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Biomedical subjects

M Kume

Publications and source records attributed to M Kume.

At least 73 records · Page 4Linked to original sources
PubMed1996

Sneddon's syndrome (livedo racemosa and cerebral infarction) presenting psychiatric disturbance and shortening of fingers and toes.

A 24-year-old man with livedo racemosa and psychiatric disturbances, manifesting as low intelligence (IQ 80) and delusions, had anti-cardiolipin antibody and showed shortening of the fingers and toes. A skin biopsy of the livedo lesion revealed endoarteritis obliterans, being compatible with Sneddon's syndrome. MRI of the brain demonstrated multiple infarction and moderate cortical atrophy. A single photon emission tomography of the brain showed a marked reduction of the blood flow in the front-temporal lobe. These findings might relate to the psychiatric disturbance. After intravenous administration of cyclophosphamide and the start of oral prednisolone, the anti-cardiolipin antibody level decreased and his physical condition improved. However, a low dose of haloperidol is still necessary to maintain his mental condition.

Adult↗
PubMed1996

[Efficacy of coronary artery reconstruction in maintaining myocardial viability: quantitative determination of local myocardial circulation with 13NH3 myocardial positron emission tomography].

Thirty patients (280 areas) whose bypass grafts remained patent after surgical reconstruction of the coronary artery were examined. Before and after reconstruction, local myocardial blood circulation in infarcted regions and post-stenotic regions was measured by 13 NH(3) myocardial positron emission computed tomography (PET) at rest of during physical exercise in order to evaluate the efficacy of coronary artery reconstruction. Before operation, mean blood flow in post-stenotic regions (n = 198) was 65 +/- 15 ml/min/100 g at rest and 85 +/- 23 ml/min/100 g during exercise. After coronary artery bypass grafting (CABG), mean blood flow was increased to 78 +/ 21 ml/min/100 g at rest (p, 0.01) and 105 +/- 32 ml/min/100 g during exercise (p < 0.01). In infarcted regions (n = 82), mean blood flow before operation was 51 +/- 23 ml/min/100 g at rest and 69 +/- 23 ml/min/100 g during exercise. After CABG, it increased to 62 +/- 19 ml/min/100 g at rest (p < 0.01) and 81 +/- 29 ml/min/100 g during exercise (p < 0.01). Thus, significant increases in blood flow were observed in both post-stenotic and infarcted regions at rest and physical exercise after operation. The regions of infarction were divided into three groups based on local myocardial blood flow at rest before operation: Group I: greater than 45 ml/min/100 g (n = 35); Group II: less than 45 ml/min/100 g (n = 30) but greater than 30 ml/min/100 g; and Group III: less than 30 ml/min/100 g (n = 30). The efficacy of reconstruction was compared among these groups. The group with preoperative myocardial blood flow greater than 30 ml/min/100 g had increased blood flow after operation, indicating myocardial viability.

Adult↗
PubMed1995

[Alterations of cardiac function and metabolism in the rat heart-lung preparation by methyl methacrylate (MMA) and their protection by ulinastatin].

We have assessed the deleterious effects of methyl methacrylate (MMA) on cardiac function and metabolism in the isolated heart-lung preparation and their protection by ulinastatin. Twenty-four male Wistar rats were prepared for the heart-lung model. They were randomly divided into 3 groups. In the MMA (M) and ulinastatin (U) groups, MMA 1000 micrograms.ml-1 was administered 7 minutes after the start of perfusion. At the end of the experimental period, the hearts were freeze-clamped and then myocardial high energy phosphates, lactate and glycogen were measured. Cardiac output decreased significantly in the M and U groups. Po2 of the perfusion blood in the M and U groups was significantly lower than that in the control (C) group. Myocardial ATP in the M and U groups was significantly lower than that in the C group. ADP and AMP in the M and U groups were higher than those in the C group. Although there was no significant difference in lactate levels among the 3 groups, glycogen in the U and C groups was significantly higher than that in the M group. MMA 1000 micrograms.ml-1 is much higher than the blood level (0.05-31.89 micrograms.ml-1) reported clinically in patients who had femoral prosthesis. Ulinastatin increased myocardial glycogen content which had been reduced by MMA. This may suggest that ulinastatin has a protective effect on heart damaged by MMA.

Adenosine Diphosphate↗
PubMed1994

Receptor-mediated endocytosis of thrombin-antithrombin III complex by the human monocytoid cell line U937.

