[A case of prosthetic valve endocarditis due to Scedosporium apiospermum].
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Aortic Valve↗
Biomedical subjects
K Nishimura
Publications and source records attributed to K Nishimura.
[Two cases of anorexia nervosa associated with grossly abnormal liver function tests].
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Adolescent↗
Sparganosis of the brain. Case report.
A rare case of cerebral sparganosis occurring in a 7-year-old boy is reported. Since his clinical symptoms fluctuated and diagnostic evaluation demonstrated multiple lesions, he was examined for a parasitic infection. Emphasis is placed on the difficulties involved in diagnosing cerebral sparganosis.
Brain Diseases↗
Modifications of circadian cortisol rhythm by cyclic and continuous total enteral nutrition.
To clarify the relationship between the pattern of diet intake and the circadian adrenocortical rhythm, we measured plasma cortisol levels at 4-h intervals over a 24-h period in 18 patients who were in the vegetative state and had been receiving total enteral nutrition (TEN) for 4 weeks. One group of 6 patients was given a liquid diet intraduodenally and continuously throughout a day (continuous TEN), whereas the two other groups received their daily enteral feeding during a restricted time of day, either in the daytime from 0800 h to 2000 h (diurnal TEN, 6 patients) or in the nighttime from 2000 h to 0800 h (nocturnal TEN, 6 patients). In patients with diurnal TEN, there was a clear cortisol rhythm with a peak of 0800 h, whose pattern was quite similar to the well-established cortisol rhythm in normal subjects. Patients with nocturnal TEN also showed a cortisol rhythm, but the peak appeared at 1600 h. There was no appreciable difference in the amplitude of the rhythm between the two groups. Patients with continuous TEN did not show any consistent circadian cortisol rhythms. Plasma levels of glucose, insulin, and free fatty acids also showed circadian fluctuations corresponding to the pattern of diet infusion in the groups with diurnal and nocturnal TEN, and remained almost constant throughout a day in the group with continuous TEN. We conclude from these results that the timing of diet intake may have a synchronizing effect on the circadian cortisol rhythm in man, as it does in laboratory animals.
Aged↗
Relationship between ventricular expression of atrial natriuretic polypeptide gene and hemodynamic parameter in old myocardial infarction.
Using Northern blot analysis and radioimmunoassay, we measured atrial natriuretic polypeptide (ANP) messenger RNA and ANP levels in the ventricle in patients with old myocardial infarction and investigated the relationship between ventricular ANP synthesis and hemodynamic parameters. Levels of ANP messenger RNA and ANP were markedly increased in the left ventricular aneurysm, and a positive correlation was observed between the ANP level in the left ventricular aneurysm and pulmonary capillary wedge pressure (r = 0.85, p less than 0.05). These findings indicate that ANP synthesis in the ventricle is increased in accordance with the severity of congestive heart failure.
Aged↗
Antihypertensive mechanism of an angiotensin converting enzyme inhibitor, SA446, in dogs.
Antihypertensive mechanisms of SA446, an angiotensin converting enzyme (ACE) inhibitor, were examined in dogs. In isolated dog pulmonary artery, SA446 inhibited the contractile response to angiotensin (Ang) I, but did not affect the response to Ang II. In conscious dogs, SA446 (1 mg/kg po) remarkably inhibited the pressor response to Ang I between 1 and 6 hr after the administration. In normotensive dogs, SA446 (30 mg/kg po) significantly lowered the arterial pressure 3 hr after administration, which recovered at 24 hr, while plasma ACE activity was apparently inhibited even at 24 hr. The antihypertensive effect of SA446 (5 mg/kg po) was more potent in 2-kidney, 1-clip renal hypertensive dogs than in normotensive dogs. SA446 (10(-9) - 10(-7) M) inhibited the ACE activities in arteries isolated from dogs in concentration-dependent fashion. These results suggest that the antihypertensive effect of SA446 is related, at least partially, to inhibition of ACE in the vascular wall.
3-Mercaptopropionic Acid↗
[Anatomical studies on a supernumerary tooth considered to be a successional tooth of the lower first molar].
