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Biomedical subjects

Y Fujimura

Publications and source records attributed to Y Fujimura.

At least 181 records · Page 10Linked to original sources
PubMed1996

[Significance of systemic inflammatory response syndrome at cardiopulmonary bypass].

Systemic Inflammatory Response Syndrome (SIRS) is a new concept of entry criteria for sepsis. This concept, when applied to area of Multiple Organ Failure (MOF), is considered to be a preparatory state for MOF. To study the significance of SIRS state at cardiac surgery, we measured the body temperature, white blood cell count, respiratory rate and heart rate of 18 patients who underwent elective cardiac surgery, from the 1st post-operative day to the 7th post-operative day. We also measured Interleukin-6 and 8 (IL-6 and IL-8) to understand the relationship between the SIRS state and inflammatory cytokines just after cardiopulmonary bypass (CPB), at the 1st, 3rd and 6th postoperative day. The result was as follows: Patients with CPB more than 120 minutes have more frequency and longer duration of SIRS than patients with CPB less than 120 minutes. Serum levels of IL-8 at SIRS state were revealed statistically higher than at non-SIRS case. Duration of SIRS state was related to CPB time and serum levels of IL-6 and IL-8 just after CPB. We concluded that SIRS state is an indication for anti-cytokine therapy to prevent MOF, and it is important to shorten CPB time in order to decrease the duration of SIRS.

Cardiopulmonary Bypass↗
PubMed1996

[Postoperative immunological capacity after coronary artery bypass grafting in a patient with chronic hemodialysis: comparison with data from patients without chronic hemodialysis].

Recently, coronary artery bypass grafting (CABG) has been performed safely in patients maintained on hemodialysis. However, the postoperative immunological capacity of patients undergoing CABG during chronic hemodialysis has not been fully investigated. Recently we performed CABG in a patient undergoing chronic hemodialysis and measured the immunological parameters. The WBC count, the populations of lymphocytes, OKT 4-positive cells, and OKT 8-positive cells, and NK activity were determined, and the lymphocyte stimulation test (using PHA) was performed before and after cardiopulmonary bypass, then, 1, 3, and 6 days after CABG. We compared these data with those from 17 patients without chronic hemodialysis. The immunological capacity after CABG in the patient with chronic hemodialysis was similar to that of patients without chronic hemodialysis. We suggest that CABG in patients with chronic hemodialysis is a safe operation with regard to the immunological capacity.

Adult↗
PubMed1996

[An approach to the emergency surgery for arch and/or ascending aortic aneurysm].

The outcome of emergency surgery for the aortic arch aneurysm and/or dissecting aneurysm is worse than that of elective surgery. To decide the future strategy of the emergency surgery for these disease, 11 patients with emergency surgery (= group E: 8 for aortic dissection and 3 for rupture of the aortic arch aneurysm, age; 61 +/- 13 SD) were compared with 12 patients who had elective surgery (= group S: 5 for aortic dissection and 7 for aortic arch aneurysm, age; 69 +/- 3 SD). Ascending aorta replacement was performed in 7 cases in group E v.s. 1 in group S, aortic arch replacement in 2 v.s. 5, ascending aorta and aortic arch replacement in 1 v.s. 4 and patch replacement of the aortic wall in 1 v.s. 2, respectively. Selective cerebral perfusion (SCP) upon the cardiopulmonary bypass (CPB) was used in 45% (5/11) in group E. v.s. in 92% (11/12) in group S, p < 0.05. CPB time, aortic clamp time and SCP time were not significantly different between E group and S group. Postoperative cardiac failure, respiratory failure, renal failure, brain injury and infection occurred at insignificant rates between both groups. Thirty-day and 3-year survivorships were 73% in group E, while in group S they were 92% and 75%, respectively. In group E there were 2 cases which had aortic wall injury due to the aortic clamp used during the surgery. We recommend the use of selective cerebral perfusion and open distal anastomosis in emergency surgery for aortic arch aneurysm and/or Stanford type A aortic dissection.

Aged↗
PubMed1996

Metastases to the upper cervical spine.

A retrospective study of 13 patients with metastases to the upper cervical spine was designed to examine the clinical efficacy of surgical treatment. All patients had severe neck pain and two had quadriplegia. Eleven patients underwent operative posterior stabilization, and two patients were treated with a brace and radiotherapy. Pain relief after surgery was significant so that 10 of the 11 patients could leave bed and resume their normal activities. The other two patients who were treated nonoperatively had severe dementia and sudden death from a respiratory arrest after a fall, despite temporary relief from pain. Surgery may be very successful in improving the quality of life of patients who have pain and/or paralysis caused by metastases to the upper cervical spine.

Adult↗
PubMed1996

Treatment protocol for fractures of the odontoid process.

