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Biomedical subjects

H Nagao

Publications and source records attributed to H Nagao.

At least 55 records · Page 3Linked to original sources
PubMed1991

[A case of Behçet's disease complicated with acute myocardial infarction].

A 23-year-old-man was admitted to our department complaining of chest oppression. He had had a diagnosis of intestinal-Behçet because of a 7-year history of recurrent oral and genital ulcers, arthritis, cutaneous folliculitis and ulcer in the ileocecal region. Cardiac catheterization revealed total occlusion at the proximal portion of the left anterior descending artery (LAD) without aneurysm formation at other coronary trees. During medical follow-up, this case showed vasospastic angina probably associated with active coronary vasculitis. The incidence of vascular involvement in the total number of cases of Behçet's disease reported in the literature is 3.6-7.7%. Overall, thrombophlebitis and arterial aneurysm formation is relatively common and frequently reported in cases of vasculo-Behçet. Our case demonstrated the following uncommon pattern as vasculo-Behçet; 1) initial clinicopathologic manifestation at the coronary artery without any other vascular lesion, 2) abrupt total occlusion (clear cut lesion) at LAD, 3) complication of vasospastic angina, which has not yet been reported in medical literature.

Adult↗
PubMed1991

[Magnetic resonance imaging of skeletal muscle in patients with Duchenne muscular dystrophy--serial axial and sagittal section studies].

Magnetic resonance imaging of skeletal muscles in thirteen patients with Duchenne muscular dystrophy was performed to estimate pathological changes. Serial axial and sagittal sections of the right lower extremity were recorded. In the early stage, the T1 values of gastrocnemius and soleus muscles were slightly lower than the control values, and in the late stage, the values were much lower in all muscles examined. In sagittal sections, the gastrocnemius muscles in the early stage showed a high density area at the distal region adjacent to soleus muscle, and the soleus muscle showed a high density area adjacent to the gestrocnemius muscle. In serial axial sections, high density areas of the anterior and posterior tibialis muscles appeared first at their proximal and peripheral regions. It was concluded that the sequence of appearance of pathological changes was different not only among individual muscles but also among various regions of each muscle; the high density changes appeared first at myotendon junctions.

Adolescent↗
PubMed1990

Hyperthermia-induced seizures with a servo system: neurophysiological roles of age, temperature elevation rate and regional GABA content in the rat.

A servo system including a microwave generator was applied to raise a rat's body temperature at a pre-set rate. Using this system the effects of age and the temperature elevation rate upon febrile seizures in rats were studied. The relationship between the brain GABA content and hyperthermia was also studied. From the results of the present study, the seizure occurrence rate was found to be highest at the age of 20 days, brain damage was speculated to be severe after hyperthermia-induced seizures with a slow temperature rise, and the regional GABA concentration in subcortical structures was found to increase during hyperthermia. These data indicate that a servo system with a microwave generator is useful for experimental febrile convulsions, and that GABA neurotransmission in subcortical structures might contribute to feed-back regulation against seizures during hyperthermia.

Aging↗
PubMed1990

The circadian rhythm of typical absence seizures--the frequency and duration of paroxysmal discharges.

Twelve patients with typical absence seizures, aged five years two months to 10 years, were examined to clarify the circadian rhythm of 3 c/s spike-and-wave paroxysms (s-w paroxysms), by means of video-electroencephalography with telemetry. S-w paroxysms combined with clinical symptoms and continuing for more than four seconds were fewer during the afternoon than the morning and, moreover, during sleep. The correlation ratio between the frequency and duration of s-w paroxysms was r = -0.74, which was statistically significant (p less than 0.02). The duration of s-w paroxysms evoked by hyperventilation or photic stimulation did not differ from that of spontaneous s-w paroxysms. The s-w paroxysms were shorter and deformed in sleep. Therefore, the observation of typical absence seizures during the morning should be regarded as important. In patients with modified s-w paroxysms during sleep, it is important that electroencephalographic recording with stimulation, such as hyperventilation, is performed sufficiently.

Brain↗
PubMed1990

Significant myocardial pathology and increase of alpha 1-adrenergic receptor number affecting the arrhythmogenic condition in cases with ventricular tachycardia.

