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Biomedical subjects

T Katoh

Publications and source records attributed to T Katoh.

At least 217 records · Page 12Linked to original sources

Relationship between respiratory distress and cytokine response after cardiopulmonary bypass.

The influence of cytokines on the inflammatory response in surgery has recently been the subject of investigations. We measured tumor necrotic factor-alpha (TNF-alpha), interleukin 1 beta (IL-1 beta), interleukin 6 (IL-6), interleukin 8 (IL-8), and granulocyte elastase (GEL) in 26 patients undergoing elective cardiac operations using cardiopulmonary bypass (CPB), preoperatively, immediately after CPB, and on post-operative days (PODs) 1, 3, and 6. To evaluate the effect of these cytokines on pulmonary function, the patients were divided according to whether the oxygenation index (OI) on POD 1 was > 250 or < 250, into groups A and B, respectively. TNF-alpha and IL-1 beta were undetectable and there were no significant differences in the preoperative IL-6, IL-8, and GEL levels. However, immediately following CPB, the mean IL-6, IL-8 and GEL levels in both groups were significantly higher than the preoperative levels (P < 0.01). Moreover, all these levels were significantly higher in group B than in group A, at 162 +/- 150 pg/ml vs 64 +/- 53 pg/ml (P < 0.05) for IL-6; 53 +/- pg/ ml vs 22 +/- 20 pg/ml (P < 0.01) for IL-8; and 2477 +/- 1642 mg/ l vs 1397 +/- 774 mg/l (P < 0.01) for GEL. The IL-6 levels returned to the preoperative values in both groups on POD 1; however, the GEL levels remained significantly higher in group B than in group A postoperatively, at 616 +/- 326 mg/l vs 378 +/- 70 mg/l on POD 1, and at 292 +/- 70 mg/l vs 218 +/- 62 mg/ l on POD 3 (P < 0.05). Thus high levels of cytokines such as IL-6, IL-8, and GEL may be detrimental to respiratory function.

Adult↗

Modified Bentall operation with concomitant total aortic arch replacement for DeBakey type I aortic dissection: report of a case.

The successful implementation of a reoperative Bentall procedure with concomitant total aortic arch replacement after ascending aortic replacement for acute aortic dissection is infrequently reported. We performed a modified Bentall procedure with total replacement of the aortic arch in a patient suffering from worsening aortic regurgitation (AR) and residual dissection. Our strategy involved the button method for coronary reconstruction, selective cerebral perfusion, the use of a composite graft with four branches for aortic arch replacement, and the administration of high-dose aprotinin to decrease bleeding.

Acute Disease↗

A video-assisted thoracoscopic surgical technique for interruption of patent ductus arteriosus.

We describe herein a technique for patent ductus arteriosus (PDA) closure using a method of video-assisted thoracoscopic surgical (VATS) interruption derived from video-assisted endoscopic surgery. This technique of repair was performed on five patients with a mean age of 3 years and a mean weight of 13.7 kg during 1994 and 1995. Under general anesthesia, two 10-mm trocars and two or three 5-mm trocars were inserted through the left thoracic wall. A video camera and specially designed surgical tools including scissors, dissectors, and a clip applicator were then introduced. The ductus was dissected, and two titanium clips were applied to interrupt the ductus completely. Successful closure of the PDA by this video-assisted technique was achieved in all patients. The only complication which developed in one patient was hoarseness for 2 weeks postoperatively. The hospital stay ranged from 7 to 12 days and there were no serious complications or deaths. There results indicate that video-assisted thoracoscopic surgical interruption is a safe and effective technique for achieving closure of PDA.

Child, Preschool↗

Purification and characterization of a glutamic-acid-specific endopeptidase from Bacillus subtilis ATCC 6051; application to the recovery of bioactive peptides from fusion proteins by sequence-specific digestion.

