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Y Kawashima

Publications and source records attributed to Y Kawashima.

At least 109 records · Page 6Linked to original sources
PubMed1998

Immunolocalization of prolyl 4-hydroxylase subunits, alpha-smooth muscle actin, and extracellular matrix components in human lens capsules with lens implants.

Lens capsules become fibrotic after the extraction of a cataract. To understand this phenomenon, we evaluated the immunolocalization of prolyl 4-hydroxylase (an enzyme involved in procollagen hydroxylation), and extracellular matrix components and cytoskeletal components in a normal human lens capsule and in others with intraocular lenses. Lens capsules containing intraocular lenses were removed from a patient with proliferative vitreoretinopathy and three with proliferative diabetic retinopathy during vitreous surgery. Two circular sections of the anterior capsules with lens epithelial cells were obtained by anterior capsulotomy during cataract surgery. In addition, a lens capsular bag was obtained immediately after phacoemulsification. The lens capsules were processed for light microscopic immunohistochemical detection of the alpha and beta subunits of prolyl 4-hydroxylase, extracellular matrix components (including collagen types, laminin and cellular fibronectin) or cytoskeletal components (such as cytokeratin, vimentin and alpha-smooth muscle actin). Monolayer lens epithelial cells were seen on the inner surface of the normal anterior capsules. Each intraocular lens was found to be fixed in the capsular bag. Light microscopic immunohistochemistry showed that these proliferating cells expressed vimentin and alpha-smooth muscle actin; in contrast, quiescent lens epithelial cells did not stain for alpha-smooth muscle actin. Marked immunostaining for subunits of prolyl 4-hydroxylase was detected in lens epithelial cells proliferating on the capsules, while no or only faint prolyl 4-hydroxylase immunoreactivity was detected in quiescent lens epithelial cells immediately after phacoemulsification. Collagen types I, III and VI and cellular fibronectin were observed diffusely in accumulated connective tissue on a capsule with an intraocular lens. Type IV collagen immunoreactivity was seen both in the capsules and in the connective tissue accumulation on the capsules. Collagen V and laminin were detected in association with cellular proliferation. Collagen VII and VIII and laminin 5 were not seen. We concluded that during wound healing of the lens capsule after cataract extraction, the lens epithelial cells that proliferate on the inner surface of the capsule transform it into a myofibroblastic phenotype, expressing prolyl 4-hydroxylase and alpha-smooth muscle actin. These proliferating cells are involved in the production of collagen on the lens capsule. This results in a postoperative fibrotic process and contraction of the lens capsule.

Actins↗
PubMed1998

Infrared and Microwave Spectra and Force Field of DBO: The Coriolis Interaction between the nu1 and nu2 + nu3 States.

The nu1 and nu3 bands of D11BO and the nu1 band of D10BO were observed by using an infrared diode laser spectrometer. The DBO molecule was generated by an ac discharge in a mixture of BCl3, D2, O2, and He. As inferred previously, a strong Coriolis interaction was in fact found to take place between the nu1 and nu2 + nu3 states, and an analysis of the observed nu1 spectra, which explicitly took into account this Coriolis interaction, predicted the pure rotational transition frequencies of DBO in the nu1 state. Pure rotational lines were then detected by microwave spectroscopy, confirming the validity of the infrared assignment. In the microwave experiment DBO molecules were generated by a discharge in a mixture of B2D6 and O2. The three fundamental bands and a hot band of D11BO, as well as the nu1 and nu3 bands of D10BO, were subsequently recorded in emission with a Fourier transform infrared spectrometer. DBO molecules were generated by the reaction of D2 with HBO at temperatures above 800 degreesC in a ceramic tube furnace. All of the observed spectra were simultaneously subjected to a least-squares analysis to obtain molecular parameters in the ground, nu1, nu2, nu3, and nu2 + nu3 states. The results thus obtained improved the force field and molecular structure of the HBO/DBO molecules reported in a previous study (Y. Kawashima, Y. Endo, and E. Hirota, 1989, J. Mol. Spectrosc. 133, 116-127). Copyright 1998 Academic Press.

Journal Article↗
PubMed1998

Fibrin glue sandwich prevents pancreatic fistula following distal pancreatectomy.

