Biomedical subjects

K Terui

Publications and source records attributed to K Terui.

At least 37 records · Page 2Linked to original sources

PubMed2000

Expression of transcription factors during megakaryocytic differentiation of CD34+ cells from human cord blood induced by thrombopoietin.

Although normal megakaryocytic development has been shown to require the presence of functional GATA-1 and NF-E2 transcription factors in vivo, the roles of other members of the GATA binding factors and NF-E2 family during megakaryocytic differentiation are unclear. the present study, the expression of GATA family members, GATA-1 and GATA-2, a GATA-binding factor, EVI-1, the large subunit of NF-E2 factor, p45 and the related factors, Nrf1, Nrf2, Nrf3, BACH1, BACH2, and the small subunit of NF-E2, MAFK and MAFG has been examined in human megakaryocytic and erythroid cells by reverse transcriptase-polymerase chain reaction. CD34+ cells isolated from human cord blood were induced to unilineage megakaryocytic or erythroid differentiation in liquid suspension culture in the presense of thrombopoietin or erythropoietin, respectively. Each lineage was identified by monoclonal antibody against GPIIb/IIIa or glycophorin A. In megakaryocytic culture, p45, Nrf1, Nrf2, BACH1, MAFK and MAFG mRNAs were induced similarly to erythroid culture. Nrf3 mRNA was barely detected in both cultures. BACH2 was induced only in megakaryocytic culture, although the level of expression was low. Furthermore, the profiles of transcription factors involved in hematopoiesis, EVI-1 and Ets-1 mRNAs were induced only in megakaryocytic culture. Megakaryocytic and erythroid differentiation pathways are closely related to each other, and these two lineage cells share a number of lineage-specific transcription factors. However, the results showed that the profile of the expression of these transcription factors in megakaryocytic cells is distinct from that of erythroid lineage. The dynamic changes in the levels of different transcription factors that occur during primary megakaryocytic differentiation suggest that the levels of these factors may influence the progression to specific hematopoietic pathways.

Antigens, CD34↗

PubMed2000

[Retardation of platelet recovery after autologous stem cell transplantation in a patient with acute lymphoblastic leukemia: possible role of decreased thrombopoietin production by bone marrow stromal cells].

A 16-year-old boy was diagnosed as having acute lymphoblastic leukemia and underwent autologous stem cell transplantation at the time of his second complete remission. Retardation of platelet recovery was evident at day 90 (< 5 x 10(4)/microliter), and at day 660 after transplantation the platelet count was 8.5 x 10(4)/microliter. Neutrophils and RBCs showed only slightly retarded recovery. Bone marrow stromal cells, which are thought to play an integral role in megakaryopoiesis, were examined. Although TPO mRNA expression per cell was normal, CFU-F was significantly decreased, resulting in a decrease of total TPO mRNA expression. In contrast, expression of G-CSF mRNA per cell was increased. It was thought that chemotherapy before bone marrow transplantation may have reduced the number of stromal cells, leading to retardation of platelet recovery because of low TPO expression.

Adolescent↗

PubMed1999

Electroencephalographic responses to the formalin test in rats.

The formalin test is an animal model of persistent pain. Although biphasic behavioral responses to formalin injection have been well described, the significance of the biphasic time course of the pain behaviors has not been established. To explore the significance of the behavioral responses to the formalin injection, we measured and analyzed cortical electroencephalogram (EEG) during the formalin tests in rats. Formalin was injected subcutaneously in the hindpaw of freely moving rats, and behavioral responses were visually counted and recorded. Results were compared with a control group which received saline injection. Neocortical EEG was recorded from implanted dural surface electrodes and analyzed using a Fast Fourier Transformation. Formalin produced biphasic pain behaviors with a transient pause between two phases. Cortical EEG recordings showed a biphasic change; a vigilant pattern (a low amplitude high frequency activity) followed by a non-vigilant pattern (a high amplitude low frequency activity), showing a good correlation with apparent arousal states of rats. Observed discrepancies between pain behaviors and EEG-measured vigilance stages included (1) a vigilant EEG pattern persisted during the transient pause of pain behavior, and (2) pain behaviors persisted even after non-vigilant EEG pattern became dominant. The results of the current study showed that there are temporal discrepancies between the pain behaviors and EEG-measured vigilance during the formalin test in rats. The temporal relationship between the 'pain' behaviors and nociception per se may not be as solid as believed.

