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Biomedical subjects

T Sakuma

Publications and source records attributed to T Sakuma.

At least 73 records · Page 4Linked to original sources
PubMed1998

Prediction of short- and intermediate-term prognoses of patients with acute myocardial infarction using myocardial contrast echocardiography one day after recanalization.

OBJECTIVES: This study sought to determine whether microvascular integrity in the risk area (RA) for myocardial infarction (MI) one day after recanalization predicts the outcome in patients with first acute MI. BACKGROUND: Immediately after recanalization, microcirculation in the RA is modified by both hyperemic response and microvascular impairment. METHODS: Fifty consecutive patients who underwent serial myocardial contrast echocardiography before and one day after recanalization (day 2) were studied. All patients had a completely occluded lesion in the left anterior descending coronary artery alone, and underwent successful reperfusion therapy. The relative size of the initial RA (RA ratio) and peak gray scale ratio (PGSR) within the RA on day 2 were determined. Patients were followed for a median of 22 months to evaluate clinical outcome. RESULTS: On day 2, PGSR was a median of 0.46. Study patients were subdivided into two groups, group A of 24 patients with acceptable opacification (PGSR > 0.46 on day 2) and group B of 26 patients without it. Major cardiac events (cardiac death, nonfatal MI and repeat admission for congestive heart failure) were more frequently observed in group B (28% vs. 4%, Cox hazard ratio=8.5, p=0.05, 95% confidence interval [CI] 1.03 to 69.9). The median value of the RA ratio was 0.45. Patients (n=15) with RA ratio > 0.45 on day 1 and PGSR on day 2 < or = 0.46 exhibited a 10.7-fold relative risk for major cardiac events (p=0.005, 95% CI 2.06 to 55.8) and a 3.69-fold relative risk for composite cardiac events (major cardiac events and target lesion revascularizations) after the initial intervention (p=0.004, 95% CI 1.51 to 9.04). CONCLUSIONS: The assessment of both the size of the initial RA and microvascular integrity on day 2 enables precise determination of the efficacy of reperfusion therapy and prediction of the short- and intermediate-term prognoses of patients with recanalized MI.

Adult↗
PubMed1998

Effects of ATP-sensitive potassium channel opener on potassium transport and alveolar fluid clearance in the resected human lung.

Since the effect of an ATP-sensitive potassium channel (KATP channel) opener on the function of alveolar epithelial cells is unknown, the effect of YM934, a newly synthesized KATP channel opener, on potassium influx into the alveolar spaces and alveolar fluid clearance was determined in the resected human lung. An isosmolar albumin solution with a low potassium concentration was instilled into the distal airspaces of resected human lungs. Alveolar fluid clearance was measured by the progressive increase in alveolar protein concentration. Net potassium transport was measured by the change in potassium concentration and alveolar fluid volume. YM934 (10(-4) M) increased net influx of potassium by 140% into the alveolar spaces and also increased alveolar fluid clearance by 60% in the experiments with a potassium concentration of 0.3 mEq/1. Glibenclamide (10(-4) M), a KATP channel blocker, inhibited the YM934-increased influx of potassium transport and the increase in alveolar fluid clearance. Also amiloride (10(-5) M), an inhibitors of apical sodium uptake, blocked the YM934 stimulated increase in net alveolar fluid clearance. These results indicate that a KATP channel opener can effect potassium transport and net vectorial fluid movement across the human alveolar epithelium.

Adenosine Triphosphate↗
PubMed1998

Nocturnal oxyhemoglobin desaturation and prognosis in chronic obstructive pulmonary disease and late sequelae of pulmonary tuberculosis. Respiratory Failure Research Group in Japan.

