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Biomedical subjects

T Nagumo

Publications and source records attributed to T Nagumo.

At least 19 recordsLinked to original sources
PubMed2004

[Surgically repaired bilateral giant bullae after long-time follow-up; report of a case].

A 44-year-old male was admitted to our hospital owing to severe dyspnea of sudden onset. Chest X-ray disclosed bilateral giant bullae. His pulmonary function was severely depressed. VC (%) was 2.61 l (66.3%) and FEV1% (%) was 1.47 l (64.5%). Indication of surgical repair of giant bullae are; space occupying lesion more than 25-50% in 1 thorax, progressive dyspnea, enlargement over time irrespective of symptoms, and expectation that re-expand the normal lung. He was conducted two-staged bullectomy using video-assisted thoracoscopic surgery (VATS) with small incisions. First operation was performed to left lung. Pulmonary function improved. VC (%) increased 3.02 l (76.8%) and FEV1% (%) 2.36 l (76.6%). After second operation, which was performed to right lung, VC (%) was 2.40 l (60.5%) and FEV1% (%) was 2.21 l (92.1%). Hugh-Jones grade improved class IV to class I. Postoperative course was uneventful and he was discharged 15 days after second operation. Two-staged bullectomy was appropriate in this case, because he might have suffered from re-expansion pulmonary edema after first surgery. The extent of recovery of pulmonary function was unpredictable. And performing right lung bullectomy just after the left bullectomy may be dangerous, because the patient have to receive anesthesia with his resected left lung. There is some possibility that patient who has bilateral giant bullae shows severe dyspnea during the progress, care should be taken to conduct operation as soon as possible.

Adult↗
PubMed2004

[Preoperative evaluation for lung resection using right ventricular hemodynamic functions by unilateral pulmonary arterial occlusion test].

We performed a unilateral pulmonary arterial occlusion (UPAO) test for the preoperative evaluation of right ventricular functions as a loading test in patients undergoing a lung resection without cardiac complications preoperatively. We investigated the relationship between changes in right ventricular hemodynamic functions and postoperative cardiac complications, namely right heart failure or arrhythmia. To evaluate the right ventricular hemodynamic function test, we measured the mean pulmonary arterial pressure, cardiac index, right ventricular ejection fraction end-diastolic volume, and stroke volume before and during the UPAO test using the thermodilution method, and calculated the total pulmonary vascular resistance and right ventricular stroke work indexes. The incidence of postoperative cardiac complications was not related to the changes in the total pulmonary vascular resistance index. However, the postoperative cardiac complications were common in patients whose right ventricular end-diastolic volume index was increased by more than 20% during the UPAO test. These results suggest that the changes in the right ventricular end-diastolic volume index during the UPAO test can predict postoperative cardiac complications in patients undergoing a pulmonary resection.

Arrhythmias, Cardiac↗
PubMed2000

Effects of a fucoidan on the activation of plasminogen by u-PA and t-PA.

The effect of an anticoagulant fucoidan (C-I-H) from the brown seaweed Ecklonia kurome on the fibrinolytic system was studied in vitro using S-2251 as a substrate of plasmin. C-I-H enhanced the activation of Glu- and Lys-plasminogen by high molecular weight urokinase-type plasminogen activator (HMW u-PA) very effectively, but the activation by low molecular weight u-PA was hardly enhanced with C-I-H. C-I-H also potentiated moderately the activation by single- and two-chain tissue-type plasminogen activators (sct- and tct-PA). These effects of C-I-H were higher than those of heparin used. But C-I-H had no effect on the amidolytic activity of plasmin to S-2251. These results indicate that C-I-H promotes the generation of plasmin in the plasminogen activation by HMW u-PA and t-PA, but not the activity of generated plasmin. Kinetic analyses suggest that C-I-H enhances the HMW u-PA-mediated plasminogen activation by increasing the affinity of the activator for Glu- and Lys-plasminogen and by increasing the molecular activity of the activator. On the other hand, C-I-H had no effect on the affinity of tct-PA for both plasminogens. The catalytic efficiencies of HMW u-PA and tct-PA for the activation of both plasminogens were increased with C-I-H about 8- and 2-fold, respectively. The present results suggest that C-I-H has the fibrinolytic activity by stimulating the plasminogen activation by HMW u-PA and t-PA. The mechanism of the enhancement effect of C-I-H on the activation is presumed to be that C-I-H binds to plasminogen, thereby inducing a structural change of plasminogen susceptible to the action of plasminogen activators.

Anticoagulants↗
PubMed1999

Inhibition of the generation of thrombin and factor Xa by a fucoidan from the brown seaweed Ecklonia kurome.

