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Biomedical subjects

G Takada

Publications and source records attributed to G Takada.

At least 109 records · Page 6Linked to original sources
PubMed1997

Symptomatic aortic regurgitation after Blalock-Taussig shunt in tetralogy of Fallot with bicuspid aortic valve.

We report here a case of a premature baby with tetralogy of Fallot and bicuspid aortic valve. After the successful completion of the Blalock-Taussig (BT) shunt, severe aortic valve regurgitation (AR) appeared, although it was trivial preoperatively. Severe postoperative heart failure was induced by progression of the AR. Postoperative echocardiography revealed that the progression of the AR was provoked by appearance of prolapse of the cusp as the result of rapid increase of blood flow through the aortic valve after the BT shunt. We propose that, in planning the BT shunt for patients with tetralogy of Fallot, preoperative examinations for a possible bicuspid aortic valve should be done and postoperative precaution considering possible appearances of severe AR and congestive heart failure will be necessary.

Anastomosis, Surgical↗
PubMed1997

Changes in left ventricular diastolic filling patterns before and after the closure of the ductus arteriosus in very-low-birth weight infants.

To evaluate serial changes in left ventricular diastolic filling patterns in preterm infants, we performed echocardiographic examinations in 18 very-low-birth weight infants and 20 fullterm infants before and after the closure of the ductus arteriosus. In the fullterm infants, the ductal closure induced significant decreases in the peak velocity and flow velocity integral of early diastole, first third filling fraction, and mitral stroke volume. In the preterm infants, by contrast, there were significant increases in the flow velocity integral of early diastole, first third filling fraction, and mitral stroke volume after the ductal closure. No differences following the ductal closure were found in the atrial phase of filling and peak filling rate normalized to stroke volume in either group. When the ductus arteriosus was open, essentially the same left-to-right shunting of the ductus arteriosus was detected in both preterm and fullterm infants, but the Doppler flow patterns of the patent foramen ovale were different: the fullterm infants had a single flow peak mainly during ventricular late systole and early diastole, but the preterm infants had two or three flow peaks with nearly equal amplitudes lasting from ventricular systole to diastole, which resembled the Doppler flow pattern of atrial septal defect. Only a faint Doppler flow signal of the foramen ovale was observed after the ductus arteriosus closed. Our results obtained from the preterms suggest that the left-to-right shunt through the foramen ovale may be one important factor to alter the Doppler transmitral filling patterns during the fetal to neonatal cardiovascular changes.

Ductus Arteriosus↗
PubMed1997

Loss of EDB+ fibronectin isoform is associated with differentiation of alveolar epithelial cells in human fetal lung.

Cell-matrix interactions have been shown to regulate the development of the lung, particularly airway branching and alveolarization. Fibronectin is the major constituent of pulmonary extracellular matrix and exists in multiple isoforms arising from alternative RNA splicing. EDA and EDB are the two major alternatively spliced segments, the expression of which is regulated in a spatiotemporal and oncodevelopmental manner. In this study, we investigated immunohistochemically the distribution of the EDA- and EDB-containing fibronectin isoforms (referred to as EDA+ fibronectin and EDB+ fibronectin, respectively) in normal and hypoplastic human lungs at different gestational ages to explore the role of these fibronectin isoforms in alveolarization. EDA+ fibronectin was expressed around the distal airspaces throughout the development of both normal and hypoplastic lungs. In contrast, the expression of EDB+ fibronectin was restricted to the lung with morphologically immature acinar complex, typically observed in normally developing lungs of < 30 gestational weeks or in hypoplastic lungs. To further confirm the restricted expression of EDB+ fibronectin in immature acinar complex, we examined the correlation of EDB+ fibronectin expression with that of the surfactant protein SP-A, a biochemical marker for the differentiated type II pneumocytes. A clear inverse relationship between the immunoreactivities for EDB+ fibronectin and SP-A was observed in both control and hypoplastic lungs. Given the proposed importance of fibronectins in the differentiation of alveolar epithelial cells, our results suggest that the EDB segment plays a regulatory role in the differentiation of immature acinar epithelial cells into type II pneumocytes. The EDB segment may also serve as a new histochemical marker for the functional maturity of fetal lung tissues.

Alternative Splicing↗
PubMed1996

Effect of anoxia on striatal monoamine metabolism in immature rat brain compared with that of hypoxia: an in vivo microdialysis study.

