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Biomedical subjects

M Nishimura

Publications and source records attributed to M Nishimura.

At least 433 records · Page 24Linked to original sources
PubMed1998

[Evaluation of cerebral circulation during cardiopulmonary bypass using near-infrared spectroscopy].

Cerebral oxygenation level during cardiopulmonary bypass (CPB) was measured using near-infrared spectroscopy as a monitor of cerebral circulation in 30 patients. Six adult cases with thoracic aortic aneurysm were operated on using selective cerebral perfusion (SCP). CPB was established under moderate hypothermic temperature in 9 adult cases (hypothermic group, lowest blood temperature during CPB; 25 degrees C) and under normothermic temperature in 9 adult cases (normothermic group, lowest blood temperature during CPB; 34 degrees C). In congenital cases (n = 6), CPB was established under moderate hypothermic temperature (congenital group, lowest blood temperature; 25 degrees C). The oxyhemoglobin (HbO2) level showed a significant positive correlation with cerebral blood flow during SCP (r = 0.715). There was no significant correlation between SjO2 and HbO2 in the SCP group. The HbO2 levels in the hypothermic group after 30 and 60 min, from the initiation of CPB and 30 min. before the weaning of CPB were significant lower than the control level (p < 0.05). HbO2 levels in the congenital group after 0, 30 and 60 min. from the initiation of CPB and 30 min. before the weaning of CPB were significantly lower than the control level (p < 0.01). The deoxyhemoglobin (HbR) level in the hypothermic group after 30 and 60 from the initiation of CPB and 30 min. before the wearing of CPB were significantly higher than the pre level (p < 0.05). The mixed venous saturation (SvO2) in the normothermic group showed significant lower levels than those in the hypothermic group (p < 0.01). However, there was no significant difference in HbO2 levels between the two groups. In conclusion, these results suggest that near-infrared spectroscopy may be a noninvasive and useful technique for the cerebral circulation monitoring during CPB.

Adolescent↗
PubMed1998

Simultaneous operation for minimally invasive direct coronary artery bypass and abdominal aortic aneurysm repair.

Simultaneous minimally invasive direct coronary artery bypass and abdominal aortic aneurysm repair were conducted in a 66-year-old man uneventful, requiring no transfusion. Surgery required 9 hours and 2 minutes. The tracheal tube was extubated in the operating room. Postoperative bleeding was 215 ml. The postoperative course was very smooth, with the patient able to walk on postoperative day 1. Postoperative coronary arteriogram and aortogram showed favorable results and the patient was discharged on day 23 after surgery.

Aged↗
PubMed1998

Increase in natural killer cell activity following living-related liver transplantation.

We monitored the serial changes of natural killer cell (NK) activity in eight recipients of living-related liver transplantation. The HLA types of all eight patients were haplotypically identical with those of their donors. Tacrolimus and methylprednisolone were used for immunosuppression. The NK activity before transplantation was 24.1 +/- 20.2% which is surprisingly low when compared with the value for normal individuals (67.7 +/- 13.2%, P < 0.01) or a liver dysfunction group (49.4 +/- 21.9%, P < 0.05). Serial changes in NK activity revealed a minimum of 6.1 +/- 3.6% 1 week after transplantation, gradually increasing to 49.2 +/- 12.5% at 2 months after transplantation. These results suggest that the diseased liver might play an important role in the suppression of NK activity.

Adolescent↗
PubMed1998

Genetic profile of the SMXA recombinant inbred mouse strains revealed with restriction landmark genomic scanning.

We have applied the restriction landmark genomic scanning (RLGS) method to the SMXA recombinant inbred (RI) mouse strain set to reveal its detailed genetic profile. A total of 663 polymorphic RLGS spot loci were identified, 576 of which were assigned to chromosomes. Strain distribution patterns (SDPs) at 55 microsatellite marker loci were also obtained. As a result, the total number of loci with distinct SDPs on chromosomes increased to 400. These loci were dispersed on all chromosomes, except for the Chromosome (Chr) Y, and effectively covered the genome with an average spacing of 4 cM. The SMXA RI strain set, hereby, would be of value for genetic study.

Animals↗
PubMed1998

Developmental study on reduction and kinks of the tail in a new mutant knotty-tail mouse.

