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Biomedical subjects

K Nakata

Publications and source records attributed to K Nakata.

At least 217 records · Page 12Linked to original sources

A newly developed silicone-coated membrane oxygenator for long-term cardiopulmonary bypass and cardiac support.

The surface of polypropylene hollow fiber was successfully coated with a very thin (0.2 micron) silicone layer. Experimental studies were performed in long-term (6 h) normothermic cardiopulmonary bypass (CPB) using 10 goats. A conventional membrane oxygenator (Mera Excelung HPO-15H, MERA, Tokyo, Japan) was used for 5 goats as a control (Group C) and a new silicone-coated membrane oxygenator, which is of the same construction as that of the one used for Group C, for 5 (Group S). The O2 transfer and CO2 removal functions showed the same ranges. In the other parameters, there were no differences between the 2 groups. As for hemolysis, however, the plasma free hemoglobin of Group S was lower than that of Group C. Currently, 3 chronic percutaneous cardiopulmonary support (PCPS) experimental models have been conducted, and there has been no evidence of thromboembolism or deterioration of the oxygenator. In conclusion, this new oxygenator is suitable not only for CPB, but also for long-term cardiac support.

Animals↗

Renal circulation and cellular metabolism during left ventricular assisted circulation: comparison study of pulsatile and nonpulsatile assists.

We examined left ventricular assist during 6 h for an acute myocardial infarction model in pigs. The outflow cannula was placed in the ascending aorta and an inflow cannula in the left atrium. A pump (Pulsatile group: Zeon Medical and Nonpulsatile group: Nikkiso HPM-15) was connected to each cannula. Items measured were the regional blood flow of the cortex and the medulla in the kidney, renal arterial flow, arterial blood ketone body ratio (AKBR), lactate/pyruvic acid, BUN, creatinine and beta 2-microglobulin. After experimental study, the kidneys were removed, and a pathological study was performed. In the pulsatile assisted group, renal cortical blood flow increased but medulla blood flow decreased. On the other hand, in the nonpulsatile assisted group, both regional blood flows decreased. That means that in the pulsatile assisted group intrarenal redistribution improved, rather than in the nonpulsatile assisted group. The results of our study indicated that pulsatile assist produced superior circulation in the kidney, and the microcirculation on the cell level was superior as well in early treatment of acute left heart failure.

Animals↗

[Suppressive effect of clarithromycin on the production of verotoxin by E. coli O157].

Effects of low concentration of clarithromycin (CAM) on the production of Verotoxin (VT) by Escherichia coli O157 was investigated in vitro. The production of VT1 was suppressed up to 10 hours when bacteria was incubated with 0.64 micrograms/ml (equivalent to the 1/100th of MIC) or higher concentrations. However, the production of VT1 reached to the control level after 22 hours even with 6.4 micrograms/ml of CAM. On the other hand, production of VT2 by 22 hours was partially suppressed with 0.64 micrograms/ml of CAM and completely with 6.4 micrograms/ml of CAM. When the eight clinical isolates were incubated with 0.64 or 6.4 micrograms/ml of CAM, VT1 and VT2 were suppressed in two and eight strains, respectively. In these strains, similar but less efficient suppression of the toxin production was also observed with erythromycin. In contrast to the macrorides, ampicillin did not inhibit or rather stimulated the production of VT1 and VT2 in some strains.

Ampicillin↗

Mycobacterium tuberculosis enhances human immunodeficiency virus-1 replication in the lung.

We investigated the in vivo effect of coinfection of Mycobacterium tuberculosis on human immunodeficiency virus type 1 (HIV-1) replication using bronchoalveolar lavage (BAL) of 11 HIV-1-infected patients with pulmonary tuberculosis and 10 patients with no lung disease. Lung segments involved with pulmonary tuberculosis had significantly elevated HIV-1 branched DNA (bDNA) levels and p24 in BAL compared with lung segments uninvolved with tuberculosis or with BAL from patients with no lung disease. The BAL viral burden was higher than plasma HIV-1 in tuberculosis patients, indicating local production of virus. BAL HIV-1 bDNA declined over the course of treatment for tuberculosis in three patients who underwent serial bronchoscopies. Tumor necrosis factor-alpha (TNF-alpha) and HIV-1 bDNA particles were strongly correlated (r2 = 0.9, p < 0.01) in lung segments involved with tuberculosis. The deduced amino acid sequence of HIV-1 gp120 V3 region from involved segments of three patients with pulmonary tuberculosis showed basic substitutions associated with altered viral phenotype. Phylogenetic analysis of V3 sequences demonstrated that BAL HIV-1 RNA had diverged from plasma. These data support the conclusion that pulmonary tuberculosis enhances local HIV-1 replication in vivo.

