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Biomedical subjects

M Kitamura

Publications and source records attributed to M Kitamura.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Clinical application of extracorporeal shock wave lithotripsy using Siemens Lithostar for upper urinary tract stones].

We performed extracorporeal shock wave lithotripsy (ESWL) monotherapy on 51 patients with upper urinary tract stones using a Siemens Lithostar (C-tube) from April 1992 to April 1993. On the x-ray film obtained three months after the final ESWL treatments, 24 patients (47%) were free from stone concrements and 22 (43%) had stone fragments less than 4 mm. The over-all success rate was therefore 90.2%. No severe side effects were observed. We also examined the relationship between the degree of fragmentation seen on the immediate post-ESWL x-ray and stone status at 3 months. There was no significant correlation between them and the post-ESWL x-ray did not reflect the stone status at three months. In our experience, ESWL monotherapy using a Siemens Lithostar (C-tube) was a safe and effective treatment for upper urinary tract stones.

Adult↗
PubMed1994

[Surgical treatment of infective endocarditis in patients with congenital heart disease].

From 1981 to March 1993, 21 patients underwent surgical treatment for infective endocarditis (IE) associated with congenital heart disease (CHD). We evaluated the surgical results with regard to various factors, including microorganisms, pre- and postoperative complications, the correlation between CHD and the infective focus in the valve, the operative methods and surgical results. Underlying CHD included ventricular septal defect (VSD) in 15 (71.5%), persistent ductus arteriosus (PDA) in 2 (9.5%), tetralogy of Fallot (TF) in 2 (9.5%) and incomplete endocardial cushion defect (IECD) in 2 patients (9.5%). Microorganisms were detected in 71.4% of the patients, including streptococcus in 11 patients (52.4%), staphylococcus in 2 (9.5%) and gram-negative bacillin in 2 (9.5%). Embolism or infarction was noted preoperatively in 5 patients (23.8%) and was located in the kidney in 4 patients, the leg in 2, and in the liver and lung in 1 patient each. Among 15 patients with VSD, the lesion of IE was seen on the left side of the heart in 11 patients, on the right side in 3 and on both sides in 1. The PDA and IECD were seen on the left side in 2 patients each, but the IE focus of the 2 patients with TF was on the left side in one and on both sides in the other patient. Aortic valve replacement was performed in 17 patients, mitral valve replacement in 3, tricuspid valve plasty in 2, tricuspid annuloplasty in 1 and pulmonary valve resection in 2 patients. The operative mortality was 4.8% and there were no reoperations or late deaths.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[A case of renal pseudotumor caused by pyelonephritis].

A case of renal pseudotumor due to pyelonephritis is reported. A 70-year-old female was admitted to our hospital for the evaluation of right renal mass in pyelogram. She had had episodes of pyelonephritis many times. Computed tomography (CT) revealed poorly marginated low density mass that exhibits inhomogenous enhancement with contrast medium. Angiography showed an avascular mass. On magnetic resonance imaging (MRI), the mass was isointensity or slightly low intensity on T1 weighted scan, while it showed low intensity on T2 weighted scan. The patient died from small cell carcinoma in the lung two years later. Autopsy was performed and no malignancy was found in the kidney. MRI was useful to differentiate such inflammatory change from renal tumor, which is mostly high intensity on T2 weighted scan.

Aged↗
PubMed1993

Germ-line transmission and developmental regulation of a 150-kb yeast artificial chromosome containing the human beta-globin locus in transgenic mice.

Sequential expression of the genes of the human beta-globin locus requires the formation of an erythroid-specific chromatin domain spanning > 200 kb. Regulation of this gene family involves both local interactions with proximal cis-acting sequences and long-range interactions with control elements upstream of the locus. To make it possible to analyze the interactions of cis-acting sequences of the human beta-globin locus in their normal spatial and sequence context, we characterized two yeast artificial chromosomes (YACs) 150 and 230 kb in size, containing the entire beta-globin locus. We have now successfully integrated the 150-kb YAC into the germ line of transgenic mice as a single unrearranged fragment that includes the locus control region, structural genes, and 30 kb of 3' flanking sequences present in the native locus. Expression of the transgenic human beta-globin locus is tissue- and developmental stage-specific and closely follows the pattern of expression of the endogenous mouse beta-globin locus. By using homology-directed recombination in yeast and methods for the purification and transfer of YACs into transgenic mice, it will now be feasible to study the physiological role of cis-acting sequences in specifying an erythroid-specific chromatin domain and directing expression of beta-globin genes during ontogeny.

