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Biomedical subjects

M Kubo

Publications and source records attributed to M Kubo.

At least 361 records · Page 20Linked to original sources
PubMed1993

Abnormal signal averaged ECG after surgical repair of tetralogy of Fallot--a combined analysis in the time and frequency domain.

PURPOSE: The clinical significance of abnormal signal averaged ECG (SA-ECG) determined by time and frequency domain analyses was assessed in tetralogy of Fallot patients after surgical repair, and the methods of analysis were compared. MATERIALS AND METHODS: SA-ECG was performed in 42 patients (mean age, 9.4 years) after radical surgical repair of tetralogy of Fallot, and in 11 preoperative patients (mean age, 2.6 years). Abnormal SA-ECGs were defined by time domain analysis (vector magnitude method) and frequency domain analysis (fast Fourier transformation). RESULTS: Abnormal SA-ECGs were recognized in 10 postoperative, patients (3 by time domain and 9 by frequency domain, analysis), but in none of the preoperative patients. Three patients with abnormal SA-ECGs had nonsustained ventricular tachycardia, 5 others had premature ventricular contractions, and the remaining 2 had no ventricular tachyarrhythmias documented by 24 h Holter monitoring. Patients with abnormal SA-ECGs more commonly had ST-T segment depression on standard ECG during exercise (8/10 versus 8/32, p < 0.001), a history of resection of a hypertrophic septoparietal muscle band (8/10 versus 2/32, p < 0.001) and histologically documented myocardial fibrosis at radical surgical repair (9/10 versus 5/19, p < 0.002). CONCLUSION: A Combination of time and frequency domain analyses was necessary to detect abnormal SA-ECGs in postoperative patients because of ventricular conduction disturbance. This technique might increase our ability to identify patients at risk of ventricular tachyarrhythmia, or those with underlying myocardial abnormalities.

Adolescent↗
PubMed1993

Usefulness of the signal-averaged electrocardiogram for evaluating the block site of right bundle branch block following surgical correction of a congenital heart disease.

It is important to distinguish proximal right bundle branch block (RBBB) from distal RBBB because patients with both proximal RBBB and left bundle branch block may progress to a late atrioventricular conduction disturbance. Signal-averaged electrocardiograms (SAECGs) were investigated in 35 patients with RBBB following surgical correction of tetralogy of Fallot or ventricular septal defect in order to determine the block site of RBBB noninvasively using a SAECG. The site of RBBB was first identified by a body surface map; 12 patients had proximal RBBB (group 1), and 23 had distal RBBB (group 2). The control groups consisted of 8 patients with RBBB without congenital heart disease (group 3) and 20 normal subjects (group 4). The mean of the filtered QRS duration in the group 1 patients was significantly longer than in the other 3 groups (p < 0.01). The number of fragmented signals in group 1 was significantly greater than that in the other 3 groups (p < 0.01). A filtered QRS pattern was divided into 4 different types (whole, early, late, and normal) according to the successive fragmented signals; the "whole" type was the most common in group 1 (83%). SAECG is successful in identifying those patients with proximal RBBB according to the following indices: a filtered QRS duration equal to or longer than 160 msec, a fragmented signal number greater than 10 and a "whole" type filtered QRS pattern. In conclusion, SAECG is a useful tool for distinguishing proximal RBBB from distal RBBB.

Bundle-Branch Block↗
PubMed1993

Balloon pulmonary valvuloplasty for infants with severe tetralogy of Fallot.

Balloon pulmonary valvuloplasty was performed in 3 infants with severe tetralogy of Fallot at days 24, 54 and 86 because of progressive hypoxemia. In two patients, the balloon catheter (4 cm long, 5-8 mm diameter) could not pass through the pulmonary valve. This necessitated a smaller balloon and required a two-step procedure. Initially, a coronary artery balloon (2 cm long, 3.5 mm diameter) was used. Following balloon valvuloplasty, arterial oxygen saturation increased from 63 to 83% in case 1, from 69 to 85% in case 2 and 63 to 86% in case 3. Immediate postvalvuloplasty right ventricular cineangiography revealed that the maximal opening diameter of the pulmonary valve leaflets increased from 1-2 mm to 3-4 mm in cases 1 and 3, and from 2-3 mm to 4-5 mm in case 2. No significant complications occurred. Echocardiographic follow-up data showed that the diameter of the right ventricular outflow tract and pulmonary arteries increased with age. The present results show that the pulmonary valvuloplasty is an effective procedure for relief of pulmonary valve stenosis in tetralogy of Fallot and to improve oxygenation and growth of the pulmonary arteries and right ventricular outflow tract without the need of an immediate aortopulmonary shunt.

