Biomedical subjects

I Yamagishi

Publications and source records attributed to I Yamagishi.

At least 19 recordsLinked to original sources

PubMed1999

Inhibitory effect of TS-962 on the formation of early atherosclerotic lesions in high fat-fed hyperlipidemic hamsters.

The hypocholesterolemic and anti-atherosclerotic effect of TS-962, a specific ACAT inhibitor, was investigated in a hamster model fed a high fat diet containing 10% coconut oil and 0.05% cholesterol. Lipid accumulated atherosclerotic lesions were detected by using oil red O staining in the lesion-prone aortic arch. A high dose, estimated to be 15 mg/kg, of TS-962 decreased serum cholesterol to normal levels with reduction of liver cholesterol contents below normal levels, and as a consequence, entirely inhibited the lipid accumulation in the aortic arch. Furthermore, a low dose, estimated to be 1.5 mg/kg, of TS-962 remarkably inhibited aortic lipid accumulation by 73% compared with the control group, without changing either serum cholesterol level or liver cholesterol content. These findings suggest that TS-962 is effective in the primary prevention of atherosclerosis by directly suppressing the formation of foam cells in arteries.

Acetamides↗

PubMed1998

Hypoproteinemia caused by tricuspid regurgitation: report of a case.

A case of tricuspid regurgitation (TR) complicated by severe hypoproteinemia is presented herein. A 68-year-old man who had undergone coronary artery bypass grafting (CABG) for postinfarction angina suffered repeated inferior myocardial infarction due to obstruction of the proximal right coronary artery, 3 years after which he developed systemic edema. Investigations revealed TR associated with hypoproteinemia; however, treatment consisting of aggressive diuretic therapy and albumin administration proved ineffective. The hypoproteinemia manifested as protein-losing enteropathy clinically, and the tricuspid valve was replaced to eliminate high venous pressure. The serum protein levels became normalized after the operation. Although TR is generally well tolerated in the absence of pulmonary hypertension, surgical management is recommended for patients with severe protein deficiency resistant to medical treatment.

Aged↗

PubMed1998

Halofuginone inhibits neointimal formation of cultured rat aorta in a concentration-dependent fashion in vitro.

Halofuginone, an anticoccidial quinoazolinone, can specifically inhibit collagen type alpha1 (I) synthesis and gene expression, and also inhibits cultured smooth muscle cell proliferation. The aim of this study was to investigate the effect of halofuginone on neointimal formation of rat aorta after culture in a concentration-dependent manner in vitro. Thoracic aorta of Wistar rats was removed and manipulated to damage the endothelium under sterile conditions, and culture for 15 days in halofuginone-free or halofuginone-added culture medium (n = 20). Segments of cultured aorta were studied by histologic and immunohistochemical methods. Proliferation of neointimal layers consisting of loose multilayer cellular structure was observed in the halofuginone-free control group after 15 days of rat aorta culture, and neointimal formation was significantly decreased as an increasing concentration of halofuginone was added. As with precultured fresh aorta, no intimal proliferation was observed in the cultured segments of aorta with 500 ng/ml halofuginone added to culture medium. The proliferation of cell nuclear antigen index was significantly higher in the halofuginone-free control group than that in the halofuginone-added groups. The present results suggest that halofuginone can inhibit neointimal formation of rat aorta after culture in a concentration-dependent fashion in vitro.

Animals↗

PubMed1998

An effective method for improving hemostasis in aortic root replacement with a composite graft.

Hemostasis during aortic root replacement with a composite graft, consisting of a separate Dacron graft and a valve, was markedly improved by using a supra-annular aortic wall reinforcing suture (SAWR). Between February 1994 and January 1998, 14 consecutive patients (10 men and 4 women) underwent replacement of the aortic valve and ascending aorta with the SAWR technique. No intraoperative bleeding of the aortic proximal suture line or early death occurred in this group. No patient required reoperation for bleeding of anastomoses. Three of 10 patients who underwent elective operations were operated on successfully without blood transfusion. In addition, no clinical complications related to the SAWR technique were observed in the follow-up period. We conclude that the SAWR technique can be performed easily and may be an effective method for improving proximal hemostasis.

