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Biomedical subjects

T Ban

Publications and source records attributed to T Ban.

At least 37 records · Page 2Linked to original sources
PubMed1999

Evaluation of a compressive-type skeletal muscle pump for cardiac assistance.

BACKGROUND: Recent investigations have focused on using the latissimus dorsi muscle for cardiac assistance. Although cardiomyoplasty has been applied clinically, other procedures remain experimental, but promising, modes of cardiac assistance. We assessed the latissimus dorsi muscle as an in situ energy source for circulatory assist devices. METHODS: We developed a pneumatic chamber as a compressive-type muscle actuator. The chamber was implanted under the latissimus dorsi muscle and converted contractile power into pneumatic pressure. The effect of chamber position and size and the influence on muscle blood flow were examined. After muscle conditioning, the pump performance of a circulatory assist device driven by the chamber was evaluated. RESULTS: The chamber functioned better when placed in the proximal position of the latissimus dorsi muscle. The size affected the generated pneumatic pressure, and the higher resting pressure of the chamber reduced the muscle blood flow. The maximum stroke work of the circulatory assist device was greater than that of the right ventricle but less than that of the left ventricle. The chamber could drive the circulatory assist device against the systemic range of afterload in which a high preload was available. Long-term adhesion surrounding the chamber reduced the pressure generation capability. CONCLUSIONS: The compressive-type muscle actuator using the latissimus dorsi muscle generated acceptable hemodynamic work for right ventricular bypass or aortic counterpulsation.

Animals↗
PubMed1998

Interaction of the Na+-K+ pump and Na+-Ca2+ exchange via [Na+]i in a restricted space of guinea-pig ventricular cells.

1. The whole-cell Na+-K+ pump current (INa-K) and Na+-Ca2+ exchange current (INa-Ca) were recorded in guinea-pig ventricular myocytes to study the interaction between the two Na+ transport mechanisms. 2. INa-K was isolated as an external K+-induced current, and INa-Ca as an external Ca2+- induced or Ni2+-sensitive current. The experimental protocol used for one ion carrier did not affect the other. 3. The amplitude of INa-K decreased to 54 +/- 17 % of the initial peak during continuous application of K+ with 20 mM Na+ in the pipette. The outward INa-Ca, which was intermittently activated by brief applications of Ca2+, decreased during activation of INa-K, and recovered after cessation of INa-K activation. These findings revealed a dynamic interaction between INa-K and INa-Ca via a depletion of Na+ under the sarcolemma. 4. To estimate changes in Na+ concentration ([Na+]i) under the sarcolemma, the reversal potential (Vrev) of INa-Ca was measured. Unexpectedly, Vrev hardly changed during activation of INa-K. However, when INa-Ca was blocked by Ni2+ at the same time that INa-K was activated, Vrev changed markedly, maximally by +100 mV, immediately after the removal of Ni2+ and K+. 5. Subsarcolemmal [Na+]i was calculated from the Vrev of INa-Ca on the assumption that the subsarcolemmal Ca2+ concentration ([Ca2+]i) was fixed with EGTA, and mean [Na+]i was calculated from both the time integral of INa-K and the cell volume. The subsarcolemmal [Na+]i was about seven times greater than the mean [Na+]i. 6. The interaction between the Na+-K+ pump and Na+-Ca2+ exchange was well simulated by a diffusion model, in which Na+ diffusion was restricted to one-seventh (14 %) of the total cell volume.

Animals↗
PubMed1998

Localization of the apoptosis-inducing activity of lupus anticoagulant in an annexin V-binding antibody subset.

Lupus anticoagulant (LAC) is associated with arterial and venous thrombosis, thrombocytopenia, and recurrent fetal loss. We have reported previously that plasma with LAC activity induces apoptosis in endothelial cells and binds annexin V (Nakamura, N., Y. Shidara, N. Kawaguchi, C. Azuma, N. Mitsuda, S. Onishi, K. Yamaji, and Y. Wada. 1994. Biochem. Biophys. Res. Commun. 205:1488-1493). In this study, we separated two IgG antibody fractions, one with and one without affinity for annexin V, from 10 patients with LAC. LAC and apoptotic activities were localized in the annexin V-binding fraction in all 10 patients. DNA fragmentation was dose-dependent, paralleling the amount of IgG added to the human umbilical vein endothelial cell culture medium, and was inhibited by preincubation with annexin V. Removal of the antiphospholipid antibodies from patient IgG with phospholipid liposomes did not abolish the apoptosis-inducing activities or binding to annexin V. These results imply that patients with LAC often have antibodies that do not bind phospholipids and are responsible for the induction of apoptosis in endothelial cells.

