Biomedical subjects
Publications and source records attributed to S Eguchi.
A 66-year-old woman with multiple rib fractures was successfully treated with the use of Rib Staplers (Judet's struts made of titanium). Rib Staplers are effective for the stabilization of fractured ribs even if fracture lines are oblique.
A 51-year-old man with stage IIIB (T4N2M0) adenocarcinoma of the lung underwent left pneumonectomy and aortic wall resection. In this operation a heparin-coated tube and roller pump system were used. Advantages of a heparin-coated tube and roller pump system for temporary bypass are as follows. 1) simple operative procedure. 2) controllable bypass flow. 3) no need for anticoagulants.
Autocrine and paracrine regulation of vascular endothelial cells by endothelins has been postulated and has been the target of many recent investigations. In the present study, we demonstrated, by affinity labeling, the presence of endothelin-1- and endothelin-3-specific receptors on cultured bovine endothelial cells that secrete endothelin; the endothelin-3 receptor was the major form. Analysis using the GTP analogue guanosine 5'-O- (thiotriphosphate) indicated that these receptors are coupled to G proteins.
Cultured bovine endothelial cells (EC) have specific receptors for endothelin (ET)-3 functionally coupled to phosphoinositide breakdown. We studied whether ET-3 stimulates synthesis of nitric oxide (NO), an endothelium-derived relaxing factor that activates soluble guanylate cyclase in EC, and whether the ET-3-induced NO formation involves G-proteins. ET-3 dose-dependently stimulated production of intracellular cGMP in EC, of which effects were abolished by pretreatment with NG-monomethyl L-arginine, an inhibitor of NO synthesis, and methylene blue, an inhibitor of soluble guanylate cyclase. The stimulatory effects of ET-3 on cGMP production, inositol trisphosphate formation and increase in cytosolic free Ca2+ concentration were similarly blocked by pretreatment with pertussis toxin (PTX). These data suggest that ET-3 induces synthesis of NO mediated by phosphoinositide breakdown via PTX-sensitive G-protein in EC.
Two cases of kitsune-tsuki (fox possession) in a mountain village are examined from psychiatric and ethnographic viewpoints. Kitsune-tsuki, one of the most familiar expressions of "madness" in Japan, represents, as an interactive performance, religious and mythopoetic contexts metaphorically in time of crises. The atypical symptoms and the complicated clinical process of these cases reflect a multistratified cultural background and its transformation; communal religion, folk tales, kyôgen play, shared concepts of illness, and the post-war rise of one religious cult. The psychiatric diagnosis, trying to arrive at a single correct understanding, partially translates the entangled indigenous illness. Focusing on these issues; the dichotomy between form and content of mental illness, the atypicality of the symptoms and the restructive process of illness experiences, the author reconsiders the possibility of interpretation, diagnosis and treatment which respect the multiple realities.
We solubilized bovine lung endothelin receptors in a nonaggregated state and identified 34- and 52-kDa species of endothelin receptor by affinity labeling. The ratio of 34-kDa species to 52-kDa species varied widely from sample to sample, suggesting that the 34-kDa species is a proteolytic product; we therefore examined the effect of various proteinase inhibitors and found that EDTA (greater than 50 mM) was very effective in preventing the conversion. These results indicate that the lower Mr species arose from the 52-kDa receptor as a result of limited proteolysis by metal proteinase(s). The resulting 34-kDa species had endothelin-binding activity, was very stable, and was not processed further even in the absence of proteinase inhibitors. We therefore first tried to purify the 34-kDa species by affinity chromatography. Bovine lung extracts were mixed with biotinylated endothelin and the ligand-receptor complexes formed were isolated with avidin-agarose. Starting from 3.5 kg of bovine lung, approximately 200 micrograms of the pure receptor was obtained. Microsequencing of two well-separated tryptic fragments yielded the following partial amino acid sequences: Ala-Asn-Asp-His-Gly-Tyr-Asp-Asn-Phe and Ser-Gly-Met-Gln-Ile-Ala-Leu-Asn-Asp-His-Leu-Lys.
