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Biomedical subjects

Y Imai

Publications and source records attributed to Y Imai.

At least 451 records · Page 25Linked to original sources
PubMed1997

Double-switch operation for congenitally corrected transposition.

Since June, 1989, 44 patients with congenitally corrected transposition associated with AV discordance who were younger than 16 years-underwent anatomical correction, or double-switch operation; 4 of the patients (9.1%) died while still hospitalized. Although double-switch operation is a time-consuming procedure, and longer follow-up is warranted, it is best indicated for CTGA, especially in the presence of systemic tricuspid regurgitation, or in cases with poor systemic RV function. Preoperative tricuspid regurgitation improved spontaneously without surgical intervention on the valve, and mere unloading of the anatomical RV was proven sufficient to control the regurgitation in our series. Postoperative ventricular function can be favorably compared with that of the conventional Rastelli procedure in the complete transposition of the great arteries. Combined atrial switch and arterial switch procedures were performed in nine cases, and eight surviving patients were currently doing well in NYHA functional class 1 at the time this report was written. This combination of anatomical repair should be considered for cases with CTGA associated with VSD and pulmonary hypertension. Two types of anatomical repair that the author first described, combined arterial switch and the Senning procedure, and combined atrial switch and direct anastomosis between the RV and the distal pulmonary artery, seemed to be preferable methods for performing anatomical correction in CTGA.

Adolescent↗
PubMed1997

[Improving surgical results for cardiovascular anomalies in neonates].

The surgical results for congenital cardiovascular anomalies in neonates between August 1987 and July 1997 were reviewed. Two hundred thirty-four neonates underwent the corrective surgery with the use of cardiopulmonary bypass (CPB) for the cardiac anomalies including transposition of the great arteries (d-TGA) (157 patients), total anomalous pulmonary venous connection (TAPVC) (44 patients), cardiac defects with the aortic arch anomalies (11 patients), and others (22 patients), with an early mortality rate of 12%. The survival rates through the arterial switch operation for d-TGA and correction for TAPVC in 30 days were satisfactory (92% and 89%, respectively). The early mortality rate of palliative surgery done without CPB in 115 neonates due to aortic arch anomalies, pulmonary outflow tract obstruction, or pulmonary hypertension was low (6%). In contrast with these results, the outcome of palliative surgery using CPB for hypoplastic left heart syndrome, the aortic arch anomalies with subaortic stenosis, or TAPVC in asplenia hearts was poor, with the surgical mortality of 80%.

Aortic Coarctation↗
PubMed1996

Growth of the neopulmonary valve annulus after arterial switch operation in transposition of the great arteries.

BACKGROUND: It is known that supravalvular pulmonary artery stenosis can occur in patients with d-transposition of the great arteries (TGA) after arterial switch operation (ASO). However, little is known about the growth of the neopulmonary valve annulus after the ASO. This study investigated the growth potential of the neopulmonary (old aortic) valve annulus. METHODS AND RESULTS: Annular diameters of the old aortic and neopulmonary valve were measured from cineangiograms in patients who underwent cardiac catheterizations both before and > 1 year after the ASO. Of 71 patients, 13 (18%) had either a small annulus (< 70% of the expected normal value) or no significant growth of the neopulmonary annulus after the ASO, and 4 (6%) had a pressure gradient of > 30 mm Hg across the valve. The small annulus or no growth of the neopulmonary valve was more frequent in patients with a history of pulmonary artery banding. After the ASO, the valve diameter in patients with a ventricular septal defect was 80 +/- 15% of normal (n = 24), and the value was significantly less than in patients with an intact ventricular septum (91 +/- 11%, n = 47). In all patients with an intact ventricular septum who underwent the one-stage ASO, the valve diameters before and after the ASO were within normal limits, and a significant increase in the pulmonary valve annulus was observed. CONCLUSIONS: These data indicate that not only supravalvular pulmonary stenosis but also pulmonary valvular stenosis due to a small annulus can occur in TGA, especially in patients with a history of pulmonary artery banding and in patients with ventricular septal defect.

Humans↗
PubMed1996

Follicular dendritic cells adhere to fibronectin and laminin fibers via their respective receptors.

