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Biomedical subjects

H Kubota

Publications and source records attributed to H Kubota.

At least 37 records · Page 2Linked to original sources
PubMed2001

Midterm results after aortic valve-sparing operation.

OBJECTIVES: We have conducted aortic valve-sparing operation for patients having aortic root dilatation and almost normal aortic valve leaflets since August 1998, and here report midterm results. METHODS: Patients with dilated aortic annulus or Marfan's syndrome were treated with reimplantation, and the remaining patients with remodeling. Either 24 or 26 mm graft was selected based on aortic annular diameter and leaflet size. Aortic valve competence was assessed regularly with echocardiography. RESULTS: Five patients (age: 29 +/- 13 yr), including 4 with Marfan's syndrome, had undergone reimplantation, and 3 (age: 46 +/- 18 yr) remodeling by December 2000. Mean follow-up was 18 (range: 10-32) months, and no postoperative death has occurred and no reintervention has been required thus far. All the patients in the remodeling group showed only a small pressure gradient through the aortic valve and decreased left ventricular diameter. Two in the reimplantation group showed a pressure gradient exceeding 20 mmHg. Two Marfan's syndrome patients in the reimplantation group showed slightly increased diastolic left ventricular diameter and 3 slightly increased systolic left ventricular diameter. Although aortic regurgitation had diminished in all patients by discharge, moderate aortic regurgitation recurred in 1 non-Marfan's syndrome patient in the reimplantation group because of degenerated aortic valve. CONCLUSION: Although postoperative aortic valve function was not perfect in all patients undergoing reimplantation, midterm results after aortic valve-sparing operation were generally satisfactory. Proper selection of patients, procedures, and graft size was thought to be important to ensure a favorable surgical outcome.

Adolescent↗
PubMed2001

A novel alkaline endoglucanase from an alkaliphilic Bacillus isolate: enzymatic properties, and nucleotide and deduced amino acid sequences.

A highly alkaline endo-1,4-beta-glucanase (Egl) was purified to homogeneity from a culture broth of alkaliphilic Bacillus sp. strain KSM-N252. The optimal pH for activity was as high as 10, and the optimal temperature was 55 degrees C. The molecular mass and isoelectric point were around 50 kDa and pH 4.2, respectively. The enzyme hydrolyzed carboxymethyl cellulose in a random fashion. Unlike previously reported Egls, the enzyme was highly active on p-nitrophenyl cello-oligosaccharides and acid-swollen cellulose, and its activity was stimulated by cellobiose at high concentrations. The entire gene for the enzyme contained a 1,476-bp single open reading frame encoding 492 amino acids, including a 29-amino-acid signal peptide. The mature enzyme (463 amino acids: 51,174 Da) exhibited moderate homology to other family 5 alkaline Egls. In the C-terminal region, a carbohydrate-binding module that belongs to family XII was repeated. Furthermore, four and six repeats of Pro-Pro-Ser/Thr-Glu/Asp-Pro-(Glu) were found immediately before the first and second carbohydrate-binding modules, respectively.

Amino Acid Sequence↗
PubMed2001

Perioperative management protocols for children with moyamoya disease.

Protocols for prevention of cerebral ischemic attacks caused by hyperventilation resulting from crying, as observed in perioperative pediatric moyamoya patients, were evaluated. The first protocol involved the use of sedation when staff were setting up the intravenous lines, performing neuroimaging studies, and controlling postoperative pain. The second involved the use of wound-handling techniques designed to ease postoperative wound care; these included steristrip closure, use of paraffin gauze and not using adhesive tapes. We compared 14 and 11 surgical cases handled before and after the protocols were introduced, respectively. The number of patients with perioperative cerebral infarction decreased from 2 to 0. Appropriate sedation reduced the incidence of transient ischemic attacks from 28.6% to 3.7%. The average postoperative hospital stay was similarly reduced, from 21.3 days to 16.1 days, as a consequence of the reduced incidence of complications. It is concluded that the perioperative risks can be minimized when invasive procedures are managed according to our protocols.

Administration, Oral↗
PubMed2001

Flexor digitorum longus accessorius in the club foot of an infant with Nager syndrome.