We examined in 5-day-old rats the effects of either anoxia or 8% hypoxia on extracellular monoamines such as dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), homovanillic acid (HVA), norepinephrine (NE), 5-hydroxytryptamine (5-HT), and 5-hydroxyindole-3-acetic acid (5-HIAA) using in vivo microdialysis and subsequent HPLC. After stabilization 64 animals were exposed to 100% nitrogen for 16 min and 40 animals to 8% oxygen for 128 min. Both anoxia and hypoxia produced acute increase in the striatal extracellular DA (anoxia: P < 0.001, hypoxia: P < 0.01). Especially in anoxia, DA levels increased transiently to 2000-times the basal levels and 6-times higher than those in hypoxia. NE also increased in both anoxia and hypoxia. DOPAC and HVA decreased during hypoxia (P < 0.01 and P < 0.001, respectively), while those in anoxia were unchanged. In anoxia, decrease tendency of their levels were in short duration and that of 5-HIAA was followed by gradual increase (P < 0.001). These data demonstrated that brief exposure to anoxia or hypoxia had significant influence on striatal monoamine metabolism in immature brain and the pattern of change of monoamine in anoxia was different from that in hypoxia.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1996

Effects of cardiac output on Doppler transmitral and transtricuspid flow velocity patterns in very low birth weight infants.

We studied effects of cardiac output on Doppler transmitral and transtricuspid flow velocities in 24 appropriate for gestational age premature infants. We measured peak flow velocity of early diastole (peak E) and atrial contraction (peak A), ratio of peak flow velocity of early diastole to atrial contraction (peak E/A), total flow velocity-time integral, the first third filling fraction, peak filling rate normalized to stroke volume, and deceleration time (DT). Cardiac output was calculated as the product of the aortic flow velocity-time integral, aortic valve area, and heart rate. The cardiac output increased significantly with advancing gestational age and body weight (r = 0.78 and 0.86, P < 0.01, respectively). With increasing cardiac output, the transmitral as well as transtricuspid peak E, peak E/A, and total flow velocity-time integral increased significantly without any change in the peak filling rate normalized to stroke volume, peak A, and deceleration time. The transmitral as well as transtricuspid peak E did not correlate with the heart rate. Although these results do not establish whether changes in ventricular relaxation process or in cardiac output is responsible for the progressive increase in the peak E and peak E/A. Unchanged peak filling rate normalized to stroke volume of the left and right ventricles suggest that changes in cardiac output with maturity is, in fact, one of the important contributory factors. This evidence should be borne in mind in interpreting ventricular diastolic filling as an index of ventricular diastolic function in premature infants.

Blood Flow Velocity↗
PubMed1996

Identification and characterization of cellulose-binding domains in xylanase A of Clostridium stercorarium.

The xynA gene encoding a major xylanase of Clostridium stercorarium F-9 was sequenced. The structural gene consists of an open reading frame of 1533 bp encoding a protein of 511 amino acids with an M(r) of 56,519. XynA consists of a catalytic domain belonging to family G at the NH2-terminus and two direct repeats of about 90 amino acids with a short spacing at the COOH-terminus. The repeated sequences, CBDI and CBDII, were not homologous with amino acid sequences of the CBDs classified into families I to V. Nevertheless, XynA showed an affinity for insoluble cellulose such as Avicel. Binding of XynA to Avicel was strongly dependent on the concentration of the incubation buffer and was inhibited by Triton X-100. XynA bound to Avicel (2.4 nmol/g-cellulose) and acid-swollen cellulose (180 nmol/g-cellulose), suggesting that this enzyme has higher affinity for amorphous cellulose than for crystalline cellulose. Functions of CBDI and CBDII were investigated by constructing the mutant enzymes and evaluating the cellulose-binding ability of each of them. XynA4 lacking CBDI and XynA5 lacking CBDII bound to Avicel to a lesser extent than the parental enzyme XynA; but XynA6, devoid of both CBDs, did not bind at all, indicating that CBDI and CBDII each functioned independently as CBD in XynA and their binding capacity was additive. Although the Ruminococcus albus endoglucanase EgIV that was joined to CBDs of XynA acquired cellulose-binding ability, the substrate specificity of EgIV was not altered in the presence or absence of CBDs.

