Biomedical subjects

K Yasuda

Publications and source records attributed to K Yasuda.

At least 55 records · Page 3Linked to original sources

PubMed2004

[Partial anomalous pulmonary venous drainage to the high superior vena cava; repair by direct anastomosis between the superior vena cava and the right atrial appendage; report of a case].

A 10-year-old boy with partial anomalous pulmonary venous connection to the high superior vena cava (SVC) underwent surgical repair by Williams method. The SVC was divided above the orifice of the anomalous pulmonary vein. The proximal end of the SVC was closed and the distal end of the SVC was anastomosed to the right atrial appendage (RAA). The anomalous pulmonary vein was rerouted to the left atrium via the SVC and the surgically enlarged central type atrial septal defect (ASD). The postoperative course was uneventful except transient sinus bradycardia and catheter study showed no stenosis of the SVC and the RAA.

Anastomosis, Surgical↗

PubMed2004

[Aberrant subclavian artery].

Aberrant subclavian artery (ASA) is the most frequently encountered congenital anomaly of aortic arch. The ASA aneurysms are rare but potentially lethal disease, it has been recognized that the presence of an aneurysm of an ASA itself is an indication for surgery. We experienced 4 cases with ASA during the past 23 years. All cases were male. Their ages ranged from 51 to 73 years old. Three patients had a right-sided aortic arch. Among the 4 patients, only 1 underwent total arch replacement, but the other 3 patients could be followed conservatively for 1, 7 and 23 years, respectively. We reviewed the problem of the diagnosis and treatment of the ASA including surgical indication.

Aged↗

PubMed2004

[Ischemic cardiomyopathy treated with overlapping ventriculoplasty].

A 58-year-old man was admitted due to congestive heart failure. Left ventriculography showed end-diastolic volume index (EDVI) of 172 ml/m2 and ejection fraction (EF) of 16%. Coronary angiography showed severe double vessel disease (the left anterior descending artery and the right coronary artery). Echocardiography showed dilated heart [left ventricular end-diastolic diameter (LVDd) of 74 mm] and severe mitral regurgitation due to tethering of the leaflets. The patient underwent our original left ventricular volume reduction operation, termed overlapping ventriculoplasty (OLVP) combined with mitral annuloplasty, papillary muscles plication (PMP) and coronary artery bypass grafting (CABG). The postoperative course was excellent. Postoperatively, the EDVI decreased to 96 ml/m2, the LVDd diminished to 67 mm, and the EF improved to 34%. This case implies the role of left ventricular remodeling procedure of OLVP and PMP in the ischemic cardiomyopathy with ischemic mitral regurgitation.

Cardiac Surgical Procedures↗

PubMed2004

Abdominal aortic aneurysm repair in a patient with a congenital solitary pelvic kidney. A case report.

Abdominal aortic aneurysm (AAA) is rarely associated witha congenital pelvic kidney. To date only 11 cases have been reported in the literature in which a solitary pelvic' kidney was associated in only 1 patient. Repair of thesaneurysm is technically demanding because the abnormal origin of the renal arteries presents the problem of renal ischemia duringaortic cross-clamping. We report a case of a 77-year-old man who was found to have an AAA associated with a congenital solitary pelvic kidney. An abdominal aortography dearly showed 2 aberrant renal arteries, one of which originated from the aortic wall just above the aortic bifurcation and the other from the left common iliac artery. At surgery, we found other associated anomalies including malrotation of the gut and a left undescended testis. The surgical procedure consisted of an aneurysmorrhaphy followed by a tube graft replacement with therenal arteries being left intact to the distal aortic wall or below. Renal preservation during aortic cross-clamping was achieved by direct perfusion of the upper renal artery with cold lactated Ringer's solution together with topical cooling with ice slush. The patient's postoperative course was uneventful. Urinary output was satisfactory and serum creatinine level remained unchanged throughout his hospital stay. The renal preservation method used in this case was simple and effective.

Abnormalities, Multiple↗

PubMed2004

Stenosis of the abdominal aorta caused by fibromuscular dysplasia.

Fibromuscular dysplasia of the aorta is an exceedingly rare disease with 26 cases reported to date in Medline. We present a case of stenosis of the infrarenal abdominal aorta in a 49-year-old woman with a history of intermittent claudication. The patient underwent aortic endarterectomy, and subsequent anatomopathologic examination of the specimen revealed fibromuscular dysplasia. The possible causes of aortic stenosis in this case, its angiographic findings, and the alternatives of treatment are discussed.