Release of endothelin-1, a novel potent vasoconstrictor peptide originally isolated from endothelial cells, from cultured bovine endothelial cells has been shown to be stimulated by arginine vasopressin and angiotensin II. To elucidate the cellular mechanism by which endothelin-1 is released by these vasoconstrictors, we tested the effects of several compounds on the agonist-induced endothelin-1 release and studied the changes of cytosolic free Ca2+ concentrations and phosphoinositide breakdown by these agonists in cultured bovine endothelial cells. Protein kinase C inhibitors (H-7, staurosporine), an intracellular Ca2+ chelator, and an inhibitor of phospholipase C (neomycin), all abolished the agonist-induced endothelin-1 release, whereas the Ca2+ channel blocker nicardipine was ineffective. Although synthetic 1,2-diglyceride (diolein) dose dependently stimulated endothelin-1 release, downregulation of protein kinase C after pretreatment with phorbol ester resulted in decreased effects to increase endothelin-1 release by the agonists. Both arginine vasopressin and angiotensin II induced immediate and transient increases in intracellular Ca2+ levels of fura-2-loaded endothelial cells as well as formation of inositol trisphosphate; the agonist-induced intracellular Ca2+ increases were not affected either by nicardipine or by chelating extracellular Ca2+. The arginine vasopressin- and angiotensin II-induced intracellular Ca2+ increases, inositol trisphosphate formation, and endothelin-1 release were completely abolished by V1-receptor antagonist and saralasin, respectively. It is concluded that arginine vasopressin and angiotensin II stimulate the release of endothelin-1 by a common mechanism, involving receptor-mediated mobilization of intracellular Ca2+ and activation of protein kinase C in endothelial cells.
2,2'-Anhydro-1-(3'-deoxy-3'-iodo-5'-O-trityl-beta-D-arabinofuranosyl) thymine (2) was synthesized from 2',3'-didehydro-3'-deoxythymidine (DHT). Compound 2 was readily converted into the 2',3'-anhydrolyxofuranosyl derivatives 4-6. Treatment of 4a with some nucleophiles (N3-, OMe-, Cl-) gave the corresponding 3'-substituted arabinosyl nucleosides (7a,c,e) together with the minor xylosyl isomers (8a,c,d). 7a,c,e were deprotected to 7b,d,f, respectively.
Using an Ussing-type chamber, the transport of fluorescein (F) across the isolated retinal pigment epithelium (RPE)-choroid of the rabbit was studied. The outward movement (from the vitreous to the choroidal side) of F was significantly greater than the inward movement (from the choroidal to the vitreous side) and was suppressed by the application of 10(-4)M probenecid, 30mM hippurate or 5mM iodipamide to 41%, 45% or 39% of the control, respectively, while the inward movement was not affected by any of these agents. As the F concentration in the chamber increased, the inward movement of F also increased in a linear fashion, but the outward movement showed nonlinearity. The difference between the outward and inward movement of F was thought to represent the net flux of F across the RPE-Choroid and this value showed nonlinearity and saturation as the F concentration increased. The Lineweaver-Burk plot of the reciprocals of the net flux of F concentration gave the apparent Km of 4.5 x 10(-5)M and apparent Vmax of 2.27 nmoles/hr/cm2, which suggested that the F transport system in the rabbit RPE-Choroid had a greater affinity to the substrate but lower transporting capacity as compared with the F transport system in the rabbit iris-ciliary body or the ascorbate transport system in the iris-ciliary body.
