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Biomedical subjects

Wataru Kitagawa

Publications and source records attributed to Wataru Kitagawa.

At least 19 recordsLinked to original sources

Genetic and biochemical characterization of the dioxygenase involved in lateral dioxygenation of dibenzofuran from Rhodococcus opacus strain SAO101.

Rhodococcus opacus strain SAO101 was shown to degrade on various polycyclic aromatic hydrocarbons such as naphthalene, dibenzofuran (DF), and dibenzo-p-dioxin (DD). One of the unique traits of the strain SAO101 is its ability to oxidize DF compounds by lateral dioxygenation. To clone the lateral dioxygenase gene involved in compound degradation in strain SAO101, we identified a cosmid clone that oxidizes aromatic compounds by using SAO101 genomic DNA. Sequencing analysis revealed that isolated cosmid clone contained ring-hydroxylating dioxygenase genes (narAaAb) with homologies to indene dioxygenase genes of Rhodococcus strain I24 and naphthalene dioxygenase genes of Rhodococcus strain NCIMB12038. The NarAaAb-expressing Rhodococcus cells exhibited broad substrate specificity for bicyclic aromatic compounds and had high ability to degrade dibenzofuran and naphthalene. Metabolite analysis revealed that dihydrodiol compounds were detected as metabolites from dibenzofuran by the NarAaAb-expressing Rhodococcus strain, indicating that dibenzofuran was converted by lateral dioxygenase activity of NarA dioxygenase. Based on reverse transcriptase-polymerase chain reaction analysis, it was found that the narAaAb genes were cotranscribed and that their expression was induced in the presence of aromatic hydrocarbon compounds. It is likely that these genes are involved in the degradation pathways of a wide range of aromatic hydrocarbons by this strain. Strain SAO101 harbors three huge linear plasmids, pWK301 (1,100 kbp), pWK302 (1,000 kbp), and pWK303 (700 kbp), and the nar genes were found to be located on the pWK301 plasmid.

Benzofurans↗

Acute renal failure due to IgM-lambda glomerular thrombi and MPGN-like lesions in a patient with angioimmunoblastic T-Cell lymphoma.

A 70-year-old man with angioimmunoblastic T-cell lymphoma developed acute renal failure. Laboratory data showed decreased levels of serum C3, C4, and CH50, elevated immunoglobulin M (IgM) levels, and the presence of cryoglobulinemia (IgM-lambda). Renal biopsy showed membranoproliferative glomerulonephritis-like lesions with azan-red-stained thrombi in the glomerular capillary lumen. Immunofluorescence showed that IgM-lambda stained strongly in the glomerular capillary lumen, equal to the azan-red-stained thrombi, whereas C3 and C4 staining was negative. Electron microscopy showed electron-dense deposits in the subendothelial space and glomerular thrombi lacking fine fibrillar structure. These findings suggest that cryoglobulin, which consists of monoclonal IgM-lambda, induced glomerular thrombi and acute renal failure in a patient with angioimmunoblastic T-cell lymphoma.

Acute Kidney Injury↗

The increase of antiglomerular basement membrane antibody following pauci-immune-type crescentic glomerulonephritis.

A 50-year-old woman was admitted because of high fever and fatigue. Proteinuria, hematuria, and elevated BUN (47.8 mg/dl) and creatinine (3.4 mg/dl) suggested rapidly progressive glomerulonephritis. The serological study revealed all negative results for rheumatoid factor, antinuclear antibody, serum cryoglobulins, MPO-ANCA, PR3-ANCA, and anti-streptolysin O. Antiglomerular basement membrane (GBM) antibody, as assessed by ELISA, was 11 EU (normal, <10). Kidney biopsy on the eighth hospital day demonstrated pauci-immune-type crescentic glomerulonephritis without ANCA. Methylprednisolone pulse therapy (500 mg/day, 3 days) and 45 mg/day prednisolone orally were started. At 3 weeks after kidney biopsy, the anti-GBM antibody value increased from 11 EU/ml to 116 EU/ml, and MPO and PR3-ANCA were still negative. HLA type was DR8 and DR 15(2), with a genotype of HLA-DRB1*08021 and HLA-DRB1*15011. The present case suggests that HLA-DR15 plays an important role on antibody production against alpha 3(IV) NC1 autoantigen after severe nephritis or tissue damage.

Anti-Inflammatory Agents↗

[Extracellular-superoxide dismutase production in mesangial cell growing in extracellular matrix].