The effects of a fucoidan (C-II), which was purified from the brown seaweed Ecklonia kurome, on the generation of thrombin and factor Xa have been investigated by measuring the amidolytic activities by using the respective specific chromogenic substrates in both plasma and purified systems. C-II inhibited significantly the generation of thrombin in both the intrinsic and the extrinsic pathways, although the intrinsic inhibitory effect by C-II was more remarkable than the extrinsic one. On the other hand, C-II was a good inhibitor of the factor Xa generation in the intrinsic pathway, while it was a poor one in the extrinsic pathway. In the purified systems C-II also inhibited the formation of prothrombin-activating complex (i.e., prothrombinase), but not its activity. The concentration of C-II required for 50% inhibition of thrombin generation was about one-tenth to one-seventh of that of the activity of the generated thrombin in plasma. These results indicate that C-II has an inhibitory effect on the generation of thrombin by blocking the formation of prothrombinase and by preventing the generation of intrinsic factor Xa in addition to its antithrombin activity, and also that the generation-inhibitory effect is more remarkable than C-II's enhancement effect on the antithrombin activity by heparin cofactor II in plasma.

Animals↗
PubMed1998

[A successful repair of infective endocarditis accompanied by a pseudoaneurysm of the left ventricle].

The present paper reports a successful surgical treatment of a 47-year-old male with a pseudoaneurysm of the left ventricle. The patient has also been administered Penicillin G for 5 months to treat endocarditis. Cardiac catheterization showed severe aortic stenosis and a pseudoaneurysm of the left ventricle which was dilating in systole. The patient underwent patch closure of the pseudoaneurysm whose ostium was situated at the miral-aortic inter valvular fibrosa followed by aortic valve replacement and direct closure of a right Valsalva sinus aneurysm. His postoperative course was uneventful. The patient had no recurrence of endocarditis nor malfunction of the prosthetic valve for one year postsurgery. This is the first report in Japan of successful surgical treatment of a pseudoaneurysm of the left ventricle due to perforation of the miral-aortic intervalvular fibrosa after endocarditis.

Aneurysm, False↗
PubMed1998

Primary aortoenteric fistula with a chronic isolated abdominal aortic dissection: report of a case.

A 47-year-old woman on long-term hemodialysis due to a chronic isolated abdominal aortic dissection was admitted to our department with severe abdominal pain. She had not suffered any hematemesis or melena. An emergency laparotomy revealed an abdominal aortic aneurysm with a diameter of 60mm, densely adhered to the ileum. An aortoenteric fistula manifesting as intramural rupture into the ileum was found after infrarenal abdominal aortic and bilateral common iliac cross-clamping. The fistula on the ileac side was nontransmural, but that on the aortic side communicated with the pseudolumen of the abdominal aorta, and contained mural thrombus. The infrarenal abdominal aorta and bilateral common iliac arteries were replaced with a collagen-sealed woven Dacron bifurcated graft. Histological examination of the ileum in this portion showed intramural bleeding and xanthomatous granulation with foam cell infiltration in the thickened subserosa. While it is difficult to diagnose nonpenetrating aortoenteric fistula preoperatively, such a fistula must be considered in a patient with severe abdominal pain, for whom previous abdominal aortic surgery has been performed or when an abdominal aneurysm is observed. To our knowledge, no other case of an aortoenteric fistula presenting as an intramural rupture into the ileum in an isolated abdominal aortic dissection has ever been reported.

Adult↗
PubMed1998

[Ruptured dissecting aneurysm of the transverse arch after replacement of the descending and ascending aorta].

A 28-year-old Marfan's syndrome woman was referred to our hospital because of sudden chest and back pain. She had received replacement of the descending and ascending aorta for acute aortic dissection previously in other two institutions. CT scan revealed the massive mediastinal hematoma and hemothorax which suggested ruptured dissecting aneurysm of the transverse arch. Emergent total arch replacement, re-ascending replacement and aortic root plasty successfully weve performed. She recovered uneventfully although she had residual thoracoabdominal dissecting aneurysm. It was suggested that total arch replacement should be performed for Stanford A type dissection in Marfan's syndrome.

Adult↗
PubMed1997

[The leaflet fracture of a 19 mm SJM (HP) valve during valve insertion to the calcified small aortic annulus].

