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Biomedical subjects

Akira Tanaka

Publications and source records attributed to Akira Tanaka.

At least 55 records · Page 3Linked to original sources
PubMed2005

Hemodynamic stability under general anesthesia in carotid artery stenting.

PURPOSE: The purpose of our study was to investigate the frequency of hemodynamic instability in patients undergoing carotid artery stenting (CAS) under general anesthesia using sevoflurane and nitrous oxide in oxygen. METHODS: A total of 97 consecutive CAS procedures were performed in 84 patients under sevoflurane anesthesia. The following hemodynamic variables were assessed: degree of systolic blood pressure change (deltaSBP) during CAS, hypotension, and bradycardia during and after CAS. RESULTS: During CAS, hypotension occurred in 43% of the patients, and bradycardia occurred in 14%. There was individual variation in the deltaSBP during CAS. Systolic blood pressure (SBP) change >50 mmHg was not seen in this series. After CAS, hypotension occurred in 24%, and bradycardia occurred in 10%. Cerebral infarction occurred in three cases. The stroke rate was 3.1% in this series. CONCLUSION: General anesthesia using sevoflurane and nitrous oxide in oxygen depressed barorecepter reflex sensitivity, induced hemodynamic stability under CAS, and may decrease the rate of occurrence of complications.

Aged↗
PubMed2004

Pitavastatin inhibits remnant lipoprotein-induced macrophage foam cell formation through ApoB48 receptor-dependent mechanism.

OBJECTIVE: Atherogenic remnant lipoproteins (RLPs) are known to induce foam cell formation in macrophages in vitro and in vivo. We examined the involvement of apoB48 receptor (apoB48R), a novel receptor for RLPs, in that process in vitro and its potential regulation by pitavastatin. METHODS AND RESULTS: THP-1 macrophages were incubated in the presence of RLPs (20 mg cholesterol/dL, 24 hours) isolated from hypertriglyceridemic subjects. RLPs significantly increased intracellular cholesterol ester (CE) and triglyceride (TG) contents (4.8-fold and 5.8-fold, respectively) in the macrophages. Transfection of THP-1 macrophages with short interfering RNA (siRNA) against apoB48R significantly inhibited RLP-induced TG accumulation by 44%. When THP-1 macrophages were pretreated with pitavastatin (5 micromol/L, 24 hours), the expression of apoB48R was significantly decreased and RLP-induced TG accumulation was reduced by 56%. ApoB48R siRNA also inhibited TG accumulation in THP-1 macrophage induced by beta-very-low-density lipoprotein derived from apoE-/- mice by 58%, supporting the notion that apoB48R recognizes and takes-up RLPs in an apoE-independent manner. CONCLUSIONS: RLPs induce macrophage foam cell formation via apoB48R. Pitavastatin inhibits RLP-induced macrophage foam cell formation. The underlying mechanism involves, at least in part, inhibition of apoB48R-dependent mechanism. Our findings indicate a potential role of apoB48R in atherosclerosis. RLPs induced macrophage foam cell formation via apoB48R. Pitavastatin inhibited RLP-induced macrophage foam cell formation, at least in part, via inhibition of apoB48R expression. Our findings indicate a potential role of apoB48R in atherosclerosis.

Animals↗
PubMed2004

Comparison of heart rate variability and stroke volume variability.

In order to compare the heart rate variability (HRV) and stroke volume variability (SVV), supine electrocardiographic (ECG) and the time series data of left ventricular (LV) volume recordings were taken in 12 healthy adult male volunteers. The low frequency (LF) and high frequency (HF) peaks of HRV and SVV were evaluated quantitatively by power spectral analysis. The fractal dimension (FD) of the time series data was analyzed by the box-counting method. A LF peak around 0.1 Hz and a HF peak around 0.3 Hz were as clearly observed in the SVV spectrum as in the HRV spectrum. The LF/HF ratio in SVV was significantly lower than that in HRV, while the FD was significantly higher in SVV than in HRV. No significant correlation of HF, LF or FD was observed between HRV and SVV. Our results indicate that SVV provides different information about the activity of the autonomic nervous system than HRV.

Adult↗
PubMed2004

Momentary changes in the cardiovascular autonomic system during mental loading in patients with panic disorder: a new physiological index "rho(max)".

