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Biomedical subjects

K Yasuda

Publications and source records attributed to K Yasuda.

At least 343 records · Page 19Linked to original sources

Biomechanical studies of the rabbit patellar tendon after removal of its one-fourth or a half.

Effects of the overstressing induced by the harvest of grafts from the patellar tendon on the mechanical properties and morphometry of remaining tendon were studied using a rabbit model. The width of the patellar tendon was reduced by one-fourth or one-half equally removing the medial and lateral portions; by this surgery, the cross-sectional area was decreased by 25 or 50 percent from the original area. After all the rabbits were allowed unrestricted activities in cages for 3 to 12 weeks, their patellar tendons were harvested for mechanical and histological studies. The one-fourth removal induced no significant changes in the mechanical properties, but significantly increased the cross-sectional area. In the case of one-half removal, tensile strength and tangent modulus did not change in some tendons, although the cross-sectional area increased significantly. In the other central half tendons, mechanical strength decreased markedly, while the cross-sectional area increased; hypercellular areas and breakage of collagen bundles were observed in these tendons. These results indicate that the patellar tendon has an ability of functionally adapting to overstressing by changing the cross-sectional area, while keeping the mechanical properties unchanged, if the extent of overstressing is less than 30 percent.

Animals↗

Quantitative detection of hepatitis B virus by transcription-mediated amplification and hybridization protection assay.

We have developed a sensitive and quantitative assay using transcription-mediated amplification and hybridization protection assay for the detection of hepatitis B virus (HBV) DNA in serum. The transcription-mediated amplification was carried out in a single tube. The hybridization protection assay was carried out in a microtiter plate with two probes with different specific activities to obtain a broad detection range. As a result, the assay had a detection range of 5 x 10(3) to 5 x 10(8) genome equivalents (GE)/ml and good quantitative accuracy on a logarithmic scale. A moderately sized manual assay run can be completed within 5 h. Measurements of the amounts of HBV DNA in clinical samples by the assay showed the amounts under various disease conditions to be widely distributed (more than 5 logs, from approximately 5 x 10(3) to 5 x 10(8) GE/ml). It was also shown that the amount of HBV DNA in one chronic hepatitis patient varied widely, with a range of more than 5 logs during long-term monitoring. Our assay has the potential to be used to monitor and determine the prognosis of HBV patients and carriers, especially during interferon treatment.

Carcinoma, Hepatocellular↗

DHEA improves glucose uptake via activations of protein kinase C and phosphatidylinositol 3-kinase.

We have examined the effect of adrenal androgen, dehydroepiandrosterone (DHEA), on glucose uptake, phosphatidylinositol (PI) 3-kinase, and protein kinase C (PKC) activity in rat adipocytes. DHEA (1 microM) provoked a twofold increase in 2-[3H]deoxyglucose (DG) uptake for 30 min. Pretreatment with DHEA increased insulin-induced 2-[3H]DG uptake without alterations of insulin specific binding and autophosphorylation of insulin receptor. DHEA also stimulated PI 3-kinase activity. [3H]DHEA bound to purified PKC containing PKC-alpha, -beta, and -gamma. DHEA provoked the translocation of PKC-beta and -zeta from the cytosol to the membrane in rat adipocytes. These results suggest that DHEA stimulates both PI 3-kinase and PKCs and subsequently stimulates glucose uptake. Moreover, to clarify the in vivo effect of DHEA on Goto-Kakizaki (GK) and Otsuka Long-Evans fatty (OLETF) rats, animal models of non-insulin-dependent diabetes mellitus (NIDDM) were treated with 0.4% DHEA for 2 wk. Insulin- and 12-O-tetradecanoyl phorbol-13-acetate-induced 2-[3H]DG uptakes of adipocytes were significantly increased, but there was no significant increase in the soleus muscles in DHEA-treated GK/Wistar or OLETF/Long-Evans Tokushima (LETO) rats when compared with untreated GK/Wistar or OLETF/LETO rats. These results indicate that in vivo DHEA treatment can result in increased insulin-induced glucose uptake in two different NIDDM rat models.

