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Biomedical subjects

K Sakai

Publications and source records attributed to K Sakai.

At least 667 records · Page 37Linked to original sources
PubMed1994

[Clinical evaluation of patients with right ventricular infarction detected by dual SPECT imaging of thallium-201 and technetium-99m pyrophosphate].

We evaluated clinical significance of dual-nuclide SPECT imaging (D-SPECT) of thallium-201 and technetium-99m pyrophosphate (PYP) in patients of acute inferior left ventricular infarction with PYP uptake in the right ventricle (PYP (+) group) in comparison with those without PYP uptake (PYP (-) group). There was no difference in coronary risk factors, history of angina, blood pressure, heart rate, and hemodynamics on admission between PYP (+) group and PYP (-) group. The duration from onset to admission was longer in PYP (+) group and coronary reperfusion therapies were carried out in few cases. In 7 of 8 PYP-positive patients, the diagnosis of right ventricular infarction was made only by D-SPECT. Four of 8 were complicated with shock within three days, and the duration of hospitalization was longer. Coronary angiography demonstrated many proximal lesions (50%) in PYP (+) group but few ones (18%) in PYP (-) group. D-SPECT was very useful for diagnosing acute right ventricular infarction, and it might contribute to the prevention of shock if performed within a few days.

Aged↗
PubMed1994

Amino acid-induced hyperfiltration--mediators and effect of captopril.

Mediators and the effect of captopril on amino acid-induced hyperfiltration were studied. Acute intravenous L-arginine (arginine) infusion tests were performed twice, without captopril administration in 6 normal subjects (group I), before and after pretreatment with captopril in 10 normal subjects (group II) and 10 IgA nephropathy patients with slight renal dysfunction (group III). It was found that in all groups with and without captopril, arginine infusion led to a significant decrease in renal vascular resistance, and significant increases in renal plasma flow and plasma glucagon level. GFR was significantly increased in response to arginine only in normals without captopril pretreatment. Captopril pretreatment attenuated the rise in GFR following arginine infusion in normal subjects. Plasma renin activity and urinary cGMP were significantly increased in response to arginine only in normals without captopril pretreatment. No significant increase in urinary PGE2 was observed after arginine infusion in any groups. It was concluded that cGMP and glucagon are possible mediators for arginine-induced hyperfiltration and inhibition of renin-angiotensin system attenuates the arginine-induced rise in GFR.

Arginine↗
PubMed1994

[Elevation of cerebral lactate detected by localized 1H magnetic resonance spectroscopy in a patient with migraine].

Localized 1H magnetic resonance spectroscopy was performed in a 45-year-old woman with migraine. She developed throbbing headache attacks without aura since thirteen years ago and the attack was accompanied with right hemiplegia since seven years ago. Brain MRI showed no abnormalities and 123I-IMP SPECT revealed mild frontal dominant decrease of cerebral blood flow. It seemed that her condition was positioned between migraine with prolonged aura and migrainous infarction of complicated migraine in the classification of International Headache Society. Spectra obtained from bilateral frontal lobe interictally showed elevation of lactate at left side. Choline, creatine, and N-acetyl-aspartate were almost equal on both side. The above results suggest that slight ischemia which is not detected by MRI is present or there is a disturbance of oxidative glycolysis, which is induced by mitochondrial dysfunction.

Brain↗
PubMed1994

Evaluation of regional myocardial perfusion in areas of old myocardial infarction after revascularization by means of intraoperative myocardial contrast echocardiography.

Because myocardial revascularization to areas of old myocardial infarction brings about functional recovery to some extent to myocytes in those areas, the assessment of regional myocardial perfusion on those areas after myocardial revascularization may allow myocardial viability to be estimated. Using intraoperative myocardial contrast echocardiography by direct injection of 2 ml sonicated 5% human albumin into saphenous vein grafts, we assessed regional myocardial perfusion in 16 revascularized areas of old myocardial infarction. We estimated the myocardial viability of areas with respect to myocardial perfusion, and we compared these results to both the improvement of regional wall motion after myocardial revascularization (increase in segmental wall thickening during systole) and relative thallium 201 activity obtained by quantitative analysis of preoperative exercise myocardial thallium 201 distribution on delayed images. The background-subtracted peak peak intensity of myocardial enhancement and the ratio of endocardial to epicardial intensity were determined in each revascularized area. An inverse correlation existed between peak intensity (18 +/- 7) and the endocardial/epicardial ratio (0.88 +/- 0.17) (r = -0.63, p < 0.01). A good correlation was found between peak intensity and both the percent increase in segmental wall thickening (r = 0.73, p < 0.005) and the relative thallium 201 activity (r = 0.81, p < 0.005). These results suggested that regional myocardial perfusion after myocardial revascularization in areas of old myocardial infarction distributed better to the epicardial halves than to the endocardial halves, and that the peak intensity could be related to myocardial viability.