BACKGROUND: Although panic disorder (PD) is suggestive of autonomic nervous system dysfunction, especially in the cardiovascular autonomic system (CAS), the results in many previous studies are still controversial. Using a new physiological index which could well reflect emotional reaction to visual stimuli (Yoshizawa, M., Sugita, N., Tanaka, A., Abe, K., Yambe, T., Nitta, S., 2001. Quantiatative Physioligical Evaluation of Three Dimensional Images. The Seventh International Conference on Virtual Systems and Multumedia, 25-27.), we studied momentary changes in the CAS in patients with PD during audiovisual stimulation (AS) as mental loading. METHODS: During AS, exposed to a video of imaginary experiences such as driving a motor vehicle or diving into the sea, blood pressure (BP) and heart rate (HR) were measured in 12 remitted patients with PD and 19 age- and sex-matched normal controls (NC). We used the maximum cross-correlation coefficient (rho(max)) from the BP to the HR, whose frequency components were limited to around 0.1 Hz. RESULTS: The rho(max) was an available index which could detect the momentary changes in the CAS during AS in both groups. The two-way ANOVA disclosed significant group and time effects on the rho(max). The momentary response to emotional stimuli in the PD patients was slower than that in the NC subjects. LIMITATIONS: Antidepressants have a potential impact on the autonomic variables in this study. CONCLUSIONS: These findings suggest that there may be a dysfunction of the CAS in remitted PD patients and that the dysfunction may be one of the trait markers of PD. To confirm these findings, however, further studies with a large sample size are required.

Acoustic Stimulation↗
PubMed2004

Systematic synthesis of four epicatechin series procyanidin trimers and their inhibitory activity on the Maillard reaction and antioxidant activity.

A systematic synthesis of four natural epicatechin series procyanidin trimers [[4,8:4",8"]-2,3-cis-3,4-trans: 2",3"-cis-3",4"-trans: 2,3-trans-(-)-epi-catechin-(-)-epicatechin-(+)-catechin, [4,8:4",8"]-2,3-cis-3,4-trans: 2",3"-cis-3",4"-trans: 2,3-cis-tri-(-)-epicatechin: procyanidin C1, [4,8:4",8"]-2,3-cis-3,4-trans: 2",3"-trans-3",4"-trans: 2,3-trans-(-)-epicatechin-(+)-catechin-(+)-catechin: procyanidin C4, and [4,8:4",8"]-2,3-cis-3,4-trans: 2",3"-trans-3",4"-trans: 2,3-cis-(-)-epicatechin-(+)-catechin-(-)-epicatechin] is described. Condensation of (2R,3R,4S)-5,7,3'4'-tetra-O-benzyl-4-(2"-ethoxyethyloxy)flavan derived from (-)-epicatechin as an electrophile with the dimeric nucleophiles in the presence of TMSOTf followed by deprotection yielded trimers. Inhibitory activities on the Maillard reaction and antioxidant activity on lipid peroxide of the synthesized oligomers were also investigated.

Antioxidants↗
PubMed2004

Organic layered crystals with adjustable interlayer distances of 1-naphthylmethylammonium n-alkanoates and isomerism of hydrogen-bond networks by steric dimension.

A series of 1-naphthylmethylammonium n-alkanoates from acetate to triacontanoate produce isomorphic layered structures in the crystalline state. The interlayer distances, d-spacings, are proportional to the lengths of the alkyl chains. This is attributed to synergic intermolecular interactions; pi-pi and CH-pi interactions of the naphthalene rings between the cations, hydrophobic interactions of the alkyl chains, and two-dimensional hydrogen-bond networks between the primary ammonium cations and the carboxylate anions. Salts made from carboxylic acids wider than 5.5 A in the cross sections produce another columnar structure with a one-dimensional ladder-type hydrogen-bond network. Steric parameters of the acid components provide an explanation for the isomerism of the hydrogen-bond network.

Journal Article↗
PubMed2004

Stratification of the biologic aggressiveness of non-small cell lung cancer using DNA flow cytometry and immunohistochemistry for the retinoblastoma protein.

DNA ploidy pattern and S-phase fraction (SPF) measured by flow cytometry and expression of the retinoblastoma gene product (pRB) estimated by immunohistochemistry were correlated with outcome in 114 patients who received a curative operation for primary non-small cell lung cancer (NSCLC). One hundred ten tumors yielded an adequate DNA histogram, and all tumors exhibited an assessable immunohistochemical stain. DNA diploidy was detected in 31 tumors and DNA aneuploidy in 79 tumors. The mean SPF was 14.1 +/- 6.4%. Eighty tumors were positively stained, and 34 tumors were negative for pRB. Multivariate analysis clarified that both TNM staging and DNA ploidy were prognostic factors after surgery. In 39 recurrent cases, the SPF value was inversely correlated with disease-free interval. With only supportive care after recurrence, high SPF tumors and pRB-negative tumors progressed rapidly, whereas active treatment yielded an equivalent effect on recurrent tumors regardless of the SPF or pRB expression. DNA ploidy is related to the risk of recurrence, while SPF is related to tumor growth rate and the impact of active treatment on recurrence. The utility of pRB expression was limited. The combination of DNA ploidy and SPF allows practical stratification of the biologic aggressiveness of NSCLC.

