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Biomedical subjects

S Yamamoto

Publications and source records attributed to S Yamamoto.

At least 145 records · Page 8Linked to original sources

[The surgical technique of heart displacement during off-pump coronary artery bypass grafting in the exposure of the anastomotic site of posterior descending artery].

Heart displacement during off-pump coronary artery bypass grafting (OPCAB) is necessary to expose the anastomotic site. However, such displacement causes hemodynamic deterioration especially in the exposure of the circumflex branches and posterior descending artery (PDA). In this study we present two different cardiac positioning for the exposure of the anastomotic site of PDA. To expose the mid-portion of PDA the heart is vertically displaced by fixing the suction cup of the heart positioner on apex. To expose the proximal portion of PDA the suction cup is attached on the acute margin of the right ventricle (off apex). By using these 2 different techniques properly, hemodynamic deterioration can be avoided during OPCAB for PDA.

Anastomosis, Surgical↗

[Traumatic laceration of the right middle lobar bronchus; report of a case].

We described the rare case of 26-year-old woman with a traumatic laceration of the right middle lobar bronchus. The patient suffered blunt chest trauma in a traffic accident. Chest roentgenography showed bilateral pneumothorax, right multiple rib and clavicle fractures and emphysema in the subcutaneous and mediastinal lesions. Bilateral thoracic drainages were performed under controlled mechanical ventilation. Massive air leakage from the right chest tube was observed. Bronchofiberscopy 2 days after the accident revealed laceration of the right middle lobar bronchus. A right middle lobectomy was performed via thoracotomy. The patient was discharged on hospital day 51. In terms of the rare bronchial laceration is discussed.

Accidents, Traffic↗

[Experience with invasive thymoma presenting pleural dissemination].

A 61-year-old man was admitted to Showa University Hospital because of a myasthenia gravis. Chest computed tomography revealed a mediastinal invasive tumor. During surgery, invasion to the pericardium and dissemination on the left visceral pleura and the left diaphragm were observed. Extended thymo-thymectomy and partial resection of the pericardium, left lung, and diaphragm were performed. Incomplete resection was achieved because of the dissemination on the diaphragm. Chemotherapy using ADOC and radiotherapy for mediastinum and left diaphragm were done. Four years after surgery, neither recurrence of the tumor nor myasthenia gravis was observed.

Chemotherapy, Adjuvant↗

Distinctly abnormal brain metabolism in late-onset ornithine transcarbamylase deficiency.

OBJECTIVE: To assess alterations in brain metabolites in patients with late-onset ornithine transcarbamylase deficiency (OTCD). METHODS: Six unrelated, asymptomatic Japanese late-onset OTCD patients were analyzed by proton MRS ((1)HMRS) using a point-resolved spectroscopy technique (repetition and echo times, 5000 and 30 ms). Localized spectra for the centrum semiovale were acquired and absolute metabolite concentrations were calculated using an LCModel. RESULTS: Compared with age-matched controls, N-acetylaspartate and creatine concentrations were normal in all patients. The glutamine (Gln) plus glutamate concentration was increased in four patients, which progressed in proportion to the clinical stage. myo-inositol (mI) could not be detected in five symptomatic patients. A decreased choline (Cho) concentration was detected in two clinically severe patients. (1)HMRS after liver transplantation in one patient revealed the normalization of all metabolites. CONCLUSION: These findings suggest progression of neurochemical events in OTCD, i.e., mI depletion and Gln accumulation followed by Cho depletion, which is reverse of that in hepatic encephalopathy, i.e., Cho depletion followed by mI depletion and Gln accumulation.

Adolescent↗

Island dynamics in the large-helical-device plasmas.

In the Large Helical Device plasma discharges, the size of an externally imposed island with mode number ( n/m = 1/1) decreases substantially when the plasma is collisionless ( nu(*)< approximately 1) and the beta is finite ( > approximately 0.1%) at the island location. For the collisional plasmas with finite beta, on the other hand, the size of the island increases. However, there is a threshold in terms of the vacuum island size below which the island enlargement is not seen.

Journal Article↗

Osteoclastogenic potential of bone marrow cells increases with age in elderly women with fracture.

