Search PubMed⌕ Search

Biomedical subjects

H Sugimoto

Publications and source records attributed to H Sugimoto.

At least 253 records · Page 14Linked to original sources
PubMed1993

[A successful repair of anomalous origin of right pulmonary artery from ascending aorta complicated with subdural hematoma, MRSA infection and postoperative intestinal perforation].

A 2-month-old male infant with anomalous origin of right pulmonary artery from ascending aorta who had subdural hematoma and MRSA infection due to the hemodynamic deterioration after cardiac catheterization was reported. The cardiac anomaly was successfully corrected by bypass grafting between the right pulmonary artery and the pulmonary trunk with an expanded polytetrafluoroethylene tube. This procedure without cardiopulmonary bypass was selected because of the presence of subdural hematoma and poor general conditions, and no signs of mediastinitis were noticed postoperatively in spite of the use of artificial material. But he had colostomy and drainage due to postoperative intestinal perforation. The complicated postoperative course of this patient recommends us the surgical correction of this anomaly without cardiac catheterization.

Aorta↗
PubMed1992

Synthesis and structure-activity relationships of acetylcholinesterase inhibitors: 1-benzyl-4-(2-phthalimidoethyl)piperidine and related derivatives.

Following the discovery of a new series of 1-benzyl-4-[2-(N-benzoyl-N-methylamino)ethyl]piperidine (2) derivatives with a potent anti-acetylcholinesterase (anti-AChE) activity, we extended the structure-activity relationships (SAR) to rigid analogues (4) and 1-benzyl-4-[2-(N-benzoyl-N-phenylamino)ethyl]piperidine derivatives (3). Introduction of a phenyl group on the nitrogen atom of the amide moieties resulted in enhanced activity. The rigid analogue containing isoindolone (9) was found to exhibit potent anti-AChE activity comparable to that of 2. Furthermore, replacement of the isoindolone with other heterobicyclic ring systems was examined. Among the compounds prepared in these series, 1-benzyl-4-[2-[4-(benzoylamino)phthalimido]ethyl]piperidine hydrochloride (19) (IC50 = 1.2 nM) is one of the most potent inhibitors of AChE. Compound 19 showed a definite selectivity to AChE over the BuChE (about 34700-fold) and, at dosages of 10-50 mg/kg, exerted a dose-dependent inhibitory effect on AChE in rat brain.

Acetylcholinesterase↗
PubMed1992

QSAR analyses of the substituted indanone and benzylpiperidine rings of a series of indanone-benzylpiperidine inhibitors of acetylcholinesterase.

QSAR analyses have been performed on the substituted indanone and benzylpiperidine ring substructures of a set of acetylcholinesterase, AChE, inhibitors of which 1-benzyl-4-[(5,6-dimethoxy-1-oxoindan-2-yl)methyl]piperidine hydrochloride is a potent in vitro and ex vivo inhibitor. The method of molecular decomposition-recomposition was used to define the sets of molecular substructures and corresponding in vitro inhibition databases. A QSAR involving the magnitude of the dipole moment, the highest occupied molecular orbital (HOMO) energy, and a specific pi-orbital wave function coefficient of the substituted indanone ring substructure was constructed and found to be significant. The absence of any molecular-shape or bulk term in the QSAR, coupled with some of the relatively large substituents used to construct the QSAR, suggests considerable space is available around the indanone ring during the inhibition process. A set of QSARs were constructed and evaluated for substituents on the aromatic ring of the benzylpiperidine substructure. The most significant QSAR involves a representation of molecular shape, the largest principal moment of inertia, and the HOMO of the substituted aromatic ring. It appears that upon binding the receptor "wall" is closely fit around the benzyl ring, especially near the para position. Overall, the QSAR analysis suggests inhibition potency can be better enhanced by substitution on the indanone ring, as compared to the aromatic sites of the benzylpiperidine ring. Moreover, inhibition potency can be rapidly diminished, presumably through steric interactions with the receptor surface of AChE, by substitution of moderate to large groups on the benzyl ring, particularly at the para position.

Cholinesterase Inhibitors↗
PubMed1992

Conformational analyses and molecular-shape comparisons of a series of indanone-benzylpiperidine inhibitors of acetylcholinesterase.

