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Biomedical subjects

H Naruse

Publications and source records attributed to H Naruse.

At least 37 records · Page 2Linked to original sources
PubMed1997

Total anomalous pulmonary vein drainage in an adult diagnosed by helical computed tomography.

A 41-year-old man visited our hospital with the complaint of palpitation by atrial flutter. He was finally diagnosed as total anomalous pulmonary vein drainage by helical computed tomography (CT). This case is very unusual due to the lack of symptoms until the age of 41. The absence of pulmonary artery stenosis, and the presence of atrial septal defect providing sufficient right to left shunt flow to maintain the output of left ventricle are some of the reasons to explain the lack of symptoms and very slight impact on daily life. Helical CT, in particular 3-dimensional imaging, is very useful in diagnosing complicated cardiovascular deformation as in this case.

Adult↗
PubMed1997

Serum concentrations of myoglobin vs human heart-type cytoplasmic fatty acid-binding protein in early detection of acute myocardial infarction.

We compared the diagnostic utility of serum concentrations of human heart-type cytoplasmic fatty acid-binding protein (H-FABPc), myoglobin, and their ratio for the early diagnosis of acute myocardial infarction (AMI) in 104 healthy volunteers and 165 patients at admission within 6 h of the onset of chest pain. The ROC curves of the H-FABPc [0.946, 95% confidence interval (CI) = 0.913-0.979] and myoglobin (0.895, 95% CI = 0.846-0.944) between patients with AMI and healthy volunteers were significantly greater than the area under the ratio of myoglobin to H-FABPc (0.823, 95% CI = 0.765-0.881). In 165 patients, the sensitivity (81.8%, 95% CI = 74.2-89.4%), specificity (86.4%, 95% CI = 78.1-94.6%), and predictive accuracy (83.6%, 95% CI = 78.0-89.3%) of H-FABPc > 12 micrograms/L in diagnosing AMI were significantly higher than those of myoglobin, and were similar to those of the combination of H-FABPc > 12 micrograms/L and the ratio < or = 14. We conclude that H-FABPc is a more sensitive and specific marker than myoglobin for the early diagnosis of AMI, and that their ratio cannot give a clear advantage over the measurement of H-FABPc alone.

Adult↗
PubMed1996

Comparative accuracy of various Tl-201 reinjection imaging protocols to detect myocardial viability.

UNLABELLED: The conventional exercise-3 hours-redistribution thallium-201 [201Tl] imaging protocol has been recognized to be suboptimal for reliable detection of myocardial viability. Although 201Tl rest-injection after exercise has improved detection of viable myocardium, it is still underestimated in some patients. The present study was designed to compare detection of viable myocardium in five separate imaging steps: step 1: initial-exercise imaging, step 2: delayed-exercise imaging, step 3: Tl-201 reinjection imaging after delayed-exercise imaging, step 4: separate day rest-injection imaging, and step 5: separate day delayed-rest imaging. The study group consisted of 22 patients scheduled for coronary revascularization (either percutaneous transluminal coronary angioplasty or coronary bypass surgery). Pre- and postintervention echocardiographic wall motion and thickness served as independent markers of myocardial viability. RESULTS: Accuracy in identifying myocardial viability gradually improved incrementally from 201Tl imaging step 1 to step 5. The positive predictive value, negative predictive value and overall accuracy were best for the separate day delayed-rest study (step 5) at 90%, 33% and 78%, respectively. Myocardial segments had fixed defects on separate day delayed-rest 201Tl imaging (step 5), but nevertheless echocardiographic evidence of myocardial viability indicated less severe defects than segments judged nonviable by echocardiography (p = 0.021). The overall accuracy of separate day delayed-rest imaging (step 5) in predicting viability improved to 88% when segments with moderate or mild defects were considered viable. In conclusion, the most reliable predictor of myocardial viability with 201Tl imaging is defect severity on separate day delayed-rest images.

Aged↗
PubMed1996

Cerebral oxygenation measured by near infrared spectroscopy during cardiopulmonary bypass and deep hypothermic circulatory arrest in piglets.

