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T Ohki

Publications and source records attributed to T Ohki.

At least 73 records · Page 4Linked to original sources

Analysis of stress in the active site of myosin accompanied by conformational changes in transient state intermediate complexes using photoaffinity labeling and 19F-NMR spectroscopy.

Myosin forms stable ternary complexes with ADP and the phosphate analogues, fluoroaluminate (Al F4-), fluoroberyllate (BeFn) or orthovanadate (Vi); these ternary complexes mimic transient intermediates in the myosin ATPase cycle. Moreover, we previously demonstrated that these complexes may mimic different myosin ATPase reaction intermediates corresponding to separate steps in the cross-bridge cycle [Maruta, S., Henry, G. D., Sykes, B. D. & Ikebe, M. (1993) J. Biol. Chem. 268, 7093-7100]. Park et al. suggested that the changing conformation of ATP during hydrolysis stresses the active site of myosin subfragment-1 (S-1) through protein-nucleotide contacts at the gamma-phosphate and nucleotide base, and the stress-induced strain in the cross-bridge may be the mechanism by which energy in ATP is transferred to the myosin structure [Park, S., Ajtai, K. & Burghardt, T. P. (1997) Biochemistry 36, 3368-3372]. In the present study, the photoactive ADP analogue, 3'-O-(N-methylanthraniloyl)-2-azido-ADP (Mant-2-N3-ADP), and the 19F-labeled ADP analogue, 2-[(trifluoromethylnitrophenyl)aminoethyl]diphosphate, were employed to examine conformational differences in protein-nucleotide contact in the ATP-binding site that may correlate with energy transduction. Mant-2-N3-ADP was trapped within the active site of skeletal and smooth muscle myosin in the presence of AlF4-, BeFn or Vi. For both skeletal and smooth muscle myosins, trapped Mant-2-N3-ADP was covalently linked to the 25-kDa N-terminal fragment of S-1 of both myosin/Mant-2-N3-ADP/AlF4- and BeFn complexes, presumably at Trp130. However, the efficiency of the incorporation was much higher for skeletal than for smooth muscle myosin suggesting that the conformations of the adenine-binding pockets of the two myosins are somewhat different. Although the amount of Mant-2-N3-ADP trapped in the presence of AlF4- and BeFn was the same for both myosins, the efficiency of photolabeling skeletal muscle myosin was approximately two times higher for BeFn complex than for AlF4- complex. The 19F-NMR spectra of the bound 2-[(trifluoromethylnitrophenyl)aminoethyl]diphosphate in the ternary complexes formed in the presence of AlF4-, BeFn or Vi showed small but distinguishable differences. Taken together, these results indicate that there is some variation in the protein-nucleotide contacts at the nucleotide base among the ternary complexes studied, and these differences mimic separate steps occurring transiently during the contractile cycle.

Affinity Labels↗

Endovascular treatment of a ruptured lumbar artery aneurysm: case report and review of the literature.

Lumbar artery aneurysms are uncommon lesions that usually present as pseudoaneurysms secondary to vessel injury. Despite their small size and retroperitoneal location, these lesions are potentially lethal once they rupture. This report describes a ruptured lumbar artery aneurysm which was successfully treated in a minimally invasive fashion. The diagnosis was suggested by computed tomography scan and confirmed with angiography. Successful treatment consisted of placing intravascular metallic coils into the lumbar artery. The literature contains only seven previous reports of ruptured lumbar artery aneurysms and these were managed either operatively or via an endovascular approach. Based upon the outcome of all reported cases, we believe that coil embolization of lumbar artery aneurysms following diagnostic angiography is an appropriate and effective mean of treating these lesions.

Aged↗

Endoleaks after endovascular graft treatment of aortic aneurysms: classification, risk factors, and outcome.

