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Biomedical subjects

K Minami

Publications and source records attributed to K Minami.

At least 271 records · Page 15Linked to original sources
PubMed1991

[Percutaneous transluminal coronary angioplasty (PTCA) in unstable angina pectoris: results and complications with reference to a new classification].

Percutaneous transluminal coronary angioplasty (PTCA) of patients with unstable angina pectoris is an established therapy, although the rate of major complications (death, myocardial infarction, emergency coronary artery bypass operation) is higher than in patients with stable angina. This study analyzes the results of PTCA in 168 patients (136 men, 32 women, mean age 60.6 +/- 9.6 years) treated between January 1989 and June 1990 for unstable angina pectoris. Unstable angina was classified according to the criteria proposed by Braunwald in 1989. PTCA was successful in 141 patients (83.9%) and failed in 27 patients (16.1%). No patient died. One patient (0.6%) suffered an acute myocardial infarction related to PTCA. After failed PTCA 16 patients (9.5%) underwent emergency coronary artery bypass grafting (CABG), 10 patients had no complication. In patients of unstable angina class III (angina at rest within the last 48 h before PTCA) emergency CABG was needed in 20.3% compared to 3.6% (p less than 0.01) in patients with unstable angina class II (last attack of angina at rest more than 48 h before PTCA). Also 30% of patients with unstable angina within 2 weeks after myocardial infarction (clinical subgroup C) needed emergency CABG after failed PTCA as compared to only 6.9% (p less than 0.01) of patients with primary unstable angina pectoris without previous infarction (clinical subgroup B). The highest frequency (66.6%/6 of 9 patients) of emergency CABG was observed in patients with class III and subgroup C. We conclude that the classification of unstable angina pectoris proposed by Braunwald might be helpful to identify patients with risk in PTCA.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Right ventricular outflow obstruction due to accessory tricuspid valve tissue in corrected transposition of the great arteries with ventricular septal defect].

A 27-year-old man known to have corrected transposition of the great arteries (CTGA) associated with a ventricular septal defect (VSD) was admitted to our hospital with a suspected increase of the shunt volume. The patient is a first class bodybuilder. Heart catheterization confirmed the diagnosis of a "right-ventricular" mass obstructing the "right-ventricular" outflow tract, which had already been seen at echocardiography. The intraoperative finding showed the tumor to be accessory tissue of the anterior tricuspid leaflet prolapsing through the VSD into the subvalvular outflow tract of the right ventricle. The accessory tricuspid valve tissue was removed by transatrial access. The VSD was closed by a dacron patch using the same route. The postoperative course was uneventful.

Adult↗
PubMed1991

[Multivessel PTCA as an alternative to bypass operation: effect of complete revascularization on long-term follow-up].

In this study we examine the influence of the initial grade of revascularisation on clinical follow-up in patients with multivessel PTCA instead of CABG. Between I/85 and VII/89 multivessel PTCA was performed in 231 patients (202 m, 29 w; age 57 +/- 9 years). 71% of the patients had 2-vessel disease (VD), 14% 3-VD. 15% had angioplasty of one major and at least one important side branch. Clinical follow-up was achieved by a questionnaire 19.8 +/- 10.1 months after PTCA. 473 of 508 (93.1%) treated stenoses were successfully (residual stenosis less than 50%). 198 patients (86%) had successful angioplasty of all treated lesions. 31 patients (13%) had failed PTCA of one stenosis, 1 patient of both treated lesions. 1 patient underwent emergency CABG. A complete revascularisation (group A) - no residual stenosis greater than 50% in any coronary artery - was achieved in 164 patients (71%). 65 patients (28%) had incomplete revascularisation [group B]. 206 patients (89.1%) had clinical follow-up by questionnaire, 144 patients in group A (87.8%) and 60 patients in group B (92.3%) [n.s.]. 3 patients had died by noncardiac reasons (two in group A and one in group B), 1 patient of group A by cardiac reason. 70% in group A and 68% in group B had continuous clinical improvement (n.s.). Total amount of cardiac events (PTCA, CABG, cardiac death, MI) showed no significance between both groups - 35 (24%) vs 23 (38%). Patients in group B had more CABG (12% vs 3%) and angioplasty of further lesions (7% vs 1%) [p less than 0.05] during follow-up. We conclude multivessel PTCA shows good primary results with low risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗
PubMed1990

Heat-inducible translational coupling in Bacillus subtilis.

