Biomedical subjects

M Ikegami

Publications and source records attributed to M Ikegami.

At least 181 records · Page 10Linked to original sources

PubMed1995

[Clinical study on cerebrovascular diseases after renal transplantation].

Between October 1975 and December 1994, 131 renal transplants were performed on our hospital. Eight of these patients had 9 cerebrovascular diseases, which were 2 cerebral hemorrhages, 5 cerebral infarctions, 2 subarachnoid hemorrhages. Five of the 8 patients whose graft functions were bad died. We studied the relationship of the incidence of these complications to some factors as follows; 1) blood pressure, 2) hypercholestemia, 3) duration of hemodialysis, and 4) graft function. The cerebrovascular diseases after renal transplantation were related to the hypertension after renal transplantation and no correlation with the other factors could be found. Therefore, we think that the control of the hypertension after renal transplantation is the most important for the cerebrovascular diseases and the patient's prognosis.

Adult↗

PubMed1995

[Clinical statistics of 67 cadaveric renal transplantation at the Department of Urology, Kinki University School of Medicine].

A statistic survey was made on the patients undergoing cadaveric renal transplantation between June, 1980 and December, 1993. The total number of patients was sixty-seven. The number of patients per year increased annually. The graft survival rate was 73.8% at 1 year and 63.1% at 5 years. Some transition was seen in immunosuppressive regimens using cyclosporin.

Adolescent↗

PubMed1994

Phosphorylation of dynamin by cdc2 kinase.

A 100kD microtubule-bundling protein dynamin was phosphorylated in vitro by cdc2 kinase to approximately 1 mol of phosphate/mol of dynamin at a serine residue. These phosphorylations of dynamin greatly reduced its binding ability to microtubules.

Animals↗

PubMed1994

Effects of propranolol on gastric mucosal perfusion and serum gastrin level in cirrhotic patients with portal hypertensive gastropathy.

Gastric mucosal hyperemia associated with elevated serum gastrin level has been suggested in cirrhotic patients with portal hypertensive gastropathy (PHG). Clinical evidence has shown that these patients may benefit from propranolol administration. The aim of this study was to investigate effect of propranolol on gastric mucosal perfusion and serum gastrin level in cirrhotic patients with portal hypertensive gastropathy. Gastric mucosal perfusion was assessed by laser Doppler flowmetry. Measurements were performed under basal conditions and after observer-blind administration of propranolol (30-60 mg/day, N = 9) or placebo (N = 9) for seven days. Placebo had no effect on either gastric mucosal perfusion or serum gastrin level. In contrast, propranolol administration significantly decreased both antrum gastric mucosal perfusion (from 0.88 +/- 0.28 to 0.73 +/- 0.26 V, P < 0.05) and corpus gastric mucosal perfusion (from 0.94 +/- 0.35 to 0.78 +/- 0.25 V, P < 0.05). However, this drug had no effect on serum gastrin level. We conclude that chronic propranolol administration in cirrhotic patients with portal hypertensive gastropathy may reduce gastric mucosal perfusion without changing serum gastrin level.

Double-Blind Method↗

PubMed1994

Wedged hepatic venous pressure reflects portal venous pressure during vasoactive drug administration in nonalcoholic cirrhosis.

Hepatic venous catheterization is widely used to assess portal pressure. However, it remains unclear whether wedged hepatic venous pressure is a close indicator of portal venous pressure during vasoactive drug administration in nonalcoholic cirrhosis. To address this issue, we analyzed the data from our previous published studies. Forty patients with nonalcoholic cirrhosis (HBV infection in five, HCV infection in 28, and cryptogenic in seven) were available in this analysis. A vasoconstrictor (N = 14), vasodilator (N = 10), or combination (N = 16) was administered. The agreement of the changes between portal and wedged hepatic venous pressures during pharmacological manipulation was assessed by an intraclass correlation coefficient. The intraclass correlation coefficient in each subgroup was more than 0.60 (0.62 in vasoconstrictor group, 0.87 in vasodilator group, and 0.73 in combination group). When the analysis was performed according to the cause of liver disease, the values were 0.67 in HBV infection, 0.73 in HCV infection, and 0.74 in cryptogenic cirrhosis. These results suggest that wedged hepatic venous pressure reflects portal venous pressure during vasoactive drug administration in patients with nonalcoholic cirrhosis.