Near infrared spectroscopy (NIRS) shows large changes in cerebral oxyhemoglobin (Hbo2), deoxyhemoglobin (Hb), and oxidation state of cytochrome aa3 (Cyto2) in infants undergoing cardiopulmonary bypass and deep hypothermic circulatory arrest (CPB-DHCA). To evaluate the physiologic significance of these clinical NIRS measurements, we applied the technique in a piglet model of CPB-DHCA. After an initial stabilization period on CPB, animals (n = 8) were cooled to 15 degrees C, subjected to DHCA for 1 h, then reperfused with rewarming and monitored for 180 min. NIRS measurements were compared with determinations of cerebral blood flow (CBF). During cooling, Cyto2 decreased markedly, whereas Hbo2 increased. DHCA was associated with a sharp decrease in Hbo2, a corresponding increase in Hb, and a smaller, less consistent further decrease in Cyto2. NIRS measurements recovered toward baseline with reperfusion. CBF decreased during cooling and recovered to baseline levels with reperfusion. These findings are consistent with existing human data and show that 1) cooling is associated with increased oxygenation of cerebral hemoglobin despite a reduction in CBF; 2) Cyto2 becomes more reduced during cooling, consistent with a net cellular oxygen deficit; and 3) DHCA is associated with rapid cerebral hemoglobin deoxygenation and a small further reduction of Cyto2.

Animals↗
PubMed1996

[The cases of acute spontaneous subdural hematoma].

In this paper, 10 cases of acute spontaneous subdural hematoma (ASSDH) among 149 cases of all acute subdural hematoma (ASDH) were reported with a review of 36 cases in the literature. The age of the patients with ASSDH ranged from 48 to 90 years (mean age of 71.9 years), and the average age of ASDH patients was 52.4 years. The male to female ratio of ASSDH and ASDH was 3:7 and 5:2, respectively. ASSDH patients were older than ASDH patients, and ASSDH patient tended to be female. Four cases of ASSDH patients had the past history of dementia. The outcome of 5 cases of ASSDH with general complications was fatal. During operation in all cases except one, spurting arterial rupture from a branch of the cortical artery adjacent to the Sylvian fissure was observed. It was presumed in the literature that the mechanism of the arterial rupture is gliding movement of the brain, tearing an arterial twig with dural attachment, or the existence of the junction of an arterial twig as an anatomically weak point. Hypertension, alcoholism, dementia, past history of subdural hematoma or subarachnoid hemorrhage may be important influencing factors in this mechanism.

Acute Disease↗
PubMed1996

Quantitative comparison of planar and SPECT normal data files of thallium-201, technetium-99m-sestamibi, technetium-99m-tetrofosmin and technetium-99m-furifosmin.

UNLABELLED: In recent years, several of 99mTc-labeled myocardial perfusion imaging agents have been developed, such as 99mTc-sestamibi, 99mTc-tetrofosmin and 99mTc-furifosmin. Although images obtained with these new tracers have a general similar appearance, there are differences in the myocardial kinetics, body distribution, general quality of images and imaging protocols. The aim of this study was to quantitatively compare normal exercise planar and SPECT data files obtained with 201TI and 99mTc-labeled agents. METHODS: Lower-limit-of-normal curves were generated for each specific radiopharmaceutical from normal subjects with low (< 3%) pretest likelihood of coronary artery disease using circumferential count distribution profiles from planar and SPECT exercise images. Lower-limit-of-normal curves were statistically compared using the nonparametric Kruskall-Wallis and Wilcoxon tests. RESULTS: Planar and SPECT lower-limit-of-normal curves generated for each radiopharmaceutical showed general similarities. Statistically significant differences among the lower-limit-of-normal curves were found in the planar left anterior oblique view and in the planar left lateral view (p < 0.05 for each). No statistically significant differences existed between lower-limit-of-normal curves of various radiopharmaceuticals on the planar anterior view and on SPECT imaging. CONCLUSION: For quantitative analysis of planar images, radiopharmaceutical-specific normal data files are mandatory. Although SPECT normal data files of various radiopharmaceuticals are not statistically different, they are not identical. It appears, nevertheless, prudent to use radiopharmaceutical-specific normal data files for quantitative analysis of SPECT images.

