Biomedical subjects

N Hayashida

Publications and source records attributed to N Hayashida.

At least 55 records · Page 3Linked to original sources

PubMed1999

Recovery from lymphocytopenia following extracorporeal circulation: simple indicator to assess surgical stress.

This study investigated whether the lymphocyte count is a useful indicator to assess surgical damage following extracorporeal bypass. In Study 1, to investigate the correlation between extracorporeal circulating time (ECCT) and lymphocyte counts, 40 elective CABG patients were studied retrospectively. The lymphocyte recovery ratio (LRR), which represented the actual lymphocyte count divided by the preoperative lymphocyte count, was determined preoperatively, and on postoperative day (POD) 1, POD 3, and POD 5. In Study 2, the correlation between the interleukin-8 (IL-8) level and LRR was examined prospectively in elective CABG patients (n = 20). We measured the LRR and serum IL-8 levels preoperatively and during extracorporeal circulation (ECC) at 5 min, at the end of ECC, and 1, 3, and 12 h following ECC termination. Study 1 showed that the LRR decreased until POD 1 and gradually increased thereafter. The LRR had a negative correlation with the ECCT. In Study 2, the IL-8 level demonstrated a time course opposite to that of the LRR; it increased until 3 h after ECC termination and declined thereafter. There was a significant negative correlation between the LRR on POD 3 and the IL-8 level at 3 h after ECC termination. In summary, long-term ECC induced significant and prolonged lymphocytopenia. The LRR had a negative correlation with IL-8. These results indicated that the LRR may represent the degree of surgical stress following ECC; therefore, the counting of lymphocytes can be a quite useful bedside monitor to assess surgical damage and prognosis.

Coronary Artery Bypass↗

PubMed1999

Expression of DnaJ homologs and Hsp70 in the Japanese willow (Salix gilgiana Seemen).

We isolated three cDNA clones (pSGJ1, pSGJ2 and pSGJ3) for DnaJ-like proteins of the Japanese willow (Salix gilgiana Seemen). The insert in pSGJ2 included the entire nucleotide sequence of the insert in pSGJ1 that was separated into four parts by three intron-like sequences, and it might correspond to the cDNA for a precursor to the SGJ1 mRNA. The predicted amino acid sequences of SGJ1 (47.5 kDa) and SGJ3 (46.6 kDa) exhibited about 70 to 91% homology to plant cytoplasmic DnaJ-like proteins. SGJ1 was encoded by one or a few genes within the willow genome while SGJ3 was encoded by several genes. Expression of the SGJ1 and SGJ3 genes was compared with that of Hsp70 (SGK1) gene. Constitutive expression of SGJ1, SGJ3 and SGK1 was detected in all organs examined. The SGJ1 mRNA was most abundant in male catkins (inflorescences). High-level expression of SGJ3 and SGK1 was detected in catkins and roots of both male and female plants. The level of the SGJ3 mRNA in the leaves increased about 10-fold after 1 h of heat stress while the expression of SGJ1 mRNA reached a maximum level after 6 h. However, the extent of induction of SGJ1 mRNA was quite low. The levels of SGJ1 and SGJ3 mRNAs in the leaves increased about 6-fold and 2-fold, respectively, after 24 h of treatment with 100 mM NaCl. Thus, the SGJ1 and SGJ3 genes showed differential expression patterns in a variety of organs and in response to different environmental conditions.

Amino Acid Sequence↗

PubMed1999

Surgical treatment of a coronary artery fistula with concomitant saccular coronary artery aneurysm: a case report.

An extremely rare case of a coronary artery fistula with a concomitant saccular aneurysm is presented. A 65-year-old woman, who had a history of chest bruising 5 years earlier, suffered from chest pain, which was diagnosed as being due to left coronary artery-pulmonary artery fistulae concomitant with a giant saccular coronary artery aneurysm. Suture closure of the afferent coronary artery to the aneurysm, aneurysmorrhaphy, and transpulmonary closure of coronary artery-pulmonary artery fistulae were performed. The postoperative course was uneventful and the patient was well at 3 months after the operation. Because the risk of surgery appears to be less than the potential development of fatal complications, it is recommended for the treatment of coronary artery fistula with a concomitant saccular aneurysm.

