PubMed Health⌕ Search

Biomedical subjects

K Suehiro

Publications and source records attributed to K Suehiro.

36 records · Page 2Linked to original sources

[A case of aortic regurgitation combined with obstruction of the left coronary ostium caused by adhesion of left coronary cusp].

A case, 31-year-old female with aortic regurgitation and ostial obstruction of left coronary artery, was reported. Her chief complaint was effort angina. The coronary angiography showed obstruction of left coronary ostium with intact main stem and its branches, perfused from right coronary artery and the aortogram revealed aortic regurgitation of grade 3-4. Left Valsalva sinus was obstructed by adhesion of left coronary cusp. Each coronary cusps were resected, and aortic valve replacement with 23 mm SJM valve and coronary arterial bypass by means of in-situ graft of left internal thoracic artery underwent successfully. The pathological findings of aortic cusps were healed valvulitis without specific inflammation as syphilis or aortitis syndrome.

Adult↗

Factor IX Fukuoka. Substitution of ASN92 by His in the second epidermal growth factor-like domain results in defective interaction with factors VIIa/X.

Hemophilia B Fukuoka, a moderately severe bleeding disorder, is a naturally occurring mutant of factor IX. Plasma from our patient had 3% clotting activity even though 64% of factor IX antigen was present. The purified mutant protein was cleaved normally by factor Xla, factor VIIa-tissue factor complex, or RVV-X (factor X-activating enzyme from Russell's viper venom), yielding a two-chain factor IXa. Amino acid composition and sequence analyses of one of the lysyl endopeptidase peptides derived from factor IX Fukuoka revealed that Asn92 in the second epidermal growth factor (EGF)-like domain had been replaced by His. The active site of the factor IXa Fukuoka was normally competent for the incorporation of p-aminobenzamidine and for the hydrolysis of a synthetic substrate, N alpha-benzyloxycarbonyl-L-arginine p-nitrobenzyl ester. Factor Xa formation by factor IXa Fukuoka was only 8% of the normal factor IXa, even in the presence of polylysine, and only 0.2% of the normal in the system containing phospholipids, Ca2+, and factor VIIIa, thereby indicating a functional defect in interaction of the mutant with factors VIIIa/X. Furthermore, catalytic efficiency (kcat/Km) of factor IXa Fukuoka toward factor X in the presence of Ca2+, phospholipids, and factor VIIIa was only 2.3% of the normal factor IXa. These results suggest that an Asn-to-His substitution at position 92 in the second EGF-like domain of factor IX Fukuoka would have an untoward effect on the specific conformational state of factor IX for binding with factors VIIIa/X.

Adult↗

A patient with congenital plasminogen deficiency manifesting primary pulmonary hypertension.

A 25-year-old Japanese man was diagnosed as having primary pulmonary hypertension, on the basis of the findings of cardiac catheterization and ventilation-perfusion scintiscans. The plasma level of plasminogen in this patient was found to be reduced to 43% by a functional assay and 61 mg/l by an antigenic assay. Based on the family study, the patient was considered to have a heterozygous congenital plasminogen deficiency. Accordingly, it is suggested that the defective fibrinolysis in this patient may have played an important role in the development of primary pulmonary hypertension through microthrombosis.

Adult↗

[Cerebral protection during aortic arch replacement: usefulness of continuous O2 saturation monitoring of internal jugular bulb to optimize cerebral perfusion].

How to optimize cerebral perfusion pressure and flow during selective extracorporeal circulation is a crucial problem for cerebral protection in surgical repair of aortic arch aneurysm. Among 47 cases of aortic arch replacement between 1980 and 1992, extracorporeal circulation (ECC) for the first 17 cases [group-1] were hypothermic ECC with selective cerebral perfusion (SCP) and 8 cases [group-2] with hypothermic ECC with hypothermic cardiac arrest. For the latest 16 cases [group-3] we introduced continuous O2 saturation monitoring by oximetry catheter placed in internal jugular bulb (SIJVO2) and maintained SIJVO2 value above 90% to effectively adjust pump flow to optimize cerebral perfusion pressure and flow for cerebral protection. We have retrospectively compared the effectiveness of SIJVO2 monitoring among these three groups. The mortality was 35% (6 cases: group-1), 37% (3 cases: group-2) and 6% (1 case: group-3) respectively. Cerebral dysfunction which were diagnosed in immediate postoperative period were 23% (4 cases: group-1), 0% (0 case: group-2) and 6% (1 case: group-3) respectively. We conclude continuous monitoring of SIJVO2 during selective ECC in aortic arch replacement is useful to optimize cerebral perfusion pressure and flow thereby reducing postoperative cerebral damage by selective ECC.