Female↗

PubMed1994

Catecholamine response to ultrasonographically guided percutaneous blood sampling in fetal sheep.

OBJECTIVE: The purpose of this study was to investigate the fetal catecholamine and arterial blood gas responses to ultrasonographically guided percutaneous needle aspiration of blood from a fetal cardiac ventricle. STUDY DESIGN: A crossover trial design was used. Nine pregnant sheep of 120 to 130 days' gestation were stratified to either percutaneous fetal blood sampling or a sham experiment performed on the first day, and the alternative study on the following day. Arterial blood samples were withdrawn from chronically implanted catheters. RESULTS: Percutaneous fetal blood sampling caused small but statistically significant increases in mean plasma epinephrine and norepinephrine levels 5 seconds after the procedure. Levels thereafter were similar to baseline values. Arterial pH and PCO2 values were unaltered except in one fetus, where blood sampling was followed by bradycardia with acidosis and elevated catecholamine levels. CONCLUSIONS: Ultrasonographically guided percutaneous fetal blood sampling from a cardiac ventricle in sheep produces a rise in catecholamine levels that return to baseline values within 5 minutes. This technique provides an alternative to chronic catheterization for some experiments in which blood sampling or drug injection is required. The results also indicate that needle insertion produces only a modest and transient stress response in the fetus.

Animals↗

PubMed1994

Portal pressure after prophylactic sclerotherapy in patients with high-risk varices.

Portal hemodynamics and transhepatic portal venographic findings were studied before and after prophylactic sclerotherapy (mean duration = 40 +/- 14 days) in 16 patients with high-risk esophageal varices. Portal pressure, evaluated by the portal venous pressure gradient, increased by a mean of 21% in eight patients (50%) and decreased by a mean of 20% in eight patients (50%) with no statistically significant change overall. The two groups were further analyzed separately to identify the mechanism of the change in portal pressure. Intrahepatic vascular resistance did not change significantly in either group. However, the prevalence of extravariceal portosystemic shunts was greater in patients with decreased portal pressure than in those with increased portal pressure (88% vs. 25%, p < 0.05). Further, the enlargement of extravariceal portosystemic shunts was more marked in patients with decreased portal pressure than in those with increased portal pressure (88% vs. 0%, p < 0.01). In addition, liver function, assessed by intrinsic clearance, was not modified in the two groups. We conclude that prophylactic sclerotherapy increases or decreases portal pressure without modifying liver function. Although the mechanism of these portal pressure changes is not clear, intrahepatic vascular resistance does not play an important role and the presence of extravariceal portosystemic shunts may prevent further increases in portal pressure.

Esophageal and Gastric Varices↗

PubMed1994

Ontogeny and effects of exogenous surfactant treatment on SP-A, SP-B, and SP-C mRNA expression in rabbit lungs.

The aims of the present study were to first characterize the ontogeny of mRNAs encoding the principal surfactant proteins SP-A, SP-B, and SP-C in rabbit lung tissues, followed by an evaluation of the effect of exogenous surfactant administration on endogenous expression of mRNA levels. Lung tissues were collected from New Zealand White rabbits on days 19, 21, 24, 26, 28, 30 of gestation, 1 day and 10 days after birth, and as adults. SP-A, SP-B, and SP-C mRNAs were first detected on gestational days 26, 24, and 19, respectively. The specific levels of these mRNAs generally increased to gestational day 28 and decreased transiently on 1 day of life. Adult values remained lower than those noted at 30 days gestation. For the second study, 29-day-gestation preterm rabbits were given either one or two treatment doses of natural surfactant or an organic solvent extract of natural surfactant, and mRNA levels were measured 10 or 24 h later. No effect of surfactant treatments, type of surfactant, or dosage (1 or 2 treatments) was noted on SP-A, SP-B, or SP-C mRNA expression. These data indicate that the mRNA expression for the three major surfactant proteins was highest late in gestation in developing rabbits and that exogenous surfactant treatment was not associated with significant changes in SP-A, SP-B, or SP-C mRNA levels.

