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Biomedical subjects

Y Asano

Publications and source records attributed to Y Asano.

At least 469 records · Page 26Linked to original sources
PubMed1993

[Carotid endarterectomy under cervical epidural anesthesia].

General anesthesia for carotid endarterectomy (CEA) imposes the need for various monitorings of cerebral function during occlusion of the carotid artery. However, there is no ideal method for detecting all the signs of cerebrovascular insufficiency under general anesthesia. We suggest that the patient's neurological state is the best monitor of cerebral function. Therefore, our patients underwent cervical epidural anesthesia (EDA) enabling them to remain conscious while experiencing analgesia of the operated areas throughout the course of the operation. Five patients with cervical internal carotid artery stenosis were operated on under EDA with lidocaine. In all patients, EDA was effective in maintaining an analgesic state in the areas being operated on. It was able to do this either alone, or in combination with a light sedation. Under EDA, although there was no complete suppression of the patient's respiration, blood pressure was elevated beyond 200mmHg in three patients and depressed to 70mmHg in one patient transiently during the operation. But control of abnormal blood pressure was achieved easily by injections of calcium antagonist or ephedrine. When consciousness of two patients deteriorated during the clamping of the internal carotid artery, it completely recovered to its preoperative level after the insertion of an internal shunt. The patient's level of neurological condition became a good guide for predicting the need for an internal shunt during the periods of occlusion of the internal carotid artery. In conclusion, we suggest that EDA which is a safe and useful anesthesia should be employed in many patients who undergo CEA.

Aged↗
PubMed1993

Postexposure prophylaxis of varicella in family contact by oral acyclovir.

OBJECTIVE: To determine whether varicella can be prevented by administration of oral acyclovir (ACV) during the incubation period of the disease. SUBJECTS AND METHODS: ACV (40 or 80 mg/kg daily in four divided doses) was given orally to 25 exposed infants and children for 7 days, starting 7 to 9 days after exposure from the index case in their families. Their clinical features were compared with those of 25 age-matched control subjects who had been exposed in their families but did not receive ACV. A fluorescent antibody to membrane antigen assay was used for determination of the antibody to varicella-zoster virus, and a nested polymerase chain reaction method was used for detection of viremia. RESULTS: Among the 25 who received ACV, 4 (16%) developed the disease and 1 (4%) had a fever. On the other hand, all of 25 control subjects developed the disease and 17 (68%) had a fever. The incidence of fever and the severity of skin rashes were significantly lower (P < .01) in the subjects who received oral ACV than in the control group. Seroconversion was observed in 84% of subjects who received ACV. In some cases, varicella-zoster virus DNA was detected by polymerase chain reaction amplification in peripheral blood mononuclear cells from blood drawn approximately 14 days after exposure. CONCLUSIONS: Varicella can be prevented or modified by administration of oral ACV late in the incubation period.

Acyclovir↗
PubMed1993

[A patient with lysosomal glycogen storage disease with normal acid maltase].

A 13-year-old boy with mental retardation developed idiopathic cardiomyopathy and glycogen storage myopathy, but with normal lysosomal enzyme activities, consistent with a syndrome of lysosomal glycogen storage disease with normal acid maltase coined by Danon et al (1981). He was in good health except for WPW syndrome diagnosed at 7 years of age. He had heart murmur with abnormal ECG, elevated serum GOT, GPT, LDH, CK and aldolase levels. An echocardiogram showed obstructive hypertrophic cardiomyopathy. Lysosomal enzyme activities including acid alpha-glucosidase in fibroblasts were within normal limits. In the biopsied biceps brachii muscle, there was a mild variation in fiber size. An approximately 10 percent of myofibers had tiny vacuoles which contained periodic acid Schiff positive granules and were slightly high in acid phosphatase activity. The vacuoles were encircled by membranes with high neuron specific enolase (NSE) and acethylcholin-esterase (AchE) activities. On electron microscopy, numerous autophagic vacuoles scavenging glycogen granules were recognized as seen in acid maltase deficiency. Because the vacuolar membranes were high in NSE and AchE activities, lysosomal membrane formation from the cell membrane may be defective. When one has a patient with mild to moderate mental retardation, idiopathic hypertrophic cardiomyopathy and high serum CK level, muscle biopsy must be performed to rule out the present disorder.

Adolescent↗
PubMed1993

Parosteal (juxtacortical) chondrosarcoma of the humerus associated with regional lymph node metastasis. A case report.