Aortic Dissection↗

PubMed1998

HL-004, the ACAT inhibitor, prevents the progression of atherosclerosis in cholesterol-fed rabbits.

HL-004, N-(2,6-diisopropylphenyl) tetradecylthioacetamide, a novel acyl-CoA:cholesterol acyltransferase (ACAT) inhibitor, was evaluated concerning the possible prevention of hyperlipidemia and atherosclerosis in 1% cholesterol-fed rabbits. HL-004 (0.2, 5 and 25 mg/kg) was orally administered once a day for 12 weeks. HL-004 inhibited the rise of total serum cholesterol at a dose of 5 mg/kg and over. In the thoracic aorta, HL-004 at the doses of 5 mg/kg and 25 mg/kg reduced the total cholesterol content by 56.3% and 84.2% compared with control, and decreased ACAT activity, dose-dependently. HL-004 also attenuated the development of aortic lesions. The area of atherosclerotic lesions was reduced by 30.3% with 5 mg/kg of HL-004 and 100% with 25 mg/kg. In this study, we suggest that the main reason for HL-004 preventing the progression of atherosclerosis is its hypocholesterolemic effect due to the inhibition of cholesterol absorption in the intestine.

Acetanilides↗

PubMed1998

Emergency coronary artery bypass grafting after acute myocardial infarction. What influences early postoperative mortality?

Although short- and long-term outcomes after elective coronary artery bypass grafting (CABG) has improved, emergency CABG after acute myocardial infarction (AMI) does not always bring satisfactory prognosis. In this report, early postoperative and follow-up results were studied. Furthermore, variables related to hospital mortality were explored. From among 186 patients who underwent CABG, 18 patients formed the basis of this research. This series included 16 males and 2 females, with a mean age of 65.3 years old. Hospital mortality of the patients was 38.9%, and actual survival rate of all the patients 5 years after CABG was 55.6%. Factors that predicted hospital mortality in those patients included increased age and preoperative cardiogenic shock. There was no difference in hospital mortality between the patients operated on with only saphenous vein (SV) and those operated on in combination with SV and internal thoracic artery (ITA). In emergency CABG, cardiogenic shock before surgery was most likely to influence hospital mortality. Therefore, an appropriate circulatory support system should be applied to improve hemodynamic status before bypass surgery.

Adolescent↗

PubMed1998

Emergency coronary artery bypass grafting after left coronary artery rupture: a case report.

Coronary artery rupture has been known as one of the complications of coronary balloon angioplasty. In this report, we describe a case of coronary artery rupture, who underwent emergency surgery for hemostasis and coronary revascularization. A 67-year-old-male with frequent angina attacks was admitted to our institution for possible coronary angioplasty. Coronary angiogram showed diffuse disease of the mid left anterior descending artery (LAD), with two 90% stenosis. Conventional balloon angioplasty was performed, however, coronary artery rupture occurred while the stent was expanded with a 3.5 mm balloon catheter. Though pericardial drainage improved his hemodynamic state, subsequent coronary angiogram revealed leakage of contrast medium. Emergency surgery was determined at this point for hemostasis and revascularization of the LAD. The revascularization was completed with the left internal thoracic artery (LITA) to the LAD. On the contrary, since the epicardial hemorrhage around the proximal LAD did not spread any further after systemic heparinization, the epicardial surface was covered with a piece of oxidazed cellulose and fibrin glue. After the surgery, the hemodynamic state improved gradually. Postoperative coronary angiogram revealed an aneurysm of the LAD, as well as excellent LITA-LAD patency.

Aged↗

PubMed1998

Cardiac surgery using only autologous blood for a patient with hereditary spherocytosis: a case report.