Receptor-mediated endocytosis of thrombin-antithrombin III (TAT) complex was characterized with the monocytoid cell line U937. At 4 degrees C, U937 cells bound TAT but not antithrombin III in a rapid, specific, saturable, and reversible manner. [125I]TAT binding to U937 cells was not inhibited by antithrombin III and hardly by thrombin, but 75% inhibited by a 50 molar excess of the unlabeled TAT. There were about 79,000 binding sites/cell (Kd = 68 nM). The TAT receptor on U937 cells may be distinct from the serpin-enzyme complex (SEC) receptor, since a synthetic peptide corresponding to the recognition sequence of SEC receptor did not compete with TAT binding to the cells. Receptor-bound TAT was internalized into the cells after switching the temperature from 4 to 37 degrees C and thereafter degraded in lysosomes.

Amino Acid Sequence↗
PubMed1994

Effects of artificial blood (FC-43 emulsion) on myocardial energy metabolism in the rat heart-lung preparation.

We have assessed the effects of artificial blood (FC-43 emulsion) on myocardial energy metabolism in the rat heart-lung preparation. Animals were allocated to four groups (n = 8 each group) according to the ratio of perfusion blood and FC-43 as follows: group 1 = control, perfusion blood only; group 2 = 50% FC-43; group 3 = 75% FC-43; and group 4 = 100% FC-43. Hearts were perfused initially to a cardiac output of 30 ml min-1 and mean arterial pressure of 50 mm Hg. Thirty minutes after perfusion, the hearts were freeze-dried for 6 days. Myocardial high energy phosphates (ATP, ADP and AMP) were measured by high pressure liquid chromatography. Myocardial lactate and glycogen concentrations were measured by enzymatic methods. There were almost no significant differences in cardiac output, systolic pressure, right atrial pressure and heart rate among the groups. Oxygen contents of the perfusate in all FC-43 groups were significantly lower than those in the control group. Myocardial ATP concentrations in rats receiving 50%, 75% and 100% FC-43 were significantly lower than those in the control group. In addition, myocardial ADP and AMP concentrations in rats receiving 75% and 100% FC-43 were significantly higher than those in the control group. Although there is adequate oxygen-carrying capacity in FC-43 to maintain cardiac function during perfusion, the energy levels in the hearts perfused with FC-43 were lower than those in normal hearts.

Adenosine Diphosphate↗
PubMed1994

Psychological evaluation of Japanese astronaut applicants.

In 1991, a new psychological selection procedure was employed during the selection of Japanese Space Station astronauts. It was based on international selection criteria developed by an international psychological/psychiatric working group. A total of 372 individuals--fewer than expected--submitted applications for Space Station astronaut in Japan. Of the applicants, 233 were given several psychological written tests [Anxiety Scale, Performance Test, General Aptitude Test Battery, and Environmental Adjustment Test Battery (EATB)] in Phase I of the selection. Forty-five applicants went on to take the General Aptitude Test Battery (GATB), Human Assessment Method (a group test), a semi-structured psychological interview and an intelligence test in Phase II of the selection. All applicants were found to be highly intelligent. Interestingly, an unexpectedly large number of candidates were disqualified by the newly developed EATB. Assessment of individual functioning in a group (the Human Assessment Method) resulted in no applicant being ranked in either the "qualified with reservation" (QR) or "disqualified" (DQ) category. Much has been learned from this initial application of psychological "select-in" testing, but further efforts are needed to improve both psychological criteria and evaluation methods and to determine their reliability and validity.

Adaptation, Psychological↗
PubMed1994

[Anesthetic management with continuous epidural buprenorphine of a patient with dystrophia myotonica].

We report an anesthetic management of a 45 year-old female patient with dystrophia myotonica who was scheduled for abdominal total hysterectomy. The patient was diagnosed as dystrophia myotonica 8 years ago. Epidural catheterization was performed through Th12-L1 interspace and spinal anesthesia was performed through L2-3 interspace using 3.3 ml of 0.5% bupivacaine. Adequate block below Th5 level was obtained. The intraoperative course of anesthesia was uneventful. Moreover, the continuous epidural administration of buprenorphine gave a satisfactory postoperative pain relief and no respiratory depression was observed. Spinal or epidural anesthesia seems to be effective and safe for the patient with dystrophia myotonica.

Anesthesia, Epidural↗
PubMed1994

[Anesthetic management of laparoscopic ovarian cystectomy in a 2-year-old child].