Conformational analyses and molecular-shape comparisons were carried out on an analogue series of indanone-benzylpiperidine inhibitors of acetylcholinesterase (AChE). It was possible to define an active conformation with respect to the flexible geometry of the benzylpiperidine moiety, as well as an active conformation of the indanone ring-piperidine ring substructure for analogues having a single spacer group between these rings. No active conformation could be postulated for analogues having two or three spacer units between the indanone and piperidine conformation could be postulated for analogues having two or three spacer units between the indanone and piperidine rings. Still, a receptor binding model can be constructed for all indanone and piperidine ring substructures. The postulated active conformation for 1-benzyl-4-[(5,6-dimethoxy-1-oxoindan-2-yl)methyl]piperidine hydrochloride (1a), a potent AChE inhibitor, is close to the crystal structures of 1a with respect to the indanone-piperidine substructure, but differs from the crystal structures for the benzylpiperidine moiety. However, the crystal conformations and the postulated active conformation of the benzylpiperidine portion of the AChE inhibitor are estimated to be about equally stable. A trans-decalin analogue of 1a can adopt the postulated active conformation as shown by calculation and as seen in its crystal structure. The inactivity of this analogue is explained by the added steric size of the decalin unit and/or the time-average valence geometry behavior at the spiro junction to the indanone ring.

Cholinesterase Inhibitors↗
PubMed1992

Spontaneous rupture of hepatocellular carcinoma: an approach with delayed hepatectomy.

Two cirrhotic patients with ruptured hepatocellular carcinoma (HCC), presenting with hemoperitoneum, were successfully treated by elective hepatectomy. Both of these patients, a 67-year-old female and a 76-year-old male, had first been taken to other primary hospitals by ambulance due to hypovolemic shock. They were then found to have a mass of approximately 5 cm in the cirrhotic liver. In the initial management, however, neither any direct hemostasis by surgery nor indirect measures such as transcatheter hepatic arterial embolization were performed in either case. Instead, conservative treatment consisting mainly of fresh blood and plasma transfusions were continued for more than a month until the liver function stabilized. In both hepatectomies, the use of a microwave tissue coagulator resulted in minimal intra-operative blood loss and an appreciably excellent post-operative course. These cases point to the effectiveness of a "wait and see" policy for selected patients with ruptured HCC.

Aged↗
PubMed1992

Left ventricular performance in patients with thermal injury or multiple trauma: a clinical study with echocardiography.

Left ventricular (LV) contractile and diastolic performance was evaluated in patients with thermal injury or multiple trauma using precordial and transesophageal echocardiography. Thirty-nine patients were divided into four groups: group B1 (within 24 hours after thermal injury); group B2 (from 24 to 72 hours after thermal injury); group M (multiple trauma); and a control group (outpatients). Left ventricular contractile indices, including ejection fraction, mean velocity of circumferential fiber shortening, and the ratio of systolic blood pressure to LV end-systolic dimension, were not impaired in any of the experimental groups. The ratio of LV filling volume during rapid filling to stroke volume, obtained from M-mode echocardiography as an index of LV distensibility, was significantly decreased in groups B1 (44.5% +/- 8.8%) and B2 (46.8% +/- 8.5%) compared with controls (61.9% +/- 7.4%) (p less than 0.05). The ratio of the peak velocity in the atrial contraction phase to that in the rapid filling phase, obtained using pulsed Doppler echocardiography, also showed significant impairment of LV distensibility in groups B1 (1.08 +/- 0.12) and B2 (1.09 +/- 0.07) compared with controls (0.71 +/- 0.12) (p less than 0.01). Group M showed no significant impairment of these diastolic indices. A profound depression of LV diastolic function thus occurs following thermal injury but not following multiple trauma.

Adolescent↗
PubMed1992

Estradiol-17 beta modifies the induction of spermidine/spermine N1-acetyltransferase activity in the liver of lipopolysaccharide-treated mice.

