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Biomedical subjects

H Sugimoto

Publications and source records attributed to H Sugimoto.

At least 307 records · Page 17Linked to original sources
PubMed1989

A study on limulus amebocyte lysate (LAL) reactive material derived from dialyzers.

The amebocytes of horseshoe crab (Limulus) hemolymph contain a coagulation system highly sensitive to bacterial endotoxins. Limulus amebocyte lysate (LAL) reactive material derived from cuproammonium rayon membranes, however, is not an endotoxin and acts upon the alternative pathway in the coagulation cascade found in Limulus amebocyte lysate. This study confirmed these facts by using the coagulation system of Limulus without factor G, which is a substrate of the alternative pathway. LAL reactive material lingered in the circulation for a relatively long time. In acute hemodialysis, its plasma concentration increased by an average of 100 pg/ml with each dialysis and eventually reached a plateau of approximately 300 pg/ml. In patients with chronic renal failure under regular hemodialysis, the mean level of LAL reactive material was 330.0 +/- 8.0 pg/ml before hemodialysis which increased by 70.6 +/- 20.7 pg/ml after four hours of hemodialysis.

Acute Kidney Injury↗
PubMed1989

Superoxide dismutase and alpha-tocopherol suppress the paraquat-induced elevation of N1-acetylspermidine and putrescine in primary culture of adult rat hepatocytes.

A transient increase in N1-acetylpolyamines and putrescine (PUT) was observed in hepatocytes at the early stage of primary culture of rat hepatocytes. After pre-culture for 36 hr when the polyamine content returned to constant levels, we tested the effects of superoxide dismutase (SOD) and alpha-tocopherol on the paraquat-induced increase in N1-acetylspermidine (N1-acetyl-SPD) and PUT in the culture. Paraquat increased (N1-acetyl-SPD in a dose-dependent manner. It also increased PUT at doses between 0.1 and 1.3 mM. Both SOD and alpha-tocopherol suppressed the increase in N1-acetyl-SPD and PUT induced by paraquat. These results suggested that superoxide anion is one of the factors which increase N1-acetyl-SPD and PUT in hepatocytes. Lipopolysaccharide (LPS) little affected the polyamine concentration in the cultured hepatocytes, though it increases polyamine in mouse liver when given in vivo. These findings suggested that the formation of superoxide anion after administration of LPS in vivo is mediated by Kupffer cells.

Animals↗
PubMed1989

Ultraviolet-induced suppressor T cells and factor(s) in murine contact photosensitivity. II. Igh-V restriction of T-cell-suppressor factor.

In murine contact photosensitivity (CPS) to 3,3',4',5-tetrachlorosalicylanilide, we have reported that antigen-specific suppressor T cells and factor(s) (TsF) are induced by preexposure of the photosensitizing site to low doses of ultraviolet B. The TsF is a single-chain factor bearing both antigen-binding site(s) and I-J determinants. In this report, we examined the genetic restriction of the factor in terms of both H-2 and Igh-associated genes. The CPS responses of BALB/c (H-2d, Igh-VaCa) and BALB.B (H-2b, Igh-VaCa) but not DBA/2 (H-2d, Igh-VcCc) were suppressed by the injection of the BALB/c TsF, and reciprocally, the response of BALB/c was suppressed by the BALB.B TsF. This demonstrated that H-2 identity was not a requirement for TsF function. Furthermore, the BALB/c TsF significantly suppressed the CPS reaction in BAB-14 (H-2d, Igh-VaCb) but not in either C.B-20 (H-2d, Igh-VbCb) or C.AL-20 (H-2d, Igh-VdCd). In addition, the BAB-14 TsF, but not the C.B-20 factor, induced suppression in BALB/c mice. These results indicated that identity at the Igh-V locus of the strain producing the factor and the recipient was required for suppression. Because of the single-chain nature of the factor, it seems that the I-J+ molecule present in our TsF is closely related to not only recognition but also Igh-V restriction functions.

Animals↗
PubMed1989

The use of continuous spinal anesthesia in severe tetanus with autonomic disturbance.

Eight patients with severe tetanus experienced episodes of marked cardiovascular instability. During these unstable periods, cardiac output and vascular resistance varied independently. Beta blocking and low doses of ganglionic blocking agents failed to control cardiovascular instability even when combined. High doses of ganglionic blockers stabilized hemodynamics for a short period, but caused the elevation of transaminases. After unsuccessful treatment with cardiovascular drugs, continuous spinal anesthesia (CSA) was applied to five patients. For 5 to 23 days circulation was regulated artificially under complete blockade of the autonomic nervous system by infusing isotonic 0.5% bupivacaine intrathecally. Catecholamine was added intravenously to maintain adequate blood pressure. Before the introduction of CSA, three patients died of circulatory failure. In contrast, CSA dramatically suppressed the cardiovascular instabilities, and all five treated patients survived. This suggests that both sympathetic and parasympathetic nervous systems need to be blocked to stabilize hemodynamics in severe tetanus.

Adult↗
PubMed1989

[Omentum in the management of thoracic surgery: especially its application to tracheobronchial surgery].

