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Biomedical subjects

A Hashimoto

Publications and source records attributed to A Hashimoto.

At least 145 records · Page 8Linked to original sources
PubMed1997

[A successful surgical treatment for huge left circumflex artery-right ventricle fistula using the fistula occlusion test].

A surgical case of rare coronary artery fistula between the left circumflex artery and right ventricle was reported. A 46-year-old woman had suffered from exertional dyspnea and palpitation for three years. Pan systolic heart murmur was heard through the left 4th inter costal space. The chest X-ray film demonstrated cardiac enlargement and lung congestion, and the electrocardiograms showed atrial fibrillation and left ventricular hypertrophy when she was admitted to our hospital. Preoperative catheterization revealed a huge coronary artery fistula originating from the left circumflex artery and opening into the right ventricle through the posterior wall of the heart. The left-to-right shunt ratio was 60% and Qp/Qs was 2.47. At operation, the dilated circumflex artery fistula was carefully dissected and the tape was passed around the fistula as a tourniquet under extra corporeal circulation on the beating heart. To estimate myocardial ischemia, the fistula occlusion test was performed by tightening the previously placed tourniquet. Monitoring of electrocardiograms, transesophageal echocardiography, and hemodynamics were useful to detect myocardial ischemia. The occlusion test was performed under ECC for 5 minutes. No ischemic changes were observed. The fistula was interrupted under cardiac arrest at the point of the occlusion test.

Arteriovenous Fistula↗
PubMed1997

[A comparative study of local mental health and welfare policies in Japan: Cases of Tokyo Metropolitan Government and Yamaguchi Prefecture].

In this article the mental health and welfare policies of the Tokyo Metropolitan Government and Yamaguchi Prefecture were analyzed, and the features of their development and problems were discussed. The results are as follows: a) The emphasis of the mental health and welfare policies both of Tokyo and Yamaguchi experienced changes according to national policies and is to be divided into the following four periods and key concepts. The 1st period (1950-1964): no policy or increase of psychiatric beds The 2nd period (1965-1975): dawn of "from hospital to community" The 3rd period (1976-1987): workplace for the mentally ill The 4th period (1988-present): accommodation for the mentally ill b) During the 2nd period, in terms of increase in psychiatric beds, the Tokyo Metropolitan Government tried to limit increase, whereas Yamaguchi Prefecture accommodated it. c) In the field of community mental health, the most remarkable development in Tokyo in recent years is that the number of workshops and group homes grew dramatically. The original policy of the Tokyo Metropolitan Government to subsidize such small institutions was recommended in the report of Local Advisory Council on Mental Health and Welfare (Chiho-Seishinhokenhukushi-shingikai). As a result many voluntary groups operate those institutions with help of subsidy. On the contrary the development in Yamaguchi is slow, because the establishment of institutions for rehabilitation was mainly implemented by the regulation of national law which demands high costs for its building and land. d) The original policies of the Tokyo Metropolitan Government, however, is based on the premise that a shortage exists of institutions for rehabilitation regulated by Mental Health and Law. In this situation, therefore, the development of community mental health depends on a subsidy from local government, development of community mental health depends on a subsidy from local government, development of voluntary groups, and accessibility to social services.

Community Mental Health Services↗
PubMed1996

Regulatory T cells in maintenance and reversal of peripheral tolerance in vivo.

Whether regulatory T cells could suppress the immune responses to an unrelated Ag and could induce tolerance to that Ag was investigated. In female B6 (I-Ab) mice tolerized to MHC class II I-Abm12 (bm12) alloantigen by cyclophosphamide-induced system, regulatory T cells specific for bm12 Ag were induced. These regulatory T cells suppressed in vivo immune responses to an unrelated Ag (male Ag) that was co-expressed with bm12 Ag on the same graft. However, the immune responses to male Ag suppressed by regulatory T cells were reverted by immunization with male Ag alone, indicating regulatory T cells suppressed the induction of immune responses to the unrelated Ag co-expressed with suppressogenic determinant, but did not inactivate T cells specific for that third Ag, such as clonal anergy or deletion. These results provided that minor Ag adjacent to major Ag, even if they were expressed on the professional APC, could be suppressed in the periphery, and the responses to those minor Ag could be activated when the suppression mechanism was abrogated or ineffective.

Animals↗
PubMed1996

Unassembled subunits of the photosynthetic oxygen-evolving complex present in the thylakoid lumen are long-lived and assembly-competent.

