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Biomedical subjects

M Fukasawa

Publications and source records attributed to M Fukasawa.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Surgical experiences of fenestrated total cavopulmonary connection in patients under four year of age].

The fenestrated Fontan operation is an interim steps for patients who considered to be at high risk for one step Fontan procedure. We performed total cavopulmonary connection with baffle fenestration in five patients under four year of age (33 month of mean age at operation). All patients previously underwent palliative surgery (Blalock shunt in 3, PA banding in 2). Three patients weighed less than 10 kg. Pulmonary vascular resistance index (PARI) were 2.03 +/- 0.18 U/BSA and exceeded 2 U/SQm in 3 patients. Nakata's indice were ranged from 282 to 644 (mean 394) mm2/BSA. Bidirectional cavopulmonary shunt was considered to be alternative pathway for three patients in staged Fontan strategy. Postoperative hemodynamics were relatively stable in all patients and weaned from mechanical ventilation within 5 days with various arterial oxygen saturation. There was no pleural effusion lasting longer than 1 week. One patient died of ileus caused from congenital malrotation. Follow up catheter examination at 1 year showed 83 to 96% of SaO2 and survived patients were doing well. Fenestrated TCPC can be applied safely in younger patients who are considered to need surgical treatments in staged Fontan strategy. Whether fenestration should be closed has to be wait further studies.

Age Factors↗
PubMed1996

[Non-decompression surgery for esophagogastric varices--indication and postoperative result of esophageal transection with paraesophagogastric devascularization and Hassab procedure].

A total of 548 patients had an non-decompression surgery for esophagogastric varices in our hospital, from September 1979 to August 1995. Type of operation includes 402 cases of esophageal transection with paraesophagogastric devascularization (via thoracic approach). 40 cases via abdominal approach, and 106 cases of Hassab procedure. The origin was cirrhosis in 454 patients, IPH in 46, extrahepatic portal occlusion in 29, primary biliary cirrhosis in 6, Budd-Chiari syndrome in 4 and others in 9. Operative mortality rate was less than 1% in child A group, although overall mortality rate including child B, C was 5.0%. By thoracic approach, residual esophageal varices were observed only in 2.5%. Postoperative variceal recurrence were appeared high in cases with hepatocellular carcinoma (HCC). Cumulative recurrence rates at 15 years after surgery were 20.2%, unless HCC had occurred. Cumulative survival rates at 10, 15 years were 52.1%, 45.6% respectively in liver cirrhosis without HCC. Present study confirmed that our operation is effective in controlling esophagogastric varices in long term of periods. Esophagogastric varices of IPH, EHO, and liver cirrhosis of Child A group should be treated by non-decompression surgery.

Esophageal and Gastric Varices↗
PubMed1995

Oligomannose-coated liposomes as an adjuvant for the induction of cell-mediated immunity.

The effect of the coating of ovalbumin-reconstituted liposomes with various oligosaccharides on their immunogenicity was investigated in mice. The coating of liposomes with oligomannose or yeast mannan drastically enhanced their ability to induce an ovalbumin-specific delayed-type footpad swelling response with a peak at 24 to 48 h post-challenge. Among various oligosaccharides tested, only those with mannose residue at the nonreducing termini manifested the activity when applied to liposomes. Since such oligosaccharides are ubiquitously found in the body, these results suggested the usefulness of oligomannose-coated liposomes as a safe adjuvant for the induction of cell-mediated immunity.

Adjuvants, Immunologic↗
PubMed1995

Chinese hamster ovary cells expressing a novel type of acetylated low density lipoprotein receptor. Isolation and characterization.

