Biomedical subjects

H Yasui

Publications and source records attributed to H Yasui.

At least 271 records · Page 15Linked to original sources

PubMed1990

Studies on topical antiinflammatory agents. IV. 21-(Alkylthio)acetates and (methylthio)methoxides of corticosteroids.

A series of 21-(alkylthio)acetates and 21-(methylthio)methoxides of corticosteroids were synthesized and examined for vasoconstrictive activities. The activities of seven compounds were equal to or greater than that of 9 alpha-fluoro-11 beta,21-dihydroxy-16 beta-methyl-17 alpha-valeryloxy-1,4-pregnadiene-3,20-dione (betamethasone 17-valerate, BV). Among them, betamethasone 21-(methylthio)acetate 17-propanoate (2Ca) was found to have the most potent activity, which is superior to that of BV. A structure-activity relationship study revealed that substitution of the 21-hydroxy group of corticosteroids with the (methylthio)acetate function is a useful approach for obtaining potent activity.

Administration, Topical↗

PubMed1990

[Surgical repair of total anomalous pulmonary venous connection in neonates and infants--prevention for pulmonary venous obstruction at the site of anastomosis].

From October, 1980, to June, 1987, thirty-eight infants less than one year old underwent correction for total anomalous pulmonary venous connection (TAPVC). Overall operative mortality and late mortality were 13% and 6%, respectively. Residual pulmonary hypertension was noted in 4 patients: three had pulmonary venous obstruction at the site of atrial anastomosis (PVOA) and one had supracardiac (Ia) lesion left after repair of mixed type (IV: Ia + III) of TAPVC. Two late deaths occurred in these with PVOA. Twenty-two patients with supracardiac (I) or infracardiac (III) TAPVC were divided into three groups according to the technical development in atrial anastomosis: the large anastomosis in which venous incision reached into at least one pulmonary vein beyond common pulmonary vein and the continuous running suture were used in 10 patients (group 1), the appropriate size of anastomosis in which venous incision limited within the common pulmonary vein and the continuous running suture used in 4 patients (group 2), and the appropriate size of anastomosis and the interrupted suture in 8 patients (group 3). PVOA were 3 (33%) in group 1, but 0 (0%) in group 2 and 3. Two late death occurred all in group 1 with PVOA. Cardiopulmonary bypass time and aortic clamp time in group 3 were 91 min and 74 min respectively, which did not become longer than those in both group 1 and group 2. Interrupted suture technique does not make operating time longer than continuous running suture one. PVOA is one of the important factors predicting late operative result.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗

PubMed1990

[Anomalous origin of the right pulmonary artery from the ascending aorta: a report of three cases].

Three patients with anomalous origin of the right pulmonary artery from the ascending aorta were reported. Case 1 was a 16-day-old girl with the right pulmonary artery arising from the base of the ascending aorta. Division and direct anastomosis of the anomalous vessel to the pulmonary trunk were successfully performed. Case 2 was a 4-month-old girl with the kinked and stenotic right pulmonary artery arising from the distal ascending aorta. At the time of surgery, however, the right pulmonary artery had been completely occluded and the pulmonary hypertension of the main pulmonary trunk had been disappeared. The chest was closed without any corrections. Case 3 was a 17-month-old girl with the stenotic right pulmonary artery arising from the distal ascending aorta. The stenotic lesion of the right pulmonary artery was longitudinally incised and anastomosed with the PTFE graft in an end-to-end fashion, followed by the end-to-side anastomosis of the graft and the pulmonary trunk.

Aorta↗

PubMed1990

[Surgical management of open lung biopsy in Eizenmenger's syndrome].

Three of 254 patients with Eizenmenger's syndrome had complications, namely bleeding during and after surgery of open lung biopsy. Histopathologic study of the lung in patients suffering from complications revealed that destruction of the collateral vessels characterized by wide lumen and weak walls is responsible for the postoperative bleeding. Such complications can be prevented by using the TA stapler which cuts off the lung tissue with little or no damage to the other lung tissues.

Adult↗

PubMed1990

[Evaluation of left ventricular function after Jatene's operation for transposition of the great arteries--influence of age at repair].

