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Biomedical subjects

H Kishimoto

Publications and source records attributed to H Kishimoto.

At least 19 recordsLinked to original sources
PubMed1992

Radial bone mineral changes in pre- and postmenopausal healthy Japanese women: cross-sectional and longitudinal studies.

Healthy premenopausal and postmenopausal Japanese women were evaluated by longitudinal and cross-sectional studies to assess changes in radial bone mineral density. A total of 300 healthy Japanese women were enrolled in the cross-sectional study, and 126 of them were chosen for the longitudinal study. In the cross-sectional study significantly lower bone mineral density was found in the women over 50 years old. In the longitudinal study, premenopausal women aged 45-54 years showed rate of change of -0.61%/year at the distal radius and 0.49%/year at the radial shaft. The perimenopausal changes were -1.95 and -0.93%/year and the postmenopausal changes were -1.88 and -1.37%/year at the distal radius and at the radial shaft, respectively, in the women aged 45-54 years. These rates of premenopausal and postmenopausal change were similar to those reported for whites in the United States. The strength of the relationship between the rate of change in radial bone mineral density and the anthropometric values, biochemical data, and menopausal status was evaluated by multiple linear regression analysis. Menopausal status had the greatest influence on the rate of change in radial bone mineral density. It is concluded that menopausal status was the most important variable related to bone loss in our longitudinal study and the rate of bone loss was greatest during the early postmenopausal period in healthy Japanese women.

Adult↗
PubMed1992

High-density-lipoprotein metabolism during a very-low-calorie diet.

We examined the changes in high-density-lipoprotein (HDL) metabolism in eight female obese patients undergoing a very-low-calorie diet (VLCD). In the first half of the study, HDL cholesterol (HDL-C), apolipoprotein A-I (apo A-I), and apo A-II showed a parallel decrease. Although lipoprotein lipase (LPL) and hepatic lipase (HTGL) did not change, lecithin: cholesterol acyltransferase (LCAT) decreased. In the latter half of the protocol, HDL-C and apo A-I increased whereas apo A-II decreased, resulting in increased apo A-I-A-II ratios. There was no change in LPL, HTGL, or LCAT. LCAT and apolipoprotein composition may be important in HDL-C changes after VLCD.

Acyltransferases↗
PubMed1992

Drug-resistant Staphylococcus aureus contamination in the ward environment.

A total of 282 strains of Staphylococcus were isolated from University Hospital ward environment from April 1991 to January 1992 and drug-susceptibility tests were performed. The main isolates were 84 strains of S. epidermidis (30%), 65 strains of S. aureus (23%), and 58 strains of S. haemolyticus (21%). One hundred and thirty-six strains of all staphylococci (48%) and 13 of 65 strains of S. aureus (20%) were methicillin (DMPPC)-resistant. The DMPPC-resistant strains of S. aureus were multiple drug-resistant to three to seven antibiotics; ampicillin. cephaloridine, cephametazole, tetracycline, erythromycin, gentamicin, and methicillin, while the DMPPC-susceptible strains were resistant to less than two drugs. These results indicate that this routine testing, along with testing of the anterior nares of the medical staff, is necessary to prevent nosocomial transmission.

Anti-Bacterial Agents↗
PubMed1992

[Total repair for truncus arteriosus].

