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Biomedical subjects

S Furuta

Publications and source records attributed to S Furuta.

At least 73 records · Page 4Linked to original sources

Functional MR imaging of cortical activation of the cerebral hemispheres during motor tasks.

PURPOSE: We used functional MR imaging to evaluate cortical activation in the precentral, central, and postcentral regions of the contralateral and ipsilateral cerebral hemispheres during left- and right-handed motor tasks. METHODS: Ten healthy right-handed volunteers were studied with echo-planner MR imaging (1.5 T) while performing alternating finger apposition tasks with both hands. During the hand tasks, the areas of activated pixels were compared between subregions (precentral, central, and postcentral) of the contralateral and ipsilateral sensorimotor cortex. RESULTS: The activated area of the contralateral sensorimotor cortex was significantly larger than that of the ipsilateral cortex during tasks with either hand, whereas the ipsilateral activated area was significantly larger during the left-handed task than during the right-handed task. Ipsilateral activation was greatest in the precentral region, less in the central region, and least prominent in the postcentral region. CONCLUSIONS: Our results confirmed those of previous investigators that ipsilateral activation is more pronounced during left-sided movements than during right-sided movements. The variation in activation of the precentral, central, and postcentral subregions suggests different roles of the ipsilateral and contralateral hemispheres during motor tasks.

Adult↗

Mitral valve aneurysm as a sequela of infective endocarditis: review of pathologic findings in Japanese cases.

Mitral valve aneurysm is defined as a localized protrusion of the valve with a different radius from that of the remaining portion of the valve. The medical records and pathological findings of seven patients with mitral valve aneurysm [aged 48-69 years (mean 64), 4 males] and the pathological findings of other 29 Japanese cases were reviewed. All seven patients were diagnosed pathologically as infective endocarditis, but two patients had no documentation of clinical symptoms suggestive of infective endocarditis (latent infective endocarditis). The underlying lesion of the heart was aortic valve disease and/or fibrosal degeneration of the mitral valve. Only 29 of 36 Japanese case reports stated a precise description of the valve pathology. Of these 29 cases, 23 were associated with infective endocarditis, two with rheumatic valvular disease with fusion and/or shrinkage of the chordae tendineae, three with mitral valve prolapse or myxomatous degeneration of the mitral valve, and one with aortitis syndrome. Neovascularization was described in eight cases. Neovascularization with thick wall should be considered as post-inflammatory vascularization. This review indicates that patients with latent infective endocarditis and mitral valve aneurysm should be considered as potential candidates for valve surgery.

Aged↗

Cloning and expression of cDNA for a newly identified isozyme of bovine liver 3-hydroxyacyl-CoA dehydrogenase and its import into mitochondria.

cDNA for a heretofore undescribed mitochondrial 3-hydroxyacyl-CoA dehydrogenase, designated as the type II enzyme with different molecular and catalytic properties, compared to those of the classical mitochondrial beta-oxidation enzyme (type I enzyme), was cloned from a bovine liver cDNA library. Nucleotide sequence of the cDNA encoded 261 amino acids with a subunit molecular weight of 27,140. The deduced primary structure of the type II enzyme showed no significant homology to the reported amino acid sequence of the classical 3-hydroxyacyl-CoA dehydrogenases. On SDS-PAGE, no differences in subunit molecular weights were observed among the in vitro translation products, the recombinant type II enzyme produced in Escherichia coli and the purified enzyme. NH2-terminal and COOH-terminal amino acid sequence analysis of the purified type II enzyme revealed that the mature enzyme had not been proteolytically processed. The in vitro translation products of the type II enzyme were efficiently incorporated into isolated rat liver mitochondria, without changes in size, thereby suggesting that unlike other mitochondrial enzymes of fatty acid beta-oxidation, the type II enzyme had no cleavable signal peptide upon import into mitochondria.

3-Hydroxyacyl CoA Dehydrogenases↗

Clinical significance of asymptomatic sinus abnormalities on magnetic resonance imaging.

