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Biomedical subjects

H Kin

Publications and source records attributed to H Kin.

At least 37 records · Page 2Linked to original sources
PubMed1998

Transcardiac 5-hydroxytryptamine release and impaired coronary endothelial function in patients with vasospastic angina.

1. The present study was designed to test the hypotheses whether platelet degranulation across the coronary bed is detectable during non-ischaemic periods in patients with vasospastic angina (VSA) and whether the exogenous nitric oxide (NO) donor nitroglycerin (GTN) is able to modify platelet degranulation, reflecting an impaired endothelial production of NO. 2. We studied 13 patients with VSA and 10 controls. The time course of coronary sinus (CS) plasma 5-hydroxytryptamine (5-HT) levels was evaluated every 4 h before and after intravenous infusion of GTN over a period of 40 h. Coronary sinus plasma 5-HT levels were significantly higher at any measured time point in patients with VSA compared with control and were significantly decreased in patients with VSA following treatment with GTN, but not in controls. Femoral artery plasma 5-HT levels remained almost constant throughout the study. The ratio of CS:aorta 6-keto-prostaglandin F1 alpha was significantly and inversely correlated with the transcardiac plasma 5-HT difference only in patients with VSA (r = -0.68; P < 0.02; n = 13). 3. The time course of CS 5-HT levels confirmed significant platelet degranulation across the coronary bed supplied by the spasming artery in patients with VSA and this was modified by GTN. The present data suggest that platelet degranulation occurs during non-ischaemic periods in patients with VSA and that prostacyclin biosynthesis may be a compensatory response to an impaired endothelial release of NO, limiting the degree of the effects of platelet degranulation.

6-Ketoprostaglandin F1 alpha↗
PubMed1998

Effect of obstructive jaundice on neutrophil chemotactic activity: an in vivo assessment in zymosan-induced peritonitis model in rats.

The effect of obstructive jaundice on local neutrophil accumulation in response to inflammatory stimulus was investigated in rats. Obstructive jaundice was produced by bile duct ligation for 7 days. Zymosan (200 mg) was injected intraperitoneally and 4h later myeloperoxidase activity in the peritoneal fluid was measured to quantify neutrophil recruitment. Zymosan-induced neutrophil recruitment was significantly greater (more than two-fold) in bile duct-ligated rats than in sham-ligated or normal animals. Depletion of peritoneal cells significantly suppressed neutrophil recruitment after zymosan injection in all three groups, with no significant differences between the groups. In normal rats, replacement of their peritoneal cells by those from bile duct-ligated rats did not enhance zymosan-induced neutrophil recruitment. In contrast, bile duct-ligated rats treated with peritoneal cell replacement from normals showed significantly increased neutrophil recruitment after zymosan injection. In vitro neutrophil chemotaxis in response to formyl-Met-Leu-Phe was significantly enhanced in bile duct-ligated rats, compared with that in sham-ligated animals. The results suggest that local neutrophil recruitment in response to inflammation may be enhanced in obstructive jaundice and that increased neutrophil chemotactic activity, not macrophage activity, may play a prime role in the mechanism.

Animals↗
PubMed1998

[Ruptured dissecting aneurysm of the transverse arch after replacement of the descending and ascending aorta].

A 28-year-old Marfan's syndrome woman was referred to our hospital because of sudden chest and back pain. She had received replacement of the descending and ascending aorta for acute aortic dissection previously in other two institutions. CT scan revealed the massive mediastinal hematoma and hemothorax which suggested ruptured dissecting aneurysm of the transverse arch. Emergent total arch replacement, re-ascending replacement and aortic root plasty successfully weve performed. She recovered uneventfully although she had residual thoracoabdominal dissecting aneurysm. It was suggested that total arch replacement should be performed for Stanford A type dissection in Marfan's syndrome.

Adult↗
PubMed1997

Angiographically unrecognized microaneurysms: intraoperative observation and operative technique.

Twenty operated cases of angiographically unrecognized microaneurysm (AUM) have been analysed with special reference to intra-operative observations and clipping-technique. Among the patients with intracranial aneurysms that the authors' facility has operated upon, the incidence of asymptomatic incidental AUM that was 2 mm or smaller amounted to 3.7%. Thirteen cases of AUM were found on the middle cerebral artery; four AUMs arose from the M1 portion, four from the bifurcation, and five from the second bifurcation. Sixty percent of AUMs were recognized on the parent arteries of ruptured aneurysms. In 90% of cases the AUMs were broad based in shape and in 70% of cases exhibited a thin-walled neck and a thin-walled fundus. Intra-operative findings revealed four reasons why AUMs were not visible in the pre-operative angiograms: (1) the AUM was sandwiched between two arteries; (2) the AUM was completely hidden by a contiguous large or giant aneurysm; (3) the AUM was diagnosed by pre-operative angiogram as a bleb of the contiguous aneurysm; (4) the AUM was not visible on angiograms because the height of the AUM was extremely low. Twelve cases of AUM were successfully clipped using four different clipping techniques; (1) clipping parallel to the bifurcation in four, (2) clipping parallel to the parent artery in four, (3) pinch-clipping in two of the cases, and (4) cross clipping in two of the cases. The other eight cases were wrapped and coated. AUMs may be present during the direct operation of intracranial aneurysms and in intravascular surgery. Neurosurgeons and neuroradiologists need to explain the possible existence of AUMs to patients and their families.

