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Biomedical subjects

A Kobayashi

Publications and source records attributed to A Kobayashi.

At least 307 records · Page 17Linked to original sources
PubMed1995

Intra-arterial infusion of papaverine combined with intravenous administration of high-dose nicardipine for cerebral vasospasm.

The clinical effect of combination therapy with high doses of intravenous nicardipine and intra-arterial infusion of papaverine on symptomatic vasospasm after subarachnoid haemorrhage (SAH) was analysed retrospectively. In 66 of 122 patients who underwent early aneurysm surgery between 1990 and 1993, the intracranial haemodynamics were documented by transcranial Doppler (TCD) ultrasonography. 33 of these 66 patients received high dose nicardipine intravenously (Group I); the other 33 patients were not treated with calcium antagonists (Group II). Symptomatic vasospasm occurred in 6 Group I patients (18%) and in 13 (39%) in Group II patients. All 19 symptomatic patients received an intra-arterial infusion of papaverine; 15 patients (79%) responded well to this therapy and the symptoms were reversed quickly. Although the mean flow velocity (MFV) was not different between the two groups, it was reduced significantly after papverine infusion. Our retrospective analysis suggests that symptomatic vasospasm can be treated effectively with the combination of intravenous high dose nicardipine and intra-arterial infusion of papaverine, and that the correct timing of the infusions is crucial.

Adult↗
PubMed1995

Autonomic hyperreflexia during labour.

We present two cases of automatic hyperreflexia (AH) during labour in women with spinal cord damage, in whom AH developed before and after delivery. The AH was successfully controlled using epidural anaesthesia in Case #1, but failed in Case #2. The blood pressure was controlled with nicardipine. However, overdose of nicardipine produces vasodilation and its side effects include headache, flushing and palpitation similar to AH. Considering these effects, we recommend epidural anaesthesia to control AH, because epidural anaesthesia does not only reduce BP, but also blocks the noxious stimuli and relieves the symptoms of AH. Our experience suggests that the epidural catheter can be placed two to three weeks before the date of predicted childbirth, because the onset of labour in a patient with spinal cord damage is difficult to predict and can proceed very rapidly. Also, the epidural catheter is available after the delivery. We recommended the epidural catheter is maintained for 24-48 hr postpartum.

Adult↗
PubMed1995

Analysis of functional domains of a GC box-binding protein, BTEB.

BTEB is a small GC box-binding protein containing three contiguous zinc finger structures in the C-terminal region of the molecule, and activates or represses the transcription of genes with the GC box sequence in the promoter, depending on the repetitiveness of the GC box sequence [Imataka et al. (1992) EMBO J. 11, 3663-3671]. We have analyzed functional domains of BTEB in a transient expression system using Y-1 cells (a mouse adrenal cortex cell line). BTEB contained two regions responsible for the transcriptional activation. These regions showed a sequence similarity to each other and appeared to enhance the transcription independently. The two sequences were rich in hydrophobic amino acids and showed no similarity to the sequences of transactivation domains so far elucidated. The DNA-binding properties of BTEB were also analyzed by means of the gel mobility shift assay. Three contiguous zinc finger motifs were needed for the binding activity. Furthermore, it was revealed that a short basic region immediately N-terminal to the zinc finger motifs was required for the DNA binding.

Amino Acid Sequence↗
PubMed1995

Magnesium status, serum HDL cholesterol, and apolipoprotein A-1 levels.

To determine the relationship between low magnesium status and lipids, we divided 27 patients with microscopic hematuria and normal renal function into two groups according to magnesium retention, as measured by a magnesium-loading test, and compared their serum lipid and apolipoproteins. Patients with low magnesium status (n = 7) had significantly lower levels of cholesterol, HDL cholesterol, and apolipoprotein A-1 than those with normal magnesium status (n = 20); however, there were no significant differences between the groups in serum concentrations of magnesium and apolipoprotein B. These data suggest that magnesium deficiencies are associated with low serum concentration of HDL cholesterol and apolipoprotein A-1.