Total repair for truncus arteriosus using an external conduit was performed in 12 patients from 1978 through 1989. Six cases were infants (mean age: 3.4 months) and 6 were children (mean age; 1 years 9 months). Two cases had Collet-Edwards type II truncus and the other 10 cases had type I truncus. One of the infants was associated with an interruption of the aorta and another had a severe regurgitation of the truncal valve (TrV). For external conduits, we used a non-valved conduit in one infant, a composite valved conduit of Dacron containing a heterograft valve in 4 children and a valved pericardial roll made of an autologous or porcine pericardium in 5 infants and 2 children. One infant with a severe regurgitation of the TrV needed valve replacement along with enlargement of the annulus of the TrV. One infant who had replacement of the TrV died early postoperatively. Another infant died 10 months after total repair due to an infection of an external conduit. Cardiac catheterization was performed in all 10 survivors. The mean value for the systolic pulmonary/systemic pressure ratio decreased from 0.98 +/- 0.09 preoperatively to 0.36 +/- 0.09 postoperatively. Replacement of an external conduit was performed due to a conduit stenosis in 2 children and 1 infant, 10 years and 2 months, 7 years and 9 months, and 1 year and 8 months after the total repair, respectively. In one of these 2 children, replacement of the aortic valve was performed due to a severe aortic regurgitation. We conclude that our results of total repair for truncus arteriosus were satisfactory. However, it remains to be solved how to manage an infant with truncus arteriosus associated with a severe regurgitation of the TrV.

Bioprosthesis↗
PubMed1992

[A case of general paresis with marked improvement of cerebral blood flow after antiluetic therapy--case report].

Although the incidence of neurosyphilis has declined dramatically after the World War II because of the development of antibiotics, it is recently increasing a little bit. There has been few reports on the neuroimaging of general paresis. We studied a fresh case of general paresis by X-ray CT (XCT), MRI and PET scans, and report the changes of neuroimages before and after the therapy. A 38-year-old man was admitted with disorientation, thought disorder and personality change. He also had insomnia and megalomania. There were neither obvious neurological signs nor particular changes of the XCT scan abnormalities on admission. His clinical symptoms were gradually worsened within three months, when the XCT and MRI scans showed moderate brain atrophy especially in the frontal and temporal lobes with mild dilatation of the lateral ventricles. In the PET study, the cerebral blood flow was decreased in the entire brain, especially in the frontal lobes, although the thalamus and the basal ganglia had normal levels. By immunological procedures and the cerebrospinal fluid (CSF) studies, the diagnosis of general paresis was made. He was treated with penicillin G and other antibiotics. In one year after his first therapy, many symptoms vanished. Although the cerebral atrophy was a little advanced, the cerebral blood flow was dramatically increased. As far as we know, this is the first PET study of general paresis before and after penicillin treatments.

Adult↗
PubMed1992

[Surgical treatment for lung cancer cases with an interlobar pleural involvement].

Among surgically resected 192 lung cancer cases, eleven with a interlobar pleural involvement (p 3) were studied to clarify their characters. The five year survival rate of interlobar p 3 was 12.5% (15.6% in case of excluding death of other diseases), which was better than that of the other parietal p 3. Result of surgical treatment of lobectomy + partial resection for interlobar p 3 had better tendency compared with that of bilobectomy or pneumonectomy. But, unfortunately it was necessary for interlobar p 3 to care the local recurrence in the future. We hope that the general rule of the treatment for interlobar p 3 was carefully discussed furthermore, including the safety margin in the partial resection or the classification on T factor.

Adenocarcinoma↗
PubMed1992

[Assessment of Blalock-Taussig shunts in children with complex cardiac anomalies associated with reduced pulmonary blood flow and total anomalous pulmonary venous drainage].

Eleven patients with syndromes of asplenia and polysplenia associated with total anomalous pulmonary venous drainage (TAPVD) were underwent Blalock-Taussig (B-T) shunt operation for reduction of pulmonary blood flow. The age of patients at operation were 6 days to 5 years (average 19.5 +/- 18.7 month). There were seven patients in supracardiac type and four in cardiac type of TAPVD. All patients didn't present obstruction to pulmonary venous return (PVO) before B-T shunt operation. There were one early (9%) and two late deaths (20%) after surgery. Although the hospital death was related to perioperative errors. Two late deaths were not due to the PVO. One of infants had moderately pulmonary congestion and cardiac failure after shunt procedure. Two patients were measured pressure gradient (3 to 4 mmHg) between common pulmonary vein to atrium chamber before shunt procedure. Repeated catheterization revealed that 6 of them could be measured pressure gradient, 3 to 7 mmHg, and no patients had clinical sign of the PVO. Our results demonstrated that B-T shunt operation could be satisfactory for syndromes of asplenia and polysplenia associated with reduced pulmonary blood flow and TAPVD.