Physiologically healthy pea chloroplasts contain unassembled, soluble subunits of the oxygen-evolving complex in the thylakoid lumen. We report that the lifetimes of two of these subunits, both on and off the membrane, exceed 8 h in vitro. We also demonstrate that each of the subunits present in the thylakoid lumen is competent for assembly into the membrane-bound complex. These data are consistent with the postulate that the soluble lumen-resident subunits play a role in photosystem II homeostasis. We also demonstrate that the reconstitution of the 33 kDa subunit is inhibited by extremely low concentrations of Triton X-100, suggesting that hydrophobic interactions are involved in the binding of this subunit to the photosystem II reaction center.

Cell Fractionation↗
PubMed1996

Regional cardiac sympathetic nerve dysfunction and the diagnostic efficacy of metaiodobenzylguanidine tomography in stable coronary artery disease.

The present study endeavors to correlate regional myocardial sympathetic nerve dysfunction with reversible and persistent perfusion abnormalities and depressed regional wall motion, and to determine the diagnostic efficacy of radio-iodinated metaiodobenzylguanidine (MIBG) tomography for detecting coronary artery disease. In 28 consecutive patients with stable coronary artery disease and 7 patients with atypical chest pain but no coronary stenosis, regional MIBG uptake was semiquantitatively evaluated in 13 left ventricular segments early (30 minutes) and late (4 hours) after injection. Regional MIBG uptake was reduced in 68 of 90 segments (76%) showing reversible perfusion abnormality and 72 of 81 segments (89%) showing persistent abnormality 4 hours after injection. Although the sensitivity and negative predictive values of late MIBG scanning for detecting myocardial perfusion abnormalities were relatively high (82% and 85%, respectively), the specificity, positive predictive value, and kappa value were low (63%, 57%, and 0.41, respectively). Right coronary lesions were detected by late MIBG scanning with a high sensitivity (85%) but a low specificity (41%). Conversely, the sensitivities for detecting lesions in the other 2 major left coronary arteries were low (55%). The overall diagnostic accuracy of late MIBG scanning was 66% and the positive and negative predictive values and kappa value were low; 60%, 70%, and 0.31, respectively. Similarly, regional sympathetic dysfunction was observed in 42 of 49 asynergic segments (86%) on late MIBG scans, of which 32 segments were viable and 10 nonviable; but the low specificity (73%) and positive predictive value (44%) reduced the kappa value (0.43). Thus, regional cardiac sympathetic innervation is impaired in ischemic, asynergic but noninfarcted myocardium as well as in myocardium which is infarcted or has a persistent perfusion abnormality. The diagnostic efficacy of MIBG tomography to detect coronary artery disease, however, is limited probably because of nonspecific reductions of MIBG uptake in the inferior and posterolateral regions.

3-Iodobenzylguanidine↗
PubMed1996

Postischemic functional recovery and BMIPP uptake after primary percutaneous transluminal coronary angioplasty in acute myocardial infarction.

To correlate asynergic wall motion after primary percutaneous transluminal coronary angioplasty with myocardial perfusion and fatty acid metabolism, quantitative tomographies using thallium and radioiodinated 15-(p-iodophenyl)-3-R,S-methylpentadecanoic acid (BMIPP) were performed during the acute and recovery stages in 56 consecutive patients with acute myocardial infarction, of whom 32 underwent primary percutaneous transluminal coronary angioplasty (group A) and 24 were conservatively treated (group B); 44 patients (79%) had 1-vessel disease. Reduced myocardial uptakes of thallium and BMIPP and regional wall motion were quantified with a bull's eye technique and a centerline method using contrast left ventriculography, respectively. BMIPP activity was significantly lower than that of thallium at an acute stage in both groups. Abnormal BMIPP activities and the difference in thallium and BMIPP abnormalities (perfusion metabolism mismatch) at an acute stage decreased significantly during follow-up in group A (111 +/- 13 to 99 +/- 12 and 30 +/- 10 to 15 +/- 10, respectively), and not in group B (129 +/- 31 vs 118 +/- 29 and 29 +/- 13 vs 30 +/- 10, respectively). Improvement in regional wall motion abnormality correlated closely with the improved uptakes of thallium and BMIPP (y = 0.64x + 26.4, r = 0.56, p < 0.05; y = 1.1x + 11.1, r = 0.81, p < 0.001; respectively). The mismatched uptake of both tracers at an acute stage was significantly related to recovery from asynergic wall motion during follow-up in group A (y = 0.45x + 13.9, r = 0.65, p < 0.005). In conclusion, despite restored myocardial perfusion by primary coronary angioplasty, BMIPP uptake is impaired in salvaged myocardium at an acute stage of infarction. However, the degree and improvement of perfusion metabolism mismatch in acute myocardial infarction may reflect subsequent recovery from postischemic wall motion abnormality in metabolically impaired but viable myocardium after coronary reperfusion.

