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Biomedical subjects

K Inui

Publications and source records attributed to K Inui.

At least 343 records · Page 19Linked to original sources
PubMed1993

[Post operative embolism and left atrial enlargement in the old-aged ASD (atrial septal defect) patients].

As the operation risk of ASD is little today, the unexpected postoperative complication such as embolism is a miserable concern. We experienced two cases of embolism, which were cerebral infarction, in old-aged patients after ASD correction. It has been reported that low cardiac function, atrial fibrillation and foreign body in the left atrium should be risk factors of the embolism after ASD correction. However, blood stasis in the left atrium due to its enlargement may be an essential risk factor of the embolism. Accordingly we evaluated the left atrial volume in 87 ASD patients without complicated cardiac disorder. There was a significant correlation between the age (X) and left atrial volume index (Y). (Y = 16.5 + 1.1X, r = 0.668, p < 0.001). Left atrial volume index in our two cases of cerebral infarction indicated 171.7, 190.8 ml/m2 respectively. The former case had sinus rhythm and its defect was directly closed, and the latter had atrial fibrillation and its defect was closed with teflon patch. In addition pulmonary artery pressure and cardiothoracic ratio correlated with left atrial volume index significantly. Although some investigators reported that pulmonary hypertension and cardiomegaly were the risk factors of embolism, the left atrial enlargement by aging was thought to be the main risk factor. Thus, we concluded that anticoagulant therapy was necessary for the ASD patients with marked left atrial enlargement.

Aged↗
PubMed1993

[In vitro evaluation of prostaglandin I2 analogue on hypothermic injury to immature myocytes].

We evaluated the functional and biochemical effects of prostaglandin I2 analogue (PGI-A) on cardiac myocytes incubated under hypothermic conditions. Myocytes were isolated from neonatal rat ventricles and cultured for 4 days. Then, myocytes (12.5 x 10(5) myocytes/flask) were incubated at 4 degrees C for 24 hrs in media with PGI-A as follows; O M PGI-A (group C: control), 10(-9) M (group P1), 10(-8) M (group P2), 10(-7) M (group P3), 10(-6) M (group P4). After hypothermic incubation, CPK and LDH were measured. The myocytes were then cultured for 24 hrs at 37 degrees C to evaluate the recovery of myocyte beating rate. For the beating rate, group P2 showed significantly increased recovery compared to the control (P2: 47.9, p < 0.025, C:18.1 percent of control; ie, beating rate prior to hypothermic incubation). The release of CPK and LDH was significantly suppressed in group P2 compared to the control (P2:57.7, p < 0.05, 275.1, p < 0.025; C:96.8 mIU/flask, 439.6 mIU/flask, respectively). In conclusion, prostaglandin I2 has direct cytoprotective characteristics for immature myocytes that may be suitable for cardiac preservation.

Animals↗
PubMed1993

[Serum and pleural SCC-antigen levels in patients with pulmonary tuberculosis].

We measured the serum and pleural levels of squamous cell carcinoma related antigen (SCC-Ag) in patients with active pulmonary tuberculosis and studied the relationship between SCC-Ag and tuberculosis. Serum levels of SCC-Ag in 63 patients with newly diagnosed untreated tuberculosis were 1.76 +/- 2.16 ng/ml, significantly higher than in 118 healthy controls (0.67 +/- 0.52 ng/ml) or in 11 patients with old tuberculosis (0.92 +/- 0.38 ng/ml; p < 0.01). Pleural effusion levels of SCC-Ag in 41 patients with tuberculosis pleurisy were 4.5 +/- 3.4 ng/ml, significantly higher than in 54 patients with non-malignant, non-tuberculous, pleurisy (2.3 +/- 1.7 ng/ml: p < 0.05). In patients who responded well to anti-tuberculous chemotherapy, serum levels of SCC-Ag decreased to the normal range (1.6 ng/ml) with clinical improvement, while in nonresponders they did not decrease. Isoelectolic focusing electrophoresis showed serum SCC-Ag to be composed of a neutral fraction as a single peak, which was corresponded to that of squamous cell carcinoma of the lung. The tuberculous lesions were stained with anti-SCC-Ag antibody in one case and weak SCC-Ag positive findings were observed in the intercellular spaces of the epidermoid cells in the area without necrosis. These results raise the possibility that SCC-Ag is produced in or released from not only squamous cell carcinoma of the lung but also pulmonary tuberculous lesions.