Recurring parosteal (juxtacortical) chondrosarcoma of the humerus occurred in a 79-year-old man. Roentgenograms of the left humerus showed minimal cortical irregularity and a large soft tissue mass without calcification or periosteal reaction. Magnetic resonance imaging (MRI) showed a multilobular tumor of high intensity (T2-weighted imaging) without marrow involvement. During the left shoulder disarticulation an enlarged axillary lymph nodes was discovered and removed. Macroscopic examination of the disarticulated humerus showed a large yellow parosteal mass, which looked like cartilage, completely surrounding the humeral shaft. The marrow cavity was almost normal except for a small erosion at the site of the olecranon fossa. The histologic diagnosis of the mass was Grade 2 chondrosarcoma of parosteal (juxtacortical or periosteal) origin associated with regional lymph node metastasis. The features that made this case unique were a long history of the tumor (for 32 years), minimal cortical destruction of the bone by the tumor, and regional lymph node metastasis. This case illustrates the differential diagnosis of the parosteal chondrosarcoma from periosteal osteosarcoma and extraskeletal myxoid chondrosarcoma.

Aged↗
PubMed1993

[ST-T changes associated with severe hypoxia in a case of obstructive sleep apnea syndrome].

A 59-year-old man with obesity was admitted with nocturnal dyspnea and nocturnal precordial oppression. Catheter data disclosed no cardiac failure. Polysomnography was performed for a total of 3 nights. The diagnosis of obstructive sleep apnea syndrome was made because apnea index was 50 times/hour in average, the max apnea time was about 80 seconds and disappearance of airflow during decrease of endoesophageal pressure was observed. At the max apnea time, ST-T change in leads V2-5 was observed with severe desaturation (arterial oxygen saturation: 49%). It was considered that myocardial hypoxia following sleep apnea might be the cause of nocturnal precordial oppression.

Electrocardiography↗
PubMed1992

Establishment of stable CD8+ suppressor T cell clones and the analysis of their suppressive function.

Stable CD8+ suppressor T cell (Ts) clones were established by a relatively simple method. Keyhole limpet hemocyanin (KLH)-primed spleen cells from C3H mice were depleted of B cells and CD4+ T cells by panning and cytotoxic treatment, and the resulting CD8+ T cells were periodically stimulated with antigen and irradiated syngeneic spleen cells followed by manifestation in interleukin-2 (IL-2) containing medium. T cell clones with a definite suppressor function were established by limiting dilution. They were defined as classical effector type Ts of CD8+ phenotype as they had constant and definite suppressor functions in antigen-induced T cell proliferation and specific antibody response against T cell-dependent antigens without detectable cytotoxic activity against both antigen presenting cells (APC) and helper T cells (Th). They showed no helper activity for B cells and produced no detectable helper type lymphokines such as IL-2 and IL-4. CD8+ Ts clones were able to inhibit the antigen-induced IL-2 production of normal and cloned T cells. Their suppressive activity was antigen-nonspecific and major histocompatibility complex-unrestricted. CD8+ Ts clones were also able to suppress the proliferative response of Th clones induced by immobilized anti-T cell receptor (TcR) and anti-CD3 mAbs but not the response induced by concanavalin A (ConA) and IL-2. All the CD8+ T cell clones established independently utilized the TcR V beta 8 gene. Syngeneic antigen presenting cells could induce proliferation of these CD8+ clones, which was blocked by anti-CD8 and anti-I-Ak monoclonal antibody (mAb) but not by anti-class I mAbs. The stimulation of CD8+ Ts clones with immobilized anti-CD3 resulted in the release of a suppressor factor(s) that potently inhibited the antigen-induced proliferation of CD4+ Th clones and the in vitro secondary antibody formation.

Animals↗
PubMed1992

On the mechanism of termination and perpetuation of atrial fibrillation.

