Rupture of gastroepiploic-coronary bypass graft due to cardiopulmonary resuscitation.
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Arteries↗
Biomedical subjects
K Minami
Publications and source records attributed to K Minami.
Receptors for C-type natriuretic peptide in cultured rat glial cells.
To characterize sites of action of C-type natriuretic peptide (CNP) in the glial cells, the effect of CNP on cGMP accumulation and the binding of [125I]CNP in rat astrocyte RCR-1 cells were studied. CNP stimulated cGMP accumulation in the cells from 10(-9) M in a dose-dependent manner, but ANP (atrial natriuretic peptide) had a negligible effect on cGMP accumulation in the cells. [125I]CNP was bound to the cells and its Kd value was 2 orders of magnitude lower than that of the ED50 value for stimulation of cGMP accumulation in the cells. Not only CNP but also ANP displaced [125I]CNP binding to the cells. These results suggest that RCR-1 cells have a B-receptor which contains a guanylate cyclase domain and is preferentially activated by CNP, and that they also have a C-receptor which does not contain a guanylate cyclase domain that reacts with both ANP and CNP.
Animals↗
Protein kinase C inhibits the Ca(2+)-activated K+ channel of cultured porcine coronary artery smooth muscle cells.
The effect of protein kinase C (C-kinase) on the Ca(2+)-activated K+ channel (KCa-channel) was studied in cultured smooth muscle cells from porcine coronary artery by the patch-clamp technique. In cell-attached patches, bath application of phorbol 12-myristate 13-acetate (PMA, 1 microM), a C-kinase activator, significantly decreased the open probability of the activated KCa-channel in the presence of the calcium ionophore A23187 (20 microM), which increases intracellular Ca2+. This decrease in the open probability was reversed by subsequent application of staurosporine (1 nM), a C-kinase inhibitor. Application of 1-oleoyl-2-acetylglycerol (OAG, 30 microM) or 1,2-dioctanoylglycerol (DG8; 30 microM), activators of C-kinase, also inhibited KCa-channel activation by A23187, and these inhibitions were also reversed by staurosporine. PMA (1 microM) also inhibited KCa-channel activation by dibutylyl cyclic AMP (db-cAMP, 2 mM) or caffeine (30 mM). In inside-out patches, bath application of the C-kinase fraction from rat brain in the presence of ATP (1 mM) and PMA (1 microM) markedly inhibited the KCa-channel. These results indicate that activation of C-kinase inhibits the KCa-channel and may cause membrane depolarization and vascular contraction.
Adenosine Triphosphate↗
Dynamics of iron-ascorbate-induced lipid peroxidation in charged and uncharged phospholipid vesicles.
Peroxidation of egg yolk phosphatidylcholine (egg PC) liposomes was induced by addition of ascorbic acid (AsA) and Fe(II) in the presence of a trace of autoxidized egg PC (PC-OOH), but not in the absence of PC-OOH. PC-OOH was degraded upon addition of AsA and Fe(II) but not of either one alone. The results suggest that PC-OOH is necessary to initiate lipid peroxidation by AsA/Fe(II). AsA oxidation in the bulk water phase was also associated with an increase in lipid peroxidation by AsA/Fe(II) in the presence of PC-OOH, but not in the absence of PC-OOH. Furthermore, the spin probe 12-NS [12-(N-oxyl-4,4'-dimethyloxazolidin-2-yl)stearic acid], which labels the hydrophobic region of dimyristoyl phosphatidylcholine (DMPC) liposomal membranes, was degraded upon addition of AsA and Fe(II) in the presence of PC-OOH, but not in the absence of PC-OOH. These results indicate that the "induction message" that is associated with decreases of PC-OOH and AsA in the initiation step of lipid peroxidation must be transferred from the membrane surface to the inner hydrophobic membrane region. AsA in the bulk phase was oxidized faster and more extensively upon its addition together with Fe(II) to egg PC liposomes than to DMPC liposomes, though the initial content of PC-OOH in the former was 5-10 times lower than in the latter. This suggests that, in egg PC liposomes, the OOH-groups of new PC-OOH generated in the inner membrane regions must become accessible from the surface, enabling reaction with AsA/Fe(II) which in turn would result in an extensive decrease in AsA.(ABSTRACT TRUNCATED AT 250 WORDS)
Ascorbic Acid↗
Traumatic sinus of Valsalva fistula and aortic valve rupture.
A rare case of nonpenetrating trauma-induced fistula from the right sinus of Valsalva to the right atrium and aortic cusp disruption is reported. The trauma occurred 2 1/2 years previously. The fistula was closed with a Dacron patch, and the cusp tear was sutured.
