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Biomedical subjects

A Maki

Publications and source records attributed to A Maki.

At least 19 recordsLinked to original sources

Advanced gallbladder carcinoma with biliobiliary fistula, resected by hepatopancreatoduodenectomy, in an aged patient.

We report a 78-year-old man with a gallbladder carcinoma and biliobiliary fistula, diagnosed by percutaneous transhepatic cholangioscopic biopsy through the fistula. The impacted stones in the common hepatic duct were crushed, and then selective cholangiography under percutaneous transhepatic cholangioscopy (PTCS) revealed a biliobiliary fistula. Cholangioscopic biopsy tissues taken from the gallbladder revealed adenocarcinoma, but biopsies taken from the fistula revealed no evidence of malignancy. Further investigations indicated that the gallbladder carcinoma involved the duodenum and the distal common bile duct. A hepatopancreatoduodenectomy, including both an extended right hepatic lobectomy with resection of the caudate lobe and a pancreatoduodenectomy, was performed. Despite the patient's advanced age, he made an unremarkable postoperative recovery and was able to enjoy an active social life for 8 months after the surgery. We discuss biliobiliary fistula associated with gallbladder carcinomas and the use of hepatopancreatoduodenectomy for advanced biliary cancer in aged patients.

Aged↗

Activation of visual cortex in REM sleep measured by 24-channel NIRS imaging.

To visualize dreaming brain functions we studied hemodynamic changes in the visual cortex during the transition from non-rapid eye movement (NREM) to rapid eye movement (REM) sleep, using a 24-channel Near-Infrared Spectroscopy (NIRS) imaging method. Results were compared to the activation in visual cortex by visual stimulation during wakefulness. Subjects were four healthy males between 25 and 49 years of age. Five all-night polysomnographic and NIRS recordings were made. Increases in the oxygenated hemoglobin concentration in visual cortex were observed from nine of 14 REM periods. The activated areas were broader during REM sleep than during visual stimulation. These findings suggest that activation of visual cortex in REM sleep might represent dream-related brain activity.

Adult↗

Acute effects of cigarette smoking on platelet-dependent thrombin generation.

AIMS: Thrombin is an important factor in the pathogenesis of thrombotic diseases. To clarify whether smoking has an effect in platelet-dependent thrombogenesis, we studied the acute effects of smoking on platelet-dependent thrombin level in smokers. METHODS AND RESULTS: Subjects consisted of ten smokers and nine non-smokers. Platelet-dependent thrombin level measured after overnight fasting was greater in smokers than in non-smokers (smokers vs non-smokers, 121 +/- 47 vs 56 +/- 5 mIU. ml(-1), P < 0.01). When subjects in the smokers group smoked two cigarettes containing 0.9 mg of nicotine per cigarette, platelet-dependent thrombin levels showed a transient three-fold increase in blood samples obtained immediately after smoking (365+/-76 mIU. ml(-1), P < 0.001). Thrombin levels in the blood samples obtained 10 min and 30 min after smoking were less than that in the samples obtained immediately after smoking ceased, but were not significantly different from those in the samples obtained before smoking. Blood nicotine level increased significantly immediately after smoking (P < 0.001), and plasma protein C activity decreased significantly 30 min after smoking (P < 0.05). When nicotine or cotinine was added to the platelet-rich plasma of non-smokers ex vivo, the platelet-dependent thrombin level increased significantly (P < 0.002). CONCLUSION: Platelet-dependent thrombin level is enhanced in smokers, even when not smoking, when compared with non-smokers and increases immediately after smoking. Increases in nicotine and cotinine levels caused by smoking induced a prothrombotic state in smokers via increased platelet-dependent thrombogenesis.

Adult↗

Wavelength dependence of the precision of noninvasive optical measurement of oxy-, deoxy-, and total-hemoglobin concentration.

The precision of noninvasive optical measurement of the concentration changes in oxy-, deoxy-, and total-hemoglobin depends on wavelength. For estimating the precision, we calculated the noise level of the concentration changes as the uncertainty in measurements using several wavelength pairs of light. Seven laser diodes (664-848 nm) were used simultaneously for spectroscopic measurement of brain activity during finger motor stimulation. We also used the analysis of error propagation from the uncertainty in direct measurements of absorbance changes to estimate indirectly the uncertainty of concentration changes. The measurement of the concentration changes made using an 830/664-nm pair are two times (oxy-Hb) and six times (deoxy-Hb) more precise than those made using an 830/782-nm pair.

