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Biomedical subjects

H Tsuboi

Publications and source records attributed to H Tsuboi.

At least 55 records · Page 3Linked to original sources

Synthesis of a new potent anti-angiogenic agent, 17 alpha-acetoxy-9 alpha-fluoro-6 alpha-methylprogesterone (9 alpha-fluoromedroxyprogesterone acetate [FMPA]).

A new anti-angiogenic agent, 17 alpha-acetoxy-9 alpha-fluoro-6 alpha-methylprogesterone (9 alpha-fluoromedoroxyprogesterone acetate [FMPA, 9] was synthetized in a 10-step sequence. FMPA (9) had about two orders of magnitude stronger anti-angiogenic activity than medroxyprogesterone acetate (MPA), as estimated in a bioassay involving chorioallantoic membranes of growing chick embryos.

Animals↗

A case of amiodarone-induced thyrotoxicosis successfully treated with prednisolone.

We describe a patient who was treated with amiodarone for ventricular arrhythmia based on arrhythmogenic right ventricular dysplasia and who subsequently developed severe amiodarone-induced thyrotoxicosis. Discontinuation of amiodarone resulted in sustained ventricular tachycardia, which was successfully treated with a DC electrical shock, and subsequently atrial fibrillation, leading to brain embolism due to occlusion of the left middle cerebral artery. Combination treatment with amiodarone and prednisolone was effective both in reducing the serum concentration of thyroid hormones and in improving the patient's general condition. As the use of amiodarone becomes more widespread, treatment with prednisolone for this kind of thyrotoxicosis, which is resistant to conventional treatment, will be required increasingly frequently because iodine overload of the thyroid gland persists for some time after discontinuation of amiodarone treatment.

Adult↗

Prevalence of activated protein C resistance in acute myocardial infarction in Japan.

To investigate the possibility that activated protein C (APC) resistance due to the factor V could be an important predisposing factor in acute myocardial infarction (AMI), we have retrospectively examined the prevalence of APC resistance with protein C, protein S and antithrombin III deficiency and antiphospholipid antibody syndrome in AMI patients (< or = 50 years) admitted to our hospital over the past 7 years. Forty-seven patients were enrolled in the study. We divided the patients into two groups, warfarin group (group A) and a non-warfarin group (group B). APC resistance is defined as when the APC ratio is below or equal to the cut-off value 2. APC resistance was not detected in either group. The prevalence of an APC ratio below or equal to 2.5 was 16.7% (1 case) in group A and 24.4% (10 cases) in group B. The prevalence of protein C deficiency was 5.0% (2 cases) in group B. Two cases (5.0%) in group B had protein S deficiency. Antithrombin III deficiency was not detected in either group. The prevalence of antiphospholipid antibody syndrome measured by APTT was 40.4% (19 cases). We compared the AMI patients with 97 healthy volunteers (< or = 50 years old) without any thromboembolic events or bleeding tendency in their past history. No significant difference were found between these groups and the volunteers. APC resistance is a major cause of venous thromboembolism in Europe and the United States, while in Japan it is believed to be a minor cause of arterial thromboembolism.

Adult↗

[Does physical status influence the axillary temperature among junior high-school students?].

The relationship between physical status and axillary temperature was examined in 373 junior high-school students. Axillary temperature was measured with a mercury glass thermometer, twice a day (8:15, 15:45) for a week, 10 minutes taken for each measurement. In addition, body mass index (BMI) was calculated from weight and height. And the subjects were divided into two groups according to the mean value of BMI (19.20 [kg/m2]), i.e., the low BMI group (LB) and the high BMI group (HB). We then compared the axillary temperature between LB and HB. The temperature both in the morning and afternoon was significantly lower in the HB than in the LB (p < 0.01, p < 0.05). In conclusion, a high BMI was associated with a decrease in axillary temperature in junior high-school students.

Adolescent↗

Differential display and cloning of shear stress-responsive messenger RNAs in human endothelial cells.

