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Biomedical subjects

S Teramoto

Publications and source records attributed to S Teramoto.

At least 235 records · Page 13Linked to original sources

Pulmonary oxygen transfer deficits of diabetic origin in patients undergoing coronary artery bypass grafting.

The objective of this study was to determine the effects of a diabetic disposition on pulmonary gas exchange by examining 72 patients who underwent coronary artery bypass grafting (CABG), using the arterial/alveolar oxygen tension ratio [(a/A)PO2] as a criterion. Patients were divided into a diabetic (DM) group and a nondiabetic (non-DM) group. The postoperative blood gases and hemodynamic data measured when the blood glucose level was at a maximum on the day of CABG were used as the postoperative pulmonary gas exchange indices, and the physicians who managed these patients were unaware of this study. The preoperative (a/A)PO2 ratio was 0.66 +/- 0.03 (SE) in the DM group and 0.78 +/- 0.02 in the non-DM group (P < 0.01), while the postoperative ratios were 0.42 +/- 0.03 and 0.52 +/- 0.03, respectively (P = 0.01). The correlation coefficient (r) for regression analysis of the relation between the postoperative PaO2/FIO2 ratio and the postoperative (a/A)PO2 ratio was 0.99 in the DM group (P < 0.01) and 0.88 in the non-DM group (P < 0.01). The r values of the relation between (a/A)PO2 and (A-a)PO2 were -0.68 (P < 0.00) and -0.84 (P < 0.01), while those for the respiratory index were -0.87 (P < 0.01), and -0.93 (P < 0.01), respectively. Thus, pulmonary oxygen transfer was compromised before and after CABG in the DM group compared to the non-DM group. Moreover, the PaO2/FIO2, being the simplest pulmonary gas exchange index to calculate, was a reliable substitute for the (a/A)PO2 ratio during the early postoperative management of CABG patients.

Coronary Artery Bypass↗

The effects of aging on the function of alveolar macrophages in mice.

In order to determine whether the function of alveolar macrophages (AM) is modulated by aging, we measured the TNF-alpha production, phagocytic function, and surface antigen expression of AM from young and old mice. When AM were primed by IFN-gamma (500 units/ml) and triggered by LPS (100 micrograms/ml), TNF-alpha production by AM was significantly smaller in old mice as compared with young mice (young mice: 161.7 +/- 28.2 units/ml; old mice: 89.3 +/- 13.6 units/ml, P < 0.05). The percentage of AM which phagocytosed latex particles (more than one particle) in old mice was significantly lower than in young mice (young: 78.1 +/- 2.5%; old: 62.8 +/- 3.4%, P < 0.05). Ia antigen expression of the AM was significantly higher and asialo-GM1 antigen expression was significantly lower in old mice than in young mice (Ia: young, 0.030 +/- 0.005; old, 0.092 +/- 0.024, P < 0.05; asialo-GM1: young, 0.-9 +/- 0.01; old, 0.75 +/- 0.07, P < 0.01). These results suggest that alveolar macrophage function is at least decreased in part with aging in mice.

Aging↗

Age changes in visceral content of glutathione in the senescence accelerated mouse (SAM).

Free radical formation is known to play a role in the aging processes. However, it is still disputable whether the scavengers of free radicals including glutathione (GSH) decrease during aging. The senescence accelerated mice (SAM) are known to show age-related disorders. Some of these syndromes were thought to be closely associated with oxidative damages. Using the two strains of SAM, SAM-R/1 and SAM-P/2, we examined age-related changes in GSH content in the tissues and its oxidation. In the eye, GSH levels were significantly decreased at the age of 16 months in SAM-P/2 and female SAM-R/1. The ratio of oxidized glutathione to total GSH increased, indicating GSH may play an important role in the eyes. But there were no remarkable age-related changes in GSH contents of other tissues such as liver, kidney and lung in both SAM-R/1 and SAM-P/2. These data suggest that the GSH level of the tissues in general can not be a proper indicator for senescence.

