[Pathophysiology of atheromatous cerebral infarction--hemodynamic ischemia and artery-to-artery embolism].
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Cerebral Infarction↗
Biomedical subjects
Y Takagi
Publications and source records attributed to Y Takagi.
[Prognosis of atherosclerotic cerebral infarction].
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Cerebral Infarction↗
[Clinical study of 8 cases of spontaneous esophageal rupture].
Among 8 patients with spontaneous esophageal rupture, mean age was 46.5 years, and there was only one female. Vomiting after drinking was the main cause of onset. In 4 patients who underwent drainage of the thoracic cavity or initial treatment by surgery within 24 hrs after onset, closure after layer-layer suture of the site of rupture was made in two patients in whom definitive diagnosis was obtained at the first medical examination and early discharge was possible. A definitive diagnosis was obtained after drainage of the thoracic cavity in the other two patients, and esophagectomy without thoracotomy was performed on the 55th day after onset in one and the other patient received only conservative treatment without surgery, both patients were discharged. Of 4 patients who underwent treatment after 24 hrs, two patients who recovered included one who received only conservative treatment and another who underwent closure by suture of the site of rupture and covering with a pedicled omental flap 12 days after onset. The other two patients died of MOF after operation. We propose the following guidelines for treatment of this condition; In patients in whom surgical treatment is possible within 24 hrs after onset, closure by layer-layer suture of the site of rupture may be indicated. In cases in which more than 24 hrs has elapsed after rupture spontaneous closure sometimes can be expected in patients with a rupture would less than 2 cm. In patients accompanied with progressing mediastinitis or pyothorax with drainage procedure surgical treatment is indicated.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[A case report underwent simultaneous CEA and CABG followed by FPB].
A case of 67-year-old man with stenoses of both carotid arteries, double vessel diseases of coronary arteries, and left superficial femoral artery obstruction, for which surgical treatments were performed, is herein reported. He was in HYHA class IV because of unstable angina pectoris and pain in the left leg and in the state of chronic renal and hepatic disorders which made his condition worse. Coronary angiography showed stenoses in the origin of the right coronary artery and in the proximal left anterior descending artery at the degrees of about 95% and 90%, respectively. Carotid arteriography revealed both internalcarotid artery stenoses over 90%. The left carotid endarteractomy was not indicated because of presence of obstructive lesions of intracranial arteries in the left side. He underwent simultaneous surgery for the coronary and carotid occlusive diseases. He gained consciousness at the post operative 1st day and underwent left femoroperoneal saphenous vein bypass at the post operative 2nd day. He is leading a normal life without angina pectoris, left intermittent claudication and neurological deficit and has been followed up for 9 months postoperatively.
Aged↗
[A case report of redo Fontan operation].
A 21-year-old man, who had undergone Fontan operation for tricuspid atresia type 1b using 21 mm Hancock valved conduit 15 years ago, had right sided heart failure when his heart rhythm turned to atrial fibrillation. On cardiac catheterization, pressure data revealed that trans valved conduit pressure gradient reached to 5.2 mmHg. Chest CT and right atrial angiography showed right atrial wall thrombus. Right upper lobe perfusion defect was detected by lung perfusion scintigraphy. Then he was recommended redo Fontan operation. He underwent resection of stenosed valved conduit, right atrial thrombectomy and reconstruction of new route between right atrium and pulmonary artery with bovine pericardium. He tolerated well that operation and now 3 months passed, he resumed fairly vigorous physical activity.
Adult↗
Urea kinetics and clinical features of long-term continuous ambulatory peritoneal dialysis patients.
The purpose of this study was to assess urea kinetic modeling (UKM) as a marker for adequate dialysis in continuous ambulatory peritoneal dialysis (CAPD) patients. UKM was conducted on 19 anuric patients on CAPD for more than 2 years. Serum beta 2-microglobulin (beta 2M) was also measured as a marker of large molecular weight substances. Patient clinical conditions were evaluated by the doctors and patients as well. The patients were thus asked to complete a questionnaire on uremic symptoms and daily activities. A comparison was made in urea kinetics and biochemical parameters based on clinical assessment scores. Patient and doctor scores showed a close correlation (r = 0.69) and were correlated to days of hospitalization. The peritonitis rate was significantly higher in the "not doing well" group. No correlation could be found between indexes of UKM or beta 2M plasma level and clinical assessment scores. A significant correlation was noted between serum albumin concentration and doctor scores (r = 0.52). It was thus concluded that UKM was not a good indicator of the adequacy of dialysis for CAPD, but serum albumin was. However, clinical symptoms and signs are more important than biochemical parameters for assessing adequacy.