Bacillus subtilis plasmid pGR71 is a promoter-probe shuttle vector derived from pUB110. The expression of the cat gene on pGR71 in B. subtilis requires the insertion of a Bacillus promoter and a ribosomal binding site (RBS) into the HindIII cloning site immediately upstream from the cat gene. A recombinant plasmid of pGR71, named pGR71-369, was obtained by a spontaneous deletion of a fragment containing most of the inserted HindIII fragment and the replication origin necessary for multiplication in Escherichia coli. The expression of the cat gene in B. subtilis cells carrying this plasmid was inducible by heat. Nucleotide sequence analysis of the upstream region of the cat gene, deletion analysis, and dot blot hybridization analysis of mRNA in various conditions revealed that the cat gene was expressed by heat-inducible translational coupling and that the regulatory region of heat inducibility was present in the upstream region of the cat gene.

Bacillus subtilis↗
PubMed1990

Surgical repair and postoperative course of an infant with infracardiac total anomalous pulmonary venous connection, cor triatriatum sinistrum and transposition of the great arteries.

The combination of a d-transposition of the great arteries, cor triatriatum sinistrum and a total anomalous pulmonary venous connection of the infracardiac type is a very rare condition. Up to now, one surgical repair in an adolescent with transposed great arteries and total anomalous pulmonary venous drainage of the supracardiac type has been reported. In this paper, an infant with the above mentioned cardiovascular malformation is presented. The common pulmonary vein drained into the inferior vena cava and was obstructed. There were arborisation abnormalities in both lungs with mild pulmonary hypertension. The infant has been successfully operated upon at the age of 6 months and a weight of 4.5 kg. The membrane within the left atrium was resected, the common pulmonary vein was anastomosed to the left atrium and a Mustard procedure was performed. During the first 6 postoperative weeks, the infant had problems with adaptation. There was both a transient ballooning of the Mustard patch with significant obstruction of the pulmonary venous drainage and a delayed pulmonary recovery. Two months later, the patch was straightened and the child could be discharged from hospital. After 12 months, the child died from an infection of the airways.

Cor Triatriatum↗
PubMed1990

[Epidemiological study on Chlamydia trachomatis infection in pregnant housewives and investigation on its influence on outcome of pregnancy and on their newborns].

We surveyed Chlamydial infection with Chlamydiazyme for 3010 pregnant housewives in Hokkaido. Four hundred and fourty six out of the 3010 pregnant housewives were also be retrospectively investigated for the influence of C. trachomatis on outcome of pregnancy and on their newborns. The results were as follows. 1) Of the 3010 pregnant housewives, 217 (7.2%) were C. trachomatis-antigen positive, when their endocervical specimens were tested. There was no difference in the positive rate of C. trachomatis among the six cities where our investigation was performed. 2) A high C. trachomatis-positive rate (21.9%) was achieved in the pregnant teen-aged housewives with a significant decrease as age increased. 3) As for placenta previa, threatened abortion, preterm delivery and small for date infants, the incidence was higher in the untreated C. trachomatis positive group than in the C. trachomatis negative group. 4) The weeks of gestation and birth weight of newborns in the untreated C. trachomatis positive group were significantly lower than those of the C. trachomatis negative group. 5) No statistical significance was found in the incidence of premature rupture of membrane, fatal distress, spontaneous abortion nor postpartum fever between the C. trachomatis negative group and the untreated C. trachomatis positive group. These results suggest that Chlamydial infection in pregnant housewives is widely spread in Hokkaido and gives some disadvantage to pregnancy outcome and newborns. Consequently, Chlamydial infection in pregnant women must be appropriately diagnosed and treated in the early stage of pregnancy.

