Biomedical subjects

M Kawada

Publications and source records attributed to M Kawada.

At least 19 recordsLinked to original sources

PubMed1992

Circumvention of multidrug resistance in human carcinoma KB cells by polyether antibiotics.

We examined the effect of various polyether antibiotics on colchicine resistance in multidrug-resistant KB-C4 cells which exhibit about 4,000-fold resistance to colchicine. As a result, 4 out of 14 polyether antibiotics were found to reverse colchicine resistance. Among them, laidlomycin was the most potent. It potentiated colchicine cytotoxicity on KB-C4 cells about 700-fold at 1 microgram/ml. Degree of potentiation was calculated by dividing of the IC50 value of colchicine in the absence of a polyether antibiotic by the IC50 value of colchicine in the presence of the polyether antibiotic. Monensin, dianemycin, and leuseramycin at 3 micrograms/ml also potentiated the cytotoxicity, about 100-fold. We previously reported that inostamycin is a potent chemosensitizer in KB-C4 cells. Although lysocellin has a structure very similar to that of inostamycin, it didn't reverse colchicine resistance. It slightly increased [3H]vinblastine accumulation in KB-C4 cells and weakly inhibited the [3H]vinblastine binding to KB-C4 plasma membranes.

Anti-Bacterial Agents↗

PubMed1992

[Urinary N-acetyl-beta-D-glucosaminidase and gamma-glutamyl-transpeptidase activities for evaluation of renal disturbance in patients with multiple myeloma].

The activities of N-acetyl-beta-D-glucosaminidase (NAG), gamma-glutamyl-transpeptidase (gamma-GTP) and NAG isoenzyme were measured in the urine of 20 patients with multiple myeloma (IgG/IgA type/Bense Jones type; 15/1/4 cases) and 25 healthy controls to evaluate these activities as indicators of renal disturbance in multiple myeloma. NAG isoenzyme fractions in urine were measured by agarose electrophoresis-m-cresol sulfonphthaleinyl-NAG reaction. Mean urinary NAG activity in the patients with myeloma was significantly higher than that in the controls (20.1 +/- 3.3 vs 4.3 +/- 0.3U/g. cr; p < 0.001). Urinary NAG activity in these patients correlated positively with the dose (mg/g. cr) of urinary protein (r = 0.755; p < 0.01), most of which were considered to be light chain protein, but not with creatinine clearance. Each urinary NAG isoenzyme fraction (NAG-1, -2, -3) was higher in the patients than that in the controls, and especially NAG-2 fraction (A form) showed a highly positive correlation with the dose of urinary protein. Urinary gamma-GTP activity in the patients did not differ from that in the controls, but urinary NAG/gamma-GTP ratio was higher in the patients, and reversely correlated with creatinine clearance (r = -0.721; p < 0.01). It is suggested that the elevation of urinary NAG activity results from the damage of lysosome in proximal tubular cells by urinary light chain protein and its degradation products. Therefore, urinary NAG activity may be a good index for proximal tubular disturbance, and NAG/gamma-GTP ratio may be an index for the extensive damage of nephrons in addition to the damage of tubular cells in multiple myeloma.

Acetylglucosaminidase↗

PubMed1992

[A case report--combined Jatene procedure and extended aortic arch reconstruction for the original Taussig-Bing malformation associated with hypoplastic aortic arch, subaortic stenosis and coarctation of the aorta].

A successful repair with combined Jatene procedure (Lecompte modification) and extended aortic arch reconstruction in a two-month-old boy with the original Taussig-Bing malformation, associated with hypoplastic aortic arch, subaortic stenosis and coarctation of the aorta was described. The ascending aorta was measuring 8 mm and the distal aortic arch was 4 mm in outer diameter. The interventricular rerouting was not feasible, because the infundibular septum was almost aligned to the interventricular septum. So that arterial switch operation was preferred. The primary interventricular foramen was enlarged by wedge resection and the secondary interventricular foramen was closed with a patch of preserved equire pericardium. An extensive patch angioplasty of entire aortic arch down to descending aorta was performed with a composite patch of Xenomedica (preserved equire pericardium) and Dacron velour. Hypertrophied muscle bundles were resected for relief of subaortic stenosis. Jatene procedure was then performed. During neo-pulmonary reconstruction, distal pulmonary orifice was shifted towards right to avoid kinking and compression on the coronary arteries. One stage correction consisting of Jatene procedure and extended aortic arch reconstruction was considered to be a procedure of choice in this type of complex anomalies.

