Biomedical subjects

Y Ohara

Publications and source records attributed to Y Ohara.

At least 55 records · Page 3Linked to original sources

PubMed1996

A case of central pontine myelinolysis after surgical removal of a pituitary tumor.

CASE REPORT: We have experienced a case in which surgical removal of a pituitary tumor from a male patient was followed by the occurrence of hyponatremia, which in turn was later associated with central pontine myelinolysis (CPM). A 4 X 3 X 3 cm pituitary tumor with hypothalamic extension was removed via a transsphenoidal approach. The post-operative course was uneventful until severe hyponatremia developed. To avoid drastic correction of electrolyte levels, reestablishment of normal serum levels was spread over 1 week. Following this, however, various neurologic symptoms such as pseudobulbar palsy, quadriplegia, extrapyramidal symptoms, and mental symptoms appeared. The case was diagnosed as CPM and extrapontine myelinolysis (EPM) on the basis of the clinical course and symptoms, and high-dosage steroid therapy was commenced. RESULTS: There was consequent gradual improvement in symptoms. One month later, MRI revealed typical demyelination lesions in the central pons and striatum. Abnormal electrolyte conditions easily occur in pituitary tumors associated with hypothalamic extension in an altered hormone environment. It is known that CPM and EPM result from drastic correction of hyponatremia. CONCLUSIONS: The frequent measurement of electrolytes and cautious correction of sodium imbalance are important for the prevention of CPM and EPM in the postoperative management of patients who undergo surgery for a pituitary tumor and whose high-dosage steroid therapy are effective.

Adenoma, Chromophobe↗

PubMed1996

Regulation of expression of the endothelial cell nitric oxide synthase.

1. Recent studies have provided insight into how the expression of endothelial cell nitric oxide synthase (ecNOS) is regulated. 2. The promoter of ecNOS has several features that are compatible with a constitutively expressed, so-called 'house keeping' gene. These include absence of a TATA box and the presence of Sp1 binding sites located near the transcription start site. The promoter also contains a number of putative binding domains which suggests that it may be regulated by a variety of transcription factor mediated signals. 3. Studies of cultured endothelial cells suggest that ecNOS expression is modulated by shear stress, transforming growth factor beta, inhibition of protein kinase C and the state of proliferation. These experiments indicate that although the ecNOS is a 'constitutively expressed' gene, its content in the endothelium is subject to modest degrees of regulation that may have important physiological and pathophysiological implications.

Animals↗

PubMed1996

Pump power loss and heat generation in a pivot bearing-supported Gyro centrifugal pump (C1E3).

Pump power loss is defined as input power that is not used for the output work of the pump. Less pump power loss means a higher pump efficiency. A common opinion is that the pump power loss is closely related to heat generation of the pump, which may affect not only the endurance of pump materials, but also blood damage in a blood pump. In this study, the relationship between pump power loss and heat generation in centrifugal blood pumps was investigated using the pivot-bearing supported Gyro C1E3 pump (C1E3) and Bio-Medicus pump (BP-80) under four different total pressure heat/flow conditions. A single special torque measuring driver motor was used for operating both the C1E3 and BP-80 in the four conditions. The pump power loss was calculated from the measured motor torque and hydraulic power. The changes in blood temperature were measured while the pump was operated at room temperature (25 degrees C) to obtain the following findings: First, the C1E3 caused less pump power loss and less temperature increase in blood than the BP-80 in all clinical simulated conditions that were tested; and second, the pump power loss and heat generation had a linear correlation with temperature rise from 22 to 25 degrees C in both the C1E3 and BP-80. During this period, approximately 30% of the pump power loss was transformed to heat, independent of the centrifugal blood pump type, provided that heat conduction through the pump housing and tubing was negligible during this particular period.

Animals↗

PubMed1996

Hemolytic characteristics of a pivot bearing supported Gyro centrifugal pump (C1E3) simulating various clinical applications.

