PubMed Health⌕ Search

Biomedical subjects

A Usui

Publications and source records attributed to A Usui.

At least 19 recordsLinked to original sources
PubMed2006

[Aortic valve replacement for the small aortic annulus].

Aortic valve surgery for the small aortic annulus is still challenging for surgeons. Recently, the new types of high performance prosthesis have been developed and the chance of an aortic root enlargement (ARE) is decreasing. In this study, we propose the ideal strategy of the aortic surgery for the small aortic annulus. We analyzed the clinical records of 158 patients who underwent aortic valve replacement from August 1999 to October 2005 in our institution. The small aortic annulus was observed in 38 patients (24%). Fourteen patients of this group underwent ARE. Patient-prosthesis mismatch (PPM) was less frequently observed in patients with ARE compared to those without ARE. The additional time required for ARE was not considerable, and neither ischemic time nor cardiopulmonary bypass time was significantly prolonged by ARE. In conclusion, we have to select a prosthesis with sufficient orifice area to avoid PPM, otherwise we should choose an option of ARE. For this consideration, we definitely need the chart that demonstrates the relationship between the nominal size of various types of prostheses and the size of a patient's annulus that those prostheses actually fit.

Aged↗
PubMed2004

[Surgery for acute aortic dissection concomitant with preceding axillofemoral bypass to prevent malperfusion of visceral organs and limb ischemia].

A 52-year-old man was admitted with sudden onset of epigastralgia. Abdominal X-ray showed dilated intestine and computed tomography (CT) revealed extended type A aortic dissection. Marked abdominal distention and weak pulse of right femoral artery were recognized so malperfusion of visceral organs due to narrowing true lumen compressed by thrombosed false lumen was suggested. In the operation, right axillo-right femoral bypass was established preceding to median sternotomy. This graft was used as an arterial perfusion site of cardiopulmonary bypass, and replacement of the ascending aorta was performed under hypothermic circulatory arrest and retrograde cerebral perfusion. Sign of malperfusion of visceral organs was showed for several days after the operation but it disappeared without further intervention. Axillofemoral inflow of cardiopulmonary bypass may be effective procedure in these cases.

Anastomosis, Surgical↗
PubMed2002

Plasma orexin-A is lower in patients with narcolepsy.

Recently identified hypothalamic peptides called orexins (or hypocretins) have been implicated in the sleep-wake cycle and in sleep disorder narcolepsy. Neuropathological studies have shown that in patients with narcolepsy, global reduction in the expression of orexins occurs due to the loss of orexin neurons in the hypothalamus. Cerebrospinal fluid analysis has confirmed a reduced or undetectable level of orexin-A in most narcolepsy patients. In this study, measurement of plasma orexin showed significantly lower concentrations in patients with narcolepsy than in age- and gender-matched normal controls. These data suggest that low levels of orexin-A in plasma could serve as a biological marker for narcolepsy.

Adult↗
PubMed2001

Giant vegetation mimicking cardiac tumor in tricuspid valve endocarditis after catheter ablation.

A 33-year-old man suffered from fever of unknown origin and developed right-sided heart failure. A transeshophageal echocardiogram revealed an progressive enlarging mass in the right atrium mainly attached to the tricuspid valve and a previous ablation site, which mimicked a cardiogenic tumor. He was operated on to remove the mass and intraoperative pathology showed it was large vegetation and secondary granulation due to tricuspid endocarditis. Tricuspid valve replacement was performed combined with reconstruction of the right atrial wall.

Catheter Ablation↗
PubMed2001

Evaluation of antibody class in response to endoscopic subureteral collagen injection in patients with vesicoureteral reflux.

PURPOSE: Clinical problems after glutaraldehyde cross-linked collagen injection for vesicoureteral reflux are the appearance of anticollagen antibodies and a decrease in collagen with time. We evaluated whether antibody production affects reflux recurrence and implanted collagen absorption. MATERIALS AND METHODS: We treated 27 patients (39 ureters) who had vesicoureteral reflux with endoscopic subureteral glutaraldehyde cross-linked collagen injection. The maximum diameter of the elevated ureteral orifice was measured 3-dimensionally and the numerical value calculated by multiplying each diameter by approximately pi/6 was used as the ultrasound estimate of injected collagen volume. The 1-to-6-month collagen volume ratio was used as an index of the decrease in implant collagen volume. The antibody class against bovine collagen was characterized by indirect enzyme-linked immunosorbent assay. RESULTS: Seroconversion in 6 patients was noted a mean 6.8 months after the first injection. In these patients the antibody class was IgG dominant and IgA or IgM was not detected. There was no significant difference in the total injected collagen volume, total number of injections or collagen volume ratio in the seropositive and seronegative groups. Reflux recurred in 4 patients and the curve of the reflux-free rate was similar regardless of antibody appearance. CONCLUSIONS: The immune response to bovine collagen injection for vesicoureteral reflux does not depend on injected collagen volume or an increased number of treatments. Antibody production had no effects on absorption of the implanted collagen or reflux recurrence.