Adult↗
PubMed1997

Coagulopathy associated with residual dissection after surgical treatment of type A aortic dissection.

PURPOSE: This study was performed to evaluate the effects of a residual dissection on coagulation, fibrinolysis, and platelet function after surgical treatment of acute type A aortic dissection. METHODS: Between 1987 and 1995, 48 consecutive patients underwent emergency surgery for acute type A aortic dissection. Thirty-five of 41 survivors were followed-up for periods ranging from 6 to 112 months (median, 30.3 months). These survivors were classified into three groups by computed tomographic scanning and angiography. Fifteen patients had no residual dissection (group I). Of the 20 patients who had residual dissection, nine had an enlarged aorta greater than 45 mm in maximal diameter (group II), and 11 had an aorta less than 45 mm in maximal diameter (group III). For all patients, blood samples were collected for coagulation, fibrinolysis, and platelet function studies on the same day that the computed tomographic scanning had been performed. RESULTS: beta-thromboglobulin, thrombin-antithrombin III complex, D-dimer, and alpha 2 plasmin inhibitor-plasmin complex concentrations were significantly higher in group II than in the other two groups. Strong correlations between the maximal diameter of the dissected aorta and beta-thromboglobulin, thrombin-antithrombin III complex, D-dimer, and plasmin inhibitor-plasmin complex concentrations were evident. In contrast, correlations between the length of the dissected aorta and coagulation/fibrinolysis measurements were weak. CONCLUSIONS: Our findings suggest that the coagulopathy worsened in proportion to the degree of dilatation of the dissected aorta.

Acute Disease↗
PubMed1997

Effects of balloon pulmonary valvuloplasty on atrial shunting--a patient with pulmonary valve stenosis and a large secundum atrial septal defect.

Percutaneous balloon valvuloplasty has been established as an effective treatment for pulmonary valve stenosis (PS) in children and adults. However, there are few reports of the use of this technique in patients with other cardiac anomalies. We report the performance of balloon pulmonary valvuloplasty in a 72-year-old woman with a large atrial septal defect (ASD). This patient had a PS with a right ventricular pressure of 108/18 mmHg and a pulmonary arterial pressure of 42/21 mmHg, corresponding to a 66 mmHg pressure gradient. The ASD measured 32 x 27 mm. Balloon pulmonary valvuloplasty reduced the pressure gradient to 5 mmHg immediately after the procedure and to 2 mmHg 40 days after the procedure. The left-to-right shunt ratio was reduced from 17% before to 12% immediately after and to 36% 40 days after the procedure. In contrast, the right-to-left shunt ratio showed a transient increase from 16% before to 28% immediately after the procedure before decreasing to 11% 40 days after the procedure. The arterial blood oxygen tension was 53 Torr before, 46 Torr immediately after and 55 Torr 40 days after the procedure. The grade of heart failure decreased from New York Heart Association class IV before to class II in the chronic stage. These findings indicated that balloon pulmonary valvuloplasty in a patient with ASD transiently increased the right-to-left shunting associated with a decrease in oxygen tension, but that the change in the chronic stage was slight. In our patient with ASD valvuloplasty was useful in relieving the symptoms associated with elevated right ventricular pressure but could not reduce the hypoxemia caused by right-to-left shunting. In conclusion, valvuloplasty in patients with ASD should be considered as a preoperative treatment with the aim of reducing the risk of surgery and to treat symptoms in patients who refuse to undergo surgery.

Aged↗
PubMed1997

Acute hydrocephalus in posterior fossa injury.

