PubMed Health⌕ Search

Biomedical subjects

A Fujiwara

Publications and source records attributed to A Fujiwara.

At least 73 records · Page 4Linked to original sources
PubMed1996

Circadian variations of onset of acute myocardial infarction and efficacy of thrombolytic therapy.

OBJECTIVES: The present study investigated whether the onset of acute myocardial infarction and resistance to thrombolysis have similar circadian variations. BACKGROUND: Circadian variations of the onset of acute myocardial infarction and resistance to thrombolysis in the early morning have been reported. Some studies have also reported a secondary peak incidence in late evening; however, it is not known whether the resistance to thrombolysis has a similar circadian variation in these patients. METHODS: Six hundred eight Japanese patients with an acute myocardial infarction were the subjects of the study. Two hundred forty-four of the 608 patients were treated with thrombolysis within 12 h of the onset of symptoms. One hundred thirteen patients received urokinase, and 131 patients received tissue-type plasminogen activator (t-PA) over 60 min. Patency of the infarct-related artery, the primary end point of the study, was evaluated at 60 min after the initiation of thrombolytic therapy, and Thrombolysis in Myocardial Infarction (TIMI) grade 0, 1 or 2 was defined as resistant to thrombolysis. RESULTS: The onset of acute myocardial infarction and resistance to thrombolysis showed circadian variations with early morning and late evening peaks (p<0.001 and p<0.05, respectively). These circadian patterns showed similar distributions as evaluated with Spearman's method (r=0.70, p<0.05), although resistance to thrombolysis showed a phase difference of about 2 h earlier than the infarction incidence. The circadian variation of the resistance to thrombolysis was independent of the types of thrombolytic agents (urokinase or t-PA). CONCLUSIONS: These findings suggest that adjustment of treatment based on the time of the onset of symptoms may be warranted for the patients with acute myocardial infarction.

Aged↗
PubMed1996

Pharmacological characterization of cardiovascular responses induced by endothelin-1 in the perfused rat heart.

The effects of the endothelin receptor antagonist TAK-044 (cyclo[D-alpha-aspartyl-3-[(4-phenylpiperazin-1-yl)carbonyl]-L-ala nyl-L-alpha-aspartyl-D-2-(2-thienyl)glycyl-L-leucyl-D-tryptophyl]+ ++disodiu m salt) and BQ-123 (cyclo[D-Asp-Pro-D-Val-Leu-D-Trp]) were studied in the rat heart to characterize the receptor subtypes responsible for the cardiovascular actions of endothelin-1. Endothelin-1 induced a transient decrease and subsequent increase in perfusion pressure in perfused rat hearts, and increased left ventricular developed pressure. TAK-044 diminished these endothelin-1-induced responses (100 pmol/heart) with IC50 values of 140, 57 and 1.3 nM, respectively. BQ-123 (1-30 mu M) partially inhibited the endothelin-1-induced hypertension (30-40%) in the rat heart, and failed to inhibit the hypotension. The positive inotropic effect of endothelin-1 was abolished by BQ-123. Neither indomethacin (10 mu M) nor Nomega-nitro-L-arginine methyl ester (100 mu M) attenuated the endothelin-1-induced hypotension. TAK-044 and BQ-123 attenuated the positive inotropic effect of endothelin-1 in rat papillary muscles. In rat cardiac membrane fractions, TAK-044 and BQ-123 inhibited [125I]endothelin-1 binding to endothelin ET(A) receptors with IC50 values of 0.39 +/- 0.6 and 36 +/- 9 nM, respectively, whereas only TAK-044 potently blocked the endothelin ET(B) receptor subtype (IC50 value: 370 +/- 180 nM). These results suggest that endothelin-1 modulates cardiovascular functions in the rat heart by activating both endothelin ET(A) and endothelin ET(B) receptors, all of which are sensitive to TAK-044.

Analysis of Variance↗
PubMed1996

Aortic counterpulsation may improve late patency of the occluded coronary artery in patients with early failure of thrombolytic therapy.