Aging↗

A two-generation reproduction study in rats with methyl bromide-fumigated diets.

Crj:CD(SD) rats were fed basal (control) diet or methyl bromide-fumigated diet containing 80, 200 or 500 ppm total bromine for two successive generations (18 wk for each generation). Compared with controls, food consumption was significantly lower in F1 parental females of the 500-ppm group during the second half of the dosing period, and F2 female pups of the 500-ppm group showed lower body weights throughout the lactation period. No other treatment-related changes were found at any dietary level of total bromine in either parental animals (F0, F1) or their offspring (F1, F2) for any of the parameters studied (i.e. clinical signs, oestrous cycle, sperm count and morphology, mating, fertility, gestation, parturition, litter size, pup viability, organ weights, and gross or histopathological examination). It was concluded that residues of 200 and 500 ppm total bromine in diets fumigated with methyl bromide are the no-observed-effect level and the minimum toxic level, respectively, for both parental rats and their offspring, and that bromine residues do not affect reproductive performance at dietary levels of up to 500 ppm.

Administration, Oral↗

Circulatory support for patients experiencing postcardiotomy cardiogenic shock: analysis of risk factors for death and long-term follow-up.

Over the last 5 years, 12 patients received ventricular assist devices (VADs) while in postcardiotomy cardiogenic shock. There were 7 male and 5 female patients ranging in age from 22 to 73 years (average age, 54). Eight patients underwent surgery for valve replacements, 3 for coronary artery bypass graftings, and 1 for closure of a ventricular septal rupture. The duration of VAD support ranged from 6 h to 9 days (mean, 4.2 days). Ten patients were weaned from the VADs, and 6 survived. Univariate analysis indicated that renal failure, infection, and heart failure had a negative impact on those patients who survived. Multivariate analysis indicated that heart failure, renal failure, and preoperative left ventricular ejection fraction were the most important predictors of hospital death. The 6 survivors were followed for 4 to 42 months (mean, 25 months); 5 were in New York Heart Association (NYHA) Class I, and 1 was in Class II. The cardiac functions in 5 patients who lived over 1 year were assessed by echocardiography. Preoperative and postoperative UCG revealed that ejection fraction and mean velocity of circumferential fiber shortening increased significantly (p < 0.01). Also, the left ventricular diastolic and systolic dimensions decreased significantly (p < 0.05). However, the patients did not show further changes in these parameters during exercise. Eight patients who had double valve replacements were observed for comparison (control group). In the control group, exercise improved cardiac output and mean velocity of circumferential fiber shortening (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Surgical Procedures↗

Effects of inhaled anticholinergic drug on dyspnea and gas exchange during exercise in patients with chronic obstructive pulmonary disease.

To elucidate the effect of oxitropium bromide (OTB), an anticholinergic drug, on dyspnea and gas exchange during exercise in patients with chronic obstructive pulmonary disease (COPD), we performed the cycle exercise test on 19 patients with COPD (mean age, 72.0 +/- 1.9 years; mean FEV1, 1.28 +/- 0.07 L) before and after inhalation of OTB, 300 micrograms, or placebo, 300 micrograms, in randomized fashion. Spirometry was performed immediately before and 30 min after inhalation of either OTB or placebo. Dyspnea during exercise was evaluated using the Borg scale (BS) and the slope of the regression between BS and oxygen uptake (VO2) during exercise (Borg scale slope: BSS). Arterial oxygen saturation (SaO2) was continuously monitored by pulse oximeter during and after exercise. We also measured the recovery time, which was defined as the time to recover decreases in SaO2 after exercise. After OTB, spirometric indices were improved (delta FEV1 16.8 +/- 0.9 percent) and maximal VO2 during exercise increased significantly (from 986 +/- 46 ml/min to 1,156 +/- 55 ml/min, p < 0.01), but not after placebo. The maximal scores of BS and the BSS were significantly decreased after OTB, but not after placebo. Although the SaO2 at rest and during exercise did not differ with or without either OTB or placebo, the recovery time after OTB (77.3 +/- 6.8 s) was significantly shorter than that before administration (98.4 +/- 14.6 s) (p < 0.01). We conclude that the inhaled OTB produces small but significant improvement both in dyspnea during exercise and in exercise performance in stable COPD and may contribute to improve the quality of life in some patients with COPD. However, gas exchange during exercise of COPD patients is little affected by OTB.

