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Biomedical subjects

H Shin

Publications and source records attributed to H Shin.

At least 19 recordsLinked to original sources
PubMed1995

Thrombin receptor-mediated synovial proliferation in patients with rheumatoid arthritis.

Synovial cell proliferation is one of the pathological bases of rheumatoid arthritis (RA). Several cytokines including IL-1 and IL-6 and growth factors have been shown to be involved in the synovial cell proliferation in RA. Thrombin is a multifunctional protease and acts as a mitogen for several cell types through its specific receptor. To assess whether thrombin is involved in overproliferation of rheumatoid synovial cells, we measured the concentration of thrombin-anti-thrombin III (ATIII) complex (TAT) in synovial fluid obtained from patients with RA or osteoarthritis (OA). We also examined the effect of thrombin or thrombin receptor agonist peptide (TRAP) on cell growth of synovial cell clones (SCCs) established from an RA patient. The concentrations of TAT in the synovial fluid from patients with RA were significantly higher than in those with OA. Moreover, both thrombin and TRAP enhanced proliferation of synovial cells in vitro. We also characterized the expression of thrombin receptor mRNA by reverse transcription-PCR. The expression of mRNA for thrombin receptor was up-regulated by thrombin or TRAP stimulation. Thrombin receptor antigen was also detected on both SCCs and synovial tissue from RA patients by immunostaining using a monoclonal antibody against thrombin receptor. These findings indicate that thrombin may act as a mitogen for synovial cells through thrombin receptor and may play some role in synovial overproliferation and remodeling in RA.

Adult↗
PubMed1995

Kissing aneurysms of distal anterior cerebral arteries demonstrated by magnetic resonance angiography.

BACKGROUND Multiple aneurysms, associated with distal anterior cerebral artery (ACA) aneurysm, are not rare; therefore, it is important to examine multiplicity of the aneurysms preoperatively. CASE REPORT A case of ruptured distal ACA aneurysm, associated with another one in a mirror position, is reported. A 43-year-old woman suffered subarachnoid hemorrhage. Conventional angiography demonstrated a saccular aneurysm on the bifurcation of the right or left distal ACA; however, magnetic resonance angiography (MRA) revealed two mirror-image aneurysms on both bifurcations. CONCLUSION MRA was useful for preoperative diagnosis of kissing aneurysms on distal ACAs.

Adult↗
PubMed1995

Disappearance of arachnoid cysts after head injury.

The mechanism of the disappearance of arachnoid cysts is not fully understood. This article discusses the spontaneous disappearance of these cysts after head injury. Five patients underwent computed tomography and were diagnosed as having a subdural hematoma or effusion associated with arachnoid cysts. In four of the five patients, the cyst decreased in size or disappeared. These cases suggest a possible mechanism by which this type of cyst associated with subdural hematoma or effusion might disappear. For the arachnoid cyst to disappear, the rupture of the cyst wall appears to be essential, and after rupture, subdural effusion must develop around the cyst. As this effusion is absorbed, the fluid in the cyst drains away, after which the cyst becomes smaller and gradually disappears. This hypothesis supports the possibility of a "natural cure" for arachnoid cysts without surgical intervention.

Adolescent↗
PubMed1995

[A case of subarachnoid hemorrhage with acute subdural hematoma due to head injury: a case report].

Acute intracranial hemorrhages can be caused by cerebrovascular disease or head injury. Diagnostic imaging is in both cases sometimes similar, so it is difficult to make an exact diagnosis. We report a case of acute subdural hematoma due to head injury after loss of consciousness due to an aneurysmal rupture. A 52-year-old male was found out fallen on the floor in a state of unconsciousness and was brought to the nearest hospital. CT scan showed subarachnoid hemorrhage with left acute subdural hematoma and he was transported to our hospital. Angiography revealed a left MCA aneurysm. The next day, a clipping operation was performed but brain contusion was observed in the left frontal lobe. Postoperative CT scan showed contusional hematoma at the left frontal lobe and plain skull X-ray films demonstrated a diastatic fracture of the right lambdoid suture. Acute subdural hematoma due to the rupture of a cerebral aneurysm is sometimes recognized, but the first CT findings are similar to those observed after head injury. When the clinical course of onset is unclear, we must keep in mind that the cause of acute subdural hematoma may be head injury, even if angiography demonstrates abnormal vessels.

Acute Disease↗
PubMed1995

["Disproportionately large, communicating fourth ventricle" due to membranous obstruction of Magendie's foramen].