A 50-year-old man was admitted to our hospital for possible surgery. Echocardiogram showed severe calcification of the aortic valve, and cardiac catheter examination recorded a gradient greater than 150 mmHg across the valve. These results determined aortic valve replacement (AVR) to relieve the pressure-overloaded ventricle. Preoperative evaluations however, demonstrated anemia derived from hereditary spherocytosis (HS), an inherited hemolytic disorder. In order to avoid homologous blood transfusion, the following strategies were tried; 1) an iron supplement and an injection of recombinant human erythropoietin (rHuEPO); 2) pre- and perioperative autologous blood transfusion; and 3) an aggressive iron supplement just after the surgery. These raised the blood hemoglobin concentration to the criterion where autologous blood donation was started, and maintained the hemoglobin level stable, up to his discharge. In conclusion, bloodless cardiac surgery is possible for cases with anemia, and some strategies should be tried to raise and maintain the blood hemoglobin concentration well.

Aortic Valve↗

PubMed1997

ACAT inhibitor HL-004 accelerates the regression of hypercholesterolemia in stroke-prone spontaneously hypertensive rats (SHRSP): stimulation of bile acid production by HL-004.

The effect of the acyl-CoA:cholesterol acyltransferase (ACAT) inhibitor HL-004 on bile acid production was studied during the regression phase of pre-established hypercholesterolemia in stroke-prone spontaneously hypertensive rats (SHRSP). These rats were fed a hypercholesterolemic diet containing 5% cholesterol, 2% cholic acid, and 20% suet for 30 days to induce hypercholesterolemia. The regression phase was started by switching the diet to normal chow, followed by another 30 days of the diet. The decrease in serum cholesterol level was accelerated by treatment with 0.09% HL-004. At the end of regression, hepatic ACAT activity was significantly lower in the HL-004 treated animals, an event concomitant with the significant decrease in cholesteryl ester content in the liver. In contrast hepatic cholesterol 7 alpha-hydroxylase activity was maintained at a higher level in the HL-004 treated animals. HL-004 increased the secretion of bile acid and biliary lipids in bile duct-cannulated SHRSP. In HepG2:cells, HL-004 at 1-30 microM dose-dependently stimulated bile acid synthesis from [3H]cholesterol. When cholesterol 7 alpha-hydroxylase activity of the liver was compared ex vivo in the presence and in the absence of exogenous cholesterol, it was suggested that the higher 7 alpha-hydroxylase activity of the HL-004 group could be attributed not only to expansion of the endogenous cholesterol pool, which may be the result of hepatic ACAT inhibition by HL-004 but to the direct effect of HL-004 on bile acid production. Thus, HL-004 accelerates the regression of hypercholesterolemia, an event which may be related to the stimulation of bile acid production in the liver.

Acetanilides↗

PubMed1997

Is the dog a useful model for accelerated calcification study of cardiovascular bioprostheses?

Chitosan posttreatment has been shown to be effective in prevention of calcification of the glutaraldehyde treated bovine pericardium when implanted subdermally in rats for 12 weeks. The efficacy of chitosan posttreatment in complete calcium mitigation of the glutaraldehyde treated porcine aortic valves implanted in the right side of the heart in dogs was well-documented in our previous study. In this study, an attempt has been made to evaluate the merit of the chitosan posttreatment in prevention of calcification of the glutaraldehyde (GA) treated porcine aortic valved conduits in the systemic circulation in dogs for a period of 5 months. Eleven mongrel dogs underwent left thoracotomy. Porcine aortic valved conduits treated with 0.625% GA (n = 5) and GA-chitosan (n = 6) were implanted in the descending thoracic aortas of the dogs for 5 months. Gross histological observations showed no calcification in either the 0.625% GA treated or in the GA-chitosan treated valved conduits at 5 months. This was confirmed by results of quantitative analyses for calcium in each explant. There was no significant difference in calcium content between the GA only (Ca, 0.43 +/- 0.26 mg/g) and GA-chitosan treated (Ca, 0.51 +/- 0.19 mg/g; p = 0.5959) valved conduits. This study suggests that the dog is not a suitable model for evaluating the efficacy of a calcium mitigating agent in bioprostheses implanted in systemic circulation.

Animals↗

PubMed1996

Surgical treatment of isolated secundum atrial septal defect in patients more than 50 years old.