Administration, Inhalation↗

Usefulness of a simplified artificial insemination technique in the rabbit for teratology studies.

We describe usefulness of our simplified artificial insemination technique in rabbits for teratology studies. Our technique includes 1) semen collection from 2 or 3 bucks with a simple artificial vagina, 2) deposition of 0.5 microliters of the diluted semen mixture in the vagina with a glass pipette, and 3) injection of 25 U. of hCG through the auricular vein. Applying these techniques and procedures and keeping about 10 proven bucks would enable 2 operators to inseminate 10-15 does daily by only 1 hour work. This artificial insemination technique should be useful for rabbit teratology studies, especially for safety evaluation studies of toxicants, where a relatively large number of pregnant are needed to be prepared in a short period.

Animals↗

Mid-term results of bilateral internal thoracic artery grafting.

Forty patients underwent coronary revascularization using bilateral internal thoracic artery (ITA) grafts between 1988 and 1992. A total of 111 coronary grafts were performed, or an average of 2.8 grafts per patient. Each patient received bilateral ITA grafts, and in 20 patients an additional 29 grafts were constructed with 18 autologous veins and 11 gastroepiploic arteries. The right ITA was grafted as a free graft in 20 patients. The ITA graft patency rate was 96 per cent (67/70) at the time of hospital discharge. The operative morbidity included 3 reoperations for bleeding, 1 perioperative myocardial infarction, 1 renal failure, 2 postcardiotomy shock, and 1 colon perforation. Two hospital deaths occurred; one due to colon perforation and the other due to postcardiotomy cardiogenic shock. One patient died of cerebral infarction 6 month after the operation. Thirty-four patients were in New York Heart Association functional class I, 2 were in class II and 1 was in class III. Cardiac function evaluated by echocardiography and scintigraphy showed significant improvement postoperatively. These data suggest that the use of bilateral ITA grafts is associated with an acceptable mortality and increases the versatility of arterial grafting.

Aged↗

Cellular immunocompetence in aortitis syndrome.

Cellular immunocompetence was investigated in 17 cases of aortitis syndrome (3 active, 14 inactive stage). Both the active and inactive groups demonstrated significantly lower interleukin-2 (IL-2) production than healthy volunteers. The active aortitis syndrome group produced significantly more interleukin-1 beta (IL-1 beta) than the inactive group. The proportion of CD11b+ CD8+ cells was significantly lower in the active aortitis syndrome group. Further, the proportions of CD11b- CD8+ cells and CD57+ CD16- cells in the aortitis syndrome patients were significantly higher than the healthy volunteers. These results suggest that there are intrinsic qualitative abnormalities in the T cells that produce IL-2 in aortitis syndrome. Pathogenesis of aortitis syndrome is considered as follows: during the active stage, diminished IL-2 production impairs differentiation and proliferation of suppressor T cells, thus creating abnormalities in the inhibitory functions of immunoregulation and promoting the proliferation of cytotoxic T and natural killer (NK) cells. This presumably initiates inflammation of the aorta and/or artery.

Adult↗

Diagnosis of rejection in the allografted rat lung: using monoclonal antibodies to T cell subsets for immunologic monitoring.