Pancreatic fistula is a major form of morbidity following pancreatic resection. We conducted a nonrandomized clinical trial comparing the sealing and sandwich techniques of spraying fibrin glue to prevent pancreatic fistula following distal pancreatectomy. The pancreas was transected with a scalpel to identify and suture the main pancreatic duct and its small branches. In the sealing group, fibrin glue was sprayed over the closed pancreatic stump and sutures. Alternatively, in the sandwich group fibrin glue was sprayed so as to cover and join the cut surface of the pancreatic remnant, which was then held closed with sutures. Altogether 111 patients were included in the study (90 with gastric cancer, 10 with esophageal cancer, and 11 with pancreatic cancer). Patients were nonrandomly assigned to the sandwich or the sealing group. Morbidity was 21.8% for the patients in the sandwich group versus 33.9% in the sealing group. Pancreatic fistulas occurred in 9.0% of the sandwich group versus 26.8% of the sealing group. The incidence of fistula was thus significantly lower in the sandwich group. The incidence of fistula was also significantly lower in the sandwich group for gastric malignancy patients undergoing extended radical lymphadenectomy down to the paraaortic lymph nodes combined with left adrenalectomy. Of the patients with gastric malignancy, pancreatic fistulas occurred in 9.3% of the sandwich group versus 25.5% of the sealing group. The fibrin glue sandwich technique is simple and reliable and should be valuable for complementing other prophylactic methods of preventing pancreatic fistula.

Adult↗
PubMed1998

Subretinal administration of tissue-type plasminogen activator to speed the drainage of subretinal hemorrhage.

BACKGROUND: Bleeding into the subretinal space in the vicinity of the macula is associated with age-related macular degeneration or retinal arterial macroaneurysm. The prognosis for restoration of vision is poor in the presence of blood clots. METHODS: Using a simple device composed of three disposable syringes we injected tissue-type plasminogen activator (tPA) into the subretinal space during conventional vitrectomy in six patients to assist the draining of subretinal clots. RESULTS: Four of six patients recovered their visual acuity postoperatively, while visual acuity in the other patients was stabilized. CONCLUSION: Early drainage of subretinal hemorrhage assisted by the introduction of tPA into the subretinal space led to uncomplicated surgery and favorable postoperative results.

Aged↗
PubMed1998

Immunohistochemical evaluation of cellular deposits on posterior chamber intraocular lenses.

PURPOSE: We used immunohistochemistry to characterize cellular and proteinaceous deposits on the surfaces of explanted posterior chamber intraocular lenses (PC-IOLs). METHODS: A total of 30 PC-IOLs were immunostained for the alpha- or beta-subunits of prolyl 4-hydroxylase, which is involved in collagen biosynthesis; cellular fibronectin; alpha B crystalline; and CD68, a macrophage marker, to characterize the cellular deposits that adhere to the IOL surfaces and to evaluate the distribution of cells involved in the deposition of extracellular matrix on IOLs. RESULTS: Cellular or proteinaceous deposits were observed on all 30 PC-IOLs. Cells that showed positive staining for alpha B crystallin were classified as lens epithelial cells; CD68-positive cells were considered to be of macrophagic origin. Positivity for cellular fibronectin, including the macrophages and related cells, appeared to be responsible for the accumulation of fibronectin on the surfaces of PC-IOLs. Prolyl 4-hydroxylase-positive cells were involved in the deposition of collagen on PC-IOLs. CONCLUSION: Immunohistochemical study revealed that macrophages, foreign-body giant cells, and lens epithelial cells adhered to explanted PC-IOLs. Such adherent cells are responsible for the deposition of extracellular matrix on the surfaces of PC-IOLs and may regulate the assembly of the extracellular matrix, influencing the biocompatibility of PC-IOLs.

Adult↗
PubMed1998

Atrial natriuretic peptide secretion and body fluid balance after bilateral atrial appendectomy by the maze procedure.