The case of a male infant is reported who had club foot on the right side and pes adductus on the left side in combination with acrofacial dysostosis; he also demonstrated preaxial anomalies of the upper limbs indicative of Nager syndrome. In addition, an unusual aberrant muscle was discovered during surgical correction of the right club foot.

Abnormalities, Multiple↗
PubMed2001

Dukes' classification as a useful staging system in resectable squamous cell carcinoma of the esophagus.

Dukes' classification for colorectal cancer is simple and has been widely used as a valuable prognostic indicator. It has been used as an assessment of gastric cancer, but it has not been evaluated for esophageal cancer. Of 251 patients with primary squamous cell carcinoma of the thoracic esophagus between February 1981 and April 1999, 155 patients underwent esophagectomy with a curative intent. Clinicopathologic characteristics of those 155 patients were retrospectively investigated according to the Dukes', tumor node metastasis (TNM) and Japanese staging systems. Dukes' classification showed a clear correlation between tumor stage and survival. The 3-year and 5-year survival rates of 64 Dukes' A cases were excellent (97.4% and 93.7%), good for 12 Dukes' B (75% and 75%), and poor for 79 Dukes' C (50.5% and 43.4%), respectively (P < 0.05; Dukes' A vs B, P < 0.0001; Dukes' A vs C, P < 0.10; Dukes' B vs C). TNM stage classification also showed a good correlation between tumor stage and survival, but there were no significant differences between stage 0, I and stage IIA cases (P = 0.2678) and between stage III and stage IV cases (P = 0.8298). In the Japanese staging system, there were no significant differences among stage 0, stage 1, and stage 2 cases (P = 0.4093). Dukes' classification was significantly correlated with tumor size, Borrmann type, histological type, and vessel invasion. Subdivision of Dukes' C according to the number of positive lymph nodes (1-4 vs > or = 5) showed a clearer correlation with survival rather than other subdivisions, such as the metastatic lymph node ratio (< 1.0 vs > 1.0) or the site of lymph node metastasis. Dukes' classification, which incorporates the number of positive lymph nodes, correlates well with tumor progression and provides a simple useful staging system after curative esophagectomy for esophageal cancer. Dukes' A tumor could be proposed as a criterion of early esophageal carcinoma.

Aged↗
PubMed2001

Extended repair of thoracic aorta through left thoracotomy after aortic root replacement.

A patent distal false lumen after repair of type A aortic dissection often poses serious late complications. We present a successful repair of dissecting aortic aneurysm through left thoracotomy, extending from the ascending to descending thoracic aorta after composite graft replacement of the aortic root. Although staged operations, including the elephant trunk procedure, are usually chosen for remaining extensive aortic disease after replacement of the aortic root or the ascending aorta, a single-stage repair from the ascending to the descending thoracic aortas through left thoracotomy can be a favorable option to treat a patient with this type of aortic disease.

Adult↗
PubMed2001

Esophageal resection in elderly esophageal carcinoma patients: improvement in postoperative complications.

BACKGROUND: Advanced age is considered to be a relative contraindication for radical esophagectomy with a three-field lymph node dissection. METHODS: Preoperative risks, postoperative morbidity and mortality, and long-term survival in 55 elderly patients (> or =70 years) who had undergone extensive esophagectomy for esophageal carcinoma were compared with those of 149 younger patients (<70 years). RESULTS: Elderly patients had worse preoperative cardiopulmonary function and had more frequent postoperative cardiopulmonary complications compared with younger patients (p < 0.05). The postoperative death rate was not statistically different between the elderly (10.9%) and younger groups (5.4%). When the study period was divided into an early and a late phase, the postoperative death rate dropped significantly (p < 0.05) in recent years (1.4%) when compared with the previous era (10.0%). The overall survival rates were not different between elderly and younger patients. CONCLUSIONS: Preoperative cardiopulmonary risk factors and postoperative complications after esophagectomy were more frequently noticed in elderly patients than in younger patients. A dramatic improvement in postoperative death was noticed in recent years. The long-term survival of elderly patients after extended esophagectomy was almost similar to that in younger patients.

Aged↗
PubMed2001

Distinct primary central nervous system lymphoma defined by comparative genomic hybridization and laser scanning cytometry.

