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Biomedical subjects

S Maki

Publications and source records attributed to S Maki.

At least 91 records · Page 5Linked to original sources

[A clinical assessment of efficacy in continuous retrograde cerebral perfusion method].

From November 1990 to June 1991, 8 patients underwent surgical repair using continuous retrograde cerebral perfusion (CRCP). We evaluated the effect of CRCP from these 8 cases. As a method of CRCP, we perfused with oxygenated blood from SVC canulae with a internal jugular vein pressure of 30-40 cmH2O. Simultaneously systemic perfusion from femoral arterial canulae was performed. At nasopharyngeal temperature of 15-21 degrees C, CRCP time was 46-115 minute. SVC perfusion flow was 280-900 ml/min, and femoral arterial perfusion flow was 450-1,200 ml/min. At 30 minute after starting CRCP, oxygen tension of the blood which was returned to aortic arch was 11-23 mmHg, whereas oxygen tension of the SVC perfusion blood was 210-398 mmHg. In only one patient, transient involuntary movement was seen after operation, but prolonged emergence from anesthesia was not seen. In conclusion, CRCP is considered as an useful method in the operation of the aortic arch.

Aorta, Thoracic↗

[A case of abdominal aortic pseudoaneurysm due to Salmonella enteritidis septicemia].

A 66-year-old man suffering from high fever and abdominal pain was diagnosed as abdominal aortic pseudoaneurysm due to Salmonella enteritidis septicemia. After complete remission of infection with the antibiotic therapy, we performed a replacement of abdominal aorta with a prosthetic graft. Infection parameters are normal 5 months postoperatively. Although Salmonella septicemia is a serious disorder, it is not a rare infection recently as compromised host increases more. Rapid diagnosis, adequate antibiotic therapy and surgical treatment are essential for successful result of Salmonella aortic aneurysm.

Aged↗

Serum hepatitis C virus sequences in posttransfusion non-A, non-B hepatitis.

We investigated 17 patients (12 males and 5 females, ages 2 to 57 years old) with posttransfusion non-A, non-B hepatitis to determine relationships between clinical courses and hepatitis C virus (HCV) markers. The patients were grouped according to time course of abnormal serum alanine aminotransferase (ALT) levels into three categories (chronic biochemical disease, biochemically resolved chronic disease, and acute disease). Latest serum samples (1.3 to 10.8 years after blood transfusion) were used to detect antibodies against C100-3 antigen (anti-HCV) by enzyme-linked immunosorbent assay and HCV sequences by polymerase chain reaction (PCR) assay. Of the 17 patients, 13 patients (76.5%) were anti-HCV positive and 8 patients (47.1%), including one anti-HCV negative case, were positive for HCV RNA. In total, 14 patients (82.4%) were positive for either HCV markers. With respect to clinical course, HCV RNA was detected in six of eight patients (75%) with chronic biochemical disease, and in two of five patients (40%) with biochemically resolved chronic disease. HCV RNA was not detectable in convalescent sera from four patients with acute disease. These results show that there is a relationship between clinical status and HCV viremia, but that normal liver function tests do not always represent the clearance of the virus. Viremia in two patients with normal ALT level suggests that hepatitis is not only caused by viral cytopathic effects, but also by immunologic reactions against virus-infected cells. Thus, PCR is useful in determining the persistence of HCV infection as well as to diagnose anti-HCV negative HCV infection.

Adolescent↗

Acute interstitial nephritis and uveitis syndrome: activated immune cell infiltration in the kidney.

Infiltrating cells were analysed in renal biopsy tissue obtained from a 15-year-old girl with acute interstitial nephritis and uveitis using monoclonal antibodies specific for mononuclear cell surface markers. The interstitial infiltrates consisted mainly of T cells and monocytes/macrophages. A considerable proportion of the infiltrating cells were identified by a monoclonal antibody against the interleukin-2 receptor, indicating that a majority of those immune cells are activated. This observation documents the participation of cell-mediated immune injury in interstitial nephritis associated with uveitis.

