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Biomedical subjects

H Yasui

Publications and source records attributed to H Yasui.

At least 199 records · Page 11Linked to original sources

[Staged repair for bilateral ductus arteriosus with pulmonary atresia and non-confluent pulmonary artery--a case report].

Staged operation was successfully performed in an infant with bilateral ductus arteriosus, and absence pulmonary artery. The first stage operation was performed at 2 months old of age. The left pulmonary artery was reconstructed using an equine pericardial roll sized 10 mm in diameter, and a 5 mm Dacron graft was anastomosed between the left subclavian artery and the roll as an aortopulmonary shunt. In the second stage, the same procedure was done on the right side at eight months of age. In the last stage, the patient underwent Rastelli procedure at 2 years old of age. The central pulmonary artery was created with a ring forced EPTFE graft above the ascending aorta, and a Carpentier-Edwards valved conduit (14 mm) was anastomosed between the right ventricle and the EPTFE graft. Post operative course was uneventful. We consider that the staged procedure including the pulmonary artery reconstruction and the aortopulmonary shunt on both sides is recommended in the case of absent central pulmonary artery in infant.

Blood Vessel Prosthesis↗

Identification of a member of the TIS11 early response gene family at the insertion point of a DNA fragment containing a gene for the T-cell receptor beta chain in an acute T-cell leukemia.

In a previous paper (Proc. Natl. Acad. Sci. USA 84, 4264, 1987) we reported that a DNA fragment containing a gene for the T-cell receptor beta chain, which had been excised from chromosome 7q35 during D beta-J beta joining, was inserted into chromosome 6p21.3 in a patient with acute T-cell leukemia. We have since screened for genes in the vicinity of the insertion point and have identified a gene that is equivalent to the murine TIS11d gene, a member of TIS11 early response gene family, that contains unique Cysteine-Histidine motifs. The human TIS11d gene consists of two exons and encodes a polypeptide of 492 amino acids. The insertion of the DNA fragment observed in this patient is located at the carboxy-terminal portion of the TIS11d protein.

Amino Acid Sequence↗

Mutations in the complementarity-determining regions do not cause differences in free energy during the process of formation of the activated complex between an antibody and the corresponding protein antigen.

Effects of mutations on antigen-antibody interactions were energetically examined using several kinds of Fv fragments, derivatives of a monoclonal antibody, D1.3, that is specific for hen egg-white lysozyme. According to the transition-state theory, the thermodynamic parameters involved in pre and post-processes of formation of the activated complex were estimated separately. In the pre-process, there is a strong compensation between changes in entropy and changes in enthalpy caused by substitutions of amino acid residues. Thus, the differences in the association constant (KA) caused by mutations are not related to the pre-process but to the post-process.

Animals↗

Morphological observations on the pathogenetic process of transposition of the great arteries induced by retinoic acid in mice.

BACKGROUND: The pathogenesis of complete transposition of the great arteries (TGA) is still controversial because useful animal models have not been established. We previously reported that all-trans retinoic acid induced complete TGA at a high proportion in mice. The aim of the present study was to clarify the morphogenesis of the cardiac outflow tract in the retinoic acid-treated embryos destined to develop TGA. METHODS AND RESULTS: We first examined the morphology of TGA in mouse fetuses treated with retinoic acid to establish an animal model of TGA (experiment 1) and then examined the retinoic acid-treated embryonic hearts by means of ink injection and histology (experiment 2). All mouse fetuses and embryos showed visceroatrial situs solitus and d-ventricular loop. In experiment 1, among 45 embryos treated with retinoic acid 70 mg/kg at day 8.5 of gestation, 35 (78%) had TGA and 3 (6.7%) had a double-outlet right ventricle with a subpulmonary ventricular septal defect. In experiment 2, all hearts already exhibited d-loop at gestation day 8.5. At gestation day 9.5, conus swellings, composed of acellular cardiac jelly, where hypoplastic, and the conotruncal cavity was nonspiral or tubular. At gestation day 11.0, aberrant conus swellings located anteroposteriorly to give a straight orientation to the conotruncal cavity. At gestation day 12.0, side-by-side great arteries were transposed in that the aorta arose from the right ventricle and the pulmonary artery arose above the interventricular foramen. CONCLUSIONS: These results suggest that a reproducible animal model of TGA can be produced in mice by treatment with retinoic acid; that there was no loop anomaly, such as an A-loop or L-loop, in our model; and that hypoplasia of the conus swellings appears to be the primary event leading to TGA.