Anastomosis, Surgical↗
PubMed1992

[Biventricular repair for right isomerism associated with transposition of great arteries and common atrioventricular canal].

A 5-years old boy, whose thoracic situs was right isomerism, was diagnosed as transposition of great arteries, common atrioventricular canal (intermediate type), severe tricuspid valve regurgitation, pulmonary valve stenosis, bilateral superior vena cava and left sided inferior vena cava. The preoperative RVEDV was 95% and LVEDV 160%, and LV/RV pressure ratio was 0.54. Atrial rerouting using pericardial patch, replacement of tricuspid valve and pulmonary valvotomy were performed. Postoperative course was uneventful. This was a rare case of right isomerism who received biventricular repair.

Child, Preschool↗
PubMed1991

Molecular events in the T cell-mediated suppression of the immune response.

To understand the mechanism of T cell-mediated suppression, we have established a number of suppressor T cell (Ts) clones of both CD4+ and CD8+ phenotypes that exert a definite suppressive effect on antigen-induced proliferative response of normal and cloned CD4+ helper T cells (Th). When an antigen-activated Ts clone was added to Th clones that were subsequently stimulated with antigen and APC, the increase of intracellular Ca2+ in the latter was greatly inhibited. The suppression was unidirectional where Ts suppressed Th but not vice versa. A Ts clone could not suppress other Ts clones. Exactly the same suppression of Ca2+ response could be induced by the treatment of T cells with an anti-I-J antibody. The anti-I-J suppressed the Ca2+ response of Th clones induced by antigen-pulsed APC and anti-TcR alpha beta antibody, whereas the responses to anti-CD3 and Con A were not inhibited. The difference in the effect of anti-TcR alpha beta and anti-CD3 suggests that the suppression is caused by a functional uncoupling of TcR alpha beta and CD3. The stimulation of Ts clones with anti-CD3, on the other hand, induced a unique suppressor factor that potently inhibits the antigen- and anti-TcR induced proliferation of CD4+ Th clones.

Animals↗
PubMed1991

[Changes in the cartilaginous contour of Legg-Calvé-Perthes disease: calculation on T1-weighted MR images].

T1-weighted MR images of Legg-Calvé-Perthes disease (LCPD) were classified into three groups on the basis of radiographic stage, and morphological differentiation for staging was attempted. In the stage of fragmentation, both enlargement and flattening of the cartilaginous contour surrounding the epiphysis could be recognized on MRI, and the growth plate showed more curvature than normal. This produced flattening of the epiphysis in the shape of a crescent. We confirmed these findings using four indexes for the measurement of cartilaginous outline, and the stage of avascular necrosis and fragmentation could be clearly differentiated. Cartilaginous deformities on MRI are very useful for differentiating between the stage of avascular necrosis and fragmentation.

Cartilage, Articular↗
PubMed1991

Modified epiphyseal index for MRI in Legg-Calve-Perthes disease (LCPD).

On radiographs flattening of the femoral head is evaluated by the Epiphyseal Index (EI). Using the ability of MRI to show articular cartilage and the physis clearly, we wish to propose the use of an Epiphyseal Index for MRI (EIM) and demonstrate the value in LCPD. Fifteen patients were examined using 1.5T MR scanner and T1-weighted coronal images were obtained. EIM was calculated as a ratio of height and width of cartilaginous contour surrounding epiphysis, and was compared between normal and the three radiographic stages. EIM of normal hips were ranged from 0.39 to 0.60 and had a tendency to decrease with increasing age. All cases of Stage 1 (avascular necrosis) were within the normal range (n = 4, mean = 0.51, SD = 0.045). EIM of Stage 2 (fragmentation, n = 15, mean = 0.31, SD = 0.055) were smaller than that of Stage 1. Stag 2 and 3 (residual, n = 12, mean = 0.31, SD = 0.077) could not be distinguished by EIM. EIM was useful to show the flattening of epiphysis with growth and very important for differentiation between Stage 1 and 2 LCPD.