Cardiac Catheterization↗
PubMed1993

[Liver impairment in kidney transplant recipients. 1. Prevalence and clinical significance of hepatitis C].

The prevalence and the clinical significance of hepatitis C (HCV) infection in recipients of kidney transplantation was assessed using second generation anti-HCV antibody (anti-HCV-2). Out of 88 patients whose preoperative sera were available for anti-HCV-2 determination, 27 patients (30.7%) were positive. Transfusion units were significantly larger and the duration of hemodialysis was significantly longer in the patients with anti-HCV-2 than those without. In 10 patients whose preoperative sera were negative for anti-HCV-2, seroconversion was documented after the operation, so that the postoperative positive rate of anti-HCV-2 increased to 42.9% (39/91). Seroconversion from positive to negative was observed in only one patient. Out of 91 patients who were followed-up at least 3 months after operation, 66 patients (72.5%) developed liver dysfunction. According to the criteria of non-A, non-B post-transfusion hepatitis established by the Japanese Society of Digestive Disease, 31 of 66 patients (34.1%) were diagnosed as "definite", 21 patients (23.1%) as "suspicious". The anti-HCV-2 positive rate was 90.3% in the "definite" group, which was significantly higher than the other groups. Liver dysfunction in the patients with anti-HCV-2 had a tendency for a chronic or prolonged course. Out of 20 patients in whom liver dysfunction continued for more than 1 year, 18 patients were positive for anti-HCV-2. It is concluded from this study that the prevalence of hepatitis C is very high in kidney transplant recipients with HCV as the main and most important etiologic factor of liver dysfunction, especially in chronic liver impairment.

Adolescent↗
PubMed1993

[Study of suitable analyzed signal duration and criteria for abnormal signal averaged electrocardiogram on frequency-domain analysis in patients with Duchenne's muscular dystrophy].

We investigated the optimal condition to detect abnormalities on the fast-Fourier transformation of the signal-averaged electrocardiogram (SA-ECG) by studying the effects of analyzed signal duration, attenuation of low frequency components by using filtering processing and the criteria for abnormal SA-ECG. Subjects were 23 patients with Duchenne's muscular dystrophy (DMD) and were divided into two groups by the presence of ventricular tachycardia (VT). Age-matched healthy volunteers were obtained as controls. Abnormal SA-ECG was identified from the data in the controls as over 97 percentile of H/L ratio. Frequency domain analysis from last 40 ms of QRS wave to 80 ms of ST segment was most capable to distinguish the DMD patients with VT from the patients without VT, compared to analysis from last 20 ms. Whereas, analysis from QRS onset failed to detect VT patients. Although filter processing reduce the power of low frequency and increase the H/L ratio, sensitivity for predicting VT was not enhanced significantly. In conclusion, the frequency-domain analysis during the terminal 40 ms of the QRS complex and 80 ms of ST segment was most optimal condition to distinguish the DMD patients with VT.

Adolescent↗
PubMed1993

Prevention and control of nosocomial infection caused by methicillin-resistant Staphylococcus aureus in a premature infant ward--preventive effect of a povidone-iodine wipe of neonatal skin.

In early 1983 we experienced a small scale epidemic of Staphylococcus aureus coagulase type IV in the premature infants unit. Children had bacteraemia or impetigo. The microorganism was resistant to methicillin, erythromycin and lincomycin and was susceptible to tetracycline, chloramphenicol and cefmetazole. The results of coagulase typing and antimicrobial sensitivities indicated that these cases represented nosocomial infection with MRSA. The source and route of the infection were investigated, and measures were taken to prevent bacterial spread from carriers and to keep instruments and environments clean. As the source of infection was not identified, we tried wiping the body surface of the premature infants with a diluted IsodineR solution (10% povidone-iodine; 1:100 dilution) in order to prevent colonization of the microorganism on the body surface. As a result, no additional MRSA infection occurred in the premature infant unit. During the subsequent 6 years of frequent surveys of carriers and wiping the appropriate body surface with diluted IsodineR solution we have had no recurrence of MRSA. None of the premature infants wiped with IsodineR solution showed any objective abnormalities, although laboratory testing disclosed an elevated blood iodine level and a transient mild reduction of T4 in some infants.