OBJECTIVES: Using a prospective, randomized design, we tested our hypothesis that the augmentation of diastolic pressure by intraaortic balloon counterpulsation (IABP) would improve the late patency of the occluded coronary artery in patients with early failure of thrombolytic therapy. BACKGROUND: Rescue angioplasty is often performed in patients in whom thrombolysis has failed, although 30% to 60% of the infarct-related arteries that are closed early after thrombolytic therapy will open later with conservative therapy. METHODS: The study included 45 patients in whom thrombolysis had failed, despite treatment with intravenous tissue-type plasminogen activator (alteplase 0.75 mg/kg body weight) delivered over 60 min within 12 h of the onset of symptoms. All patients underwent coronary angiography 60 min after initiation of thrombolytic therapy (baseline), and Thrombolysis in Myocardial Infarction (TIMI) grade 0, 1 or 2 flow was defined as failed thrombolysis. The patients were randomized to groups receiving IABP for 48 h (n = 23) or conservative therapy (n = 22, control subjects) at the end of cardiac catheterization. The late patency of the infarct-related artery, the primary end point of the study, was evaluated 3 weeks after myocardial infarction. Stenosis of the infarct-related artery was measured using a computer-assisted quantitative angiographic system in blinded manner. Data are expressed as mean value +/- SEM. RESULTS: There was no difference with regard to the baseline value for TIMI flow grade between the groups. However, 3 weeks after myocardial infarction, the patients treated with IABP had a significantly higher frequency of TIMI flow grade 3, lower residual percent stenosis and larger minimal lumen diameter of the infarct-related artery than did the control subjects (74% vs. 32%, p < 0.05; 42 +/- 5% vs. 68 +/- 6%, p < 0.01; and 1.6 +/- 0.1 vs. 0.9 +/- 0.2 mm, p < 0.01, respectively). CONCLUSIONS: These findings suggest that in patients with early failure of thrombolytic therapy, IABP may improve late patency of the occluded coronary artery, probably due to augmented perfusion pressure.

Constriction, Pathologic↗
PubMed1996

[Rupture of thoracic aorta due to blunt trauma: a report of three cases].

Three cases of the thoracic aortic rupture due to blunt trauma were successfully treated. All of the cases were young male motorcyclists. The chest X-ray on admission showed either a widened mediastinum or an apical extrapleural cap sign. Ruptures were confirmed by an enhanced CT clearly showing the presence of a psuedoaneurysm and a hematoma around the isthmus of the aorta. One of them was operated upon urgently and others in whom heparin could not be used because of associated injuries were operated upon electively two and three months after the traffic accident, respectively. In two of them, aneurysms were removed and replaced with dacron grafts and in the remaining one, the aneurysm was resected and repaired directly under the femoro-femoral bypass. Post-operative courses were uneventful. They discharged and are doing well after the treatment for associated injuries. In view of the high early mortality of aortic rupture, an early diagnosis and treatment is important. But in the case who has stable hemodynamics and contraindication for heparinization, a delayed operation may be recommended.

Accidents, Traffic↗
PubMed1995

Involvement of the Sonic hedgehog gene in chick feather formation.

To elucidate the molecular mechanisms of chick feather formation, we observed expression patterns of the Sonic hedgehog (Shh) gene, which is one of the vertebrate homologs of the Drosophila segment polarity gene, hedgehog, and encodes a signaling molecule functioning in limb pattern formation and motor neuron induction. We found that the Shh gene is also expressed in the apical region of the feather placodes and then in nine to eleven longitudinal stripes along feather filaments. The stripe was found to correspond to one of the outer marginal zones of each barb ridge, termed the zone of Shh expression. No significant expression signal was detected in the scale bud of developing legs. Thus, Shh is likely to function as an epithelial signaling molecule in epithelio-mesenchymal interaction during feather formation. Furthermore, since genes of bone morphogenetic protein-2 (BMP-2) and fibroblast growth factor-4 (FGF-4) are coexpressed with Shh during feather formation as observed in limb morphogenesis, interactions among FGF-4, Shh and BMP-2 may be involved in formation of feather filaments and barbs in a similar fashion as elucidated in limb pattern formation.