Adult↗
PubMed1998

Temporal lobe epilepsy in a genius of natural history: MRI volumetric study of postmortem brain.

Kumagusu Minakata (1867-1941), a Japanese genius devoted to natural history and folklore, is famous for his immense range of works, including his discovery of many new varieties of mycetozoa, or slime molds. His diary reveals that he was affected by epilepsy. In this study of his brain, we adopted a method of measuring the volume of the hippocampi by MRI of postmortem brain and found evidence of right hippocampal atrophy. This finding, together with the striking parallels between his behavior and the known behavioral syndrome in temporal lobe epilepsy (TLE), suggests that he was affected by TLE. The postmortem imaging analysis of brain, as performed in this study, offers a bridge between neuroscience and classic psychopathologic approaches to the creativity of geniuses.

Aged↗
PubMed1998

[A successful case of minimally invasive direct coronary artery bypass (MIDCAB) followed by PTCA].

A 70-year-old man who developed angina pectoris underwent cardiac catheterization, which showed total occlusion of the left anterior descending coronary artery (LAD), associated with 75% stenosis of the right coronary artery (RCA) and 90% stenosis of the small circumflex coronary artery (CX). The LAD received good collateral flow from the RCA. The patient was scheduled to undergo the MIDCAB for the LAD using the internal thoracic artery (ITA), combined with percutaneous transluminal coronary angioplasty (PTCA) for the RCA subsequently. A left anterior submammarian skin incision of 10 cm in length was made. The fifth costal cartilage was removed. The left ITA was directly harvested from the chest wall from the 4th to 7th intercostal space, and was anastomosed to the midportion of the LAD without cardiopulmonary bypass. The patient was quickly recovered after the operation. On the 8th postoperative day, the patient successfully underwent the PTCA for the RCA after the ITA-LAD graft had been verified to be patent. The MIDCAB could be indicated for multivessel coronary disease in conjunction with the PTCA.

Aged↗
PubMed1998

[Re-sternotomy].

The indications and techniques for an pitfalls to avoid which might result in complications after resternotomy are reviewed. The relationship between anterio mediastinal structures and the posterior aspect of the sternum (as visualized on chest, films, CT, or tomography), and other approach(es) including the pros and cons of the contemplated procedure must be assessed carefully. Preparations for emergency F-F cardiopulmonary bypass must be completed before resternotomy. The Wires of the previous operation are undone, but kept in place as safeguards during sternal division using an oscillating (not reciprocating) bone saw. After their removal, the pericardium or other mediastinal structures adhering to the posterior aspect of the sternum are freed before applying a small sternal retractor. The pericardial dissection plane is developed at the cardiophrenic angle, advanced cephalad and laterally on the surface of the right ventricle and atrium. Cephalad dissection starts with imnominate vein identification down the superior vent cave, keeping in mind the location of the right phyenic nerve, and toward the anterior aspect of the great vessels. Repairing small ventricular or aerial lacerations should not be attempted before releasing the tension by sharp dissection of the adhesions surrounding the laceration, and repair of great vessel injuries is best done under cardiopulmonary bypass.

Humans↗
PubMed1997

Evolution of phosphagen kinase V. cDNA-derived amino acid sequences of two molluscan arginine kinases from the chiton Liolophura japonica and the turbanshell Battilus cornutus.

The cDNAs of arginine kinases from the chiton Liolophura japonica (Polyplacophora) and the turbanshell Battilus cornutus (Gastropoda) were amplified by polymerase chain reaction (PCR), and the complete nucleotide sequences of 1669 and 1624 bp, respectively, were determined. The open reading frame for Liolophura arginine kinase is 1050 nucleotides in length and encodes a protein with 349 amino acid residues, and that for Battilus is 1077 nucleotides and 358 residues. The validity of the cDNA-derived amino acid sequence was supported by chemical sequencing of internal tryptic peptides. The molecular masses were calculated to be 39,057 and 39,795 Da, respectively. The amino acid sequence of Liolophura arginine kinase showed 65-68% identity with those of Battilus and Nordotis (abalone) arginine kinases, and the homology between Battilus and Nordotis was 79%. Molluscan arginine kinases also show lower, but significant homology (38-43%) with rabbit creatine kinase. The sequences of arginine kinases could be used as a molecular clock to elucidate the phylogeny of Mollusca, one of the most diverse animal phyla.

Amino Acid Sequence↗
PubMed1997

Plasma levels of brain and atrial natriuretic peptides elevate in proportion to left ventricular end-systolic wall stress in patients with aortic stenosis.