OBJECTIVE: To investigate the prevalence of abnormalities of the paranasal sinus detected by magnetic resonance imaging (MRI) in asymptomatic subjects. DESIGN: Prospective study. SETTING: Outpatient clinic. PATIENTS: A total of 325 patients who underwent MRI for suspected intracranial disease. Of those, 257 patients lacked nasal or sinus symptoms. RESULTS: Sinus abnormalities were seen on MRI in 153 (47.1%) of 325 patients, including 107 (41.6%) of the 257 asymptomatic patients. Subjects older than 50 years had a significantly higher frequency of sinus abnormalities on MRI (49.8%) vs those younger than 50 years (39.5%) (P < .05). The maxillary sinus abnormality was observed in 99 patients (38.5%) and the ethmoid sinus abnormality was observed in 52 (20.2%) (P < .01). The most common abnormality was mucosal thickening in the maxillary and ethmoid sinuses. CONCLUSION: A high prevalence of sinus abnormalities was detected in asymptomatic subjects on MRI.

Ethmoid Sinus↗

Hepatic artery reconstruction in living donor liver transplantation from the microsurgeon's point of view.

Microvascular surgery for the reconstruction of the hepatic artery in living donor liver transplantation is discussed from the microsurgeon's point of view. A refined operative procedure to improve the safety of the anastomosis is described. In living donor liver transplantation, the hepatic artery of the graft is short and small, the operative site is deep and mobile, and the anatomic arrangement of the graft left hepatic artery may differ from that of the recipient's dilated hepatic artery. To create a safe anastomosis under these conditions, recipient arteries that were slightly smaller than the graft artery were dissected. Without the size discrepancy, and end-to-end anastomosis could be created. Some refinements to create a good operative field made the anastomosis easy. The apparatus and techniques used in free-flap transfer facilitated a clean anastomosis. We anastomosed 44 arteries in 40 patients undergoing living donor liver transplantation using microsurgical techniques. Neither a decrease in the arterial blood flow nor hepatic artery thrombosis was noted. The refined operative procedure we describe in this report can be used to overcome the problems associated with the hepatic artery anastomosis in living donor liver transplantation.

Adolescent↗

Monitoring the free radial forearm flap in pharyngo-oesophageal reconstruction.

Monitoring the viability of the free radial forearm flap after pharyngo-oesophageal reconstruction poses technical problems. A method of monitoring using a small island flap elevated distal to the main forearm flap is presented. This monitor flap is easy to elevate. It is placed externally and provides information about the perfusion of the buried reconstruction flap. Postoperative management requires only assessment of tissue colour, turgor, capillary refill and bleeding, as for standard skin flap monitoring.

Adult↗

Demonstration of antibodies against human papillomavirus type-11 E6 and L2 proteins in patients with recurrent respiratory papillomatosis.

Recurrent respiratory papillomatosis (RRP) is highly prevalent in Thailand, with the human papillomavirus (HPV) type-11 being the most widespread. In this study, we isolated the HPV type-11 (HPV-11) genome from subjects with RRP and subcloned the E6 and L2 open reading frames (ORFs) with the expression vectors pEX1 and pEX3. The recombinant E6/beta-gal and L2/beta-gal fusion proteins were expressed in E. coli. Using the recombinant proteins, we demonstrated the presence of antibodies against HPV-11 E6 and L2 in RRP patients by Western blot analysis. The prevalence of seropositivity for HPV-11 E6 and L2 were 5% (1/20) and 10% (2/20), respectively. Although RRP is caused by infection on the mucosal surface, it appears that an immune response occurs against viral proteins expressed in the epithelial lesions.

Antibodies, Viral↗

Reduced sialylation of glycoproteins in nasal glands of patients with chronic sinusitis.