Adult↗
PubMed2004

Tissue velocity imaging of coronary artery by rotating-type intravascular ultrasound.

Intravascular ultrasound (IVUS) provides not only the dimensions of coronary artery but the information of tissue components. In catheterization laboratory, soft and hard plaques are classified by visual inspection of echo intensity. So-called soft plaque contains lipid core or thrombus and it is believed to be more vulnerable than a hard plaque. However, it is not simple to analyze the echo signals quantitatively. When we look at a reflection signal, the intensity is affected by the distance of the object, the medium between transducer and objects and the fluctuation caused by rotation of IVUS probe. The time of flight is also affected by the sound speed of the medium and Doppler shift caused by tissue motion but usually those can be neglected. Thus, the analysis of RF signal in time domain can be more quantitative than intensity of RF signal. In the present study, a novel imaging technique called "intravascular tissue velocity imaging" was developed for searching a vulnerable plaque. Radio-frequency (RF) signal from a clinically used IVUS apparatus was digitized at 500 MSa/s and stored in a workstation. First, non-uniform rotation was corrected by maximizing the correlation coefficient of circumferential RF signal distribution in two consecutive frames. Then, the correlation and displacement were calculated by analyzing the radial difference of RF signal. Tissue velocity was determined by the displacement and the frame rate. The correlation image of normal and atherosclerotic coronary arteries clearly showed the internal and external borders of arterial wall. Soft plaque with low echo area in the intima showed high velocity while the calcified lesion showed the very low tissue velocity. This technique provides important information on tissue character of coronary artery.

Coronary Artery Disease↗
PubMed2004

Addition of rhythm to non-pulsatile circulation.

The development of a rotary blood pump (RP) is desirable as it can be used as a small ventricular assistance device (VAD). However, a RP does not generate any pulse. It may be physiologically better for the patient if the RP could generate a pulse. We have attempted to develop a device that produces a pulse in the RP. Intra-aortic balloon pumping (IABP) is effective in producing a pulse. However, the IABP cannot be implanted inside the body. Therefore, an attempt was made to develop pulse-generating equipment that was not driven by air pressure. The ball screw motor was considered as a possible candidate. In the future, we plan to apply small shape memory alloys. An electrohydraulic system was adopted, and actuator power output was connected to the diaphragm. The diaphragm was placed outside the ventricle. Most RPs developed throughout the world drain blood from the ventricle. The pulse wave should be generated if a pulse is added by the part from which blood is being drawn. In this study, animal experiments were conducted and the output assistance was tested from outside the ventricle. The device operated effectively in the animal experiment. The RP can easily be equipped with this device at the time of performing the implant operation. For a patient with problems of peripheral circulation and the internal organ function, it may prove to be an effective device.

Animal Experimentation↗
PubMed2004

Inhibition of tumor necrosis factor-induced apoptosis in transgenic mouse liver expressing creatine kinase.

BACKGROUND: The mitochondrion acts as a pivotal decision center in many types of apoptotic responses. To clarify the effects of the enhanced mitochondrial function on tumor necrosis factoralpha (TNFalpha)-induced apoptosis, we studied hepatic injuries in transgenic mice whose livers express creatine kinase (CK). METHODS: Mice fed a diet containing 10% creatine, came to accumulate phosphocreatine and to enhance hepatic ATP levels and mitochondrial oxidative phosphorylation activities. TNFalpha-mediated hepatic apoptosis in normally fed and Cr-feeding CK transgenic mice were assessed. RESULTS: TNFalpha and actinomycin D cause severe liver failure in normally fed transgenic mice, and in the wild-type mice. In contrast, no significant elevations in transaminase levels after injection were observed in Cr feeding transgenic mice. The disruption of the mitochondrial transmembrane potential at 2 h after TNFalpha injection, prior to ATP depletion, activation of caspase 3 like protease, and DNA fragmentation at 4-6 h after injection, were observed in normally fed transgenic mice. These were fully suppressed in Cr feeding transgenic mice. However, anti-Fas antibody-induced apoptosis was not inhibited in both groups. CONCLUSIONS: The results indicate that TNFalpha-induced apoptosis was inhibited in CK transgenic mice livers by maintaining mitochondrial function.

