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Biomedical subjects

H Nishida

Publications and source records attributed to H Nishida.

At least 109 records · Page 6Linked to original sources
PubMed1999

Erythropoietic protoporphyria with fatal liver failure.

A 33-year-old woman with a history of photosensitivity, persistent abdominal pain, and liver dysfunction was admitted to our department because of abdominal pain and progression of liver dysfunction. On admission, levels of protoporphyrin and coproporphyrin within erythrocytes were markedly increased. Autofluorescent erythrocytes were also detected, leading to a diagnosis of erythropoietic protoporphyria. A liver biopsy specimen revealed cirrhosis with dark brown granules filling hepatocytes, bile canaliculi, and bile ductules. Transfusion of washed erythrocytes, hemodialysis, and administration of cholestyramine and beta-carotene transiently improved levels of porphyrins and liver function. The patient died of rupture of esophageal varices followed by multiple organ failure. However, the treatments were believed to have extended survival.

Adult↗
PubMed1999

Current strategy of temporary circulatory support for severe cardiac failure after operation.

BACKGROUND: After open heart operations about 1% of patients still need temporary circulatory support for severe cardiac failure, and over half of those patients die during or after the support. This study assessed the efficacy of the current strategy of circulatory support. METHODS: We assessed clinical outcome of 64 consecutive patients (1.5% of pump cases) who had temporary circulatory support associated with perioperative variables. The results were analyzed by logistic regression analysis. RESULTS: The weaning and discharge rates were 50.0% and 26.7% with venoarterial bypass, 76.2% and 57.1% with biventricular bypass, 87.5% and 37.5% with isolated left ventricular bypass, and 60.0% and 40.0% with pulsatile left ventricular assistance, respectively. Logistic regression analysis identified presupport cardiogenic shock (odds ratio, 9.922) and support type (14.684) as factors significantly associated with nonweaning from the temporary support, and cardiogenic shock (28.268), support duration (2.948), and support type (14.184) as factors significantly associated with mortality during or after the circulatory support. CONCLUSIONS: The current strategy of temporary circulatory support improved clinical outcome of patients with severe cardiac failure. Early application of circulatory support before profound cardiogenic shock and proper selection of the support type might be key factors for successful circulatory support postoperatively after operation.

Adult↗
PubMed1999

Decreased skeletal muscle capillary density is related to higher serum levels of low-density lipoprotein cholesterol and apolipoprotein B in men.

The relationships between skeletal muscle morphology, particularly muscle fiber capillary density, and serum lipid profiles were evaluated in 25 non-obese men aged 18 to 36 years (body mass index [BMI], 22.7 +/- 2.5 kg/m2; body fat, 13.6% +/- 4.0%, maximal oxygen uptake [VO2max], 46.2 < or = 6.3 mL/kg/min). Skeletal muscle samples were taken from the vastus lateralis using the needle-biopsy method. The fiber types (I, IIa, and IIx) and their percent distribution, the indices of capillary density, and the diffusion index expressed as the cross-sectional area occupied by one capillary were determined. Blood samples were drawn from the antecubital vein after a 12-hour fast. Based on Pearson's correlation analysis, the number of capillaries around type IIx fiber correlated inversely with the serum level of low-density lipoprotein cholesterol ([LDL-C] r = -.50, P < .05). The number of capillaries per fiber (cap/fiber ratio), number of capillaries per area (cap/mm2), and capillaries around each fiber type correlated inversely with the serum level of apolipoprotein B ([apo B] r = -.40 to -.54, P < .05 to .01). Further, the diffusion index for each fiber type correlated positively with LDL-C and apo B (r = .42 to .50, P < .05 to .01). Among 14 subjects in whom high-density lipoprotein cholesterol (HDL-C) subfractions were analyzed, a positive correlation was found between cap/mm2 and HDL2-C (r = .64, P < .05). Partial correlation analysis showed that these correlations either remain or improve after adjusting for age, VO2max, and body fatness. These results indicate that skeletal muscle capillary density and diffusion capacity are related to lipid and apolipoprotein concentrations for both type I and type II fibers.

Adipose Tissue↗
PubMed1999

Hearing impairment in patients with acoustic neuroma--analysis by electrocochleography.