Treatment results in 104 patients with odontoid fractures were reviewed. There were 2 type I, 62 type II, 32 type III fractures and eight epiphysiolyses in children <7 years old. Thirty-seven patients were managed nonoperatively using plaster casts, cervical braces, or halo devices. Sixty-seven patients were treated surgically including anterior screw fixation (ASF), posterior fusion (PF), and transoral anterior fusion (TAF). Plaster casts and cervical braces were effective for type I fractures and epiphysiolyses only. Halo devices provided successful results in stable type III fractures. ASF is the treatment of choice for most type II and unstable III fractures including some old cases. PF also provided successful union, although impaired cervical motion remained. It should be reserved for irreducible fractures, established nonunions, and as a salvage procedure. TAF should be limited to exceptional cases requiring anterior spinal cord decompression.

Adolescent↗
PubMed1996

Usefulness and reliability of neurological signs for level diagnosis in cervical myelopathy caused by soft disc herniation.

We retrospectively analyzed neurological signs of 106 patients with cervical myelopathy caused by single-level soft disc herniation. Neurological signs that were intensively analyzed were deep tendon reflexes, the uppermost level of impaired pinprick sensation, the uppermost weak muscle, and region of numbness in the hands. Characteristic signs for each intervertebral level were deduced, and sensitivity, specificity, and accuracy of these signs were calculated. Deep tendon reflexes were specific signs for each intervertebral level, although not as sensitive as the neurological signs. Muscle weakness and pinprick sensation were neither sensitive nor specific. Hand numbness was moderately sensitive and specific. On the whole, there was no neurological sign that was both highly sensitive and specific for an intervertebral level, and therefore, neurological level diagnosis in cervical myelopathy should be performed comprehensively according to more specific signs, i.e., deep tendon reflexes and hand numbness.

Adult↗
PubMed1996

[Thoracoscopic closure of patent ductus arteriosus for children: two case report].

We reported thoracoscopic closure of patent ductus arteriosus (TCPDA) performed on two children. All of two patients had no residual shunt postoperatively. Postoperative pain was less than left thoracotomy procedure. In addition TCPDA had merits cosmetically. We concluded that TCPDA was less invasive and safety procedure compared with conventional procedure.

Child, Preschool↗
PubMed1996

[A case of pulmonary sarcoma with a differential diagnosis from preoperative pulmonary thromboembolism].

Primary sarcoma of pulmonary artery is a rare tumor. A 46-year-old man was hospitalized because of dyspnea and hemoptysis. Pulmonary thromboembolism was suspected by chest X-ray, scintigraphy, and CT. But the mass had a to-and-fro movement above the pulmonary valve on pulmonary arterial cineangiography. We strongly suspected that it was primary neoplasm of pulmonary artery. The pulmonary artery was opened under cardiopulmonary bypass. The tumor arised pulmonary trunk and extended peripherally. The tumor was surgically removed as complete as possible, though a proxymal balloon embolectomy was unsuccessful. The histological finding was malignant fibrous histiocytoma of the pulmonary artery.

Cardiopulmonary Bypass↗
PubMed1996

[A case report of open heart surgery in an infant with MNMS caused by femoral arterial cannulation during cardiopulmonary bypass].

We report a case of myonephropathic metabolic syndrome (MNMS) and compartment syndrome caused by femoral arterial cannulation during long-term cardiopulmonary bypass. A boy who had been diagnosed with truncus arteriosus type 1 and who subsequently underwent a Rastelli operation at age 3 months had a second Rastelli operation at age 6 years due to graft stenosis (pressure gradient 82 mmHg between RV and PA). MNMS and compartment syndrome occurred postoperatively due to long-term femoral arterial cannulation during cardiopulmonary bypass. However, acute renal failure was successfully managed with CAPD. The patient recovered from acute renal failure 40 days postoperatively. CAPD is considered useful for postoperative acute renal failure in infants. We conclude that retrograde insertion of the cannula should be changed to anterograde insertion at an earlier time, or else the cannula should be inserted via the prosthetic graft.

Acute Kidney Injury↗
PubMed1996

[Reconstruction of right ventricular outflow tract-pulmonary artery utilizing autologous tissue in extreme tetralogy of Fallot after coil embolization for major aortopulmonary collateral artery: report of a case].

We report a successful surgical treatment for tetralogy of Fallot with pulmonary atresia. A 18-year-old girl was admitted because of increasing exertional dyspnea and cyanosis. She had undergone bilateral classical Blalock-Taussing shunt. Prior to the correction, two major aortopulmonary collateral arteries were embolized using steel coils. Under cardiopulmonary bypass, posterior wall of the pulmonary artery was anastomosed directly to the cranial margin of the ventriculotomy for a floor made of autologous tissue. The roof was reconstructed using a patch with a monocusp. The patient is in a good postoperative condition. A coil embolization is useful and this reconstruction utilizing autologous tissue could prevent a late stenosis of the reconstructed pulmonary artery tract.

Adolescent↗
PubMed1996

[Usefulness of scheduled IABP for CABG].