A case of disproportionately large, communicating fourth ventricle (DLCFV) with the entire ventricular system dilated symmetrically due to membranous obstruction of Magendie's foramen is reported. A 20-year-old female complained of headache and nausea. Slight papilledema was found in both eyes. CT scan and MRI showed that the entire ventricular system was dilated symmetrically, but we could not locate the cause of this disease, for example, tumor, arachnoid cyst, cerebellar malformation and so on. Although cinemode-MRI showed CSF pulsation as if CSF flowed through Magendie's foramen, we were not convinced that CSF flowed through it. We speculated that something obstructed CSF flow at Magendie's or Luschka's foramen, so surgery was performed by suboccipital craniectomy. As expected, a membranous obstruction was found at Magendie's foramen. After excision of the membrane, all symptoms improved. Postoperative cinemode-MRI clearly demonstrated CSF flow through Magendie's foramen. Ventriculoperitoneal shunting is generally effective for DLCFV, but we do not consider it the optimal treatment. The cause of DLCFV must be confirmed by suboccipital craniectomy if evidence of NPH, mass lesion or cerebellar malformation cannot be found anywhere especially around Magendie's foramen.

Adult↗
PubMed1995

[A case report of surgical repair for distal aortic arch aneurysm with abdominal aortic aneurysm].

A 77-year-old female was referred to our hospital with hoarseness and an abnormal shadow on her chest X ray film. Computed tomography and aortography revealed aneurysms of the distal aortic arch and the infrarenal abdominal aorta. Total aortic arch replacement was performed successfully on the patient, utilizing hypothermic selective cerebral perfusion. The operation employed three technical characteristics for avoidance of cerebral complication. Those were as follows: First, total aortic arch replacement was performed instead of distal aortic arch replacement because of severe sclerosis of the proximal aortic arch. Secondly, to prevent cerebral embolism due to the thrombi on the wall of the abdominal aortic aneurysm, an arterial cannula for cardiopulmonary bypass was inserted in the ascending aorta initially and after completion of the distal anastomosis, it was placed on the graft. Thirdly, the so called "non clamping technique" operation was employed because clamping onto the sclerotic arteries might have caused cerebral embolism. There was no cerebral complication and the postoperative course was satisfactory.

Aged↗
PubMed1994

Involvement of NF-kappa B activation in thrombin-induced human vascular smooth muscle cell proliferation.

A thrombin receptor has been cloned and is thought to mediate a variety of thrombin-induced responses. However, the transcription factors important for postreceptor signaling have been little clarified. The post-receptor signals are mediated by several protein kinases responsible for NF-kappa B activation, and most thrombin-inducible genes have the kappa B sequence in the regulatory elements. The possibility that NF-kappa B may participate in thrombin signaling was therefore investigated in cultured human vascular smooth muscle cells (VSMCs). Thrombin receptor stimulation resulted in activation of NF-kappa B. Furthermore, treatment of cells with antisense p65 ODNs of NF-kappa B inhibited thrombin-stimulated growth of VSMC in vitro. Results indicate that the activation of NF-kappa B is involved in thrombin signaling and that this pathway causes the proliferation of VSMC induced by thrombin. Therapeutic potential of antisense NF-kappa B ODNs for the treatment with atherosclerosis and restenosis is also indicated.

Acid Phosphatase↗
PubMed1994

E5510 antagonizes thrombin receptor signals by inhibiting NF-kappa B activation.

We have recently demonstrated that NF-kappa B is involved in a thrombin-signaling and that the antisense oligodeoxynucleotides (ODNs) of NF-kappa B has a marked inhibitory effect on thrombin-induced cellular responses. In this study, we demonstrate that E5510 (4-cyano-5,5-bis(methoxyphenyl)-4-pentenoic acid), a compound with anti-platelet activity preferentially inhibits the thrombin-inducible NF-kappa B activation and then antagonizes the following thrombin-induced cellular responses, proliferation and cytokines production in vascular smooth muscle cell, and the adherency of differentiated HL-60 cells. These data suggest that E5510 is an anti-atherosclerotic or anti-restenotic drug induced by thrombin.

Amino Acid Sequence↗
PubMed1994

[A case report of the maze procedure with mitral valve replacement].

