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Biomedical subjects

S Kitamura

Publications and source records attributed to S Kitamura.

At least 379 records · Page 21Linked to original sources
PubMed1996

[Ten-year survival and cardiac event-free rates in Japanese patients with the left anterior descending artery revascularized with internal thoracic artery or saphenous vein graft: a comparative study].

To evaluate the long-term results of surgical patients with coronary artery bypass grafting (CABG), we comparatively analyzed the 10-year survival and cardiac event-free rates between 713 patients group with at least one internal thoracic artery to the left anterior descending artery (LAD), (ITA-CABG) and 241 patients group revascularized with vein grafts alone (SVG-CABG). ITA-CABG patients had more progressed diseases with a higher incidence of risk factors than SVG-CABG patients: number of vessel diseased 2.5 +/- 0.7 vs 2.3 +/- 0.7, LMTD 20.2% vs 14.1%, diabetes mellitus 37.3% vs 27.0% and hyperlipidemia 38.0% vs 30.7%. The 10-year cumulative LAD graft patency and severe disease-free rate was 90.3 and 67.0% for ITAs and vein grafts in this series. The 10-year overall actuarial survival, cardiac death-free and cardiac event-free rates for ITA and SVG groups were 88.8 vs 79.5%, 97.4 vs 92.6% and 84.1 vs 73.1%, all with a statistical significance (generalized Wilcoxon or logrank method). For the patients with reduced ventricular systolic function (EF < or = 0.4), ITA-CABG offered a significantly better 10-year cardiac death free rate. Also, for the diabetic patients, ITA-LAD offered a significantly better 10-year cardiac event-free rate. In conclusion, the use of ITA graft can reduce postoperative cardiac events and enhance the long-term survival in Japanese patients. The ITA should be utilized at least for LAD in all CABG patients whenever feasible.

Coronary Artery Bypass↗
PubMed1996

[A case of mucoepidermoid carcinoma of the thymus].

A 19-year-old man was admitted to our hospital with anterior mediastinal cystic tumor. Subtotal thymectomy with the tumor was performed. The tumor was localized inside the thymus without outer infiltration. It weighed 145 g and measured 9 x 8 x 5 cm. The cut surface was cystic and spongy, partially with a solid focus. Pathological findings of the solid area was compatible with mucoepidermoid carcinoma of the thymus. The histogenesis of mucoepidermoid carcinoma of the thymus was discussed.

Adult↗
PubMed1996

[Diffuse panbronchiolitis with P-ANCA-positive arteritis and necrotizing glomerulitis].

A 53-year-old man was admitted to our hospital with a skin eruption, a high fever, and diplopia in April of 1992. He had been given a diagnosis of diffuse panbronchiolitis in 1981. After administration of erythromycin began in 1987, symptoms and chest roentgenographic findings gradually improved. Arteritis of peribronchial muscular arteries with medial destruction was seen in lung biopsy specimens, and periglomerular granulomatous inflammation and necrotizing glomerulitis were seen in renal biopsy specimens. P-ANCA was found, but a test for cytoplasmic ANCA (which is the most specific antigen of Wegener's granulomatosis) was negative. Chronic pulmonary infection due to diffuse panbronchiolitis might have formed ANCA, which may have caused the vasculitis in this patient.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1996

[Radiation-induced coronary ostial stenosis, a case of redo coronary bypass for the restenosis following patch angioplasty].

The patient was a 45-year-old woman who had had a tumor resection for thymic carcinoid and subsequent mediastinal irradiation (50 Gy) 3 years before the onset of angina pectoris during exercise. Coronary angiography (CAG) revealed an isolated ostial stenosis of the left main coronary trunk (LMT). Angiography also showed an occluded right internal thoracic artery (ITA) at its origin. The patient underwent patch angioplasty of the LMT orifice using a piece of the saphenous vein graft (SVG). One month after the operation, CAG revealed a success of operation with an enlarged LMT orifice and she was discharged. However, 3 months after the operation, angina pectoris recurred and a repeated CAG showed a 90% stenosis of the LMT at the place 1 cm distal to the orifice. Emergency CABG (the left ITA to the LAD and the SVG to the LCX) was accomplished with disappearance of angina. Post-CABG angiography revealed patent left ITA and SVG in association with complete obstruction of the LMT. One year after the second operation, she was free from symptoms. This case as well as other reports concerning radiation-induced coronary stenosis suggest that patch angioplasty for this specific lesions may have a high incidence of stenosis recurrence. Coronary bypass grafting that can be performed at the place away from the active proliferative lesion may be a better selection.

Angioplasty↗
PubMed1996

[Effects of substance P and neurokinin A on pulmonary circulation in the isolated perfused guinea pig lung].

