PubMed Health⌕ Search

Biomedical subjects

K Suehiro

Publications and source records attributed to K Suehiro.

At least 19 recordsLinked to original sources

[Ventricular free wall re-rupture after surgical treatment of ventricular free wall rupture due to acute myocardial infarction; report of a case].

An in-hospital 72-year-old male with complaint of anterior chest pain was presented with shock. Pericardial effusion was confirmed by echocardiography, and therefore, he was brought to the operating room immediately with diagnosis of ventricular free wall rupture. The repair was performed using fibrin glue, fibrin sheet, and pericardial patch. His post-operative course was uneventful until massive bleeding came through the chest tube on the 5th day from the initial surgery. The emergency sternotomy was made again for hemostasis. In the re-operation, an approximately 20 mm laceration along the proximal circumflex artery was found and this was successfully repaired with 2 pledgetted horizontal mattress sutures. It is important and necessary to treat a postoperative patient taking care of re-rupture.

Aged↗

Initiation of smooth pursuit in humans. Dependence on target saliency.

We examined the influence of target saliency on the initiation of smooth pursuit. The eye movements of five human subjects were recorded with the scleral search-coil technique. A video-projection system was used to create a pursuit target, consisting of a cluster of 14 red or green dots (0.5 degrees squares) extending randomly over a 3 degrees x3 degrees region, and a surrounding background, consisting of stationary, random dots of the same size and density extending over an area 70 degrees x 40 degrees. When the dots in the background and the target were of the same color, the target was indistinguishable from the background until it started to move. On the other hand, when the colors were different, the target was salient, even when stationary. We measured the changes in eye position over the 70-ms interval starting 70 ms after the onset of target motion (initial tracking response). When the target moved toward the fovea (centripetal motion), the initial tracking responses developed earlier when the dots in the target and background were of different color than when the two sets of dots were of the same color. However, in order to see this effect of target salience, it was critical that the colors be different before the onset of motion, but not afterwards. When the target moved away from the fovea (centrifugal motion), the initial tracking responses were independent of whether the colors of the target and the background were the same or different. Our data indicate that the initiation of tracking responses is very sensitive to the saliency of the target before the onset of target motion when that motion is toward the fovea.

Adult↗

Posttransplant function of a nonbeating heart is predictable by an ex vivo perfusion method.

BACKGROUND: We attempted to predict the posttransplant cardiac function of nonbeating donor hearts. METHODS: A total of 13 dogs were studied. Hearts were left in situ for 45 minutes after cardiac arrest caused by exsanguination. Hearts were then excised and reperfused in an ex vivo perfusion apparatus after 60 minutes of warm ischemia to test whether they could eject against an 80 mm Hg afterload from a preload of 10 mm Hg. Thereafter, all hearts were transplanted orthotopically. RESULTS: Four of 13 hearts were able to eject in the apparatus (group A). However, the other nine hearts could not eject under the defined conditions (group B). All four hearts in group A showed good posttransplant hemodynamics (systolic arterial pressure > 80 mm Hg with mean left atrial pressure < 10 mm Hg) without dopamine. However, none of nine hearts in group B could support the circulation without dopamine. CONCLUSIONS: Nonbeating donor heart function evaluated in the perfusion apparatus predicts posttransplant heart function. This method may be applicable for selection of transplantable hearts from nonbeating heart donors.

Animals↗

Direct coronary artery perfusion from the left ventricle.