In an effort to further clarify the mechanism of termination and perpetuation of atrial fibrillation (AF), the intraatrial potentials during AF induced by programmable electrical stimulation were analyzed using the concept of wavelength which represents the size of a microreentrant circuit. Thirty patients with inducible AF were divided into 2 groups: 20 patients with AF that terminated spontaneously (group 1) and 10 patients with AF that did not terminate spontaneously (group 2). Wavelength is the product of refractory period and conduction velocity. During AF, the refractory period of the local atrial tissue was considered to correlate with the mean interval between each intraatrial potential (mean ff). An inverse relation was considered present between conduction velocity of the impulse and the width of intraatrial potentials (f width). Thus, the wavelength index was defined as (mean ff)/(mean f width). Ten intraatrial potentials at the high right atrium were sampled for measurement. Group 1 had higher wavelength indexes just after the induction of AF than did group 2 (1.33 +/- 0.31 vs 1.10 +/- 0.05, p less than 0.05). In group 1, the wavelength indexes were increased from the initial value to 1.49 +/- 0.36 just before termination of AF (p less than 0.001). In 3 group 2 patients, AF stopped after disopyramide was administered intravenously, whereas the wavelength indexes at the end of AF were higher than those before drug administration (1.27 +/- 0.08 vs 1.16 +/- 0.04, p less than 0.05). In conclusion, prolongation of the wavelength appears to be a major determinant for termination of AF, and shorter wavelengths are necessary for perpetuation of AF.

Adult↗
PubMed1992

Synergy of interleukin 3 and tumor necrosis factor alpha in stimulating clonal growth of acute myelogenous leukemia blasts is the result of induction of secondary hematopoietic cytokines by tumor necrosis factor alpha.

Colony growth of leukemic colony-forming units (L-CFU) obtained from patients with primary acute myelogenous leukemia stimulated with recombinant human interleukin 3 (rh IL-3) is significantly potentiated when recombinant human tumor necrosis factor alpha (rh TNF-alpha) is present in cultures. The costimulatory activity of tumor necrosis factor (TNF) alpha is dose dependent and maximum at TNF-alpha concentrations of 10 ng/ml. At high density, L-CFU proliferatively respond to TNF-alpha stimulation in the absence of exogenous rh IL-3. Studies of the mechanism of action of rh TNF-alpha on acute myelogenous leukemia L-CFU growth suggest that TNF-alpha acts by inducing release of growth stimulatory hematopoietic cytokines by the leukemic cells themselves, including IL-1 alpha, IL-1 beta, Granulocyte-macrophage colony-stimulating factor (CSF), granulocyte CSF, and IL-6. Treatment of L-CFU cultures, with neutralizing antibodies to IL-1 alpha, IL-1 beta, granulocyte-macrophage CSF, granulocyte CSF, and IL-6 to eliminate the endogenous source of these factors is associated with significant inhibition of the synergistic interplay of TNF-alpha and IL-3.

Drug Synergism↗
PubMed1992

Structural similarity of D-aminopeptidase to carboxypeptidase DD and beta-lactamases.

The gene for D-aminopeptidase (dap) has been isolated from the bacterium Ochrobactrum anthropi SCRC C1-38 [Asano, Y., Nakazawa, A., Kato, Y., & Kondo, K. (1989) J. Biol. Chem. 264, 14233-14239] and its nucleotide sequence determined. An expression plasmid pC138DP (4.5 kb) was constructed by placing the gene downstream of the lac promoter of pUC19. The amount of the enzyme in the cell-free extract of Escherichia coli JM109/pC138DP was elevated to 288,000 units/L of culture, which is about 3600-fold over that of O. anthropi SCRC C1-38. The enzyme comprised about 30% of the total extractable cellular protein. The gene consisted of an open reading frame of 1560 nucleotides which specifies a protein of Mr 57,257. The deduced amino acid sequence of the enzyme showed that it is related to carboxypeptidase DD, beta-lactamases, and penicillin-binding proteins. Seven mutants of the enzyme were generated by site-specific mutagenesis to explore the roles of the residues of interest, around the sequence Ser61-Xaa-Xaa-Lys64, where Xaa is any amino acid, since the identical sequences also appear in the penicillin-recognizing peptide hydrolases with Ser at the active sites. The mutant enzymes expressed in E. coli were purified to homogeneity and kinetically characterized. Replacements of the site at Ser61 and Lys64 yielded mutants showing significantly reduced Vmax values, while most of the Km values remained unchanged. Changes at Cys60, which is adjacent to the likely active center Ser61, to Ser and Gly resulted in the production of enzyme less sensitive to PCMB, with almost unaltered Vmax/Km values. The enzyme appears to be a serine peptidase rather than a thiol one. The inhibition by PCMB in the wild-type enzyme may have been caused by a formation of a mercaptide bond between Cys 60 and PCMB. Considering that D-aminopeptidase, carboxypeptidase DD (a penicillin-binding protein), and beta-lactamase have a common feature in recognizing peptides containing D-amino acid and that the former two catalyze transpeptidation reactions with substrates containing D-alanyl-D-alanine moieties, we propose that the enzyme is a new member of the "penicillin-recognizing enzymes". We showed that the enzyme is actually inhibited by beta-lactam compounds, such as 6-APA, 7-ACA, benzylpenicillin, and ampicillin, although they are not the substrate for the enzyme. The relationship between the primary structures and the reactions catalyzed by D-aminopeptidase and other serine hydrolases beta-lactamases and carboxypeptidase DD is discussed.(ABSTRACT TRUNCATED AT 400 WORDS)

Alcaligenes↗
PubMed1992

Direct interaction between an antigen-specific B cell clone and an MHC class II-reactive helper T cell clone.

