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Expectations for the Next Generation of Simulated Patients Born from Thoughtful Anticipation of Artificial Intelligence-Equipped Robot. J NIPPON MED SCH 2019; 85:347-349. [PMID: 30568063 DOI: 10.1272/jnms.jnms.2018_85-57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
It is predicted that in the near future robot simulated patients (SPs) will come into use. Through the impressions of five SPs about robot SPs, we explored their vision of the future of medical education as an indicator of what ordinary citizens think. The opinions of SPs were collected using a semi-structured focus group interview, after which the perspectives provided were explored using a qualitative research method called Steps for Coding and Theorization (SCAT). Although SPs accepted the introduction of robot SPs, they regard them as potential substitutes. The use of robot SPs raised concerns about the level of response to human diversity and the level of emotional intelligence. The problem of how much diversity among patients and doctors is acceptable in the field of education was identified. On the part of citizens, there is not much expectation that artificial intelligence (AI) will lead to sophisticated machines capable of human conversation. However, looking ahead to the AI era, real SPs anticipate that, along with the evolution of AI, the next generation of SPs will have thought deeply about their role within a program employing both humans and robots.
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How do the first year students find the way of learning medicine in Japan? MEDEDPUBLISH 2018. [DOI: 10.15694/mep.2018.0000125.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article was migrated. The article was marked as recommended. Background : There are students who drop out medical school during the early years. Objectives: We investigated how the first year students find the way of learning medicine. Material and methods : We developed a freshman orientation program that combined PBL and simulation learning with SPs. We collected freshman's impressions in 2013 and 2014 from their freely written comments after the course and then qualitatively analyzed their responses. Results : Five main categories were labeled anxiety, knowledge, reconstructing visions, expanding community and readiness. The story lines generated from this result is as follows. The students were obsessed with the large volume of knowledge they needed to acquire. They began to reconstruct their future visions. Many recognized the necessity to expand their range of relationships through learning with peers and SPs. They also began to transfer this learning activity to diverse social experiences. These experiences were useful for building readiness to learn. Conclusion: Freshmen, who are neither laypersons nor medical professionals, could lead to establishing a readiness to start a medical career through expanding their community. This can be experienced only at this stage of their learning. It is a good time for an intervention to modify behavior to improve the learning of medicine.
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Characteristics predicting laparoscopic skill in medical students: nine years’ experience in a single center. Surg Endosc 2017. [DOI: 10.1007/s00464-017-5643-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Laparoscopic skill improvement after virtual reality simulator training in medical students as assessed by augmented reality simulator. Asian J Endosc Surg 2015. [PMID: 26216064 DOI: 10.1111/ases.12209] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Definitive assessment of laparoscopic skill improvement after virtual reality simulator training is best obtained during an actual operation. However, this is impossible in medical students. Therefore, we developed an alternative assessment technique using an augmented reality simulator. METHODS Nineteen medical students completed a 6-week training program using a virtual reality simulator (LapSim). The pretest and post-test were performed using an object-positioning module and cholecystectomy on an augmented reality simulator(ProMIS). The mean performance measures between pre- and post-training on the LapSim were compared with a paired t-test. RESULTS In the object-positioning module, the execution time of the task (P < 0.001), left and right instrument path length (P = 0.001), and left and right instrument economy of movement (P < 0.001) were significantly shorter after than before the LapSim training. With respect to improvement in laparoscopic cholecystectomy using a gallbladder model, the execution time to identify, clip, and cut the cystic duct and cystic artery as well as the execution time to dissect the gallbladder away from the liver bed were both significantly shorter after than before the LapSim training (P = 0.01). CONCLUSIONS Our training curriculum using a virtual reality simulator improved the operative skills of medical students as objectively evaluated by assessment using an augmented reality simulator instead of an actual operation. We hope that these findings help to establish an effective training program for medical students.
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A freshman orientation program to provide an overview of the medical learning roadmap. J NIPPON MED SCH 2014; 81:378-83. [PMID: 25744481 DOI: 10.1272/jnms.81.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
International accreditation of medical education was introduced in Japan in 2013 and is planning to be applied in late 2014 or 2015. Students will need to cope with the resulting changes and to recognize by what route they will learn medicine. Therefore, a freshman orientation course, which was based on problem-based learning (PBL) and had been held for first-year students, was modified as an awareness reform program in which students would learn "how to learn medicine." We investigated whether this program has led to useful changes in students' recognition of the way of learning in medical school and their directions as learners. The program was held for 114 first-year medical school students in 2013 and consisted of PBL tutorials, large-classroom lectures, simulation learning using role-play with simulated patients, and team-based learning (TBL), presented in this order. Learning modules that is made with an integration of the clinical sciences with the basic biomedical and the behavioral and social sciences were provided. A nonanonymous questionnaire survey asking" what learning methods are effective for you?" was conducted before and after completion of the course. Furthermore, group answers obtained in TBL were investigated. The score for the question" To what extent can you imagine your route of learning during your 6 years?" significantly increased from 3.1±0.99 (mean±SD) before the course to 3.5±0.88 (p<0.01) after the course. The score for the question" To what extent is the small-group learning, such as PBL, useful for you?" significantly increased from 3.9±0.73 to 4.2±0.71 (p<0.05). Group responses in TBL sessions indicated that students desired classes that presented tasks and regarded" emphasis on reflection" and" observation of senior physicians as role models" as the most important methods for learning interview skills. We believe students should acquire active learning attitudes as adults early in their 6 years of medical school. The level of understanding of" how to learn as adults" was 3.7 and indicated a moderate result. This course employed many educational strategies, and we believe it helped students understand what they learn and how to learn during their 6 years of medical and to get an overview of the learning roadmap.
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Solitary fibrous tumor arising from the superior nasal turbinate: a case report. J NIPPON MED SCH 2013; 79:373-6. [PMID: 23123395 DOI: 10.1272/jnms.79.373] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Solitary fibrous tumor is a rare neoplasm, which was first described as a primary spindle-cell tumor of the pleura, is a type of mesenchymal tumor. Although the majority of these tumors originate in the pleura, they can also derive from extrapleural sites, such as the liver, lung, abdomen, and extremities. We report a rare case of a nasal solitary fibrous tumor that originated from the nasal superior turbinate. The tumor, measuring 45 × 25 × 10 mm, was in the right nasal cavity. We successfully removed the tumor in one piece through endonasal endoscopic surgery. The tumor had spindle-shaped cells within a collagenous stroma and was positive for CD34. There has been no evidence of tumor recurrence in the 14 months following surgery.
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AKI - experimental models. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Team-based Learning Using an Audience Response System: A Possible New Strategy for Interactive Medical Education. J NIPPON MED SCH 2013; 80:63-9. [DOI: 10.1272/jnms.80.63] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Spectrophotometric determination of trace sulphate in rain and snow after preconcentration with 2-aminoperimidine on a membrane filter. Talanta 2012; 37:633-6. [PMID: 18964991 DOI: 10.1016/0039-9140(90)80208-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/1989] [Revised: 08/31/1989] [Accepted: 09/30/1989] [Indexed: 11/25/2022]
Abstract
A simple and precise preconcentration technique, based on collecting a precipitate on a membrane filter and dissolving the filter and precipitate in an organic solvent, has been applied to the spectrophotometric determination of trace sulphate in rain and snow. The sulphate is precipitated with 2-aminoperimidine and the resulting compound is dissolved in nitric acid, made alkaline with sodium hydroxide and then adsorbed on tetradecyldimethylbenzylammonium nitrate. The precipitate is then collected on a membrane filter and both precipitate and filter are dissolved in dimethylsulphoxide (DMSO). The absorbance of the DMSO solution is measured at 550 nm against a reagent blank. The molar absorptivity is 2.1 x 10(4) 1 . mole(-1) . cm(-1) and the coefficient of variation for six measurements is < 1.5%. The detection limit (S/N = 3) is 0.06 mug of sulphate in 5 ml of sample solution.
