PubMed Health⌕ Search

Biomedical subjects

H Terasaki

Publications and source records attributed to H Terasaki.

At least 19 recordsLinked to original sources
PubMed1996

Structural organization and chromosomal assignment of the mouse embryonic TEA domain-containing factor (ETF) gene.

Embryonic TEA domain-containing factor (ETF) belongs to the family of proteins structurally related to transcriptional enhancer factor-1 (TEF-1) and is implicated in neural development. Isolation and characterization of the cosmid clones encoding the mouse ETF gene (Etdf) revealed that Etdf spans approximately 17.9 kb and consists of 12 exons. The exon-intron structure of Etdf closely resembles that of the Drosophila scalloped gene, indicating that these genes may have evolved from a common ancestor. The multiple transcription initiation sites revealed by S1 protection and primer extension analyses are consistent with the absence of the canonical TATA and CAAT boxes in the 5'-flanking region, which contains many potential regulatory sequences, such as the E-box, N-box, Sp1 element, GATA-1 element, TAATGARAT element, and B2 short interspersed element (SINE) as well as several direct and inverted repeat sequences. The Etdf locus was assigned to the proximal region of mouse chromosome 7 using fluorescence in situ hybridization and linkage mapping analyses. These results provide the molecular basis for studying the regulation, in vivo function, and evolution of Etdf.

Amino Acid Sequence↗
PubMed1996

Cytokine generation in rabbits during extracorporeal lung assist with a mini hollow fiber lung.

To examine host responses to extracorporeal lung assist (ECLA) in small animals, we developed a mini hollow fiber lung of nonmicroporous polyolefin and an extracorporeal bypass circuit with a priming volume of 25 ml. This circuit allowed ECLA of up to 72 h without blood transfusion in 20 rabbits. The ECLA procedure induced the appearance of tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1) receptor antagonist (IL-1Ra) in plasma, but not IL-1 beta. However, these changes were observed only at the initial stage of ECLA, and the levels returned to pre-ECLA levels within 24 h. Although leukocytes adhering to the hollow fibers were immunohisto-chemically positive for IL-1 beta and IL-Ra, the plasma levels of these cytokines in response to ECLA were not different from those observed in rabbits given anesthesia and subjected to minor surgery but without ECLA. Thus, ECLA itself is a minor factor in the production of these cytokines.

Anesthesia↗
PubMed1996

S-cone pathway sensitivity in diabetes measured with threshold versus intensity curves on flashed backgrounds.

PURPOSE: To study sensitivity loss to short wavelength lights in patients with diabetes with or without retinopathy and to identify changes that cannot be attributed to preretinal screening. METHODS: Flash-on-flash thresholds were measured in 41 patients with diabetes and were compared to those in age-matched normals. A 50-ms, 1 degree blue test spot was presented simultaneously with a 500-ms, 2 degree blue flash. A bright yellow background isolated the S-cone system. RESULTS: The mean flash-on-flash threshold curve shifted up as the stage of retinopathy progressed in 16 patients with insulin-dependent diabetes mellitus (IDDM), including those without retinopathy. In 25 patients with noninsulin-dependent diabetes mellitus (NIDDM), those with preproliferative retinopathy revealed sensitivity loss; however, those with background retinopathy or without retinopathy showed no statistically significant change in sensitivity. CONCLUSIONS: The pattern of sensitivity loss in the patients with IDDM cannot be caused by changes in preretinal screening, including yellowing of the lens. Further, early functional changes in the patients with IDDM without retinopathy can be detected by this method.

Adolescent↗
PubMed1996

[Endobronchial treatments made possible by extracorporeal lung assist in a patient in status asthmaticus refractory to mechanical ventilation].

A 19-year-old endotracheally intubated women was admitted to our hospital in severe status asthmaticus that was not relieved by inhalation of beta 2-agonists or by epinephrine, aminophylline, or corticosteroids. A chest radiography revealed pneumomediastinum and subcutaneous emphysema. Pressure-limited mechanical ventilation at a peak airway pressure of 20--30 cmH2O failed to ventilate the lungs, and caused a left pneumothorax and atelectasis. Extracorporeal lung assist (ECLA) was begun and enabled repeated suctioning through a fiberoptic bronchoscope for more than a minute with no serious complications. During ECLA aerosol therapy with a large dose of a beta 2-agonist (procatherol 0.15 mg) increased the tidal volume with no adverse effects. Atelectatic areas of the lungs re-expanded, pulmonary function improved, and ECLA was stopped 86 hours after it had been started. We suggest that, although it is highly invasive, ECLA can be useful in patients with status asthmaticus refractory to mechanical ventilation, and can allow endobronchial suctioning to be done safely.

