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Biomedical subjects

S Endo

Publications and source records attributed to S Endo.

At least 829 records · Page 46Linked to original sources
PubMedDate not supplied

Biological rhythms in patients with lissencephaly (agyria-pachygyria).

Lissencephaly is a congenital malformation of the brain characterized by an extensive absence of cerebral gyral formation. Polysomnograms were recorded in 8 cases with lissencephaly (4 of agyria and 4 of pachygyria), and 24-h secretion of growth hormone, prolactin, luteinizing hormone, follicle-stimulating hormone and cortisol was examined in 6 of the 8 cases. The sleep-waking cycle and body temperature (BT) rhythm were studied in all 8 cases. The results were as follows: (i) the sleep-waking circadian rhythm was well preserved in 6 of the 8 cases; (ii) %REM (rapid eye movement) sleep decreased in 4 cases, but the ultradian rhythm of REM sleep was well observed in all cases except one; (iii) the secretion of GH and PRL showed normal or borderline increases with sleep; (iv) although these cases had not reached puberty, LH and FSH increased with sleep in 3 of 5 cases; (v) the circadian rhythm of cortisol secretion was preserved in all cases except one; (vi) BT showed a circadian rhythm after infancy. These findings suggest that the circadian rhythms function normally in lissencephaly, that the secretion of GH and PRL during sleep occurs almost normally, and that the cerebral cortex does not play a significant role in the regulation of these biological rhythms in lissencephaly.

Birth Weight↗
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Serial EEG and sleep polygraphic studies on lissencephaly (agyria-pachygyria).

We carried out serial EEG studies on 12 cases of lissencephaly (6 of agyria and 6 of pachygyria), polysomnograms being recorded in 8 of the 12 cases. Fourteen Hz sleep spindles appeared from early infancy in all cases. They were poorly observed after the age of 1 year, and 5-11 Hz high-amplitude rhythmic activity (HARA) of more than 300 microV appeared predominantly in place of the 14 Hz spindles. Both the 14 Hz spindles and HARA showed asymmetry, but the dominant cerebral area for both types of waves was much the same. Four of the 6 agyria cases showed hypsarrhythmia within the first 6 months after birth, 3 of the 4 cases showing asymmetric hypsarrhythmia at first. Their hypsarrhythmia consisted of very high-voltage 5-7 Hz slow sharp waves and delta waves. The EEG abnormalities transformed from hypsarrhythmia to focal spikes in the 6 pachygyria cases. The polygraphic study on 8 cases revealed that the proportion of REM sleep decreased in 3 cases and the REMs/min values decreased in 7. Infantile spasms occurred in 4 of the 8 cases. The REM/min values decreased in all of these 4 cases, and, furthermore, the proportion of REM sleep decreased in 3 of the 4 cases. These findings suggest that lissencephaly involves a disorder of the brainstem, and that the combination of brainstem lesions and severe cerebral dysplasia is important for the manifestation of infantile spasms in lissencephaly.

Aging↗
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Detection of DNA damages and repair in human culture cells with simulated space radiation.

DNA damages and its repair of cultured WI38 human fibroblast cells and T98G human glioblastoma cells were studied by exposing to carbon ion beams of HIMAC accelerator. The exposed cells were incubated at 37 degrees C for appropriate intervals and the damages were analyzed by alkaline comet assay and quantitative RT-PCR with p53 mRNA. Highly inhomogeneous DNA damages were observed among the electrophoretic cell images of the comet assay. The degree of the damages was analyzed semi-quantitatively by using the Comet Index. The damaged fraction of WI38 cells was 85% immediately after 4 Gy (100keV/micrometer) irradiation and decreased to 50% after 120 min. incubation indicating a repair of cell DNA. Time dependent p53 gene expression as also analyzed by the quantitative RT-PCR method.

Carbon↗
PubMedDate not supplied

Effects of long-term nonpulsatile left heart bypass on the mechanical properties of the aortic wall.

