PubMed Health⌕ Search

Biomedical subjects

Daisuke Fukui

Publications and source records attributed to Daisuke Fukui.

10 recordsLinked to original sources

Antithrombotic therapy and predilection for cerebellar hemorrhage.

BACKGROUND: With the recent increase in the use of antithrombotic therapy, intracerebral hemorrhage (ICH) has been found to be a common complication. We determined whether the use of oral antithrombotic therapy and the patients' preexisting comorbidities were predictive of cerebellar hemorrhage (CH; previously reported to be associated with anticoagulants) as compared to other ICH, and whether antithrombotic therapy affected the clinical severity of CH. METHODS: A study of 327 consecutive patients hospitalized in our institute within 3 days after the onset of ICH, including 38 patients with a CH. RESULTS: CH accounted for 12% of all ICH, 75% of which occurred in patients on warfarin therapy with an international normalized ratio (INR) for prothrombin time >2.5 (p < 0.0001), and 33% of which occurred in patients on ticlopidine therapy (p = 0.017). Warfarin therapy with an INR >2.5 and high blood glucose on admission were independently predictive of CH as compared to other ICH. In addition, previous ischemic stroke (p = 0.002) and heart diseases (p = 0.018) were more prevalent in patients with CH than in those with other ICH. The number of major arteriosclerotic comorbidities and risk factors was also independently predictive of CH risk. CONCLUSIONS: We confirmed that warfarin therapy with an INR >2.5 is associated with CH. Patients with CH frequently had arteriosclerotic comorbidities requiring antithrombotic therapy that can complicate their acute management.

Administration, Oral↗

Therapeutic angiogenesis by bone marrow implantation for critical hand ischemia in patients with peripheral arterial disease: a pilot study.

OBJECTIVE: Implantation of bone marrow mononuclear cells (BM-MNCs), including endothelial progenitor cells, into ischemic lower limbs has been shown to improve symptoms in patients with peripheral arterial diseases (PAD). This study investigated whether BM-MNC implantation (BMI) is also effective for the ischemic hands of these patients. METHODS: Seven PAD patients with hand ischemia were enrolled: six patients had thromboangiitis obliterans and one had collagen disease. All seven had symptoms involving either resting pain or non-healing ischemic ulcers of the hand. Approximately 600 mL of MNCs were separated from BM and concentrated to a final volume of 40-50 mL, which were injected into ischemic hands. Ischemic status was evaluated by measuring the digital/brachial pressure index (DBI), visual analog pain scale, and the healing of ulcers before and 6 months after BMI. RESULTS: The mean number of implanted MNCs, CD34-positive cells, and CD34,133-positive cells was 3.67 +/- 0.53 x 10(9), 4.94 +/- 2.45 x 10(7), and 2.52 +/- 1.57 x 10(7), respectively. Mean DBI in those patients was 0.15 +/- 0.30 before BMI and significantly increased to 0.67 +/- 0.19 at 6 months after BMI (p = 0.004). All patients also showed improvement of pain scale and ischemic ulcers. There was no significant correlation between the number of implanted cells and improvement in the degree of DBI or the pain scale. CONCLUSION: Autologous BMI could be a promising and safe method of therapeutic angiogenesis for critical hand ischemia in PAD patients.

Adult↗

Neutralizing antibodies against feline parvoviruses in nondomestic felids inoculated with commercial inactivated polyvalent vaccines.

The virus neutralization (VN) antibody titers of serum samples from 18 individuals representing 8 carnivore species vaccinated with commercial polyvalent vaccines optimized for domestic cats containing inactivated feline panleukopenia virus (FPLV) were evaluated against canine parvovirus type 2 (CPV2). In addition, the titers among 5 individuals from 4 carnivore were evaluated against antigenic variants of feline parvoviruses; FPLV, CPV2, CPV2a, CPV2b, CPV2c, mink enteritis virus type 1 (MEV1) and MEV2. The polyvalent vaccines induced cross-reactive VN titers against antigenic variants of feline parvoviruses in nondomestic felids. However, we observed very low cross-reactive VN antibody in lions and Siberian tigers, therefore we should pay attention to CPV infections in these animals even if they were vaccinated with inactivated FPLV vaccines.