Omentum is now not only policeman of the abdomen but also of the thorax. We applied omental pedicle flap in the management of 14 patients with thoracic surgery including chest wall reconstruction, empyema, thoracic skeletal infection and tracheobronchial problems. Especially, tracheobronchial reconstruction using omental pedicle flap for the patient combined with lung cancer (T4N2M0 STAGE IIIB) and asthma under steroid therapy was reported. The case was 71-year-old man with complaint of hemosputum. He had 5-6 year history of bronchial asthma with disturbed pulmonary function of % VC 44%, FVC1.0% 37%. Bronchoscopic study revealed the tumor invading the right side of trachea originating from right upper bronchus with histological diagnosis of moderately differentiated squamous cell carcinoma. Preoperatively, he experienced a heavy asthma attack which was controlled by steroid administration. Following extended right sleeve upper lobectomy, we applied omental pedicle flap around the reconstructed portion for the protection of infection, impaired wound healing due to postoperative steroid therapy and strong tension at anastomoses. Postoperative course was satisfactory. We suggest omental pedicle flap is an effective surgical armamentarium in the management of tracheobronchial surgery for the patient with strong anastomotic tension, immunocompromised condition, preoperative irradiation at bronchial stump and use of drug causing delayed wound healing (steroid, anticancerous drug etc).

Aged↗
PubMed1989

[Clinical studies on 228 renal transplants].

We studied patient survival and graft survival rates by dividing 228 renal transplants into seven groups according to their immunosuppressive regimen and the degree of histocompatibility. Both patient survival and graft survival rates of HLA identical sibling (Id Sib), living related transplantation with cyclosporin (CYA), transplantation with donor-specific transfusion and anti-lymphocyte globulin (DST.ALG) and cadaveric transplantation with cyclosporin (CYA.Cad) groups were better than those of living related transplantation with ALG, without DST (ALG), living related transplantation with azathioprine and steroid (Non-DST.Non-ALG) and cadaveric transplantation without cyclosporin (Conv.Cad) groups. The incidence and severity of acute rejection were lower in Id Sib, CYA, DST.ALG and CYA.Cad groups than in other groups. The incidence of infections was the highest in Conv.Cad group and that of fatal infections was higher in ALG, Non-DST.Non-ALG and Conv.Cad groups than in other groups. These results indicated that acute rejection and infection were two important factor that influenced the survival rates of these patients. Up to now, the graft survival rate of CYA.Cad group has been much improved as compared to that of Conv.Cad group and was better than those of ALG and Non-DST.Non-ALG groups. The fact urges us to promote more cadaveric renal transplantation in our country by virtue of ciclosporin.

Adult↗
PubMed1989

[Study of blunt hepatic injury by ultrasonography].

Sixty five consecutive patients with blunt hepatic injury were evaluated retrospectively to assess the clinical usefulness of emergency ultrasonography (US). In 30 patients before introduction of US, five patients (16.7%) were treated nonoperatively since they were hemodynamically stable with negative paracentesis. Another four hemodynamically stable patients were surgically treated due to positive paracentesis. After introduction of US, on the other hand, 17 out of 35 patients (48%) were successfully managed nonoperatively. Furthermore, US revealed small intraperitoneal bleeding and enabled conservative treatment of four hemodynamically unstable patients. There was no change in the management of central liver rupture or Makiya's type III injury. The number of nonoperatively managed cases of Makiya's types I and II increased from 1 to 7 after using US, and that of operative cases decreased from 21 to 12. Thus US was helpful to exactly assess the amount of intraperitoneal bleeding and successfully reduce the number of unnecessary laparotomy. We conclude that US provides useful information to decide early management of blunt hepatic injury.

Adult↗
PubMed1989

[Invasive candidiasis: its predisposing factors, usefulness and limitation of cultural study in its diagnosis, and consideration on the appropriate amphotericin B therapy].

We have reviewed 38 patients with invasive candidiasis and examined its predisposing factors, usefulness and limitation of cultural study in its diagnosis, and effective usage of amphotericin B in its treatment. Invasive candidiasis was diagnosed in 2.4% of the patients admitted during the past 5 years. One of the most important predisposing factors for development of invasive candidiasis was extensive use of antibiotics. Destruction of the mechanical barrier against bacteria and fungi caused by endotracheal intubations and various catheterization was another important factor. Mucosal lesion of the gastrointestinal tract, including stress ulcer, non-specific inflammatory bowel disease and esophageal ulcer, was seen in 30% of the patients. These lesions were thought to be the portal of entry for candida to systemic dissemination. AMPH is the most effective antifungal agent. Total dose of 300 to 1000 mg was effective in the patients. Dosage over 1000 mg was associated with progressive decrease in creatinine clearance. This decrease was irreversible even after discontinuation of AMPH. Candidal overgrowth within the G1 tract was considered to precede invasive candidiasis. Oral AMPH administration was effective in such conditions.

Adult↗
PubMed1989

[Polymorphonuclear leukocyte elastase (PMNE) levels in sepsis; the effect of PMNE on multiple organ failure (MOF)].