OBJECTIVES: Trends in coronary bypass surgery require less invasive techniques and more conduits. We investigated the ability of direct coronary perfusion from the left ventricle to support regional and global cardiac function. METHODS: A conduit was established between the left ventricle and left anterior descending coronary artery (n = 6) with an interposed Starling resistor that allowed for graded regulation of backward flow. Changes of coronary flow, regional function in the territory of the left anterior descending coronary artery, and reactive hyperemia were studied. In 3 separate dogs, functional tolerance to increased heart rate was tested. In another 3 dogs, left ventricle-left anterior descending and left ventricle-left circumflex coronary artery conduits were established simultaneously (double conduit), and global function was tested. RESULTS: Without flow regulation, flow through the left ventricle-left anterior descending conduit exhibited high peaking (102 +/- 35 mL/min), midsystolic forward flow, and large pandiastolic backward flow (peaking at -47 +/- 22 mL/min). Mean coronary flow and regional function were maintained at 46.0% +/- 7.1% (35.8%-54.2%) and 45.3% +/- 29.1% (-1.8%-74.2%) of their respective normal values. When the Starling resistor was used to regulate backward flow, these values increased to 70.8% +/- 12.5% (56.8%-90.4%) and 70.2% +/- 27.8% (23.6%-107.7%), respectively. Coronary and functional reserve with a left ventricle-left anterior descending conduit were not observed. With the double conduit, global ventricular contractility indexed by end-systolic pressure-volume relation averaged 46% +/- 35% of its normal value. CONCLUSIONS: A left ventricle-coronary artery conduit supplied approximately 45% of normal blood flow and regional function, and both were improved by regulation of backward flow. Therefore, a conduit from the left ventricle to an epicardial vessel could serve as a rapidly deployable means of revascularizing totally occluded coronary vessels for which suitable natural conduits are not available.

Anastomosis, Surgical↗

Assessment of segmental wall motion abnormalities using contrast two-dimensional echocardiography in awake mice.

Murine models of cardiac disease are becoming an important tool for studying pathophysiological processes. Development of methods to accurately assess ventricular function are therefore important. The purpose of this study was to evaluate the feasibility of echocardiographic assessment of segmental wall motion abnormalities in a murine model of myocardial infarction. Two-dimensional contrast (C+) and noncontrast (C-) echocardiography were performed in 76 awake mice 2 days before and 2 days after left coronary ligation. The short-axis images obtained with two-dimensional echocardiography and corresponding postmortem cross-sectional histological samples stained with Evans blue dye were each divided into 16 segments, and all matched segments were examined for correlation between wall motion abnormalities and myocardial hypoperfusion. With the use of contrast enhancement, the number of visualized segments was significantly increased (base: C- 86%, C+ 98%; midpapillary: C- 57%, C+ 89%; apex: C- 30%, C+ 74%). Agreement between echocardiographically assessed regional wall motion abnormalities and pathologically determined hypoperfusion in basal, midpapillary, and apical levels were 90%, 93%, and 93%, respectively. Agreement between echocardiographically normal wall motion and pathologically normal findings in basal, midpapillary, and apical levels were 99%, 88%, and 71%, respectively. Thus echocardiographic assessment of segmental wall motion in awake mice was feasible and the accuracy was improved with the use of a contrast agent.

Animals↗

Anesthetic inhibition in ischemic and nonischemic murine heart: comparison with conscious echocardiographic approach.

It is well known that the level of anesthesia obtained by intraperitoneal injection is variable and may alter cardiac function. In this study, we compared the effects of different anesthetics on cardiac function with the conscious state using high-resolution two-dimensional echocardiography in nonischemic and ischemic mice. Eighty-four mice were tested before and after surgery with ligation of the coronary artery. All 84 mice were studied in the conscious state and under high-dose intraperitoneal anesthesia. Twenty-two of 84 mice were studied under low-dose intraperitoneal anesthesia. Another 22 mice were also studied under gas anesthesia and spontaneous breathing. Experiments in the conscious state were performed by two investigators before the administration of anesthesia: one investigator held the animal and the transducer and the other operated the ultrasound equipment. Left ventricular systolic function was measured, and measurements obtained after surgery were compared with infarcted areas assessed by histological staining. Results showed that both high- and low-dose intraperitoneal anesthesia significantly reduced heart rates and left ventricular contractility in both pre- and postsurgical mice as opposed to conscious mice (P < 0.01). There were significantly higher correlation coefficients between mean fractional area change (FAC) and infarcted area in conscious state compared with high-dose intraperitoneal anesthesia (P < 0.05). The correlation coefficient between FAC and infarcted area during gas anesthesia was also significantly higher compared with high-dose intraperitoneal anesthesia (P < 0.05). In conclusion, conscious experiments or the use of gas anesthesia is preferred for echocardiographic assessment of cardiac function in mice because intraperitoneal injection significantly induces a significant reduction in heart rate and left ventricular systolic function.

