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Biomedical subjects

M Kitamura

Publications and source records attributed to M Kitamura.

At least 307 records · Page 17Linked to original sources
PubMed1995

[A case of deep neck abscess and acute mediastinitis, secondary to peritonsillar abscess].

A 60-year-old female visited a hospital complaining of fever and pharyngeal pain. She was diagnosed as peritonsillar abscess. Initial conservative treatment was not curative, and deep neck and mediastinal abscess developed. After cervical drainage, she was referred to our hospital. Drainage tube was inserted via epigastrium into anterior mediastinum upwardly under local anesthesia. Postoperative course was uneventful, and she was cured and discharged after about 1 month of hospitalization. We stressed the importance of recognition of the mediastinitis as a complication of cervical infections. And immediate drainage procedure is required as soon as the diagnosis is established.

Abscess↗
PubMed1995

Different functional recovery of the left ventricle after valve replacement for aortic regurgitation: correlation between grade of ventricular arrhythmia and long-term mortality.

Although aortic valve replacement for aortic regurgitation relieves left ventricular volume overload, ventricular size often remains abnormal after operation, particularly in the setting of marked or prolonged preoperative left ventricular dysfunction. The aim of this study is to assess the relationship between the grade of ventricular arrhythmias before operation and the recovery of left ventricular function after aortic valve replacement. Between January 1980 and August 1993, 229 patients with pure aortic regurgitation underwent aortic valve replacement at our institution. In this group, 50 patients (21.8%) who showed left ventricular end-systolic volume index (LVESVI) of 150 ml/m2 or greater received 24-hour ambulatory electrocardiographic recordings before and after operation. According to the preoperative grade of ventricular arrhythmias, the patients were divided into three groups. Group A included 20 patients with severe and frequent ventricular premature beats (VPBs). Group B included nine patients with severe and non-frequent ventricular premature beats (VPBs). Group C included 21 patients with non-severe and non-frequent VPBs. Left ventricular end-systolic dimension (LVDs), end-diastolic dimension (LVDd) and fractional shortening (LVFS) were measured in each echocardiogram before, and one year and five years after operation. LVDd significantly decreased at one year after operation in all three groups. At one year after operation, LVDs significantly decreased in group B (42.0 +/- 7.6 mm) and group C (42.6 +/- 8.6 mm), while LVDs showed no significant change in Group A (55.4 +/- 11.1 mm). After five postoperative years, further significant decrease of LVDs was found in group C (32.4 +/- 7.1 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Current strategy of circulatory support for profound heart failure.

The purpose of this study is to assess the current strategy of mechanical circulatory support for profound heart failure. In the last 10 years, 37 patients with profound heart failure underwent mechanical circulatory support after open heart surgery and 9 patients with non-cardiotomy cardiogenic shock received emergency circulatory support. All patients showed severe cardiac failure and/or fatal ventricular arrhythmia and required circulatory support as a life-saving measure. After cardiovascular surgery, 12 of those patients underwent venoarterial bypass (VAB), 13 had biventricular bypass (BVB), 8 had left ventricular bypass (LVB) and the remaining 4 patients received left ventricular assist device (LVAD). And 9 patients with non-cardiotomy cardiogenic shock received percutaneous cardiopulmonary support (or PCPS) as an emergency assist system. Weaning and discharge rates of the patients by the 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. Clinical results of post-cardiotomy circulatory support (64.9% of weaning and 37.8% of discharge) were acceptable, but the patients with non-cardiotomy cardiac failure needed early application of more advanced circulatory support.

Adult↗
PubMed1995

[Relation between preoperative ventricular arrhythmias and postoperative results in aortic valve regurgitation].

Sudden death is a well known complication of aortic valve regurgitation and remains a common cause of late mortality after aortic valve replacement. Although malignant arrhythmias have been suggested as the cause of these outcome, there has been little information concerning the frequency and severity of ventricular arrhythmias in patients with aortic valve regurgitation. In order to evaluate the relation between the severity and/or frequency of ventricular arrhythmias and late postoperative results in patients with pure aortic valve regurgitation, 24-hour ambulatory electrocardiographic recordings were obtained before surgery in 107 patients without coronary artery disease. Grading of ventricular arrhythmias was based on a Lown method and compared with hemodynamic data. Ventricular premature beats were observed in 101 patients (94.4%) before operation. Multiformity was found in 10 patients (9.3%) couplets in 19 patients (17.8%) and ventricular tachycardia in 32 patients (29.9%). Patients with severe ventricular arrhythmias (Lown grade 3 or 4: 57.0%) had a higher left ventricular end systolic volume index (LVESVI) 153.1 +/- 76.4 ml/m2 vs 96.5 +/- 35.0 ml/m2 (p = 0.0001); a higher left ventricular end diastolic volume index (LVEDVI) 257.0 +/- 85.4 ml/m2 vs 206.5 +/- 58.3 ml/m2 (p = 0.0009); a lower left ventricular ejection fraction (LVEF) 43.4 +/- 12.5% vs 54.2 +/- 9.8% (p = 0.0001). LVESVI was not related to the severity of ventricular arrhythmias, but was significantly related to the frequency (p < 0.05). All patients with late death were belonging to Lown grade 3 or 4 in severity and more than 30 beats per hour in frequency (28.6%). This study indicates that ventricular arrhythmias are common in patients with aortic valve regurgitation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve↗
PubMed1995