Adult↗
PubMed1995

Cerebral oxygen supply and utilization during infant cardiac surgery.

The survival of infants with congenital heart disease has improved dramatically. However, the incidence of neurological injury in infants surviving cardiac surgery remains considerable. These neurological sequelae are attributable at least in part to hypoxia-ischemia/reperfusion, which inevitably accompanies infant heart surgery with deep hypothermia, cardiopulmonary bypass, and circulatory arrest. To begin to identify mechanisms of brain injury during infant cardiac surgery, we used near-infrared spectroscopy to study the relationship between cerebral intravascular (hemoglobin) and mitochondrial (cytochrome aa3) oxygenation in 63 infants (aged 1 day to 9 months) undergoing deep hypothermic repair of congenital heart defects, throughout the intraoperative period. Moreover, we assessed the effect of postnatal age on these changes. The cerebral concentration of oxidized cytochrome aa3 decreased from the onset of deep hypothermic cardiopulmonary bypass, despite apparent abundant intravascular oxygenation manifested by a simultaneous increase in the cerebral concentration of oxyhemoglobin. During this interval infants older than 2 weeks had a greater decrease in oxidized cytochrome aa3 than did infants 2 weeks old or younger. During deep hypothermic circulatory arrest, cerebral levels of oxidized cytochrome aa3 remained depressed while those of oxyhemoglobin declined. With reperfusion following circulatory arrest, the recovery of oxidized cytochrome aa3 was delayed, despite a rapid recovery of intravascular oxygenation (HbO2). After rewarming and 60 minutes of reperfusion, only 46% of infants recovered to the baseline level of cerebral oxidized cytochrome aa3. These findings demonstrate a paradoxical dissociation of changes in intravascular and mitochondrial oxygenation during hypothermic cardiopulmonary bypass; a pronounced decrease of mitochondrial oxygenation is established during induction of hypothermia and a delay in recovery of mitochondrial oxygenation occurs following circulatory arrest. These effects were more pronounced in infants older than 2 weeks than in younger infants. The data suggest potentially deleterious impairments of intrinsic mitochondrial function or of delivery of intravascular oxygen to the mitochondrion or both, effects previously undetected and apparently influenced by cerebral maturation.

Brain↗
PubMed1995

Reduction of cytochrome aa3 measured by near-infrared spectroscopy predicts cerebral energy loss in hypoxic piglets.

Near-infrared spectroscopy is a noninvasive monitoring technique that allows quantitative measurement of changes in cerebral oxygenated Hb (HbO2), deoxygenated Hb (Hb), total Hb, and oxidized cytochrome aa3 (CytO2). Changes in cerebral Hb oxygenation and CytO2 have been measured in human neonates and infants under a variety of conditions. However, the association of these measurements with cerebral high-energy phosphate loss is not known. We studied simultaneous changes in cerebral HbO2, Hb, total Hb, and CytO2 by near-infrared spectroscopy and changes in nucleoside triphosphate (NTP, mostly ATP) and phosphocreatine (PC) concentrations and intracellular pH by in vivo 31P-labeled magnetic resonance spectroscopy. Four-wk-old piglets (n = 8) underwent sequential hypoxic episodes of increasing severity (inspired O2 concentration, 12, 8, 6, 4, and 0%). Animals were anesthetized and mechanically ventilated. At all levels of hypoxia, cerebral HbO2 decreased, and Hb increased. Loss of PC or NTP was not observed until inspired O2 concentration was decreased to less than 12%. With such severe hypoxia, hypotension, intracellular acidosis, and increasingly severe PC and NTP depletions occurred. Decreases in PC and NTP correlated closely with decreased CytO2 and arterial blood pressure (p < 0.0001) but not with changes in HbO2 and Hb. In conclusion, cerebral hypoxemia is readily detected by near-infrared spectroscopy as a decrease in HbO2 and an increase in Hb. However, relative changes in cerebral HbO2 and Hb have low predictive value for cerebral energy failure. Reduction of CytO2 is highly correlated with decreased brain energy state and may indicate impending cellular injury.

Animals↗
PubMed1994

A potential peptide vaccine against two different strains of influenza virus isolated at intervals of about 10 years.