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Acute kidney injury - Experimental models. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Adrenomedullin level in the nasal discharge from allergic rhinitis cohort. Peptides 2011; 32:368-73. [PMID: 21050876 DOI: 10.1016/j.peptides.2010.10.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 10/23/2010] [Accepted: 10/25/2010] [Indexed: 12/01/2022]
Abstract
Adrenomedullin (AM) is a potent hypotensive and vasodilatory peptide. AM may exert protective actions against the development of many diseases by modulating the blood circulation and body fluid balance. In addition to these functions, it has recently been reported to play important roles in the development of allergy and infections. The purpose of the present study was to demonstrate the existence of AM in the human nasal mucosa and to discuss whether AM might contribute to the pathogenesis of nasal congestion. We measured the total AM concentrations in the nasal discharge. The total AM concentration in the nasal discharge was significantly higher in the non-allergy group (72.1 ± 55.5 fmol/ml) than in the allergy group (37.1 ± 44.2 fmol/ml). By immunohistochemical examination, we identified AM-containing cells in the nasal mucosa from both subjects with and without nasal allergy, and also in nasal polyps. Moreover, those cells were positive for anti-tryptase antibody which recognizes mast cells. In nasal allergy, vasodilatation and increase in vascular permeability are characteristic features of the immediate phase response. Reduced AM levels in the nasal discharge may be associated with attenuation of both of these factors. On the other hand, immunohistochemical analysis demonstrated AM-immunoreactive cells in the chronic phase of rhinosinusitis. In the late and inflammatory phase, mast cells produce AM, which possibly acts as an inhibitor of inflammatory cell migration. In conclusion, AM may be actively secreted into the nasal discharge. AM in the nasal discharge may have protective and anti-inflammatory effects in the nasal mucosa.
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Nasal myoepithelioma removed through endonasal endoscopic surgery: a case report. J NIPPON MED SCH 2010; 77:273-6. [PMID: 21060240 DOI: 10.1272/jnms.77.273] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Myoepithelioma is a rare neoplasm that can occur in either the major or minor salivary gland and accounts for less than 1% of salivary gland neoplasms. We report a rare case of a nasal myoepithelioma that originated from the nasal inferior turbinate. The tumor, measuring 50 × 30 × 20 mm, was in the right nasal cavity and had a necrotic surface. We removed the tumor through endonasal endoscopic surgery. The tumor had spindle-shaped cells and was positive for cytokeratin, (AE1/AE3), vimentin, S-100β, and MIB-1 but was negative for CD34, desmin, neuron-specific enolase, and synaptophysin. Slight immunoreactivity for smooth muscle actin was noted in some tumor cells. There has been no evidence of tumor recurrence in the 18 months following surgery.
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Clinical application of virtual endoscopy as a support system for endoscopic sinus surgery. Acta Otolaryngol 2009; 129:674-80. [PMID: 18728915 DOI: 10.1080/00016480802360640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
CONCLUSIONS Computer processing of conventional CT images can provide virtual endoscopic images (VEIs). Surgeons observing these images feel as if they are observing the lesion using an endoscope. Simulation based on animated VEIs before endoscopic sinus surgery (ESS) is useful for the improvement of surgical safety and surgeons' education. Although the production of VEIs requires certain surgical experience, after the production of VEIs, surgeons can repeat simulation of a surgical procedure and have confidence in the actual operation. OBJECTIVE We investigated the clinical application of CT-reconstructed VEIs as a support system for ESS. MATERIALS AND METHODS A GE Light Speed Ultra 16 as a 16-slice CT scanner and Advantage Workstation 4.2 were used. Software called Navigator in this workstation allows the production of CT-reconstructed VEIs. We applied simulation based on VEIs to endoscopic operations for mucocele or sinusitis. RESULTS In nine cases of mucoceles and sinusitis, simulation based on animated VEIs was applied. According to the simulation, surgeries were performed, and the mucoceles and obstructed sinuses could be opened readily and safely. This system was more effective when there were landmarks such as polyps or irregular mucosal surfaces allowing macroscopic confirmation ahead of the viewpoint.
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Cloudy dialysate and pseudomembranous colitis in a patient on CAPD. Perit Dial Int 2008; 28:562-563. [PMID: 18708558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
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The effect of H1 antagonists carebastine and olopatadine on histamine induced expression of CC chemokines in cultured human nasal epithelial cells. Allergol Int 2007; 56:171-7. [PMID: 17460445 DOI: 10.2332/allergolint.o-06-446] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Accepted: 12/19/2006] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND CC chemokines have been shown to play an important role in inducing selective recruitment of inflammatory cells into local allergic inflammatory sites. CC chemokines are also known as histamine releasing factors. We previously showed that histamine enhances transcription of CC chemokines from nasal mucosa which leads to further induction of histamine release. This cyclic cascade may cause prolonged allergic inflammation. The aim of this study is to clarify the relationship between histamine and CC chemokine production by using human nasal epithelial cells (HNECs) and to examine the potential of H1 receptor (H1R) antagonists in new therapeutic approaches for the treatment of nasal allergy. METHODS HNECs were isolated from the nasal turbinates of patients diagnosed with nasal allergy. HNEC monolayers were cultured for 48 hours with or without histamine (10(-3) to 10(-5) mol/L). Furthermore, an H1R antagonist, either carebastine or olopatadine, was added to the supernatant (10(-3) to 10(-7) mol/L) 30 minutes before incubation with histamine. The expression of Regulated on Activation, Normal T-cell Expressed and Secreted (RANTES) and monocyte chemotactic protein-1 (MCP-1) in the culture media were measured by ELISA. RESULTS The release of RANTES and MCP-1 was significantly upregulated by histamine compared with the control group. Both carebastine and olopatadine inhibited the release of CC chemokine production to the control level in both groups. CONCLUSIONS This study suggests that the interaction between histamine and CC chemokines may prolong allergic inflammation in human nasal mucosa. We also demonstrate the potential use of H1R antagonists in new therapeutic approaches to the treatment of nasal allergy through inhibiting this histamine-CC chemokine interaction.