Screening cultures of nonpathogenic microorganisms led us to a glutamic-acid-specific endopeptidase from Bacillus subtilis ATCC 6051, which we purified and named BSase. The nucleotide sequence encoding BSase, with a molecular mass of 23,894 Da, completely agreed with that of the mpr gene, which had been reported by Rufo Jr. and Sloma et al. to encode a metalloprotease [J Bacteriol (1990) 172: 1019-1023 and 1024-1029 respectively]. However, enzymatic characterization revealed it to have the catalytic triad of a serine protease and not the consensus sequence of a metalloprotease, and it was inhibited by diisopropylfluorophosphate. We therefore consider BSase (mpr) to be a serine protease. In the alignment of the acidic-amino-acid-specific proteases, the proteases from bacilli have a highly conserved histidine residue, which is most important in the histidine triad in the proteases from streptomycetes. Furthermore, Ca2+ was necessary for its activity and stability. BSase cleaved the C-terminal glutamic acid with high specificity and was very stable over a wide pH range. On the basis of these properties, we tried to retrieve a bioactive peptide from a fusion protein by sequence-specific digestion, and succeeded in obtaining the bioactive peptide. BSase was found to be very useful as a tool for selective cleavage.

Amino Acid Sequence↗

Evaluation of brain oxygenation during selective cerebral perfusion by near-infrared spectroscopy.

BACKGROUND: Although selective cerebral perfusion (SCP) has been used for cerebral protection in aortic arch operations, the appropriate perfusion conditions of SCP are unclear. METHODS: We used near-infrared spectroscopy, which evaluates brain ischemia noninvasively and continuously, to determine whether perfusion with SCP (core temperature, 20 degrees C; flow rate, 10 mL.kg-1.min-1) was acceptable in terms of oxyhemoglobin and deoxyhemoglobin in patients having SCP for aortic arch operations (SCP group, n = 6) versus patients having cardiopulmonary bypass (CPB) for coronary artery bypass grafting (CPB group, n = 6). RESULTS: There were no significant differences in age (65 +/- 10 versus 63 +/- 12 years), CPB time (199 +/- 67 versus 199 +/- 52 minutes), changes in hematocrit (-12.9% +/- 3.7% versus -12.5% +/- 6.0%), lowest blood pressure (43 +/- 7 versus 45 +/- 10 mm Hg), or highest central venous pressure (8 +/- 2 versus 9 +/- 4 mm Hg) between the SCP and CPB groups. In the SCP group, the maximum decrease in oxyhemoglobin level and the maximum increase in deoxyhemoglobin level were -5.0 to -11.4 mumol/L and -0.1 to 3.9 mumol/L, respectively; in the CPB group, the respective changes were -3.2 to -14.2 mumol/L and -0.4 to 3.6 mumol/L. Changes of oxyhemoglobin and deoxyhemoglobin levels in the SCP group were almost within the range of those in the CPB group. There were no brain complications in either group. CONCLUSIONS: As described here, SCP is acceptable and safe for brain protection in aortic arch procedures.

Adult↗

Treatment of acute myeloid leukemia and myelodysplastic syndrome with orally administered cytarabine ocfosfate and granulocyte colony-stimulating factor.

Cytarabine ocfosfate (SPAC) was administered orally to 19 patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). SPAC was administered at doses of 200-300 mg/day for more than 14 days with granulocyte colony-stimulating factor (G-CSF). Four of the 12 patients with AML and 1 of the 7 patients with MDS achieved complete remission (CR) after one cycle of SPAC treatment. Especially, 3 of the 6 patients with newly diagnosed AML achieved CR. Major side effects of SPAC were myelosuppression and tolerable gastrointestinal disorders. The treatment with SPAC is a therapeutic option in elderly patients or patients with organ failure.

Administration, Oral↗

Tyrosine kinase dependent expression of TGF-beta induced by stretch in mesangial cells.