TP67.14 established by somatic hybridization is a 2,4,6-trinitrobenzenesulfonic acid (trinitrophenyl, TNP)-specific B cell clone with a receptor molecule for TNP on the cell membrane, and MS202 is an interleukin-2 (IL-2)-dependent T helper (Th) cell clone reactive to auto-MHC class II antigens (IAk and IEk) as previously reported. In the present study it was shown that MS202 considerably induced the maturation of TP67.14 into anti-TNP plaque-forming cells (PFCs), and this response was markedly augmented by the addition of TNP-keyhole limpet hemocyanin (KLH). Recombinant cytokines and the culture supernatant of MS202 with TP67.14 did not affect the generation of anti-TNP antibodies by TP67.14. Also, neither anti-IL-4 nor anti-IL-5 monoclonal antibody (mAb) inhibited the maturation of TP67.14 mediated by MS202. The differentiative effect of MS202 on TP67.14 was completely lost when each cell was separately cultured using a semipermeable membrane. Monoclonal antibodies against LFA-1 beta molecules significantly blocked the development of anti-TNP PFCs induced by MS202, as well as anti-IAk and anti-IEk mAbs. Interestingly, the plasma membrane-enriched fraction (PM) derived from MS202 exhibited much more differentiative effects on TP67.14 treated with TNP-KLH than PM from other T cell lines and concanavalin A-induced T lymphoblasts. In addition, TNP-conjugated PM from MS202 by itself induced a great number of anti-TNP PFCs. The present findings indicate that MS202 is capable of inducing the maturation of TP67.14, which is considered to represent a population of B cells with antigen specificity in a late lineage of B cell maturation, through direct cell contact but not soluble factors. This suggests that B cells with antigen specificity, in the presence of antigen, can be induced to mature into antibody-secreting cells through direct contact with Th cells; in this process surface major histocompatibility complex class II and lymphocyte function-associated antigen 1 (LFA-1) molecules are directly involved and the cell membrane derived from Th cells provides a transductional signal for maturation of B cells with antigen specificity in the presence of antigen.

Animals↗
PubMed1992

Endonuclease analyses of DNA of human herpesvirus-6 isolated from blood before and after bone marrow transplantation.

Three strains of human herpesvirus-6 (HHV-6) were isolated from peripheral blood mononuclear cells of a leukemic child with the antibody of HHV-6 before and after bone marrow transplantation (BMT); two strains were obtained before BMT and one after BMT. The DNA extracted from the three isolates was analyzed by six different restriction endonucleases. The cleavage profiles of two strains obtained before BMT were different, but the third strain isolated after BMT was identical with one of the two, which suggest reactivation of HHV-6 from the recipient's own body after BMT and possible mutation or super-infection of the virus in an immunocompromised patient.

Bone Marrow Transplantation↗
PubMed1992

Activation of human herpesvirus-6 in children with acute measles.

Virological and serological studies were carried out prospectively to evaluate the possible activation of human herpesvirus-6 (HHV-6) in 50 infants and children with acute measles by isolation of HHV-6 from peripheral blood and by determining neutralizing antibodies to the virus. All but 5 patients (90%) were seropositive to HHV-6 in the acute stage of measles and 18 (40%) had a significant increase in HHV-6 antibody titers thereafter, whereas only 2 of 27 patients who were initially seropositive to Epstein-Barr virus (EBV) viral capsid antigen (VCA) had a significant rise in antibody titers to EBV VCA. Among 18 patients with a significant increase in HHV-6 titers, the virus was isolated from the peripheral blood mononuclear cells of three patients in the early convalescent stage of measles. These results indicate that activation of HHV-6 may occur frequently a few weeks after primary infection with the measles virus.

Acute Disease↗
PubMed1992

The pharmacokinetics of fluconazole during haemodialysis in uraemic patients.