Animals↗

Moment analysis of stereoselective biliary excretion and chiral inversion of ketoprofen enantiomers in perfused rat liver.

The stereoselective local disposition of ketoprofen was evaluated by the single-pass perfusion experiment following a bolus injection of R(-)- or S(+)-ketoprofen into the liver from the portal vein. The elution time profiles of enantiomers into the hepatic vein and the excretion time profiles into the bile were kinetically assessed by local moment analysis. The hepatic recovery ratios (FH) of both enantiomers were < 1%, and the mean hepatic transit times (tH) were approximately 7 s. After the injection of S-ketoprofen into the liver, the biliary excretion ratio (Fb) of total S-ketoprofen was 68% (15% S-ketoprofen and 53% glucuronide) and the mean biliary transit time (tb) of S-ketoprofen was 10 min. R-Ketoprofen inversion from S-ketoprofen was not observed in either the perfusate or in the bile. After the injection of R-ketoprofen, the Fb of total R-ketoprofen was 12% (3% R-ketoprofen and 9% glucuronide), and tb of R-ketoprofen was 8 min. The Fb of total S-ketoprofen inverted from R-ketoprofen was 24% (7% S-ketoprofen and 17% glucuronide), and the tb of inverted S-ketoprofen was 17 min. Forty-six percent of R-ketoprofen was inverted to S-ketoprofen during a single pass through the rat liver, and the mean inversion time was 7.5 min. It was concluded that the unidirectional chiral inversion of ketoprofen was stereospecific, and the hepatic uptake and biliary excretion were stereo-nonspecific.

Animals↗

Hepatocarcinogenesis in rodents and humans.

In hepatocarcinogenesis in rodents, induction of foci and nodules comprising clonally proliferated initiated cells is considered to be essential for the future development of carcinomas. Nodules in human cirrhotic liver, though known to be associated with a high hepatocellular carcinoma risk, have generally been regarded as regenerative in nature, and not the result of clonal or neoplastic cell proliferation, on a morphological basis. However, when we analyzed 83 cirrhotic nodules from 11 HBV carrier patients, utilizing hepatitis B virus (HBV) integration as a marker for clonal proliferation, we found the existence of clonal populations of more than 10(5) hepatocytes in 26 (31.3%) of them. Although such clonal cell populations are morphologically not discernible from neighboring hepatocytes, they may have particular histogenetic significance in human hepatocarcinogenesis and clearly deserve further investigation. Allelotype analysis of mouse hepatocellular carcinomas (HCC), induced by a single dose of diethyl nitrosaminine in C3H/MSM F1 hybrids, revealed no remarkable alterations in the original tumors when microsatellite probes were used, but loss of heterozygosity of chromosome 4 at extremely high frequency (95%) in cultured cell lines derived from these HCC. The shortest common region was about 10 cM distal to the interferon alpha gene, in which the p16 gene is located. The results indicated that loss of gene function, most probably including that of the p16 gene, may be essential for immortalization of cultured hepatocytes but that it may not play any role in initiation or early events in mouse hepatocarcinogenesis in vivo. The mouse HCC used for analysis in this study may be comparable with human HCC at an early stage, for which only very limited genetic alterations have so far been identified.

Alleles↗

A rare case of large ventricular septal defect with minimal pulmonary vascular obstructive changes in a 41-year-old woman.

We describe a case of large ventricular septal defect (VSD) with minimal obstructive changes in the small pulmonary arteries of a 41-year-old woman. Before cardiac catheterization, some laboratory findings led us to consider that surgical closure of the defect would not be possible. However, because hemodynamic examinations showed only mildly elevated pulmonary vascular resistance, we patch-closed the VSD successfully. The histology of lung specimens showed only minimal obstructive changes in the small pulmonary arteries. Considering the size of the VSD and the age at which we hemodynamically evaluated the patient, the mildness of the pulmonary vascular obstructive changes appeared to be atypical in the natural course of a VSD of this size.