PURPOSE: Incomplete endovascular graft exclusion of an abdominal aortic aneurysm results in an endoleak. To better understand the pathogenesis, significance, and fate of endoleaks, we analyzed our experience with endovascular aneurysm repair. METHODS: Between November 1992 and May 1997, 47 aneurysms were treated. In a phase I study, patients received either an endovascular aortoaortic graft (11) or an aortoiliac, femorofemoral graft (8). In phase II, procedures and grafts were modified to include aortofemoral, femorofemoral grafts (28) that were inserted with juxtarenal proximal stents, sutured endovascular distal anastomoses within the femoral artery, and hypogastric artery coil embolization. Endoleaks were detected by arteriogram, computed tomographic scan, or duplex ultrasound. Classification systems to describe anatomic, chronologic, and physiologic endoleak features were developed, and aortic characteristics were correlated with endoleak incidence. RESULTS: Endoleaks were discovered in 11 phase I patients (58%) and only six phase II patients (21%; p < 0.05). Aneurysm neck lengths 2 cm or less increased the incidence of endoleaks (p < 0.05). Although not significant, aneurysms with patent side branches or severe neck calcification had a higher rate of endoleaks than those without these features (47% vs 29% and 57% vs 33%, respectively), and patients with iliac artery occlusive disease had a lower rate of endoleaks than those without occlusive disease (18% vs 42%). Endoleak classifications revealed that most endoleaks were immediate, without outflow, and persistent (71% each), proximal (59%), and had aortic inflow (88%). One patient with a persistent endoleak had aneurysm rupture and died. CONCLUSIONS: Endoleaks complicate a significant number of endovascular abdominal aortic aneurysm repairs and may permit aneurysm growth and rupture. The type of graft used, the technique of graft insertion, and aortic anatomic features all affect the rate of endoleaks. Anatomic, chronologic, and physiologic classifications can facilitate endoleak reporting and improve understanding of their pathogenesis, significance, and fate.

Aged↗

Endoleak after endovascular graft repair of experimental aortic aneurysms: does coil embolization with angiographic "seal" lower intraaneurysmal pressure?

PURPOSE: To investigate the relation between endoleaks and intraaneurysmal pressure (IAP) and the effect of coil embolization in the management of endoleaks. METHODS: The infrarenal aorta of a dog (n = 15) was replaced by a polytetrafluoroethylene aneurysm containing a pressure transducer. Group I (n = 4) had untreated aneurysms. Group II (n = 4) had endovascularly excluded aneurysms without an endoleak. Group III (n = 7) had aneurysms excluded by means of grafts with a defect that represented the source of an endoleak. After 4 weeks of follow-up study, the endoleaks in group III dogs were subjected to coil embolization. Systolic IAP was measured daily and expressed as a ratio of systolic blood pressure obtained from a forelimb cuff. Arteriography, duplex ultrasonography, and spiral contrast computed tomography were performed to evaluate endoleaks. RESULTS: In group I, the LAP remained close to systolic blood pressure (ratio of 0.96 +/- 0.06), whereas in group II the IAP ratio showed a decline to 0.34 +/- 0.16 (p = 0.0009 group I versus II). After an initial decrease, the IAP ratio in group III stabilized at 0.75 +/- 0.18 (p = 0.003, group II versus III). Aneurysms with an endoleak remained pulsatile with a pulse pressure of 30 +/- 16 mm Hg, which was less than that of untreated aneurysms (62 +/- 15 mm Hg; p < 0.0001 group I versus III). Arteriography and computed tomography revealed "sealing" of endoleaks after coil embolization, but IAP ratio did not decrease (0.76 +/- 0.14) after coil embolization. CONCLUSIONS: Incomplete endovascular aneurysm exclusion caused by an endoleak fails to reduce IAP ratio and may subject the aneurysm to a continued risk for rupture. Although coil embolization resulted in angiographic and computed tomographic sealing, it failed to reduce IAP ratio.

Aneurysm, False↗

Ex vivo human carotid artery bifurcation stenting: correlation of lesion characteristics with embolic potential.

PURPOSE: To develop an ex vivo human carotid artery stenting model that can be used for the quantitative analysis of risk for embolization associated with balloon angioplasty and stenting and to correlate this risk with lesion characteristics to define lesions suitable for balloon angioplasty and stenting. METHODS: Specimens of carotid plaque (n = 24) were obtained circumferentially intact from patients undergoing standard carotid endarterectomy. Carotid lesions were prospectively characterized on the basis of angiographic and duplex findings before endarterectomy and clinical findings. Specimens were encased in a polytetrafluoroethylene wrap and mounted in a flow chamber that allowed access for endovascular procedures and observations. Balloon angioplasty and stenting were performed under fluoroscopic guidance with either a Palmaz stent or a Wallstent endoprosthesis. Ex vivo angiograms were obtained before and after intervention. Effluent from each specimen was filtered for released embolic particles, which were microscopically examined, counted, and correlated with various plaque characteristics by means of multivariate analysis. RESULTS: Balloon angioplasty and stenting produced embolic particles that consisted of atherosclerotic debris, organized thrombus, and calcified material. The number of embolic particles detected after balloon angioplasty and stenting was not related to preoperative symptoms, sex, plaque ulceration or calcification, or artery size. However, echolucent plaques generated a higher number of particles compared with echogenic plaques (p < 0.01). In addition, increased lesion stenosis also significantly correlated with the total number of particles produced by balloon angioplasty and stenting (r = 0.55). Multivariate analysis revealed that these two characteristics were independent risk factors. CONCLUSIONS: Echolucent plaques and plaques with stenosis > or = 90% produced a higher number of embolic particles and therefore may be less suitable for balloon angioplasty and stenting. This ex vivo model can be used to identify high-risk lesions for balloon angioplasty and stenting and can aid in the evaluation of new devices being considered for carotid balloon angioplasty and stenting.

