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Biomedical subjects

M Kitamura

Publications and source records attributed to M Kitamura.

At least 271 records · Page 15Linked to original sources
PubMed1995

Dissimilarities between cholinergic and dopaminergic turning elicited by nucleus accumbens stimulation in freely moving rats.

Contralateral turning was produced by unilateral injection of carbachol (0.5, 2.5, 5 micrograms) into the nucleus accumbens, but not into the dorsal or ventral striatum. This behaviour was inhibited by muscarinic M1 acetylcholine receptor blockade in the nucleus accumbens, and less effectively by blockade of muscarinic M2 and nicotinic acetylcholine receptors. Unilateral injection of a mixture of the dopamine D1 receptor agonist 1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepine-7,8-diol (SKF 38393, 5 micrograms) and the dopamine D2 receptor agonist quinpirole (10 micrograms) also produced contralateral turning. The stepping pattern, however, completely differed from that induced by carbachol. The number of carbachol-induced turnings was reduced by dopamine D1 or D2 receptor blockade (8-chloro-2,3,4,5-tetrahydro-3-methyl-5-phenyl-1H-3-benzazepine-7-ol (SCH 23390) and l-sulpiride, respectively) in the nucleus accumbens. However, the reduction was due to a change in the turning pattern. Blockade of muscarinic acetylcholine receptors in the nucleus accumbens did not change the contralateral turning induced by unilateral injection of dopamine receptor agonists into the nucleus accumbens. The results demonstrate that there is no functional interaction between the cholinergic and dopaminergic substrates involved, although blockade of the dopamine receptors elicited behavioural deficits that competed with the turning elicited by carbachol. The contralateral turning elicited by carbachol injection into the nucleus accumbens requires an intact dopamine activity at the level of dopamine D1 and D2 receptors in the ipsilateral, but not contralateral, ventrolateral striatum.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
PubMed1995

Lesser sac herniation through the greater omentum and gastro-pancreatic ligament: report of a case.

We report herein the case of a woman who developed a lesser sac hernia which was especially unusual in that the small bowel prolapsed through a defect in the greater omentum and was thereafter strangulated by a hole in the gastro-pancreatic ligament. The gastro-pancreatic ligament has never before been documented as causing an internal hernia. In our patient, a plain abdominal X-ray demonstrated as soft-tissue mass displacing the stomach to the left while abdominal computed tomography and ultrasonography showed a sac-like encapsulation of the small bowel loops between the liver and stomach. Careful evaluation of these radiographic findings allowed for the preoperative diagnosis of a lesser sac hernia to be made.

Adult↗
PubMed1995

Detection of aberrations in androgen receptor gene by analysis of single-stranded conformation polymorphisms in polymerase chain reaction products.

Analysis of single-stranded conformation polymorphisms in polymerase chain reaction (PCR) products (PCR-SSCP) is a sensitive method for detecting point mutations in genomic DNA. To investigate its utility in examining the androgen receptor gene, we analyzed data on a patient with the testicular feminization syndrome (TFS) with a known point mutation in exon C. We detected mobility shifts of fragments of the corresponding region. Since examination of the subject's brother (legally sister), who also has TFS, revealed an identical shift pattern, we sequenced the exon C of the sibling and detected a mutation identical to that in the former. We conclude that PCR-SSCP is available for screening mutations of the androgen receptor gene.

Adult↗
PubMed1995

Long-term results of aortic valve translocation for mycotic periannular abscess: comparative study of Danielson's original method and our threadless method.

Between June, 1983, and October, 1992, we performed Danielson's original translocation method in four patients (group I) and our translocation method in seven patients (group II), for the treatment of active periannular abscess. There were no perioperative or hospital deaths in either group. The long-term results of these two groups are compared in this report. There were four late deaths (mortality rate 100%) in group I, and three late deaths (mortality rate 43%) in group II. The causes of death were cardiac in six patients and noncardiac in one patient. Vein graft failure occurred in one group I patient (25%) and in two group II patients (28%). Rupture or aortic pseudoaneurysm formation occurred in three group I patients (75%). These findings suggest that our threadless method may be superior to Danielson's original translocation method. Therefore, with close observation, especially of saphenons vein great (SVG) failure, arterial graft use could be acceptable for translocation.