To study the pathogenesis of idiopathic ventricular tachycardia with left bundle branch block morphology (LBBB-VT), histopathological findings in 34 patients and adrenergic receptor (AR) density obtained by micro-autoradiography in 11 patients were analyzed, using endomyocardial biopsy samples. According to the ventricular volume, we divided the patients into 3 groups. Group A patients (n = 8) were diagnosed as having arrhythmogenic right ventricular dysplasia (ARVD) showing right ventricular enlargement, group B patients (n = 7) showed decreased left ventricular function and/or enlarged left ventricle, and group C (n = 19) included patients with idiopathic ventricular tachycardia (VT) without enlargement or dysfunction of either ventricle. Histologically, there was a high incidence of significant pathology showing myocardial hypertrophy, degeneration, abnormal branching, and interstitial fibrosis in all groups (group A, 100%; group B, 86%; group C, 56%). There was a higher incidence of fatty tissue infiltration in groups A (100%), B (71%), C (48%) than in the control groups. As for AR, specific grains of alpha 1- and beta-AR were 23.0, and 18.3 (grains/25 x 25 mm square) respectively, in patients with LBBB-VT. The number of alpha 1 grains in patients with LBBB-VT was apparently higher than in the control group, sick sinus syndrome (SSS; 11.2), and the beta-AR density in the LBBB-VT group was the same as in the control group (SSS; 15.4). We concluded that the significant pathology in cases with VT might affect the arrhythmogenic condition. Moreover, these results suggested that the increase in the number of alpha 1-AR might have a great influence in idiopathic VT.

Adult↗
PubMed1989

[Direct percutaneous transluminal coronary angioplasty (PTCA) for treatment of acute myocardial infarction: comparison with PTCA immediately after thrombolysis].

We studied 73 patients with acute myocardial infarction (AMI) treated by percutaneous transluminal coronary angioplasty (PTCA) without thrombolysis (direct PTCA) and 52 patients with AMI treated by PTCA immediately after thrombolysis (PTCR + PTCA). The initial results, angiographic findings and preservation of ventricular functions of the direct PTCA group were compared with those of the PTCR + PTCA group. 1. The success rate of coronary recanalization was higher in the direct PTCA group than in the PTCR + PTCA group, but there was no statistical significance (89% vs 77%; p = NS). 2. Major complications occurred in 4.1% of the direct PTCA group and in 5.8% of the PTCR + PTCA group (p = NS). 3. The incidence of acute coronary reocclusion was higher in the PTCR + PTCA group than in the direct PTCA group (7.4% vs 22%; p less than 0.05). 4. Angiographic haziness at the dilated site following PTCA was seen more frequently in patients in the PTCR + PTCA group than in those of the direct PTCA group (43% vs 23%; p less than 0.05). 5. Patients with haziness at the dilated site had a significantly higher incidence of acute coronary reocclusion than did the patients without such haziness (28% vs 6.3%; p less than 0.05). 6. Left ventricular ejection fraction and regional wall motion were better preserved in the direct PTCA group than in the PTCR + PTCA group, but there was not statistical significance. It was suggested that direct PTCA is safe and can be performed with good success rates. It is superior to PTCR + PTCA in avoiding acute coronary reocclusion, and thus we supposed that the response of lesions to angioplasty may be altered by the administration of thrombolytic agents.

Adult↗
PubMed1989

[Effects of early myocardial reperfusion on left ventricular function in patients with acute myocardial infarction].

The effect of early myocardial reperfusion (within six hours after the onset of symptoms) on left ventricular (LV) function in 106 patients with acute myocardial infarction was studied. The subjects consisting of 26 with conventional therapy, 19 with percutaneous transluminal coronary recanalization (PTCR), 16 with percutaneous transluminal coronary angioplasty (PTCA) after PTCR, 32 with direct-PTCA and 13 with coronary artery bypass graft (CABG) were randomly observed after 1981. In these patients, left ventricular ejection fraction (LVEF), regional wall motion, end-diastolic pressure and the contractility index were measured as the indices of LV function. 1. Compared to the conventional therapy group, LVEF and regional wall motion improved significantly in all groups with reperfusion therapy except in the PTCR group. This LV function in patients with subtotal obstruction or good initial collaterals significantly improved compared to patients with total obstruction and no collateral circulation. Patients with a 75 percent or more residual stenosis after reperfusion therapy had significantly decreased LV function compared to those with residual stenosis of less than 75 percent. These findings support the potential role for reperfusion therapy in patients with acute myocardial infarction.

