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Biomedical subjects

K Kamata

Publications and source records attributed to K Kamata.

At least 19 recordsLinked to original sources

Thrombosed tricuspid valves presenting some 20 years after the surgical correction of Ebstein's anomaly: report of two cases.

We present herein the cases of two patients who were diagnosed as having thrombosed tricuspid valves by electrocardiography after undergoing valve replacement with Starr-Edwards caged ball valves for Ebstein's anomaly 19 and 27 years earlier. In both patients, the valves were found to be attached to the right ventricular septum and covered with massive thrombus, the balls being completely jammed in a half-open position in the cages. Re-replacement of the valves was successfully performed with Hancock II porcine heterograft prostheses and both patients are now classified as being in Functional Class I or II.

Adolescent

Endothelium-derived hyperpolarizing factor does not contribute to the decrease in endothelium-dependent relaxation in the aorta of streptozotocin-induced diabetic rats.

1. We examined the contribution of endothelium-derived hyperpolarizing factor (EDHF) to the impairment of endothelium-dependent relaxation caused by acetylcholine (ACh) in the aorta of streptozotocin-induced diabetic rats, by using N omega-L-nitro-arginine methylester (L-NAME) and tetraethylammonium chloride (TEA) to inhibit nitric oxide (NO) and EDHF, respectively. 2. ACh-induced relaxation of the aorta decreased in diabetic rats. In contrast, sodium nitroprusside-induced relaxation was the same in diabetic rats and control rats. 3. Treatment with 5 x 10(-7) M L-NAME resulted in a right shift of the dose-response curves of ACh-induced relaxation in the aorta. The shift was greater in the control aorta. 4. Treatment with 5 x 10(-4) M TEA resulted in a similar right shift in both the control and diabetic aorta. 5. Therefore, while endothelium-derived NO appears to contribute to the impairment of ACh-induced endothelium-dependent relaxation in the aorta of diabetic rats, EDHF does not.

Acetylcholine

Branch retinal vein occlusion in a child with ocular sarcoidosis.

PURPOSE/METHODS: A 13-year-old girl had unilateral iridocyclitis and periphlebitis. The periphlebitis exacerbated, and macular edema as well as branch retinal vein occlusion developed. The patient was treated with systemic corticosteroids. RESULTS/CONCLUSIONS: The lesions responded well to systemic corticosteroids. Histologic diagnosis of sarcoidosis was obtained by transbronchial lung biopsy. Ocular lesions in this child were similar to those seen in adult sarcoidosis. Branch retinal vein occlusion may occur as a rare vascular complication of sarcoidosis.

Adolescent

Regional cerebral blood flow measurement using Tc-99m HMPAO SPECT in a patient with adrenoleukodystrophy.

Regional cerebral blood flow (rCBF) measurement using Tc-99m HMPAO angiography and SPECT was performed in a patient with adrenoleukodystrophy. The whole brain CBF showed great reduction to 31 ml/100 g/min as compared with an age-matched normal value of 45.9 ml/100 g/min. rCBF showed extremely decreased values of approximately 28 and 10 ml/100 g/min in bilateral frontal cortex and white matter respectively. The SPECT scan provided useful information on gray matter involvement to MRI findings of widespread white matter lesions. This quantitative nuclear medicine technique may contribute to pathophysiologic evaluation of adrenoleukodystrophy complementary with MRI.

Adrenoleukodystrophy

Renal dysfunction in multiple myeloma.

This study aims to determine the clinical factors that may affect renal function and patient survival in 82 multiple myeloma patients. The patients were divided into 3 groups according to their renal function during the initial 8 weeks after diagnosis: Group I, 54 patients with serum creatinine (S-Cr) < 177 mumol/L; Group II, 11 with S-Cr > or = 177 mumol/L and receiving no dialysis; Group III, 17 undergoing dialysis treatment. Clinical status at diagnosis, subsequent renal function and patient survival were compared. Bence Jones proteinuria (BJP) was found in all patients in Groups II and III, compared to 67% of patients in Group I (p < 0.05, I vs II or III). Hypercalcemia, hyperuricemia and intravenous administration of contrast medium, together with BJP each constituted independent risk factors of renal dysfunction. The incidence of hypercalcemia in Group II was significantly higher than in the other 2 groups. Patient survival was 26.8 +/- 23.7 months in Group I, 8.1 +/- 10.3 in II and 12.1 +/- 16.6 in III (p < 0.05, I vs II or III). Renal function and patient survival depended on the initial renal function. Renal function was likely compromised in the presence of BJP.

