PubMed Health⌕ Search

Biomedical subjects

F Murakami

Publications and source records attributed to F Murakami.

At least 37 records · Page 2Linked to original sources

Mixed connective tissue disease with multiple organ damage: successful treatment with plasmapheresis.

A 24-year-old-woman with mixed connective tissue disease (MCTD) developed multiple organ failure, disseminated intravascular coagulation (DIC), metabolic acidosis, and respiratory and renal failure resulting from visceral vasospasm, so-called visceral Raynaud's phenomenon. After plasmapheresis, the condition of multiple organ failure was markedly improved. The successful treatment with plasmapheresis was dependent upon the removal of immune complexes in serum and improvement of visceral circulation. Thus plasma exchange is recommended as a possible a treatment for multiple organ damage in MCTD.

Acidosis↗

Allele frequency of human endothelial nitric oxide synthase gene polymorphism in abdominal aortic aneurysm.

OBJECTIVE: This study was performed to examine the role of the endothelial constitutive NO synthase (ecNOS) gene in patients with abdominal aortic aneurysm (AAA). METHODS: We determined the distributions of polymorphism in intron 4 of the ecNOS (ecNOS4) gene, amplified by polymerase chain reaction, and compared the allele frequencies between subjects with abdominal aortic aneurysms (AAAs) and healthy individuals. PATIENTS: Fifty-eight patients with AAAs and 410 race-matched healthy controls were studied. RESULTS: Two alleles of the ecNOS4 gene, containing 4 (a-allele) and 5 (b-allele) repeats, were identified. We found that the a-allele frequency of this gene was significantly higher in the surgical than in the non-surgical group. CONCLUSION: The results of this study suggest that the a-allele of the ecNOS4 gene is indicative of the need for surgery for AAA. Analysis of the alleles of the ecNOS4 gene polymorphism could provide useful information concerning the clinical course of AAA progression.

Aged↗

Coronary artery bypass grafting for spontaneous coronary artery dissection: a case report and a review of the literature.

A 37 year-old woman underwent coronary angiography because of chest pain at rest. Selective coronary angiography demonstrated dissection and stenosis with a filling delay from the left main trunk to the left anterior descending coronary artery. The patient was successfully managed with urgent coronary artery bypass grafting. Spontaneous coronary artery dissection is relatively rare and threatens both elderly and young patients with acute coronary disturbances. Patients can be divided etiologically into three groups. The first was comprised of those in the postpartum period. The second was those with atherosclerotic coronary artery disease, and the third was those associated with coronary vasospasm. Dissections are frequently fatal and most of the known cases have been diagnosed at autopsy. Only a few cases have been documented by coronary angiography, and operative cases of spontaneous coronary artery dissection have rarely been reported.

Adult↗

[Coronary artery bypass grafting by warm blood cardioplegia and normothermic cardiopulmonary bypass].

Warm blood cardioplegia and normothermic cardiopulmonary bypass (CPB) have been used in coronary artery bypass grafting (CABG). The method of myocardial protection was intermittent combined antegrade and retrograde warm blood cardioplegia with terminal warm blood cardioplegia. We performed elective CABG in 30 patients above the age of 70 years (elderly group). These patients were compared with 30 patients below 70 years who underwent elective CABG (young group). No significant differences were observed about the preoperative data between two groups. No significant differences were obtained in the postoperative cardiac function, cerebral or renal complication between two groups. Warm blood cardioplegia and normothermic CPB were not associated with adverse effects on postoperative recovery in elderly as well as young patients. We may conclude that warm blood cardioplegia with normothermic CPB is a safe procedure for CABG in elderly as well as young patients.

Aged↗

[Significance of interferon alpha therapy for advanced renal cell carcinoma. Fukushima Renal Cancer Study Group].

We ranked prognostic factors to retrospectively evaluate the clinical significance of interferon alpha (IFN-alpha) therapy in patients with Robson stage IVB renal cell carcinoma. A total of 44 Robson stage IVB renal cancer patients were divided into 2 groups, one with more than 6 months administration of IFN-alpha (3-7 times a week: group A) and another without any IFN-alpha administration. The distribution of these 2 groups was not randomized. In addition to IFN-alpha therapy, survival was analyzed with respect to performance status (PS), mass reductive nephrectomy, concomitant use of other cytotoxic therapies, the number of metastatic organs, growth type, site of metastasis and the period of diagnosis, using a multivariate method with Cox proportional hazards regression. The multivariate analysis showed administration of IFN-alpha to be the most significant factor influencing a good prognosis. Improved survival was also significantly correlated with slow growing type and good PS. Among group A, a significant favorable prognosis was obtained in patients with the responses of no change (NC), partial response (PR) and complete remission (CR) 6 months after initiating administration of IFN-alpha, as well as with good PS and a slow growing type carcinoma. We conclude that IFN-alpha therapy might improve the prognosis of patients with Robson stage IVB renal cell carcinoma, especially, in cases when a greater than NC response is obtained after 6 months administration of IFN-alpha.