OBJECTIVE: In patients with acoustic neuroma, the site and severity of hearing impairment are important in discussing surgical approaches. Since the effectiveness of conventional auditory psychological testing is limited, we studied objectively hearing impairment of the cochlea and the cochlear nerve due to the tumor. METHODS: Electrocochleography (ECochG) was carried out in 21 patients with acoustic neuroma. Cochlear microphonic potential (CM) and action potential (AP) in ECochG evoked with clicks and short tone bursts were recorded through a transtympanic needle electrode technique. Cochlear function was studied using the detection thresholds of CM, and cochlear nerve involvement was analyzed by differences between AP and CM detection thresholds. RESULTS: The 1 kHz CM detection threshold was elevated in 17 (81.0%) of 21 patients indicating cochlear impairment. Of seven patients with normal hearing or mild sensorineural hearing loss in pure tone audiometry, three had a slightly elevated CM detection threshold. Of five patients with pronounced pure tone levels, four showed a CM response and were thought to have mild cochlear dysfunction. Cochlear nerve impairment was confirmed in three of four patients with well-developed CM based on elevated AP detection thresholds. Three patients had CM response but no AP response, suggesting severe cochlear nerve impairment. CONCLUSION: Disorders of the cochlea and the cochlear nerve can be evaluated with ECochG AP and CM measurement. The findings of ECochG are thought to be important information to judge hearing prognosis, thereby enhancing its clinical utility.

Adult↗
PubMed1999

Localization of mitochondrial large ribosomal RNA in the myoplasm of the early ascidian embryo.

Mitochondrial large ribosomal RNA (mtlrRNA) is transferred out of mitochondria and associates with germinal granules in Drosophila and Xenopus embryos. It has been revealed that mtlrRNA outside of mitochondria is required for formation of the germ-line progenitor, or pole cells in Drosophila. In the present study, the distribution of mtlrRNA was examined in embryos of the ascidian, Halocynthia roretzi, during cleavage stages by whole-mount in situ hybridization. Until the 4-cell stage, the distribution of mtlrRNA coincided with that of mitochondria. which are localized to the cortical cytoplasm in the posterior region of the embryos. Both mitochondria and mtlrRNA were preferentially partitioned into muscle-lineage blastomeres during cleavage stages. After the 8-cell stage, a discrepancy in intracellular localization of mitochondria and mtlrRNA became evident. Mitochondria translocated into central yolkless cytoplasm, while mtlrRNA remained in the posterior cortex in the posterior muscle-lineage b astomeres. The significance of the cortical localization of mtlrRNA in muscle precursor cells in ascidian embryos is obscure. However, the results suggest that mtlrRNA is also transferred out of mitochondria in early ascidian embryos and may play some roles in developmental processes.

Animals↗
PubMed1999

Duration of competence and inducing capacity of blastomeres in notochord induction during ascidian embryogenesis.

Notochord cells in ascidian embryos are formed by the inducing action of cells of presumptive endoderm, as well as neighboring presumptive notochord, at the 32-cell stage. Studies of the timing of induction using recombinations of isolated blastomeres have suggested that notochord induction must be initiated before the decompaction of blastomeres at the 32-cell stage and is completed by the 64-cell stage. However, it is not yet clear how the duration of notochord induction is strictly limited. In the present paper, the aim was to determine in detail when the presumptive notochord blastomeres lost their competence to respond, and when the presumptive endoderm blastomeres produced inducing signals for the notochord. Presumptive notochord blastomeres and presumptive endoderm blastomeres were isolated from early 32-cell embryos, and were heterochronously recombined at various stages ranging from the early 32-cell stage to the 64-cell stage. Presumptive notochord blastomeres could respond to inductive signals at the early 32-cell stage, and started to lose their responsiveness at the decompaction stage. By contrast, the presumptive endoderm blastomeres persisted in their inducing capacity even at the 64-cell stage. These observations suggest that the loss of competence in presumptive notochord blastomeres limits the duration of notochord induction in intact ascidian embryos.

Animals↗
PubMed1999

Ultrastructural studies on the centrosome-attracting body: electron-dense matrix and its role in unequal cleavages in ascidian embryos.