Adolescent↗
PubMed1991

Post-translational attainment of allelic exclusion of the T cell receptor alpha chain in a T cell clone.

Two in-frame rearranged mouse TCR alpha chain genes from a single CD4+ T cell clone, MS202, specific for self-class II MHC antigen were transfected into a TCR-negative T cell hybridoma together with a beta chain gene derived from the same T cell clone. Both alpha chain genes were efficiently transcribed and translated in the cytoplasm of host cells, but only one alpha chain (V alpha 5) was expressed on the cell surface in association with the partner beta chain (V beta 4). The other alpha chain gene (V alpha 4) was translated into a mature form of the alpha chain but was unable to make a pair with the beta chain, being prohibited from the surface expression. The supertransfection of the CD4 gene into the alpha beta transfectants did not alter the transcription and expression of both combinations of TCR alpha and beta genes. The original self-class II reactivity was, however, reconstituted only in the cells expressing V alpha 5 and V beta 4 genes supertransfected with CD4. These results indicate that the allelic exclusion of MS202 was achieved by a post-translational mechanism where the product of an in-frame rearranged alpha chain was unable to be expressed on the cell surface, allowing further rearrangement and expression of the other alpha chain gene. The self-class II reactivity of TCR was dependent on the co-expression of CD4 molecules.

Alleles↗
PubMed1991

The antihypertensive effect of calcitonin gene-related peptide in rats with norepinephrine- and angiotensin II-induced hypertension.

To investigate the role of calcitonin gene-related peptide (CGRP) in blood pressure regulation, we used rats with hypertension, induced by the chronic infusion of norepinephrine or angiotensin II, and examined changes in the systemic hemodynamics using the radioactive microspheres method. CGRP (0.05 micrograms/kg per min) administered simultaneously with norepinephrine (1.8 mg/kg per day) significantly reduced the systolic blood pressure of conscious rats compared with norepinephrine infusion alone. Similarly CGRP given with angiotensin II (0.9 mg/kg per day) significantly reduced the systolic blood pressure compared with angiotensin II alone. The antihypertensive effect of CGRP was sustained for 6 days. CGRP infusion decreased the total peripheral resistance but caused no change in cardiac output compared with rats given only pressor substances. Thus, a subdepressor dose of CGRP can modulate the vasopressor effects of norepinephrine and angiotensin II. CGRP may be involved in the regulation of blood pressure via an effect on peripheral vascular resistance.

Angiotensin II↗
PubMed1991

Effects of parathyroid hormone-related protein on systemic and regional hemodynamics in conscious rats. A comparison with human parathyroid hormone.

PTHrp was discovered as a humoral hypercalcemic factor of malignancy and has been shown to bind the same receptor as PTH in rat bone cells, canine renal membranes, and rabbit renal microvessels. We investigated the global effect of human PTH(hPTH) and PTHrp on systemic and regional hemodynamics in conscious rats. The hypotensive response to PTHrp was more potent than that to hPTH. Although hPTH (15 micrograms/kg/min, i.v.) caused a significant increase in cardiac output, whereas PTHrp (5 micrograms/kg/min, i.v.) caused no change in cardiac output despite a similar hypotensive effect to hPTH, the effects of PTHrp and hPTHrp on regional hemodynamics were quite similar, and both peptides had a prominent vasodilatory effect on the coronary and hepatic arteries. Therefore, PTHrp appears to have an important role in blood pressure and regional hemodynamics as does hPTH.

Animals↗
PubMed1991

Cardiac function and exercise capacity of diabetic patients.

