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Biomedical subjects

Y Furutani

Publications and source records attributed to Y Furutani.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Report of a case of angiodysplasia of the sigmoid colon associated with aortic stenosis].

Partial sigmoidectomy and then after 84 days aortic valve replacement were performed as a staged operation on a patient with Heyde syndrome, consisting of aortic stenosis and angiodysplasia of the sigmoid colon. An emergent sigmoidectomy was performed because of continuous bleeding from angiodysplasia of the sigmoid colon. Postoperative arteriography showed the persistence of angiodysplasia. Endoscopic examination of the residual angiodysplasia was performed before and after valve replacement and there was no morphological change.

Aged↗
PubMed1993

[2 cases report of open heart surgery with non-blood transfusion in severe valvular heart disease with cardiac cachexia--the efficacy of recombinant human erythropoietin].

Open heart surgery with non-blood transfusion was performed in 2 cases of severe mitral valve disease with cardiac cachexia by administering recombinant human erythropoietin (EPO). Case 1 was a 72-year-old and case 2 was a 66-year-old woman whose % usual body weight was 71-79% and Ht value on admission was 28.5-30%. Both patients were administered 9000-18000 U/week of EPO and ferrous sulfate pre- and postoperatively. In each case 800-1200 ml of autologous blood was drawn within 3 weeks preoperatively without hemodynamic change or decrease of Ht value. Both patients were received mitral valve replacement with non-blood transfusion. Preoperative administration of EPO and autologous blood preservation allowed open heart surgery with non-blood transfusion even in such a serious case as cardiac cachexia.

Aged↗
PubMed1992

Processing of the prepropeptide portions of the Bacillus amyloliquefaciens neutral protease fused to Bacillus subtilis alpha-amylase and human growth hormone during secretion in Bacillus subtilis.

A set of nested 3'-terminal deletions of the prepropeptide of the Bacillus amyloliquefaciens neutral protease gene was constructed. Alpha-amylase and human growth hormone were secreted using these truncated genes in Bacillus subtilis. The level of the secreted alpha-amylase varied with the region for the truncated prepropeptide contained in the fusion gene but was independent of its length. Even though length of the prepropeptide varied, the mobilities of secreted alpha-amylases were the same as that of the control alpha-amylase derived from the alpha-amylase clone, pTUB4 (Yamazaki et al., 1983). Analyses of the secreted N-terminal amino acid sequences confirmed that they were all identical to that of the authentic one. Precursor proteins of the alpha-amylase were found in the cell-associated fraction, suggesting that the prepropeptide portion was processed during secretion. On the other hand, the N-terminus of hGH secreted using one of these prepropeptide portions varied by 1 to 4 additional N-terminal amino acid residues derived from the junction sequence between the sequence for propeptide portion and mature hGH or from C-terminal region of the propeptide portion. These results suggest that the prepropeptide portion can be generally processed even in the heterogeneous fusion. A probable mechanism of processing and maturation of the fusion gene products is also discussed.

Amino Acid Sequence↗
PubMed1992

[Emergent cardiovascular operation in patients older than 75 years].

From January 1988 through December 1990, 7 patients older than 75 years underwent emergent cardiovascular operation. We evaluated those operative results. The mean age was 80.1 years (range 77 to 85 years) and there were 5 men and 2 women. Coronary artery bypass grafting for 2 cases, closure of ventricular septal perforation for 1 case, graft replacement of ascending aorta and suspension of aortic valve in 2 cases, closure of left ventricular free wall rupture (LVFWR) in 1 case and closure of arch aneurysm rupture for 1 case were performed. Operative mortality was 14.3% (1/7). There was one hospital death. Five survivors had uneventful course in early postoperative term, but they needed long elaborate hospital care because of complications in noncardiac general organs in late postoperative term. They need nutritional support, rehabilitation for muscle weakness and so on. Their mean postoperative hospital period was 53 days. All of them were improved in New York Heart Association I or II. We concluded that we attained a good operative result in emergent cardiovascular operation in patients older than 75 years by effective operation as a result of long elaborate postoperative hospital care.

Aged↗
PubMed1991

Adaptational changes of MHC gene expression and isozyme transition in cardiac overloading.