The expression of adhesion molecules on human tonsillar follicular dendritic cells (FDCs) in the secondary lymphoid follicle (LF) in vivo and in vitro was investigated using cryostat sections and cytospin preparations of FDCs isolated with a magnetic cell sorter, respectively. FDCs were immunochemically positive for Mac-1 (CD11b), sialyl-Lex (CD15s), CD22, integrin beta 1 (CD29), CD40, very late activation antigen (VLA)-alpha 3 (CD49c), VLA-alpha 5 (CD49e), VLA-alpha 6 (CD49f), intercellular adhesion molecule (ICAM)-3 (CD50), ICAM-1 (CD54), B7 (CD80), and vascular cell adhesion molecule (VCAM)-1 (CD106). With respect to ligands on B cells for these adhesion molecules, the CD11b-CD54, CD50-leukocyte function-associated molecule (LFA)-1 (CD11a/18), and CD106-VLA-4 (CD49d/29) interactions in the apical light (ALZ) and basal light (BLZ) zones; the CD15s-L-selectin (CD62L) and CD106-CD49d/29 interactions in the mantle zone; and the CD54-CD11a/18 interaction in the entire LF may participate in FDC-B cell adhesion. Namely, the adhesion molecules participating in FDC-B cell interactions may differ in each of the five zones. Furthermore, the immunochemical evidence that FDCs were fibronectin (VLA-5, CD49e/29) and laminin (VLA-6, CD49l/29) receptor-positive discussed above was confirmed by immunoelectron microscopy and binding assays. Immunoelectron microscopy revealed fibers surrounded by cytoplasmic FDC extensions that were CD29-, CD49e-, and CD49f-positive. In the binding assays, the numbers of FDCs bound to fibronectin- and laminin-coated dishes and LFs of cryostat sections of human tonsils were reduced markedly by pretreatment with monoclonal antibodies against CD29, CD49e, and CD49f. These data indicate clearly that FDCs bind to reticulin and laminin fibers in LFs via their respective receptors.

Antigens, CD↗
PubMed1996

Circadian blood pressure variation related to morbidity and mortality from cerebrovascular and cardiovascular diseases.

The mortality rate of stroke has decreased dramatically over the past 30 years in Japan, but the prevalence of cerebral infarction has increased, mainly because of the higher incidence of nonfatal cerebral infarction in the elderly. Significant advances in the development of antihypertensive drugs over the last 30 years have contributed to the decrease in stroke mortality, but antihypertensive treatment appears to relate to an increase in the prevalence of cerebral infarction in the elderly. We investigated the risks of low BP levels determined by ambulatory BP monitoring and home BP measurements to clarify the previously reported J-shaped relationships between the incidence of ischemic cardiovascular disease and BP levels after treatment. A long-term prospective study of all causes of mortality and cerebrovascular and cardiovascular mortality has been conducted in Ohasama, Japan, since 1987. Cox proportional hazard model after adjusting for age and sex demonstrated that during a 5-year follow-up period involving 893 of the subjects aged 50 years and over in this cohort, those with the lowest quintile of ambulatory BP levels exhibited a significantly high hazard ratio of cardiovascular as well as all causes of mortality. During the same follow-up period in 1,226 subjects aged 50 years and over, those with the lowest and highest quintiles of home BP levels demonstrated a significantly high hazard ratio of cardiovascular as well as all causes of mortality (i.e., J-shaped relationship). The amplitude of the fall in nocturnal BP obtained by ambulatory BP monitoring correlated positively with the severity of silent cerebrovascular lesions in elderly women, but not in elderly men. These results suggest the significantly high risk associated with low BP levels, which can be determined only by ambulatory and home BP measurements, but not by casual BP measurements.

Age Factors↗
PubMed1996

A novel gene iba1 in the major histocompatibility complex class III region encoding an EF hand protein expressed in a monocytic lineage.

We successfully isolated a rat cDNA clone encoding a novel EF hand protein with a molecular weight of about 17 kDa and designated this gene iba1 (ionized calcium binding adapter molecule 1). The genomic copy of the iba1 gene was located within a segment of the major histocompatibility complex class III region between the Bat2 and TNF alpha genes. The iba1 gene was shown to be highly expressed in testis and spleen, but weakly expressed in brain, lung, and kidney. Among brain cells, the iba1 gene was specifically expressed in microglia. A screening of hemopoietic cell lines showed that the Iba1 protein was clearly expressed in monoblastic cell lines but only very weakly expressed in myeloid cell lines. Iba1 protein is therefore suggested to act as an adapter molecule, mediating calcium signals that may function in a monocytic lineage including microglia.

Amino Acid Sequence↗
PubMed1996

Apoptosis occurs in granulosa cells but not cumulus cells in the atretic antral follicles in pig ovaries.