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MESH Headings
- Adolescent
- Adult
- Anti-Inflammatory Agents/pharmacology
- Anti-Inflammatory Agents/therapeutic use
- Butyrophenones/pharmacology
- Butyrophenones/therapeutic use
- Cells, Cultured
- Chemokine CCL2/metabolism
- Chemokine CCL5/metabolism
- Chemokines, CC/metabolism
- Child
- Dibenzoxepins/pharmacology
- Dibenzoxepins/therapeutic use
- Dose-Response Relationship, Drug
- Epithelial Cells/drug effects
- Epithelial Cells/metabolism
- Epithelial Cells/pathology
- Female
- Histamine/metabolism
- Histamine H1 Antagonists/pharmacology
- Histamine H1 Antagonists/therapeutic use
- Humans
- Male
- Middle Aged
- Nasal Mucosa/drug effects
- Nasal Mucosa/metabolism
- Nasal Mucosa/pathology
- Olopatadine Hydrochloride
- Piperidines/pharmacology
- Piperidines/therapeutic use
- Rhinitis/drug therapy
- Rhinitis/metabolism
- Rhinitis/pathology
- Rhinitis, Allergic, Perennial/drug therapy
- Rhinitis, Allergic, Perennial/metabolism
- Rhinitis, Allergic, Seasonal/drug therapy
- Rhinitis, Allergic, Seasonal/metabolism
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Subjective evaluation of post-tympanoplasty hearing in relation to the pure tone threshold. Auris Nasus Larynx 2004; 31:347-51. [PMID: 15571906 DOI: 10.1016/j.anl.2004.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2004] [Accepted: 03/19/2004] [Indexed: 11/23/2022]
Abstract
OBJECTIVE In the year 2000, the Otological Society of Japan proposed a new criteria to assess the levels of hearing known as Criteria 2000. However, these criteria are intended to assess pure tone threshold after tympanoplasty and the results do not necessarily reflect the hearing condition from the patient's perspective. Thus, it is essential to study the relationship between the subjective evaluation of post-operative hearing based on the patient's own assessment and the objective assessment by audiometry. METHODS The present study is a questionnaire-based survey on the levels of post-operative hearing in 460 patients whose degree of satisfaction with their levels of hearing was assessed by visual analogue scale (VAS). The hearing level was assessed based on the Criteria 2000 established by the Otological Society of Japan. RESULTS The post-operative results indicated a success rate of 78.7%. According to the questionnaire-based survey, 64.4% patients considered their hearing as "improved". The average VAS score was the highest in the "improved" group and gradually decreased when in the "deteriorated" group. The highest success rate was obtained in patients who assessed their hearing as "improved" and the lowest rate was seen in those who assessed their hearing as "deteriorated". On the other hand, the success rate in the three groups, "slightly improved", "unchanged", and "slightly deteriorated", was almost similar and did not relate to the objective audiometry findings. Therefore, except for the "improved" and deteriorated" groups, there is no relation between the subjective self-assessment and the objective post-operative hearing. CONCLUSION A bi-directional approach, one from an audiological (objective) and one from the patient's perspective (subjective), especially using VAS, is quite useful for the post-operative assessment of hearing.
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Subjective Evaluation and Overall Satisfaction after Tympanoplasty for Chronic Simple Suppurative Otitis Media. J NIPPON MED SCH 2004; 71:17-24. [PMID: 15129591 DOI: 10.1272/jnms.71.17] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A questionnaire survey was conducted in 324 patients with chronic, simple, suppurative otitis media who had undergone tympanoplasty 6 months or more previously to investigate post-operative hearing, tinnitus, vertigo, occlusive feeling of the ear and otorrhea. In addition, the overall satisfaction with tympanoplasty was assessed by VAS value. Subjective hearing improvement was observed in 73.1% of the patients whose hearing was poor and in 50% of those whose hearing was good before the operation. The degree of satisfaction assessed by VAS value corresponded with the subjective hearing assessment. As to tinnitus, 66.2% of the patients became aware of the disappearance or alleviation of symptoms. In the case of patients who had tinnitus before the operation, the degree of awareness of tinnitus and the degree of satisfaction assessed by VAS value coincided. However, no changes in the VAS value were observed in those who did not have tinnitus before the operation. As for vertigo, 30.5% of the patients who had vertigo preoperatively became aware of the disappearance of the symptoms after the operation. The degree of satisfaction assessed by VAS value corresponded with the presence or absence, severity and frequency of vertigo. As to the fullness of the ear, alleviation of the symptoms was subjectively noted by 85.9% of the patients who had symptoms before the operation. The degree of satisfaction assessed by VAS value corresponded with the severity of the symptoms in those who had symptoms before the operation. As for otorrhea, the disappearance of the symptoms was subjectively noted by 85.5% of the patients who had otorrhea before the operation. The degree of satisfaction assessed by VAS value corresponded with the post-operative changes in otorrhea. Based on the above results, it was assumed that the patients placed greatest expectation on hearing improvement when they underwent tympanoplasty. VAS is considered a useful method to evaluate the degree of satisfaction of patients after surgery.
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New therapeutic approaches to the treatment of nasal allergy: Antiinflammatory effects of H(1) receptor antagonists. Drugs Today (Barc) 2001; 37:455-461. [PMID: 12750763 DOI: 10.1358/dot.2001.37.7.844188] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Histamine is recognized as an important mediator of allergic rhinitis. In addition to the role it plays in the immediate-phase reaction of nasal allergy, histamine may play an important role in the late-phase reaction and protracted allergic inflammation. Histamine induces the synthesis or secretion of proinflammatory cytokines and the expression of adhesion molecules. Besides their traditional effects via H(1) receptor antagonism, antihistamines have been reported to possess multiple antiinflammatory effects. Continuous use of antihistamines may reduce the level of minimal persistent inflammation of nasal mucosa in allergy. Treatment of allergic rhinitis using antihistamines could contribute to the improvement in coexisting allergic inflammation of the lower airways. (c) 2001 Prous Science. All rights reserved.
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Abstract
This article describes regional differences in the homicide patterns which occurred in Sapporo City and the surrounding area, and in Akita, Ibaraki, Chiba and Toyama prefectures in Japan. Information collected from each case of homicide included factors such as age, sex of the victim and assailant, causes of death, disposition of the offender, relationship between assailant and victim, reasons for criminal action, et al. The statistical features of homicidal episodes among the five different regions showed considerable variation, as follows. The mean death rates for homicide (number of victims per 100,000 of population) during the period 1986-1995 were 0.44 (Sapporo), 0.8 (Akita), 0.58 (Toyama), 0.7 (Ibaraki) and 0.75 (Chiba), respectively. Close family relationship between the victim and assailant was observed in the homicidal acts which occurred in Sapporo, Akita and Toyama. Assailant's relationship to victim was commonly extra-familial in Ibaraki and Chiba-neighboring megalopolis Tokyo, where some events of murder by a foreigner occurred. Homicide by female assailant, murder by mentally abnormal killers and homicide-suicide events were closely associated with family members. And these factors contributed to the considerable number of victims in Sapporo, Akita and Toyama. But, this close family relationship of the victim to the assailant did not correspond with the elevation in the number of deaths, and it was rather inversely related to the higher death rates recognized in Ibaraki and Chiba. This comparative study suggested that rapid urbanization considerably affects regional differences in homicide patterns.
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Regulatory effect of histamine H1 receptor antagonist on the expression of messenger RNA encoding CC chemokines in the human nasal mucosa. J Allergy Clin Immunol 2001; 107:123-8. [PMID: 11150001 DOI: 10.1067/mai.2001.111236] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Allergic rhinitis is characterized by tissue accumulation of inflammatory cells. CC chemokines, including monocyte chemotactic protein (MCP) 1, MCP-3, RANTES, and eotaxin, are thought to play an important role in inducing selective recruitment of these cells to the allergic inflammatory site. Furthermore, MCPs have been indicated as histamine-releasing factors. Histamine is an important mediator in the pathogenesis of nasal allergy. The regulation of histamine may have a role in the management of allergic inflammation. OBJECTIVE The objectives of this study were to investigate the expression of MCP-1, MCP-3, RANTES, and eotaxin in the nasal mucosa of patients with allergic rhinitis and to clarify the effect of histamine and antihistamine on the regulation of the expression of these CC chemokines. METHODS By using a semiquantitative reverse transcriptase PCR technique, the numbers of copies of messenger RNA encoding MCP-1, MCP-3, RANTES, and eotaxin were measured in explant cultures of human nasal mucosa. In culture medium, specific antigen or histamine was added. Furthermore, the effect of preincubation with the antihistamine carebastine was estimated. RESULTS Mite antigen (1:2 x 10(4) dilution) and histamine (10(-4) to 10(-3) mol/L) upregulated the messenger RNA expression of these CC chemokines at 3- to 10-fold increases. Carebastine (10(-7) to 10(-6) mol/L) inhibited this upregulation. CONCLUSION Our results suggest that histamine may induce CC chemokine production in the nasal mucosa of patients with allergic rhinitis. This indicates that there may be a prolonged inflammatory cycle in the histamine-MCP axis in allergic rhinitis. The regulation of histamine-CC chemokine interaction could lead to new therapeutic approaches in the treatment of nasal allergy.