Biophysical Phenomena↗

Platelet-dependent thrombin generation in patients with unstable angina pectoris.

Platelet-dependent thrombin generation was assessed during both unstable and stable periods in 59 patients with unstable angina and at rest in 31 healthy controls. Thrombin generation during the unstable period was significantly greater than that at rest in the healthy control group (p < 0.0001) and that during the stable period (p < 0.0001). Changes in thrombin generation were related to the time after onset of unstable angina, not to degree of improvement in the severity of coronary stenosis.

Adult↗

[Noninvasive higher-order brain-function imaging by near-infrared spectroscopy].

The simultaneous position encoding method for optical topography was developed. Each channel has dual-wavelength optics to separately determine the changes in oxy-hemoglobin and deoxy-hemoglobin concentrations around their isobestic points at 805 nm. Part of the incident light penetrates the scalp and skull and is reflected from brain tissues including the cerebral cortex. Any change in the light extinction is mainly due to changes in the oxy-hemoglobin and/or the deoxy-hemoglobin concentration during the activation of a functional area linked to a neuronal activity. Unlike conventional functional imaging methodologies, it can be used for behavioral studies because the flexible optical fibers allow a subject to move, and a very light and compact system can be made. Noninvasive dynamic optical topography has a wide variety of applications from basic science to clinical medicine. Several applications, such as the study of the Broca and Wernicke language areas, the assessment of the dominant hemisphere of the brain, epilepsy focus determination, and sleep studies are reported. We also tested a 14-month-old baby with a extremely abnormal brain.

Brain↗

Spontaneous oscillation of oxy- and deoxy- hemoglobin changes with a phase difference throughout the occipital cortex of newborn infants observed using non-invasive optical topography.

We investigated spontaneous changes in the cerebral oxygenation state of infants during quiet sleeping by using a form of multi-channel near-infrared spectroscopy: non-invasive optical topography. Eight infants born at 32-39 weeks were studied at postconceptional term age (38-43 weeks). Spatially synchronized oscillations of changes in the concentration of oxy- and deoxy- hemoglobin ([oxy-Hb] and [deoxy-Hb]) were observed throughout the occipital cortex. Time series analysis based on the theory of non-linear oscillators showed that the mean periods of the oscillation for each infant ranged from 11 to 18 s. The phase lag of [oxy-Hb] relative to [deoxy-Hb] was stable at about 3pi/4. This phase difference may result from interplay between the vasomotion and the oxygen consumption in relation to brain activity.

Female↗

Association between elevated plasma fibrinogen and the small, dense low-density lipoprotein phenotype among postmenopausal women.

A predominance of small, dense low-density lipoprotein (LDL) particles (subclass pattern B) has been associated with a 2- to threefold increase in coronary heart disease risk. Recently, it has been reported that LDL subclass pattern B is associated with hyperfibrinogenemia, which is also a coronary heart disease risk factor. The present study examined the relation between hyperfibrinogenemia and LDL subclass pattern in 258 postmenopausal women. A significant univariate correlation was observed between the concentration of cholesterol carried in small, dense LDL particles and plasma fibrinogen concentration (r = 0.17, p = 0.01). The prevalence of LDL subclass pattern B was 41.9% in the highest fibrinogen tertile, compared with 27.9% and 24.4% in the first and second tertiles, respectively (global chi-square 6.8, p = 0.03). The crude odds ratio (OR) for LDL subclass pattern B among women in the highest fibrinogen tertile, compared with the lower tertiles, was 2.03 (95% confidence interval [CI] 1.18 to 3.51, p = 0.01). After adjustment for age and plasma lipids (log(e) triglycerides, LDL cholesterol, and high-density lipoprotein cholesterol), the OR was 2.14 (95% CI 1.17 to 3.96, p = 0.01). Further adjustment for hematocrit, indicators of carbohydrate homeostasis, body mass index, waist circumference, and several variables related to lifestyle did not attenuate this association (OR 2.56, 95% CI 1.27 to 5.27, p = 0.01). These data suggest that hyperfibrinogenemia and LDL subclass pattern B may be 2 components of a common syndrome and suggest that hyperfibrinogenemia may contribute to the increased coronary heart disease risk associated with LDL subclass pattern B.