Acute Disease↗

Transient massive proteinuria associated with Mycoplasma pneumoniae infection.

A 5-year-old girl presented with Mycoplasma pneumoniae infection, which was associated with eyelid edema and massive proteinuria. Her clinical manifestations were similar to those of nephrotic syndrome, except for the absence of hypoproteinemia. Light microscopy of renal biopsy tissue showed minor glomerular abnormalities, with no tubulointerstitial changes. Electron microscopy showed sparse fusion of the foot processes, regular nonthickened glomerular basement membrane, and no electron-dense deposits. Immunofluorescent staining of the glomeruli for immunoglobulins (IgG, IgA, IgM) and complement (C3, C4) was negative. Mycoplasma antigen was not detected by indirect immunofluorescence. These findings suggest a causal relationship between M pneumoniae infection and transient renal injury.

Child, Preschool↗

Serum Tamm-Horsfall glycoprotein level in children with various renal diseases.

Serum Tamm-Horsfall glycoprotein (THGP) concentrations were measured by a competitive enzyme-linked immunosorbent assay using peroxidase-labeled THGP in 168 patients, aged 10.5 +/- 4.6 years, with various renal diseases. Using this method, THGP was determined in the concentration range of 10-10(3) micrograms/l. Serum THGP levels ranged from 130 to 350 micrograms/l in 32 control subjects, aged 1-16 years with normal renal function. In most patients with renal disease, the serum THGP levels were lower than those in control subjects. In particular, the serum THGP levels were more reduced according to the decrease in the clearance values of endogenous creatinine (CCR). These findings suggested that the measurement of serum THGP levels is helpful in the evaluation of renal function. On the other hand, 3 patients with vesicoureteric reflux showed higher serum THGP levels than control subjects, though the CCR values in 1 of these patients was lower. These high serum THGP levels may be the result of urinary backflow into circulation.

Adolescent↗

[A surgical experience of aortoventriculoplasty (Konno's procedure) for aortic stenosis associated with hypoplasia of aortic valve ring progressed after the repair of supravalvular aortic stenosis].

A 14-year-old boy with aortic stenosis associated with hypoplasia of aortic valve ring underwent aortoventriculoplasty (Konno's procedure) successfully nine years after the repair of supravalvular aortic stenosis. His aortic annulus diameter before enlargement was 17 to 18 mm and after the procedure, a 25 mm St. Jude Medical prosthetic valve was implanted. It was adequate size for this large-sized student (173 cm in height, 67 kg in weight). After this operation, mild stenosis of right ventricular outflow tract was presented probably due to insufficient reconstruction of right ventricular outflow for such a dramatic enlargement of aortic annulus. Although this procedure makes possible to implant more than three-size larger prosthetic valve without major complications, we have to be careful about preventing right ventricular outflow tract stenosis in case of requiring enlargement over 40 or 50% of aortic annular circle.

Adolescent↗

[Effects of electrical or chemical stimulation of the prefrontal cortex on arrhythmias induced in cats by electrical stimulation of the anteromedial hypothalamus].

