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Inuzuka Y, Yamamoto-Hanada K, Kobayashi T, Pak K, Toyokuni K, Ogita H, Miyoshi T, Ogawa K, Sago H, Ohya Y. Prevention of atopic dermatitis in high-risk neonates via different types of moisturizer application: A randomized, blinded, parallel, three-group, phase II trial (PAF study). J Eur Acad Dermatol Venereol 2023; 37:2526-2536. [PMID: 37478291 DOI: 10.1111/jdv.19375] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND The effectiveness of moisturizers in preventing infant atopic dermatitis (AD) remains unclear. We previously showed that using 2e moisturizer of commercial moisturizer (Shiseido Japan Co., Ltd.) at least once a day significantly prevented AD in infants as compared with as-needed petroleum jelly. This trial aimed to determine the effectiveness of twice- or once-daily application of Fam's Baby moisturizer (Fam's Inc.) in preventing AD compared with once-daily 2e moisturizer. METHODS This trial was a single-centre, three-parallel-group, assessor-blinded, superiority, individually randomized, controlled, phase II trial that was conducted from 25 August 2020 to 28 September 2021. We randomly assigned 60 newborns with at least one parent or sibling who has AD to receive Fam's Baby moisturizer twice daily (Group A) or once daily (Group B), or 2e once daily (Group C) in a 1:1:1 ratio until they were 32 weeks old. The primary outcome was the time of AD onset. RESULTS Atopic dermatitis was observed in 11/20 (55%), 5/20 (25%) and 10/20 (50%), infants in Groups A, B and C, respectively. Cumulative incidence values for AD according to the Kaplan-Meier method showed that infants in Group B tended to maintain an intact skin for a longer period than those in Group C (median time, not reached [NR] vs. 212 days, log-rank test, p = 0.064). Cox regression analysis showed that the risk of AD tended to be lower in Group B (hazard ratio with group C as control, 0.36; 95% confidential intervals: 0.12-1.06). No serious adverse events occurred in any of the enrolled infants. CONCLUSION Fam's Baby moisturizer may better prevent AD than 2e. Further large-scale trials should be performed to confirm the efficacy of Fam's Baby moisturizer in preventing AD in infants.
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Affiliation(s)
- Y Inuzuka
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - K Yamamoto-Hanada
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - T Kobayashi
- Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan
| | - K Pak
- Division of Biostatistics, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan
| | - K Toyokuni
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - H Ogita
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - T Miyoshi
- Department of Clinical Research Promotion, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan
| | - K Ogawa
- Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - H Sago
- Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Y Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
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Kim BS, Kang J, Jun S, Kim H, Pak K, Kim GH, Heo HJ, Kim YH. Association between immunotherapy biomarkers and glucose metabolism from F-18 FDG PET. Eur Rev Med Pharmacol Sci 2020; 24:8288-8295. [PMID: 32894535 DOI: 10.26355/eurrev_202008_22625] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To assess associations between parameters derived from F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) and mRNA expression levels of immune checkpoint biomarkers such as programmed death receptor 1 (PD-1), programmed death-ligand 1 (PD-L1), cytotoxic T-lymphocyte antigen 4 (CTLA-4) as well as tumor mutation burden (TMB) in non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS Integrated data were downloaded from Genomic Data Common Data Portal. Clinical, mRNA-seq, and whole exome-seq data of lung adenocarcinoma and squamous cell carcinoma from The Cancer Genome Atlas (TCGA) database were analyzed. TMB was defined as the total number of somatic missense mutations per megabase of the genome examined. Expression levels of PD-1, PD-L1, CTLA4 mRNA and TMB were collected. Correlations between imaging parameters of glucose metabolism and the expression levels of genomic biomarkers from cancers were evaluated. Bonferroni correction (adjusted p<0.0027) was applied to reduce type 1 error. RESULTS Of 31 NSCLC cases, 11 cases were adenocarcinoma (LUAD) and 20 were squamous cell carcinoma (LUSC). In linear regression analysis, texture parameters such as low gray-level run emphasis (LGRE, R2=0.48, p<0.0001), short run low gray-level emphasis (SRLGE, R2=0.45, p<0.0001) and long run low gray-level emphasis (LRLGE, R2=0.41, p=0.0001) derived from gray-level run length matrix (GLRLM) showed remarkable correlation with PD-L1 mRNA expression. Expression of PD-1, CTLA-4, and TMB failed to show any significant correlation with parameters of the F-18 FDG PET/CT. CONCLUSIONS Texture parameters derived from PET, known to indicate glucose uptake distribution, were correlated with expression of PD-L1 mRNA but not with expression of PD-1, CTLA-4 and TMB. Thus, tumoral heterogeneity could be a surrogate marker for the identification of PD-L1 level in NSCLC.
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Affiliation(s)
- B S Kim
- Department of Nuclear Medicine, Kosin University Gospel Hospital, University of Kosin College of Medicine, Busan, Republic of Korea.
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Takahashi N, Omodaka K, Pak K, Kikawa T, Kobayashi W, Akiba M, Nakazawa T. Evaluation of Papillomacular Nerve Fiber Bundle Thickness in Glaucoma Patients with Visual Acuity Disturbance. Curr Eye Res 2019; 45:847-853. [PMID: 31880172 DOI: 10.1080/02713683.2019.1703006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Assessing the papillomacular nerve fiber bundle (PMB) can identify glaucoma patients with decreased visual acuity. In this study, we explore efficient methods for evaluating PMB thickness in glaucoma patients, based on swept source-optical coherence tomography (SS-OCT). METHODS This study included 347 eyes of 205 open-angle glaucoma (OAG) patients. Patients were excluded if they had best-corrected decimal visual acuity < 0.3, axial length >28 mm, non-glaucoma ocular disease, or systemic disease affecting the visual field. We obtained vertical 12.0 × 9.0 mm 3D volume scans covering both the macular and optic disc regions with SS-OCT (DRI OCT Triton, Topcon), and measured the thickness of the PMB, as well as average macular retinal nerve fiber layer thickness (mRNFLT) and macular ganglion cell complex thickness (mGCCT) in the macular map and temporal-quadrant circumpapillary RNFL thickness (tcpRNFLT). We also measured central-strip RNFLT (csRNFLT) and GCC (csGCCT) in a 1.5 × 6.6 mm area of the scan centered between the fovea and optic nerve head. CsRNFLT and csGCCT were divided lengthwise into three 1.5 × 2.2 mm sections. We then calculated Spearman's rank correlation coefficient between these OCT measurements and visual acuity. Logistic regression analysis was used to find the cutoff value for the OCT measurements to predict logMAR < 0. RESULTS The correlation coefficients with logMAR were 0.38 for mRNFLT, 0.44 for mGCCT, 0.37 for middle csRNFLT, 0.50 for middle csGCCT, and 0.33 for tcpRNFLT (all P < .0001). For middle csGCCT, the area under the curve indicating decreased visual acuity was 0.80, with a cutoff value of 88.6 μm (P < .001). CONCLUSIONS We found strong associations between OCT parameters in the PMB, especially middle csGCCT, and visual acuity in patients with OAG. The thickness of the PMB may therefore be valuable information for glaucoma care and may help prevent visual acuity disturbance.