Adult↗

New hepatocellular diffusion model for analysis of hepatobiliary transport processes of drugs.

A new hepatocellular diffusion model was developed to kinetically evaluate the hepatobiliary transport processes of drugs in the perfusion system, based on the physiological structure of the liver. Since the equations describing the hepatocellular diffusion phenomena were derived as image forms in the Laplace domain, the fast inverse Laplace transform (FILT) was adopted to manipulate the image equations. Cefixime and cefpiramide were selected as model drugs. The concentrations in the perfusate and the excreted amounts into the bile were simultaneously measured at appropriate intervals after the rapid administration of each drug into the portal vein. The hepatocellular diffusion model was fitted to the biliary excretion profiles from rat livers, by means of a nonlinear least squares program, MULTI(FILT). According to this model, the hepatobiliary transport process of drug is kinetically separated into three steps, that is, the diffusion into and through the hepatocytes, the transfer from the hepatocytes into the bile canaliculi, and the movement through the bile canaliculi to the outlet of bile duct. These steps are characterized by the diffusion rate constant through hepatocytes (kdif), the permeability rate constant into the bile canaliculi (kbmc) and the transit time through the bile canaliculi to the outlet of bile duct (tcan), respectively. It was demonstrated that kdif of cefixime (0.023 min-1) was significantly smaller than that of cefpiramide (0.044 min-1), while the differences in kbmc and tcan were not obvious between cefixime and cefpiramide. kbmc and tcan of both drugs were about 1.2 min-1 and about 1.0 min, respectively. These parameters were correlated to the excretion ratio into the bile (Fbile) and the mean transit time from the sinusoid through the hepatocytes to the outlet of bile duct (tbile).

Animals↗

Left ventricular-coronary sinus shunt through a septal aneurysm after mitral valve re-replacement.

We describe a case in which a left ventricular-coronary sinus communication through a dissecting ventricular septal aneurysm developed after a redo mitral valve replacement. The outlet orifice of the communication was located in the side wall of the ostium of the coronary sinus. Both the communication and the aneurysm were successfully dealt with by performing a right atriotomy and by opening the aneurysm from its outlet orifice.

Aged↗

Simplified Manouguian's aortic annular enlargement for aortic valve replacement.

A simplified Manouguian's aortic annular enlargement for aortic valve replacement with prosthetic valve was performed in a patient with severe aortic stenosis and mild regurgitation by preserving both the anterior mitral leaflet and the left atrial roof intact. This method minimized the operative risk by avoiding injury to the mitral valve, while inserting a possibly two-size-larger prosthetic valve. The inserted prosthetic valve was positioned parallel to the original aortic valve. Moreover, the incision from the top of the commissure between the noncoronary cusp and left coronary cusp through the interventricular fibrous trigone appears to be easily extended into the exact center of the anterior mitral leaflet if further enlargement is required.

Aorta↗

Preoperative autologous blood donations in pediatric cardiac surgery.

BACKGROUND: Preoperative autologous blood donation is one of the most effective methods to avoid homologous blood transfusion in cardiac operations. However, there have been few reports about the safety and efficacy of autologous blood donation in children. METHODS: Since 1986, we have instituted a blood conservation program including preoperative autologous blood donations in children. Eighty children as young as 3 years old (mean +/- SD, 8.6 +/- 3.9 years) and weighing as little as 12.3 kg (29.2 +/- 14.5 kg) were enrolled in the program, and 735 +/- 388 mL of blood was donated during an average of 3.1 +/- 1.5 phlebotomies before the operations. RESULTS: Two episodes of mild vasovagal reaction were observed in 2 patients as a complication of the phlebotomy. Seventy-six percent of the collected blood was stored by cryopreservation; the remaining 24% was preserved by liquid storage. Seventy-eight of these patients (97.5%) underwent operations using cardiopulmonary bypass. Seventy-five patients (94%) were operated on successfully without the need for a homologous blood transfusion. As for the other 5 patients, 2 received only platelet concentrate. CONCLUSION: Preoperative autologous blood donation is a safe and effective method to avoid homologous blood transfusion in pediatric cardiac operations.