In ascidian embryos, three successive unequal cleavages occur at the posterior pole, generating a specific cleavage pattern. A recently reported novel structure designated the centrosome-attracting body (CAB) has been suggested to play essential roles in the unequal cleavages attracting centrosomes and the nucleus towards the posterior pole. To examine the morphological features of the CAB, the ultrastructure of the CAB of two ascidian species, Halocynthia roretzi and Ciona intestinalis was observed by transmission electron microscopy. Detailed observations clarified that the electron-dense matrix (EDM) was a CAB-specific component that was commonly observed in the CAB of both species but was not found in other areas of the embryo. Further observations of the CAB in various staged embryos revealed that the ultrastructure was quite stable, with no difference between points of a cell cycle or between each stage from the 8- to 64-cell stage when unequal cleavage occurred. Observations of extracted embryos implied that the EDM was the extraction-resistant component of the CAB and was tightly anchored to the plasma membrane. It has been proposed that the EDM functions as a physical attachment site at the cell cortex for microtubules emanating from centrosomes and provides a scaffold for the centrosome-attracting machinery. Interestingly, the ultrastructure of the CAB resembled germ plasm reported in other animals, raising the possibility that the CAB-containing posterior-most blastomeres are germline precursors.

Animals↗
PubMed1999

Clinical experience of left ventricular assist systems at the Heart Institute of Japan.

The main indications for left ventricular assist system (LVAS) support are postcardiotomy ventricular failure as temporary circulatory support and end-stage cardiomyopathy as chronic circulatory support. To clarify the efficacy of LVAS support, we assessed the clinical outcome of a pneumatic LVAS and an electromagnetic LVAS for patients with severe ventricular failure. As of March 1998, 5 patients with postcardiotomy ventricular failure had received the pneumatic LVAS support, and 2 other patients with end-stage idiopathic cardiomyopathy had undergone implantation of the electromagnetic LVAS. The drive control of the LVAS was mainly counterpulsation in the diastole of the native heart. In the 5 postcardiotomy patients, the duration of pneumatic LVAS support ranged from 30 to 312 h (mean, 109.2). All 3 patients with more than 72 h support were successfully weaned, and 2 of them survived. The other 2 patients with cardiogenic shock and less than 36 h support could not be weaned from the LVAS. In the 2 cardiomyopathy patients, 1 patient was well maintained by the electromagnetic LVAS support and underwent successful heart transplantation 7 months later. The other patient has been chronically supported by the LVAS for 2 months and is doing well so far. These results suggest that selective application of the pneumatic LVAS as a temporary support and the electromagnetic LVAS as a chronic support might be appropriate for maximizing the effectiveness of LVAS treatment for profound cardiac failure.

Adult↗
PubMed1999

Ex vivo evaluation of a roller screw linear muscle actuator for an implantable ventricular assist device using trained and untrained latissimus dorsi muscles.

In this study, the power output and contraction length of trained and untrained canine latissimus dorsi (LD) muscles were measured using a roller screw linear muscle actuator (RSLMA). The RSLMA consisted of a roller screw-nut assembly and translation unit to convert the linear pull force of the muscle into an axial displacement of the roller screw. When a cable wound around a spool attached at each end of the roller screw nut was pulled in either direction, the nut was rotated which in turn advanced the roller screw in the axial direction. Under anesthesia, a Telectronics myostimulator (Model 7220) was implanted in the subcutaneous area of the canine left thoracic region with its bipolar intramuscular leads implanted around the thoracodorsal nerve and the distal muscle. A total of 6 dogs went through the myostimulator implantation, followed with 8 weeks of continuous stimulation. After completion of the training, the contraction lengths of the trained and untrained LD muscles were measured, and they were 4.25 and 5.5 cm, respectively, while the instantaneous power outputs were 4.24 and 8 W, respectively. Although untrained muscles could provide much higher instantaneous power immediately following the start of the stimulation, it diminished rapidly. On the other hand, the trained muscle showed prolonged fatigue resistance. The thoracolumbar and humeral approaches in attaching the actuator cable did not show a difference with respect to muscle power output. The trained LD muscle can provide sufficient power in the range of 3-4 W to drive a left heart assist device, but its long-term evaluation awaits development of an appropriate muscle-device interface for chronic in vivo application.