Accidents, Traffic↗
Mechanism of activation of the Ca(2+)-activated K+ channel by cyclic AMP in cultured porcine coronary artery smooth muscle cells.
Activation of the Ca(2+)-activated K+ channel (KCa-channel) by adenosine 3', 5'-cyclic monophosphate (cAMP) and cAMP-dependent protein kinase (A-kinase) in cultured smooth muscle cells from porcine coronary artery was investigated using the patch-clamp technique. In cell-attached patches, the KCa-channel was activated when forskolin (10 microM) was applied to the bath. In excised inside-out patches, application of 50 microM cAMP to the bath activated the KCa-channel in the presence of A-kinase (10 units/ml) and ATP (1 mM). In addition, the KCa-channel was activated directly by application of cAMP to the cytoplasmic side of the membrane in the absence of A-kinase. The activation by cAMP or by A-kinase required intracellular Ca2+, and was enhanced by increase of intracellular Ca2+. At a low concentration (3 x 10(-7) M) of Ca2+, more than 2 mM cAMP was required for activation of the KCa-channel, but with 10(-6) M Ca2+, 100 microM cAMP was sufficient for activation. These results suggest that there are two mechanisms of activation of the KCa-channel by cAMP: direct activation, and indirect activation via phosphorylation of the channel by A-kinase.
Animals↗
Elderly presentation of tetralogy of Fallot precipitated by an occult bronchial carcinoid tumour.
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Biomarkers, Tumor↗
Delayed brachial plexus paralysis due to subclavian pseudoaneurysm after clavicular fracture.
Injuries to the brachial plexus and subclavian artery are serious complications of shoulder girdle trauma. Due to the close anatomical relationship between the brachial plexus and the subclavian artery in the thoracic outlet, both structures are often simultaneously involved in shoulder girdle injuries. Isolated lesions of the subclavian artery or the brachial plexus can also occur, especially with clavicular fractures. When a false subclavian aneurysm leads to a gradually increasing compression of the brachial plexus, the neurological signs and symptoms develop insidiously after the traumatic event.
Adult↗
Alpha-2 plasmin inhibitor-plasmin complex and postoperative blood loss: double-blind study with aprotinin in reoperation for myocardial revascularization.
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Antifibrinolytic Agents↗
[Aortic regurgitation developed seven years after mediastinal radiation therapy: report of a case].
We report on radiation-induced valvular dysfunction in a 41-year-old woman who developed aortic regurgitation with clinical symptoms, requiring aortic valve replacement seven years after mediastinal radiation therapy for carcinoma of the breast. She was treated with cobalt radiation therapy of 4000 rads to her left mediastinum. The excised three-cuspid aortic valve was edematous and densely fibrotic without commissural fusion. Histological examination strongly suggested that the aortic valve with diffuse fibrosis, destruction of elastic fibers and bizarre nucleus in fibroblasts had been induced by mediastinal radiation therapy. To our knowledge, symptomatic radiation-induced valvular dysfunction in the aortic position has been reported infrequently, with only eleven reported cases. In this case, symptomatic aortic regurgitation was diagnosed seven years after mediastinal radiation therapy. It is emphasized that long-term follow-up is important for patients receiving mediastinal radiation therapy.
Adult↗
Long term follow-up of Mitroflow pericardial valve prostheses in the small aortic annulus.
Between January 1985 and April 1992 we implanted 477 Mitroflow pericardial bioprostheses in 476 patients in our clinic. All except one valve prostheses were implanted in the aortic position. There were 160 male and 316 female patients, with a mean age of 74.1 years (range 30-89 years). Combined cardiac procedures were performed concomitantly with aortic valve replacement in 45 patients (9.5%): coronary artery revascularisation (n = 38), endarterectomy of the internal carotid artery (n = 4) and multiple valve replacement (n = 3). The sizes of the implanted Mitroflow prostheses were 100% in 19 mm, 70% in 21 mm, 60% in 23 mm and 8% in more than 25 mm. The hospital mortality was 1.3% (n = 5). During the mean follow-up period of 47.6 months valve failure requiring reoperation occurred in 7 patients (1.2%). The actuarial freedom from tissue failure is 89.9 +/- 2.5% and the actuarial survival rate is 90.3 +/- 1.7% (27 deaths) at 7 years. These findings corroborate our policy to continue to implant a pericardial prosthesis in the aortic position, especially in elderly patients with a smaller aortic annulus.
Adult↗
[A case of gastric cancer with multiple liver metastases responding significantly to intra-arterial infusion of epirubicin/mitomycin C-lipiodol suspension].