Adult↗
Enhanced c-fos expression after intracellular iron deprivation.
Intracellular iron deprivation by deferoxamine treatment, which leads to cells arrest in the S phase, enhanced c-fos expression in the neuroblastoma cell line, IMR32. The c-fos expression of iron deprived cells retained its response to stimulation by TPA, and cytosolic PKC activity did not decline after iron deprivation. The data suggest that PKC was not down-regulated. Creatine kinase activity also remained constant in the cytosol of iron deprived cells, indicating intact cellular function. Iron deprivation may activate the growth-related oncogene, c-fos, through some means other than the PKC pathway.
Creatine Kinase↗
[A case report of total intravenous anesthesia for renal transplantation].
A 20-year-old female patient with chronic renal failure received renal transplantation under total intravenous anesthesia with droperidol, fentanyl and ketamine. Anesthesia was induced with droperidol 12.5 mg, fentanyl 100 micrograms, ketamine 100 mg and vecuronium bromide 5 mg, and maintained with fentanyl and ketamine. Ketamine was given continuously at a rate of 2.0 mg.kg-1.h-1. After the renal artery and vein of the donor kidney were anastomosed with the patient's internal iliac artery and vein, the urine output of 7.7 ml.min-1 was obtained. The patient recovered from anesthesia smoothly and her postoperative course was uneventful. Although plasma epinephrine, cortisol and ADH levels showed significant changes during anesthesia mainly due to surgical stress, they returned to normal values after the end of operation. We conclude that this method of anesthesia would be a choice for renal transplantation.
Adult↗
Identification of an amino acid residue involved in the substrate-binding site of rat liver uricase by site-directed mutagenesis.
Computer analysis has shown that a conserved amino acid sequence (Leu 160 to Lys 164) of rat liver uricase is also present in other enzymes with purine substrates. The significances of the amino acids in this sequence were studied by site-directed mutagenesis. Replacement of Lys 164 by Glu or Ile resulted in loss of uricase activity and decrease in binding of the competitive inhibitor xanthine. The far ultraviolet circular dichroic spectra of the mutant uricases were identical to that of the wild type protein, indicating that the replacement of Lys 164 by other amino acids did not result in serious modification of the conformation of uricase. These findings suggest that this amino acid is involved in the substrate-binding site of the enzyme.
Amino Acid Sequence↗
Expression and transport into mitochondria of bovine cytochrome P-450(SCC) in insect cells using the baculovirus expression system.
Bovine cytochrome P-450(SCC) introduced with the baculovirus host vector system was found to be expressed in Spodoptera frugiperda cells. Cell fractionation analysis indicated that the P-450(SCC) expressed as the precursor form was transported into mitochondria and converted to a mature form. However, this form did not exhibit definite activity for cholesterol side chain cleavage. These findings suggest that most of the P-450(SCC) expressed by this system is an inactive protein within mitochondria that is not folded to the conformation of the active enzyme and/or does not incorporate heme appropriately.
Animals↗
Biochemical and molecular genetic analyses on placental aromatase (P-450AROM) deficiency.
Biochemical and molecular genetic studies were made on a case of placental aromatase (P-450AROM) deficiency. Of the enzymes participating in the electron transport system of placental microsomes, only aromatase activity was decreased specifically in the patient, being less than 0.3% of the normal activity. Northern and Western blotting analyses showed that the transcription of the aromatase gene and the translation of its mRNA proceeded normally in the placenta of this patient. However, aromatase cDNA isolated from a placental cDNA library of the patient was found to have an insert of 87 base pairs, encoding 29 amino acids in frame with no termination codon. The insert was located at the splicing point between exon 6 and intron 6 of the normal aromatase gene, and the extra DNA fragment was the first part of intron 6, except that its initial GT was altered to GC. These findings indicated that in this patient with aromatase deficiency, splicing between exon 6 and intron 6 did not occur at the normal position because of a point mutation in its consensus sequence and was forwarded to GT in the next cryptic consensus sequence 87 base pairs downstream according to the canonical GT/AG rule, resulting in translation of an abnormal protein molecule with 29 extra amino acids. During the transient expression in COS-7 cells, the aromatase cDNA of the patient was found to produce a protein with a trace of activity. This is the first report of a genetic defect for aromatase deficiency.