To study the protective function against oxygen radicals in the mesangial area, we assessed extracellular superoxide dismutase (EC-SOD) production in mesangial cells (MCs) in vitro. These cells have a major protective function against oxygen radicals in the extracellular space. In two different kinds of culture conditions: "growth medium" with fetal cow serum, and "differentiation medium" with reduced growth factor, and four extracellular matrixes; type I collagen, type IV collagen, laminin and fibronectin, were added to the MC culture. With the difference in the culture media, differentiation medium induced EC-SOD hyper-production associated with the both of the slowing down of cell proliferation and the suppression of IL-6 and IL-8 production. With difference in the extracellular matrix, the presence of type VI collagen and laminin promoted higher production of EC-SOD than fibronectin and type I collagen. Type IV collagen and laminin associated with the physiological condition of the glomeruli promoted EC-SOD production compared with the presence of type I collagen and fibronectin dominantly located in pathological condition. Suppression of EC-SOD production in growth medium along with MC proliferation and chemokine hyper-production compared with production in differentiation medium might mimic reduction of the protective capacity against oxygen radical toxity during mesangial proliferation in the glomerular nephritis. MC proliferation with type I collagen and fibronectin might enhance oxygen radical toxity in the glomeruli, and accelerate glomerular sclerosis through the suppression of EC-SOD production.

Cell Proliferation↗

A case of tuberculous granuloma at the supra-sternal notch that was difficult to differentiate from a thyroid tumor.

BACKGROUND: Despite a decline after World War II, the rate of tuberculosis remains higher in Japan than in other countries. We report a case of tuberculous granuloma at the supra-sternal notch that was difficult to differentiate from a thyroid tumor. CASE REPORT: The patient was a 75-year-old Japanese woman who was referred to our hospital for further investigations and treatment of an anterior neck tumor, that was diagnosed as a suspected of thyroid malignancy by another institute. The thyroid function and biological data were normal except for an elevated erythrocyte sedimentation rate. Imaging studies showed a mass at the supra-sternal notch, and the border between the tumor and the thyroid gland was indistinct. The tuberculosis bacillus group was identified by fine needle aspiration cytology. The patient was treated surgically for tuberculous granuloma, and histopathological findings revealed that the lymph node tuberuculosis had invaded the thyroid gland. We started anti-tuberculous therapy after the operation. The post-operative course was uneventful with good wound healing. CONCLUSIONS: When a markedly elevated erythrocyte sedimentation rate and c-reactive protein value are associated with an anterior neck mass, tuberculosis should be considered in the differential diagnosis of thyroid swelling. Fine needle aspiration cytology is a rapid, simple and effective diagnostic method for extra-pulmonary tuberculous lesions involving the neck. When there is abscess formation or features of compression, or if the mass cannot be differentiated from a thyroid tumor, combined therapy involving anti-tuberculous agents and surgery must be considered.

Aged↗

Adenolipoma of the thyroid gland: report of a case.

We report a case of adenolipoma of the thyroid gland, which is very unusual because thyroid adenoma rarely contains mature adipose tissue. A 55-year-old Japanese woman presented with a 1-month history of a neck mass. A blinded fine-needle aspiration biopsy showed benign follicular cells with no adipose cells, and we performed a left hemithyroidectomy. The specimen measured 7.0 x 4.4 cm and weighed 59.9 g. The cut surface of the tumor revealed a solid yellowish mass, and hematoxylin-eosin staining showed that the solid tumor was well separated from the adjacent thyroid tissue by a thin fibrous capsule. The tumor was found to be follicular adenoma composed of epithelial cells arranged in monotonous microfollicular patterns, intermingled with mature adipose tissue. No adipose tissue was found outside the tumor, and there were no signs of amyloid deposits in the tumor or adjacent thyroid tissue. The pathological diagnosis was adenolipoma of the thyroid gland. We discuss the pathogenesis of this entity and review the previously documented cases.

Adipose Tissue↗

Establishment of anti-rat-Cu,Zn-superoxide dismutase monoclonal antibodies applied to a highly sensitive immunoassay and immunohistochemistry system.