Centrifugal blood pumps are playing a key role in circulatory mechanical assist systems including cardiopulmonary bypass (CPB), right and left ventricular assist devices (RVAD and LVAD), percutaneous cardiopulmonary support (PCPS), and extracorporeal membrane oxygenation (ECMO). Each of these circulatory assist systems requires specific flow and pressure conditions. In vitro hemolysis tests were performed using five compact mock loops with flow and pressure set equivalent to clinical conditions. These studies determined the hemolytic characteristics and clinical applicability of the pivot bearing-supported Gyro centrifugal pump with an eccentric port (C1E3) compared with the Bio-Medicus pump (BP-80). Normalized index of hemolysis (NIH) values of the C1E3 were less than those of the BP-80 under all conditions; in particular, they were significantly less in the CPB, LVAD, and RVAD conditions. In addition, linear correlation was observed between NIH values, rotational pump speed (RPM), total pressure head (delta P), and flow rate (Q) with both the C1E3 and BP-80: NIH = a(RPM/Q) + b, NIH = c(delta P/Q) + d. However, the slopes (a and c) of these equations were smaller with the C1E3 than those with the BP-80, which suggests that the C1E3 has decreased hemolytic characteristics when increasing the RPM and delta P. In other words, the increase of RPM and delta P results in less shear stress with the C1E3 than with the BP-80. One cause of these decreased hemolytic characteristics of the C1E3 is thought to be less pump power loss against an increase of RPM and delta P than with the BP-80. Furthermore, the average exposure time is shorter with the C1E3 than with the BP-80 because the priming volume of the C1E3 (30 ml) is smaller than that of the BP-80 (80 ml). From the point of both shear stress and exposure time, the C1E3 has less hemolytic features than the BP-80.

Animals↗

PubMed1996

Epidemiological analysis of tularemia in Japan (yato-byo).

A total of 1372 cases of tularemia observed in Japan since 1924 were analysed. More than 90% of the cases were reported in the north-eastern part of the main island of Japan. After World War II, more than 40 cases were reported yearly for 20 years. Since 1966, however, there have been less than 10 cases per year. Ninety-three % of the cases were caused by contact with infected wild rabbits. The pattern of monthly distribution showed a peak in December and also a lower peak in May. The number of patients older than 40 years of age and the proportion of cases in females have gradually increased. In the earlier survey periods almost 70% of the cases were engaged in agriculture but at present this rate is less than 50%. The changes in the occurrence of tularemia in Japan is thought to be related to the change of life style caused by the rapid growth of the Japanese economy after World War II.

Adolescent↗

PubMed1996

Modulation of endothelial cell nitric oxide synthase expression.

The 5' promoter region of endothelial cell nitric oxide synthase (ecNOS) gene has several features which are compatible with a constitutively expressed, so called "housekeeping" gene. These include absence of a TATA box and the presence of Sp1 binding sites situated near the transcription start site. The promoter also contains sequences which suggest that it may be regulated by a variety of transcription factor-mediated signals. Studies of cultured endothelial cells show that ecNOS expression is modulated by shear stress, transforming growth factor beta, inhibition of protein kinase C, and the state of proliferation. These experiments indicate that although the ecNOS is a "constitutively expressed" gene, its content in the endothelium is subject to modest degrees of regulation which may have important physiological and pathophysiological implications.

Animals↗

PubMed1996

[Cardiac output in patients in their 90's].

Cardiac output was measured by the thermodilution method in nine patients aged 90 to 97 years. The patients were capable of walking in their daily lives before the injury or admission to the hospital, after which they were scheduled for operations. The causes for operations were localized and did not markedly influence general conditions of the patients. After heart rate, arterial blood pressure and mental condition of the patients had been stabilized, their cardiac outputs were determined before the induction of anesthesia. The results are as follows: Cardiac output: 3.58 +/- 0.90 l.min-1, cardiac index: 2.72 +/- 0.57 l.min-1.m-2. Previously published reports in Japan and the results of this study about the relationship between cardiac index and age suggest that as a whole there is a tendency for the cardiac index to decrease with aging.