Aged↗

PubMed1999

Aortic valve replacement for aortic regurgitation caused by aortitis.

Between January 1984 and December 1998, 19 patients (16 with Takayasu's arteritis, 3 with non-Takayasu's aortitis) underwent surgical treatment for aortic regurgitation resulting from the aortitis. Of the 19 patients, 14 had aortic valve replacement (AVR) and 5 had aortic root replacement. One patient (5.3%) died of graft infection during the hospital stay. During the follow-up period, 1 (5.6%) of the 18 postoperative patients died of paravalvular leakage due to valve detachment, which also required redo-operations in 2 patients with non-Takayasu's aortitis. Both patients were operated on during the active phase of the inflammation without perioperative steroid therapy. Although transmural pledgeted sutures were used for replacement of the detached prosthetic valve in 1 of these 2 patients, disruption of the aortic wall resulted in recurrence of valve detachment. In the other patient, aortic root replacement was successfully performed with the Cabrol technique in the second operation. Perioperaitve steroid therapy plays an important role in preventing complications after AVR when the valve replacement is carried out during the active phase of the inflammation, and for patients with non-Takayasu's aortitis, aortic root replacement should be considered to reduce the tension on the suture line and the native aortic valve annulus.

Adult↗

PubMed1999

Effects of four antigenic fractions of Pasteurella multocida serotype A on phagocytosis of chicken peripheral blood leukocytes.

The effects of four antigenic fractions of Pasteurella multocida serotype A isolated from a duck in the Philippines on the phagocytic activity of chicken peripheral blood leukocytes were studied by a flow cytometer. These fractions were the lipopolysaccharide-protein complex (LPS), crude capsular antigen (CCA), ribosomal fraction (RS) and outer cell layer (OCL). Among these four antigens, only CCA but not LPS RS and OCL, significantly increased the phagocytic activities of mononuclear cells (MNC) and polymorphonuclear cells (PMN). This result indicates that CCA has an immunological property enhancing the phagocytic activities of MNC and PMN.

Animals↗

PubMed1999

Effects of the lipopolysaccharide-protein complex and crude capsular antigens of Pasteurella multocida serotype A on antibody responses and delayed type hypersensitivity responses in the chicken.

The effects of the lipopolysaccharide-protein complex (LPS) and crude capsular antigen (CCA) prepared from Pasteurella multocida serotype A isolated from a duck in the Philippines, on antibody responses to sheep red blood cells (SRBC) and Brucella abortus (BA) and delayed type hypersensitivity (DTH) responses to bovine serum albumin (BSA) in the chickens were studied. Chickens injected subcutaneously with LPS and CCA at 1 and 2 weeks of age and immunized intravenously with the mixed antigens of SRBC and BA, at 3 and 4 weeks of age showed significantly increased antibody responses against both SRBC and BA, when evaluated at 7 days after each immunization. In addition, these chickens sensitized intramuscularly with the emulsion of BSA in complete Freund's adjuvant at 5 weeks of age, and then injected into the wattle with BSA at 7 weeks of age also showed significantly increased DTH responses against BSA, when evaluated at 24 and 48 hr after challenge. These results indicate that LPS and CCA of P. multocida serotype A have a property enhancing humoral and cell-mediated immune responses.

Animals↗

PubMed1999

Constrictive pericarditis following hemopericardium due to ascending aortic dissection: A case report.