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Giant hornet (Vespa mandarinia) venomous phospholipases. The purification, characterization and inhibitory properties by biscoclaurine alkaloids. Toxicon 2000; 38:1803-16. [PMID: 10858518 DOI: 10.1016/s0041-0101(00)00109-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Two species of giant hornet phospholipase B (PLB), alpha and beta, were purified from the venom of Vespa mandarinia. The purification procedure was simplified by two steps of column chromatographies, Sephadex G-100 and SP-Sepharose. The molecular sizes of PLB alpha and beta were 29.5 and 26.0 kDa, respectively. The isoelectric point of alpha and beta enzymes were pH 10.6 and 10.7, respectively. The temperature optimum for egg yolk lecithin was a broad peak at 40-60 degrees C for both enzymes. Amino acid compositions of both enzymes were high contents of aspartic acid, glycine, leucine, lysine and other aliphatic amino acids. Cystine was similar amounts to other species of phospholipases (PLs). The K(m) values of alpha and beta enzymes were 8.29 and 7.53 mg/ml for egg yolk lecithin, respectively. In the catalytic specificity for L-alpha-phosphatidylcholine-beta-oleoil-gamma-palmitoil, the K(m) values of alpha enzyme for gamma-palmitoil and beta-oleoil residues were 0.528 and 1.392 mM, respectively. While the K(m) values of beta enzyme for gamma-palmitoil and beta-oleoil residues were 7.91 and 2. 68 mM, respectively. Both alpha and beta enzymes were inhibited strongly by cepharanthine. The lecithin hydrolysis of alpha enzyme was competitively inhibited, but beta enzyme was uncompetitive. Cepharanthine also inhibited noncompetitively PLA(2)s of bovine pancreas, bee venom and Naja mossambica mossambica.
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Acute cerebellar hemorrhage in a patient with Klinefelter syndrome: XXY karyotype obtained postmortem from cells from pericardial fluid. J Forensic Sci 2000; 45:1148-50. [PMID: 11005194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
A case of Klinefelter syndrome and a spontaneous cerebellar hemorrhage in a 12-year-old boy is presented. Autopsy revealed that the hemorrhage was due to the rupture of a dilated artery in an arteriovenous malformation in the right cerebellar hemisphere. The small, undescended testes exhibited partial atrophy of the seminiferous tubules. Postmortem chromosome analysis of cells from the pericardial fluid demonstrated a 47, XXY karyotype. He had previous surgical treatment for bilateral thumb polydactyly and patent ductus arteriosus. In juvenile cases of sudden death with overlapping morphological dysgenesis, postmortem karyotyping may provide important diagnostic information.
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YM116, 2-(1H-imidazol-4-ylmethyl)-9H-carbazole, decreases adrenal androgen synthesis by inhibiting C17-20 lyase activity in NCI-H295 human adrenocortical carcinoma cells. JAPANESE JOURNAL OF PHARMACOLOGY 1999; 79:213-20. [PMID: 10202857 DOI: 10.1254/jjp.79.213] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The concentrations of androstenedione and dehydroepiandrosterone, products of C17-20 lyase, in the medium after a 6-hr incubation of NCI-H295 cells were decreased by YM116 (2-(1H-imidazol-4-ylmethyl)-9H-carbazole) (IC50: 3.6 and 2.1 nM) and ketoconazole (IC50: 54.9 and 54.2 nM). 17Alpha-hydroxyprogesterone, a product of 17alpha-hydroxylase, was increased by YM116 (1-30 nM) and by ketoconazole (10-300 nM) and then was decreased at higher concentrations of both agents (IC50: 180 nM for YM116, 906 nM for ketoconazole), indicating that YM116 and ketoconazole were 50- and 16.5-fold more specific inhibitors of C17-20 lyase, respectively, than 17alpha-hydroxylase. Compatible with these findings, progesterone, a substrate of 17alpha-hydroxylase, was increased by these agents. Cortisol production was inhibited by YM116 and ketoconazole (IC50: 50.4 and 80.9 nM, respectively). YM116 was a 14-fold more potent inhibitor of androstenedione production than cortisol production, whereas ketoconazole was a nonselective inhibitor of the production of both steroids. YM116 and ketoconazole inhibited the C17-20 lyase activity in human testicular microsomes (IC50: 4.2 and 17 nM, respectively). These results demonstrate that YM116 reduces the synthesis of adrenal androgens by preferentially inhibiting C17-20 lyase activity.
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Monocyte chemotactic and activating factor/monocyte chemoattractant protein-1-mediated histamine release from human nasal mucosa. ARCHIVES OF OTOLARYNGOLOGY--HEAD & NECK SURGERY 1998; 124:1331-5. [PMID: 9865755 DOI: 10.1001/archotol.124.12.1331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To demonstrate the existence and localization of monocyte chemotactic and activating factor or monocyte chemoattractant protein-1 (MCAF/MCP-1) in human nasal mucosa and to verify its activity as a histamine-releasing factor. DESIGN Detection of MCAF/MCP-1 in culture supernatants of nasal mucosa using Western blot analysis and assay of histamine release from basophils induced by these culture supernatants. Detection of MCAF/MCP-1 expression in nasal mucosa of patients with perennial allergic rhinitis using immunohistochemistry. PATIENTS Twenty-one patients with house dust mite allergy, 7 nonallergic patients, and 5 patients with chronic inflammatory sinusitis participated in the study. All the allergic patients had positive test results for mite nasal allergy, detected by a clinical history, a nasal provocation test, and determination of specific mite IgE antibodies by a radioallergosorbent test. RESULTS In Western blot analysis of supernatants of explant culture of human nasal mucosa, the band corresponding to approximately 13 to 15 kd was observed. This band was considered to be MCAF/MCP-1. These supernatants induced histamine release from basophils (approximately 3%-5% in net histamine release), and anti-MCAF/MCP-1 antibody inhibited this histamine-releasing activity. Immunoreactivity of MCAF/MCP-1 was observed in the nasal submucosa but not in the epithelium. Immunoreactive cells of MCAF/MCP-1 were also stained with the antibody, which recognizes monocytes and macrophages. CONCLUSIONS These results suggest that MCAF/MCP-1, which is produced constantly by monocytes and macrophages and is stored in human nasal mucosa, possibly participates in the protracted histamine release from basophils and in the pathogenesis of perennial allergic rhinitis.
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Novel nonsteroidal inhibitor of cytochrome P450(17alpha) (17alpha-hydroxylase/C17-20 lyase), YM116, decreased prostatic weights by reducing serum concentrations of testosterone and adrenal androgens in rats. Prostate 1998; 37:10-8. [PMID: 9721064 DOI: 10.1002/(sici)1097-0045(19980915)37:1<10::aid-pros3>3.0.co;2-c] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The purpose of this study was to determine the effects of a nonsteroidal C17-20 lyase inhibitor, 2-(1H-imidazol-4-ylmethyl)-9H-carbazole (YM116), on serum concentrations of androgens and ventral prostatic weight in rats. METHODS Serum concentrations of testosterone and of dehydroepiandrosterone sulfate and prostatic weights were measured in rats treated with YM116. RESULTS YM116 inhibited testicular C17-20 lyase competitively (Ki, 0.38 nM), and decreased the serum testosterone concentration in gonadotropin-releasing hormone-treated rats (ED50, 0.7 mg/kg), indicating that YM116 was about 21-24 times more potent than other C17-20 lyase inhibitors such as ketoconazole and liarozole, and was twice as potent as CB7630. YM116 also reduced dehydroepiandrosterone sulfate levels in ACTH-treated castrated rats (ED50, 11 mg/kg). YM116 (40 mg/kg, p.o., for 2 weeks) was almost comparable to bilateral orchiectomy with respect to the time course and magnitude of the reduction in prostatic weight. Each of these two treatments decreased the prostatic weight 3 days following the treatment. Contrarily, leuprolide transiently increased the prostatic weight and then decreased it. YM116 (100 mg/kg) had no effect on the serum cortisol level in guinea pigs, and slightly decreased the serum aldosterone level in rats. CONCLUSIONS YM116 is a selective C17-20 lyase inhibitor which decreases rat prostatic weight by reducing androgen production in the testes and adrenal glands.