Aorta, Abdominal↗

PubMed2003

The effects of pitch tilt on postrotatory nystagmus in cats.

When the head is tilted away from the upright position immediately after termination of earth-vertical axis (EVA) head rotation at a constant velocity, the rotation axis of postrotatory nystagmus (PRN) is gradually directed toward gravity (spatial reorientation). During roll tilt, the extent of the axis shift varies among species. In cats, the reorientation is limited to about 30-45 degrees of head tilt. In the present study, we examined features of PRN during pitch tilt in cats. The animals were rotated about EVA at a constant velocity of 100 degrees /s for 120 s. Within 2 s after stopping EVA rotation, the animals were tilted toward the pitch plane by as much as +/-90 degrees (nose-down or nose-up) in steps of 15 degrees. Eye movements were measured with 3D magnetic search coils. The angle of the PRN plane and its slow phase eye velocity (SPV) were measured. The duration of PRN decreased as pitch tilt increased regardless of whether the direction was nose-up or nose-down. The mean time constant of SPV was significantly longer for nose-up than for nose-down. PRN maintained its horizontal orientation without any vertical drift during pitch tilt, but there was little reorientation toward gravity. That is, no significant torsional component of SPV emerged to reorient the eyes according to gravity. Our results indicate that spatial reorientation depends on head orientation. For the PRN responses after pitch tilts in cats, the interactions of semicircular canal and otolith inputs in the central vestibular system might be vestigial.

Animals↗

PubMed2003

Two molecular forms of adrenomedullin in congenital heart disease.

To investigate the pathophysiological role of two forms of adrenomedullin (AM), a mature AM (AM-m) and a glycine-extended AM (AM-Gly), in congenital heart disease, we measured plasma levels of AM in patients with cyanotic heart disease, high pulmonary blood flow without pulmonary hypertension (PH), high pulmonary blood flow with PH, Fontan procedure, intracardiac repair without complication, and intracardiac repair with PH and control subjects. Plasma AM-m and AM-Gly were increased only for cyanotic heart disease (2.5 +/- 1.3 pmol/L, p < 0.001; 13.1 +/- 6.2 pmol/L, p < 0.05) and intracardiac repair with PH (2.3 +/- 1.5 pmol/L, p < 0.01; 13.0 +/- 7.0 pmol/L, p < 0.05) compared with control (1.0 +/- 1.4 and 8.6 +/- 1.3 pmol/L, respectively). They were similarly correlated with mean systemic arterial pressure (r = -0.40 and -0.37 respectively; p < 0.001), mixed venous oxygen saturation (r = -0.60 and -0.50; p < 0.0001), systemic arterial oxygen saturation (SA(sat)) (r = -0.56 and -0.46; p < 0.0001), and pulmonary arterial resistance (Rp) (r = 0.41 and 0.38; p < 0.005). Multiple regression analysis revealed that SA(sat) and Rp were independently correlated with AM. Interestingly, the venous AM-m level was significantly higher than the arterial AM-m, suggesting that the mature form is extracted in pulmonary circulation, whereas there were no venoarterial differences in AM-Gly. These results suggest that plasma AM-m and AM-Gly are similarly regulated and the main clearance site of AM-m is the lung in patients with congenital heart disease.

Adolescent↗

PubMed2003

Long-term therapeutic effects of voglibose, a potent intestinal alpha-glucosidase inhibitor, in spontaneous diabetic GK rats.

The effect of long-term (6 months) administration of voglibose in a dietary mixture (10 ppm) on intestinal disaccharidase activity was examined in non obese type 2 diabetes model Goto-Kakizaki (GK) rats. The postprandial blood glucose level in voglibose-treated GK rats was significantly lower than in untreated GK rats (190+/-19 vs. 250+/-25 mg/dl, P<0.01; 1 h, 212+/-23 vs. 256+/-20, P<0.05; 2 h), and the activities of maltase, sucrase, and isomaltase remained significantly lower throughout the 6 months of voglibose treatment. The expressions of protein and mRNA of sucrase-isomaltase (SI) complex were significantly higher in voglibose-treated GK rats. Voglibose administration then was stopped after 6 months of treatment. The mRNA level and protein level of the SI complex became normalized during the interruption of drug administration, and disaccharidase activities increased almost to the level of the untreated group 1 month after treatment was stopped. After 1 day of re-administration of the drug, however, disaccharidase activities again became significantly inhibited. These results indicate that voglibose may improve glucose tolerance since it inhibits activities of disaccharidases in spite of increasing the expression of them on intestine, furthermore voglibose may be reversible and reproducible through interruption and re-administration.

