Biomedical subjects
Publications and source records attributed to J Hayashi.
This report presents successful replantation of the upper lip after 17 hours of ischemia. In spite of successful venous anastomoses, the postoperative use of leeches was necessary because of severe congestion. However, sensory and functional recovery was excellent.
OBJECTIVE: The aim was to demonstrate specific detection of the fluorescence spectra of mono-L-aspartyl chlorin e6 (NPe6) emitted from atherosclerotic arterial lesions using an extravascular approach. METHODS: Cholesterol fed atherosclerotic rabbits were injected intravenously with 0.5 mg.kg-1 of NPe6. A fluorescence spectrum analysis system with a dual real time imaging system and a flexible endoscopic catheter was used. The pulsed excimer dye laser excited the photosensitiser. The fluorescence spectra were measured by a fluorescence spectrophotometer. RESULTS: Analysis of fluorescence spectra detected from outside the adventitia showed that a fluorescence spectrum peak at 675 nm was obtained only in parts of the artery with an atheromatous plaque; however, no fluorescence could be shown in aortic segments free of atheroma. It was also noted that the intensity of the specific peak of the spectrum detected from outside a vessel was closely related to the depth of atheromatous lesions, as determined by histological analysis. An in vivo study revealed good correlation between the peak intensity (which could vary with the amount of NPe6 accumulated in the tissue) measured laparoscopically from outside the abdominal aorta and the peak intensity measured angioscopically from inside the abdominal aorta. CONCLUSIONS: It is possible to detect atheroma from outside a vessel by fluorescence spectrum analysis employing NPe6 as the probe.
OBJECTIVE: The aim was to determine whether left ventricular apical myocardium has mechanisms to compensate for sparse sympathetic innervation. METHODS: Contractile and metabolic responses to various adrenergic stimuli and beta adrenergic receptor density were compared between left ventricular basal and apical regions in 26 anaesthetised mongrel dogs, weight 12-28 kg. RESULTS: Regional contractile changes in response to graded cardiac sympathetic nerve stimulation were compared among three basal (anterior, middle, and posterior) regions, and between basal middle and apical regions. There were significant differences in contractile changes among the three basal regions with distinct regions of innervation from right and/or left sided sympathetic ganglia, but not between apical and basal regions. Constant infusion of noradrenaline (0.2-0.4 microgram.kg-1.min-1) produced a greater response in normalised end systolic length in the apical myocardium than in the basal region, at 9.86(SEM 0.06) mm v 10.14(0.04) mm (n = 5, p < 0.025), and a greater increase in tissue cyclic AMP: 1.04(0.20) v 0.60(0.08) pmol.mg-1 (n = 5, p < 0.05). Giving a forskolin derivative (30 micrograms.kg-1, n = 5) produced a greater increase in cyclic AMP in the apical region than in the basal region: 1.26(0.18) v 0.88(0.19) pmol.mg-1 (p < 0.02). beta Adrenergic receptor density in the apical region was greater than in the basal region: 455(45) v 341(35) fmol.mg-1 protein (n = 5, p < 0.05). CONCLUSIONS: Greater beta adrenergic receptor density and/or increased myocardial responsiveness to adenylate stimulation in apical myocardium compensates, at least in part, for its sparse sympathetic innervation.
Two cases of Acquired Immune Deficiency Syndrome (AIDS) with disseminated non-tuberculous mycobacterial infection are reported. Both patients had hemophilia and were infected with Human Immunodeficiency Virus type 1 (HIV) by antihemophilic factor infusion. In case 1, a 44-year-old male, Mycobacterium marinum, which ordinarily causes cutaneous infection, was isolated from sputum before death and from the lung, spleen, bone marrow, liver and lymph node at autopsy. This is the first report of disseminated M. marinum infection with AIDS. In case 2, a 25-year-old male, Mycobacterium avium complex, which is the most common strain in non-tuberculous mycobacterial infection among patients with HIV, was isolated from the lung by TBLB and at autopsy from the lung, liver, spleen, bone marrow, lymph node, stomach, small intestine and testis. He also had a giant intraabdominal lymphadenopathy, associated with the M. avium complex infiltration. In conclusion, non-tuberculous mycobacteria can be easily disseminated in patients with AIDS because of dysfunction of cellular immunity, even when their primary lesions are not severe.
To evaluate the immunogenicity of the Chinese hamster ovary cell derived HB vaccine (CHB), CHB and yeast derived HB vaccine (YHB) were given to 110 medical students divided into four groups. CHB was given to group A subcutaneously (0.5 ml, 3 times) and to group B intradermally (0.125 ml, 3 times). YHB was given to group C (Y company) and to group D (Z company) subcutaneously (0.5 ml, 3 times). The anti-HBs positive rate at 7 months was 85.7% in group A, 95.8% in group B, and 100% in groups C and D. The percentage responding with high anti-HBs concentration (> or = 100 mIU/ml by RIA) at 7 months was 67.9% in group A, 79.2% in group B, 58.3% in group C and 63.3% in group D. Thus, although the anti-HBs positive rate was rather low when CHB was given subcutaneously, it was almost the same as YHB when given intradermally. The percentage of high responders to CHB given both subcutaneously and intradermally was high compared to YHB. These data suggest that CHB has almost the same immunogenicity to the conventional YHB.