When the anteromedial hypothalamus is stimulated with a chronically implanted electrode in conscious cats, negative emotional behaviors such as restlessness and escape occur during stimulation and ventricular extrasystoles occur in rapid succession immediately after the end of stimulation. It has been shown in the lightly anesthetized cat that the activity of the sympathetic nervous system becomes predominant during stimulation of the anteromedial hypothalamus thereby causing the rises in blood pressure and heart rate. However, immediately after the cessation of the stimulation, this 'sympathetic dominant' state was observed to be switched to the 'parasympathetic dominant' state with falls in blood pressure and heart rate which was very frequently followed by the appearance of the ventricular extrasystoles (Poststimulus Arrhythmia: PSA). The purpose of this experiment was to examine how the electric and pharmacological stimulation of the prefrontal cortex modulate the rise in the blood pressure and heart rate and PSA caused by electric stimulation of the anteromedial hypothalamus. When the prefrontal cortex was electrically stimulated simultaneously with stimulation of the anteromedial hypothalamus in 24 lightly anesthetized cats, PSA was inhibited or facilitated or remained unchanged depending on the site of stimulation in the prefrontal cortex. When dopamine or noradrenaline was microinjected into the site of prefrontal cortex where PSA was inhibited, PSA was suppressed and this effect was blocked by microinjection of haloperidol or phenoxybenzamine, respectively. Dopamine was ineffective when injected in the site where PSA was facilitated; PSA was facilitated by microinjection of noradrenaline and this effect was inhibited by microinjection of propranolol. Although changes in blood pressure and heart rate were observed when the inhibition or facilitation of PSA was elicited by prefrontal injection of noradrenaline, no changes in cardiovascular parameters occurred when dopamine injection caused the inhibition of PSA. These results suggest (1) that activation of the dopamine receptor or alpha adrenoceptor in the prefrontal cortex is involved in the inhibition of PSA, and activation of beta adrenoceptor is concerned with facilitation of PSA and (2) that the mechanisms of dopamine receptor mediated inhibition of PSA appear to be different from those of inhibition of PSA by activation of the alpha adrenoceptor in the prefrontal cortex.

Animals↗

Distribution of type I collagen in human kidney diseases in comparison with type III collagen.

The distribution of type I collagen in normal and diseased renal tissues was studied using immunofluorescence and immunoelectron microscopy, and was compared with that of type III collagen. In normal human kidneys, a monoclonal antibody against type I or type III collagen reacted with the renal interstitium, but not with the intra-glomerular structures. In various types of glomerulonephritis, immunofluorescent staining for type I collagen was positive in the fibrocellular and fibrous crescents, sclerosed glomeruli, and infrequently within the glomerular mesangium. In the crescents and sclerosed glomeruli, type I collagen was co-localized with type III collagen. The staining intensity of type I collagen in those areas was generally stronger than that in the interstitium. Mesangial staining for type I collagen was present within the glomeruli, particularly with a marked mesangial matrix increase, but was less in amount and frequency compared with type III collagen staining. These findings indicate that the fibrosclerotic process in damaged glomeruli is accompanied by the appearance of interstitial collagens, and that participation of type I collagen is prominent in crescent organization and global glomerular sclerosis, but is less frequent in mesangial expansion, compared with type III collagen.

Adolescent↗

[Three cases of oligomeganephronia].

Three cases of bilateral renal hypoplasia with oligomeganephronia are reported. In all three patients urine abnormalities were pointed out by annual urine screening for school-children and they showed mild or moderate deterioration of renal function. One patient had repeated episodes of urinary tract infection, and bilateral vesico-ureteral reflux (grade III) was found by the voiding cystourethrography. Light microscopic findings of renal biopsy specimens were similar in three cases; significant hypertrophy of the glomerulus and tubulus; mild mesangial expansion, and interstitial changes. Further histological examination which was done in one case showed widespread foot process fusion, mesangial interposition and membrane-like structures by electron microscopy, and mesangial IgA deposition by immunofluorescence. Three was no alteration in immuno-staining pattern for basement membrane components, including type VI and V collagens, laminin and fibronectin, in the glomeruli.

Adolescent↗

Identification and localization of epidermal growth factor and its receptor in the human glomerulus.

Radioimmunoassay for epidermal growth factor (EGF) was performed using the homogenates of glomeruli and tubular preparations obtained from normal human kidneys. EGF-immunoreactive material was 3- to 5-fold higher in the glomerular fractions than in the tubular fraction. By indirect immunofluorescence with a monoclonal antibody, EGF was positive in three of five normal human kidney tissues and in tissues of 24 of 33 patients with proliferative and nonproliferative types of glomerular diseases. Acid-urea treatment of tissue sections to unmask a hidden epitope of the EGF molecule disclosed EGF immunoreactivity in four more kidney specimens. EGF was localized along the glomerular capillary walls and was also present in the arterioles and small arteries. Staining with three monoclonal antibodies recognizing two different epitopes of EGF receptor (EGF-R) was positive in tissues of 2 normal subjects and 15 patients with glomerular diseases. EGF-R was found along the glomerular capillary walls, in peritubular capillaries, and within the epithelial cells of distal tubules and collecting ducts. Immunoelectron microscopy with colloidal gold staining showed that EGF and EGF-R were localized in the plasma membrane of glomerular endothelial cells. Immunofluorescence with or without acid-urea denaturation showed coexpression of EGF and EGF-R in glomeruli of 1 normal subject and 12 patients. This study demonstrated the presence of EGF and EGF-R in human glomeruli. There was no obvious difference in EGF and EGF-R expression in glomeruli derived from normal or diseased state.

