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Biomedical subjects

T Kawano

Publications and source records attributed to T Kawano.

At least 307 records · Page 17Linked to original sources
PubMed1991

[Changes in CSF pressure induced by acetazolamide administration test--as an indicator of shunt operation for so-called normal pressure hydrocephalus].

Lumber subarachnoid pressure was monitored via intrathecally introduced catheter in 9 patients, who showed ventricular dilatation on brain CT and were suspected of normal pressure hydrocephalus. During the pressure measurement, 500 mg of acetazolamide was rapidly injected intravenously and changes of CSF pressure were recorded. The results of the study were compared to clinical signs, brain CT findings and results of continuous pressure monitoring. The types of response of CSF pressure induced by acetazolamide administration were classified into 2 groups. In 5 cases (Group A), more than 50 percent increase of CSF pressure compared to the resting value was noted. On the contrary, in the remaining 4 cases (Group B), CSF pressure showed only slight increase (less than 25 percent or none). VP shunt was performed in 4 cases in Group A. Definite improvement of clinical symptoms was observed in all of these surgically treated cases. Correlation was found between the response to Acetazolamide administration and the appearance of B wave in the continuous spinal pressure monitoring. This study suggests that Acetazolamide test may be useful diagnostic test to select the patients for shunt operation.

Acetazolamide↗
PubMed1990

Immunological agglutination kinetics of latex particles with physically adsorbed antigens.

The influence of the properties of antigens and particles on the immunological agglutination kinetics of the antigen-coated latex particles was studied. Horse cytochrome c, hen egg-white lysozyme (HEL), bovine serum albumin (BSA), and Aspergillus sp. glucose oxidase were physically adsorbed onto the surfactant free latices of styrene-methacrylic acid (MAA) copolymer (P (S/MAA)) and polystyrene (PS). The initial rates of the immunological agglutination of these protein-coated particles initiated by the addition of antibodies were quantified by the absorbance change at a wavelength of 680 nm. The initial agglutination rates of the particles covered with smaller antigens were lower. This effect of the molecular size of antigens was larger in P(S/MAA), because small antigens are probably buried in the hydrous polymethacrylic acid layer on the surface of particles. Thus, both the molecular size of antigens and the surface properties of particles affect the sensitivity of the immunological agglutination. On the other hand, the dependence of the initial rate of the immunological agglutination on the ionic strength and pH was similar irrespective of antigen-particle systems. The initial agglutination rates were largest at an ionic strength of approximately 0.05 at pH 7.0 and decreased with increasing pH. This dependence of the sensitivity on the pH and ionic strength is attributed to the electrostatic interactions of particle-particle and antibody-particle.

Adsorption↗
PubMed1990

Serum complements as indicator for predicting vasospasm and its severity after aneurysmal subarachnoid hemorrhage.

We investigated serum complements (CH50, C3, C4) after aneurysmal subarachnoid hemorrhage in 21 patients over a 2 to 3-week period. For a control, we performed the same examination on patients with non-subarachnoid hemorrhage such as hypertensive intracerebral hemorrhage. There were no remarkable changes of serum complements in the control patients. Preoperative grading (by Hunt and Hess) was well correlated with the C4 level but not the C3 level. C4 levels in patients without symptomatic vasospasm did not change markedly after subarachnoid hemorrhage over investigation. They decreased severely, however, in patients with severe vasospasm and major neurological deficits. The patients with mild symptomatic vasospasm and no major neurological deficits showed transient decreases of C4 levels 5 to 10 days after subarachnoid hemorrhage. Our data showed that sequential measurements of serum complements C4 after subarachnoid hemorrhage was useful for choosing the method of therapy and for predicting the prognosis of aneurysmal patients after subarachnoid hemorrhage.

Adult↗
PubMed1990

Endoscopic injection sclerotherapy using a transparent overtube with intraluminal negative pressure (np-EIS) for esophageal varices.

Endoscopic injection sclerotherapy (EIS) using the transparent overtube (OT) method can be conducted safely and easily not only in elective esophageal varices but also in emergency cases because of the ability to obtain a good field of view and fixation of the varix. However, application of the OT method is limited because intravariceal injection into small varices through the slit of the OT is impossible. We devised a technique to apply the OT method to small varices by utilizing negative pressure in the OT (np-OT method). By using negative pressure, EIS with a transparent overtube is now suitable for all grades of esophageal varices, and the accuracy of puncture in EIS has been improved. Injection of the target area was successful in all cases. The rate of intravariceal injection has also been improved (47% in low-grade varices) because injection of all sites was possible. We call EIS by the np-OT method "np-EIS".