Macrophage scavenger receptors mediate the recognition of a wide range of negatively charged macromolecules including acetylated low density lipoproteins (AcLDL). Chinese hamster ovary (CHO) cells were cultured in the presence of increasing concentrations of simvastatin, a cholesterol biosynthesis inhibitor, and AcLDL as the sole source of exogenous lipoproteins. The cells surviving under these conditions specifically bound 125I-labeled AcLDL with high affinity and degraded them via an endocytic pathway. Unexpectedly, the association and degradation of 125I-labeled AcLDL by these CHO cells were not inhibited by dextran sulfate, fucoidan, and polyinosinic acid, competitors of macrophage scavenger receptors, but were completely inhibited by maleylated bovine serum albumin. Furthermore, these cells effectively took up negatively charged liposomes containing acidic phospholipids such as phosphatidylserine and phosphatidic acid, whereas CHO cells expressing macrophage scavenger receptors did not. AcLDL and negatively charged liposomes were cross-competed with each other. Northern blot analysis using the cDNA for the macrophage scavenger receptor revealed that these CHO cells did not express this receptor. From these observations, we conclude that the isolated CHO cells express a novel type of AcLDL receptor, which is distinct from macrophage scavenger receptors with respect to ligand specificity and competitor sensitivity.

Albumins↗
PubMed1995

In vitro evaluation of nicorandil, diltiazem, and prostaglandin E1 on hypothermic injury to immature myocytes.

The purpose of the present study was to evaluate the functional and biochemical effects of nicorandil (NRD), diltiazem (DTZ), or prostaglandin E1 (PGE) on cardiac myocytes incubated under hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days with MCDB 107 medium. Myocytes (12.5 x 10(5) myocytes/flask) were then incubated at 4 degrees C for 24 hr in media containing various concentrations of NRD, DTZ, or PGE. After hypothermic incubation, creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) were measured. The myocytes were then cultured for an additional 24 hr at 37 degrees C to evaluate the recovery of myocyte beating rate. In the nicorandil groups, 10(-4) M NRD showed significantly increased beating rate recovery compared to control (44.2% vs 24.6%, respectively, as a percentage of control, i.e., beating rate prior to hypothermic incubation). Treatment with 10(-6) M diltiazem showed no beneficial effects (10(-6) M: 25.2%; control: 29.8%); however, beating was not observed at 10(-4) or 10(-5) M. There were no significant changes among the PGE groups. The release of CPK and LDH was significantly suppressed with 10(-4) M NRD (10(-4) M: 24.1, 257.2 MIU/flask; control: 125.4, 459.5 mIU/flask, respectively). However, 10(-4) M DTZ showed significantly increased CPK and LDH levels compared to the control (10(-4) M: 203.3, 883.4 mIU/flask; control: 112.3, 457.4 mIU/flask, respectively). There were no significant differences for CPK and LDH levels among the PGE groups. In conclusion, nicorandil has protective characteristics for immature myocytes that may be suitable for cardiac preservation in the neonatal period.

Alprostadil↗
PubMed1995

Long-term hypothermic preservation of cardiac myocytes isolated from the neonatal rat ventricle: a comparison of various crystalloid solutions.

In this study, the functional and biochemical effects of crystalloid solutions on immature cardiac myocytes incubated under hypothermic conditions were evaluated. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days, following which 12.5 x 10(5) myocytes per flask were incubated at 4 degrees C for 3, 6, 12, and 18 h in five types of crystalloid solutions: lactated Ringer's (LR), St. Thomas' Hospital (ST), University of Wisconsin (UW), 5% glucose-based potassium (GK), and normal saline (NS). The levels of creatine phosphokinase (CPK) and lactate dehydrogenase (LDH) in the solutions were measured after each hypothermic incubation, following which the myocytes were cultured for an additional 24 h at 37 degrees C to evaluate the recovery of the myocyte beating rate. In the LR, UW, and NS groups, the recovery ratios of the myocyte beating rate were over 95% of the control (the beating rate prior to hypothermic incubation) at 3 h, but decreased to 20.3, 15.1, and 0%, respectively, at 18 h. The ST and GK groups had significantly lower recovery ratios than the other three groups (72.9% and 63.4%, respectively) at 3 h. The release of CPK and LDH in the LR, UW, and NS groups was significantly suppressed compared to the ST and GK groups, with the greatest suppression observed in the LR group. Moreover, the ST and GK groups had the highest CPK and LDH levels, respectively. Thus, LR solution had the least cytotoxic effects, indicating that it could be the most suitable basic solution of the various cardioplegic or preservation solutions during the neonatal period.

Adenosine↗
PubMed1995

Astroglial localization of cholesteryl ester transfer protein in normal and Alzheimer's disease brain tissues.