To investigate the effect of shear stress on endothelial gene expression, we performed differential display of mRNAs from cultured human umbilical vein endothelial cells either incubated under static conditions or exposed to shear stress (15 dynes/cm2) for 6 h in a flow-chamber. Around 4% of the total number of mRNAs detected were either up- or down-regulated by shear stress. DNA sequencing of some of these shear stress-responsive mRNAs revealed homology of several clones to known gene sequences and many other clones for unknown genes. Known genes, including those for human laminin B1 chain, H(+)-ATP synthase coupling factor 6, lysyl oxidase, myosin light chain kinase, and interleukin-8 receptor, were upregulated by shear stress, while the gene encoding NADH dehydrogenase was down-regulated. The present results suggest that shear stress can change the expression of numerous genes in endothelial cells, far more than reported to date, and that mRNA differential display is quite useful for cloning known and unknown shear stress-responsive genes.

Antigens, CD↗

Surgical repair of a coronary sinus diverticulum not associated with Wolff-Parkinson-White syndrome.

Diverticulum of the coronary sinus is rare. A 58-year-old man without Wolff-Parkinson-White syndrome underwent repair of a coronary sinus diverticulum accompanies by mitral regurgitation. The coronary sinus diverticulum had been identified 6 years earlier and had enlarged over time. At surgery, the neck of the diverticulum was closed, and the mitral valve replaced with a CarboMedics prosthetic valve (diameter, 29 mm). This the first case report of the surgical repair of a coronary sinus diverticulum not associated with Wolff-Parkinson-White syndrome.

Coronary Angiography↗

Effect of cardioplegic arrest and reperfusion on coronary reserve and autoregulation.

BACKGROUND: The effects of cardioplegic arrest and reperfusion on the coronary vasculature remain to be characterized. This study was designed to investigate changes in coronary reserve and autoregulation after hypothermic cardioplegic arrest and reperfusion. METHODS: Isolated rabbit hearts were perfused in a retrograde manner with Krebs-Henseleit bicarbonate buffer solution at a pressure of 80 cm H2O. Baseline measurements were performed for (1) coronary flow; (2) vasodilatory response to 5-hydroxytryptamine (10(-7) mol/L) and nitroglycerin (10(-4) mol/L); (3) autoregulatory capacity, quantified as closed-loop gains; and (4) isovolemic left ventricular function. Hearts were then subjected to cardioplegic arrest for 90 minutes. Twenty minutes after reperfusion, measurements were repeated. RESULTS: Coronary flow decreased significantly after reperfusion (6.2 +/- 1.1 versus 5.3 +/- 1.1 mL.min-1.g-1; p < 0.01). The response to 5-hydroxytryptamine as percentage increase of flow decreased significantly after reperfusion (134.0% +/- 12.0% versus 109.1% +/- 6.8%; p < 0.01). However, there was no significant change in the response to nitroglycerin after reperfusion (121.3% +/- 17.6% versus 136.6% +/- 13.3%). The closed-loop gain demonstrated negative values before arrest but became positive after reperfusion, indicating loss of autoregulation after reperfusion. There was no significant change in left ventricular function. CONCLUSIONS: The coronary flow reserve in response to 5-hydroxytryptamine and autoregulation were impaired after cardioplegic arrest and reperfusion, whereas nitroglycerin-induced vasodilatory response and left ventricular function were preserved.

Animals↗

Granulocyte phagocytic function is impaired during cardiopulmonary bypass.

BACKGROUND: The presence of impaired phagocytic function of the reticuloendothelial system after cardiac operations using cardiopulmonary bypass remains controversial. METHODS: In this study, the phagocytic function of granulocytes in 14 patients undergoing cardiac operations with cardiopulmonary bypass was examined using a chemiluminescence method. Seven patients with abdominal aortic aneurysms served as controls. Electron microscopy also was employed to evaluate morphologic changes. RESULTS: The 14 cardiac patients showed impaired phagocytic function from immediately after operation until 12 hours after the operation. This phagocytic function recovered within 24 hours. The 7 control patients showed no change in phagocytic function during or after the operation. Scanning electron microscopic examination of the cardiac patients' granulocytes revealed the loss of villi on cell surfaces immediately after operation. However, these villi were restored within 24 hours after the operation. CONCLUSIONS: The phagocytic function of granulocytes was impaired in the early postoperative period in patients undergoing cardiopulmonary bypass, and this was probably due to the loss of villi on granulocyte surfaces.

