Biomedical subjects
Publications and source records attributed to T Mitsui.
We describe a simply modified coronary perfusion cannula for the widely patent coronary ostium. This cannula is protective and adaptable to any size of the ostium, and ensures coronary perfusion without leakage.
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A 22-year-old woman presented with left subcostal pain and nausea. A radiograph and a computed tomographic scan of the chest revealed diaphragmatic hernia. Thoracoscopic surgery was performed. The herniated organs were put back into the peritoneal cavity and the hernial hilum was closed with interrupted silk suturing.
The Chediak-Higashi syndrome is characterized by partial albinism and recurrent infections with giant granules in granulocytes. This syndrome has been proposed to have a defect in vesicular transport. Rab 4 is a member of a family of Ras-related small GTP-binding proteins, which has been mapped in the locus of the Chediak-Higashi syndrome. We isolated a full length cDNA of rab 4 from a cDNA library of mouse liver. The clone is 1428 base pairs (bp) in length and contains a 639 bp open reading frame encoding a polypeptide of 213 residues. The deduced amino acid sequence is highly homologous to rab 4 from rat and human. We analyzed rab 4 as a candidate gene of the beige mouse, but we could not find any change in the sequence of the coding region of rab 4 mRNA.
We describe a two-dimensional reconstruction method for tangential magnetocardiograms (MCGs). This method is based on two-dimensional Fourier analysis, and we used a new type of window function for tangential MCG to solve the problem of the small number of measurement points. By using this method, cardiac activity can be estimated as a two-dimensional current distribution. To determine the effectiveness of this method, we measured tangential MCGs of normal subjects, and compared the estimated current distribution with the actual cardiac muscle activity. Using this method, we were able to clearly show cardiac activity.
The precise localization and semiquantitative correlation of dystrophin, utrophin and beta-dystroglycan expression on the sarcolemma of skeletal muscle cells obtained from patients with Becker muscular dystrophy (BMD) was studied using three types of double immunofluorescence. Staining intensity was measured using a confocal laser microscope. Each of these proteins was identified at the same locus on the sarcolemma. The staining intensities of dystrophin and utrophin were approximately reciprocal at sarcolemmal sites where dystrophin expression was obviously observed. The staining intensity of beta-dystroglycan was strong in areas where dystrophin staining was also strong and utrophin expression was weak. Quantitative analysis revealed that the staining intensity of beta-dystroglycan minus that of dystrophin approximated the staining intensity of utrophin, indicating that the sum of dystrophin and utrophin expression corresponds to that of beta-dystroglycan. These results suggest that utrophin may compensate for dystrophin deficiency found in BMD by binding to beta-dystroglycan.
We have identified, purified, and characterized 10 alpha-amylase isoforms from suspension-cultured rice (Oryza sativa L.) cells having different isoelectric point values. They had distinguishable optimum temperatures for enzymatic activity and molecular sizes. The results of immunoblotting indicated that polyclonal anti-A + B antibodies bound well to isoforms A, B, Y, and Z but weakly or not at all to E, F, G, H, I, and J. However, the anti-A + B antibodies inhibited the enzyme activities of only isoforms A and B. Polyclonal anti-H antibodies strongly bound to isoforms F, G, H, I, and J, whereas polyclonal anti-E antibodies preferentially recognized isoform E. A monoclonal antibody against isoform H (H-G49) inhibited the activities of isoforms E, G, H, I, and J, whereas it did not inhibit those of isoforms A, B, Y, and Z. Judging from their physicochemical and serological properties, we classified the rice alpha-amylase isoforms into two major classes, class I (A, B, Y, and Z) and class II (E, F, G, H, I, and J), and into four subgroups, group 1 (A and B), group 2 (Y and Z), group 3 (E), and group 4 (F, G, H, I, and J). Partial amino acid sequences for isoforms A, E, G, and H were also determined. In addition, the recombinant alpha-amylases expressed by plasmid pEno/103 containing the rice alpha-amylase gene RAmy1A in yeast were identified as both isoforms A and B. These analyses indicated that isoforms A and B were encoded by the gene RAmy1A, isoforms G and H were encoded by the gene RAmy3D, and isoform E was encoded by RAmy3E. The results strongly suggest that some isoforms within subgroups are formed by posttranslational modifications.