Adult↗

Acetabular osteolysis and migration in bipolar arthroplasty of the hip: five- to 13-year follow-up study.

We have reviewed 65 bipolar arthroplasties of the hip in 55 patients with osteoarthritis secondary to dysplasia. The mean age at operation was 56 years (42 to 79) and the mean period of follow-up was 7.2 years (5.0 to 13.0). The average Merle d'Aubigné and Postel score before operation was 10.3 and at final follow-up 15.0. There were excellent or good results in 42 hips (65%). Migration of the outer head was observed in 50 hips (77%), most often in the group with a centre-edge angle of less than 0 degrees, an acetabular head index of less than 60%, coverage of the outer head by the original acetabulum of less than +10 degrees and after bone grafting of the acetabulum. This migration was progressive in 31 (62%) of the 50 hips, with massive osteolysis of the acetabulum in eight. The extent and progression of migration were closely associated with this osteolysis. Four hips required revision for extensive migration of the outer head with destruction of the acetabulum or severe acetabular osteolysis, and nine hips are awaiting revision for failure of the bipolar prosthetic head. The overall failure rate was 18%. We report major problems after bipolar hip arthroplasty for osteoarthritis secondary to hip dysplasia with progressive migration of the outer head and massive acetabular osteolysis at five years or more after operation.

Acetabulum↗

Early deterioration after modified rotational acetabular osteotomy for the dysplastic hip.

We performed a modified, rotational acetabular osteotomy through a lateral transtrochanteric approach on 19 hips in 18 patients with a dysplastic joint. Six hips in six patients were operated on using the original approach. The mean age at operation was 28 years (14 to 54) and the mean period of follow-up 2.3 years (1 to 4.4). Clinical evaluation using the Merle d'Aubigne score showed excellent or good results in 76%. Radiologically, 15 hips showed good acetabular remodelling and no signs of progressive osteoarthritis. In ten hips (40%) there was chondrolysis and collapse of the transferred acetabulum or both within one year, although this gave only mild pain in some patients. Factors which were significantly associated with the grade of outcome included age at the time of operation, the thickness of the transferred acetabulum, failure to use a bone graft, and a transtrochanteric approach.

Acetabulum↗

Contralateral hip in patients with unilateral nontraumatic osteonecrosis of the femoral head.

To clarify the risk of the development of osteonecrosis of the femoral head in the contralateral hip of patients with unilateral nontraumatic osteonecrosis of the femoral head, a followup study was performed using magnetic resonance imaging. Forty-six asymptomatic contralateral hips with no evidence of osteonecrosis on magnetic resonance imaging, in patients with unilateral osteonecrosis, were subjects of this study. The period from the onset of unilateral osteonecrosis to entrance in this study ranged from 1 month to 20 years (mean, 3.1 years). There were 29 males and 17 females ranging in age from 16 to 71 years (mean, 41 years). Twenty-three patients had previous steroid therapy for various conditions: 16 had alcoholism and 7 had no etiologic factors. The followup term ranged from 3 to 8 years (average, 5.5 years). During the followup period, 1 patient (2%) had a band of low signal intensity demarcating the lesion of normal fat intensity on T1 weighted images, which progressed to collapse of the femoral head. These results suggest that in unilateral osteonecrosis cases, osteonecrosis rarely develops in the contralateral hip that has appeared normal on magnetic resonance imaging. The contralateral hip with a negative magnetic resonance imaging scan is not in Stage 0 of osteonecrosis, but is normal.

Adolescent↗

[Diagnosis of local recurrence of colorectal cancer, using PET and immunoscintigraphy by means of 131I or 111In anti-CEA monoclonal antibody].

The accurate and early diagnosis of the tumor in the point of the size, the location, the depth of invasion of other organs or the stages of the recurrent cancer became much more important than before, not only for the selection of the treatment method but also for the decision of the quality of the operation for preserving the function as much as possible for the quality of the life of the patient. The usefulness of positron emission tomography (PET) and immunoscintigraphy by means of 131I or 111In anti-CEA onoclonal antibody for the diagnosis of the recurrent colorectal cancer had been confirmed in clinical use of colorectal cancers. No adverse effect of this monoclonal anti-body of the mouse was seen in this studies. The differential absorption ratio (DAR) was useful indicator in PET-imaging to differentiate the true tumor tissue from the scar tissue or granulation-tissue around the tumor. Even though the imaging, structure of PET is inferior to those of CT or MRI, the imaging of PET reflects the biological character of tumor, itself and makes the more accurate diagnosis possibly by combined use with regular CT and MRI.