Aorta, Thoracic↗

PubMed1992

[Surgical treatments of nonconfluent pulmonary arteries with congenital cardiac defects].

Pulmonary artery angioplasty or reconstruction was performed in seven patients with nonconfluent pulmonary arteries and congenital cardiac defects. Age of these patients were ranged from 6 months to 41 years old. Five of them had pulmonary truncal atresia and complex cardiac anomalies. Two of these five patients demonstrated nonconfluent pulmonary arteries due to deformities at ductal insertion of pulmonary arteries. Three patients had had previous systemic to pulmonary artery shunt operations which caused pulmonary artery distortions. Other two patients had intrapulmonary arterial obstructions due to pulmonary artery thrombosis. Patch pulmonary artery plasty was carried out in three patients, dilatation of severe stenotic pulmonary artery was done in one patient simultaneously with pulmonary valvotomy. Central shunt operation was added in one patient with the pulmonary artery which was unable to be reconstructed. Last two patients underwent intrapulmonary artery reconstruction with the rolled pericardial graft. Hospital death occurred in one patient with unproperly increased pulmonary blood flow by central shunt. Average follow-up period of these six survivors after operation was 1.4 +/- 0.8 years. As definite repairs, two patients had Fontan operation, two patients had right ventricle to pulmonary artery reconstruction. And remaining two patients are still to be followed until sufficient growth of pulmonary artery suitable for Fontan operation.

Adolescent↗

PubMed1992

[Successful Norwood operation for single left ventricle associated with severe subaortic stenosis, coarctation of aorta and hypoplastic aorta].

A 4 month-old boy who had double-inlet left ventricle, severe subaortic stenosis, hypoplastic ascending aorta and coarctation of the aorta revealed severe respiratory failure. An urgent Norwood operation was done. The procedure consisted of enlargement of the ascending aorta and main pulmonary artery and a systemic-pulmonary shunt using 5 mm PTFE tube. Postoperative course was uneventful.

Aorta↗

PubMed1991

Palliative repair of aortic atresia associated with tricuspid atresia and transposition of the great arteries.

Successful palliative repair of aortic atresia and hypoplastic aortic arch associated with tricuspid atresia in a neonate is described. The repair consisted of reconstruction of the hypoplastic aortic arch with an equine pericardial patch, division of the patient ductus arteriosus, connection of the pulmonary artery to the aorta, implantation of the proximal part of the ascending aorta into the main pulmonary artery, and anastomosis of a polytetrafluoroethylene graft 5 mm in diameter between the right ventricular outflow tract and the central pulmonary artery, which was transferred anteriorly to the main pulmonary artery.

Abnormalities, Multiple↗

PubMed1991

Long-lasting accumulation of vinblastine in inostamycin-treated multidrug-resistant KB cells.

Inostamycin, a novel polyether compound, reverses multidrug resistance in KB cells. The mechanism of its action was studied by use of radioactively labeled vinblastine. Inostamycin dose-dependently increased the accumulation of [3H]vinblastine in multidrug-resistant KB-C4 cells at 0.5-2 micrograms/ml, while it did not enhance accumulation in the drug-sensitive KB-3-1 cells. At a concentration of 1 microgram/ml inostamycin inhibited active [3H]vinblastine efflux from KB-C4 cells, but not from KB-3-1 cells, and inhibited [3H]vinblastine binding to KB-C4 membranes with an IC50 of 0.94 microgram/ml (1.3 microM). Furthermore, [3H]vinblastine accumulated by treatment with 1 microgram/ml of inostamycin was resistant to efflux from KB-C4 cells, even after the removal of inostamycin.

Biological Transport↗

PubMed1991

[Fontan type procedure in patient with borderline hemodynamics: using a temporary R-L shunt in early postoperative period].