Aged↗

Mental stress and physical exercise increase platelet-dependent thrombin generation.

Thrombin generation is an important factor in the pathogenesis of thrombogenic disorders and acute coronary syndromes. Increase in mental stress has been associated with the initiation of the acute coronary syndromes, but the exact mechanism is not known. The present study examined the effects of physical exercise and mental stress on platelet-dependent thrombin generation. Twelve healthy men (mean age 34.2 +/- 2.4 years) underwent a treadmill exercise test and a mental stress test by performing mental arithmetic. Platelet-dependent thrombin generation and plasma concentrations of catecholamines, thrombin-antithrombin III complex (TAT), plasmin-alpha2 plasmin inhibitor complex (PIC), and plasminogen activator inhibitor-1 (PAI-1) were measured before, immediately after, and at 10 and 30 min after stress. Thrombin generation increased significantly immediately after exercise, followed by rapid normalization. Mental stress caused a significant increase in thrombin generation 10 min after stress. While plasma concentrations of epinephrine, norepinephrine, and dopamine were elevated immediately after exercise, and rapidly returned to baseline, only plasma norepinephrine increased immediately after mental stress. TAT and PIC concentrations did increase immediately after exercise; however, PAI-1 remained unchanged. The increase in thrombin generation with exercise and mental stress was unaffected by treatment with 81 mg/day of aspirin of 7 days. However, it was inhibited by a single oral 40-mg dose of metoprolol. Both exercise and mental stress cause an increase in platelet-dependent thrombin generation, which was suppressed by beta-blocker therapy, but not by aspirin.

Adrenergic beta-Antagonists↗

Activation of the visual cortex imaged by 24-channel near-infrared spectroscopy.

Near-infrared spectroscopy (NIRS) is a noninvasive technique for continuous monitoring of the amounts of total hemoglobin (total-Hb), oxygenated hemoglobin, (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb). The purpose of the present study was to demonstrate the utility of NIRS in functional imaging of the human visual cortex. A new NIRS imaging system enabled measurements from 24 scalp locations covering a 9 cm sq area. Topographic images were obtained from interpolations of the concentration changes between measurement points. Five healthy subjects between 25 and 49 years of age were investigated. After a resting baseline period of 50 s, the subjects were exposed to a visual stimulus for 20 s, followed by a 50 s resting period in a dimly lit, sound attenuating room. The visual stimulus was a circular, black and white, alternating checkerboard. In four of five subjects the visual cortex was the most activated area during visual stimulation. This is the first reported use of a NIRS-imaging system for assessing hemodynamic changes in the human visual cortex. The typical hemodynamic changes expected were observed; the total-Hb and oxy-Hb increased just after the start of stimulation and plateaued after 10 s of the stimulation period.

Adult↗

Noninvasive cerebral blood volume measurement during seizures using multichannel near infrared spectroscopic topography.

Near infrared spectroscopic topography (NIRS) is widely recognized as a noninvasive method to measure the regional cerebral blood volume (rCBV) dynamics coupled with neuronal activities. We analyzed the rCBV change in the early phase of epileptic seizures in 12 consecutive patients with medically intractable epilepsy. Seizure was induced by bemegride injection. We used eight-channel NIRS in nine cases and 24 channel in three cases. In all of the cases, rCBV increased rapidly after the seizure onset on the focus side. The increased rCBV was observed for about 30-60 s. The NIRS method can be applied to monitor the rCBV change continuously during seizures. Therefore, this method may be combined with ictal SPECT as one of the most reliable noninvasive methods of focus diagnosis.

Adult↗

Climbing the Bending Vibrational Ladder in D13C15N by Hot Gas Emission Spectroscopy.