To evaluate the relationship between cardiac function at rest and the exercise capacity of diabetic patients, left ventricular function and exercise capacity were evaluated in 15 non-insulin-dependent male diabetic patients. Isovolumic relaxation time (IRT) and the PEP/LVET ratio were obtained by simultaneous echophonocardiograms, electrocardiograms, and recordings of the carotid arterial pulse. VO2 at anaerobic threshold was obtained from a cycle ergometer exercise test with expired gas analysis. Patients were divided into two groups: those with IRT less than 90 msec (Group 1) and those with IRT greater than or equal to 90 msec (Group 2). Group 2 patients had a lower VO2 at anaerobic threshold than Group 1 (Group 1: 17.4 +/- 3.6, Group 2: 12.9 +/- 2.5 ml/min/kg; M +/- SD, p less than 0.05). There was a good correlation between the IRT at rest and delta HR, defined as the change in heart rate from rest to anaerobic threshold (r = 0.666, p less than 0.01), and between delta HR and the beat-to-beat variation in R-R interval at rest (r = 0.637, p less than 0.02). There was also a good correlation between VO2 at anaerobic threshold and IRT (r = 0.555, p less than 0.05), and between VO2 at anaerobic threshold and delta HR (r = 0.858, p less than 0.01). Our data suggests that both left ventricular diastolic function and cardiac sympathetic nervous system reflexes, reflected by delta HR, may affect the exercise capacity of diabetic patients. Thus, IRT obtained by a non-invasive method may provide a useful index for cardiovascular response to exercise in diabetic patients without coronary artery disease.

Adult↗
PubMed1991

Lipoprotein metabolism in normolipidemic obese women during very low calorie diet: changes in high density lipoprotein.

We examined changes in high density lipoprotein (HDL) metabolism during a very low calorie diet weight reduction program in 6 massively obese normolipidemic women. The diet protocol consisted of a 1st low calorie diet (LCD; 1440, 1280, and 880 kcal daily for 1 week, each, in succession), a 1st very low calorie diet (VLCD; 420 kcal daily for 4 weeks, using Optifast 70), intermission (880 kcal daily for 1 week), the 2nd VLCD (4 weeks) and the 2nd LCD (880 and 1280-1440 kcal daily for 1 week, each). Mean body weight reduction was 18.9 kg. HDL-cholesterol, more specifically HDL2-cholesterol, reduced transiently during the 1st VLCD, intermission, and 2nd VLCD periods, and tended to increase in the 2nd LCD. Apolipoprotein (apo) A-I showed a similar change to HDL-cholesterol. However, apo A-II decreased persistently throughout the weight reduction program, and the apo A-I/apo A-II ratio increased significantly in the later part of the program. Serum triglyceride, apo B, and lipoprotein lipase (LPL) activity in post-heparin plasma did not change. These data suggest that the observed decrease in HDL-cholesterol was not due to a reduction in very low density lipoprotein-derived HDL production or to an LPL deficiency, but was consistent with reduction in chylomicron-derived HDL formation following dietary fat restriction.

Adult↗
PubMed1991

[Modified Fontan operation for a single ventricle with a nonconfluent pulmonary artery].

A 8-year-old boy with a double inlet right ventricle with a non-confluent pulmonary artery was operated on with a modified Fontan operation. He had right isomerism, right aortic arch, bilateral superior caval veins, and left-sided inferior caval vein. Hepatic veins were separately drained to the right-side atrium. Left Blalock-Taussig shunt and right central shunt operations had been previously performed. Firstly, we had reconstructed the central pulmonary artery with a 16 mm porcine pericardial roll to unify the nonconfluent pulmonary arteries. Secondly, about 2 months after the first operation, we performed a modified Fontan operation. Systemic venous return from the inferior caval vein and the hepatic veins were drained to a reconstructed pericardial roll with an intraatrial Gore-Tex graft, and bilateral superior caval veins were also anastomosed to the roll. The structure of the pulmonary arterial system is one of the most important factors to determine the outcome of a modified Fontan operation. Even if the central pulmonary artery is absent, however, a modified Fontan operation is applicable for the patient whose peripheral pulmonary arteries have enough growth.

Blood Vessel Prosthesis↗