Aged↗

Non-mycotic pseudoaneurysm in the ascending aorta following cardiac surgery.

Cannulation of the ascending aorta is the recognized method to achieve arterial return during cardiopulmonary bypass. Mediastinal infection after cardiac surgery can cause disruption at the point of insertion, and give rise to a pseudoaneurysm in the ascending aorta. Although rare, a pseudoaneurysm can occur without clear evidence of infection. Here we report two cases that received aortic valve replacement and that developed ascending aortic aneurysms after surgery. Based on our clinical findings, these aneurysms were related to the arterial cannulation into the aorta and not to any infection.

Aneurysm, False↗

Protective effect of nisoldipine on myocardial ischemia during coronary bypass surgery.

BACKGROUND: Nisoldipine, a calcium antagonist, was assessed for myocardial protection and the prevention of reperfusion injury in patients undergoing CABG. METHODS: Of the 34 subjects undergoing CABG in this study, 20 were given nisoldipine orally at 10 mg/day for 2 weeks before surgery (N group) and the other 14 untreated controls (C group). Myocardial protection was conducted via ante-grade cold blood cardioplegia at 20-minute intervals. RESULTS: Myocardial blood flow was significantly higher in the N group (67.8 +/- 21.8 ml/100 g vs. 47.2 +/- 14.4 ml/100 g, p < 0.05) after cardiopulmonary bypass. Serum interleukin-6 levels were significantly lower in the N group 1 hour after reperfusion (116 +/- 58 vs. 409 +/- 362 pg/ml, p < 0.05), as were serum lactate dehydrogenase levels immediately after surgery (888 +/- 268 vs. 1350 +/- 486 IU/L, p < 0.05). The N Group showed a better left ventricle stroke work index 6 hours after surgery (43 +/- 8 vs. 36 +/- 9 g.m/m2). Dopamine dosage in the N group on postoperative day 1 was lower than in controls (5.3 +/- 1.9 vs. 3.0 +/- 2.4 micrograms/kg/min). CONCLUSIONS: Preoperative nisoldipine treatment increased blood flow in the postischemic myocardium and prevented myocardial damage and reperfusion injury to some extent.

Administration, Oral↗

Anxiety traits associated with a polymorphism in the serotonin transporter gene regulatory region in the Japanese.

We determined polymorphism in the serotonin (5-HT) transporter gene-linked polymorphic region (5-HTTLPR) in 501 healthy Japanese, individuals, using the polymerase chain reaction of Lesch et al., with minor modifications. The distribution of allele frequencies was determined and found to differ from that in Caucasians. We also investigated the relationship of polymorphism in 5-HTTLPR to anxiety traits, by having 189 of the 501 subjects complete a self-rating questionnaire for anxiety and depression. Subjects with the short/short (s/s) genotype had significantly higher anxiety scores than those with the long/long (l/l) or l/s genotype. It is suggested that populations with the s/s genotype of 5-HTTLPR have stronger anxiety-related personality traits than those with the 1 allele.

Adult↗

Platelet nitric oxide metabolites in migraine.

Nitric oxide (NO) is a candidate as a causative molecule in migraine. We determined nitrite, total nitrate/nitrite, and cyclic guanosine 3',5'-monophosphate (cGMP) concentrations in platelets from 30 migraine without aura (MwoA) patients and 17 migraine with aura (MwA) patients. All migraine patients were studied during their migraine attacks. The control group consisted of 28 healthy volunteers. Concentrations of platelet nitrite and total nitrate/nitrite were determined using simple and sensitive nitrate/nitrite fluorometric assay techniques. High concentrations of platelet nitrite and total nitrate/nitrite were found in patients with MwoA and MwA when compared with healthy controls. High concentrations of platelet cGMP were also found in patients with MwoA and MwA. The levels of platelet total nitrate/nitrite significantly decreased in headache-free periods after treatment with oral propranolol. These findings suggest that NO is produced in platelets during migraine attacks. It may also be related to the migrainous pain and the changes in cerebral blood flow experienced during migraine attacks. These data may provide new strategies for the treatment of migraine.

Adult↗

[Postoperative mediastinitis after the coronary artery bypass grafting using internal thoracic artery graft].

It has been pointed out in general that the resistance against infection is decreased in the diabetic patients. This problem is very important in patients undergoing major surgery. In cardiovascular surgery, the median wound infection may result in life threatening sequelae. We have used the internal thoracic artery as the appropriate graft for its excellent long-term patency. In this series of the diabetic patients who underwent coronary artery bypass grafting with bilateral internal thoracic artery grafts, the incidence of postoperative mediastinitis was significantly higher than other cases. Therefore the use of bilateral internal thoracic artery grafts should be avoided, if possible in the diabetic patients.

Aged↗

Valvulotomy of calcified aortic valves using the neodymium: yttrium-aluminum-garnet (Nd:YAG) laser.