We prospectively examined the survival rate of 67 chronic obstructive pulmonary disease (COPD) and 74 late sequelae of pulmonary tuberculosis (TB seq) patients to clarify whether nocturnal oxyhemoglobin desaturation (NOD) could be one of the independent factors determining their mortality. The sleep monitoring of arterial oxygen saturation (SpO2) and pulmonary function tests were assessed in all patients at the time of registration. Forty % of COPD and 24% of TB seq died as the direct result of deterioration of chronic respiratory failure during the 7-year observation period. Cox's proportional hazards analysis showed that NOD was an independent prognostic factor in both groups, and this was especially prominent when evaluated in terms of sleep lowest SpO2 in COPD and 85% desaturation time in TB seq. No significant prognostic factor was observed among age, vital capacity percent predicted (%VC), forced expiratory volume in one second (FEV(1.0)%) and partial pressure of carbon dioxide (PaCO2). We conclude that the degree of NOD can affect mortality in COPD and TB seq.

Blood Gas Analysis↗
PubMed1998

[Ultrasonographic screening in healthy 3-month-old children for congenital malformations of the urinary tract].

BACKGROUND AND METHODS: We performed renal ultrasonographic screening on 3799 healthy 3-month-old infants, who showed up for the routine health check up in Nobeoka City, for congenital malformations of the urinary tract. RESULTS: Urinary tract disorders were suspected in 139 (3.7%). Almost all ultrasonographic abnormalities of these were dissociation of CEC (Central Echo Complex). Thirty-three (24.4%) of the 135, which was 0.9% of the original 3799, were diagnosed as having significant congenital anomalies in urinary tract, such as vesicoureteral reflux (VUR) in 17, hydronephrosis in 10, unilateral renal agenesis in 2, unilateral small kidney in 2 and each case of horseshoe kidney, simple ureterocele, ectopic ureterocele, megaureter and mild dilated ureter. Minor or mild renal pelvis enlargement without the dilatation of calyx was found in 78 cases. Fifty-three of the 78 were followed more than 3 months, and complete or partial reduction of the pelvic enlargement was noted in 39 (74%), while enlarged pelvis remained unchanged in 14. There was no progressive hydronephrosis among these patients during the follow-up. Urinary tract infections were found in 6 cases (5 in VUR and 1 in ectopic ureterocele). Eleven ureters in 9 children of VUR (44%) were cured spontaneously (follow-up period: 3 months-6 months and 2 years). Surgical correction was required in 6 cases, antireflux surgery for VUR in 4, heminephroureterectomy for ectopic ureterocele in 1 and endoscopic incision of ureterocele for simple ureterocele in 1. CONCLUSION: Our result indicate that infant ultrasonographic screening is a useful and valuable method of detecting urinary tract malformations.

Diagnostic Tests, Routine↗
PubMed1998

[A case of renal pelvic carcinoma in a completely duplicated pelvis and ureter].

We report a case of renal pelvic carcinoma with a completely duplicated pelvis and ureter. A 72-year-old man was referred to our hospital because of asymptomatic and macroscopic hematuria. Excretory urography and retrograde pyelography revealed a tumor in the left upper renal unit of a completely duplicated pelvis and ureter. Left total nephroureterectomy was performed. Histological diagnosis was transitional cell carcinoma. This is the 8th case of upper urotherial tumor occurring in a completely duplicated pelvis and ureter in the Japanese literature.

Aged↗
PubMed1997

Marmoset liver cytochrome P450s: study for expression and molecular cloning of their cDNAs.

Northern blot and immunoblot analyses indicated that considerable levels of CYP2B, CYP2C, CYP2D, CYP2E, and CYP3A were expressed in the liver of untreated marmosets. CYP1A was also expressed but to lesser extents. CYP3A mRNA was also detectable in the small intestine of untreated marmoset; the amount was increased by treatment with polychlorinated biphenyl. From a liver cDNA library, two cDNA clones coding for CYP2D19 and CYP3A21 (clones CM2D-1 and CM3A-10, respectively) were isolated. CM2D-1 and CM3A-10 contained an entire coding region for polypeptide 497 and 503 amino acid residues, respectively. The deduced amino acid sequences of CYP2D19 and CYP3A21 showed 90% identities to human CYP2D6 and CYP3A4, respectively. The value of CYP3A21 was 3% lower than that of cynomolgus monkey CYP3A8. On the other hand, these values were 11 to 23% higher than those of the other experimental animals, including dogs, rabbits, guinea pigs, rats, mice, and hamsters. These results indicate that the marmoset stands at a midpoint between human and nonprimate experimental animals.