Amino Acid Sequence↗
PubMed1996

Changes in left ventricular volume and systolic function before and after the closure of ductus arteriosus in full-term infants.

Using echocardiographic techniques, the change in left ventricular (LV) volume and its effect on systolic function were studied before and after the closure of ductus arteriosus in 18 full-term infants. Examinations were performed twice in each infant, within 6 h after birth and on day 5, and the patency of the ductus with left-to-right shunt was confirmed at the first examination by Doppler echocardiography. A biplane Simpson's rule method was used for volume measurements. The LV end-diastolic volume, stroke volume, and cardiac output were more than 1.3-fold before the ductal closure, and the ejection fraction showed the similar change. However, the mean normalized systolic ejection rate, an index of contractility, and heart rate showed no significant difference. The Frank-Starling curve was obtained from the relationship between the LV end-diastolic and stroke volumes, and the LV performance was operated at a higher level on that curve when the ductus was open. Our data indicated that LV cardiac output was significantly higher during the patency of the ductus arteriosus and that this high cardiac performance might depend more on the Frank-Starling response to the volume load through the ductus arteriosus than on the increase of LV contractility and heart rate.

Cardiac Output↗
PubMed1996

Cytotoxic activity against tumour cells mediated by intermediate TCR cells in the liver and spleen.

Morphological and phenotypic characterization in previous studies has indicated that intermediate (int) T-cell receptor (TCR) cells or T natural killer (TNK) cells may stand at an intermediate position between NK cells and high TCR cells of thymic origin in phylogenetic development. In this study, a functional study on cytotoxic activity against various tumour targets was performed in each purified subset. When a negative selection method entailing in vivo injection of anti-asialo GM, antibody or anti-interleukin (IL)-2R beta monoclonal antibody (mAb) was applied, IL-2R beta 1 CD3 NK cells were found to have the highest NK activity while IL-2R beta 1 int CD3 (or TCR) cells had a lower level of the NK activity. High CD3 cells (freshly isolated) did not have any such activity. Sorting experiments further revealed that the NK function mediated by int CD3 cells was augmented when they were exposed to anti-CD3 mAb. anti-TCR alpha beta, or anti-TCR-delta mAb. This phenomenon was not observed in NK cells and high CD3 cells. More importantly, when anti-CD3 mAb (or anti-TCR mAb) was added to the assay culture, int CD3 cells became cytotoxic against even NK-resistant tumour (Fc gamma R-. Fas+) targets. Liver mononuclear cells or int CD3 cells exposed to anti-CD3 mAb for 6 hr showed an elevated level of perforin in their cytoplasms. The present results suggest that int CD3 cells are usually non-cytotoxic against various tumours but become functional after being stimulated via the TCR CD3 complex.

Animals↗
PubMed1996

Doppler echocardiographic findings of indomethacin-induced occlusion of the fetal ductus arteriosus.

We present an unusual case of indomethacin-induced occlusion of the fetal ductus arteriosus, which occurred in one of twins. In fetal echocardiography, the characteristic findings, a to and fro regurgitation pattern at pulmonary valve and postvalvular dilation of the main pulmonary artery, were obtained in addition to right ventricular dilation and hypertrophy, tricuspid regurgitation, right atrium dilation, and pericardial effusion. This fetus developed fetal distress and was delivered by an emergency cesarean section at 35 weeks' gestation. We suggest that these fetal echocardiographic findings may be the end-stage signs of the fetal ductal occlusion as well as the signs for emergent delivery.

Adult↗
PubMed1996

Relationships between clinical and histological profiles of non-familial idiopathic neonatal hepatitis.

Idiopathic neonatal hepatitis (INH) is a syndrome characterized clinically and histologically but there is little information concerning the relationship between the clinical features and histological findings. In the present study, sixty-two patients clinically diagnosed as non-familial INH were histologically classified into four groups according to a provisional definition based on predominant lesions and examination of their clinical features. Patients of cholestasis (n = 23) and giant cell hepatitis (GCH, n = 21) were most frequent (37% and 33%, respectively), and patients of fatty liver (n = 10) and hepatitis (n = 8) were less common (16% and 13%). The GCH group showed a dominance of male, low birthweight, older and breast-fed babies. The cholestasis group demonstrated a dominance of male, low birthweight, younger and bottle-fed babies. The hepatitis group had the highest frequencies of high-grade hepatomegaly and splenomegaly. Fifty six cases completely recovered. Two died of hepatic failure in early infancy and four had chronic liver diseases at the age of 12 months. The fatty liver group had the worst outcome. Histological features in non-familial INH were variable and typical giant cell hepatitis was seen in only one-third of patients. Characteristic clinical features in each histologically classified group may suggest heterogenous etiologies underlying non-familial INH.