Female

Enterogenous cyst in the fourth ventricle--case report.

A 53-year-old male presented with a rare enterogenous cyst in the fourth ventricle associated with repeated ventriculoperitoneal shunt malfunction. Surgical excision of the cyst resolved the shunt problems. Electron microscopy findings of the surgical sample were microvilli covered with electron-dense coating materials, basement membrane, and several intercellular junctional devices, suggesting the cyst was derived from the endodermal structure. The viscous and gelatinous contents of the cyst might be responsible for the shunt malfunction.

Cerebral Ventricles

Ocular absorption, distribution, and systemic absorption of a novel antiglaucoma medication, prostaglandin derivative, in male white rabbits.

A prostaglandin derivative, (5Z,9 alpha,11 alpha,13E)-9,11-dihydroxyprosta- 5,13-dienoic acid sodium salt (S-1033), that lowers intraocular pressure with little adverse effect, may have clinical value in the treatment of glaucoma. After [14C]S-1033 (0.2% solution) was instilled into the eye of a white rabbit, radioactivity and S-1033 appeared in systemic plasma so rapidly (tmax, 5 min) and S-1033 was eliminated very rapidly with half-lives of 2.8 and 11.0 min at alpha- and beta-phases, respectively. The metabolite, M-1, [1R-[1 alpha,2 beta-(1E),3 alpha,5 alpha]]-3,5-dihydroxy-2-(1- octenyl)-cyclopentanepropanoic acid (tetranor-S-1033), appeared in plasma very rapidly (tmax, 5 min), suggesting that a fast metabolism was a major factor in the rapid elimination of S-1033 from plasma. The values for the ratios of the area under the curve of ocular instillation to intravenous administration for radioactivity and S-1033 were 1.01 and 0.52, respectively, indicating that more than half of the S-1033 instilled was transported into the systemic circulation. To clarify the contributing pathway of the massive and rapid systemic absorption of S-1033 after topical dosing, plasma levels of S-1033 were investigated after instillation to rabbits in which the nasolacrimal ducts were occluded. Plasma concentrations of S-1033 were slightly higher than those in intact rabbits, suggesting that conjunctiva would be as important as nasal mucosae for the systemic absorption under the physiological condition. As for the intraocular distribution, the highest levels of radioactivity were found in the cornea, conjunctiva, and anterior sclera.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption

Tooth pulp stimulation induces c-fos expression in the lateral habenular nucleus of the cat.

Detection of Fos protein expression by the peroxidase-antiperoxidase method was used to determine the area in the habenular (Hb) complex responding to electrical stimulation of the tooth pulp in the cat anaesthetized with pentobarbital. In the anaesthetic-injected group, the Fos-positive neurones were found bilaterally in the lateral Hb nucleus (HbL). Tooth pulp stimulation (intensity: 3 times the threshold for jaw-opening reflex) increased the number of positive neurones within the HbL by up to 300%, but did not induce any expression in the medical Hb nucleus. The increase in HbL was inhibited by morphine (2 mg kg-1, i.p.). These findings and the results of previous research suggest that HbL neurones are involved in defensive mechanisms by means of antinociception following noxious stimulation.

Animals

Decrease in vasodilator effects of platelet-activating factor in resistance vessels of spontaneously hypertensive rats.

We studied the endothelium-dependent vasodilator effects of platelet-activating factor (PAF) on the mesenteric arterial bed of Wistar Kyoto rats (WKYs) and spontaneously hypertensive rats (SHRs) and found that vasodilation induced by PAF was significantly attenuated in SHRs. We discovered no significant differences in reactivity or sensitivity of the mesentery to acetylcholine between WKYs and SHRs. Our results strongly suggest that the attenuated vasodilator effects of PAF on the SHR mesenteric arterial bed may be due in part to desensitization rather than impairment of the endothelium.

Animals

Liquid chromatographic determination of carnitine by precolumn derivatization with pyrene-1-carbonyl cyanide.