We have developed a strategy for making synthetic peptide vaccines, in which a peptide, HA127-133, derived from the hemagglutinin (HA) of A/Aichi/2/68(H3N2) influenza virus (Aichi/68) is introduced into the Ab binding component consisting of 43-46 and 54-58 residues of a pigeon cytochrome c analogue peptide, 46F50V54A. Indeed, this hybrid peptide, 46F/HA127-133/54A, induced impressive T-cell responses and antibody production neutralizing infectivity of Aichi/68 in vitro. In a subsequent study we found that 46F/HA127-133/54A(18mer) peptide antigen, which had been prepared by substitution at the central five residues of 46F50V54A with HA127-133, generated T-cell responses and neutralizing antibody responses as well. On the basis of these prior findings, in the present study we analyzed immunopotency of 46F/HA127-133/54A(18mer) in vivo administered in several ways to I-Ab mice. We show herein that this peptide vaccine loaded in multilamellar liposomes without adjuvant protects the mice against infection with Aichi/68 within 2 weeks after final immunization. Further, this peptide vaccine was shown to be effective in preventing infection with a naturally occurring antigenic variant, A/Texas/1/77(H3N2), carrying the same sequence at 127-133 of the HA as Aichi/68 virus. Since this part of the HA is relatively conserved among H3 subtype influenza viruses, our peptide vaccine may become the basis for a new strategy to prepare effective vaccines that will overcome the ineffectiveness of classical vaccines attributable to antigenic drift of influenza viruses.

Animals↗
PubMed1994

Determination of amino acids on agretopes of pigeon cytochrome c-related peptides specifically bound to I-A allelic products.

In our prior study it was demonstrated that residues 46 and 54 on a synthetic peptide, AEGFSYTVANKNKGIT (50V), work as an agretope (site contacts with major histocompatibility complex molecules) and residues 50 and 52 function as an epitope (site contacts with T cell receptor), when tri-molecular complexes are formed among 50V,I-Ab and the T cell receptor. 50V was composed of residues 43 to 58 of pigeon cytochrome c (p43-58) except that the aspartic acid (D) at residue 50 was substituted by valine (V). Substitution of agretopic residues on 50V changed this I-Ab-binding peptide to an I-Ak-binding peptide, suggesting that positions 46 and 54 work as an agretope in I-Ak-restricted T cell responses. In the present study we examined whether residues 46 and 54 of 50V worked as agretopes in T cell responses restricted to other I-A haplotypes. The 50V-related peptides with phenylalanine (F) at position 46 and alanine (A) at position 54 bound tightly to I-Ab, I-Ad, I-Aq and I-As molecules and stimulated T cells most potently in mice bearing these I-A haplotypes. In contrast, 50V-related peptides carrying D at position 46 and A at position 54 bound most potently to I-Ak molecules, and the peptides with arginine (R) at position 46 and A at position 54 bound most efficiently to I-Av molecules. The present findings, thus, demonstrate that the agretopic positions on the p43-58 related peptides are preserved in T cell responses restricted to each I-A haplotype studied, and that the specific amino acids on the agretopic positions exist a priori for each I-A allele-specific structure.

Amino Acid Sequence↗
PubMed1994

Immunocytochemical survey of the neuroepithelial endocrine system in the respiratory tract of the Tokyo salamander, Hynobius nebulosus tokyoensis TAgo.

