Effect of new ET-Kyoto solution on 17-hour lung preservation in isolated rat lungs.
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Acetylcysteine↗
Biomedical subjects
H Wada
Publications and source records attributed to H Wada.
The impact of thrombolytic therapy on arterial and graft occlusions: a critical analysis.
BACKGROUND: The indications for intraarterial thrombolytic therapy of lower extremity native arterial and synthetic graft occlusions prior to vascular reconstructions requires further refinement before firm conclusions can be made. STUDY DESIGN: A retrospective review of 55 patients undergoing 81 lytic treatments with high dose urokinase from February 1989 to February 1993 was performed. The cases were divided into three groups: Group I: successful thrombolysis with residual defects followed by surgical reconstruction or percutaneous transluminal angioplasty (PTA); Group II: successful thrombolysis alone; and Group III: failure of thrombolysis requiring reconstruction or leading to amputation. No effort was made to analyze the particular type of reconstruction. Follow-up ranged from 1 to 1627 days (4 years and 5 1/2 months). RESULTS: One, two, and three year patency rates were 47%, 24%, and 8% for Group I; 57%, 46%, and 46% for Group II; and 24%, 10%, and 10% for Group III respectively. The one, two and three year limb salvage rates were 92%, 76%, and 76% for Group I; 82%, 82%, and 82% for Group II; and 48%, 37%, and 37% for Group III respectively. Forty-one complications occurred in 35 of the 81 (43%) lytic treatments. CONCLUSIONS: Intraarterial thrombolytic therapy can be regarded as a possible consideration in the initial management of acute lower extremity arterial and synthetic graft occlusions especially in patients with multiple prior vascular reconstructions. Unsuccessful thrombolysis results in a poor outcome despite surgical reconstruction in the majority of cases.
Aged↗
[Sinus bradyarrhythmia during administration of all-trans retinoic acid in a patient with acute promyelocytic leukemia].
A case of acute promyelocytic leukemia (APL) complicated by sinus bradyarrhythmia during the course of all-trans retinoic acid (ATRA) administration is reported. A 3-year-old boy was admitted for evaluation of petechiae and APL was diagnosed. He was initially treated with 45 mg/m2 of ATRA without success, and a complete remission was achieved when the dose was increased to 135 mg/m2. Sinus bradyarrhythmia was first recognized 3 days after the induction therapy with ATRA. It did not disappear even when the patient stopped taking the medication. However, the arrhythmia tended to be augmented whenever he received ATRA again. Close observation of his cardiac condition was mandatory to continue ATRA as an integral part of the therapy for APL, combined with multidrug chemotherapy including anthracyclines, which themselves are potentially toxic to myocardium. In conclusion, the present case revealed the possibility that ATRA therapy induces sinus node arrhythmia, or that it can potentiate preexisting node dysfunctions.
Arrhythmia, Sinus↗
[Plasma fibrin monitor level in DIC patients with a hematopoietic malignancy].
The Plasma level of soluble fibrin monomer (sFM) was measured in 218 patients with a hematopoietic malignancy. Of them, 198 were diagnosed with disseminates intravascular coagulation (DIC), 20 with Pre-DIC, and 20 with Non-DIC. Pre-DIC was retrospectively defined as the condition at least 1 week before the onset of DIC. The plasma levels of sFM, thrombin-anti-thrombin III complex (TAT), plasmin alpha 2-antiplasmin inhibitor complex (PIC), and FDP-D-dimer were significantly higher in patients with DIC than in those with Non-DIC. These levels were significantly higher in patients with Pre-DIC than in those with Non-DIC. Among these hemostatic parameters, the plasma sFM showed the highest sensitivity and specificity for DIC or Pre-DIC. These findings suggests that sFM is the most valuable marker hemostatic for the diagnosis of DIC and Pre-DIC.
Biomarkers↗
[CT and MR imaging findings in a case of cerebral alveolar echinococcosis masquerading as brain tumor].