Aged↗

PubMed1996

Development of a pivot bearing supported sealless centrifugal pump for ventricular assist.

Since 1991, in our laboratory, a pivot bearing-supported, sealless, centrifugal pump has been developed as an implantable ventricular assist device (VAD). For this application, the configuration of the total pump system should be relatively small. The C1E3 pump developed for this purpose was anatomically compatible with the small-sized patient population. To evaluate antithrombogenicity, ex vivo 2-week screening studies were conducted instead of studies involving an intracorporeally implanted VADs using calves. Five paracorporeal LVAD studies were performed using calves for longer than 2 weeks. The activated clotting time (ACT) was maintained at approximately 250 s using heparin. All of the devices demonstrated trouble-free performances over 2 weeks. Among these 5 studies, 3 implantations were subjected to 1-month system validation studies. There were no device-induced thrombus formations inside the pump housing, and plasma-free hemoglobin levels in calves were within the normal range throughout the experiment (35, 34, and 31 days). There were no incidents of system malfunction. Subsequently, the mass production model was fabricated and yielded a normalized index of hemolysis of 0.0014, which was comparable to that of clinically available pumps. The wear life of the impeller bearings was estimated at longer than 8 years. In the next series of in vivo studies, an implantable model of the C1E3 pump will be fabricated for longer term implantation. The pump-actuator will be implanted inside the body; thus the design calls for substituting plastic for metallic parts.

Blood Cell Count↗

PubMed1995

Dietary correction of hypercholesterolemia in the rabbit normalizes endothelial superoxide anion production.

BACKGROUND: We have shown that hypercholesterolemia increases vascular superoxide anion (O2-) production, which could be responsible for augmented inactivation of endothelium-derived vascular relaxing factor. We sought to determine whether this increased vascular O2- production is due to infiltration of macrophages into the intima and whether dietary treatment of hypercholesterolemia normalizes O2- production. METHODS AND RESULTS: A specific and sensitive assay for O2- based on chemiluminescence of lucigenin was used; the amount of O2- produced by vascular ring segments was quantified based on known quantities of O2- produced by xanthine-xanthine oxidase standards. O2- production of aortic segments from normal rabbits (n = 9), cholesterol-fed rabbits (1% cholesterol diet for 1 month, n = 7), and rabbits fed a 1% cholesterol diet for 1 month followed by a normal diet for 1 month (regression rabbits, n = 5) was measured. At the end of these diets, serum cholesterol levels were 1.5 +/- 0.2, 26.0 +/- 3.9, and 1.8 +/- 0.5 mmol/L (58 +/- 6, 1000 +/- 150, and 71 +/- 19 mg/dL) in the normal, cholesterol-fed, and regression animals, respectively. Vessels from normal rabbits with endothelium produced 0.32 +/- 0.06 nmol O2-/mg dry wt per minute, whereas those without endothelium produced approximately twice as much O2- (0.66 +/- 0.12 nmol O2- mg dry wt per minute. Vessels with endothelium from cholesterol-fed rabbits produced 4.5-fold more O2- than vessels from normal animals. This increased production of O2- was normalized by endothelial removal. This increased production of O2- was not due to infiltration of macrophages in the intima, because there was no correlation between vascular O2- production and macrophage infiltration assessed by immunohistochemistry with use of a specific antibody against rabbit macrophage. O2- production by vessels from regression rabbits was similar to that observed in normal animals, and as in the normal rabbits, endothelial removal increased O2- production. Aortic rings from these animals also were studied in organ chambers. Dietary lowering of cholesterol dramatically improved vasodilator responses to acetylcholine and A23187 (P < .05 versus cholesterol-fed rabbits). CONCLUSIONS: Dietary lowering of cholesterol not only improves endothelium-dependent vascular relaxation but also normalizes endothelial O2- production. Decreases of O2- production by dietary lowering of cholesterol not only may improve vasomotor control but also may improve other aspects of vascular integrity in atherosclerosis.