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Affiliation(s)
- N Takahashi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine , Sendai, Japan
| | - K Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine , Sendai, Japan
| | - K Pak
- Division of Biostatistics, Department of Data Management, Center for Clinical Research, National Center for Child Health and Development , Tokyo, Japan
| | - T Kikawa
- Topcon Corporation , Tokyo, Japan
| | - W Kobayashi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine , Sendai, Japan
| | - M Akiba
- Topcon Corporation , Tokyo, Japan
| | - T Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine , Sendai, Japan.,Department of Retinal Disease Control, Ophthalmology, Tohoku University Graduate School of Medicine , Sendai, Japan.,Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine , Sendai, Japan
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Kim N, Jeong W, Heo C, Park K, Lee J, Ryu M, Kim J, Pak K, Kim Y, Shin Y. Skin-adhesive extracranial photobiomodulation improved memory and depression in mild cognitive impairment: A randomized, controlled, single-blind pilot study. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Lee J, Cha J, Shin S, Kim Y, Lee S, Cha H, Kim J, Kim D, Kang E, Ahn J, Kim H, Pak K, Yoon J, Park S. Comparison of clinical outcomes between laser-assisted zona pellucida opening and thinning. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kim J, Cha J, Lee J, Shin S, Kim Y, Lee S, Cha H, Kim D, Kang E, Ahn J, Kim H, Pak K, Yoon J, Park S. When semen viscosity was overcome, it did not afeect the clinical outcomes of fresh embryo transfer cycles regardless of insemination methods. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Saito M, Yamamoto-Hanada K, Pak K, Ayabe T, Mezawa H, Ishitsuka K, Konishi M, Yang L, Matsumoto K, Saito H, Ohya Y. Having small-for-gestational-age infants was associated with maternal allergic features in the JECS birth cohort. Allergy 2018; 73:1908-1911. [PMID: 29802633 DOI: 10.1111/all.13490] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Saito
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - K. Yamamoto-Hanada
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - K. Pak
- Department of Clinical Medicine (Biostatistics); Kitasato University School of Pharmacy; Tokyo Japan
| | - T. Ayabe
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - H. Mezawa
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - K. Ishitsuka
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - M. Konishi
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - L. Yang
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - K. Matsumoto
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - H. Saito
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
| | - Y. Ohya
- Medical Support Center for the Japan Environment and Children's Study; National Center for Child Health and Development; Tokyo Japan
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Pak K, Kim SJ, Kim IJ, Kim DU, Kim K, Kim H, Kim SJ. Splenic FDG uptake predicts poor prognosis in patients with unresectable cholangiocarcinoma. Nuklearmedizin 2018; 53:26-31. [DOI: 10.3413/nukmed-0566-13-03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 07/14/2013] [Indexed: 12/18/2022]
Abstract
Summary
Aim: Diffuse splenic 18F-Fluorodeoxyglucose (FDG) uptake has shown to be associated with concurrent inflammation. We evaluated the prognostic value of diffuse splenic FDG uptake for predicting prognosis in cholangiocarcinoma patients. Patients, methods: Sixty-four patients with unresectable cholangiocarcinoma performed Positron emission tomography/computed tomography (PET/CT) using FDG between July 2009 and April 2012. Patients were divided into two groups according to splenic FDG uptake relative to hepatic FDG uptake. Eleven patients showing splenic FDG uptake exceeding hepatic uptake were included in group A, while 53 patients with hepatic FDG uptake exceeding splenic uptake were included in group B. Prognostic factors for overall survival were evaluated using log-rank test. Variables with a probability of less than or equal to 0.1 on univariate analysis were considered as possible independent factors. Cox-proportional hazards Cholangiocarcinoma, a malignant neoplasm of biliary epithelium, is a rare disease with an increasing incidence worldwide (19). The chances of survival with cholan- giocarcinoma depend on its location and model was used to analyze univariate and multivariate analysis. Results: Mean standardized uptake value of the liver (Liver SUVmean)/ Spleen SUVmean (L/S) ratio <1 (p = 0.0034), WBC > 10 000 (p = 0.1155) and CEA >30 (p = 0.0946) were predictors of overall survival on univariate analysis. In a subsequent multivariate analysis, L/S ratio <1 remained a significant independent predictor of poor prognosis (HR 6.0153, 95% CI, 1.7193-21.0460, p = 0.0052). Conclusion: Our study has shown that splenic FDG uptake could be a predictor of overall survival of unresectable cholangiocarcinoma patients.
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Kim H, Park S, Yoon J, Pak K, Ahn J, Cha J, Lee J, Shin S, Kim Y, Lee S, Cha H, Kim J. Preconception thyroid stimulating hormone level does not affect the pregnancy outcome in women undergoing in vitro fertilization. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pinal-Fernandez I, Parks C, Tiniakou E, Albayda M, Paik J, Lahouti A, Casal-Dominguez M, Pak K, Huang W, Lloyd T, Danoff S, Casciola-Rosen L, Christopher-Stine L, Mammen A. FRI0284 Anti-Srp-Associated Autoimmune Myopathy: Younger Age at Onset Is Associated with More Severe Disease and Worse Outcome. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Punnoose A, Norrish A, Wellwood I, Pak K. The effectiveness of shockwave therapy on achilles and patellar tendinopathy: a systematic review and meta-analysis. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The value of (18)F-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in the detection of carcinoma of unknown primary (CUP) differs among the studies. This study aimed to evaluate the role of (18)F-FDG PET/CT in CUP. Fifty-one patients (19 women, 32 men) with metastasis confirmed by histopathology from an unknown primary tumor were included in this study. Patients received 370 MBq of (18)F-FDG intravenously, and PET/CT was performed at 60 minutes after injection. Primary tumor sites were detected in 5 of 51 patients (9.6%): in 2 patients with carcinoma of the lung, in 1 patient with carcinoma of the gallbladder, in 1 patient with carcinoma of the esophagus, and in 1 patient with carcinoma of the stomach. No primary tumor was discovered in the remaining 46 patients (90.4%) during the follow-up. The sensitivity, specificity, and accuracy of (18)F-FDG PET/CT were 100%, 80.4%, and 82.4%. The positive and negative predictive values were 35.7 and 100%, respectively. Based on the data presented, (18)F-FDG PET/CT has a clinical implicative value in detecting the primary tumor of CUP. PET/CT can be useful to rule out the possibility of detecting the primary tumor during the follow-up.
