Biomedical subjects
T Fujino
Publications and source records attributed to T Fujino.
Human long-chain acyl-CoA synthetase: structure and chromosomal location.
A complementary DNA clone encoding the entire human long-chain acyl-CoA synthetase was isolated and the total 698-amino acid sequence was deduced. The amino acid sequence of human long-chain acyl-CoA synthetase shows 84.9% identity to that of rat long-chain acyl-CoA synthetase. The nucleotide sequences of the protein coding regions between human and rat long-chain acyl-CoA synthetase mRNAs are highly conserved (85.6%), whereas those of the 3' untranslated regions are less conserved (72%). The location of the human long-chain acyl-CoA synthetase gene was identified on chromosome 4 by spot hybridization of flow-sorted chromosomes. Computer-assisted homology search revealed a significant similarity of the enzyme with the enzymes of the luciferase family. Based on this similarity, the structure of human long-chain acyl-CoA synthetase can be divided into five domains: the N-terminus, two domains similar to those in enzymes of the luciferase family, a long gap region between the similar domains and the C-terminus.
Cloning and functional expression of a novel long-chain acyl-CoA synthetase expressed in brain.
Complementary DNA clones encoding a protein highly homologous to the previously characterized long-chain acyl-CoA synthetase (LACS) in liver were isolated from rat brain cDNA libraries. This protein consists of 697 amino acids and has 64.7% identity with the rat liver LACS sequence. The brain protein and the liver LACS share essentially the same domain structure, having two regions similar to those of click beetle luciferase and a long discrete gap flanking the similar domains. A significant sequence similarity was found between the brain protein and malaria octapeptide-repeat antigen, suggesting a functional similarity. COS cells transfected with the cDNA for the brain protein expressed LACS activity with slightly different fatty acid specificity from that of the liver LACS. This new LACS is expressed predominantly in brain and, to a much lesser extent, in heart and adrenal. The 2.9- and 6.3-kb mRNAs coding for the brain enzyme are coregulated with the development of brain, suggesting the physiological importance of the enzyme in fatty acid metabolism in brain.
Acute abdomen due to adenomyosis of the uterus: a case report.
A Japanese woman with severe abdominal pain underwent an emergent exploratory laparotomy. Intraperitoneal bleeding from the uterine serosal surface was observed, and a pathologic examination showed that the bleeding was caused by an exudative hemorrhage from the endometrial tissues in the myometrium close to the uterine serosal surface.
Effects of vagal stimulation on cesium-induced early afterdepolarizations and ventricular arrhythmias in rabbits.
BACKGROUND: Previous evidence has shown that increased sympathetic tone enhances the cesium chloride (Cs)-induced early afterdepolarizations (EADs) and ventricular tachycardias (VTs). METHODS AND RESULTS: We assessed the effects of vagal stimulation on Cs-induced EADs and ventricular arrhythmias in the rabbit heart. Monophasic action potentials (MAPs) of the left ventricular endocardium were recorded simultaneously with surface ECG. Two protocols were used: 1) While in their intrinsic sinus rhythm, 11 rabbits were given three intravenous Cs injections (1 mM/kg) 20 minutes apart, and the effects of vagal stimulation on the ventricular arrhythmias thus induced were examined. 2) Under constant atrial pacing (cycle length, 250 msec), EAD amplitude was measured after Cs injection (1 mM/kg) without (five rabbits, control group) or with (four rabbits, vagal stimulation group) vagal stimulation. We observed the following. 1) Cs produced EADs and VTs of polymorphic (PVT) and monomorphic (MVT) types. During PVT, the take-off potential of repetitive premature action potentials in MAP recordings was about the same as the peak level of EADs, and during MVT, the take-off potential was the level of full repolarization. Vagal stimulation suppressed PVT but not MVT. Vagal stimulation after spontaneous termination of MVT restarted MVT of the same morphology at a rate much slower than the preceding sinus rate. 2) EAD amplitude was significantly smaller in the vagal stimulation group than in the control group. CONCLUSIONS: The results suggest that PVT originated from triggering by EADs, whereas MVT was of different origin, and that vagal stimulation suppressed PVT by decreasing the amplitude of EADs.
Mexiletine and disopyramide suppress ventricular premature contractions (VPC) irrespective of the relationship between the VPC and the underlying heart rate.