Animals↗
PubMed1999

Comparative study of biocompatibility between the open circuit and closed circuit in cardiopulmonary bypass.

The theoretical benefit of a centrifugal pump or heparin coating demonstrated through in vitro or in vivo studies is not recognizable in cardiopulmonary bypass (CPB) during chemical open heart surgery. The objective of this study was to investigate the influence of the interface of air and blood in current CPB with an open circuit system and its relative significance in relationship to the heparin dose and heparin coating. Using the same oxygenator and circuit, an open circuit and closed circuit CPB with the same priming volume were prepared for a 4 h perfusion experiment using diluted and heparinized (3.6 U/ml) fresh human blood. In these experiments, both heparin-coated and noncoated circuits were examined. Blood was sampled before and 2, 30, 60, 120, and 240 min after the start of perfusion, and the platelet and white blood cell counts and beta-thromboglobulin (beta-TG) and C3a levels were measured. The amount of adsorbed protein in the hollow fibers was also measured after retrieval. Although the results demonstrated significantly better biocompatibility of the heparin-coated circuit than the noncoated circuit, the difference between the open and closed circuits was unexpectedly small and insignificant with either the heparin-coated circuit or noncoated circuit. In contrast, the C3a level was higher in the closed circuit than the open circuit. However, the amount of adsorbed protein was markedly lower in the closed circuit (0.7 microgram/cm2) than in the open circuit (11.1 micrograms/cm2). An immunoblot of the adsorbed protein showed a higher density of fibrinogen bands and conversion to fibrin in the open circuit. We speculate that the lower blood C3a level in the open circuit suggests that C3a was taken in by the adsorbed protein. In conclusion, analysis of the adsorbed protein indicates the lower biocompatibility of the open circuit. Similar experiments with less heparin use and more severe conditions will be necessary to elucidate the essential benefit of making a CPB closed circuit.

Adsorption↗
PubMed1999

Simultaneous measurement of prostaglandin and arachidonoyl CoA formed from arachidonic acid in rabbit kidney medulla microsomes: the roles of Zn2+ and Cu2+ as modulators of formation of the two products.

Under physiological conditions, small amounts of free arachidonic acid (AA) is released from membrane phospholipids, and cyclooxygenase (COX) and acyl-CoA synthetase (ACS) act competitively on this fatty acid to form prostaglandins (PGs) and arachidonoyl-CoA (AA-CoA). To date, there is no information about the factors deciding the metabolic fate of free AA into these two pathways. In this study, we tried to establish a method for the simultaneous measurement of PG and AA-CoA synthesis from exogenous AA in microsomes from rabbit kidney medulla. The kidney medulla microsomes were incubated with [14C]-AA in 0.1 M-Tris/HCI buffer (pH 8.0) containing cofactors of COX (reduced glutathione and hydroquinone) and cofactors of ACS (ATP, MgCl2 and CoA). After incubation, PG (as total PGs), AA-CoA and residual AA were separated by selective extraction using petroleum ether and ethyl acetate. When 60 microM AA was used as the substrate, indomethacin (an inhibitor of COX) and triacsin C (an inhibitor of ACS) reduced only PG and AA-CoA formation, respectively. On the other hand, when 5 microM AA was used as the substrate, indomethacin and triacsin C came to increase significantly the AA-CoA and PG formation, respectively. Thus, the experiments utilizing indomethacin and triacsin C revealed that the incubation using 60 microM AA can simultaneously detect the changes in the activities of COX and ACS caused by drugs, while the incubation using 5 microM AA can detect the changes in the product formation elicited by the resulting shunt of AA. Further, using these incubation conditions, the effects of Zn2+ and Cu2+ on the PG and AA-CoA formation were examined. Zn2+ inhibited the AA-CoA synthesis from 60 microM AA without affecting the PG synthesis. In contrast, when 5 microM AA was used as the substrate, a significant increase in the PG formation was observed in the presence of this ion, indicating that drug actions on the PG formation from AA by the kidney medulla microsomes may change depending on the substrate concentration. On the other hand, Cu2+ increased PG synthesis and inhibited AA-CoA synthesis from both 60 and 5 microM AA. These results suggest that the simultaneous measurements of PG and AA-CoA formation by the kidney medulla microsomes under high (60 microM) and low (5 microM) substrate concentrations can investigate the direct and indirect actions of drugs on the COX and ACS activities, and are useful for clarifying the haemostatic control of the metabolic fate of AA into the two enzymatic pathways. Furthermore, this study showed that Zn2+ and Cu2+ can modulate PG and AA-CoA formation by affecting COX activity, ACS activity, and/or the AA flow into the two enzymatic pathways.