Anesthetics, Inhalation↗

Assessment of left ventricular systolic function using contrast two-dimensional echocardiography with a high-frequency transducer in the awake murine model of myocardial infarction.

The estimation of global left ventricular function using M-mode echocardiography has technical limitations in the murine model of myocardial infarction (MI), but the recent improvements in 2-dimensional (2-D) echocardiography using a high-frequency transducer provide more accessible images. Furthermore, intravenous injection of contrast agent has the additional benefit of enhancing the endocardial border in the murine heart. The present study was designed to evaluate the value of 2-D echocardiography with intravenous injection of contrast agent in the assessment of global systolic function of the murine heart with MI. Two-dimensional and M-mode echocardiography without and with intravenous injection of contrast agent (Optison, 0.1-0.15 ml) were performed in 76 awake mice 2 days before and 2 days after left coronary artery ligation. Fractional shortening (FS) was calculated from the end-diastolic and end-systolic diameters on M-mode echocardiography, and fractional area change (FAC) from the end-diastolic and end-systolic areas on 2-D echocardiography. Both FS and FAC were compared with the areas of hypoperfusion observed in the pathological samples. The use of contrast agent improved the number of hearts that could be evaluated by both the M-mode and 2-D method (M-mode: non-contrast 87% vs contrast 99%, p<0.01; 2-D: non-contrast 26% vs contrast 89%, p<0.001). FAC from the 2-D method correlated better with the region of hypoperfusion in the pathological samples than did FS from the M-mode method (FAC: r=0.84 vs FS: r=0.51). In conclusion, FAC obtained from 2-D contrast echocardiography is useful for noninvasive assessment of global systolic function in infarcted murine hearts and can be used to serially assess systolic function in various models of the murine heart.

Albumins↗

Selective renal vasodilation and active renal artery perfusion improve renal function in dogs with acute heart failure.

Renal failure is common in heart failure due to renovascular constriction and hypotension. We tested whether selective pharmacological renal artery vasodilation and active renal artery perfusion (ARP) could improve renal function without adverse effects on systemic blood pressure in a canine model of acute heart failure (AHF). AHF was induced by coronary microembolization in 16 adult mongrel dogs. In five dogs, selective intrarenal (IR) papaverine (1, 2, and 4 mg/min) was administered into the left renal artery. In six dogs, ARP was performed in the left renal artery to normalize mean renal arterial pressure followed by administration of IR papaverine (2 mg/min). In five dogs, ARP plus intravenous furosemide was tested. Urine output (UO) and cortical renal blood flow decreased during AHF and were restored by 2 mg/min IR papaverine (UO: baseline 4.2 +/- 0.6, AHF 1.6 +/- 1.3, IR papaverine 5.8 +/- 1.1 ml/15 min; cortical blood flow: baseline 4.3 +/- 0.2, AHF 2.4 +/- 0.6, IR papaverine 4.2 +/- 1.2 ml/min/g) with no significant change in aortic pressure. ARP also increased urine output and cortical renal blood flow (UO: baseline 5.0 +/- 1.1, AHF 0.5 +/- 0.4, ARP 3.8 +/- 3.1 ml/15 min; cortical blood flow: baseline 4.0 +/- 0.5, AHF 2.0 +/- 0.8, ARP 3.52 +/- 1.1 ml/min/g). A combination of these methods in AHF further increased urine output to twice the normal baseline (10.5 +/- 7.5 ml/15 min). Addition of furosemide synergistically increased UO above that achieved with ARP alone (5.5 +/- 2.6 versus 40.3 +/- 24.7 ml/15 min, p = 0.03). In conclusion, ARP and selective renal vasodilation may effectively promote salt and water excretion in the setting of heart failure, particularly when systemic blood pressure is low.

