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Biomedical subjects

M Kohno

Publications and source records attributed to M Kohno.

At least 397 records · Page 22Linked to original sources

[Comparison of myocardial perfusion assessments by digital subtraction angiography with those of left ventricular wall dynamics].

In clinical and experimental studies we assessed images of digital subtraction coronary angiography (DSA) for evaluating regional myocardial perfusion. Myocardial perfusion was assessed by injecting contrast medium into the coronary artery, and by imaging the regional myocardium using DSA. On the time-density curve obtained from the myocardial region of interest, we calculated the time to peak concentration (TPC) and the exponential washout rate (T). TPC and T were measured in five patients with stable effort angina pectoris (AP) and left anterior descending (LAD) lesions before and after percutaneous transluminal coronary angioplasty (PTCA). The values of 1/T increased significantly from 0.09 +/- 0.02 l/sec to 0.21 +/- 0.04 l/sec (p less than 0.01) after PTCA, but l/TPC did not change. No significant difference in ejection fractions was observed between the patients with AP and the normal subjects (n = 7), while the regional percent area shrinkage in the anterolateral and apical regions supplied by the LAD was significantly decreased in the patients with AP compared with those of normal subjects (anterolateral: 39.8 +/- 8.8% vs 51.3 +/- 6.8%, apical: 36.6 +/- 8.4% vs 52.4 +/- 13.4%, both p less than 0.01). In 10 anesthetized dogs with varying degrees of reduction in the left circumflex coronary artery (LCX) blood flow (CBF: categories of stenosis (S1-S5), we compared 1/TPC and 1/T with regional myocardial function (systolic wall thickening: %WTh). With varying LCX stenosis, there were no significant changes in heart rate and mean aortic pressure and significant linear correlations were observed between %WTh and 1/TPC (r = 0.51), between %WTh and 1/T (r = 0.55). At S1 (CBF: 100-90% of the control), neither %WTh nor 1/TPC differed from that of the controls, but 1/T was significantly decreased (80% of the controls, p less than 0.01). From S3 (CBF: 79-60%) to S5 (CBF: 39-0%), %WTh, 1/TPC and 1/T were significantly decreased from those of the control levels (all p less than 0.01). However, at S5 (CBF: 39-0%) the values of 1/TPC (71% of controls) and 1/T (33%) did not differ from those at S4; whereas, %WTh was markedly reduced and the systolic thinning of the ventricular wall occurred at S5. Therefore, in critical coronary stenosis, 1/T was more sensitive than 1/TPC or wall dynamics for assessing myocardial ischemia. Both 1/TPC and 1/T, as well as %WTh, were useful for assessing moderate myocardial ischemia; however, these DSA indices had considerable limitations for evaluating the severity of myocardial ischemia when CBF was markedly reduced.

Aged↗

[Acute lymphocytic leukemia with thrombophlebitis of lower limbs and translocation (4;11)].

On November 22, 1985, a 54-year-old male was admitted to the cardiovascular department of our hospital suffering from thrombophlebitis, with redness, swelling and pain around the right ankle and left knee. He was transferred to our department on Nov. 26, because of hyperleukocytosis. Peripheral blood examination revealed hyperleukocytosis with 93.0% blastic cells and thrombocytopenia. The bone marrow aspirate was hypercellular and almost all cells were consistent with peroxidase negative blastic cells. The blastic cells were Leu M1 positive and Leu M2, M3 and lymphocytic markers were negative. The patient was diagnosed to have acute lymphocytic leukemia with Leu M1 positive blast cells. BH-AC/DMP therapy was began on the 1st hospital day but he died of cerebral haemorrhage on the 4th hospital day. An autopsy revealed systemic infiltration of leukemic cells including thrombophlebitis of the legs. Chromosome analysis of the bone marrow cells showed t(4;11)(q21;q23).

Antigens, Differentiation, Myelomonocytic↗

Reversal of relative proteinase F activity and onset of androgen-dependent proteinases in the submandibular gland of postnatal mice.