This is the first known report of the use of computerized tomography (CT) scanning to examine acute hydrocephalus in posterior fossa injury. Of the 1802 patients with acute head trauma treated at Funabashi Municipal Medical Center, 53 (2.9%) had suffered injury to the posterior fossa. Of these, 12 patients (22.6%) had associated acute hydrocephalus: nine patients with acute epidural hematoma (AEH) and three with intracerebellar hematoma and contusion (IH/C). There was a significant relationship between cases of AEH with hydrocephalus and supratentorial extension, hematoma thickness of 15 mm or more, and abnormal mesencephalic cisterns. In cases of IH/C, bilateral lesions and no visible fourth ventricle were significant causes of hydrocephalus. According to these results, possible mechanisms of acute hydrocephalus in posterior fossa injury may be as follow: in cases of AEH, hematoma that extends to the supratentorial area compresses the aqueduct posteriorly and causes hydrocephalus; in cases of IH/C, hematoma and contusional lesions may directly occlude the fourth ventricle and cause acute hydrocephalus. Seven patients suffering from AEH with acute hydrocephalus underwent evacuation of their hematoma without external ventricular drainage. In these cases, CT scanning showed that the hydrocephalus improved immediately after evacuation of the hematoma. Two patients suffering from IH/C with hydrocephalus underwent a procedure for evacuation of the hematoma and external ventricular drainage. The authors do not believe that ventricular drainage is necessary in treating posterior fossa AEH. However, both evacuation of the hematoma and ventricular drainage are necessary in cases of IH/C with hydrocephalus to provide the patient with every chance for survival. There was no significant difference in mortality rates when cases of AEH with acute hydrocephalus (0%) were compared with cases of AEH without hydrocephalus (7.7%). The observed mortality rates in cases of IH/C with hydrocephalus and those without hydrocephalus were 100% and 15.4%, respectively; this is statistically significant.

Acute Disease↗
PubMed1997

[Two-staged repair of coarctation of the aortic arch with severe subaortic stenosis and ventricular septal defect].

Aortic arch coarctation proximal to the left subclavian artery is a rare anomaly. It is about 1% of all coarctation of the aorta. This 16 days neonate with coarctation of aortic arch with severe subaortic stenosis and ventricular septal defect was underwent two staged repair. In the first-stage operation, coarctation of the aortic arch was reconstructed by extended end to end direct anastomosis through posterolateral thoracotomy. In the second stage, we performed intracardiac repair with use of a technique which included resection of superior margin of conus septum through VSD and patch closure of VSD. The postoperative pressure study showed no gradient between left ventricle and left radial artery. The postoperative course was satisfactory. This patient is doing well.

Anastomosis, Surgical↗
PubMed1996

Differential effect of precursor ribose binding protein of Escherichia coli and its signal peptide on the SecA penetration of lipid bilayer.

Digestion of vesicle-bound SecA by trypsin entrapped within the vesicles showed that refolding precursor ribose-binding protein (pRBP) of Escherichia coli retards the lipid bilayer penetration by SecA while the signal peptide enhances it. This discrepancy was found to be due to reduced SecA binding to the vesicles in the presence of the pRBP while the signal peptide induced a tight binding. Studies on the binding of 1-anilino-8-naphthalene sulfonate (ANS) to SecA indicated that SecA assumes more closed conformation upon interaction with pRBP and signal peptide induces more open structure of SecA. Kinetic studies of ANS binding to SecA upon dilution of unfolded pRBP with SecA solution showed an initial fast ANS binding, which was followed by a slow release of ANS. This suggests that first the signal peptide portion of the pRBP binds with the SecA making its structure more open and then the subsequent binding of the mature domain makes the SecA structure more compact. The pRBP enhanced the digestion of SecA added to the E. coli inverted vesicles, suggesting an inhibition of SecA penetration while the signal peptide had an opposite effect, agreeing with the results from the model systems above. When the pRBP and ATP were present together, however, the penetration of SecA increased dramatically underlining the importance of the SecY/E complex for the membrane insertion of SecA.

Adenosine Triphosphatases↗
PubMed1994

Effect of single and multiple administrations of cisapride on postprandial gallbladder emptying in healthy humans.

Effects of a clinical dose of the prokinetic drug, cisapride, on postprandial gallbladder emptying were evaluated in 8 healthy normal volunteers. Gallbladder and gastric emptying after a liquid test meal were simultaneously measured by ultrasonography. Compared with placebo, a single oral dose of cisapride (5 mg) accelerated gastric emptying, but not gallbladder contraction. Cisapride enhanced gallbladder refilling. The same individuals took oral cisapride (15 mg TID) for 14 days, and were reassessed on the following day after oral 5 mg of cisapride. Fasting gallbladder volume was significantly increased. Although gallbladder contractility was not affected, the residual volume was significantly large. Gastric emptying rate returned to the control value. Fasting and post-test meal plasma CCK levels were not significantly attenuated by either single or multiple administration of cisapride. These results suggest that a clinical dose of cisapride may attenuate gallbladder motor function via mechanisms other than direct neural stimulation of the gallbladder.

Administration, Oral↗
PubMed1994

Endoscopic endoprosthesis for large stones in the common bile duct.