Distribution of cardiac myosin heavy-chain (MHC) isozymes is regulated during development by hemodynamic change and hormonal stimuli. To understand the evolution of cardiac hypertrophy and the underlying processes, the interaction between acute or chronic cardiac over-loading and serum thyroid hormone levels was studied. Biochemical, physiological, and pathological studies were performed using coarctated (Coa) rats with or without administration of thyroid hormone (Thy) and on sham-operated (Sham) rats and normal rats with or without administration of Thy. The results showed that 1) although serum Thy levels in Coa and Sham rats were nearly the same at all timing points, a significant induction of beta-MHC mRNA and isozyme occurred in Coa rats; 2) in Coa rats where Thy was administered, there was no increase in beta-MHC mRNA and isozyme as seen in Coa rats, and this level was nearly the same as in Sham rats, whereas serum Thy levels were significantly high, as in the normals with administration of Thy; and 3) 77 days after surgery, the hypertrophy was completed, judging from pathological findings at this time, and beta-MHC mRNA and isozyme reached similar levels in all groups, except for the normals with administration of Thy. These results demonstrate the following: 1) the MHC isoform transitions induced by pressure overload are not induced by decreases in serum Thy levels, and the regulation of MHC gene expression is responsive to other triggers in addition to Thy; and 2) the first adaptational process of the heart to hemodynamic overload is the MHC isoform transition, and the second adaptational process of that is the hypertrophy itself.

Adenosine Triphosphatases↗
PubMed1991

[Reliability of the exercise ECG in detecting silent ischemia in patients with prior myocardial infarction].

To assess the reliability of the exercise ECG in detecting silent ischemia, ECG results were compared with those of stress-redistribution thallium-201 single-photon emission computed tomography (SPECT) in 116 patients with prior myocardial infarction and in 20 normal subjects used as a control. The LV was divided into 20 segmental images, which were scored blindly on a 5-point scale. The redistribution score was defined as thallium defect score of exercise subtracted by that of redistribution image and was used as a measure of amount of ischemic but viable myocardium. The upper limit of normal redistribution score (= 4.32) was defined as mean +2 standard deviations derived from 20 normal subjects. Of 116 patients, 47 had the redistribution score above the normal range. Twenty-five (53%) of the 47 patients showed positive ECG response. Fourteen (20%) of the 69 patients, who had the normal redistribution score, showed positive ECG response. Thus, the ECG response had a sensitivity of 53% and a specificity of 80% in detecting transient ischemia. Furthermore, the 116 patients were subdivided into 4 groups according to the presence or absence of chest pain and ECG change during exercise. Fourteen patients showed both chest pain and ECG change and all these patients had the redistribution score above the normal range. Twenty-five patients showed ECG change without chest pain and 11 (44%) of the 25 patients had the abnormal redistribution. Three (43%) of 7 patients who showed chest pain without ECG change had the abnormal redistribution score. Of 70 patients who had neither chest pain nor ECG change, 19 (27%) had the redistribution score above the normal range. Thus, limitations exist in detecting silent ischemia by ECG in patients with a prior myocardial infarction, because the ECG response to the exercise test may have a low degree of sensitivity and a high degree of false positive and false negative results in detecting silent ischemia.

Aged↗
PubMed1990

A novel Bacillus subtilis gene involved in negative control of sporulation and degradative-enzyme production.

We have cloned a 2.5-kilobase fragment of the Bacillus subtilis genomic DNA which caused the reduction of extracellular and cell-associated protease levels when present in high copy number. This fragment, in multicopy, was also responsible for reduced levels of alpha-amylase, levansucrase, alkaline phosphatase, and sporulation inhibition. The gene relevant to this pleiotropic phenotype is referred to as pai. By DNA sequencing, two open reading frames--ORF1 and ORF2, encoding polypeptides of 172 and 207 amino acid residues, respectively--were found. These open reading frames seemed to form an operon. Deletion analysis revealed that an entire region for ORF1 and ORF2 was necessary for the pai phenotype. In addition, it was observed that the presence of the pai gene, in multicopy, caused overproduction of two proteins (molecular masses, 21 and 24 kilodaltons [kDa]). Analyses of the N-terminal amino acid sequences of these two proteins suggested that they were products of ORF1 and ORF2. Disruption of the pai gene at ORF1 in the genomic DNA resulted in the release of repression on protease synthesis and sporulation in glucose-enriched (2%) medium. The mutant carrying insertional disruption at ORF2 could not be constructed, suggesting that the ORF2 product, the 24-kDa protein, is essential for growth. The 21-kDa protein contains a helix-turn-helix domain observed in other DNA-binding proteins. Chromosomal mapping of pai indicated that this gene is located close to thr-5. These results suggest that the pai gene is a novel transcriptional-regulation gene involved in glucose repression.