Adult↗
PubMed1993

Effect of preoperative irradiation on wound healing after bronchial anastomosis in mongrel dogs.

To determine the endurable radiation dose before bronchial anastomosis, the bronchial circulation of mongrel dogs was assessed after bronchoplastic surgery conducted after various single doses of radiation. Plastic surgery of the right main bronchus was carried out 1 week after cobalt 60 irradiation to the right hilar region. Bronchial blood flow was measured with laser Doppler velocimetry 7, 14, and 30 days after operation. Animals were killed 30 days after operation and the region of the bronchial anastomosis was examined histologically. The animals were divided into five groups: group A (control group without irradiation), group B (8 Gy irradiation), group C (16 Gy), group D (19 Gy), and group E (24 Gy). Wound healing of the anastomosed bronchus was excellent in groups A and B. In group A, bronchial blood flow did not drop below 80% of the preoperative level throughout the postoperative observation period. In group B, bronchial blood flow on day 7 after operation was only 65% of the preoperative level, but blood flow had returned to the preoperative level by day 30. In groups C, D, and E, bronchial blood flow was less than 60% of the preoperative level on day 30. There was a high prevalence of radiation-induced morbidity in the region of anastomosis in groups C, D, and E. Postoperative recovery of bronchial blood flow and wound healing of the anastomosed bronchus were thus delayed in dogs that had received high doses of radiation before operation. We conclude that the safe dose of preoperative radiation in clinically used fractionation is 36 Gy or less (corresponding to a single dose of 16 Gy or less in dogs).

Anastomosis, Surgical↗
PubMed1993

[The effects of synthetic protease inhibitor on motility of the human duodenal papilla].

We studied the effects of synthetic protease inhibitors on the motility of the human duodenal papilla. Before and after the intravenous administration of gabexate mesilate (GM) or nafamostat mesilate (NM), the duodenal papillary pressure was measured with a catheter tip pressure transducer under duodenoscopy. GM was administered to fourteen subjects at 1 and 3 mg/kg/h. The peak pressure and the basal pressure were dose-dependently reduced by GM, but the frequency did not change. The blood CCK concentration was not changed after GM administration. NM was administered to twelve subjects at 0.3 mg/kg/h. Both the papillary pressure and the frequency were not changed by NM. GM inhibited the papillary motility, but NM had no consistent effect on the papillary motility.

Adult↗
PubMed1993

[A clinical experience of agranulocytosis just after open heart surgery].

A 63-year-old woman who underwent aortic and mitral valve replacement developed agranulocytosis just after operation. It was considered that agranulocytosis was caused by bone marrow suppression by antiarrhythmic agent and extracorporeal circulation. Her white blood cell counts decreased to 300/mm3 on the third postoperative day, but increased surprisingly 5 days after administration of G-CSF. Fortunately she did not suffered from severe infection, and thereafter postoperative course was uneventful. Although agranulocytosis just after open heart surgery has not been reported, it appears that G-CSF might be useful.

Agranulocytosis↗
PubMed1993

[Molecular pathology of hepatic glycogen storage disease].

Recent advances of molecular analyses of hepatic glycogen storage diseases have made some progress in understanding of glycogen metabolism. Glucose-6-phosphatase has been shown to comprise at least five different polypeptides, the catalytic subunit, a regulatory Ca2+ binding protein, three transport proteins (glucose-6-phosphate, phosphate/pyrophosphate, glucose). A defect of these protein could cause type I glycogenosis. Only cDNAs of the regulatory Ca2+ binding protein and glucose transport protein were cloned. In type III glycogenosis, using monospecific antibody, correlation of biochemical defects with myopathy and cardiomyopathy was investigated. In type VI glycogenosis, the cDNA of liver phosphorylase was cloned, which will be useful for delineating the molecular defect involved in the disease and family analysis. In type VIII glycogenosis, phosphorylase kinase deficiency, only subunits of muscle type (alpha, beta, gamma, delta) were cloned and clonings of hepatic type subunits were waited. In the near feature, hepatic glycogen storage disease and glycogen metabolism were reevaluated from the points of molecular defects.