Alkaline Phosphatase↗

PubMed2003

FcgammaRIIB gene polymorphisms in Japanese periodontitis patients.

Human type II low-affinity receptor for immunoglobulin G (FcgammaRII) constitutes a clustered gene family consisting of FcgammaRIIA, IIB and IIC genes. FcgammaRIIB is unique in its ability to transmit inhibitory signals in B cells via immunoreceptor tyrosine-based inhibitory motif (ITIM). B-cell activation and subsequent elevated production of IgG are the immunopathological features of inflammatory disease such as periodontitis. To determine whether an association with periodontitis susceptibility exists, genetic polymorphisms of FcgammaRIIB were examined in Japanese patients with aggressive periodontitis (AGP) and chronic periodontitis (CP), and in the race-matched healthy controls (HCs). A significant difference was observed in the distribution of FcgammaRIIB-232I/T allele (exon 5) between the AGP and HC groups, with enrichment of the 232T in the AGP group (P=0.006). In addition, the FcgammaRIIB-nt 646-184A/G allele (intron 4) distribution was significantly different between the CP and HC groups, with enrichment of the nt 646-184A in the CP group (P=0.011). These results document the association of FcgammaRIIB gene polymorphisms with susceptibility to periodontitis in the Japanese.

Adolescent↗

PubMed2003

Changes in cerebral oxygenation in children undergoing surgical repair of ventricular septal defects.

There have been few published studies on changes in cerebral oxygenation during paediatric cardiac surgery as measured by conventional near-infrared spectroscopy. We studied changes in cerebral oxygenation in 16 children undergoing surgical repair of ventricular septal defects. Fifteen of the patients showed similar patterns of changes: brain tissue concentrations of oxyhaemoglobin decreased significantly during cardiopulmonary bypass, whereas there was no significant change in brain tissue concentrations of deoxyhaemoglobin. In the remaining patient, who suffered decreased blood flow to the lower body during surgery, the pattern of changes was different to that of the other subjects. This patient suffered postoperative respiratory and renal failure. This study suggests that conventional near-infrared spectroscopy may be useful for clinical monitoring during ventricular septal defect repair.

Analysis of Variance↗

PubMed2003

Intraoperative three-dimensional reconstruction of power Doppler vascular images.

We have developed a simple method for reconstructing a three-dimensional (3D) image in the operating room from sequentially scanned intraoperative two-dimensional (2D) power Doppler images using a personal computer and commercially available software. During three operations, 2 for cerebral aneurysm and 1 for cerebral tumor, intracranial vessel images were digitally transferred to a personal computer by freehand scanning over the dura mater or surface of the brain with a 7.5-MHz linear probe. A series of 2D images were converted to a smaller file, and 3D image was reconstructed with volume-rendering software. It took about 15 minutes to reconstruct of the initial 3D image. In the cases of cerebral aneurysm, the vessels connected to the lesion or running nearby were easily identified on the image. In the tumor case, the anatomical relation between the vascular structures and the tumor was clear. This simple 3D reconstruction method provides spatial information about intracranial vascular structures that is useful in intraoperative surgical planning.

Aged↗

PubMed2003

Microarray analysis of genes controlled by progesterone in human endometrial stromal cells in vitro.

The steroid hormone progesterone is a key factor in establishment and maintenance of pregnancy in the human endometrium. To obtain a global view and identify new target genes for progesterone in human endometrial stromal cells in short-term (3 days) culture, we used a screening strategy to analyze the expression of nearly 1000 human genes by DNA microarray analysis. The results showed that six genes were up-regulated (at least a two-fold increase), and 27 genes were down-regulated (at least a two-fold decrease) after progesterone treatment compared with control. Progesterone stimulated the expression of the interleukin (IL)-1 receptor type 1, fibulin-1, fibulin-2, microsomal glutathione S-transferase 1, fumarylacetoacetate hydrolase and orphan G protein-coupled receptor (RDC1). Progesterone inhibited the expression of insulin-like growth factor binding protein-5, heparin-binding epidermal growth factor-like growth factor, and IL-13 receptor alpha2. In addition, progesterone inhibited the expression of genes involved in immune modulators, DNA/chromatin-related proteins, signal transduction, transcription factors, transport proteins, enzyme, receptor and structural proteins. Our results demonstrate that microarray analysis can be used to identify progesterone-regulated genes in endometrial stromal cells, thus contributing to a more detailed understanding of the molecular mechanisms in response to progesterone in the endometrium during the preparatory period for implantation.