Membrane cofactor protein (CD46) in seminal plasma is a prostasome-bound form with complement regulatory activity and measles virus neutralizing activity.

Human seminal plasma contains 0.55 microgram/ml of membrane cofactor protein (MCP; CD46) of 60,000 MW. By ultracentrifugation, gel filtration and immunoelectron microscope methods, we found that the MCP in seminal plasma was associated with prostasomes. The functional properties of the prostasome-bound MCP were assessed in comparison with a recombinant soluble form, gamma MCP1, which is composed of four short consensus repeats (SCR), type C of the serine/threonine-rich domain (STC), and unknown significance (UK). The MCP in seminal plasma, although demonstrably bound to prostasomes, behaved more like the soluble form of MCP. In the absence of detergent it, together with factor I, degraded the fluid-phase ligand, methylamine-treated C3 [C3(MA)], which is insensitive under no-detergent conditions to the membrane form of MCP and factor I. Moreover, C3dg fragment was generated as a final product instead of C3bi during the incubation, indicating that the prostasomal MCP and proteases may be responsible for the C3dg generation. The prostasomes neutralized measles virus (MV) infectivity, while gamma MCP1, for the most part, did not. These results, taken together with the CD59 concentration on the prostasomes, suggest that the prostasomes are potential immunomodulators for complement activation, providing the C3- and C9-step inhibitors. The present report also reinforces the idea that there are two different forms of MCP in semen. One is located in the inner acrosomal membrane of spermatozoa, which appears through acrosomal reaction and spermatoon-egg interaction. The other is a prostasome-bound form maintaining activities sufficient to regulate complement activation and, probably, MV infection.

Antigens, CD↗
PubMed1995

[Surgical results of aortitis syndrome (Takayasu disease) combined with annuloaortic ectasia].

From March 1973 to December 1994, 8 patients (2 males and 6 females) aged 34.4 +/- 7.8 years, underwent composite graft replacement (CGR) for aortitis syndrome combined with annuloaortic ectasia (AAE) in our institute. Five patients showed active aortitis syndrome and steroid therapy was administrated to 2 of them. The mean value of the C-reactive protein (CRP) was 1.6 +/- 1.8 before the operation. The maximum diameter of the ascending aorta was 67.1 +/- 10.3 mm (range 53 to 85 mm). Stenosis and/or ectasia of the neck vessels were recognized in 5 cases, as well as the coronary artery in 2 cases. Isolated CGR was performed in 6 cases, and combined with single CABG to LAD in 1 case and with total arch replacement in 1 case. The enlarged ascending aorta was replaced with main graft using the exclusion method and interposed grafts for coronary arteries were sutured with pledgetted mattress sutures all around the coronary ostia. In patients with stenosis of neck vessels, oxygen saturation of the jugular vein was monitored during extracorporeal circulation for surveillance of cerebral ischemia. There was 1 early death due to pulmonary failure. Seven cases survived without any complications during 4-132 months (mean 83.4 months) of the follow-up period. After the operation, 3 cases required steroid therapy during 4-50 months. We concluded that preoperative control of active inflammation, selection of operative procedures, timing for the operation, and the long-term precise management of the intractable disease were essential for successful treatment of aortitis syndrome with AAE.

Adult↗
PubMed1995

[Comparison of exercise-stress single photon emission computed tomography with thallium-201 reinjection and postextrasystolic potentiation to assess myocardial viability in patients with myocardial infarction].