To study the role of lysosomal protease released from polymorphonuclear leukocytes during MOF, plasma PMNE levels were measured serially in 38 patients. The patients were divided into two groups, 14 patients of MOF from sepsis (group 1), and 24 injured patients without MOF (group 2). The normal value of PMNE was from 21 to 165 micrograms/l. The PMNE levels of the group 1 elevated (831 +/- 241 micrograms/l) at the time of diagnosis of sepsis and remained high during MOF. On the contrary, those of the group 2 were high on admission (574 +/- 131 micrograms/l), but returned to normal within seven days. There was no relationship between the levels of PMNE and the number of neutrophils. However, the PMNE/neutrophils ratio was significantly higher in group 1. Correlations were demonstrated between the amount of PMNE and the decrease in the levels of platelet counts, fibronectin and coagulation factor XIII. It is suggested that PMNE might play a major role in the pathobiochemical changes and tissue injury during MOF.

Adult↗
PubMed1989

[Arterial switch operation for simple transposition of the great arteries in infancy].

Five infants (22-42 days of life) underwent arterial switch operation for simple transposition of the great arteries under deep hypothermic cardio-pulmonary bypass. Three babies required prostaglandin E1 infusion to keep ductus arteriosus opened widely before surgery. Balloon atrioseptostomy was necessary in 0-10 days of life in all babies because of poor condition. Left to right ventricular peak pressure ratio ranged from 0.75 to 0.86, preoperatively. Four of the five survived the operation, and one died of coronary insufficiency because of kinking of the implanted coronary artery. Hypothermic circulatory arrest was used in three (38-41 minutes). Aortic cross clamp time was 70-100 minutes, and cold crystalloid cardioplegia was given only one time just after aortic clamp in 3 babies. Single dose of cardioplegia protected left ventricular muscle well in babies with transposition of the great arteries as same as multiple dose method used in those with ventricular septal defect.

Humans↗
PubMed1989

Effects of vasopressin and catecholamines on the maintenance of circulatory stability in brain-dead patients.

The effectiveness and reliability of long-term control of circulatory stability in brain-dead patients by combined administration of vasopressin and catecholamine was examined in detail. Twenty-five patients were divided into three groups according to the dose of vasopressin. The first group (n = 10) received no vasopressin, the second group (n = 2) an antidiuretic dose (0.1-0.4 U/hr), and the third group (n = 13) a pressor dose (1-2 U/hr), respectively. Patients given no vasopressin or an antidiuretic dose demonstrated circulatory deterioration and cardiac arrest within a short time after brain death, despite administration of a large dose of epinephrine. All patients with a pressor dose of vasopressin, however, demonstrated stable circulation as long as vasopressin and epinephrine were administered. Five patients in whom stable circulation was maintained by this technique were randomly chosen from the third group and studied under the following four conditions: (1) neither vasopressin nor epinephrine; (2) vasopressin only; (3) epinephrine only; and (4) both vasopressin and epinephrine. Compared with the controls (neither vasopressin nor epinephrine), vasopressin only increased the total peripheral resistance index, whereas epinephrine alone increased the cardiac index. Combined administration, however, raised the mean arterial blood pressure significantly by markedly increasing the total peripheral resistance index and cardiac index. Finally, in four brain-dead patients also randomly chosen from the third group, epinephrine, norepinephrine, and dopamine were compared in their circulatory effects with a pressor dose of vasopressin. Epinephrine increased both the total peripheral resistance index and cardiac index, whereas norepinephrine increased the total peripheral resistance index, compared with the baseline (no catecholamine). The required dose of norepinephrine, however, was four times that of epinephrine. The major effect of dopamine was to increase the cardiac index. We conclude that a pressor dose of vasopressin plays a central role in circulatory stabilization of brain-dead patients, and that long-term maintenance of stable circulation for a desired length of time is possible by the combined use of vasopressin and a catecholamine. Individually, catecholamines exhibit characteristic differences. Epinephrine has significant effects on both peripheral vessels and the heart, whereas norepinephrine keeps the circulation stable by increasing the total peripheral resistance index, with a much larger dose than epinephrine. Dopamine acts primarily on the heart.

Blood Circulation↗
PubMed1988

Ki-1+ cutaneous lymphoma. Gene rearrangement analysis of tumor cells in tissue and short-term culture of a patient.

Cutaneous malignant lymphomas developed in an 80-year-old man without any evidence of leukemic disseminations of lymphoma cells. Immunohistologic staining showed the expression of Leu-3a, Leu-4, Ki-1, Tac, and HLA-DR antigens on tumor cells in tissue and large lymphoid cells in long-term, interleukin 2-containing culture of tumor explants. DNA samples extracted from the skin tumors and cultured lymphoid cells showed a clonal rearrangement of T-cell receptor (TCR) gene C beta 1 with the molecular size of 9 kilobases. These findings suggested the T-cell origin of Ki-1+ cutaneous lymphoma cells and the occurrence of a clonal proliferation of tumor cells in culture.

Aged↗