Abscess↗
PubMed1995

Operation for type A aortic dissection: introduction of retrograde cerebral perfusion.

Circulatory support during operation for type A aortic dissection is controversial among many medical centers. In the last 21 years, 100 patients with type A aortic dissection underwent 102 operations including 2 reoperations, and 29 patients showed Marfan's syndrome. During operation, no cerebral perfusion technique was used through February 1985 (period I), antegrade cerebral perfusion was applied since March 1985 (period II), and retrograde cerebral perfusion was introduced in November 1990 (period III). Surgical results were compared among these subgroups. Operative mortality was 12.1% in 33 chronic and 57.1% in 7 acute patients in period I, 11.1% in 27 chronic and 54.5% in 11 acute patients in period II, and 6.7% in 15 chronic and 0% in 9 acute patients in period III (period II versus III; p = 0.04). Retrograde cerebral perfusion decreased permanent brain complications. The 5-year actuarial survival was 59.7% in period I and 63.2% in period II (not significant), and the 3-year survival of period III was 91.7%. Actuarial survival of period III was significantly higher than those of periods I and II (p < 0.05). Surgical repair of aortic arch with cerebral perfusion techniques reduced the residual aneurysms. These results show that surgical results of type A aortic dissection in this series improved with the introduction of retrograde cerebral perfusion and extended surgical procedures.

Adult↗
PubMed1995

Operation for type B aortic dissection: introduction of left heart bypass.

Various support techniques for surgical treatment of type B aortic dissection have been used and recommended in many medical centers. In the last 21 years, 55 patients with type B aortic dissection underwent 65 operations including 10 reoperations, and 10 cases showed Marfan's syndrome. As circulatory support during operation, venoarterial bypass mainly was used until March 1987 (period I) and low-dose heparinized left heart bypass was applied since April 1987 (period II). Surgical results were compared among subgroups by the Kaplan-Meier actuarial method and Cox-Mantel statistical analysis. After the operation, early mortality was 27.3% in 33 patients in period I and 9.4% in 32 patients in period II (p = 0.06). The incidence of fatal hemorrhagic complications was decreased significantly by using the left heart bypass technique (p < 0.02). The 5-year actuarial survival of type B dissection was 60.6% in period I and 79.2% in period II (p = 0.07). These results suggest that surgical results of type B aortic dissection in this series might be improved with the introduction of left heart bypass and extended surgical procedures.

Adult↗
PubMed1995

Long-term results of coronary artery bypass grafting in elderly Japanese patients.

BACKGROUND: This study was undertaken to examine long-term results of coronary artery bypass grafting in elderly Japanese patients. METHODS: Of 1,425 coronary artery bypass grafting patients over the last 13 years, 137 patients were 70 or more years old and 1,288 were less than 70 years old. Mean number of distal anastomoses was similar in both groups. Postoperative survival and event-free proportion were estimated by the Kaplan-Meier actuarial method and compared among the groups by Cox-Mantel statistical analysis. RESULTS: Operative mortality and the incidence of late cardiac death after coronary artery bypass grafting were equivalent between the elderly and younger groups, although the rates of left main trunk disease, acute myocardial infarction, and emergency operation in the elderly group were significantly higher than those in the younger group. Coronary artery bypass grafting in elderly patients had a relatively high hospital mortality and more late noncardiac deaths, but the incidence of postoperative cardiac intervention in elderly patients was lower than that in younger patients. CONCLUSIONS: These results suggest that coronary artery bypass grafting for elderly patients is encouraged as well as is that for younger patients in a representative Japanese population.