By isoelectric focusing, we separated trypsin-like proteinases of the mouse submandibular gland (ICR strain) into isozymes with pI values of 4.6 (proteinase F), 5.6 (protease D), 5.8 (protease A), 7.1 and 9.9 (P-esterase). During postnatal development, proteinase F appeared earliest (on the 15th day after birth) and increased in both sexes; however, its percentage ratio to total activity decreased markedly with time because of the rapid increase of other proteinases. On the 22nd day of life, proteinases A and D appeared, and the increase of a proteinase with pI-7.1 followed thereafter. P-esterase was the last isozyme to appear, becoming detectable around 29-45 days. After maturation, the activities of protease A plus D, P-esterase, and the isozyme with a pI value of 7.1 were higher in males than in females, whereas the relative level of proteinase F was reversed. We conclude that proteinase F is appreciably different from the other four proteinases in its development pattern as well as in its responsiveness to sexual hormones.

Androgens↗

[Preoperative therapeutic embolization for massive hemoptysis from bronchial collaterals in tetralogy of Fallot--a case report successfully treated by total correction].

Hemoptysis from bronchial collateral arteries in cyanotic heart diseases is a troublesome complication. We report a case of Tetralogy of Fallot presented with massive hemoptysis which was successfully treated with transcatheter therapeutic embolization prior to the radical operation. A 28-years old man was admitted to our hospital because of hemoptysis and dyspnea. On the day of admission, he had a massive hemoptysis and became asphyxic. Diagnostic cardiac catheterization performed next day revealed Tetralogy of Fallot. Bronchial arteriogram demonstrated large bronchial collateral arteries with heavy staining around the right lower lobe bronchus. Therapeutic embolization with Gelfoam was performed and the hemostasis was obtained. The radical operation was performed 4 months later. Before cardiopulmonary bypass, the right bronchial artery was ligated. He was weaned from the extracorporeal circulation under the stable circulatory condition, and respirator on the first post operative day without any complications, and he was discharged on the 57th day after the operation. We emphasize the efficacy of therapeutic embolization of the well developed bronchial collateral arteries as a pretreatment of hemoptysis in the cyanotic heart disease.

Adult↗

[Influence of hepatic arterial embolization on diabetic patients with hepatocellular carcinoma].

Uncontrollable change of diabetes mellitus (DM) has occurred in one of our patients who had received hepatic arterial embolization (HAE) for hepatocellular carcinoma (HCC). This prompted us to examine the influence of HAE to the diabetic patients with HCC. Thirty-four patients accompanying DM who had received HAE were examined fasted blood glucose (FBG) and the liver function before and after the procedure. HAE was performed using Gelatin Sponge and Lipiodol containing anticancer agents, either alone or combined. Of 34 patients 6 showed increase of FBG level of more than two times after HAE. The FBG level had a tendency to elevate as the grade of DM advanced. The tendency was also recognized on pre-HAE oral glucose tolerance test. However, FBG elevation had no relation to the changes of liver function (GPT, Choline Esterase), the difference of embolic materials and pre-HAE status of DM control. From the results, one must be aware that HAE or Lipiodol infusion to diabetic patients with HCC sometimes may cause uncontrollable change of DM, especially in case of advanced DM patients. Consequently, careful follow-up of HCC as DM is advisable for improvement of the patients' prognosis.

Adult↗

Analysis of digital subtraction coronary angiography for estimation of flow reserve in critical coronary stenosis.

