Biomedical subjects

E Kai

Publications and source records attributed to E Kai.

17 recordsLinked to original sources

PubMed2001

[Effects of colforsin daropate hydrochloride in patients undergoing coronary artery bypass surgery].

The effects of Adehl, colforsin daropate hydrochloride, on hemodynamics were studied in patients undergoing cardiac surgery. Twenty-six patients who underwent coronary artery bypass grafting were divided into two groups according to the intraoperative administration of Adehl. The control group (n = 14) received no Adehl treatment and the Adehl group (n = 12) received Adehl infusion immediately after anesthesia induction (0.5 microgram.kg-1.min-1) for 6 hours. Hemodynamic measurements and clinical results were accessed perioperatively. The Adehl group resulted in significantly (p < 0.05) lower pulmonary capillary wedge pressure and systemic vascular resistance, and significantly (p < 0.05) greater cardiac indices and left ventricular stroke work indices than those in the control group. No significant difference was found in the rate pressure product between the groups. The Adehl group resulted in significantly shorter duration of intubation and ICU stay. Adehl was not associated with a significant increase in the prevalence of adverse effects. The results suggest that Adehl has positive inotropic and vasodilator effects without increasing myocardial oxygen consumption. Thus, it is suggested that Adehl can be a useful agent for the perioperative management in patients undergoing cardiac surgery.

Aged↗

PubMed2001

Influence of renal function on serum and urinary heart fatty acid-binding protein levels.

BACKGROUND: Serum heart fatty acid-binding protein (H-FABP) has been reported to be a sensitive and early indicator of myocardial damage. However, circulating H-FABP may be cleared considerably from kidney, similar to that found for myoglobin. Therefore, the possibility exists that any change in renal function affects serum H-FABP concentration, and thus leads to erroneous interpretation. To evaluate the influence of renal function on H-FABP levels, we conducted a prospective study. METHODS: Nineteen patients undergoing isolated primary coronary artery bypass grafting were enrolled in this study. The patients were classified by the preoperative creatinine clearance into two groups: the control group (n=12); patients with creatinine clearance of 40 mL/min or greater, and the renal dysfunction group (n=7); patients with creatinine clearance of less than 40 mL/min. Serum H-FABP, CK-MB, troponin-T and urinary H-FABP levels were measured perioperatively. RESULTS: None of the patients had perioperative myocardial infarction. No significant differences were found in CK-MB and troponin-T levels between the groups. The renal dysfunction group resulted in significantly (p<0.05) higher serum H-FABP levels and lower urinary H-FABP levels than those in the control group, postoperatively. The creatinine clearance correlated inversely with the peak levels of serum H-FABP (r=-0.75, p=0.0001) and correlated with the peak levels of urinary H-FABP (r=0.64, p=0.003). CONCLUSIONS: The results indicate that the kidneys play an important role in the clearance of serum H-FABP. Thus, caution must be taken in interpreting this marker for myocardial damage during cardiac surgery in patients with renal dysfunction.

Aged↗

PubMed2000

Effects of angiotensin-converting enzyme inhibitor during warm blood cardioplegia.

BACKGROUND: Effects of captopril, an angiotensin-converting enzyme inhibitor, during warm blood cardioplegia were assessed in the blood-perfused, isolated rat heart. METHODS: The isolated hearts were arrested for 60 minutes with warm blood cardioplegia given at 20-minute intervals and were reperfused for 60 minutes. The control group (n = 10) received standard cardioplegia and the captopril group (n = 10) received cardioplegia supplemented with captopril (2 mmol/L). Cardiac function, myocardial metabolism, and cardiac release of circulating adhesion molecules were assessed before and after cardioplegic arrest. RESULTS: Left ventricular end-diastolic pressure and -dp/dt were significantly (p<0.05) lower and coronary blood flow was significantly (p<0.05) greater in the captopril group than the control group during reperfusion. The captopril group resulted in significantly (p<0.05) less cardiac release of lactate, thiobarbituric acid reactive substances during reperfusion. Cardiac release of intercellular adhesion molecule-1 was significantly (p<0.05) less in the captopril group at 60 minutes of reperfusion. CONCLUSIONS: The results suggest that supplementation of captopril during warm blood cardioplegia provides superior myocardial protection by suppressing lipid peroxidation and leukocyte-endothelial cell interaction during reperfusion.

Angiotensin-Converting Enzyme Inhibitors↗

PubMed2000

Internal thoracic artery as a collateral source to the ischemic lower extremity.