Animals↗

PubMed1999

Preoperative pulse wave velocity fails to predict hemodynamic responses to anesthesia and to surgical stimulation.

STUDY OBJECTIVE: To determine whether pulse wave velocity (PWV), which is a useful indicator of cardiovascular disease, can predict the hemodynamic responses to anesthesia and surgical stimulation in surgical patients. DESIGN: Prospective, randomized study. SETTING: Operating rooms at a university hospital. PATIENTS: 30 ASA physical status I and II female patients presenting for elective gynecologic surgery. INTERVENTION: Patients who received one of the following anesthesia techniques were studied; isoflurane, sevoflurane and sevoflurane with nitrous oxide (N2O). MEASUREMENTS AND MAIN RESULTS: Patients underwent preoperative PWV measurements using an automatic PWV measurement device. Systolic blood pressure and heart rate levels were recorded at baseline, during anesthesia, and at skin incision. PWV had no significant correlation with percent changes of systolic blood pressure or heart rate, even after controlling the choice of anesthetic drugs. CONCLUSIONS: Preoperative PWV fails to predict hemodynamic responses to anesthesia and to surgical stimulation.

Adult↗

PubMed1999

Xenon suppresses the hypnotic arousal in response to surgical stimulation.

STUDY OBJECTIVE: To evaluate the suppressive effects of xenon (Xe) on hypnotic arousal at skin incision. DESIGN: Prospective, randomized study. SETTING: Operating rooms at a university hospital. PATIENTS: 35 ASA physical status I and II patients presenting for elective lower abdominal surgery. INTERVENTIONS: Patients were randomly assigned to receive one of the following regimens: 1.3 minimum alveolar concentration (MAC) isoflurane, 1.3 MAC sevoflurane, 0.7 MAC Xe with 0.6 MAC sevoflurane, 1 MAC Xe with 0.3 MAC sevoflurane, or 0.7 MAC nitrous oxide (N2O) with 0.6 MAC sevoflurane (n = 7 each group). MEASUREMENTS AND MAIN RESULTS: The bispectral index (BIS) was measured at baseline, during anesthesia, and after skin incision. BIS increased significantly at skin incision from the values noted during anesthesia in the sevoflurane and N2O groups, whereas it remained stable at incision in the other three groups (mean change in BIS: 0 +/- 9 for isoflurane, 15 +/- 8 for sevoflurane, 5 +/- 6 for 0.7 MAC Xe, 4 +/- 11 for 1 MAC Xe, and 9 +/- 5 for N2O). CONCLUSIONS: Unlike N2O, Xe was able to suppress hypnotic arousal in response to surgical stimulation when administered with sevoflurane.

Abdomen↗

PubMed1999

Platelet hyporeactivity in young infants during cardiopulmonary bypass.

UNLABELLED: Platelet dysfunction is one of the most important factors contributing to a postoperative hemorrhagic diathesis in children with congenital heart disease undergoing operations requiring cardiopulmonary bypass (CPB). However, very little is known about the influence of CPB on platelets in neonates and young infants. We studied 16 patients--8 young infants (<2 mo old) and 8 children (>12 mo old)--with congenital heart disease undergoing CPB. Surface density of an important platelet adhesive receptor, glycoprotein Ib, and degree of platelet activation, indicated by p-selectin positivity, were measured by whole blood flow cytometry in samples obtained at seven time points during the operations. We found that the percentage of p-selectin-positive platelets increased significantly in children, but not in young infants, during CPB. The young infant group exhibited a significantly smaller reduction of glycoprotein Ib than the child group during CPB (21.0% +/- 12.0% vs 32.7% +/- 18.1%; P < 0.05). Lack of CPB-induced increase of p-selectin and a smaller decrease of glycoprotein Ib in young infants in the current study suggest reduced platelet reactivity in young infants and neonates during CPB. The clinical significance of the reduced platelet reactivity in young infants and neonates remains to be determined. IMPLICATIONS: Platelets of young infants are less reactive than those of children during cardiopulmonary bypass, as determined by the cardiopulmonary bypass-induced alterations in platelet membrane adhesive receptors.

Age Factors↗

PubMed1999

The effects of heparin coating of oxygenator fibers on platelet adhesion and protein adsorption.