Increased glomerular hydraulic pressure has been suggested as a major causative factor in the development of glomerular sclerosis. The elevation of glomerular pressure increases the magnitude of stretch to mesangial cells. The study was, therefore, designed to investigate the effect of mechanical stretch on expression of TGF-beta and extracellular matrix components in cultured rat mesangial cells. The results showed that mechanical stretch stimulated mRNA expression for TGF-beta1 and TGF-beta3 in a time dependent manner, and that mesangial cells secreted substantial amounts of TGF-beta proteins in response to stretch. Stretch was also shown to stimulate mRNA expression for collagen types I and IV, and fibronectin, major components of mesangial extracellular matrix. The stretch-induced mRNA expression for extracellular matrix components was inhibited by neutralizing antibody to TGF-beta. Moreover, stretch-induced mRNA expression of TGF-beta was inhibited by tyrosine kinase inhibitors, genistein or herbimycin A, whereas Ca channel blockers nitrendipine or Gd3+, and inhibitors for protein kinase A or C had no effect. These findings indicate that stretch induced TGF-beta mRNA primarily through tyrosine kinase-dependent mechanisms in cultured rat mesangial cells, and the secreted TGF-beta may play a significant role for the stretch-induced expression of extracellular matrix proteins. Our results suggest that stretch-induced TGF-beta of mesangial cells might be a mediator in the progression of glomerular sclerosis as an autocrine/paracrine factor.

Angiotensin II↗

Modulation of renal hemodynamics by IGF-1 is absent in spontaneously hypertensive rats.

We recently reported that attenuation of vasoactive agent-induced calcium signal and cell contraction of mesangial cell by insulin-like growth factor 1 (IGF-1), observed in normal mesangial cells, is totally abolished in spontaneously hypertensive rat (SHR) mesangial cells. This phenomenon might be related to the well-known aberrant regulation of SHR glomerular hemodynamics. Since it has been reported that in vivo IGF-1 infusion increases renal plasma flow (RPF) and glomerular filtration rate (GFR), we examined whether the modulation of renal function by IGF-1 is altered in SHR. We performed in vivo renal clearance studies using eight-week-old SHR and control Wistar Kyoto rats (WKY) before and after IGF-1 (5 micrograms/kg) infusion into the left renal artery for 20 minutes. Mean arterial pressure was not affected by IGF-1 in both WKY and SHR. In WKY, IGF-1 increased GFR and RPF, and decreased renal vascular resistance (RVR). However, GFR, RPF, and RVR were not altered by IGF-1 in SHR, while systemic infusion of angiotensin II antagonist, CV-11974, increased GFR and RPF. The present data show that the modulation of renal hemodynamics by IGF-1 is absent in SHR. This might be related the pathophysiology of the development of hypertension.

Animals↗

Does nitrous oxide antagonize sevoflurane-induced hypnosis?

We have studied 64 ASA I and II patients (aged 20-60 yr) to determine if nitrous oxide affects sevoflurane requirement for achieving 50% probability of no movement in response to verbal commands (MACawake). Patients were allocated randomly to one of four nitrous oxide concentration groups (0, 20, 40 and 60 vol.%). Patients in each group received sevoflurane at two different end-tidal concentrations according to a predetermined randomization table. After steady state sevoflurane and nitrous oxide concentrations had been maintained for at least 15 min, patients were assessed as being awake or asleep. The MACawake for sevoflurane was 0.63% and this was reduced significantly in a non-linear manner by increasing nitrous oxide concentration. A 50% reduction in MACawake was produced by a nitrous oxide concentration of 45%. The reduction in MACawake by nitrous oxide was non-linear; the interaction coefficient between nitrous oxide and sevoflurane being significantly less than zero (P = 0.0238), indicating that the reduction in MACawake by nitrous oxide was smaller than would be expected from simple additivity and that nitrous oxide antagonized the effects of sevoflurane in preventing response to verbal commands.

Adult↗

Conformation and activity of smooth muscle myosin probed by various essential light chains.

Porcine aorta smooth muscle myosin contains two essential light chain (LC17) isoforms and the light chain was replaced with one of the LC17 isoforms, rabbit skeletal muscle myosin alkali light chain 2 (A2), or scallop striated muscle myosin essential light chain (SHLC). The myosin containing either an LC17 isoform or A2 showed phosphorylation-dependent properties in the monomer conformation, filament formation, ATPase activities, and superprecipitation, behaving in essentially the same way as native myosin. On the other hand, the replacement of LC17 with SHLC destabilized the 10S conformation and the myosin was predominantly filamentous under physiological conditions, irrespective of the phosphorylation state. This myosin containing dephosphorylated regulatory light chain showed higher actin-activated ATPase activity than native dephosphorylated myosin and was further activated by Ca2+, resulting in a decrease of phosphorylation-dependent regulation. Superprecipitation for the myosin was observed only when the regulatory light chain was phosphorylated. Superprecipitation for myosin containing SHLC was significantly slow in the absence of Ca2+ in comparison with that for myosin containing LC17, and was further activated by the presence of Ca2+. On the basis of the differences in amino acid sequences of these essential light chains, it appears that the N-terminal domain of LC17 may be implicated in these phosphorylation-dependent properties of smooth muscle myosin.

