PubMed Health⌕ Search

Biomedical subjects

S Kuki

Publications and source records attributed to S Kuki.

32 records · Page 2Linked to original sources

Sodium-23 MR imaging of the kidney in guinea pig at 2.1 T, following arterial, venous, and ureteral ligation.

In vivo 23Na magnetic resonance images of guinea pig kidney were obtained at 2.1 T using a spin-echo sequence with an echo time of 19 ms. The intact kidney showed a very strong signal intensity in the sodium image. The signal intensity of the kidney decreased to 55% after ligation of the renal artery together with the vein and the ureter. The total sodium content in the excised kidney after arterial occlusion, measured by flame photometry, was 24% higher than that in the intact kidney. The transverse relaxation time (T2) of the extracellular sodium in the isolated kidney decreased to one-third of that in the intact kidney. This shortening of T2 may be partly responsible for the decrease in the 23Na signal intensity from the kidney after arterial occlusion.

Animals↗

Leakage of cytoplasmic enzymes from rat heart by the stress of cardiac beating after increase in cell membrane fragility by anoxia.

The effects of spontaneous beating after anoxia and the pumping stress induced by a left ventricular balloon on the leakage of myocardial enzymes from the isolated perfused rat heart were investigated. Beating of the heart was arrested by perfusion with high-K+ medium. When the beating was arrested during reoxygenation after anoxia, the leakage of lactate dehydrogenase (LDH) was significantly lower than during reoxygenation with spontaneous cardiac beating. After changing from K+ arrest to spontaneous beating by perfusion with low-K+ medium during reoxygenation, the leakage of LDH increased markedly. Imposition of left ventricular wall stress on the K(+)-arrested heart by repetitive passive distension during aerobic perfusion and after 20 min and 60 min of anoxia caused LDH leakages of 1.0, 4.6 and 21.0 units/g in 30 min, respectively. Under this mechanical stress, the release of LDH as a percentage of its total myocardial activity coincided well with that of cytoplasmic aspartate aminotransferase (AST), while the percentage release of mitochondrial AST was much less. These results appeared to indicate that the leakage of cytoplasmic enzymes during reoxygenation is accelerated by cardiac beating because of fragility of the cell membranes developing during the preceding anoxia.

Adenosine Triphosphate↗

Adenosine triphosphate compartmentation in the rat heart: a 31P spin-lattice relaxation study.

Longitudinal relaxation times (T1) of phosphorus compounds in the perfused rat heart and erythrocytes were measured using the 31P Driven-Equilibrium Single-Pulse Observation of T1 relaxation (DESPOT) method at 33 degrees C. Both creatine phosphate in the heart and the three phosphate groups of adenosine triphosphate (ATP) in erythrocytes showed single-exponential relaxation. The three phosphate groups of ATP in the heart, however, had two T1 components. The T1 values of the short and the long T1 components of the beta-phosphate of ATP were ca. 0.4 and 14 s, respectively. The fraction with the long T1 represented ca. 30% of the total ATP content. These results suggested that there were two major pools of intracellular ATP in the rat heart which could be determined by 31P NMR spectroscopy.

Adenosine Triphosphate↗

Potassium-39 nuclear magnetic resonance observation of intracellular potassium without chemical shift reagents during metabolic inhibition in the isolated perfused rat heart.

The intracellular potassium content of perfused rat heart was measured by potassium-39 nuclear magnetic resonance (NMR) spectroscopy at 33 degrees C with an inversion recovery technique based on the fact that the spin-lattice relaxation time (T1) of the intracellular potassium (8.3 msec at 8.45 T) is much faster than that of the extracellular potassium (68 msec). Intracellular potassium decreased to 60.2 +/- 4.3% of the control level (mean +/- SEM, n = 6) at 40 minutes from the start of metabolic inhibition (2 mM cyanide, 0 mM glucose). Removal of cyanide restored intracellular potassium to 94.2 +/- 3.9% at 30 minutes from the restart of oxidative metabolism. The cumulative potassium loss was determined from the flow rate and potassium concentration of the coronary effluent, which reached 139 +/- 12 mumol/g dry wt during 40 minutes of metabolic inhibition. This value was calculated as 41.8% of intracellular potassium in the control heart and agreed with the decrement of intracellular potassium measured by NMR. During the metabolic inhibition and recovery period, a linear correlation was observed between the changes in 39K NMR-observed intracellular potassium and the cumulative potassium loss. The present results evaluate the inversion recovery technique as a method to successfully monitor the myocardial intracellular potassium.