Adenine↗
PubMed2004

Open-loop analysis of transfer characteristics from blood pressure to heart rate using an effectively total artificial heart.

It is desirable for the dynamic behavior of the drive rate of the artificial heart to be as similar as possible to that of the recipient's heart rate (HR) before implantation. This requires a model which can simulate the behavior of HR on the basis of only the information measured with the limited number of approvable implanted sensors. This article provides a linear time series model for explaining the behavior of HR only with aortic pressure and right atrial pressure. This could be obtained from open-loop analysis using a total artificial heart, which was introduced for measuring HR in vivo and for eliminating its effect on blood pressure. The model was identified in a goat equipped with a special biventricular assist device called the effectively total artificial heart (ETAH). The ETAH was introduced to make an open loop and awake situation in the animal with almost intact autonomic nerves, which could enhance the accuracy and reliability of the identification of the model. The adequacy of the proposed model was ascertained in several data sets measured in two goats, which were different from the data set used for identification. Most of the mean estimation errors were less than 3 beats/min and auto-correlation analysis showed approvable statistical appropriateness. However, it was clarified through comparison with the 1/R control method that the proposed model has a few problems still to be solved before its future implementation as an automatic controller of the TAH.

Animals↗
PubMed2004

Development of an implantable undulation type ventricular assist device for control of organ circulation.

It is well known that a rotary blood pump (RP) is effective as a small ventricular assist device (VAD). It might be still more effective if pulsation was available. The undulation pump (UP), which is a type of small RP, can also produce pulsation. In Japan, a development project for an implantable type UP ventricular assist device (UPVAD) is now advanced. Six universities and some companies together have been in charge of the development project for 5 years. In this study, the influence which the UP under development has on circulation in internal organs was investigated. Goats with the same weight as an average Asian person were used for the experiment. The left chest cavity was opened after resection of the fourth rib and the heart was approached. A cannula was inserted in the left ventricle from the apex. An outflow cannula was inserted into the left descending aorta. Heart muscle was excised using a newly developed puncher. The UPVAD was implanted using a left-heart bypass system. The myocardial blood flow, carotid arterial blood flow, and the kidney blood flow were recorded together with an electrocardiogram, blood pressure, and the flow rate. In these animal experiments, the blood circulation dynamic state was stabilized and sufficient support of the left heart was observed. Myocardial blood flow, carotid arterial flow, and a kidney blood flow increase resulting from UPVAD support was observed. Often the problem of multiple organ failure is important at the time of clinical application of a ventricular assist device. Assisting circulation to internal organs is important for prevention of multiple organ failure. It was concluded that the UPVAD might be useful for prevention of multiple organ failure.

Animals↗
PubMed2004

[A case of primary pulmonary cryptococcosis showing lobar pneumonia on chest X-ray].

A 36-year-old male who had been in good health visited our hospital because of fever, productive cough and lobar pneumonia of the right lower lobe. Bronchoscopic examination revealed pulmonary cryptococcosis. After the initiation of fluconazole the pneumonia started to improve, however, it was aggravated after the discontinuation of fluconazole because of liver dysfunction induced by it. The pulmonary cryptococcosis improved by lobectomy of the right lower lobe. There have been few reports of lobar pneumonia caused by primary pulmonary cryptococcosis. We report this case with fourteen other cases of primary pulmonary cryptococcosis which have been experienced in our hospital.

Adult↗
PubMed2004

Diastereomeric selective effects for growth inhibition of synthesized mini parallel double-stranded peptides on Escherichia coli and Staphylococcus aureus.

The synthesis of a series of mini double-stranded peptides containing chiral-x-Phe-y-Phe-peptide residues and the diastereomeric selective effects of these compounds on Escherichia coli NIHJ JC-2 and Staphylococcus aureus FDA 209P growth are described. In the case of bis(y-Phe-x-Phe)-N,N-ethane-1,2-diamine, bis(y-Phe-x-Phe)-N,N-buthane-1,4-diamine, bis(y-Phe-x-Phe)-N,N-hexane-1,6-diamine, and bis(y-Phe-x-Phe)-N,N-dodecane-1,12-diamine, etc., the four configurations, (L-, L-), (D-, L-), (L-, D-) and (D-, D-), where the symbols x- and y- represent optical isomers with L- and D- forms, were used to investigate the relationship between chirality and antibacterial activity. The level of activity increased in the following order: (L-, L-)<(D-, D-)<(L-, D-)<(D-, L-). The data show that (D-, L-) chilarity is more potent than (L-, L-) chilarity. Then, these results suggest that the -y-Phe-x-Phe Phe-sequence in the double-stranded peptide has anti-bacterial activity and the chirality of -y-Phe-x-Phe affects the anti-bacterial activity. Our results show that the uptake by penetration through the membrane of bis(y-Phe-x-Phe)(2)-Spacers is a first step in the expression of anti-bacterial activity. This study provides new insights in the chirality-antibacterial activity relationships of a series of mini double-stranded peptides.