The postoperative left ventricular function (LV) of Jatene's operation for transposition of the great arteries (TGA) was evaluated by angiocardiography and echocardiography in 39 patients. In 16 patients repaired at less than 3 months of age, left ventricular endodiastolic volume (LVEDV) was significantly decreased at the angiography 2 months after repair: form 215 +/- 685% normal of preoperative LVEDV to 120 +/- 14% normal postoperatively (p less than 0.05) in 7 patients with simple TGA (Group IA), and from 220 +/- 64% normal to 130 +/- 33% normal (p less than 0.05) in 8 patients associated with ventricular septal defect (Group IIA). On the other hand, among 24 patients repaired at 3 or more months of age, 19 patients with simple TGA (Group IB) showed the significant increase of LVEDV (from 159 +/- 40% normal to 183 +/- 23% normal, p less than 0.05), and 5 patients associated with ventricular septal defect (Group IIB) showed no remarkable change (from 208 +/- 96% normal to 193 +/- 23% normal). There was no significant difference of postoperative pulmonary artery (PA) wedge pressure among the four groups. Postoperative left ventricular diastolic dimension (LVDd) revealed the tendency of normalization in all groups during the first postoperative year. Group IA and IIA completed the normalization of LVDd in 2 months and Group IIB in 6 months after the repair. However, LVDd in Group IB could not decrease to normal range even in 12 months after repair. There was a significant correlation between postoperative LVDd and the age at PA banding in 14 patients of Group IB, who had the preparatory PA banding for LV training.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

PubMed1990

[A case report of total anomalous pulmonary venous drainage corrected with Vargas' method].

A 50-day-old infant with Darling's type Ib of total anomalous pulmonary venous drainage (TAPVD) was operated on with the Vargas' method. Pulmonary veins drained separately into the right superior vena cava (SVC). A J-shaped right atriotomy was performed according to the Vargas' method. The posterior flap was sutured to the anterior border of a previously enlarged atrial septal defect, directing the pulmonary blood flow toward the left atrium. The right SVC was divided just above the site of drainage of pulmonary veins, the proximal end of the right SVC was closed, and the anastomosis between the distal end of the right SVC and the previously opened right atrial appendage was performed. However, pulmonary hypertension remained because of the restrictive orifices of pulmonary venous drainage into SVC, and then side-to-side anastomoses between pulmonary veins and left atrium had to be added. Eight months after the operation pulmonary hypertension progressed markedly, because the orifices of the anastomoses became severely stenotic. Re-operation was performed to create a large anastomosis between pulmonary veins and left atrium. The indication and the long-term prognosis of the Vargas' method were discussed.

Female↗

PubMed1990

Early and midterm results of the arterial switch operation for transposition of the great arteries in Japan.

A total of 267 infants and children who underwent the arterial switch operation for transposition of the great arteries in the 6 years before Jan. 1, 1988 in six main Japanese institutions were entered into this review. The current status of patients surviving more than 1 year after the operation were evaluated along with early operative results. One hundred forty-six patients had an intact ventricular septum, 103 had a significant ventricular septal defect, and 18 had so-called Taussig-Bing anomaly of the transposition type. Eighteen patients were less than 28 days of age, 73 were 1 to 5 months of age, and 176 were older than 6 months of age at the time of operation. The overall mortality rate was 35% in the first 3 years and 12% in the more recent 3 years. There was a significant difference between the overall mortality rate of primary and two-stage repair (22% versus 10%, p = 0.047) in patients with intact ventricular septum. The overall mortality rate in patients with type B or C coronary arteries of Yacoub, and Radley-Smith's classification was significantly higher than that of other types of arteries (86% versus 18%, p = 0.0001). A total of 156 patients survived more than 1 year after the operation, and 44 children (28%) were noted to have supravalvular pulmonary stenosis (greater than 20 mm Hg). This complication was more common in patients operated on in the newborn period. Trivial or mild aortic regurgitation was noted in 29 patients (19%) and was more common in patients with two-stage than with primary repair (24% versus 14%). Aortic regurgitation was significantly more prevalent in patients in whom coronary arteries were implanted into slits or U-shaped defects than in those whose arteries were implanted into punched-out holes made on the pulmonary root (28% versus 8%, p = 0.049). Normal sinus rhythm was present in 97% of 154 patients and left ventricular ejection fraction was within the normal range in 97% of 115 patients at catheterization 1 to 5 months after the operation.