To examine the accuracy of digital subtraction angiographic assessment of coronary flow reserve in critical coronary stenosis, time-density curves were obtained from digital angiograms for a myocardial region of interest. Time-to-peak contrast (TPC) and contrast washout rate (T) were measured in 11 patients with critical 1-vessel lesions before and after percutaneous transluminal coronary angioplasty (PTCA). Collectively, the values of TPC and T were significantly shortened, from 5.8 +/- 1.1 to 4.4 +/- 1.0 seconds (p less than 0.01) and from 11.3 +/- 4.0 to 5.2 +/- 1.2 seconds (p less than 0.001) after PTCA, respectively. All 11 patients except 1 showed shortened T after PTCA; however, in 5 of the 11 patients, TPC after PTCA had approximately the same values as those before PTCA. In experiments in dogs with critical circumflex stenosis, coronary flow and posterior wall thickening at rest were not different from control; however, contrast media-induced hyperemia was markedly attenuated, accompanied by a significant prolongation of T (7.7 +/- 4.5 vs 15.8 +/- 1.9 seconds, p less than 0.01) and completely unchanged TPC (both 6.8 seconds). With simultaneous tracings of coronary flow and time-density curves, TPC and the washout phase on the curve corresponded with contrast-induced transient flow reduction and hyperemic phases, respectively. It is concluded that T appears more sensitive than TPC when basal coronary flow is maintained to almost normal levels, as in patients with stable effort angina pectoris having critical coronary stenosis.

Aged↗

Effect of salt-loading on erythrocyte deformability in spontaneously hypertensive and Wistar-Kyoto rats.

Effects of salt-loading on erythrocyte and erythrocyte ghost deformabilities were measured by laser diffractometry using a flat cell and a helium-neon laser in spontaneously hypertensive rats (SHR) and age-matched normotensive Wistar-Kyoto rats (WKY). Salt-loading did not affect the deformability of erythrocytes in SHR and WKY, although a significantly reduced deformability was observed in salt-loaded SHR compared with values in control WKY and salt-loaded WKY (p less than 0.05, p less than 0.05, respectively). In contrast, salt-loading significantly reduced the deformability of erythrocyte ghosts in WKY and SHR (p less than 0.05, p less than 0.05, respectively). Our results suggest that salt-loading reduces erythrocyte membrane viscoelasticity in both WKY and SHR, and that the observed reduction of ghost deformability induced by salt-loading may influence the peripheral circulation.

Animals↗

Possible involvement of atrial natriuretic factor in the antihypertensive action of a high-calcium diet in spontaneously hypertensive and Wistar-Kyoto rats.

The present study was designed to determine the possible involvement of atrial natriuretic factor (ANF) in the hypotensive action of a high-calcium diet. The effects of increased dietary calcium (2.9% calcium, HCa) on blood pressure, urinary sodium excretion, and ANF were examined in 30 spontaneously hypertensive rats (SHR) and 30 Wistar-Kyoto rats (WKY). Control groups of 30 SHR and 30 WKY were fed normal calcium lab chow (0.4% calcium, NCa). The HCa diet reduced blood pressure and serum phosphorus concentration and increased urinary excretion of sodium and calcium in SHR and WKY. The HCa diet also caused a sustained increase in plasma ANF concentration and, finally, a decrease in atrial ANF concentration in both groups. A significant inverse correlation was observed between ANF concentrations in plasma and atria of the four experimental groups. Plasma ANF concentration was positively correlated with daily calcium consumption, and blood pressure was inversely correlated with daily calcium consumption in HCa- and NCa-SHR groups and in HCa- and NCa-WKY groups, respectively. Furthermore, a significant inverse correlation between blood pressure and plasma ANF concentration was observed in SHR groups and in WKY groups, respectively. The observed sustained increment in endogenous plasma ANF concentration, which is probably caused by increased secretion from the atrium, may contribute, in part, to the blood-pressure-lowering effects of the HCa diet.

Animals↗

Prolonged blood pressure elevation after endothelin administration in bilaterally nephrectomized rats.