Angioplasty, Balloon↗

Technique for obtaining proximal intraluminal control when arteries are inaccessible or unclampable because of disease or calcification.

When proximal arterial control cannot be obtained by standard methods, it may be achieved safely and bloodlessly by intraluminal routes with balloon catheters, hemostatic sheaths, and catheter-guide wire techniques. This method was used successfully in 20 patients to achieve proximal arterial control without complications in a variety of locations. Use of this method or its modifications may facilitate and simplify a variety of vascular operations that would otherwise be difficult or hazardous.

Angioplasty, Balloon↗

Accuracy of duplex ultrasound in evaluating carotid artery anatomy before endarterectomy.

PURPOSE: Anatomic features, such as a high carotid bifurcation (< 1.5 cm from the angle of the mandible), excessive distal extent of plaque (> 2.0 cm above the carotid bifurcation), or a small diameter (< or = 0.5 cm) redundant or kinked internal carotid artery can complicate carotid endarterectomy. In the past, arteriography was the only preoperative study capable of imaging these features. This study assessed the ability of duplex ultrasound to evaluate their presence before surgery. METHODS: A consecutive series of 20 patients who underwent 21 carotid endarterectomies had preoperative duplex ultrasound evaluations of these anatomic features. These evaluations were correlated with operative measurements from an observer blinded to the duplex findings. RESULTS: The mean difference between duplex and operative measurements for the distance between the carotid bifurcation and the angle of the mandible, the distal extent of plaque, and the internal carotid artery diameter was 0.9 cm, 0.3 cm, and 0.8 mm, respectively. The correlation coefficient between the two methods was 0.86, 0.75, and 0.59, respectively. Duplex ultrasound predicted a high carotid bifurcation, excessive distal extent of plaque, or a redundant or kinked internal carotid artery with 100% sensitivity (p < 0.05, p < 0.01, and p < 0.001, respectively). The sensitivity of duplex ultrasound in predicting a small internal carotid artery diameter was 80%. The specificity of duplex ultrasound for predicting excessive distal extent of plaque, small internal carotid artery diameter, high carotid bifurcation, and a coiled or kinked carotid artery was 92%, 56%, 100%, and 100%, respectively. CONCLUSION: Duplex ultrasound can predict the presence of anatomic features that may complicate carotid endarterectomy. Preoperative duplex imaging of these features may be helpful in patients who undergo carotid endarterectomy without preoperative arteriography.

Aged↗

Five-year experience with endovascular grafts for the treatment of aneurysmal, occlusive and traumatic arterial lesions.

Standard therapy for most aneurysmal, occlusive, and traumatic arterial lesions has historically consisted of surgical exposure and repair or placement of an interposition bypass graft. Endovascular grafting techniques are an alternative treatment. These techniques blend stent and graft technology and enable a vascular graft to be placed from a remote access site under fluoroscopic guidance to treat a variety of arterial lesions. The major advantage of this approach is its less invasive nature. During the last 5 years, 234 endovascular grafts have been implanted at Montefiore Medical Center to treat a variety of arterial lesions including aneurysms, occlusions and traumatic or iatrogenic injuries. Although many of these procedures were complex and difficult, results have improved steadily as appropriate devices, techniques and indications have been developed. These endovascular grafts have facilitated successful treatment in many patients and have permitted correction of limb- or life-threatening lesions in some patients who would otherwise be impossible or difficult to treat. Based on this 5-year experience, it is likely that endovascular grafts will play an important role in the future treatment of various types of arterial pathology. Although the value and limitations of endovascular graft for the treatment of aneurysmal and occlusive lesions in good-risk patients remains to be precisely defined, their usage in high-risk patients and in those with iliac aneurysms and central artery traumatic false aneurysms and arteriovenous fistula already appears justified.

Aneurysm↗

The effect of nonporous PTFE-covered stents on intimal hyperplasia following balloon arterial injury in minipigs.

