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Biomedical subjects

K Sakai

Publications and source records attributed to K Sakai.

At least 1,009 records · Page 56Linked to original sources
PubMed1989

[Report of surgical treatment of ASD in the aged].

5 surgical cases of atrial septal defect of the secundum type, aged 43, 45, 54, 58 and 67 respectively, are reported. Two of them were initially in functional class III, one in class II and two in class I. CTR were increased in all cases. Three of them had severe heart failure, especially in a 67 years-old patient severe respiratory obstructive disfunction was observed (FEV1.0:0.561). All of the cases had large pulmonary to systemic flow ratio (QP/QS greater than 3.0) and one had pressure-gradient of 20 mmHg between RV and PA. After the surgery CTR decreased, pulmonary arterial pressure also fell to normal value, and all cases symptomatically improved. It is concluded that surgery is life saving and appears to offer sustained clinical benefit to the older age group with advanced symptomatic disability, even if pulmonary hypertension or congestive heart failure are associated.

Adult↗
PubMed1989

Technical evaluation of newly-developed inorganic membranes for plasma fractionation.

Constant transmembrane pressure experiments were made by crossflow filtration to clarify sieving characteristics of microporous glass membranes for plasma fractionation. The distribution of pore diameters is more limited in the microporous glass membranes than in currently utilized synthetic polymer membranes. The filtration resistance of the concentration polarization layer is the dominant factor in plasma fractionation. Proteins are separated more sharply with a higher wall shear rate because of destruction of the concentration polarization layer formed on membrane surfaces. Plasma fractionation using a microporous glass membrane with a pore diameter of 15 nm may allow separation of albumin and IgG at higher wall shear rates. Cascade filtration techniques using microporous glass membranes with various pore diameters may be suitable for plasma fractionation.

Glass↗
PubMed1989

Cases of infective endocarditis caused by Campylobacter fetus.

An 18-year-old man with infective endocarditis caused by Campylobacter fetus is reported. This bacterial species has long been of interest in veterinary medicine, and recently it has been reported to be one cause of infantile diarrhea. Infective endocarditis arising from campylobacter fetus is rare. This is the fourth case reported in Japan. The organism was resistant to several antibiotics, and large vegetations were found to involve the aortic valve. Emergency excision of the infected aortic valve and replacement with a valve prosthesis were successful. Current clinical treatment of infective endocarditis is discussed, and the literature briefly reviewed.

Adolescent↗
PubMed1989

Depressed myocardial contractility and normal ejection performance after aortic valve replacement in patients with aortic regurgitation.

Left ventricular cineangiography and pressure measurement were performed in 33 patients with chronic aortic regurgitation before and after aortic valve replacement and in 25 normal control subjects. Stress and volume were analyzed. The 33 patients were divided into three groups based on preoperative end-systolic volume index: 15 with an index of less than 100 ml/m2 (group I), 12 with an index of 100 to 200 ml/m2 (group II), and six with an index of more than 200 ml/m2 (group III). Afterload estimated as end-systolic stress, which was significantly elevated in all groups before operation, returned to normal postoperatively. Systolic pump function improved postoperatively in all groups; group I and group II showing the most improvement with group III still having an abnormal ejection fraction. The ratio of end-systolic stress to end-systolic volume index, which is an index of contractile state that is relatively independent of preload and afterload, was abnormal in each group preoperatively. Postoperatively, the ratio improved in each group (from 2.8 +/- 0.5 to 4.8 +/- 0.9 for group I, from 1.4 +/- 0.3 to 3.2 +/- 0.6 for group II, and from 0.8 +/- 0.2 to 2.6 +/- 0.8 for group III, compared with 5.9 +/- 1.0 for control subjects). Group I had normal values whereas group II and group III had subnormal ratios, suggesting a depressed contractility. All 15 patients in group I had values that fell within the 95% confidence limits of the linear inverse relationship between ejection fraction and end-systolic stress for control subjects. Nine of the 12 patients in group II and all six in group III had values that fell below the 95% confidence limits of the normal ejection fraction-end-systolic stress relationship. Aortic valve replacement may reduce afterload and improve systolic pump function in many patients with aortic regurgitation. However, there is a subgroup of patients who, despite normal or near-normal pump performance as assessed by ejection fraction, have depressed myocardial contractility characterized by an abnormal relationship between end-systolic stress and either ejection fraction or end-systolic volume.

