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Biomedical subjects

T Mitsui

Publications and source records attributed to T Mitsui.

At least 145 records · Page 8Linked to original sources
PubMed1998

[Acute myocardial infarction due to traumatic hemorrhagic shock with open fracture: a case report of staged amputation and CABG].

A 55-years-old man was admitted to an emergent hospital with hypovolemic pre-shock and open fracture of the right lower extremity. CPR was needed for myocardial infarction induced by hemorrhagic shock. Wound infection and bacteremia (Enterococcus SP) were noted 10 days after admission. Severe three vessel disease was demonstrated by preoperative (amputation) evaluation, he was also referred for CABG. For a control of infectious focus before using cardiopulmonary bypass, two-stage-operation (amputation and CABG) were selected. Both perioperative courses were uneventful and the patient recovered well after rehabilitation.

Amputation, Surgical↗
PubMed1998

Right thoracotomy as an alternative for redo mitral valve replacement and concomitant repair of the tricuspid valve.

BACKGROUND: We report the results of a right thoracotomy for reoperation on the mitral plus concomitant procedures. Access to aorta or repair of other lesions by this approach is controversial. EXPERIMENTAL DESIGN AND SETTING: Retrospective study. Institutional practice (University of Tsukuba Hospital, Tsukuba Japan). METHODS: Until 1995, 9 patients underwent right thoracotomy for mitral reoperation. The indication for this approach was no retrosternal space with the pericardium left open. Seven patients had deteriorated bioprosthesis, 1 periprosthetic valve leakage, and 1 re-stenosis. Four were associated with moderate tricuspid regurgitation. Operations were performed under fibrillation. Cardioplegia was used in 1. RESULTS: Through thoracotomy, 4 underwent mitral valve re-replacement, and 4 mitral valve re-replacement plus tricuspid annuloplasty. One was abandoned because of severe pleural adhesion. No neurological injury, or perioperative myocardial infarction occurred. CONCLUSIONS: The right thoracotomy was an effective alternative to repeat sternotomy for redo mitral valve operation. Also, concomitant repair of the tricuspid valve could be safely done by this approach.

Aged↗
PubMed1998

[Simultaneous cholecystectomy and CABG for acute cholecystitis and post-infarction angina].

A 71-year-old man was admitted to our hospital with massive GI bleeding and followed by acute myocardial infarction. Severe three vessel coronary artery disease with poor left ventricular performance (EF: 40%) was demonstrated by coronary angiography. He was referred for CABG. He had also cholecystitis, which needed surgical treatment simultaneously. Combined CABG and cholecystectomy were performed without using gastroepiploic artery as a bypass graft, and through separate median sternotomy and through right upper transrectal laparotomy. Postoperative course was uneventful. This combined procedure is beneficial for the patients with acute cholecystitis and unstable angina.

Acute Disease↗
PubMed1997

Effect of aging on the concentrations of nitrous oxide in exhaled air.

Trace gases in exhaled air have been used as a simple means of assessing metabolic reactions. The investigations of trace gases derived from bacteria in human exhalation are usually hydrogen (H2) or methane (CH4). On the other hand, nitrous oxide (N2O) is also derived from microorganisms, especially denitrifying bacteria. Although many kinds of denitrifying bacteria have been isolated on and in the human body, there has been few concerning N2O. We studied 222 healthy people from the age of 5 to 85 years. The analysis of N2O in exhaled air was carried out by a infrared-photoacoustic (IR-PAS) analyzer. It was found that N2O ranged from 0 to 1670 ppbv in exhaled air and that 59% (131) of the subjects were producers of N2O. A highly significant relationship was observed between age and concentrations of N2O (r = 0.40, P < 0.01). The rate of production in young children and in the aged was significantly higher than that in adults aged 20-39 years (P < 0.01), and less than 30% were producers during puberty. The change of normal microflora on and in human body with aging may have caused the significant relationship between age and emissions of N2O.

Adolescent↗
PubMed1997

Aprotinin inhibits plasmin-induced platelet activation during cardiopulmonary bypass.