We studied the effect of sensory nerve peptide substance P (SP) and neurokinin A (NKA) in isolated perfused guinea pig lungs. SP and NKA increased pulmonary arterial pressure, capillary pressure, pulmonary venous resistance, and lung weight, but they did not change pulmonary arterial resistance or pulmonary vascular permeability. The effects of SP on pulmonary vascular dynamics were greater than those of NKA. Ozagrel hydrochloride, a thromboxane synthase inhibitor, partially attenuated the effect of SP. This indicates that thromboxane contributes to SP-induced pulmonary vasoreactivity. However, ozagrel hydrochloride did not change the effects of NKA. FK224, an NK-1/NK-2 receptor antagonist, abolished both SP- and NKA-induced pulmonary vasoconstriction. This indicates that SP and NKA acted on the pulmonary vasculature through the NK-1 or NK-2 receptor, or both. Papaverine, a smooth muscle relaxant, abolished the effects of SP. The SP-induced increase in lung weight was caused by a rise in pulmonary hydrostatic pressure, especially that caused by pulmonary venoconstriction.

Animals↗
PubMed1996

[Interstitial pneumonia associated with mixed connective tissue disease--marked improvement with azathioprine].

A 55-year-old man who complained dyspnea on exertion was given a diagnosis of interstitial pneumonia associated with mixed connective tissue disease, based on symptoms and on physical and laboratory findings. Soon afterward, he experienced an acute exacerbation of the interstitial pneumonia. He was given three courses of steroid pulse therapy and cyclophosphamide, but his condition worsened. After administration of azathioprine in addition to corticosteroids, his respiratory status improved. The dose of corticosteroids was tapered and the patient has been free of disease for two years. Pulmonary involvement in mixed connective tissue disease has been considered to be relatively benign and easily treated with corticosteroids. Recently, however, many cases of corticosteroid-resistant disease with poor outcome have been reported. Azathioprine was very effective against the interstitial pneumonia in this case, but general conclusions about the most effective type of immunosuppressive agent and the timing of its administration must await the results of further study.

Azathioprine↗
PubMed1996

[Surgery for WPW syndrome with concomitant CABG: a case report].

A 58-year-old man underwent simultaneous surgery for WPW syndrome complicated by frequent attacks of atrial tachyarrhythmia combined with angina pectoris persisting after anterior myocardial infarction. Repeated PTCA of 3 times failed and restenosis occurred with recurrent angina particularly when atrial tachyarrhythmia took place. The preoperative ECG suggested the presence of a left free wall accessory pathway confirmed by an electro-physiolosical study. Coronary bypass grafting (LITA-LAD, SVG-4 PD) and division with cryoalation of the accessory pathway were performed using a transseptal left atrial approach. The patient is doing well now and free from both angina and tachycardia.

Angina Pectoris↗
PubMed1996

[A case report of aortic root replacement with fresh aortic homograft for valve detachment due infective endocarditis].

A 28-year-old male received a redo aortic valve replacement (AVR) with a 19 mm St. Jude Medical mechanical valve 3 months after the initial AVR because of recurrent valve detachment. We re-operated on this patient by aortic root replacement using a fresh aortic homograft. The donor of the homograft was a 59-year-old female who died of a traffic accident. The aortic root and valve was harvested aseptically and stored in a nutrient medium including antibiotics at 4 degrees C for 4 days. At the 3rd operation, aortico-ventricular discontinuity and an annular-abcess-like cavity were found. After debridement, the cavity was closed with a homograft aortic wall and then aortic root replacement was performed using a fresh aortic homograft. At first, prosthetic valve detachment seemed to be caused by infective endocarditis on the basis of his clinical history. However, causative organisms had never been recovered from the blood or the specimens obtained at the time of operation and reoperation. Post-operative HLA examination revealed No. 51 on HLA-B locus and thus we suspected that valve detachment might have been due to inflammation of the aortic wall caused by a subtype of Behçet disease. The early post-operative course was uneventful with a low dose of predonine. Post-operative aortography showed no aortic regurgitation and normal coronary anastomosis. Unfortunately however, he died suddenly 8 months after the operation. Autopsy demonstrated the presence of aortic wall necrosis with massive infiltration of macrophages and leucocytes resulting in dehiscence of the coronary anastomotic site. The cause of homograft detachment could not be determined for sure but might be recurrent infective endocarditis, although causative organisms were never identified, or infective endocarditis in combination with Behçet vasculopathy.

Adult↗
PubMed1996

[Use of the the ED046 kit to analyze serum KL-6 in patients with pneumonitis].