Brain natriuretic peptide (BNP) is a novel cardiac hormone secreted predominantly from the ventricle. We examined the plasma levels of BNP and atrial natriuretic peptide (ANP) in 13 patients with aortic stenosis undergoing corrective surgery. Preoperative plasma BNP and ANP levels correlated highly with preoperative left ventricular end-systolic wall stress (ESS) (r = 0.96, p < 0.0001 and r = 0.95, p < 0.0001, respectively). Moreover, between preoperative and late postoperative states, the difference of the plasma levels of BNP and ANP correlated with the difference of ESS. In two patients with elevated ESS and quite high preoperative plasma BNP (> 1000 pg/ml), rapid decrease of the plasma level after operation was observed. These results suggest that synthesis and secretion of BNP and ANP are stimulated by the increase of left ventricular end-systolic wall stress in patients with aortic stenosis.

Aged↗
PubMed1997

Pulmonary hypertension caused by medial hypertrophy associated with aortic stenosis and preductal coarctation.

A 7-month-old female infant with aortic stenosis, preductal coarctation, and pulmonary hypertension underwent operation. Intraoperative lung biopsy revealed marked medial hypertrophy of the pulmonary arterioles. This histopathology is compatible with persistent pulmonary hypertension in the newborn. She is alive about 5 years after the operation, but pulmonary hypertension remains. The pathogenesis is discussed.

Aortic Coarctation↗
PubMed1997

Chronic animal experiment with magnetically suspended centrifugal pump.

We have been developing a new type of centrifugal pump for long-term use. The magnetically suspended centrifugal pump (MSCP) contains no shaft and seal so that long life expectancy is predicted. Paracorporeal left ventricular (LV) assist circulation between the left atrium and the descending aorta was instituted using sheep. The flow rates ranged from 2.5-5.5 L/min. The sheep that lived the longest (46 days) died of an embolism as a result of the thrombus in the pump. No thrombus formation was observed in other pumps. Plasma free hemoglobin levels ranged from 9 to 18 mg/dl, which led to the conclusion that the hemolysis level remained within an acceptable range. Two driving modes were compared. The slope of the pressure-flow relationship plot under a constant motor current mode was steeper than that under a constant rotational speed mode, and thus, the flow fluctuation decreased. In conclusion, the MSCP is durable for more than a month at the current stage of development and is a promising device for long-term ventricular assist.

Animals↗
PubMed1997

[A successful surgical repair of total anomalous pulmonary venous connection associated with Williams syndrome].

The surgical correction was performed successfully in a 14-year-old boy with total anomalous pulmonary venous connection (type Ia) associated with Williams syndrome. The diagnosis was made at the age of 3 and he had been well until the age of 13 when sudden chordal rupture caused severe mitral regurgitation and supraventricular tachyarrhythmia. The operational procedure includes common pulmonary vein and left atrium anastomosis through Gersony-Malm approach, chordal reconstruction of mitral valve with 4-0 Core Tex sutures. His postoperative course has been well without the sign of venous obstruction. As far as we know, this is the first documentation of a case of Williams syndrome associated with total anomalous pulmonary venous connection.

Adolescent↗
PubMed1997

[A successful surgical repair of congenital mitral stenosis due to commissural papillary muscle fusion].

A case of congenital mitral stenosis, patent ductus arteriosus, pulmonary hypertension was reported. At one year of age, the patient underwent surgical division of PDA because of persistent left heart failure. She went well after the operation. At seven year of age, she was readmitted to our hospital for easy fatigability. The cardiac catheterization revealed remarkably elevated pulmonary arterial pressure and pulmonary capillary wedged pressure. She underwent a surgical intervention for the mitral stenosis at eight year of age. At operation, the mitral valve exhibited the characteristics of type IIc according to Carpentier's classification: thickened and dysplastic leaflet, extremely short chordae tendanae fused with papillary muscles, obliteration of interchordal space and hypertrophic two papillary muscles. We replaced the valve with 23 mm Carbomedicus prosthetic valve because it seemed to be difficult to repair the native valve satisfactorily without residual stenosis or insufficiency. Her postoperative course was uneventful and the pulmonary arterial pressure and pulmonary capillary wedged pressure decreased remarkably one year after the operation.

Child↗
PubMed1997

In vivo testing of a magnetically suspended centrifugal pump designed for long-term use.