PURPOSE: To report an experimental study investigating the ability of nonporous polytetrafluoroethylene (PTFE) covering on a metallic stent to retard the development of neointimal hyperplasia (NIH). METHODS: Three groups of Hanford miniature swine underwent standardized balloon injury to both external iliac arteries. Group I animals (control) received balloon injuries only. Group II had the site of balloon injury supported by a properly sized, balloon-expandable Palmaz stent placed directly over the injury site. Group III animals received a Palmaz stent covered with PTFE graft. All animals underwent arteriography immediately after intervention and again prior to sacrifice and specimen harvest at 4 weeks. The specimens were examined grossly and histologically at the proximal, middle, and distal segments for NIH development. RESULTS: Uncovered stents developed significantly more NIH (p < 0.0001) and greater luminal narrowing (p < 0.001) than the controls. PTFE-covered stents (group III) exhibited less NIH (p < 0.001) and luminal reduction (p < 0.01) than bare stents (group II) at the middle portion of the stent-graft, but the PTFE cover had no effect on NIH and lumen reduction at the proximal or distal ends of the prosthesis. CONCLUSIONS: PTFE-covered stents retarded NIH at 4 weeks, but only at the midportion of the devices; the covering did not prevent neointimal pannus ingrowth at the proximal and distal ends.

Angiography↗

Sudden natural death in driving: case studies in the western area of Kanagawa.

To assess their incidence and implications, we made a retrospective study of sudden unexpected natural deaths during driving that occurred in the five year-period between 1992 and 1997. During that period, 188 postmortem examinations were performed on driver victims of traffic accidents. Of these, 15 (8%) were found to have died of natural causes such as heart disease or cerebral hemorrhage. Marked findings in this study were that no persons over 70 years of age and more occupational drivers suffered natural death. Although no passengers or pedestrians were injured, as many as eight vehicles collided with another object or vehicle. Sudden natural death, particularly from cerebral hemorrhage, of drivers might be hazardous to other road users.

Accidents, Traffic↗

Endovascular therapy for upper extremity injury.

Various endovascular techniques, including the placement of embolization coils, intravascular stents, and the use of stented grafts, have been used in the setting of traumatic upper extremity injuries. Coil embolization and stent placement are effective in a limited number of cases. Endovascular grafts have greatly extended the potential of endovascular therapy for upper extremity vascular trauma. The ideal graft material, stent, and the best mechanism for stent deployment have not been determined. In addition, long-term effectiveness of such therapy is yet to be shown. Nevertheless, endovascular grafts offer distinctive advantages in some cases and are important tools for the treatment of vascular trauma and should be included in the armamentarium of all vascular surgeons.

Angioplasty, Balloon↗

Conformational changes at the highly reactive cystein and lysine regions of skeletal muscle myosin induced by formation of transition state analogues.

Myosin forms stable ternary complexes with Mg2+-ADP and phosphate analogues of aluminum fluoride (AlF4-), beryllium fluoride (BeFn), and scandium fluoride (ScFn). These complexes are distinct from each other and may mimic different transient states in the ATPase cycle [Maruta et al. (1993) J. Biol. Chem. 268, 7093-7100]. Regions of skeletal muscle myosin containing the highly reactive residues Cys 707 (SH1), Cys 697 (SH2), and lysine 83 (RLR) dramatically alter their local conformation when myosin hydrolyzes ATP, and these changes may reflect formation of a series of transient intermediates during ATP hydrolysis. We used the fluorescent probes 4-fluoro-7-sulfamoylbezofurazan, 2-(4'-maleimidylanilino)naphthalene-6-sulfonic acid, and trinitrobenzene-sulfonate, which bind to SH1, SH2, and RLR, respectively, to examine differences in local conformations within myosin.ADP.phosphate analogue (BeFn, Vi, AlF4-, and ScFn) complexes. It was observed that the ternary complexes had SH1 conformations similar to those seen on S-1 in the presence of ATP. In contrast, local conformations in the SH2 and RLR regions of S-1.ADP.BeFn were different from those in corresponding regions of S-1.ADP.AlF4- or ScFn. These results suggest that SH1 and SH2 move distinctly during ATP hydrolysis and that the local conformations of the SH2 and RLR regions more sensitively reflect different transient states.

Adenosine Triphosphatases↗

Structure of the gene encoding human alpha 2-HS glycoprotein (AHSG).

Alpha 2-HS glycoprotein (AHSG) is a human plasma glycoprotein and fetuin is the homologue in the calf. In this report, we present the structure and organization of the AHSG gene. Introns and the 5' and 3'-flanking regions were obtained by polymerase chain reaction (PCR) and the inverted PCR, respectively, from genomic DNA using AHSG cDNA-specific oligonucleotide primers. The sequence of the PCR products shows that the coding region spans approximately 8.2 kb and is composed of seven exons interrupted by six introns. The exon-intron splice junctions agree with the consensus sequence, and the positions interrupted by introns are precisely identical to those of the rat insulin receptor tyrosine kinase inhibitor (fetuin) gene. The 5'-promoter region contains several characteristic sequences such as an A + T-rich sequence of TAAATAA, C/EBP-binding site, and hepatocyte nuclear factor-5 (HNF-5) and serum response factor (SRF) sites.