Age Factors↗
PubMed1993

Reevaluation of the two-component hypothesis for turning behaviour by manipulating activities in the striatum and the nucleus accumbens of intact rats.

The role of dopamine D1 and D2 receptor stimulation in the production of turning behaviour in rats was studied. In rats pretreated with unilateral injections of the non-selective dopamine D1/D2 receptor antagonist, cis(Z)-flupentixol (10 micrograms/0.5 microliter), into the ventral striatum, quinpirole (1, 3, 5, 10 mg/kg i.p.), a selective dopamine D2 receptor agonist, induced dose-dependent turning behaviour, while SKF 38393 (1, 3, 5, 10 mg/kg i.p.), a selective dopamine D1 receptor agonist, did not. The effect of the two drugs together was much greater than the effect of quinpirole alone and was reduced by additional blockade of dopamine D1/D2 receptors in either the ipsilateral or contralateral nucleus accumbens. The role of the nucleus accumbens in turning behaviour was determined from the effects of unilateral injections of SKF 38393 and quinpirole into the nucleus accumbens. The results show that unilateral injections of a mixture of the two drugs (SKF 38393 5 micrograms + quinpirole 10 micrograms/0.5 microliter) into the nucleus accumbens produced turning while injections of single drugs did not. Turning was abolished by the blockade of dopamine D1/D2 receptors in the ipsilateral but not contralateral ventral striatum. Turning was also reduced by the blockade of the contralateral nucleus accumbens. Moreover, turning was not produced by injections of the drug mixture into the dorsal or ventral striatum.

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗
PubMed1993

Rhabdomyosarcoma arising in transgenic mice harboring the beta-globin locus control region fused with simian virus 40 large T antigen gene.

The beta-globin locus control region (LCR) confers a high level of erythroid-specific and copy-number-dependent expression to human globin genes in transgenic mice. Simian virus 40 T (tumor) antigen (Tag) with its own natural enhancer causes choroid plexus tumors in mice. We investigated the effect of the LCR on Tag gene expression, reasoning that mice harboring a LCR-Tag fusion gene might develop hematopoietic malignancies. To test this hypothesis we introduced an enhancerless Tag gene downstream of a LCR cassette into the germ lines of mice. The phenotypes of the transgenic mice depended on the copy number of the transgene. While mice with 1-2 copies matured normally, those with 3-7 copies developed rhabdomyosarcomas in different anatomic sites at high frequency and showed hyperplasia of the pancreatic islet cells which progressed to pancreatic islet tumors. In addition, the mice bearing 7 copies of the transgene had hypoglycemia and were stunted in growth. Mice with more than 10 copies were markedly stunted in growth and died within 2-4 weeks. Tag expression was detected at high levels in the mouse tumors but not in any other tissues, including the hematopoietic cells.

Animals↗
PubMed1993

Proenzyme from of cathepsin L produced by thymic epithelial cells promotes proliferation of immature thymocytes in the presence of IL-1, IL-7, and anti-CD3 antibody.

A thymic epithelial cell line (TEC1-4) established from newborn mouse thymus produced a cofactor to promote proliferation of double-negative (CD4-8-) thymocytes in the presence of IL-1, IL-7, and anti-CD3 antibody. Based upon the sequence of 8 amino acid residues near the N terminal portion, the factor was identified as the mouse proenzyme form of cathepsin L which is almost identical to the rat proenzyme form of cathepsin L (95% in homology). Production of the proenzyme form of cathepsin L was confirmed in the TEC1-4 and mouse embryonic thymus by Western blotting analysis and Northern blotting analysis. Furthermore, immunohistologically, the presence of cathepsin L was observed in the epithelial cells of the subcapsular layer and around the small vessels in the thymic cortex. It has been concluded that a subpopulation of thymic cortical epithelial cells produces the proenzyme form of cathepsin L which can act as a cofactor to promote proliferation of DN immature thymocytes.

Amino Acid Sequence↗
PubMed1993

The intrapleural administration of recombinant interleukin-2 (rIL-2) to patients with malignant pleural effusion: clinical trials.