Abortion, Threatened↗
PubMed1990

[Studies on the detection rate of Chlamydia trachomatis in married and unmarried pregnant women--field survey in Hokkaido].

Chlamydia trachomatis infection in the general population has recently been attracting attention. In this regard, we examined the incidence of positive antigen in the genital organs in pregnant female women in order to investigate the prevalence of this infection. EIA (Chlamydiazyme) was performed in 5,000 married pregnant women, and in 317 unmarried women who underwent artificial termination of pregnancy. The study was carried out between June 1986 and September 1989 in Sapporo City (3,932 subjects), Kushiro City (328 subjects), Muroran City (280 subjects), Kitami City (357 subjects), Kucchan Town (220 subjects) and Urakawa Town (200 subjects). 1. Among married pregnant women, the detection rate of C. trachomatis was 6.1% (222/3,666) in Sapporo City, 7.3% (24/328) in Kushiro City, 6.1% (17/280) in Muroran City, 7.8% (24/306) in Kitami City, 6.8% (15/220) in Kucchan Town and 7.5% (15/200) in Urakawa Town, showing no particular difference according to the area. The overall detection rate was 6.3% (317/5,000). 2. The rates of detection of C. trachomatis antigen by EIA were 22.9% (61/266) and 15.7% (8/15) for the unmarried women who underwent artificial termination of pregnancy in Sapporo and Kitami, respectively. Both rates were higher than those in the married pregnant women. This result suggests the prevalence of C. trachomatis among young women showing a high level of sexual activity. 3. Among married subjects, the detection rate was 21.3% for those in their late teens, 8.9% for those in their early 20s, 6.0% for those in their late 20s, 3.7% for those in their early 30s, and 2.9% for those 35 years or older; thus, the younger they were, the detection rate became elevated. The above findings show that latent epidemics of C. trachomatis infection are present to a considerable extent among young women.

Adolescent↗
PubMed1990

Does isoflurane lead to a higher incidence of myocardial infarction and perioperative death than enflurane in coronary artery surgery? A clinical study of 1178 patients.

To examine if the choice of volatile agents influences cardiac outcome in coronary artery surgery, 1178 patients undergoing elective coronary artery bypass grafting without additional operations received enflurane (608) or isoflurane (570) as their primary anesthetics. The inspired concentration of volatile agent (administered with 50% nitrous oxide) was adjusted depending on the level of blood pressure at the discretion of the anesthesiologist. In addition to the volatile agent assigned, each patient received small doses of fentanyl at induction and before sternotomy (total 0.006-0.008 mg/kg). The groups did not differ in preoperative and surgical characteristics except for a more frequent history of renal dysfunction in patients given isoflurane. The rates of postoperative myocardial infarction, administration of positive inotropic agents at the time of weaning from cardiopulmonary bypass, and in-hospital deaths in the enflurane and isoflurane groups were 1.8% and 4.0% (P less than 0.05), 4.9% and 8.1% (P less than 0.05%), and 0.3% and 2.1% (P less than 0.01), respectively. Although the mechanism of the adverse effects of isoflurane could not be clarified in this study, these results demonstrate that the use of isoflurane could be inappropriate in patients undergoing coronary artery bypass grafting.

Aged↗
PubMed1990

[Efficiencies of contamination source for flooring and some materials used in unencapsulated radioactivity handling facilities].