Epidermal growth factor (EGF) is a potent inhibitor of adipose differentiation in vitro and delays adipose tissue development in vivo. Here we show that in the homozygous male obese mice the level of EGF in the submaxillary gland and plasma is significantly lower than in the glands and plasma of age-matched control littermates. This EGF deficiency in ob/ob mice was observed as early as 5 wk of age when obesity had just become apparent and was also found in adult mice. The level of prepro-EGF mRNA expression in the submaxillary gland was also lower in obese mice than in control littermates. However, the level of kidney prepro-EGF mRNA was the same in mice with both phenotypes, suggesting that the regulation of prepro-EGF mRNA expression is different in both tissues. These results indicate that genetic obesity in mice is accompanied by a decrease in the production of EGF.
This study was performed to determine the effect of recombinant human erythropoietin (rEPO) on preoperative autologous blood donation in patients undergoing elective coronary bypass or valvular operations. Nineteen patients received 200 u/kg of rEPO intravenously 3 times a week, and 210 mg/day of iron sulfate orally, for 2 weeks before surgery (EPO group). Seven matched patients only took the same dose of iron sulfate (control group). Bone marrow was aspirated from the sternum during surgery, and the Myeloids/Erythroids ratio was calculated in 13 patients of the EPO group. The total donated blood mass was 853 +/- 231 g in the EPO group, and 657 +/- 140 g in the control group (p < 0.05). The average increase in hemoglobin (Hb) mass from admission to the day before surgery was 87 +/- 33 g in the EPO group, and 24 +/- 13 g in the control group (p < 0.001). Furthermore, the logarithm of the ratio of "increased Hb mass/Hb mass at admission" was significantly correlated to the Myeloids/Erythroids ratio (r = -0.9130, p < 0.01). These results strongly indicate that rEPO is a very useful agent for predonation of autologous blood for cardiac operations.
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To determine whether clonidine can improve the central alteration of the baroreflex in SHR, the centrally cut end of the aortic depressor nerve was electrically stimulated in SHR with intravenously administered clonidine. Aortic depressor nerve (ADN) stimulation elicited depressor and sympatho-inhibitory responses in a frequency-dependent manner in WKY and SHR. These responses were significantly smaller in SHR than in WKY. The attenuated depressor and sympatho-inhibitory responses to ADN stimulation in SHR were restored following i.v. injections of clonidine, although the drug did not affect the responses to ADN stimulations in WKY. These findings suggest that clonidine can improve central attenuation of the baroreflex in hypertension.
An unusual pheochromocytoma was incidentally discovered in a 48-year-old woman. The patient had a 3-year history of myasthenia gravis. At the time of examination in our hospital, the right adrenal tumor was incidentally discovered by ultrasonography of the abdomen. She had no history of headache, perspiration, palpitation or hypertension. Although blood catecholamine levels were within the normal limits, urinary secretion of catecholamine was elevated. Histologically, the tumor was diagnosed to be mixed ganglioneuroma/pheochromocytoma and histochemically confirmed to produce vasoactive intestinal polypeptide. Such a tumor is quite rare.
Successful direct revascularization in a 54-year-old man with embolism of the basilar artery following St Jude Medical valve replacement for mitral regurgitation 6 years earlier is reported. He arrived at the hospital in a deep coma. Computed tomography showed no new lesions, but subsequent angiography revealed occlusion of the basilar tip, bilateral posterior cerebral arteries and right superior cerebellar artery. Direct thrombolytic therapy was performed using 420,000 units urokinase through an infusion catheter placed in the basilar artery. The patient immediately regained consciousness, with only slight diplopia. Direct thrombolytic therapy is considered to be an effective treatment for thromboembolism following prosthetic valve replacement in certain selected cases.
Intraoperative ultrasonography during laparoscopic cholecystectomy is a new procedure for examining the bile duct. The ultrasonic probe used in this study utilized a 7.5-MHz convex array designed for easy insertion through a 10-mm cannula. This probe was 90 cm long, had a 10-mm diameter, and was equipped with an angulation system controlled by levels. Additionally, this ultrasound system could detect the direction of the blood flow using a color Doppler display. Both laparoscopic ultrasound and laparoscopic cholangiography were attempted in 45 patients. In 41 of the 45 patients, laparoscopic ultrasound was successful in visualizing the first-order hepatic branches and the common bile duct. On the other hand, laparoscopic cholangiography was successful only in 38 of the 45 patients. The color Doppler capability helped to distinguish the bile duct from the portal vein and hepatic artery. Visualization of the bile duct was achievable by laparoscopic ultrasound. Also, the color Doppler system easily identified the bile duct. However, further design improvements in the ultrasound probe are required to establish laparoscopic ultrasound as an effective intraoperative routine procedure.