Retinal pigment epithelium (RPE)-choroid preparations from albino rabbits were sealed in an Ussing type chamber under stabilized conditions for 3 hours. The transepithelial potential was 1.2 +/- 0.08 mV and the transepithelial resistance was 175.2 +/- 9.1 omega.cm2 (mean +/- SE, n = 16). The transport of fluorescein across the isolated rabbit RPE-choroid was studied under short circuit condition and outward (vitreous----choroid) and inward (choroid----vitreous) permeability to fluorescein were determined. The outward permeability was 1.63 +/- 0.20 x 10(-5) cm/sec and inward permeability was 0.44 +/- 0.13 x 10(-5) cm/sec (mean +/- SE, n = 8). The former was 4 times greater than the latter (p less than 0.01). The outward permeability was decreased to 1.02 +/- 0.08 x 10(-5) cm/sec (n = 7), 0.75 +/- 0.11 x 10(-5) cm/sec (n = 5), 0.67 +/- 0.11 x 10(-5) cm/sec (n = 6) by 10(-6) M of ouabain, 10(-5) M of 2,4-dinitrophenol and 10(-4) M of probenecid, respectively. Low temperatures (0.5-1.0 degree C) markedly decreased the outward permeability to 0.05 +/- 0.04 x 10(-5) cm/sec (n = 4, mean +/- SE). These results suggest that active transport plays a role in the outward movement of fluorescein across the rabbit RPE-choroid.
Twenty four patients underwent surgical treatment for ascending aortic lesions with aortic insufficiency at our institution. There were 16 male and 8 female patients from 12 to 67 years. Of 24 patients, 11 patients had Marfan's syndrome, and were younger at the time of operation. Three types of operative procedure were performed, that is, aortic valve replacement (AVR) and supracoronary graft replacement in 4 patients, AVR and covering the aneurysm of ascending aorta in 9, and composite graft replacement of the aortic valve and ascending aorta in 11. One patient died of perioperative myocardial infarction within 30 days after operation (early mortality rate, 4.2%). Another 5 patients died during the initial hospitalization, but no deaths were related to operative procedures. There was a total of 5 (27.8%) late deaths among the 18 patients follow-up with 5 and 10 years survival rate, 60.8%, 52.1%, respectively. Four of five patients was the cases with Marfan's syndrome. There were no statistically significant differences among three different procedures, but all patients who underwent composite graft replacement and left the hospital alive are doing well.
From 1965 to 1990, 49 valve replacements were performed on 43 patients under the age of 15. Mitral valve replacements were performed on 21 patients, and re-replacements were done on 4 of them afterwards. In the first 9 mitral valve replacements before 1974, Starr-Edwards (S-E) ball valves were used. Five of these patients died in the hospital (early mortality rate was 56%). Since 1975, bioprosthetic valves were used in three cases, but all of these valves ceased to function due to primary tissue failure (PTF) within 3 years. Consequently, SJM valves are now used as a first choice. Ten aortic valve replacements were performed on 9 patients with the results of one early death, two late deaths, and one late re-operation. Tricuspid valve replacements were performed on 11 patients, 5 of whom utilized S-E ball valves. Three of the five patients died in the hospital. One patient was re-operated on, swapping the S-E ball valve for the SJM valve. SJM valves were used primarily in 2 patients, and bioprosthetic valves in 4. Two patients died, one with a SJM valve, and the other with a bioprosthetic valve. Two pulmonary valve replacements were performed, one employing a SJM valve, the other a bioprosthetic valve. Two adult patients with SJM valve in the right side of the heart had thrombotic complications, though the patients with bioprosthetic valves had none. Atrioventricular valve replacements were performed on 5 patients under the age of 3, but all of them died.(ABSTRACT TRUNCATED AT 250 WORDS)
We reported a patient of 46-year-old man, who had undergone reinforced aortic valve replacement using a composite Björk-Shiley prosthesis for infective endocarditis on April 13, 1988. Because of recurrent periannular endocarditis and periprosthetic dehiscence, reoperation was undertaken eighteen months after the initial operation. Following debridement, a composite Dacron vascular prosthesis with a St. Jude Medical valve and two saphenous vein grafts were transposed in the ascending aorta. The operative procedures were entirely smooth. A modified Danielson's technique may be adequate for recurrent periannular endocarditis which make orthotopic re-replacement impossible in most cases.