Alkaline Phosphatase↗
PubMed1990

Increased dependence on slow filling for left ventricular diastolic filling in patients with coronary artery disease and a depressed systolic function--assessment with radionuclide ventriculography.

Contributions of rapid filling, slow filling and atrial systole to the left ventricular (LV) filling volume were analyzed with the use of radionuclide ventriculography at rest, both globally and regionally, in 34 patients with isolated disease of the left anterior descending coronary artery. The patients included 17 with a normal ejection fraction (EF greater than or equal to 50%; group 1) and 17 with a depressed EF (less than 50%; group 2), and the data were compared with those obtained from 13 normal subjects. A computer program subdivided the LV image into 4 regions, and time-activity curves were constructed globally and regionally by reverse-gating from the R wave. In both groups the contribution of rapid filling to the LV filling volume was decreased significantly in the affected septal and apical regions, and in the global left ventricle compared with that in normal subjects. In group 1, the contribution of atrial systole showed an increase in these affected regions and in the global left ventricle. In contrast, in group 2, the atrial contribution was not increased globally or regionally as much as was expected. However, the contribution of slow filling was either increased significantly or tended to increase in the affected regions and in the global left ventricle. There were negative correlations between the contribution of rapid filling and that of slow filling in the global left ventricle (r = -0.73, p less than 0.001) and in each of the septal, apical and lateral regions (r greater than or equal to -0.60, p less than 0.001), which suggested that the contribution of slow filling as well as of atrial systole undergoes an increase as rapid filling is impaired. Thus, in patients with coronary artery disease, the left ventricle relies on slow filling as well as atrial systole to affect diastolic LV filling in the affected regions and in the global left ventricle in the presence of LV systolic dysfunction.

Adult↗
PubMed1990

Correlation of in vitro bromodeoxyuridine labeling index and DNA aneuploidy with survival or recurrence in brain-tumor patients.

There are no previous reports correlating the in vitro bromodeoxyuridine (BUdR) labeling index (LI) with the clinical outcome in patients with brain tumors. The reliability of the LI as a predictor of patient survival or recurrence was examined in this study of 66 human brain tumors (19 gliomas, 18 meningiomas, and 29 others). Anti-BUdR staining was performed on surgically extirpated tumor tissue that had been treated with BUdR as previously described. Correlation of the BUdR LI with patient survival or tumor recurrence rate was carried out by the method of Kaplan and Meier. Deoxyribonucleic acid (DNA) aneuploidy was estimated in 52 cases. The results of this study indicate that BUdR LI values correlated well with the clinical course of patients with brain tumor. In comparison with patients with higher LI's, there was both a significantly higher survival rate for tumors other than meningiomas and a higher recurrence-free rate for meningiomas in patients with LI's of less than 4% and 1%, respectively. Although there was a tendency for patients without tumor aneuploidy to show better survival data than the others, no statistical difference was observed. These results suggest that the in vitro BUdR labeling method is reliable for prediction of a patient's prognosis, whereas prognosis on the basis of DNA aneuploidy alone is uncertain.

Adolescent↗
PubMed1990

[Effects of anteroseptal myocardial infarction on systolic and diastolic filling function of the right ventricle].

To assess the effects of wall motion abnormalities of the anterior left ventricle and interventricular septum on right ventricular (RV) systolic and diastolic filling function, multiple-gated radionuclide angiography was performed at rest in 53 patients with previous anteroseptal myocardial infarction and 14 normal subjects. There were 26 patients with left ventricular ejection fraction (LVEF) greater than or equal to 45% (group 1) and 27 with LVEF less than 45% (group 2). Six measurements were obtained simultaneously in both ventricles: 1) EF, 2) peak ejection rate, 3) duration of systole, 4) peak filling rate, 5) time to the peak filling rate, and 6) ratio of the peak filling rate to the peak ejection rate. The mean RV ejection fraction and the peak ejection rate in groups 1 and 2 were similar to those in the normal subjects. The ratio of the peak RV filling rate to the peak RV ejection rate, a sensitive indicator of diastolic filling function, decreased significantly in group 1 (0.61 +/- 0.15, p less than 0.02) and group 2 (0.59 +/- 0.15, p less than 0.02) as compared with that in the normal subjects (0.74 +/- 0.14). This indicates an impairment of early diastolic RV filling compared with RV systolic function. Thus, RV systolic function appears to be normally maintained even when anteroseptal wall motion is severely impaired; however, even in the presence of mild anteroseptal wall motion abnormality, RV filling may be impaired without reduced RV systolic function.