Based on the superior long-term results, internal thoracic artery is widely used for coronary artery bypass grafting. However, the vessel can play an important role as a collateral source to the chronically ischemic lower limbs. We reported two cases who underwent simultaneous revascularization to the myocardium and lower limbs because this particular condition was anticipated. Selective angiography of internal thoracic artery was useful to determine its role before harvesting in our cases. Careful preoperative examinations and choice of surgical approach are required for such patients to avoid serious vascular complications.

Angiography, Digital Subtraction↗

PubMed2000

Detection of PCR products of Escherichia coli O157:H7 in human stool samples using surface plasmon resonance (SPR).

A method for the rapid detection of verotoxin-producing Escherichia coli O157:H7 in stools was evaluated. Strains possessing Shiga toxin-2 (stx-2) genes were isolated from stool samples and amplified using oligonucleotide primers. Stools spiked with cultured E. coli O157:H7 (strain 298 or strain 1646) were detected to be polymerase chain reaction (PCR) positive at 10(2) cfu per 0.1 g of stool. Stool samples from patients and healthy carriers showed a high correlation between positive results for a PCR and the presence of verotoxin-producing E. coli O157:H7, confirmed by isolation of serotype O157:H7 on sorbitol MacConkey medium (10 of 10 stool samples). These PCR products could be detected using a BIAcore 2000 surface plasmon resonance device using peptide nucleic acid as a sensor probe. In this report we use this method for the rapid detection of DNA from significant pathogenic organisms.

Carrier State↗

PubMed2000

Plasma and urinary levels of heart fatty acid-binding protein in patients undergoing cardiac surgery.

To evaluate the clinical significance of the plasma and urinary levels of heart fatty acid-binding protein (H-FABP) in patients undergoing cardiac surgery, a prospective study was conducted. Ten patients undergoing coronary artery bypass grafting were enrolled. Blood samples for determination of plasma H-FABP (pH-FABP), the MB isoenzyme of creatine kinase (CK-MB) and troponin-T (TnT), and urine samples for determination of urinary H-FABP (uH-FABP) were collected serially. None of the patients had perioperative myocardial infarction. The time to reach the peak level after aortic declamping was significantly (p<0.05) shorter for pH-FABP (1.4+/-0.5 h) than for CK-MB (2.5+/-0.5 h), TnT (6.6+/-1.3 h) or uH-FABP (3.0+/-0.6 h). Peak levels of pH-FABP correlated with those of CK-MB (r = 0.51, p = 0.04), TnT (r = 0.60, p = 0.03) and uH-FABP (r = 0.61, p = 0.03), and peak levels of uH-FABP correlated with CK-MB (r = 0.57, p = 0.04). Postoperative uH-FABP levels correlated inversely with the left ventricular stroke work index (r = -0.63, p = 0.04). This study demonstrated that H-FABP appears rapidly in plasma after reperfusion and reaches its peak earlier than other available biochemical markers; it appears also in urine and the levels correlated with cardiac function. Plasma and urinary H-FABP may be an early and sensitive biochemical marker for the diagnosis of myocardial injury in patients undergoing cardiac surgery.

Blood Pressure↗

PubMed2000

Coronary artery bypass surgery in a patient with myasthenia gravis.

A 73-year-old man with myasthenia gravis required quadruple coronary artery bypass grafting due to triple-vessel disease. Anesthetic management was performed with general anesthesia using a reduced dose of muscle relaxant with the aid of a neuromuscular transmission monitor. He was extubated 14 hrs after surgery without difficulty under this monitor. His postoperative course was uneventful. A patient with myasthenia gravis who required coronary artery bypass surgery was successfully performed by the deliberate preoperative evaluation of patient's myasthenic and cardiac status, and by the careful perioperative management.

Aged↗

PubMed2000

Effects of supplemental L-arginine during warm blood cardioplegia.