We report a rare case of cerebral alveolar echinococcosis that was verified by pathological examination. The lesion presented as an intracranial mass which was slightly hyperdense on CT scans and very hypointense with central hyperintensity on T2-weighted MR images. The lesion exhibited marked contrast enhancement on both CT and MR images and was accompanied by extensive white matter edema. Although radiological differentiation from brain tumor was difficult, hypointensity on T2-weighted MR images appeared to be characteristic of lesions of cerebral alveolar echinococcosis.
Brain↗
[Benign infantile mitochondrial myopathy caused by reversible cytochrome c oxidase deficiency].
A 2-month-old girl had generalized weakness, profound muscular hypotonia, hepatomegaly and severe lactic acidosis. She needed ventilatory support. Muscle specimen taken at 2 months showed ragged-red fibers, abnormal mitochondria, and reduced cytochrome c oxidase (CCO) staining Biochemical analysis showed CCO activity to be reduced to about 16% of the normal mean. She received carnitine and coenzyme Q10 supplementation from the age of 3 months and abnormal blood lactate values declined to near normal values during the first three weeks. Gradually her condition started to improved: she held her head at 9 months, and walked alone at 15 months. The second biopsy specimen at 3 years and 8 months showed almost normal CCO staining and she was free of clinical signs. This case is an example of a rare benign infantile mitochondrial myopathy caused by CCO deficiency. Early diagnosis is crucial to provide intensive treatment until spontaneous clinical improvement appears. We concluded that carnitine and coenzyme Q10 supplementation was a useful treatment for clinical improvement in patients with a benign infantile mitochondrial myopathy caused by CCO deficiency.
Carnitine↗
[Diagnosis and surgical treatment of metastatic lung tumors].
To investigate the chance of discovery of metastatic lung tumors and the five-year survival rates of patients undergoing surgical resection, we followed 99 patients who underwent initial surgical treatment at our hospital between 1979 and 1996. With regard to primary organs or sites, 32 patients had rectal cancer, 27 patients had breast cancer, 19 patients had colon cancer and 21 patients had osteosarcoma. For 22 of 99 patients (22%), discovery was due to subjective symptoms such as cough and sputum (n = 12), chest (or back) pain (n = 7) or hemosputum (n = 5). Ten of 19 patients (53%) with colon cancer experienced subjective symptoms which led to the discovery of metastases. In 76 of 99 patients (78%), metastatic lung lesions were not discovered through subjective symptoms. In 63 of those 76 patients, such lesions were initially found by plain chest roentgenography or CT. In 20 of 21 patients (95%) who had osteosarcoma, metastatic lung tumors were discovered by chest roentgenography or CT. In 14 of 76 patients, all of whom had metastatic lung carcinomas, the lesions were discovered through elevated levels of tumor markers. Therefore the importance of periodic chest roentgenography and tumor marker testing was demonstrated. Disease-free interval (DFI) was over six years in five of 32 patients (16%) with rectal cancer and 13 of 27 (48%) with breast cancer. DFI was less than five years for 15 of 19 patients (79%) with colon cancer, and less than two years for 16 of 21 (75%) with osteosarcoma. Thus, DFI differed according to the sites of the tumors. The five-year survival rates of 97 patients were examined. Patients were divided according to the sites of their primary tumors, and then subdivided according to the type of surgery they received. Patients were thus divided into five categories: I) those who underwent incomplete resection of metastatic lung lesions, II) those who underwent complete resection of both pulmonary lesions and involved mediastinal lymph nodes, III) those who had undergone previous treatment for tumors in organs other than the lung, IV) those who underwent complete resection of multiple lung lesions, and V) those who underwent complete resection of solitary lung lesions. For all primary sites, none of the patients in group I) survived for more than two years. Therefore complete resection seems very important for the treatment of metastatic lung tumors. With regard to the other groups, several facts were noted. For rectal cancer, the five-year survival rate of groups V) and III) was 55.6% in either case. Therefore complete resection of rectal cancer metastatic to the lung may improve the five-year survival rate even for patients who have previously been treated for cancers in organs other than the lung. For colon cancer, the five-year survival rate of group V) was 51.4%. Complete resection of only a solitary lung lesion may improve the five-year survival rate for colon cancer. For breast cancer, the five-year survival rate of group V) was 37.5% and that of group II) was 60.0%. This may indicate that for patients who have both pulmonary lesions and mediastinal lymph node involvement, complete resection of both is important. For osteosarcoma the five-year survival rate of group IV) was 26.0%. Thus, osteosarcoma patients have a chance of survival if they undergo complete resection of lung metastases.