Diagnosis, Differential↗
PubMed1996

Relationship of feeding modality to clinical features in Japanese infants with idiopathic neonatal hepatitis of the non-familial form.

To clarify the relationship between idiopathic neonatal hepatitis and feeding type, that is, formula-milk feeding and breast-milk feeding, the medical records of 100 patients (68 male and 32 female babies) with idiopathic neonatal hepatitis of non-familial form referred to the medical centers of Akita University and Tohoku University during the past 18 years were reviewed. The patients were divided into two 9 year periods (1975-83 and 1984-92), and their clinical features were analyzed in terms of feeding type and sex. The number of patients enrolled decreased from 69 in the first half to 31 in the second half. The number of male patients dropped from 53 to 15, although the number of female patients (n = 16) remained the same in both 9 year periods. The frequency of formula-milk feeding significantly decreased in the second half (42/69 to 6/31, P < 0.01). Compared with the expected numbers of patients in the second half, calculated on the changes in the live birth population and feeding modality between the two halves, the actually enrolled numbers of patients in the second half were less in both the male and the formula-milk fed groups (x0.35 and x0.22), whereas the numbers of female and breast-milk feeding groups were close to the expected values (x1.26 and x1.08). When sex and feeding modality were combined, the formula-milk fed male group showed the lowest value (x0.10), and the breast-milk fed female group showed the highest value (x2.85). In conclusion, feeding type, especially in combination with gender, might be one causative factor in the occurrence of idiopathic neonatal hepatitis.

Breast Feeding↗
PubMed1996

Prediction of adult height in healthy Japanese children.

Longitudinal records from 13,707 children (6749 boys and 6958 girls), aged 6-17 years, were fitted by a smoothing cubic spline function, and the factors influencing changes in height SD score (SDS) during puberty were analysed. Height SDS at 6 years correlated closely with final height SDS. However, short children at 6 years of age tended to increase their height SDS at final height, whereas tall children at the same age tended to decrease their final height SDS for children with the same prepubertal height, the later that pubertal maturation occurred, the greater was the final height achieved. As short children entered puberty relatively late and tall children entered puberty relatively early, height SDS tended to approach 0 SD during puberty. A prediction function obtained by multiple regression analysis using height SDS at 6 years, the percentage by which the child is overweight at 6 years, age at onset of the pubertal growth spurt (PGS) and height at onset of the PGS provides a reasonable model for the prediction of final height SDS without the need to estimate bone age.

Adolescent↗
PubMed1996

An infant case of Ebstein's anomaly of the tricuspid valve with abnormal diastolic filling pattern of the left ventricle.

We report herein an infant case of Ebstein's anomaly with abnormal diastolic filling pattern of the left ventricle. We also compare the case with a comparable case without such abnormal filling pattern. The patient, who had pulmonary valve stenosis, patent ductus arteriosus and mild mitral regurgitation, underwent transventricular valvotomy at 30 days of age. Postoperative course was uneventful. Serial Doppler echocardiographic studies were performed at 2 hr, 40 days, and 52 days of age. Peak velocity and flow velocity-time integral of early diastole, and ratios of the peak velocities and velocity time integrals of the early diastole and atrial contraction were below the 95% confidence limits of the normal controls. Our case suggests that left ventricular diastolic dysfunction may exist in the Ebstein's anomaly when it is associated with mitral valve abnormality such as mitral regurgitation.

Diastole↗
PubMed1995

Role of age on transmitral flow velocity patterns in assessing left ventricular diastolic function in normal infants and children.

This study demonstrated that both peak E and flow velocity integral of early diastole increased to reach the older children's values by 36 months of age and leveled off thereafter, whereas both peak A and flow velocity integral of atrial contraction had little change. These results suggest that age-related changes in E wave reflect the maturational or developmental alterations in LV diastolic properties, especially in the relaxation process.

Adolescent↗