Adult↗

Amelioration of type II collagen induced arthritis in rats by treatment with thymulin.

OBJECTIVE: To investigate the effects of thymulin (serum thymic factor + Zn2+) in collagen induced arthritis (CIA) in rats. METHODS: SD rats were immunized with bovine type II collagen plus Freund's incomplete adjuvant, and thymulin was administered intraperitoneally on the first day of first immunization. We determined the level of serum thymulin by rosette inhibition assay. Effects of thymulin on CIA rats were estimated by measuring the extent of hind paw edema, the level of serum anti-type II collagen antibody, and changes in histopathological features of the affected joints. RESULTS: Serum thymulin levels in CIA rats were significantly lower than in untreated rats. Thymulin diminished hind paw swelling and onset of arthritis compared with control rats. The serum anti-type II collagen antibody level was also reduced by thymulin. Histopathological examination showed inhibition of granulation tissue and new bone formation after injection of thymulin. CONCLUSION: Our results suggest thymulin plays a significant role in the onset and development of CIA in rats. Our data indicate thymulin may be therapeutically effective in preventing the development of rheumatoid arthritis.

Animals↗

[Three-dimensional transesophageal echocardiographic assessment for prosthetic valves].

We evaluated three-dimensional transesophageal echocardiographic assessment of the implanted mechanical valves by rotational scanning method. Patients were 7 mitral valve replacement and one aortic valve replacement, 2 mitral and aortic valve replacement. In 2 cases of 7 mitral valve replacement, the prosthetic valve regurgitation was evaluated using by color Doppler echocardiography. In this study, multiplane transesophageal probe was used. It rotated at 2-degree intervals from 0 to 180 degrees and the three-dimensional reconstruction was performed by echo scan workstation system (TOMTEC Inc, Munich, Germany). In mitral valve replacement cases, the valve motion of bileaflet valve (St. Jude Medical valve and ATS valve) were showed very clearly. The struts was easily recognized in the St. Jude Medical valve (SJM valve) cases. In one of SJM valve cases, the pannus formation was revealed, but it did not disturb valve motion. The prosthetic valve regurgitation can be seen accurately. However, aortic valve and ball valve cases cannot be reconstructed because of artifact from prosthetic valve and ultrasonic direction. The prosthetic valve regurgitation, pannus formation which was difficult to be showed in two-dimensional echocardiography and relationship between annulus and sewing cuff can be evaluated by this three-dimensional echocardiography. In this study, this system has some problems, for example real-time evaluation is impossible, aortic valve and ball valve cases cannot be reconstructed. However, we think that this new technology is suitable for evaluating valve thrombus, valve dysfunction and paravalvular leakage. In conclusion, the three-dimensional echo-cardiography demonstrated, reliable and accurate examination, and it can evaluate various complications of prosthetic valve.

Adult↗

Bypass grafting for a right proximal subclavian artery pseudoaneurysm patient using a long temporary bypass.

We report an 80-year-old woman, with pseudoaneurysm of the right proximal subclavian artery despite the absence of a history of trauma. On preoperative examinations, the aneurysm involved to the common carotid arteries. A long temporary bypass using a heparin-coated tube from the right femoral artery to the right common carotid artery was created under low dose systemic heparinization. A Dacron bifurcation graft bypassing was then performed successfully. At surgery for right proximal subclavian artery aneurysm, which often involves the right common carotid artery, intraoperative accident or bleeding can induce brain ischemia. A temporary bypass should be prepared. Although the short temporary bypass from the aorta to the right common carotid artery was reported, this carries the risk of complications due to microemboli. The heparin-coated tube provided excellent anti-thrombosis. Inflow cannulation should be placed at the peripheral artery not the aorta.

Aged↗

[Allogeneic peripheral blood stem cell transplantation for multiple myeloma].

We report here with a 46-year-old man with refractory multiple myeloma receiving allogeneic peripheral blood stem cell transplantation from his HLA-matched brother. The preparative regimen consisted of TBI (12Gy), VP16 (15 mg/kg) and cyclophosphamide (120 mg/kg). GVHD prophylaxis consisted of cyclosporin A and short course of methotrexate. The donor received G-CSF at 10 micrograms/kg/day for 5 consecutive days and underwent leukapheresis on days 5 and 6. The neutrophil recovery to 500/microliter and platelet recovery to 20,000/microliter were day 12 and day 15, respectively. The patient is currently well with no GVHD or graft failure and a complete donor's chimerism.