Acyl Coenzyme A↗
PubMed1999

Transcatheter adrenal arterial embolization of cortisol-producing tumors. Two cases of Cushing's syndrome.

Transcatheter arterial embolization (TAE) was performed in 2 patients with Cushing's syndrome caused by adrenal adenoma by using a mixture of absolute ethanol and iohexol. In 1 patient successful suppression of the hypersecretion of cortisol has continued for 9 months after TAE without complications. However, in the other patient, TAE was discontinued due to marked hypertension and tachycardia induced by a massive release of catecholamines from the embolized "normal" part of the tumor-bearing adrenal gland during the procedure. These results suggest that it is important to perform TAE of only the arterial branches feeding the tumor.

Adenoma↗
PubMed1999

Permineralized Ferns from the Middle Eocene Princeton Chert. I. Makotopteris princetonensis Gen. et Sp. Nov. (Athyriaceae).

The occurrence of numerous anatomically preserved specimens of an extinct filicalean fern in the middle Eocene Princeton chert from southern British Columbia, Canada, provides the basis for characterizing a new genus and species of the Athyriaceae. Fossils include narrow horizontal rhizomes with a radial amphiphloic dictyostele and internodes up to 1.5 cm long. Fronds are monomorphic. Adventitious roots are diarch and display a parenchymatous cortex. Stipes diverge in a radial fashion and display two hippocampiform bundles at the base. Distally, the bundles unite into a single trace, and pinnules are produced in an opposite to subopposite arrangement. The stipe, rachis, and pinnules display a continuous U-shaped groove on the adaxial surface. Sori of annulate sporangia are borne below veins on swollen receptacles. The sporangia are characterized by a vertical annulus and a narrow, elongated stalk. Spores are monolete and ellipsoidal, with a psilate exine and a distinctly spiny perispore. Makotopteris princetonensis gen. et sp. nov. significantly increases our knowledge of the fossil record for the Athyriaceae and documents that essentially modern athyrioids were present in the flora of North America by the early Tertiary.

Journal Article↗
PubMed1999

Cochlear microphonics for hearing preservation in vestibular schwannoma surgery.

OBJECTIVES: To determine whether cochlear function is beneficial in decision-making concerning the selection of hearing preservation surgery for vestibular schwannoma. STUDY DESIGN: Retrospective review of 44 patients undergoing tumor resection with a middle fossa approach. METHODS: Cochlear microphonics in electrocochleography together with tumor size, pure-tone average (PTA), speech discrimination score (SDS), auditory brainstem response (ABR), and compound action potentials were examined. As acoustic stimuli, short tone-bursts with frequencies of 0.5, 1, and 2 kHz were employed to measure cochlear microphonics and a click was used to obtain compound action potentials. We determined detection thresholds of cochlear microphonics and action potentials. RESULTS: The overall rate of preservation of serviceable hearing was 59.1% (26/44). There were significant differences between patients with and without serviceable postoperative hearing in PTA, SDS, finding of ABR, compound action potential detection threshold, and mean cochlear microphonic detection threshold (at 0.5, 1, and 2 kHz). However, tumor size was unrelated to hearing outcome. Serviceable hearing was preserved in 23 (76.7%) of 30 patients, with a mean cochlear microphonic detection threshold of 40 dB nHL or less, suggesting normal or slightly impaired cochlear function. Hearing recovery was recognized in three patients, who also had a mean cochlear microphonic detection threshold of 40 dB nHL or less. Of the three patients, two had lower cochlear microphonic detection thresholds than audiometric thresholds, demonstrating the existence of a retrocochlear component in their hearing loss. CONCLUSIONS: The cochlear microphonic detection threshold predicts not only hearing preservation but also hearing improvement in patients with vestibular schwannomas.

Adult↗