Antibodies, Monoclonal↗

Clinical evaluation of a pasteurized factor XIII concentrate administration in Henoch-Schönlein purpura. Japanese Pediatric Group.

Arthral, abdominal and renal symptoms in Henoch-Schönlein purpura (HSP) were scored. Coagulation factor XIII (F XIII) activity was determined in fifty-six children with HSP and the correlation with the severity score of the clinical symptoms was investigated. As a result, it was found that the decrease in F XIII level was correlated with the severity score of clinical symptoms, particularly abdominal symptoms. Based on the results, a controlled study was performed in 24 cases with moderate symptoms divided into a group treated with F XIII concentrate and a non-treated group to investigate clear-cut efficacy as a next study. In three days after the administration the symptoms were improved remarkably in accordance with the increase of F XIII level compared with non-treated group and scoring of clinical symptoms was confirmed to be useful for assessing the application of the F XIII concentrate to HSP.

Abdominal Pain↗

Immunoelectron microscopic localization of membrane attack complex and hepatitis B e antigen in membranous nephropathy.

Immunoelectron microscopy was used to localize membrane attack complex (MAC) and hepatitis B e (HBe) antigen in renal tissue specimens from a total of 9 patients with membranous nephropathy (MN); 6 with MN associated with a hepatitis B virus (HBV) infection, 2 with idiopathic MN, and 1 with lupus nephritis. All the patients were proteinuric, and 2 patients were classified as stage I-II, 6 as stage II, and 1 as stage IV. MAC, along with IgG and C3, was distributed within the subepithelial electron dense deposits in all the stages. MAC was also stained in the striated membranous structures within the glomerular basement membrane and mesangial matrix of some patients. In HBV-associated MN, HBe antigen was localized in the subepithelial electron dense deposits of 5 patients, while it was absent from the subepithelial deposits in a patient that was sero-positive for hepatitis B s antigen but negative for HBe antigen. This patient also lacked MAC deposition in these loci. These results suggest that MAC is associated with the formation of subepithelial deposits and proteinuria in MN. In HBV-associated MN, HBe antigen-antibody immune complex makes up the subepithelial deposits and is likely to activate the terminal components of complement in situ.

Complement Membrane Attack Complex↗

A mapping study of hypothalamic defensive attack and related responses in cats.

Effective stimulation sites for the hypothalamic defensive attach and its related responses were mapped in 65 tame adult cats (107 sites). The hypothalamic defensive attack was classified into two types according to its locomotion component: one with only directed attack and the other with retreat. The retreat appeared accompanied by back arching and intermingled with the directed attack. Otherwise, the directed attack and the retreat were accompanied by the same kinds of threat responses, including piloerection, ear retraction, growling and hissing. Stimulation sites for the directed attack with thresholds under 100 microA were located at the dorsal half of the ventromedial hypothalamic nucleus (VM) and areas just rostral to it. Directed attack with thresholds above 100 microA was elicited by stimulation of the marginal portion of the VM and adjacent areas, especially those rostral to it. Stimulation sites for the directed attack, which was replaced by stereotyped circling at higher intensities, were located at the part of the above-mentioned areas most distant from the VM. The retreat was elicited from the ventral half of the VM. Stimulation sites which evoked stereotyped circling with threat responses were distributed in a wider area of the medial hypothalamic area outside the VM.

Animals↗

Glomerular localization of type III collagen in human kidney disease.