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Affiliation(s)
- K Pak
- Department of Nuclear Medicine and Medical Research Institute, Pusan National University Hospital, Busan, South Korea
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Taura A, Taura K, Choung YH, Masuda M, Pak K, Chavez E, Ryan AF. Histone deacetylase inhibition enhances adenoviral vector transduction in inner ear tissue. Neuroscience 2010; 166:1185-93. [PMID: 20060033 DOI: 10.1016/j.neuroscience.2009.12.064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 12/16/2009] [Accepted: 12/23/2009] [Indexed: 10/20/2022]
Abstract
Adenovirus vectors (AdVs) are efficient tools for gene therapy in many tissues. Several studies have demonstrated successful transgene transduction with AdVs in the inner ear of rodents [Kawamoto K, Ishimoto SI, Minoda R, Brough DE, Raphael Y (2003) J Neurosci 23:4395-4400]. However, toxicity of AdVs [Morral N, O'Neal WK, Rice K, Leland MM, Piedra PA, Aguilar-Cordova E, Carey KD, Beaudet AL, Langston C (2002) Hum Gene Ther 13:143-154.] or lack of tropism to important cell types such as hair cells [Shou J, Zheng JL, Gao WQ (2003) Mol Cell Neurosci 23:169-179] appears to limit their experimental and potential clinical utility. Histone deacetylase inhibitors (HDIs) are known to enhance AdV-mediated transgene expression in various organs [Dion LD, Goldsmith KT, Tang DC, Engler JA, Yoshida M, Garver RI Jr (1997) Virology 231:201-209], but their effects in the inner ear have not been documented. We investigated the ability of one HDI, trichostatin A (TSA), to enhance AdV-mediated transgene expression in inner ear tissue. We cultured neonatal rat macular and cochlear explants, and transduced them with an AdV encoding green fluorescent protein (Ad-GFP) under the control of a constitutive promoter for 24 h. In the absence of TSA, GFP expression was limited, and very few hair cells were transduced. TSA did not enhance transduction when applied at the onset of Ad-GFP transduction. However, administration of TSA during or just after Ad-GFP application increased GFP expression in supporting cells approximately fourfold. Moreover, vestibular hair cell transduction was enhanced approximately sixfold, and that of inner hair cells by more than 17-fold. These results suggest that TSA increases AdV-mediated transgene expression in the inner ear, including the successful transduction of hair cells. HDIs, some of which are currently under clinical trials (Sandor et al., 2002), could be useful tools in overcoming current limitations of gene therapy in the inner ear using Ad-GFP.
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Affiliation(s)
- A Taura
- Division of Otolaryngology, Departments of Surgery, UCSD School of Medicine, San Diego, CA 92093, USA
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Choung YH, Taura A, Pak K, Choi SJ, Masuda M, Ryan AF. Generation of highly-reactive oxygen species is closely related to hair cell damage in rat organ of Corti treated with gentamicin. Neuroscience 2009; 161:214-26. [PMID: 19318119 DOI: 10.1016/j.neuroscience.2009.02.085] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2008] [Revised: 02/13/2009] [Accepted: 02/14/2009] [Indexed: 01/01/2023]
Abstract
Reactive oxygen species (ROS) have been suggested to play a major role in aminoglycoside-induced hair cell (HC) loss, but are difficult to detect. Moreover, ROS can occur normally in cells where they have roles in metabolism, cell signaling and other processes. Two new probes, aminophenyl fluorescein (APF) and hydroxyphenyl fluorescein (HPF) are dyes which selectively detect highly-reactive oxygen species (hROS), those most associated with cellular damage. We assessed the presence of hROS in the neonatal rat organ of Corti during chronic exposure to 50 microM gentamicin in vitro, to examine the relationship between cell damage and hROS across HC type and across the three cochlear turns. hROS were initially detected at 48 hours (h), with an increase at 72 h and persistence until at least 96 h. At 48 h, hROS were restricted to outer HCs and occurred prior to loss of stereocilia. At 72 h, outer HCs showed both hROS and stereocilia loss, and hROS were noted in a few inner HCs. Basal turn HCs showed more hROS than middle turn HCs. Very little hROS accumulation or stereocilia loss was observed in the apical turn, even at 72 h. First row outer HCs were most vulnerable to gentamicin-induced hROS, followed by second and then third row outer HCs. Inner HCs behaved similarly to third row outer HCs. By 96 h stereocilia damage was extensive, but surviving HCs showed persisting fluorescence. APF consistently showed more fluorescence than HPF. The results suggest that hROS accumulation is an important initial step in gentamicin-induced HC damage, and that the differential sensitivity of HCs in the organ of Corti is closely related to differences in hROS accumulation.
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Affiliation(s)
- Y H Choung
- Department of Surgery Otolaryngology, UCSD School of Medicine and VA Medical Center, 9500 Gilman Drive 0666, La Jolla, CA 92093-0666, USA
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Tabuchi K, Pak K, Chavez E, Ryan AF. Role of inhibitor of apoptosis protein in gentamicin-induced cochlear hair cell damage. Neuroscience 2007; 149:213-22. [PMID: 17869439 DOI: 10.1016/j.neuroscience.2007.06.061] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2007] [Revised: 06/01/2007] [Accepted: 07/16/2007] [Indexed: 10/23/2022]
Abstract
Apoptotic cell death is considered to play a key role in gentamicin-induced cochlear hair cell loss. Inhibitor of apoptosis proteins (IAPs) are important regulators of apoptosis that can prevent activation of effector caspases. This study was designed to investigate the possible involvement of X-linked inhibitor of apoptosis protein (XIAP) in hair cell death due to gentamicin. Basal turn organ of Corti explants from postnatal day (p) p3 or p4 rats were maintained in tissue culture and were exposed to 35 muM gentamicin for up to 48 h. Effects of specific XIAP inhibitors on gentamicin-induced hair cell loss and caspase-3 activation were examined. XIAP inhibitors increased gentamicin-induced hair cell loss but an inactive analog had no effect. Caspase-3 activation was primarily observed at 36 or 48 h in gentamicin-treated hair cells, whereas caspase-3 activation peaked at 24-36 h when explants were treated with gentamicin and an XIAP inhibitor. The inhibitors alone had no effect on hair cells. Finally, a caspase-3 inhibitor decreased caspase-3 activation and hair cell loss induced by gentamicin and an XIAP inhibitor, but caspase-8 and -9 inhibitors did not. The results indicate that XIAP normally acts to decrease caspase-3 activation and hair cell loss during gentamicin ototoxicity, as part of a protective response to potentially damaging stimuli.
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Affiliation(s)
- K Tabuchi
- Department of Surgery, Division Otolaryngology and Neurosciences, University of California, San Diego School of Medicine, 9500 Gilman Drive #0666, La Jolla, CA 92093, USA
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Wasserman S, Ebmeyer J, Pak K, Ryan A. The Role of MyD88 and TNF-α in the Inflammatory Response in the Middle Ear. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
To identify possible intracellular mediators of hair cell (HC) death due to ototoxins, we treated basal-turn, neonatal, rat HCs in vitro with several intracellular signaling inhibitors, prior to and during gentamicin exposure. The general guanine nucleotide-binding protein (G-protein) inhibitor, GDP-betaS (1 mM), provided potent HC protection, suggesting involvement of G-proteins in the intracellular pathway linking gentamicin exposure to HC death. ADP-betaS had minimal effect, indicating that the protection is specific to guanosine diphosphate (GDP)-binding, rather than a general reaction to nucleotides. Azido-GTP(32) photolabeling and gel electrophoresis indicated activation of an approximately 21 kDa G-protein in HCs after exposure to gentamicin. Spectroscopic analysis of peptide fragments from this band matched its sequence with H-Ras. The Ras inhibitors B581 (50 microM) and FTI-277 (10 microM) provided potent protection against damage and reduced c-Jun activation in HC nuclei, suggesting that activation of Ras is functionally involved in damage to these cells due to gentamicin.