Anti-Bacterial Agents↗
PubMed2004

Postprandial hyperlipidemia and atherosclerosis.

The development of the remnant like particle (RLP) method for conveniently measuring serum remnant lipoprotein levels in 1993 promoted much research on atherogenic significance and metabolism of remnant lipoproteins. This research brought about many results as the following. A novel apolipoprotein B48 receptor incorporating remnant lipoproteins into macrophages in arterial wall was discovered and the structure of the gene of the receptor was clarified. The expression of apolipoprotein B100 was recognized in the human small intestine, suggesting that dietary very low density lipoproteins (VLDL) might be synthesized in the human small intestine and converted into VLDL remnants and low density lipoproteins (LDL). It is recognized that the atherosclerotic risk of postprandial hyperlipidemia is derived from an increase of remnant lipoproteins and that measurement of serum RLP levels in postprandial state is more sensitive and necessary for evaluating an atherosclerotic risk because serum RLP levels remain high all day in patients with diabetes mellitus or coronary heart disease. The relation between postprandial hyperlipidemia and insulin resistance was clarified.

Arteriosclerosis↗
PubMed2004

Differences in penetration force of intravenous catheters: effect of grinding methods on inner needles of intravenous catheters.

OBJECTIVES: To compare penetration forces of intravenous catheters based on two grinding methods used for the inner needle tip. METHOD: Forty intravenous catheters were divided into two groups according to two inner needle grinding methods: Lancet and Backcut. To compare the characteristics of inner needles, 18 gauge Surflo outer catheters, were attached to all inner needles. We measured penetration forces by attaching a "Push-Pull-Gauge" to the chamber of intravenous catheters, then we penetrated intravenous catheters through a 0.04-mm thick polyethylene film. The penetration velocity was 3.3 mm/sec. we measured penetration forces at 30- and 45-degree penetration angles. RESULTS: There was no significant difference in the penetration forces of inner needle and outer catheter between the two groups at the 45-degree penetration angle. Penetration forces of the inner needle and the outer catheter in the Backcut group was significantly lower than those of the Lancet group at the 30-degree penetration angle. The penetration force of the outer catheter was reduced from 0.3 N to 0.18 N, a 40 % reduction at 30-degree penetration angle. Computerized measurements of penetration holes indicate that the Y-shaped incision mark of the Backcut leaves larger incision hole than the actual puncture size. We hypothesize that the Y-shaped incision mark creates more efficient path for the outer catheter to advance. Therefore, lower penetration force was indicated compared to the other group. CONCLUSION: Backcut shows less penetration force of inner needles of peripheral intravenous catheters than lancet.

Catheterization↗
PubMed2003

Remnant lipoprotein-induced smooth muscle cell proliferation involves epidermal growth factor receptor transactivation.

BACKGROUND: Remnant lipoproteins (RLPs) have been shown to play a causative role during atherosclerosis. Furthermore, it is known that vascular smooth muscle cell (SMC) proliferation is crucial for the development of atherosclerosis and restenosis after percutaneous coronary intervention. We examined the direct effect of RLPs on the proliferation and signal transduction of SMCs. METHODS AND RESULTS: Incubation in the presence of RLPs (20 mg cholesterol per dL) for 48 hours induced rat aortic SMC proliferation (2.3-fold over medium alone). RLPs also induced the phosphorylation of epidermal growth factor (EGF) receptor in SMCs, which was followed by the activation of mitogen-activated protein kinases. Moreover, the activation of protein kinase C (PKC) as well as the shedding of membrane-bound soluble heparin-binding EGF-like growth factor (HB-EGF) was observed after RLP treatment of SMCs, whereas PKC inhibitors and metalloprotease inhibitors inhibited RLP-induced EGF receptor transactivation and HB-EGF shedding in SMCs. Furthermore, anti-HB-EGF neutralizing antibody inhibited RLP-induced EGF receptor transactivation. Phosphorylation of EGF receptor and HB-EGF shedding were also observed in the aortas of apolipoprotein E-knockout mice but not in those of C57BL6 mice. CONCLUSIONS: These results suggest that RLPs transactivate EGF receptor via PKC and HB-EGF shedding from SMCs, resulting in SMC proliferation.

Animals↗