Cholesteryl ester transfer protein (CETP) is a plasma glycoprotein that facilitates the transfer of cholesteryl esters, phospholipids and triglycerides between the lipoproteins, and regulates plasma high-density lipoprotein levels. We examined CETP-like immunolabeling in non-neurological and Alzheimer's disease (AD) liver and brain tissues. The anti-CETP antibodies showed positive staining in round cells in the liver sinusoid and in brain astrocytes. In the brains of non-neurological cases, positively stained astrocytes were preferentially distributed in the white matter. In AD tissue, many reactive astrocytes in the gray matter as well as the white matter astrocytes had CETP-like immunoreactivity. CETP-positive astrocytes may play a role for AD pathology such as tissue repair.

Aged↗
PubMed1995

Binding affinities of beta-lactam antibodies for penicillin-binding protein 2' in methicillin-resistant staphylococcus aureus.

We devised an accurate procedure with which to measure the affinities of beta-lactam antibiotics for penicillin-binding protein (PBP) 2' in methicillin-resistant Staphylococcus aureus (MRSA). In the present study, we used two isogenic strains of MRSA, on heterogeneous and the other homogeneous, derived from the methicillin-susceptible strain FDA209P, harbouring the mecA gene. In these MRSA strains, PBP2' was saturated by [14C]benzylpenicillin (PCG) at a concentration of 300 mg/L. In addition, the saturation of PBP2' by [14C]PCG required an incubation period of 30 min. According to these results, the precise affinities of beta-lactam antibiotics for PBP2' were determined by the 'accurate competition assay', using a high concentration of [14C]PCG and extending the reaction time. This procedure yielded lower IC50 values of beta-lactams than the 'usual competition assay'. However, each beta-lactam had almost the same affinity for PBP2' in heterogeneous and homogeneous strains. These results suggest there is a factor(s) other than PBP2' responsible for controlling resistance levels and the heterogeneity or homogeneity of MRSA strains.

Anti-Bacterial Agents↗
PubMed1995

Potent activity of meropenem against Escherichia coli arising from its simultaneous binding to penicillin-binding proteins 2 and 3.

A mutant strain of Escherichia coli with reduced susceptibility to imipenem, designated TL2740, was selected following serial passage of the parent strain, E. coli C600, in broth containing increasing concentrations of the carbapenem; the MIC of imipenem for TL2740 was eight-fold greater than that of the parent strain. The mutant also exhibited reduced susceptibilities to panipenem and biapenem and high-level resistance to mecillinam, but was as susceptible to meropenem, ceftazidime, piperacillin and the other beta-lactams tested as strain C600. The affinity of penicillin-binding protein (PBP) 2 of TL2740 for imipenem and meropenem was ten-fold less than that of C600, thereby providing an explanation for the mutant's reduced susceptibility to some carbapenems and mecillinam. However, this theory was confounded by the observation that the in-vitro activities of meropenem against both parent and mutant strains were virtually the same and by the fact that PBP 2 is the principal target of the antibiotic. Imipenem and aztreonam, which bind to PBP 2 and PBP 3 respectively, demonstrated synergic activity when tested in combination against both C600 and TL2740. These results suggest that the potent activity of meropenem against the mutant strain might also be due to a synergic effect resulting from simultaneous binding to both PBP 2 and PBP 3 and that the variable activities of the carbapenems against TL2740 were related to their different PBP binding profiles. Compared with C600, TL2740 appeared shorter on electron microscopy and had a longer generation time, discrepancies which are compatible with defective PBP 2 activities in the mutant strain. We also identified three clinical isolates of E. coli with beta-lactam susceptibility profiles which resembled that of TL2740 i.e. high-level resistance to mecillinam and low-level resistance to carbapenems, with the exception of meropenem to which these strains were susceptible; in common with TL2740, the combination of imipenem and aztreonam was synergic against these isolates. The genetic basis of resistance in all of the mecillinam-resistant strains, including TL2740, mapped close to lip at 15' on the E. coli chromosome with transductional analysis. The results strongly suggest that the reduced susceptibilities of the clinical isolates to carbapenems were due to mutations in the genes encoding the PBP 2s of these strains which affected their affinities for beta-lactam antibiotics.