Thymic epithelial cell line TEA3A1 produce prostaglandin E2 (PGE2) and express high levels of annexin I. In order to study the relationship between the levels of annexin I expression and the arachidonic acid metabolism, TEA3A1 cells transfected with expression vector containing full length annexin I cDNA in either sense or anti-sense orientation was studied. In the anti-sense cells where the level of annexin I was reduced, the PGE2 production was significantly lower. On the other hand, PGE2 production was significantly higher in sense cells where the production of annexin I was also higher than in control cells. Our results show that increased PGE2 production in sense cells was accompanied by higher levels of PLA2 enzymatic activities. These results suggest that the production of annexin I is positively associated with the phospholipase A2 enzymatic activity and the prostaglandin production in thymic epithelial cells.
Guanosine 5'-O-(thiotriphosphate) (GTP gamma S), an activator of guanine nucleotide binding protein (G protein), increased prostaglandin E2 (PGE2) production in saponin permeabilized rat thymic epithelial cells, TEA3A1. Aluminum fluoride (A1F4-), a cell permeable G protein activator, also stimulated PGE2 production and arachidonic acid (AA) release from TEA3A1 cells. Using A1F4- instead of GTP gamma S as a G-protein activator, we have investigated the mechanism of G-protein mediated stimulation of PGE2 production in TEA3A1 cells. Results from our experiments indicate that G protein mediated activation of AA metabolism in TEA3A1 cells is regulated by two independent mechanisms. One is by the stimulation of AA release via the activation of PLA2 enzymatic activity through PLC and PKC mediated pathway and the other is by a concomitant inhibition of AA incorporation into membrane phospholipids.
A 4-year-old boy admitted to our hospital due to congestive heart failure one year after the intracardiac repair of tetralogy of Fallot. Echocardiography and cineangiography revealed severe aortic regurgitation. The aortic valve replacement was performed with a prosthesis larger than the aortic annulus. Operative findings showed that the cause of aortic regurgitation was infective endocarditis. The aortic root was enlarged with pericardial patch and a 21 mm St. Jude Medical valve prosthesis was inserted in supraannular position. This technique was very useful for insertion of a prosthetic valve one or two sizes larger than the aortic annulus without risk of distorting the mitral valve or left ventricular function.
DNA and RNA contents in cells of human colorectal cancer transplanted in nude mice were analysed by a flow cytometric method after the cells were stained with Acridine Orange. The results revealed that the method was found to be useful for the analysis of proliferative activity of tumor cells. Relative DNA and RNA contents in the cells were expressed as DNA index (DI) and RNA index (RI), respectively. Of the six colorectal cancer materials used to measure DI, RI and their tumor doubling time (TD), KLM3, KLM1, KRK1 and KRK4 are well differentiated adenocarcinoma, COLO 205 is poorly differentiated adenocarcinoma, and KSK1 is well differentiated mucinous carcinoma. A significant correlation was found between RI and TD in the total six models (n = 92, r = 0.49, p < 0.001) and every models of KLM3 (n = 27, r = -0.67, p < 0.001) and KRK4 (n = 10, r = -0.65, p < 0.05), while no correlation between DI and TD was found in all models. The results indicated that the measurement of the cellular RNA content is a useful index to evaluate the proliferative activity of human solid tumors.
We evaluated the nutritional states before and after operation in patients with severe valvular heart disease characterized by malnutrition. The patient population consisted of 6 females, age range between 42 and 60, average 52.2 years old. The valve lesions were mitral stenosis in 2, combined aortic and mitral valve diseases in additional 4 patients, and moderate to severe tricuspid regurgitation was noted in 5 of these 6 patients. All 6 patients underwent a successful mitral (c/s aortic) valve replacement, and 5 of 6 tricuspid annuloplasty. The ideal body weight increased significantly from 77.9 +/- 3.4% preoperatively to 84.6 +/- 3.9% postoperatively (p < 0.01). Late postoperative cardiac catheterization revealed an improvement of mixed oxygen saturation (61.3 +/- 3.8%, preoperatively vs 67.3 +/- 5.6%, postoperatively; p < 0.01). The postoperative serum prealbumin, retinol binding protein and K value in intravenous glucose tolerance test increased significantly (p < 0.05) compared to those before operation. In conclusion, our data suggested that corrective surgery would have a good effect on nutritional improvement of the protein-calorie malnutrition caused by valvular heart diseases.
We treated 15 children with atrioventricular septal defects (6 complete type and 9 incomplete type) using total circulatory annuloplasty for mitral regurgitation. In 14 patients, total circulatory annuloplasty was performed with absorbable suture and in one patient with polypropylene suture. Operative death was one patient associated with tetralogy of Fallot and another 14 patients survived. Preoperative mitral regurgitation was grade 1 in one patient, grade 2 in 6 patients and grade 3 in 7 patients. After operation mitral regurgitation reduced to grade 1 in 13 patients and grade 2 in one patient. In the late results, only one patient underwent reoperation for exacerbation of mitral regurgitation. The present data suggested that total circulatory annuloplasty with absorbable suture was very useful technique for the repair of mitral regurgitation of atrioventricular septal defects in children.