Animals↗

Successful surgical treatment for acute aortic dissection in pregnancy with Marfan's syndrome.

A 34-year-old pregnant woman with Marfan's syndrome in the 34th week of gestation was diagnosed with acute DeBakey type I aortic dissection. Immediately after cesarean section, she underwent emergent operation of combined total aortic arch and aortic root replacement using cardiopulmonary bypass, deep hypothermia and antegrade cerebral perfusion. Both maternal and fetal outcomes were good and uneventful. Pregnancy increases the risk of aortic dissection especially for patients with Marfan's syndrome. Moreover it should be noted that cardiac surgery using cardiopulmonary bypass and deep hypothermia generally results in fetal loss. If fetal maturity can be confirmed as in our case, cesarean section should be done before cardiovascular surgery. We describe here a case of successful operation for mother and infant at the 34th week of gestation.

Aortic Dissection↗

Neurogenic double-peaked vasoconstriction of human gastroepiploic artery is mediated by both alpha1- and alpha2-adrenoceptors.

1. The contribution of postjunctional P2X receptors and subtypes of alpha-adrenoceptors to vasoconstrictor responses following periarterial electrical nerve stimulation (PNS, 30 s trains of pulses at a frequency of 2, 4 or 8 Hz) was investigated in human gastroepiploic arteries. 2. The vasoconstrictor response to PNS at a stimulation of 4 or 8 Hz was a two-peaked response, whereas at a frequency of 2 Hz it appeared only as a late peak. All vasoconstrictions evoked by PNS were abolished by phentolamine, a nonselective alpha-adrenoceptor inhibitor, but not by alpha,beta-methylene ATP, a P2X receptor-desensitizing agent. 3. The early peak to PNS at 4 or 8 Hz was abolished by prazosin, an alpha1-adrenoceptor antagonist, while the late one still remained, although it was markedly inhibited. The responses remaining after prazosin were blocked by rauwolscine. The vasoconstrictor response to PNS at 2 Hz was not affected by prazosin (0.1 microM), but was abolished by rauwolscine (0.1 microM), an alpha2-adrenoceptor antagonist. 4. OPC-28326 (10 microM), a newly developed vasodilator, which preferentially exerts its antagonistic actions on the alpha2B- and alpha2C-adrenoceptors, significantly reduced the noradrenaline-induced vasoconstriction in the absence or presence of prazosin. OPC-28326 had a greater inhibitory effect on the late peak evoked by PNS than the early one. The neurogenic responses remaining after OPC-28326 were abolished by prazosin. 5. The present results suggest that sympathetic vasoconstriction of the human gastroepiploic artery is mediated by both alpha1- and alpha2-adrenoceptors postjunctionally, but not by P2X receptors. The alpha2-adrenoceptors may be preferentially activated at a low frequency of stimulation, which induces a constriction more slowly than that by alpha1-adrenoceptors. The existence of alpha2-adrenoceptors may cause an enhancement of alpha1-adrenoceptor-induced responses.

Adrenergic alpha-1 Receptor Antagonists↗

Effects of repeated anthelmintic treatment on Enterobius vermicularis infection in chimpanzees.

Effects of repeated treatment with pyrantel pamoate on Enterobius vermicularis infection in chimpanzees were assessed by observing worms discharged in the feces after administration of anthelmintic treatment. Three of 9 chimpanzees reared in a zoological garden in Japan were subjected to fecal worm count and morphometric observation, and all were given oral pyrantel pamoate 6 times at 10-day intervals simultaneously. Following the first and second treatments, more than 30,000 pinworms were discharged from 1 chimpanzee. The number of discharged worms abruptly decreased after the third treatment, and only a few worms were recovered after the fifth treatment, indicating that repeated treatment at short intervals was very effective. Complete eradication was not achieved, however, presumably because of reinfection. The female proportion among discharged worms tended to increase as the treatment was repeated.

Animals↗

Existence of alpha-adrenoceptor subtypes in isolated human gastroepiploic and omental arteries.