We investigated the mechanical properties of the descending aortic wall relative to its structural change caused by reduced pulse pressure in long-term nonpulsatile left heart bypass (LHB). Fifteen adult goats (53-68 kg) were divided into three groups: five goats underwent LHB with a nonpulsatile pump for 31 to 381 days (Group N), five goats underwent LHB with a pulsatile pump for 24 to 130 days (Group P), and the other five goats were used as normal control animals (Group C). The aortic pulse wave pressure was 17+/-7 mm Hg in Group N, 43+/-1 mm Hg in Group P, and 39+/-2 mm Hg in Group C. Structural changes were evaluated using wall thickness and the volume ratio of elastin and collagen. The mechanical properties were evaluated using "beta," which was calculated according to the equation: = (In P/Ps)/(Do/Ds-1), where Ps was the standard pressure, Ds was the wall diameter at pressure Ps, and Do was the wall diameter at pressure P. The wall thickness of the aortic wall in Group N (1.6+/-0.3 mm) was significantly thinner than that in either Group P (2.2+/-0.3 mm) or Group C (2.1+/-0.2 mm). The volume ratio of elastin in Group N (51 +/- 3%) was higher than that in Group P (44+/-1%) or Group C (40+/-1%), whereas no significant difference was found in the volume ratio of collagen between those in Group N (10+/-1%), Group P (9+/-2%), and Group C (10+/-1%). The stiffness parameter, beta, in Group N (3.1+/-0.7) was slightly higher than that seen in Group P (2.9+/-0.4) or Group C (2.9+/-0.2), but there was no significant difference between the three groups. These results indicate that long-term nonpulsatile LHB caused marked structural changes in the aortic wall, whereas the change in mechanical properties were not significant with regard to stiffness.

Animals↗
PubMedDate not supplied

Progress of an electrohydraulic total artificial heart system with a separate energy converter.

We have been developing an electrohydraulic total artificial heart (EHTAH) system. The system consists of diaphragm blood pumps, an abdominally placed energy converter, an internal controller, a transcutaneous energy transfer (TET) system, a transcutaneous optical information transfer system, and internal and external lithium-ion (Li-ion) batteries. The energy converter was optimized to obtain better oil transfer. Maximum cardiac output and efficiency of the EHTAH were increased from 8 L/min to 10 L/min and from 10% to 12%, respectively. The volume of the energy converter was reduced from 280 to 210 ml. The pumping unit was successfully implanted in 68-85 kg calves without anatomic problems, and the calves survived up to 10 days with good circulatory results. The maximum temperature rise of the implanted energy converter was only 1 degrees C. Stable performance of the TET system was confirmed in goats for more than 1 month. DC-DC energy transfer efficiency with 20 W of energy transmission remained within the range of 80% to 85%, and no significant temperature rise was observed in the implanted circuit. The internal Li-ion battery was also evaluated in a goat, and the maximum temperature rise during the charging period was 1.5 degrees C, while the charging and discharging times were 72 and 58 min, respectively. We conclude that our system has progressed in its development as a practical implantable system.

Animals↗
PubMedDate not supplied

Gastric intramucosal pH during lower body circulatory arrest under open distal anastomosis with selective cerebral perfusion in aortic arch repair.

Selective cerebral perfusion (SCP) and open distal anastomosis (OD) with hypothermia has been used as a popular means for circulatory assistance in aortic arch surgery. Although SCP has become accepted for brain protection, the influence of OD accompanying circulatory arrest on lower body ischemia is not known. We studied gastric tonometry (gastric intramucosal pH [pHi]) to estimate splanchnic ischemia during OD, and its relationship to postoperative organ function. In five patients (pts) (range, 65-78 years; mean, 71 years; group OD) who underwent arch replacement using SCP and OD with moderate hypothermia (25 degrees C) during the period from March to August of 1999, pHi was measured precardiopulmonary bypass (pre-CPB), 30 min of CPB (CPB30), 10 min after OD (OD10), at end of CPB, and post-CPB. Eight pts (range, 52-78 years; mean; 66 years) who underwent standard CPB (33 degrees C) during the same period (coronary artery bypass surgery in six and valve surgery in two) served as controls (group C). In group OD, pHi was significantly decreased at OD10 (7.35 +/- 0.03 at CPB30 vs. 7.23 +/- 0.07 at OD10, p < 0.05) but recovered by the end of CPB (7.32 +/- 0.02). Creatinine clearance on the first postoperative day (1POD) was significantly (p < 0.05) lower in group OD (82 +/- 40 ml/min) than in group C (126 +/- 25 ml/min), although there was no significant difference in preoperative values between the two groups. The pHi at OD10 did not correlate with the duration of OD (range, 30-47 min; mean, 38 min), whereas pHi at OD10 significantly correlated with BUN (r = -0.973, p = 0.0054), Cr(r = -0.977, p = 0.0043), and CCr (r = 0.908, p = 0.0328) on 1POD. One patient in group OD developed paraplegia and renal failure postoperatively. His pHi at OD10 was severely decreased to 7.11. These results suggest that intraoperative monitoring of pHi may be useful for the evaluation of visceral organ ischemia during OD in arch replacement and may contribute to improved technique for circulatory assistance in aortic surgery.