Amino Acid Sequence↗
PubMed1997

Increased alveolar fluid clearance following thoracotomy: report of a case and results of an analysis.

Alveolar fluid clearance was studied in the resected lung of a 58-year-old man who had undergone exploratory thoracotomy 9 days earlier. An isosmolar albumin solution was instilled into the distal air spaces, and the albumin and electrolyte concentrations were measured over 4 h. Alveolar sodium and fluid clearance had increased by nearly 200% from the control values in the resected lungs of patients without prior thoracotomy (n = 5), and histological examination showed that the number of alveolar type II epithelial cells was markedly elevated. These results suggest that an increase in the number of alveolar type II cells may accelerate alveolar fluid clearance under certain clinical conditions.

Aged↗
PubMed1997

Hypothermia inhibits the alveolar epithelial injury caused by hyposmotic albumin solution during preservation of the resected human lung.

This study was conducted to determine whether hypothermia inhibited alveolar epithelial injury in the resected human lung during preservation. Hyposmotic albumin solution, 248 mOsm/kg, was instilled into the alveolar spaces of resected human lungs which were inflated with an airway pressure of 7 cmH2O and stored at either 37 degrees C or 8 degrees C for 4 h. Alveolar fluid was aspirated and the influx of lactate dehydrogenase (LDH) and globulin into the alveolar spaces, as markers of alveolar epithelial injury, was measured. Ion transport and fluid clearance across the alveolar epithelium were calculated by the changes in electrolyte and albumin concentrations in the alveolar fluid, respectively. While the LDH levels and globulin concentrations increased significantly in the hyposmotic experiments at 37 degrees C, hypothermia inhibited these increases. Alveolar fluid clearance at 37 degrees C increased to 20% in the hyposmotic experiments compared with 12% in the control isosmotic experiments; however, sodium and chloride transport in the hyposmotic experiments was not significantly different from that in the isosmotic experiments. Thus, we conclude that hypothermia at 8 degrees C inhibits alveolar epithelial injury caused by the hyposmotic solution in resected human lungs. Moreover, alveolar ion and fluid clearance mechanisms were preserved across the injured alveolar epithelial cells.

Epithelium↗
PubMed1997

Marmoset CYP1A2: primary structure and constitutive expression in livers.

Complementary DNA of marmoset CYP1A2 was isolated by means of screening the cDNA library and reverse-transcriptase polymerase chain reaction. The deduced amino acid sequence of marmoset CYP1A2 consisted of 516 residues and showed 88.2 and 90.0% identities to corresponding forms in human and cynomolgus monkey, respectively. S1 nuclease protection assay demonstrated that CYP1A2 mRNA was expressed constitutively in the liver, but not in the lung, kidney and small intestine. The level of CYP1A2 mRNA in the liver was increased by treatment with 3-methylcholanthrene and polychlorinated biphenyls. Marmoset CYP1A2 expressed in recombinant yeast activated 2-amino-3-methylimidazo [4,5-f]quinoline (IQ) and 2-amino-3,8-dimethylimidazo [4,5-f]quinoxaline (MeIQx) efficiently, and also activated 2-amino-1-methyl-6-phenylimidazo [4,5-b]pyridine (PhIP), but at a relatively lower rate in the umu mutagenicity test. Marmoset CYP1A2 also showed ethoxyresorufin O-de-ethylase activity. Based on these results, we demonstrate that marmosets constitutively express CYP1A2 in the liver as in humans.

Amino Acid Sequence↗
PubMed1997

CD9 antigen interacts with heparin-binding EGF-like growth factor through its heparin-binding domain.