Bacterial Outer Membrane Proteins↗
PubMed1995

Antimicrobial activity of SM-17466, a novel carbapenem antibiotic with potent activity against methicillin-resistant Staphylococcus aureus.

The in vitro and in vivo antibacterial activities of SM-17466, a new 1 beta-methyl carbapenem, were evaluated against a wide range of clinical bacterial isoaltes and compared with the activities of meropenem, imipenem, vancomycin, and arbekacin. SM-17466 had a broad spectrum of action against gram-positive bacteria, showing especially potent activity against methicillin-resistant staphylococci. The MICs of SM-17466, meropenem, imipenem, vancomycin, and arbekacin at which 90% of clinical isolates of methicillin-resistant Staphylococcus aureus were inhibited were 3.13, 50, 100, 1.56, and 3.13 micrograms/ml, respectively. This activity of SM-17466 was almost equivalent to those of the antibiotics used for the treatment of infections caused by this organism. SM-17466 also showed bactericidal activity against methicillin-resistant S. aureus. In contrast, SM-17466 was less active against gram-negative bacteria, especially against Pseudomonas aeruginosa, compared with the other carbapenems; however, of the carbapenems, SM-17466 exhibited the highest activity against Haemophilus influenzae and Bacteriodes fragilis. SM-17466, at a 50% inhibitory concentration of less than 1 microgram/ml, bound to penicillin-binding proteins 1 to 4 in methicillin-susceptible S. aureus and also had good binding to penicillin-binding protein 2' in a methicillin-resistant strain (50% inhibitory concentration, 5.9 micrograms/ml). This high affinity, which was 10 and 20 times greater than those for meropenem and imipenem, respectively, was reflected in the potent activity of SM-17466 against methicillin-resistant S. aureus. SM-17466 demonstrated excellent in vivo efficacy against methicillin-susceptible and -resistant S. aureus strains in a mouse peritoneal infection model: the efficacy of SM-17466 against methicillin-resistant strains was equal to or one-third that of vancomycin. This activity was comparable to the in vitro activity of SM-17466. The subcutaneous injection of SM-17466 in mice revealed that the half-life of SM-17466 in serum was about 18 min, intermediate between those of vancomycin and arbekacin and 1.5-fold that of imipenem-cilastatin. SM-17466 was resistant to hydrolysis by swine renal dehydropeptidase I, to an extent comparable to the resistance shown by meropenem.

Animals↗
PubMed1995

Hypoxic injury of immature cardiac myocytes under various hypothermic conditions using an in vitro cell-culture model.

The purpose of this study was to evaluate the functional and biochemical effects in immature cardiac myocytes under hypoxic and hypothermic conditions. Cardiac myocytes were isolated from neonatal rat ventricles and cultured for 4 days, after which 12.5 x 10(5) myocytes/flask were incubated under 3% hypoxic conditions at 4 degrees C, 10 degrees C, 15 degrees C, 20 degrees C, 25 degrees C, and 37 degrees C for 6, 12, and 24 h. After each hypoxic incubation, creatine kinase (CK) and lactate dehydrogenase (LDH) were measured in the incubation medium. The myocytes were then cultured for an additional 24 h at 37 degrees C to evaluate the recovery of the myocyte beating rate. In the 4 degrees C and 37 degrees C groups, the myocyte beating rate recovery markedly decreased with increasing incubation times from 78.1% and 97.2% at 6 h to 0.0% and 38.4% of the control, which was the beating rate prior to hypoxic incubation, at 24 h, respectively. However, in the 10 degrees C, 15 degrees C, and 25 degrees C groups, this value decreased significantly only at 24 h. In the 20 degrees C group, beating rate completely recovered in 24 h. A marked increase was found in the release of CK and LDH in the 4 degrees C group from 28.5 mIU/flask and 232.9 mIU/flask at 6 h to 83.7 mIU/flask and 640.7 mIU/flask at 24 h, respectively. However, in the 25 degrees C and 37 degrees C groups, this release was significantly increased only at 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Clinical evaluation of polymerase chain reaction DNA amplification method for the diagnosis of pulmonary tuberculosis in patients with negative acid-fast bacilli smear.