In an attempt to elucidate the effects of estrogen on polyamine metabolism in lipopolysaccharide (LPS)-treated mice, we assayed polyamine content and the activity of spermidine/spermine N1-acetyltransferase (SAT) and ornithine decarboxylase (ODC) in some organs. LPS elevated N1-acetylspermidine levels in the liver and lung and putrescine levels in the liver, lung and spleen. LPS increased the activity of ODC at 6 h and that of SAT at 12 h in the liver. When estradiol-17 beta was simultaneously administered with LPS, the maximum increase in hepatic N1-acetylspermidine levels was found 6 h earlier than in the LPS control. Likewise, the peak of the hepatic SAT activity after LPS-treatment was observed 6 h earlier in the estradiol-17 beta-treated mice than in the LPS control. No such effect of estradiol-17 beta was found in the lung and spleen. The LPS-induced ODC activity was not affected by estradiol-17 beta in the liver, lung or spleen. Estrone and 16 beta-ethylestradiol (an anti-estrogen) were also effective in enhancing the LPS-induced elevation of N1-acetyl-spermidine and putrescine in the liver, while both diethylstilbestrol, which has a potent estrogenic activity without steroid structure and estradiol-17 alpha (a non-estrogenic isomer of estradiol-17 beta) were without effect. Tamoxifen (an estrogen receptor antagonist) did not suppress the estrogen-induced increase in hepatic N1-acetylspermidine levels.

Acetyltransferases↗
PubMed1992

Obliteration of the descending aortic interface in pectus excavatum: correlation with clockwise rotation of the heart.

Obliteration of the descending aortic interface is a new radiographic finding in pectus excavatum. Seventy frontal and lateral chest radiographs and 33 computed tomographic (CT) scans of patients with pectus excavatum were retrospectively reviewed to evaluate the frequency, possible cause, and clinical significance of this finding, which was detected in 21 of 70 cases (30%) of pectus excavatum. No significant relationship was found between this finding and the extent of the thoracic deformity. In patients with this finding, the left inferior pulmonary vein (PV) entered the left atrium at an acute angle to the sagittal plane, as demonstrated at CT, and this angle was significantly smaller than that in patients without this finding. The PV angle also significantly correlated with the cardiac rotation angle. In pectus excavatum, partial obliteration of the descending aortic interface can be mistaken for adjacent disease.

Adult↗
PubMed1992

Airway responses to repeated exercises detected by krypton-81m in asthmatic children.

A repeated exercise program was used to test 7 asthmatic children for changes in ventilation. These changes were examined by continuously inhaled Krypton-81m and compared in subjects with positive and negative refractoriness, as defined by forced expiratory volume in 1 second (FEV1). Three of the seven patients showed significant refractoriness (% reduction in FEV1 > 50%). After the first exercise, they showed one or two ventilation defects which improved after the second exercise. The patient with incomplete refractoriness showed similar results. On the contrary, subjects without refractoriness showed several ventilation defects which fluctuated after the second or third exercise program. One defected area improved after the second exercise session, but deteriorated after the third; and another area deteriorated after the second exercise and improved after the third. It was concluded that approximately half of the patients were refractory in view of FEV1, but that they were all refractory in view of regional ventilation 81mKr images.

Acetylcholine↗
PubMed1992

[Isolated abducens nerve palsy caused by pontine infarction].

An 82-year-old hypertensive man suddenly developed diplopia during right lateral gaze. Neurological examination revealed right isolated abducens nerve palsy without any other findings. By cranial CT scan, a low density area over the posterior limb of right internal capsule and tortuosity of basilar artery were noted. 3 months later, his symptom disappeared and then he was well in next 2 years til he felt diplopia during left lateral gaze. On this time he showed left isolated abducens nerve palsy. Though cranial CT scan failed to find out new abnormality, T2-weighted cranial MRI disclosed high intensity spot over left pontine base located between medial lemniscus and pyramidal tract, which was supposed to coincide to fascicle of left abducens nerve Three months later, he recovered in the same manner as 2 years before. Hemilateral isolated abducens nerve palsy may be caused by many origins, but pontine infarct was not detected so much in pre-MRI era. Being the long-term prognosis of the lacunar infarction not satisfactory, it is important for the cases of isolated abducens palsy to ascertain whether there is pontine small infarction or not. So in these cases, precise examination including MRI should be needed.

Abducens Nerve↗