Early diagnosis of rejection and timely immunosuppression are absolutely important in clinical lung transplantation. We studied surface markers of peripheral blood lymphocytes (PBL), graft infiltrating lymphocytes (GIF) and bronchoalveolar lavage fluid (BALF) in a rat using flow cytometric monitoring to diagnose rejection. Left lung transplantation was performed on Brown Norway (BN) rats and Lewis (LEW) rats in the following groups; Group 1: LEW-LEW (isograft), Group 2: BN-LEW (allograft; no immunosuppression), Group 3: BN-LEW (allograft; treated with Cyclosporine A at a dose of 15 mg/kg/day i.m.). In each group, rats were killed 3, 5, 7 days postoperatively (n = 6 on each day). Monoclonal antibodies investigated in this study were W3/25 (anti-helper T lymphocyte), OX8 (anti-suppressor/cytotoxic T lymphocyte), and OX39 (anti-interleukin 2 receptor). Histological classification of rejection in Group 2 showed vascular phase at 3 days, alveolar phase at 5 days, and destructive phase at 7 days, respectively. No evidence of rejection was found in Group 1 or 3. In Group 2, W3/25 positive cell proportion in GIL and BALF significantly decreased as the rejection progressed, but OX8 positive and OX39 positive cell proportion increases were significantly greater than in Groups 1 and 3 as the rejection progressed. These results lead us to speculate that the studies of T cell subsets in GIL and BALF lymphocytes are useful for diagnosis of rejection in lung transplantation.

Animals↗

Assessment of left ventricular diastolic function in chronic mitral regurgitation by Doppler left ventricular inflow and left ventricular ultrastructural morphometry.

Doppler left ventricular (LV) inflow is reportedly affected by LV diastolic properties. We evaluated 48 subjects consisting of 27 patients with chronic mitral regurgitation (MR) and 21 patients with noncardiac disorders who received echocardiographic examinations. The deceleration rate divided by diastolic dimension (DR/Dd) derived from Doppler early diastolic LV inflow was correlated with the peak diastolic velocity divided by diastolic dimension (peak DV/Dd), a conventional index of LV diastolic function derived from the M-mode echocardiogram in the 48 patients, regardless of the presence of normal sinus rhythm or atrial fibrillation. LV diastolic function was then estimated by comparing perioperative echocardiographic examination and LV micro-and ultrastructural findings of biopsy specimens from 12 patients with MR who received mitral valve replacement. Fiber diameter, volume fraction of interstitial fibrosis (int. % Fib), and volume fractions of three intracellular components; the myofibrils (% MF), the sarcoplasmic reticulum (% SR) and the mitochondria (% MT), were measured in LV transmural biopsy specimens. DR/Dd was significantly correlated with peak DV/Dd before and after operation. Peak DV/Dd and DR/Dd were inversely correlated with int. % Fib and % SR, and were positively correlated with % MF. We subdivided the 12 MR patients according to their postoperative DR/Dd values as "recovered", and "non-recovered" based on their postoperative LV diastolic function. % MF was significantly lower in the 'non-recovered' group. Thus, DR/Dd can serve as an index of LV diastolic function. A decrease in % MF may inhibit the recovery of postoperative LV diastolic function.

Adult↗

Evaluation of the viability of the canine cadaver lung for transplantation.

We evaluated the viability of the cadaver lung and the effect of lung inflation with 100% oxygen using a canine allotransplantation model. Donor animals were killed by potassium chloride (KCl) injection and were kept at room temperature until lung extraction. The animals were divided into the following 3 groups: group 1 (n = 6) in which the donor lungs were retrieved 2h after sacrifice, group 2 (n = 6) in which the donor lungs were retrieved 3h after sacrifice, and group 3 (n = 6) in which the donor lungs were retrieved 3h after sacrifice as in group 2 except that they were kept inflated for 3h with 100% oxygen using a double lumen endotracheal tube. Heparin was not given and lungs were not flushed with preservation solution. After left lung transplantation, the transplanted lung function including gas exchange and pulmonary hemodynamics was assessed for 6h by ligating the right pulmonary artery of the recipient animals. All 6 animals in groups 1 and 3 survived for 6 h with excellent lung function. Only 2 of 6 animals in group 2 survived for 6h with poor lung function. These results led us to conclude the following: a) the cadaver lung kept at room temperature for 2h might be available for lung transplantation, and b) when the cadaver lung is inflated with 100% oxygen, the length of safe ischemic time could be prolonged up to 3h.