We have experienced the anesthetic management of laparoscopic ovarian cystectomy in a 2-year-old child. The patient was anesthetized with isoflurane and manually ventilated to keep PaCO2 at 30 mmHg prior to the carbon dioxide insufflation of the peritoneal cavity. Two minutes after the abdomen was distended, end-tidal CO2 began to increase and after 10 minutes PaCO2 was 50 mmHg. We had to increase tidal volume and respiratory rate, although airway pressure was 30 cmH2O. We should be careful because children who undergo pneumoperitoneum become hypercapnic easily during general anesthesia.

Anesthesia, General↗
PubMed1993

Orally active cephalosporins. IV. Synthesis, antibacterial activity and oral absorption of 3-(1H-1,2,3-triazol-4-yl)thiomethylthio-cephalosporins.

The synthesis, antibacterial activity and oral absorption of 3-(1H-1,2,3-triazol-4-yl)thiomethylthio-3-cephem-4-carboxyli c acids with various C-7 side chains (2) are described. The (1H-1,2,3-triazol-4-yl)thiomethylthio C-3 side chain was found to be an effective substituent for good oral absorption of cephalosporins with some C-7 side chains.

Animals↗
PubMed1993

Orally active cephalosporins. II. Synthesis and structure-activity relationships of new 7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-hydroxyiminoacetamido]-cephalospori ns with 1,2,3-triazole in C-3 side chain.

The synthesis, antibacterial activity and oral absorbability of 7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-hydroxyiminoacetamido]-3 -(1H-1,2, 3-triazol-4-yl)thiomethylthio-3-cephem-4-carboxylic acid (1g) and related compounds are described. Their oral absorbability was influenced by the spacer length between C-3 of a cephem nucleus and C-4' of 1,2,3-triazole. The SCH2S structure was also found to contribute to their good oral absorption. The quantitative relationship between the bioavailability and the spacer length of cephalosporins (1a-1n) is discussed.

Absorption↗
PubMed1993

Orally active cephalosporins. III. Synthesis and structure-activity relationships of new 3-heterocyclicthiomethylthio-7 beta-[(Z)- 2-(2-aminothiazol-4-yl)-2-hydroxyiminoacetamido]-3-cephem-4 -carboxylic acids.

3-Heterocyclicthiomethylthio-7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2- hydroxyiminoacetamido]-3-cephem-4-carboxylic acids (2) were synthesized. Their antibacterial activity and oral absorbability were much influenced by the structure of heteroaromatic moiety in the side chain at the 3-position of a cephem nucleus. In this cephalosporin series, 3-thiadiazolylthiomethylthiocephalosporins (2k, 2l and 2m) exhibited potent antibacterial activity against both Gram-positive and Gram-negative bacteria, whereas 3-(2-methyl-1,2,3-triazol-4-yl)thiomethylthiocephalosporin (2b) and 3-(pyridin-2-yl)thiomethylthiocephalosporin (2n) showed better oral absorption in mice than the other cephalosporins prepared. The structure-activity relationships of 2 are presented.

Administration, Oral↗
PubMed1993

[Anesthetic management of a patient with hypertrophic obstructive cardiomyopathy under epidural anesthesia with high dose fentanyl].

Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by asymmetric hypertrophy of the intraventricular septum, causing intermittent obstruction of the left ventricular outflow tract. General principles of management for HOCM include maintenance of adequate preload and afterload, and avoidance of tachycardia and increased myocardial contractility. A 57 year old male for subtotal gastrectomy and gastrojejunostomy received epidural anesthesia with epidural high dose fentanyl (0.5 mg) and 0.5% isoflurane with N2O and oxygen. Blood pressure and heart rate decreased mildly but were stable during the operation and during the recovery period from anesthesia without any complaints of pain. The results suggest that epidural high dose fentanyl anesthesia is a good method for patients with HOCM.

Anesthesia, Epidural↗
PubMed1993

[A case of intrathoracic colon perforation due to adult Bochdalek hernia].

The patient, a 70-year-old man, diagnosed as having left pneumothorax and hydrothorax, was admitted and had a thoracic drain inserted. The evacuation of stool was noted from 3 days after insertion. With the abscess in the left thoracic cavity shown on emergency CT, a diagnosis of perforation of the digestive tract in the left thoracic cavity was made and emergency operation was performed. On the basis of the intraoperative findings, the case was diagnosed as adult Bochdalek hernia with intrathoracic colon perforation, and repair of hernia and colostomy were done by laparotomy and thoracotomy. However, the patient died of DIC and sepsis 5 days after operation. Two cases of adult Bochdalek hernia complicated with spontaneous pneumothorax have hitherto been report. However, there has been no reported case which had adult Bochdalek hernia complicated with pneumothorax considered due to intrathoracic colon perforation as in this case. So this case was considered very rare and worthy of reporting.