Animals↗

Anastomotic intimal hyperplasia: a comparison between conventional and endovascular stent graft techniques.

Endovascular grafts (EVGs) have been proposed as a treatment for a variety of vascular diseases; however, the impact of EVGs on graft healing has not been fully evaluated. The aim of this study is to compare anastomotic intimal hyperplasia (AIH) and endothelialization in EVGs and conventional bypass grafts (CGs). Seven mongrel dogs received an EVG in one iliac artery and a CG in the other iliac artery using a 5 mm x 4 cm polytetrafluoroethylene graft. The EVG was secured to the native vessel wall, with balloon expandable stents at either ends of the graft. CGs were anastomosed using running sutures. Intravascular ultrasound was performed at the time of sacrifice (8 weeks) to determine percentage of stenosis at the distal anastomosis. Specimens were divided longitudinally for light microscopic analysis (thickness of distal AIH) and scanning electron microscopic studies (percentage of endothelial coverage of the graft). Percentage of stenosis at the distal anastomosis was significantly higher in EVGs compared with CGs (28.2 +/- 18.2% versus 1.8 +/- 2.8%; P < 0.01) due to significantly greater mean intimal thickness in the EVGs (441.1 +/- 101.1 microns versus 82.4 +/- 41.9 microns; P < 0.01). The total percentage of area covered by endothelial cells was also significantly greater in EVGs compared with CGs (80.5 +/- 37.5% versus 30.3 +/- 37.1%; P < 0.05). Intraluminal location enhanced endothelialization of the polytetrafluoroethylene graft; however, it also resulted in greater AIH. Further device refinements including stent design may be required to maximize the potential of these endovascular procedures.

Anastomosis, Surgical↗

Molecular evidence for human alpha 2-HS glycoprotein (AHSG) polymorphism.

Alpha 2-HS glycoprotein (AHSG) is a human plasma glycoprotein that exhibits genetic polymorphism on isoelectric focusing (IEF). To identify the origin of two common alleles, AHSG*1 and *2, we examined nucleotide exchanges in the gene. AHSG cDNA was obtained by RT-PCR from poly(A) RNA of seven liver tissue samples and subcloned into a plasmid vector. After sequencing, we found six single nucleotide differences in comparison with the originally reported sequence. In particular, the nucleotide substitutions of C to T at amino acid position 230 and C to G at position 238 were common among the samples exhibiting phenotype 2-1 or 2. Since these substitutions might give rise to a NlaIII site and a SacI site, respectively, for the potential AHSG*2, we analyzed these substitutions by PCR-RFLP using genomic DNA of 68 individuals. The result was consistent with the IEF analysis of the corresponding serum, indicating that AHSG*1 was characterized by ACG (Thr) at position 230 in exon 6 and ACC (Thr) at position 238 in exon 7, and that AHSG*2 was characterized by ATG (Met) at position 230 and AGC (Ser) at position 238.

Amino Acid Sequence↗

Endovascular grafts for noninfected aortoiliac anastomotic aneurysms.

PURPOSE: This report describes our experience with endovascular repair of aortic and iliac anastomotic aneurysms. METHODS: Between June 1994 and March 1996, 12 noninfected aortic or iliac anastomotic aneurysms in 10 patients who had serious comorbid medical conditions that precluded or made difficult standard operative repair were treated using endovascular grafts. No patient in this study had a history of fever, leukocytosis, or computed tomographic evidence of a periprosthetic fluid collection that was suggestive of infection of the original graft. Endovascular grafts composed of polytetrafluoroethylene and balloon-expandable stents were introduced through a femoral arteriotomy and were placed using over-the-wire techniques under C-arm fluoroscopic guidance. RESULTS: Endovascular grafts were successfully inserted in all patients with aortic or iliac anastomotic aneurysms. There were no procedure-related deaths, and complications included one postprocedure wound hematoma and one perioperative myocardial infarction. Graft patency has been maintained for a mean of 16.1 months, with no computed tomographic evidence of aneurysmal enlargement or perigraft leakage. CONCLUSIONS: Endovascular grafts appear to be a safe and effective technique for excluding some noninfected aortoiliac anastomotic aneurysms in high-risk patients and may become a treatment option in all patients who have clinically significant lesions.

Aged↗