We treated surgically 567 patients with primary lung cancer from June 1975 to December 1989. There were nine patients with advanced (p-stage III.IV) lung cancer less than 2.0 cm in size. The five year survival rate was 50.8%. The histological diagnosis was adenocarcinoma in 6, squamous cell carcinoma in 3. A curative resection was performed in seven of nine patients. Six patients had one level metastasis of mediastinal lymph node. Three patients in whom relative curative resection was performed at surgery later developed regional recurrence. However, distant metastasis was not evident in all but one of nine patients. In conclusion surgical resection is considered to be significant in patients with advanced (p-stage III.IV) lung cancer less than 2.0 cm in size.
Bovine lung endothelin receptors were solubilized in a non-aggregated state and characterized in terms of their minimal functional size and chemical nature of the ligand-binding site. A variety of detergents and their combinations were tested for their efficiency to solubilize endothelin receptors from bovine lung plasma membranes, and a combination of 0.4% digitonin and 0.25% CHAPS was found to be very effective in obtaining highly dispersed receptor solution. Gel filtration of the CHAPS/digitonin-solubilized receptors revealed the presence of two receptor species eluting at the positions corresponding to 34 and 52 kDa. These values were in good agreement with those estimated by affinity labeling and SDS-polyacrylamide gel electrophoresis, establishing that they represent minimal functional units. Chemical modification of ligand-occupied and free receptors with p-chloromercuriphenylsulfonic acid revealed that both 34 and 52 kDa receptors have SH group(s) essential for the receptor activity in their ligand-binding sites.
A new ophthalmic electronic videoendoscope system has a 20-guage probe for intraocular observation, a standard size for vitreous microsurgical instruments, and both endoscopic and operating microscopic images are displayed on a split-screen monitor system to provide surgeos a simultaneous view of both images. Using this endoscope system at any time during surgery, surgeons can examine the intraocular structure such as the ciliary sulcus, pars plana, or vitreous base and obtain valuable but otherwise unobtainable information for completing the surgery.
A 9-year-old boy with heart failure and long-term incessant atrial tachycardia mimicking dilated cardiomyopathy was treated surgically. Intraoperatively he was found to have atrial aneurysm, and the ectopic automatic focus was located at the base of it. Excision of the aneurysm including the focus without using cardiopulmonary bypass cured the tachycardia and heart failure.
Sixty-five patients (pts) with sustained ventricular tachycardia (VT) and 1 patient with symptomatic nonsustained VT were included in this study. Of these, 5 had died before electrophysiologic study (EPS) or determination of effective antiarrhythmic drugs. Inducibility of VT by our protocol varied from 69 to 100% according to underlying diseases. Drug efficacy was evaluated by using conventional drugs in all and using flecainide and amiodarone in some. However, more than 50% of pts with inducible VT were found to be resistant to pharmacological therapy. Fourteen of 26 pts with drug-refractory VT, underwent surgical therapy. In all pts, the site of VT origin was determined and VT was either eradicated or clinically controlled in 86% of the patients. Catheter ablation was tried in 9 pts at the earliest activation site of VT or at the site where pace-mapping produced the best result in configuration in the QRS complex as the clinical VT. Prophylactic effect was confirmed in 60% but VT recurred in 3 pts. These VT became responsive to anti-arrhythmic drugs in 2 pts. In thirteen pts who died suddenly during the follow up period, none had adequate antiarrhythmic drugs. One patient died after operation because of residual VT among four different QRS morphologies found preoperatively. In conclusion, the success rate antiarrhythmic drug prophylaxis against VT induction or recurrence did not exceed 50%, therefore non-pharmacological interventions such as surgery or catheter ablation may be required.