A method is described for the determination of carnitine chloride in pharmaceutical preparations by precolumn derivatization and high-performance liquid chromatography (HPLC). Carnitine chloride is derivatized by reaction with pyrene-1-carbonyl cyanide (PCC) in dimethyl sulphoxide. The PCC derivative of carnitine is then used for quantitative HPLC analysis on a cation-exchange column with fluorescence detection. The calibration graph was linear over a sample concentration range from 2.0 to 20 micrograms/ml; the limit of detection was 0.5 microgram/ml under the conditions studied. The proposed method was applied satisfactorily to the determination of carnitine chloride in pharmaceutical preparations.

Carnitine

Hypotensive effects of lithospermic acid B isolated from the extract of Salviae miltiorrhizae Radix in the rat.

1. The in vivo and in vitro effects of lithospermic acid B (LSA-B), which was extracted from Salviae miltiorrhizae Radix, on vascular relaxation responses were examined in rats. 2. Intravenous injection of LSA-B (10-30 mg/kg) decreased the blood pressure in a dose-dependent manner. 3. In perfused mesenteric arterial bed precontracted with methoxamine (10(-5) M), LSA-B (10(-5) - 10(-3) M) produced a concentration-dependent relaxation. 4. Vasodilator response of the mesentery in response to LSA-B was reversed by 10(-4) M NG-monomethyl-L-arginine (L-NMMA). 5. The inhibition of vasodilation by L-NMMA was reversed by L-arginine (3 x 10(-4) M). 6. These results suggest that LSA-B-induced hypotensive effect may be due to the endothelium-dependent vasodilation of resistance artery such as mesenteric arterial bed.

Anesthesia

T and R states in the crystals of bacterial L-lactate dehydrogenase reveal the mechanism for allosteric control.

The crystal structure of L-lactate dehydrogenase from Bifidobacterium longum, determined to 2.5 A resolution, contains a regular 1:1 complex of T- and R-state tetramers. A comparison of these two structures within the same crystal lattice and kinetical characterization of the T-R transition in solution provide an explanation for the molecular mechanism of allosteric activation. Substrate affinity is controlled by helix sliding between subunits which is triggered by the binding of the activator, fructose 1,6-bisphosphate. The proposed mechanism can explain activation by chemical modification and mutagenesis, as well as suggesting why vertebrate counterparts are not allosteric.

Allosteric Regulation

Vasodilator effects of clonidine on the mesenteric arterial beds in normotensive and spontaneously hypertensive rats.

Clonidine, an alpha 2-agonist, caused a concentration-dependent vasodilation of the mesenteric arterial beds in both normotensive and hypertensive rats. The clonidine-induced vasodilation was inhibited by NG-nitro-L-arginine, and the inhibition was reversed by L-arginine. The concentration-dependent vasodilation was not significantly different between normotensive and hypertensive rats. These results suggest that clonidine has an endothelium-dependent vasorelaxant action in the resistance artery such as rat mesenteric arterial bed, and the endothelium-dependent vasodilator effects of clonidine in the mesentery may be involved in the depressor effect of the drug.

Animals

[Comparative study of type of prosthesis on late results after double valve replacement].

This study was performed to clear the influence of combination of prostheses on late results by comparing our patients. The patients were divided into two groups. Group I patients received a mechanical valve in the aortic position and a bioprosthesis in the mitral position (n = 25): and group II, dual mechanical valves (n = 89). The duration of follow-up ranged from 0.2 to 13.5 years, with a total of 466 patient-years. There was no difference between the two groups in terms of actuarial survival or incidence of reoperations, thromboemboli, or nonstructural dysfunction. Group I, however, had a significantly greater incidence of structural valve deterioration, anticoagulant-related hemorrhage, and all valve-related morbidity and mortality when compared with group II. In conclusion, 1. combining a mechanical valve and a bioprosthesis is disadvantageous: 2. dual mechanical valves have excellent long-term results.

Aortic Valve

[Clinical characteristics of hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP) in adult].