The hemodynamic effect of a novel potent vasoconstrictive peptide (endothelin) on systemic blood pressure was studied in bilaterally nephrectomized and sham-operated rats under conscious and almost unrestrained condition. Following bolus IV administration of porcine endothelin, plasma endothelin concentration was measured by radioimmunoassay. After a transient decline, blood pressure was gradually elevated by endothelin administration. At 20, 30, and 40 minutes after injection, blood pressure was significantly elevated in bilaterally nephrectomized rats compared with sham-operated rats. Arterial plasma endothelin concentrations increased and rapidly decreased after injection in both rat groups. Bilateral nephrectomy significantly delayed the disappearance of endothelin from the plasma. These results suggest that the kidney plays a role in the plasma clearance of IV bolus endothelin administration and that the prolonged plasma half-life of endothelin is in part associated with the prolonged blood pressure elevation after endothelin administration in bilaterally nephrectomized rats.

Animals↗

Acute effects of endothelin on renal hemodynamics and blood pressure in anesthetized rats.

A novel and potent vasoconstrictive peptide, endothelin, has recently been purified from the culture supernatant of porcine aortic endothelium. In this study we examined the acute effects of synthetic endothelin on renal hemodynamics and blood pressure in anesthetized rats. Blood pressure and renal blood flow were measured before and 1, 2, 5, and 10 minutes after endothelin administration (1.0, 0.5, or 0.1 nM/kg body weight). After a transient fall, the blood pressure gradually increased. At five and ten minutes after administration of each of the three doses, the blood pressure was significantly elevated compared with baseline values. Renal blood flow decreased immediately after infusion of 1 nM/kg endothelin, and this decrease lasted throughout the observation periods, while 0.1 nM/kg endothelin did not affect renal blood flow. At 2, 5, and 10 minutes after infusion of 1.0 or 0.5 nM/kg endothelin, renal vascular resistance was significantly elevated. These hemodynamic alterations were dose-dependent. The results show that endothelin has potent hypertensive and renal vasoconstrictive effects in rats.

Animals↗

Reevaluation of the spin-trapped adduct formed from 5,5-dimethyl-1-pyrroline-1-oxide during the respiratory burst in neutrophils.

By employing EPR spectrometry with the aid of a spin-trapping agent, 5,5-dimethyl-1-pyrroline-1-oxide (DMPO), the generation of superoxide anion and hydroxyl radical was reevaluated during the respiratory burst of porcine and human neutrophils. Properly prepared resting neutrophils did not generate any spin-trapped radical, and, when the cells were stimulated with phorbol myristate acetate, only DMPO-OOH, the spin-trapped adduct of superoxide anion, was detected. No formation of DMPO-OH, the spin-trapped adduct of the hydroxyl radical, was observed. DMPO-OOH was also detected principally when the neutrophils were stimulated with opsonized zymosan, a particulate stimulus. In the latter case, however, the formation of DMPO-OOH ceased shortly after the addition of zymosan and subsequent production of DMPO-OH was observed. The production of DMPO-OH was found to be associated with cell injury. DMPO at the concentration usually used for the experiment (0.045-0.09 M) injured phagocytizing neutrophils, causing lysis of the cells. On the other hand, an addition of cell homogenate or glutathione-glutathione peroxidase system to the suspension of intact cells which were producing DMPO-OOH resulted in the formation of DMPO-OH. Thus, DMPO-OH was probably derived from DMPO-OOH by the action of enzymes and/or factor(s) which were released from the lysed cells.

Animals↗

Production of endothelin by cultured porcine endothelial cells: modulation by adrenaline.

Cultured porcine endothelial cells derived from aortas spontaneously released immunoreactive endothelin into the medium in a time-dependent manner. This release was completely inhibited by cycloheximide and is, therefore, directly related to de novo protein synthesis. The endothlin-induced release was further stimulated by adrenaline. Adrenaline-induced stimulation was completely inhibited by the alpha-adrenergic blocker phentolamine and was not inhibited by the beta-adrenergic blocker propranolol. Cycloheximide completely prevented the adrenaline-stimulated as well as the basal release. These results suggest that cultured endothelial cells release endothelin slowly but continuously and that this release can be stimulated by adrenaline via alpha-adrenergic receptors. We speculate that the endothelium generates vasoconstrictor signals through endothelin production, thus contributing to the regulation of vascular tone.