Aged↗
PubMedDate not supplied

A quantitative study of trunk muscle strength and fatigability in the low-back-pain syndrome.

A quantitative study of the trunk muscle strength and fatigability was performed using an isokinetic dynamometer to determine the role of trunk muscles in the low-back-pain syndrome and in particular to investigate the correlation of trunk muscle strength and lumbar lordosis. Most patients demonstrated a generalized weakness of the trunk muscles. The trunk muscle strength of patients suffering from backache for less than one month was significantly lower than that of the controls. The strength of the trunk muscles was not influenced by the duration of symptoms. There was no imbalance between the trunk flexors and extensors. The patients with back pain had a greater fatigability of the trunk flexors than the controls. There was negative correlation between the trunk muscle strength or fatigue and lumbar lordosis.

Adult↗
PubMedDate not supplied

Epithelial-myoepithelial carcinoma of the nasopharynx.

We present a patient with a rare epithelial-myoepithelial carcinoma of the nasopharynx with a typical biphasic histopathologic pattern. Immunohistochemical findings support the concept that the inner cells differentiate to ductal epithelium and the outer cells to myoepithelium. In this patient complete excision of the tumor and reconstruction with a pedicled sternocleidomastoid myocutaneous flap were performed. A DNA diploid pattern from flow cytometric study indicates a favorable prognosis. There was no recurrence nor metastasis for 55 months.

Aged↗
PubMedDate not supplied

Cytokine profile of serum and bronchoalveolar lavage fluids following thoracic esophageal cancer surgery.

OBJECTIVES: The body's response to stress is comprised of two opposing reactions, namely inflammation and immunosuppression. The balance between these two reactions not only changes over time, but also varies among different cells or organs. Limited information is available regarding the cytokine balance of circulating blood and inflammatory sites after thoracic surgical stress. DESIGN: The subjects of the present study were 10 patients undergoing esophageal cancer surgery which requires thoracolaparotomic manipulation. The postoperative levels of interleukin (IL)-8, IL-10, IL-1 receptor antagonist (IL-1ra) and soluble tumor necrosis factor receptor I (sTNF-RI) in bronchoalveolar lavage fluids (BALFs) and peripheral blood were measured by enzyme-linked immunosorbent assay. The absolute concentration of cytokines in lower respiratory tract ([cytokine](LRT)) was estimated by using the ratio of urea concentration in BALF and serum. RESULTS: The levels of these cytokines in peripheral blood peaked within 24 h of start of the surgery (IL-8 85.6 +/- 29.8 pg/ml; IL-10 65.1 +/- 10.6 pg/ml; IL-1ra 2,807.8 +/- 652.8 pg/ml, and sTNF-RI 3,996.3 +/- 380.1 pg/ml). The level of [IL-8](LRT) immediately after surgery was approximately 20 times higher than that in peripheral blood, and the level of [IL-1ra](LRT) was approximately 4 times higher. In contrast, the level of [IL-10](LRT) immediately after surgery was comparable to that in peripheral blood, but the level of [sTNF RI](LRT) immediately after surgery was approximately one fifth of that in peripheral blood. CONCLUSIONS: The balance between pro- and anti-inflammatory reactions varies from one part of the body to the next, and changes over time after surgery. The profile of stress-induced pro-inflammatory cytokines and anti-inflammatory cytokines should be analyzed further to establish appropriate and effective cytokine modulatory therapeutic approaches.

Aged↗
PubMedDate not supplied

Involvement of soluble adhesion molecules in acute pancreatitis.