Aged↗
PubMed1989

[Effect of continuous epidural infusion of morphine for postoperative analgesia on pituitary-adrenocortical function].

Plasma levels of cortisol, ACTH and beta-endorphin like immunoreactivity (beta-ELI) were measured to evaluate postoperative pain relief with epidural morphine and systemic analgesics in conjunction with endocrine functions in 16 patients who underwent gastrectomy. Eight of these patients (epidural morphine group) obtained postoperative analgesia with continuous epidural infusion of morphine with a pump as in our previous report. A bolus of epidural morphine was administered through an indwelling thoracic (Th8,9) catheter at 3 hrs prior to the proposed end of the surgery, which was followed with continuous epidural infusion of morphine at a rate of 0.167-0.042 mg.hr-1 with a pump (CADD-PCA, Model 5200P, Pharmacia) during and after anesthesia and surgery with gradual decrease in dose until the third postoperative day. The remaining eight patients (systemic analgesics group) repeatedly received systemic pentazocine and buprenorphine when needed. Plasma cortisol levels increased significantly at the end of surgery and after in both groups. However plasma concentrations of cortisol in the epidural morphine group were significantly lower than those in the systemic analgesics group on the first and second postoperative days. Plasma levels of ACTH and beta-ELI increased significantly at the end of surgery but returned to levels of the previous day in both groups postoperatively. Our study suggests that continuous epidural infusion of morphine is adequate for postoperative pain relief and has suppressing effect on plasma cortisol levels as compared with systemic analgesics regimen.

Adult↗
PubMed1987

Local structural features around the C-terminal segment of Streptomyces subtilisin inhibitor studied by carbonyl carbon nuclear magnetic resonances three phenylalanyl residues.

The carbonyl carbon NMR signals of the Phe residues in Streptomyces subtilisin inhibitor (SSI) were selectively observed for [F]SSI, in which all phenylalanines were uniformly labeled with [1-13C]Phe. The three enhanced resonances in the spectrum of [F]SSI were unambiguously assigned to the specific sites in the amino acid sequence by means of 15N,13C double-labeling techniques. Namely, the resonances at 174.9 and 172.6 ppm (in D2O, pH 7.3, 50 degrees C) showed the satellite peaks due to 13C-15N spin coupling in the spectra of [F,GS]SSI and [F,A]SSI, in which Ser/Gly and Ala residues were labeled with [15N]Gly/Ser and [15N]Ala, respectively, together with [1-13C]Phe. The carbonyl groups of Phe-97 and Phe-111 are involved in peptide bonds with the amino nitrogens of Ser-98 and Ala-112, respectively. These results clearly indicate that the signals at 174.5 and 172.6 ppm are due to Phe-97 and Phe-111, respectively. The signal at the lowest field (177.1 ppm) was thus assigned to the carboxyl carbon of the C-terminal Phe-113. The lifetimes of the amide hydrogens of the three Phe residues and their C-terminal-side neighbors (Ser-98 and Ala-112) were investigated by using the effect of deuterium-hydrogen exchange of amide on the line shapes (DEALS) for the Phe carbonyl carbon resonances. In this method, the NMR spectra of [F]SSI dissolved in 50% D2O (pH 7.3) were measured at various temperatures, and the line shape changes caused by deuteriation isotope shifts were analyzed.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗
PubMed1987

Continuous vs. bolus epidural morphine.

The clinical evaluation of continuous administration of epidural morphine was undertaken using an infusion pump (Act-A-Pump 1000). Eleven patients who had undergone abdominal surgical procedures were treated with this therapeutic modality for postoperative pain control, and two cancer patients for chronic pain relief. The results were satisfactory and the advantages over repeated epidural injections are discussed.

Adult↗