The purpose of this study is to investigate features of the successional tooth of the lower first molar. Materials investigated in this study deal with a supernumerary tooth formed at the distolingual deep part to the lower right first molar of a male patient aged twenty-four. It was observed with binocular microscopy and under X-ray. The occlusal surface of it was observed with scanning electron microscopy. Horizontal ground sections of it were prepared and observed with polarizing microscopy, fluorescent microscopy, and scanning electron microscopy. It is thought that this supernumerary tooth is a true successional tooth of the lower first molar because it was formed at the distolingual deep part to the lower first molar and the fissure of it is Y-shaped and it has five cusps. It is considered that two impressions at buccal and distal surfaces of it isn't original hereditary features but was accidentally formed by pressures of mesial and distal roots of the lower first molar. The rough form of it has most resemblance to the lower second premolar and distal and lingual parts of it are smaller than that of the lower first molar. But fundamental features of the lower first molar are preserved in it. It is thought that the center of the molarization field of human lower successional teeth lies at the successional tooth of the lower first molar because the form of the occlusal surface of it is more complex and functional than those of the lower first and second premolars.
Adult↗
[Influence of tooth extraction on postural stability].
A study was conducted to analyze how tooth extraction procedure would affect patient's physical equilibrium sensation, using the positional centric equilibrium measuring device. Forty-five health subjects, between the ages of 20 to 30, with no systemic nor equilibrium abnormalities were selected for this study. The results obtained were as follows. 1. No noticeable changes in the centric movement were observed during the postural change from a sitting to a standing position. 2. Centric movement was transiently increased immediately after the movement from a horizontal to standing position. The average arterial pressure was decreased immediately after the alteration in body posture, suggesting that changes in body posture may influence the controlling mechanism of BP. 3. Increases in the area and velocity of the centric movement were found immediately after and up to 10 minutes after, respectively, topical administration of the anesthetic. During this time span, no correlation found between centric movement changes and circulatory changes suggested that topical anesthesia might influence the recovery reflex via central nervous system. 4. The effect of the extraction procedure on the centric movement area and the anteroposterior centric movement speed lasted for 10 minutes after extraction. On the other hand, the increase in the velocity of bilateral centric movement as well as whole body centric movement was found up to a point immediately after extraction. No correlation was found between circulatory changes and centric movement changes. It therefore was assumed that the topical anesthesia affected the recovery reflex via central nervous system.
Adolescent↗
Mechanism of action of 15-deoxyspergualin. I. Suppressive effect on the induction of alloreactive secondary cytotoxic T lymphocytes in vivo and in vitro.
The effects of 15-deoxyspergualin (DSG) and its derivative deoxymethylspergualin (MeDSG), which is more stable than DSG in solution, on the induction of alloreactive secondary cytotoxic T lymphocytes (CTL) in mice in vivo and in vitro were determined. Secondary CTL were generated in vivo or in vitro by injecting mice with mitomycin C (MMC)-treated allogenic tumour cells twice with a 1-week interval or by culturing spleen cells of alloantigen-primed mice with MMC-treated allogenic mouse spleen cells, respectively. DSG preferentially suppressed the generation of secondary CTL at the differentiation but not at the effector phase. DSG also suppressed the responsiveness of spleen cells to secondary antigen in a non-specific manner. MeDSG suppressed the in vitro induction of secondary CTL in a dose-dependent manner; however, it did not suppress the activity of CTL already induced. The inhibitory effect of MeDSG on CTL induction was totally abolished by exogenous recombinant murine interferon-gamma (IFN-gamma) and partly by interleukin-2 (IL-2), suggesting that suppressive mechanisms of MeDSG (DSG) may be mainly mediated by the inability of lymphocytes to produce IFN-gamma or by impairment of an unknown cascade(s) reconstituted by IFN-gamma.
Animals↗
[Pulsatile assistance for profoundly hypothermic circulatory arrest, low-flow perfusion, and moderate-flow perfusion: comparative study of brain tissue pH, PO2, and PCO2].