The knotty-tail (knt/knt) mouse has a short and knotty tail. The tail deformity is caused by a decrease in the number of caudal vertebrae and a deformity of them in the distal part of the tail. The objective of the study was to determine how reduction and kinks of the tail region were formed during secondary body formation. By day 12.0 pc, the somitogenesis of knt/knt embryos was completed; the number of caudal somites more or less agreed with those of the caudal vertebrae in knt/knt mice and were similar to those of knt/+ embryos. On the other hand, the somitogenesis of knt/+ embryos continued up to day 12.5 pc. The somites below about the sixth caudal somite were wedge-shaped with a dorsal apex in knt/knt embryos. The location of abnormal somites also corresponded well to that of deformed caudal vertebrae. Abnormal somitogenesis was always preceded by abnormalities in the presomitic region. Under gross observation, this could be seen to become markedly thickened, and histologically its dorsoventral diameter increased in the transverse plane on days 10.5-12.0 pc. In the mesenchyme there was often obvious cell death at the boundary of the unsegmented area and the tail bud after day 10.5 pc. These results suggested that the shortness of tail was primarily caused by the agenesis of distal caudal vertebrae following the agenesis of distal caudal somites, and partly by the disappearance of the presomitic part due to cell death, while the tail kinks were caused by the deformation of each caudal vertebra following disturbances of the caudal somites. Also, it is highly probable that the prominent cell death at the boundary of the unsegmented area and the tail bud may involve a defect or deformity of somites in this mutant.

Animals↗
PubMed1998

Isolated mediastinal Hodgkin's disease mimicking thymoma: report of a case.

Mediastinal Hodgkin's disease has rarely been reported in the literature in Japan; however, it is not uncommon in Europe and North America. A 32-year-old woman with isolated mediastinal Hodgkin's disease mimicking thymoma is herein described. A preoperative diagnosis of thymoma led to a combined resection of the mediastinal tumor together with the entire thymus, left innominate vein, and left phrenic nerve. The resected tumor was histologically diagnosed to be Hodgkin's disease of the nodular sclerosis type. Adjuvant 40 Gy irradiation of the mediastinum and neck was added postoperatively. The patient is doing well at present with no signs of recurrence 8 months after the operation.

Adult↗
PubMed1998

Human mesotheliomas contain the simian virus-40 regulatory region and large tumor antigen DNA sequences.

BACKGROUND: A cohort (20%) of patients with mesothelioma will not have an exposure to asbestos. Recently, a DNA tumor virus (simian virus 40) has been shown to cause hamster mesotheliomas; we previously described simian virus 40-like DNA amino terminus sequences in 29 of 48 mesotheliomas. We analyzed an additional 42 mesotheliomas to determine (1) whether our initial observations were durable and (2) the extent to which the simian virus 40 genome is present in mesotheliomas. METHODS: Genomic DNA was extracted from snap frozen mesothelioma tumor samples and from the simian virus 40-induced hamster mesothelioma tumor H9A. Polymerase chain reaction primers were used to amplify various simian virus 40 large T-antigen regions including a 105-base pair amino terminus fragment, a 281-base pair carboxyl terminus fragment, and a 310-base pair fragment of the enhancer promoter region. Endonuclease digestions and Southern blotting were used to verify the expected product. RESULTS: Thirty of the 42 (71%) samples amplified T-antigen amino sequences, and specificity was verified by Southern hybridization. Sixteen of 42 samples (38%) amplified the appropriate size fragment for the carboxyl terminus, and digestion with BsaB1 matched that of H9A. Twenty-two of 42 samples (52%) amplified simian virus 40 regulatory sequences and Fok1 digestion matched that of the hamster control tumor. Sequence analysis (4 patients) revealed 100% homology with the regulatory region of simian virus 40 strain 776. CONCLUSIONS: These data suggest an association between the simian virus 40 virus and human mesothelioma that could be exploited for diagnostic/therapeutic options including early detection and potential vaccination strategies.

Animals↗
PubMed1998

Antibodies to gangliosides and galactocerebroside in patients with Guillain-Barré syndrome with preceding Campylobacter jejuni and other identified infections.