Aortic Valve Insufficiency↗

PubMed1989

Class switch from mu to delta is mediated by homologous recombination between sigma mu and sigma mu sequences in human immunoglobulin gene loci.

Class switch of immunoglobulin from mu to gamma occurs by recombination between two repetitive switch sequences: S mu and S gamma. However, there are no such sequences in the mu-delta introns of human and mouse genomes. Although the frequency of IgD-secreting cells is extremely low in mouse about 1% of patients with myeloma produce IgD in human. In a previous report (Nucleic Acids Res. 1988. 16: 9497) we reported that a 442-bp DNA sequence located in the JH-mu intron (defined as sigma mu) was inserted into the mu-delta intron (defined as sigma mu) in human genome. There is no such insertion in mouse. We analyzed Ig H chain gene loci of two human IgD myelomas: one was analyzed by cloning and sequencing and the other by Southern hybridization. We found that recombination had occurred between these two homologous DNA sequences, resulting in loss of the DNA segment from sigma mu to sigma mu. On the other hand, in a Burkitt lymphoma, Daudi, the DNA fragment from sigma mu to sigma mu was duplicated. These results suggest that homologous recombination between sigma mu and sigma mu sequences mediates class switch from mu to delta in human and that it occurs via unequal crossing-over between sister chromatids or daughter chromosomes.

Amino Acid Sequence↗

PubMed1989

Micronucleus test with ethyl methanesulfonate administered by intraperitoneal injection and oral gavage.

The effect of route of administration on the outcome of the micronucleus test was studied by administering ethyl methanesulfonate (EMS) by oral gavage (p.o.) and intraperitoneal injection (i.p.) to males of 2 mouse strains, MS/Ae and CD-1. Based on preliminary studies, consisting of a small-scale acute toxicity test and a pilot experiment to determine the optimal sampling time and the appropriate dosages, a micronucleus test was conducted with a 24-h sampling time and doses of 50-400 mg/kg i.p. and p.o. EMS significantly induced micronucleated polychromatic erythrocytes (MNPCEs) with a clear positive dose response by both routes in both strains. Moreover, both routes showed almost the same induction rate of MNPCEs at each dose level tested in both strains.

Administration, Oral↗

PubMed1989

Studies on topical antiinflammatory agents. I. Synthesis and vasoconstrictive activity of corticosteroid 17-succinyl esters.

A series of 17-succinyl derivatives of four corticosteroids was prepared. They were tested for vasoconstrictive activity in humans, using 9 alpha-fluoro-11 beta, 21-dihydroxy-16 beta-methyl-17 alpha-valeryloxy-1,4-pregnadiene-3,20-dione (betamethasone 17-valerate, BV) as a standard. The activities of the 21-chloro 17-methylsuccinate compounds (6A, 6C and 6D) were greater than that of BV. A structure-activity relationship study showed that the activities of the 21-chloro 17-methylsuccinates were more potent than those of the corresponding 21-esters.

Administration, Topical↗

PubMed1989

Studies on topical antiinflammatory agents. II. Synthesis and vasoconstrictive activity of 21-substituted corticosteroids with sulfur-containing moieties.

As part of the search for new topical antiinflammatory agents, various 21-substituted corticosteroids having sulfur-containing moieties were prepared and tested for vasoconstrictive activity in humans. A structure-activity relationship study revealed that substitution of the 21-hydroxy group with a lower alkyl-thio group enhanced the activity. The activities of the 21-methylthio (3Ad) and the 21-ethylthio (3Ae) compounds were more potent than that of 9 alpha-fluoro-11 beta,21-dihydroxy-16 beta-methyl-17 alpha-valeroyloxy-1,4- pregnadiene-3,20-dione (betamethasone 17-valerate, BV).

Administration, Topical↗

PubMed1989

Studies on topical antiinflammatory agents. III. Synthesis of 17 alpha-acyloxy-9 alpha-fluoro-11 beta-hydroxy-16 beta-methyl-1,4-pregnadiene-3,20-dione 21-thio derivatives and related compounds.