UNLABELLED: Platelet adhesion on the cardiopulmonary bypass oxygenator membrane is associated with impaired hemostasis. We investigated the effects of heparin coating of the oxygenator membrane on protein adsorption and platelet adhesion on the surface. Noncoated and heparin-coated polypropylene membranes were incubated in whole blood with small- (1 U/mL) or large-dose (5 U/mL) heparin as an anticoagulant for 3 h at 37 degrees C. The amount of platelets adhering on each fiber was assessed by using enzyme immunoassays using monoclonal antibodies directed against CD42b (GP Ib) and CD61 (GP IIb/IIIa). Platelet activation was assessed by measuring plasma guanosine monophosphate 140 levels. The amount and composition of the adsorbed proteins on the surface were analyzed by using a bicinchoninic acid protein assay and by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting technique. The heparin coating of the fibers significantly reduced platelet adhesion on the surface. However, platelet activation was reduced by heparin coating only with small-dose heparinization. The adsorption of platelet adhesive proteins such as fibrinogen and von Willebrand factor was not altered, whereas that of fibronectin was increased by heparin coating. We conclude that heparin coating of the oxygenator fibers can decrease platelet adhesion without affecting adsorption of major adhesive proteins. Surface heparin coating is associated with an increased fibronectin adsorption on the fibers. IMPLICATIONS: Heparin coating can reduce platelet adhesion and activation in the presence of small-dose heparinization, potentially reducing the inflammatory response and activation of thrombosis and fibrinolysis.

Absorption↗

PubMed1999

Anesthetic doses of sevoflurane to block cardiovascular responses to incision when administered with xenon or nitrous oxide.

BACKGROUND: The authors' previous study demonstrated that xenon (Xe) and nitrous oxide (N2O) in combination with sevoflurane can attenuate cardiovascular responses to skin incision. To quantitatively evaluate their suppressive effects on cardiovascular responses, the authors compared the MAC-BAR (minimum alveolar concentration that blocks adrenergic or cardiovascular response to incision) values of sevoflurane when administered with Xe or N2O. METHODS: Forty-three patients received sevoflurane with one of three anesthetics; 1 MAC Xe, 0.7 MAC Xe and 0.7 MAC N2O. The MAC-BAR of sevoflurane was determined in each anesthetic using the "up and down" method. The response was considered positive if the heart rate or mean arterial pressure increased 15% or more. The end-tidal sevoflurane concentration given to the next patient was increased or decreased by 0.3 MAC if the response was positive or negative in the previous patient, respectively. The MAC-BAR was calculated as the mean of four independent cross-over responses. RESULTS: The MAC-BAR of sevoflurane, including the contribution of Xe or N2O, was 2.1+/-0.2 MAC and 2.7+/-0.2 MAC when administered with 1 MAC and 0.7 MAC Xe, respectively, and 2.6+/-0.4 MAC when administered with 0.7 MAC N2O (mean +/- SD). CONCLUSIONS: Although 1 MAC Xe has a more potent suppressive effect on cardiovascular responses to incision than 0.7 MAC Xe or N2O, Xe and N2O have a similar suppressive effect at 0.7 MAC.

Adult↗

PubMed1997

[Respiratory arrest after a ventriculoscopic surgery in infants: two case reports].

Case-1: A 4 month old, 7120 g, girl with hydrocephalus underwent endoscopic fenestration of the septum pellucidum. Her development had been normal without signs or symptoms of intracranial hypertension. She had no history of convulsion or apnea. Ventriculoscopic diagnosis was complete obstruction of the right foramen of Monro and partial defect of right ependyma. Intraoperative course was uneventful under general anesthesia. She had two episodes of respiratory arrest accompanied with myoclonus and the left conjugate deviation 15 min after extubation. Postoperative CT scan showed no abnormal findings such as intracranial hemorrhage. The respiratory arrest and conjugate deviation disappeared after phenobarbital administration. She had no further respiratory arrest. Case-2: A 1-month old boy with congenital hydrocephalus underwent endoscopic third ventriculostomy. He had no signs or symptoms of intracranial hypertension. CT scan showed enlargement of lateral ventricle and third ventricle due to aqueductal stenosis. Respiratory arrest was noted 10 min after extubation in the recovery room. His anterior fontanel sank abnormally and rigidity of the extremities was observed. His trachea was reintubated and he was transferred to ICU. After 24 h of respiratory care in the ICU he was extubated and discharged to the ward. He had no further episodes of respiratory arrest. We believe that postanesthetic apnea monitoring is mandatory in young infants who undergo ventriculoscopic surgery.