The relationship between preceding infections and antibodies to glycolipids was investigated in 205 Japanese patients with Guillain-Barré syndrome (GBS). Serological evidence of recent Campylobacter jejuni (C. jejuni) infection was found in 45% of the patients, compared with 1% in healthy controls. In contrast, recent infection of cytomegalovirus (CMV), Mycoplasma pneumoniae (M. pneumoniae) and Epstein-Barr virus (EBV) was detected in only 5%, 2% and none of the patients, respectively. C. jejuni-associated GBS was more frequent in early spring than in other seasons. All stool specimens positive for C. jejuni isolation were obtained within 10 days after the onset of GBS symptoms. Of 13 C. jejuni isolates from GBS patients, 10 (77%) belonged to Penner serotype 19 (heat-stable, HS-19). Elevated titers of anti-GM1 antibody were found in 8 (80%) of 10 GBS patients whose C. jejuni isolates belonged to HS-19 and in none of those infected with non-HS-19 C. jejuni (P = 0.04), and in 49% of 92 patients with C. jejuni infection and 25% of patients without infection of C. jejuni, CMV, EBV, or M. pneumoniae (P = 0.0007). The frequencies of elevated antibody titers to GD1a, GD1b and GQ1b were also significantly higher in GBS patients associated with C. jejuni than those not associated with C. jejuni, CMV, EBV, and M. pneumoniae. GBS in Japan seems to be associated more frequently with C. jejuni and less frequently with CMV than in Europe and North America.

Adolescent↗
PubMed1998

Synchronous double primary lung carcinomas associated with multiple atypical adenomatous hyperplasia.

A 71-year-old woman with synchronous bilateral primary lung carcinomas accompanied by multiple atypical adenomatous hyperplasias is described. The patient was found to have bilateral tumors during preoperative workup for the previously detected well differentiated adenocarcinoma of the right lung. Thoracoscopic wedge resection of the left upper lobe was performed to obtain a definitive diagnosis of the left lesion. Although intraoperative diagnosis was made by frozen section as atypical papillary lesion, postoperative diagnosis of this lesion was changed to well differentiated adenocarcinoma accompanied by surrounding atypical adenomatous hyperplasia (AAH). We diagnosed that the bilateral lesions were synchronous primary well differentiated adenocarcinomas independent to each other based on the criteria of Martini and Melamed and performed right upper and mediastinal lymph node dissection. The resected lobe contained not only the primary adenocarcinoma but also multiple small gray nodules which were diagnosed as AAHs. In summary, it was diagnosed that the patient had synchronous double primary lung adenocarcinomas of T1 N0 M0 pathological stage and 12 solitary atypical adenomatous hyperplasias. The patient is doing well with no signs of recurrence 24 months after the operation. This case might be an example of the adenoma-carcinoma sequence of lung cancer. A careful follow-up study is mandatory for this patient with special regard to the further development of lung carcinoma in the future.

Adenocarcinoma↗
PubMed1998

Enhanced production of nitric oxide may be involved in acute hypotension during maintenance hemodialysis.

To investigate the possible involvement of endogenous nitric oxide (NO) in acute hypotension during maintenance hemodialysis, we measured the plasma concentration of the nitrate anion NO3-, a stable metabolite of NO, in 19 patients undergoing hemodialysis. We analyzed heart rate variability to estimate the relationship between autonomic nervous activity and NO production, low-frequency/high-frequency components (L/H) as a parameter of cardiac sympathetic activity, and high-frequency power as a parameter of cardiac vagal activity. Six patients developed severe hypotension (a change in mean blood pressure during dialysis > or = 20 mm Hg), four patients developed mild hypotension (a change in mean blood pressure < or = 19 mm Hg and > or = 1 mm Hg), and nine patients did not develop hypotension. The plasma levels of NO3- before dialysis were markedly elevated in the severely hypotensive group compared with the patients who showed no hypotension (566+/-122 micromol/L v 133+/-38 micromol/L; P < 0.01), and this difference disappeared midhemodialysis and after hemodialysis. The plasma concentration of NO3- before dialysis was significantly associated with both the change in mean blood pressure during dialysis (r= -0.735; P = 0.003) and the mean blood pressure after dialysis (r = -0.675; P = 0.0015). The L/H ratio was inhibited before or after dialysis in the severely hypotensive group compared with the nonhypotensive group, and hypotension during dialysis was correlated with the inhibited L/H ratio before (r = 0.784; P = 0.001) or after (r = 0.822; P = 0.001) dialysis. Plasma NO3- concentrations were correlated with the L/H ratio before (r = -0.553; P = .014) or after (r = -0.546; P = 0.015) dialysis. These results suggest that inhibited sympathetic activity is one of the causes of acute hypotension during dialysis, and the enhanced production of NO is involved in this inhibition of the sympathetic activity in patients having a hypotensive episode during dialysis. The plasma concentration of NO3- before dialysis may be a predictor of the risk of hypotension during dialysis in patients with end-stage renal disease.