Animals↗

PubMed1995

Physiologic consequences of increased vascular oxidant stresses in hypercholesterolemia and atherosclerosis: implications for impaired vasomotion.

During the past 8 years, it has become apparent that endothelium-dependent vascular relaxation is abnormal in a variety of disease states, including hypercholesterolemia, atherosclerosis, diabetes, hypertension, and following heart transplantation. Our laboratory and several others have examined dysfunctional regulation of vasomotor tone in hypercholesterolemia and atherosclerosis. These studies have led to the concepts that altered regulation of vasomotion by the endothelium (1) is an early development in atherosclerosis, (2) involves both large vessels (with overt atherosclerosis) and the microcirculation (in which atherosclerosis does not develop), and (3) can be reversed by lipid-lowering strategies. The mechanisms for the abnormalities underlying this form of endothelial dysfunction are likely multifactorial, but a major underlying factor appears to be increased oxidant degradation of endothelium-derived nitric oxide. In this review we examine the evidence supporting this conclusion and consider the implications of these findings.

Animals↗

PubMed1995

The endothelial cell nitric oxide synthase: is it really constitutively expressed?

During the past two years, the enzyme responsible for production of endothelium-derived nitric oxide, the endothelial cell NO synthase (ecNOS) has been cloned and the gene encoding this enzyme isolated, cloned and its structure characterized. This research has provided direction for a variety of studies of regulation of the ecNOS. Several features of the ecNOS are compatible with a constitutively expressed, poorly regulated gene, including absence of a TATA box and numerous SP-1 sites. The promoter also contains a number of putative binding domains which suggest that it may be regulated by a variety of transcription factor mediated signals. In this review we will discuss evidence to support the concept that the ecNOS is a constitutively expressed gene subject to a modest degree of regulation by important physiological influences.

Amino Acid Oxidoreductases↗

PubMed1995

Clinical evaluation of the oscillometric blood pressure monitor in adults and children based on the 1992 AAMI SP-10 standards.

OBJECTIVE AND METHODS: A noninvasive blood pressure monitor (model BP8800MS, Colin Medical Instruments Corp., San Antonio, TX) that uses the oscillometric principle was evaluated against the manual auscultatory method in 85 adults and 85 children following the requirements of the 1992 AAMI SP-10 standard. This was the first evaluation study of the electronic sphygmomanometers according to the new AAMI standards. RESULTS: In adult subjects, the mean difference and standard deviation of the differences between the oscillometric and auscultatory methods were 2.81 +/- 5.35 mm Hg (mean +/- SD) for systolic and 0.04 +/- 4.90 mm Hg for diastolic; in children, they were 3.18 +/- 5.96 mm Hg for systolic and -0.82 +/- 5.24 mm Hg for diastolic. Excellent correlation between the oscillometric and auscultatory methods, particularly the diastolic pressure, is due to usage of the Phase V Korotkoff's sounds for auscultatory detection of the diastolic pressure, increased accuracy of the two observers' measurements, and proper selection of cuff sizes depending on the mid-arm circumference. Five different-sized cuffs were used in this study. The cuff-width-to-midarm circumference ratio was adjusted to be 0.4 or larger to minimize the measurement error associated with mismatch of cuff-size/arm-size relationship. The distribution of errors associated with each cuff was nearly the same. CONCLUSIONS: The 1992 AAMI SP-10 standards offer a thorough evaluation of the oscillometric sphygmomanometer by enforcing more stringent criteria on (1) agreement between two observers, (2) wide spectrum of blood pressure from hypertensive (above 180 mm Hg) to hypotensive, and (3) data analysis. The oscillometric blood pressure monitor evaluated in this study meets the specifications of the new AAMI SP-10 standards and can offer an accurate, automatic, and noninvasive measure of both systolic and diastolic blood pressure in adults and children. It can safely replace the manual or automatic auscultatory system in various clinical settings.