Adipocytes↗

A multicenter placebo-controlled, double-blind trial of urapidil, an alpha-blocker, on neurogenic bladder dysfunction.

OBJECTIVES: To assess the efficacy of urapidil, an alpha-blocker, on neurogenic bladder dysfunction in a placebo-controlled, double-blind trial. METHODS: 149 patients were randomly assigned to receive a placebo or 60 mg/day of urapidil for 4 weeks. The evaluation of efficacy included changes in urinary symptom scores and the results of a pressure/flow study. RESULTS: There were significant intergroup differences with regard to straining and the sum of urinary symptom scores, with the urapidil group showing marked improvements (p = 0.016 and p = 0.011, respectively). In the urapidil group, the average and maximum flow rates were unchanged, but the residual urine volume decreased significantly (p < 0.001) as compared with the baseline value. The pressure at maximum flow and the minimum urethral resistance decreased significantly (p = 0.040 and p = 0.040, respectively) in the urapidil group, and there was a significant (p = 0.005) intergroup difference with regard to pressure at maximum flow. There was also a significant (p < 0.001) inter-group difference with regard to the overall therapeutic effect. Side effects were noted in 2 patients treated with urapidil and 6 in the placebo group. CONCLUSION: Urapidil is effective for the treatment of voiding dysfunction in patients with neurogenic bladder.

Adrenergic alpha-Antagonists↗

The association between Trp64Arg polymorphism of the beta3-adrenergic receptor and autonomic nervous system activity.

The beta3-adrenergic receptor plays a significant role in the control of lipolysis and thermogenesis in brown adipose tissue through autonomic nervous system (ANS) activity. As the Trp64Arg polymorphism of the beta3-adrenergic receptor gene might affect ANS activity, we investigated the association of the polymorphism with ANS activity. The prevalence of the polymorphism was determined in 204 subjects. Ten normal homozygous, 10 heterozygous, and 1 variant homozygous subjects were examined for ANS activity during supine rest and standing by electrocardiogram R-R interval power spectral analysis. Subjects with the variant did not differ from subjects without the variant in body mass index, plasma glucose, plasma insulin, or family history of diabetes or obesity. The total power of heterozygotes at supine rest was lower than that of normal subjects (1124.6 +/- 191.6 vs. 3029.8 +/- 758.8 ms2; mean +/- SE). With a postural change to standing, the parasympathetic and sympathetic nervous system activity indexes of heterozygotes showed a higher response than those of normal subjects (parasympathetic nervous system index, 0.10 +/- 0.02 vs. 0.17 +/- 0.02; sympathetic nervous system index, 10.55 +/- 1.47 vs. 6.26 +/- 1.09), and the difference in total power disappeared. These findings show that subjects with the variant, even the heterozygotes, had lower resting ANS activity than normal subjects.

Adult↗

Coexpression of mineralocorticoid receptors and 11beta-hydroxysteroid dehydrogenase 2 in human gastric mucosa.

The role of mineralocorticoids in human gastrointestinal tract is well established. In the stomach, aldosterone is thought to regulate electrolyte transport associated with gastric acid secretion. In mineralocorticoid target organs, the action of the glucocorticoid inactivating enzyme 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD2) facilitates aldosterone binding to a nonselective mineralocorticoid receptor (MR) in the face of high levels of circulating glucocorticoids. In the present study, we examined 25 specimens of human stomach for the presence of MR and 11beta-HSD2 using a [3H]aldosterone binding assay, Northern blot analysis, RT-PCR, and immunohistochemistry. Specific [3H]aldosterone binding sites were detected in gastric fundic mucosa, but not in the antrum. In fundic mucosa the Kd was 0.72+/-0.05 nmol/L (mean +/- SE), and Bmax was 6.0+/-1.4 fmol per milligram of protein. Northern blot analysis demonstrated a faint band for MR mRNA at 6.0 kb, although message for 11beta-HSD2 was undetectable. However, RT-PCR demonstrated specific PCR products for both MR and 11beta-HSD2. Immunohistochemistry demonstrated the colocalization of MR and 11beta-HSD2 only in parietal cells. MR-positive cells were further characterized by electron microscopy, confirming the identity of parietal cells. This study shows that parietal cells contain both MR and 11beta-HSD2, suggesting that the human stomach is a novel target organ for mineralocorticoids. Aldosterone may, therefore, regulate biological functions of parietal cells including gastric acid secretion.