Myocardial viability was examined in 20 patients with myocardial infarction 24 +/- 3 (mean +/- standard deviation) days after onset. Postextrasystolic potentiation (PESP) was measured by left ventriculography and thallium-201 (Tl) single photon emission computed tomography (SPECT) redistribution was assessed after stress loading and reinjection of Tl. The results were compared with the improvement of left ventricular segmental wall motion after coronary revascularization which was performed successfully in all patients. The uptake of Tl was impaired initially in 41 segments, classified into three groups: normal group, 13 segments with smooth reversion to normal; new fill-in group, 15 segments with a new fill-in after reinjection of Tl; no fill-in group, 13 segments with no fill-in after reinjection. When evaluated by the PESP before coronary revascularization, segmental wall motion was significantly augmented in all segments in the normal group and new fill-in group (p < 0.001), but not in the no fill-in group. After coronary revascularization, left ventriculography revealed that segmental wall motion was significantly improved in normal group and new fill-in group, but not in the no fill-in group except for mild improvement in five segments. The sensitivity and specificity of PESP (90% and 93%) and Tl SPECT (80% and 100%) for improvement of segmental wall motion after the coronary revascularization were very high, with the accuracy of either method attaining 87%. This result indicates that both Tl SPECT and PESP are useful for detecting viable myocardium in patients with recent myocardial infarction.

Aged↗
PubMed1995

Long-term outcome of left ventricular dysfunction after surgery for severe aortic stenosis.

Thirteen patients with severe aortic stenosis and left ventricular dysfunction (ejection fraction < 0.50, Group A) received echocardiographic evaluation before, and early and late after isolated aortic valve replacement. The results were compared with those of 11 aortic stenosis patients without left ventricular dysfunction (Group B). Using two-dimensional echocardiography, left ventricular diastolic internal diameter (LVIDd), left ventricular systolic internal diameter (LVIDs), left ventricular wall thickness (interventricular septum + posterior wall: LVWT), left ventricular fractional shortening (FS), left ventricular mass index (LVMI) and left ventricular end-systolic wall stress (ESWS) were assessed before (Pre), at one month (Early) and 4-7.6 (mean 5.5 +/- 1.0) years (Late) after operation. In the early postoperative period in Group A, significant decrease was observed in LVIDd (5.4 +/- 0.8 to 4.5 +/- 1.0 cm, p = 0.010), LVWT (3.3 +/- 0.7 to 2.9 +/- 0.7 cm, p = 0.027) and LVMI (336 +/- 149 to 222 +/- 112 g/M2, p = 0.013). From the early to late postoperative period FS showed significant improvement in both groups (0.23 +/- 0.12 to 0.32 +/- 0.12 in Group A, p = 0.025 and 0.27 +/- 0.07 to 0.36 +/- 0.07, p = 0.014). However, changes of other parameters were not significant and LVMI in Group A remained twice as high as the normal value. It is concluded from the above results, that LV contraction in aortic stenosis patients with preoperative left ventricular dysfunction improved during the late postoperative period. Although LVMI in the early postoperative period significantly decreased as compared with the preoperative value, it showed no further improvement and remained at an abnormally high level. Therefore, early surgical treatment of severe aortic stenosis before appearance of LV dysfunction should be recommended for postoperative recovery from LV hypertrophy.

Aged↗
PubMed1994

Expression of an endogenous retroviral gene product in human placenta.

To investigate the presence and potential pathophysiological role of endogenous retroviruses in humans, we prepared a recombinant protein using clone 4-I, a proviral sequence. DNA fragments containing the env region of clone 4-I were subcloned into a prokaryotic expression vector (pET3), and 2 fusion proteins, SU413 and SU415, were then expressed in Escherichia coli after treatment with isopropyl-beta-thiogalactopyranoside (IPTG). By sonicating lysates of the transformed E. coli, the recombinant protein SU413 was successfully separated from the native bacterial components, and was used to raise an antiserum in rabbits. In immunoblot analysis, this antiserum specifically recognized the recombinant protein, but did not react with other components of E. coli. This antiserum was then used for an immunofluorescence study of human placenta, in which the env gene transcript has been reported. As a result, the anti-SU413 serum detected substances in syncytiotrophoblasts and vascular endothelia from a human placenta. No such reactivity was detected in human kidney or human liver. Immunoblot analysis revealed that this antiserum reacted to a single molecule of 38-kDa in placenta, and its reactivity was reduced by the antiserum absorbed with SU413 antigen. These findings suggest that human placental syncytiotrophoblasts and vascular endothelia preferentially express a molecule encoded by human endogenous retrovirus clone 4-I.

Animals↗
PubMed1994

Heparin selectively inhibits gene expression of matrix metalloproteinase transin in cultured mesangial cells.