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Inhibitory effects of YM175, a bisphosphonate, on the progression of experimental periodontitis in beagle dogs. J Periodontal Res 1998; 33:196-204. [PMID: 9689615 DOI: 10.1111/j.1600-0765.1998.tb02191.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study examined the efficacy of YM175 [disodium dihydrogen (cycloheptylamino) methylene-1, 1-bisphosphonate] in reducing alveolar bone loss caused by experimental periodontitis in beagle dogs. Thirty-six dogs were used and divided into 6 groups. Periodontitis was induced in 30 dogs (groups 2-6) by ligating the bilateral mandibular third and fourth premolar teeth with silk ligatures and by feeding a soft diet. Six dogs were sham-operated (group 1). Saline (placebo), flurbiprofen (0.02 mg/kg) and YM175 (0.01, 0.1 and 1.0 mg/kg) were administered to the dogs (groups 2-6) 5 d/wk for 25 wk. Radiographic and morphometric analyses were performed. In placebo-treated animals (group 2), the ligation caused a significant decrease in the alveolar bone height by 0.57 and 1.91 mm at 2 and 25 wk, respectively. YM175 (1.0 mg/kg) prevented the decrease in bone height by 47 and 31% at 2 and 25 wk. YM175 (0.1 mg/kg) and flurbiprofen tended to prevent bone loss after 15 wk. Although the ligation elicited no significant change in bone mineral density, it significantly decreased bone volume. YM175 (1.0 mg/kg) and flurbiprofen tended to increase the bone volume. The number of formative or resorptive Haversian canals and the bone turnover through the periosteal bone surface were increased by the ligation, indicating the increased turnover of the cortical bone. YM175 (1.0 mg/kg) reduced the increased bone turnover. The gingival index was maximally increased at 2 wk and was suppressed by YM175. These results suggest that YM175 prevents alveolar bone loss by reducing the increased alveolar bone turnover in dogs with periodontitis.
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Abstract
The World Health Organization (WHO) estimates that human tuberculosis (TB) incidence and deaths for 1990 to 1999 will be 88 million and 30 million, respectively, with most cases in developing countries. Zoonotic TB (caused by Mycobacterium bovis) is present in animals in most developing countries where surveillance and control activities are often inadequate or unavailable; therefore, many epidemiologic and public health aspects of infection remain largely unknown. We review available information on zoonotic TB in developing countries, analyze risk factors that may play a role in the disease, review recent WHO activities, and recommend actions to assess the magnitude of the problem and control the disease in humans and animals.
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Abstract
Homicides occurring in the Toyama prefecture, Japan, during the past 10 years were reviewed. Between 1985 and 1994, 56 offenders committed 63 homicides. The mean death rate for homicide was 0.55 per 100,000. The ratio of male to female victims was 1:1, while 82% of the assailants were male and 18% were female. The victim and the assailant had a close family relationship in 58.7% of the cases. Dyadic death (homicide followed by suicide) accounted for 27% of all victims. Twenty-nine per cent of the victims were murdered by mentally unstable offenders, and in almost half (44%) of the cases the offender was convicted. Homicides during robbery were rare (only two cases), and there was only one homicide during sexual assault. Death was caused by blunt instrument injury in 38.1% of cases, asphyxia in 31.7%, stabbing in 17.5%, burns in 9.5% and shooting in 3.2% (only two cases). The majority (80%) of homicides occurred at the residence of the victim(s). None of the victims had a history of drug abuse. Social conditions in Toyama prefecture, and their possible relevance to local homicide patterns, are discussed briefly.
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Abstract
OBJECTIVE To study placental cavities by gross and microscopic examination and ultrasonography and their frequency with various epidemiologic factors and intervillous thrombosis. METHODS After formalin fixation, interval sections of 567 placentas were prepared to search for cavities and intervillous thrombosis. Cavities were subjected to histologic and ultrasonographic examinations. RESULTS Frequency of cavities with diameter of 1 cm or more was 34.9% in 567 mature placentas. Frequency of cavities was significantly higher in heavy, thick placentas associated with male fetuses. Histologic examination revealed villus laceration in cavities and syncytial cells, isolated chorionic villi, or air bubbles in placental fetal veins. All 82 placentas with cavities showed villus lacerations in the cavities and air bubbles in the fetal veins. Intervillous thromboses in fetal lobules were located only in the cavities. Cavities were first found by ultrasonography at a mean gestational age of 30.9 +/- 3.8 weeks. Ultrasonography did not always differentiate accurately between intervillous thrombosis and cavities. CONCLUSION Placental cavities were found significantly more often in heavy, thick placentas associated with male fetuses. Strong uterine contractions during placental detachment could produce villus laceration in cavities, following contamination by air bubbles and isolated villus tissue in the fetal veins. Placental cavities are vulnerable to villus laceration. Intervillous thrombosis occurred only in cavities.
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Increase of bone mass and mechanical strength in rats after treatment with a novel bisphosphonate, YM175, for two years. PHARMACOLOGY & TOXICOLOGY 1997; 81:42-7. [PMID: 9258984 DOI: 10.1111/j.1600-0773.1997.tb00029.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
We have evaluated the relationship between bone mass and mechanical properties of bone from male and female rats treated with YM175, a novel bisphosphonate, for 104 weeks. YM175 [disodium (cycloheptylamino) methylenediphosphonate monohydrate] was given via the drinking water at a concentration of 0, 0.005, 0.015, 0.05, or 0.15%. Since the mortality in the male 0.15% group exceeded the exclusion criteria (75%) at week 88, this-group was omitted from the study. Mean daily intake of YM175 was 2.2-22.1 mg/kg for males and 3.6-104 mg/kg for females. After the treatment, mechanical properties and ash weight of the humerus were determined. In males, 0.015 and 0.05% of YM175 (6.6-22.1 mg/kg) significantly increased failure load of the midshaft. In females, failure load and stiffness of the midshaft tended to be increased by YM175 (up to 104 mg/kg). Furthermore, ultimate compressive load at the humeral metaphysis treated with the highest dose of YM175 was 2- or 3.5-fold greater than that of untreated male or female control. Ash weight of the humerus was increased dose-dependently and was positively correlated with failure load of the midshaft. These findings indicate that treatment for 2 years with YM175 increased bone mass and mechanical strength without blocking bone mineralization.
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4-(3,4-Dihydroxyphenyl)-1,2,3,4-tetrahydroisoquinoline derivatives. II. Their renal vasodilation activity and structure-activity relationship. Chem Pharm Bull (Tokyo) 1996; 44:1865-70. [PMID: 8904813 DOI: 10.1248/cpb.44.1865] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A series of 4-(3,4-dihydroxyphenyl)-1,2,3,4-tetrahydroisoquinoline derivatives showed potent DA1 agonistic activities. We investigated the structure-activity relationship of the racemic compounds of this series. 4-(3,4-Dihydroxyphenyl)-7-methanesulfonamido-1,2,3,4-tetrahydroiso quinoline (43) was identified as a potent renal vasodilator with activity almost equal to that of YM435 (1).