Blotting, Northern↗

PubMed2003

Prediction of functional recovery after coronary bypass surgery using quantitative gated myocardial perfusion SPECT.

Previous studies have demonstrated that myocardial perfusion imaging using 99mTc-tetrofosmin at rest allows viability assessment similar to that obtained with 201Tl imaging and 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET). The simultaneous assessment of perfusion and regional function is now available by quantitative gated myocardial perfusion single-photon emission computed tomography (SPECT). This study was designed to evaluate the utility of quantitative values of wall motion and wall thickening, calculated by quantitative gated myocardial perfusion SPECT, for the prediction of functional recovery after coronary bypass grafting (CABG). Fifty-six patients with coronary artery disease scheduled for CABG were included prospectively. All patients underwent 99mTc-tetrofosmin gated SPECT imaging at rest preoperatively and 3 months after CABG. The myocardium was divided into nine segments and the average quantitative values of regional perfusion (percentage uptake) (%), wall motion (mm) and wall thickening (%) were determined automatically using quantitative gated SPECT (QGS) software. The wall motion score was defined visually using a four-point scale (0, normal; 3, akinesis), and segments with severe asynergy (score of 2 or 3) with patent grafts were assessed. Of 77 segments with severe asynergy, 56 segments showed improved wall motion and 21 segments did not improve after CABG. The area under the receiver operating characteristic curve of wall thickening for the prediction of functional recovery was significantly higher (0.92) than that of the percentage uptake (0.77, P<0.017) or wall motion (0.60, P<0.0001). When each analysis used the optimal threshold, the wall thickening analysis (>or=10%) had a sensitivity of 95% and a specificity of 81%. These values tended to be higher than those of the percentage uptake (sensitivity, 86%; specificity, 67%). The wall motion analysis (>or=1.5 mm) had a significantly lower sensitivity of 75% and specificity of 43% than the wall thickening analysis (P=0.0038 and P=0.011, respectively). The results indicate that wall thickening, calculated by QGS software, may be more useful than regional perfusion or wall motion analysis for the prediction of functional recovery after CABG. The areas of asynergy with relatively preserved wall thickening may have the potential for improved function despite severely decreased perfusion.

Aged↗

PubMed2003

Pulmonary adenocarcinoma with osteoblastic bone metastases in a cat.

A 12-year-old male cat with depression and dyspnoea was presented for investigation. Radiography and computed tomography revealed hydrothorax and solid masses involving the sternum, ribs and thoracic vertebrae. The cat died two days after first presentation, and postmortem examination revealed lung masses and proliferative bony lesions. Histologically, a neoplastic proliferation of epithelial cells was seen in the lungs, with a large amount of collagen and deposits of cholesterin. The bone lesions were also composed of neoplastic epithelial cells and abundant calcified osteoid, without atypia. A diagnosis of pulmonary adenocarcinoma with osteoblastic bone metastases was made. This is the first reported case of osteoblastic metastases in the cat.

Adenocarcinoma↗

PubMed2003

[Infected false aneurysm due to methicillin-resistant staphylococcus aureus after proximal aortic grafting].

A 70-year-old man developed meticillin-resistant staphylococcus aureus (MRSA) mediastinitis after prosthetic graft replacement of the ascending aorta. The sternal wound was reexplored and a single-stage procedure of irrigation, debridement, and omental transposition was performed. Ten months after the first operation, he suffered recurrence of pyrexia and the presence of false aneurysm originated from the distal suture line was diagnosed by the chest computed tomography (CT) scan. Re-replacement of the ascending aorta and proximal hemiarch with rifampicin soaked Gelseal was successfully performed. Hypothermic perfusion with circulatory arrest through peripheral cannulation and left ventricular venting via a left anterior thoracotomy was useful to obtain safe reentry in the operation of retrosternal false aneurysm.