Adolescent↗

Maldistribution of the cerebral blood flow in retrograde cerebral perfusion.

Retrograde cerebral perfusion (RCP) through a superior vena caval (SVC) cannula has now become a useful alternative for brain protection during aortic arch operations. However, little is still known about its physiological effects, especially regarding the flow distribution in the brain. We studied the cerebral blood flow distribution under hypothermic conditions using mongrel dogs (n = 6, weighing 9.5 to 14 kg). We measured the cerebral tissue blood flow of the cortex with a laser Doppler flowmeter and cerebral tissue blood flow of the medulla using the hydrogen clearance method. The cerebral blood distribution at 28 degrees C with a whole body bypass flow of 100 ml/kg per min and aortic pressure of 88.3 +/- 20.4 mmHg was used as a control. Then the body temperature was decreased to 20 degrees C and the descending aorta was cross-clamped just distal to the origin of the left subclavian artery to establish antegrade cerebral perfusion (ACP). The perfusion flow was decreased to 54.8 +/- 12.4 ml/kg per min so as to make the aortic pressure similar to the control conditions. After measuring the cerebral blood flow distribution in ACP, the perfusion was then switched to RCP through the bilateral internal maxillary vein and the SVC pressure was kept at 40 mmHg. In RCP, the cerebral blood flow of the medulla was quite similar to that in ACP (12.4 ml/min per 100 g versus 15.2 ml/min per 100 g, NS). In contrast, the cerebral blood flow of the cortex significantly decreased to 16% of the flow in ACP (7.8 perfusion units versus 50 perfusion units, P < 0.01). Because of the maldistribution of the cerebral blood flow in RCP, careful attention should be paid to the clinical application of this method.

Animals↗

Passive protection against rotavirus-induced diarrhea of mouse pups born to and nursed by dams fed Bifidobacterium breve YIT4064.

Mouse pups born to and nursed by dams fed Bifidobacterium breve YIT4064 and immunized orally with rotavirus were more strongly protected against rotavirus-induced diarrhea than those born to and nursed by dams immunized with rotavirus only. The level of antirotavirus IgA in milk of dams fed B. breve YIT4064 and immunized orally with rotavirus was significantly higher than that of dams immunized with rotavirus only. The antirotavirus IgA level in feces of dams immunized orally with rotavirus was also increased by oral administration of B. breve YIT4064. These findings demonstrate that oral administration of B. breve YIT4064 enhanced antigen-specific IgA antibody in the mammary gland and in the intestine. Oral administration of B. breve YIT4064 may enhance antigen-specific IgA antibody against various pathogenic antigens taken orally and induce protection against infections in various mucosal tissues.

Age Factors↗

Effect of temperature in perfusate on local hepatic disposition of BOF-4272, a new xanthine oxidase inhibitor.

The effect of temperature on the local hepatic disposition of BOF-4272 [(+/-)-8-(3-methoxy-4-phenylsulfinyl-phenyl)pyrazolo[1,5-a]-1,3,5- triazine-4-olate], a new drug used to treat hyperuricemia, was investigated by means of a perfusion experiment following the pulse input into the portal vein of rat, in which the temperature of the perfusate was changed from 37 degrees C down to 4 degrees C. The same perfusion experiment was also attempted using bovine serum albumin (BSA) as a reference substance to compare with the hepatic disposition of BOF-4272. The elution time profiles of BOF-4272 and BSA from the liver into the hepatic vein were evaluated by moment analysis. The recovery ratio (FH) and the mean transit time (tH) of BOF-4272 were 22.8 +/- 3.3% and 0.111 +/- 0.008 min at 37 degrees C, respectively. Both FH and tH significantly increased with the decrease in the temperature of the perfusate, 3 times and 2 times greater at 4 degrees C than at 37 degrees C, respectively. The FH and tH of BSA were 98.3 +/- 4.5% and 0.129 +/- 0.013 min at 37 degrees C, respectively. These parameters of BSA were independent of temperature, while those of BOF-4272 showed a definite dependency on temperature. A new estimation method for the elimination rate constant (kc) and the partition ratio (k') in the dispersion model was developed by rearranging the theoretical equations of FH and tH. The index for the elimination (ke) of BOF-4272 decreased with the decrease in temperature, while the index for the distribution (k') increased with the decrease in temperature. This result shows that the metabolism (or the biliary excretion) decreased and the distribution increased with a decrease in temperature, indicating that the hepatic metabolizing pathway which is presumably temperature-dependent is blocked, and the blocked portion of BOF-4272 thus returns back to the perfusate at the low temperature.