Actuarial Analysis↗
PubMed1995

Left ventricular function on exercise after surgical treatment of small aortic annuli.

To evaluate left ventricular function during exercise after aortic annular enlargement 15 patients with either aortic (group I, n = 8) or aortomitral (group II, n = 7) annuloplasty for small aortic annuli and eight patients (group III) with standard valve replacement for aortic stenosis without small aortic annuli received gated cardiac pool imagining by technetium-99m-labelled red blood cells at rest and during exercise at a mean of 23 months after operation. Left ventricular ejection fraction, preload requitable stroke work and stroke power index (preload requitable stroke work/systolic ejection period) were measured. Compared with resting values, left ventricular performance and stroke work rate on exercise after aortic annular enlargements increased significantly, as did those after standard aortic valve replacement. These results suggest that aortic annular enlargement can be indicated for surgical treatment of valvular heart diseases associated with small aortic annuli.

Adult↗
PubMed1995

Medium-term results after surgery for aortic arch aneurysm with hypothermic cerebral perfusion.

We have used two techniques of hypothermic cerebral perfusion (CP) for the surgical treatment of aortic arch aneurysm in the last 10 years. Between March 1985 and December 1993, 83 patients underwent surgery for aortic arch aneurysm. Fifty-one cases had aortic dissection (AD) in the transverse arch and/or its branches, and 32 cases showed true aneurysm (TA) of the aortic arch. In those 83 patients, 37 cases received antegrade CP and 46 cases underwent retrograde CP. Surgical results were compared among the groups by Kaplan-Meier actuarial method and Cox-Mantel statistical analysis. The early mortality after surgery for aortic arch aneurysm was 11.8% in the AD group and 21.9% in the TA group. The early mortality was 21.6% with antegrade CP and 10.9% with retrograde CP. The 6-year actuarial survival rate was 71.7% in the TA group and 67.1% in the AD group. In the AD group, the 3-year survival rate was 93.9% with retrograde CP and 61.1% with antegrade CP (P < 0.005). In the TA group, the 3-year survival rate was similar for antegrade CP (73.3%) and retrograde CP (69.2%). These results suggest that current surgical results of aortic arch aneurysm with hypothermic CP are acceptable and the retrograde CP technique might be recommended, especially for surgery of aortic arch aneurysm with AD.

Actuarial Analysis↗
PubMed1995

Transfer of a mutated gene encoding active transforming growth factor-beta 1 suppresses mitogenesis and IL-1 response in the glomerulus.

Using in vivo gene transfer, we examined the anti-inflammatory potential of transforming growth factor-beta 1 (TGF-beta 1) in the renal glomerulus. TGF-beta 1 cDNA, modified to allow for secretion of the active form of TGF-beta 1, was introduced into cultured rat mesangial cells. The responses of the established transfectants were examined in culture. In vitro, the transduced mesangial cells showed a reduced mitogenic response to fetal calf serum and were insensitive to induction of matrix metalloproteinase-9 (MMP-9) by the proinflammatory cytokine IL-1 beta. To examine whether glomeruli which express active TGF-beta 1 in vivo are insensitive to these same stimuli, TGF-beta transfectants were transferred into normal rat glomeruli via renal artery injection. After 24 hours, isolated glomeruli containing transfectants exhibited TGF-beta bioactivity, a reduced mitogenic response, and repressed expression of MMP-9 in response to IL-1 beta. We further examined the responses of these chimeric glomeruli to an in vivo mitogenic stimulus by transferring TGF-beta transfectants into glomeruli of kidneys one day after the induction of anti-Thy-1 nephritis. The mitogenic activity of isolated glomeruli was examined four days after the cell injection. Compared to unmodified or mock cell-containing glomeruli, the in vivo mitogenic activity of glomeruli containing TGF-beta transfectants was significantly repressed. Furthermore, cellular outgrowth from nephritic glomeruli expressing active TGF-beta 1 was also suppressed ex vivo compared to controls. These data indicate that TGF-beta 1 inhibits mitogenesis and IL-1 response of the glomerulus and may, in part, act as a potential early suppressor of glomerular inflammation.