The relationship between inflammatory cytokines and adhesion molecules in cases of acute pancreatitis was studied. Twenty-five patients were divided into three groups based on the severity of their disease as rated by the Ranson score. They were also divided into two groups according to the presence or absence of the complications of the multiorgan dysfunction syndrome (MODS) and the prognosis. As the severity of acute pancreatitis increased, the plasma levels of TNF-alpha, slCAM-1, sE-selectin, and sVCAM-1 also increased. The levels of all of these soluble adhesion molecules were significantly higher in the MODS-complicated group than in the non-MODS-complicated group. The levels of TNF-alpha, slCAM-1, and sVCAM-1 were significantly higher in patients who eventually died than in patients who survived. Significant correlations were observed between the levels of TNF-alpha and slCAM-1, between those of TNF-alpha and sVCAM-1, and between the levels of slCAM-1 and sVCAM-1. These results suggest that inflammatory cytokines stimulate the expression of adhesion molecules on the vascular endothelium and that mediators, including these adhesion molecules, are closely involved in the pathogenesis of acute pancreatitis. The plasma levels of these soluble adhesion molecules reliably reflected the severity of the disease.

Acute Disease↗
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Involvement of IL-18 and soluble fas in patients with postoperative hepatic failure.

We measured the levels of tumor necrosis factor alpha (TNF-alpha), interleukins (IL)-6 and -18, and soluble Fas (sFas) in 11 patients with postoperative hepatic failure and assessed whether IL-18-mediated apoptosis is involved in the onset of liver dysfunction. The serum TNF-alpha, IL-18, and sFas levels were significantly higher in patients with sepsis as a complication than in those without sepsis. The TNF-alpha and IL-18 levels were significantly higher in nonsurvivors than in survivors. Significant correlations were observed between TNF-alpha and IL-6, between TNF-alpha and IL-18, and between TNF-alpha and sFas levels. These results showed that Fas-mediated hepatocyte apoptosis functions as an important mechanism responsible for the onset of postoperative hepatic failure in humans. They especially suggested that IL-18 and TNF-alpha function both as apoptosis-promoting factors and as apoptosis-inhibiting factors, depending on the conditions to which hepatocytes are subjected.

Aged↗
PubMedDate not supplied

Perioperative serum procalcitonin concentrations in patients with acute aortic dissection.

We investigated the perioperative serum procalcitonin (PCT) concentrations in 5 consecutive patients who underwent surgery for acute aortic dissection (2 men, 3 women; mean age 72 +/- 9 years, age range 52-81 years). Surgery used cardiopulmonary bypass with deep hypothermic circulatory arrest. Blood samples were taken prior to surgery, upon arrival in the intensive care unit, and 6, 12, 18, 24, and 48 h after intensive care unit arrival. Prior to surgery, the PCT level was 4.2 +/- 3.4 (range 0.8-8.3) ng/ml. The PCT increase was greatest at 24 h (5.8 +/- 4.5 ng/ml). Preoperatively, the C-reactive protein concentration was 8.0 +/- 8.3 (range 0.9-23.8) mg/dl, and the white blood cell count was 8.5 +/- 3.1 x 10(3). C-reactive protein continued to increase at 48 h, while the white blood cell count peaked at 24 h. In spite of no symptoms of infectious diseases or septicemia, all patients had a significant preoperative PCT elevation. This finding may have something to do with the specific preoperative condition of acute aortic dissection. However, more clinical investigation is needed to clarify the PCT changes during and after surgery for acute aortic dissection.

Acute Disease↗
PubMedDate not supplied

Serum procalcitonin levels are elevated in esophageal cancer patients with postoperative infectious complications.