Animals↗

Effect of a new angiotensin converting enzyme inhibitor, cilazapril, on circulating atrial natriuretic factor during exercise in patients with essential hypertension.

In seven patients with mild to moderate essential hypertension, the effect of a new angiotensin converting enzyme (ACE) inhibitor, cilazapril, on atrial natriuretic factor (ANF) was examined at rest and during exercise. The exercise protocol consisted of three fixed workloads (25, 50 and 75W) every 4 min with the use of a sitting bicycle ergometer. Cilazapril reduced blood pressure without increasing the heart rate, both at rest and during exercise. The resting pre-exercise left ventricular ejection fraction was not altered. The plasma ANF level was increased by exercise, but at the 75-W workload it was decreased by cilazapril; the resting plasma ANF value was not altered. At the 75-W workload the plasma ANF level was inversely correlated to the left ventricular ejection fraction (n = 14, r = -0.64, P less than 0.01). These results suggest that the observed decrease in the plasma ANF level during exercise induced by cilazapril is, in part, related to an improvement in the cardiac overload, and that cilazapril may be effective in physically active hypertensive patients.

Angiotensin-Converting Enzyme Inhibitors↗

Effect of diltiazem on aortic pressure-diameter relationship in dogs.

To study the effects of diltiazem (Dz) on aortic (Ao) pressure-diameter (P-D) relationships, the external diameter (D) of the thoracic Ao (sonomicrometry) and Ao pressure (AoP, micromanometer) were simultaneously measured in 10 anesthetized dogs. The P-D relationship from 80 ms after the dicrotic notch of AoP (t80) to 20 ms after the peak of the next R wave on the electrocardiogram (ECG) (t20) was plotted at 30-ms intervals. To depict the P-D relationship in a wide range of AoP, Ao occlusion immediately after the release of inferior vena caval (IVC) occlusion was performed both before and after a Dz (0.03 mg.kg-1.min-1, over 10 min) infusion. The P-D relationship so obtained was a sigmoid curve under both conditions and was reasonably described by a cubic curve (P = aD3 + bD2 + cD + d, where a, b, c, and d are constants and r greater than 0.99). The first derivative of cubic regression equation (dP/dD) value of the cubic curve was used as an index of Ao stiffness. In all dogs, the dP/dD-D relationship, which was parabolic, was similar to the delta P/delta D-D relationship measured from the actual P-D relationship (delta P/delta D is the ratio of the change in AoP to that in AoD), suggesting that it corresponded to a cubic curve.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Glucocorticoids and dopamine-1 receptors on vascular smooth muscle cells.

The effect of glucocorticoids on the dopamine (DA)-mediated cyclic adenosine monophosphate (cAMP) by intact vascular smooth muscle cells (VSMC) was studied in rats. Cultured VSMC were obtained from renal arteries of 14-week-old Wistar-Kyoto rats by explant method. Micromolar concentrations of dexamethasone (DEX) pretreatment for 48 hours potentiated DA-mediated response without any change of affinity constant. However, micromolar concentrations of aldosterone pretreatment for 48 hours had almost no effect on DA-mediated response. The DEX-induced facilitation began at 6 hours and reached maximum at 24 hours after DEX administration in a dose-dependent manner. Inhibitors of protein and RNA synthesis blocked this glucocorticoid effect. The basal activity of adenylate cyclase in DEX-treated cells was twofold higher than that in control cells. Treatment of VSMC with DEX increased cholera toxin-stimulated and forskolin-stimulated adenylate cyclase activity. However, pertussis toxin treatment did not augment or reduce the effect of DEX treatment. These results suggest that glucocorticoids increase DA-mediated cAMP formation by VSMC through glucocorticoid type II receptors and the induction of protein synthesis and that the activation of the catalytic unit may play some role in this facilitation.

Adenylyl Cyclases↗