A 79-year-old woman, who had had no history of trauma, tuberculosis, or collagen diseases, was referred for examination of general fatigue and shortness of breath on exertion. Physical examination revealed engorged neck veins, hepatomegaly, and ascites with abdominal distention. On chest x-ray the cardiac shadow was slightly enlarged and bilateral pleural effusion was present. An electrocardiogram showed low voltage of the QRS complex. Computed tomographic scans revealed two lumens in the remarkably dilated ascending aorta and the severely thickened pericardium. Cardiac catheterization showed elevated right atrial pressure and elevated right and left ventricular end-diastolic pressures, in addition to a pressure record of early diastolic dip and end-systolic plateau in the right ventricle. Aortography demonstrated aortic dissection localized to the ascending aorta. On the basis of these findings, the diagnosis of chronic ascending aortic dissection complicated with constrictive pericarditis was made. After subtotal pericardiectomy, graft replacement of the ascending aorta and proximal aortic arch was performed with successful results. Her postoperative recovery was uneventful. Histological studies of the pericardium showed fibrosis and marked infiltration of the inflammatory cells. No findings of specific pericarditis such as tuberculosis or collagen diseases were detected.

Aged↗

PubMed1999

[Influence of milrinone on internal mammary artery grafts].

To evaluate the effects of milrinone on blood flow in the left internal mammary artery (LIMA) grafts and hemodynamic variables, we conducted a prospective randomized study. Twenty-four patients undergoing coronary artery bypass grafting were randomized to receive milrinone treatment (Milrinone; n = 12) or no milrinone treatment (Control; n = 12). Milrinone was given after induction of anesthesia at a speed of 0.5 microgram/kg/min for 24 hours. After start of cardiopulmonary bypass (CPB), CPB perfusion flow was adjusted to 2.4 l/m2 and LIMA blood flow was measured. Blood samples for determination of plasma cAMP levels were collected and hemodynamic measurements were also assessed perioperatively. LIMA blood flow was significantly greater in Milrinone than that in Control (40 +/- 4 vs 29 +/- 4 ml/min/m2, p < 0.05). Plasma levels of cAMP were significantly (p < 0.05) greater in Milrinone than those in Control at tha start of CPB (18 +/- 1 vs 13 +/- 1 pmol/ml) and at the end of CPB (24 +/- 2 vs 17 +/- 2 pmol/ml). Systemic vascular resistance was significantly (p < 0.05) lower and cardiac index was significantly (p < 0.05) greater in Milrinone than those in Control postoperatively. With its positive inotropic and systemic vasodilator activities, milrinone may have direct vasodilator effect on LIMA.

Aged↗

PubMed1998

Molecular cloning and characterization of three cDNAs encoding putative mitogen-activated protein kinase kinases (MAPKKs) in Arabidopsis thaliana.

We isolated three Arabidopsis thaliana cDNA clones (ATMKK3, ATMKK4 and ATMKK5) encoding protein kinases with extensive homology to the mitogen-activated protein kinase kinases (MAPKKs) of various organisms in the catalytic domain. ATMKK3 shows high homology (85% identity) to NPK2, a tobacco MAPKK homologue. ATMKK4 and 5 are closely related to each other (84% identity). Phylogenetic analysis showed that the plant MAPKKs constitute at least three subgroups. The recombinant ATMKK3 and ATMKK4 were expressed as a fusion protein with glutathione S-transferase (GST) in Escherichia coli. Affinity purified GST-ATMKK3 and GST-ATMKK4 proteins contained phosphorylation activity, which shows that both the ATMKK3 and ATMKK4 genes encode functional protein kinases. Northern blot analysis revealed that the ATMKK3 gene expressed in all the organs. The levels of ATMKK4 and 5 mRNAs were relatively higher in steins and leaves than in flowers and roots. We determined the map positions of the ATMKK3, 4 and 5 genes on Arabidopsis chromosomes by RFLP mapping using P1 genomic clones.

Amino Acid Sequence↗

PubMed1998

Establishment of framework P1 clones for map-based cloning and genome sequencing: direct RFLP mapping of large clones.