Establishing the existence of alpha-adrenoceptor subtypes in isolated human gastroepiploic and omental arteries was the goal of the present study. Functional vascular reactivity of selective alpha(1)- and alpha(2)-adrenoceptor agonists and antagonists was studied, using a cannula inserting technique. Intraluminal administration of norepinephrine (NE), phenylephrine (PE) or BHT-933 caused a vasoconstrictive response in a dose-related manner. The relative potencies of the 3 agonists were almost the same in both arteries. NE-induced vasoconstrictions were significantly antagonized by either prazosin or rauwolscine. PE-induced responses were strongly inhibited by prazosin. BHT-933-induced constrictions were inhibited by rauwolscine. These results indicate that both alpha(1)- and alpha(2)-adrenoceptors exist in the human gastroepiploic and omental arteries.

Adrenergic alpha-1 Receptor Agonists↗

Use of near-infrared spectroscopic measurement at the buttocks during abdominal aortic surgery.

During abdominal aortic surgery, dynamic changes occur in the pelvic circulation. Near-infrared spectroscopy (NIRS) was used in this study to evaluate arterial flow in the buttocks as a monitor of arterial flow in the pelvic area during abdominal aortic surgery. Twenty-two patients who underwent abdominal aortic aneurysmectomy comprised the study group. The NIRS probe was mounted on the left buttock during surgery, and the changes in oxy- and deoxy-hemoglobin (Hb) concentration were measured. In all cases Hb values reflected decreased arterial flow caused by aortic clamping and increased arterial flow after reconstruction of the distal arteries. The recovery pattern of the Hb values varied, but all recovered to the baseline value recorded before aortic clamping. None of the patients exhibited postoperative claudication of vessels supplying the gluteal muscles or colonic ischemia, and recovery time varied in accordance with the patient's arterial condition. This method is simple and enables individual evaluation of blood flow recovery from reconstructed arteries. This method allows approximate evaluation of the pelvic arterial flow of individual arteries, helps to predict postoperative claudication of the gluteal muscles, and offers additional information for evaluating colonic ischemia.

Aged↗

Malignant melanoma of the eyelid in a red squirrel (Sciurus vulgaris orientis).

A 6-year-old male red squirrel (Sciurus vulgaris orientis) developed bilateral tumors of upper and lower eyelids. The tumors in the left lid recurred despite surgical removal. Necropsy revealed metastasis to the lung. The neoplastic cells were epithelioid and highly pleomorphic, and only a few cells contained melanin granules. Occasionally melanoma cells were immunoreactive for S100, neuron-specific enolase and vimentin, and a small number of cells for cytokeratin. Ultrastructurally, the presence of premelanosomes was confirmed in the cytoplasm. Possible presence of cytokeratin-positive neoplastic melanocytes should be taken into account when differentiating a nonpigmented epithelioid melanoma from other tumors such as anaplastic carcinomas.

Animals↗

Increasing circulation in the lower limb under general anesthesia using the A-V impulse system.

The action of foot impulse technology (FIT) in reducing the risk of deep vein thrombosis (DVT) is well established. We hypothesized that intraoperative use of FIT devices will be effective in the prophylaxis of DVT. The aim of this study was to investigate the effect of a FIT device (A-V impulse system) on the venous flow of the lower extremity using duplex ultrasound scanning while the patient was under general anesthesia. Thirteen surgical patients who had no lower limb vessel lesions were selected for the study. Duplex scanning was used to measure blood velocity in the right common femoral vein, with and without the foot pump, before and during general anesthesia. The mean resting velocity was 33.2 +/- 5.5 cm/sec in the pre-anesthetic state, 32.1 +/- 4.2 cm/sec under anesthetic, and 30.4 +/- 5.0 cm/sec postoperatively. The peak velocities with the pump active were 38.6 +/- 5.0 cm/sec before anesthetic, 54.6 +/- 5.9 cm/sec while anesthetized, and 52.7 +/- 7.8 cm/sec postoperatively. The measured increases while under anesthesia and postoperatively both reached statistical significance (p<0.05). Our study demonstrated that use of the A-V impulse system causes a statistically significant increase in venous velocity of the lower extremity while the patient is under general anesthesia.

Adult↗