Adult↗
PubMed2000

Detection of interstitial Ga in GaN

We report the direct detection of interstitial Ga by optical detection of electron paramagnetic resonance (ODEPR) in the photoluminescence of n-type GaN after irradiation in situ at 4.2 K with 2.5 MeV electrons. It is stable upon annealing until room temperature, where it becomes mobile and trapped to form a new defect which is observed to emerge as the interstitial disappears. The time constant of the process at room temperature is approximately 200 min. The emergence of another ODEPR center beginning at approximately 135 K suggests even easier migration of one of the other intrinsic defects in the GaN lattice.

Journal Article↗
PubMed2000

Sarpogrelate reduces mechanical hemolysis in patients with heart valve prostheses.

OBJECTIVE: We evaluate the clinical efficacy of sarpogrelate, an antiplatelet drug that improves red blood cell deformability, to reduce the intravascular hemolysis problems suffered frequently by patients implanted with heart valve prostheses. SUBJECTS: Subjects were 34 patients undergoing mechanical heart valve replacement and having serum lactate dehydrogenase concentrations 20% above the maximum normal range. METHOD: Sarpogrelate was given daily, 100 mg orally for the first 6 months and 200 mg thereafter. RESULTS: Average serum lactate dehydrogenase decreased significantly from 423 +/- 108 IU/l, to 391 +/- 83 IU/l with the 100 mg dose, and to 361 +/- 86 IU/l with the 200 mg dose. The percentage of reticulocytes decreased from 15.5 +/- 5.3/1000 to 15.3 +/- 5.7/1000 at the 100 mg dose and 13.1 +/- 4.0/1000 at the 200 mg dose. Serum iron concentrations increased significantly from 63.2 +/- 24.8 micrograms/dl to 76.2 +/- 16.2 micrograms/dl at the 100 mg dose, and to 70.9 +/- 26.2 micrograms/dl with the 200 mg dose. CONCLUSION: Sarpogrelate is a useful drug for patients with implanted heart valve prostheses and subsequent high serum lactate dehydrogenase because it works as an antiplatelet drug and reduces mechanical hemolysis.

Adult↗
PubMed2000

Clinical results of implantation of an endovascular covered stent-graft via midsternotomy for distal aortic arch aneurysm.

UNLABELLED: We have been implanting endovascular stent grafts (EVG) via midsternotomy for distal aortic arch surgery since February 1997. The early clinical results are evaluated. METHODS: There were 11 true aneurysms (8 fusiform, 3 saccular) and one chronic type B dissection. The average age was 68 yr (63-81). EVGs were PTFE-covered two-8 bend Z stents in the first eight cases and made with the same stents and ultrathin woven Dacron grafts in the last four cases. RESULTS: Total arch replacement and aortocoronary bypass grafting were combined in one and two patients, respectively. The average retrograde cerebral perfusion time was 42+/-8 min. The cardiopulmonary bypass time averaged 211+/-26 min. All patients awoke early after operation (4.5+/-1.2 h). All but one case was extubated within 24h. There was no operative mortality, but paraplegia and cerebral infarction were complicated in one case each. Their maximum diameter (73.9+/-21.2mm) decreased significantly after operation (68.7+/-20.1mm) and one year thereafter (63.1+/-16.0 mm). True aneurysms were thrombosed completely. A chronic type B dissection revealed impending rupture due to false lumen infection one year after operation. The whole descending aorta replacement was performed but the patient died 6 months thereafter due to cerebro-vascular complication. CONCLUSION: Implantation of EVGs reduces operative invasion for distal arch surgery. This procedure should improve mortality, while long-term results have not been clarified.

Aged↗
PubMed2000

Seasonal changes in human sleep-wake rhythm in Antarctica and Japan.

The subjects were eight men of the Japanese Antarctic Research Expedition (average age 35.8 years), and 10 healthy people living around Kofu, Japan (28.9 years). They completed a sleep log for 12 to 18 months, and the sleep-wake state was scored in 10-min epochs. Q24 values calculated by chi2 periodgram were low in the Antarctic midwinter. This means that there was difficulty in synchronizing to a 24-h period in the Antarctic midwinter. In Antarctica, sleep onset and offset times were delayed mostly in the midwinter. In Japan, sleep offset time was delayed mostly around the winter solstice.