The most reliable explanation for decreasing bone mass in elderly women is an imbalance of osteoclastic resorption and osteoblastic formation resulting from a relative increase in osteoclastic resorption. However, it is not clear whether an increase in osteoclastic bone resorption with age is due to increased osteoclast formation or to osteoclastic bone resorption activity. In this study, using a human bone marrow culture system, we attempt to clarify the increase in osteoclast formation with age. The mononuclear cell-rich fraction from bone marrow, obtained from the proximal region of the femur from female elderly patients with fracture, were cultured for 14 days in the presence of 1,25 dihydroxyvitamin D(3). Tartrate-resistant acid phosphatase-positive multinucleated cells were counted as osteoclasts. In our investigation, human osteoclast formation in the bone marrow culture increased with age in elderly women (age 64-96 years). The osteoclast formation was positively correlated with macrophage-colony stimulation factor and prostaglandin E(2) production in bone marrow culture. Also, osteoclast formation ex vivo was negatively correlated with bone mineral density of the lumbar spine (L2-L4). The above results indicate that the osteoclastogenic potential of bone marrow cells increases with aging in elderly women with fracture, and suggest that a decrease in bone mass of elderly women may be due to an increase in osteoclast population associated with aging.

Age Factors↗

Effects of volume and concentration of lidocaine on epidural anaesthesia in pregnant females.

BACKGROUND AND OBJECTIVE: The effects of altering the concentration of a local anaesthetic on the development of epidural anaesthesia in pregnant females are unclear. We compared the anaesthetic effects of a constant dose of two different concentrations of epidural lidocaine for Caesarean section. METHODS: After Institutional Review Board approval and informed consent, patients undergoing elective Caesarean section were randomized to receive either lidocaine 1% 30 mL (+epinephrine 5 microg mL(-1)) or lidocaine 2% 15 mL (+epinephrine 5 microg mL(-1)) (n = 20 each) for epidural anaesthesia at the L1-L2 interspace. The spread of the sensory block to pinprick and the degree of motor block (modified Bromage scale) were measured at 5, 10, 15, 20 and 30 min after injection. RESULTS: No significant differences in the progression of analgesia and motor block were observed at any time between 1 and 2% lidocaine. The maximum cephalad spread was observed 30 min after injection; the median was at T4 (range T3-T5) and at T4 (range T3-T6) for lidocaine 1 and 2%, respectively. CONCLUSIONS: The same doses but different volumes of lidocaine 1 and 2% produced comparable anaesthetic effects in pregnant females. The effects of epidural anaesthesia depend primarily on the total dose of the local anaesthetic.

Adult↗

Development of safe and efficient novel nonviral gene transfer using ultrasound: enhancement of transfection efficiency of naked plasmid DNA in skeletal muscle.

Although clinical trials of stimulation of angiogenesis by transfection of angiogenic growth factors using naked plasmid DNA or adenoviral vector have been successful, there are still unresolved problems for human gene therapy such as low transfection efficiency and safety. From this viewpoint, it is necessary to develop safe and efficient novel nonviral gene transfer methods. As therapeutic ultrasound induces cell membrane permeabilization, ultrasound irradiation might increase the transfection efficiency of naked plasmid DNA into skeletal muscle. Thus, we examined the transfection efficiency of naked plasmid DNA using ultrasound irradiation with echo contrast microbubble (Optison) in vitro and in vivo experiments. First, we examined the feasibility of ultrasound-mediated transfection of naked plasmid DNA into skeletal muscle cells. Luciferase plasmid mixed with or without Optison was transfected into cultured human skeletal muscle cells using ultrasound (1 MHz; 0.4 W(2)) for 30 s. Interestingly, luciferase activity was markedly increased in cells treated with Optison, while little luciferase activity could be detected without Optison (P < 0.01). Electron microscopy demonstrated the transient formation of holes (less than 5 microM) in the cell surface, which could possibly explain the rapid migration of the transgene into the cells. Next, we studied the in vivo transfection efficiency of naked plasmid DNA using ultrasound with Optison into skeletal muscle. Two days after transfection, luciferase activity in skeletal muscle transfected with Optison using ultrasound was significantly increased about 10-fold as compared with plasmid alone. Successful transfection was also confirmed by beta-galactosidase staining. Finally, we examined the feasibility of therapeutic angiogenesis using naked hepatocyte growth factor (HGF) plasmid in a rabbit ischemia model using the ultrasound-Optison method. Five weeks after transfection, the angiographic score and the number of capillary density in rabbits transfected with Optison using ultrasound was significantly increased as compared with HGF plasmid alone (P < 0.01), accompanied by a significant increase in blood flow and blood pressure ratio (P < 0.01). Overall, the ultrasound transfection method with Optison enhanced the transfection efficiency of naked plasmid DNA in vivo as well as in vitro. Transfection of HGF plasmid by the ultrasound-Optison method could be useful for safe clinical gene therapy to treat peripheral arterial disease without a viral vector system.