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Studies on aromatase inhibitors. I. Synthesis and biological evaluation of 4-amino-4H-1,2,4-triazole derivatives. Chem Pharm Bull (Tokyo) 1996; 44:1871-9. [PMID: 8904814 DOI: 10.1248/cpb.44.1871] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Various 4-N-substituted amino-4H-1,2,4-triazole derivatives were synthesized and evaluated for aromatase-inhibitory activity (in vitro) and for pregnant mare serum gonadotropin (PMSG)-induced estrogen synthesis-inhibitory activity (in vivo). The 4-(4-cyanophenyl) amino derivative and 4-(4-nitrophenyl)amino derivative, each possessing a strong electron-withdrawing group on the phenyl moiety, showed potent aromatase-inhibitory activity. Structure-activity relationship studies indicated that 4-[(4-bromobenzyl)(4-cyanophenyl)amino]-4H-1,2,4-triazole (5k, YM511) is a highly potent aromatase inhibitor with IC50 values of 0.4 and 0.12 nM in in vitro experiments using rat ovary and human placenta, respectively, and an in vivo ED50 of 0.002 mg/kg in rats on oral administration. YM511 was also a weak inhibitor of other steroid hormone synthesis enzymes. These data suggest that YM511 is a highly selective aromatase inhibitor and may be a useful agent for the treatment of estrogen-dependent diseases such as breast cancer.
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Prevention of bone loss by bisphosphonate YM175 in ovariectomized dogs with dietary calcium restriction. JAPANESE JOURNAL OF PHARMACOLOGY 1996; 71:239-46. [PMID: 8854206 DOI: 10.1254/jjp.71.239] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We have evaluated the effects of YM175 (disodium dihydrogen (cycloheptylamino) methylenebisphosphonate monohydrate), a novel bisphosphonate, on bone mineral densities (BMD) at the lumbar spine and forelimb in ovariectomized beagles with dietary calcium restriction. Groups 1 and 2 were given a sham operation and Groups 3-6 were ovariectomized. One month later (month 0), a low calcium diet was given to Groups 2-6. Groups 4-6 were orally treated with YM175 at doses of 0.01, 0.1 and 1.0 mg/kg, respectively, for 18 months. Changes in BMD at the lumbar spine and left forelimb were determined serially by dual energy X-ray absorptiometry. Calcium restriction decreased lumbar BMD by 19% at month 2 and by up to 30% at month 17 compared to its baseline value, but ovariectomy itself had a minimal effect on bone mass in dogs with restricted calcium intake. YM175 (1 mg/kg) prevented the bone loss at month 2 and YM175 at 0.1 mg/kg or more inhibited the BMD reduction at month 17. The magnitude of BMD reduction of the forelimb was less remarkable as compared to that of the lumbar spine. Urinary hydroxyproline excretion and plasma osteocalcin levels were increased by calcium restriction, indicating a high turnover of bone. YM175 reduced hydroxyproline excretion but not osteocalcin levels. These results indicate that YM175 prevents bone loss induced by calcium restriction and ovariectomy through partially normalizing high bone turnover.
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Inhibitory effect of a novel non-steroidal aromatase inhibitor, YM511 on the proliferation of MCF-7 human breast cancer cell. J Steroid Biochem Mol Biol 1996; 58:189-94. [PMID: 8809200 DOI: 10.1016/0960-0760(96)00023-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The proliferation of MCF-7, human breast cancer cell line, was stimulated by testosterone and estradiol. The aromatase activity in MCF-7 cells, which catalysed the conversion of testosterone to estradiol, was inhibited by a novel non-steroidal aromatase inhibitor, YM5111, with the IC50 of 0.2 nM, indicating that its inhibitory activity was 5.5 times more potent than that of CGS 16949A. YM511 inhibited the proliferation of MCF-7 stimulated by testosterone but did not inhibit the cell proliferation stimulated by estradiol. The IC50 values of YM511 for cell growth and DNA synthesis were 0.13 nM and 0.18 nM, respectively, demonstrating that YM511 was about 3-5 times more potent than CGS 16949A and had no anti-estrogenic or cytotoxic activity. YM511 significantly inhibited testosterone-stimulated transcriptional activation of estrogen-responsive element (ERE) in MCF-7 cells transfected transiently with ERE-luciferase reporter plasmid. The IC50 of YM511 for transactivation was 0.36 nM, suggesting that its inhibitory potency was comparable to the inhibition of aromatase activity of MCF-7 cells. These data may indicate that the inhibition by YM511 of cell proliferation of MCF-7 is attributed to the decreased production of estrogen due to the inhibition of aromatase activity. YM511 may be useful in the treatment of estrogen-dependent cancers.
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Novel potassium channel activators: synthesis and structure-activity relationship studies of 3,4-dihydro-2H-1,4-benzoxazine derivatives. Chem Pharm Bull (Tokyo) 1996; 44:103-14. [PMID: 8582029 DOI: 10.1248/cpb.44.103] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Strong potassium channel-activating effects were found among a series of novel 4-substituted 3,4-dihydro-2H-1,4-benzoxazine derivatives. The key step in preparation was the nucleophilic substitution of 3,4-dihydro-2H-1,4-benzoxazine (3) with activated halogenopyridines, such as halogenopyridine N-oxides (15a--c) and the borane adduct (15d) of 4-bromopyridine. Structure-activity relationship studies identified 2-(3,4-dihydro-2,2-dimethyl-6-nitro-2H-1,4-benzoxazin-4-yl)pyridin e-1-oxide (16a: YM934) as the optimal compound. This compound (16a) showed a more potent oral antihypertensive effect than cromakalim in conscious spontaneously hypertensive rats.
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Abstract
OBJECTIVE To measure blood gases in uterine venous blood and maternal and fetal blood from the placenta, and to characterize gas exchange in the intervillous space. METHODS Blood gas measurements were performed immediately after collecting placental and uterine blood from the subchorial and marginal lakes, from the chorionic vein and artery in the placenta in utero, and from the uterine vein during 12 cesarean deliveries. RESULTS The mean oxygen pressure (PO2) values of the chorionic vein and subchorial lake were 28.7 +/- 6.0 and 29.9 +/- 7.5 mmHg, respectively, with a difference of 1.2 mmHg. The individual data for PO2 of the chorionic vein exceeded those of the subchorial lake in five subjects and were almost equal in two of the 12 subjects. The mean values of carbon dioxide pressure (PCO2) and bicarbonate were greater in the chorionic vein than in the subchorial lake, but the mean pH values were the same in the two groups. The mean values of blood gas analysis were not different between subchorial and marginal lakes with similar blood composition. The mean PO2 of the uterine vein in ten subjects was 45.9 mmHg, significantly higher than that of the subchorial lake. CONCLUSIONS The human placenta may be defined as a multivillous model with a high degree of oxygen transfer. Arteriovenous anastomoses are suspected in the pregnant uterus beyond 37 weeks' gestation. Subchorial and marginal lakes contain similar admixed blood, which circulates and performs gas exchange.