Aged↗
PubMed1994

Evaluation of leukocyte-depleted terminal blood cardioplegic solution in patients undergoing elective and emergency coronary artery bypass grafting.

Leukocyte depletion at reperfusion may have a role in myocardial protection when combined with terminal cardioplegia. We applied this method in a selected group of 68 patients with coronary artery bypass grafting either for elective surgical procedures (n = 38) or emergency surgical procedures with the use of a preoperative intraaortic balloon pump (n = 30) because of developing acute myocardial infarction. Basic cold potassium crystalloid cardioplegic solution was used. During delivery of leukocyte-depleted terminal cardioplegic solution, warm arterial blood delivered from cardiopulmonary bypass was passed through a leukocyte removal filter, mixed with potassium crystalloid cardioplegic solution, and administered to the aortic root for the first 10 minutes of reperfusion. Patients were randomized into three groups for reperfusion: whole blood, terminal cardioplegic solution, and leukocyte-depleted terminal cardioplegic solution reperfusion groups. In elective coronary artery bypass grafting, no significant difference was found in the clinical data. However, in emergency coronary artery bypass grafting, the leukocyte-depleted terminal cardioplegic solution group (n = 10) showed significantly lower peak creatine kinase MB levels (leukocyte-depleted terminal cardioplegic solution versus terminal cardioplegic solution versus whole blood: 27 +/- 11, 56 +/- 13, 74 +/- 18, respectively; p < 0.05) and maximum dopamine doses required at the weaning of cardiopulmonary bypass (6.3 +/- 1.1 versus 11.2 +/- 3.3 versus 9.2 +/- 2.2; p < 0.05) than did the terminal cardioplegic solution (n = 10) and whole blood groups (n = 10). Moreover, the leukocyte-depleted terminal cardioplegic solution group showed significantly lower difference of malondialdehyde between arterial and coronary sinus blood (0.15 +/- 0.09 versus 0.36 +/- 0.06 versus 0.06 +/- 0.12 nmol/ml, p < 0.05) than did the terminal cardioplegic solution or whole blood groups. These results showed that leukocyte-depleted terminal blood cardioplegic solution may have a role in attenuating reperfusion injury in patients with critical conditions such as preoperative myocardial ischemic injury.

Adult↗
PubMed1994

Angiogenic activity of human villi and decidua in the first trimester of pregnancy.

Angiogenic activity in the extracts of human villi and decidua in the first trimester of pregnancy was examined using chorioallantoic membrance assay. Blood vessel density on the chorioallantoic membrane increased greatly with the addition of villi extract, and slightly by decidua extract. Neovascularization with a spoke wheel appearance was induced by both villi and decidua, and this response pattern by the villi was stronger than that by the decidua. Maternal serum did not induce any vascular response. These results suggested that angiogenic activity was present both in the villi and decidua in the first trimester of pregnancy and that the villi activity was stronger than the decidua.

Blood Vessels↗
PubMed1994

[Recent advances in paraneoplastic encephalomyeloneuronopathy].

Small cell lung carcinoma-associated paraneoplastic encephalomyeloneuronopathy involves the nervous system at various levels resulting in cerebellar degeneration, limbic encephalitis, myelopathy, sensory neuronopathy or brainstem encephalitis. Anti-neuronal nuclear antibody, which has been termed ANNA-1/anti-Hu/Type II a antibody, is observed in the serum or cerebrospinal fluid of the patients and is highly specific for the disorder. This antibody reacts with the nucleoproteins of most neurons in the nervous system and recognizes a group of nucleoproteins in neurons with a molecular weight of 34-42 kd, suggesting that the pathogenesis of this disorder may be autoimmune. Several cDNA clones encoding the antigens have been cloned; that is, HuD, PLE21/HuC and He1-N1. These antigens contain three highly similar RRMs as well as Drosophila ELAV and RBP9 proteins do. Several autoantigens 70K, A, B", and Ro contain RRM, and Ro antigen shares B cell epitopes with these antigens. Thus, RRMs may represent or encompass an autoimmune crossreactive determinant.

Amino Acid Sequence↗
PubMed1994

Power spectral analysis of blood pressure fluctuations during sleep in normal and decerebrate cats.

Arterial blood pressure fluctuations during sleep were investigated with power analysis technique in both normal and decerebrate cats. In the initial postoperative stage lasting about 3 to 4 days, intact cats displayed, during paradoxical sleep, phasic increases in arterial blood pressure which were superimposed on a tonic hypotension. In the later chronic stage, however, the animals showed the phasic hypertension being superimposed on the background of a tonic hypertension. Regardless of these stages, the blood pressure during paradoxical sleep exhibited a 1/f-like spectrum, expressed by the power spectral density which is inversely proportional to the Fourier frequency f. On the other hand, a power spectral profile of the blood pressure during slow wave sleep presented a white noise-like pattern within the same frequency range of 0.1-0.01 Hz. After brainstem transections at the pontomesencephalic border, the cats exhibited consistently a sustained fall in blood pressure during paradoxical sleep and the power spectral density of the blood pressure displayed a white noise-like pattern throughout the survival periods of one month or more. These observations indicate that the blood pressure fluctuations in the 1/f spectrum during paradoxical sleep originate in rostral brain structures.