Aged↗
PubMed1992

[Orally active cephalosporins. I. Synthesis and structure-activity relationships of 7 beta-[2-(R)-amino-2-phenylacetamido]-3-(1H- 1,2,3-triazol-4-yl)alkylthiomethyl-3-cephem-4-carboxylic acid and related compounds].

The synthesis, antibacterial activity and oral absorbability of 7 beta-[2-(R)-amino-2-phenylacetamido]-3-(1H-1H-1,2,3-triazol- 4-yl)methylthiomethyl-3-cephem-4-carboxylic acid (1a) and related compounds (1b-p and 2) are described. The replacement of 1,2,3-triazole at the C-3 position of 1a with other heteroaromatics such as 1,2,4-triazole, imidazole and so on decreased its oral absorbability in mice (1b-j). The oral absorbability was also influenced by the spacer length between C-3 of cephem nucleus and C-4 of 1,2,3-triazole. The quantitative relationship between the bioavailability and the spacer length of cephalosporins (1a and 1k-p) is discussed. These results suggest that 1,2,3-triazole in the side chain at the C-3 position of cephems plays an important role in good oral absorption through its interaction with the transport system of small intestine.

Animals↗
PubMed1992

Functional and metabolic effects of mexiletine in the rat heart-lung preparation.

The effects of mexiletine on cardiac function and myocardial metabolism were assessed in the isolated rat heart-lung preparation. Mexiletine 1, 2, 4 or 8 micrograms ml-1 was administered 5 min after the start of perfusion. Heart rate decreased in the 2, 4 and 8 micrograms ml-1 groups significantly following the drug administration. The highest dose of mexiletine reduced cardiac output significantly, and this dose was associated with a higher incidence of dysrhythmias than the other groups. Although there was no significant difference in myocardial glycogen concentration among groups, ATP contents in the 4 micrograms ml-1 and 8 micrograms ml-1 groups were significantly less than in the control group. Lactate contents in the 4 micrograms ml-1 and 8 micrograms ml-1 groups were significantly higher than in the control group. Generally, the therapeutic plasma concentration of mexiletine is 0.5-2.0 micrograms ml-1. These results suggest that mexiletine may have a lesser margin of safety than lignocaine.

Adenosine Triphosphate↗
PubMed1991

Protective effects of prostaglandin I2 analogues on CPK release in rat's heart-lung preparation.

The effects of prostaglandin I(2) analogues (PGI(2)-a: op-41483 and op-2507) on oxygen toxicity during hyperoxic perfusion were evaluated in an experiment on isolated rat heart lung preparation, with the release of creatine phosphokinase (CPK) in the perfusate blood. There were no significant differences in heart rate and right atrial pressure between PGI(2)-a treated and untreated hearts. The CPK release from the heart with oxygen was significantly higher than that of the air ( P < 0.001). However, the CPK release from the PGI(2)-a treated hearts was significantly less than that from the untreated hearts ( P < 0.05). These results indicate that PGI(2)-a may prevent cell damage which was induced by hyperoxia.

Journal Article↗
PubMed1991

[The effect of prostaglandin E1 (PGE1) on body temperature and on postoperative shivering under high dose epidural fentanyl].

Ninety-nine elective abdominal surgeries were performed under high dose epidural fentanyl anesthesia. PGE1 (0.02 microgram.kg-1.min-1 = 0.02 gamma) was administered to 34 patients (0.02 gamma group), and PGE1 (0.05 gamma) was administered to 16 patients (0.05 gamma group). PGE1 was not administered to 49 patients (control group). The effect of PGE1 on body temperature and on postoperative shivering was compared within three groups. In the 0.02 gamma group, the temperature of the fingertip was significantly higher and the rectum-fingertip temperature gradient was significantly lower than in the other groups. The forearm-fingertip temperature gradient was lower in the 0.02 gamma and 0.05 gamma groups than in the control group. The incidence of postanesthetic shivering was significantly lower in the 0.05 gamma group than in the other groups. These results suggest that; 1) PGE1 (0.02 gamma and 0.05 gamma groups) affects the peripheral blood flow and peripheral temperature, and 2) PGE1 (0.05 gamma group) significantly affects the incidence of postanesthetic shivering.

Abdomen↗