Large insert capacity, clone stability and convenient propagation in Escherichia coli have made bacterial artificial chromosome and phage P1 vector-based libraries the first choice for large-scale sequencing projects, and these libraries have also proven useful for chromosome walking. The application of these libraries for either purpose is greatly facilitated by the establishment of a set of framework clones distributed across the genome. Using a P1-based library of Arabidopsis thaliana with genomic inserts of 70-90kb (Liu, Y.-G., Mitsukawa, N., Vazquez-Tello, A., Whittier, R.F., 1995. Generation of a high-quality P1 library of Arabidopsis suitable for chromosome walking. Plant J. 7, 351-358), we have now established such a set of framework clones. To date, such clones have usually been identified by hybridization to smaller, previously mapped clones that detect restriction fragment length polymorphisms (RFLPs). In order to establish framework clones more efficiently, we refined protocols for P1 clone DNA isolation and RFLP detection in order to employ whole P1 clones directly as probes. This strategy enabled a very high rate of RFLP detection, and obviated the need to screen the P1 library with smaller RFLP probes. Altogether 95 clones were mapped providing a framework into which further clones can be integrated by physical overlap.

Arabidopsis↗

PubMed1998

Minimally diluted tepid blood cardioplegia.

BACKGROUND: To evaluate the effects of minimally diluted tepid blood cardioplegia, a prospective, randomized study was undertaken. METHODS: Thirty-seven patients undergoing isolated primary coronary artery bypass grafting were randomized to receive standard 4:1 diluted tepid blood cardioplegia (4:1 group, n = 18) or minimally diluted tepid blood cardioplegia (Mini group, n = 19). Cardioplegic solution was delivered in an intermittent antegrade fashion in both groups. Myocardial oxygen and lactate metabolism, release of the MB isoenzyme of creatine kinase and thiobarbituric acid reactive substances, and cardiac function were measured during and after the operation. RESULTS: Myocardial oxygen consumption was significantly greater and lactate release was significantly lower in the Mini group than in the 4:1 group during cardioplegia. Minimally diluted blood cardioplegia resulted in more prompt resumption of lactate extraction, lower levels of release of the myocardial-specific isoenzyme of creatine kinase and thiobarbituric acid reactive substances during reperfusion, and better postoperative left ventricular function compared with the standard 4:1 cardioplegia. CONCLUSIONS: Minimally diluted tepid blood cardioplegia may provide superior myocardial protection than the standard 4:1 dilution technique by optimizing the aerobic environment through an increase in oxygen supply during intermittent cardioplegia.

Adult↗

PubMed1998

Effect of skeletonizing dissection on the internal thoracic artery.

BACKGROUND: Skeletonization of the internal thoracic artery (ITA) produces greater length for coronary bypass grafting. We studied the effect of skeletonization on the morphology, histology, and tissue viability of the ITA wall. METHODS: Six mongrel dogs underwent unilateral ITA dissection; the contralateral ITA was the control. Study periods were 3 weeks (n=3) and 12 weeks (n=3). At sacrifice, the entire anterior chest wall was removed and dynamically fixed with formalin. Extensive histologic comparisons were performed on three tissue blocks taken from each ITA, 2, 8, and 24 cm from their origin. RESULTS: Flows at the end of the study were comparable to measurements taken during operation, immediately after skeletonization. Grossly, the ITA wall was not injured by skeletonization and there was no adventitial hematoma or bleeding from the sealed branch ends. Microscopic observations showed intact, normal wall structures. Histologic data showed no major significant difference between controls and skeletonized ITAs. CONCLUSIONS: Careful skeletonizing dissection is not detrimental to the integrity of ITAs, which justifies their use for myocardial revascularization.

Animals↗

PubMed1998

[Minimally invasive direct coronary artery bypass for ischemic heart disease associated with preoperative severe complications].