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Histochemical and functional characteristics of metachromatic cells in the nasal epithelium in allergic rhinitis: studies of nasal scrapings and their dispersed cells. J Allergy Clin Immunol 1995; 96:528-36. [PMID: 7560665 DOI: 10.1016/s0091-6749(95)70297-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND In allergic rhinitis, metachromatic cells in the nasal epithelium increase in number and are thought to play an important role in nasal allergic manifestation. METHODS To determine immunohistochemical and functional characteristics of the metachromatic cells, nasal scrapings and their dispersed cells from patients with perennial allergic rhinitis were studied. RESULTS Eighty-three percent of all metachromatic cells in dispersed cell preparations were tryptase-positive mast cells (MCT), 10% were tryptase-chymase-positive cells (MCTC), and 7% were negative (n = 10). The mean histamine chymase-positive cells (MCTC), and 7% were negative (n = 10). The mean histamine content per metachromatic cell was 1.9 +/- 2 pg. The histamine content and histamine release from nasal surface scrapings of patients sensitized with mite antigen were strongly correlated with the level of serum IgE antibody for mite antigen. The net histamine release from nasal scraping was antigen-dose-dependent (1:2 x 10(7) to 1:2 x 10(3) dilution), and the antigen stimulated release of up to 17% of cell-associated histamine within 5 to 7 minutes. Histamine release from nasal scrapings induced by calcium ionophore A23187 was up to 21% of cell-associated histamine within 2 to 4 minutes, but no histamine release was stimulated by compound 48/80, substance P, or poly-L-lysine. Histamine release from nasal scrapings was inhibited 46% (10(-5) mol/L) to 96% (10(-4) mol/L) by quercetin and 58% (10(-4) mol/L) to 72% (10(-3) mol/L) by sodium cromoglycate. CONCLUSIONS These findings show the predominant characteristics of mast cells in the nasal epithelium in allergic rhinitis, and this information may be useful in relation to a therapeutic approach.
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[Operative removal of esophageal leiomyosarcoma: a case report]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 1995; 48:967-70. [PMID: 7564027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This is a case report of 56-year-old man complaining of dysphasia. Upon admission, his chest X-ray film revealed medium amount of fluid accumulation in the right pleural space. Cytological examination of the aspirated fluid revealed nothing particular. Preoperative radiological examination including esophagogram, CT and MRI demonstrated cystic appearance of mass lesion, measuring approximately 5 cm in size located in posterior aspect of the lower portion of the mediastinum. Upon operation, it was found that a tumor with pedunculated connection to the esophageal muscle layer, suspecting diagnosis of leiomyoma of the esophagus. Then, tumor was removed together with the part of esophageal muscle. Postoperative pathology reported leiomyosarcoma of the esophagus with low grade malignancy. We added no esophagectomy. He made uneventful recovery without no sign of recurrence of the malignancy, 4 years after the surgery.
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Abstract
Benign prostatic hyperplasia (BPH) is an age-related disorder characterized by urinary outlet obstruction. This obstruction is due to both mechanical compression of the urethra by the hypertrophied prostate and to functional contraction of the prostate and urethra by sympathetic stimulation. We invented a novel compound tamsulosin hydrochloride, a sulphamoylphenethylamine derivative which possesses potent and selective alpha a-antagonism, and showed that this compound selectively reduced the intra-urethral pressure in the prostatic segment of the urethra in vivo. We also found that the alpha 1-adrenoceptor plays an important functional role in the prostate and urethra. For clinical use, a control release formulation was developed. This formulation did not induce orthostatic hypotension and could be administered at a fixed dose. A placebo-controlled double-blind dose finding study resulted in 0.2 mg/d as the optimal dose. This formulation significantly improved urinary outlet obstruction without affecting blood pressure as compared with placebo in P-III study, and was approved in 1993 for use in the treatment of bladder outlet obstruction associated with BPH. Tamsulosin hydrochloride is the first alpha 1-antagonist which improves bladder outlet obstruction associated with BPH without affecting blood pressure, and the treatment can be initiated and maintained at a fixed dose. Recently, the alpha 1-adrenoceptor subtypes alpha 1A, alpha 1B and alpha 1C were identified. The alpha 1C subtype is predominant and plays an important role in the human prostate. Tamsulosin hydrochloride shows high selectivity for this subtype, further supporting the clinical findings that tamsulosin hydrochloride improves bladder outlet obstruction associated with BPH with no effect on the cardiovascular system.
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The potent and selective inhibition of estrogen production by non-steroidal aromatase inhibitor, YM511. J Steroid Biochem Mol Biol 1995; 54:265-71. [PMID: 7577709 DOI: 10.1016/0960-0760(95)00136-n] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
YM511 inhibited aromatase activities in microsomes from rat ovary and human placenta competitively (IC50s: 0.4 and 0.12 nM, respectively). YM511 was about 3 times more potent than other aromatase inhibitors, such as CGS 16949A, CGS 20267 and R 76713. YM511 decreased the contents of estradiol stimulated by pregnant mare's serum gonadotropin in rat ovary with an ED50 of 0.002 mg/kg, indicating that YM511 was equipotent to CGS 20267 and 3 times more potent than the other two inhibitors. Serum estradiol levels in female rats were reduced by YM511 at 0.01 mg/kg into the ovariectomized range. YM511 at 1 mg/kg for 2 weeks decreased rat uterine weight to levels comparable to ovariectomy, showing it was 10 times more potent than other inhibitors. But the maximal inhibitory effect of tamoxifen failed to reach ovariectomized level. YM511 slightly inhibited production of other steroid hormones in vitro and in vivo. The IC50s of YM511 for aldosterone and cortisol production from adrenal cells were from 5500 to 9800 times higher than that for rat ovarian aromatase and 130,000 times higher for testosterone production, indicating that YM511 is a highly specific aromatase inhibitor. The data suggest that YM511 may be a potent and selective agent for suppressing estrogen-dependent action without affecting serum levels of other steroid hormones.
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[Study of monocyte chemotactic and activating factor in the human nasal mucosa]. NIHON JIBIINKOKA GAKKAI KAIHO 1995; 98:579-88. [PMID: 7540203 DOI: 10.3950/jibiinkoka.98.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recently monocyte chemotactic and activating factor (MCAF) has been reported to be a potent histamine releasing factor (HRF) for human basophils. In this study we investigated the localization and biological activity of MCAF in human nasal mucosa. To investigate the localization of MCAF within the nasal mucosa we performed specific immunohistochemical staining of sections of large pieces of the inferior turbinate obtained by conchotomy from patients with nasal allergy and without nasal allergy and compared them. Sections of nasal mucosa from allergic subjects stained with anti-MCAF mAb demonstrated the presence of many MCAF-positive cells in the lamina propria especially around small vessels and excretory gland, but only a few positive cells were found in the nasal mucosa of normal subjects. We cultured allergic nasal mucosa and sinus mucosa from patients with chronic inflammation for 2 days and detected MCAF by western blot analysis of the culture supernatants. One portion separated from sinus mucosa supernatant by column chromatography also released histamine from human basophils. Mean release was 3-4% and the difference from the control was statistically significant (p < 0.05). In the human nasal mucosa it seemed to exist IgE independent histamine releasing system sustained by MCAF producing cells. These results suggested that MCAF is one of the important mediators causing histamine release in the late phase reaction and in protracted inflammation of the nasal mucosa.
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[A case report of the radical correction of a truncus arteriosus and peripheral pulmonary stenosis in association with Holt-Oram syndrome]. KYOBU GEKA. THE JAPANESE JOURNAL OF THORACIC SURGERY 1995; 48:133-6. [PMID: 7897882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A one year and 6 months old female infant was admitted to our department for a radical correction of a truncus arteriosus (Collett-Edwards type II). She also had a peripheral pulmonary stenosis and Holt-Oram syndrome. Under a cardiopulmonary bypass with deep hypothermia, PFO was closed directly. First of all, the pulmonary arteries were dissected from the aorta, the defect of the aorta was closed directly and VSD was closed with Dacron fabric patch. The reconstruction of the pulmonary arteries were performed with valved conduit which consisted of Dacron graft and 14 mm Björk-Shily valve. The post-operative course was uneventful. Cardiac catheterization study, done 77 days after surgery, revealed 44 mmHg of pressure gradient between RV outflow tract and right PA. The patient was doing well and two years have passed since the surgery. She should be observed carefully at the out-patient clinic due to the mechanical valve and the presence of pressure gradient at RV outflow tract.