OBJECTIVE: To study antibodies to Escherichia coli O:14, which expresses large amounts of enterobacterial common antigen (ECA), and their corresponding antigen molecules in serum and synovial fluid samples from patients with rheumatoid arthritis (RA). METHODS: Enzyme linked immunosorbent assay (ELISA) was used to measure antibodies to heat killed E coli O:14 in serum and synovial fluid samples from patients with RA and control subjects including healthy donors and patients with osteoarthritis. ELISA was also used to perform absorption analyses of antibodies to E coli O:14 with several enteric bacteria and their lipopolysaccharide (LPS). In addition, antigenic molecules reacting with E coli O:14 antibodies from patients with RA were examined using immunoblot analysis and N-terminal amino acid analysis. RESULTS: Compared with control subjects, patients with RA showed significantly increased titres of antibodies against heat killed E coli O:14 in 33 of 83 serum samples (39.8%) and 38 of 58 joint fluid samples (65.5%). Absorption analyses with enteric bacteria and their LPS resulted in the reduction of antibody titres to heat killed E coli O:14 in serum and synovial fluid samples from the RA patients. In addition, immunoblot analysis of the samples from RA patients revealed not only a ladder-like banding pattern equivalent to ECA associated with LPS, but also two clear bands of bacterial outer membrane proteins of 35 kDa (Omp A) and 38 kDa (Omp C), having amino acid sequence homology with those of other Enterobacteriaceae. CONCLUSION: These results suggest that some patients with RA are sensitised to antigens common to Enterobacteriaceae, and this may prove relevant to the future development of immunotherapy for RA. Furthermore, this sensitisation to antigens found commonly in Enterobacteriaceae may have a key role in the pathogenesis of human RA similar to that described previously in our animal model.
Renal insufficiency and pulmonary disfunction are the major risk factors of surgical treatment for thoracic aortic aneurysm (TAA). The 1st case was 79-year-old female with ruptured TAA. The 2nd case was 76-year-old female with thoraco-abdominal aortic aneurysm. Both patients successfully treated with graft replacement using temporally shunt (12 mm Gore-Tex graft), tracheostomy and epidural analgesia.
The relationship between bullous pemphigoid and malignancies of visceral organs is still controversial. A case of lung cancer associated with bullous pemphigoid is reported. A 63-year-old man admitted hospital because of multiple bullae of the whole body skin and continuous fever. The skin lesions were diagnosed as bullous pemphigoid by the skin biopsy. However, the chest x-ray on admission revealed a large tumor in the left upper lung field. The tumor was diagnosed as a lung cancer by trans-bronchial lung biopsy. The fever withdrew with the administration of prednisolone. The left upper lobectomy of the lung and mediastinal lymph node dissection were performed. The skin lesion disappeared 5 days after the surgery. This clinical course is thought to indicate the relationship of both diseases. Bullous pemphigoid is thought to have many problems during perioperative period, such as hypoproteinemia and delayed wound healing due to administration of the steroid, therefore intensive care is necessary in the perioperative care.
OBJECTIVES: To investigate the histopathological and immunohistochemical features of intraductal "nodular" tumor located in the main pancreatic duct. METHODS: Four cases were studied, and the results were compared with those in 10 cases of common ductal adenocarcinomas of the pancreas. RESULTS: The intraductal nodular carcinoma were large, more than 3 cm in diameter (range, 3-7 cm), lacked macroscopic mucin production, and presented a papillotubular adenocarcinoma. These tumors showed minimal invasion into the periductal tissue, duodenum, and choledochus. Immunohistochemically, the tumor cells were negative for anti-CEA and faintly positive for anti-CA19-9, in all except one tumor, whereas the common ductal adenocarcinomas were clearly positive for both. The postoperative course was favorable, and all three living patients remained healthy for more than 4 yr. CONCLUSION: These tumors may be variants of intraductal tumors with a more favorable prognosis.
Two-year-old boy with Down's syndrome was treated with inhaled nitric oxide for pulmonary hypertensive crisis after correction of complete atrioventricular canal and persistent ductus arteriosus. The acute rise in pulmonary pressure and hemodynamic instability occurred on 3rd, 4th and 6th post operative days and pulmonary vasodilation with prostaglandin E1 and amrinone had failed. Twenty ppm of inhaled nitric oxide effectively reduced the pulmonary pressure and the patient was subsequently weaned from ventilation. Inhaled nitric oxide exerted a pulmonary vasodilation without decreasing systemic pressure in this patient with postoperative pulmonary hypertensive crisis.