Adult↗
PubMed2000

Bright light treatment for night-time insomnia and daytime sleepiness in elderly people: comparison with a short-acting hypnotic.

Night-time bright light (BL) treatment and triazolam (0.125 mg/day) were given to three healthy elderly people in a cross-over design. They kept a daytime sleepiness test and a sleep log, and their wrist-activity was monitored simultaneously. Subjectively, BL increased daytime sleepiness and naps, and decreased night-time sleep. Triazolam decreased daytime sleepiness and naps, and increased night-time sleep. Actigraphic night-time sleep and naps on the first day were similar to these results. However, on the fourth day night-time insomnia induced by BL had recovered, and naps were shorter than the baseline. Triazolam increased actigraphic naps as the days passed.

Aged↗
PubMed2000

Maintenance of blood heparin concentration rather than activated clotting time better preserves the coagulation system in hypothermic cardiopulmonary bypass.

In cardiopulmonary bypass (CPB), despite heparin regimens in which the activated clotting time (ACT) is kept at more than 400 s, there is biochemical evidence of thrombin generation indicating activation of the coagulation system and increased fibrinolytic activity. Therefore, to reduce the coagulant activation has been one of the main issues in the improvement of CPB. The purpose of this study was to compare the heparin concentration with the ACT and to evaluate the effect of keeping higher heparin concentration on the coagulation and fibrinolytic systems during hypothermic CPB, employing moderate hypothermia (MHT) or deep hypothermic circulatory arrest (DHT). Heparin was either administered to maintain an ACT >400 s (ACT group) or to maintain a whole blood heparin concentration of 3 mg/kg (heparin group). At the lowest core temperature during CPB, the ACT and the heparinase ACT (unrelated to heparin concentration) were increased the most whereas the whole blood heparin concentration was less than half the initial concentration in both ACT groups of MHT and DHT. The thrombin-antithrombin III (TAT) content just after CPB in both MHT and DHT was significantly lower in the heparin group than in the ACT group. In conclusion, ACT does not reflect the whole blood heparin concentration during hypothermic CPB. Furthermore, maintenance of the higher heparin concentration during hypothermic CPB may suppress the activation of the coagulation system via thrombin inhibition. That effect was more remarkable in deep hypothermic CPB. Therefore, we believe that anticoagulation management during hypothermic CPB should be based on the maintenance of the higher blood heparin concentration.

Aged↗
PubMed2000

Dislocation propagation in GaN films formed by epitaxial lateral overgrowth

We have investigated by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) the relationship between surface morphological evolution and dislocation propagation in GaN films formed by epitaxial lateral overgrowth (ELO) in hydride vapour phase epitaxy. The SEM observations revealed that step and terrace structures were formed on (0001) surfaces of the films both in the earlier and the later stages of growth, suggesting the occurrence of step-flow growth during ELO. Bending dislocations with laterally propagated segments were frequently observed in the ELO films and their morphology led to a reduction in threading dislocation density in the film surface regions. Systematic TEM observations were performed to reveal the detailed structure of the bending dislocations. Comparison between the SEM and the TEM results showed that the lateral propagation of the dislocation was closely related to the appearance of the [1101) facets. A mechanism for dislocation propagation is discussed that explains the observed dislocation structure and surface step morphology.

Journal Article↗
PubMed2000

The endothelin-2/vasoactive intestinal contractor gene: expression and promoter activity in PC12 rat pheochromocytoma cells.

In order to understand the physiological roles of vasoactive intestinal contractor (VIC)/endothelin-2 (ET-2), we examined the expression of this peptide by specific reverse transcriptase polymerase chain reaction (RT-PCR) analysis and found that PC12 rat pheochromocytoma cells express the VIC gene. The 5'-flanking 1.0 kilo base pair (kb) region of the mouse VIC gene is sufficient to express a secreted alkaline phosphatase (SEAP) reporter gene in transiently transfected PC12 cells. The 1.0 kb promoter region may contain cis-acting elements that determine the rate of the VIC gene transcription in PC12 cells.

Animals↗
PubMed2000

Arabidopsis ethylene-responsive element binding factors act as transcriptional activators or repressors of GCC box-mediated gene expression.