BACKGROUND: In the past few years, aprotinin has been used in cardiac surgery with impressive results of reducing blood loss, but several adverse effects of aprotinin also have been reported. One of the most likely mechanisms is the inhibition of plasmin by aprotinin, although this indirect effect has not been reproduced in all experimental studies. METHODS AND RESULTS: We evaluated the platelet function and fibrinolytic activity during human cardiac surgery, with or without aprotinin. During cardiopulmonary bypass (CPB) in humans without aprotinin (n=16), decrease of platelet aggregation induced by thrombin, increase of alpha-granule secretion of platelet and microparticle formation, and increase of plasmin/alpha2-antiplasmin complex (PIC) were observed. In contrast, low-dose aprotinin (1.0 x 10(6) KIU), which was administered only into the priming fluid of extracorporeal circuits (n=10), maintained platelet aggregation induced by thrombin and reduced alpha-granule secretion and microparticle formation of platelets during CPB. In vitro, plasmin (0.8 CU/mL) released alpha-granules of washed platelets, and this activation was completely inhibited by aprotinin (10 KIU/mL). CONCLUSIONS: Aprotinin has indirect effects to inhibit platelet activation, and this may partly explain the reduction of blood loss during cardiac surgery. To prevent the adverse effects, a single and minimal use of aprotinin is important. The results of in vivo and in vitro studies suggest that platelet preservation was demonstrated by the lower concentration of aprotinin (1.0 x 10(6) KIU per patient or 10 KIU/mL) compared with the concentration that inhibits plasma fibrinolysis.

Aged↗
PubMed1997

Mutation rate of GB virus C/hepatitis G virus over the entire genome and in subgenomic regions.

A patient on maintenance hemodialysis was infected with a recently discovered putative non-A to -E hepatitis virus designated GB virus C (GBV-C) or hepatitis G virus (HGV) by transfusion. The viral isolate was recovered from the patient soon after she turned positive for GBV-C/HGV RNA in serum (GS185) and 8.4 years thereafter (GS193), and the entire nucleotide sequences were determined. They both had a genomic length of 9391 nucleotides with a defective C gene made of only 42 nucleotides. Between GS185 and GS193, 31 (0.33%) nucleotides were different, which changed 5 (0.18%) of the encoded 2842 amino acids. Thus, GBV-C/HGV was estimated to have a mutation rate of 3.9 x 10(-4) base substitutions per site per year. Nucleotide conversions were distributed over subgenomic regions, except in the 5' untranslated region of 552 nucleotides and a defective short C gene, which were conserved in sequence. The change in the putative envelope genes (E1 and E2) was no different from that in the entire genome with only 6 (0.35%) nucleotide substitutions among the 1730, just 1 of which induced an amino acid conversion. Taken along with the comparison of the two isolates with the reported five GBV-C or HGV isolates, these results indicate that GBV-C/HGV would not have hypervariable regions and would use a strategy for viral persistence that is different from immune escape.

Amino Acid Sequence↗
PubMed1997

Molecular pathogenesis of type I congenital plasminogen deficiency: expression of recombinant human mutant plasminogens in mammalian cells.

We previously reported the genetic abnormality in a Japanese family with type I congenital plasminogen deficiency caused by a Ser572 to Pro572 mutation. To characterize the molecular pathogenesis of the disease in this family, we expressed recombinant human wild-type and mutant (rS572P) plasminogens in COS-1 cells. Activation-resistant wild-type and mutant plasminogen stable transfectants in CHO-K1 cells also were established. Transient transfection and metabolic labeling experiments followed by immunoprecipitation analysis showed that the mutant plasminogen was secreted from COS-1 cells in reduced amounts, compared with the wild type. Endo H digestion of the wild-type and mutant plasminogen showed no shift in their migrations on sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis, indicating that both contain complex type oligosaccharide structures and could therefore be secreted. Furthermore, the secretion of activation-resistant mutant plasminogen was significantly reduced. Pulse-chase experiments and Northern blot analysis showed that the impaired secretion of the mutant plasminogen was the consequence of the accumulation of the mutant protein inside the cells but not of reduced plasminogen mRNA. Immunocytochemical staining of stable transfectants also revealed that CHO-K1 cells expressing the activation-resistant mutant plasminogen stained mainly in the perinuclear area, suggesting delayed processing of the mutant protein in the intracellular transport pathway. We conclude that the impaired secretion of mutant plasminogen, due to intracellular accumulation, is the molecular pathogenesis of type I congenital plasminogen deficiency caused by a Ser572 to Pro572 mutation.

Animals↗
PubMed1997

Chromosomal aberration in lipoblastoma: a case with 46,XX,ins(8;6)(q11.2;q13q27).

Chromosomal aberrations involving 8q11.2 have been reported in lipoblastoma. We report here a case of lipoblastoma with new chromosomal aberration. 46,XX,ins(8;6)(q11.2;q13q27). Cytogenetic analysis would facilitate the clinical differentiation between myxoid liposarcoma and the pathologically similar lipoblastoma and the identification of genetic loci related to cellular growth.

Chromosome Aberrations↗
PubMed1997

Rapid and simple determination of methamphetamine and amphetamine in blood by simultaneous extraction-derivation.