Adolescent↗
PubMed1996

Mitochondrial DNA mutations associated with the 11778 mutation in Leber's disease.

To clarify the characteristics of possible synergestic mitochondrial DNA (mtDNA) mutations associated with Leber's hereditary optic neuropathy (LHON), we analyzed the entire nucleotide sequences of mitochondrial genome of two Japanese patients from independent pedigrees harboring the 11778 mtDNA mutation, and compared their sequences with those of 47 disease and 6 normal controls. We have detected several unique mutations in the mtDNA in addition to the 11778 mutation. Two nucleotide substitutions, an A-to-G transition at position 856 in the 12S rRNA gene and an A-to-G transition at 14692 in the T psi C loop of the tRNA(Glu) gene, occurred at highly conserved sites among various species. These mutations in combination with the 11778 mutation might synergetically contribute to the pathogenesis of LHON.

Adolescent↗
PubMed1996

[Veno-arterial bypass and intraaortic balloon pumping for profound right heart failure--a case report of perioperative right heart infarction].

A combination of veno-arterial bypass (VAB) and intraaortic balloon pumping (IABP) was applied to a 54-year-old male patient whose right heart function was severely damaged immediately following aortic valve replacement. A diagnosis of perioperative myocardial infarction was made with findings of severe hypokinesis of the right heart, new Q wave with ST elevation, and increased cardiac escaping enzyme. The VAB was maintained wih a pump flow rate of 2.0-2.5 L/min. The system was exchanged to the second one 42 hours after the surgery. According to repeated on/off testing, the VAB was successfully weaned on the 5th postoperative day followed by weaning IABP on the 6th postoperative day. This case report shows a recovery from isolated right heart failure by an immediate switching from a cardiopulmonary bypass to VAB and IABP.

Aortic Valve↗
PubMed1995

Structural organization of the gene for CD40 ligand: molecular analysis for diagnosis of X-linked hyper-IgM syndrome.

CD40 ligand (CD40L) on activated T cells plays a crucial role for Ig heavy-chain class switching and the mutation of the gene for this ligand in the X-chromosome causes immunodeficiency with hyper-IgM (X-HIM). We isolated and characterized the human genomic clone for CD40 L to obtain information about the transcriptional regulatory regions of the gene and to develop a molecular diagnostic method for X-HIM patients. The genomic DNA isolated was over 12 kb long containing 5 exons that cover full sequence of mRNA for the ligand. DNA motif analysis based on transcription factor database revealed the presence of a GATA 1 box at around -265 bp. The typical TATA box, CAT site or GC rich region was not found in the 5' flanking region. However, two possible TATA like sequences were found at around -27 and -136 bp. Using the oligonucleotide primers corresponding to the introns, we performed a PCR-SSCP analysis of each exon from a patient with X-HIM syndrome and detected abnormality in exon 5. When sequenced, dinucleotide deletion in this exon was found in the patient and in one X allele of his mother as the only different sequence from that of the control gene. This procedure is simple and could be used for diagnosis of the X-HIM syndrome.

Adolescent↗
PubMed1995

The determinant of severe cerebral dysfunction in patients undergoing emergency extracorporeal life support following cardiopulmonary resuscitation.

