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Biomedical subjects

S Kitamura

Publications and source records attributed to S Kitamura.

At least 721 records · Page 40Linked to original sources
PubMed1989

[Multiple organ failure following open heart surgery in adults].

The cases multiple organ failure (MOF) which occurred post-operatively following open heart surgery in adults were studied on a pre and post-operative hemodynamics. Post-operative low cardiac output syndrome (LOS) was thought to result in decreased renal and hepatic perfusion with subsequent ischemic damage to these organs. Therefore, to management MOF, we have to prevent post-operative LOS, for example, administration of cathecholamine and vasodilator, and early clinical application of IABP and ventricular assist device (VAD). In a post-operative hemodynamics, the cases of severe right ventricular failure tend to have more protracted MOF. It was though that MOF could be minimized with shortened cardiopulmonary bypass duration, and early application of assisted circulation.

Adult↗
PubMed1989

[Combined operation for patients with ischemic heart disease and thoracic aortic aneurysm].

Myocardial infarction is one of the chief causes of operative mortality after surgical treatment of aortic aneurysm. For this reason, coronary bypass grafting combined with aneurysmectomy has been recommended by some surgeons. We advise routine preoperative cardiac catheterization in all patients with clinical indications of coronary artery disease who are scheduled for aneurysmectomy. For patients with operative indication of coronary bypass grafting, we would think that patients with unstable coronary artery disease and symptomatic thoracic aneurysm might have both lesions safely repaired as a combined operative procedure.

Aortic Aneurysm, Thoracic↗
PubMed1989

[Surgical treatment for chronic constrictive pericarditis through a combined median sternotomy and left anterolateral thoracotomy].

A 61-year-old and a 64-year-old male patients with chronic calcified constrictive pericarditis underwent pericardiectomy through a combined midsternotomy and anterolateral thoracotomy. X-ray films and CT scans of the chests demonstrated prominent calcification of the pericardium. At cardiac catheterization, the right atrial and ventricular enddiastolic pressures were elevated and the typical dip and plateau pressure curves were found in the right ventricle. A combined midsternotomy and left anterolateral thoracotomy gave a good operative view for the surgery. The post-operative course was uneventful in both patients. This combined approach has greater ease of decorticating the lateral to posterior surfaces of the left ventricle than a simple conventional approach.

Chronic Disease↗
PubMed1988

Synthesis and structural identification of four dihydroxy acids and 11,12-leukotriene C4 derived from 11,12-leukotriene A4.

Using a partially purified 12-lipoxygenase from porcine leukocytes, (5Z,8Z,10E,14Z)-12-hydroperoxy-5,8,10,14-icosate traenoic acid was synthesized from arachidonic acid with a yield of over 35%. The absolute configuration of C-12 was determined as S by chiral-phase column chromatography. It was chemically converted to at least three epoxides with the conjugated triene structure. Two were identified by proton NMR and mass spectrometry to be (5Z,7E,9E,14Z)-(11S,12S)-11,12-oxido-5,7,9,14-ic osatetraenoic acid (11,12-leukotriene A4) and (5Z,7Z,9E,14Z)-(11S,12S)-11,12-oxido-5,7,9,14-ic osatetraenoic acid (7-cis-11,12-leukotriene A4). 11,12-Leukotriene A4 underwent acid hydrolysis to yield two diastereomers of (6E,8E,10E,14Z)-(12S)-5,12-dihydroxy-6,8,10,14-i cosatetraenoic acid and two isomers of (14Z)-(12S)-11,12-dihydroxy-5,7,9,14-icosatetraenoic acid. Upon incubation with rat liver glutathione S-transferase, 11,12-leukotriene A4 was converted to 11,12-leukotriene C4, a spasmogenic compound.

Animals↗
PubMed1988

Highly purified murine interleukin 5 (IL-5) stimulates eosinophil function and prolongs in vitro survival. IL-5 as an eosinophil chemotactic factor.