Anesthesia, General↗

PubMed1997

[Hemodynamic effects of amrinone in children during cardiopulmonary bypass and postoperative 12 hours].

Hemodynamic effects of amrinone in children during cardiopulmonary bypass (CPB) and postoperative 12 hours were studied. In 10 patients undergoing open heart surgery, 1 mg/kg of amrinone was infused as the initial CPB dose and 5 - 10 micrograms/kg/min of amrinone was continuously administered as the maintenance dose during CPB and postoperative 12 hours. Amrinone levels ranged from 0.9 to 1.4 micrograms/ml during CPB and postoperative 12 hours. After infusion of amrinone, mean arterial blood pressure decreased significantly, but other parameters did not show remarkable change. The administration of amrinone during CPB showed enough vasodilating effect and decreased the need of conventionally used other vasodilators (nitroglycerin or prostaglandin E1). The postoperative course of 10 patients was clinically uneventful. The administration of amrinone in 10 patients did not produce thrombocytopenia compared with the control group (5 patients) in the postoperative period. In conclusion, the administration of amrinone during CPB and postoperative 12 hours in children was useful in producing enough vasodilating effect without major side effect.

Amrinone↗

PubMed1996

[Cesarean section in a patient with uncontrolled hyperthyroidism, preeclampsia, and congestive heart failure].

A case of a pregnant woman who underwent urgent cesarean section is presented. The patient had severe hyperthyroidism, preeclampsia, and congestive heart failure, which had not been treated until 36 weeks of gestational age. At 38 weeks, fetal distress occurred and an urgent cesarean section was performed successfully under epidural anesthesia with preoperative treatments using iodide, hydrocortisone and propylthiouracil. The patient required postoperative intensive care for heart failure. Thyroid function of the neonate was almost normal. No abnormality was observed except low birth weight.

Adult↗

PubMed1995

Maternal and neonatal fentanyl and bupivacaine concentrations after epidural infusion during labor.

Labor analgesia using continuous epidural infusions of low-dose bupivacaine and fentanyl may be maintained for many hours. We examined the potential for drug accumulation in both mother and neonate after these long-term infusions. Pregnant women receiving a 10-mL/h continuous infusion of labor analgesia with 0.125% bupivacaine and 2 micrograms/mL of fentanyl were evaluated. Maternal venous and umbilical venous drug concentrations were measured at delivery. Umbilical artery blood gases were obtained. Scanlon neurobehavioral testing was performed on all infants. Length of infusion times varied from 1 to 15 h. Maternal and neonatal drug concentrations remained relatively constant throughout the infusion period. All umbilical blood gas values and neurobehavioral scores were within normal limits. In conclusion, even when maintained for many hours, continuous infusion labor analgesia does not appear to result in significant fetal drug accumulation. No adverse neonatal effects were seen.

Analgesia, Epidural↗

PubMed1994

[Informed consent in anesthesia].

Informed consent is required for not only operative procedures but also anesthesia. One hundred and sixty-two patients, including those in a control group, were interviewed between the 3rd and 10th days after operations. An information sheet describes the anesthetic management and complications (possibilities of teeth damage, hoarseness and sore throat) in a simple style. This survey showed that those who had received the information sheet before operation showed significantly deeper understanding of anesthesia (56.2%) compared with those who had not received the information sheet (40.3%) (P < 0.05). The information sheet did not cause or increase anxiety about anesthesia. Those who had anxiety about anesthesia before the operation needed detailed printed information (63.8%) compared with those without anxiety (36.6%) (P < 0.01). An information sheet describing the anesthetic management and complications is useful for obtaining informed consent.

Aged↗

PubMed1993

[Coronary artery spasm under general and epidural anesthesia].

A 66-year-old man without history of angina pectoris was scheduled for subtotal gastrectomy under epidural anesthesia supplemented with nitrous oxide and isoflurane. ECG showed an elevation of ST segment after hypotension. It passed into Wenckebach A-V block and complete A-V block. But an elevation of ST segment was relieved by raising blood pressure and it became sinus rhythm. Serum enzymes (CPK-MB, GOT and LDH) were normal after operation. It is suspected that coronary spasm was induced by hypotension and vagal stimulation under inadequate level of anesthesia, though we could not prove this arteriographically.

Aged↗

PubMed1991

[Radiologic features of focal nodular hyperplasia. Comparison with hepatocellular carcinoma by angiography and CT scan].