Adult↗

Immunological analysis of acquired factor VIII inhibitor in a case with immunologic disorder.

Coagulation factor VIII inhibitor arising in a patient with autoimmune disease was immunologically analyzed. A 63-year-old man who had been diagnosed as suffering from polyarteritis nodosa was treated with prednisolone for 10 years. Severe bleeding tendency developed and coagulation studies demonstrated a high titer of inhibitor to factor VIII:C. As a result of immunological analysis, the inhibitor was found to be IgG type autoantibody having both kappa and lambda light chains. The subclasses were IgG1 and IgG4. The inhibitor recognized the COOH-terminal light chain (72-kDa thrombin fragment) on the factor VIII molecule as an epitope.

Autoantibodies↗

[11 cases of anaphylaxis caused by grand keyhole limpet (abalone like shellfish)].

We reported 11 cases of patients who developed moderate to severe anaphylactic reactions induced by the ingestion of grand keyhole limpet (GKL) and abalone. Specific IgE-mediated hypersensitivity to these shellfish was demonstrated by history, skin prick test, RAST and immunoblotting. The RAST inhibition technique revealed cross antigenicity between GKL, abalone and keyhole limpet hemocyanin. By immunoblotting analysis, the major antigens of GKL are shown in the MW range of about 38 Kd and 80 Kd.

Adolescent↗

Blood clotting factor IX Nagoya 3: the molecular defect of zymogen activation caused by an arginine-145 to histidine substitution.

Factor IX Nagoya 3 (IX Nagoya 3) is a natural mutant of factor IX recognized in a patient with moderately severe hemophilia B. The patient had 0.60 units/ml of factor IX antigen and 2-5% of clotting activity. IX Nagoya 3 was purified from the patient's plasma by immunoaffinity chromatography with an anti-factor IX monoclonal antibody column. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) showed that the treatment of IX Nagoya 3 with factor XIa/calcium ions resulted in cleavage only at the Arg180-Val181 bond. The amino acid sequence analysis of one of the lysyl endopeptidase peptides derived from IX Nagoya 3 revealed that Arg-145 is replaced by His. This substitution impairs the cleavage between the light chain and the activation peptide by factor XIa/calcium ions.

Amino Acid Sequence↗

[A study of proteinuria. (12) The incidence of the patients with proteinuria, microscopic hematuria and glycosuria in Fukuoka Dental College students in 1987 and 1988].

An investigation was made on the incidence of patients with proteinuria, microscopic hematuria and glycosuria in 757 (in 1987) and in 681 (in 1988) students of Fukuoka Dental College; and the results were as follows. 1) The incidence of patients with proteinuria was 6.3% (48/757) in 1987, and 6.9% (47/681) in 1988. 2) The incidence of patients with microscopic hematuria was 4.0% (30/757) in 1987, and 5.0% (34/681) in 1988. 3) The incidence of patients with glycosuria was 0.5% (4/757) in 1987, and 0.1% (1/681) in 1988. 4) Further medical examinations were made on 33 students in 1987, and 37 students in 1988. a) 27 students in 1987 and 34 students in 1988 were diagnosed as normal respectively. b) In three cases, clinical diagnoses could not be established without long-term observation and two cases were diagnosed as urinary tract infection and a case was diagnosed as possible chronic glomerulonephritis in 1987. c) In 1988, a case was diagnosed as urinary tract infection, a case was urethritis and a case should be needed a longterm observation.