Adolescent↗
PubMed1995

Plasma endothelin-1 levels of children with cirrhosis.

We measured plasma concentration of endothelin-1 in three children with Byler's disease, five with biliary atresia after portoenterostomy, and nine controls. No patients had ascites or hepatorenal syndrome. Plasma endothelin-1 levels were significantly higher in patients with Byler's disease than in the controls (5.19 +/- 0.90 versus 1.81 +/- 0.19 pg/ml, respectively; p < 0.01), but were normal in operated biliary atresia. Urinary concentrations of N-acetyl-beta-D-glucosaminidase (NAG) were significantly higher in the patients with Byler's disease than in controls. Plasma endothelin-1 level correlated significantly with serum concentration of bile acid (r = 0.91; p < 0.01) and urinary concentration of NAG (r = 0.92; p < 0.01). We conclude that plasma endothelin-1 levels are high in patients with severe biliary cirrhosis and that endothelin-1 may partially contribute to development of renal injury in cirrhosis.

Acetylglucosaminidase↗
PubMed1995

Quantitative analysis of stromal fat content of human parathyroid glands associated with thyroid diseases using computer image analysis.

The stromal fat content in the parathyroid glands and its significance are still controversial. Several methods have also been introduced to evaluate the content in the literature. In an attempt to better understand the significance of stromal fat content, a computer image analyzing system was applied and 62 glands were investigated using routinely processed tissue. Our study revealed that the average stromal fat content was 34.8 +/- 18.7% which was lower than that of other studies. The stromal fat content was correlated with the age, grade of obesity, area of the gland and serum parathormone level; however, no consistent patterns were obtained with other clinical parameters. These results indicate that the change of stromal fat content may be related to the general condition of the patient similar to the change of fat in other organs. However, the decrease of the content may indicate the early change of parathormone secretory activity even if the serum examination shows no evidence of hyperfunction of the glands.

Adipose Tissue↗
PubMed1995

Creatine kinase kinetics in diabetic cardiomyopathy.

One feature of the diabetic cardiomyopathy is the appearance of contractile dysfunction as the workload increases. We hypothesized that this resulted from an impaired creatine kinase/phosphocreatine system and therefore examined the creatine kinase kinetics at both low and high workloads. Creatine kinase flux (by 31P nuclear magnetic resonance saturation transfer method), cardiac performance, and oxygen consumption were measured in control and streptozotocin-induced diabetic rat hearts. Creatine kinase flux was inhibited by iodoacetamide in control hearts to confirm the role of the creatine kinase/phosphocreatine system in cardiac performance. In diabetic hearts, 1) the contractile dysfunction became apparent only at high workloads, 2) the ATP synthesis rate was not significantly different from control hearts, 3) the creatine kinase flux was reduced by 30.8% (257.5 +/- 7.7 mumol.g wet wt-1.min-1 in control vs. 178.3 +/- 9.4 in diabetes, P < 0.001), and 4) the creatine kinase flux did not increase as the workload increased. In control hearts, 5) iodoacetamide inhibited the creatine kinase flux to the same degree as that in diabetic hearts, and 6) the contractile dysfunction was not as severe as that observed in diabetic hearts. These results suggest that the impaired creatine kinase/phosphocreatine system is, at least in part, responsible for the contractile dysfunction in the diabetic cardiomyopathy.

Adenosine Triphosphate↗
PubMed1995

Na+/H+ and Na+/Ca2+ exchange in regulation of [Na+]i and [Ca2+]i during metabolic inhibition.