The life of currently-available centrifugal pumps is limited to no more than three days. As a magnetically suspended centrifugal pump (MSCP) contains no shaft or seal, it could be expected to have a longer life expectancy. The MSCP was evaluated in a chronic animal model using eight adult sheep. Left ventricular assist with the MSCP was instituted between the left atrium and the descending aorta. The flow rates ranged from 2.5 to 6.0 L/min. The duration of the experiments ranged from 14 to 60 days. No mechanical failure occurred. The plasma free hemoglobin levels remained within an acceptable range (3-19 mg/dL). No reduction in the counts of red blood cells or platelets was observed. Thrombus formation within the MSCP was recognized in one pump. The main reason for termination was thromboembolism derived from the circuits. Three types of regulation methods (constant rotational speed, constant motor current, and controlled motor current) were also investigated. Regulation by a constant motor current mode altered the pressure-flow (P-Q) characteristics, and thereby, a steadier pump flow was obtained compared with regulation in the constant rotational speed mode. Moreover, the controlled motor current mode can change the P-Q relationship. These results demonstrate that the MSCP is a promising device for long-term use.

Animals↗
PubMed1996

Reperfusion causes significant activation of heat shock transcription factor 1 in ischemic rat heart.

BACKGROUND: The myocardial protective role of heat shock protein (HSP) has been demonstrated, and there has been increasing interest in stress response in the heart. We examined the DNA-binding activity of heat shock transcription factor (HSF), by which the transcription of heat shock genes is mainly regulated, during heat shock or ischemia/reperfusion in isolated rat heart. METHODS AND RESULTS: Rat hearts were isolated and perfused with Krebs-Henseleit buffer by the Langendorff method. Whole-cell extracts were prepared for gel mobility shift assay using oligonucleotides containing the heat shock element, which is present upstream of all heat shock genes. Induction of mRNAs for HSP70, HSP90, and GRP78 (glucose-regulated protein) was examined by Northern blot analysis. Although the activation of HSF during global ischemia was weak and rapidly attenuated, postischemic reperfusion induced a significant activation of HSF. In addition, although HSP70 mRNA was hardly induced during ischemia, its burst induction was detected during postischemic reperfusion. Supershift assays using specific antisera for HSF1 and HSF2 revealed that ischemia/reperfusion as well as heat shock induced the activation of HSF1 in hearts. Although the expression of HSP70 mRNA during heat shock was more vigorous than the expression during ischemia/reperfusion, the induction of HSP90 mRNA in postischemic reperfusion was significantly greater than that in heat shock. CONCLUSIONS: Our findings demonstrated that reperfusion causes a significant activation of HSF1 in ischemia-reperfused heart. The striking contrast between the induction of HSP70 mRNA and that of HSP90 mRNA suggests the presence of regulatory mechanisms other than HSF.

Animals↗
PubMed1996

Analysis of right ventricular function during bypass of the left side of the heart by afterload alterations in both normal and failing hearts.

This study investigated the mechanism of right ventricular failure during bypass of the left side of the heart by precisely assessing right ventricular function with use of a conductance catheter. Bypass of the left side of the heart was established with a centrifugal pump in 10 mongrel dogs weighing 11 to 19 kg. Right ventricular function during left heart bypass was evaluated by two parameters that were both derived from measurement of relative change in right ventricular volume by the conductance catheter technique. One parameter was the right ventricular end-systolic pressure-volume relationship as a load-independent index, and the other was the peak right ventricular pressure-right ventricular stroke volume relationship as a "force-velocity relationship." These parameters were measured in both normal and failing hearts while afterload was increased by bilateral intrapulmonary balloon inflation. Moreover, changes in these relationships were observed by varying assist ratios of left heart bypass from 0% to 100%. Failing heart models were induced by normothermic aortic clamping for 20 minutes. The right ventricular end-systolic pressure-volume relationship in normal hearts did not change, irrespective of the assist ratio of left heart bypass, whereas that in failing hearts decreased from 4.25 +/- 1.41 mm Hg/ml without bypass of the left side of the heart to 3.53 +/- 1.30 mm Hg/ml after 100% assist of left heart bypass (p < 0.05). In the peak right ventricular pressure-right ventricular stroke volume relationship, right ventricular stroke volume was almost constant in normal hearts when afterload was increased regardless of the assist ratio of left heart bypass. Moreover, right ventricular stroke volume was maintained at a higher level during bypass of the left side of the heart compared with that without left heart bypass. However, that slope of the relationship in failing hearts was inversely linear and became significantly steeper after 100% assist of bypass of the left side of the heart compared with that without left heart bypass (-0.131 +/- 0.042 versus -0.051 +/- 0.038, p < 0.005). Therefore ++these two slopes of the relationship intersected at a point that was considered the critical point of afterload during bypass of the left side of the heart. In other words, right ventricular stroke volume was decreased by 100% left heart bypass above the critical point of afterload. In conclusion, this study demonstrates not only that bypass of the left side of the heart results in an increase in right ventricular stroke volume in both normal and failing hearts at the physiologic range of afterload, but also that right ventricular function against higher afterload is impaired by 100% assist of bypass of the left side of the heart in failing hearts.

Animals↗