The neodymium: yttrium-aluminum-garnet (Nd:YAG, wavelength; 1064 nm) laser knife was used for valvulotomy of severely calcified aortic valves in 12 patients. The fibrous layer enveloping the calcium deposits was peeled off the valvular annulus and the native valvular leaflet. The underlying calcium deposits were then resected. The average aortic cross-clamp time was 69 +/- 21 minutes. The cardiopulmonary bypass time averaged 118 +/- 32 minutes. All of the patients were discharged from the hospital without complications. Laser valvulotomy can be used to resect severely calcified aortic valves without mechanical crushing, reducing the risk of embolization.

Aged↗

[Preoperative autologous blood donation in coronary artery bypass grafting in elderly patients].

Allogeneic blood transfusion still carries risks of transfusion reaction and infection. We examined the effect of a preoperative autologous blood donation (800-1,200 g) by subcutaneous epoetin alpha injection on a series of patients undergoing elective coronary artery bypass grafting (CABG). CABG was being performed with increased frequency in elderly patients. We have performed CABG in 18 patients over 65 years of age (elderly group). These patients were compared with 20 patients under 64 years of age (younger group). Postoperative bleeding and allogeneic blood transfusion were significantly larger in quantity in the elderly group than the younger group (p < 0.05). The incidence of allogeneic blood usage was significantly higher in the elderly group than the younger group (p < 0.05). Therefore, a preoperative autologous blood donation in CABG was considered to be not so effective for saving allogeneic blood transfusion and preventing transfusion reaction or infection in elderly patients.

Aged↗

Development of functional topography in the corticorubral projection: An in vivo assessment using synaptic potentials recorded from fetal and newborn cats.

In mammals, topographic maps emerge from initially diffuse projections during development. To gain insight into the mechanisms governing the transition from a diffuse projection to a topographic map, we studied topographic specificity of functional connections during development, using the cat corticorubral system as a model. In the adult cat, rubrospinal neurons in the dorsomedial part of the red nucleus (RN) receive input primarily from the forelimb area of the sensorimotor cortex, whereas those in the ventrolateral part receive input primarily from the hindlimb area. During development, axons from the sensorimotor cortex arrive in the RN at embryonic day 50 (E50) (Song et al., 1995a) and are diffusely distributed in the RN until postnatal day 13 (P13) (Higashi et al., 1990). Here, we studied the development of the pattern of functional cortical inputs to individual rubrospinal neurons, using synaptic potentials recorded in vivo. The functional topography in each rubrospinal neuron in developing cats was examined and classified either as adult-like or nonadult-like by comparison with the adult pattern. In preterm kittens from E61 to E65, only about half of the recorded neurons (41%; n = 22) showed adult-like functional topography. This percentage, however, increased to 82% (n = 56) in P1-P8 kittens and to 93% (n = 42) in P13-P28 kittens. These results, in conjunction with the above mentioned anatomical observations, suggest that corticorubral axons make functional synapses nonselectively with rubrospinal neurons before birth. Furthermore, the functional topographic map developed earlier than the anatomical map ( P13), suggesting that there is a developmental step of selective promotion of synapse formation and/or selective enhancement of synaptic efficacy in topographically appropriate regions in the RN, before the emergence of the mature anatomical map.

Age Factors↗

Change in chemoattractant responsiveness of developing axons at an intermediate target.

Developing axons reach their final targets as a result of a series of axonal projections to successive intermediate targets. Long-range chemoattraction by intermediate targets plays a key role in this process. Growing axons, however, do not stall at the intermediate targets, where the chemoattractant concentration is expected to be maximal. Commissural axons in the metencephalon, initially attracted by a chemoattractant released from the floor plate, were shown to lose responsiveness to the chemoattractant when they crossed the floor plate in vitro. Such changes in axon responsiveness to chemoattractants may enable developing axons to continue to navigate toward their final destinations.

Animals↗

Fulminant hepatitis complicated by small intestine infection and massive hemorrhage.

A 34-year-old man diagnosed with fulminant hepatitis, caused by hepatitis B virus, and acute renal failure was referred to our hospital. After admission to the intensive care unit, the liver and renal failure were ameliorated. Melena requiring transfusion occurred during the course of his illness. Endoscopic examination demonstrated pseudomembranes, erosions, ulcers, and hemorrhage in the duodenum, the upper jejunum, and the terminal ileum, suggesting widespread lesions throughout the small intestine. Pseudomonas putida, Xanthomonas maltophilia, and Candida glabrata were cultured from ileal fluid. Candida glabrata was also detected in sputum, feces, and on an intravenous catheter tip. The patient was treated with amphotericin B and miconazole. The melena was ameliorated, but inflammation of the small intestine persisted. Although we had difficulty in treating the enteritis, the patient survived, and 1 year later colonoscopic examination demonstrated no abnormalities. The small intestine is a difficult site to examine, but endoscopic examination of this site is important when massive hemorrhage develops.

Adult↗