Fontan type procedure was successfully performed to a 14-year-old patient with borderline hemodynamics using a temporary R-L shunt in early post operative period. Preoperative diagnosis was DORV (ILD), small RV, PS, ASD, juxtaposition of atrial appendages and post bilateral B-T shunts. Preoperative catheterization studies showed low PARI but insufficient pulmonary arterial size (PA-index 220). In the Fontan procedure, RA was partitioned obliquely with a composite patch of xenograft and Dacron velour. A 5.5 mm hole was created only in xenograft to allow a temporary R-L shunt. During rewarming period, systemic pressure hovering around 60 mmHg with 10 micrograms/kg/min of dopamine and dobutamine. Then a R-L shunt was created by a side to side anastomosis between the appendages with the orifice diameter of 10 mm, followed by a rise in the systemic pressure up to about 80 mmHg. One post operative day, a readjustable occluder was applied at the site of appendage anastomosis to control R-L shunt flow. According as CVP decreased, the occluder was tightened up step by step. Finally, the occluder was fully tightened up in 10 post operative days. This experience suggests that a temporary R-L shunt in early post operative period may be applicable in patient with borderline hemodynamics for Fontan type procedure.

Adolescent↗

PubMed1991

[Conotruncal repair of tetralogy of Fallot under 2 years old].

From October 1985 to September 1990, a repair within the conotruncal portion of the right ventricle-Conotruncal repair-was used for the primary repair of consecutive 34 patients with tetralogy of Fallot under the age of 2 years. There were three summarized points of this maneuver: the first was non-use of the tricuspid septal leaflet for closure of the ventricular septal defect, the second was short patch infundibuloplasty with a large monocusp, and the last was total resection of the infundibular septum. Length of the patch infundibuloplasty was just 30% of the right ventricle length according to our formula: 30% of RV (cm) = 1.28 X BSA (m2) + 1.10. The VSD patch was placed between the pulmonary annulus and the ventricular septal crest, consisting of the membranous flap and the posterior extension of the trabecula septomarginalis. The right ventricular (RV) to systemic arterial pressure ratio was 0.49 +/- 0.15 (N = 33) and central venous pressure was 10.2 +/- 1.9 cmH2O (N = 33) six hours after ICU admission and 8.4 +/- 1.5 cmH2O (N = 7) 18 days after operation. RV end-diastolic volume showed no increase after operation: 105 +/- 31 before repair to 104 +/- 23% of Normal after repair in the same patients. Post-operative intubation period was 14 +/- 8 hours and hospital admission period was 17 +/- 6 days after operation. All patients were in sinus rhythm. The 28% of patients showed incomplete right bundle branch block (RBBB) and other 28% of patients showed complete RBBB.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac Surgical Procedures↗

PubMed1991

[A case report of Konno procedure for Ebstein's anomaly with subaortic stenosis after Hardy procedure and repair of coarctation and VSD].

A rare case of Ebstein's anomaly with coarctation and VSD is reported. Severe subaortic stenosis and LV dysfunction were progressed after PA banding and coarctation repair at four months old and Hardy procedure and VSD closure at five month old. Konno procedure was successfully performed with SJM 21A at one year and nine months old. Since coarctation type VSD may cause subaortic stenosis after its closure due to posteriorly deviated infundibular septum, anterosuperior margin of VSD would occasionally better to be eliminated at the time of VSD closure. This is the youngest one of Konno procedure to our knowledge.

Aortic Coarctation↗

PubMed1991

[Hemodynamic changes and ventricular function before and after Fontan procedure for univentricular heart].

Ventricular function and hemodynamic parameters before and after Fontan operation were studied in patients with univentricular heart (UVH) of left ventricular (LV) type (9 cases, ages: 6-66, mean 13 years) and right ventricular (RV) type (13 cases, ages: 6-17, mean 9 years) without atrioventricular valve regurgitation. The preoperative ejection fraction (EF) was poor and only 44% of LV type and 23% of RV type met the Choussat's criterion (EF greater than or equal to 60%). There were 2 hospital deaths each in LV type and in RV type, but their causes could not be attributed to preoperative parameters of ventricular function. In survivors, the EF reduced from 62.9 +/- 7.0% before Fontan procedure to 43.4 +/- 12.6% after the procedure in LV type (p less than .05) and from 54.5 +/- 7.0% to 47.0 +/- 9.0% in RV type (p less than .01), although the ventricular end-diastolic pressure (EDP) also reduced from 12.7 +/- 2.7 mmHg before to 6.6 +/- 1.9 mmHg after the operation in LV type (p less than .05) and 10.4 +/- 2.6 mmHg to 5.5 +/- 2.4 mmHg in RV type (p less than .05). the ventricular end-diastolic volume (EDV) also reduced from 185 +/- 35% to 126 +/- 58% of expected normal volume in LV type (p less than .05) and 173 +/- 28% to 99 +/- 18% of expected normal volume in RV type (p less than .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1990

Regulatory effects of epidermal growth factor and retinol on the glucocorticoid receptor level in cultured chick embryonic skin.