Animals↗

Early detection of acute allograft rejection in rat heart transplantation: flowcytometric monitoring of interleukin 2 receptor expression on CD8 positive lymphocytes.

To assess the usefulness of flowcytometric monitoring in the early detection of acute allograft rejection, we studied surface markers of graft infiltrating lymphocytes, coronary sinus blood lymphocytes and peripheral blood lymphocytes after rat heart transplantation. Fisher rats served as donors and Lewis rats as recipients. Among recipients that received no immunosuppression, grafts were removed 2 days after transplantation (Ongoing Rejection Group: n = 7) and on the day of terminal rejection (Rejection Group: n = 7). The Immunosuppression Group (n = 7) was treated with cyclosporine A at a dose of 3 mg/kg/day intramuscularly for 14 days. The following two color analyses were studied: OX8 (anti-CD8) with OX39 (anti-interleukin 2 receptor; IL2R), W3/25 (anti-CD4) with OX39, W3/25 with OX8. Histological grading demonstrated no significant difference between the Ongoing Rejection Group and the Immunosuppression Group, which showed mild rejection (1.29 +/- 0.27 versus 1.14 +/- 0.24). The proportion of CD8(+)IL2R(+) graft infiltrating lymphocytes showed a more significant increase in the Ongoing Rejection Group than in the Immunosuppression Group (32.1 +/- 3.05 versus 20.6 +/- 9.02; p < 0.01). The proportion of CD8(+) IL2R(+) coronary sinus blood lymphocytes also showed significant increase in the Ongoing Rejection Group compared with the Immunosuppression Group (4.63 +/- 1.91 versus 2.52 +/- 1.60; p < 0.05). These results suggest that this technique can detect acute allograft rejection earlier than endomyocardial biopsy, before the phase in which histological findings become evident.

Acute Disease↗

Transplantation of the canine cadaver heart using a core-cooling technique.

We studied whether a cardiopulmonary bypass (CPB) and a core-cooling technique could resuscitate an arrested heart, and whether this procedure benefited canine cadaveric heart transplantation. Donor dogs were subjected to brain death by an intracranial balloon technique, and then, to cardiac arrest conducted by cutting off ventilatory support. In the control group (Group 1; n = 8), arrested hearts were flushed with cardioplegic solution and harvested thereafter without any resuscitation technique. In the experimental group (Group 2; n = 8), arrested hearts were once resuscitated using CPB, and then harvested using a core-cooling technique and cardioplegia. These hearts were transplanted orthotopically. Seven of eight recipients in Group 1 were weaned from CPB, and five of them finally became independent of dopamine administration. All recipients in Group 2 were successfully weaned from CPB, and also became dopamine free eventually. In Group 2, all post-transplantation hemodynamic values such as cardiac output during the period of dopamine administration were equivalent to those of post-brain death period. Chemical analysis of the serum and myocardial muscle demonstrated no difference between groups. We conclude that CPB combined with a core-cooling technique makes it possible to utilize an arrested heart as a donor organ for transplantation.

Animals↗

Effective preoperative and postoperative respiratory training in a lung cancer patient with chronic respiratory failure.

A case illustrating the value of aggressive respiratory training in improving the prognosis of lung cancer complicated by low pulmonary function is reported. Preoperative and postoperative respiratory training enabled the patient with chronic respiratory failure to survive a lengthy operation and eventually breathe without assistance. The patient has survived more than 71 months, and experiences only exertional dyspnea at the time of publication. Aggressive preoperative and postoperative respiratory management may make more of the growing number of lung cancer patients eligible for standard surgical procedures.