To estimate the oxidative damage to skeletal muscle DNA in mitochondrial encephalomyopathies, we studied the amount of 8-hydroxy-deoxyguanosine (8-OH-dG) and the localization of superoxide dismutase (SOD) in the skeletal muscles of patients with progressive external ophthalmoplegia (PEO) or Kearns-Sayre syndrome (KSS). The molar ratio of 8-OH-dG/deoxyguanosine in skeletal muscle from PEO or KSS patients was significantly higher than the control value. The ratio from patients with polymyositis or Duchenne's muscular dystrophy was not significantly elevated. Immunohistochemical staining for both Mn-SOD and Cu,Zn-SOD showed pronounced staining in the subsarcolemmal and intermyofibrillar regions of cytochrome-oxidase-negative ragged red fibers of KSS or PEO muscles. Our findings suggest that overproduction of 8-OH-dG and mitochondrial dysfunction with gene deletions are associated with each other in muscle cells of patients with PEO or KSS, and that free radicals may play an important role in the pathophysiology of mitochondrial encephalomyopathies.
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Among 176 pediatric patients who underwent open heart surgery from 1990 to 1996, 7 developed severe pulmonary hypertensive crisis (PHC) postoperatively. All patients were treated with conventional medical therapy consisting of hyperventilation and deep sedation. Prostaglandin E1 and/or amrinone were administered initially as a pulmonary vasodilator, and in 3 of the 7 patients this resulted in immediate improvement in hemodynamics. These patients subsequently weaned off ventilatory support and they were discharged from the hospital. In 4 other patients, pulmonary vasodilator therapy with prostaglandin E1 and amrinone had failed and they were treated with inhaled nitric oxide (NO). In all patients, inhalation of NO resulted in immediate decrease in pulmonary pressure without significant change in systemic arterial pressure. Two patients successfully weaned from the ventilator, whereas in 2 patients decrease in pulmonary pressure was transient. They developed airway bleeding and died as a result of respiratory insufficiency. Although inhaled NO effectively reduced pulmonary pressure in patients with PHC, this effect was not maintained over 12 hours in patients associated with bronchopulmonary dysplasia. In patients at risk for severe PHC, rapid treatment with NO inhalation after initial event as well as the prevention of lung injury caused by mechanical ventilation were found to be important in the postoperative management.
A 3-year-old boy with hereditary spherocytosis (HS) underwent anatomical correction for double-outlet right ventricle. In addition to acute injury to the red blood cells during cardiopulmonary bypass, chronic mechanical trauma related to the presence of internal conduit and transannular patch must be considered in this patient with HS. We therefore performed splencetomy prior to cardiac surgery to prevent perioperative serious hemolysis. Preoperative examination showed the anatomy was considered suitable for REV procedure. The position of the aorta was anterior, VSD was classified as subpulmonic and associated with subvalvular stenosis. Under cardiopulmonary bypass, infundibular septum was resected and intraventricular tunnel was constructed. The pulmonary artery was transected at the level of the valve commissures and translocated onto the right ventricle without transection of aorta. Right ventricular outflow tract was reconstructed with a patch bearing monocusp. No serious complication due to hemolysis occurred perioperatively. Postoperative angiocardiography revealed no stenosis in both left and right ventricular outflow tract. The patient was discharged on the 57th postoperative day and is doing well.
A 65-year-old woman was admitted to the hospital because of an abnormal shadow on a chest X-ray film. Chest CT scans showed enlargement of the right mediastinal lymph nodes. However, no primary lesion was detected despite thorough examination. Mediastinoscopic biopsy revealed that the tumor was a lymph-node metastatic lesion of a squamous cell carcinoma of unknown origin. A thoracotomy was done and the mass was completely resected. Radiotherapy was given after the operation. We have followed the patient for 1 year since the operation, but no primary lesion has yet been detected. Metastasis of cancer of unknown origin to hilar or mediastinal lymph nodes is extremely rare, and only 6 cases have been reported previously in the Japanese medical literature.