A series of 21-thio derivatives of 9 alpha-fluoro-11 beta,17 alpha-dihydroxy-16 beta-methyl-1,4-pregnadiene-3, 20-dione 17-esters and related compounds were synthesized and evaluated as topical antiinflammatory agents. These compounds were prepared by the reaction of 9 alpha-fluoro-11 beta,17 alpha,21-trihydroxy-16 beta-methyl-1,4-pregnadiene-3, 20-dione (betamethasone, I) 17-ester derivatives and various mercapto compounds. A structure-activity relationship study revealed that the structural combination of a thio group at the 21-position and an ester group at the 17-position contributed to vasoconstrictive activity. Among these compounds, the 21-methylthio 17-propanoate compound (6) was found to have the most potent activity, being more potent than betamethasone 17-valerate (BV).

Administration, Topical↗

PubMed1989

Immunogenicity of Bifidobacterium breve and change in antibody production in Peyer's patches after oral administration.

Immunogenicity in the intestine of Bifidobacterium breve, included in fermented milk, was compared with that of Bacteroides thetaiotaomicron, also predominant in human intestine. In vivo, serum antibody to B. breve was detected first in mice fed the organism for 33 d; antibody decreased in mice fed these for more than 33 d. Serum antibody to Bact. thetaiotaomicron was detected in mice fed the organism for 7 d and was maintained at the same level in mice fed these for more than 7 d. From in vitro tests, the optimal doses of B. breve and Bact. thetaiotaomicron to induce antibody production by Peyer's patch cells, intestinal lymphoid tissue cells, were 5 x 10(8) and 5 x 10(7) bacteria/ml, respectively. Therefore, it was suggested that immunogenicity of B. breve is weaker than that of Bact. thetaiotaomicron. Furthermore, the change of antibody production to the organism by Peyer's patch cells in the mice administered B. breve orally was tested by the Peyer's patch cell culture method. Antibody production against B. breve by Peyer's patch cells in mice given B. breve for 25 and for 33 d increased and decreased, respectively, in comparison with the control. These results suggest that when serum antibody to B. breve increases significantly, anti-B. breve antibody production by Peyer's patch cells is suppressed, and thereafter, serum antibody to B. breve decrease and is not detected. These findings favor the view that serum antibody production to B. breve is regulated in Peyer's patches.

Animals↗

PubMed1989

[Current status of Jatene's operation].

The current status of Jatene's operation for transposition of the great arteries was described by showing the analysis of our results of an arterial switch operation addition to the review of the literatures. The arterial switch operation recently has become the operation of first choice because of its low surgical mortality (4.5% in author's series) and low incidence of postoperative complication. Surgical techniques to avoid complications such as postoperative bleeding, kinking of the transplanted coronary arteries, aortic valve insufficiency and pulmonary arterial stenosis were presented. One-stage anatomic correction has been performed with low mortality less than 10% in centers dealing high volumes of neonatal surgery (7% in author's series). One-stage correction in the neonate is advocated in views of its low surgical mortality and excellent postoperative left ventricular function.

Aorta↗

PubMed1989

[Total repair of complete atrioventricular canal: relationship between age at operation and late results].

Twenty five consecutive patients with complete atrioventricular canal (CAVC) underwent one-stage operation from April 1981 to Aug. 1987. Average ages at operation was 18 months (2 to 72) and average weight was 7.0 kg (2.8 to 13.8). Fifteen patients were infants and fifteen had Down syndrome. Conventional cardiopulmonary bypass with pulsatile bypass pump (PBP) and moderate hypothermia at 28 degrees C was utilized in all patients. Single patch technique (SPT) was adopted for initial five patients and two patch technique for the latter twenties. Two patients died perioperatively (operative mortality 8.0%), one of whom from mitral stenosis after SPT and the other from misdiagnosis of large subpulmonary VSD. There was no hospital death. Mean pulmonary artery pressure (mPA), pulmonary systolic pressure to systemic systolic pressure ratio (Pp/Ps) and pulmonary vascular resistance index (PVRI) were decreased remarkably from preoperative values of 56 +/- 14 mmHg, 0.92 +/- 0.13 and 6.2 +/- 4.9 WU.m2 to postoperative of 31 +/- 16 mmHg (p less than 0.001), 0.54 +/- 0.20 (p less than 0.001) and 4.6 +/- 4.0 WU.m2 (NS), respectively. Six patients had residual pulmonary hypertension in which mPA was more than 40 mmHg. One patient who was complicated with severe mitral regurgitation due to dehiscence of suture line and torn chordae had mitral valve replacement. Mean follow-up period was 26 months (5 to 63). The mean weights of 67%N at operation catched up with 87%N 3 years after operation. There were two late deaths, 4 and 20 months after operation between age at operation, both of whom had residual pulmonary hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

PubMed1989

[Retrograde coronary sinus perfusion of cardioplegic solution in Jatene operation in neonates and infants].