The relationships among intracellular Na+ and Ca2+ concentrations ([Na+]i and [Ca2+]i, respectively) and cell morphology were investigated during metabolic inhibition (MI) in isolated guinea pig myocytes. [Na+]i and [Ca2+]i were measured using the fluorescent indicators, Na(+)-binding benzofuran isophthalate and fluo 3. During the initial 20 min of MI, [Na+]i increased from 6.2 +/- 0.5 to 18.6 +/- 1.6 mM (n = 31), whereas [Ca2+]i, expressed as the percent change of fluo 3 fluorescence, remained at the low level. In the following 30 min, 94% of the cells developed contracture, and [Ca2+]i began to increase after cells had contracted (167 +/- 14% at 50 min). The level of [Ca2+]i during MI was lower than that during 500 microM strophanthidin perfusion. The increase in [Na+]i was not affected by 10 microM tetrodotoxin but was suppressed by 1 microM hexamethylene amiloride (HMA). The application of 10 mM glucose from the start of MI prevented both the increase in [Na+]i and cell contracture. However, the addition of glucose after 20 min of MI [energy repletion (ER)] led to a dramatic increase in [Ca2+]i (442 +/- 72% at 50 min, n = 31), and 84% of the cells developed contracture. The increase in [Ca2+]i and the cell contracture were suppressed by HMA or Ca(2+)-free solution. Intracellular pH decreased from 7.23 +/- 0.07 to 6.95 +/- 0.09 during MI but did not change after ER (6.90 +/- 0.11 at 35 min, n = 9). These findings suggested that during MI 1) [Na+]i increased by both the activated Na+ influx via Na+/H+ exchange and the suppressed Na+ extrusion via the Na+/K+ pump, 2) Na+/Ca2+ exchange was inhibited by energy depletion and intracellular acidosis, and 3) cell contracture was not related to Ca2+ overload but was related to rigor due to energy depletion.

Amiloride↗
PubMed1995

Analysis of mutations in the human HPRT gene induced by accelerated heavy-ion irradiation.

Multiplex PCR analysis of HPRT(-) mutations in human embryo (HE) cells induced by 230 keV/microns carbon-ion irradiation showed no large deletion around the exon regions of the locus gene in contrast to the irradiations at different LETs. To identify these mutations, the sequence alterations in a cDNA of hprt gene were determined for 18 mutant clones in this study. Missing of exon 6 was the most frequent mutational event (10 clones), and missing of both exons 6 and 8 was next most frequent event (6 clones), then base substitutions (2 clones). These characteristics were not seen in a similar analysis of spontaneous mutations, which showed base substitution (5 clones), frameshift (2 clones), missing of both exons 2 and 3 (2 clones), and a single unidentified clone. Direct sequencing and restriction enzyme digestion of the genomic DNA of the mutants which showed missing of exons 6 and 8 in the cDNA, supports the possibility that they were induced by aberrant mRNA splicing.

Base Sequence↗
PubMed1995

A case of glycogen storage disease type III (glycogen debranching enzyme deficiency) with liver cirrhosis and hypertrophic cardiomyopathy.

We present a 26-year-old woman with glycogen storage disease type III (debranching enzyme deficiency) complicated with liver cirrhosis and hypertrophic cardiomyopathy. Glycogen debranching enzyme has two catalytic sites, oligo-1,4,-1,4- glucantransferase (EC 2.4.1.25) and amylo-1,6-glucosidase (EC 3.2.1.33). Variability in the clinical phenotype could be a function of the involvement of one or other catalytic site, or differences in tissue expression of the defective enzyme, or both. We hypothesize that some subtypes of glycogen storage disease (GSD) type III may cause liver cirrhosis as seen in GSD type IV due to the accumulation of glycogen of abnormal structure.

Adult↗
PubMed1995

[Effect of the ketogenic diet for West syndrome into which early infantile epileptic encephalopathy with suppression-burst was evolved].

A male infant with early infantile epileptic encephalopathy (EIEE) was reported. Tonic spasms in series appeared since 1 month after birth and EEG showed a typical suppression-burst pattern. The patient was treated with a high-dose pyridoxal phosphate and thyrotropin-releasing hormone (TRH), but seizures were not controlled. ACTH was administered and the seizures disappeared transiently. The seizures reappeared during tapering ACTH and apparent cerebral shrinkage followed the ACTH therapy. Then, the patient who evolved into West syndrome was treated with ketogenic diet. The seizures disappeared immediately and EEG findings were improved. It is suggested that the ketogenic diet should be tried early for the treatment of EIEE.