11-beta-Hydroxysteroid Dehydrogenases↗

Marked increase in plasma ACTH with tumor reduction after chemotherapy in ectopic ACTH syndrome.

We report on a case of rapid and marked hormone release as a result of rapid tumor reduction due to chemotherapy in a 36-year-old woman with ectopic ACTH syndrome due to small cell lung cancer. Treatment of the cancer with cisplatin and etoposide resulted in an 80% reduction in tumor size on computed tomographic scan within two weeks. Concurrently, plasma ACTH exhibited an unexpected and astonishing increase from 373 pg/ml before treatment to more than 1200 pg/ml. There were no biochemical characteristics observed in tumor lysis syndrome of solid tumors such as azotemia, increased LDH and hyperkalemia. The present case indicates that anticancer chemotherapy instituted in patients with ectopic ACTH syndrome could result in an acute increase of plasma ACTH and exacerbation of hypercortisolism, similar to tumor lysis syndrome, which is a potentially fatal complication following anti-cancer chemotherapy.

ACTH Syndrome, Ectopic↗

High molecular weight corticotropin measured with immunoradiometric assay in a patient with asymptomatic pituitary corticotropinoma.

A 57-yr-old female with corticotropinoma showing no Cushingoid stigmata is reported. Basal plasma levels of ACTH measured with immunoradiometric assay and beta-endorphin were high, 12.6-15.9 pmol/l and 3.5 pmol/l, respectively. Plasma cortisol level and urinary free cortisol excretion were normal, 303-359 nmol/l and 171-226 nmol/day, respectively. Plasma ACTH markedly increased to 70.5 pmol/l with intravenous administration of 100 microg CRH. Diurnal rhythm of plasma ACTH was seen, but its level in the night was still high. Plasma ACTH suppression with dexamethasone was insufficient. CRH stimulation after dexamethasone suppression increased plasma ACTH level from 4.4 to 13.7 pmol/l. Intravenous administration of 4 microg desmopressin increased plasma ACTH from 15.6 to 19.6 pmol/l. Oral administration of 16 mg lepramide insufficiently decreased plasma ACTH from 7.3 to 5.3 pmol/l. However, plasma cortisol responses in these conditions were normal. Postoperative pathological study revealed subtype 1 corticotropinoma immunohistochemically and electron-microscopically. Postoperative basal plasma ACTH decreased to 3.9 pmol/l, although plasma cortisol did not change. Diurnal rhythm and dexamethasone suppressibility of plasma ACTH became normal. Plasma sample was chromatographed on a Sephadex G-75 column. The elution profile showed two peaks of ACTH, one of which was compatible with 1-39 ACTH and another with higher molecular weight ACTH which was probably secreted from corticotropinoma. Anomaly in processing of proopiomelanocortin was suspected.

Adenoma↗

Pharmacological treatments for GH-induced insulin resistance.

Troglitazone (T) and d-chiroinositol (DCI) have been reported to improve insulin resistance associated with obesity and NIDDM. We tested whether these compounds counteract the insulin antagonistic effects of recombinant human GH. Male Wistar rats were allocated to 4 different treatment groups, rhGH (n=8), rhGH+T (n=7), rhGH+DCI (n=8) and control (saline, n=8). rhGH (2 IU/100 g/day) was injected sc twice daily for 2 days. T and DCI were given (20 mg/day) po for 5 days preceding and 2 days along with rhGH. Euglycemic hyperinsulinemic clamp studies were done to assess the hepatic glucose output (HGO) and glucose disappearance rate (GDR). Fasting plasma glucose, insulin, serum FFA and basal HGO were similar in all 4 treatment groups. During the hyperinsulinemic clamp which raised plasma insulin levels to 7.2 +/- 0.4 ng/ml, HGO was suppressed in the control and rhGH+T treated rats but not in the rats treated with rhGH and rhGH+DCI. GDR decreased in the rats which received rhGH (18.1 +/- 5.8 vs 30.3 +/- 5.2 mg/kg/min) compared to the control rats. The rats given either T (24.7 +/- 2.7) or DCI (31.4 +/- 2.7) along with rhGH showed comparable GDR to the control rats. These results indicated that rhGH induced hepatic and peripheral insulin resistance. Troglitazone counteracted the insulin-antagonistic action of rhGH both in the liver and the peripheral tissues. DCI was effective in offsetting peripheral insulin resistance but without any effect on hepatic insulin resistance associated with rhGH treatment.