Esophageal and Gastric Varices↗
PubMed1990

Noninvasive evaluation of the magnitude of aortic and mitral regurgitation by means of Doppler two-dimensional echocardiography.

Using transmitral flow velocity and left ventricular ejection flow velocity, we measured left ventricular inflow volume (LVIV) and left ventricular outflow volume (LVOV) by pulsed Doppler echocardiography in 73 patients who had mitral valve regurgitation (MR), aortic valve regurgitation (AR), or no valvular regurgitation. Doppler-determined regurgitant volume (DOPRV), Doppler-determined regurgitant fraction (DOPRF), total stoke volume, and forward stroke volume were calculated to compare the severity assessed by angiographic scoring and the regurgitant fraction determined by radionuclide angiography (RIRF). In 17 patients with MR, LVIV (84.4 +/- 20.4 ml) was significantly greater (p less than 0.01) than LVOV (52.5 +/- 15.7 ml). LVOV, which is equivalent to forward stroke volume, was lower in patients with MR (52.2 +/- 15.7 ml) than in normal subjects (67.0 +/- 15.7 ml). In 15 patients with AR, LVOV (121.7 +/- 61.1 ml) was significantly greater (p less than 0.01) than LVIV (75.1 +/- 28.1 ml) and LVOV, which is equivalent to total stroke volume, was greater in patients with AR (121.7 +/- 61.1 ml) than in normal subjects (64.0 +/- 14.4 ml). DOPRF correlated with RIRF (r = 0.79, p less than 0.01, n = 11). DOPRV (mild: 10.5 +/- 8.5 ml; moderate: 28.8 +/- 13.6 ml; severe: 74.5 +/- 36.7 ml) and DOPRF (mild: 13.7% +/- 11.5%; moderate: 33.1% +/- 14.2%; severe: 52.6% +/- 15.3%) increased markedly with the severity of regurgitation as assessed by cineangiography. In AR, total stroke volume influenced both forward stroke volume and regurgitant volume, and in MR, regurgitant volume influenced both total stroke volume and forward stroke volume. Total stroke volume in AR and regurgitant volume in MR may play a key role in valvular regurgitation.

Adolescent↗
PubMed1990

Participation of cytochrome b5 in CMP-N-acetylneuraminic acid hydroxylation in mouse liver cytosol.

The activity of CMP-N-acetylneuraminic acid hydroxylase, that converts CMP-N-acetylneuraminic acid (CMP-NeuAc) to CPM-N-glycolylneuraminic acid (CMP-NeuGc), in mouse liver was determined by a newly developed HPLC method using non-radioactive CMP-NeuAc as a substrate. The activity was detected in the cytosol fraction but not in the microsomal fraction. Either NADH or NADPH was used as an electron donor by the cytosol enzyme, but NADH was much more efficiently used than NADPH. An antibody against cytochrome b5 markedly reduced the CMP-NeuAc hydroxylase activity when added to incubation mixture containing either NADH or NADPH as an electron donor. These data led us to postulate the following electron transport system, which is involved in the CMP-NeuAc hydroxylation in mouse liver cytosol: (formula; see text) where X, Y, and Z are components supposedly involved.

Animals↗
PubMed1990

Effects of intravenous nitroglycerin on hemodynamics in neonates with refractory congestive heart failure or PFC.

(1) Continuous intravenous infusion (2-10 micrograms/kg/min) of nitroglycerin (TNG) was administered to 20 neonates consisting of 17 with refractory congestive heart failure and 3 with PFC (Persistent Fetal Circulation). (2) At doses of 2-4 micrograms/kg/min, there were no significant changes in heart rate or systemic blood pressure. (3) At doses of 2-4 micrograms/kg/min, the CVP was significantly reduced and urinary output increased. (4) Echocardiograms revealed a significant decrease in LVS at 4-5 micrograms/kg/min. In addition, the EF and cardiac output were significantly increased at 2-5 micrograms/kg/min. (5) The right ventricle systolic time interval (STI) was reduced significantly at 2 micrograms/kg/min. The left ventricle STI was not reduced below doses of 4 micrograms/kg/min. (6) In the dose range 2-5 micrograms/kg/min, TNG is an effective and safe vasodilator in the treatment of refractory congestive heart failure or PFC in neonates.

Female↗
PubMed1990

Ruptured amebic liver abscess.