Kidney specimens taken from normal humans and patients with various renal diseases were examined by immunofluorescent and immunoelectron microscopy using a monoclonal antibody to the alpha 1 chain of type III collagen. Indirect immunofluorescent staining revealed that intraglomerular localization of type III collagen antigen in 41 of 66 patients, while it was absent from the glomeruli of normal human kidneys. Type III collagen was found within the mesangium of 22 patients with various types of renal diseases, and was distributed in a focal and segmental manner in most of the cases. Mesangial localization of the collagen correlated with the increase in the mesangial matrix. Type III collagen was also present in the vascular pole, crescents (particularly in the organizing phase) and sclerosed glomeruli. Immunoelectron microscopy using pre-embedding and post-embedding techniques confirmed the above observations. These findings indicate that type III collagen participates in mesangial expansion, crescent organization, and glomerulosclerosis.

Antibodies↗

[Two brothers with reflux nephropathy].

This paper reports two brothers with reflux nephropathy. Patients who were 10-year-old and 12-year-old were referred to our hospital due to proteinuria and deterioration of renal function. Diagnosis of reflux nephropathy was made on drip infusion pyelography (DIP), voiding cystogram (VCG), and renal biopsy findings. The following findings were observed in renal tissues; focal and segmental sclerosis by light microscopy, IgM deposition by immunofluorescent microscopy, and glomerular basement membrane alterations and detachment of podocytes by electron microscopy. The HLA typing and analysis showed that both brothers and their mother possessed HLA-A9, which is reported to be closely associated with progression of primary reflux nephropathy to end-stage renal disease.

Child↗

Monocyte infiltration and cross-linked fibrin deposition in IgA nephritis and Henoch-Schoenlein purpura nephritis.

To clarify the role of immune cell infiltration and fibrin deposition in glomerular injury, renal biopsy specimens taken from patients with primary IgA nephritis and Henoch-Schönlein purpura nephritis (HSPN) were evaluated using monoclonal antibodies specific to mononuclear cell surfaces and cross-linked fibrin (XFb). Monocytes/macrophages were the predominant cell type infiltrating glomeruli in IgA nephritis and HSPN. The intraglomerular monocyte population in both diseases was significantly higher than that in normals, mesangial proliferative (non-IgA) glomerulonephritis or minimal change nephrotic syndrome. In IgA nephritis, there was a clear correlation between glomerular monocyte accumulation and the degree of proteinuria. Although the monocyte influx tended to decline with time in HSPN, it remained unchanged in IgA nephritis. XFb deposition was found in the glomeruli of 27 out of 48 patients with IgA nephritis, and in 15 out of 20 with HSPN. The degree of XFb deposition in IgA nephritis correlated significantly with the degree of mesangial proliferation. These findings indicate a close relationship of monocyte/macrophage infiltration and XFb deposition with glomerular injury in IgA nephritis.

Adolescent↗

Facilitatory effects of caerulein on hypothalamic defensive attack in cats.

Effects of intraventricularly microinjected caerulein (0.1, 1.0 and 10.0 micrograms) on the thresholds for hypothalamically elicited defensive attack and influences of haloperidol (0.5 mg/kg, i.p.) on the effects were studied in chronic cats. Directed attack and hissing were selected for threshold determination, and thresholds for these responses were measured under two situations: one with provocations by a human, and the other without such provocation. Results were as follows. (1) Caerulein lowered all thresholds in generally equal decrements and in a dose-related manner, accompanied by a general behavioral arousal. (2) Prior injection of haloperidol prevented the effects of caerulein, suggesting an antagonism-like interaction between haloperidol and caerulein. (3) Observed facilitatory effects of caerulein on the hypothalamic defensive attack were very similar to those observed with dopamine (DA) agonists such as methamphetamine and apomorphine and opposite to those with DA antagonists such as haloperidol and chlorpromazine. These findings suggest that caerulein exerts its facilitatory effects on the excitability of the ventromedial hypothalamic nucleus through its synergistic interaction with DA.

Aggression↗