The porcine antral follicles, 3-6 mm in diameter, were dissected from the ovaries of mature pigs, and then granulosa and cumulus cells were isolated from each follicle. In atretic follicles, high activity of neutral Ca2+/Mg2+-dependent endonuclease and DNA ladder formation, estimated by electrophoresis, were noted in granulosa cells but not in cumulus cells. Extremely low activity of the endonuclease and no DNA ladder formation were observed in both types of cells obtained from healthy follicles. Moreover, apoptotic cells were observed histochemically among granulosa cells only. A good correlation (r = 0.987) between the endonuclease activity of granulosa cells and the progesterone/estradiol ratio of follicular fluid in each follicle was found. These results suggest that apoptosis occurs in granulosa cells but not cumulus cells in the atretic antral follicles in pigs.

Animals↗
PubMed1996

Somatic mutations of the APC gene in sporadic hepatoblastomas.

Hepatoblastoma is a rare hepatic malignancy that occurs in children with an average age of 2 or 3 years and is known to be one of the extracolonic manifestations of familial adenomatous polyposis. Only a single hepatoblastoma with a germ-line mutation of the adenomatous polyposis coli (APC) gene has been reported thus far. To elucidate the possible roles of APC gene alterations in sporadic hepatoblastomas, we examined loss of heterozygosity (LOH) at the APC and MCC loci and performed a sequencing analysis of a part of the APC gene, including the mutation cluster region, in 13 hepatoblastomas of non-familial adenomatous polyposis patients. LOH at the APC and/or MCC loci was observed in four of seven (57%) informative cases. Of the 13 cases, somatic mutations were detected in 8 (61.5%), with 9 (69%) cases showing genetic alterations in the APC gene as LOH or somatic mutations. Two cases demonstrated double mutations. Furthermore, the nature of the somatic mutations observed in the present study was unusual because 9 of the 10 mutations were missense, with only 1 case featuring a frame-shift mutation due to an insertion. Previous reports have described almost all (>90%) mutations of the APC gene in colorectal tumors to result in a truncated APC protein due to either frame-shift or nonsense mutations. These findings suggest that a mutation of the APC gene may play an important role in the genesis of sporadic hepatoblastomas, and the mechanisms of APC gene alteration may be different from those reported previously for colorectal tumors.

Base Sequence↗
PubMed1996

Cloning and characterization of a functional promoter of the rat pp120 gene, encoding a substrate of the insulin receptor tyrosine kinase.

Cloning of the 5 -flanking region of the rat pp120 gene has indicated that it is a housekeeping gene: it lacks a functional TATA box and contains several Sp1 binding sites and multiple transcription initiation sites at nucleotides -101, -71, -41, and -27 spread over a GC-rich area. A fragment between nucleotides -21 and -1609 exhibited promoter activity when ligated in a sense orientation into a promoterless luciferase reporter plasmid and transiently transfected into rat H4-II-E hepatoma cells. 5' progressive deletion and block substitution analyses revealed that the three proximal Sp1 boxes (boxes 3, 5, and 6) are required for basal transcription of the pp120 gene. Promoter activity was stimulated 2-3-fold in response to insulin, dexamethasone, insulin plus dexamethasone, and cAMP. Although unaltered by phorbol esters alone, promoter activity was stimulated 4-5-fold in response to phorbol esters plus cAMP. Several motifs resembling response elements for insulin (in the rat phosphoenolpyruvate carboxykinase gene), glucocorticoids, cAMP, and phorbol esters as well as a number of putative binding sites for activating proteins-1 (Jun/Fos) and -2, and liver-specific factors were detected. The role of these sites in tissue-specific expression of pp120 remains to be investigated.

Animals↗
PubMed1996

Roles of cytochrome b5 in the oxidation of testosterone and nifedipine by recombinant cytochrome P450 3A4 and by human liver microsomes.