Endoscopic biliary endoprosthesis was performed for 34 high-risk patients with common bile duct stones too large to be extracted by conventional endoscopic means. Bile duct drainage was established in all the patients without complications. Late complications developed in four patients and included cholangitis (three) and biliary pain (one). Twenty-five patients underwent a second endoscopic retrograde cholangiopancreatography between 4 and 30 months (mean, 15.1) during follow-up. Stone fragmentation was obtained in 76% (19/25) of the patients. Ten patients had complete stone clearance, and nine patients had disintegrated stones which could be readily removed endoscopically. The remaining nine patients were followed up with endoprostheses in situ for four to 60 months (mean, 24.8) without any symptoms. These results suggest that endoscopic endoprosthesis for difficult common bile duct stones is an effective method to clear the duct in selected cases, as well as an important definitive treatment in high-risk patients.

Aged↗
PubMed1993

Findings on magnetic resonance imaging of the spine and femur in a case of McCune-Albright syndrome.

Polyostotic fibrous dysplasia, a major osseous change in McCune-Albright syndrome, is seen in the cranium, facial bones, bones of the extremities, and ribs, but rarely in the spine. Spinal X-rays revealed no abnormalities in an 8-year-old girl with this syndrome, but 99mTc-methylene diphosphonate bone scintigraphy disclosed high-density areas in the thoracic and lumbar vertebrae. Multiple well-circumscribed areas of low signal intensity were seen on T1-weighted magnetic resonance imaging (MRI) of the spine. Although MRI spine scans in this disease have never been reported, our findings in this case proved interesting for evaluating osseous lesions. MRI made it possible to differentiate between fibrous lesions (low signal intensity on T1- and T2-weighted MRI) and cartilaginous lesions (low signal intensity on T1-weighted MRI and high signal intensity on T2-weighted MRI).

Child↗
PubMed1993

Assessment of body composition measured by bioelectrical impedance in children.

Bioelectrical impedance methods have been found to be a valid and reliable way of estimating per cent body fat (%BF) in adults. We applied them to healthy children and compared them with conventional anthropometry methods. One thousand two hundred and sixteen children participated in this study. Impedance and skinfold thickness were measured, and %BF was estimated using these values. Bodyweight and height were measured, and per cent obesity (%OB) and body mass index (BMI) were obtained. The values of %BF by the bioelectrical impedance method (%BFi) were 8.6 +/- 4.0% in the junior male group, 14.2 +/- 2.8% in the junior female group, 7.9 +/- 4.7% in the senior male group and 16.1 +/- 2.9% in the senior female group. The %BFi correlated strongly with skinfold thickness, %OB and BMI. Thus %BFi correlated strongly with variables from conventional methods. It was concluded that it is a reliable way of assessing lipid storage in children.

Adolescent↗
PubMed1993

Simultaneous ultrasonic monitoring of gallbladder emptying and gastric emptying after liquid test meal.

Gastric emptying and gallbladder emptying were measured simultaneously using simplified ultrasound (US) techniques after a liquid test meal in seven volunteers on two separate days. Sequential changes in cross-sectional areas of the gastric body and antrum and in gallbladder volume were represented as a monoexponential process after the test meal. There was a close correlation between the half emptying time (T1/2) of the stomach at the gastric body measured by US and that by simultaneous scintigraphic technique, but not between US at the antrum and scintigraphy. Gastric emptying measured at the gastric body was more reproducible than that at the gastric antrum. Sequential measurement of cross-sectional areas at the gastric body using ultrasound is simple and reliable for the assessment of gastric emptying after a liquid meal. US technique is promising for the evaluation of the relationship of gallbladder emptying to gastric emptying as a routine practice.

Adult↗
PubMed1993

Endoscopic transpapillary biopsy for diagnosis of patients with pancreaticobiliary ductal strictures.

We used recently developed biopsy forceps to acquire transpapillary tissue in a consecutive series of 43 patients with pancreaticobiliary ductal strictures found during endoscopic retrograde cholangiopancreatographic examinations. There were 19 cholangiocarcinomas, 15 pancreatic carcinomas, five benign biliary, and four benign pancreatic ductal strictures. Tissue sampling from the strictures was successful in 41 patients (95.3%), without complications. All specimens were adequate for histologic evaluation. Eighty-one percent of the patients with carcinomas were diagnosed histologically by this technique. Sensitivity was 88% for cholangiocarcinoma and 71% for pancreatic carcinoma. There were no false-positive results. We conclude that transpapillary biopsy, being a simple, safe, and convenient method, should be applied as an initial diagnostic means during endoscopic retrograde cholangiopancreatography.

Adult↗
PubMed1989

[Palinopsia caused by tentorial meningioma. Case report].

Palinopsia is defined as persistence or recurrence of a visual image when the stimulus is no longer present. The authors describe a female patient with a left tentorial meningioma who experienced recurrent visual images. Computed tomography revealed a well demarcated, high-density mass above the left side of the tentorium, but formal field testing revealed no visual field defect. The findings in this case suggest that the palinopsia may have been the result of disordered temporal synthesis of visual experiences.

Female↗