OBJECTIVES: One of the earliest recognized postoperative complications of the maze procedure was the fluid retention in the immediate postoperative period. Routine postoperative administration of diuretics markedly reduces the frequency and severity of the fluid retention. However, the cause of the abnormal fluid balance is still uncertain. METHODS: We evaluated 24 patients: 15 patients underwent the maze procedure (maze group) and 9 patients did not (nonmaze group). Blood samples were obtained before and in the time course after operation for atrial natriuretic peptide measurement. To evaluate the influence of atrial natriuretic peptide on the body fluid balance, we also measured the amount of body fluid balance and the total doses of furosemide and dopamine administered after operation. To examine the effect of the maze procedure on atrial natriuretic peptide secretion in chronic phase, we measured plasma atrial natriuretic peptide levels during dynamic exercise in 21 patients who had undergone cardiac operations 2 years before. RESULTS: Plasma atrial natriuretic peptide levels in the nonmaze group significantly increased after operation. In contrast, plasma atrial natriuretic peptide levels in the maze group did not increase, and these levels were significantly lower than in the nonmaze group. Although significantly greater doses of furosemide and dopamine were administered to the maze group than to the nonmaze group, the body fluid balance in the maze group was comparable with that in the nonmaze group in the early postoperative period. The response of atrial natriuretic peptide secretion by exercise was significantly attenuated in the maze group (n = 12) compared with the nonmaze group (n = 9) even 2 years after surgery, although there were no significant differences in heart rate or blood pressure during exercise between two groups. CONCLUSIONS: These results suggest that the maze procedure attenuates atrial natriuretic peptide secretion in the early postoperative period and persists in chronic phase. This attenuated atrial natriuretic peptide secretion may reduce the ability of the kidneys to handle fluid load early after surgery.

Atrial Fibrillation↗
PubMed1998

The outcome and indications of the Cox maze III procedure for chronic atrial fibrillation with mitral valve disease.

OBJECTIVE: The efficacy of the Cox maze III procedure for chronic atrial fibrillation associated with mitral valve disease is unclear, and so was evaluated in this study. METHODS: In 30 patients, we applied the maze III procedure (cut and suture), except for one modification in the case of a left posterior sinus node artery. After dividing the patients into sinus rhythm and atrial fibrillation groups more than 6 months after the operation, we compared various parameters. RESULTS: Sinus rhythm was restored in 27 patients (90%). One patient had atrioventricular reentrant tachycardia and needed a pacemaker for sick sinus syndrome (3.3%). The f-wave voltage in lead V1, the preoperative cardiothoracic ratio, the preoperative left atrial systolic dimension, and the duration of atrial fibrillation were 0.23 +/- 0.10 mV, 60.4% +/- 5.2%, 57.4 +/- 8.2 mm, respectively, and 5.1 +/- 4.6 years in the group with sinus rhythm, and were 0.06 +/- 0.05 mV, 77.7% +/- 10.3%, 95.3 +/- 24.0 mm, respectively, and 11.8 +/- 5.5 years in the group with atrial fibrillation. These parameters were all significantly different between the groups. Regarding atrial function, a transmitral flow A wave was detected in 66.7% and a transtricuspid flow A wave in 100%. Only the duration of atrial fibrillation had a significant influence on the restoration of left atrial function. CONCLUSION: The maze III procedure was effective for atrial fibrillation associated with mitral valve disease. This procedure should be applied to patients with a cardiothoracic ratio less than 70% and a left atrial systolic dimension less than 80 mm.

Adult↗
PubMed1998

Mortality and cerebral outcome in patients who underwent aortic arch operations using deep hypothermic circulatory arrest with retrograde cerebral perfusion: no relation of early death, stroke, and delirium to the duration of circulatory arrest.

OBJECTIVE: Our goal was to investigate factors for mortality and cerebral outcome in patients with aneurysm of the aortic arch. METHODS: From 1993 to 1996, 148 patients with aortic arch aneurysm underwent operations involving deep hypothermic circulatory arrest with retrograde cerebral perfusion. Age was 63.9 +/- 11.6 years (mean +/- standard deviation) and 52 patients were older than 70 years. Twenty-eight had acute aortic dissection. Twelve had ruptured aneurysms. Fourteen had redo operations. Seventy had aortic dissection. The aneurysms were caused by atherosclerosis in 123 patients and by other causes in 25. Median sternotomy was used in 92 and left thoracotomy in 56. Twenty-eight patients underwent replacement of the ascending aorta to the proximal arch, 62 had total arch replacement, 38 had distal arch replacement, 12 had simultaneous replacement of the distal arch and the descending aorta or thoracoabdominal aorta, and 8 had patch repair. RESULTS: Fifteen (10.1%) early deaths occurred. New stroke occurred in six (4.0%) patients and transient delirium in 37 (25.0%). The duration of deep hypothermic circulatory arrest plus retrograde cerebral perfusion was 49 +/- 17 minutes, and it was more than 60 minutes in 36 patients. Patients awoke 7.5 +/- 8.2 hours after the operation. Logistic regression analysis demonstrated that risk factors for mortality were ruptured aneurysm, chronic obstructive pulmonary disease, arterial cannulation in the ascending aorta, and stroke. Risks for stroke were ruptured aneurysm and replacement of the distal arch. Risks for delirium were age older than 70 years and atherosclerotic aneurysm. Duration of circulatory arrest plus cerebral perfusion did not correlate with length of time before the patient regained consciousness. No difference was found in mortality, stroke, and delirium between patients with and those without more than 60 minutes of circulatory arrest and cerebral perfusion. CONCLUSION: Prolonged (> 60 minutes) deep hypothermic circulatory arrest with retrograde cerebral perfusion was not a risk factor for mortality and stroke in patients who underwent surgery for aneurysms of the aortic arch. However, the prevalence of transient delirium necessitates further investigations.