Hematopoietic Stem Cell Transplantation↗

Ameliorating effect of SA4503, a novel sigma 1 receptor agonist, on memory impairments induced by cholinergic dysfunction in rats.

We found a potent and selective sigma 1 receptor agonist, SA4503 (1-(3,4-dimethoxyphenethyl)-4-(3-phenylpropyl)piperazine dihydro-chloride), with high affinity for the sigma 1 receptor subtype (IC50 = 17 nM), but low affinity for the sigma 2 receptor subtype (IC50 = 1800 nM). The binding activity and selectivity of SA4503 resembled those of (+)-pentazocine, a prototype sigma 1 receptor agonist. We have previously shown that the sigma 1 receptor agonist activated central cholinergic functions. Therefore, we examined the effects of SA4503 on the cholinergic dysfunction-induced memory impairments in a passive avoidance task. Scopolamine, a muscarinic acetylcholine receptor antagonist, produced memory impairment, when it was administered 30 min before the training session of the passive avoidance task in rats. Single administration of SA4503 significantly reduced the scopolamine-induced memory impairment. In addition, the lesioning by injection of alpha-amino-3-hydroxy-5-isoxazole acetic acid (ibotenic acid) into the basal forebrain area produced memory impairment in rats. Repeated administration of SA4503 after lesioning of the basal forebrain area ameliorated the basal forebrain lesion-induced memory impairment. Moreover, the ameliorating effect of SA4503 against the scopolamine-induced memory impairment was antagonized by both 4-[4-(4-chlorophenyl)-4-hydroxy-1-piperidinyl]-1-(4-fluorophenyl)-1-buta none (haloperidol), a sigma receptor antagonist, and N,N-dipropyl-2- [4-methoxy-3-(2-phenylethoxy)phenyl]-ethylamine monohydrochloride (NE-100), a putative sigma 1 receptor antagonist. These results suggest that SA4503 has an anti-amnesic effect against cholinergic dysfunction-induced memory impairment, and that the effect of SA4503 is mediated by the sigma 1 receptor subtype.

Animals↗

Molecular genetic analysis of variant phenotypes of the ABO blood group system.

ABO is clinically the most important blood group system in transfusion medicine and includes many variant phenotypes. To understand the molecular genetic basis of this polymorphic system, we have analyzed genomic DNAs obtained from Japanese individuals possessing variant ABO phenotypes including A2, Ax, Ael, cis-AB, Bx, and Bel. By polymerase chain reaction-single-strand conformation polymorphism (SSCP) and nucleotide sequence analyses, we identified 11 different alleles. These alleles had nucleotide sequences different from those of the previously described 13 different alleles responsible for the common ABO phenotypes. Analysis of the nucleotide sequences of the alleles responsible for those variant phenotypes showed that the amino acid residues at position 266 and 268 may be crucial for transferase specificity, whereas those at positions 214, 216, 223, 291, and 352 may be critical for the activity level. Nine of the 11 alleles, responsible for the A2, Ax, Ael, cis-AB, Bx, and Bel phenotypes, were presumed to be generated from common ABO alleles by single nucleotide mutations such as nonsynonymous substitution, deletion, or insertion. Two other alleles, responsible for the A2 and Ael phenotypes, may have originated by recombination, gene conversionlike events or accumulation of nucleotide substitutions. Our data indicate that different alleles could cause the same ABO variant phenotypes, and that these alleles do not necessarily belong to a single evolutionary lineage.

ABO Blood-Group System↗

Effects of age on levels of cysteine, glutathione and related enzyme activities in livers of mice and rats and an attempt to replenish hepatic glutathione level of mouse with cysteine derivatives.

There was a large statistically significant decrease in the hepatic level of cysteine and glutathione (GSH) in 24 month-old mice compared to young mice, while, cystine and glutathione disulfide (GSSG) contents in the liver did not differ between young and old mice. Activities of cystathionine gamma-lyase and beta-synthase in mouse liver of the 24 month-old group were significantly decreased. In rats, the hepatic levels of cysteine, cystine, GSH and GSSG exhibited no statistically significant change during aging to 30 month. As the rats matured, total hepatic activities of both cystathionine gamma-lyase and beta-synthase increased with maximum levels at 24 months of age and decreased to the same level found in 5 week old for the former and to 22% of that in 5 week old for the latter. Intraperitoneal administration of diethyl maleate to mice led to depletion of hepatic GSH. When N-acetylcysteine and a thiazolidine derivative were intravenously injected after diethyl maleate administration, the hepatic GSH level of mice was restored to the normal level.

Acetylcysteine↗