The maze procedure was performed simultaneously with mitral valve replacement for atrial fibrillation and mitral stenosis in a 66-year-old female. On the first postoperative day, the cardiac status deteriorated suddenly due to a very rapid heartbeat which was later diagnosed as a 1:1 AV conduction of atrial flutter. The atrial flutter responded to an injection of verapamil and changed to a 2:1 conduction. Although atrial flutter had continued until the thirteenth postoperative day, the heart achieved sinus rhythm on that day. Since then it has continued without any antiarrhythmic drugs except digitalis. It was difficult to make a diagnosis of the rapid heartbeat on the 12-lead ECG because P waves could not be seen clearly on the ECG. Recording the electrical cardiac status by using the temporal atrial pacing leads, which were placed during the operation, was helpful in diagnosing the heartbeat as atrial flutter. The electrophysiological examination eight weeks after the operation revealed that the sinus node function was normal and atrial flutter or atrial fibrillation could not be induced. The patient is well and in sinus rhythm 12 months after the operation.

Aged↗
PubMed1993

[Purification of pig adrenal 3 beta-hydroxysteroid dehydrogenase/isomerase and influence on microsomal membrane destruction on its enzyme activity].

A 3 beta-hydroxysteroid dehydrogenase/delta 4-delta 5-isomerase (3 beta-HSD/isomerase) has been purified to homogeneity from the pig adrenal microsomes by solubilization with sodium cholate, followed by some conventional column chromatographies. The molecular weight of the enzyme was estimated to be 42000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The Km value for pregnenolone as the substrate of the purified enzyme was higher than that of the microsomal enzyme. The purified enzyme was less stable for heat treatment than the microsomal binding enzyme. The microsomal enzyme was treated with various agents or enzymes which destroyed the membrane structure. Lipid peroxidation with Fe2+, digestion with phospholipase A2 or C, and the addition of various free fatty acids, imidazole containing compounds and polymyxin B were utilized for the membrane destruction. Consequently, the 3 beta-HSD/isomerase activity was significantly reduced in all cases, and the Km value of the 3 beta-HSD/isomerase for pregnenolone increased. And the Vmax and Vmax/Km values significantly decreased. Therefore, it is strongly suggested that the normal membrane structure plays an important role in the maintenance of the 3 beta-HSD/isomerase activity.

3-Hydroxysteroid Dehydrogenases↗
PubMed1993

[Three cases of aortic root replacement by cryopreserved homograft with effective usage of its anterior mitral leaflet].

Homograft aortic root replacement was done to three patients and the anterior mitral leaflet of the homograft was used with success in all cases. Case 1. A 37-year-old man had late-onset active prosthetic valve endocarditis with a fistula from the aortic annulus to the left atrium. The fistula was closed by using a homograft anterior mitral leaflet and the aortic root was replaced by a homograft with reimplantation of the coronary arteries. He is very well without evidence of recurrent endocarditis 29 months after the operation. Case 2. A 37-year-old man had early-onset active prosthetic valve endocarditis and developed the same fistula as case 1. He was treated successfully as in case 1. He is very well 4 months after the operation. Case 3. A 50-year-old woman, who had undergone aortic commissurotomy due to aortic valvular stenosis fifteen years before, deteriorated again. She had subvalvular membranous stenosis and a small aortic annulus. Konno-Soma procedure was applied to enlarge the annulus and the aortic root was replaced by a homograft. The interventricular septal incision was closed successfully with use of the anterior mitral leaflet of the homograft. Homograft aortic root replacement was an attractive procedure for prosthetic valve endocarditis or a small aortic annulus, and the homograft anterior mitral leaflet was useful for closing the fistula due to the infection and for closing the interventricular septal incision of Konno-Soma procedure.

Adult↗
PubMed1993

[A case of mitral regurgitation treated by combined superior transseptal approach and electrophysiological examination of the sinus node function].

A 67-year-old man with mitral regurgitation underwent mitral valvoplasty and annuloplasty successfully. Combined superior transseptal approach was adopted to expose the mitral valve, because the left atrium was small. The exposure of the mitral valve was excellent. But this approach cannot avoid damaging the sinus node artery, so that why the sinus node function was examined electrophysiologically before and after the operation. Sino-atrial conduction time (SACT) and corrected sinus node recovery time (CSRT) were measured as the indices of the sinus node function. Both SNCT and CSRT after the operation was within normal range. As far as this case, combined superior transseptal approach, which gave good exposure of the mitral valve but needed to cut the sinus node artery, did not deteriorate the sinus node function.

Aged↗
PubMed1993

[Surgical treatment with aortic valve homograft harvested from heart transplant recipients or donors].

