiol (E2) and has a dominant negative effect on ER alpha function. Immunohistochemical analysis with an ER beta cx specific antibody in 115 ER alpha-positive breast cancers revealed that about half of the samples expressed ER beta cx protein. Initial analysis of samples from patients with preoperative tamoxifen treatment revealed that ER alpha-positive tumors expressing ER beta cx and lacking PR seemed to be resistant to the anti-estrogen. We conclude that, in order to better characterize breast cancers and design appropriate therapy for individual patients, assays for ER beta cx must be made available to clinicians.

Blotting, Western↗
PubMed2002

Patchy renal vasoconstriction after exercise in a child without renal hypouricemia.

Here, I present a case of patchy renal vasoconstriction and renal injury in a girl without renal hypouricemia, following exercise and ingestion of an analgesic. For the previous 2 years, she had suffered from re-current abdominal pain following exercise. Postcontrast renal computed tomographic scan showed low-density patchy areas immediately after contrast medium injection, and then patchy wedge-shaped contrast enhancement 22 h later. These symptoms and signs are typical findings of patchy renal vasoconstriction. Although precise mechanisms for the development of patchy renal vasoconstriction after exercise in patients without renal hypouricemia remain obscure, both exercise and ingestion of an analgesic were active in the development of patchy renal vasoconstriction and renal injury in our patient.

Abdomen↗
PubMed2002

Tubulo-interstitial nephritis caused by sodium valproate.

A severely handicapped 14-year-old Japanese girl had epilepsy and was treated with sodium valproate (SV) from the age of 7 years. Although the epileptic seizures were well controlled, she sometimes had a fever and hypokalemia from the age of 13 years. Laboratory examinations revealed metabolic acidosis, hypouricemia, hypophosphatemia, glycosuria, proteinuria and aminoaciduria, thus suggesting Fanconi syndrome. Gallium scanning showed marked renal uptake. A renal biopsy revealed interstitial nephritis without immuno-deposition. SV was replaced since it was considered to be the most probable cause of the renal involvement. Thereafter, she showed marked improvement of the clinical symptoms and the laboratory data gradually, and she never had a fever. Although SV is an effective anti-epileptic drug, we have to pay attention to adverse renal effects such as Fanconi syndrome and interstitial nephritis.

Adolescent↗
PubMed2002

Fanconi syndrome caused by sodium valproate: report of three severely disabled children.

We report three severely disabled children with epilepsy, a 4-year-old boy, 8-year-old girl and 14-year-old girl, who were treated with sodium valproate from the age of 2 months, 3 months and 7 years, respectively, and who developed Fanconi syndrome. All three patients were bed-ridden and fed by means of a nasogastric or gastrostomy tube. Since Fanconi syndrome was considered to be caused by sodium valproate, it was stopped. After the discontinuation of sodium valproate, renal involvement improved in all patients in 2-12 months. Severely handicapped children may be at risk for sodium valproate-induced renal involvement. Although among the adverse effects of sodium valproate, renal involvement is uncommon, Fanconi syndrome due to valproate therapy has rarely been reported. We have to pay attention to Fanconi syndrome in epileptic children treated with sodium valproate, especially in severely disabled children.

Adolescent↗
PubMed2002

Membranous glomerulonephritis in a patient with unilateral renal agenesis.

Secondary membranous glomerulonephritis (MGN) is usually caused by drugs or systemic disorders that produce circulating immune complexes. However, some disorders that did not seem to form circulating immune complexes have been listed as underlying diseases of secondary MGN. The case of a 13-year-old boy with MGN and unilateral renal agenesis is presented. Renal histology showed segmental MGN with mesangial proliferation and mesangial electron-dense deposits, and no other underlying disorder except for unilateral renal agenesis. Patients with MGN, who have histological findings suggesting secondary MGN and no underlying disorder distinctly causing formation of circulating immune complexes, should not be defined as having idiopathic or secondary forms, but as having a 'cryptogenic' form.

Child↗
PubMed2002

[Genetic testing for effective Herceptin therapy].

Herceptin has provided the first proof that tyrosine kinase modulation, through monoclonal antibodies can translate into improved clinical outcomes in cancer therapy. The development of Herceptin was encouraged by the biologic significance of HER2 overexpression. Although the number of patients affected by the targeted molecular abnormality(30% of breast cancer patients) is small and the response rate observed in patients after treated with single agent Herceptin is rather low, the ability to document overexpression of the target in breast biopsies, and a growing interest in biologic therapy facilitated the rapid accrual of patients to clinical trials. The challenges of applying research techniques of molecular biology to routine clinical testing have been demonstrated by the experiences with the HER2/neu oncogene. Immunohistochemistry and fluorescence in situ hybridization yielded discrepant results regarding the frequency and degree of HER2 alterations even within the same sample. In order to make the complexity of interpretation of the discrepancy simple, it is wise to build an algorithm to help clinicians follow the ideal sequence of laboratory testings. The experience gained in the testing of Herceptin has provided important lessons for the future testing of molecularly targeted compounds.

Animals↗