Adult↗

[A case of psittacosis].

A 67-year-old Japanese housewife, who had been attended the out patient department of medicine, Fukuoka Dental College (FDC) Hospital for paroxysmal atrial fibrillation, was admitted to FDC Hospital because of high fever, exhaustion, anorexia, myalgia and mild stupor. Her ECG finding revealed atrial fibrillation and roentgenologic examination of the chest showed diffuse opacities in the left lung field (S10) without pleural effusion. As she had told her physician that her pet parakeet had been dead recently, she was diagnosed immediately as psittacosis. She was instantly treated with minocycline orally and deslanoside intravenously. Laboratory findings on admission disclosed the following results: Complement-fixing antibodies against Chlamydia psittaci were 1:64, and liver dysfunction (GOT 253, GPT 86, LDH 846) was shown. The white blood cell count was 4,700 associated with shift to the left, C-reactive protein was 6 plus and the erythrocyte sedimentation rate was 109 mm in 1 hour. The course in the hospital was satisfactory and after 38 hospital days she was discharged with complete recovery from the psittacosis. It is emphasized the importance of that the question about the history of contact with psittacine birds or other avian species is essential to diagnose psittacosis.

Aged↗

Blood clotting factor IX BM Nagoya. Substitution of arginine 180 by tryptophan and its activation by alpha-chymotrypsin and rat mast cell chymase.

Factor IX BM Nagoya (IX Nagoya) is a natural mutant of factor IX responsible for severe hemophilia B. A patient with this mutant is characterized by a markedly prolonged ox brain prothrombin time. IX Nagoya was purified from the patient's plasma by immunoaffinity chromatography with an anti-factor IX monoclonal antibody column. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that treatment of IX Nagoya with factor XIa/Ca2+ resulted in cleavage only at the Arg145-Ala146 bond. Reversed-phase high performance liquid chromatography of a trypsin digest of IX Nagoya showed an aberrant peptide, which was further digested with proteinase Asp-N. Primary structure analysis of one of the Asp-N peptides revealed that Arg180 is replaced by Trp. An essentially complete (99%) amino acid sequence of IX Nagoya was obtained by sequencing fragments derived from a lysyl endopeptidase digest in which no other substitutions in the catalytic triad or substrate binding site were found. We also found that IX Nagoya is activated by alpha-chymotrypsin or rat mast cell chymase by monitoring the rate of factor X activation using a fluorogenic peptide substrate in the presence of factor VIII, phospholipids, and Ca2+. These results indicate that the substitution of Arg180 by Trp impairs the cleavage by factor XIa required for activation of this zymogen and that the substitution causes hemophilia BM.

Amino Acid Sequence↗

Carrier detection in Japanese hemophilia A by use of three intragenic and two extragenic factor VIII DNA probes: a study of 24 kindreds.

The three factor VIII intragenic restriction fragment length polymorphisms (RFLPs), Bcll, Xbal, and Bgll and the two extragenic RFLPs, Bglll/DX13 and Taql/St14, were analyzed in 60 normal Japanese subjects and 24 families with hemophilia A. The allele frequencies were determined and the extent of linkage disequilibrium among the polymorphisms was assessed. In contrast to intragenic RFLPs of the factor IX gene, intragenic and extragenic RFLPs of the factor VIII gene in Japanese were similar to those observed in whites. As in whites, marked linkage disequilibrium severely compromised the value of the Bgll RFLP. The combination of the Bcll, Xbal, and Taql/St14 RFLPs gave 100% carrier detection in the hemophilia A families analyzed.

Asian People↗

[A case of hyperthyroidism combined with thyroid carcinoma].

A 33-year-old woman, with hyperthyroidism combined with thyroid carcinoma is presented. She was given antithyroid medication before the operation, and sub-total thyroidectomy was performed under local anesthesia. Her postoperative course was smooth. Histologically, the resected thyroid was shown to have two small nodular lesions of papillary carcinoma in the diffuse goiter. The current classification, statistics, diagnosis and therapy of this disease are discussed.

Adenocarcinoma, Papillary↗