Cloning, Molecular↗
PubMed1993

[Two siblings of type 3 GM1 gangliosidosis with different clinical features and different ages of onset].

We experienced two siblings of type 3 GM1 gangliosidosis. A 33-year-old woman developed dysarthria, dysbasia and bradykinesia at around the age of 30. Her 28-year-old brother showed locomotor retardation and skeletal deformity in infancy. He lost the ability to stand walk at childhood, and developed progressive dystonia. The major neurologic manifestations were parkinsonian symptoms in the elder sister, and progressive dystonia in her brother. Both had markedly reduced beta-galactosidase activity in peripheral blood lymphocyte and were diagnosed as having type 3 GM1 gangliosidosis. Gene analysis revealed that these patients were homozygotes of the adult type mutant gene. The two siblings are unique in that the clinical manifestations and the age of onset of symptoms differed markedly between them despite the same mutant gene in both cases.

Adult↗
PubMed1993

[Surgical therapy with adjuvant radiotherapy of thymoma: results of 104 cases].

One hundred and four cases of thymomas were treated between 1967 and 1991 at the Chest Disease Institute, Kyoto University. Forty-two cases were clinical stage I, 12 cases were stage II, 42 cases were stage III and 8 cases were stage IV. Nineteen patients had MG, 17 patients had SVC syndrome. Ninety-six cases were surgically resected combined with radiation therapy. Overall survival was 77.9% at 5 years and 62.5% at 10 years. The survival of 62 cases of invasive thymoma was 77.5% at 5 years and 54.8% at 10 years. We've got better prognosis when total or subtotal resection of invasive thymoma could be accomplished, i.e. 88.8% at 5 years and 72.6% at 10 years.

Female↗
PubMed1993

[Suppurative mediastinitis after open heart surgery: in comparison between infants-children and adults].

Among 361 consecutive patients who underwent open surgery from Jan. 1987 to Sept. 1991, risk factors and clinical courses were analyzed retrospectively in comparison between infants-children and adults. Seven mediastinitis (4.0%) occurred in 173 adult patients (20 to 75 y/o, mean: 54.4 y/o) and were not associated with age, sex, type of disease, and duration of operation or cardiopulmonary bypass. Postoperative mediastinitis significantly increased in the patients with low output syndrome (LOS) determined as use of IABP and/or assistant circulations (p < 0.001) and reexploration for bleeding or tamponase was associated with an increased risk for mediastinitis (p < 0.01). Five mediastinitis (2.7%) occurred in 188 infants and children (0 to 17 y/o, mean: 4.2 y/o). All patients involved with mediastinitis were less than 12 month old (2.6 +/- 3.3 month). None of the other factors was associated with an increased risk for this complication. Bacterial cultures of exudate were positive in 11 of 12 patients, and identified as MRSA in 10 and Staphylococcus epidermidis in one. In the seven of adult patients, two developed sepsis and four died with other organic failures or mediastinal bleeding. All five of infants healed after postoperative 33 to 145 days. The immature state of immune response might associate with postoperative mediastinitis in infants, whether LOS may be important in the immune suppression by surgical stress in adults, and the prognosis of mediastinitis might be effected by prolonged depression of postoperative cardiac function in adult patients.

Adolescent↗
PubMed1993

Bronchial circulation after experimental lung transplantation. The effect of long-term administration of prednisolone.