Electroencephalography↗
PubMed1995

Acute aortic dissection, aortic insufficiency, and a single coronary artery in a patient with Turner's syndrome.

A rare case of acute aortic dissection and aortic regurgitation in a patient with Turner's syndrome is reported. A 25-year-old woman with a history of Turner's syndrome presented to our hospital with complaints of chest pain and dyspnea. Emergent surgery was performed after chest roentgenography and two-dimensional echocardiography. Intraoperatively, the patient was found to have a single coronary artery and a bicuspid aortic valve. The patient was treated successfully with a composite graft consisting of a 24 mm woven dacron graft, a 21 mm St. Jude Medical aortic prosthetic valve, and an equine pericardial skirt. The composite graft was inverted into the ascending aorta and connected to a small coronary artery graft. The patient's postoperative course was uneventful. A cardiac catheterization was performed postoperatively and revealed a competent anastomotic site and no evidence of aortic regurgitation. We provide a brief review of coronary anomalies and aortic diseases associated with patients with Turner's syndrome. The most commonly associated complications include coarctation of the aorta and bicuspid aortic valve disease. The incidence of coronary anomalies in patients with Turner's syndrome is maybe rare.

Acute Disease↗
PubMed1995

[A case report of corrected TGA with ventricular septal defect, tricuspid valve regurgitation and atrioventricular block].

A 61-year-old woman was admitted for heart failure. She was diagnosed as corrected TGA with tricuspid regurgitation, perimembronous ventricular septal defect and atrioventricular block by echocardiography and cardiac catheterization. We chose tricuspid valve replacement with preservation of valve leaflet and subvalvular apparatus, direct closure of ventricular septal defect and implantation of permanent pacemaker (myocardial lead). Although IABP was needed for 24 hours, after that postoperative course was uneventful. It is preferable that tricuspid valve replacement with preservation of valve leaflet and subvalvular apparatus is applied to similar adult cases from standpoint of morphological structure.

Cardiac Pacing, Artificial↗
PubMed1995

[Experimental study on embolic materials for simultaneous segmental embolization through transarterial route].

To determine suitable embolic materials for simultaneous arterioportal embolization through the arterial route, transcatheter arterial embolization (TAE) using iodized oil (Lipiodol) mixed with monomeric n-butyl-2-cyanoacrylate, with absolute ethanol, or mixed with Gelfoam powder was carried out in 14 dogs. Following TAE, the distribution of Lipiodol in hepatic artery, peribiliary plexus, and portal vein was analyzed by soft tissue x-ray radiography and en bloc silver impregnation. As a result, Lipiodol mixed with absolute ethanol, and Gelfoam powder was considered to be the most reasonable embolic materials for this purpose.

Animals↗
PubMed1995

Rapid formation of multicellular spheroids composed of Propionibacterium acnes pretreated adult rat liver cells by rotary culture and their immunological properties.

An experimental acute liver injury model can be produced by the injection of bacterial lipopolysaccharide (LPS) into Propionibacterium acnes (P. acnes) pretreated rats. The massive liver cell necrosis is estimated by elevation of serum transaminase activities. In this study, we produced this necrosis in an in vitro model by using primary co-cultured rat liver cells. A novel method for the preparation of spheroids consisting of P. acnes pretreated parenchymal and nonparenchymal liver cells has been successfully developed quickly by the rotary culture system within 24 hr although it takes 7 days to form the spheroid using a collagen-conjugated thermo-responsive polymer such as a cell substratum. Clear elevations of transaminase activities, TNF-alpha and CINC-1/gro/KC leaked from these spheroids into the medium caused by the exposure of 10 microgram/ml LPS for 48 hr were observed. These results suggest that this rotary co-culture system of rat liver cells is a useful model as an alternative to animal tests for fulminant hepatitis.

Animals↗