KL-6 is a mucinous glycoprotein expressed on Type 2 pneumonocytes, and serum levels of KL-6 are reported to be abnormally high in patients with interstitial pneumonia. A new assay kit for serum KL-6 (ED046) was used in the evaluation of patients with pneumonitis. To clarify whether KL-6 is a useful marker of pneumonitis activity, 649 subjects were studied, including 185 healthy controls, 187 patients with 3 types of interstitial lung diseases, and 277 patients with 4 types of non-interstitial lung diseases. The serum KL-6 level was significantly higher in the patients with pneumonitis (1285 +/- 1196 U/ml) than in the patients without pneumonitis (307 +/- 232 U/ml). The KL-6 level was also significantly higher in patients with clinically active pneumonitis (1708 +/- 1338 U/ml) than in those with inactive pneumonitis (820 +/- 796 U/ml) (p < 0.0001). Serum KL-6 levels correlated significantly with serum c-reactive protein, lactic dehydrogenase, and PaO2 values. These results suggest that the ED046 assay is useful for measuring KL-6 as a marker of pneumonitis activity.

Adult↗
PubMed1996

Involvement of mammalian liver cytosols and aldehyde oxidase in reductive metabolism of zonisamide.

Zonisamide (1,2-benzisoxazole-3-methanesulfonamide), an anticonvulsant agent, is primarily metabolized to 2-sulfamoylacetylphenol by reductive cleavage of the 1,2-benzisoxazole ring. Rabbit liver cytosol with an electron donor of aldehyde oxidase exhibited a significant zonisamide reductase activity that was sensitive to inhibition by menadione, an inhibitor of aldehyde oxidase. The result suggested that the cytosolic activity is caused by aldehyde oxidase, a cytosolic enzyme. In fact, rabbit and rat liver aldehyde oxidase had the ability to reduce zonisamide when supplemented with its electron donor. Apparent KM and Vmax values of aldehyde oxidase for zonisamide were 217 microM and 42 nmol/10 min/mg protein in the case of the rabbit liver enzyme, and 542 microM and 382 nmol/10 min/mg protein in the case of the rat liver enzyme, respectively. In rabbits, hamsters, mice, and guinea pigs, zonisamide reductase activity of the liver cytosols with 2-hydroxypyrimidine, an electron donor of aldehyde oxidase, was much higher than that of the liver microsomes with NADPH. In rats, zonisamide reductase activity was examined with liver microsomes and cytosols from seven strains. The 2-hydroxypyrimidine-dependent cytosolic activity exhibited marked strain differences, unlike the NADPH-dependent microsomal activity. 1,2-Benzisoxazole was also reduced to salicylaldehyde by rabbit liver cytosol and aldehyde oxidase in the presence of 2-hydroxypyrimidine. Stoichiometric studies showed that 2-sulfamoylacetylphenol was formed accompanying nearly equimolar ammonia from zonisamide.

Aldehyde Oxidase↗
PubMed1996

[Changes of respiratory system compliance by closure of congenital abdominal wall defects and postoperative complications].

We treated four neonates with congenital abdominal wall defects and performed pulmonary function testing before and after closure of abdominal wall defects. Pulmonary mechanics were measured by passive occlusion technique. Static respiratory system compliance (Crs) was 0.61 +/- 0.16 ml.cmH2O-1 .kg-1 (mean +/- SD) preoperatively and decreased to 0.31 +/- 0.03 ml.cmH2O-1.kg-1 postoperatively. Two cases with a marked decrease in Crs after the abdominal wall closure seemed to have longer intubation time and N.P.O period and to have more complications than with the other two cases. Our experience provides an evidence that Crs measurement could be a useful index in decision-making of the treatment of neonates with congenital abdominal wall defects.

Abdominal Muscles↗
PubMed1996

[Establishment of reference intervals and cut-off value by an enzyme immunoassay for KL-6 antigen, a new marker for interstitial pneumonia].

KL-6 antigen is a novel marker for interstitial pneumonia. In a similar manner as the protocol developed in serum protein standardization project, reference intervals for KL-6 was established using a newly developed enzyme immunoassay. The cut-off value was thus determined by ROC curves. Reference interval for a total of 273 subjects was 94.9-458.2 U/ml (median , 181.1 U/ml), with the age-dependent elevation. Sex-difference was observed over 40 years of age, being higher in males than in females (p < 0.01). Although no statistical difference, smokers showed higher levels than non-smokers did. The KL-6 value was 133.0-527.0 U/ml in 23 cases with diseased controls and 225.0-6740.0 U/ml in 54 cases with the group of interstitial pneumonia. In the latter, the value in active cases was significantly higher than that in inactive cases (p < 0.0001). Based on above results, the optimal cut-off value was established as 500 U/ml by the ROC curves. By using the cut-off, serum KL-6 antigen can be used as a powerful diagnostic and prognostic marker for interstitial pneumonia.

Adult↗