The effect of corticosteroids on bronchial healing after modified left lung transplantation was investigated in pigs. In groups I (n = 6) and II (n = 6), animals received cyclosporine (15 mg/kg per day) and azathioprine (2 mg/kg per day). In group II, prednisolone (1 mg/kg per day) was also administered. Bronchial blood flow was estimated at the donor carina and donor second carina with laser Doppler velocimetry and radioisotopes 7 days postoperatively; macroscopic and microscopic assessments of graft airways were performed. Bronchial blood was calculated relative to the recipient carina. In group II, bronchial blood flow at the donor carina and donor second carina was significantly higher than that of group I. Macroscopic assessment revealed more pronounced ischemic changes in group I (5 of 6 animals) than in group II (2 of 6 animals, p = not significant). Microscopically, airway samples from the donor carina revealed marked destructive changes in five of six animals in group I. In group II, only mild ischemic changes, which were limited to the respiratory epithelium, were seen. We concluded that the administration of prednisolone results in improved bronchial blood flow and decreased bronchial ischemia after lung transplantation.

Animals↗
PubMed1993

[Participation of platelet activating factor in the pulmonary injury during cardiopulmonary bypass].

Activations of leukocytes and platelets have been considered to be one of the major harmful factors related to Adult Respiratory Distress Syndrome (ARDS). As a hypothesis of the present study, similar events may exaggerate the post perfusion lung syndrome following the cardiopulmonary bypass (BPB). Since platelet activating factor (PAF) is a strong activator of leukocytes and platelets, we measured the kinetics of PAF level, number of leukocytes and platelets in 20 anesthetized dogs. beta-TG and PF4 were also measured in patients with organic heart disease before and after CPB. We also studied the preventive effects of PAF antagonist (CV-3988) on the postperfusion lung injury in dogs. The PAF activities increased twice 5 minutes after the beginning of CPB, then it was progressively increased to a level 4.5 times at the end of CPB. Circulating numbers of leukocytes and platelets depleted sharply after the CPB, and then decreased gradually. Such depletion was not modified by PAF antagonist, CV-3988. Accumulation of leukocytes at the pulmonary circulation, and the microscopic evidence of leukocyte sequestration in pulmonary capillary beds were noted in cases without PAF antagonist. Rapid increases of beta-TG and PF45 minutes after the beginning of CPB also showed that activation of platelets occurs immediately. Adhesion of activated leukocytes or platelets to the pulmonary capillary bed in dog cases may suggest the ensuring damage to the vascular beds by releasing free radicals, lysosomal enzymes, or other chemical mediators. Restriction of inflow rate of activated leukocytes to the lung or the heart before aortic clamping may attenuate harmful effects of leukocytes on the respiratory function related to the CPB.

Animals↗
PubMed1993

[A blind point of vent catheter: air aspiration].

We experienced a case of saphenous vein air embolism after coronary artery bypass graft, in which case we used vent catheter kept in the left atrium. Though it was considered that air bubbles were never aspirated through vent catheter, we speculated that the origin of air bubbles must be the vent catheter. And we made an experiment on the motion of air in the vent catheter using a model of left heart composed with soft reserver (atrium) and pulsatile pump (ventricle). When the pulsatile pump was arrest, the air bubbles were never aspirated from the vent catheter to the soft reserver even if we vented with strong negative pressure. But, when the pulsatile pump was in motion and the left atrium was vented with some negative pressure, some leaks of air bubbles were recognized. So we must pay much more attention to the degree of venting when the heart is in motion. Sometimes we use overpressure safety valve composed with vent catheter, but measured left atrial pressure showed that decreased left atrial pressure was only 2 mmHg. So its use should be restricted in the patients with good ventricular function.

Catheterization, Central Venous↗
PubMed1992

Structure of serum transferrin in carbohydrate-deficient glycoprotein syndrome.

The structure of the defective transferrin in carbohydrate-deficient glycoprotein syndrome was characterized. Structurally abnormal sugar chains were not found in reversed phase chromatograms of pyridylaminated derivatives from the transferrin of two patients in different families. Electrospray ionization mass spectrometry of the whole transferrin molecules revealed an abnormal species that was smaller than normal tetrasialotransferrin by 2,200 daltons, just the size of the disialylated biantennary sugar chain. These data indicated that the disialotransferrin specifically found in this syndrome is missing either of two N-linked sugar chains, suggesting a metabolic error in the early steps of protein glycosylation.