The epithelial lining of the respiratory tract of urodeles has been shown to harbor an innervated system of neuroepithelial endocrine (NEE) cells. Even between phylogenetically closely related species, large differences have been reported in the appearance and chemical coding of the NEE system. Although urodeles are well suited for the purpose, none of the prior studies have provided an immunocytochemical survey of the NEE system in all parts of the respiratory tract. In the present study, many bioactive substances and a general marker were immunocytochemically demonstrated in serial sections of the entire respiratory tract of the Tokyo salamander, Hynobius nebulosus tokyoensis, a species in which neuroepithelial bodies (NEBs) were previously characterized at the electron microscopic level. In the current study, serotonin-immunoreactive solitary NEE cells were observed in variable numbers in the larynx, in all parts of the trachea, and in areas of the lungs covered with ciliomucous epithelium. Serotonin-containing NEBs, however, were detected in small cranial areas of the lung only. Solitary NEE cells were seen in the trachea and lungs of H. nebulosus tokyoensis by immunocytochemical staining for somatostatin, calcitonin, calcitonin gene-related peptide, and bombesin, but the number, localization, and appearance of the labeled NEE cells differed considerably. Only calcitonin-like immunoreactivity was also noted in some NEB-like cell clusters in the cranial parts of the lungs. Unlike many other vertebrates, neuron specific enolase was found to be a poor marker for the NEE system in the salamander species used in this investigation. It may be concluded that the NEE system of H. nebulosus tokyoensis contains at least five different bioactive substances.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Analysis of epitopic residues introduced into the hybrid peptide vaccines prepared according to the cassette theory.

In our previous study, we prepared a synthetic peptide vaccine (46F/HA127-133/54A) against influenza strain A/Aichi/2/68 (H3N2) virus by introducing haemagglutinin (HA) 127-133 to an I-Ab,b binding component that consisted of residues 43-46 and 54-58 of an I-Ab,d binding peptide, 46F50V54A. This hybrid peptide vaccine induced considerable immunological responses against A/Aichi/2/68 as well as against the peptide vaccine in I-Ab mice. In the present study, we have attempted to increase the immunogenicity of the peptide vaccine by introducing HA peptides of various lengths into the I-Ab,d binding components consisting of residues 43-46 and 54-58 or 43-47 and 53-58 of 46F50V54A. We demonstrate here that, among the peptide vaccines prepared, 46F/HA127-133/54A (18 mer) consisting of HA127-133 and the I-Ab,d binding component constructed from 43-47 and 53-58 of 46F50V54A induces the most vigorous T-cell responses and neutralizing antibodies against A/Aichi/2/68 in both I-Ab and I-Ad mice.

Amino Acid Sequence↗
PubMed1994

Determination of the agretopic residues of a peptide co-restricted to different class II isotypes, I-Au and I-Eu, and its application for preparation of a synthetic peptide vaccine against influenza virus A/Aichi/2/68.

We have defined that residues 46 and 54 on a synthetic peptide composed of residues 43-58 of pigeon cytochrome c (p43-58) work as agretopes (sites bound to an MHC molecule) in I-Ab mice. Substitution of amino acid residues on these positions altered the peptide to bind with the other MHC molecules. Furthermore, by substituting the agretopic residues with a variety of amino acids, we could determine the class II binding motif for each MHC molecule. In the present study, immunogenicity of a peptide, 46R50V54A, carrying valine (V) at epitopic (site bound to TCR) position 50, arginine (R) and alanine (A) at agretopic positions 46 and 54 of the p43-58, respectively has been analyzed in B10.PL (H-2u) mice. We found that this peptide bound to two different class II isotypes, I-Au and I-Eu. Arginine at position 46 or alanine at position 54 of the 46R50V54A was shown to be critical for binding to I-Au or I-Eu, respectively. Further, on the basis of this class II binding motif we could prepare potent peptide vaccines against influenza A/Aichi/2/68 virus in B10.PL mice.

Amino Acid Sequence↗
PubMed1994

[Clinical evaluation of aciclovir granules in the treatment of chickenpox in otherwise healthy children].

The efficacy and safety of aciclovir granules (containing 40% w/w aciclovir) were evaluated in the treatment of chickenpox in otherwise healthy children. Patients presenting with chickenpox received aciclovir granules at a dose of 20 mg/kg four times daily for five to seven days. Overall 51 children received treatment with aciclovir. A further 53 patients receiving conventional symptomatic therapy acted as a control. In the aciclovir group the overall efficacy rate was 92.2%. There were reductions in the numbers of lesions, fever, itching and the duration of symptoms. No adverse experiences were reported. Overall this formulation of aciclovir appears to be a safe and effective treatment for chickenpox in this patient population. However the need for anti-viral therapy in otherwise healthy children is still the subject of debate and it might be appropriate to identify sub-groups for whom such therapy is justified.