Animals↗
PubMed1995

Resection margin for squamous cell carcinoma of the esophagus.

OBJECTIVE: The safe resection margin in esophagectomy for esophageal squamous cell carcinoma (SCC) was determined based on the extent of epithelial and subepithelial accessory lesions from the main lesions of esophageal SCC. BACKGROUND: There have been many reports on the high incidence of a positive resection margin for esophageal cancer. Although there were some studies on the relationships of the proximal clearance to postoperative local recurrence, no pathologic study on the resection margin has been reported. METHODS: Four hundred twenty specimens of a whole resected esophagus were examined histopathologically and the longitudinal length from the main lesion to the five types of accessory lesions was measured on microscopic slides. RESULTS: Contiguous intraepithelial carcinoma existed in 69 (46%) of 150 sites of main lesions restricted to the mucosa or submucosa and subepithelial lesions existed in 131 (54%) of 245 sites and 82 (55%) of 150 sites of main lesions invading an adventitia and into neighboring structures, respectively. The risk of a positive resection margin due to subepithelial lesions was below 5% at 10 mm in the main lesion, restricted to the submucosa or the muscularis propria, and at 30 mm in the main lesion, invading the adventitia in the potentially curative operation cases. CONCLUSION: These clearances of the resection margin, in which the risk of a positive resection margin is below 5%, are acceptable, although these clearances should only be accepted after the extent of epithelial accessory lesions is accurately determined by the Lugol's stain method.

Adult↗
PubMed1995

A gene encoding a cytochrome c oxidase-like protein is located closely to the cytochrome c-553 gene in the anaerobic bacterium, Desulfovibrio vulgaris (Miyazaki F).

The gene encoding cytochrome c-553 from Desulfovibrio vulgaris (Miyazaki F) was cloned using a synthetic oligodeoxyribonucleotide probe. The nucleotide sequence indicated that cytochrome c-553 was synthesized as a precursor protein with an NH2-terminal signal sequence of 23 residues. In the cloned DNA fragment, there are three other open reading frames whose products have 191, 157, 541 amino acid residues, respectively. The putative ORF-4 product is highly homologous with the cytochrome c oxidase subunit I from various organisms.

Amino Acid Sequence↗
PubMed1995

Soluble ICAM-1 as a regulator of nasal allergic reaction under natural allergen provocation.

BACKGROUND: Intercellular adhesion molecule-1 (ICAM-1) plays a key role in the early stage of the signal cascade leading to cellular extravasation and development of an inflammatory response. Recently, it has been reported that the soluble form of this adhesion molecule is present in human sera, possibly mediating biological actions. OBJECTIVE: The purpose of this study was to investigate levels of soluble ICAM-1 (sICAM-1) and its receptors in patients with allergic rhinitis, and to discuss sICAM-1's biological function. METHODS: The levels of sICAM-1 in sera and nasal epithelial lining fluids (ELF), the percentage of CD11a-positive lymphocytes in the peripheral blood, and scores of subjective symptoms from 14 patients with pollinosis (allergic group) were measured from pre- to post-season, results were compared with those from 10 non-allergic subjects (control group). RESULTS: The levels of sICAM-1 in sera and ELF were upregulated, and CD11a-positive lymphocytes were downregulated during the in-season in the allergic group. In addition, levels of sICAM-1 sera from the allergic group remained high during the post-season, when levels of other parameters (symptoms, blood eosinophil counts, sICAM-1 in ELF and CD11a-positive lymphocytes) had roughly returned to the initial pre-season levels. CONCLUSIONS: We demonstrate systemic and local upregulation of sICAM-1 and systemic downregulation of LFA-1 positive lymphocytes in patients with seasonal allergic rhinitis under natural allergen provocation, suggesting that sICAM-1 plays a role in regulating seasonal allergic inflammation.