Aged↗

Diagnostic significance of thrombin-antithrombin III complex (TAT) and D-dimer in patients with deep venous thrombosis.

Thrombin-antithrombin III (TAT) and D-dimer were measured in 50 patients suspected of deep venous thrombosis (DVT) to assess the usefulness of these indicators in the diagnosis of DVT. DVT was diagnosed by ultrasonography (compression method and Doppler imaging). In patients who were negative for DVT (Group A), TAT was 3.8 +/- 2.36 micrograms/L (mean +/- SD) and D-dimer was 0.7 +/- 0.69 micrograms/ml, whereas in patients diagnosed with DVT (Group B), TAT was 20.4 +/- 19.10 micrograms/L (p < 0.001) and D-dimer was 9.0 +/- 9.21 micrograms/ml (p < 0.001). Thus, Group B had significantly higher levels of both markers. Moreover, 19 of the 23 cases in Group B had acute DVT, with symptoms appearing within 2 weeks of onset. When the cutoff for a positive diagnosis of DVT was set at TAT of 7.0 micrograms/L or more and D-dimer of 3.0 micrograms/ml or more, sensitivity was 84%, specificity was 96%, and accuracy was 90%. Based on these results, we concluded that TAT and D-dimer are extremely useful in screening for acute DVT.

Adult↗

Effects of the mycelial extract of cultured Cordyceps sinensis on in vivo hepatic energy metabolism in the mouse.

Mice were given the extract of cultured Cordyceps sinensis (Cs) (200 mg/kg daily, p.o.) for 3 weeks. In vivo phosphorus-31 nuclear magnetic resonance (NMR) spectra of the liver were acquired at weekly intervals using a surface coil. From 1 to 3 weeks, a consistent increase in the ATP/inorganic phosphate ratio, which represents the high energy state, was observed in the Cs extract-treated mice. The intracellular pH of the Cs extract-treated mice was not significantly different from that of the control mice. No steatosis, necrosis, inflammation or fibrosis were observed in the liver specimens from Cs extract-treated mice.

Adenosine Triphosphate↗

[Surgical treatment for ruptured aneurysm of distal arch or aortic arch: report of three cases].

We experienced three cases of surgery for ruptured aneurysm of the distal aortic arch (2 cases) or aortic arch (1 case). A 59-year-old man who was diagnosed as distal arch aneurysm ruptured to the pericardial cavity underwent graft replacement of the aneurysm and reconstruction of a left subclavian artery under selective cerebral perfusion (SCP). This patient had left hemiplegia postoperatively. A 73-year-old man who was diagnosed as an aneurysm of distal arch and descending aorta ruptured to left pleural cavity underwent graft replacement of the aneurysm and reconstruction of a left subclavian artery under SCP, and died of severe left ventricular failure possibly due to preoperative myocardial ischemia. A 70-year-old man who was diagnosed as a saccular aneurysm of aortic arch ruptured to mediastinum underwent resection of the aneurysm and patch plasty of the aorta under SCP. The postoperative course was uneventful. We discussed the approach to aneurysm, adjunctive method and surgical precedures from standpoint of our ruptured three cases.

Aged↗

[Early and late results of pericardiectomy for constrictive pericarditis].

Seven patients (4 males and 3 females: age 1 to 71 years old) who underwent operations for constrictive pericarditis from 1980 were reviewed. The median sternotomy approach was used without cardiopulmonary bypass. The pericardial flap was excised just anterior to both phrenic nerves. The postoperative hemodynamic improvement was good, especially in cardiac index (from 2.30 to 3.30 l/min/m2). Two patients were operative death. One was metastasis to pericardium from gastric cancer and another was multiple organ failure due to sepsis. Long-term survival was 3 to 13 years. One patient was dead at nine years after operation. Others were in New York Heart Association Class 1 or 2 in the long-term period after surgery. We conclude that our method can lead to good cardiac functional results and long-term good results. Our report wishes to emphasize early diagnosis and operation.

Adult↗

[Significance of systemic inflammatory response syndrome at cardiopulmonary bypass].