Animals↗

Evaluation of prostacyclin analogue OP-41483 as an adjunct to crystalloid cardioplegia in infants and children.

A chemically stable prostacyclin analogue (PGI2-A, carbacyclin, OP-41483) was evaluated as an adjunct to potassium cardioplegia in infants (n = 13) and children (n = 32), in whom the current potassium cardioplegia may be limited in its effects. PGI2-A was added in a dose of 300 micrograms/L to the potassium cardioplegic solution. Postoperatively, peak levels of the myocardial-specific isoenzyme of creatine kinase (MB-CK) were compared for the PGI2 group and a control group (n = 65). In patients 1 year of age or older (n = 32 and 49 for the PGI2 and control groups, respectively), the MB-CK level was significantly lower in the PGI2 group only when compared between the subgroups with an aortic cross-clamp time of 120 minutes or more (n = 9 and 10; MB-CK level, 35.2 +/- 15.6 vs 68.3 +/- 32.4 IU/L;p less than 0.05). In patients less than 1 year of age, in whom aortic cross-clamp times were generally less than 120 minutes, the MB-CK level was also lower in the PGI2-A group than in the control group (n = 13 and 16; MB-CK level, 33.6 +/- 14.3 vs 61.6 +/- 36.3 IU/L;p less than 0.05). Infants less than 6 months of age (n = 18) underwent ultrastructural assessment of left ventricular myocardial biopsy specimens, and the PGI2-A group showed better results in mitochondrial and intracellular edema scores. This clinical trial showed beneficial effects of PGI2-A used with crystalloid potassium cardioplegia in infants and children.

Adolescent↗

[Clinical evaluation of immunosuppressive factors (IAP-immunosuppressive acidic protein, IS-immunosuppressive substance) in head and neck cancer].

It is reported that the levels of serum IAP and IS are useful parameters to evaluate the prognosis along with the clinical course of tumor bearing patients. Serum IAP and IS were examined in 149 patients with head and neck cancer. The level of serum IAP and IS increased in patients with not only advanced stages, but also poor prognosis. In general, the patients with death or recurrence had higher levels of serum IAP and IS than those with good prognosis. It is concluded that serum IAP and IS well reflect the immunological condition and clinical course of patients with cancer and may be one of the useful parameter for them.

Adolescent↗

[Clinical study of penetrating thoracic injuries].

During the 13-year period ending in December 1987, 39 patients (pts) of penetrating thoracic injuries were treated. Thirty-five pts (89.7%) were male, and the age range was 21 to 56 years with average of 38.7 years. Thirty-one pts (79.5%) sustained stab wounds and eight (20.5%) had gun-shot wounds. 5 pts died in all (2 pts with stab wounds, 3 with gun-shot wounds). The wounds were limited on chest wall in 14 pts, and penetrated to thorax in 25. In these pts with penetrating wounds, lung injuries were found in 18, heart in 7 and esophagus in 1, respectively. Twenty-one pts had multiple injuries, and abdominal injuries were found in 20 pts (95.2%), limbs in 7 (33.3%), and neck in 2 (9.5%). All 5 dead pts had multiple injuries. Prognoses were fair in cases of simple chest wall injuries or lung injuries. In the cases of lung injuries, thoracotomy was performed in 8 pts (44.4%) and tube thoracostomy in 10 (55.6%). Thoracotomy was performed for massive bleeding (over 600 ml/1-2 hours) (6 cases) and the sites of the injuries suspecting of heart injuries (2 cases). Two pts undergoing tube thoracostomy and one pt done thoracotomy died, but the causes of the death were not related to lung injuries. Regarding the heart injuries, the injured sites were left ventricle in 1, right ventricle in 1, right atrium in 2, and pericardium in 3. All the 7 pts were in shock on arrival. In these pts with heart injuries, all the wounds were in and near the Sauer's danger zone. In all pts, emergent thoracotomy was performed, and 5 pts could be saved (mortality 28.6%). As the risk factors, heart injuries, multiple injuries, and gunshot injuries were noticed with mortality of 28.6%, 23.8%, and 37.5%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Experimental and clinical assessment of myocardial protective effect of a prostacyclin analogue (OP 41483)].