When undifferentiated skin from 13-day-old chick embryos was cultured in a chemically defined medium, glucocorticoid specifically decreased the dexamethasone-binding activity of the epidermal cytosol after 1 day of culture, 3 days before it induced formation of a cornified layer over the intermediate cells of the epidermis. The binding activity reappeared after removal of the steroid from the medium. This reappearance was inhibited by epidermal growth factor (EGF, 100 ng/ml). The Addition of 2 microM retinol resulted in a 3-fold increase in specific dexamethasone binding in the epidermal cytosol within 12 h with no change in the binding affinity. The inhibition of glucocorticoid-induced keratinization by retinol is due a to mechanism other than inactivation of the glucocorticoid receptor.

Animals↗

PubMed1990

[Pulmonary artery banding for double inlet left ventricle].

Thirteen patients with double-inlet left ventricle who had undergone pulmonary artery banding (PAB) were reviewed. At the time of PAB, the age ranged from 2 months to 3 years. Pulmonary-systemic arterial pressure ratio and pulmonary arterial mean pressure were reduced from 0.95 +/- 0.12 to 0.4 +/- 0.18, and from 57.3 +/- 11.6 mmHg to 29.9 +/- 12.7 mmHg after PAB. Pulmonary resistance showed no statistically significant change after PAB. (from 7.6 +/- 5.2 unit to 4.8 +/- 3.9 unit) Ventricular end-diastolic volume decreased from 379.9% +/- 140.0% to 275.7% +/- 118.0% after PAB. The smallest one was 170% who successfully underwent septation procedure. Ejection fraction significantly decreased from 64.5 +/- 6.1% to 56.3 +/- 7.9%. (p less than 0.005) Ventricular end-diastolic pressure showed no significant change after PAB. (from 9.2 +/- 2.8 mmHg to 9.9 +/- 2.0 mmHg) After PAB subaortic stenosis occurred in three cases and pressure gradient were 10, 20, and 85 mmHg, respectively. Seven cases, including three cases with subaortic stenosis, underwent septation procedure and all survived. Before septation, ventricular end-diastolic volume calculated as % of normal left ventricular volume ranged from 173% to 570% and pulmonary resistance ranged from 1.6 unit to 11 unit. These data suggested that the patients with double-inlet left ventricle had efficient ventricular volume and cardiac function for septation even after PAB.

Child, Preschool↗

PubMed1990

[Surgical treatment of hypoplastic left heart syndrome: a successful case report].

A successful case of Norwood operation for a 5-day-old infant with hypoplastic left heart syndrome is reported. Norwood procedure and central shunting with a 4 mm PTFE tube was performed. Cerebral and coronary artery were perfused independently during reconstruction of aorta in order to shorten the time of circulatory arrest. Post operative UCG documented un-obstructive systemic output from the right ventricle, well regulated pulmonary arterial blood flow and widely patent interatrial communication. This baby was discharged the hospital 66 days after surgery. He has been clinically well for six month after the operation.

Anastomosis, Surgical↗

PubMed1990

[Acute renal failure in a case of paroxysmal nocturnal hemoglobinuria--a review of literature in Japan].

A case of paroxysmal nocturnal hemoglobinuria (PNH) associated with acute renal failure (ARF) is described. A 57-year-old female, who had been diagnosed as having PNH in 1983 at Kochi Medical School, was admitted to our hospital in April 1989, because of ARF with dark urine after a common cold. Hemodialysis was performed 5 times for ARF, and after almost completely recovering from ARF, she was discharged. The renal biopsy showed the deposition of hemosiderin in the proximal tubular cells. We surveyed fourteen case reports of PNH associated with ARF in Japan including our case. Ten cases developed ARF after infection causing hemolytic attack. Twelve of 14 cases were treated by hemodialysis and 13 cases were reversible. The histopathology of their renal biopsies revealed the deposition of hemosiderin in the proximal tubular cells in six of seven cases and tubular necrosis in three cases. These data showed that hemolytic attack and dehydration related to infection facilitated the induction of ARF.