We investigated the factors associated with cerebral dysfunction in patients undergoing extracorporeal life support (ECLS) following conventional advanced cardiac life support (ACLS). The subjects were 9 patients in whom ECLS was started following ACLS because of intractable cardiac arrest. We investigated whether the irreversibility of cerebral dysfunction during ECLS was related to the cardiopulmonary resuscitation (CPR) time, arterial pH and blood gases, hemoglobin concentration (Hb), peak arterial pressure (PAP) before the start of ECLS and total doses of epinephrine and sodium bicarbonate administered during CPR. Two of the 3 patients who recovered consciousness were weaned from ECLS and survived, while all 6 patients who did not recover from coma were not weaned and died. There was no difference in the CPR time, Hb and PAP before the start of ECLS along with total doses of epinephrine and sodium bicarbonate administered during CPR between the patients who recovered consciousness and those who did not. In addition, there was no difference in arterial pH and blood gases except the arterial oxygen tension (PaO2) between the groups. The PaO2 values before the start of ECLS in the patients who remained in coma ranged from 34 to 58 mmHg, whereas those in the patients who recovered consciousness ranged from 132 to 442 mmHg. The PaO2 values before the start of ECLS in the patients who remained in coma were less than 60 mmHg, whereas those in the patients who recovered consciousness were over 60 mmHg. The present study suggests that hypoxemia during CPR may play a major role in severe cerebral dysfunction in patients undergoing ECLS and PaO2 during CPR.

Adult↗
PubMed1995

Association of acquired color vision defects in blue cone monochromatism.

The retinal functions of a 43-year-old man with diabetic retinopathy in a family affected by blue cone monochromatism were studied. While changes in visual acuity and color vision were similar to those seen in patients affected by rod monochromatism, and his spectral sensitivities on high intensity background and his threshold versus intensity curve indicated only suggestive blue cone function, mass electroretinograms (ERG) findings demonstrated well preserved blue cone function. The disparity in blue cone function between psychophysical and mass electroretinographical evaluation may be caused by the difference in how much the fovea influenced each testing. Diabetic retinopathy most likely caused significant reduction of the psychophysical blue cone function and resulted in clinical findings similar to rod monochromatism. The mass blue cone ERG was useful to differentiate blue cone monochromatism from rod monochromatism in this diabetic patient.

Adult↗
PubMed1995

[Visual functions of dominantly inherited juvenile optic atrophy].

Visual functions including color vision and spectral sensitivity were investigated in 18 of 36 patients and in 2 persons with normal visual acuity in 8 families with dominantly inherited juvenile optic atrophy. Seven of the 8 families had at least one member who showed mainly acquired blue-yellow color vision deficiency. However, only 4 patients showed typical blue-yellow color vision deficiency, which suggested nonspecific characteristics of color vision deficiency in optic neural diseases. One family showed mainly acquired red-green color vision deficiency. Spectral sensitivity functions measured in 5 patients of 3 families showed sensitivity loss in the middle and long wavelength range as well as markedly decreased sensitivity in the short wavelength range. Decrease in spectral sensitivity in the short wavelength range or minimal blue-yellow color vision defect in a subject's brothers with normal visual acuity is interesting, but further study is needed because blue sensitivity decreases easily in various conditions.

Adolescent↗
PubMed1994

Extracorporeal life support: present status and the future.

Extracorporeal life support (ECLS), which is prolonged cardiopulmonary bypass with an artificial membrane lung, is one of the most efficient life support means for patients with severe cardiopulmonary failure. Its practice will become much simpler, safer and popular in the near future. In this article, the history of ECLS and the acronyms related to it, together with its present status in the world are introduced. Also mentioned are the various methods of ECLS. Heparin-bonded hollow-fibre lungs made of non-microporous membrane are recommended for prolonged cardiopulmonary bypass to prevent gas embolism and fluid leakage from the artificial lungs. Several special clinical cases where patients were saved from moribund cardiopulmonary failure, such as severe barotrauma after excessive ventilator therapy and prolonged cardiac standstill after myocardial infarction, are described to explain the life-support effects and indications of ECLS. Research on ECLS, now taking place, such as the use of an intravenacaval oxygenator, manually operated cardiopulmonary bypass system for emergency resuscitation and transportation of the patient, as well as respiratory care of a premature newborn in artificial amnion fluid, is also introduced.

Adolescent↗
PubMed1994

[A comparative study on long-term care facilities for the aged in Japan].