Adult↗
PubMed1996

Differential effects of phencyclidine and methamphetamine on dopamine metabolism in rat frontal cortex and striatum as revealed by in vivo dialysis.

We have examined the effects of schizophrenomimetic drugs including phencyclidine (PCP) and methamphetamine (MAP) on cortical and striatal dopamine (DA) metabolism using an in vivo dialysis technique in the rat. An acute systemic injection of PCP (2.5-10 mg/kg, intraperitoneally (i.p.)) dramatically increased concentrations of DA, 3,4-dihydroxy-phenylacetic acid, and homovanillic acid in the dialysates from the medial frontal cortex in a dose-dependent fashion. However, PCP (2.5-10 mg/kg, i.p.) caused a much lower augmentation of extracellular DA release, with a significant decrease in dialysate DOPAC levels in the striatum. Moreover, continuous infusion of tetrodotoxin (TTX, 10(-5) M) into the prefrontal or striatal region through the microdialysis tube completely blocked the ability of PCP (10 mg/kg, i.p.) to alter the extracellular release of DA and its metabolites in the respective areas. In contrast, MAP (4.8 mg/kg, i.p.) elicited a marked and tetrodotoxin-resistant increase in DA levels with a significant loss of DOPAC contents in the extracellular space of both the frontal cortex and the striatum. The present results clearly demonstrate the differential effects of PCP on cortical and striatal DA transmission, suggesting that PCP may facilitate DA release in the medial frontal cortex by increasing impulse flow in the DA neurons projecting to the cortical area, whereas PCP-induced elevation of extracellular DA in the striatum may be caused mainly by reuptake inhibition of DA liberated by basal activity of the striatal DA neurons. The regional variation in PCP-induced DA release would be due to the combination of NMDA (N-methyl-D-aspartate) receptor blocking and DA reuptake inhibition by the drug. The uniform and TTX-resistant nature of MAP-induced changes in brain DA metabolism may result from the direct actions of MAP at DA nerve terminals.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1996

An alternative procedure to intra-arterial aortoinfundibuloplasty.

Intra-arterial aortoinfundibuloplasty is a newly developed aortic annular enlargement procedure in which, originally, the annulus was split anteriorly via the main pulmonary arteriotomy. An alternative method of aortoinfundibuloplasty was studied experimentally which creates spiral incisions on the free walls of both great arteries descending together into the aortopulmonary and infundibular septum via both commissures of right and left facing cusps of pulmonary and aortic valves. The valve prosthesis is implanted through this three-dimensional incision, followed by patch reconstruction. The ratio of annular augmentation was three sizes in two animals and four sizes in three animals. Immediate postoperative haemodynamics were satisfactory and there was no significant postoperative increase in systolic pressure gradient at the right ventricular outflow tract and in the right ventricular end-diastolic pressure. This alternative procedure could be applied to cases requiring radical annular enlargement and would give a wider view of both ventricular outflow tracts.

Animals↗
PubMed1996

Surgical treatment of ischaemic valve disease.

Mitral valve regurgitation secondary to ischaemic heart disease carries a significant mortality even after open-heart surgery. In this study, 21 patients with mitral regurgitation associated with ischaemic heart disease were evaluated with respect to valvular pathology. Pathological examination of the mitral valve revealed chorda elongation or rupture in seven patients (group 1), papillary muscle dysfunction in 10 (group 2), and papillary muscle rupture in four (group 3). Significant preoperative characteristics in each group were subacute haemodynamic deterioration in group 1, chronic severe left ventricular failure in group 2, and a high incidence of acute renal failure associated with haemodynamic shock in group 3. Mitral valve plasty was performed in six patients and mitral valve replacement, using the St Jude Medical valve, in 15. Fourteen patients underwent mitral valve surgery combined with coronary artery bypass grafting. Mitral plasty was applied to the patients with low left ventricular function with mean(s.d.) fraction shortening of 19.2(6.2)% compared with 30.2(8.4)% in patients with mitral valve replacement. There were no operative deaths. Of four late deaths, two in group 1 resulted from infection and myocardial infarction, respectively and one in group 2 resulted from arrhythmia. One patient in group 3 died from renal failure. It is suggested that incorporation of these therapeutic concepts may lead to satisfactory results in the surgical treatment of ischaemic mitral regurgitation.