Animals↗
PubMed1995

Purification and some properties of six chitinases from Aeromonas sp. no. 10S-24.

Six chitinases were purified from a culture supernatant of Aeromonas sp. no. 10S-24 by ammonium sulfate precipitation, DEAE-Sephadex A-50, Butyl-Toyopearl 650M, and chromatofocusing. These enzymes were most active at pH 3.5-4.5 and the optimum temperature were 50 degrees C. The molecular weights of the enzymes were 89,000 to 120,000 from SDS-polyacrylamide gel electrophoresis. N-Terminal amino acid sequences of the enzymes were similar to that of chitinase I.

Aeromonas↗
PubMed1995

[Hemodynamics of the transverse sinus using cine angiography].

Numerous anatomical observations of the transverse sinus (TS) have been reported and features of this sinus, as assessed by cerebral angiography, are referred to in many monographs. However, there are no studies on the hemodynamics in the TS. We recently investigated the TS, using cerebral angiography with cinematographic films. The subjects were 35 patients who underwent angiography of 3 or 4 vessels at our institute, using Seldinger's method. The contrast material was infused manually. Cinematography permitted observation of the size of the bilateral TS and the direction of blood flow. Depending on the features of the bilateral TS, the patients could be divided into three groups. Type I (cases where the right TS was dominant) accounted for the highest percentage (54.3%, 19/35). In 11 of these 19 cases, the left TS also showed antegrade blood flow. In 6 of the Type I group, the blood flow through the left TS was in two directions (towards the Torcular Herophili and towards the left sigmoid sinus). In the other two cases rated as Type I, the blood flow through the left TS was in the direction from the Torcular Herophili to the right TS. Fourteen cases (40.0%) were rated as Type II (in which both sinuses were similar in size). In 13 of these 14 cases, blood flow through the bilateral TS was almost symmetrical (Type II-A). In one of the 14 cases, the blood flow through the left TS was in two directions (towards the Torcular Herophili and towards the left sigmoid sinus).

Aneurysm, Ruptured↗
PubMed1995

[Experiences of reoperative coronary artery bypass grafting by left thoracotomy without aortic clamping].

We reported two cases which had reoperative coronary artery bypass grafting (CABG) through the left thoracotomy approach without aortic clamping with good results. Case 1. A 50-year-old man, who underwent a double CABG to left anterior descending coronary artery (LAD) and right coronary artery (RCA) in 1983, had a recurrent unstable angina due to new significant stenosis of the diagonal branch (DG) and obtuse marginal branch (OM) in 1989. He was reoperated upon, having a new double CABG to DG and OM through the left thoracotomy using hypothermic ventricular fibrillation without aortic clamping for the myocardial protection without any blood transfusion. Case 2. A 61-year-old man, who underwent a double CABG to LAD and RCA in 1982, had a recurrent unstable angina and a left ventricular aneurysm in 1991. He had a reoperation of a single CABG to OM combined with left ventricular aneurysmectomy by the same approach. Both cases showed satisfactory recoveries of the left ventricular function in the early postoperative period and patent grafts on postoperative angiograms. The left thoracotomy approach is a preferable alternative to median resternotomy for the reoperative CABG to OM, DG and left ventricular aneurysmectomy.

Angina, Unstable↗
PubMed1994

Regional expression of the Cwnt-4 gene in developing chick central nervous system in relationship to the diencephalic neuromere D2 and a dorsal domain of the spinal cord.