Actin Cytoskeleton↗

The effect of clonidine on sevoflurane requirements for anaesthesia and hypnosis.

We evaluated the effects of clonidine given orally on sevoflurane requirements for anaesthesia and hypnosis. Patients received either clonidine (5 micrograms.kg-1) by mouth (n = 21) 90 min before surgery or no premedication (n = 21) by random allocation. MAC was calculated using repeated tetanic nerve stimulation with end-tidal sevoflurane concentration increased or decreased by 0.3 vol.% depending on the previous response. MAC awake was calculated according to the response to verbal command. The mean (SD) MAC in the clonidine-treated patients was 1.53 (0.20)% compared with 1.83 (0.15)% in the control group (p < 0.001). Similarly, MAC awake was reduced in the clonidine group (0.50 (0.08)% compared with 0.60 (0.07)% in the control group) (p < 0.001). We conclude that clonidine 5 micrograms.kg-1 orally administered pre-operatively reduces sevoflurane requirements for anaesthesia and hypnosis.

Adult↗

Long-term efficacy of a self-retaining intraurethral catheter for the treatment of prostatic obstruction.

BACKGROUND: Transurethral prostatectomy is a standard treatment modality for infravesical obstruction with benign prostatic hyperplasia. However, some patients cannot undergo this procedure, so alternative devices or surgical procedures have recently been developed. METHODS: We treated 26 patients with prostatic outflow obstruction by placement of a self-retaining intraurethral catheter (IUC). All patients had coexisting medical complications which contraindicated transurethral prostatectomy. RESULTS: In the short-term, the treatment was successful in 96.2% of the patients, however, longer follow-up demonstrated a significant failure rate, and the 3-year success rate declined to 12.5%. The majority of late failures were associated with urinary tract infections. CONCLUSION: These results showed that although placement of an IUC to treat prostatic obstruction was effective in the short-term, its long-term efficacy was highly limited.

Aged↗

[The basics for establishing a needlestick injury prevention program in hospitals].

Although the risk of occupationally acquired infection is a matter of considerable concern for health care workers, the problem of needlestick injuries has yet to be fully understood in Japan. We investigated 257 cases of needlestick injuries in five Nagoya Municipal Hospitals from 1989 to 1994 using the Japan EPInet. The number of needlestick injuries increased each year of the study. In one of these hospitals, the Higashi Municipal Hospital, a specialist committee began activities in April, 1993, and protective equipment and devices were also introduced during 1994. HCV contamination injuries accounted for 70%-80% of the total number of injuries reported during the 1991-1994 period at the four hospitals and during 1991-1992 period at the Higashi Municipal Hospital. At the Higashi Municipal Hospital, HCV contamination injuries decreased from 22 cases (48%) in 1993, to 15 cases (25%) in 1994. The use of the Japanese EPINet for analytical purposes enabled us to clearly identify the causes and status of needlestick injuries, resulting in the establishment of an effective prevention program.

Female↗

Increased expression of parathyroid hormone-related peptide gene in blood vessels of spontaneously hypertensive rats.

We have shown recently that mechanical stretch of cultured rat aortic smooth muscle cells induces a marked increase in gene expression of the vasorelaxant parathyroid hormone-related peptide. In the present study, we investigated whether mechanical force affected the in vivo parathyroid hormone-related peptide gene expression in blood vessels. Northern blot analysis revealed that stretch of isolated rat aortic strips increased the expression level of parathyroid hormone-related peptide mRNA. The parathyroid hormone-related peptide transcript level in aorta and mesenteric vessels from 18-week-old spontaneously hypertensive rats (SHR) was 2.5- and 2.2-fold higher, respectively, compared with age-matched Wistar-Kyoto (WKY) controls, whereas the parathyroid hormone-related peptide mRNA level in aorta from normotensive 4-week-old SHR was similar to that of age-matched WKY controls. The aortic parathyroid hormone-related peptide content was higher in 18-week-old SHR than in age-matched WKY controls. Moreover, treatment of mature SHR with an angiotensin II type 1 receptor antagonist or hydralazine caused a concomitant decrease in the parathyroid hormone-related peptide transcript level in aorta with lowering of blood pressure. These results suggest that the in vivo parathyroid hormone-related peptide gene expression in blood vessels is under the control of mechanical force, pointing to a role of parathyroid hormone-related peptide in the regulation of vascular tone.