Adolescent↗

PubMed1995

Mechanisms of coronary hyperconstriction in response to serotonin induced by X-irradiation in miniature pigs: increased constrictive response of medial smooth muscle.

Experimental and clinical studies suggest that X-irradiation to the coronary artery may enhance vasoconstrictive response. This study aimed to clarify the effect of X-irradiation on the vasomotor response of porcine coronary artery. X-ray (15 Gy) was selectively irradiated to the left anterior descending coronary artery (LAD) in 14 Göttingen miniature pigs. The coronary vasomotor responses to serotonin at the irradiated site (LAD) and the control site (the left circumflex artery; LCX) were assessed by quantitative arteriography before and 1 h and 1, 2, and 4 weeks after X-irradiation. At 2 weeks, endothelium-dependent vasodilation in response to substance P was also evaluated arteriographically in vivo. At 2 weeks, isometric tension studies were performed to evaluate the constrictive responses of medial muscle strips and endothelium-dependent relaxation. Coronary vasoconstriction in response to serotonin was enhanced 1 week after, and further augmentation was noted 2 and 4 weeks after X-irradiation. Endothelium-dependent vasodilation in response to substance P in vivo was preserved 2 weeks after X-irradiation. Coronary arteriography showed no organic stenosis at the irradiated site. In vitro studies demonstrated that medial muscle strips of the irradiated site showed hypercontraction in response to serotonin and that endothelium-dependent relaxation in response to serotonin and substance P was preserved at the irradiated site. A histological study revealed no appreciable changes of the endothelial cells or intimal thickening.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1995

Inhibitory effects of aspirin on coronary hyperreactivity to autacoids after arterial balloon injury in miniature pigs.

We examined the effects of aspirin on coronary hyperreactivity to autacoids after arterial balloon injury in miniature pigs. Coronary vasoconstriction induced by histamine and serotonin were examined angiographically before, 1 h, 1 week, and 1 month after balloon injury in 29 hypercholesterolemic miniature pigs. The animals were divided into three groups: group A, no treatment (n = 16); group B, pretreated with aspirin 50 mg/day for 2 days before injury (n = 7); and group C, treated with aspirin 50 mg/day for 2 days before and 5 days after injury (7 days in all) (n = 6). In group A, coronary vasoconstriction induced by autacoids was significantly greater at the injured than at the noninjured site at all times examined (p < 0.01). Hyperconstriction induced by the autacoids 1 h after injury were significantly less in groups B and C than in group A (p < 0.01). Hyperconstriction induced by autacoids 1 week after injury were significantly less in group B than in group A (p < 0.01) and were significantly less in group C than in group A (p < 0.01) or group B (p < 0.05). Treatment with aspirin for 2 or 7 days had no effect on the constrictive responses at the injured site 1 month after injury or on those at the noninjured site at all times examined. These results suggest that platelet-vessel wall interaction may play an important role in coronary hyperconstrictive responses to autacoids 1 h and 1 week after injury.

Angiography↗

PubMed1995

Correlation of the polysaccharide antigens of Francisella tularensis with virulence in experimental mice.

Francisella tularensis gives rise to two distinct colony types, acriflavine agglutination test-positive (acf+) and -negative (acf-) colonies. The acf+ variants were exclusively low virulent in mice, while the acf- variants were shown to be either high or low virulent. Three fractions, phosphate-buffered saline-extractable without heating, with heating at 60 C, and with heating at 100 C, were obtained from cultures of both the acf+ and acf- variants on agar media, and the polysaccharide antigens in those fractions were quantitated. All of the highly virulent acf- variants possessed a large amount of the polysaccharide antigen in the fraction extractable with heating at 60 C. This antigen was not, however, detected in any of the acf+ variants and one low-virulent acf- variant. It was also detected in a very low amount in some other acf- variants with low virulence. The amount of this polysaccharide antigen was therefore shown to be correlated with bacterial virulence in mice.