Amino Acid Sequence↗
Regulation of acetylcholine release in vivo from rat hippocampus by monoamines as revealed by novel column-switching HPLC with electrochemical detection.
To clarify monoaminergic regulation of acetylcholine (ACh) release in the rat hippocampus, the effects of administration of monoamines through a dialysis probe on extracellular ACh levels were examined using in vivo brain microdialysis combined with a novel column-switching HPLC system. Infusion of dopamine or 5-hydroxytryptamine, but not noradrenaline, increased ACh levels. The ACh levels also increased following infusion of apomorphine and 5-methoxy-N,N-dimethyltryptamine. These results demonstrate that hippocampal ACh release is regulated by dopamine and 5-hydroxytryptamine.
Acetylcholine↗
Beneficial effects of dietary intervention on serum lipid and apolipoprotein levels in obese children.
Effects of weight reduction on serum levels of lipids and apolipoproteins were measured in 13 obese children (seven girls, six boys). Mean weight loss of 8.4% of the initial body weight was achieved after 4 weeks of energy intake restriction and exercise. Serum total cholesterol (5.46 +/- 1.01 mmol/L) and triglyceride (2.08 +/- 0.52 mmol/L) levels were significantly high compared with control values before treatment and were significantly reduced to 4.32 +/- 0.75 and 1.31 +/- 0.42 mmol/L, respectively, after treatment. Serum high-density lipoprotein cholesterol level (1.03 +/- 0.23 mmol/L) was significantly low and unchanged after treatment (0.94 +/- 0.25 mmol/L). Serum apolipoprotein A-I level (0.039 +/- 0.009 mmol/L or 111 +/- 0.26 g/L) was normal before treatment and significantly reduced, to 0.032 +/- 0.007 mmol/L or 0.92 +/- 0.19 g/L, after weight reduction. Serum apolipoprotein B level (0.00019 +/- 0.00007 mmol/L or 1.07 +/- 0.21 g/L) was significantly high before treatment and decreased to the normal range after treatment (0.00014 +/- 0.0009 mmol/L or 0.76 +/- 0.24 g/L). The ratio of apolipoprotein B to apolipoprotein A-I (1.09 +/- 0.29) was significantly high on admission and decreased significantly to 0.64 +/- 0.12 after treatment. Serum apolipoprotein E level (0.0014 +/- 0.0006 mmol/L or 0.05 +/- 0.02 g/L) was normal and decreased to 0.0008 +/- 0.0002 mmol/L or 0.03 +/- 0.01 g/L after treatment. In conclusion, weight reduction achieved by energy intake restriction and exercise had beneficial effects on serum lipid and apolipoprotein concentrations for the prevention of future atherosclerosis.
Adolescent↗
Zinc-deficient diet impairs adaptive changes in the remaining intestine after massive small bowel resection in the rat.
An investigation was conducted on the influence of the presence of zinc in an elemental diet on the mucosa of residual intestine after massive small bowel resection. A total of 34 male Sprague-Dawley rats were divided into five groups: control animals (n = 10) were killed after overnight fasting; a second group (n = 14) underwent massive small bowel resection preserving 10 cm of terminal ileum, and the third group (n = 10) underwent sham operation. Animals in the second and third groups were fed either a commercially available elemental diet or a zinc-deficient diet for 2 weeks; they were then killed. In animals receiving the zinc-deficient diet, a significant decrease (P < 0.05) was noted in plasma zinc and total protein, and in mucosal wet weight (duodenum), thickness (duodenum and ileum), and protein (duodenum) and DNA (duodenum) content. Mucosal sucrase and maltase specific activities in the duodenum and ileum fell but diamine oxidase levels did not. These results suggest that zinc plays an important role in intestinal adaptation in the rat, and indicate that this trace element is essential for intestinal mucosal preservation in this animal.
Adaptation, Physiological↗
Massive small bowel resection in neonates--is weaning from parenteral nutrition the final goal?