We investigated chromosomal alterations using comparative genomic hybridization (CGH), and DNA ploidy patterns using laser scanning cytometry (LSC) in 8 primary central nervous system lymphomas (PCNSLs). The average number of chromosomal alterations detected by CGH was 6.9 (gain: 4.1, deletion: 2.8). Frequent alterations were gains of chromosomes 12, 18q, and X, and deletion of 6q, which were similar to those seen in non-CNS diffuse large B-cell lymphoma. DNA aneuploidy was detected by LSC in 4 of the 8 cases. The DNA aneuploid lymphomas had more chromosomal alterations than the DNA diploid ones (9.3 vs. 4.5, P <.05). The former had higher MIB-1 indices than the latter. The present investigation indicates that although most of the PCNSL are histologically uniform, they are divided cytogenetically into DNA aneuploid and diploid tumors.

Aged↗
PubMed2001

Novel hydroxyphenylurea dual inhibitor against acyl-CoA: cholesterol acyltransferase (ACAT) and low density lipoprotein (LDL) oxidation as antiatherosclerotic agent.

Novel hydroxyphenylurea derivatives were synthesized and their inhibitory potency evaluated against acyl-CoA: cholesterol acyltransferase (ACAT). Quantitative structure activity relationship analysis revealed that their ACAT inhibitory activities were controlled by the hydrophobicity of the whole molecule. the substitution pattern of urea moiety, and the existence of carboxylic acid. The derivatives with strong activities inhibited foam cell formations. Moreover, these compounds showed antioxidative effects against low density lipoprotein (LDL), owing to their characteristic 3-lert-butyl-2-hydroxy-5-methoxyphenyl substructure. Based on the mechanism of atherosclerosis generation, this hydroxyphenylurea-type dual inhibitor against both ACAT and LDL oxidation is expected to be a promising drug for atherosclerosis.

Anisoles↗
PubMed2001

Thoracoscopy for minimally invasive axillo-coronary artery bypass.

Minimally invasive axillo-coronary artery bypass via a small thoracotomy or a limited sternotomy was performed in five patients. For this approach, videoscopy was used to determine the intrapleural path of each vein graft, which was curved by the expanded lung tissue and had the potential for kinking or distortion. Postoperative angiography confirmed the patency of each graft with no kinking or distortion. Thoracoscopy facilitates this approach, allowing appropriate placement of the vein graft in the chest cavity.

Aged↗
PubMed2001

Cytosolic chaperonin-containing t-complex polypeptide 1 changes the content of a particular subunit species concomitant with substrate binding and folding activities during the cell cycle.

The chaperonin-containing t-complex polypeptide 1 (CCT) is a cytosolic molecular chaperone composed of eight subunits that assists in the folding of actin, tubulin and other cytosolic proteins. We show here that the content of particular subunits of CCT within mammalian cells decreases concomitantly with the reduction of chaperone activity during cell cycle arrest at M phase. CCT recovers chaperone activity upon resumption of these subunits after release from M phase arrest or during arrest at S phase. The levels of alpha, delta and zeta-1 subunits decreased more rapidly than the other subunits during M phase arrest by colcemid treatment and recovered after release from the arrest. Gel filtration chromatography or native (nondenaturing) PAGE analysis followed by immunoblotting indicated that the alpha and delta subunit content in the 700- to 900-kDa CCT complex was appreciably lower in the M phase cells than in asynchronous cells. In vivo, the CCT complex of M-phase-arrested cells was found to bind lower amounts of tubulin than that of asynchronous cells. In vitro, the CCT complex of M phase-arrested cells was less active in binding and folding denatured actin than that of asynchronous cells. On the other hand, the CCT complex of asynchronous cells (a mixture of various phases of cell cycle) exhibited lower alpha and delta subunit content and lower chaperone activity than that of S-phase-arrested cells obtained by excess thymidine treatment. In addition, turnover (synthesis and degradation) rates of the alpha and delta subunits in vivo were more rapid than those of most other subunits. These results suggest that the content of alpha and delta subunits of CCT reduces from the complete active complex in S phase cells to incomplete inactive complex in M phase cells.

