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Biomedical subjects

M Hayase

Publications and source records attributed to M Hayase.

At least 55 records · Page 3Linked to original sources

Microwave catheter ablation using a clinical prototype system with a lateral firing antenna design.

Microwave has been considered a potentially more effective and more versatile form of energy than radiofrequency. Its feasibility has been tested using various prototype systems and catheter designs. This study assessed the safety and efficacy of a clinically-suitable prototype microwave power supply and catheter system with a lateral-firing antenna design for atrioventricular (AV) junction ablation in canines and to correlate with tissue histopathology. The system consisted of a deflectable catheter with a 6-mm antenna and a thermocouple; and a 2.45-GHz frequency generator with power, time, and temperature controls. AV junction ablations were performed using 75 W energy for up to 60 seconds. Effective heating was confirmed by a rise in catheter temperature to 69.3 +/- 8.8 degrees C. Complete AV nodal block was accomplished in all canines after an average of 4.1 +/- 2.8 applications at 66.8 +/- 7.7 degrees C, and persisted after 28 days in all chronic animals. Lesions were consistent with thermal necrosis, were hemispherical to semi linear in shape and have distinct borders. Acute lesions were 3.4 +/- 1.5 mm wide, 4.8 +/- 2.1 long, and 2.0 +/- 0.9 deep. Chronic lesions showed typical healing and were smaller in size. Ablations did not cause any transvalvular, vascular or other cardiac structural damage, and no coagulum formation was noted on the antenna or catheter tip. Microwave AV junction ablation using this clinical prototype system specifically designed for it was safe and effective. Lesion's depth was limited to 5 mm with 60-second heating while its shape corresponded to the antenna's length. Microwave energy may provide greater versatility for producing discrete or linear ablation.

Animals↗

The arcuate nucleus as a primary site of satiety effect of leptin in rats.

The obese (ob) gene encodes a fat cell-derived circulating satiety factor (leptin) that is involved in the regulation of energy homeostasis. In the present study, we examined effects of i.c.v. injection of recombinant human leptin on food intake and body weight gain in rats. We also studied effects of direct microinjections of leptin into the arcuate nucleus (Arc), ventromedial hypothalamus (VMH), and lateral hypothalamus (LH). A single i.c.v. injection of recombinant human leptin (0.25-2.0 micrograms/rat) reduced significantly and dose-dependently food intake and body weight gain in rats. Microinjections (0.125-0.5 microgram/site) into the bilateral Arc, VMH, and LH caused dose-related decreases in food intake and body weight gain as compared with vehicle-treated groups with a rank order of potency; Arc > VMH = LH. The present study provides the first direct evidence that the Arc is a primary site of satiety effect of leptin.

Animals↗

Percutaneous method of laser transmyocardial revascularization.

Laser transmyocardial revascularization (TMR) creates conduits from the left ventricular cavity into the myocardium and has been forwarded as a potential method of perfusing ischemic myocardium. The procedure typically employs a CO2 laser to produce transmyocardial channels from the epicardial to the endocardial surface via an open thoracotomy. Preliminary studies in animals and human subjects have yielded promising results, and clinical trials evaluating the long-term efficacy of the procedure are in progress. We now report the use of a percutaneous method of TMR using a laser delivered through a novel catheter system. To assess the feasibility of performing percutaneous TMR, studies were performed on 15 adult canine subjects utilizing a holmium:YAG laser. Via a femoral artery approach, novel laser catheters were introduced into the left ventricular cavity under fluoroscopic guidance. Biplane coronary angiography, ventriculography, and transesophageal echocardiography were employed to direct catheters to specific regions and assess the efficacy of creating transmyocardial channels. Multiple channels could be created in the anterior, lateral, inferoposterior, and septal regions as demonstrated by contrast ventriculography with confirmation by subsequent gross and histologic examination. The procedure was tolerated well without any ventricular dysfunction or sustained ventricular arrhythmias. We have demonstrated that laser transmyocardial revascularization via a percutaneous approach is feasible with creation of channels from the endocardial surface of the left ventricle into the myocardium. On gross and histological examination, these channels are similar in appearance to those created by the currently employed open chest, epicardial method of TMR.

Angioplasty, Balloon, Laser-Assisted↗

Peptides derived from cardiovascular G-protein-coupled receptors induce morphological cardiomyopathic changes in immunized rabbits.