Acute Disease↗

A growth factor mixture that significantly enhances angiogenesis in vivo.

Studies of therapeutic angiogenesis have generally focused on single growth factor strategies. However, multiple factors participate in angiogenesis. We evaluated the angiogenic potential of a growth factor mixture (GFm) derived from bovine bone. The major components of GFm (SDS-polyacrylamide gel electrophoresis, mass spectrometry, and Western blot) include transforming growth factor-beta1-3, bone morphogenic protein-2-7, and fibroblast growth factor-1. GFm was first shown to induce an angiogenic response in chorioallantoic membranes. Next, myocardial ischemia was induced in 21 dogs (ameroid) that were randomized 3 weeks later to received GFm 1 mg/ml (I), GFm 10 mg/ml (II), or placebo (P) (with investigators blinded to conditions) injected in and adjacent to ischemic myocardium. Dogs were assessed 6 weeks later using quantitative and semiquantitative measures. There were GFm concentration-dependent improvements in distal left anterior descending artery (LAD) opacification by angiography (P: 0.4 +/- 0.2, I: 1.1 +/- 0.14, II: 1.6 +/- 0.3, angiographic score p = 0.014). Histologically, there was also concentration-dependent vascular growth response of relatively large vessels (P: 0.21 +/- 0.15, I: 1.00 +/- 0.22, II: 1.71 +/- 0.18, vascular growth score p = 0.001). Resting myocardial blood flow (colored microspheres) was not significantly impaired in any group. However, maximum blood flow (adenosine) was reduced in ischemic territories and did not improve in GFm-treated hearts. GFm, a multiple growth factor mixture, is a potent angiogenic agent that stimulates large vessel growth. Although blood flow did not improve during maximal vasodilatory stress, large intramyocardial collateral vessels developed and angiographic visualization of the occluded distal LAD improved significantly. The use of multiple growth factors may be an effective strategy for therapeutic angiogenesis provided a more effective delivery strategy is devised that can achieve improved maximum blood flow potential.

Animals↗

Fibrinogen binds to integrin alpha(5)beta(1) via the carboxyl-terminal RGD site of the Aalpha-chain.

Fibrinogen interactions with vascular endothelial cells are implicated in various physiological and pathophysiological events, including angiogenesis and wound healing. We have shown previously that integrin alpha(5)beta(1) is a fibrinogen receptor on endothelial cells [Suehiro, K., Gailit, J., and Plow, E.F. (1997) J. Biol. Chem. 272, 5360-5366]. In the present study, we have characterized fibrinogen interactions with purified alpha(5)beta(1) and have identified the recognition sequence in fibrinogen for alpha(5)beta(1). The binding of fibrinogen to immobilized alpha(5)beta(1) was selectively supported by Mn(2+). Fibrinogen bound to purified alpha(5)beta(1) in a time-dependent, specific, and saturable manner in the presence of Mn(2+), and the binding was blocked completely by Arg-Gly-Asp (RGD)-containing peptides and by anti-alpha(5) and anti-alpha(5)beta(1) monoclonal antibodies. A monoclonal antibody directed to the C-terminal RGD sequence at Aalpha572-574 significantly inhibited the binding of fibrinogen to alpha(5)beta(1), whereas monoclonal antibodies directed to either the N-terminal RGD sequence at Aalpha95-97 or the C-terminus of the gamma-chain did not. Furthermore, substituting RGE for RGD at position Aalpha95-97 in recombinant fibrinogen had a minimal effect on binding, whereas substituting RGE for RGD at position Aalpha572-574 decreased binding by 90%. These results demonstrate that the C-terminal RGD sequence at Aalpha572-574 is required for the interaction of fibrinogen with alpha(5)beta(1).

Amino Acid Sequence↗

Effects of smooth pursuit eye movement on ocular responses to sudden background motion in humans.