Aged↗

Evaluation of radiograph signs for the diagnosis of solitary peripheral pulmonary nodules less than 3 cm.

Ten radiograph signs were assessed by two experts for their usefulness in the diagnosis of small solitary peripheral pulmonary nodules less than 3 cm. The ten categories included notching, spicula formation, pleural indentation, vascular convergence, contour, paleness, homogeneity, cavitation, air bronchogram, and calcification. The cases included 134 lung cancers and 44 benign lung lesions resected between 1972 and 1988 at the Second Department of Surgery, Okayama University Medical School. Notching, spicula formation, pleural indentation, vascular convergence, contour, and air bronchogram were useful signs in differentiating lung cancer from benign lung lesions. However, since the radiograph signs exhibited great variation in both lung cancer and benign lung lesions, a diagnostic operation is sometimes inevitable.

Humans↗

Efficacy of percutaneous transluminal coronary recannalization for preservation of the post-infarct left ventricular regional wall motion: a trial of the evaluation by weighting coronary artery segments.

Efficacy of the percutaneous transluminal coronary recannalization (PTCR) therapy was evaluated by weighting infarct-related coronary artery segments in 28 consecutive patients with acute myocardial infarction. The study focused on the influences of the time interval from the onset of chest pain to PTCR (PTCR-Time) and on the post-infarct left ventricular regional wall motion in conjunction with the serum levels of GOT, LDH and CPK and with PTCR-Time. PTCR success rate was 84.0%, and re-occlusion rate was 4.0%. The thrombolysis in myocardial infarction grade 2, however, was observed in 7 (33.3%) of 21 cases with successful PTCR. There was no significant difference in PTCR-Time between the PTCR success and nonsuccess groups. Significant correlations were observed between the PTCR-Time and each peak value of standardized serum levels of LDH and CPK, and between the PTCR-Time and the post-infarct regional wall motion abnormality. There were also significant correlations between the standardized serum level of each of these three enzymes and the post-infarct regional wall motion abnormality. It was clearly demonstrated that the earlier the recannalization of the infarcted artery was achieved, the less extensive the myocardial damage in quantitative and qualitative aspects.

Adult↗

[An aspiration pneumonia in acute airway damage model induced by HCl and/or LPS].

The purpose of this study is to evaluate chemical and pathological changes of the lung and to elucidate the role of TNF alpha and elastase in acute lung injury induced by HCl or lipopolysaccharide (LPS). Anesthetized rats were injected with pH 1.4 0.7 ml/kg body weight of HCl and 0.5 mg/kg body weight (BW) of LPS (E. coli) into the lung. Acute tracheal injury model (Mendelson Syndrome) were made. Control animals received only saline. Animals were sacrificed 1, 6, or 12 hours after the HCl or LPS or HCl and LPS injection, bronchoalveolar-lavage (BAL) was performed in the same way in control and experimental groups. The other animals which were treated as well were excised by histology. There was neither increase in TNF alpha-production nor increase in neutrophils resulting from HCl injection only. Elastase-like activity was not detected in animals treated only with HCl. However, 1 hour after LPS injection, the production of TNF alpha (37.0 +/- 8.0 Units/ml) was significantly greater than that of the control group (12.1 +/- 4.2 Units/ml) in BALF. Six hours after HCl and LPS injection, the concentration of elastase-like activity (0.023 +/- 0.002 nM) was significantly greater than that of the LPS group (0.011 +/- 0.001 nM). Only patches of intraalveolar hemorrhage and elevation of fibrin was observed in the HCl injected rats at 1 hour after injection. Six hours after LPS injection, the alveolar spaces were filled with large amounts of neutrophils. These findings suggest that TNF alpha and elastase play a significant role in HCl and LPS-induced acute lung injury.

Acute Disease↗