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Elevation of ratio of urinary N-acetylneuraminlactose to free sialic acid in some advanced cancer patients. J Gastroenterol 1995; 30:21-7. [PMID: 7719410 DOI: 10.1007/bf01211370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We estimated the levels of free sialic acid and sialylated oligosaccharides excreted in the urine of normal donors (n = 10) and patients with gastric cancer (n = 6) and colorectal cancer (n = 4). The total sialic acid level in cancer patients was similar to that in normal donors. However, the ratios of glycosidically bound sialic acids to free sialic acid were higher in some advanced cancer patients than in the normal donors. A major component of sialylated oligosaccharides was N-acetylneuraminyl alpha (2-->3) lactose. The elevation of the urinary ratio of this sialylated oligosaccharide to free sialic acid observed in some advanced cancer patients in this study may reflect the elevation of sialyltransferase activity in tumor tissues.
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Pharmacologic profiles of YM934, a novel potassium channel opener. J Cardiovasc Pharmacol 1994; 23:180-7. [PMID: 7511745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Pharmacologic profiles of YM934, a newly synthesized 1,4-benzoxazin derivative K channel opener were evaluated in in vitro and in vivo experiments. In isolated rat portal vein, YM934 and a benzopyran derivative K channel opener lemakalim inhibited the frequency of spontaneous rhythmic contractions concentration dependently, with IC50 values of 14 and 38 nM, respectively. These inhibitory effects were competitively antagonized by glibenclamide (an ATP-sensitive K channel blocker; 10(-7)-3 x 10(-6) M). In isolated rabbit aorta, YM934 (10(-8)-10(-6) M) and lemakalim (10(-8)-10(-6) M) relaxed the contractions induced by 20 mM KCl concentration dependently but were ineffective against the contractions induced by 50 mM KCl. YM934 (10(-8)-3 x 10(-6) M) and lemakalim (3 x 10(-8)-10(-5) M), but not the calcium antagonist nifedipine, relaxed the contractions induced by norepinephrine (NE 10(-6) M) or prostaglandin F2 alpha (PGF2 alpha 3 x 10(-6) M) in the aorta. In pentobarbital-anesthetized dogs, YM934 (1-10 micrograms/kg intravenously, i.v.) dose-dependently increased coronary artery blood flow (CBF), and decreased total peripheral resistance (TPR) and mean blood pressure (MBP). YM934 selectively increased CBF, but had little effect on vertebral, carotid, mesenteric, renal and femoral artery BF. These vasodilatory effects of YM934 were antagonized by glibenclamide. YM934 is a potent K channel opener and possesses potent vasodilatory effects, with particularly pronounced effects on the coronary artery. These effects of YM934 may, like lemakalim, be mediated by opening of ATP-sensitive K channels.
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Abstract
The distribution and abundance of mast cells in nasal polyps, the maxillary sinus mucosa of patients with sinusitis and the turbinate mucosa of allergic rhinitis was microscopically examined using different methods of fixation. In the epithelium of the surface and the ducts of nasal polyps (n = 8), the mean number of mast cells was over 20,000 per mm3 using Mota's fixation and the increase was correlated with the epithelial thickness (P < 0.05). On the other hand those of the maxillary sinus mucosa (n = 6) and the nasal turbinate mucosa (n = 7) were less than 6,000 per mm3. In the subepithelial layer or areas deeper than the area with the glands, however, mast cell counts were less than 3,200 per mm3 in all diseases. More than 70-90 per cent of all mast cells in the epithelium of the mucosal surface and the ducts of the polyp, the maxillary sinus mucosa and nasal turbinates were formalin sensitive. Most of the mast cells in the subepithelial and deeper areas were formalin resistant in all diseases. These results suggest that conditions for mast cell growth differ between polyps and the other diseases, and that the conditions which affect mast cells may contribute to polyp development.
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Heterogeneous expression of blood group A-determinant in a human gastric cancer cell line derived from a blood group A individual. EUROPEAN JOURNAL OF IMMUNOGENETICS : OFFICIAL JOURNAL OF THE BRITISH SOCIETY FOR HISTOCOMPATIBILITY AND IMMUNOGENETICS 1992; 19:1-9. [PMID: 1373646 DOI: 10.1111/j.1744-313x.1992.tb00042.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The human gastric cancer cell line MKN 45 was derived from the tumour of a blood group A individual, and was known to express large quantities of blood group A-antigen. Using immunofluorescence we found the MKN 45 cells, donated from the Japanese Cancer Research Resources Bank, consisted of A-antigen positive cells (18%) and A-antigen negative cells (82%). After limiting dilution, wild type and mutant cells were cloned with regard to the expression of a cell surface A-antigen. ELISA was used to detect A-antigen in the cell extract of the wild type cells, but none was evident in those of the mutant cells. However, blood group A-gene-specified transferase activity of the mutant cells was comparable to that of the wild type cells.
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Abstract
A novel renin inhibitor, YM-21095 [2RS), (3S)-3-[N alpha-[1,4-dioxo-4-morpholino-2-(1-naphthylmethyl)-buthyl]-L- histidil-amino]-4-cyclohexyl-1-[(1-methyl-5-tetrazolyl)thio]-2-but anol), has been synthesized in our laboratories. The aim of this study was to evaluate the pharmacological properties of YM-21095 in in vitro and in vivo experiments. YM-21095 inhibited human renin with an IC50 value of 4.7 x 10(-10) mol/L. YM-21095 was also a potent inhibitor against squirrel monkey renin, but less effective against renins from dog, rabbit, and rat. The effect of YM-21095 is highly specific for renin, since it did not inhibit cathepsin D, pepsin, or angiotensin converting enzyme up to a concentration of 10(-4) mol/L. YM-21095 was resistant to proteolytic actions of the enzymes (pepsin, chymotrypsin, trypsin) and squirrel monkey tissue homogenates (liver, kidney, small intestine). Intravenous infusion of YM-21095 (0.1 to 100 micrograms/kg/min) decreased mean blood pressure and inhibited plasma renin activity in a dose-dependent manner with no effect on heart rate in anesthetized sodium-depleted and sodium-replete squirrel monkeys. The hypotensive effect of YM-21095 in sodium-depleted squirrel monkeys was about ten times as potent as that in sodium-replete squirrel monkeys. Oral administration of YM-21095 to conscious sodium-depleted squirrel monkeys produced dose-related decreases of systolic blood pressure. We conclude that YM-21095 is a potent and highly specific inhibitor of primate renin and produces a blood pressure lowering effect.
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Synthesis, resolution, and renal vasodilation activity of novel DA1 agonists: 4-(3,4-dihydroxyphenyl)-1,2,3,4-tetrahydroisoquinoline derivatives. Chem Pharm Bull (Tokyo) 1991; 39:2910-4. [PMID: 1839245 DOI: 10.1248/cpb.39.2910] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
7,8-Dihydroxy-4-(3,4-dihydroxyphenyl)-1,2,3,4-tetrahydroisoquinoline (1) and 4-(3,4-dihydroxyphenyl)-7-hydroxy-8-methyl-1,2,3, 4-tetrahydroisoquinoline (2) are potent renal vasodilators which selectively stimulate DA1 (peripheral dopamine receptor-1) receptors. Especially, (S)-(-)-1 is the most potent. Its DA1 agonist activity is about 10 times stronger than dopamine for increasing renal blood flow in anesthetized dogs. The renal and cardiovascular effects of (S)-(-)-1 may be suitable for the treatment of patients with renal insufficiency, heart failure and hypertension.
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