Animals↗
PubMed2001

Manic episode in epilepsy and bipolar I disorder: a comparative analysis of 13 patients.

PURPOSE: To determine whether the manic episode of patients with epilepsy has different characteristics from manic episode of patients with bipolar disorder. METHODS: Interictal manic episodes in patients with epilepsy (epilepsy group) were compared with mood disorders in patients with bipolar I disorder (bipolar group), as defined by the DSM-IV. There were 13 patients (five women and eight men) in each group. RESULTS: Five epilepsy patients had relatives with epilepsy and/or convulsions, and four bipolar patients had relatives with mood disorders. In the epilepsy group, two had substance-related or organic factors associated with the episodes besides epilepsy, and two exhibited a postictal manic state that had the same symptoms as those of their interictal manic episodes. Ten patients of the epilepsy group had dependent-childish behavior. The epilepsy group had fewer severe mood episodes than the bipolar group. Ten epilepsy patients had fluctuating mood disturbances, and eight had rapid cycling of mood episodes. The epileptogenic zone was in the frontal and/or temporal lobes of eight patients and in multiple lobes of two others; it could not be localized in the three remaining patients. CONCLUSIONS: The clinical features of the interictal manic episodes in the epilepsy group were different from those in the bipolar group. The manic episodes of the epilepsy group appeared heterogeneous in their causal factors. An epileptogenic zone in the frontal and temporal lobes seems to play an important role in the mood episodes of the majority of patients with epilepsy.

Adolescent↗
PubMed2001

Effect of absorbable polydioxanone flexor tendon repair and restricted active mobilization in a canine model.

We performed an experimental study to evaluate the mechanical and histologic healing process of flexor tendon repair using absorbable polydioxanone monofilament followed by active mobilization. Sixty-four canine flexor digitorum profundus tendons were repaired using polydioxanone monofilament or control braided polyester. Animals were evaluated 7, 14, 28, and 42 days after surgery with 12 day 0 control tendons. All repaired tendons healed without rupture or gap formation. Mechanically, all specimens had adequate tensile strength enabling active mobilization. The tendons that were repaired using braided polyester healed without initial tensile depression; however, the ultimate tensile strength values of polydioxanone specimens showed a significant decrease at day 14. Histologically, an inflammatory response was observed around the polydioxanone monofilament; this reaction increased from day 14 to day 42. However, the inflammatory response did not cause large adhesions or large tendon callus formation. This method of using absorbable suture material for tendon repair has the potential for use in the clinical setting.

Animals↗
PubMed2001

Comparison of mechanical properties of polyvinylidene fluoride and polypropylene monofilament sutures used for flexor tendon repair.

We performed an experimental study to evaluate the mechanical properties of polyvinylidene fluoride sutures and to compare their use with that of standard polypropylene sutures for the circumferential, epitendinous suture of a flexor tendon repair. Polyvinylidene fluoride sutures had a smaller suture diameter, a greater knot pull strength and less delayed extension when under creep testing, than polypropylene sutures. Tendons repaired using polyvinylidene fluoride sutures had significantly greater gap and breaking strengths than those repaired using polypropylene sutures.

Animals↗
PubMed2001

Comparison of postoperative early active mobilization and immobilization in vivo utilising a four-strand flexor tendon repair.

We evaluated a technique of four-strand double-modified locking Kessler flexor tendon repair in healing tendons. Seventy-two canine flexor digitorum profundus tendons in Zone 2 were repaired and evaluated following either active mobilization or immobilization at 0, 7, 14, 28 and 42 days after surgery. Fifty-six tendons were examined for gap and ultimate strength using a tensile testing machine and 16 were evaluated with standard hematoxylin and eosin, and Masson's trichrome staining. All tendons healed without rupture or gap formation of more than 1 mm, thus demonstrating that this repair technique has enough tensile strength to withstand early active mobilization. The gap and ultimate strength of actively mobilized tendons did not decrease significantly during the first 7 days, and were significantly greater than those of immobilized tendons throughout the 42-day study period. Actively mobilized tendons healed without the extrinsic adhesions and large tendon calluses that were found in immobilized tendons.

Animals↗