Ethylene-responsive element binding factors (ERFs) are members of a novel family of transcription factors that are specific to plants. A highly conserved DNA binding domain known as the ERF domain is the unique feature of this protein family. To characterize in detail this family of transcription factors, we isolated Arabidopsis cDNAs encoding five different ERF proteins (AtERF1 to AtERF5) and analyzed their structure, DNA binding preference, transactivation ability, and mRNA expression profiles. The isolated AtERFs were placed into three classes based on amino acid identity within the ERF domain, although all five displayed GCC box-specific binding activity. AtERF1, AtERF2, and AtERF5 functioned as activators of GCC box-dependent transcription in Arabidopsis leaves. By contrast, AtERF3 and AtERF4 acted as repressors that downregulated not only basal transcription levels of a reporter gene but also the transactivation activity of other transcription factors. The AtERF genes were differentially regulated by ethylene and by abiotic stress conditions, such as wounding, cold, high salinity, or drought, via ETHYLENE-INSENSITIVE2 (EIN2)-dependent or -independent pathways. Cycloheximide, a protein synthesis inhibitor, also induced marked accumulation of AtERF mRNAs. Thus, we conclude that AtERFs are factors that respond to extracellular signals to modulate GCC box-mediated gene expression positively or negatively.

Amino Acid Sequence↗
PubMed2000

Endovascular stent-graft deployment: temporary vena caval occlusion with balloons to control aortic blood flow-experimental canine study and initial clinical experience.

Vena caval occlusion was evaluated in animal experiments. In five patients with thoracic aortic aneurysms, two balloon catheters were introduced via the femoral vein to the inferior vena cava and superior vena cava and inflated before stent-graft deployment. Aortic pressure and flow were immediately decreased, which minimized the downstream shift of the stent-grafts. Temporary vena caval occlusion is safe and effective for precise aortic stent-graft deployment.

Aged↗
PubMed2000

Endoscopic subureteral glutaraldehyde cross-linked collagen injection for the treatment of secondary vesicoureteral reflux: comparison with primary vesicoureteral reflux in adults.

PURPOSE: We assessed the effectiveness of endoscopic subureteral glutaraldehyde cross-linked collagen injection for treating vesicoureteral reflux in patients with vesicoureteral disorders. MATERIALS AND METHODS: All 51 ureters studied had grade II or greater vesicoureteral reflux. We treated 18 patients (24 refluxing ureters) with secondary and 17 adults (27 refluxing ureters) with primary vesicoureteral reflux. The primary group served as controls to establish normal urination. A total of 14 patients with secondary vesicoureteral reflux had a low compliant autonomous bladder, including 11 with myelodysplasia and 3 after pelvic surgery and radiotherapy. One patient had an unstable bladder due to cerebral palsy and 3 had anatomical abnormalities of the urinary tract. We evaluated the estimated reflux-free rate in the secondary and adult primary vesicoureteral reflux groups. RESULTS: Repeat injection was required in 24 ureters because of recurrent reflux. Average injected volume in the secondary and primary groups was 2.72 and 2.88 ml. per refluxing unit, respectively. The estimated reflux-free rate after the initial injection decreased gradually to about 35% in each group, while 12 and 24 months after the last injection it remained constant at 70% in the secondary group but decreased from 84.7% to 62.1% in the primary group. The percent of late recurrence was higher in the primary group. CONCLUSIONS: Long-term efficacy of the endoscopic correction of vesicoureteral reflux in the secondary group was similar to that in the primary group. Thus, endoscopic subureteral glutaraldehyde cross-linked collagen injection is useful for treating complicated secondary vesicoureteral reflux as a minimally invasive procedure. It is considered optional treatment of primary vesicoureteral reflux to avoid long-term prophylactic treatment.

Absorbable Implants↗
PubMed1999

Cytosolic NADPH-UQ reductase, the enzyme responsible for cellular ubiquinone redox cycle as an endogenous antioxidant in the rat liver.

Cellular ubiquinone (UQ) is expected to act as an endogenous antioxidant against oxidative stress. To confirm this, UQ-reductases which are necessary to regenerate ubiquinol (UQH2) were investigated in rat tissue, and a novel NADPH-dependent UQ (NADPH-UQ) reductase was found in cytosol. The cytosolic NADPH-UQ reductase activity accounted for more than 80% of UQ-10 reduction by the rat liver homogenate in the presence of NADPH. Furthermore, the NADPH-UQ reductase activities in various tissues were correlated to the redox states of UQ in the corresponding tissues. Rat liver cytosol with NADPH protected lecithin liposomes containing UQ-10, as well as UQH2-10 from AMVN (2,2'-azobis(2,4-dimethylvaleronitrile))-induced lipid peroxidation. The enzyme purified from rat liver cytosol, reduced UQ-10 in lecithin liposomes at approximately the same rate as did cytosol. These results supported that cytosolic NADPH-UQ reductase is the enzyme responsible for nonmitochondrial UQ reduction acting as an endogenous antioxidant against oxidative stress. The antioxidant role of the UQ redox cycle and NADPH-UQ reductase was discussed in relation to other cellular NADPH-dependent antioxidant enzymes.

Animals↗