Coronary Artery Bypass↗
PubMed1996

Rapid detection and identification of mycobacteria by combined method of polymerase chain reaction and hybridization protection assay.

A new method for the rapid detection and identification of mycobacteria, combining polymerase chain reaction (PCR) with DNA probe, was developed. The mycobacterial 16S rRNA encoding gene was amplified by nested PCR, and the PCR product was identified by hybridization protection assay using acridinium ester labelled DNA probe. The optimum temperature for hybridization of PCR product and DNA probe was estimated as 55 degrees C. The specificity of the combined method was excellent in the detection and identification of Mycobacterium tuberculosis and Mycobacterium avium-intracellulare complex (MAC). The detection limit was 10 fg DNA for M. tuberculosis, and 100 fg DNA for MAC. Results of preliminary clinical investigation of this method using 207 clinical specimens demonstrated an efficient detection and identification of M. tuberculosis and MAC. These results indicate that the new combined method may be a useful test for the rapid detection and identification of M. tuberculosis and MAC in clinical specimens.

Humans↗
PubMed1996

Antibody responses against Echinococcus multilocularis antigens in naturally infected Rattus norvegicus.

Two Norway rats, Rattus norvegicus, were found to be naturally infected with Echinococcus multilocularis in Japan. One of them was simultaneously infected with at least three different sized metacestodes of Taenia taeniaeformis. These two R. norvegicus rats and another R. norvegicus naturally infected with T. taeniaeformis and Capillaria hepatica were examined to see if they showed any antibody responses against these two cestode parasites with the view to obtaining more information on the importance of rats as the intermediate host for E. multilocularis. These R. norvegicus showed very poor antibody responses against the two cestode species, although the Wistar rats, R. rattus, experimentally infected with a single smaller sized metacestode of T. taeniaeformis showed stronger responses not only against T. taeniaeformis but also against E. multilocularis. Therefore the three R. norvegicus naturally infected with E. multilocularis and/or T. taeniaeformis demonstrated virtually no immune response, at least against these cestodes.

Animals↗
PubMed1996

[Detection of DNA specific for Aspergillus species in serum samples from two patients with invasive pulmonary aspergillosis].

We investigated the possible presence of DNA specific for Aspergillus species in serum samples of two patients who were strongly suspected for invasive pulmonary aspergillosis (IPA) by a nested polymerase chain reaction (PCR) method. Both patients were diagnosed as having acute myelogenous leukemia and treated with induction chemotherapy. During chemotherapy-induced granulocytopenia, they complained of high fever, and the chest X-rays indicated infiltration shadows in their lungs. They were treated with antibiotics intravenously, but no clinical improvement was observed. As the results of the nested PCR were positive at the acute stage of infection, amphotericin B i.v. and granulocyte colony stimulating factor s.c. administrations were started in both cases. In case 1, the infectious disease improved and the nested PCR results turned negative after treatment. In case 2, in spite of the progression of the disease, the nested PCR results turned negative during treatment. Although we consider this method very useful for the diagnosis of IPA, further prospective evaluation with a large clinical population sample is required.

Aged↗
PubMed1996

A recombinant baculovirus 42-kilodalton C-terminal fragment of Plasmodium falciparum merozoite surface protein 1 protects Aotus monkeys against malaria.

The immunogenicity and protective efficacy of baculovirus recombinant polypeptide based on the Plasmodium falciparum merozoite surface protein 1 (MSP-1) has been evaluated in Aotus lemurinus griseimembra monkeys. The MSP-1-based polypeptide, BVp42, corresponds to the 42-kDa C-terminal processing fragment of the precursor molecule. Immunization of Aotus monkeys with BVp42 in complete Freund's adjuvant resulted in high antibody titers against the immunogen as well as parasite MSP-1. Fine specificity studies indicated that major epitopes recognized by these antibodies localize to conserved determinants of the 19-kDa C-terminal fragment derived from cleavage of the 42-kDa processing fragment. Effective priming of MSP-1-specific T cells was also demonstrated in lymphocyte proliferation assays. All three Aotus monkeys immunized with BVp42 in complete Freund's adjuvant showed evidence of protection of protection against blood-stage challenge with P. falciparum. Two animals were completely protected, with only one parasite being detected in thick blood films on a single days after injection. The third animal had a modified course of infection, controlling its parasite infection to levels below detection by thick blood smears for an extended period in comparison with adjuvant control animals. All vaccinated, protected Aotus monkeys produced antibodies which inhibited in vitro parasite growth, indicating that this assay may be a useful correlate of protective immunity and that immunity induced by BVp42 immunization is mediated, at least in part, by a direct effect of antibodies against the MSP-1 C-terminal region. The high level of protection obtained in these studies supports further development of BVp42 as a candidate malaria vaccine.