Adolescent↗
Prostaglandin E1 ameliorates decreased tracheal blood flow after esophagectomy and aggressive upper mediastinal lymphadenectomy for esophageal carcinoma.
BACKGROUND: Aggressive upper mediastinal lymphadenectomy contributes to a better survival rate after esophageal resection to treat esophageal carcinoma, but it also increases postoperative respiratory complications. Devascularization of the airways because of mediastinal dissection is considered to be a cause of respiratory dysfunction. The present study attempts to clarify whether or not tracheal blood flow (TBF) deteriorates after esophagectomy and, if so, whether or not intravenous prostaglandin E1 (PGE1) attenuates the deterioration. STUDY DESIGN: Patients undergoing esophagectomy and aggressive upper mediastinal lymphadenectomy for the treatment of esophageal carcinoma (EC group, n = 12) or abdominal surgery (control group, n = 6) were enrolled in this study. Measurement of TBF was performed using a laser Doppler flowmeter. Changes in TBF induced by surgery and postoperative intravenous PGE1 were studied in both groups. RESULTS: The TBF deteriorated significantly in the EC group (21.78 +/- 9.60 to 11.24 +/- 4.45 mL/minute/10(-1) kg, p = 0.002) but did not change in the control group (26.13 +/- 6.84 to 26.61 +/- 4.69 mL/minute/10(-1) kg, p = 0.7371). Postoperative intravenous PGE1 partially, but significantly, reversed the deterioration in TBF in the EC group (11.53 +/- 4.58 to 14.87 +/- 6.30 mL/minute/10(-1) kg, p = 0.0207) but did not effect the control group (29.41 +/- 7.89 to 29.41 +/- 8.79 mL/minute/10(-1) kg, p = 0.9989). CONCLUSIONS: Esophagectomy and aggressive upper mediastinal lymphadenectomy cause a deterioration in TBF that is partially attenuated by PGE1.
Alprostadil↗
[The complete band4.2 deficiency in human red cells].
The complete band4.2 deficiency with a point mutation (GCT-->ACT at codon142: Nippon type) in red cell membrane protein4.2 gene is specific for the Japanese population. The biochemical properties of band4.2 protein have been studied extensively. However, the physiolosical functions of this protein in situ have been unknown. Therefore, we tried to clarify the physiological role of band4.2 by biochemical, biophysical and electron microscopic studies in the patient with the Nippon type mutation. Band4.2 deficient red cells demonstrated significant abnormalities in the function of both the cytoskeletal network and band3 protein, as summarized in our results. 1 Deformability of red cell membrane was decreased when heat-treated up to 48 degrees C. 2 Under the these conditions, the cytoskeletal network became markedly disrupted, and the number of intramembrane particles was reduced with a shift to larger sizes, indicating the possibility of increased oligomerization of band3 molecules in the red cells. 3 The lateral and rotational mobility of band3 in the red cells was substantially increased. 4 Band4.2 protein was found to bind to spectrin in solution and to promote the binding of spectrin to ankyrin-stripped inside-out vesicles. These results indicate the possibility that band4.2 may play a role in connecting the cytoskeletal network to band3 protein as a kind of anchoring protein.
Anemia, Hemolytic, Congenital↗
[Paroxysmal nocturnal hemoglobinuria].