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Affiliation(s)
- A Battaglia
- Department of Surgery, University of California, San Diego, School of Medicine, 9500 Gilman Drive 0666, La Jolla, CA 92093-0666, USA
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Losada L, Sussan T, Pak K, Zeyad S, Rozenbaum I, Hutcheson SW. Identification of a novel Pseudomonas syringae Psy61 effector with virulence and avirulence functions by a HrpL-dependent promoter-trap assay. Mol Plant Microbe Interact 2004; 17:254-262. [PMID: 15000392 DOI: 10.1094/mpmi.2004.17.3.254] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The hrp pathogenicity island of Pseudomonas syringae encodes a type III secretion system (TTSS) that translocates effectors into plant cells. Most genes encoding effectors are dispersed in the P. syringae genome. Regardless of location, all are regulated coordinately by the alternative sigma factor HrpL. An HrpL-dependent promoter-trap assay was developed to screen genomic libraries of P. syringae strains for promoters whose activity in Escherichia coli is dependent on an inducible hrpL construct. Twenty-two HrpL-dependent promoter fragments were isolated from P. syringae Psy61 that included promoters for known HrpL-dependent genes. One fragment also was isolated that shared no similarity with known genes but retained a near consensus HrpL-dependent promoter. The sequence of the region revealed a 375-amino acid open reading frame encoding a 40.5-kDa product that was designated HopPsyL. HopPsyL was structurally similar to other secreted effectors and carried a putative chloroplast-targeting signal and two predicted transmembrane domains. HopPsyL':'AvrRpt2 fusions were translocated into host cells via the P. syringae pv. tomato DC3000 hrp TTSS. A hopPsyL::kan mutant of Psy61 exhibited strongly reduced virulence in Phaseolus vulgaris cv. Kentucky Wonder, but did not appear to act as a defense response suppressor. The ectopically expressed gene reduced the virulence of Pseudomonas syringae DC3000 transformants in Arabidopsis thaliana Col-0. The gene was shown to be conserved in 6 of 10 P. syringae pv. syringae strains but was not detected in 35 strains of other pathovars. HopPsyL appears to be a novel TTSS-dependent effector that functions as a host-species-specific virulence factor in Psy61.
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Affiliation(s)
- L Losada
- Department of Cell Biology and Molecular Genetics, Microbiology Bldg, University of Maryland, College Park 20742, USA
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Aletsee C, Beros A, Mullen L, Palacios S, Pak K, Dazert S, Ryan AF. Ras/MEK but not p38 signaling mediates NT-3-induced neurite extension from spiral ganglion neurons. J Assoc Res Otolaryngol 2001; 2:377-87. [PMID: 11833610 PMCID: PMC3201072 DOI: 10.1007/s10162001000086] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Neurotrophin (NT)-3 is expressed in the neuronal target tissue of the developing rat cochlea and has been shown to promote the survival and neurite outgrowth of spiral ganglion (SG) neurons, suggesting a role for this protein during the innervation of the organ of Corti. In other neurons, NT-3 can mediate neuritogenesis and survival via a number of intracellular signal pathways. To date, the intracellular transduction pathways involved in the mediation of NT-3 effects have not been investigated in SG neurons. To determine whether the activities of NT-3 on SG neurons are dependent on the activation of mitogen-activated protein kinase kinases (MEK)/extracellular-signal-regulated kinases (ERK), Ras, and/or p38, SG explants from postnatal-day 4 rats were cultured with NT-3 and increasing concentrations of the MEK inhibitor U0126, the Ras farnesyl-transferase inhibitor (FTI)-277, and the p38 inhibitor SB203580. After fixation and immunocytochemical labeling, neurite growth was evaluated. A dose-dependent decrease of the effects of NT-3 on length and number of processes was observed in the U0126- and FTI-277-treated SG neurons. In contrast, SB203580 had no significant effect on NT-3-mediated stimulation of neurite growth, in terms of either number or length. The results suggest that NT-3 effects on SG neurons are mediated primarily by the Ras/MEK/ERK signaling pathway.
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Affiliation(s)
- C Aletsee
- Department of Surgery/Otolaryngology and Neurosciences, UCSD School of Medicine and VA Medical Center, La Jolla, CA 92093, USA
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20
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Hutcheson SW, Bretz J, Sussan T, Jin S, Pak K. Enhancer-binding proteins HrpR and HrpS interact to regulate hrp-encoded type III protein secretion in Pseudomonas syringae strains. J Bacteriol 2001; 183:5589-98. [PMID: 11544221 PMCID: PMC95450 DOI: 10.1128/jb.183.19.5589-5598.2001] [Citation(s) in RCA: 119] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In Pseudomonas syringae strains, the hrp-hrc pathogenicity island consists of an HrpL-dependent regulon that encodes a type III protein translocation complex and translocated effector proteins required for pathogenesis. HrpR and HrpS function as positive regulatory factors for the hrpL promoter, but their mechanism of action has not been established. Both HrpR and HrpS are structurally related to enhancer-binding proteins, but they lack receiver domains and do not appear to require a cognate protein kinase for activity. hrpR and hrpS were shown to be expressed as an operon: a promoter was identified 5' to hrpR, and reverse transcriptase PCR detected the presence of an hrpRS transcript. The hrpR promoter and coding sequence were conserved among P. syringae strains. The coding sequences for hrpR and hrpS were cloned into compatible expression vectors, and their activities were monitored in Escherichia coli transformants carrying an hrpL'-lacZ fusion. HrpS could function as a weak activator of the hrpL promoter, but the activity was only 2.5% of the activity detected when both HrpR and HrpS were expressed in the reporter strain. This finding is consistent with a requirement for both HrpR and HrpS in the activation of the hrpL promoter. By using a yeast two-hybrid assay, an interaction between HrpR and HrpS was detected, suggestive of the formation of a heteromeric complex. Physical interaction of HrpR and HrpS was confirmed by column-binding experiments. The results show that HrpR and HrpS physically interact to regulate the sigma(54)-dependent hrpL promoter in P. syringae strains.
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Affiliation(s)
- S W Hutcheson
- Department of Cell Biology and Molecular Genetics, University of Maryland, College Park, Maryland 20742, USA.
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21
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Abstract
OBJECTIVE Otitis media is a major cause of morbidity in pediatric and adult patients. This inflammatory condition is characterized by mucosal hyperplasia that is thought to be mediated by the complex actions of growth factors and their respective receptors. It was the purpose of this study to determine which growth factors might be responsible for the growth and differentiation of the middle ear epithelium during otitis media. STUDY DESIGN The effect of several growth factors on the expansion and differentiation of normal middle ear mucosa was evaluated in tissue culture. MATERIALS AND METHODS Explants of normal rat middle ear mucosa were exposed in vitro to six different growth factors known to influence epithelial cells in other tissues: epidermal growth factor, amphiregulin, betacellulin, heregulin-alpha, keratinocyte growth factor, and hepatocyte growth factor. RESULTS After 12 days, the growth and level of cytokeratin expression were analyzed for each of the explant outgrowths. Each factor appeared to have a significant, concentration-dependent effect on either the growth or differentiation of the cultured middle ear epithelial cells. CONCLUSION The results suggest that several of the tested growth factors may play a significant role in controlling hyperplasia of the middle ear mucosa during otitis media.