Our experiences of minimally invasive direct coronary artery bypass (MIDCAB) were reported with review of literatures. Patient #1 was a 69 years-old man with left main lesion associated with cerebral infarction and impaired renal function. Preoperative CT examination showed calcified ascending aorta. There was no significant lesions in the large right coronary artery and the circumflex was small. The patient underwent MIDCAB via minithoracotomy on the fourth intercostal space with left internal thoracic artery (ITA) to left anterior descending artery (LAD). The patient was weaned from ventilator 3 hours after the operation and his postoperative course was uneventful. Patient #2 was a 80 years-old man with acute myocardial infarction requiring intraaortic balloon pumping (IABP) due to significant stenosis in the right coronary artery and left main lesion associated with chronic hemodialysis due to renal failure. The right coronary artery was dilated by balloon angioplasty at the time of emergency coronary angiogram. However, the emergent operation was required because of the left main lesion. The circumflex was relatively small and because of severe complication, MIDCAB was selected to improve his condition. He underwent MIDCAB via minithoracotomy. The heart was enlarged because of congestive heart failure and left inferior epigastric artery was used to extend the length of the left ITA. The composite graft of ITA and IEA was anastomosed to the LAD under beating heart. The IABP was removed 8 hours after the operation and his postoperative course was uneventful. The MIDCAB for coronary artery bypass was first reported by Benetti et al in 1995 and the procedure seemed to be very effective for preventing postoperative complications in selected patients as seen in ours.

Aged↗

PubMed1998

Bilateral thoracotomy for coronary artery bypass grafting in a patient with unfavorable median sternotomy.

In this report, we describe a patient who underwent coronary artery bypass grafting (CABG) through bilateral thoracotomy and distal median sternotomy, because he had received terminal tracheotomy as a treatment to prevent aspiration pneumonia due to Wallenberg's syndrome. On the first day after the terminal tracheotomy, he suddenly complained of severe anterior chest pain. Emergency coronary angiogram revealed complete occlusion of the proximal right coronary artery (RCA), severe stenosis of the left anterior descending artery (LAD) and the large first diagonal branch. Catheter intervention for RCA was attempted but it was unsuccessful, and therefore he was required to have urgent operation. The patient had received total laryngectomy and terminal tracheotomy two weeks before urgent CABG, and the large hole of the tracheotomy was just placed above the incisura juglaris of the sternum. So high risks of sternal infection and severe mediastinitis after ordinary median sternotomy were considered and we applied the bilateral thoracotomy approach. To our knowledge, this is very rare but effective approach to vascularize both right and left coronary artery and to use both left internal thoracic artery (LITA) and gastroepiploic artery (GEA) graft. It seemed that this approach is safe and effective for cardiac surgery in such situations that median sternotomy is not favorable as in the described patient or in patients having reoperation.

Coronary Angiography↗

PubMed1997

Coronary artery revascularization concomitant with vascular surgery.

Patients with vascular disease and coronary disease are usually treated initially by coronary artery bypass grafting (CABG), and vascular surgery is generally performed later. In this study we assessed the feasibility of combined CABG and vascular surgery in a single operation. Between 1988 and 1995, 16 patients received combined operations for vascular and cardiac lesions and the clinical results were assessed. There were no operative or hospital deaths. The mean time for operation was 421 min and the duration of the stay in the intensive care unit (ICU) was a mean of 3.6 days. In one patient with an ischemic left leg, the left internal thoracic artery (ITA) had become a collateral source of the ischemic leg, and the need for preoperative angiography of the ITA in such patients was indicated. The combined operation clearly takes longer than either vascular surgery or CABG alone, but the length of the postoperative intensive care unit stay was essentially the same as that after a single operation and the patient was still managed safely after the combined operation. In patient requiring both operations, the combined procedure therefore appears to be safe and to have a good clinical outcome.

Aged↗

PubMed1997

Accelerated endothelialization model for the study of Dacron graft healing.