Animals↗

Size-class differences in genetic structure and individual distribution of Camellia japonica L. in a Japanese old-growth evergreen forest.

Size-class differences in genetic structure and individual spatial distribution were investigated for Camellia japonica within a 1-ha plot in a Japanese old-growth evergreen forest using microsatellite markers. Three size-classes were considered containing plants that were: 30-32.5 cm tall, 103.8 cm-200 cm tall and those that had a diameter at breast height > or =5 cm, designated JV1, JV2, and ADL, respectively. Each size-class contained 174 individuals. Morisita's index of dispersion indicated clumping of individuals was present within all size-classes, with JV2 displaying the highest level. The clumped distribution of JV1 individuals may be a result of limited seed dispersal, while that of JV2 may be attributed to heterogenieties of favourable microsites, such as canopy gaps. There were no significant differences in allele frequencies among size-classes. There were, however, some differences in spatial genetic structure among them. Moran's I spatial autocorrelation analysis revealed clear spatial genetic structure in class JV1 probably due to limited seed dispersal. In class JV2, genetic structure was not observed. Overlapping seed shadows, probably in canopy gaps, may lead to blurred genetic structure in JV2.

Camellia↗

Combination of molecular mimicry and aberrant autoantigen expression is important for development of anti-Fas ligand autoantibodies in patients with systemic lupus erythematosus.

We have reported previously that circulating anti-Fas ligand (FasL) autoantibodies able to inhibit Fas/FasL-mediated apoptosis were present in patients with systemic lupus erythematosus (SLE). In the present study, we describe the epitopes recognized by these anti-FasL autoantibodies. Rabbit antihuman antibody, raised against a FasL fragment consisting of amino acids (aa) 103-179 (fragment 2.0), inhibited Fas/FasL-mediated apoptosis, whereas an antibody against a FasL aa 103-146 fragment (fragment 1.0) did not. This suggested that an epitope around aa 146-179 was important for Fas/FasL interaction. Epitope mapping of anti-FasL autoantibodies using deletion mutants indicated that the epitope was located around aa 163-179. Three-dimensional molecular modelling of the Fas/FasL complex revealed that the aa 162-169 region was located on the outermost side of FasL, which suggested that the anti-FasL autoantibody would easily have access to the epitope. FasL point mutants involving aa positions 162-169 resulted in complete loss of apoptosis-inducing capability, which suggested that the aa 162-169 region was important for Fas/FasL interaction. A synthetic FasL peptide consisting of aa 161-170 blocked the binding of anti-FasL autoantibodies to FasL fragment 2.0 (aa 103-179). The FasL aa 161-170 sequence was found to be highly homologous with aa sequences from several infectious agents. Synthetic peptides derived from some of these microorganisms cross-reacted with the epitope recognized by the autoantibodies, suggesting that several foreign infectious agent-derived proteins may share an epitope with human FasL. As lymphocytes from SLE patients aberrartly expressed FasL, it is possible that infection by one of several infectious agents may trigger cross-reactive antibody responses, after which aberrantly expressed endogenous FasL might induce the shift from a cross-reactive response to an authentic autoimmune response. Therefore, a combination of molecular mimicry and aberrant autoantigen expression may be important for the development of anti-FasL autoantibodies in SLE patients.

Adolescent↗

Non-secretor status is associated with female acute uncomplicated pyelonephritis.

OBJECTIVE: To retrospectively analyse the secretor status in women with acute uncomplicated pyelonephritis, as non-secretors of histo-blood group antigens are reportedly at risk of recurrent urinary tract infections (UTIs). PATIENTS AND METHODS: The study included 245 women who had been diagnosed as having acute uncomplicated pyelonephritis in affiliated hospitals over the past 5 years. All women were sent antiseptic swabs, to collect saliva, and a questionnaire to survey their past UTI episodes and menstrual status. Responses with written informed consent were obtained from 106 women (median age 50.5 years, range 17-85). The secretor status was determined using the haemagglutination inhibition assay from the saliva on the swabs. RESULTS: Forty-four (41%) of the women were non-secretors, a significantly higher frequency than in the (control) Japanese population (217 of 960, 22.6%; P< 0.001). The incidence of non-secretors was significantly higher (P < 0.01) in premenopausal (26 of 46, 57%) than in postmenopausal women (18 of 60, 30%). CONCLUSION: These results suggest that non-secretor status is associated with a genetic susceptibility to acute uncomplicated pyelonephritis, especially in premenopausal women.