The beneficial effects of a stable prostacyclin analogue (PGI2-A), OP 41483 against myocardial ischemic injury were experimentally and clinically evaluated. In 31P-NMR study, the preischemic treatment with PGI2-A prevented myocardial ATP depletion of rat hearts which were subjected to 20 min global ischemia. In patients with congenital heart disease, the PGI2-A of 300 ng/ml was added to the glucose-insulin-potassium cardioplegia (PGI2-group), and this group was compared to control group without PGI2-A in terms of postoperative maximal leakage of CPK-MB (maxCPK-MB). In patients under 1 yr or patients over 1 yr with aortic cross clamp time exceeded 120 min, the maxCPK-MB was significantly (p < 0.05) reduced as compared to the control. This stable PGI2 analogue has shown significant myocardial protective effects experimentally and also in clinical setting.

Animals↗

Myasthenia gravis and premature ovarian failure.

Myasthenia gravis is believed to be an autoimmune disorder that results from antibodies directed against acetylcholine receptors. Not infrequently, it is associated with other autoimmune diseases, and, recently, several cases have been reported of coexistent premature ovarian failure. A 25-year-old nullgravida woman with myasthenia gravis became amenorrheic and then had ovarian failure with increased gonadotropin and negligible estrogen levels. Other endocrine functions were normal. An in vitro assay demonstrated the presence, in serum, of an inhibitor of binding to the luteinizing hormone (LH) receptor that suggested the possibility of a similar autoimmune process underlying the myasthenia gravis and premature ovarian failure. This could be the first case in which both disorders occurred with evidence for an LH receptor antagonist.

Adult↗

Gastric intramucosal pH during lower body circulatory arrest under open distal anastomosis with selective cerebral perfusion in aortic arch repair.

Selective cerebral perfusion (SCP) and open distal anastomosis (OD) with hypothermia has been used as a popular means for circulatory assistance in aortic arch surgery. Although SCP has become accepted for brain protection, the influence of OD accompanying circulatory arrest on lower body ischemia is not known. We studied gastric tonometry (gastric intramucosal pH [pHi]) to estimate splanchnic ischemia during OD, and its relationship to postoperative organ function. In five patients (pts) (range, 65-78 years; mean, 71 years; group OD) who underwent arch replacement using SCP and OD with moderate hypothermia (25 degrees C) during the period from March to August of 1999, pHi was measured precardiopulmonary bypass (pre-CPB), 30 min of CPB (CPB30), 10 min after OD (OD10), at end of CPB, and post-CPB. Eight pts (range, 52-78 years; mean; 66 years) who underwent standard CPB (33 degrees C) during the same period (coronary artery bypass surgery in six and valve surgery in two) served as controls (group C). In group OD, pHi was significantly decreased at OD10 (7.35 +/- 0.03 at CPB30 vs. 7.23 +/- 0.07 at OD10, p < 0.05) but recovered by the end of CPB (7.32 +/- 0.02). Creatinine clearance on the first postoperative day (1POD) was significantly (p < 0.05) lower in group OD (82 +/- 40 ml/min) than in group C (126 +/- 25 ml/min), although there was no significant difference in preoperative values between the two groups. The pHi at OD10 did not correlate with the duration of OD (range, 30-47 min; mean, 38 min), whereas pHi at OD10 significantly correlated with BUN (r = -0.973, p = 0.0054), Cr(r = -0.977, p = 0.0043), and CCr (r = 0.908, p = 0.0328) on 1POD. One patient in group OD developed paraplegia and renal failure postoperatively. His pHi at OD10 was severely decreased to 7.11. These results suggest that intraoperative monitoring of pHi may be useful for the evaluation of visceral organ ischemia during OD in arch replacement and may contribute to improved technique for circulatory assistance in aortic surgery.