This study was conducted to investigate the sialylations of glycoproteins in the nasal glands of patients with chronic sinusitis. Sialic acids were detected using lectin histochemistry, and the mRNA of sialyltransferase was evaluated by in situ hybridization histochemistry. Sambucus nigra agglutinin (SNA), which recognizes terminal sialic acids, strongly stained the glandular mucous cells of normal subjects, but not those of patients with chronic sinusitis. In situ hybridization histochemistry showed that the expression of alpha2,6 sialyltransferase mRNA was decreased in the secretory cells of patients with chronic sinusitis. Our present results suggest that a reduction in sialyltransferase activity at the mRNA level in the nasal glands may lead to the persistence of chronic sinusitis.

Adolescent↗

Expression of glycoconjugates in normal and Sjögren's syndrome labial glands.

Glyconjugate expression in formalin-fixed, paraffin-embedded Sjögren's syndrome labial glands (nine cases) was compared with that in normal glands (12 samples) using a wide panel of lectins. Mucous cells expressed mainly mucous-type glycoproteins including sialyl, fucosyl, galactosyl and galactosaminosyl residues, and some N-linked glycoconjugates. Demilunar cells expressed mainly alpha D-mannose, GlcNAc and Gal beta 1.3-GalNAc. Duct cells and cellular glycocalyx expressed O-linked and N-linked residues. Sjögren's syndrome samples showed a statistically significant increase in the expression of GlcNAc. A significantly decreased expression of Gal beta 1,3-GalNAc and alpha D-mannose, residues not usually present in mucous cells, was found (p < 0.05). This suggests that anatomic rather than functional alterations determine mucous cell impairment and the symptoms in Sjögren's syndrome.

Female↗

Serial histopathologic myocardial findings in a patient with ectopic atrial tachycardia-induced cardiomyopathy.

A 17-year-old woman was found to have ectopic atrial tachycardia by her physician. Echocardiography and cardiac catheterization revealed findings resembling dilated cardiomyopathy at the time of initial presentation. The tachycardia was controlled with atenolol only at a dose of 50 mg/day. However, at the age of 22, the presence of ectopic atrial tachycardia was once again confirmed. We successfully performed catheter ablation for persistent ectopic atrial tachycardia. Serial echocardiographic findings showed the left ventricular dimension and function appeared to return to normal 1 year postablation. However, despite pharmacologic control and catheter ablation therapy, histopathology revealed myocardial fibrosis presumably representing permanent damage of the heart secondary to tachycardia 1 year postablation.

Adolescent↗

[Mitral valve re-replacement in patients aged 70 years and older: is age alone not operative risk factor?].

We analyzed the risk of mitral valve re-replacement (re-MVR) in patients over 70-year-old. Surgical and late follow-up results were compared between 14 elderly patients over 70-year-old (group I) and 23 patients aged from 60 to 69-year-old (group II) who underwent re-MVR due to primary tissue failure (PTF). Donation of autologous blood and a rate of replaced valve prosthesis (mechanical/biological) were different between the two groups. There were no differences in the other factors such as clinical profile, preoperative organ function, operative characteristics, post operative relating factors. No operative death occurred in both groups. There was one hospital death in group I (a hospital mortality rate of 7.1%). The cause of death was related to massive cerebral infarction due to anticoagulant-related thromboembolic event. 4-64 months after re-MVR, the improvement of a NYHA function class was I-II in the two groups. With improvement in myocardial protection and intraoperative strategies, the operative risk in patients undergoing re-MVR over 70-year-old has been markedly reduced. Surgical results in aged patients were satisfactory and age alone is not a contraindication for this operation. The re-MVR in aged patients should be done at the early stage of PTF before progress of cardiac failure.

Age Factors↗

[Clinical results of single-stage mobilization of pectoral muscle flaps and omental transposition for infected mediastinitis after open heart surgery].