The superoxide anion has been implicated in a wide range of diseases. The major protector against superoxide anion in the cell cytosol is Cu,Zn-superoxide dismutase (Cu,Zn-SOD). In this study, anti rat Cu,Zn-SOD was established in murine monoclonal antibodies for the first time. These antibodies were applied to both a highly sensitive EIA system in serum and immunohistochemical methods for detection in gastric mucosa tissues. The proposed EIA method had a high sensitivity within the assay range, 10-300 pg/mL, good percentage, 96.9 +/- 5.60%, and good reproducibility; within-day assay CV = 8.6-10.2%, between-day assay CV = 6.5-11.7%. Inmmunohistochemically, Cu,Zn-SOD localized in the esophagus epithelial cells, gastric oxyntic cells, surface of the gastric lumen side in the small intestine and colonic epithelial cells. The establishment of anti-rat CuZn-SOD monoclonal antibody allows both specific analysis of immunoquantitation in rat Cu,Zn-SOD and highly specific detection of Cu,Zn-SOD location by immunohistochemical methods.

Animals↗

A novel p-nitrophenol degradation gene cluster from a gram-positive bacterium, Rhodococcus opacus SAO101.

p-Nitrophenol (4-NP) is recognized as an environmental contaminant; it is used primarily for manufacturing medicines and pesticides. To date, several 4-NP-degrading bacteria have been isolated; however, the genetic information remains very limited. In this study, a novel 4-NP degradation gene cluster from a gram-positive bacterium, Rhodococcus opacus SAO101, was identified and characterized. The deduced amino acid sequences of npcB, npcA, and npcC showed identity with phenol 2-hydroxylase component B (reductase, PheA2) of Geobacillus thermoglucosidasius A7 (32%), with 2,4,6-trichlorophenol monooxygenase (TcpA) of Ralstonia eutropha JMP134 (44%), and with hydroxyquinol 1,2-dioxygenase (ORF2) of Arthrobacter sp. strain BA-5-17 (76%), respectively. The npcB, npcA, and npcC genes were cloned into pET-17b to construct the respective expression vectors pETnpcB, pETnpcA, and pETnpcC. Conversion of 4-NP was observed when a mixture of crude cell extracts of Escherichia coli containing pETnpcB and pETnpcA was used in the experiment. The mixture converted 4-NP to hydroxyquinol and also converted 4-nitrocatechol (4-NCA) to hydroxyquinol. Furthermore, the crude cell extract of E. coli containing pETnpcC converted hydroxyquinol to maleylacetate. These results suggested that npcB and npcA encode the two-component 4-NP/4-NCA monooxygenase and that npcC encodes hydroxyquinol 1,2-dioxygenase. The npcA and npcC mutant strains, SDA1 and SDC1, completely lost the ability to grow on 4-NP as the sole carbon source. These results clearly indicated that the cloned npc genes play an essential role in 4-NP mineralization in R. opacus SAO101.

Bacterial Proteins↗

[Endocrine surgery: the tenth report. Diagnosis, surgical indications and operative strategy of renal hyperparathyroidism].

In Japan, there are many dialysis patients because of the successful development and wide application of dialysis techniques. Almost all patients require long-term hemodialysis treatment because kidney transplantation is performed rarely. Renal hyperparathyroidism is one of the serious complications for hemodialysis patients. According to the overview of regular dialysis treatment reported by the Japanese Society for Dialysis Therapy, parathyroidectomy is required in 9.2%of patients who remain on hemodialysis more than 10 years and in 33.5%of those who so remain for more than 25 years. In this paper, we will describe the diagnosis, surgical indications, and operative strategy of renal hyperparathyroidism. The symptoms and biochemical variables were high serum parathyroid hormone (PTH) level, hyperphosphatemia, bone and joints pain, itching, irritability, muscle weakness, severe skeletal deformity, progression of ectopic calcification, and anemia. The clinical indications for performing parathyroidectomy to treat renal hyperparathyroidism in our institute are based on the indications reported by Tominaga et al. These are 1) high serum PTH level, 2) detection of enlarged parathyroid glands, 3) detection of osteitis fibrosa cystica on radiography or detection of high bone turnover by bone metabolic markers or bone scintigram, 4) resistance of symptoms to medical treatment. The routine operative procedure for renal hyperparathyroidism is total parathyroidectomy with forearm autograft. For autotransplantation, 30 pieces sliced 1x1x3 mm of diffuse hyperplasia are implanted into 30 pockets in the forearm without arteriorvenous (A-V) fistula for hemodialysis. In any surgical procedure for renal hyperparathyroidism, it is crucial to identify all parathyroid glands, including supernumerary glands and ectopic glands. At the initial operation for renal hyperparathyroidism, the surgeon must remove all parathyroid glands to avoid persistent and recurrent hyperparathyroidism and choose proper and adequate parathyroid tissue for autograft.

Humans↗

Surgical therapy in Hashimoto's thyroiditis.