Recombinant IL-2 (rIL-2) was administered intrapleurally according to an original protocol to 11 patients with malignant pleural effusion, 7 of whom suffered from breast cancer and 4 from esophageal cancer. The pleural effusions either disappeared or decreased roentgenographically, and malignant cells disappeared from all 13 pleural cavities in the 11 patients, confirming the validity of this therapy to be 100%. The mean survival time from the initial administration of rIL-2 was 15.9 months. We ensured that the concentration of IL-2 in the effusion was maintained at a high level for a sufficient period of time, and that the lymphokine-activated killer (LAK) activity of lymphocytes in the effusion was augmented. Fever, eosinophilia, and a transient increase in the pleural effusion were the main side effects, but the symptoms were temporary and not serious. The results of this study therefore suggest the efficacy of intrapleural rIL-2 for patients with malignant pleural effusion.

Adult↗
PubMed1993

Mechanical circulatory support for postcardiotomy ventricular failure: the Heart Institute of Japan experience 1984-1992.

In the last 9 years, 30 patients received assisted circulation or a ventricular assist device after open-heart operations at the Heart Institute of Japan. After cardiovascular surgery, 9 of those patients underwent venoarterial bypass, 10 had biventricular bypass, 7 had left ventricular bypass, and the remaining 4 received a left ventricular assist device. Of the first 15 patients, only 3 (20%) were discharged from the hospital. In contrast, 7 (46.7%) of the last 15 patients were discharged without major complications. With respect to complications, bleeding and ventricular arrhythmia (immature weaning) decreased with low-heparinized isolated left ventricular supports. However, profound biventricular failure, infection, and multiple organ failure remain as possible complications with any type of assisted circulation. These results suggest that early application of circulatory support and appropriate selection of the mode of support and devices used are important for successful circulatory support.

Adult↗
PubMed1993

Percutaneous cardiopulmonary support as the second generation of venoarterial bypass: current status and future direction.

We have developed a new percutaneous cardiopulmonary support (PCPS) system in cooperation with Terumo Corporation, called the Emergency Bypass System (EBS). This preassembled system is unique in terms of its small priming volume (470 cc), fully automatic priming function, originally developed membrane oxygenator, and Capiox straight path centrifugal pump. The priming process takes only 5 min. We have used this system in 4 patients (all were male; mean age 56 years, range 35-73 years). The duration of assist ranged from 15 min to 210 h. Maximum bypass flow ranged from 2.2 to 3.6 L/min, systemic circulation was very well maintained, and urinary output was acceptable. Although the centrifugal pump was in good working condition, we had to change the oxygenator because of serum leakage 36 to 48 h after initiation of the assist. One patient was weaned from the PCPS, but died of brain death. The other patients could not be weaned from the PCPS. The cause of death in these patients was irreversible myocardial damage. Disseminated intravascular coagulopathy triggered by surgical trauma related to various procedures developed in 2 patients during assist and was the cause of cessation of the assist. Problems to be ratified and future directions in the EBS and PCPS were earlier introduction through the establishment of clear indications and endpoint, heparin coating, improvement in durability of the oxygenator, and cost.

Adult↗
PubMed1993

Development of fabrication system of prostheses using electric discharge machining.

This paper outlines the principles and uses of electric discharge machining (EDM) in the fabrication of prostheses. The three areas of use of EDM are classified as supplementary use, direct fabrication of crowns and bridges and fabrication of titanium copings using a CAD/CAM process. The problems associated with the use of EDM in each area are discussed and the methods employed to overcome these problems are described. The application of numerically controlled (NC) EDM to prosthodontic work is found to be promising. Further refinement and development are necessary before EDM can be widely accepted as a means of fabricating prostheses.

Computer-Aided Design↗
PubMed1993

[Congenital arteriovenous malformation of the kidney: report of two cases--detection by digital subtraction angiography with carbon dioxide].

Two cases of arteriovenous malformation of the kidney were reported. The first case was a 19-year-old female, complaining of right flank pain and gross hematuria. Right selective renal arteriography revealed a 2 x 1.5 cm large cisoid type arteriovenous malformation at the most distal region of the lower branch of the renal artery. Transcatheter embolization, using Gelfoam and absolute ethanol, was successfully done, which was confirmed with repeated digital subtraction angiography with carbon dioxide (CO2-DSA). The second patient was a 55-year-old female with past history of right idiopathic renal bleeding, complaining of right flank colicky pain and gross hematuria. Right selective renal arteriography was done without any pathological findings, while CO2-DSA documented an arteriovenous malformation in the hilar region. Transcatheter embolization was not done, because the malformation seemed to be proximally located. Thus CO2-DSA was thought to be a reliable method in the diagnosis of arteriovenous fistula.