Animals↗
PubMed1996

PCR detection of DNA specific for Aspergillus species in serum of patients with invasive aspergillosis.

We investigated the possible presence of DNA specific for Aspergillus species in serum samples of patients with invasive aspergillosis (IA) by the nested PCR method. Fourteen strains of fungi including 5 strains of Aspergillus species and 10 strains of common bacteria were used for examination of specificity and sensitivity of the nested PCR. Two sets of oligonucleotide primers were derived from the sequence of the variable regions V7 to V9 of the 18S rRNA genes of Aspergillus fumigatus. The specific fragment was amplified from five strains of Aspergillus species in the single and nested PCR but not from other microorganisms. Target DNA was detected by the nested PCR with as little as 50 fg of the extracted DNA of A. fumigatus. We investigated the detection of DNA specific for Aspergillus species in serum samples of a murine model of aspergillosis and 20 patients with IA. The specific fragment was detected by the nested PCR in 71% of serum samples of infected mice and 70% of serum samples of patients with IA, while galactomannan antigen was detected in 43 and 60% of samples, respectively. The high sensitivity and specificity of the nested PCR indicate that the assay can provide early diagnosis with sufficient accuracy to be clinically useful for immunocompromised patients with IA.

Animals↗
PubMed1996

In vitro susceptibility of Trichosporon beigelii to antifungal agents.

The minimum inhibitory concentrations (MICs) and minimum fungicidal concentrations (MFCs) of amphotericin B, flucytosine, miconazole, fluconazole and itraconazole against 21 isolates of Trichosporon beigelii in RPMI-1640 medium were determined using National Committee for Clinical Laboratory Standards (NCCLS) methodology in microdilution method. Most isolates were sensitive to miconazole (MIC90 0.78 microgram/ml), fluconazole (MIC90 6.25 micrograms/ml), and itraconazole (MIC90 0.19 microgram/ml), with the former being the most active agent tested (MFC90 3.12 mu/ml). Although amphotericin B inhibited most strains (MIC range, 0.78-3.12 micrograms/ml), poor fungicidal activity was observed (MFC range, 1.56-12.5 micrograms/ml) showing a pattern of relative resistance in vitro. Flucytosine showed generally poor activity against most isolates tested. These in vitro findings confirm the resistance of T.beigelii to amphotericin B and suggest that azoles may be an alternative to the former for the treatment of disseminated trichosporonosis. However, in vivo studies would better validate these in vitro findings.

Amphotericin B↗
PubMed1996

Relationship between bronchial hyperreactivity and symptoms of cardiac asthma in patients with non-valvular left ventricular failure.

To determine whether a relationship exists between bronchial hyperreactivity and cardiac asthma, which is commonly observed in patients with left heart failure, a methacholine inhalation test was performed in 15 patients with stable left ventricular failure (LVF) and 10 normal subjects. The subjects were divided into 3 groups based on symptoms of nocturnal coughing and/or wheezing in acute exacerbation of LVF. Group A consisted of 8 patients with nocturnal coughing and/or wheezing. Group B consisted of 7 patients without such symptoms, and Group C consisted of the 10 age-matched normal controls. Eleven of the 15 patients with LVF showed a significant increase in respiratory resistance in the methacholine inhalation test, as opposed to none of the normal subjects. The median cumulative dose which produced a 35% decrease in respiratory conductance (PD35Grs) was significantly lower in Group A than in Group B (1.45 log units and 1.90 log units, respectively, p < 0.05). The results of pulmonary function tests were not significantly different between Groups A and B. The minimum cumulative dose required to initiate a decrease in respiratory conductance from the baseline, as an index of bronchial sensitivity to methacholine, was significantly correlated with DLCO/VA (r = 0.710, p < 0.01). We conclude that bronchial hyperreactivity is responsible for cardiac asthma and that it might be related to pulmonary interstitial changes in stable patients with non-valvular LVF.

Adult↗