Carbohydrate Metabolism, Inborn Errors↗
PubMed1992

Transport of procainamide in a kidney epithelial cell line LLC-PK1.

Transport of procainamide, an anti-arrhythmic drug, was investigated in LLC-PK1 kidney epithelial cell line. The uptake of procainamide by LLC-PK1 monolayers cultured in plastic dishes was temperature-dependent, saturable and inhibited by organic cations such as cimetidine and N-acetylprocainamide. An aminocephalosporin antibiotic, cephalexin, also inhibited procainamide uptake, but an organic anion, p-aminohippurate, did not. The uptake of procainamide was greater at an alkaline external pH than at an acidic pH. In addition, procainamide uptake increased when intracellular pH was decreased and the uptake decreased when the intracellular pH was increased by ammonium chloride treatment, indicating the involvement of an H+/procainamide antiport system in apical membrane. The basolateral to apical flux of procainamide across LLC-PK1 monolayers cultured on permeable supports was 2.5-times larger than the apical to basolateral flux, and only the former process was inhibited by other organic cations. These findings suggest that LLC-PK1 cells can transport procainamide by the organic cation transport system and that procainamide is transported unidirectionally from basolateral to apical side across the cell monolayers.

Animals↗
PubMed1992

Mitochondrial tRNA(Ile) mutation in fatal cardiomyopathy.

A patient with mitochondrial encephalomyopathy who died from progressive intractable cardiac failure at the age of 18 is reported. At the age of 4, he presented with short stature, but multiorgan disorders including deafness, focal glomerulosclerosis, epilepsy and dilated cardiomyopathy appeared later in his clinical course. Laboratory tests showed hyperlactatemia and hyperpyruvatemia. Histopathological findings demonstrated mitochondrial myopathy with ragged red fibers and focal cytochrome C oxidase-deficient fibers in skeletal and cardiac muscles. The activity of cytochrome C oxidase was 30% less than the control level in skeletal muscle. Sequencing of the entire mitochondrial tRNA genome revealed a novel point mutation in the tRNA(Ile) region (nt 4269). This A-to-G substitution was found in none of the 30 controls by screening using mispairing PCR and Ssp I digestion methods, suggesting that this new mutation was pathogenic in our case.

Adolescent↗
PubMed1992

GM1 gangliosidosis in adults: clinical and molecular analysis of 16 Japanese patients.

Clinical findings were compared with the results of molecular analysis in 16 Japanese patients from 10 unrelated families with the adult/chronic form of GM1 gangliosidosis. Age of onset ranged from 3 to 30 years. Major clinical manifestations were gait and speech disturbances caused by persistent muscle hypertonia. Dystonic postures and movements, facial grimacing, and parkinsonian manifestations were commonly seen. Cerebellar signs, myoclonus, severe intellectual impairment, dysmorphism, or visceromegaly were not observed. A common single-base substitution, 51Ile(ATC)----Thr(ACC), reported in a previous study of ours, was confirmed in 14 patients by the Bsu36I restriction site analysis; one was a compound heterozygote with another mutation (457Arg[CGA]----Gln[CAA]) and the others were homozygotes of this mutation. Clinically, the compound-heterozygous patient showed more severe neurological manifestations and a more rapid clinical course than those of homozygotes. The homozygotes showed considerable variations in the age of onset and subsequent clinical course. The 51Ile----Thr mutant allele expressed a significant amount of beta-galactosidase activity, whereas the 457Arg----Gln mutant allele expressed extremely low activity in human GM1 gangliosidosis fibroblasts. We conclude that these gene mutations causing different residual enzyme activities are related to the severity of clinical manifestations, but some other genetic or environmental factors contribute to clinical heterogeneity. The Bsu36I restriction site analysis was performed in 7 families and provided clear results for the diagnosis of heterozygotes as well as homozygotes of this specific clinical form of GM1 gangliosidosis. The technique is applicable to prenatal diagnosis and genetic counseling.

Adult↗