Administration, Topical↗
PubMed1993

[A case of deletion of the short arm of chromosome 18 associated with chronic polymyositis].

A case of deletion of the short arm of chromosome 18 (18p- syndrome) associated with chronic polymyositis is described. The patient was a 37-year-old woman, who had psychomotor retardation in her early childhood. She started to notice a difficulty in raising both arms at 14 years of age and furthermore, she developed a gait disturbance due to weakness of the proximal muscles of the lower extremities from 34 years of age. Her parents were first cousins. On physical examination, she showed many dysmorphic features, such as short stature, round face, hypertelorism, low nasal bridge, small chin, high arched palate, abnormal dentition, short and webbed neck, and broad chest. Neurological examination revealed a low intelligence (IQ 47), severe proximal muscle weakness with moderate proximal muscle atrophy in all extremities, a waddling gait, and decreased or absent deep tendon reflexes of all extremities except for bilateral ankle jerks. Serum creatine kinase and myoglobin levels were slightly elevated. Needle EMG study showed fibrillation potentials at rest and polyphasic and low amplitude motor unit potentials of short duration on volitional activity in the affected muscles. Muscle biopsy demonstrated a variation in fiber size, necrotic fibers and mononuclear cell infiltration. These findings were compatible with those of chronic polymyositis. In addition, cytogenetic findings revealed 46.XX.18p- karyotype, although her parents had no chromosome abnormality. She had no immunological abnormality except for a positive rheumatoid factor and elevation of CD4/CD8 ratio on lymphocyte subset analysis in peripheral blood.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Characteristics of the EOG potential changes generated by saccadic eye movements of large amplitude].

The time curve of the electrooculogram (EOG) as applied to clinical diagnosis is measured as the changes in the standing potentials around the eyes when a subject performs saccadic eye movements of constant amplitude. If the characteristics of these potential changes caused by the eye movements are known, the time curves of EOG can be derived from the potential changes generated by saccadic eye movements of random amplitude, by transforming the measured potentials into the exact values corresponding to the constant amplitudes of saccades. We have already reported that the characteristic curves of EOG are proportional to the angles of the eye movements within +/- 20. However, Fenn and Hursh reported that the characteristics of saccadic eye movements for larger amplitudes up to about 80 degrees were sinusoidal functions. Other workers have reported linear relations of the characteristics of EOG. In this report we attempted to clarify whether the characteristics of EOG were linear or sinusoidal. From our experiments it became clear that the characteristics of EOG could be approximated to straight lines up to about 80 degrees (visual angle).

Adult↗
PubMed1993

Decrease of hepatic triglyceride lipase levels and increase of cholesteryl ester transfer protein levels in patients with primary biliary cirrhosis: relationship to abnormalities in high-density lipoprotein.

Serum levels of high-density lipoprotein cholesterol are often increased in patients with primary biliary cirrhosis. To elucidate the mechanism of the elevation of high-density lipoprotein cholesterol levels in this disease, lipoprotein abnormalities were analyzed in 10 patients subdivided into two groups according to concentration of high-density lipoprotein cholesterol. Activities and protein masses of lipoprotein lipase, hepatic triglyceride lipase and cholesteryl ester transfer protein were also determined. Serum high-density lipoprotein cholesterol concentration exceeded 90 mg/dl in 5 of 10 patients. Lipoprotein particles in the high-density lipoprotein2 fraction (with density between 1.063 and 1.125 gm/ml) were enriched with apolipoprotein E and larger in size than those of normal controls. In patients with and without hyperalphalipoproteinemia, hepatic triglyceride lipase activity was significantly decreased (p < 0.05); this was due to the reduction of its protein mass. Lipoprotein lipase activity and protein mass were normal. It is noteworthy that increases in cholesteryl ester transfer protein activity and mass were observed. The enhancement of cholesteryl ester transfer protein activity was more remarkable in the patients with hyperalphalipoproteinemia than in those without hyperalphalipoproteinemia. Because a significant positive correlation was demonstrated between activity and protein mass (r = 0.90, p < 0.001), the increase of cholesteryl ester transfer protein activity may be attributed to the increase of its protein mass. These data suggest that the decrease of hepatic triglyceride lipase levels at least partly explains the appearance of apolipoprotein E-rich large high-density lipoprotein particles in patients with primary biliary cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Frequency domain analysis of signal-averaged electrocardiogram in patients with right bundle branch block following repair of congenital heart disease].