We treated two patients with a ruptured amebic liver abscess. The diagnosis was made at a relatively early stage and treatment was successful for one patient, but an accurate diagnosis of liver abscess was not made and invasive extraintestinal amebiasis led to multiple organ failure and to death for the other. Neither patient had been outside of Japan, and both were heterosexual. The origins of Entamoeba histolytica infection could not be determined. Though the mortality rate is high in cases of ruptured amebic liver abscess, appropriate management can lead to a good prognosis.

Adult↗
PubMed1990

Alteration in expression of smooth muscle alpha-actin associated with transformation of rat 3Y1 cells.

Expression of actin was examined in a cultured rat embryonic cell line 3Y1 and transformed cell lines that originated from 3Y1. An alpha-actin in addition to cytoplasmic beta- and gamma-actins was detected in 3Y1 by two-dimensional gel electrophoresis. This alpha-actin was hardly detected at all in the transformants induced by Rous sarcoma virus, v-H-ras oncogene or adenovirus type 12, while the alpha-actin was retained in the transformed cell lines induced by N-methyl-N'-nitro-N-nitrosoguanidine or in SV40, which are cell lines of relatively low malignancy. Western and Northern blot analyses established that this alpha-actin was a smooth muscle alpha-isoform. An immunofluorescence study revealed that smooth muscle alpha-actin in 3Y1 cells is present in stress fibers. Thus, smooth muscle alpha-actin is also a component of actin stress fibers, as beta- and gamma-actins are in 3Y1 cells. An alteration in the expression of this actin isoform may be related to phenotypical changes accompanying transformation.

Actins↗
PubMed1990

Neutrophil recruitment in the respiratory tract of a patient with plasma cell granuloma of the lung.

A 69-year-old woman had plasma cell granuloma of the left middle lobe of the lung. Her symptoms and roentgenologic findings improved with antibiotic treatment. Before treatment, the number of neutrophils and NCA were markedly increased in BAL fluid obtained from the affected region of the left lung and moderately increased in BAL fluid obtained from the nonaffected region of the right lung. The number of neutrophils, the NCA as well as the contents of C5 and C5a des Arg (neutrophil chemotactic factors) in the BAL fluids from both these regions decreased during treatment. These findings suggest that plasma cell granuloma was due to chronic immune and inflammatory reactions in the lung, that neutrophils are involved in development of the symptoms and signs of this disease, and that neutrophil chemotactic factors, including complement-derived factors, are important in neutrophil recruitment at the lesion and in nonaffected parts of the lung.

Aged↗
PubMed1990

Intra-abdominal cyst following revision of ventriculoperitoneal shunt--case report.

An intra-abdominal cyst is a rare complication of ventriculoperitoneal (VP) shunt. A 19-year-old male was admitted complaining of abdominal pain and distension, dysuria, constipation, headache, and fever. He had undergone a VP shunt for obstructive hydrocephalus caused by a cerebellar astrocytoma 16 years earlier, and had received shunt revision twice, 5 years and 3 months earlier, respectively. Examination on admission revealed neck stiffness, early papilledema, a mass in the lower abdomen, and abdominal muscular guarding with rebound tenderness. Laboratory studies showed leukocytosis of the peripheral blood and pleocytosis of the cerebrospinal fluid (CSF). Abdominal ultrasonograms and computed tomographic scans demonstrated a cystic lesion. Under the diagnosis of meningitis and local peritonitis with an intra-abdominal cyst, we sistemically administered antibiotics and externalized the shunt. However, since the cyst fluid could not be aspirated through the abdominal catheter, it was exchanged with a flexible catheter under fluoroscopic control, according to Seldinger's method. A total of 400 ml of cyst fluid was drained. Staphylococcus epidermidis was detected in both the cyst fluid and the CSF. After meningitis subsided, repositioning of the abdominal catheter into the other side of the abdomen was performed but resulted in shunt malfunction and meningitis due to the same organisms. After meningitis again subsided, the VP shunt was converted to a ventriculoatrial shunt. The clinical course was uneventful thereafter.

Abdomen↗
PubMed1990

[Shielding ability of lead loaded radiation resistant gloves].

The shielding ability of radiation resistant gloves was examined. The gloves are made of lead loaded (as PbO2) polyvinyl chloride resin and are about 0.4 mm in thickness (70 mg/cm2). Eleven test pieces were sampled from each of three gloves (total 33) and the transmission rates for radiations (X-ray or gamma-ray) through the test pieces were measured with radiation sources, 99mTc, 57Co, 133Ba, 133Xe and 241Am. The differences of the transmission rates for radiations by the positions of the gloves were smaller than 15%, and the differences by three gloves were smaller than 5% in the case of 60 keV and 141 keV radiations. The average transmission rates for radiations in the 33 test pieces were about 40% for 30 keV radiation, about 90% for 80 keV and 140 keV radiations. The shielding characteristic of the gloves is equivalent to about 0.026 mm thick lead plate.