ABO Blood-Group System↗

Helicobacter pylori infection in rheumatoid arthritis: effect of drugs on prevalence and correlation with gastroduodenal lesions.

OBJECTIVE: The aim of this study was to investigate the impact of Helicobacter pylori infection on clinical features in patients with rheumatoid arthritis (RA) under medication with non-steroidal anti-inflammatory drugs. METHODS: One hundred and eighty-four patients with RA were tested for the presence of H. pylori infection. Clinical features and gastroduodenal lesions were compared between H. pylori-positive and -negative patients. RESULTS: One hundred and thirteen patients were positive and 71 patients were negative for H. pylori. The age, severity of RA, prevalence of gastrointestinal symptoms and gastroduodenal lesions and the class of gastroprotective drugs were not different between the two groups. Reflux oesophagitis was less frequent and sulphasalazine was less frequently administered in the H. pylori-positive group. CONCLUSIONS: The severity of RA, prevalence of gastroduodenal lesions other than reflux oesophagitis and the application of gastroprotective drugs do not seem to depend upon H. pylori infection in RA patients. Sulphasalazine may be protective against H. pylori infection.

Adult↗

Macular configuration determined by optical coherence tomography after idiopathic macular hole surgery with or without internal limiting membrane peeling.

AIMS: To evaluate the effect of pars plana vitrectomy (PPV) with or without internal limiting membrane (ILM) peeling on the closure and configuration of idiopathic macular holes (IMH). METHODS: PPV was performed for IMH on 44 eyes with ILM peeling (ILM peeled group) and on 42 eyes without ILM removal (ILM preserved group). Optical coherence tomography (OCT) was performed on 34 ILM peeled eyes and 14 ILM preserved eyes after successful surgery. The repaired macular holes were classified by the OCT images as being of "good shape" (nearly normal foveal contour) or "poor shape" (abnormal foveal contour with flat fovea and steep edge, or with a thick retina without a foveal pit). RESULTS: The anatomical closure rate was significantly higher in the ILM peeled group (93.2%) than in the ILM preserved group (76.2%) (p = 0.028). In the ILM peeled group, 31 eyes had a fovea of good shape and three eyes had a fovea with a poor shape, while in the ILM preserved group, six eyes had a fovea of good shape and eight eyes had a fovea of poor shape. The percentage of eyes with good macular configuration in the ILM peeled group was significantly higher than in the ILM preserved group (p = 0.0003). No significant difference was found in the postoperative visual acuity and the increase of visual acuity between the ILM peeled group and the ILM preserved group (p = 0.26, and p = 0.91 respectively). There was also no significant difference in the postoperative visual acuity and improvement in visual acuity between eyes with a fovea of good shape and those with fovea of poor shape fovea (p = 0.99 and p = 0.66, respectively). CONCLUSIONS: ILM peeling may provide better anatomical success and recovery of the macular shape, but the postoperative visual acuity and improvement of visual acuity were not related to the morphological results.

Aged↗

Serum alpha2-macroglobulin and cytokine measurements in an acute inflammation model in rats.

An enzyme-linked immunosorbent assay (ELISA) for rat alpha2-macroglobulin (alpha2M) using a monoclonal antibody was developed, and used to measure alpha2M in sera from rats injected intramuscularly with turpentine oil as an inflammatory agent. The mean concentration of alpha2M gradually increased and peaked 2 days after the turpentine oil injection. The peak alpha2M concentration ranged from 2362-8472 microg/ml (mean 4531 microg/ml), which was 50-290 times higher than the pre-dosing levels of 23-61 microg/ml. In addition, interleukins (IL)-1, IL-2, IL-4, IL-6, IL-8, IL-10, and interferon (IFN)-gamma were measured using commercial ELISA reagent kits. IL-6 and IL-8 increased and peaked 12 h after turpentine oil injection, the levels being 5-51 times and 2-38 times the pre-dosing ones, respectively. The concentrations of IL-1, IL-2, IL-4, IL-10 and IFN-gamma in rats injected with turpentine oil did not change.

Acute Disease↗