The purpose of this study was to retrospectively evaluate the outcome of refractory infected mediastinitis managed primarily with mobilization of pectoral muscle flaps and omental transposition. From January 1992 to December 1995, infected mediastinitis occurred in 11 (2.5%) of 447 consecutive patients. All patients required sternal debridement. The wound was thoroughly irrigated with a solution of 0.5% povidone-iodine in physiological saline after debridement and then the defect was repaired. Reconstruction of the chest wall was attained using pectoral muscle flaps in seven patients and pectoral muscle flaps and omental transposition in four. Antibiotic therapy was provided for 6 weeks or more according to the regimen in North America. No hospital deaths occurred after surgery. Significant early complications occurred in four patients. The reasons for the prolonged hospitalization were a recurrent wound infection, prosthetic valve endocarditis and saphenous vein graft pseudoaneurysm formation caused by Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-resistant Staphylococcus epidermidis (MRSE). Length of stay in ICU after surgical treatment was range 1 to 140 days (an average of 11 +/- 3 days in 9 patients without complications in ICU). Duration between surgical treatment and discharge was range 47 to 300 days (an average of 58 +/- 8 days in 7 patients without significant early complications). At the time of this report, the patients are doing well with no signs of recurrence of infection. The mean follow-up was 28.8 months (range 8 to 48 months). We conclude that single-stage mobilization of pectoral muscle flaps together with omental transposition is very usefull for managing refractory infected mediastinitis. But careful follow-up is needed after this procedure in case of MRSA-caused mediastinitis because of its tendency to recur.

Adult↗

[Coronary artery bypass grafting in a patient with a permanent tracheal stoma].

The performance of open heart surgery in a patient with a tracheostoma can present difficult problems, including mediastinitis and inadequate operative exposure. A 79-year-old man was admitted because of angina pectoris, and had undergone tracheostomy for carcinoma of the larynx 14 years previously. He underwent coronary artery bypass grafting with saphenous vein graft to # 8, 12. A skin incision was made from the angle of Louis to the xiphoid process and carried down through the subcutaneous tissue. The sternum was divided from the xiphoid process to the manubrium and then dislocated from the intact manubrium. Operative time was 165 minutes and arrest time was 64 minutes. Postoperative course was satisfactory and discharged within 24 days after operation. We think that in a case of open heart surgery with a tracheostoma no dissection near a tracheostoma is necessary in order to decrease the risk of postoperative wound infection and mediastinitis.

Aged↗

Should all hepatic arterial branches be reconstructed in living-related liver transplantation?

BACKGROUND: Because graft arteries are smaller and shorter in living-related liver transplantation (LRLT) than in whole or reduced-size liver transplantation from cadavers, arterial reconstruction is thought to be one of the critical points for success. METHODS: Thirty LRLT patients were classified into two groups: those in whom all graft hepatic arteries were reconstructed (group A), and those whom only had some were reconstructed (group B). In group A 17 patients had a single hepatic artery and three had two hepatic arteries. In group B the thickest one of several arteries was reconstructed, but the others were ligated after pulsatile back-bleeding from their cut stumps had been confirmed. The clinical results were compared between the two groups. RESULTS: Neither arterial thrombosis nor liver dysfunction related to the arterial blood supply was observed during the postoperative course. One case of bile leakage and two cases of bile duct stenosis occurred in group A. No significant difference was noted in the postoperative values of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase between the two groups. Overall patient and graft survival was 90%. CONCLUSIONS: Although several hepatic arteries may supply the potential allograft in LRLT, it is not always necessary to reconstruct all of them.

Adolescent↗

Relationship between abnormal sensation in the throat and menopause.

Abnormal sensations in the throat (AST) are commonly encountered in general and otolaryngological practice, especially among middle aged women. These sensation may occur alone, or more often, in combination with the systemic symptoms, including those of menopause. We analyzed 26 Japanese women with a complaint of an abnormal sensation in the throat who were taking a synthetic sex hormone (Methermon-F). Multianalysis of variance (MANOVA) was used to evaluate the efficacy of the treatment using the quantitative scores of Kupperman's climacteric symptoms. The presence of the excessive perspiration and vertigo, insomnia, and the absence of fatigue were associated with clinical efficacy of the hormone, while the presence of hyposthenia and tingling sensation were associated with a poor response. Results suggested that the clinical efficacy of this hormone in treating middle-aged menopausal women with AST was related to the menopausal symptoms.

Adult↗