NADH-dependent testosterone 6 beta-hydroxylation and nifedipine oxidation activities could be reconstituted in systems containing cytochrome b5 (b5), NADH-b5 reductase, and bacterial recombinant cytochrome P450 (P450) 3A4 with a synthetic phospholipid mixture, cholate, MgCl2, and reduced glutathione. Replacement of NADH-b5 reductase with NADPH-P450 reductase produced an eightfold increase in testosterone 6 beta-hydroxylation activity. Further stimulation could be obtained when NADPH was used as an electron donor instead of NADH. Removal of b5 from the NADH- and NADPH-supported systems caused a 90% loss of testosterone 6 beta-hydroxylation activities in the presence of NADPH-P450 reductase but resulted in complete loss of the activities in the absence of NADPH-P450 reductase. These results suggested that about 10% of the activities was due to electron flow from NADPH-P450 reductase to P450 3A4 in the absence of b5. In the presence of testosterone and MgCl2, P450 3A4 was reduced by b5 and NADH-b5 reductase, although the rate of P450 3A4 reduction was much slower than that by NADPH-P450 reductase. Anti-human b5 immunoglobulin G (IgG) (purified using rabbit b5 affinity chromatography) inhibited testosterone 6 beta-hydroxylation activity catalyzed by human liver microsomes more strongly in NADH- than in NADPH-supported reactions. However, anti-rat NADPH-P450 reductase IgG inhibited microsomal activities in both NADH- and NADPH-supported systems to similar extents. Addition of NADH enhanced NADPH-supported testosterone and nifedipine oxidations in human liver microsomes. MgCl2 stimulated rates of reduction of b5 by NADPH-P450 reductase, but not by NADH-b5 reductase, in reconstituted systems. These results suggest that b5 is an essential component in P450 3A4-catalyzed testosterone hydroxylation and nifedipine oxidation in human liver microsomes. Our previous observation that rates of reduction of ferric P450 3A4 by NADPH-P450 reductase are accelerated by complexation with substrates and b5 is supported in this study.

Animals↗
PubMed1996

Background exposure of general population to cadmium and lead in Tainan city, Taiwan.

Venous blood samples, 24-h total food duplicate samples, and rice samples were collected from 52 adult non-smoking women in the city of Tainan, southern Taiwan, in 1994, and analyzed for cadmium (Cd) and lead (Pb) by wet-digestion followed by graphite furnace atomic absorption spectrophotometry. Daily dietary intake was 10 micrograms for Cd and 22 micrograms for Pb as geometric means, of which Cd and Pb in rice accounted for 34% and 1.4% of daily Cd and Pb intakes, respectively. The counterpart values for blood were 1.11 ng/ml and 44.5 ng/ml for Cd and Pb, respectively. International comparison with recently published data suggests that the exposure to Cd in Tainan should be among the lowest in the world.

Adult↗
PubMed1996

Reduced cadmium and lead burden in Japan in the past 10 years.

OBJECTIVE: To investigate the current levels of exposure of the Japanese population to cadmium and lead, in comparison with the levels in 1980s. DESIGN: A nation wide survey was conducted in 1991-1994 (the 1990 study) in 19 study sites in Japan as a follow-up to a study conducted in 1979-1983 (the 1980 study). Blood samples and 24-h total food duplicates were collected from women who did not smoke or drink habitually. METHODS: Blood and food duplicates (after homogenization) were analysed for cadmium (Cd-B and Cd-F, respectively) and lead (Pb-B and Pb-F) by graphite furnace atomic absorption after wet-ashing. RESULTS: Altogether, 467 women volunteered for blood sampling. Of these women, 375 also gave food duplicates. Geometric mean (GM) Cd-B levels in the 1990 study were lower than the corresponding 1980 values in most study sites so that the 1990 grand GM (1.98 ng/ml) for Cd-B was significantly lower than the 1980 GM (3.58 ng/ml). This reduction in Cd-B was related to the reduction in Cd-F (GM for Cd-F was 38.0 micrograms/day in the 1980 study and 30.0 micrograms/day in the 1990 study). Dietary intake was almost exclusively the route of Cd burden among the populations studied. Both Pb-B and Pb-F also showed a remarkable reduction, i.e. from 33.9 ng/ml (1980 GM) to 23.2 ng/ml (1990 GM) in the case of Pb-B, and from 32.2 micrograms/day (1980 GM) to 7.1 micrograms/day (1990 GM) in the case of Pb-F. Pb-B, however, did not correlate with Pb-F either in the 1980 or the 1990 study, because Pb intake via inhalation of air remained significant when compared with dietary intake. CONCLUSION: The Cd burden in Japan has decreased markedly in the past 10 years, although it is still higher than in other countries. The Pb burden has been quite low.

Adult↗
PubMed1996

Efficacy of ursodeoxycholic acid therapy in chronic viral hepatitis C with high serum gamma-glutamyltranspeptidase levels.