Systemic Inflammatory Response Syndrome (SIRS) is a new concept of entry criteria for sepsis. This concept, when applied to area of Multiple Organ Failure (MOF), is considered to be a preparatory state for MOF. To study the significance of SIRS state at cardiac surgery, we measured the body temperature, white blood cell count, respiratory rate and heart rate of 18 patients who underwent elective cardiac surgery, from the 1st post-operative day to the 7th post-operative day. We also measured Interleukin-6 and 8 (IL-6 and IL-8) to understand the relationship between the SIRS state and inflammatory cytokines just after cardiopulmonary bypass (CPB), at the 1st, 3rd and 6th postoperative day. The result was as follows: Patients with CPB more than 120 minutes have more frequency and longer duration of SIRS than patients with CPB less than 120 minutes. Serum levels of IL-8 at SIRS state were revealed statistically higher than at non-SIRS case. Duration of SIRS state was related to CPB time and serum levels of IL-6 and IL-8 just after CPB. We concluded that SIRS state is an indication for anti-cytokine therapy to prevent MOF, and it is important to shorten CPB time in order to decrease the duration of SIRS.

Cardiopulmonary Bypass↗

[Postoperative immunological capacity after coronary artery bypass grafting in a patient with chronic hemodialysis: comparison with data from patients without chronic hemodialysis].

Recently, coronary artery bypass grafting (CABG) has been performed safely in patients maintained on hemodialysis. However, the postoperative immunological capacity of patients undergoing CABG during chronic hemodialysis has not been fully investigated. Recently we performed CABG in a patient undergoing chronic hemodialysis and measured the immunological parameters. The WBC count, the populations of lymphocytes, OKT 4-positive cells, and OKT 8-positive cells, and NK activity were determined, and the lymphocyte stimulation test (using PHA) was performed before and after cardiopulmonary bypass, then, 1, 3, and 6 days after CABG. We compared these data with those from 17 patients without chronic hemodialysis. The immunological capacity after CABG in the patient with chronic hemodialysis was similar to that of patients without chronic hemodialysis. We suggest that CABG in patients with chronic hemodialysis is a safe operation with regard to the immunological capacity.

Adult↗

[An approach to the emergency surgery for arch and/or ascending aortic aneurysm].

The outcome of emergency surgery for the aortic arch aneurysm and/or dissecting aneurysm is worse than that of elective surgery. To decide the future strategy of the emergency surgery for these disease, 11 patients with emergency surgery (= group E: 8 for aortic dissection and 3 for rupture of the aortic arch aneurysm, age; 61 +/- 13 SD) were compared with 12 patients who had elective surgery (= group S: 5 for aortic dissection and 7 for aortic arch aneurysm, age; 69 +/- 3 SD). Ascending aorta replacement was performed in 7 cases in group E v.s. 1 in group S, aortic arch replacement in 2 v.s. 5, ascending aorta and aortic arch replacement in 1 v.s. 4 and patch replacement of the aortic wall in 1 v.s. 2, respectively. Selective cerebral perfusion (SCP) upon the cardiopulmonary bypass (CPB) was used in 45% (5/11) in group E. v.s. in 92% (11/12) in group S, p < 0.05. CPB time, aortic clamp time and SCP time were not significantly different between E group and S group. Postoperative cardiac failure, respiratory failure, renal failure, brain injury and infection occurred at insignificant rates between both groups. Thirty-day and 3-year survivorships were 73% in group E, while in group S they were 92% and 75%, respectively. In group E there were 2 cases which had aortic wall injury due to the aortic clamp used during the surgery. We recommend the use of selective cerebral perfusion and open distal anastomosis in emergency surgery for aortic arch aneurysm and/or Stanford type A aortic dissection.

Aged↗

[Thoracoscopic closure of patent ductus arteriosus for children: two case report].

We reported thoracoscopic closure of patent ductus arteriosus (TCPDA) performed on two children. All of two patients had no residual shunt postoperatively. Postoperative pain was less than left thoracotomy procedure. In addition TCPDA had merits cosmetically. We concluded that TCPDA was less invasive and safety procedure compared with conventional procedure.

Child, Preschool↗