A method capable of extracting and derivatizing methamphetamine (MA) and amphetamine (AM) in blood simultaneously was developed. In this method ethyl acetate, triethylamine and pentafluorobenzyl bromide were added to blood, the extraction and pentafluorobenzyl derivatization of MA and AM were performed simultaneously by heating and stirring on a hot place stirrer. Pentafluorobenzyl derivatives were determined by gas chromatography/chemical ionization-mass spectrometry (GC/CI-MS). Deuterium labeled MA and AM were used as internal standards. This method enabled an accurate and precise quantitative analysis from blood containing MA and AM. Excellent results were obtained for autopsy cases with possible MA.

Acetates↗
PubMed1997

QT corrected for heart rate and relation between QT and RR intervals in beagle dogs.

The beagle dog has been widely used in cardiovascular research, but the adequacy of QT prediction formulas in dogs over a wide range of RR intervals has not been evaluated sufficiently. We investigated the QT-RR relation in beagles by analysis of the QT and preceding RR intervals obtained from 24-h ambulatory electrocardiograms. The acceptability of 14 QT prediction formulas was evaluated by use of 100-150 selected pairs of QT-RR points per animal in seven male and seven female beagles. The accuracy of fit with the measured data was assessed according to the minimum Akaike information criterion. The best fit was given by the logarithmic and inverse Kovács' formulas among one- and two-parameter linear regression equations, respectively. Exponential formulas produced a better fit than did the linear regression formulas, but are impractical because of the complicated interpretation of parameters due to the nonlinearity. In addition, the results obtained under physiological conditions were also confirmed by those of the pharmacological intervention study with disopyramide. Consequently, we propose a one-parameter logarithmic formula (QTc= log600 x QT/logRR) for correcting the QT interval for a heart rate of 100 bpm and the inverse Kovács' formula for evaluating a reverse-use-dependency of QT prolongation.

Animals↗
PubMed1997

Quantitation of sinusoid-like vessels in hepatocellular carcinoma: its clinical and prognostic significance.

Angiogenesis is crucial for tumor growth and metastasis. Hepatocellular carcinoma (HCC) is a typical hypervascular tumor. However, the relationship between tumor vascularity and the outcome of patients with HCC has not been evaluated. To clarify whether tumor angiogenesis is related to the prognosis of patients, immunohistochemical staining, using anti-von Willebrand factor (vWF) and anti-CD34, was applied in resected specimens from 43 cases of HCC. In nonmalignant tissue, staining was confined to vessels in the portal tract and to a few periportal sinusoids with both of the endothelial markers applied. In tumor tissue, however, sinusoid-like vessels reacted intensively with anti-CD34 but not with anti-vWF. The intratumor microvessel density (MVD) highlighted by anti-CD34 was 297 +/- 88 (per 0.74 mm2), which was significantly higher than that highlighted by anti-vWF (4 +/- 7). When only the MVD highlighted by anti-CD34 was analyzed, tumor diameter larger than 2 cm, poor differentiation (Edmondson's II to IV), and portal invasion were significantly related to the subgroup with MVD > or = 290. Overall survival curves of patients with MVD < 290 were better, and these patients were more likely to remain tumor free. Cox hazards model revealed intratumor MVD and Edmondson's grade to be independent prognostic factors for the overall survival of patients. These results demonstrated for the first time that tumor angiogenesis assessed by anti-CD34 was correlated with the outcome of patients with HCC, suggesting a potential role for anti-CD34 in the diagnosis and treatment of HCC.

Adult↗
PubMed1997

Does laser Doppler flowmetry aid the prevention of ischemic colitis in abdominal aortic aneurysm surgery?

Acute ischemic colitis is noted as a rare but lethal complication of abdominal aortic aneurysm (AAA) surgery. Because of its high mortality a reliable method of monitoring colonic blood perfusion to predict the possible occurrence of ischemic colitis is highly desirable for AAA surgery. We have tested the use of a laser Doppler flowmeter placed on the surface of the sigmoid colon for intraoperative monitoring in 31 patients with AAA. Although most of the patients showed the same flow levels after aorto-iliac or aorto-femoral grafting (at least unilaterally the internal iliac artery was perfused), in 6 cases poor colonic perfusion (below 50% of the basal flow) was observed and inferior mesentric arterial reconstruction was performed. In these 6 patients, sigmoid colonic blood perfusion returned from 37% to 82% of preoperative value after the reconstructions. No ischemic colitis was noted in this series of patients. We suggest that monitoring of serosal blood flow in the sigmoid colon using a laser Doppler flowmeter is useful for the management of patients during abdominal aortic aneurysm surgery.

Acute Disease↗