Using a newly constructed Fourier transform emission apparatus, we have measured the threefold substituted HCN isotopomer, D13C15N, at 1370 K in the range from 450 to 700 cm-1. We could assign hot bands with upper states up to Kvl2 = 12(12). The assignments have been verified for states up to v2 = 5 by fitting with earlier room temperature absorption measurements of overtone and hot bands. The intensities are shown to be in qualitative agreement with the expected intensity pattern for such emission spectra. All the measurements for D13C15N have been combined in a single least-squares fit that includes approximately 2700 rovibrational lines which have a root-mean-square deviation on the order of 0.000 4 cm-1. The spectroscopic constants for the bending states v2 = 1, ellipsis,12 are reported, as well as for some combination states involving the other vibrational modes. We also give the spectroscopic constants of various states of DCN, D13C14N, and D12C15N which where obtained from room temperature absorption measurements. Copyright 1999 Academic Press.

Journal Article↗

Effects of repeated brief episodes of ischemia and reperfusion in isolated perfused rat hearts.

The effects of ischemia and reperfusion on the coronary endothelium and myocardium as well as tolerance to ischemia/reperfusion injury were assessed using isolated retrogradely perfused rat hearts. Repeated brief episodes of myocardial ischemia followed by reperfusion is known to have a protective effect against subsequent myocardial infarction. However, no studies have been performed with perfusion in the absence of blood cells to determine the effect of repeated ischemia and reperfusion on the coronary endothelium and myocardium. Using the Langendorff perfusion technique, rat hearts were subjected to a 30-, 10-, 5-, or 2-min period of low-flow perfusion by reducing the coronary flow to 3 ml/min followed by reperfusion at 20 ml/min for the same period of time. Control perfusion was then performed at a constant flow rate of 20 ml/ min for 60 min. Acetylcholine-induced coronary vasodilation was significantly (P < 0.05) lower in hearts subjected to 30 min of ischemia and 30 min of reperfusion when compared with the control hearts. Myocardial creatinine kinase (CK) activity was significantly reduced (P < 0.01) in hearts subjected to ischemia and reperfusion for either 30, 10, or 5 min. To assess the effect of repeated episodes of ischemia and reperfusion, the following protocols were used: a control study with constant perfusion for 60 min (group A), 30 min of ischemia and 30 min of reperfusion (group B), three 10-min episodes of ischemia and reperfusion (group C), six 5-min episodes of ischemia and reperfusion (group D), and 15 2-min episodes of ischemia and reperfusion (group E). Acetylcholine-induced coronary vasodilation was significantly inhibited in group B (80% +/- 12%, P < 0.05) and group C (70% +/- 13%, P < 0.01), but did not change significantly in either group D (123% +/-19%) or group E (142% +/- 15%), compared with the control group (group A; 127% +/- 15%, mean +/-SEM). Nitroglycerin-induced coronary vasodilation was not altered by ischemia/reperfusion in any group. In contrast, myocardial CK activity was significantly lower in group B (3.6 +/- 0.6IU/mg protein, P < 0.01), group C (3.2 +/- 0.1 IU/mg protein, P < 0.01), and group D (3.3 +/- 0.21U/mg protein, P < 0.01) than in group A (47 +/- 6.7 IU/mg protein). The myocardial CK activity of group E was not significantly different from that of group A, but was significantly higher than in groups B, C, and D (P < 0.01). In isolated perfused rat hearts, both the coronary endothelium and myocardium are damaged by repeated episodes of ischemia and reperfusion. However, the coronary endothelium is more resistant to such damage than is the myocardium.

Acetylcholine↗

Induction of smooth muscle cells in the fibrous capsule of human hepatocellular carcinoma but not in the septa of hepatic cirrhosis.