The effects of mexiletine (300 mg/day, 24 patients) and disopyramide (300 mg/day, 20 patients) on ventricular premature contractions (VPCs) were studied using a 24-hour ambulatory electrocardiogram. The VPC frequency was evaluated as a function of the underlying heart rate (HR). The VPC-HR correlation was classified into 2 major types, depending on whether the frequency of the VPC increased with the increased HR (positive type) or not (nonpositive type). The effects of the drugs were assessed based on the VPC-HR correlation and on the percent reduction of the VPC frequency. Mexiletine and disopyramide significantly decreased the frequency of the VPCs of both the positive and nonpositive types. Each drug was assumed to be effective when the percent reduction of the VPC frequency exceeded 70%. Mexiletine (300 mg/day) was 58.5% effective in positive type patients and 33.3% effective in nonpositive type patients, with a total efficacy of 45.8%. Disopyramide was effective in 50% of total cases with 44.4% in positive type patients and 54.5% in nonpositive type patients. However, the efficacy of these drugs on the 2 different types of VPCs was the same statistically. The findings strikingly contrasted those obtained with diltiazem and atenolol, which predominantly suppressed VPCs of the positive type which share similar characteristics with a triggered activity in vitro. We conclude that the mode of action of class I antiarrhythmics on the VPCs differs from that of class II or IV antiarrhythmics, as viewed from the VPC-HR relationship, and that the difference probably comes from the different arrhythmogenesis for positive and nonpositive types of VPCs, in addition to the different electrophysiological actions of mexiletine and disopyramide.
[In vitro experiment of transmission of human T-lymphotropic virus type I (HTLV-I) to placental villous cells].
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Long-term follow-up of cardiac rhythms after biatrial transseptal approach (Dubost's incision).
Biatrial transseptal approach (Dubost's incision) was performed 54 times on 47 patients from November 1973 to December 1982 at National Fukuoka Higashi Hospital in Japan. The patients consisted of 19 males and 28 females, with ages ranging from 14 to 66 (mean 45.9 years). Forty-four out of 47 cases had rheumatic heart disease while one had endocardial cushion defect, one had Lutembacher's syndrome, and one had left atrial myxoma. Preoperative electrocardiograph showed atrial fibrillation in 37 cases (78.7%) and normal sinus rhythm in 10 cases (21.3%). The follow-ups of the patients were a minimum of 8 years and a maximum of 16 years (mean 9.6 years) with 97.8% completion. Cumulative follow-up period was 448.9 patient years. Postoperatively, atrial fibrillation persisted in all except two. In those patients, normal sinus rhythm was observed until postoperative six months and seven years, respectively. Normal sinus rhythm persisted in six cases, and changed into junctional rhythm in four. One of them changed into atrial fibrillation at 10.6 years postoperatively. We conclude that Dubost's incision provides an excellent operative field for mitral and tricuspid valve surgery without serious internodal conduction disturbances.
Frequency of valvular regurgitation by color Doppler echocardiography in systemic lupus erythematosus.
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Spontaneous rupture of the ascending aorta.
A case of spontaneous non-traumatic rupture of the thoracic aorta in a hypertensive patient is presented. The clinical findings suggested acute aortic dissection, and a large pericardial effusion was detected by echocardiography. The typical angiographic features of aortic dissection were not found. Autopsy revealed a longitudinal intimal tear and a rupture in the postero-lateral aspect of the ascending aorta. No false lumen was seen in the ascending aorta. When acute intrapericardial or intrapleural bleeding develops with no evidence of aortic aneurysm or dissection, spontaneous aortic rupture should be suspected.
Primary anastomosis for acute ascending aortic dissection.
Intimal tear resection and primary anastomosis of the aorta were used for the treatment of eight patients with DeBakey I and II type acute aortic dissection. Five patients were of DeBakey I type, and three patients were of the II type. Moderate or severe aortic regurgitation (AR) was observed in six of eight patients. The site of the intimal tear was diagnosed by intraoperative echocardiography, and the adventitia corresponding to the intimal tear was transversely opened under total cardiopulmonary bypass. While resuspension of the aortic valve was performed on only one of six patients, AR disappeared in four, postoperatively. Two of eight patients died early postoperatively. The cause of death was postoperative cardiac tamponade in one patient and cerebral herniation in the remaining one. The other six patients have been observed for a mean period of 27 months. There is no late death, and they show no dilatation of the aortic root and deterioration of AR. We believe that this operative method is a simple and safe emergency procedure for DeBakey I and II type acute aortic dissection.
Diffuse endocardial thrombus in left ventricle associated with a case of hypereosinophilic syndrome.
A 16-year-old girl appeared with fever and dyspnea. In her peripheral blood, leukocytes were found to have increased up to 25,200/mm3, and eosinophils occupied 49% of the leukocyte population. By echocardiography, an abnormal echo layer which appeared to be thrombus was observed over the entire left ventricular endocardium including the posterior leaflet of the mitral valve, and mild mitral valve regurgitation was noted. After treatment, the abnormal echoes were markedly reduced simultaneously with the improvement of subjective symptoms.
Left ventricular function in patients with stable systemic lupus erythematosus.