The aim of this study is to examine the transcriptional regulation of matrix metalloproteinase transin in glomerular mesangial cells responding to inflammatory cytokines and heparin. Northern blot analysis revealed that IL-1 beta preferentially induced transin mRNA. The stimulatory effect was not specific to transin, and upregulation of procollagen alpha 1(IV), laminin B2 and tissue inhibitor of metalloproteinases-1 (TIMP-1) mRNAs was also observed. After IL-1 stimulation, expression of the transin transcript increased progressively for up to 48 hours, differing from the limited induction of procollagen alpha 1(IV) or TIMP-1. When mesangial cells were stimulated by IL-1 beta in the presence of heparin, transin expression was markedly suppressed in a dose-dependent manner. The inhibitory effect of heparin was specific to transin, and induction of procollagen alpha 1(IV), laminin B2 or TIMP-1 by IL-1 beta was not affected. These findings revealed the selective counter regulation by IL-1 beta and heparin of the transin expression in mesangial cells.

Animals↗
PubMed1994

Novel FMN-binding protein from Desulfovibrio vulgaris (Miyazaki F). Cloning and expression of its gene in Escherichia coli.

A gene encoding a novel FMN-binding protein from Desulfovibrio vulgaris (Miyazaki F) was cloned, and its expression system was constructed in Escherichia coli. The 1.4-kilobase pair DNA fragment isolated from D. vulgaris (Miyazaki F) by double digestion with KpnI and SmaI was found to express a protein binding FMN as a prosthetic group under control of the lac promoter in E. coli. This DNA fragment contained several putative open reading frames. The partial amino acid sequence of the polypeptide portion of the purified FMN-binding protein and its tryptic peptides were completely consistent with those deduced from the nucleotide sequence of the third open reading frame in the cloned SmaI-SmaI fragment of D. vulgaris (Miyazaki F) DNA, which may include promoter and regulatory sequences. The nucleotide sequence of FMN-binding protein indicated that the protein is composed of 122 amino acids including an initiator Met residue and lacks a signal peptide for secretion. The main redox potential of the FMN-binding protein was measured as -325 mV using direct current cyclic and differential pulse voltammetric techniques and an electroreflectance method, suggesting that this FMN-binding protein functions as a redox protein like other FMN-binding proteins. Immunoblot analysis of the whole proteins from D. vulgaris (Miyazaki F) clearly indicated that this protein is expressed in this bacteria. However, the protein was found to have a primary structure distinct from those of other FMN-binding proteins and to be the smallest FMN-binding protein yet reported.

Amino Acid Sequence↗
PubMed1994

Postoperative chemotherapy including intraperitoneal and intradermal administration of the streptococcal preparation OK-432 for patients with gastric cancer and peritoneal dissemination: a prospective randomized study.

We studied the effects on survival time of postoperative immuno-chemotherapy, including the streptococcal preparation OK-432, in patients with gastric cancer and synchronous peritoneal dissemination. The patients were prospectively randomized and a valid statistical assessment could be made for 109. Patients randomized to group B received therapy that is widely used in Japan to treat patients with gastric cancer: mitomycin C (MMC) and UFT, a combination of tegafur and uracil in a molar ratio of 1:4, for 1 year. Patients randomized to group A received the same drugs as were given to group B patients plus OK-432 i.p. for 7 days, beginning on postoperative day 0, and OK-432 by intradermal injection for 1 year, at 2-week intervals. There were no differences between the two groups in any known prognostic factor or in the dose of any drug administered except for OK-432. There was no difference in the toxicity rate between the groups. In this negative trial, there was no improvement in survival time with the addition of OK-432 to MMC and UFT for patients with gastric cancer and peritoneal dissemination.

Aged↗
PubMed1994

Five-year results of a randomized clinical trial comparing modified radical mastectomy and extended radical mastectomy for stage II breast cancer.

A controlled cooperative study was carried out to assess the value of modified radical mastectomy for patients with stage II breast cancer. The data was analyzed from 11 institutions in the Shikoku District participating in a prospective clinical trial in which patients were randomly assigned either to a modified radical mastectomy group or an extended radical mastectomy group. These two groups of patients were similar to each other in terms of such background factors as age distribution, menopausal status, TNM classification, tumor size, location of the primary tumor, axillary nodal involvement, histological type, and estrogen receptor status. The median follow-up times in the modified and extended radical mastectomy groups were 4.7 and 4.5 years, respectively. The cumulative curves indicated no difference between the two groups in either disease-free survival or overall survival. The survival rates were classified according to the presence or absence of axillary nodal metastases. However, no significant difference was found between the two groups. These findings thus suggest that the routine removal of the grossly uninvolved major pectoral muscle and parasternal lymph nodes is not necessary in patients with stage II breast cancer.

Adenocarcinoma↗