Paroxysmal Nocturnal Hemoglobinuria (PNH) is an acquired hemolytic anemia characterized by chronic hemolysis, deep thrombosis, and hypoplastic marrow, and thought to be a clonal hematopoietic stem cell disorder. Affected blood cells are deficient in glycosylphosphatidylinositol (GPI)-anchored cell surface proteins. Recent investigations revealed that the PIG-A gene, which participates the biosynthesis of the GPI-anchor, was identified and the mutations were detected in the patients with PNH. Here we discuss the following problems related to the PIG-A gene; (1) the inconsistency of the expression of the GPI-anchored proteins and the mutations of the PIG-A gene, (2) the existence of the multiple PNH clones bearing different PIG-A mutations in a single patient, (3) aplastic anemia-PNH syndrome and PIG-A gene.
Animals↗
[Evaluation of improvement in prognosis in surgical cases of lung cancer based on the 5-year survival rate].
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Combined Modality Therapy↗
[Analysis of maternal and fetal risk in 594 pregnancies with heart disease].
The purpose of this study was to estimate the risk of heart diseases in pregnancy. A total of 594 patients with heart diseases treated at the National Cardiovascular Center between 1982 and 1993 were evaluated. The heart diseases were classified into eight categories: congenital heart disease with or without pulmonary hypertension (8 cases (1%) and 219 cases (37%), respectively), mitral valve prolapse (38 cases (6%)), valvular heart disease with or without valve replacement (9 cases (2%) and 54 cases (9%), respectively), arrhythmia (222 cases (37%)), cardiomyotitis (15 cases (3%)) and miscellaneous (29 cases (5%)). Maternal risk was estimated from the incidence of maternal mortality and artificial preterm delivery. Maternal death within two years after delivery was observed in 7 cases (1.2%): 4 cases with cardiomyotitis (3 DCM and 1 HCH), 2 cases with heart disease with pulmonary hypertension (1 PPH and 1 PDA), and a single case with valvular heart disease with aortic valve replacement. Artificial preterm delivery was carried out in 32 cases (5.4%), most frequently in cases with congenital heart disease with pulmonary hypertension (6/8, 75%) which follows cardiomyotitis (4/15, 27%) and cases with valvular heart disease with valve replacement (2/9, 22%). Fetal risk was measured by the incidence of fetal death, fetal growth retardation and congential heart disease of the fetus. IUFD because of maternal heart disease was observed in 4 cases: two cases with valvular heart disease with valve replacement, a single case with Marfan's syndrome and a single case with DCM. Fetal growth retardation was observed in 59 cases, most frequently in cases with congenital heart disease with pulmonary hypertension and cases with valvular heart disease with valve replacement (3/8 (38%) and 3/9 (33%), respectively). Neonatal congenital heart disease was found in 8 of 228 neonates (3.5%) whose mothers also had congenital heart disease. It is therefore suggested that intensive medical care be recommended in pregnancies complicated with congenital heart disease with pulmonary hypertension or with valvular heart disease with valve replacement, which increase both maternal and fetal risk, and in pregnancies complicated with cardiomyotitis which significantly increases the maternal risk.
Arrhythmias, Cardiac↗
[Self-expanding nitinol stents for treatment of tracheobronchial and esophageal stenosis caused by lung cancer].
A 57-year-old man was admitted because of dysphagia. Two year earlier, endoscopic ND-YAG laser treatment had been performed for squamous cell carcinoma of the tracheal carina. The esophagus was compressed and narrowed by invasion of lung cancer. After ballooning, under endoscopic and fluoroscopic control, a self-expanding nitinol stent (SENS, Ultraflex, Microvasive) was implanted in the esophagus. Immediately after esophageal prosthesis implantation, severe dyspnea and stridor developed because of tumor strictures in the left main bronchus. Under fluoroscopic and guide-wire control, SENS (Accuflex, Microvasive) was implanted in the tracheobronchial tree. Dyspnea, dysphagia and stridor were markedly improved after placement of two nitinol stents. Highly flexible, knitted, self-expanding nitinol stent is made of a nickel titanium alloy. Although the implantation of SENS in tracheobronchial stenosis has not previously been reported, it should be useful for prevention of airway obstruction.