Adolescent↗
PubMed1989

[Successful CYVADIC combination chemotherapy of metastatic pulmonary lesions involving a mediastinal leiomyosarcoma--a case report].

Discussed is a 34-year-old man who hospitalized for manifesting the superior vena cava syndrome. Chest radiograph and chest CT scan revealed a gross tumor shadow in the superior mediastinum and a tiny shadow in the right lung. Superior vena cavography showed intimal stenosis, irregularities, and stiffness of the superior vena cava. Thus, radiotherapy applied to primary lesion of the mediastinum was provided to relieve his complaints. One year later, predominant metastatic pulmonary lesions and skin lesions developed. Light and electron microscopic findings of a biopsied specimen of the skin lesion were consistent with leiomyosarcoma. CYVADIC combination chemotherapy reduced the pulmonary metastatic lesions dramatically. The literature of mediastinal leiomyosarcoma is reviewed and the origin of this tumor is discussed.

Adult↗
PubMed1989

[Therapeutic effect of interferon-alpha on hairy cell leukemia].

Hairy cell leukemia (HCL) is characterized by slow proliferation of special mononuclear cells. Although splenectomy has been evaluated to be the most effective traditional treatment for HCL, the response of patients to splenectomy is not necessarily satisfactory. Recently, the treatment of HCL with Interferon-alpha has been reported to be effective, and we report a female case of HCL who showed marked improvement in her hematological findings with this therapy.

Aged↗
PubMed1989

[Successful surgical treatment of patent ductus arteriosus with severe pulmonary hypertension using temporary long external bypass in an adult].

A 22-year-old man with patent ductus arteriosus with severe pulmonary hypertension was operated upon successfully. The operation, trans-aortic direct closure of ductus, was done using temporary long external bypass. Postoperative course was uneventful, and the patient is now well 6 years and 8 months after operation. Postoperative cardiac catheterization revealed decreased pressure of pulmonary artery from 116 to 44 mmHg. The details of the operative procedure and postoperative course were described and a brief review of literatures was also done.

Adult↗
PubMed1989

Mapping of cholinoceptive brainstem structures responsible for the generation of paradoxical sleep in the cat.

In order to determine the cholinoceptive brainstem structures critical for PS generation, we investigated the effect on PS induction of the injection of a small dose and volume (0.4 microgram/0.2 microliter) of the cholinergic agonist carbachol in the following caudal brainstem structures: 1) the caudal mesencephalic reticular formation, especially the nucleus pedunculopontinus pars compacta or X area; 2) the mediodorsal pontine tegmentum, in particular the nuclei locus coeruleus (LC), locus coeruleus alpha (LC alpha), peri-locus coeruleus alpha (peri-LC alpha) and laterodorsalis tegmenti (Ldt); 3) the pontine; and 4) bulbar gigantocellular (FTG) and magnocellular tegmental fields (FTM). We found that the only brainstem area from which a high amount of PS was induced by carbachol applications with short latencies, less than 5 minutes, is the mediodorsal pontine tegumentum, namely the LC alpha and peri-LC alpha, where ChAT-and TH- immunoreactive neurons are intermingled. Injections in an area immediately ventral to the peri-LC alpha induced physiological states resembling PS but lacking certain electrophysiological (PS-like) and behavioral components of PS (dissociated states I and II). The weak PS induction following carbachol administration in the anteromedial part of the FTG was due to the spread of the drug toward the efficient site since the latencies to PS onset were in the range of 20 to 60 minutes. No effects on PS generation were obtained after carbachol microinjections in the LC and the laterocaudal part of the FTG, while carbachol injections in the X area or in the bulbar FTG or FTM resulted in the increase of waking and the decrease of PS. In addition to these effects on PS induction, we also found that carbachol induced: 1) stereotyped PGO-like bursts when injected in the ventral part of the FTG and the rostral part of the FTM, 2) postural atonia with very short latencies, less than two minutes, when injected in the LC alpha and peri-LC alpha; and 3) hippocampal theta waves of 3-5 Hz persisting during light slow wave sleep (S1) when injected in and around the LC alpha and peri-LC alpha and in some points of the mediocaudal part of the FTG. These results support the hypothesis that PS is generated by highly localized neuronal populations and suggest that the mediodorsal pontine tegmentum (namely the nuclei LC alpha and peri-LC alpha) may represent a cholinoceptive PS generator.