Members of the Wnt gene family code for cysteine-rich, secreted proteins, which are differentially expressed in the developing brain and possibly act as an intercellular signaling molecule. A Wnt gene, e.g., Wnt-1 is known to be essential for specification of the midbrain cell fate. Since other members of the Wnt genes are likely to be also involved in development of the brain, we searched chick Wnt members expressing in specific domains of the brain. We found several novel Wnt members expressing specifically in the central nervous system of chick embryos. One of the genes was intensely expressed in a segment of the diencephalon at stages 14 and 20 and in a dorsal region of the spinal cord at stage 20. Although the expression patterns differ from those of mouse or Xenopus Wnt-4, the gene is highly homologous to the mouse or frog Wnt-4. Thus, we designated the gene as Cwnt-4 (chick Wnt-4). Our results suggested that Cwnt-4 is involved in segmentation of the forebrain into the neuromere D2 and in differentiation of the dorsal region of the spinal cord.

Amino Acid Sequence↗
PubMed1994

Use of human leukocyte antigen-mismatched allogeneic lymphokine-activated killer cells and interleukin-2 in the adoptive immunotherapy of patients with malignancies.

Clinical effects and side effects were studied in the adoptive immunotherapy of patients bearing malignant diseases using human leukocyte antigen (HLA)-mismatched allogeneic lymphokine-activated killer (LAK) cells. Allogeneic LAK cells were induced from peripheral blood lymphocytes (PBL) of normal donors by means of initial stimulation with pokeweed mitogen (PWM). Six of 15 patients applied in the adoptive immunotherapy showed clinical effects such as partial or complete regression of pulmonary metastasis, pleural effusion and primary tumor. All pulmonary metastatic lesions were eliminated in one case by this adoptive immunotherapy combined with chemotherapy. Generally toxic effects were chillness, fever and general fatigue which were reversible, and no allergic side effects occurred even though allogeneic LAK cells were injected frequently except one patient who showed preshock like symptom accompanied with leukocytopenia and continuous hypotension immediately after infusion but was finally rescued. In the patients who received more than 10(11) of allogeneic LAK cells, anti-HLA class I antibodies appeared without any evidence of autoantibody. However, immunological side effects were never experienced after injection of allogeneic LAK cells even when the anti-HLA class I antibodies appeared in the patients. Taken together, allogeneic LAK cells could be considered as alternative therapy for patients with malignancies who could not supply sufficient materials of autologous LAK cells.

Adult↗
PubMed1994

Left ventricular wall motion abnormalities in patients with subarachnoid hemorrhage: neurogenic stunned myocardium.

OBJECTIVES: The purpose of this study was to determine whether a relation exists between electrocardiographic (ECG) abnormalities and left ventricular wall motion in patients with subarachnoid hemorrhage. BACKGROUND: Although ECG changes simulating acute myocardial infarction are frequently seen in patients with subarachnoid hemorrhage, their relation to left ventricular wall motion has not been established. METHODS: Twelve patients with subarachnoid hemorrhage were classified according to the presence of ST segment elevation in at least two consecutive leads on admission: seven patients with ST segment elevation (group I) and five patients without ST segment elevation (group II). No patients had a previous history of heart disease. Left ventricular regional wall motion was evaluated by the centerline method. The mean (+/- SEM) duration from onset of subarachnoid hemorrhage to left ventriculography was 9 +/- 3 h in group I and 10 +/- 1 h in group II. Coronary angiography was performed to rule out wall motion abnormalities due to coronary artery disease while the ST segment was still elevated. Two-dimensional echocardiography was used to evaluate wall motion thereafter. RESULTS: All patients in group I showed ST segment elevation in ECG leads V4 to V6. Wall motion of the left ventricular apex was significantly reduced in group I compared with group II (-2.48 +/- 0.41 vs. -0.45 +/- 0.72, p < 0.02). No patients showed organic stenosis or vasospasm, or both, of epicardial coronary arteries. Wall motion abnormalities decreased echocardiographically in all patients, but one patient in group I died in hospital at 2 or 3 weeks after the onset of subarachnoid hemorrhage, when the T wave was inverted in leads V4 to V6. CONCLUSIONS: These findings suggest that patients with subarachnoid hemorrhage and ST segment elevation may demonstrate transient corresponding regional wall motion abnormalities. The mechanism of neurogenic stunned myocardium was not clearly elucidated in the present study.

Aged↗