Frequency domain analysis of signal-averaged electrocardiograms (SAECGs) were investigated in 24 patients with right bundle branch block (RBBB) following repair of congenital heart disease, in order to determine the block site of RBBB using a SAECG. The block site of RBBB was first identified by a body surface map; 10 patients had proximal RBBB, 14 had distal RBBB. The peak amplitude, the amplitudes on 20 Hz, 40 Hz, 50 Hz, and 100 Hz in the proximal RBBB patients were significantly (p < 0.01) smaller than in the distal RBBB patients. The areas between 0 to 20 Hz, between 0 to 40 Hz, between 20 to 50 Hz, between 40 to 100 Hz in the proximal RBBB patients were significantly (p < 0.01) smaller than in the distal RBBB patients. In conclusion, frequency domain analysis of SAECG was useful for determining the block site of RBBB following surgical correction.

Adolescent↗
PubMed1993

[Signal-averaged electrocardiogram in right bundle branch block patients after surgical repair for congenital heart disease].

Right bundle branch block (RBBB) type was investigated using signal-averaged electrocardiogram (SAECG) in 35 RBBB patients after surgical repair of ventricular septal defect and tetralogy of Fallot. The type of RBBB was first identified by body surface mapping; 12 patients had proximal RBBB, and 23 had peripheral RBBB. The control group consisted of 20 healthy volunteers. The following three findings were seen in most patients with proximal RBBB, and were useful for determining the type of RBBB; a filtered QRS duration equal to or longer than 160 msec, a fragmented signal number equal to or greater than 10 and the whole type of filtered QRS pattern. The sensitivity and specificity of SAECG for proximal RBBB were shown to be high. In conclusion, SAECG was found to be useful for non-invasive determination of RBBB types.

Adolescent↗
PubMed1992

Stimulation of the activity and mRNA level of hepatic triacylglycerol lipase by triiodothyronine in HepG2 cells.

We have studied the effects of triiodothyronine (T3) on the production of hepatic triacylglycerol lipase (HTGL) in the human hepatocellular carcinoma cell line, HepG2, by measuring its activity and mRNA levels. The HTGL activity released into the medium by heparin, increased after the addition of T3 in a both time- (27% increase after 24 and 75% increase after 48 h) and dose-dependent manner (maximum activity with over 0.2 micrograms/ml of T3 in the medium). Messenger RNA levels of HTGL in cells incubated with T3 for 24 and 48 h were increased by 33% and 98% compared to those of the control. These results suggest that the production of HTGL may be regulated by thyroid hormone at the level of gene expression.

Blotting, Northern↗
PubMed1992

Exocytosis upon osmotic swelling in human epithelial cells.

Upon osmotic swelling human epithelial cells exhibited significant increases in the membrane capacitance. Evidence for exocytosis includes its dependency on temperature, cytosolic Ca2+ and ATP as well as its sensitivity to guanosine 5'-O-(3-thio)triphosphate (GTP gamma S) and N-ethylmaleimide (NEM). A role of the osmotic exocytosis in the subsequent cell volume regulation is suggested.

Adenosine Triphosphate↗
PubMed1992

Antibodies to native type III collagen in the serum of patients with Kawasaki disease.

Pathological studies have revealed that the vasculitis in Kawasaki disease (KD) begins in the intima and the adventitia of blood vessels resulting in panvasculitis. In the present study we investigated the possibility that auto-antibodies to types III and II collagen are involved in the vascular injury. Seven out of 38 patients (18%) with KD had elevated serum levels of IgG antibody to type III collagen. None had increased serum antibodies to type II collagen. Specificity of the antibody to type III collagen in patients with KD was 86%. Three out of seven KD patients (42.9%) with coronary complications had elevated serum levels of the antibody. It is conceivable that the more severe the inflammation of systemic blood vessels, the more frequently antibodies to type III collagen are detected and coronary complications develop. Accordingly, this antibody may be secondarily detected in the serum of KD when systemic blood vessels are severely damaged. Detection of antibodies to type III collagen might be a risk factor predicting coronary complications.

Autoantibodies↗
PubMed1992

Non-macrophage-related accumulation of cholesterol during probucol treatment in familial hypercholesterolemia: report of two cases.