OBJECTIVES: Effects of supplemental L-arginine, nitric oxide precursor, during warm blood cardioplegia were assessed in the blood perfused isolated rat heart. METHODS: The isolated hearts were perfused with blood at 37 degrees C from a support rat. After 20 minutes of aerobic perfusion, the hearts were arrested for 60 minutes with warm blood cardioplegia given at 20-minute intervals. This was followed by 60 minutes of reperfusion. The hearts were divided into the following three groups according to the supplemental drugs added to the cardioplegic solution. The control group (n = 10) received standard warm blood cardioplegia. The L-ARG group (n = 10) received warm blood cardioplegia supplemented with L-arginine (3 mmol/l). The L-NAME group (n = 10) received warm blood cardioplegia supplemented with L-arginine (3 mmol/l) and L-nitro-arginine methyl ester, a competitive inhibitor of nitric oxide synthase (1 mmol/l). After 60 minutes of cardioplegic arrest, cardiac function, myocardial metabolism and myocardial release of circulating adhesion molecules were measured during reperfusion. RESULTS: Left ventricular end-diastolic pressure was significantly lower (p<0.05) in the L-ARG group than in the control group and the L-NAME group during reperfusion. Isovolumic left ventricular developed pressure, dp/dt and coronary blood flow were significantly greater (p< 0.05) in the L-ARG group during reperfusion. The L-ARG group resulted in early recovery of lactate metabolism during reperfusion. Myocardial release of circulating intercellular adhesion molecule-1 (ICAM-1) and E-selectin were significantly less (p<0.05) in the L-ARG group at 15 minutes of reperfusion. CONCLUSIONS: The results suggest that augmented nitric oxide by adding L-arginine to warm blood cardioplegia can preserve left ventricular function and ameliorate endothelial inflammation. The technique can be a novel cardioprotective strategy in patients undergoing cardiac surgery.

Animals↗

PubMed1999

Application of peptide nucleic acid to the direct detection of deoxyribonucleic acid amplified by polymerase chain reaction.

Double-stranded DNA amplified by polymerase chain reaction (PCR) was detected by peptide nucleic acid (PNA) using a BIAcore 2000 biosensor based on surface plasmon resonance (SPR). PNA is an artificial oligo amide that is capable of forming highly stable complexes with complementary oligonucleotides. We succeeded in the direct detection of double-stranded DNA, amplified by PCR with high-sequence specificity. It was shown that the target DNA was available for detection over the range of 40-160 nM. Therefore, the detection limit was 7.5 pmol of the target DNA (143 bases, applied volume 30 microliters). Our DNA detection system, the combination of BIAcore and the probe PNA, could detect the target DNA with good reproducibility. In this report, we show that our system is a powerful tool for the diagnosis of pathologically significant DNA.

Bacterial Toxins↗

PubMed1999

Detection of PCR products in solution using surface plasmon resonance.

Polymerase chain reaction (PCR) products were detected using a flow injection-type sensor based on surface plasmon resonance. Asymmetric PCR was used to amplify the target DNA sequence, and two products with different length were produced. The novelty of our DNA detection system was that our target DNA was double stranded but the probe binding site, located in the 3'-terminus, was single stranded. This avoids the formation of intra- and intermolecular complexes. This novel design permitted us not only to detect PCR product but also to develop a rapid detection system for the detection of the verotoxin 2 gene of Escherichia coli O157:H7.

Bacterial Toxins↗

PubMed1997

[Aortic arch surgery in the elderly].

A consecutive series of 16 patients over 75 years old who underwent aortic arch operations with hypothermic selective cerebral perfusion from 1994 to 1997 was analyzed. These patients (group O) was compared with 18 patients aged from 70 to 74-year-old (group M) and 38 patients under the age of 69 (group Y) who underwent aortic arch operation during the same period. There were 5 males and 11 females with a mean age of 77.8 years (range 75 to 86) in group O. Twelve patients were in aortic dissection and 4 patients were in atherosclerotic aneurysms. There were 5 hospital deaths (31.2%) in group O, 2 (11.1%) in group M and 2 (5.3%) in group Y. There was significant difference in hospital mortality rate between group O and group Y. Cerebral complication occurred in 2 patients (12.5%) and postoperative respiratory failure occurred in 7 (47%) in group O. Aortic arch operations for the elderly patients can be performed with increased but operative mortality in the elderly patients remains high. In this study, we discussed that influence of risk factors on the operative result and operative indication in the elderly patients.

Age Factors↗

PubMed1997

Novel detection system of flow injection analysis (1). The existence of significant relation between secondary structure of DNA and sensitivity in signal detection.

Polymerase Chain Reaction (PCR) products was detected quantitatively using a flow injection type sensor, based on Surface Plasmon Resonance (SPR). We used asymmetric PCR to amplify the two kinds of products; their DNA lengths are different. This novel design permitted us not only to detect PCR products with high-sensitivity, but also to develop a rapid DNA detection system for the sense of the genetic pathogen.