We encountered a case of partial response in a patient with multiple liver metastases from gastric cancer as a result of treatment by hepatic artery infusions of epirubicin/mitomycin C-Lipiodol suspension. A 56-year-old man was diagnosed as having advanced gastric cancer with multiple liver metastases. Subtotal gastrectomy with regional lymph node dissection and cholecystectomy were performed, and an injection port was implanted in the proper hepatic artery. Ten days after the operation, the intermittent chemotherapies were performed, and 3 months after the effect was judged to be a partial response by CT scan. Severe side effects were not seen during treatment, and the man is now healthy and working for more than one year after the operation. Thus, this regimen may be found useful for patients with liver metastases.
Adenocarcinoma, Papillary↗
Sexual transmission of hepatitis C virus among female prostitutes and patients with sexually transmitted diseases in Fukuoka, Kyushu, Japan.
The authors investigated the prevalence of antibody to hepatitis C virus (anti-HCV) in 404 female prostitutes, 428 clinic patients with a history of at least one episode of sexually transmitted disease, and 8,944 blood donors who served as the controls. All subjects were Japanese, and all studies were carried out in Fukuoka, Kyushu, Japan, in 1989. The prevalence of anti-HCV was significantly higher in the prostitutes (6.2%), in the female patients with sexually transmitted diseases (6.1%), and in the male patients with sexually transmitted diseases (2.9%) than in the controls (1.5%). Prevalence of anti-HCV increased with age in prostitutes and in the controls. The prevalence of anti-HCV in those who had been involved in prostitution for 1 year or more (8.1%) was higher than in those who had been involved in prostitution for less than 1 year (1.4%), but the difference was not statistically significant. One of the 152 anti-HCV negative prostitutes seroconverted between 1 and 2 years later. Among the subjects with sexually transmitted diseases, patients with a history of at least one episode of syphilis had a significantly higher prevalence of anti-HCV (4.4%) than the controls. Patients with acute urethritis and cervicitis also showed a high prevalence of anti-HCV (3.6% and 6.7%, respectively). These data support the possibility of sexual transmission of hepatitis C virus.
Adolescent↗
Therapy for acute vascular complications in percutaneous transluminal coronary angioplasty with the autoperfusion balloon catheter.
Prolonged dilatation with an autoperfusion balloon catheter (APBC) (High-Flow-CPC-Mainz (Schneider) in 23 cases and Stack Perfusion (ACS) in 50 cases) was carried out in 73 patients (60 men, 13 women, mean age 59.3 +/- 8.8 years) with acute vascular complications occurring during PTCA (25 occlusive dissections (34%), five thrombotic occlusions (7%), 42 non-occlusive dissections (58%) and one non-occlusive thrombus with reduction of flow (1%)) in order to avoid stent implantation or emergency bypass surgery. On average 1.5 +/- 0.8 inflations were carried out per patient with a mean maximum inflation time of 14.1 +/- 8.4 min and a mean total inflation time of 16.8 +/- 12.3 min. In 61 patients (83.5%), the vascular complication could be controlled successfully with APBC, but in 12 APBC was not successful. Eight patients (11%) had emergency surgery. A stent was implanted in three patients (4.1%), and one suffered an acute myocardial infarction. Out of the 61 patients with positive result after prolonged dilatation, the hospital phase was uncomplicated in 53 (86.9%), five (8.2%) suffered an infarct with a maximum rise in CK of 350 U.l-1, two with multivessel disease had elective operations and one was dilated a second time because of a subacute reocclusion. Our experience indicates that when an acute vascular complication occurs, prolonged dilatation with an APBC is good interventional therapy avoiding stent implantation or emergency bypass surgery. However, new techniques cannot always replace surgery so an emergency bypass operation may still be necessary.
Adult↗
[Detection of human papillomavirus DNA in cases of sexually transmitted diseases (STD)].
Human papillomavirus (HPV) has been detected on the genitalia without any macroscopic abnormality and the possibility of latent infection of HPV has been suggested. Using Vira Type (Toure Co.), we have detected 7 genotypes of HPV DNA under a high stringent condition on the genitalia of patients with sexually transmitted diseases (STD), who were suspected of having had many sexual partners. In male cases of STDs other than condyloma acuminatum, the HPV-positive rate of the glans and sulcus coronarius was 4.7% (5/106). In healthy men, the HPV-positive rate was 6.1% (2/33), while in chronic prostatitis cases it was 3.4% (7/205) and in benign prostatic hypertrophy cases HPV was not detected. In female cases of STDs other than condyloma acuminatum, the HPV-positive rate of uterine cervix was 5.1% (3/58). In pregnant women, the HPV-positive rate was 4.6% (9/197). With regard to the HPV-positive rate within different age groups of STD and non STD cases, the rate tended to be higher in young people. After several weeks, follow-up studies were conducted on HPV-positive cases. HPV DNA was detected in one case of 10 males STD cases and two of 10 pregnant women, and the HPV DNA was the same type as at the first examination. However, after 3-4 months, all three of these cases had become negative for HPV DNA.