Heparin/heparan-sulfate proteoglycan (HSPG) binds to heparin-binding epidermal growth factor-like growth factor (HB-EGF) through its heparin-binding domain (HBD), which consists of 21 amino acid residues (P21). The CD9 antigen also interacts with a membrane-anchored form of HB-EGF (proHB-EGF) and enhances its juxtacrine activity. The CD9 antigen potentiates the juxtacrine activity of both proHB-EGF and proamphiregulin, but has no effect on proTGF-alpha. While both HB-EGF and amphiregulin contain an HBD, TGF-alpha does not. This suggests that the HBD of HB-EGF is also involved in CD9 antigen binding. Mutant CHO cells which lack HSPG recovered their capacity to bind to immobilized P21 when transfected with CD9 antigen cDNA. This binding was competitively inhibited by heparin in a dose-dependent manner. The interactions between synthetic peptides corresponding to the extracellular domain of CD9 antigen and the immobilized P21 were analyzed with surface plasmon resonance. The 119VIKEVQEFYKDTYNKLKTKD138 sequence of the CD9 antigen is thought to represent the binding site for HB-EGF. The k(D) values for heparin/P21 and 119V-D138/P21 were (2.82+/-0.10) x 10(-8) M and (3.71+/-0.71) x 10(-5) M, respectively. These results suggest that the 119V-D138 sequence of the CD9 antigen is the site which interacts with the HBD and may play an essential role in the upregulation of the juxtacrine activity of proHB-EGF.

Amino Acid Sequence↗
PubMed1997

Infant influenza.

Reports on the symptoms of infant influenza (less than 1 year of age) are very few. From 1989 to 1996, 105 infants with influenza were examined. The symptoms, nutrition and source of infection of the 105 patients were investigated in Sakuma Pediatric Clinic and viral studies were performed at the Kitakyushu City Institute of Environmental Sciences. The symptoms of patients under 6 months old are very mild, with a low maximum body temperature and a short duration of fever. Other complications are few. The symptoms gradually become more severe with each month of age. The ratio of patients displaying a diphasic fever with two peak temperatures increases with each month of age. Over 50% of patients over 9 months old have this diphasic fever with two peak temperatures. It is inconclusive whether an anti-infective factor in human milk exists or not. Of the 105 patients in this study, 28 were under 4 months of age: of these 28, all but 3 were infected by family members.

Age Factors↗
PubMed1997

Beta-adrenergic agonist stimulated alveolar fluid clearance in ex vivo human and rat lungs.

Because beta-adrenergic agonist therapy may be useful clinically as a treatment to hasten the resolution of alveolar edema, this study was designed to examine the dose-dependent effects of beta-adrenergic agonist therapy on alveolar epithelial fluid clearance. The studies were done by instilling an isosmolar 5% albumin solution into the distal air spaces of both ex vivo rat and ex vivo human lungs that were inflated with 8 to 10 cm H2O with 100% oxygen and placed in a 37 degrees C humid incubator. Alveolar fluid clearance was measured by the progressive increase in concentration of protein over 1 or 4 h. Salmeterol, a new long-acting lipophilic agent, was more potent than terbutaline in stimulating alveolar fluid clearance from the ex vivo human lung. Therefore, salmeterol was used for these studies. The results indicated that: (1) basal, unstimulated alveolar fluid clearance in rat lungs was significantly faster than in human lungs (24 +/- 4% over 4 h in rat lungs compared with 11 +/- 2% over 4 h in human lungs, p < 0.05); (2) comparison of equivalent doses of beta-adrenergic stimulation indicated that stimulated clearance rates were also faster in rat lungs than in human lungs; (3) very low doses of salmeterol were effective in ex vivo rat lungs (10(-8) M); and (4) relatively low doses were effective in the ex vivo human lungs (10(-6) M) as a treatment for increasing alveolar fluid clearance. In summary, there are significant differences in the basal and stimulated rates of alveolar epithelial fluid clearance in rat and human lungs, although the ex vivo human studies may have underestimated maximal alveolar fluid clearance in the intact human lung. The human lung responds well to relatively low doses of beta-adrenergic agonist therapy, a finding with potentially important clinical implications for hastening the resolution of alveolar edema.

Adrenergic beta-Agonists↗
PubMed1997

Carcinomatous change in the cranial metastasis from a metastasizing mixed tumor of the salivary gland--case report.

A 57-year-old female who had had a mixed tumor of the submandibular gland for 30 years presented with a cranial metastasis in the ipsilateral occipital region. Detailed histological examinations of the primary tumor failed to detect any carcinomatous component. In contrast, the metastasis contained a carcinomatous component. This histological discrepancy was confirmed by assessment of the expression of Ki-67 antigen in these tumor specimens and comparison with five typical benign mixed tumors. Cranial metastasis of a histologically benign mixed tumor is extremely rare, and a carcinomatous change in the metastatic tumor is apparently unique.