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Affiliation(s)
- S D Palacios
- Department of Head and Neck Surgery, University of California-San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Aletsee C, Mullen L, Kim D, Pak K, Brors D, Dazert S, Ryan AF. The disintegrin kistrin inhibits neurite extension from spiral ganglion explants cultured on laminin. Audiol Neurootol 2001; 6:57-65. [PMID: 11385179 DOI: 10.1159/000046811] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The influence of laminin-1 (LN) and tenascin-C (TN), extracellular matrix molecules expressed spatially and temporally along the neural growth route from spiral ganglion (SG) neurons to the cochlear sensory cells, was evaluated in cultured SG explants from postnatal day 4 rats. Increasing concentrations of LN resulted in a strong, dose-dependent increase in the length of neurites and in a higher number of neural processes, while varying TN concentrations had relatively minor effects on both parameters. The results suggest differential receptor activation by LN and TN. When explants grown on LN were treated with Kistrin, an inhibitor of the alphavbeta3 integrin, the LN-induced increase in neurite length was reduced in a dose-dependent manner. However, the number of extending neurites was not affected, indicating that different receptors mediate this response, perhaps by increasing neuronal survival.
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Affiliation(s)
- C Aletsee
- Department of Surgery/Otolaryngology, UCSD School of Medicine La Jolla, Calif. 92093, USA
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Scher DM, Pak K, Lonner JH, Finkel JE, Zuckerman JD, Di Cesare PE. The predictive value of indium-111 leukocyte scans in the diagnosis of infected total hip, knee, or resection arthroplasties. J Arthroplasty 2000; 15:295-300. [PMID: 10794224 DOI: 10.1016/s0883-5403(00)90555-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
To evaluate the usefulness of the indium-111 scan in detecting actually or potentially infected total hip, knee, and resection arthroplasties, 153 scans were performed on 143 patients who underwent reoperation for a loose or painful total joint arthroplasty or a resection arthroplasty between 1990 and 1996. Scans were interpreted as infected, not infected, or equivocal by an experienced nuclear medicine radiologist. Patients were considered to be infected if they met any 2 of the following criteria: i) positive intraoperative cultures, ii) final permanent histologic section indicating acute inflammation, and iii) intraoperative findings of gross purulence within the joint. Twenty-six patients (17%) met the infection criteria at the time of reoperation. Indium scans were found to have a 77% sensitivity, 86% specificity, 54% and 95% positive and negative predictive values, and 84% accuracy for the prediction of infection. Of 6 equivocal scans, none were infected. The results of this study suggest limited indications for the use of the indium-111 scan in the evaluation of painful hip, knee, or resection arthroplasties. A negative indium scan may be helpful in suggesting the absence of infection in cases in which the diagnosis is not otherwise evident.
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Affiliation(s)
- D M Scher
- Department of Orthopaedic Surgery, NYU-Hospital for Joint Diseases, New York, New York, USA
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Affiliation(s)
- K Pak
- Department of Biochemistry and Microbiology, Rutgers University, Cook College, 76 Lipman Drive, New Brunswick, NJ 08901-8525, USA
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25
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Abstract
Cocultures of Desulfovibrio desulfuricans and Methanococcus maripaludis grew on sulfate-free lactate medium while vigorously methylating Hg2+. Individually, neither bacterium could grow or methylate mercury in this medium. Similar synergistic growth of sulfidogens and methanogens may create favorable conditions for Hg2+ methylation in low-sulfate anoxic freshwater sediments.
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Affiliation(s)
- K Pak
- Department of Biochemistry and Microbiology, Cook College, Rutgers University, New Brunswick, New Jersey 08903-0231, USA
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26
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Furukawa A, Murata K, Pak K, Yamasaki M, Kawaguchi N, Inoue H, Tomoyoshi T, Abe H, Sako H, Okino K, Kodama M, Nakane Y, Morita R. [Dynamic Gd-DTPA-enhanced MR imaging in evaluation of the function of transplanted kidneys]. Nihon Igaku Hoshasen Gakkai Zasshi 1996; 56:807-12. [PMID: 8940808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of the study was to evaluate the potential of dynamic Gd-DTPA-enhanced MR imaging in assessing of the function of transplanted kidneys. Dynamic MR imaging was performed using the GRASS pulse sequence in 21 subjects (56 examinations), and in each examination 30 images were obtained after a bolus injection of Gd-DTPA. Imaging findings including signal increase and/or signal drop in cortex, signal drop in medulla, and signal drop in calyces were utilized for the evaluation of renal function. Renal function was also evaluated using the following parameters: Ta, time between the initial observation of signal increase in cortex and signal drop in medulla. Tb, time between the initial observation of signal drop in medulla and in calyces; Tc, Ta + Tb, and Max. C/M, maximum ratio of signal intensity between cortex and medulla among 30 images. In the group of patients with normal graft function (Ccr > or = 60ml/min), all imaging findings were observed. In the group of patients with mild graft dysfunction (30ml/min < or = Ccr < 60ml/min), all imaging findings but signal drop in cortex were observed. The time parameters of Ta, Tb, and Tc were significantly larger, and Max. C/M was significantly smaller than those observed in the group with normal graft function. In the group of patients with severe graft dysfunction (Ccr < 30ml/min), almost none of the findings were observed. The investigation in patients in the postoperative state revealed a close correlation of the imaging findings and the values of parameters with changes in graft function over time. The results indicated the usefulness of the method in semiquantitative evaluation of graft function, including that of patients in postoperative state. This study suggests that dynamic Gd-DTPA-enhanced MR imaging could be a valuable method for the management of transplanted kidneys.
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Affiliation(s)
- A Furukawa
- Dept. of Radiology, Shiga University of Medical Science, and Omihachiman City Hospital
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Abstract
In an experimental evaluation with 14 paired cadaveric scapulae we found that the transacromial arthroscopy portal, used occasionally in the repair of superior labral lesions, will reduce the structural integrity of the acromion to approximately 60% (range 25% to 85%) of its original strength, thereby placing it at increased risk of fracture. These studies provide baseline biomechanical information and suggest that limited shoulder activity is indicated after use of this portal.
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Affiliation(s)
- M J Coen
- Department of Orthopaedic Surgery, School of Medicine, Loma Linda University, CA 92350, USA
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Abstract
BACKGROUND Malignant melanoma is one of the rarest tumors of the female urethra. The prognosis of urethral melanoma is poor. METHODS A 59-year-old woman underwent total urethrectomy, bilateral inguinal lymph node dissection, and vesicostomy for Stage A primary malignant melanoma of the urethra. She received adjuvant therapy consisting of dacarbazine, vincristine, cyclophosphamide, and alpha-interferon. Two years later, repair of the parastomal hernia and interposition of an isoperistaltically ileum intussusception between the bladder and the abdominal wall were done. RESULTS Complete continence was achieved, and the patient catheterizes herself every 3-5 hours during the day and once at night without difficulty. She has survived 5 years without any evidence of tumor recurrence. CONCLUSIONS There have been only six case reports of women with primary malignant melanoma of the urethra surviving more than 5 years, including this case. Total urethrectomy with bilateral inguinal lymph node dissection should be done as the initial form of the treatment in patients with this disease who have no evidence of distant metastasis. The postoperative adjuvant therapy, consisting of alpha-interferon and chemotherapy, should be administered immediately; therefore, vesicostomy was done because it is a simple procedure. However, this type of urinary diversion requires an external appliance. Clinicians should consider the patient's quality of life, prognosis, and general condition and attempt to solve the problems of patients 2-3 years after the operation.