Eight surviving cases from an original 15 pediatric patients who underwent massive small bowel resection during their neonatal period were reviewed for a period of 2-19 years to assess long-term prognosis. the primary diseases were congenital intestinal atresia in 6 cases and midgut volvulus in 2. The length of the residual small intestine ranged from 27-75 cm and the ileocaecal valve had been resected in 3 cases. All cases were able to be weaned from parenteral nutrition and at present, 6 of the children can tolerate normal meals but 2 are still receiving enteral nutrition, in the form of a low residue diet at home. Near normal somatic growth was achieved in the most recent 5 cases who received intensive nutritional treatment in the immediate postoperative period, whereas 3 who did not receive nutritional management exhibited growth retardation. The D-Xylose absorption test revealed gradual improvement and finally normal absorption in all except one case with the shortest remaining intestine (27 cm). However, the fat absorption test revealed abnormal absorption in cases with a residual intestine of less than 45 cm. Late metabolic complications such as renal calculi, cholelithiasis and pathologic fractures were encountered in 3 cases.
Child↗
Usefulness of ultrasonography and Doppler color flow imaging in the diagnosis of internal jugular phlebectasia.
A 20-year-old woman presented to our hospital for investigation of a left neck mass. Ultrasonographic examination of the jugular mass demonstrated an echo-free space, the caliber of which markedly increased when the patient shifted from the sitting to the recumbent position or performed a Valsalva maneuver. On color Doppler flow imaging, a slow flow signal flowing in the direction opposite to that of the common carotid artery was found within this space. Ultrasonography and color Doppler flow imaging thus proved to be useful for correctly diagnosing internal jugular phlebectasia.
Adult↗
Development of early bovine embryos to the blastocyst stage in serum-free conditioned medium from bovine granulosa cells.
Bovine granulosa cell-conditioned medium (BGC-CM) was prepared in a serum-free medium consisting of TCM 199, 5 micrograms/ml insulin, and 0.5 micrograms/ml aprotinin (TCM 199 IAP). Granulosa cells surrounded with embryos were denuded 24 to 30 h after in vitro fertilization. The proportion of denuded granulosa cell-free embryos that developed to the blastocyst stage in BGC-CM (43/219; 20%) as well as in the co-culture system (43/178; 24%) was significantly greater (P less than 0.001) than in fresh TCM 199 IAP medium (FM: 10/191; 5%), whereas the proportion of embryos that developed to the eight-cell stage was similar (P greater than 0.05) in all three culture systems (95/178; 53% in co-culture, 111/219; 51% in BGC-CM, and 86/191; 45% in FM, respectively). Higher rates of hatching and hatched blastocysts 8.5 days after in vitro fertilization were observed in co-culture (13/44; 29.5%) and in conditioned medium (8/39; 20.5%). On the other hand, no hatching or hatched blastocysts were obtained in the fresh medium (0/7; 0%). Cell numbers per blastocyst in BGC-CM (178.3 cells/blastocyst) were approximately two-fold higher than those in FM (97.1 cells/blastocyst). However, higher cell numbers (249.3 cells/blastocyst) were observed in co-culture with BGC than in BGC-CM. The embryotrophic activity in BGC-CM was stable upon freezing and thawing, lyophilization, and heating at 56 degrees C whereas activity was reduced by dilution in fresh medium, dialysis, pronase digestion, and heating at 80 degrees C. These results suggest that BGC cultured in a serum-free medium can synthesize and secrete an embryotrophic factor(s) that supports blastocyst formation in vitro beyond the 8- to 16-cell stage.
Animals↗
Effects of growth hormones on bone formation and resorption in rainbow trout (Oncorhynchus mykiss), as examined by histomorphometry of the pharyngeal bone.
Effects of salmon and eel growth hormones (GHs) on bone metabolism in rainbow trout (Oncorhynchus mykiss) were studied using histomorphometry of their pharyngeal bones. When salmon GH (sGH) was injected intraperitoneally at a dose of 0.01 or 0.1 microgram/g/week for 10 times into fed trout, body growth in both length and weight was accelerated. Formation and resorption of bone were enhanced only by the higher dose of sGH. When a cholesterol pellet containing recombinant eel GH (reGH-pellet) was implanted subcutaneously into starved trout for 1 week (37 micrograms reGH/18 g fish), formation and resorption of bone increased, although activity of bone formation was low. The results indicate that the GHs increased both formation and resorption of bone, regardless of the nutritional status of the fish.
Animals↗