Accelerated endothelialization was studied by creating a vascular tissue environment around porous Dacron grafts. Three study groups, each containing 10 dogs, were divided equally into 2- and 4-week implant periods, with 8 mm x 6 cm knitted Dacron grafts implanted in the abdominal aorta. Grafts in group 1, the control group, were implanted conventionally. In group 2 each implanted graft was completely wrapped in a resected segment of the autogenous inferior vena cava, with its intima against the wall. In group 3 the adventitial side of the vein was wrapped against the wall. The vein wrap produced accelerated endothelialization as follows: endothelial-like cell coverage scores at 2 and 4 weeks were, respectively, 78% and 98% for group 2 and 80% and 95% for group 3, compared to only 14% and 50% for group 1 (p < 0.05). The neointima, which contained smooth muscle cells, was formed as early as 2 weeks in the vein-wrapped grafts. There were no differences in the speed of healing or in healing patterns according to whether the intimal or the adventitial side of the inferior vena cava was placed against the graft. Histologic findings did not support the hypothesis that accelerated flow surface endothelialization results in direct migration of endothelial cells from the intima of the vein wrap, and there was no clear correlation between the surface endothelial-like cell coverage and microostia. To gain further insight into why accelerated healing occurs in this model, earlier observations accompanied by molecular biology analysis are needed, and vein wrap studies provide a method of comparison for this work.

Animals↗

PubMed1997

Effects of minimal-dose aprotinin on coronary artery bypass grafting.

OBJECTIVE: To evaluate the effects of minimal-dose aprotinin in patients undergoing coronary artery bypass grafting, we conducted a prospective randomized study. METHODS: A total of 167 patients were randomized to receive no aprotinin treatment (control, n = 57), minimal-dose aprotinin (1.0 x 10(6) KIU; n = 55), or low-dose aprotinin (2.7 +/- 0.5 x 10(6) KIU; n = 55). Blood loss and transfusion requirements, parameters of clotting and fibrinolysis, renal function, and early graft patency rates were assessed. RESULTS: Postoperative blood loss and transfusion requirements were significantly (p = 0.01) lower in both the minimal-dose and low-dose groups than in the control group. The increase in D-dimer level after cardiopulmonary bypass was significantly (p < 0.05) less marked in the low-dose group than in the control group. The alpha 2-plasmin inhibitor and plasminogen activator inhibitor-1 levels were significantly (p < 0.05) greater in the minimal-dose and low-dose groups than in the control group after bypass, suggesting the prevention of fibrinolysis by both aprotinin doses. No statistically significant differences in postoperative renal function and early vein graft patency rates were noted (control group, 93.8%; minimal-dose group, 95.5%; low-dose group, 92.3%; p = 0.25). CONCLUSIONS: Aprotinin was not associated with a significant increase in the prevalence of renal dysfunction or early vein graft occlusion. Minimal-dose aprotinin inhibited enhanced fibrinolytic activity and reduced blood loss and transfusion requirements after bypass equivalently to low-dose aprotinin. The dose of 1 x 10(6) KIU added to the pump prime may be acceptably effective in reducing blood loss in patients undergoing primary coronary operations.

Aprotinin↗

PubMed1997

Coronary artery revascularization in an adult with coronary aneurysms probably secondary to childhood Kawasaki disease.

Kawasaki disease is an acute febrile illness affecting mainly infants and children. The fatal complication of Kawasaki disease is coronary involvement pertaining to coronary artery aneurysms. Surgical experience of adults that had childhood Kawasaki disease with coronary lesion has been rarely reported. We experienced coronary artery bypass grafting in a 44 year old man with no risk factors for atherosclerosis but with coronary lesions possibly secondary to Kawasaki disease. Coronary artery sequelae of Kawasaki disease may become part of a cause of coronary disease in young adults and we should recognize this condition in such patients with coronary disease but no coronary risk factors.

Adult↗