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Affiliation(s)
- C J Kim
- Department of Urology, Shiga University of Medical Science, Otsu, Japan
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29
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Pak K, Kim CJ, Konishi T, Yoshiki T, Tomoyoshi T, Moro K, Tatewaki K, Iwai M, Miyahira Y, Okabe H. [Experimental study on intraoperative autotransfusion during urological operation]. Nihon Hinyokika Gakkai Zasshi 1991; 82:1972-7. [PMID: 1779501 DOI: 10.5980/jpnjurol1989.82.1972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The value of autotransfusion is widely recognized in the surgical community and may be of increasing importance in prevention of acquired immunodeficiency syndrome and hepatitis. The concern of possible contamination of the blood with urine, bacteria in urine or viable tumor cells has limited the wide use of intraoperative autotransfusion (IAT) in urological operation. There have been no experimental reports about protection of the blood from such contamination. To investigate separation of the blood from a contaminated mixture by using an autotransfusion machine, Haemonetic Cell Saver, a study composed of three experiments was performed. First, 200 ml of blood was mixed 200 ml of urine, and thereafter, the mixture was processed by the machine and the concentration erythrocytes were collected in a bag. Biochemical analysis of the collected erythrocyte solution (CES) was performed. Second, 200 ml of blood was mixed with 200 ml of urine that was adjusted to contain each 10(7)/ml of four bacterial strains. The bacteriological study of the CES was performed. Third, 200 ml of blood was mixed with 200 ml of urine that was adjusted to contain 10(7) cancer cells. Two cell lines, KK47 originated from human bladder cancer and ACHN originated from human renal cell carcinoma was used. The cytological study of the CES was performed. The results of these experiments were: Urine constituents were completely removed from the mixture. However, all strains of bacteria could not be separated, although the number of bacteria decreased. Cancer cells were found in the CES. In conclusion IAT should be done at urological operation in selected patients that have sterile urine and do not have tumor cells in the operation field.
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Affiliation(s)
- K Pak
- Department of Urology, Shiga University of Medical Science
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30
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Kim CJ, Pak K, Kounami T, Tomoyoshi T. Emphysematous cystitis: report of a case. Hinyokika Kiyo 1991; 37:1711-3. [PMID: 1785398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Emphysematous cystitis is characterized by gas collection within the bladder wall and lumen. A case of emphysematous cystitis in a 74-year-old diabetic male is reported. Radiogram demonstrated an enlarged bladder with intraluminal gas.
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Affiliation(s)
- C J Kim
- Department of Urology, Shiga University of Medical Science
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31
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Kim CJ, Pak K, Tomoyoshi T, Nakajima Y. [Multilocular cystic renal cell carcinoma: report of a case]. Hinyokika Kiyo 1991; 37:163-7. [PMID: 2048496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We report a case of multilocular cystic renal cell carcinoma seen in a 54-year-old man. At the annual health check he was found to have numerous cysts of various sizes in the lower pole of the left kidney. Plain CT scan disclosed a mass in the lower pole of the left kidney. On enhanced CT scan septa were visible, suggesting a multilocular cyst. Left renal arteriography disclosed a hypervascular mass in the lower pole of the left kidney. Radical nephrectomy was performed. The gross appearance of the cut surface showed a feature of multilocular cyst. The histopathological diagnosis was clear cell carcinoma. We describe the clinical features of multilocular cystic renal cell carcinoma and discuss the differential diagnosis.
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Affiliation(s)
- C J Kim
- Department of Urology, Shiga University of Medical Science
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32
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Pak K, Kim CJ, Inoue H, Wakabayashi Y, Watanabe J, Arai Y, Konishi T, Tomoyoshi T, Sako H, Okino K. [A study on the hemodialysis period following cadaveric kidney transplantation--a comparison between two centers sharing cadaver donor kidney pairs]. Nihon Hinyokika Gakkai Zasshi 1990; 81:1500-5. [PMID: 2273700 DOI: 10.5980/jpnjurol1989.81.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
To study the hemodialysis period following cadaveric renal transplantation, we reviewed 18 consecutive cadaver donor kidney pairs of which one kidney was transplanted at Shiga University of Medical Science (SUMS) while the contralateral kidney was transplanted at Kyoto Prefectural Medical University (KPMU) between January 1983 and September 1988. Of these 18 pairs, graft function was satisfactory and the recipient was free from hemodialysis in 13 pairs. However, the postoperative hemodialysis periods were different between the two centers. To clarify the factors causing this difference, recipient factors, such as age, HLA matching, total ischemic time of the graft (TIT), immunosuppression, onset of diuresis and postoperative complications were studied. There were no significant differences in age, HLA matching, or immunosuppression. TIT of cases at SUMS was significantly longer than that of cases at KPMU. The postoperative hemodialysis period at SUMS was 25.8 days and that at KPMU was 17.8 days, however, the difference was not statistically significant. The results of this study indicate that TIT seems to be a major factor relating to delayed graft function in cadaveric renal transplantation.
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Affiliation(s)
- K Pak
- Department of Urology, Shiga University of Medical Science
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Pak K, Kim CJ, Ishida A, Kushima M, Tomoyoshi T, Sako T, Okino K, Nakane Y, Kodama M, Shibata N. [Cyclosporin levels in semen of renal transplant patients]. Nihon Hinyokika Gakkai Zasshi 1990; 81:1494-9. [PMID: 2273699 DOI: 10.5980/jpnjurol1989.81.1494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cyclosporin (CsA) has powerful immunosuppressive properties, and its recent application to organ transplantation has resulted in markedly improved graft survival. However, CsA has certain adverse side effects, the most notable being nephrotoxicity and hepatotoxicity. Among other untoward effects, little is known about the effects of CsA on the reproductive organs. Since good graft survival is now expected with CsA, the long term effect of the drug on the gonads should be monitored carefully, particularly for young recipients. Prior to investigation of the effect of CsA on the testis, the level of CsA in semen of the adult renal transplant patients were measured. Twelve samples of semen from eight recipients, mean age 35 (SD 9), were collected by masturbation in the morning just before taking CsA after more than 5 day abstinence, and it was frozen at -80 degrees C. They had been taking immunosuppressants that were a combination of either CsA and prednisolone, or CsA, azathioprine and prednisolone for 5 to 63 months. The dose of CsA was 3.7 mg/kg to 5.0 mg/kg. The range of the level of serum creatinine was 1.1 mg/dl to 2.9 mg/dl. CsA in whole blood was measured by high performance liquid chromatography (HPLC), and CsA in semen was also measured by HPLC after extracting CsA with diethylether. The level of CsA in semen was 27 ng/ml to 165 ng/ml and that in whole blood was 51 ng/ml to 133 ng/ml. The relation between both levels was linear (r = 0.68, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- K Pak
- Department of Urology, Shiga University of Medical Science
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Kim CJ, Okada Y, Konishi T, Kounami T, Pak K, Tomoyoshi T, Kushima R. [Cavernous hemangioma of the penis: report of a case immunohistochemically studied]. Hinyokika Kiyo 1990; 36:1085-8. [PMID: 2239617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
An 18-month-old boy was admitted in April, 1988 because of a penile mass which had been first noted at the age of one month. From nine months after birth, transient bleeding from the mass accompanied by pain had been occasionally noted. At the age of 14 months, the mass seemed to grow markedly. On physical examination, there was an irregularly shaped mass on the right side of the prepuce. It was palpated subcutaneously, soft in consistency and was 10 mm in diameter. It had a light-purple color. Upon surgery, the mass was found not to have originated from the cavernous body of the penis, so that it could be excised without difficulty. Histopathological diagnosis was cavernous hemangioma. Electron microscopic examination revealed findings suggestive of newly formed blood vessels such as abnormal cuboidal shape of endothelial cells and a high nucleocytoplasmic ratio. Immunohistochemical examination of factor VIII-related antigen was in homogeneously positive in vascular endothelial cells. To our knowledge, this is the twenty-eighth case reported in Japan.