The clinical benefits of retrograde coronary sinus perfusion of a cardioplegic solution were investigated in 7 neonates and 23 infants undergoing Jatene operation. After an initial infusion of albumin-containing crystalloid cardioplegic solution via the aortic root, 21 patients received additional solution delivered by retrograde coronary sinus perfusion (retrograde group) and 9 patients received by selective antegrade coronary perfusion (antegrade group) every 20 to 30 minutes. There were no differences in age, weight, and left ventricular preoperative pressure and morphology between the two groups. Aortic cross-clamping time was 130 +/- 18 minutes in retrograde group and 147 +/- 20 minutes in antegrade group. Postoperative assays of CPK-MB, GOT and LDH, and hemodynamic measurements immediately after cessation of cardiopulmonary bypass (CPB) were carried out in all patients. Although there was no significant difference between the two groups in terms of enzyme indexes, retrograde group showed a greater variation of sigma CPK-MB from patient to patient than antegrade group. However, hemodynamic parameters of CVP, left atrial pressure and rate-pressure product at 20-30 minutes after CPB were similar in the two groups. Six neonates in retrograde group also demonstrated the similar enzyme indexes and hemodynamic state immediately after CPB to other older patients. We concluded, therefore, that retroperfusion of cardioplegic solution in neonates and infants provides satisfactory myocardial protection as well as antegrade perfusion, and it was a useful means of cardioplegic delivery in Jatene operation, because of its simplicity.

Aorta↗

PubMed1989

Arterial switch operation for transposition of the great arteries, with special reference to left ventricular function.

Between June 1984 and September 1987, 48 patients underwent Lecompte's modification of the arterial switch operation for transposition of the great arteries, including transposition with intact ventricular septum with preparatory pulmonary artery banding (n = 18), with patent ductus arteriosus (n = 11), with dynamic left ventricular outflow tract obstruction (n = 4), and transposition with ventricular septal defect (n = 15). Ages ranged from 12 days to 36 months (mean 8 months) and weights ranged from 2.7 to 12.8 kg (mean 5.7 kg). Two deaths occurred, yielding an operative mortality rate of 4.2%. Preparatory pulmonary artery banding resulted in an increase to 65 +/- 5 mm Hg in the left ventricular afterload. Linear regression of the optimum circumference of the band (Y, millimeters) against left ventricular end-diastolic volume (X, milliliters) yielded the following formula: Y = 0.23X + 19.7 (r = 0.885, p less than 0.001). Influence of left ventricular mass on cardiac function after anatomic correction was evaluated. The total amount of dopamine used after repair in patients in whom the left ventricular mass was less than 60% of normal was significantly larger than that in patients with a left ventricular mass greater than or equal to 60% of normal (p less than 0.002). The left ventricular end-diastolic volume in patients with a left ventricular mass less than 60% of normal increased significantly 2 months after operation (p less than 0.05), whereas it decreased in patients with a left ventricular mass greater than 60% of normal (p less than 0.01). We believe it is safe to perform this procedure in patients in whom the left ventricular mass is larger than 60% of normal. Most newborn infants with simple transposition can undergo correction between 10 and 20 days of life if the ductus arteriosus is kept patent with prostaglandin E1 and the left ventricle is thereby loaded. Preparatory pulmonary artery banding, when necessary, will be satisfactory if the left ventricular pressure is greater than 65 mm Hg and/or the left ventricular/right ventricular pressure ratio is greater than 0.8.

Aorta↗

PubMed1989

[Anatomic correction of transposition of the great arteries].

The present status of the surgical treatment of transposition of the great arteries was described by showing the analysis of our results of an arterial switch operation in addition to the review of the literatures. The arterial switch operation recently has become the operation of first choice because of its low surgical mortality (author 4.5%) and low incidence of postoperative complication. One-stage anatomic correction has been performed with low mortality less than 10% in centers dealing high volumes of neonatal surgery (author: 7%). One-stage correction is preferable and it can be accomplished with the cooperative treatment plan of surgeon and pediatrician, starting immediately after birth.

Humans↗