Adult↗
PubMed1995

Development of an autoflow cruise control system for a centrifugal pump.

To improve the ease of driving a centrifugal pump that is afterload dependent, we have developed an automatic flow control system for the Terumo Capiox centrifugal pump system. This system consists of an autoflow cruise control system with a safety cutoff. The Capiox Pump Console 3000 was controlled by a personal computer through a serial communication line. In the usual manual mode, the motor speed knob works as a pump speed control, and in the autoflow mode, the same knob works as a blood flow rate control. After selecting and obtaining the desired flow rate, the mode was changed from manual to autoflow mode. In the autoflow mode, the computer compares the desired flow rate with the actual flow measured by an ultrasonic Doppler flowmeter and adjusts the motor rotational speed accordingly. During both in vivo and in vitro testing, this autoflow mode was able to return the changed flow that was disrupted by either clamping and declamping of the tubing or by the bolus injection of a vasomotor drug to the selected flow rate within 10 s without any significant fluctuation. In conclusion, the newly developed computer controlled autoflow system was able to produce a reliable and effective flow regulation for a centrifugal pump.

Animals↗
PubMed1995

Current strategy for severe heart failure with mechanical circulatory support.

In the last 10 years, 37 patients received assisted circulation or a ventricular assist device after open-heart operations at the Heart Institute of Japan. After cardiovascular surgery, 12 patients underwent venoarterial bypass (VAB), 13 had biventricular bypass (BVB), 8 had left ventricular bypass (LVB), and the remaining 4 received a left ventricular assist device (LVAD). Weaning and discharge rates of the patients by type of circulatory supports were 41.7 and 25.0% with VAB, 69.3 and 46.2% with BVB, 87.5 and 37.5% with LVB, 75.0 and 50.0% with LVAD, and 44.4 and 11.1% with PCPS, respectively. Concerning complications of postcardiotomy circulatory support, hemorrhage and ventricular arrhythmia postcardiotomy circulatory support, hemorrhage, and ventricular arrhythmia (immature weaning) decreased with low-heparinized isolated left ventricular supports (i.e., LVB, LVAD). However, profound biventricular failure, infection, and multiple organ failure remain as possible complications with any type of assisted circulation. These results suggest that early application of circulatory support and appropriate selection of the mode of support and devices used are important for successful circulatory support.

Adult↗
PubMed1995

Endotoxin-induced hydrogen peroxide production in intact pulmonary circulation of rat.

Although the importance of free oxygen radical has been reported in acute lung injury, the direct evidence in vivo model was lacking. We report a new method, which for the first time allows direct detection of hydrogen peroxide in the intact rat pulmonary microcirculation. We used the computer image-analyzing system and 2',7'-dichlorofluorescin diacetate for the marker of hydrogen peroxide production in vivo. A rat sepsis model was produced by continuous infusion of endotoxin for 30, 60, and 120 min. Hydrogen peroxide production in the pulmonary microcirculation of the sepsis rat was higher than in the control rat at each time point (p < 0.01) and increased time-dependently (p < 0.01). Catalase (5,000 U/kg) almost completely inhibited the hydrogen peroxide production in the sepsis rat (p < 0.01). In high-power view, hydrogen peroxide was detected in granulocytes that adhered to the capillaries and endothelial cells that were adjoining adherent granulocytes. These observations suggest that hydrogen peroxide in the endothelium was diffused from granulocytes. In this study, we demonstrated direct evidence of hydrogen peroxide production from adherent granulocytes in intact rat lung treated with endotoxin. We conclude that endotoxin causes the granulocyte adhesion and oxidative stress to the endothelium due to adherent granulocytes within 30 min in the pulmonary microcirculation.

Animals↗