DNA, Viral↗
Purification, properties, and partial amino acid sequences of thermostable xylanases from Streptomyces thermoviolaceus OPC-520.
Two types of xylanases (1,4-beta-D-xylan xylanohydrolase, EC 3.2.1.8) were isolated from the culture filtrate of a thermophilic actinomycete, Streptomyces thermoviolaceus OPC-520. The enzymes (STX-I and STX-II) were purified by chromatography with DEAE-Toyopearl 650 M, CM-Toyopearl 650 M, Sephadex G-75, Phenyl-Toyopearl 650 M, and Mono Q HR. The purified enzymes showed single bands on sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The molecular weights of STX-I and STX-II were 54,000 and 33,000, respectively. The pIs were 4.2 (STX-I) and 8.0 (STX-II). The optimum pH levels for the activity of STX-I and STX-II were pH 7.0. The optimum temperature for the activity of STX-I was 70 degrees C, and that for the activity of STX-II was 60 degrees C. The enzymes were completely inhibited by N-bromosuccinimide. The enzymes degraded xylan, producing xylose and xylobiose as the predominant products, indicating that they were endoxylanases. STX-I showed high sequence homology with the exoglucanase from Cellulomonas fimi (47% homology), and STX-II showed high sequence homology with the xylanase from Bacillus pumilus (46% homology).
Amino Acid Sequence↗
Heart transplantation at the Heart Center North Rhine-Westphalia.
Since 1989, 427 heart transplants were performed at our center, limited only by donor availability, not by moderating donor criteria. Therefore, an increasing number of possible recipients was bridged with mechanical circulatory support systems. Immunosuppression was based on double-drug therapy (CsA, Aza) without steroid maintenance if possible and without mono- or polyclonal antibody prophylaxis. Monitoring adult transplant patients was based on endomyocardial biopsies only during the first 12 months posttransplant. In the pediatric group, only noninvasive diagnostic procedures were performed. Our present 1- and 3-year survival rates for heart transplant patients are 85% and 78%, respectively. We believe that only centers performing approximately 1,000 routine open-heart surgery procedures per year should be allowed to perform heart transplantation, with a minimum of 25 procedures per year (5). Our goal is to start our heart-lung and lung transplant programs in the near future. Our research interests are mainly in the field of postoperative monitoring, induction of immune tolerance, and in establishing a method to determine an individual immunosuppression protocol for each patient (6).
Academic Medical Centers↗
Role of the carotid sinus in response of integrated venous system to pulsatile and nonpulsatile perfusion.
Effects of pulsatile and nonpulsatile perfusion on capacity system were investigated in 33 open-chest mongrel dogs with extracorporeal circulation. In 28 dogs with intact carotid sinus nerves, after changing from nonpulsatile to pulsatile systemic perfusion the mean arterial pressure decreased by 14 +/- 1.5 mm Hg, peripheral resistance by 423 +/- 15 dyne.cm-5.sec, and venous blood volume by 3.3 +/- 0.4 ml/kg. After changing from pulsatile perfusion to nonpulsatile systemic perfusion the mean arterial pressure increased by 15 +/- 2.2 mm Hg, the peripheral resistance by 431 +/- 15 dyne.cm-5.sec, and venous volume by 3.9 +/- 0.5 ml/kg. The same effects were observed in five dogs with bilateral isolated carotid pulsatile perfusion or nonpulsatile perfusion and systemic nonpulsatile perfusion. These effects were abolished after denervation of pressor receptors and pharmacologic blockade of alpha and beta receptors. It is proposed that with nonpulsatile perfusion carotid sinus-mediated vasoconstriction occurs in the downstream part of the capacitive system, where more pronounced wall musculature with increased number of adrenergic receptors is present. The throttle effect caused by this "resistance" part of venous circulation leads to increase of pressure in the upstream section of the capacitive system, compensates for the constrictive effect of the sympathetic tone, and leads finally to an increased volume of the capacity system. We conclude that venous response to different perfusion modalities is critically dependent on intact carotid sinus nerves and adrenergic receptors in the veins.
Animals↗