Hemolytic uremic syndrome (HUS) and thrombotic thrombocytopenic purpura (TTP) were originally described as separate disease entities. Recently, HUS and TTP have been considered a single disease, because of the identical microangiopathic lesion. In the present study, we investigated the clinical and histological characteristics of HUS/TTP. Eleven patients with a definite diagnosis of HUS/TTP were found from a cohort of adult patients who were admitted to Kitasato University Hospital in the past two decades. Their clinical and histological characteristics were retrospectively analyzed. All of the 11 patients with HUS/TTP were sporadic and non-diarrheal cases with a mean age of 49 years +/- 10. Preceding episodes of flu-like syndrome and the administration of mitomycin C were observed in 3 and 5 patients, respectively. On admission, two of 10 patients with renal dysfunction required dialysis treatment, while none developed nephrotic syndrome. Six patients showed CNS manifestation, such as consciousness disturbance and convulsion. Three patients with severe hypertension did not show consciousness disturbance. As for the final outcome, 6 patients recovered and the remaining 5 died. Two died after 60 hospital days. In the histopathological investigation, renal biopsy specimen showed narrowing of the capillary loops in the glomeruli due to swelling of the endothelial cells, double contour of the glomerular basement membrane, or mesangial cell necrosis and sclerosis. In the autopsy specimen, internal organ infarction with fibrin thrombi in small arteries was observed in multiple organs, such as brain, kidneys, hearts, lungs, jejunum, liver, pancreas, adrenal glands and pituitary gland. A circumferential myocardial infarction with hyaline thrombi in the medial layer of myocardium was characteristic of HUS/TTP. In conclusion, microangiopathic lesions with infarction spread widely throughout various organs in HUS/TTP. Involvement of internal organs, not to mention kidneys and brain, is lethal and their prognosis remains poor.

Adult

Simultaneous measurement of vasodilation and changes in cyclic nucleotides in the perfused mesenteric arterial bed of the rat.

We examined the relationship between relaxation responses of the mesenteric arterial bed and the levels of cAMP and cGMP released from the rat mesenteric arterial bed. Perfusions of mesentery preparations with 1 microM acetylcholine, 0.1 microM calcium ionophore A23187, and 1 microM sodium nitroprusside all produced complete and long-lasting relaxation and increased the levels of cAMP as well as cGMP in the effluent. In endothelium-denuded preparations, acetylcholine did not elicit either vasorelaxation or an increase in cAMP and cGMP levels. Perfusion of the endothelium-denuded preparation with 1 microM sodium nitroprusside evoked complete relaxation and a marked increase in cGMP levels but not cAMP levels. Isoproterenol (1 microM) produced complete relaxation and an increase in cAMP levels, but did not affect cGMP levels either in the preparation with or in that without endothelium. Acetylcholine (0.001-1 microM) relaxed the preparation and increased cAMP and cGMP levels in the effluent in a dose-dependent manner. The acetylcholine-induced relaxation was reversed by 45% following perfusion with 10 microM methylene blue, and both the cAMP and cGMP levels were decreased. L-NG-Monomethyl arginine (L-NMMA) (100 microM), a nitric oxide synthase inhibitor, completely reversed the relaxation induced by 0.1 microM acetylcholine and reduced the elevated cGMP levels. Indomethacin (1 microM) reduced the acetylcholine-induced cAMP release, but did not alter the vasorelaxation in response to acetylcholine. We propose a novel method for the simultaneous measurement of vasodilation and changes in cAMP and cGMP levels released from the rat mesenteric arterial bed. We conclude that this method may provide information about the function of the endothelium of resistance vessels.

Acetylcholine

Endothelium-dependent vasodilator effects of the extract from Salviae Miltiorrhizae radix. A study on the identification of lithospermic acid B in the extracts.

1. The aqueous extract of Salviae Miltiorrhizae radix (Chinese crude drug named "dan-shen") relaxed the noradrenaline-precontracted aorta with endothelium. 2. Vasodilation by the extract disappeared in aorta without endothelium, and was inhibited by pretreatment with 10(-4) M NG-monomethyl-L-arginine (L-NMMA) or 10(-5) M methylene blue. 3. The inhibition of the extract-induced vasodilation by L-NMMA was reversed by L-arginine (3 x 10(-4) M). 4. The component of the extract was analyzed by chromatography, fast atom bombardment mass spectroscopy (FAB-MS) and 1H-NMR. 5. An active component of the extract, which showed endothelium-dependent vasodilation, was found to be identical with lithospermic acid B.

Acetylcholine