Acute Kidney Injury↗

PubMed1990

[Left ventricular function after Konno procedure for congenital aortic stenosis].

From February, 1984 to September, 1988, eighteen patients with congenital aortic stenosis underwent Konno procedure. There was no operative death, but one late death (5.6%). The annular diameter ranged from 9 mm to 23 mm (mean 15 mm). Preoperative left ventricular ejection fraction (LVEF) measured by cineangiography ranged from 0.59 to 0.92 (mean 0.77) and half of the patients had more than 0.80 of LVEF. Left ventricular function after the operation was evaluated at rest or during exercise by radionuclide ventriculography. Postoperative LVEF ranged from 0.59 to 0.89 (mean 0.75). Although there were no statistically significant changes between preoperative and postoperative LVEF, there was a trend that preoperative supernormal LVEF improved to normal after surgery. The response to exercise also improved in some cases after surgery. We concluded that Konno procedure can be safely undertaken with improvement of left ventricular function.

Adolescent↗

PubMed1990

Ten-year follow-up after valve replacement with the St. Jude Medical prosthesis in children.

Since 1979, 50 children, 4 months to 15 years of age, have successfully undergone cardiac valve replacement with the St. Jude Medical prosthesis (St. Jude Medical, Inc., St. Paul, Minn.). There were 24 boys and 26 girls. The valve replaced was mitral in 28 children, aortic in 15, mitral and aortic in 1, and mitral and tricuspid in 1. A left-sided tricuspid valve was replaced in 3 children. Anticoagulant therapy was maintained in all children; 40 children were treated with warfarin, whereas 10 children who underwent aortic or mitral valve replacement were on a regimen of aspirin combined with dipyridamole. The follow-up period, comprising 224 patient-years, ranged from 1 to 10 years. There were four valve-related complications: one from thromboembolism, two from valve thrombosis, and the other one from prosthetic valve endocarditis. Actuarial rate free from all valve-related complications at 10 years was 84.7%. There were four late deaths: one from valve thrombosis and the others from non-valve-related complications. Actuarial survival rate at 10 years was 90.8%. All surviving children are in functional class I, and no child so far has needed replacement of a prosthesis because of somatic growth. These results indicate that the St. Jude Medical prosthesis is a cardiac valve substitute of choice for valve replacement in children.

Actuarial Analysis↗

PubMed1990

[Surgical problems in d-TGA with VSD and PS associated with insertion of tricuspid valve chordae to the infundibular septum--the Rastelli operation by translocation of the infundibular septum].

Twelve (37.5%) out of 32 patients who underwent surgical repair of complete transposition of the great arteries (d-TGA) with ventricular septal defect (VSD) and pulmonary stenosis (PS) from 1978 to 1987 had insertion of tricuspid valve (TV) chordae to the infundibular septum, i.e. superior margin of the VSD, which precluded the ordinary Rastelli type operation. Of these 12 patients early 5 patients (ages: 2-11 mean 7 years) underwent atrial switch operations with VSD closure and pulmonary valvotomy with or without fibromyotomy, and recent 6 patients (age: 4-8, mean 6 years) underwent the Rastelli operation (3 cases) or REV (3) by translocating the infundibular septum with TV chordae to the right ventricular side of the internal conduit. None died in hospital in the former group and 1 in the latter. Pulmonary/systemic ventricular peak pressure ration (Ppv/sv) was 0.75 +/- 0.22 (mean +/- standard deviation) in the atrial switch group v. 0.49 +/- 0.08 in the Rastelli/REV group 1 month postoperatively. The higher Ppv/rv in the atrial switch group was attributed to the pressure gradient across the pulmonary outflow tract, which was 37.8 +/- 16.6 mmHg in the atrial switch v. 16.7 +/- 4.2 mmHg in the Rastelli/REV (p less than 0.05). No pressure gradient was demonstrated between left ventricle (LV) and aorta in the both groups. Pulmonary wedge pressure was higher in the atrial switch group (13.8 +/- 1.9 mmHg) than in the Rastelli/REV (10.0 +/- 2.7 mmHg) (p less than 0.05). Systemic atrioventricular (AV) valve regurgitation was noted in 2 of the atrial switch group but none in the Rastelli/REV.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