We studied the effects of horizontal smooth pursuit on the ocular tracking responses to brief perturbations of a textured background in humans. When the subject was fixating a stationary spot, a brief perturbation (60 degrees/s, 40 ms) of the background in any one of four directions (right, left, up, down) elicited a small tracking response. When the subject was pursuing a target moving against the stationary background, the same background perturbation elicited a larger response when in the same direction as the pursuit, but a smaller response when its direction was opposite to the pursuit; the response to vertical background perturbations was also enhanced during pursuit. When the subject was pursuing while the target and background were moving together, the same background perturbations elicited the larger responses regardless of their direction. These results indicate that the sensitivity to background motion is increased during smooth pursuit. However, when pursuit is executed against a stationary background--the usual situation in everyday life--the system is selectively insensitive to the reafferent visual input associated with pursuit, thereby reducing the potentially adverse effect of the background on pursuit performance.

Adult↗

The effect of graft perfusion with warm blood cardioplegia for cadaver heart transplantation.

This study was designed to verify the effect of reperfusion of donor hearts in a perfusion apparatus after 60 min of global ischemia prior to heart transplantation. Thirteen dogs were exsanguinated from the femoral artery and cardiac arrest was achieved. The hearts were left in situ at room temperature (25 degrees C) for 60 min. In group A (n = 7), the hearts were excised and reperfused 60 min after cardiac arrest in the perfusion apparatus with substrate-enriched warm blood cardioplegia (WBCP) containing a hydroxyl radical scavenger, EPC, followed by 45 min of blood perfusion. Next, the hearts were preserved in cold (4 degrees C) University of Wisconsin (UW) solution. In group B (n = 6), the hearts were perfused with cold (4 degrees C) St. Thomas' solution 60 min after cardiac arrest and preserved in cold UW solution. Thereafter, all hearts in both groups were transplanted orthotopically to recipient dogs. In group A, 6 of 7 dogs were weaned from cardiopulmonary bypass (CPB). In group B, only 2 of 6 dogs were weaned from CPB. Moreover, 3 of the 6 hearts in group B did not start beating after transplantation (stone heart). This study suggested reperfusion of the donor heart in the perfusion apparatus with WBCP to be a beneficial preconditioning method when utilizing 60-min arrested hearts for transplantation.

Animals↗

Short-latency vergence eye movements elicited by looming step in monkeys.

The looming associated with forward and backward motion of the observer has been shown to elicit vergence eye movements with short-latency (approximately 80 ms) in human subjects. We studied the vergence eye movements elicited by looming in three monkeys (Macaca fuscata). The animals faced a large tangent screen onto which a random dot pattern was back-projected. The movements of both eyes were recorded with an electromagnetic induction technique. Fifty milliseconds after a centering saccade, this first pattern was replaced with a new one that showed the same image viewed from a slightly different distance. This looming step (two-frame movie) included both radial optic flow and a size change. As expected from the optical geometry, centrifugal flow coupled with enlargement (signaling forward motion) increased the vergence angle, whereas the converse combination decreased the vergence angle. In both cases, the optimal step-change in apparent viewing distance was 2%. The latency of these vergence responses was very short and similar to those induced when disparity steps are applied to such large patterns (approximately 60 ms). We suggest that these two systems act in synergy to help maintain binocular alignment during forward and backward motion of the observer.

Animals↗

Fibrinogen is a ligand for integrin alpha5beta1 on endothelial cells.

Previous studies have shown that fibrinogen can associate with endothelial cells via an Arg-Gly-Asp (RGD) recognition specificity. In the present study, we have characterized the specificity of fibrinogen binding to endothelial cells under different cation conditions. Fibrinogen binding to suspended endothelial cells was selectively supported by Mn2+ and was suppressed by Ca2+. The Mn2+-supported interaction was completely inhibited by RGD peptides but not by alphavbeta3 blocking monoclonal antibodies. In contrast, the interaction was completely blocked by two alpha5beta1 monoclonal antibodies. This interaction was not mediated by fibronectin bound to the integrin; could be demonstrated with purified alpha5beta1; and also was observed with a second alpha5beta1-bearing cell type, platelets. The binding of fibrinogen to alpha5beta1 on endothelial cells in the presence of Mn2+ was time-dependent, specific, saturable, and of high affinity (Kd = 65 nM). By employing anti-peptide monoclonal antibodies, the carboxyl-terminal RGD sequence at Aalpha 572-574 was implicated in fibrinogen recognition by alpha5beta1. Two circumstances were identified in which alpha5beta1 interacted with fibrinogen in the presence of Ca2+: when the receptor was activated with monoclonal antibody (8A2) or when the fibrinogen was presented as an immobilized substratum. These results identify fibrinogen as a ligand for alpha5beta1 on endothelial and other cells, an interaction which may have broad biological implications.