Hand↗
PubMed1990

[Evaluation of cardiac function at rest and under acute loading in patients with essential hypertension using pulsed Doppler echocardiography].

We studied 45 untreated patients with mild to moderate essential hypertension (EH) and 27 normotensive controls to assess the relationship between pulsed Doppler echocardiographic parameters and cardiac function, and the effects of acute changes in preload or afterload on these parameters. The following pulsed Doppler parameters were measured: as left ventricular (LV) inflow parameters, rapid filling peak velocity (R), presystolic peak velocity (A), and A/R; as LV outflow parameters, preejection period (PEP), ejection period (ET), ET/PEP, and peak velocity (PV). These parameters were compared with those relating to cardiac function, such as age, interventricular septal thickness (IVST), LV mass index (LVMI), % fractional shortening (%FS), LV end-systolic wall stress (WS), blood pressure, and heart rate. The changes in preload and afterload were induced by sodium nitroprusside (SNP) or phenylephrine infusion, which caused decreases or increases in the mean blood pressure by approximately 15%. 1. LV inflow parameters: Compared to normals, A and the A/R were higher in the group EH (p less than 0.01). IVST in the group EH correlated with R and the A/R, but LVMI did not correlate with these parameters. In normals, A correlated with %FS and WS, but did not in the group EH. R and the A/R correlated with age in normals, but not in the group EH. 2. LV outflow parameters: There were no significant differences between the two groups. PV in the group EH correlated positively with %FS, and negatively with WS. The ET/PEP in normals correlated with %FS and WS, but not in the group EH. 3. Effects of SNP: Reduction in preload caused a decrease in R and an increase in the A/R in both the groups (p less than 0.01). At the same time, reduction in afterload induced increase in PV. 4. Effects of phenylephrine: An increase in afterload did not change A, R or the A/R, though PV decreased significantly in normals and tended to decrease in the group EH. In summary, though the significance of the pulsed Doppler parameters of the LV was not always the same between the two groups, these parameters may be used to evaluate cardiac function in EH, if we pay attention to the influence of preload and afterload.

Adult↗
PubMed1990

[Genesis and clinical significance of an apical diastolic rumble in patients with mitral Björk-Shiley valve: a Doppler echocardiographic study].

The genesis and clinical significance of an apical diastolic rumble after replacement with mitral Björk-Shiley prosthesis were studied in 20 patients by left ventricular (LV) inflow dynamics using Doppler echocardiography. 1. The rumble was audible in 17 of the 20 patients (85%). In all but one patient, its intensity was less than Levine 2/6. Duration of the rumble ranged from 248 to 544 (mean 377) msec. There was no case of prosthetic valve dysfunction. Duration of the slow filling wave (SF interval) of the apexcardiogram in 19 cases ranged from 150 to 541 (mean 317) msec, and it correlated significantly with the duration of the rumble (r = 0.95) in 15 cases. 2. In 20 patients, peak velocity of the LV inflow obtained from continuous wave Doppler echocardiograms ranged from 1.17 to 1.89 (mean 1.56) m/sec, and pressure half time (PHT) ranged from 82 to 233 (mean 134) msec. In 19 patients, the SF interval correlated significantly with PHT (r = 0.87), but not with peak inflow velocity. 3. Peak inflow velocity was significantly slower in cases without a rumble than in cases with a rumble. PHT and the SF interval tended to be shorter in the former than in the latter. 4. There was no significant difference in the SF interval, peak inflow velocity and PHT between eight patients with smaller valve sizes (less than or equal to 25 mm) and 12 with larger valve sizes (greater than or equal to 27 mm). 5. There was no obvious relation between the direction of the main LV inflow jet as assessed by Doppler color flow mapping and the presence of the rumble in 19 patients. 6. In 19 patients, the SF interval correlated significantly with left atrial dimension (r = 0.47), but it did not correlate with LV end-diastolic dimension, fractional shortening of the LV, and the peak lengthening rate of LV internal dimension. 7. Three patients with both the rumble and SF lasting 500 msec had prolonged PHT longer than 190 msec. One of these three had congestive heart failure and suspected prosthetic mitral valve stenosis. From these results, we concluded that an apical diastolic rumble after replacement with mitral Björk-Shiley valve is mainly due to the increase in resistance and velocity of the LV inflow, and that both durations of the rumble and the SF intervals as well as PHT of the Doppler echocardiogram are useful in detecting stenosis of prosthetic mitral valves.