The recent molecular cloning of the complementary DNA encoding T cell--replacing factor (TRF) has demonstrated that a single molecule is responsible for B cell growth factor II (BCGF-II) activity and eosinophil differentiation activity. It has been proposed that this molecule be called interleukin 5 (IL-5). We previously reported that purified rIL-5 supports the terminal differentiation and proliferation of eosinophilic precursors. In this study, we examined the effects of IL-5 on functional activities of mature eosinophils. IL-5 maintained the viability of mature eosinophils obtained from peritoneal exudate cells of mice infected with parasites. It also induced superoxide anion production in a dose-dependent manner. The Boyden's chamber Millipore assay revealed that IL-5 had a marked chemokinetic effect on eosinophils in a dose-dependent manner. Moreover, IL-5 was found to be an eosinophil chemotactic factor by the checkerboard assay. In conclusion, IL-5 is suggested to play an important role in increasing the functional activities of eosinophils as well as their production in allergic and parasitic diseases.

Animals↗
PubMed1988

Solubilization and partial purification of leukotriene C4 synthase from guinea-pig lung: a microsomal enzyme with high specificity towards 5,6-epoxide leukotriene A4.

Enzymic activities catalyzing allylic epoxide, leukotriene A4, to leukotriene C4 by conjugation with glutathione were present mainly in microsomal fractions of spleens and lungs of guinea pigs and rats. Leukotriene C4 (LTC4) synthase was solubilized from the microsomes of guinea-pig lung by the new procedures of a combination of 3-[3-cholamidopropyl)dimethylammonio)-1-propanesulfonate (CHAPS), digitonin and KCl. The enzyme was partially purified by two steps of column chromatography which resulted in a complete resolution of the enzyme from glutathione S-transferases (EC 2.5.1.18). The partially purified LTC4 synthase showed a Vmax value of 40 nmol/min per mg, and the apparent Km values for LTA4 and glutathione were 36 microM and 1.6 mM, respectively. The enzyme was unstable, and half of the activity was lost by incubation at 37 degrees C for 3 min. Glutathione at 10 mM completely protected the enzyme against this inactivation, while other sulfhydryl-group-reducing reagents were ineffective. The partially purified enzyme revealed a high specificity towards 5,6-epoxide leukotrienes (LTA4 and its methyl ester), while rat cytosolic glutathione S-transferases catalyzed conjugation of glutathione to various positional isomers of epoxide leukotrienes.

Animals↗
PubMed1988

Relations of preoperative hemodynamics and coronary blood flow to improved left ventricular function after valve replacement for aortic regurgitation.

In this study of the limits of reversibility of left ventricular function after aortic valve replacement for aortic regurgitation, measurements were made of pre- and postoperative coronary blood flow and left ventricular volumes. Eighteen patients who had undergone aortic valve replacement for pure aortic regurgitation using the Björk-Shiley valve or the Bicerval valve were restudied an average of 8 +/- 3 months after surgery. Postoperative left ventricular end-systolic and end-diastolic volumes returned to near normal values. The slight left ventricular wall thickening apparent before surgery remained unchanged after surgery and, consequently, left ventricular mass, though somewhat reduced, remained abnormally high. Ejection fraction, which was low preoperatively, returned to normal postoperatively. Total coronary sinus blood flow decreased after surgery, but coronary sinus blood flow per 100 g of left ventricular mass increased. This recovery of coronary flow per unit mass was believed to cause the improvement in left ventricular function. A significant correlation was found between postoperative systolic function and preoperative left ventricular end-systolic and end-diastolic volumes, wall thickness and, especially, left ventricular mass, the latter indicating that, if preoperative left ventricular mass is less than 350 g/m2, postoperative improvement of systolic function is attainable. Another significant correlation was indicated by measurements of coronary sinus blood flow per 100 g of left ventricular mass. If this is greater than 35 ml/min before surgery, a postoperative improvement in systolic function to within the normal range may be expected.

Adult↗
PubMed1988

Ultrasonically guided needle biopsy in the diagnosis of mediastinal masses.