Acute Disease↗
PubMed1998

Inappropriate microvascular constriction produced transient ST-segment elevation in patients with syndrome X.

OBJECTIVES: The aim of this project was to study the responsible site(s) and underlying cardiac disease(s) of patients with transient ST-segment elevation and normal coronary angiograms. BACKGROUND: Transient ST-segment elevation has been demonstrated in patients with variant angina or unstable angina. In those patients, epicardial coronary arteries, not microvessels, are always the responsible site for the transient ST-segment elevation. METHODS: This study consisted of three cases with a transient ST-segment elevation and normal coronary angiograms. Treadmill testings were performed before coronary angiography in all cases. Coronary angiography was undertaken during the control state and during ST-segment elevation and, when possible, a Doppler guide wire was positioned in the left anterior descending artery (LAD). Coronary responses to vasodilators were observed. Finally, cardiac biopsy was performed and pathologic observation was conducted. RESULTS: All three cases had significant ST-segment depression during treadmill testing in II, III, aVF and V4-6 leads; however, no angiographic coronary stenosis was demonstrated and vasospasm was not provoked. A transient ST-segment elevation associated with chest pain was observed in V1-5 leads, but normal coronary angiograms during ST-segment elevation were observed in every case. Coronary blood flow (CBF) velocity profile remained normal during ST-segment elevation. In one case, vasodilator responses to the LAD during ST-segment elevation were also measured. A 0.5 mg intracoronary injection of nitroglycerin increased CBF velocity (220%), but ST-segment elevation was not normalized and chest pain persisted. A 10 mg intracoronary injection of papaverine (PVN) further increased CBF velocity up to 340%, and this normalized ST-segment elevation and relieved chest pain quickly. Either endothelium-dependent coronary flow reserve (CFR) measured with a 100 microg intracoronary infusion of acetylcholine, or flow-dependent CFR by a 10 mg intracoronary injection of PVN was reduced in one of two cases measured. Pathologic findings supported syndrome X as the underlying cardiac disease in all cases. CONCLUSIONS: These findings suggested a new clinical implication involving transient ST-segment elevation mimicking variant angina and normal coronary angiograms in patients with syndrome X. The major responsible site for this phenomenon was suggested to be coronary arterioles of less than 200 microm in diameter.

Acetylcholine↗
PubMed1998

Persephin, a novel neurotrophic factor related to GDNF and neurturin.

A novel neurotrophic factor named Persephin that is approximately 40% identical to glial cell line-derived neurotrophic factor (GDNF) and neurturin (NTN) has been identified using degenerate PCR. Persephin, like GDNF and NTN, promotes the survival of ventral midbrain dopaminergic neurons in culture and prevents their degeneration after 6-hydroxydopamine treatment in vivo. Persephin also supports the survival of motor neurons in culture and in vivo after sciatic nerve axotomy and, like GDNF, promotes ureteric bud branching. However, in contrast to GDNF and NTN, persephin does not support any of the peripheral neurons that were examined. Fibroblasts transfected with Ret and one of the coreceptors GFRalpha-1 or GFRalpha-2 do not respond to persephin, suggesting that persephin utilizes additional, or different, receptor components than GDNF and NTN.

Animals↗
PubMed1998

Granulocyte colony-stimulating factor (G-CSF) dependent hematopoiesis with monosomy 7 in a patient with severe aplastic anemia after ATG/CsA/G-CSF combined therapy.