Aortic valve replacement was undergone in a 70-year-old woman with calcified aortic stenosis. Calcified and fused tricuspid aortic valve was excised and a 21 mm sizer passed with some difficulty through the annulus. A 19 mm SJM HP serious was selected and the horizontal mattress suturing technique was used. The valve was held at the cuff near the hinge guard and seated into the annulus by the usual amount of pressure, however, one leaflet fracture was retrieved and the valve was removed. A 19 mm standard SJM valve was then successfully implanted. The potential factors of leaflet fracture suggested that the leaflet thickness of smaller sized SJM valves showed smaller values than other bileaflet valves in the same sized-valves. In addition, the SJM valve does not have an orifice stiffening ring like other bileaflet valves. So, needless to say direct pressure to the leaflet, indirect pressure might cause valve destruction during insertion. The abnormal pressure applied to the direction from one hinge guard to the other can introduce deforming of the orifice ring resulting in leaflet fracture like this case. The pressure directed to the perpendicular direction may introduce leaflet escape due to the deforming of the valve orifice.

Aged↗
PubMed1997

[One stage operation for sternal turnover with preserved rectus muscle pedicles and aortic root replacement associated with Marfan's syndrome].

A 40-year-old man with Marfan's syndrome had annulo aortic ectasia with Sellers grade 4 aortic valve regurgitation and Wada grade 3 pectus excavatum. Simultaneous operation was successfully performed by aortic valve composite graft insertion and sternal turnover with the rectus muscle pedicles. Following a midline skin incision, the cost-sterno complex (plastron) was dissected together with the bilateral rectus muscle pedicles, and the sternum was divided transversely through the second intercostal space. The plastron with muscle pedicles was retracted away from the anterior chest toward the abdomen and was covered by the moistened sternal bag made of polyethylene to prevent dryness and contamination during the composite graft insertion. The aortic root was replaced with a composite graft consisting of a 25 mm SJM valve and a 26 mm Hemashield graft. A short interposed 10 mm Hemashield graft was inserted between the ostia of the left coronary artery and the composite graft. The right coronary artery was reimplanted in the aortic conduit using the button technique with a doughnut pledget. This one stage method offered excellent operative exposure and enabled us to prevent possible necrosis of the sternum, infection of the mediastinal sinus, and postoperative cardiac failure resulting from chest wall compression. In this procedure, active usage of the rapid autologous transfusion system effectively reduced the total amount of blood transfusion.

Adult↗
PubMed1997

Immunopharmacological activity of polysaccharide from the pericarb of mangosteen garcinia: phagocytic intracellular killing activities.

Polysaccharides from the pericarbs of mangosteen, Garcinia mangostana Linn., was obtained by treating the dried ground pericarbs with hot water followed by ethanol precipitation (M fraction). The extract was fractionated by anion exchange chromatography on a DEAE-cellulose column as MDE1-5 fractions. The fractions of MDE3 and MDE4 composed of mainly D-galacturonic acid and a small amount of neutral sugar (L-arabinose as the major one and L-rhamnose and D-galactose as the minor ones) were studied for immunopharmacological activities by phagocytic test to intracellular bacteria (Salmonella enteritidis) and nitroblue tetrazolium (NBT) and superoxide generation tests. The results showed that the number of S. enteritidis in cultured monocyte with extract of pericarb of mangosteen (MDE3) was killed. Activating score (mean +/- SD) of NBT test of 100 polymorphonuclear phagocytic cells were 145 +/- 78, 338 +/- 58, 222 +/- 73, 209 +/- 77, 211 +/- 63, 372 +/- 19, 369 +/- 20, 355 +/- 34 in normal saline control, phorbol myristate acetate (PMA), MDE3, MDE4, indomethacin (I), PMA + MDE3, PMA + MDE4 and PMA + I, respectively. Superoxide generation test was also done by color reduction of cytochrome c. Both MDE3 and MDE4 stimulate superoxide production. The number of S. enteritidis in cultured monocyte with extract of pericarb of mangosteen was killed. This paper suggests that polysaccharides in the extract can stimulate phagocytic cells and kill intracellular bacteria (S. enteritidis).

In Vitro Techniques↗
PubMed1997

[A successful surgical treatment for huge left circumflex artery-right ventricle fistula using the fistula occlusion test].

A surgical case of rare coronary artery fistula between the left circumflex artery and right ventricle was reported. A 46-year-old woman had suffered from exertional dyspnea and palpitation for three years. Pan systolic heart murmur was heard through the left 4th inter costal space. The chest X-ray film demonstrated cardiac enlargement and lung congestion, and the electrocardiograms showed atrial fibrillation and left ventricular hypertrophy when she was admitted to our hospital. Preoperative catheterization revealed a huge coronary artery fistula originating from the left circumflex artery and opening into the right ventricle through the posterior wall of the heart. The left-to-right shunt ratio was 60% and Qp/Qs was 2.47. At operation, the dilated circumflex artery fistula was carefully dissected and the tape was passed around the fistula as a tourniquet under extra corporeal circulation on the beating heart. To estimate myocardial ischemia, the fistula occlusion test was performed by tightening the previously placed tourniquet. Monitoring of electrocardiograms, transesophageal echocardiography, and hemodynamics were useful to detect myocardial ischemia. The occlusion test was performed under ECC for 5 minutes. No ischemic changes were observed. The fistula was interrupted under cardiac arrest at the point of the occlusion test.