Radiographic features of eight focal nodular hyperplasia (FNH) of livers of 6 patients were described in comparison with those of 72 hepatocellular carcinoma (HCC). In arterial angiograms, 3 of the examined 4 FNH showed a large tumor vessel entering the center of the lesion. However, 1 of the examined HCC (1/39) had such a vessel. Tumor vessels in all of the examined FNH (4/4) were mainly curvilinear, without an encased and obstructive appearance. These angiographic features were not found in the examined HCC (0/39). Spoke-wheel patterns of tumor vessels were observed in 2 FNH (2/4) and in 3 HCC (3/39). In CT scan without contrast imaging, 5 HCC (5/39) and 3 FNH (3/5) were isodense. One of HCC (1/50) and 3 FNH (3/5) were isodense in the late phases of dynamic CT images. 4 HCC (4/50) and 4 FNH (4/5) had an irregular margin in the lesions. 5 HCC (5/50) and 4 FNH (4/5) demonstrated central low density areas in lesions in the early phases of dynamic CT imaging. In the late phases of the image, central high density areas in lesions were found in 2 HCC (2/50) and 3 FNH (3/5). Based on the above radiographic features such as a large tumor vessel having a curvilineal appearance, irregular margin of the lesions in FNH, we conclude that it is possible to make a differential diagnosis between FNH and HCC clinically.

Adolescent↗

PubMed1991

[Two cases of pulmonary edema during and after cesarean section].

Pulmonary edema occurred during and after Cesarean section under general anesthesia in two pregnant women. They had no preoperative complication. After delivery, anesthesia was maintained with 66% N2O in oxygen and intravenous injection of pentazocine and diazepam. At the same time, 0.2 mg of methylergometrin was injected intramuscularly and 2,000 micrograms of prostaglandin F2 alpha was injected to the muscle of the uterus in order to induce uterine contraction. In one case, SpO2 dropped and airway pressure increased immediately after the administration. In another case, chest rale was auscultated on postoperative round at 2 hours after operation. The cases suggest that pulmonary edema was caused by a large quantity of oxytocics, which increased volume load on systemic circulation.

Adult↗

PubMed1990

[Acute megakaryoblastic leukemia with complex chromosomal aberrations].

A case of acute megakaryoblastic leukemia with complex chromosomal aberrations is reported. A 63-year-old man was admitted to our hospital because of pancytopenia. Bone marrow aspiration resulted in a dry tap and biopsy showed hypoplastic marrow with fibrosis. Blast cells in the peripheral blood were identified as megakaryoblasts because they were positive for electron microscopic platelet peroxidase (PPO). In addition, monoclonal antibody, TP80, to platelet glycoprotein II b-III a reacted with in about 26% of the blast cells. Chromosomal analysis of the peripheral blood revealed a mosaic pattern of a normal karyotype and abnormal ones, including 44, XY, -5, -7, -18, 10q-, +marker.

Chromosome Aberrations↗

PubMed1988

Expression of TGF-beta gene in adult T cell leukemia.

Peripheral mononuclear cells from adult T cell leukemia (ATL) patients were analyzed in comparison with other types of leukemia cells, for the expression of transforming growth factor-beta (TGF-beta) mRNA, for the presence of TGF-beta activity (colony stimulating activity for normal rat kidney fibroblasts [NRK]) in conditioned medium and for their susceptibility to exogenous TGF-beta. Highly elevated TGF-beta mRNA levels were observed in all five ATL cell samples tested; however, in three acute myelogenous leukemia (AML) samples, in one acute lymphatic leukemia (ALL), and one chronic myelogenous leukemia (CML), TGF-beta expression was relatively lower. In normal peripheral mononuclear cells TGF-beta mRNA was weakly detectable. Colony stimulating activity for NRK found in the conditioned medium from ATL cells as well as other leukemia cells correlated well with the levels of TGF-beta mRNA expression. In all three ATL samples tested, stimulation of 3H-thymidine uptake by purified TGF-beta from platelets was apparent. These results suggest that ATL cells are secreting active TGF-beta in a relatively high amount, as compared with other leukemia cells, and may proliferate in response to the factor via an autocrine manner. Furthermore, considering that TGF-beta stimulates bone resorption, we can speculate that the relatively high amount of TGF-beta in ATL cells contributes to the hypercalcemia frequently seen in ATL patients.

Cell Division↗