Adult↗
PubMed1993

Photochemical cleavage of DNA by phosphorus(V) porphyrin derivatives.

Photocleavages of double-stranded circular DNA and oligonucleotide were investigated by the use of phosphorus(V)tetraphenylporphyrin (P(V)TPP) derivatives. The P(V)TPP derivatives cleaved the DNA and the oligonucleotide under the visible light irradiation, in air and in argon, respectively. It is suggested that the photocleavage reactions include an electron transfer mechanism as well as a singlet oxygen (1O2) one.

Bacteriophage phi X 174↗
PubMed1993

[The effectiveness of ulinastatin on granulocyte H2O2 production in acute lung injury rat model].

Oxygen radicals produced by granulocytes play an important role in acute lung injury. The effectiveness of ulinastatin in adult respiratory distress syndrome and an acute lung injury animal model has been reported. We investigated the effect of ulinastatin on oxygen radical production in the intact pulmonary circulation of a rat acute lung injury model using our new method, which demonstrated the granulocyte adhesion and H2O2 production in vivo. The pulmonary microcirculation was observed by intravital fluorescence microscopy and a TV monitor using a SIT TV camera. Then images were recorded on a videotape. The granulocytes and H2O2 were stained with an intravenous injection of acridine red and dichlorofluorescin diacetate, respectively. The images which were recorded on the videotape were digitized by a computer image digitizer and analyzed with a personal computer and the software Ripp II. When the rat received a continuous infusion of endotoxin (4.5 mg/kg/hour) for 2 hours, the granulocytes adhered to the pulmonary capillaries and generated H2O2 (n = 25 p < 0.001 respectively, compared with the control rat which received saline alone). Then, the acute lung injury model rat was infused with 50,000 U/kg of ulinastatin just before endotoxin infusion and also received a continuous infusion of ulinastatin (50,000 U/kg/hour) for 2 hours. Ulinastatin inhibited the granulocyte adhesion to the pulmonary capillaries (n = 25, inhibition rate: 46% p < 0.001) and H2O2 production (n = 25, inhibition rate; 51% p < 0.001) caused by the continuous infusion of endotoxin. In conclusion, ulinastatin significantly inhibits the granulocyte adhesion and H2O2 production in the intact pulmonary circulation of a rat acute lung injury model.

Acute Disease↗
PubMed1993

[Quantitative analysis of right ventricular overloading by 201Tl myocardial SPECT].

Clinical usefulness of quantitative analysis of right ventricular overloading was evaluated by 201Tl myocardial SPECT in comparison with cardiac catheterization and MRI. Seventy-four MBq of 201TlCl was intravenous injected and 201Tl myocardial SPECT was performed on 40 patients (mean age: 61.0 +/- 11.8) with right ventricular overloading. Regions of interest (ROI) were selected on right and left ventricular walls in a midventricular short axis image of SPECT and uptake of each ROI were counted. The right ventricle (RV)/left ventricle (LV) 201Tl uptake ratio (R/L-Tl) was calculated. Wall thickness of RV and LV were measured on MRI and the RV/LV wall thickness ratio (R/L-WT) was calculated. RV and LV pressure were recorded in cardiac catheterization, and the RV/LV systolic pressure ratio (R/L-P) was calculated. There was significant positive correlation (Y = 0.73X + 0.19, r = 0.71, p < 0.001) between R/L-Tl and R/L-WT. R/L-Tl was positively correlated with R/L-P in patients with pressure overload (Y = 1.14X - 0.049, r = 0.85, p < 0.001) and in patients with volume overload (Y = 0.51X + 0.023, r = 0.88, p < 0.001) and the slope of the regression line in patients with pressure overload was significantly steeper than that in patients with volume overload (p < 0.001). In conclusion, quantitative analysis of right ventricular overload by 201Tl myocardial SPECT is useful to estimate RV/LV wall thickness ratio and pressure ratio.

Adult↗
PubMed1993

[Mechanical circulatory support for profound heart failure].

Profound heart failure, such as acute myocardial infarction with cardiogenic shock and postcardiotomy ventricular failure, requires mechanical circulatory support when recent medical treatment is ineffective. Intra-aortic balloon pumping, venoarterial bypass, cardiopulmonary bypass, left ventricular bypass, biventricular bypass and left ventricular assist device are commonly used circulatory support methods. Type selection and application timing of circulatory supports, based on the understanding of type of cardiac failure, respiratory function and other organ conditions, appears to be most important for successful treatment of profound heart failure.

Assisted Circulation↗