Acriflavine↗

PubMed1995

In vitro analysis of the floating mode phenomenon in the Free Impeller Gyro Pump.

The Free Impeller Gyro Pump was designed based on a new concept of free impeller, in which the rotational shaft and the mechanical bearings were completely eliminated from the impeller. Due to this characteristic design, a phenomenon occurred in which the impeller lifted off the bottom of the pump housing in a certain range of pumping conditions during the initial in vitro studies (floating mode). We studied this floating mode in detail using a Hall effect position sensor to monitor the impeller position. A Hall sensor signal recorded on the strip chart, which represents the distance between the impeller top and the pump ceiling, proved the existence of the floating mode. By analyzing the data in detail, it was also verified that the floating mode was composed of three subdivided phases: latent, transitional, and dominant. Furthermore, stability of the impeller rotation in the floating mode against the change of pump orientation was also exhibited in this study. These results suggests that the Free Impeller Gyro Pump should possess high antithrombogenicity, atraumatic features, no bearing wear, and stable performance when operated within the range of the floating mode.

Biomechanical Phenomena↗

PubMed1995

Initial clinical experience with the Baylor-Nikkiso centrifugal pump.

Recently, a newly developed centrifugal pump, the Baylor-Nikkiso pump, was approved for clinical use in the United States. This pump is the most compact centrifugal pump with a priming volume of only 25 ml. Although it is small, this pump can provide a flow of 4 L/min against a total pressure head of 300 mm Hg at 3,000 rpm. In vitro and in vivo validation of the Baylor-Nikkiso pump has proved that this pump could effectively reduce blood trauma even under high total head pressure. In addition, 48-h durability tests with biventricular bypass using calves verified the reliability of shaft sealing and antithrombogenicity. Clinical trials of the Baylor-Nikkiso pumps have been initiated in our department. This pump provides flows of 60-70 ml/kg/min with stable hemodynamic conditions. No leakage of thrombus formation was observed. The results of the initial clinical experience of the Baylor-Nikkiso pump suggest that it is suitable for cardiopulmonary bypass surgery.

Animals↗

PubMed1995

Regulation of endothelial cell nitric oxide synthase mRNA expression by shear stress.

Shear stress enhances expression of Ca(2+)-calmodulin-sensitive endothelial cell nitric oxide synthase (ecNOS) mRNA and protein in bovine aortic endothelial cells (BAEC). The present studies were performed to investigate mechanisms responsible for regulation of ecNOS mRNA expression by shear stress and to determine if this induction of ecNOS mRNA is accompanied by an enhanced nitric oxide (NO) production. Shear stresses of 15 dyn/cm2 for 3-24 h resulted in a two- to threefold increase of ecNOS mRNA content quantified by Northern analysis in BAEC. Shear stresses (1.2-15 dyn/cm2) for 3 h resulted in an induction of ecNOS mRNA in a dose-dependent manner. In human aortic endothelial cells, shear stresses of 15 dyn/cm2 for 3 h also resulted in ecNOS mRNA induction. In BAEC, this induction in ecNOS mRNA was prevented by coincubation with actinomycin D (10 micrograms/ml). The K+ channel antagonist tetraethylammonium chloride (3 mM) prevented increase in ecNOS mRNA in response to shear stress. The ecNOS promotor contains putative binding domains for AP-1 complexes, potentially responsive to activation of protein kinase C (PKC). However, selective PKC inhibitor calphostin C (100 nM) did not inhibit ecNOS induction by shear stress. Finally, production of nitrogen oxides under both basal conditions and in response to the calcium ionophore A-23187 (1 microM) by BAEC exposed to shear stress was increased approximately twofold compared with cells not exposed to shear stress. These data suggest that ecNOS mRNA expression is regulated by K+ channel opening, but not by activation of PKC, and that shear not only enhances ecNOS mRNA expression but increases capacity of endothelial cells to release NO.

Animals↗