Presently in Japan, care for the aged who are bedridden, afflicted with dementia or other conditions, is provided by hospitals, skilled nursing homes (providing a certain amount of medical care) and special nursing homes (for those needing ADL assistance). Facilities for long term care of the aged are insufficient, and there are many problems in matching care needs to the services supplied in these facilities. In October 1990, a survey was conducted to collect data for helping define the optimum services needed for the aged in long term care facilities. The subjects consisted of 1,262 persons in 12 facilities: 314 in three general hospitals (average age: 78.5); 391 in three hospitals for the aged (80.8); 410 in four skilled nursing homes (81.2); 147 in two special nursing homes (81.3). Results of the survey are as follows: 1. The proportion of "seriously demented" and "very seriously demented" subjects, (according to Karasawa's scale.), was 17.5% in general hospitals, 28.7% in hospitals for the aged, 16.4% in skilled nursing homes, and 22.6% in special nursing homes. 2. For ADL, "mobility" with whole assistance was required for 40.5% of the subjects in general hospitals, 58.7% in hospitals for the aged, 22.9% in skilled nursing homes, and 37.5% in special nursing homes. 3. During the month preceding the survey, medical examinations were conducted on 98.4% in general hospitals, 99.5% in hospitals for the aged, 23.0% in skilled nursing homes, and 59.4% in special nursing homes. These examinations consisted mostly of urine and blood analyses. ECGs and x-ray tests were also performed on more than 70% of subjects in the two types of hospitals.

Activities of Daily Living↗
PubMed1994

[Effects on hemolysis of the manually operated portable cardiopulmonary bypass system].

We studied the effects on hemolysis of our manually operated, portable cardiopulmonary bypass system with two self-inflatable reservoir-pumps in parallel by using bovine blood. The blood shed from both the jugular vein and the carotid artery, immediately after slaughter, was divided into three plastic containers, one for the control, one for manual circulation, and the other for conventional circulation with a roller-pump. Small bore catheters were intentionally placed into the inflow and outflow routes of both circulation systems to simulate clinical situations. Free hemoglobin and potassium in plasma were measured every 30 min during the experimental circulation for 120 min. The free hemoglobin in plasma increased gradually under manual circulation, but this increase was statistically insignificant when compared with the variances of those in the conventional circulation and the control blood groups. The values of the potassium in the plasma showed no differences among the three blood groups. Our manually operated, portable cardiopulmonary bypass system will be a valuable adjunct for emergency medicine.

Animals↗
PubMed1994

Scotopic threshold response in complete and incomplete types of congenital stationary night blindness.

PURPOSE: To study the function of the rod visual pathway in the complete and incomplete types of congenital stationary night blindness (CSNB), with special reference to the scotopic threshold response (STR) of electroretinograms (ERGs) METHODS: Using full-field stimuli with light intensities ranging from near absolute threshold to bright, ERG intensity series from two patients with complete CSNB, four patients with incomplete CSNB, and four normal subjects were recorded. RESULTS: Neither the rod b-wave nor the STR was recordable from the patients with complete CSNB. In the patients with incomplete CSNB, the STR was clearly recorded, although the absolute threshold was elevated in accordance with elevation of the psychophysical absolute threshold. The b-wave stimulus threshold was not elevated, and the b-wave amplitude near the threshold was normal. The peak time of the STR was delayed by approximately 80 msec, whereas that of the b-wave was normal. CONCLUSIONS: These STR results indicate that the rod system abnormality in complete CSNB differs from that in incomplete CSNB. Furthermore, the greatly delayed peak time of STR in the patients with incomplete CSNB made the interaction between b-wave and STR different from that in normal subjects.

Adolescent↗
PubMed1994

Safety of high-dose of nafamostat mesilate: toxicological study in beagles.

The acute effects of a high dose of nafamostat mesilate (NM, 6-amidino-2-naphthyl-p-guanidinobenzoate dimethanesulfonate) were studied in 14 beagles (six controls). NM (10 mg kg-1 hr-1) was continuously administered intravenously for 24 hr. The activated coagulation time was dose-dependently prolonged with NM. Plasma electrolyte imbalances such as hyponatremia, hypochloremia, hyperkalemia and active excretion of sodium into urine were found. Aldosterone levels tended to increase in blood and urine after the administration of NM. Although the precise mechanism of these electrolyte imbalances remains unknown, the increase of aldosterone in blood and urine may have been a secondary response to, rather than the cause of, the electrolyte imbalances. Mean arterial pressure gradually decreased after 5 hr of NM. This hypotension may have reflected the vasodilatation with NM. Although the biochemical and histological studies did not reveal significant side effects, further study will be required to confirm the safety of long-term, high-dose NM. These results indicate that the high-dose NM administration at a rate of 10 mg kg-1 hr-1 during 24 hr has no serious side effects.

Aldosterone↗