We administered ursodeoxycholic acid (UDCA) orally, at a daily dose of 600 mg, for 4 months to 36 patients with chronic viral hepatitis C. Another 36 patients with chronic viral hepatitis C, treated with placebo for 4 months, served as controls. None of the patients were alcoholics and none suffering from autoimmune hepatitis. Of the 36 patients in the UDCA-treated group, 13 had high levels of serum gamma-glutamyltranspeptidase (GGT), i.e., exceeding 150 U/l (normal < 50 U/l). Histological examination of liver biopsy specimens obtained from 10 patients in this group before treatment suggested that damage of the interlobular bile ducts was prominent in patients with higher levels of serum GGT. After 1 month of UDCA treatment, significant decreases in the levels of serum GGT, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were observed (P < 0.05 for GGT and AST), and the decreases continued for the 4-month treatment period. The reduction of GGT levels was the most prominent change in the liver function indices; the percent change in the GGT level was -25.2 +/- 4.4 (mean percent change +/- SE) at 1 month and -38.0 +/- 5.0 at 4 months. A significant correlation was observed between the serum delta GGT level (GGT value before treatment minus value after 3 months of treatment) and the total score for morphological injury of the bile ducts (P < 0.05). These results suggested that UDCA has the potential to reverse hepatocellular damage in patients with chronic viral hepatitis C, in whom high GGT levels may be due, in part, to a damaged interlobular bile duct. UDCA may be useful for the treatment of chronic viral hepatitis C, especially in patients exhibiting a high level of GGT.

Administration, Oral↗
PubMed1996

Diffuse cavernous hemangioma of the rectum: MR imaging with endorectal surface coil and sphincter-saving surgery.

We describe the clinical features, diagnostic procedures, and treatment of two patients with diffuse cavernous hemangioma of the rectum. Sphincter-saving operations were performed in both patients, with satisfactory results. Magnetic resonance imaging (MRI) with an endorectal surface coil, as well as a conventional body coil, was used to determine the extent of the hemangiomas. We recommend sphincter-saving surgery for the treatment of this benign disease that can cause life-threatening hemorrhage. MRI with an endorectal coil achieves higher-resolution images than conventional MRI.

Adult↗
PubMed1996

A congenitally "poor" pulmonary artery is a major reason for exclusion from Fontan operation.

We reviewed the clinical records of 185 patients who were possible candidates for Fontan operation. We did this to clarify whether all patients with suitable anomalies ultimately underwent a Fontan operation. Of the 152 patients with decreased pulmonary blood flow, 38 (26%) did not fulfill the criteria for Fontan operation, and 17 of the 33 patients (52%) with increased pulmonary blood flow (P < 0.01) were excluded as candidates. Of 48 non-candidate survivors, 19 had high pulmonary artery (PA) pressure or resistance and small PA (which we term "poor PA"), 17 had pulmonary hypertension, 6 had a markedly distorted PA, and 6 had severe ventricular dysfunction. A significant proportion of possible candidates with a suitable anomaly ultimately did not undergo a Fontan operation, because of "poor PA", a congenital condition that precluded Fontan operation.

Adolescent↗
PubMed1996

A mathematical model of the pancreatic ductal epithelium.

A mathematical model of the HCO-3-secreting pancreatic ductal epithelium was developed using network thermodynamics. With a minimal set of assumptions, the model accurately reproduced the experimentally measured membrane potentials, voltage divider ratio, transepithelial resistance and short-circuit current of nonstimulated ducts that were microperfused and bathed with a CO2/HCO-3-free, HEPES-buffered solution, and also the intracellular pH of duct cells bathed in a CO2/HCO-3-buffered solution. The model also accurately simulated: (i) the effect of step changes in basolateral K+ concentration, and the effect of K+ channel blockers on basolateral membrane potential; (ii) the intracellular acidification caused by a Na+-free extracellular solution and the effect of amiloride on this acidification; and (iii) the intracellular alkalinization caused by a Cl--free extracellular solution and the effect of DIDS on this alkalinization. In addition, the model predicted that the luminal Cl- conductance plays a key role in controlling both the HCO-3 secretory rate and intracellular pH during HCO-3 secretion. We believe that the model will be helpful in the analysis of experimental data and improve our understanding of HCO-3-transporting mechanisms in pancreatic duct cells.

Animals↗
PubMed1996

Origin of the left coronary artery from the right pulmonary artery.

We report the successful surgical treatment of a 12-year-old boy with a rare type of Bland-White-Garland syndrome with mitral regurgitation, in which an anomalous left coronary artery arose from the middle portion of the right pulmonary artery, employing the direct translocation of the left coronary artery and mitral valvuloplasty.

Child↗