Aged↗

Usefulness of the low profile "True 8" intra-aortic balloon pumping catheter for preventing limb lschemia.

The most important limitation in the use of an intra-aortic balloon pumping (IABP) is the risk of vascular complications. Recently, an IABP catheter with an 8.0 French shaft and low profile that may decrease the risk of vascular morbidity has been developed. We evaluated the in vitro balloon performance and the prevention of limb ischemia in clinical use. An 8.0 French IABP catheter was compared with a standard 9.5 French catheter. Inflation time (IT), deflation time (DT), and changes in volume (V) generated by the balloon were measured during the pumping cycle in an experimental model. The inflation velocity (V/IT) and deflation velocity (V/DT) were calculated as parameters of balloon performance. At 120 bpm the V/IT and V/DT were 0.34 ml/msec and 0.28 ml/msec with the 8.0 French, and 0.33 ml/msec and 0.24 ml/msec with the 9.5 French catheter. Twelve patients with coronary artery disease, ranging in age from 41 to 87 years (mean, 66 years), who underwent IABP support, were divided into group 1 (8.0 French, n = 4) and group 2 (9.5 French, n = 8). Ankle-arm pressure index (API), lactate extraction ratio (LER) in the limb with IABP insertion, and cardiac index (CI) were measured at 1, 12, and 24 hours postoperatively. There were no major vascular complications and no counterpulsation related morbidity. There was no significant difference between the two groups with regard to age, duration of IABP support, and incidence of peripheral vascular disease and diabetes. The percentage of women patients was significantly higher in group 1 (100% vs. 25%), whereas body surface area was significantly smaller (1.45 +/- 0.14 vs. 1.68 +/- 0.12 m2). The API in group 1 were slightly higher than those in group 2 throughout the observed period (not significant). The LER and Cl showed no significant differences between the two groups. These results suggest that the 8.0 French IABP catheter with a low profile has an acceptable in vitro performance, and its clinical application may be effective in preventing limb ischemia in a high-risk subset of patients such as women and smaller patients.

Adult↗

Attenuation of pulmonary leukocyte sequestration during extracorporeal circulation by a new c-AMP phosphodiesterase inhibitor.

Activated leukocytes may have an important role in developing complement-related lung injury, with pulmonary leukocyte sequestration in the presence of blood-material interaction in cardiopulmonary bypass and hemodialysis. The authors evaluated the effects of a new cAMP phosphodiesterase inhibitor (DN-9693) on leukocyte aggregation in vitro, utilizing canine heparinized blood and pulmonary leukocyte sequestration during extracorporeal circulation (ECC) in dogs. On in vitro evaluation, DN-9693 inhibited the leukocyte aggregation response to leukotriene B4 in a dose response manner; the aggregation response elicited by contact with a membrane lung was inhibited by a 50% inhibition dose of approximately 0.2 mumol/L. Leukocyte kinetics were assessed in a venovenous bypass system with a silicone hollow fiber membrane lung. The control group (n = 6) without DN-9693 developed a reduction in the arterial leukocyte count of 55 +/- 17% at 2 minutes of ECC. The transpulmonary difference in leukocyte count (pulmonary artery count minus systemic artery count) was significantly increased (P less than 0.05) from -175 +/- 206/microliters at baseline to 1225 +/- 330/microliters after 2 minutes of ECC. In the DN-group (n = 4, DN-9693; 60-80 micrograms/kg/min), there was no significant reduction in the arterial leukocyte count during ECC, and the transpulmonary difference showed no significant increases (75 +/- 386/microliters; baseline, versus 125 +/- 263/microliters; 2 minutes of ECC). These results suggest that DN-9693 inhibits the aggregation of leukocytes in the presence of blood-material interaction in vitro, and also prevents pulmonary leukocyte sequestration induced by ECC, with attenuation of systemic leukocyte depletion.

3',5'-Cyclic-AMP Phosphodiesterases↗