Action Potentials↗
PubMed1989

[Replacement of omniscience mitral valve in suboptimal opening].

This 57-year-old female of MS had been treated by MVR with a 25 mm Omniscience valve on October 26, 1983. She was doing well until November 1984 when she developed general malaise and dyspnea. She was hospitalized again on June 3, 1985. Studies including echocardiogram and cardiac catheterization revealed mitral stenosis. The echocardiogram showed rapid blood stream toward the interventricular septum. The maximum opening angle of the disc was measured 30 degrees on the cine film. The cardiac catheterization showed increased PA and PA wedge pressures. The Omniscience valve was replaced with a 25 mm SJM valve on July 19, 1985. The postoperative course was uneventful. The postoperative echocardiogram and cardiac catheterization showed significant improvements in flow pattern and intracardiac pressure. She is doing well as an instructor of Japanese dancing after discharge from the hospital.

Female↗
PubMed1989

[Total anomalous pulmonary venous connection in adult: report of a case].

Total anomalous pulmonary venous connection (TAPVC) is a cardiac disorder that seldom permits survival into adulthood without surgical correction in infancy. We reported a successful total correction in a 47-year-old man with TAPVC. Cardiovascular angiography demonstrated the features of Darling I a type TAPVC. Cardiac catheterization showed Qp/Qs: 5.8, Pp/Ps: 0.31, Rp/Rs: 0.06 and mild pulmonary hypertension. On operation, the posterior wall of left atrium anastomosed to the common pulmonary vein over 4 cm length, ASD (5.0x3.8 cm) was closed with patch, and the communicating vein was ligated. The patient made uneventful postoperative recovery and is well 3 months following surgery.

Anastomosis, Surgical↗
PubMed1989

[Decreased plasma alpha 1-proteinase inhibitor activity in idiopathic nephrotic syndrome].

We measured plasma alpha 1-proteinase inhibitor (alpha 1-PI) levels in patients with idiopathic nephrotic syndrome (INS), chance proteinuria and/or hematuria, and normal controls to examine the roles of proteinase inhibitors in the pathogenesis of renal diseases. Plasma alpha 1-PI concentrations were significantly decreased in patients with INS at relapses and remissions of INS. The alpha 1-PI activities, anti-trypsin and anti-elastase activities, were also decreased in relapses of INS. However, the values revealed no statistically significant difference in remissions of INS. Significant correlations between the PI activities and alpha 2-macroglobulin levels were revealed, which suggested a possible contribution of alpha 2-macroglobulin to the plasma PI activities in INS. From these results we conclude that the decrease in plasma alpha 1-PI activities may be responsible for the reduction of glomerular negative charge, possibly caused by some unknown proteinase(s), and the resultant development of proteinuria.

Adolescent↗
PubMed1989

[A case report of aortitis syndrome with massive aortic regurgitation (AR), and ostial stenosis of the right coronary artery].

A 55-year-old female with massive aortic regurgitation and ostial stenosis of the right coronary artery due to aortitis syndrome was reported. The patient was admitted to the hospital with anterior chest pain and dyspnea on exertion. Retrograde aortogram showed massive aortic regurgitation and selective coronary angiogram revealed ostial stenosis of the right coronary artery. She was treated with aorto-coronary bypass (A-C bypass) and aortic valve replacement (AVR) with St. Jude Medical prosthetic valve. At operation, ostial stenosis of the right coronary artery due to aortitis syndrome was confirmed. Aortic valve replacement with a prosthetic valve and saphenous vein grafting to the distal right coronary artery were performed. Steroid therapy was started immediately after the operation. She recovered well and no complications was recognized after the operation.