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Affiliation(s)
- C J Kim
- Department of Urology, Shiga University of Medical Science
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Abstract
Cystic diseases in the male pelvis are uncommon, and stones found in male pelvic cysts are very rare. We report a case of a giant stone found in the male pelvis. Computed tomography was helpful in locating the stone, and surgery revealed it to be a Müllerian duct cyst.
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Affiliation(s)
- C J Kim
- Department of Urology, Shiga University of Medical Science, Japan
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36
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Affiliation(s)
- K Pak
- Department of Urology, Shiga University Medical Science, Otsu, Japan
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37
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Kim CJ, Pak K, Wakabayashi Y, Ishida A, Arai Y, Konishi T, Kounami T, Tomoyoshi T, Sako H, Okino K. [Pneumocystis carinii pneumonia in renal transplant recipients treated with cyclosporin]. Hinyokika Kiyo 1989; 35:653-9. [PMID: 2544088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Four cases of pneumocystis carinii pneumonia occurred among 38 renal transplant recipients. Diagnosis was confirmed by cyst concentration technique in 2 cases. The other 2 cases were clinically, from the rapid improvement of fever, pulmonary infiltrates and hypoxia following a therapeutic trial of high dose sulfamethoxazole-trimethoprim. All patients responded to treatment with high dose sulfamethoxazole-trimethoprim. Three patients survived pneumocystis carinii pneumonia, but i died due to aspergillosis. One patients showed serological evidence of concomitant cytomegalovirus infection.
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Affiliation(s)
- C J Kim
- Group of Renal Transplantation, Shiga University of Medical Science
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Ishida A, Pak K, Omatsu S, Konishi T, Tomoyoshi T. [The foreign body granuloma after pyeloplasty: report of a case]. Hinyokika Kiyo 1989; 35:485-8. [PMID: 2660512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We report a rare case of foreign body granuloma on plain catgut which developed after Anderson-Hynes pyeloplasty for obstruction of the ureteropelvic junction in a 3-year-old boy. We use plain catgut as the suture material on pyeloplasty and seldom experience such a complication. Regarding suture material on pyeloplasty, excessive sutures intended to make anastomosis water-tight to prevent urinary leakage should be avoided in children because they are apt to form foreign body granuloma.
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Affiliation(s)
- A Ishida
- Department of Urology, Shiga University of Medical Science
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Konami T, Wakabayashi Y, Kim T, Ishida A, Arai Y, Konishi T, Pak K, Takeuchi H, Tomoyoshi T, Watanabe J. [Sequential combination chemotherapy consisting of vincristine, peplomycin, methotrexate, cis-diamminedichloroplatinum (II) and adriamycin in urothelial cancer]. Hinyokika Kiyo 1989; 35:231-7. [PMID: 2472048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The VPM-CisA (vincristine (VCR), peplomycin (PLM), methotrexate (MTX), cisplatin (CDDP) and doxorubicin (ADM), regimen was used to treat 33 patients with urothelial tract tumors. Twenty-two patients had bi-dimensionally measurable disease parameters and 11 patients with locally advanced tumors were given postoperative adjuvant chemotherapy. The protocol consisted of 0.6 mg/m2 VCR on days 1 and 3, 3 mg/m2 PLM on days 1 to 4, 3 mg/m2 MTX on days 2 and 4, 35 mg/m2 CDDP on day 4, and 20 mg/m2 ADM on day 5. These doses were adjusted for each case: the above mentioned dose x [(80/(40+Age]2 +[(Karnofsky's performance status/100)2]. Of these patients, 28 (86 percent) were treated adequately, including 8 (36 per cent) who achieved a complete (2) or partial (6) remission. The mean duration of survival was 65.2 weeks for complete and partial responders, and 48.8 weeks for non-responders, which was not a statistically significant difference. Of 11, who were given post-operative adjuvant chemotherapy (mean observation period: 83.5 weeks) 9 were alive without evidence of disease, 1 had a recurrence 8 months after first chemotherapy, 1 died due to pulmonary and liver metastasis 2 years after the chemotherapy. Toxicity included mild myelosupression, moderate anorexia, vomiting, and severe gastric ulcer, pulmonary fibrosis.
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Affiliation(s)
- T Konami
- Department of Urology, Shiga University of Medical Science
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40
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Pak K, Tomoyoshi T, Nomura Y, Okabe H. [Studies on nephrotoxicity of cyclosporin. II. Nephrotoxicity in rats receiving cyclosporin and sulfamethoxazole-trimethoprim]. Hinyokika Kiyo 1988; 34:1723-31. [PMID: 3266713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A cyclosporin (CS) has a serious nephrotoxic effect which is synergistic with sulfamethoxazole-trimethoprim (ST) on renal allograft recipients. The effects of CS and ST on renal function and structure, were examined biochemically and morphologically in rats. Male Wistar rats each weighing 250 g were given various dose regimens (CS 50 mg/kg + ST 600 mg/kg, CS 25 mg/kg + ST 600 mg/kg, CS 10 mg/kg + ST 600 mg/kg) orally for 21 days, and were killed and examined on the 22nd day. Blood urea nitrogen (BUN), serum and urinary creatinine, and urinary N-acetyl-s-D-glucosaminidase (NAG) were measured before administration and on the 7th, 14th and 21st day after administration. The serum levels of CS, sulfamethoxazole (SMX) and trimethoprim (TMP) were measured on the 21st day after administration. Kidneys were examined by light and electron microscopy. All rats that had received 50 mg/kg CS and 600 mg/kg ST died within 9 days after a severe loss in body weight. Rats that had received 25 mg/kg CS and 600 mg/kg ST had lost weight. A high dose CS and ST caused a significant elevation of BUN. The level of serum creatinine was significantly elevated only in rats that had received 25 mg/kg CS and 600 mg/kg ST. Decrease in creatinine clearance was not significant and the urinary NAG activity was not altered significantly during the experimental course. Morphological alterations were confined to the proximal tubuli and they consisted of PAS positive globules, loss of nuclei, tubular cell vacuolation and increased number of lysosomes. However, these alterations were mild and not related to the dose of CS and ST.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- K Pak
- Department of Urology, Shiga University of Medical Science
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Abstract
We report a case of noncrossed renal ectopia with fusion associated with a single ectopic ureterocele. This association is rare, and it is extremely rare that an ectopic ureterocele is not a part of the duplicated urinary collecting system. Some problems about classification of renal fusion and ectopia are presented, and a new classification is introduced.