Animals↗

PubMed1994

Distribution of surfactant and ventilation in surfactant-treated preterm lambs.

Surfactant-deficient ventilated preterm lambs were treated with 100 mg/kg of surfactant radiolabeled with microspheres at 30 min and 2.5 h of age to evaluate the effect of treatment technique on surfactant distribution. The treatments were four positions with four boluses (bolus 4), two lateral positions with two boluses (bolus 2), or a 30-min infusion (infusion). The bolus groups had uniform surfactant distributions to the > 100 pieces analyzed for each lung. Infusion resulted in a very nonuniform surfactant distribution (P < 0.01). Surfactant was recovered equivalently in all lobes of the bolus groups, whereas infusion lungs contained surfactant preferentially in upper lobes (P < 0.01). The second dose of surfactant localized into the same lung doses as the first dose (P < 0.001). Blood flow increased proportionately to surfactant content in the bolus groups. With infusion, blood flow decreased and ventilation measured with 99Tc-labeled aerosol increased to pieces of lung receiving large amounts of the infusion surfactant, suggesting that localized overinflation was likely. Physiological measurements indicated better responses to bolus treatments, although the infusion lambs did improve. These results indicate that different treatment techniques can have large effects on surfactant distributions.

1,2-Dipalmitoylphosphatidylcholine↗

PubMed1994

Developmental changes of sheep surfactant: in vivo function and in vitro subtype conversion.

Developmental differences in the intrinsic characteristics of surfactant have not been evaluated. Therefore, heavy-subtype surfactant was recovered from alveolar washes of 132-, 139-, and 148-day preterm lambs, 2- to 3-day-old newborn ventilated lambs, and adult sheep. The density of heavy-subtype surfactant and surfactant protein-A-to-saturated phosphatidylcholine ratios increased significantly with developmental age. In contrast, percent conversion from heavy to light surfactant forms was more rapid for surfactant from preterm animals than for surfactant from mature or adult animals. The function of the heavy-subtype surfactant was tested by treating ventilated 27-day gestational age preterm rabbits. The surfactant from the most immature animals was less effective at improving compliance or maintaining lung volumes on deflation than was surfactant from newborn or adult animals. These results demonstrate intrinsic and functional differences in surfactant from developing compared with mature sheep that correlated with the surfactant protein-A-content. The pattern of changes indicates that the preterm animal is at a disadvantage, because the surfactant is intrinsically abnormal relative to that of the adult.

Aging↗

PubMed1994

Lung parenchyma and type II cell morphometrics: effect of surfactant treatment on preterm ventilated lamb lungs.

The effect of exogenous surfactant treatment on lung and type II cell structure of ventilated lambs of 137-138 days gestational age was studied. Thirty-four lambs were delivered and randomized to control or 100 mg/kg of natural sheep surfactant treatment groups. Lungs from one group of lambs not treated with surfactant were fixed before ventilation, and the other animals were ventilated to maintain normal blood gas values for 3, 24, or 48 h. Morphometric assessment of the inflation-fixed lung parenchyma of ventilated lungs was compared with the architectural appearance of alveoli and alveolar ducts in the unventilated lungs. Mechanical ventilation resulted in distension of alveolar ducts accompanied by the shallowing and loss of well-defined alveoli and areas of atelectasis at 3 h. These abnormalities increased in severity after 24 and 48 h of ventilation. Surfactant treatment before ventilation significantly reduced the extent and degree of dilatation and concomitant atelectasis. The fraction of normal parenchyma was 38 +/- 7% in untreated lambs vs. 64 +/- 6% in treated lambs after 24 h of ventilation. After 48 h of ventilation, significant differences between control (39 +/- 6%) and surfactant-treated (55 +/- 6%) lambs were still evident. Alveolar type II cells contained approximately 15% lamellar bodies by volume. Neither surfactant treatment nor time of ventilation altered the volume density of lamellar bodies or other organelles, except for a decrease in glycogen from 8% in nonventilated lungs to 2.5% in lungs ventilated for 24 h. These findings indicate that a surfactant treatment at birth results in the maintenance of more normal parenchyma with less atelectasis during prolonged ventilation of the immature lung.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Surfactant subtypes. In vitro conversion, in vivo function, and effects of serum proteins.