Echocardiography was used to compare the left ventricular function of 43 female patients with stable systemic lupus erythematosus with 93 healthy females in 3 age groups. Left ventricular systolic function was evaluated by the left ventricular ejection fraction and left ventricular diastolic function was evaluated by the diastolic descent rate of the anterior mitral leaflet (DDR), the ratio of mean systolic velocity to mean diastolic velocity in the left ventricular posterior wall (D/S ratio) and the ratio of peak mitral inflow velocity during the atrial filling period to that in the early filling period (A/E ratio). The left ventricular ejection fraction was not significantly different between patients and normal subjects. However, left ventricular diastolic function evaluated by these indexes in patients was different from normal subjects. These data suggest that left ventricular diastolic function is lower in patients with stable systemic lupus erythematosus than in normal subjects. It appears to deteriorate progressively with age. However, left ventricular systolic function remains normal.
[Antiphospholipid antibodies induced by immunization with husband's lymphocytes in the sera of women with unexplained recurrent spontaneous abortion].
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[Clinical comparison of active primary tuberculosis in recent years and the past].
Three hundred and forty-four cases of active primary tuberculosis admitted to the National Sanatorium Seiransou Hospital from 1980 to 1987 were studied and compared with 101 cases admitted from 1966 to 1969. None had a previous history of tuberculosis, and all were diagnosed via positive smears for acid-fast bacilli and/or positive Mycobacterium tuberculosis cultures. The age distribution showed that in the recent cases, the highest incidence among the male patients was observed in the middle-age group (30-59 yr) and in the older age group (over 60 yr) among the female patients. In the earlier cases, the younger (under 29 yr) and middle-age groups showed a higher incidence than the older age group for both sexes. However, when the prevalence rate was calculated for recent and past cases using the total population of the districts where the patients lived, it was observed that tuberculosis was most prevalent among the older age group for both sexes. Seventy percent of these cases were admitted to the hospital due to self-conscious symptoms, and 20% were referred as a result of mass-screening chest X-ray examinations. The rest of cases were discovered by routine radiographs taken during admission for unrelated illnesses. Some of the middle- and older-aged patients had predisposing factors, such as diabetes mellitus, gastric ulcers and malignancy, in their past histories or as complicating diseases. Twenty percent of all cases had a family history of tuberculosis. In most cases, a second family member was admitted with tuberculosis within 10 years after the first family member's presentation; however, some cases developed after 30-40 years. This fact suggests a possible hereditary or genetic disposition rather than direct transmission of M. tuberculosis. Drug resistance was observed in 5-19% of the primary cases, highest in the younger age group, in whom tuberculous lesions revealed on chest X-rays were unilateral rather than bilateral as in the older patients. Radiograph findings were primarily infiltrative in the past, whereas cavitation was the prominent feature in recent cases. Tuberculin skin testing was 90% positive in all groups except the older-age males, whose positivity rate was 71%. In the past, 25% of the cases were treated with both surgery and chemotherapy, including SM, PAS and INH, whereas only 2.5% were operated in recent cases. There were 11 cases (3.2%) of extrapulmonary tuberculosis that included involvement of the urinary tract, larynx, ribs and cervical lymph nodes.(ABSTRACT TRUNCATED AT 400 WORDS)
[Local MTX injection under laparoscopy in the treatment of ectopic pregnancies].
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The cell content of peritoneal exudates following the injection of neutral thiol protease into guinea pigs.
The cell content of the peritoneal exudate was examined 4 days after an intraperitoneal injection of glycogen in uninfected and Paragonimus westermani-infected guinea pigs. In uninfected animals a reduction in macrophage count and an accumulation of granulocytes in the exudate were observed at 3 and 6 hr after an intraperitoneal injection of purified neutral thiol protease from P. westermani metacercariae. No such effect occurred after the enzyme was injected into infected animals. At 9 hr after enzyme injection, vacuoles were found in the cytoplasm of macrophages in uninfected animals.
[Surgical treatment of acute ascending dissection--a simplified operative method].
Primary anastomosis for acute ascending aortic dissection was performed in 8 patients. Primary anastomosis included resection of the intimal tear where applicable, a circumferential suture line in the ascending aorta at the site of the tear, and wrapping of the anastomosis of the ascending aorta with Dacron vascular prosthesis. The aortic valve was resuspended in 1 of 6 patients associated with aortic regurgitation. In 4 patients, aortic regurgitation disappeared postoperatively. Two patients show minor non-progressive valve regurgitation. Two of 8 patients died early postoperatively. There was no late death and dilatation of the aortic root in the follow-up period of mean 27 months. On the basis of these results, we believe that primary anastomosis is a simpler and safer operative method for acute dissection of the ascending aorta.