Aged↗

PubMed2003

A proposal on the hard tissue remineralization in osteoarthritis of the knee joint investigated by FT-IR spectrometry.

An investigation was performed on hard tissues of the affected area in the cases of osteoarthritis of the knee joint by using Fourier transform infrared spectroscopy (FT-IR) to obtain the information on components and characteristics of the compounds in the hard tissues at the molecular level. Biological specimens used were: normal cortical bone, normal cancellous bone, sclerotic area of the affected site (subchondral bone), osteophyte and cartilage of the affected joint. FT-IR spectra of these specimens were measured and spectroscopic characteristics of various types of hard tissues were quantified. As the result of the analysis, signal ratio of PO4(3-) to amide I (PO4(3-)/amide I) was 0 in cartilage, and the ratio was at the highest in normal cortical bone of the ulna, being as high as 1.82. The signal ratio of the sclerotic area of the affected site was 1.69, and this was higher than the values in osteophyte (1.44) or cancellous bone of the tibia (1.61). It is inferred from these data that the degree of remineralization was considerably higher in osteoarthritis of the knee joint. On the other hand, in the osteophyte, which is frequently seen in the radiography of osteoarthritis, it was 1.44 for the attached osteophyte and 1.37 for the detached osteophyte, and these values were lower compared with the values in the sclerotic area of the affected site (1.69). From these results, it appears that remineralization of mineral components is very likely to occur under the acidic conditions in the articular region in this disease. We propose that the mechanism of hard tissue formation in the knee joint of osteoarthritis is a form of remineralization.

Aged↗

PubMed2003

Autologous transplantation of peripheral blood endothelial progenitor cells (CD34+) for therapeutic angiogenesis in patients with critical limb ischemia.

AIM: Intramuscular injection of endothelial progenitor cells (EPCs) may constitute an alternative treatment strategy for patients with critical limb ischemia (CLI). We performed transplantations of EPCs (CD34(+)) extracted from peripheral blood in patients with CLI. The objective of this report is to present the method and early results of intramuscular autologous peripheral blood CD34(+) cell transplantation in the ischemic limb. METHODS: CD34(+) cell transplantation was performed in 2 limbs of 2 patients with CLI, in cases in which it was not possible to perform surgical or percutaneous revascularization. The patients received a granulocyte colony-stimulating factor (G-CSF) prior to the treatment. CD34(+) cells were retrieved from peripheral blood and injected directly into the muscle of the ischemic limb. RESULTS: CD34(+) cells retrieved in patient 1 were 1 x 10(5)/ml and in patient 2 were 1.6 x 10(5)/ml. Transcutaneous oxygen pressure in the foot increased and clinical symptoms improved. Newly visible collateral blood vessels were directly documented by angiography. CONCLUSION: Satisfactory clinical improvement was achieved by using peripheral blood EPCs (CD34(+)) in the patients with CLI. No complications arose following the intramuscular administration of peripheral blood CD34(+) cells.

Aged↗

PubMed2002

Soy product intake and serum isoflavonoid and estradiol concentrations in relation to bone mineral density in postmenopausal Japanese women.

To evaluate soy intake and serum concentrations of estradiol and isoflavonoids and their relationship to bone mineral density (BMD) and serum bone-specific alkaline phosphatase (bone ALP) activity, we conducted a cross-sectional study of 87 postmenopausal Japanese women. Soy product and isoflavone intake from soy products and intake of nutrients were assessed with a semiquantitative food-frequency questionnaire. BMD (mg/cm2) was measured by single-energy X-ray absorptiometry at the site of the calcaneus. Serum estradiol (E2) and the sex hormone-binding globulin (SHBG) were measured by radioimmunoassay. Serum genistein and daidzein concentrations were measured by a high-performance liquid chromatography MS/MS method. A statistically significant correlation was observed between the ratio of E2 to SHBG and BMD (Spearman r=0.38, p=0.0003) after controlling for age, body mass index, smoking status, age at menarche, and intake of vegetable fat, vitamin C and salt. Soy product and isoflavone intake and serum isoflavones were not significantly correlated with BMD after controlling for the covariates. Serum ALP was not significantly correlated with soy product and isoflavone intake, the E2/SHBG ratio or serum isoflavones. The present study supports the association of BMD with serum estradiol; however, it does not support the association of BMD with soy or isoflavone intake or serum isoflavone levels.

Adult↗