The efficiencies of contamination source, defined in ISO Report 7506-1, were experimentally determined for such materials as flooring, polyethylene, smear-tested filter paper and stainless steel plate. 5 nuclides of 147Pm, 60Co, 137Cs, 204Tl and 90Sr-Y were used to study beta-ray energy dependence of the efficiency, and 241Am as alpha-ray emitter. The charge-up effect in the measurement by a window-less 2 pi-proportional counter was evaluated to obtain reliable surface emission rate. The measured efficiencies for non-permeable materials, except for two cases, are more than 0.5 even for 147Pm. The ISO recommendations were shown to be conservative enough on the basis of present results.

Filtration↗
PubMed1990

Identification of soybean protein components that modulate the action of insulin in vitro.

We have reported that a 37-kDa protein from a soybean isolate shows an affinity for bile acids and modulates insulin action on fat decomposition in vitro [Makino et al., Agric. Biol. Chem., 52, 803 (1988)]. In this study, the major components of the protein were identified as the acidic A1a and A2 subunits of glycinin, via amino-terminal sequence analyses of purified proteins and examination of their effects on fat decomposition in rat adipose cells. The most hydrophobic region of the subunits was found to be responsible for the bile acid-binding ability, and the binding region probably does not contribute to the insulin-modulating activity. These bile acid-binding and insulin-modulating properties were also noted in a 40-kDa protein from pea seeds, probably acidic subunits of legumin, suggesting that these characteristics may be common to legume proteins.

Adipose Tissue↗
PubMed1990

[Risk factors in patients with recurrent coronary heart disease].

Progression of the coronary heart disease (CHD) and early occlusion of the coronary artery bypass grafts (CABG) represent significant problems for patients after myocardial revascularisation. Between November 1984 and August 1988 121 patients underwent surgery for a second and 3 patients for a third myocardial revascularisation. The mean age at the time of the second and third operation was 59 and 62 years, respectively. The mean interval between the first and second operation was 5.4 years, between the second and third 4.0 years. The indications for reoperation were graft stenosis or occlusion (graft dysfunction) in 43 patients (35%), progression of CHD in 25 patients (25%) and graft dysfunction as well as progression of CHD in 56 patients (45%). During the reoperation 109 patients received new venous CABG, whereas 15 patients were given an IMA-bypass graft, either solely or in addition to venous CABG. The IMA-grafts implanted during the first operation were patent in all 6 patients. They did, however, in some cases cause considerable preparatory difficulties during the reoperation. Perioperative complications were: low-output-syndrome in 9 patients (4 x lethal), myocardial infarction in 5 patients (1 x lethal), malignant ventricular cardiac dysrhythmia in 5 patients (2 x lethal), postoperative bleeding in 3 patients and cerebrovascular insufficiency in 2 patients. The perioperative lethality amounted to 5.7% (n = 5). The results of our retrospective study indicate that one third of the patients had to undergo a reoperation primarily as a result of graft dysfunction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[A cephalometric, electromyographic and kinesiographic appraisal of a patient with mandibular prognathism and anterior openbite malocclusion before and after surgical orthodontic therapy: a case report].

A 19-year-old female patient with skeletal 3 and anterior openbite malocclusions was treated by a surgical orthodontic approach. A glossectomy was also performed. Cephalometric, electromyographic and kinesiographic records were taken before and after the treatment. The treatment results were as follows: 1. Esthetic improvement in facial profile and static alignment and intercuspation of teeth was obtained. 2. The dimension of the tongue with respect to that of the oral cavity proper measured on the lateral cephalograms revealed a value similar to that determined for the control data after the active treatment. 3. The proportion of reversed strokes with respect to the total chewing strokes increased at the completion of the active treatment both for the right- and the left-sided chewings, but it decreased during the retentive period. 4. At the initial stage, an earlier onset of the masseter muscle activity relative to the temporal muscle group was determined, while the temporalis muscles showed an earlier onset of activity in the postoperative phase. 5. The durations of chewing strokes became shortened in a postoperative phase both on the working and the balancing sides. This observation was particularly significant for the opening and the closing phases. In addition, the proportion of the duration of significant temporalis muscle activity with respect to that of the concomitant chewing stroke increased. 6. Anterior temporalis muscle and masseter muscle activity during clenching performance revealed a value similar to the control data. In summary, the current case suggests that the patients who receive surgical orthodontic treatment require sufficient time to obtain functional readaptation during the retentive period.