Cells, Cultured↗

Ligand recognition by beta 3 integrins.

Integrins are alpha/beta heterodimeric adhesion receptors, alpha IIb beta 3 (GPIIb-IIIa) and alpha v beta 3 (the vitronectin receptor) share the same beta subunit, beta 3, but have distinct alpha subunits. These sister integrins not only recognize many of the same ligands but also have certain unique ligands. Based upon current information in the literature, we propose that four classes of beta 3 ligands can be distinguished. Since the beta 3 integrins have multiple functions in vivo and are targets for therapy, this classification system may be useful in the design and characterization of therapeutic agents.

Antigens, CD↗

The ligand recognition specificity of beta3 integrins.

AlphaIIbbeta3 (platelet membrane glycoprotein IIb-IIIa) and alphavbeta3 are members of the beta3 subfamily of integrin adhesion receptors. A cyclic peptide, KYGC(s-s)HarGDWPC(s-s) (cHarGD), originally described by Scarborough et al. (Scarborough, R. M., Naughton, M. A., Teng, W., Rose, J. W., Phillips, D. R., Nannizzi, L., Arsten, A., Campbell, A. M., and Charo, I. F.(1993) J. Biol. Chem. 268, 1066-1073) has been employed as a high affinity ligand for alphaIIbbeta3 to examine the specificity of the beta3 integrins. cHarGD interacted with high affinity with purified alphaIIbbeta3 (Kd = 10 nM) or with platelets (Kd = 120 nM). While cHarGD was specific for alphaIIbbeta3 in the presence of Ca2+, it bound to both beta3 integrins in the presence of Mn2+. Barbourin, a snake venom disintegrin containing a reactive KGD sequence, remained alphaIIbbeta3-specific, even in the presence of Mn2+. cHarGD became cross-linked to a site in beta3 of alphaIIb beta3, which is distinct from that of RGD peptides. These results allow identification of at least four classes of beta3 ligands: Class I, represented by RGD peptides and vitronectin, react similarly with alphaIIbbeta3 and alphavbeta3; Class II, represented by cHarGD, gamma-chain peptides and fibrinogen, react with both receptors in the presence of Mn2+ but only with alphaIIbbeta3 in the presence of Ca2+; Class III, represented by barbourin, are alphaIIbbeta3-specific under all cation conditions; Class IV, represented by osteopontin, bind primarily to alphavbeta3.

Amino Acid Sequence↗

[Cardiac operations in nine patients aged 80 years or older].

Nine patients aged 80 years or older underwent cardiac operations with cardiopulmonary bypass. Seven patients underwent coronary artery bypass surgery, one modified Bentall's operation and another patch closure of ventricular septal perforation. One patient died soon after operation (11 POD) and operative mortality was 11%. One died 7 months after operation because of rupture of dissecting thoracic aortic aneurysm. Seven patients are still alive within physical status of New York Heart Association Classes I or II. We conclude that cardiac operations should not be excluded in octogenarians because of their chronological age alone.

Age Factors↗

[A case report of aneurysm of the diverticulum of the ductus arteriosus in the elderly].

A 82-year-old female was admitted to our department with complaint of hoarseness. Retrograde aortogram revealed an aneurysm arising from distal aortic arch. The aorta including the aneurysm was resected and replaced with woven Dacron graft under partial cardiopulmonary bypass. An Aneurysm of the diverticulum of the ductus arteriosus is rare in adult and because of its high fatality it should be resected.

Aged↗