An experimental model of early-stage cardiomyopathy was created by immunizing rabbits for 1 year with synthetic peptides corresponding to the sequence of the second extracellular loop of either beta-adrenoceptors or M2-muscarinic receptors. Thirty male rabbits were used and divided into three groups: a control group (n = 10), a group immunized with the peptide corresponding to the beta-adrenoceptor (beta 1 group) (n = 10) and a group immunized with the peptide corresponding to the M2-muscarinic receptor (M2 group) (n = 10). If the sera from both groups of immunized rabbits high-titres of anti-peptide antibodies were found throughout the study period but not in the sera from control rabbits or in the preimmune sera of immunized rabbits. No significant cross-reaction with peptides other than those used for immunization was found. The myocardial receptor density of both immunized groups displayed a strong trend toward receptor up-regulation. This was significant in the beta 1 group but not in the M2 group. Both groups of immunized rabbits displayed significantly enlarged ventricles and thinner walls, as compared with the control group. However, in contrast to the beta 1 group, which showed enlarged cavities in both left and right ventricles, the M2 group was mainly affected in the right ventricles. Moreover, morphological examinations of the hearts of rabbits from both immunized groups demonstrated focal myofibrillar lysis, loss of myofilament, mitochondrial swelling and condensation, sarcoplasmic vacuolation, deposition of dense granules in the sarcoplasm and the myofibrils. One of the sex control rabbit hearts which were examined showed mild degenerative changes in the myocardium and scant mononuclear cell infiltration. However, when all the control rabbit hearts were examined by electron microscopy, no significant alterations were found. These results suggest that immunization by peptides, corresponding to the target sequences for anti-receptor autoantibodies in idiopathic dilated cardiomyopathy, induces morphological changes in the heart similar to those found in the human disease.

Amino Acid Sequence↗

Pathophysiological significance of the obese gene product, leptin, in ventromedial hypothalamus (VMH)-lesioned rats: evidence for loss of its satiety effect in VMH-lesioned rats.

To explore the pathophysiological significance of the obese (ob) gene product, leptin, in ventromedial hypothalamus (VMH)-lesioned rats, we examined the synthesis and secretion of leptin and its satiety effect in VMH-lesioned rats compared with those in sham-operated rats. Northern blot analysis revealed that ob gene expression is markedly augmented in the mesenteric and sc white adipose tissue, but remained unchanged in the epididymal white adipose tissue during the development of obesity in VMH-lesioned rats. Plasma leptin levels were relatively constant in sham-operated rats, but were elevated during the development of obesity in VMH-lesioned rats. In sham-operated rats, a single i.v. (1.0 mg/rat) or intracerebroventricular (2.0 micrograms/rat) injection of recombinant human leptin reduced food intake and body weight gain in sham-operated rats. By contrast, no significant effect on food intake or body weight gain was observed in VMH-lesioned rats. The present study provides evidence that VMH-lesioned rats overproduce leptin and increase its release but cannot respond to it and suggests that the loss of its satiety effect contributes to the development of obesity and the obesity-related phenotypes in VMH-lesioned rats.

Animals↗

Regulation of obese gene expression in KK mice and congenic lethal yellow obese KKAy mice.

To elucidate the regulation of obese (ob) gene expression in obesity and diabetes, we examined ob gene expression in KK mice and congenic lethal yellow obese KKAy mice. Northern blot analysis revealed that the ob mRNA levels are roughly equivalent in each of the epididymal, mesenteric, and subcutaneous white adipose tissue (WAT) from KK and KKAy mice at 4 wk of age, when the obese phenotype of KKAy mice was not apparent. Expression of the ob gene was augmented in the mesenteric and subcutaneous WAT but was unchanged in the epididymal WAT in KKAy mice at 12 wk of age, when KKAy mice developed marked obesity with hyperglycemia, hyperlipidemia, and hyperinsulinemia. The ob gene expression was also examined during fasting in 12-wk-old KK and KKAy mice. After 24 or 72 h of fasting in both mouse strains, ob gene expression was downregulated in the epididymal and mesenteric WAT but was unchanged in the subcutaneous WAT. The present study demonstrates that adipose tissue expression of the ob gene is regulated depending on the nutritional status in KK and KKAy mice.

Animals↗

[Acute lupus pneumonitis presenting as multiple nodular shadows].

A 24-year-old woman consulted a physician because of fever, dry cough, and arthralgia of one month duration. She was transferred to our hospital for more detailed examination of pancytopenia and diffuse infiltrative shadows on a chest X-ray film. On admission she was depressed, and had oral ulcers. Pleural and pericardial effusions were observed. Laboratory studies were positive for anti-nuclear antibody, anti-DNA antibody, and lupus erethymatosus. Casts were found in the urine, and systemic lypus erythematosus was diagnosed. Chest radiography and CT scan showed nodular shadows in the right S8 (2nodules with 1 cm diameter)(1 cm x 2), right S10 (0.5 cm diameter), and left S8 (0.5 cm diameter) regions, as well as diffuse infiltrative shadows in both lower lung fields. A specimen obtained by transbronchial lung biopsy revealed acute interstitial pneumonia with arteritis. After treatment with prednisolone (60 mg/day), the nodular and infiltrative shadows rapidly disappeared. Cases of lupus pneumonitis presenting as nodular shadows are very rare and are valuable in diagnostic imaging.