Surfactant in the alveolar space can be separated into heavy and light subtypes by differential centrifugation or on isopyknic sucrose density gradients. The conversion from heavy subtypes to light subtypes occurs in vitro by surface-area cycling. However, the function of light subtypes made by cycling and substances that might influence in vitro conversion have not been evaluated. Therefore, we compared the in vivo function of the heavy and light subtypes isolated from rabbit surfactant and similar density fractions prepared in vitro by surface-area cycling. We then asked if serum, globulin, or albumin would alter the in vitro conversion. The function of surfactant fractions was studied in vivo by treating surfactant-deficient 27 d gestational age preterm rabbits with 50 mg/kg of heavy or light subtype surfactant. Dynamic compliance values and lung volumes from PV curve measurements showed that heavy subtypes had superior in vivo function compared with light subtypes independent of in vivo or in vitro sources (p < 0.01). Light subtypes prepared in vitro lost surfactant function and were similar to in vivo light forms. When serum proteins were added to the heavy subtype surfactant, the conversion rate from heavy to light subtypes was accelerated. Serum accelerated conversion more than globulin, and the serine proteinase inhibitor diisopropylfluorophosphate blocked the conversion. Albumin had no significant effect. The increased rate of conversion caused by serum identifies a new mechanism for surfactant inactivation that could occur with lung injuries associated with increased alveolar protein.

Animals↗

PubMed1994

Time course of changes in lung mechanics following fetal steroid treatment.

We studied the effect of a single-dose, corticosteroid treatment on preterm lambs (gestational age: 128 d). A low, medium, or high betamethasone dose (0.1, 0.5, and 2.0 mg/kg) or saline control was administered directly to the fetus by ultrasound-guided intramuscular injection 48 h before delivery. A second group received either the high dose of betamethasome or saline 24 h before delivery. The lambs were delivered at 128 d gestation, anesthetized with ketamine, and ventilated for 50 min. Respiratory system elastance and resistance were measured at 10-min intervals using multiple linear regression analysis of pressure, flow, and volume. Similarly, estimates of lung mechanics were calculated from transpulmonary pressure. The viscoelastic time constant (tau) was calculated by fitting an exponential to the pressure changes occurring after occluding the airway during expiration. Excised lung volume at 40 cm H2O and lung weight were used to calculate specific elastance and resistance correcting for lung size using volume or weight, respectively. Of the 13 lambs in the 48-h high-dose betamethasone group, five developed pulmonary interstitial emphysema (PIE) as did 3 of 11 animals in the high-dose group treated 24 h before delivery. These animals were analyzed separately. The lambs receiving medium- or high-dose (24 and 48 h predelivery) betamethasone had significantly lower elastance and a trend toward lower resistance when compared with the control groups. Ten minutes after delivery, the animals that developed PIE all had elastance values comparable to that of the control animals despite corticosteroid treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

PubMed1994

In vivo function of surfactants containing phosphatidylcholine analogs.

Increased phospholipase A2 activity demonstrated in some forms of lung injury may contribute to surfactant dysfunction. Phospholipase A2-resistant analogs of dipalmitoylphosphatidylcholine (DPPC) with surfactant properties might therefore be useful lipid components of treatment surfactants for certain lung injuries. The in vivo function of surfactants containing DPPC or the phospholipase-resistant analogs dihexadecylphosphatidylcholine (DEPC) or dihexadecylphosphonotidylcholine (DEPnC), with or without surfactant proteins B and C (SP-B+C), was thus evaluated in preterm rabbits (27 days' gestation). Rabbits randomly received one of seven surfactants (DPPC, DEPC, DEPnC, DPPC+SP-B+C, DEPC+SP-B+C, DEPnC+SP-B+C, or lipid extract surfactant [LES]) or 0.45% NaCl (control) and were ventilated for 30 min. Lipid-only surfactants decreased ventilatory pressures (peak inspiratory pressures minus positive end-expiratory pressure) relative to control (p < 0.05). Addition of SP-B+C further decreased ventilatory pressures to levels similar to LES (p < 0.01 versus control, lipid-only surfactants). Lung dynamic compliances and postventilation pressure-volume curves improved in the following order: LES, SP-B+C lipid surfactants > lipid-only surfactants > control (p < 0.05). All surfactant preparations decreased intravascular 125I-albumin recoveries in the lungs relative to control (p < 0.01 for all surfactants versus control). These results indicate that DEPC and DEPnC were as effective as DPPC as lipid components of synthetic surfactants. And like DPPC, the analogs interacted with isolated SP-B+C and improved in vivo function to levels comparable to LES.