The pH, oxygen tension, and carbon dioxide tension of canine brain tissue were experimentally examined during profoundly hypothermic cardiopulmonary bypass with and without pulsatile assistance. After core cooling, a 60-minute of circulatory arrest was performed in group 1 (n = 16), a 120-minute of low-flow perfusion (25 ml/kg/min) in group 2 (n = 16), and 120 minute of moderate-flow perfusion (50 ml/kg/min) in group 3 (n = 16). The core rewarming was done to the temperature above 32 degrees C. Each group was divided into two subgroups with and without pulsatile assistance (subgroup-p; n = 8, subgroup-c; n = 8). In group 1, progressive brain tissue acidosis and hypercapnea were recovered by use of pulsatile assistance. In group 2, brain tissue acidosis and hypercapnea were recovered completely with pulsatile assistance, but incompletely without it. In group 3, mild acidosis and hypercapnea were eliminated with pulsatile assistance. Brain tissue hypoxia was severe in group 1, slight in group 2, but not found in group 3. We conclude that a pulsatile assistance provides brain protection at any flow-ratio, and that the less flow-ratio and the longer perfusion period will make the pulsatile assistance the more necessary.
Animals↗
[A case of complete rupture of the righ TMJ disc].
A case of complete rupture of the right TMJ disc was described. A 43 year old woman visited our hospital with the chief complaint of a mild pain in the right TMJ. Initially, a conservative treatment using the occlusal splint (condylar repositioning appliance) was carried out. This was because she had reciprocal clicking of the right TMJ which had occurred not long before and it seemed that the symptoms were due to the trouble with the disc. In spite of this treatment, for 6 months no improvement was obtained and the reciprocal clicking changed into crepitation. Moreover the double contrast arthrotomographic image indicated a perforation or a wide rupture of the disc, and deformities of the articular bone. Then a right TMJ osteoarthrosis with wide (complete) disc rupture was diagnosed, and a discectomy was performed. The symptoms were greatly reduced by this treatment. It was conceivable that the steroid which she had used for a long time to treat bronchial asthma caused a remarkable inhibition of the tissue repairing, and an internal derangement of the TMJ rapidly progressed to osteoarthrosis.
Adrenal Cortex Hormones↗
[Aortic aneurysm associated with coarctation of the aorta].
An 8-year-old female of coarctation of the aorta associated with thoracic aortic aneurysm is reported. Under cardiopulmonary bypass, a 7 cm section of the aorta containing the aneurysm and coarctation was resected and replaced by a 16 mm woven Dacron tube. The postoperative recovery was complicated by chylothorax treated by thoracic aspiration. She is doing well 3 months after the operation. Histologic sections of the resected portions of the thoracic aorta revealed intimal hyperplasia, medial fibrosis and decrease of elastic fibers, especially in the aneurysm.
Aorta, Thoracic↗
[A case of double primary cancer of lung and trachea].
A 57-year-old male was admitted to our hospital with bloody sputum, whose right lung had been resected for squamous cell carcinoma of the lung three and a half years ago. Tomographic examinations and chest CT films showed the presence of tracheal tumor. Histological examinations of the biopsy specimen obtained from tracheal tumor, using bronchofiberscopy, identified squamous cell carcinoma. Trachea was resected in the length of six cartilages and end to end anastomosis was performed. Though lung cancer and tracheal cancer were same histological type, clinical findings confirmed that this case was double primary cancer. Postoperative course was uneventful except for minor leakage of anastomosis site.
Carcinoma, Squamous Cell↗
[Benefits and limitation of extracorporeal circulation with autologous blood using low priming membrane oxygenator].
The high incidence of hepatitis following cardiopulmonary bypass has stimulated attempts to develop a technique of perfusion without homologous blood. Between October, 1987 and March, 1988, 36 patients underwent open heart surgery without homologous blood transfusion were investigated. Patients with infective endocarditis and urgent surgical cases were excluded from this study. Out of 36 patients using hemoconcentrator, autologous blood and the Variable Prime Cobe Membrane Lung (VPCML), 28 patients (78%) could avoid homologous blood transfusion during the operation and 24 patients (67%) received no homologous blood throughout their hospital stay. Thus, the application of lower volume extracorporeal oxygenator system, reinfusion of residual pump volume using hemoconcentrator and predonated autologous blood could achieved cardiac surgery without homologous blood transfusions in the majority of patients. Moreover, the VPCML had sufficient gas transfer in adult patients with body weight ranging from 37 kg to 70 kg. In renal function, serum creatinine levels in patients without homologous blood were within normal limits throughout 1 month after surgery. However, creatinine level was significantly elevated at the third postoperative day in the homologous blood transfusion group. Thus, these results suggest that application of VPCML and hemoconcentrator combined with predonated autologous blood is useful to achieve open heart surgery without donor blood.