Acyclovir↗
PubMed1994

[Development of synthetic peptide vaccine against influenza--T cell epitope the hemagglutinin of A/Aichi/2/68(H3N2) influenza virus induced immune response in mice].

Residues 46 and 54 of a synthetic peptide composed of residues 43-58 (AEGFSYTDANKNKGIT) of pigeon cytochrome c (p43-58) function as the agretope (the site of contact between the major histocompatibility complex and the antigen) and residues 50 and 52 function as the epitope (the site of contact between the T cell receptor and the peptide antigen). 46F54A peptide which was prepared by reserving phenylalanine (F) at an agretopic position 46 but substituting asparagine (N) to alanine (A) at the other agretopic position 54 bound to I-Ab molecule more tightly than p43-58. Previously, it was demonstrated that F at position 46 and A at position 54 functioned as the agretope in the 46F54A-specific and I-Ab-restricted T cell responses. Then I proved that these substitutions of amino acids at the agretopic positions did not affect the epitopic function, and substitutions of amino acids at the epitopic positions did not affect the binding between the agretope and MHC class II molecule each other. In the present study, I synthesized peptide vaccine by introducing several peptide fragments deduced from the hemagglutinin (HA) of A/Aichi/2/68 (H3N2) influenza virus into the central epitopic part of 46F54A. 46F/HA127-133/54A (18mer) which was synthesized by substituting residues 48-52 of 46F54A to residues 127-133 of the HA could induce antigen specific proliferative response of T cells in I-Ab mice. In the sera obtained from the I-Ab mice immunized intraperitoneally with 46F/HA127-133/54A (18mer) specific antibodies to A/Aichi/2/68 (H3N2) influenza virus were detected by ELISA. In addition, the sera neutralized infectivity of the virus in plaque reduction test using MDCK cells in vitro. This synthetic peptide vaccine was incorporated in multi-lamella-liposome and administered intranasally to I-Ab mice. The mice were protected from challenge infection with A/Aichi/2/68 (H3N2) influenza virus in vivo.

Animals↗
PubMed1994

Stages in the development of the rat lung: morphometric, light and electron microscopic studies.

Ontogenic changes of the pulmonary epithelium of the rat, ranging from fetal day 15 to 1 hour after birth (21st day), were observed using light and electron microscopy as well as morphometric analysis on the area occupied by terminal segments of epithelial tubes or by alveolar sacs (ATETAS) in the terminal region of the lung. The development of the lung was classified into four stages. In the pseudoglandular period (fetal days 15 and 16), epithelial tubes lined by columnar epithelium were not yet associated with blood capillaries. The percentages occupied by ATETASs in the terminal region of the lung were 15.3% and 15.7%, respectively, on fetal days 15 and 16. In the precanalicular period (fetal days 17 and 18), blood capillaries began to appose to epithelial tubes lined by cuboidal epithelium. Small osmiophilic lamellar bodies (OLBs) emerged in cuboidal epithelial cells (type II cells) on day 18. The percentages occupied by ATETAS were 24.9% and 25.5%, respectively, on days 17 and 18. In canalicular period (fetal days 19 and 20), sac-like end segments showed progressive thinning of the epithelial linings, and the amount of interstital tissues markedly decreased. The epithelial cells differentiated into squamous, or type I cells, and type II cells containing OLBs. Extrusion of OLBs was recognized on day 20. Most of the capillaries were located close to the epithelial linings. The thickness of the blood-air barrier on day 20 was 10 times that of the adult. The percentages occupied by ATETAS were 35.8% and 38.5%, respectively, on days 19 and 20. In the terminal sac period (in neonate), the wall of terminal sacs showed a thin epithelial lining. Blood capillaries protruded close to the air-way surfaces. The thickness of the blood-air barrier was 3.5 times as thick as that of adult. The percentage occupied by ATETAS was 53.1% of the total terminal region of the lung. When the area occupied by ATETAS at a given day was compared to the area of the adult, the percentage on day 20 was approximately 60% of the adult value, whereas the percentage in neonates was 85%. This suggested that a remarkable transformation took place in ATETAS between day 20 and neonate. In addition to the four periods mentioned above, we also discussed the embryonic and alveolar periods in the development of the rat lung.

Animals↗