We report a case of secondary myelodysplastic syndrome (MDS) with monosomy 7, which evolved from severe aplastic anemia (SAA) after long-term use of granulocyte colony-stimulating factor (G-CSF). A 36 year old female was admitted for detailed examination and treatment of pancytopenia. SAA was diagnosed based on hypoplastic bone marrow and a normal chromosome study. She was treated with anti-thymocyte globulin (ATG), ciclosporin A (CsA) and G-CSF, which resulted in gradual improvement of not only the myeloid but also the erythroid-megakaryocyte series. However, bone marrow dysplasia with monosomy 7 was observed after 7 months of a combination therapy of immunosuppressant and G-CSF, which prompted the discontinuation of G-CSF administration. Thereafter, bone marrow hypoplasia gradually progressed, resulting in a second aplastic crisis. During this process, the proportion of marrow cells showing monosomy 7 decreased, and the proportion with normal karyotype increased. Re-administration of G-CSF induced a trilineage, though dysplastic, hematological response; but the monosomy 7 positive population increased again. These observations indicated the presence of G-CSF dependent hematopoiesis associated with monosomy 7 in this patient. Although many G-CSF related MDS/AML cases with this leukemia-specific abnormal karyotype have been reported with emphasis on the harmful effects of G-CSF, G-CSF was useful even after the appearance of monosomy 7 as a means of avoiding life-threatening infection in this patient.

Adult↗
PubMed1998

Effect of intermittent feeding on the development of disaccharidase activities in artificially reared rat pups.

We investigated the effect of an intermittent feeding schedule on the development of disaccharidase activities in the small intestine of artificially reared (AR) rat pups. Rat pups were fitted with an intragastric cannula at 5 days of age. A milk formula similar to the composition of rat milk was supplied by intermittent gastric infusion over the following 15-19 days. The body weight gain and plasma corticosterone levels of the AR pups matched those of pups reared naturally by dams (MR pups). At 10, 15 and 19 days of age, the small intestine from the ligament to Treitz to the ileocecal junction was divided into three segments of equal length and enzyme activities were measured in each. At the age of 10 and 15 days, sucrase and isomaltase activities were undetectable in AR pups fed according to a controlled schedule from the early postnatal period. These activities were first detected in the middle segment of the small intestine at 9 days of age in both AR and MR pups. Sucrase and isomaltase activities at the age of 19 days were diurnal in AR pups, but arrhythmic in MR pups. We conclude that artificial rearing via the intermittent gastric infusion of a milk formula containing only lactose as the carbohydrate source did not prematurely increase intestinal sucrase and isomaltase activities. Diurnal changes started from the beginning of development of these enzyme activities in AR pups.

Animals↗
PubMed1998

Functional residual capacity measurement during tracheal gas insufflation.

OBJECTIVE: Tracheal gas insufflation (TGI) is considered an adjunctive method to enhance carbon dioxide elimination during permissive hypercapnia in patients with acute respiratory distress syndrome. Due to increasing tidal volume and/or expiratory resistance, TGI may cause intrinsic PEEP (PEEPi), and may lessen the advantages of permissive hypercapnia. There is no reliable method to measure PEEPi during TGI. Using an argon washout method to evaluate dynamic hyperinflation, we developed a method to measure FRC with TGI flow. METHODS: We measured FRC during TGI by washing out both the ventilator and TGI circuit with 100% oxygen (O2) previously equilibrated with 10% argon and 90% O2. To test the accuracy of our system, we measured the volume in a model lung composed of two flasks. The FRC of the model lung was changed by varying its volume of water, to active 500, 1000, and 1500 mL. The change of FRC (deltaFRC) of the model lung was measured at a flow of 0, 4, 8, and 12 L/min. Then the FRC of a bellows-type model lung was measured at the same TGI flow. PEEPi of the model lung was also recorded as the pressure inside the bellows at end-expiration. RESULTS: Our FRC measurements were accurate within 10% except for that of 500 mL without TGI (12.7%+/-1.1%). As inspiratory time (TI) and/or TGI flow increased, the FRC of the bellows-type model lung increased. PEEPi and deltaFRC showed a positive correlation (r = 0.843, p < 0.001). The higher the TGI flow, the greater was the deltaFRC with both continuous and expiratory-phase TGI. FRC during continuous TGI was higher than during expiratory-phase TGI especially during long TI and high TGI flow. CONCLUSIONS: The system developed in this study can be used as a method to detect air-trapping during TGI.

Functional Residual Capacity↗