Animals↗

Hot flushes and other menopausal symptoms in relation to soy product intake in Japanese women.

OBJECTIVE: To examine the relationships between dietary intake of soy products and hot flushes and other menopausal symptoms. METHODS: Subjects were 284 women aged 40-59 years who attended a health check-up program provided by a general hospital in Gifu, Japan. They completed a health questionnaire including the Kupperman test of menopausal distress. Diet was assessed by a semiquantitative food frequency questionnaire. RESULTS: Fermented soy product intake but not total soy product intake was significantly negatively correlated with hot flush severity (r = -0.16, p = 0.01) after controlling for age and menopausal status. Neither total soy product intake nor fermented soy product intake was significantly correlated with menopausal index score. Estimated isoflavone intake from total and fermented soy products was significantly lower by 15% (p = 0.02) and 19% (p = 0.01), respectively, in women with hot flushes, compared to those without hot flushes after controlling for covariates. CONCLUSION: The data support a hypothesis that intake of fermented soy products alleviates the severity of hot flushes.

Adult↗

[Effect of compression with aerosolized fibrin sealant on surgical hemostasis].

In order to decrease complications following incomplete hemostasis after surgery, especially in the case of arterial bleeding, we experimentally investigated an effective way of applying fibrin glue as a sealant. Using white rabbits as a model, in which arterial bleeding from the abdominal aorta was induced, fibrin glue and a related hemostatic agent were tested to evaluate the hemostatic effectiveness. Group I (n = 9): Fibrin glue was applied by spraying it on the fingertip and then placing the fingertip on the bleeding part and pressing. Group II (n = 9): Fibrin glue was applied with oxycellulose on the fingertip and then placing the fingertip on the bleeding part and pressing. The results demonstrated that: 1) Although complete hemostasis could not be obtained with finger-pressing alone in 30 second, it could be obtained in 9/9 cases 100%) in Group I but in only 3/9 cases (33%) in Group II. 2) Pressure-resistant force was higher for Group I at an earlier time after hemostasis (p < 0.05). 3) Pathological study reconfirmed the predominance of Group I. We conclude from this study that ideal hemostasis can be obtained with fibrin glue applied simply by spraying it on the fingertip and then placing the fingertip on the bleeding part and pressing.

Aerosols↗

Abdominal aortic aneurysms in aged patients: analysis of risk factors in non-ruptured cases.

BACKGROUND AND METHODS: A retrospective analysis of 304 patients (274 males and 30 females) surgically treated for non-ruptured, infrarenal abdominal aortic aneurysm (AAA) to determine the relative contribution of preoperative, operative, and postoperative factors to mortality and to the development of postoperative complications. 1) Risk factors, hospital mortality and long-term survival rate were compared between patients aged 75 or older (- group I; n=79) and those under 75 years of age (group II; n=225). 2) These risk factors were subjected to univariate and multivariate analysis to determine their relative contribution to patient hospital mortality and to the development of major postoperative complications in aged patients. RESULTS: Maximum diameter of AAA, the prevalence of respiratory dysfunction, diabetes mellitus and the total volumes of intraoperative blood loss were significantly different between the two groups. A higher hospital mortality was noted in the aged patients (10.1% versus 3.1%, p<0.05). The majority of deaths in group I resulted from organ dysfunctions, especially involved with respiratory failure. The long term survival rate at 3 and 5 years was not different between operative survivors in the two groups. Incremental risk factors for hospital death in aged patients included the presence of symptomatic AAA, the maximum diameter of AAA, the postoperative development of myocardial infarction, respiratory complications and gastrointestinal bleeding. Operation time and the volumes of intraoperative blood loss significantly correlated with the postoperative development of respiratory failure, renal failure and multiple organ failure. CONCLUSIONS: 1) A higher operative mortality and higher prevalence of postoperative complications were noted in aged patients with AAA. 2) To reduce operation time and the volumes of intraoperative blood loss would be essential to improve surgical results of AAA in aged patients.