Hashimoto's thyroiditis (HT) is usually considered to be manageable by levothyroxine (L-T4) administration, which can reduce the thyroid volume and supplement the lack of hormone. However, we sometimes encounter a huge goiter that has not shrunk in response to L-T4 therapy. These goiters continue to produce symptoms of compression and an unsightly appearance. Here we discuss the surgical indication and procedure for HT. Thirteen patients with clinically diagnosed Hashimoto's thyroiditis involving a huge diffuse goiter that produced pressure symptoms or nodular lesions were treated with surgery. The gender, age distribution, total dose and period of L-T4 administration prior to the operation, and clinical symptoms caused by the large goiter were evaluated in each case. The titer of antibodies was extremely elevated in 8 HT patients with a diffusely enlarged goiter. The total period of L-T4 medication ranged from 6 to 25 years. A subtotal thyroidectomy in which a small amount of thyroid was left in the posterior area of the bilateral lobes was performed in the 8 cases of diffusely enlarged goiter. Pressure symptoms and the unsightly appearance caused by the goiter were relieved by the surgery in all cases. No surgical complications developed. In conclusion, the surgery is an effective therapy for HT patients who have persistent compression symptoms and/or an unsightly neck appearance due to a large goiter despite long-term L-T4 treatment.

Aged↗

[Endocrine surgery. The ninth report: the latest data on and clinical characteristics of the epidemiology of thyroid carcinoma].

Thyroid disease is comparatively prevalent, and it is important to perform careful palpation of the anterior neck when patients are first examined. In this paper, the latest data on and clinical characteristics of the epidemiology of thyroid carcinoma are described. According to Japanese cancer statistics, in 1996, the number of cases of thyroid carcinoma was 1,390 men and 5,437 women. The female to male ratio was 3.91: 1. The crude rate of thyroid carcinoma per 100,000 population was 2.3 men and 8.5 women. The age-adjusted incidence rate showed a gradual increase with age, and the peak of the age-adjusted incidence rate was over 80 years old among men, and from 70 to 80 years old among women. According to the Japanese Thyroid Cancer Registration Committee, from 1977 to 1999, papillary thyroid carcinoma accounted for more than 85% (30,256) of thyroid carcinomas among 35,312 patients. Medullary thyroid carcinoma (1.4%) and anaplastic thyroid carcinoma (1.6%) were rare. The female to male ratio of thyroid carcinoma was 6.1: 1. Registration was made in accordance with the general rules issued by the Japanese Society of Thyroid Surgery. According to the vital statistics, mortality related to thyroid carcinoma among all cancer-related deaths was 0.23% among men (411) and 0.76% among women (887) in 2000. The female to male ratio of mortality was 2.16: 1. The peak of mortality was from 70 to 80 years old among men, and from 80 to 90 years old among women. Most patients with differentiated thyroid carcinoma had a low mortality rate, but anaplastic carcinoma had a poor prognosis. Lung and bone were the main distant metastatic sites, and respiratory insufficiency was the most common specific fatal condition.

Adolescent↗

Radioguided parathyroidectomy for renal hyperparathyroidism.

BACKGROUND: The usefulness of radioguided parathyroidectomy for primary hyperparathyroidism has been demonstrated in recent years, however, its applicability to renal hyperparathyroidism is uncertain. We report a case in which radioguided parathyroidectomy was used to treat renal hyperparathyroidism and was found to be helpful in preventing persistent and recurrent hyperparathyroidism. CASE REPORT: The patient was a 55-year-old Japanese woman who had received hemodialysis for 67 months. Three enlarged parathyroid glands were identified preoperatively by ultrasonography. Two hours before the operation, the patient received an intravenous injection of 600 MBq 99mTc-sestamibi and radioguided parathyroidectomy was performed. The three enlarged parathyroid glands were resected easily by the use of radioguided surgery. However, the localization of the residual parathyroid gland was uncertain. The operative field was analyzed using an intraoperative gamma probe, and the upper mediastinum was found to have higher radioactivity than the other regions. The upper mediastinum was dissected and the enlarged parathyroid gland was identified in the anterosuperior mediastinum in front of the trachea. The target parathyroid gland was then removed. The pathological diagnosis was hyperplasia of the parathyroid. No complications were observed and a follow-up examination 30 months later did not show any recurrence. CONCLUSIONS: An intraoperative gamma probe can be used to locate supernumerary and ectopic parathyroid glands. Radioguided parathyroidectomy for renal hyperparathyroidism can theoretically decrease the risk of persistent and recurrent hyperparathyroidism that is due to remaining parathyroid tissue.