Aortic Arch Syndromes↗
PubMed1988

The nuclei of origin of monoaminergic, peptidergic, and cholinergic afferents to the cat nucleus reticularis magnocellularis: a double-labeling study with cholera toxin as a retrograde tracer.

Using a sensitive double-immunostaining technique with nonconjugated cholera toxin B subunit (CT) as a retrograde tracer, we examined the cells of origin and the histochemical nature of afferents to the cat nucleus reticularis magnocellularis (Mc) of the medulla oblongata. After injections of CT confined to the Mc, we found that the major afferents to the Mc arise from: (1) the lateral part of the bed nucleus of the stria terminalis, the nucleus of the anterior commissure, the preoptic area, the central nucleus of the amygdala, the posterior hypothalamus, and the nucleus of the fields of Forel; (2) the Edinger-Westphal nucleus, the mesencephalic reticular formation, and the ventrolateral part of the periaqueductal grey; (3) the nuclei locus coeruleus alpha (LC alpha), peri-LC alpha, locus subcoeruleus, and reticularis pontis oralis and caudalis; (4) the caudal raphe nuclei; and (5) the nucleus reticularis ventralis of the medulla.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1988

Low-cytopathic infectious clone of human immunodeficiency virus type I (HIV-I).

Single genotypic variants of HIV-I, contained in a parental cytopathic HIV-I isolate, were isolated by molecular cloning and propagated in susceptible cells. Two such HIV-I clones, designated N1T-E and N1T-A, exhibited similar restriction endonuclease maps but strikingly different biological activities. Infection of T lymphocytes or monocytes by clone N1T-E was characterized by slow kinetics and lack of significant cytopathic effects, but high reverse transcriptase activity levels in culture supernatants of chronically-infected cells. Clone N1T-A, like the parental HIV-I isolate, exhibited fast kinetics of infection in T cells and monocytes and strong cytopathicity in these cells. Full characterization of the low-cytopathic virus in comparison to the structurally similar cytopathic clone may facilitate the elucidation of the molecular basis of HIV cytopathogenicity.

Cloning, Molecular↗
PubMed1988

Multiple discrete encephalitogenic epitopes of the autoantigen myelin basic protein include a determinant for I-E class II-restricted T cells.

Immunization with the autoantigen myelin basic protein (MBP) causes experimental allergic encephalomyelitis (EAE). Initial investigations indicated that encephalitogenic murine determinants of MBP were located only within MBP 1-37 and MBP 89-169. Encephalitogenic T cell epitopes within these fragments have been identified. Each epitope is recognized by T cells in association with separate allelic I-A molecules. A hybrid I-E-restricted T cell clone that recognizes intact mouse (self) MBP has been examined. The epitope recognized by this clone includes MBP residues 35-47. When tested in vivo, p35-47 causes EAE. T cell recognition of p35-47 occurs only in association with I-E molecules. These results provide the first clear example that antigen-specific T cells restricted by I-E class II molecules participate in murine autoimmune disease. Furthermore, it is clear that there are multiple (at least three) discrete encephalitogenic T cell epitopes of this autoantigen, each recognized in association with separate allelic class II molecules. These results may be relevant to human autoimmune diseases whose susceptibility is associated with more than one HLA-D molecule.

Amino Acid Sequence↗
PubMed1988

Regulation of cytosolic protein-tyrosine kinase from porcine spleen by polyamines and negative-charged polysaccharides.

In vitro regulation of cytosolic protein-tyrosine kinase from porcine spleen (CPTK-40) by various positive or negative charged compounds was studied. Spermine and spermidine stimulated the activity of CPTK-40 about two-fold using (Val5)angiotensin II as a substrate. This stimulation was not specific for the peptide but was also observed in the case of tubulin phosphorylation indicating a direct effect of these compounds on the enzyme itself. On the contrary, negative-charged polysaccharides were shown to be strong inhibitors of CPTK-40. The possibility of the physiological regulation of CPTK-40 by these compounds is briefly discussed.

Angiotensin II↗