Adaptation, Physiological↗
PubMed1990

[Transaortic myectomy for hypertrophic obstructive cardiomyopathy--efficacy of intraoperative pressure measurement].

The many aspects of postoperative course of hypertrophic obstructive cardiomyopathy (HOCM) have been apparent, while many studies concerning long-term follow up have been published in recent years. Many surgical approaches have been performed but recently transaortic subvalvular myectomy is most common. This study reviews 22 patients with HOCM operated on between 1984 and 1989. Transaortic approach was used for all adult patients. One patient had a complication with an iatrogenic VSD, which was closed by Dacron patch during the procedure. There was one hospital death; She is a 67 year-old woman who died due to an acute abdomen. All 14 patients followed up over 3 months had significant functional improvement. Our retrospective study suggests that myectomy in patient with HOCM seems to be not only palliative but curative operative method. Left atrial- and left ventricular dimension tended to normalize in the postoperative course. The intraoperative estimation of Brockenbrough phenomenon is effective to assess the release of left ventricular outflow obstruction.

Adult↗
PubMed1990

Effects of pulsatile perfusion on plasma catecholamine levels and hemodynamics during and after cardiac operations with cardiopulmonary bypass.

Thirty patients scheduled for elective coronary artery bypass grafting were studied in two groups. Group A had standard cardiopulmonary bypass with nonpulsatile perfusion and group B had pulsatile perfusion. Measurements of plasma epinephrine, norepinephrine, granulocyte elastase, and hemodynamic parameters including mean arterial pressure total peripheral resistance, cardiac index, and pulmonary capillary wedge pressure were made before and after anesthesia induction, after surgical incision, during cardiopulmonary bypass, and 2, 4, and 24 hours after the operation. The venous compliance of the total body venous bed was measured at the end of the operation. In all patients the total net fluid balance was determined during bypass and in the postoperative period. In both groups plasma catecholamine levels increased 5 minutes after institution of bypass (epinephrine 176 +/- 56 to 611 +/- 108 pg/ml and norepinephrine 231 +/- 48 to 518 +/- 100 pg/ml in group A; epinephrine 168 +/- 40 to 444 +/- 100 pg/ml and norepinephrine 162 +/- 44 to 267 +/- 52 pg/ml in group B). The maximum catecholamine level was measured between the end of bypass and 2 hours after the end of bypass (epinephrine 1489 +/- 169 pg/ml and norepinephrine 1542 +/- 108 pg/ml in group A; epinephrine 990 +/- 134 pg/ml and norepinephrine 934 +/- 197 pg/ml in group B). During the same period mean arterial pressure and total peripheral resistance were also significantly higher in group A than in group B mean arterial pressure, 61.4 +/- 3 versus 53.6 +/- 3, p less than 0.06; total peripheral resistance, 1055 +/- 60 versus 899 +/- 45, p less than 0.01). The venous compliance was significantly higher in group A than in group B (2.4 +/- 0.3 versus 1.2 +/- 0.3 ml/mm Hg/kg body weight). The intraoperative and perioperative net fluid balance were significantly higher in group A than in group B (p less than 0.005). The average postoperative tracheal intubation time was also significantly longer in group A than in group B (4.6 +/- 1.2 hours versus 2.7 +/- 0.8 hours, p less than 0.001). No significant difference was detected in either hemoglobin or plasma free hemoglobin content between the two groups postoperatively. The results suggest that pulsatile perfusion, when compared with nonpulsatile perfusion, can attenuate the catecholamine stress response to cardiopulmonary bypass, reduce the fluid overloading of patients, and improve the postoperative recovery period as evaluated by tracheal intubation time.

Cardiopulmonary Bypass↗