Aged↗
PubMed1998

Enantioselective immunoaffinity extraction for simultaneous determination of optically active bufuralol and its metabolites in human plasma by HPLC.

A combined method of immunoaffinity extraction with high-performance liquid chromatography has been developed for the enantioselective determination of bufuralol and its metabolites in human plasma. The antibodies having high affinity toward the asymmetric center at the C-1 position of bufuralol and its 1'-oxidized metabolites and low affinity to their antipodes were elicited by immunization of rabbits with immunogens, (1R)- and (1S)-1'-oxobufuralol O-carboxymethyloxime-bovine serum albumin conjugates, respectively. 0.5 ml Of the immunoaffinity adsorbent (7.6 mg.ml-1 for anti-(1S)-antibody and 28.8 mg.ml-1 for anti-(1R)-antibody) prepared by immobilization of an antibody was capable of retaining up to 1 microgram of (R)- and (S)-bufuralol and up to 500 ng of other metabolites. The adsorbates were recovered quantitatively by elution with methanol-10 mM ammonium acetate buffer (pH 5) (95:5, v/v) without any interfering peaks on the high-performance liquid chromatogram. The proposed method was evaluated to be useful for the simultaneous determination of optically active bufuralol and its metabolite in plasma with acceptable recovery and precision.

Adrenergic beta-Antagonists↗
PubMed1998

Immunolocalization of prolyl 4-hydroxylase in rabbit lens epithelial cells.

PURPOSE: To localize the enzyme prolyl 4-hydroxylase in the crystalline lens and determine the ability of lens epithelial cells (LECs) to synthesize procollagen. SETTING: Research laboratory, Department of Ophthalmology, Wakayama Medical College, Wakayama, Japan. METHODS: Phacoemulsification and aspiration of the crystalline lens followed by implantation of a poly(methyl methacrylate) intraocular lens (IOL) were performed in 1 eye each of 6 albino rabbits; the eye was enucleated 1 or 2 months later. Crystalline lenses were also extracted from the eyes of 2 rabbits. These samples were processed for immunohistochemical detection of the alpha- and beta-subunits of prolyl 4-hydroxylase. RESULTS: A monolayer of LECs was detected on the inner surface of the intact anterior capsule. Antibodies directed against both subunits of prolyl 4-hydroxylase reacted strongly to LECs proliferating on capsules with IOLs, whereas little or no reaction was observed in quiescent LECs or in the regenerated lenticular structure. CONCLUSION: The presence of prolyl 4-hydroxylase in LECs proliferating on the inner surface of the lens capsule suggests that these cells are involved in the production of procollagen and fibrosis during capsular injury and repair. Suppression of prolyl 4-hydroxylase activity may prevent the capsule opacification that results from cataract removal and IOL implantation.

Animals↗
PubMed1998

Immunolocalization of hyaluronan and CD44 in quiescent and proliferating human lens epithelial cells.

PURPOSE: To investigate the role of hyaluronan and its receptor CD44 in capsular repair, their localization in opacified human posterior capsules and in lens epithelial cells (LECs) was assayed. SETTING: Research laboratory, Department of Ophthalmology, Wakayama Medical College, Japan. METHODS: In 8 patients, circular sections of the anterior capsules obtained during cataract surgery, the extracted crystalline lens, and the opacified lens capsules resulting from intraocular lens implantation were examined immunohistochemically to detect hyaluronan or CD44. RESULTS: Both hyaluronan and CD44 were found in the extracellular matrix that accumulated on the inner surface of the capsular bags. In contrast, LECs exhibited immunoreactivity to CD44 but not to hyaluronan. CONCLUSIONS: The cell surface antigen CD44 was expressed ubiquitously by LECs. Expression of its ligand hyaluronan by proliferating LECs suggests that this glycosaminoglycan may be important in the development of posterior capsule opacification.

Adult↗