BACKGROUND: Arrhythmia-related thromboembolic accidents continue to occur in patients even after closure of secundum atrial septal defect. Older age is usually not a contraindication to the repair of an atrial septal defect. To assess the importance of the type of management in elderly patients with atrial septal defect our clinical experience is reviewed. METHODS: Between 1974 and 1994, 49 patients 50 years of age or older (average, 57.4 years) underwent surgical closure of secundum atrial septal defect. All patients have been followed up for 2 to 21 years (mean, 9.7 years). RESULTS: There were no operative deaths. Functional classes in most of the patients were improved after operation. There were two cerebrovascular thromboembolic accidents with one permanent neurologic dysfunction, hemiparesis, and one septal dehiscence in the early postoperative period. One patient (2%) died of renal failure 6 years after operation, late arrhythmias developed in 3 patients (6%), 3 patients had a late stroke (6%), and 1 patient was not available for follow-up. CONCLUSIONS: Long-term operative results are satisfactory and beneficial to the quality of life in elderly patients. Because there is no safe and effective nonsurgical alternative to surgical closure, atrial septal defect repair in elderly patients without severe pulmonary vascular disease should not be delayed once the diagnosis had been made.

Age Factors↗

PubMed1996

Composite graft replacement of the aortic root in patients with Marfan's syndrome.

Between October, 1979 and September 1994, 18 consecutive patients with Marfan's syndrome underwent replacement of the ascending aorta and aortic valve with a composite graft. There were 11 men and seven women; the mean age was 38.7 years. All patients had annuloaortic ectasia with significant aortic regurgitation. Ten of the 18 patients had aortic dissection. Concomitant procedures were performed in three patients. The hospital mortality rate was 17%, and two patients with concomitant procedures died early after surgery. There were three late deaths, two of which were related to late aortic complications. The actuarial 8-year survival rates in patients with and without aortic dissection were 58.3% and 77.8%, respectively. Since aortic dilatation and its complications are progressive in patients with Marfan's syndrome, improved surgical results can be obtained early in the course of the disease before cardiac disturbances and aortic dissections emerge.

Actuarial Analysis↗

PubMed1996

The hypolipidemic action of the ACAT inhibitor HL-004 in hamsters fed normal chow.

1. A novel ACAT (acyl-CoA: cholesterol acyltransferase) inhibitor, HL-004, exhibited a strong inhibitory effect on the hepatic and intestinal ACAT, but was less effective on the adrenal ACAT in vitro. 2. HL-004 selectively decreased serum VLDL cholesterol, and inhibited hepatic ACAT activity in hamsters fed normal chow. 3. These results suggest that the cholesterol-lowering effect of HL-004 can be attributed to a decrease in hepatic VLDL secretion via inhibition of ACAT.

Acetanilides↗

PubMed1996

Hypolipidemic effect of taurine in stroke-prone spontaneously hypertensive rats.

The hypolipidemic and antiatherosclerotic effects of taurine were investigated in genetically hypertensive rats: strokeprone spontaneously hypertensive rats (SHRSP). SHRSP were fed a hypercholesterolemic (HC) diet supplemented with 3% taurine for 50 days, and serum cholesterol was monitored. Cholesterol content and enzymatic activity responsible for cholesterol synthesis and metabolism were also determined in the liver, aorta, and intestine. Taurine prevented increases in the cholesterol level of the serum, liver, and aorta induced by a HC diet. Severe fat deposits of the mesenteric arteries induced by a HC diet were improved by the taurine treatment, showing the hypolipidemic and antiatherosclerotic effects of taurine. Taurine enhanced the activity of cholesterol 7 alpha-hydroxylase, a rate-limiting enzyme of bile acid synthesis, and stimulated bile acid production. These results suggest that taurine stimulates bile acid synthesis, which is closely related to the enhancement of cholesterol 7 alpha-hydroxylase activity, and thereby reduces serum cholesterol. In addition, a decrease in the intestinal acyl CoA:cholesterol acyltransferase activity by taurine suggests that the inhibition of cholesterol absorption may also be related to the hypolipidemic effect of taurine, in part.

Animals↗

PubMed1996

[Coronary artery bypass grafting in a patient with severe coronary disease due to Kawasaki disease: a case report].