Female↗

Radioguided parathyroidectomy for primary hyperparathyroidism using the solid-state, multi-crystal gamma camera.

BACKGROUND: Minimally invasive radioguided parathyroidectomy (MIRP) offers several cosmetic and surgical advantages. Intraoperative 99m-Tc sestamibi scintigraphy using a solid-state, multi-crystal gamma camera was used to perform the MIRP. We report a case of primary hyperparathyroidism treated with this surgical procedure and discuss the usefulness of intraoperative scintigraphy. CASE REPORT: The patient was a 58-year-old Japanese woman was given a diagnosis of primary hyperparathyroidism. One hour before the operation, 99m-Tc sestamibi was injected intravenously and scintigraphy was performed in the operating room before the skin incision. Sestamibi imaging revealed an abnormal uptake close to the lower right lobe of the thyroid gland and MIRP was performed. After the tumor behind the right recurrent laryngeal nerve close to the lower right lobe of the thyroid gland was removed, intraoperative scintigraphy still revealed an abnormal uptake. MIRP was continued and an abnormal parathyroid gland behind the right carotid artery near the right recurrent laryngeal nerve was identified. After removing a parathyroid adenoma from this second location, intraoperative sestamibi imaging revealed no abnormal uptake. RESULTS: The operation time was 80 minutes and the amount of bleeding was 12 ml. Postoperatively, serum calcium and PTH levels were within normal range. No complications were observed. CONCLUSIONS: Intraoperative sestamibi imaging using a portable gamma camera is useful for locating abnormal parathyroid glands.

Female↗

Video-assisted endoscopic thyroid and parathyroid surgery using a gasless method of anterior neck skin lifting: a review of 130 cases.

PURPOSE: Endoscopic endocrine neck surgery is desirable from a cosmetic viewpoint. We compared the effectiveness of our new technique with that of conventional surgery in a clinical study. METHODS: We performed our original endoscopic method of video-assisted neck surgery (VANS) on 130 patients: 126 with thyroid tumors and 4 with parathyroid tumors. The percentage of patients who underwent VANS among all those who underwent neck surgery and the procedure involved were analyzed. Operating time and blood loss were compared between the first 40 patients and last 39, and all factors were statistically analyzed in the most recent 20 patients who underwent the VANS method and the most recent 20 who underwent conventional surgery. RESULTS: More than 60% of benign thyroid tumors and 5.3% of malignant thyroid tumors were operated on by the VANS method. Nearly total lobectomy was the most common procedure (57.7%), followed by total lobectomy (26.1%), for benign tumors. Malignancy was defined as papillary carcinoma less than 1 cm in diameter. Total lobectomy with lymph node clearance was performed for all malignant tumors. There was less bleeding when the VANS method (P < 0.001) was used than when conventional surgery was performed, and the operating time has been reduced with experience. CONCLUSION: The VANS method is feasible, practical, and safe, and has great cosmetic benefits.

Humans↗

Video-assisted minimally invasive endoscopic thyroid surgery using a gasless neck skin lifting method--153 cases of benign thyroid tumors and applicability for large tumors.

Endoscopic surgery is often considered to be 'minimally invasive surgery' in the light of recent developments. In particular, endoscopic endocrine neck surgery is desirable from a cosmetic viewpoint. Here we compared the usefulness of our original endoscopic method of video-assisted neck surgery (the VANS method) with conventional surgery when challenged with the removal of thyroid tumors measuring more than 5 cm in diameter, based on our experience with 167 cases (162 thyroid tumors, five parathyroid tumors). The percentage of patients who underwent the VANS method of the total number of patients who underwent neck surgery was determined and the operative procedures used in the different surgeries were analyzed. The operating time and blood loss for 153 benign thyroid tumors were statistically compared between the small-tumor group (n = 130, < 5 cm) and the large-tumor group (n = 23, > or = 5 cm). More than 60% of the benign and 5.3% of the malignant thyroid tumors were operated on by the VANS method. Near- or subtotal lobectomy was the most common procedure (64.1%) for benign tumors. Malignancy was defined as papillary carcinoma less than 1 cm in diameter. Total lobectomy with lymph node clearance was performed for all malignant tumors. Although the operating time and the blood loss were statistically greater in the large-tumor group than the small-tumor group, with increased experience it was possible to remove tumors of up to 7.4 cm safely. Our findings support the idea that the VANS method is feasible, practical, and safe, and has great cosmetic benefits, even for the removal of large benign tumors.

Humans↗