Animals↗

Left atrial myxoma associated with severe congestive heart failure, pulmonary hypertension, and multiple organ insufficiency.

We have experienced a case of left atrial (LA) myxoma with rapid progression of congestive heart failure and ensuing multiple organ insufficiency. After the tumor excision, the hemodynamic derangement was totally corrected and the patient dramatically recovered from kidney, liver, and lung insufficiency. Specifically, pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), and central venous pressure (CVP) significantly decreased in the intensive care unit. Administration of prostaglandin E1 (PGE1) was effective in treating residual pulmonary hypertension.

Adult↗

Effect of liver intoxication by carbon tetrachloride on hepatic local disposition of oxacillin using moment characteristics as index.

The effect of liver intoxication by carbon tetrachloride (CCl4) on the hepatic local disposition using oxacillin as a test drug and bovine serum albumin (BSA) as a reference substance was evaluated by single-pass bolus input method in the isolated perfused rat liver. Oxacillin and BSA were introduced into the liver from the portal vein, and the outflow concentration-time profiles of oxacillin and BSA from the rat liver into the hepatic vein were kinetically assessed by moment analysis. Liver damage was monitored by plasma SGOT, plasma SGPT, and bile flow rate. Hepatic recovery ratio FH of oxacillin increased from 50% to 80%, with an increase in liver intoxication by CCl4; whereas FH of BSA was naturally 100%. Mean transit time tH of oxacillin increased from 6 to 12 sec, with an increase in liver intoxication; whereas tH of BSA increased from 7 to 10 sec. The relative variance sigma 2/tH2 of oxacillin increased from 0.2 to 0.7, with an increase in liver intoxication; whereas sigma 2/tH2 of BSA took the value of approximately 0.4, independent of liver damage. In the relationship between the dispersion model and moments, it was shown that the blood space VB increased from 15 to 20%, the index for distribution (1 + k') of oxacillin from 1.0 to 1.5, the efficiency number RN of oxacillin decreased from 0.7 to 0.3 with the increase in liver damage, and the extent of eddy mixing was predicted to be unaffected by liver damage. The intensive increases in tH and sigma 2/tH2 of oxacillin with the liver intoxication by CCl4 were explained by increases in the extent of distribution and nonequilibrium distribution, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗

[Postoperative pulmonary stenosis after arterial switch operation, comparison in three methods of pulmonary reconstruction: modified Pacifico, autologous pericardial patch, and equine pericardial patch].

To prevent postoperative pulmonary stenosis in arterial switch operation for transposition of the great arteries, pulmonary reconstruction without patch augmentation (modified Pacifico method: Pa-group) and reconstruction using W-shaped fresh autologous pericardium (AW-group) were introduced instead of the former method using equine pericardium (XW-group). Postoperative pulmonary stenosis (RV-PA pressure gradient greater than 30 mmHg) was not seen among the 17 cases in the Pa-group (0%), and was seen in 2/14 (14.3%) in the AW-group and in 4/14 (29%) in the XW-group. Progressive increase in pressure gradient was seen in the XW-group in the midterm cardiac catheterization (p < 0.01), but such tendency was not observed in the Pa-group and the AW-group. Sectional area at the pulmonary valve ring, at the anastomotic site in the main pulmonary artery, and at the pulmonary branches just distal to the bifurcation, standardized by the body surface area, increased in the Pa-group and the AW-group, but were unchanged or slightly decreased in the XW-group in the midterm cardiac angiography. We believe that postoperative pulmonary stenosis can be best avoided if modified Pacifico method is used. The cases in which postoperative pulmonary stenosis or coronary artery compression is anticipated such as those with side-by-side aortopulmonary relationship or after pulmonary artery banding, should be operated upon using fresh autologous pericardial patch.

Humans↗