Animals↗

Antibacterial activity of two alkylamines integrated an indane scaffold: mimicry of a complementary unit on magainin 2.

Based on the antibacterial activity of 9-phenylnonylamine (pC9a) against Escherichia coli (ATCC29522) and Staphylococcus aureus (ATCC25923), we have further tested the inhibitory ability of the growth of the bacteria by (+/-)1-(4-aminobutyl)-6-benzylindane (PM2) and (+/-)1-benzyl-6-(4-aminobutyl) indane (PM3), that is, two kinds of 1,6-disubstituted indanes. In an in vitro assay, they showed almost the same antibacterial activities against the bacteria as pC9a, as well as that of magainin 2 analogs (i.e., the peptides MSI-78 and 87-ISM), except in the case of 87-ISM against S. aureus. At the MIC (minimum inhibitory concentration) values, however, their killing rate of E. coli is actually quicker than pC9a. This indicates that an indane scaffold, used as a template to mimic a part of the alpha-helical structure of magainin 2, can accelerate the killing rate. At present, however, it is unknown whether either the hydrophobicity or the alpha-helical structure, or both, of the indane scaffold is involved in accelerating the rate. Moreover, these two indanes also showed stronger antibacterial activity against two strains of Helicobacter pylori (ATCC43526, ATCC43579) than either pC9a or magainin 2 related peptides.

Anti-Bacterial Agents↗

Mutations within the reactive-site region of human pancreatic secretory trypsin inhibitor confer alpha-thrombin and factor Xa inhibitory activities.

Mutations were introduced into the reactive-site region of human pancreatic secretory trypsin inhibitor (PSTI) to produce thrombin and/or factor Xa inhibitors. All of five mutants showed trypsin inhibitory activity as strong as wild-type PSTI. Moreover, the Arg (P1), Pro-Arg (P2-P1), and Pro-Arg-Ile-Tyr-Asn (P2-P1-P1'-P2'-P3') (bold letters indicated replaced amino acids compared to the wild type) mutants had additional inhibitory activities toward factor Xa, both thrombin and factor Xa, and thrombin, respectively, at 1 x 10(-5) M.

Antithrombins↗

Curative percutaneous catheter ablation for various supraventricular and ventricular tachyarrhythmias. Results in 187 consecutive patients during the first five years.

Closed-chest transcatheter electrical ablation (catheter ablation) has been applied to various supraventricular and ventricular tachyarrhythmias as a radical therapeutic technique since its introduction in 1982. Currently, it has become a first line therapy for supraventricular tachyarrhythmias except atrial fibrillation and uncommon types of atrial flutter. We first carried out the ablation procedure in 1991 for the treatment of ventricular tachycardia. Up to February 1997, a total of 187 patients underwent catheter ablation in our institution. The aims of this study are to demonstrate our results of catheter ablation in the early 5 years and to show the usefulness of this new curative method. Successful results were obtained in 168 of 187 patients (overall final success rate: 89.8%). The success rates of each category of tachyarrhythmias were 100/105 patients (95%) with WPW syndrome, 41/46 (89%) with atrioventricular nodal reentrant tachycardia, 7/10 (70%) with atrial flutter, 4/4 (100%) with atrial tachycardia, 2/2 (100%) with medically refractory atrial fibrillation, 13/15 (85%) with idiopathic ventricular tachycardia and 3/7 (43%) with sustained ventricular tachycardia associated with structural heart disease, respectively. Complications that required invasive treatments were observed in 3 patients (2 hemopericardium and 1 complete atrioventricular block). Our results indicate that catheter ablation is highly effective in most categories of tachyarrhythmias and can be applied safely without lethal complications.

Adult↗