BACKGROUND: The normal systemic inflammatory response to surgical stimuli often makes early diagnosis of postoperative infections difficult. PURPOSE: We investigated whether serum procalcitonin (PCT) levels may be a useful marker of bacterial infections in patients after invasive surgery. SUBJECTS AND METHODS: The subjects were 40 patients who had undergone radical surgery for esophageal carcinoma by a right thoracoabdominal approach. Nine patients were diagnosed to have a postoperative infection during the first 7 days after surgery. Changes in serum PCT levels were compared between the group diagnosed to have postoperative infection (infection group) and the group without infection (noninfection group). RESULTS: The postoperative serum PCT levels were significantly higher in the infection group than in the noninfection group (ANOVA: p < 0.01). Serum PCT peaked on postoperative day (POD) 5 in the infection group (8.7 +/- 8.2 ng/ml, mean +/- SD) and on POD 1 in the noninfection group (0.5 +/- 0.5 ng/ml). No significant differences were found between the two groups in leukocyte count, serum CRP or cytokine levels. The receiver operating characteristics (ROC) curve was constructed for infection identification. The area under the ROC curve for peak postoperative PCT was 0.968, and at a cutoff value of 2.0 ng/ml, the sensitivity was 89% and the specificity was 93%. CONCLUSIONS: Serum PCT levels may be useful for the early diagnosis of postoperative infectious complications.

Aged↗
PubMedDate not supplied

Angioarchitecture in experimental hydrocephalus.

The angioarchitecture of microcorrosion casts in 12 hydrocephalic rats and 5 normal control rats was investigated by using scanning electron microscopy to observe the changes of the vascular bed in the cerebral mantle in hydrocephalus. Reduction in the number and caliber of the capillaries in the white matter was the most remarkable change in the hydrocephalic rats. This change increased in proportion to the severity of hydrocephalus. A similar change was observed in the basal ganglia. The change in the cortical capillaries was mild, but the cortical 'palisade' pattern had disappeared in some cases. Three-dimensional consideration of the angioarchitecture by using microvascular casts compared with microangiographic technique in rat hydrocephalus was discussed.

Animals↗
PubMedDate not supplied

Experimental cerebral vasospasm after subarachnoid hemorrhage. Participation of adrenergic nerves in cerebral vessel wall.

Distribution and morphology of nerves in basilar-artery-induced vasospasm were investigated electronmicroscopically. Small cored vesicles were transformed, decreased and disappeared gradually after development of vasospasm induced by blood-CSF mixture incubated 5--10 days. These changes were not induced by fresh arterial blood, lysed platelets in saline and mechanical stimulation. In the portion with severe vasospasm induced by incubated blood-CSF mixture, nerve distribution was rich and uniform in all portions of the adventitia. In the portion with slight vasospasm, nerves were extremely scanty in the innermost area of the adventitia, within 10 mu from the outer edge of the media. The severity of experimental vasospasm became definitely lighter and the duration shorter after bilateral cervical sympathectomy. These findings indicate that nerves, especially the adrenergic axon in the innermost area of the adventitia, may play an important role on the genesis of late vasospasm. The difference in nerve distribution may be a factor influencing individual differences in frequency or severity of vasospasm.

Adrenergic Fibers↗
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Measurement of regional blood flow using hydrogen gas generated by electrolysis.

Electrochemically generated hydrogen gas was used to measure local blood flow by Stosseck et al. The data obtained by their method, however, did not correlate well with those obtained by hydrogen inhalation. We have modified the equation proposed by Stosseck, prolonging the stimulus duration in order to increase the amount of hydrogen generated. In dog white matter the resulting clearance curves were formed to be monoexponential both in the living animal as well as after circulatory arrest when all the clearance is by diffusion away from the electrode. The values calculated by our equation correlated well with those obtained by hydrogen inhalation.

Animals↗
PubMedDate not supplied

Experimental cerebral vasospasm after subarachnoid hemorrhage: development and degree of vasospasm.

Vasospasm of the basilar artery in 57 cats was induced by application of fresh blood, or a blood and cerebrospinal fluid (CSF) mixture incubated at 37 degrees C for 2 to 16 days. In animals treated with fresh blood or mixtures incubated for over 15 days, the severity of induced vasoconstriction is slight and duration short. Mixtures incubated 5 to 10 days induced severe and prolonged vasoconstriction. This incubation period for blood and CSF mixtures inducing severe vasospasm coincides with the developmental period of vasospasm after the onset of subarachnoid hemorrhage in our clinical experience. The prolongation of severe vasoconstriction induced by mixtures incubated for 7 days with clotted components is definitely greater than one induced by a mixture without clotted components. This experimental study suggests the existence of a vasospasmogenic substance in the blood in the subarachnoid space. Activity begins about 3 days after subarachnoid hemorrhage, increases strongly at 5 to 10 days, and disappears after 15 days.

Animals↗