Animals↗

PubMed1994

Surfactant protein A labeling kinetics in newborn and adult rabbits.

Surfactant protein A (SP-A), the major hydrophilic protein specifically associated with surfactant, has multiple metabolic and host defense functions as well as primary surfactant biophysical functions in association with the other surfactant proteins and lipids. To characterize its kinetics of secretion and clearance from the airspace, we measured specific activity-time curves for alveolar and lamellar body associated SP-A following the intravascular and/or intratracheal administration of the radiolabeled precursors Tran 35S-label containing primarily methionine and cysteine or [3H]methionine to newborn and adult rabbits. Alveolar SP-A specific activity peaked 30 min after precursor injection in both newborn and adult rabbits, and labeled SP-A was not detected in lamellar bodies until after 2 h. In newborns, a second peak of labeled SP-A appeared at 15 h. In both newborns and adult rabbits, lamellar body specific activity-time curves were most consistent with SP-A entering lamellar bodies via a recycling pathway from the airspaces. The airspace clearance of SP-A in adult rabbits had a biologic half-life of about 4.5 h. There was very little decrease in SP-A specific activity in the newborn rabbits, indicating minimal catabolism. These studies demonstrate secretion of endogenously synthesized SP-A by a pathway separate from lamellar bodies. The kinetics of secretion of SP-A and the surfactant phospholipid in newborn and adult rabbits indicate separate metabolic pathways.

Animals↗

PubMed1994

Changes in alveolar surface area, surfactant protein A, and saturated phosphatidylcholine with postnatal rat lung growth.

Most previous studies of the relationship between surfactant and growth have correlated surfactant pool size with lung weight or body weight. We asked how the quantities of the surfactant components surfactant protein A (SP-A) and saturated phosphatidylcholine (Sat PC) recovered by alveolar wash changed with age in relationship to morphologic measurements of alveolar surface area in rats. We also calculated SP-A and Sat PC in total lung per surface area. In groups of three to 14 rats studied on d 1, 7, 14, 21, 50, and 100 of age, the ratio of alveolar surface area to body weight was highest at d 14 and lowest at d 100. Alveolar and total lung SP-A and Sat PC were higher relative to body weight and surface area on d 1 than at all other ages. Alveolar and total lung SP-A peaked relative to surface area at d 21 and subsequently decreased significantly at d 100. The alveolar Sat PC to surface area ratio also was highest at d 21 and decreased significantly at d 50 and 100. The SP-A to Sat PC ratio in alveolar washes was not constant across this age range, being highest at d 21 and 50. These measurements demonstrate age-dependent changes in alveolar and total lung SP-A and Sat PC in the rat that continue beyond the newborn period.

Age Factors↗

PubMed1994

[A case of 48 XXYY Klinefelter's syndrome].

We observed a patient with 48 XXYY Klinefelter syndrome who visited our hospital because of a short penis as chief complaint. The patient was a 21-year-old, tall and obese man. He had gynecomastia. The penis was short and bilateral testes were underdeveloped. Endocrinologically the LH and FSH showed high level and the testosterone was low. A diagnosis of very rare 48 XXYY Klinefelter was made based of the chromosomal analysis.

Adult↗

PubMed1994

[Clinical statistics on patients operated at the Department of Urology, Kaizuka Municipal Hospital during ten years (from 1983 to 1993)].

A statistic survey was made on the patients undergoing operations between July, 1983 and June, 1993. The total number of patients was 1780, comprising 1469 males and 311 females. The most frequent organ was the prostate with 526 cases (29.6%), followed by 415 (23.3%) penile and scrotum cases, and 290 (16.3%) bladder cases. Major operations were transurethral resection of prostate (418 cases) and bladder tumor (191 cases).

Adult↗