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Affiliation(s)
- K Pak
- Department of Urology, Shiga University of Medical Science, Otsu, Japan
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Ishida A, Watanabe J, Takeuchi H, Konami T, Pak K, Tomoyoshi T. Metastasis to the spermatic cord as the first sign of bladder carcinoma. Hinyokika Kiyo 1988; 34:1269-71. [PMID: 3177146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- A Ishida
- Department of Urology, Uji-Tokushukai Hospital
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43
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Pak K, Shirasu A, Okino K, Sako H, Nakane Y, Umemura K, Maeda S, Tomoyoshi T. [Effectiveness of FUT-175, protease inhibitor, as an anticoagulant to hemodialysis]. Hinyokika Kiyo 1988; 34:1077-81. [PMID: 3223453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
(6-Amidino-2-naphthyl 4-guanidino benzoate) dimethanesulfonate (FUT-175), a protease inhibitor, has been reported to be an effective anticoagulant during hemodialysis without heparin. The anticoagulant activity of FUT-175 is also reported to be short. We applied FUT-175 to 33 patients who were undergoing hemodialysis and susceptible to bleeding, to avoid the use of heparin. The concentration and anticoagulant activity of FUT-175 were relatively stable during hemodialysis. A 20-40 mg/h dose of FUT-175 prolonged coagulation time sufficiently in the instrumental blood of the extracorporeal circuit but not in the systemic blood. Its anticoagulant activity decreased immediately after hemodialysis. Therefore, we could manage all patients without any bleeding trouble during hemodialysis with FUT-175 as an anticoagulant. Although there were side effects of FUT-175, such as nausea, vomiting, itching and eruption, they were not serious, and FUT-175 could be administered without interruption. FUT-175 seems to be useful as an anticoagulant during hemodialysis for patients susceptible to bleeding.
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Affiliation(s)
- K Pak
- Division of Hemodialysis, Shiga University of Medical Science
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Abstract
We describe a case of Russell-Silver syndrome associated with horseshoe kidney in a three-year-eleven-month-old boy. Several urologic anomalies are reported in this syndrome, but to our knowledge, horseshoe kidney has not been reported previously in the English literature.
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Affiliation(s)
- Y Arai
- Department of Urology, Shiga University of Medical Science, Otsu, Japan
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Ishida A, Omatsu S, Pak K, Tomoyoshi T, Yamamoto A, Fujimura M. [Hydronephrosis presenting as the first sign of malignant lymphoma of the small intestine: report of a case]. Hinyokika Kiyo 1988; 34:673-8. [PMID: 3041777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A 45-year-old man was admitted to hospital on November 26, 1985 with the chief complaint of left hypochondrial pain. Excretory and retrograde pyelography revealed left hydronephrosis due to extrinsic obstruction of ureter. Computerized tomography and angiography revealed that a tumor of the small intestine was the cause of ureteral obstruction. In addition to the presence of a tumor, a fistula in the small intestine was disclosed on the upper gastrointestinal series. During the operation, a large mass which involved several organs was identified without mobility. The sophisticated operation was composed of wide resection of small intestine including the tumor, left hemicolectomy, left nephroureterectomy, splenectomy, partial pancreatectomy, duodeno-ileostomy and transverse sigmoidostomy was done on December 19, 1985. Pathological diagnosis was malignant lymphoma, diffuse small cell type infiltrating ureter, kidney and perirenal connective tissue. Because of poor postoperative course systemic chemotherapy was not performed and he died of disseminated intravascular coagulation on April 2, 1986.
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Affiliation(s)
- A Ishida
- Department of Urology, Shiga University of Medical Science
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Pak K, Tomoyoshi T, Tanaka H, Nakajima Y. [Ureteral obstruction secondary to iliac artery aneurysm]. Hinyokika Kiyo 1988; 34:496-501. [PMID: 3389294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A 65-year-old woman was seen in September, 1986, because of general malaise and dull pain in the left flank. Physical examination was unremarkable. Murmur was not heard over the abdomen. An excretory urogram showed left hydronephrosis and a retrograde pyelogram showed extrinsic obstruction at the level of the transverse process of the 5th lumbar spine. Computed tomography (CT) showed a mass with irregular calcification in its center. The mass was assumed to be located in the left iliac artery and as it was enhanced homogeneously, iliac aneurysm was suspected. Angiography revealed an aneurysm of the left iliac artery involving common, external and internal iliac arteries. The patient was treated by ligation of aneurysm, aorto-femoral graft bypass and ureterolysis. Histopathological findings showed aneurysm due to atherosclerosis. A postoperative excretory urogram showed improvement of hydronephrosis. Ureteral obstruction due to iliac aneurysm is unusual but it should be considered when performing differential diagnosis of extrinsic ureteral obstruction. CT is a useful diagnostic tool and aortography should be done to make a final diagnosis. Treatment is based on resection or ligation of aneurysm with ureterolysis.
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Affiliation(s)
- K Pak
- Department of Urology, Shiga University of Medical Science
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Abstract
An unusual case of xanthogranuloma of the spermatic cord is described. This benign condition should be included in the differential diagnosis of intrascrotal tumors and simple surgical excision is recommended although we performed high inguinal orchiectomy.
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Affiliation(s)
- K Pak
- Department of Urology and Pathology, Shiga University of Medical Science, Otsu, Japan
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Taniguchi T, Tsuchiya M, Matsuo M, Daijo K, Hosokawa S, Pak K, Hanasaki K, Sasaki M, Yamazaki A, Nishimura K. [Clinical statistics at the Department of Urology, Kitano Hospital (1968-1986)]. Hinyokika Kiyo 1987; 33:2068-83. [PMID: 3448934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A clinical statistic survey was carried out on the patients, diseases and operations experienced at our department between 1968 and 1986. In 1968, the urological department became independent from the dermato-urological department, and in 1981 the urological ward was established. The 19 years are divided in three periods; first period: 1968-1974 (7 years), second period: 1975-1981 (7 years), and third period: 1982-1986 (5 years). The total number of new outpatients during the 19 years was 50,443. They have gradually but steadily increased and have reached recently about 4,000 per year. The total number of inpatients was 3,422 (male: 2,561, female: 861). The proportion of the elderly patients, especially male, has remarkably increased and that of patients more than 60 years old was 44.9% of all inpatients in the third period. Among the major diseases of the inpatients, tumors has got most remarkable increase of its number and proportion. And among tumors, increases of benign prostatic hyperplasia, bladder cancer, prostatic cancer were prominent and at the third period the proportion of those three has reached 81.3% of all tumors. Percutaneous nephrolithotripsy (PNL) and transurethral ureterolithotripsy (TUUL) were introduced in 1985. Recently endoscopical operations such as transurethral resection (TUR), PNL, TUUL and so forth have become a large part of the urological operations.
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Konishi T, Pak K, Takayama H, Tomoyoshi T, Okino K, Nakane Y. [A case of left inferior vena cava discovered by chance at nephrectomy for renal transplantation]. Hinyokika Kiyo 1987; 33:2111-4. [PMID: 3329457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A case of left inferior vena cava, in a 35-year-old woman, discovered by chance at nephrectomy for renal transplantation is reported. She was admitted to our hospital as a donor of the kidney to her son. She had no remarkable physical signs on chest or abdomen. All laboratory tests were within normal limits. Intravenous pyelogram showed no major abnormality except for the lower position of left kidney than right one. Abdominal aortogram and selective renal arteriogram revealed no abnormality. Bilateral renal arteries were single. Left nephrectomy for transplantation was performed on April 13, 1983. In this operation the left sided inferior vena cava was discovered by chance. Inferior vena cavography was taken postoperatively. It showed the left sided inferior vena cava, type C. Knowledge of the abnormalities of the left renal vein and inferior vena cava is of surgical importance for the urologist when renal transplantation is being considered.
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Affiliation(s)
- T Konishi
- Department of Urology, Shiga University of Medical Science
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