We have studied the pharmacokinetics of fluconazole in five patients on long-term haemodialysis. The single-pass extraction rate of the dialyzer was 59 (3.5)% (n = 4), and the serum concentration was reduced by haemodialysis for 3 or 4 h by 26 (3.2)% (n = 5) and 39 (2.2)% (n = 9) respectively. The estimated amount extracted by a dialysis of 4 h was 33 (3.2)% (n = 4) of the dose. During repeated administration the serum fluconazole concentration increased, reaching a plateau at about 4 times the peak concentration after the first dose. After discontinuing administration the serum fluconazole concentration fell by 25% in every 3 h dialysis session. We conclude that fluconazole should be given in the usual dose of 100 or 200 mg at the end of every haemodialysis session.

Aged↗
PubMed1992

Pharmacokinetics of carteolol in patients with impaired renal function.

In order to determine the appropriate dosage of carteolol in renal dysfunction, the pharmacokinetics of carteolol has been examined in appropriate patients. The plasma concentrations and urinary excretion of carteolol were investigated in 15 patients with varying degrees of renal impairment during the administration of 5-20 mg carteolol hydrochloride (5 mg/tablet) for 2-45 months. Plasma carteolol levels were linearly correlated with the serum creatinine concentration (r = 0.87) and reciprocally with the creatinine clearance (r = 0.82). The urinary carteolol concentration was correlated with the urinary creatinine concentration (r = 0.69) and the urinary carteolol excretion was also correlated with the creatinine clearance (r = 0.79). These relationships become even closer when the plasma carteolol concentrations and urinary excretion rate of carteolol were factored by the administered tablets. The fractional renal excretion of carteolol was virtually constant at various degrees of renal function, and it always exceeded 100%, which indicates that carteolol was actively secreted, even in patients with renal failure. The estimated tubular secretion rate of carteolol was logarithmically correlated with the fractional renal excretion of carteolol (r = 0.93). The results indicate that the dose of carteolol should be determined according to the degree of renal impairment.

Adult↗
PubMed1992

A case of neurofibromatosis associated with clitoral enlargement and hypertension.

We report a case of clitoral and renovascular involvement of neurofibromatosis resulting in an enlarged phallus with juvenile hypertension. The patient was successfully treated by removal of the clitoral tumor and nephrectomy. This is the first of 15 reported cases with clitoral involvement, that showed concurrent renovascular hypertension.

Child↗
PubMed1992

Immunization of the elderly and patients with collagen vascular diseases with live varicella vaccine and use of varicella skin antigen.

Elderly subjects and patients with collagen vascular diseases were immunized with a live varicella vaccine to assess the vaccine's potential for preventing herpes zoster. An improved varicella-zoster virus (VZV) skin test antigen was then used to assess cell-mediated immunity to VZV. The antigen was prepared from culture fluid of VZV-infected cells and had far less protein content than crude antigen prepared by sonication of infected cells. In 11 of 12 patients with ophthalmic zoster and 17 of 21 with dermal zoster, the skin reaction was negative at the beginning of the disease but became positive later. After two doses of VZV vaccine, 8 of 12 elderly subjects (greater than 60 years old) and 4 of 6 patients with collagen vascular diseases, who were VZV-skin test negative but purified protein derivative tuberculin test-positive, became VZV skin test-positive.

Adolescent↗
PubMed1992

A prospective study of human herpesvirus-6 infection in renal transplantation.

Sixty-five kidney transplant recipients and their (22 living related and 43 cadaveric) donors were studied prospectively to determine the relationship between kidney transplantation and human herpesvirus-6 (HHV-6) infection. The virus isolation from peripheral blood and other tissues and sequential determination of neutralizing antibodies to HHV-6 were performed during 3 months following the transplantation. All of the donors and their recipients examined had neutralizing antibodies to HHV-6 at the time of renal transplantation and the virus was not isolated from them. HHV-6 was isolated from 3 renal tissues (2 living related and 1 cadaveric) obtained during transplant surgery, but not from their blood at that time. HHV-6 viremia occurred in 9 (14%) of the 65 recipients around 2 to 4 weeks after the transplantation. An additional 27 recipients showed a significant rise in the antibody titer. Thus, the infection with HHV-6 was confirmed in 36 (55%) of the 65. These results indicate that the virus is activated in many cases in the early posttransplant period and that HHV-6 establishes in vivo latency in the kidney tissue. There was no correlation between HHV-6 infection and acute rejection or the antirejection prophylaxis.

Adolescent↗