Adult↗

[Long-term results of mitral valve regurgitation after surgical repair of incomplete atrioventricular septal defect].

Although the postoperative outcome in patients with incomplete atrioventricular septal defect (iAVSD) is excellent, deterioration of mitral valve regurgitation (MR) is still remained to be resolved. Therefore, this study was undertaken to compare surgical procedures for mitral cleft repair with their long-term results of MR. From 1991 to 1996, 52 patients underwent surgical repair of iAVSD. Age at operation ranged from 2 months to 62 years old with mean age of 14.2 years. Mean follow-up period was 8.6 +/- 4.4 years. All patients underwent patch closure of ostium primum defect. Two patients did not have cleft (Group A). Seven patients did not close the cleft at all (Group B), while 40 patients had the repair of valve by closing cleft near septal attachment only (Group C). The latest 3 patients had the complete closure of cleft from annulus to margin of leaflet where chorda is attached. MR was evaluated by echocardiography grading 0 to IV and regurgitation more than grade II was considered to be significant. In Group A, MR remained grade I. In Group B, MR was deteriorated in 5 patients (71%). Consequently, 6 patients (86%) had grade II or more regurgitation and 4 patients (57%) revealed grade III/IV regurgitation including one (14%) reoperation. In Group C, MR was deteriorated in 10 patients (55%). Consequently, 22 patients (86%) had grade II or more regurgitation and 5 patients (13%) had grade III/IV regurgitation including 3 (7.5%) reoperations. In Group D, no deterioration of MR was noted and all had grade I or less regurgitation. These results suggest that the closure of cleft near septal attachment is not sufficient to prevent MR in late phase and the complete closure of cleft from annulus to margin of leaflet, where chorda is attached, would be useful to prevent the deterioration of MR in late phase.

Adolescent↗

[A case of mitral valve replacement and left atrial plication for infantile Marfan syndrome with giant left atrium due to mitral valve regurgitation].

In Marfan syndrome, there is a subset, called infantile Marfan syndrome, in which the disease is diagnosed during infancy and cardiac lesions including mitral regurgitation and aortic root dilatation tend to be deteriorated rapidly. In infantile Marfan syndrome, respiratory function is sometimes impaired when skeletal abnormalities such as scoliosis and pectus excavatum are severe. In this report, we describe a 2-year and 4-months old boy with infantile Marfan syndrome who presented with severe mitral regurgitation and the collapsed left lung. In addition to the impairment of respiratory function due to severe scoliosis, the left lung was collapsed because of the compression of the left bronchus by the enlarged left atrium. The patient required mitral valve replacement concomitantly with left atrial plication, resulting in the decompression of the left bronchus and the re-expansion of the left lung. Characteristics and surgical management of infantile Marfan syndrome are discussed in this report.

Child, Preschool↗

[Utilization of NIH image for quantification of emphysema by computed tomography].

The percentage of the low attenuation area (LAA%) is understood to be the most accurate index in quantifying emphysema by computed tomography (CT). To date, CT scanners with enhanced post-processing programs have been used for measurements of LAA%. In this study, we sought develop a method of LAA% determination using a conventional density mapping program for CTs and NIH Image, an image-analysis software package for personal computers. Our results for overall LAA%, together with the correlations between overall LAA% and pulmonary function tests, agreed well with the findings of earlier reports. In reproducibility trials utilizing our method interoperator error for LAA% was within +/- 2%. A phantom experiment indicated that there was little difference between LAA% values obtained by this method and the values obtained by direct CT measurements. Therefore, we concluded that this method is sufficiently reliable for clinical use and capable of facilitating LAA% measurements with CT scanners that are not equipped with enhanced post-processing software.

Aged↗