From March 1988 to November 1991, 24 patients underwent aortic valve replacement or aortic root replacement with an aortic homograft harvested from a heart transplant recipient or donor that was not suitable for heart transplantation. Those patients were followed from 2 to 34 months (mean 12.6 months). The mean age was 44 years (range 19 to 77 years). The main lesion was aortic stenosis in 8 patients, aortic regurgitation in eight, mixed lesion in eight, annulo-aortic ectasia in two, active prosthetic valve endocarditis in two, and recurrent LVOTO in one. Cardiac status before operation was NYHA class II in one patient, III in nineteen, IV in four. Aortic valve replacement was performed in 17 patients, and aortic root replacement in seven. There was no early or late death. No structural deterioration was found. Surgical technical error resulted in moderate aortic regurgitation in one patient and mild paravalvular leak in another patient immediately after operation. All patients except one were not given anticoagulants postoperatively, but the entire group was free from thromboembolism. All patients returned to NYHA class I. Most homografts in this series were cryopreserved without antibiotic sterilization immediately after harvest, but homograft valve endocarditis did not occur. The results in this series suggested that homografts from heart transplant recipients or donors were encouraging, but more long-term follow-up was required to be determined whether homografts from heart transplant recipients without antibiotic sterilization were superior to homografts prepared in ordinary manner.

Adolescent↗
PubMed1993

[One-staged operation for funnel chest, mitral regurgitation and annulo-aortic ectasia associated of Marfan's syndrome].

One-staged operation was successfully performed in a 23-year-old female with funnel chest, mitral regurgitation and annulo aortic ectasia secondary to Marfan's syndrome. A midline skin incision was made and the sternum and costal cartilages were mobilized for sternal turnover with rectus muscles pedicle. This procedure offered an excellent operative field, even though the heart and aneurysmal ascending aorta were displaced into the left hemithorax. The combined superior-transseptal approach to the left atrium was used to perform mitral valve replacement. This approach also provided an excellent exposure of the mitral valve. Cabrol's operation was done for annulo aortic ectasia. Our concepts for the operation of open heart surgery complicated with severe funnel chest were discussed.

Adult↗
PubMed1992

Molecular diagnosis of Borrelia burgdorferi infection (Lyme disease).

In spite of significant advances in immunologically based testing, accurate diagnosis of Lyme borreliosis remains problematic. To address this issue, a DNA amplification-based diagnostic test was developed utilizing the polymerase chain reaction (PCR) and oligonucleotide primers specific for the OspA and OspB genes of Borrelia burgdorferi. In this approach, a relatively large DNA fragment is amplified with an outer set of primers, and a "nested" internal sequence of the PCR product subsequently reamplified with an inner set of primers. This nested approach coupled with simple differential centrifugation allowed specific detection of as few as four B. burgdorferi organisms mixed in 2 ml of blood. This methodology was utilized on patients' samples, and it allowed detection of B. burgdorferi in the peripheral blood and urine of several individuals with clinical evidence of Lyme borreliosis. PCR became negative and symptoms improved following antibiotic therapy of treated individuals. These studies suggest that direct detection of Borrelia in infected individuals can aid in diagnosis and evaluation of therapy for Lyme borreliosis.

Base Sequence↗
PubMed1992

[An adult case of anomalous origin of the left coronary artery from the pulmonary artery].

An adult case of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) was presented. A 37-year-old male was admitted for ventricular arrhythmia and chest pain. The catheterization, left ventriculography and coronary arteriography revealed ALCAPA with anterolateral ventricular aneurysm and mild mitral regurgitation. An operation using Takeuchi procedure was performed. The postoperative course was uneventful and the results of the catheterization, left ventriculography and coronary arteriography performed immediately and five years after the operation were excellent except mild supravalvular pulmonary stenosis. Six years later, the patient is asymptomatic and well.

Adult↗
PubMed1991

[A case report of aortic stenosis complicated with complete atrioventricular block].

A case of aortic stenosis complicated with complete atrioventricular block preoperatively was reported. The patient was a 73-year-old woman who had been suffering from dyspnea and fatigability. Preoperative echocardiography revealed severe left ventricular hypertrophy, marked left ventricular-aortic pressure gradient (144 mmHg), and the impairment of left ventricular distensibility. Therefore, DDD pacemaker was implanted in addition to aortic valve replacement. Postoperative cardiac catheterization revealed that cardiac output was increased about 25% by DDD pacing compared with VVI pacing. It is more reasonable to employ DDD pacemaker to the case of which distensibility is impaired.

Aged↗