Adult↗
PubMed1990

[Relationship between regurgitant flow dynamics and cardiac physical in tricuspid regurgitation: a phono-, mechano- and Doppler echocardiographic study].

To evaluate the relationships between regurgitant flow dynamics of tricuspid regurgitation (TR) and cardiac physical signs, and to clarify the role of atrial function on central venous flow, we investigated physical signs by cardiac auscultation and palpation of the liver. In addition, phonocardiography, jugular venous and hepatic pulse tracings and Doppler echocardiographic recordings were performed. The subjects, 109 patients with Doppler-detected TR, were categorized as an SR group of 42 with sinus rhythm, an Af group of 63 with atrial fibrillation and four with sinus arrest. Thirty-five patients underwent open heart surgery before six months or more. Results were as follows: 1. In the Af group, the maximum systolic flow velocity data in the superior vena cava (SVC) and hepatic vein (HV) correlated well with the maximum tricuspid regurgitant signal area on the color Doppler echocardiogram, and systolic backward flow from the heart was more evident in the HV than in the SVC. In the SR group, however, no correlation was observed between the maximum systolic flow velocity and the TR signal area, and systolic backward flow was not evident even in cases with severe TR. 2. After open heart surgery, systolic flow velocities in the SVC and HV were significantly decreased in the SR group compared to the Af group. 3. There was close correlation between the presence of hepatomegaly and systolic backward flow towards the liver. Hepatomegaly was more marked in the Af group than in the SR group. 4. Jugular venous and hepatic pulse data correlated well with the flow velocity data in the SVC and HV and with the TR signal area. 5. Intensity of the tricuspid regurgitant murmur as estimated by the Levine's classification correlated relatively well with the systolic pressure gradient between the right ventricle and right atrium as calculated by the modified Bernoulli equation, but did not correlate with the TR signal area. From these results, we conclude that the intensity of the tricuspid regurgitant murmur and the jugular venous or hepatic pulse patterns are useful for evaluating tricuspid regurgitant dynamics, when they are applied clinically with precise recognition of their significance and limitations, and that sinus rhythm or atrial fibrillation is also an important factor.

Atrial Fibrillation↗
PubMed1990

[A study of hemodynamic effects during dental treatment under local anesthesia. Observation of parasympathetic activity based on the index of R-R interval variation in ECG].

Observing hemodynamic changes occurring during dental treatment performed under local anesthesia is very important. Although many reports on such changes have been made on the basis of blood pressure and heart rate indexes, few have been made on the basis of parasympathetic activity. This is a report of a study on observations of parasympathetic activity on the basis of the index of R-R interval variation in ECG. A multipurpose monitoring system was used to observe and record hemodynamic changes in 52 patients undergoing dental treatment under local anesthesia. In addition, parasympathetic activity was observed on the basis of the index of the coefficient of variation of the R-R interval in ECG (CVR-R = SD/MEAN x 100%). To evaluate R-R interval variations in ECG during dental treatment clearly, comparisons were made between subjects to whom atropine sulfate was administered (prior to treatment) and subjects to whom no drug was administered. In instances of which the subject experiences no unpleasant symptom (for instance, the fainting) during dental treatment, comparative examinations of R-R interval variations in ECG were made at various points during the course of therapy. In instances of which the fainting was induced, examinations of these variations were made during, before, and after the occurrence of the fainting. Results and Conclusions 1. In measuring R-R interval variations in ECG, maintaining stable heart rates and respiratory frequency and depth made it possible to evaluate parasympathetic activity during dental treatment. 2. Consistently low CVR-R values after administration of atropine sulfate clearly showed that patients treated in this way were in a state of parasympathetic blockade. 3. Patients to whom atropine sulfate was administered demonstrated higher values for systolic and diastolic blood pressure and for heart rate than controls: and their posttreatment recovery was slower. 4. Increasing age produced a correlative decrease in CVR-R during both the pretreatment rest period and immediately before treatment. 5. Systolic and diastolic blood pressure and heart rate increased at local anesthesia and maintained such levels until the end of treatment in no fainting cases, however, CVR-R increased just before the end of treatment. This finding leads to the assumption that, as a result of intensified sympathetic activity at the initial stage and the maintenance of this condition, parasympathetic activity increases just before the end of therapy to keep hemodynamic activity in balance.(ABSTRACT TRUNCATED AT 400 WORDS)

Anesthesia, Dental↗