We examined the expression of smooth muscle cytoskeleton in spindle-shaped cells in the capsule of hepatocellular carcinoma (HCC) and the septa of liver cirrhosis (LC). Serial sections of livers resected from 11 patients were stained with monoclonal antibodies against vimentin, desmin, smooth muscle actin (1A4, HHF35, CGA7) and smooth muscle myosin heavy chain isoforms (SM1, SM2). Capsular spindle-shaped cells exhibited a cytoskeletal feature indicative of intermediately differentiated smooth muscle cells. Computer-assisted morphometry revealed that the proportions of 1A4-, HHF35-, CGA7- and SM1- positive areas to vimentin-positive area were 88.0+/-11.0%, 50.8+/-17.4%, 25.3+/-16.4% and 19.4+/-12.4% (n=11) in main tumours and 86.6+/-9.4%, 50.9+/-18.7%, 21.1+/-12.3% and 17.6+/-9.7% (n=12) in daughter tumours, indicating that spindle-shaped cells are heterogeneous in cytoskeletal expression. Septal spindle-shaped cells in LC lacked the cytoskeletal proteins specific to differentiated smooth muscle cells (CGA7, SM1, SM2 and desmin). Electron microscopically, capsular spindle-shaped cells contained more microfilaments and less rough endoplasmic reticulum than do septal cells. Intermediately differentiated smooth muscle cells are induced in the capsule of HCC but not in the septa of LC, suggesting a role for stromal interaction by tumour cells in the induction of smooth muscle cells.

Actins↗

Minimal change nephrotic syndrome: a possible complication of ehrlichiosis.

Ehrlichiae are rickettsial organisms recently shown to be human pathogens. Infections often cause fever, myalgia, and hematological abnormalities, and sometimes mild elevation in transaminases, creatinine, and urinary protein. We report a teenager with nephrotic syndrome from minimal change glomerulonephritis and serological evidence of ehrlichiosis. In the appropriate clinical setting, Ehrlichiae should be considered in the etiological assessment of patients with minimal change disease.

Adolescent↗

Effects of six weeks of chronic ethanol administration on the behavioral outcome of rats after lateral fluid percussion brain injury.

This study examined the effects of 6 weeks of chronic ethanol administration on the behavioral outcome in rats after lateral fluid percussion (FP) brain injury. Rats were given either an ethanol liquid diet (ethanol diet-groups) or a pair-fed isocaloric sucrose control diet (control diet groups) for 6 weeks. After 6 weeks, the ethanol diet was discontinued for the ethanol diet rats and they were then given the control sucrose diet for 2 days. During those 2 days, the rats were trained to perform a beam-walking task and subjected to either lateral FP brain injury of low to moderate severity (1.8 atm) or to sham operation. In both the control diet and the ethanol diet groups, lateral FP brain injury caused beam-walking impairment on days 1 and 2 and spatial learning disability on days 7 and 8 after brain injury. There were no significant differences in beam-walking performance and spatial learning disability between brain injured animals from the control and ethanol diet groups. However, a trend towards greater behavioral deficits was observed in brain injured animals in the ethanol diet group. Histologic analysis of both diet groups after behavioral assessment revealed comparable ipsilateral cortical damage and observable CA3 neuronal loss in the ipsilateral hippocampus. These results only suggest that chronic ethanol administration, longer than six weeks of administration, may worsen behavioral outcome following lateral FP brain injury. For more significant behavioral and/or morphological change to occur, we would suggest that the duration of chronic ethanol administration must be increased.

Animals↗

Non-invasive assessment of language dominance with near-infrared spectroscopic mapping.

Hemispheric dominance for language is usually assessed by means of the Wada test where amobarbital is injected into the carotid artery. Recently, positron emission tomography and functional MRI have been used as non-invasive alternatives to this method. We have applied 24-channel near-infrared spectroscopic topography (NIRS) as another non-invasive method to detect the unilateral cerebral activation during a language task. We used 11 healthy volunteers and six patients with intractable epilepsy. A word-generation task was applied for 17 s, followed by an extinction/resting period of 60 s. In healthy volunteers, the inferior frontal region was activated on the side opposite to the subject's handedness in infancy. In the epilepsy cases, the activated side agreed with the dominance determined by the Wada test. Our results demonstrate that NIRS is a feasible non-invasive alternative to the Wada test.

Adult↗

Infrared Spectrum of 15N13C13C15N near 2100 cm-1

The high resolution infrared spectrum of the linear centro-symmetric molecule 13C215N2 (cyanogen) has been measured in the region from 1950 to 2150 cm-1. The nu3 fundamental band and the difference band nu1-nu5 were observed in that region. Hot-band transitions arising from the nu5, 2nu5, 3nu5, and nu4 levels were also measured with the nu3 band. The nu3 fundamental band and first hot band for 15N12C13C15N were also measured. Copyright 1998 Academic Press. Copyright 1998Academic Press

Journal Article↗