Arteriovenous Fistula↗
PubMed1995

Callosal disconnection syndrome and knowledge of the body: a case of left hand isolation from the body schema with names.

A patient is described who presented with a disturbance of body cognition confined to the left side of the body. She showed difficulties in naming the left fingers and in moving the named left fingers. She also showed great difficulty in pointing to named parts of the body with her left hand. Earlier in the course of the disease she showed a personification phenomenon of the left hand. Brain MRI showed involvement of the entire corpus callosum, probably due to occlusion of a branch of the anterior cerebral artery. It is speculated that this syndrome is caused by disconnection of the right hemisphere from the left hemispheric body schema.

Brain Diseases↗
PubMed1994

Isolation and partial characterization of a novel amino sugar-containing fucan sulfate from commercial Fucus vesiculosus fucoidan.

Commercial crude fucoidan (Sigma) from the brown seaweed Fucus vesiculosus was fractionated into its polysaccharide components by gel filtration and anion-exchange chromatography to clarify the structure-anticoagulant activity relationship. The products comprised a wide spectrum of fucans ranging from typical fucoidans (major components) containing mainly fucose, sulfate, and no uronic acid to low sulfate-containing heteropolysaccharide-like fucans (minor components) being composed of neutral sugars other than fucose and a high content of uronic acid(s). The polysaccharide components also had a wide range of molecular weight. The typical fucoidans showed a potent anticoagulant activity, whereas the other fucans had no or only slight activity. One of the fractions found as a minor component, was a novel polysaccharide containing an appreciable amount (11.5%) of glucosamine and a small amount (5.2%) of protein in addition to fucose and sulfate, and having a low apparent molecular weight of 6800. This is the first report that a proteoglycan-like, amino sugar-containing fucan sulfate, composed of fucose, galactose, glucose, mannose, xylose, uronic acid, glucosamine, and sulfate in the molar ratio of 1.00:0.04:0.01:0.48:0.24:0.18:0.56:1.90, could be obtained from brown seaweed. However, this polysaccharide showed no anticoagulant activity.

Amino Sugars↗
PubMed1993

Crossed avoiding reaction: a disturbance of the manual spatial function.

A patient with MRI confirmed lesions in the corpus callosum and the left cingulate gyrus had a rare syndrome of crossed avoiding reaction of the left hand. With the right hand she could reach a stimulus object in whatever space it was presented. With the left hand, however, she could not mobilise it to reach a stimulus presented in the right hemispace relative to her body axis. In the left hemispace relative to her body axis her left hand reached an object without any difficulty. This left unilateral difficulty in the right unilateral space may be related to a unique spatial function that controls manual space, which is represented differentially in the two hemispheres. In the left hemisphere this function covers bilateral hemispace and is operated by the right hand. In the right hemisphere this function covers only the left hemispace and is operated by the left hand.

Brain↗
PubMed1992

Anticoagulant and antithrombin activities of oversulfated fucans.

Three species of oversulfated fucans having different sulfate contents (the ratio of sulfate/total sugar residues, 1.38-1.98) were prepared by chemical sulfation of a fucan sulfate (sulfate/sugar ratio, 1.28) isolated from the brown seaweed Ecklonia kurome. The anticoagulant activities of the oversulfated fucans were compared with that of a parent fucan with respect to activated partial thromboplastin time (APTT) and thrombin time (TT) in plasma. The respective activities (for APTT and TT) of the oversulfated fucans increased to 110-119% and 108-140% of the original values with increase in their sulfate content. The anticoagulant activity with respect to APTT (173 units/mg) of an oversulfated fucan (sulfate/sugar ratio, 1.98) was higher than that (167 units/mg) of heparin used as a standard. The heparin cofactor II-mediated antithrombin activity of the oversulfated fucans also increased significantly with increase in sulfate content. The maximum activity was higher than those of the parent fucan and heparin. However, the increment of the anticoagulant and the antithrombin effects gradually decreased with increase in the sulfate content of the fucans. These results indicate that the effects of the fucan sulfate are dependent on its sulfate content until a plateau is reached.

Anticoagulants↗