Acute Disease↗

[Pulmonary non-Hodgkin's lymphoma that arose in mucosa-associated lymphoid tissue of the salivary gland and was diagnosed at autopsy].

A 70-year-old woman complained of a dry mouth and swelling in the area of the left parotid gland for 6 years, and was admitted for evaluation of an abnormal shadow on chest X-ray film. She underwent a lip biopsy and a 99mTcO4- scintigram of the salivary gland, and Sjögren's syndrome was diagnosed. Histopathological examination of the percutaneous lung biopsy specimen showed pseudolymphoma, and examination of a specimen of the left parotid gland tumor showed myoepithelial sialadenitis. The patient died of respiratory failure due to a right pleural effusion 4 years later. Autopsy revealed pulmonary non-Hodgkin's lymphoma (diffuse, large, B cell, IgG) with monotonous infiltration of centrocyte-like cells. A retrospectively resected specimen of the left parotid gland tumor showed non-Hodgkin's lymphoma similar to that found in the autopsied lung. This patient probably had pulmonary non-Hodgkin's lymphoma that arose in mucosa-associated lymphoid tissue of the salivary gland and was associated with Sjögren's syndrome.

Aged↗

[Spontaneous coronary artery dissection: a case report and a review of literature].

Operative cases of spontaneous coronary artery dissection have rarely been reported. We report an operative case of spontaneous right coronary artery dissection. The patient was a 60-year-old man with a history of angina pectoris. A selective coronary angiography demonstrated the dissection of right coronary artery #2-#3 and the stenosis in both 4 postero-lateral branch and left anterior descending artery. He was successfully managed with aorta-coronary bypass. Postoperative coronary angiography revealed the existence of dissecting lesion, however the native RCA flow was improved.

Aortic Dissection↗

Gastric acid secretion and lesion formation in rats under water-immersion stress.

In attempts to investigate the roles of acid in the pathogenesis of stress-induced gastric lesions, gastric acid secretion was studied in pylorus-ligated and lumen-perfused rats under restraint alone (R) or restraint with additional water immersion (WI). Gastric mucosal blood flow (GMBF) was measured with the aminopyrine clearance method in acute fistula rats. Acid secretion in pylorus-ligated rats significantly decreased under R or WI of either 3.5 or 7 hr stress. In the lumen-perfused or acute-fistula rats, exposure of rats to stress for 7 hr produced a similar decrease; however, in the WI group, there was a significant increase of acid secretion for 3-4 hr during stress, but not exceeding the prestress level. Only in the WI group did GMBF exhibit similar increases to those of acid secretory activity, and these increases were significantly inhibited by intraperitoneal administration of atropine (1 mg/kg) or cimetidine (60 mg/kg). Gastric lesions developed in both groups at 3.5 hr and became extensively severe at 7 hr only in the WI group. Cimetidine failed to influence the formation of lesions at 3.5 hr but significantly inhibited the later outgrowth of lesions at 7 hr, while atropine or pylorus ligation all but completely prevented lesions induced by either 3.5- or 7-hr WI stress. These results indicate that exposure of rats to stress (R or WI) generally decreased acid secretory activity, but there was a rise in acid secretion toward normal levels during WI stress, which may play an important role in the aggravating process of stress-induced gastric lesions.

Animals↗

Isolation of Clostridium absonum and its cultural and biochemical properties.

A new procedure for isolation of Clostridium absonum was devised. Sixtyseven strains of C. absonum were isolated from 135 soil samples, but no strain of C. absonum could be found from human fecal samples. The lecithinase, hemolysin, and lethal toxin in the culture filtrates of this species exhibited low avidity for C. perfringens type A antitoxin. The three activities were inseparable by the present method of purification. A reinvestigation of biochemical properties revealed that incomplete suppression of lecithinase reaction by C. perfringens type A antitoxin and no fermentation of raffinose, melibiose, and starch are useful criteria to differentiate C. absonum from C. perfringens, and that positive, although weak, gelatin liquefaction and fermentation of trehalose are useful to differentiate it from C. paraperfringens.

Antitoxins↗