We evaluated the sensitivity and specificity of polymerase chain reaction (PCR) for the detection of Mycobacterium tuberculosis among 109 patients who were suspected to have active pulmonary tuberculosis (PTB) and showed negative acid-fast bacilli (AFB) smears in a total of 393 samples of sputum (169), gastric aspirate (134), and urine (90) which fulfilled different criteria for the positivity of PCR. The patients were subsequently divided into one group of active PTB composed of 15 patients with definite PTB and 43 patients with highly suspected PTB, and another group of 51 non-active PTB patients. The PCR assay using samples of sputum and gastric aspirate proved to be specific for active PTB. The PCR method for diagnosis of active PTB using sputum samples was sensitive (97.8%) but lacked specificity (27.0%) when regarded as PCR positive when at least one positive reaction was obtained among all samples examined. However, the PCR of gastric aspirate demonstrated a sensitivity of 63.4% and a specificity of 76.7%. Our data supports that the PCR method for detecting active PTB in AFB smear negative patients using gastric aspirate shows markedly improved sensitivity over the conventional method (25.9%), although it still lacks specificity. PCR assay for M. tuberculosis using multiple samples of gastric aspirate in conjunction with careful clinical observations for the presence of active infection is essential for the diagnosis of active PTB among patients with negative AFB smear.

Bacteriological Techniques↗
PubMed1995

[Rastelli operation for congenital heart disease complicated with peripheral pulmonary artery stenosis].

Peripheral pulmonary artery stenosis following the occlusion of ductus arteriosus is not rare in patients with pulmonary atresia. It is also seen after the creation of Blalock-Taussig shunt for various types of cyanotic congenital heart disease. Although pericardial patch enlargement for the pulmonary artery stenosis has been done at corrective surgery, the results were unsatisfactory because of restenosis. So, we proposed and performed a new method of pulmonary artery plasty using large rectangular heterogeneous pericardium, by which pulmonary artery could be widely enlarged from the pulmonary trunk to periphery of the stenosis. A 3-year-old female (case 1) was diagnosed with pulmonary atresia, ventricular septal defect, patent ductus arteriosus and coronary anomaly associated with left pulmonary artery stenosis. She previously received left Blalock-Taussig shunt. Another patient was a 4-year-old male (case 2) diagnosed with double-outlet right ventricle, pulmonary stenosis and patent ductus arteriosus. He also received right Blalock-Taussig shunt and had left pulmonary artery stenosis. Both patients received Rastelli operation with pulmonary artery plasty simultaneously. Rastelli operation was performed using composite graft consisted of valved heterogeneous pericardial roll and knitted Dacron graft. Post operative courses were uneventful and they were doing well one year after operation. We consider that the pulmonary artery plasty with rectangular heterogeneous pericardial patch is an effective surgical procedure to avoid restenosis compared with conventional pericardial patch enlargement or balloon pulmonary artery plasty.

Blood Vessel Prosthesis↗
PubMed1995

[Limited skin incision and partial median sternotomy for the repair of atrial septal defects in children].

Eight patients underwent the repair of atrial septal defect using the limited skin incision and partial median sternotomy. The average length of skin incision was 55% of the longitudinal size of the sternum. Our approach did not prolong the operation time and decreased the bloodloss. Moreover, postoperative events, such as hematoma, sternal instability, and wound infection, were not observed, and the cosmetic result was excellent. We think this method is safe and effective especially for children with atrial septal defect.

Child↗
PubMed1995

[A case of tricuspid atresia treated with fenestrated total cavopulmonary connection at late infantile stage].

A one-year-old girl with tricuspid atresia (TA) underwent fenestrated totalcavopulmonary connection (TCPC) after pulmonary artery banding. Under cardiopulmonary bypass, an fenestrated intraatrial cavocaval channel was constructed with a prosthetic graft of polytrafluorothylene. The SVC was transsected and each end of SVC was anastomosed to the pulmonary artery in a end-to-side fashion. She did not need "high CVP management" nor "low HR management" in the post operative course. We suggest that fenestrated TCPC may be indicated for the patients of TA at late infantile stage.

Blood Vessel Prosthesis↗