Aged↗
PubMed1990

[A case report of right ventricular infarction clearly detected by transesophageal echocardiography].

We reported a case of a 70 year-old woman who suffered from right ventricular infarction with cardiogenic shock, detected clearly by transesophageal echocardiography. On admission, her pulse rate was 31 bpm and her blood pressure was unobtainable. Conscious level was III-1-2 and she was cold and clammy. The ECG showed complete AV block with junctional escape rhythm at a rate of 31 bpm which required temporary pacing and ST elevation in leads II, III, a VF, V4R, V3R, V1. An echocardiogram showed akinesis of RV free wall and paradoxical septal motion. Transesophageal echocardiography was performed safely on the 5th hospital day and detected RV wall motion abnormality clearly. A Swan-Ganz catheter was inserted. Mean PCW was 12 mmHg. PA pressure was 19/11 mmHg. Mean RA pressure was 13 mmHg. Cardiac index was 1.33 l/min/m2. SvO2 was 54%. Volume loading, administration of dopamine, dobutamine and nitroprusside were started. Cardiac index increased to 1.88 l/min/m2, and SvO2 increased to 59%. On the 4th hospital day, mean RA pressure increased to 29 mmHg and PA pressure increased to 47/31 mmHg acutely. Endotracheal intubation was done and PEEP 6 cmH2O was used and mean RA pressure and PA pressure decreased. On the 6th hospital day, cardiac index increased 4.08 l/min/m2. Cardiac catheterization done two months after acute myocardial infarction showed 75% stenosis of the proximal right coronary artery.

Aged↗
PubMed1990

[A successful removal of a left atrial massive ball thrombus caused by mitral stenosis].

A 66-year-old female with a mitral stenosis and a left atrial massive ball thrombus is presented. She was admitted due to a transient right hemiplegia and a speech disturbance. This thrombus had been detected preoperatively by an echocardiogram and a left atriography. A mitral valve replacement using a Björk-Shiley valve 27 mm, accompanied with the removal of the thrombus was performed. The ball thrombus was dark red, 55 x 35 x 32 mm in size and 15 g in weight. After the surgery, the patient progressed well. Because of the high frequency of peripheral embolism and of sudden death, a left atrial ball thrombus should be removed immediately.

Female↗
PubMed1990

[Age-related modification of regional left ventricular filling in normal subjects].

Age-related reduction in global left ventricular filling has been reported. To assess how regional left ventricular filling is modified by aging, radionuclide ventriculography was conducted in 48 normal subjects aged 15 to 73 years. Left ventricular regional filling was assessed by dividing left ventricular region of interest into 4 quadrants, from which global (GLB), septal (SEP), apical (Ax) and lateral (LAT) time-activity curves and first-derivative curves were derived. Indexes of left ventricular systolic function at rest did not vary with age, but early diastolic filling significantly declined with age: peak filling rate normalized to end-diastolic volume (EDV/S), peak filling rate normalized to stroke volume (SV/s) and peak filling rate/peak ejection rate decreased (r = -0.42; p less than 0.01, r = -0.48; p less than 0.001, r = -0.47; p less than 0.001), time to peak filling rate increased (r = 0.41; p less than 0.01) with aging. Early diastolic asynchrony was measured as the sum of the absolute values of the time differences from global peak filling rate to that in each of three quadrants (delta TPFR). delta TPFR increased with age (r = 0.37; p less than 0.01). Moreover, delta TPFR correlated with global peak filling rate (EDV/s), peak filling rate (SV/s) and peak filling rate/peak ejection rate (r = -0.40; p less than 0.01, r = -0.45; p less than 0.01, r = -0.51; p less than 0.001). Time to peak filling rate of the lateral region was the shortest (163 +/- 38 ms), followed by the global (179 +/- 36 ms), apical (184 +/- 38 ms) and finally the septal region (195 +/- 35 ms). This suggested that physiologic asynchrony with regard to the sequence of regional filling exists in resting condition in normal subjects. Time to peak filling rate in the septal and apical regions increased with age (r = 0.29; p less than 0.05, r = 0.30; p less than 0.05), but that in the lateral region did not correlate with age (r = 0.11). These regional differences correlated with increase in delta TPFR. Thus, aging alter left ventricular diastolic function, with reduced rate related to increased asynchronous early diastolic filling due to prolongation of time to peak filling rate in the septal and apical regions.