Blood Transfusion, Autologous↗
[Movement of plasma leu-enkephalin-like substance concentrations during pregnancy].
By the use of high performance liquid chromatography and a specific radioimmunoassay method combined with a new dialysis technique, plasma levels of leu-enkephalin were determined in 26 women who had become pregnant normally, some of whom were in 5 to 40 weeks gestation and the others were 3 days postpartum. Leu-enkephalin-like immunoactivity rose during 5-6 weeks gestation (982.0 +/- 388.3pg.ml-1) and 3 days after delivery (594.4 +/- 289.2pg.ml-1). This pattern differed significantly from that of the normal adult control groups (174.9 +/- 75.3pg.ml-1). The concentrations of serum leu-enkephalin during 10-40 weeks of gestation were within normal limits. These results indicate that the serum leu-enkephalin concentrations increase in the early stage of pregnancy. Whereas the physiological mechanism and exact meaning of this change are still unknown, the results strongly suggest that this substance has an important part to play in such physiological functions as pregnancy.
Biological Factors↗
[Management of urinary incontinence by patients--comparison between England and Japan].
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England↗
[An enzyme-linked immunosorbent assay for measuring desmosine in vivo].
Pulmonary emphysema may be a disease in which some elastin in lung is lost. In order to evaluate lung elastin degradation, we developed an enzyme-linked immunosorbent assay for desmosine and measured urinary desmosine excretion and serum desmosine levels in healthy individuals and patients with pulmonary emphysema and other chronic pulmonary disorders. The measurement was performed by the inhibition technique of ELISA so that the samples had to be applied to CF11 cellulose mini-column for partial purification of desmosine. Total urinary excretion of desmosine was uniformly low in healthy individuals and patients with lung cancer, but urinary desmosine was elevated in some cases of pulmonary emphysema and diffuse panbronchiolitis. Using this ELISA method, more than 0.06 micrograms/ml serum desmosine concentration could be measured in 3 out of 25 healthy subjects who had never smoked (13.6%), 4/9 healthy current smokers (44.4%) and 19/26 patients with pulmonary emphysema (73.1%). Mean serum desmosine levels of meseared 19 cases of empysema were 0.182 micrograms/ml. It has been reported that approximately 15% of smokers develop pulmonary emphysema. The most important problem now is whether smokers with elevated urinary desmosine or with high serum desmosine will eventuality develop pulmonary emphysema.
Amino Acids↗
Participation of food antigens in increased polyclonal antibody production induced by alcohol.
In order to obtain a better understanding of hyperglobulinemia in chronic alcoholism, we investigated whether food antigens participated in the effects of long-term oral alcohol (AL) administration on serum immunoglobulin levels and polyclonal antibody production in spleen, Peyer's patch and bone marrow of C57BL/6 mice in specific pathogen free (SPF) circumstances. In animals fed antigen food (AF), three weeks of oral AL administration elicited an increase in polyclonal IgA antibody production in Peyer's patch. Moreover, seven weeks of oral AL administration elicited increases in both polyclonal IgA antibody production and serum IgA level. However, in animals fed antigen free food (AFF), oral AL administration failed to elicite increases in serum IgA level and polyclonal antibody production in spleen, Peyer's patch and bone marrow. Furthermore, in animals fed AF or AFF, oral AL administration failed to elicite increases in polyclonal IgM and IgG antibody production in any organ and serum IgM and IgG level. It is suggested that food antigens participated greatly in the elevation of serum IgA level in chronic alcoholism and that Peyer's patch is the major site of polyclonal IgA antibody production.
Animals↗