The value of ultrasonic examination and ultrasonically guided needle biopsy (UGNB) of mediastinal masses was investigated in 45 patients. Fifteen of the masses were malignant and 30 were benign. The diagnoses were histologically confirmed by examination of surgical or autopsy specimens. Only teratoma could be confidently diagnosed by ultrasonography alone. Diagnosis of other types of mediastinal masses required examination of tissue samples. Using ultrasonically guided aspiration biopsy (UGAB), we were able to diagnose 13 of 15 malignant tumors and 18 of 27 benign mediastinal masses. Ultrasonically guided cutting biopsy was performed in conjunction with UGAB in 11 patients, and the diagnosis was histologically confirmed in 9 cases. Complications with UGNB occurred in only 1 case. Our results indicate that UGNB is a safe, simple technique that can be applied to most of the mediastinal masses. We believe that it is the method of choice in such cases.

Biopsy, Needle↗
PubMed1988

Ultrasonographic evaluation of pleural and chest wall invasion of lung cancer.

The significance of ultrasonography was tested in evaluation of cancerous invasion into the pleura and chest wall in patients with lung cancer. The degree of the invasion was ultrasonographically classified into four grades, that is, uP-0, uP-1, uP-2 and uP-3, corresponding with the classification proposed by the Japan Lung Cancer Society, which is graded by surgical findings. The total accuracy of this method was 77 percent. Especially for uP-3, which is the most critical grade regarding decisions on surgical intervention, this figure was 100 percent. It is suggested that this approach can delineate cancerous invasion into the pleura and chest wall sufficiently well for daily clinical use and staging of patients with lung cancer.

Carcinoma↗
PubMed1988

Sjögren's syndrome with multiple bullae and pulmonary nodular amyloidosis.

We treated a patient with Sjögren's syndrome associated with multiple bullae and pulmonary nodular amyloidosis, both of which were identified by open lung biopsy. The mechanism of bullae formation appeared to be narrowing of the airway, as a result of extensive inflammatory cell infiltration to the bronchiolar wall, which acted as the check valve mechanism. We believe this to be the first reported case of Sjögren's syndrome accompanied by these two pulmonary manifestations.

Amyloidosis↗
PubMed1988

Ultrasonographic approach to diagnosing chest wall tumors.

The value of ultrasonography and UGAB for diagnosing chest wall tumors was investigated in 21 patients of whom 13 had metastatic and eight benign disease. Chest wall tumor showed a hypoechoic mass with tapered edges. The margin between the tumor and lung was curved and smooth in all cases. Movement of the tumor during breathing was synchronized with that of the chest wall. We believe that the ultrasonography is of value in identifying tumors that are localized to the chest wall by examination of their margin and movement with respiration, in addition to their shape. Using UGAB, we were able to diagnose correctly all eight metastatic tumors and two of four benign tumors. UGAB is a safe and simple procedure for diagnosing chest wall tumors.

Adolescent↗
PubMed1988

Detection of the mediastinal lymph nodes metastasis in lung cancer by endoscopic ultrasonography.

Mediastinal lymph nodes metastasis of lung cancer was analysed by endoscopic ultrasonography in 96 patients in whom histological diagnosis of the lymph nodes could be proven by thoracotomy. A Receiver Operating Characteristic (ROC) curve was drawn up for determining the criteria for metastatic lymph nodes by endoscopic ultrasonography. The ROC curve was evaluated by using four parameters: The long diameter, the short diameter, the long diameter plus the short diameter, and the product of the long diameter times the short diameter. The long plus short diameter and the long-times-short diameter showed the highest detectability of the metastasis of all histological types on the ROC curve. The reasonable criteria levels were found to be 18 mm and 75 mm2 by means of a moderate threshold. In this level, sensitivity were 77%, 76%; specificity 84%, 84%; and accuracy 82%, 82%, respectively. When examinations were done by histological types, the criteria level for the epidermoid carcinoma should be increased to more than that for the adenocarcinoma. And, sensitivity and specificity were better in the epidermoid carcinoma. Thus, these results suggest that endoscopic ultrasonography is clinically useful for the detection of lymph nodes metastasis in lung cancer.

Adenocarcinoma↗