Adolescent↗
PubMed1989

Cloning and sequencing of the cDNA for human monocyte chemotactic and activating factor (MCAF).

cDNA clones having a nucleotide sequence encoding a human monocyte chemotactic and activating factor (MCAF) were isolated and sequenced. The amino acid sequence deduced from the nucleotide sequence reveals the primary structure of the MCAF precursor to be composed of a putative signal peptide sequence of 23 amino acid residues and a mature MCAF sequence of 76 amino acid residues. The amino acid sequence of MCAF showed 25-55% homology with other members of an inducible cytokine family, including macrophage inflammatory protein and some putative polypeptide mediators known as JE, LD78, RANTES and TCA-3. This suggests that MCAF is a member of family of factors involved in immune and inflammatory responses.

Amino Acid Sequence↗
PubMed1989

Cerebral endothelial regeneration following experimental brain injury. Variation in the regeneration process according to the severity of injury.

It is still unknown when and in which area endothelial regeneration occurs after brain injury, and to what extent such changes depend on the severity of the injury. We have, therefore, studied bromodeoxyuridine (BrdU) uptake by regenerating endothelial cells in two different groups of rats given cold lesions using immunohistochemistry employing anti-BrdU monoclonal antibody, anti-factor VIII-related antigen antibody and anti-glial fibrillary acidic protein antibody. The earliest evidence for the presence of BrdU-positive endothelial cells (BrdU + end) was observed at 2 days after injury, the injured endothelial cells regenerating from the edge toward the center of the lesion in both groups. We considered that edema fluid could act as an important factor, since at 2 days post-injury BrdU + end were not in contact with macrophages and were always found in Evans blue-stained areas. Study of endothelial cell kinetics also confirmed that the repair of injured endothelial cells was intimately involved in the reconstruction of the blood-brain barrier, since the time of disappearance of BrdU + end coincided with the disappearance of Evans blue-stained areas. The difference in the process of endothelial regeneration was first apparent on the 3rd day, there being no difference at 2 days.

Animals↗
PubMed1989

Extradural nasal and orbital extension of malignant glioma. Case report.

A rare case of extradural nasal and orbital extension of malignant glioma is presented. The development of malignant changes was observed during 10 years. The mode of transdural extension was via the olfactory nerve, where it was directly destructive in all four cases that have been reported to date. The biological malignancy of transdurally extending glioma is also described.

Adult↗
PubMed1989

Flow-cytometric DNA analysis and immunohistochemical measurement of Ki-67 and BUdR labeling indices in human brain tumors.

Cell proliferation potential was assessed by measuring the labeling indices of the monoclonal antibody Ki-67 and of 5-bromodeoxyuridine (BUdR), and the cellular deoxyribonucleic acid (DNA) content in 48 human brain tumors. The diagnostic and prognostic value of flow-cytometric DNA analysis was also evaluated using ethanol-fixed paraffin-embedded BUdR-labeled specimens; these were the same specimens as were used for measuring the BUdR and Ki-67 labeling indices. Both the Ki-67 and the BUdR labeling indices correlated with the degree of malignancy estimated from conventional histological preparations. The Ki-67 labeling index was 1.7 times greater than the BUdR labeling index. The relationship of DNA aneuploidy to the labeling indices or to morphology in cases of glioma was examined. All of the tumors with an aneuploid line corresponded to malignant glioma classified by histological criteria, although malignant glioma did not always show DNA aneuploidy. In addition, the cases with aneuploid lines showed high BUdR and Ki-67 labeling indices. The cell kinetic data, which indicate the biological character of tumors, allowed prediction of the prognosis of the patients with gliomas. In contrast, despite the presence of an aneuploid line, three of 13 meningiomas showed a benign histological pattern without an aggressive clinical course, and neither the Ki-67 nor the BUdR labeling index was high. These results indicate an unequivocal relationship between DNA aneuploidy and clinical behavior; in general, both labeling indices may prove to be objective indicators of the outcome of patients with brain tumors.

Aneuploidy↗