Two patients receiving long-term (3-4 years) treatment with probucol for familial hypercholesterolemia (FH) developed diffuse yellow lesions over the upper eyelids suggesting lipid storage in those tissues (diffuse lipid-storage lesions). Interestingly, each patient had shown a substantial reduction in their cholesterol levels together with a marked regression of their tendon xanthomas or typical xanthelasmas during treatment. To evaluate the role of probucol in this unusual finding we conducted histological and immunochemical evaluations of the lesions (removed surgically) and compared them with those of a non-probucol-treated subject with FH and typical audinal xanthelasma. In both probucol-treated patients the lesions were filled with foam cells and contained large amounts of cholesteryl ester. However, immunochemical analysis of the lesions of one patient using anti-monocyte monoclonal antibody (HAM56) demonstrated that they were not composed of macrophage-derived foam cells in contrast to those of the non-probucol-treated subject which stained clearly with anti-monocyte monoclonal antibody. In each case the foam cells did not react with muscle-actin-specific monoclonal antibody (HHF35). It appears that non-macrophage-related diffuse lipid-storage lesions may occur even during treatment with probucol despite the reduction in cholesterol levels and the regression of xanthomas, suggesting that probucol may alter the distribution of cholesterol from the macrophage to other cells.

Adult↗
PubMed1992

Polydisperse low-density lipoproteins in hyperalphalipoproteinemic chronic alcohol drinkers in association with marked reduction of cholesteryl ester transfer protein activity.

Long-term heavy alcohol intake is well known to increase serum high-density lipoprotein (HDL) cholesterol concentrations. Epidemiologic studies have shown that the protective effect of alcohol intake against coronary heart disease (CHD) is observed in moderate alcohol drinkers, but not in heavy ones. To clarify whether heavy alcohol intake may cause abnormalities in lipoprotein metabolism, we analyzed the plasma lipoproteins in eight male chronic heavy alcohol drinkers with marked hyperalphalipoproteinemia. Although their serum HDL cholesterol levels were remarkably high, ranging from 2.67 to 3.58 mmol/L, three patients had CHD and corneal arcus was present in seven patients. Cholesteryl ester transfer protein (CETP) activity was reduced in all subjects (7.3% +/- 4.2%/10 microL/18 h in alcohol drinkers v 20.5% +/- 2.4%/10 microL/18 h in control; mean +/- SD, P < .001). The CETP mass levels were also markedly reduced in these subjects. The analysis of low-density lipoprotein (LDL) on nondenaturing polyacrylamide gradient gel electrophoresis revealed that four subjects with severely low CETP activity (< 25% of control) had polydisperse LDLs, similar to those observed in genetic CETP deficiency. The other four subjects with approximately half the normal CETP activity had homogeneous but smaller-sized LDLs, as compared with control subjects. Particle size of HDL was larger than that of normal control HDL in all subjects. After cessation of alcohol intake, plasma HDL cholesterol levels were decreased and LDLs became more homogeneous and normal in size, in parallel with elevation of CETP activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Sudden death of calves by experimental infection with Strongyloides papillosus. I. Parasitological observations.

Recently, an unknown disease, 'sudden death', in calves has been found in Japanese beef production farms. A previous study conducted by Taira and Ura indicated that sudden death can be effected in calves by hyperinfection of Strongyloides papillosus (SPL) and that the disease is possibly caused by SPL infection. In the present work, an experimental infection of SPL in calves was conducted to confirm the field occurrence. Fifteen Holstein Friesian calves, ranging from 45.5 to 85.6 kg in body weight, were divided into six groups. Calves of Groups A, B, C, D, E and F were infected once at the rate of 100,000, 320,000, 1,000,000, 3,200,000, 10,000,000 and 32,000,000 SPL larvae per 100 kg of body weight, respectively. Five calves were assigned to Group B, while two calves were assigned to the other groups. After showing no premonitory signs, sudden death of ten calves took place. The survival time of these calves was 27.4 and 16.8 days (Group B), 14.8 and 14.8 days (Group C), 13.3 and 14.2 days (Group D), 11.0 and 11.1 days (Group E) and 11.6 and 10.8 days (Group F). Three calves of Group B did not exhibit sudden death. The results of this study demonstrate that strongyloidiasis was the cause of sudden death.

Animals↗