Animals↗
PubMed1994

[Auer-rod-like bodies in plasma cells in patient with plasma cell dyscrasia].

Auer-rod-like bodies were found in plasma cells from a 74-year-old man with plasma cell dyscrasia. These bodies exhibited red purple staining by May-Giemsa staining and were indistinguishable from Auer bodies often found in acute myeloid leukemia. These bodies, however, failed to stain with peroxidase and showed acid phosphatase positivity. Bone marrow examinations were performed three times at the sternum or iliac crest. The proportions of plasma cells were 4.4%, 3.4% and 3.8%. The Auer-rod-like bodies were found in 0.05% (2/3824), 0.07% (4/6883) and 0.08% (2/2656) of the plasma cells.

Aged↗
PubMed1994

Compressed allograft chips for acetabular reconstruction in revision hip arthroplasty.

We report the results of 24 acetabular reconstructions in which cemented polyethylene cups and tamped corticocancellous allografts were used for severe acetabular bone deficiency. Eleven hips had type-II (cavitary) bone deficiency and 13 had type-III (combined) defects. At a mean follow-up of 5.8 years, two components had migrated more than 5 mm and had accompanying radiolucent zones of more than 2 mm width. A radiolucency 5 mm wide was also seen in zone III of an acetabular implant which had not migrated. None of the patients had required revision because of loosening or infection.

Acetabulum↗
PubMed1994

Fatty acid compositions of plasma lipids in atopic dermatitis/asthma patients.

The proportions of linoleic acid in total plasma lipids and phospholipids were significantly greater and those of oleic acid were lower in pre-puberal and puberal atopic patients as compared with age-matched healthy controls. The n-3/n-6 fatty acid ratio of the triacylglycerol fraction was also lower in atopic patients. However, no significant decreases in the proportions of dihomo-gamma-linolenic acid and arachidonic acid were observed in plasma lipids of atopic patients, suggesting that delta 6-desaturase activity is not impaired in atopic patients. We provide an explanation for the beneficial effects of raising the n-3/n-6 ratio of dietary oils in the context of suppressing allergic hyper-reactivity in humans.

Adolescent↗
PubMed1994

Efficacy of additive DMARD therapy in patients with rheumatoid arthritis. Double blind controlled trial using bucillamine and placebo with maintenance doses of gold sodium thiomalate.

OBJECTIVE: To examine the efficacy of the addition of small doses of additional disease modifying antirheumatic drugs (DMARD) to ongoing DMARD treatment [additive DMARD therapy (ADT)]. METHODS: A 3-month prospective, double blind, randomized, placebo controlled study was performed using either 100 mg/day of bucillamine (Buc) or an inactive placebo (P1). Two groups of 12 patients each who had experienced an insufficient benefit from gold sodium thiomalate (GSTM) alone were enrolled in the study. RESULTS: The addition of Buc proved more beneficial than P1 regarding improvement in disease activity (p = 0.0032) and drug usefulness (p = 0.0025). A significant within group improvement was observed in joint swelling count, the Lansbury activity index, erythrocyte sedimentation rate and C-reactive protein. However, the difference in the clinical variables between the 2 groups was minimal. CONCLUSION: The usefulness of ADT was suggested by this trial; however, further confirmation by additional studies is still needed.

Aged↗
PubMed1994

[Report of a case of small cell lung cancer associated with Lambert-Eaton myasthenic syndrome and subacute cerebellar degeneration--with a review of the Japanese literature].

We report a patient with small cell lung cancer associated with Lambert-Eaton myasthenic syndrome (LEMS) and subacute cerebellar degeneration (SCD). The patient was a 71-year-old man suffering from weakness of the limbs and a gait disturbance who developed limb ataxia and dysarthria one month after admission. Electrophysiologic studies confirmed the diagnosis of Lambert-Eaton myasthenic syndrome. Chest X-rays 2 months after admission revealed an abnormal shadow, and small cell lung cancer was diagnosed on the basis of biopsy specimens. Anti-voltage-gated calcium channel antibody was positive. Anti-Yo and -Hu antibodies were negative. The patient was treated by plasmapheresis and chemotherapy, which resulted in a transient improvement in the LEMS symptoms but not in the SCD. Fifteen cases of LEMS associated with SCD have been reported in the Japanese literature, and all were accompanied by small cell lung cancer. We discuss the frequency of association with LEMS and SCD and the effects of plasmapheresis and chemotherapy in both diseases.

Aged↗