Adenoma, Pleomorphic↗
PubMed1997

[Giant thrombosed fusiform aneurysm at the branch of the middle cerebral artery presenting with intramural hemorrhage: a case report].

We report a rare case of a giant thrombosed fusiform aneurysm at the branch of left middle cerebral artery presenting with intramural hemorrhage of the aneurysm. A twenty-year-old man with familial and past history of migraine presented sudden temporalgia on August 13, 1995. Computed tomography (CT) scan on the day of the first attack revealed a well delineated high density area at the left Sylvian fissure, 2.5cm in diameter. Angiogram showed avascular area corresponding to the lesion, but no visualization of the aneurysm. On October 18, this patient presented sudden temporalgia again. CT scan on the day of the second attack indicated new intramural hemorrhage and surgery was performed on October 31. No evidence of subarachnoid hemorrhage was shown during the operation, and the lesion was proven to be a thrombosed fusiform aneurysm at the branch of the middle cerebral artery. The parent artery was clipped at both proximal and distal sides of the aneurysm, and the aneurysm was totally removed with success. Histological finding further supported the idea that the attacks mentioned were due to intramural hemorrhage of the thrombosed aneurysm. Postoperative course was uneventful and the patient was discharged without any neurological deficit. Intramural hemorrhage of a giant fusiform aneurysm is relatively rare, only reported in several autopsy cases. Furthermore, we failed to discover any comparable cases of giant fusiform aneurysm presenting symptoms directly caused by intramural hemorrhage of the aneurysm.

Adult↗
PubMed1997

[A case of bronchial stenosis due to postoperative inflammation treated with expandable metallic stent].

We presented a 61-year-old man who had undergone a left sleeve upper resection because of a squamous cell carcinoma of the upper lobe of the left lung. At 5 weeks after the operation, the anastomosis between the left main bronchus and the left lower bronchus became stenotic, therefore pneumonitis occurred below the anastomosis. Because of the inflammatory granulo stenosis for short time, we used an expandable metallic stent to save a residual lung function of the operated side. The anastomosis between the left main bronchus and the left lower bronchus was kept open satisfactorily, and in the late postoperative periods the residual lung function recovered until the levels of predicted residual lung function.

Anastomosis, Surgical↗
PubMed1997

Appositional angle closure in eyes with narrow angles: an ultrasound biomicroscopic study.

PURPOSE: To demonstrate appositional angle closure using ultrasound biomicroscopy under dark room conditions, to investigate patterns of appositional closure, and to correlate those patterns with the angle topology in eyes with narrow angles. METHODS: Forty-six eyes that met the study criteria, from 46 individuals, were examined by ultrasound biomicroscopy under dark room and illuminated conditions. RESULTS: In 40 of the 46 eyes (87.0%), appositional closure was identified by ultrasound biomicroscopy. Two distinct patterns of angle closure were seen: type B, in which closure starts from the bottom of the angle, and type S, in which closure starts in the vicinity of Schwalbe's line. In type B, the iris root was located closure to the chamber angle than in type S. CONCLUSIONS: Ultrasound biomicroscopy performed under dark room conditions is a useful technique for identifying appositional angle closure in eyes with narrow angles. The topology of the iris root is related to the pattern of the appositional angle closure.

Adult↗
PubMed1997

[A case of infant testicular tumor diagnosed ultrasonographically in the prenatal period].

We report a case of testicular tumor detected by ultrasonography during the prenatal period. Ultrasonography performed at 32 weeks of gestation showed that one testis was larger than the other. The right testis was markedly enlarged at 38 weeks of gestation. The heterogeneous echo pattern of the right testis suggested a testicular tumor. Right high orchiectomy was performed 3 months after birth. Pathological findings of the tumor were teratoma with mature and immature components according to the histological classification of testicular tumor. In Japan, this is the second case diagnosed in the prenatal period using ultrasonography.

Female↗