Bacterial Toxins↗

PubMed1997

Novel DNA detection system of flow injection analysis (2). The distinctive properties of a novel system employing PNA (peptide nucleic acid) as a probe for specific DNA detection.

In order to realize immediate detection of a double stranded DNA amplified by Polymerase Chain Reaction (PCR), we applied Peptide Nucleic Acid (PNA) to the probe of DNA detection system using Surface Plasmon Resonance (SPR). We report our success in immediate detection of PCR products solution with high sequence-specificity.

Bacterial Toxins↗

PubMed1996

Aortic valve replacement for aortic regurgitation due to Kawasaki disease. Report of two cases.

Two cases of severe aortic regurgitation due to Kawasaki disease are reported. Both patients were diagnosed as having Kawasaki disease in their infancy, and were followed up by a pediatrician. Aortic regurgitation was detected 18 months in one case and 36 days in the other case after onset of the illness. With the passage of time, the aortic regurgitation increased and aortic valve replacement was scheduled in both patient at the age of 13. On admission, two-dimensional echocardiography showed thickening of the aortic cusps, and severe aortic regurgitation was detected by color flow Doppler studies. Successful aortic valve replacement was performed, and histological studies of the cusps showed sequelae of valvulitis. In conclusion, aortic regurgitation is a rare complication of Kawasaki disease, and the aortic valve function, especially occurrence of aortic regurgitation, should be carefully observed in patients with a past history of Kawasaki disease.

Adolescent↗

PubMed1996

[Surgical treatment for active infective endocarditis].

Between April 1975 and December 1995, 33 patients with active infective endocarditis underwent surgical treatment at our hospital. The location of diseased valve was shown as ; 18 in aortic, 11 in mitral, and 4 in aortic and mitral position. Of these, 14 patients had an annular abscess or mycotic aneurysm. All patients achieved antibiotic therapy previously, and predominant indication for operation was congestive heart failure. All patients underwent valve replacement. The reconstructive procedures for 14 patients with paravalvular involvement were as follows ; direct closure : 5 cases, direct closure+tilted prosthesis technique : 5 cases, and another 4 cases were, patch closure of VSP resulting from a septal abscess, patch closure+translocation, translocation, and reconstruction of annulas with pericardial patch. There were five (15.2%) operative and hospital deaths and actuarial survival rate was 81% and 61% at 5 and 10 years after operation. Including one who died early after operation, there were 5 cases with postoperative paravalvular leakage and its main cause were persistent infection. In conclusion, it considered that the principles of treating active infective endocarditis is to decide the optimal timing for operation, debride the infected tissue, and close the defect completely.

Adolescent↗

PubMed1996

[Acute aortic dissection complicated with acute myocardial infarction--a case report of successful operation for the case of DOA].

A 61-year-old woman who suddenly manifested chest and back pain was admitted after the diagnosis of acute type A dissection complicated with acute inferior myocardial infarction at another hospital. While being transported to our hospital by ambulance, her ECG repeatedly demonstrated ventricular fibrillation of cardiac arrest. She was in the state of dead on arrival (DOA) when arrived at our hospital. ECG demonstrated complete A-V block and cardiac arrest alternately. However, soon after right ventricular pacing was done, her blood pressure increased and she recovered consciousness. We therefore performed an emergency operation. We performed reconstruction of the ascending aorta and right coronary bypass grafting, since she had aortic dissection and conus brach avulsion. The postoperative course was uneventful.

Aortic Dissection↗

PubMed1992

Hydroxamamide as a chelating moiety for the preparation of 99Tcm radiopharmaceuticals (I).

Hydroxamamides contain a nitrogen and an oxygen as donor atoms, and can be synthesized by the simple reaction of nitriles with hydroxylamine. Benzohydroxamamide (BHam) was investigated as a new ligand for 99Tcm. The yield of the 99Tcm-BHam complex was determined by thin-layer chromatography using cellulose strips. A high yield of the complex was obtained at room temperature over a wide pH range, even at BHam concentrations as low as 5 x 10(-7) M. Cellulose acetate electrophoresis indicated that the complex was uncharged. When the 99Tcm-BHam complex was injected into mice, it was cleared gradually from the blood by means of the hepatobiliary system with low urinary excretion. Uptake by the stomach and the spleen was low. These results demonstrate the high affinity of BHam for 99Tcm and the high stability of the 99Tcm-BHam complex. The hydroxamamide group may be a promising chelating moiety for designing new 99Tcm radiopharmaceuticals.

Animals↗