A 14-year-old girl with severe coronary artery disease due to mucocutaneous lymph node syndrome, "Kawasaki disease", admitted to our hospital. Though she had no angina on any effort in her daily life, coronary angiography (CAG) demonstrated 90% stenosis and a large aneurysm of left main trunk. Based on the CAG findings, we determined to do the coronary artery bypass grafting (CABG) to left anterior descending artery (LAD) and 1st diagonal branch (D1) to prevent the occurrance of fatal acute myocardial infarction. We attempted to use bilateral internal thoracic arteries (ITAs) at the beginning of this surgery. While LAD was grafted with left one, D1 was done with saphenous vein (SV) because of difficulty of harvesting right one. The weaning from cardiopulmonary bypass was easy and the postoperative course was of no event. A month later, CAG showed the good patency of both left ITA and SV graft.

Adolescent↗

PubMed1996

[Aortic root replacement employing Cabrol and Piehler techniques].

Between February, 1982, and September, 1994, 24 patients underwent aortic root replacement using a valve-bearing composite graft and coronary perfusion grafts. The indications for surgery were annulo-aortic ectasia in 21 patients, and aortic dissection associated with significant aortic regurgitation in 3 patients. Aortic root was reconstructed employing the techniques described by Cabrol and colleagues (Cabrol operation) in 16, and by Piehler and Pluth (Piehler operation) in 8. Two of 16 patients who underwent Cabrol operation required concomitant procedures. Four patients (25.0%) who underwent Cabrol operation had technical troubles relating to coronary reattachements (kinking and torsion of coronary grafts in 2, obstruction of left limb of coronary graft in 1, and coronary graft compression by aortic wall wrapping in 1), while one patient (12.5%) having Piehler operation had coronary graft compression by partial wrapping of aortic root. The hospital deaths occurred in 4 patients undergone Cabrol operation, with the hospital mortality rate being 16.7%. Three patients including 2 with concomitant procedures died of low cardiac output and one died of rupture of residual dissecting aneurysm of the aortic arch. No pseudoaneurysm nor anastomotic stenosis was observed in any hospital survivors. Late deaths occurred in 5 patients, in whom there was no late complication relating to coronary reconstruction. However, late obstruction of left ostial stenosis developed in one patient who underwent Piehler operation, which required coronary artery bypass. We conclude that aortic root replacement using coronary perfusion grafts provides sound coronary anastomoses without late pseudoanurysm. Coronary reattachments is facilitated by use of Piehler technique, preventing coronary graft kinking or torsion. Late coronary ostial stenosis should be considered as a possible cause of fatal myocardial infarction and sudden death, and careful follow-up is required for patients having these kinds of operation for the prevention of late cardiac events.

Adult↗

PubMed1996

Effect of the ACAT inhibitor, HL-004, on cholesterol metabolism in macrophages.

The effects of a novel acyl-CoA: cholesterol acyltransferase (ACAT) inhibitor, HL-004, on cholesterol metabolism were examined in mice peritoneal macrophages. Cholesteryl ester-rich foam cells were induced by incubating macrophages with acetylated LDL. HL-004 prevented the accumulation of cholesteryl ester in the presence of the cholesterol acceptor, HDL. In the absence of HDL, HL-004 generated large amounts of free cholesterol in the cell. Moreover, HL-004 stimulated the efflux of cholesterol from preestablished foam cells in the presence of HDL. These results suggest that the inhibition of foam cell formation and the stimulation of foam cell regression by HL-004 are attributed to intracellular ACAT inhibition, and that HL-004 would be expected to exhibit an antiatherosclerotic effect through direct action on arterial wall.

Acetanilides↗

PubMed1995

Dacron coronary graft obstruction after composite graft replacement of aortic root.

Obstruction of the left coronary ostial anastomosis is a rare late complication after composite graft replacement of the ascending aorta and the aortic valve with separate Dacron coronary grafts. Intimal proliferation caused by the turbulent blood flow at this site may be the cause of the obstruction, which is considered a possible cause of late cardiac events such as sudden death and global myocardial infarction. We describe a case of tight stenosis at the left coronary ostial anastomosis in a 38-year-old woman with Marfan's syndrome who had undergone a composite graft replacement that employed separate Dacron coronary grafts.

Adult↗