Alloys↗
Rejection antigen peptides on BALB/c RL male 1 leukemia recognized by cytotoxic T lymphocytes: derivation from the normally untranslated 5' region of the c-akt proto-oncogene activated by long terminal repeat.
Tumor antigen peptides on BALB/c leukemia RL male 1 that were recognized by cytotoxic T lymphocytes were shown to be derived from a normally untranslated region of the akt proto-oncogene (Uenaka, A. et al., J. Exp. Med., 180: 1599, 1994). We show here that the murine leukemia virus (MuLV) long terminal repeat (LTR) was inserted directly into the exon of c-akt in RL male 1 leukemia and that transcription started from the cap site of the LTR. Translation appeared to start from the ATG codon created in the six nucleotides of unknown origin, which were inserted into the LTR/akt junction. The deduced molecular size is approximately M(r) 59,000 due to the addition of 33 amino acid residues to the normally expressed c-AKT protein. Western blot analysis demonstrated the presence of M(r) 59,000 molecules in an RL male 1 lysate, and their expression at about ten times the level of normal AKT molecules of M(r) 56,000, which is consistent with the increased expression of akt mRNA demonstrated by Northern blot analysis. The findings show that the molecular alteration of AKT protein by insertion of MuLV LTR is the mechanism for creating rejection antigen peptides derived from the untranslated region of akt.
Amino Acid Sequence↗
Dopamine release in the medial preoptic area during male copulatory behavior in rats.
In vivo microdialysis was employed to measure the extracellular concentrations of dopamine (DA) in the medial preoptic area (MPOA) of rats during male sexual activity to look for a correlation with sexual activity. During copulation, the concentration of DA in the MPOA was significantly increased. A significant difference was detected in changes of DA between copulators and non-copulators. These findings were consistent with the assertion that DA neuron activity in the MPOA facilities male copulatory behavior.
3,4-Dihydroxyphenylacetic Acid↗
Establishment and molecular characterization of a novel leukemic cell line with Philadelphia chromosome expressing p230 BCR/ABL fusion protein.
The cell line AR230 was established from the peripheral blood mononuclear cells of a patient with chronic myeloid leukemia and t(9;22) translocation bearing a variant type of BCR/ABL rearrangement. AR230 expresses a BCR/ABL fusion protein with a molecular mass of 230 kilodaltons (kDa) due to the insertion of 180 amino acids encoded by 3' exons of BCR (b4 to c3). An immune complex kinase assay showed that the 230-kDa BCR/ABL protein ahd autophosphorylation activity. Immunoprecipitation analysis revealed a stable complex of GRB2 and 230-kDa BCR/ABL proteins, indicating that the Ras activation pathway is involved in the process of transformation. AR230 expressed another short transcript consisting of a BCRc2/ABL junction, which is associated with a stop signal shortly after the junction. To our knowledge, this is the first cell line expressing a 230-kDa fusion product of BCR/ABL. AR230 will be useful for studying the biological function of divergent BCR/ABL proteins.
Amino Acid Sequence↗
Acyl-lipid desaturases and their importance in the tolerance and acclimatization to cold of cyanobacteria.
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Adaptation, Physiological↗
Site-directed mutagenesis of histidine residues in the delta 12 acyl-lipid desaturase of Synechocystis.
In the cyanobacterium Synechocystis sp. PCC 6803, there are four acyl-lipid desaturases that are, respectively, specific to the delta 6, delta 9, delta 12 and omega 3 positions of fatty acids. The desA gene for the delta 12 acyl-lipid desaturase was modified by site-directed mutagenesis, such that four of the histidine residues that are conserved in the four desaturases and one histidine residue that is not conserved were replaced by arginine, and the mutated desA genes were overexpressed in Escherichia coli. All of these mutations eliminated the delta 12 desaturase activity. These results demonstrate that the five histidine residues are essential for the activity of the delta 12 desaturase, perhaps by providing the ligands for the catalytic Fe center.
Amino Acid Sequence↗