We examined the usefulness of intra-aortic balloon pumping (IABP) before the coronary arterial bypass grafting (IABP) before the coronary arterial bypass grafting (CABG) in patients with severe ischemic heart disease. Left main trunk (LMT) disease, unstable angina and low ejection fraction (less than 40%) were indications for scheduled IABP. Eleven patients underwent IABP before CABG surgery (the scheduled IABP group), and five patients didn't before CABG surgery (the unscheduled IAPB group). Analysis comprised the duration of IABP and mortality. There were no significant differences between the two groups in age, pre-operational cardiac index, ejection fraction, aorta clamp time or total perfusion time. IABP application times were significantly longer in the unscheduled IABP group than in the scheduled IABP group (p < 0.05). No death occurred in the scheduled group, but three patients in the unscheduled group died (p < 0.05). No complications were observed due to IABP in any patient of either group. We conclude that scheduled IABP is useful for patients with severe ischemic heart disease.

Aged↗
PubMed1995

Reduction of mono(ADP-ribosyl)ation of histones in rat testis by gonadotropin-testosterone system.

Mono(ADP-ribose) synthetase activity in the nuclear fraction of immature rat testis was investigated in reference to the effect of testosterone. When the nuclear fraction was incubated with [32P] NAD in the presence of nicotinamide, an inhibitor of poly (ADP-ribose) synthetase, some proteins with a molecular mass of 14.4-21.5 kDa were ADP-ribosylated. In these proteins, H2B and H3 histones were found by sequencing 20 amino acids in the N-terminus. Their incorporations of ADP-ribose moiety were significantly decreased in immature rats at 4 hr after the subcutaneous injection of testosterone. Furthermore, the treatments with LH and FSH of the immature rats reduced mono(ADP-ribosyl)ations of H2B and H3 histones in a time-dependent manner. These results suggest that the testicular mono(ADP-ribose) synthetase activity is under the control of gonadotropin-testosterone system and is possibly related to differentiation of the testis.

ADP Ribose Transferases↗
PubMed1995

Loss of tumorigenicity of Ewing's sarcoma cells expressing antisense RNA to EWS-fusion transcripts.

Cytogenetic analysis of Ewing's sarcoma, primitive neuroectodermal tumors and Askin tumors revealed characteristic translocations t(11;22) or t(21;22). Molecular analysis of these translocations revealed 5'-region of EWS gene (from band 22q12) is fused to the 3'-region of either Fli-1 gene (from band 11q24) or erg gene (from band 21q22). Functional characterization of the EWS-Fli-1 and EWS-erg chimeric proteins suggested that they function as transcriptional activators. In order to develop therapeutic agents, it is essential to know whether expression of the EWS-fusion gene products is coupled to tumorigenicity of Ewing's sarcoma cells and if targeting the EWS-fusion products results in loss of tumorigenicity of Ewing's sarcoma cells. For this reason, we have made stable Ewing's sarcomas expressing antisense EWS-Fli-1 or EWS-erg expression plasmids. Expression of antisense EWS fusion transcripts resulted in a significant loss of endogenous EWS-Fli-1 and EWS-erg proteins in Ewing's sarcoma cells. These cells expressing antisense EWS fusion transcripts showed loss of anchorage independent growth and tumorigenicity in nude mice unlike the parental Ewing's sarcoma cells. These results demonstrate the necessity of a certain threshold level of expression of EWS-fusion products in the clonogenicity and tumorigenicity of Ewing's sarcoma cells and therefore emphasizes the importance of targeting the EWS-fusion products as a therapy for Ewing family of tumors.

Animals↗
PubMed1995

Tokaracetin, a new platelet antagonist that binds to platelet glycoprotein ib and inhibits von Willebrand factor-dependent shear-induced platelet aggregation.

A new platelet antagonist, tokaracetin, was isolated from the venom of Trimeresurus tokarensis by ion-exchange chromatography, heparin-Sepharose chromatography and hydrophobic HPLC. The purified protein showed an apparent molecular mass on SDS/PAGE of 28.9 kDa under non-reducing conditions. On reduction, 16.1 and 15.4 kDa subunits were observed, suggesting that the molecule is a heterodimer. Tokaracetin inhibited the binding of 125I-labelled bovine von Willebrand factor (vWF) and 125I-labelled human vWF in the presence of botrocetin to fixed human platelets. It did not block ADP-, collagen- or thrombin receptor agonist peptide-induced platelet aggregation in human platelet-rich plasma (PRP), or induce platelet agglutination in PRP. On reduction, tokaracetin lost its inhibitory activity on the agglutination of fixed human platelets by bovine vWF. 125I-Tokaracetin specifically bound to washed human platelets with high affinity (Kd 3.9 +/- 1.4 nM) at 47,440 +/- 2780 binding sites per platelet. Binding of tokaracetin to fixed human platelets was reversible, and was inhibited by monoclonal antibody GUR83-35, which is directed against the N-terminal vWF-binding domain of human glycoprotein Ib (GPIb). Tokaracetin completely inhibited vWF-dependent shear-induced platelet aggregation in PRP at 3 micrograms/ml. The N-terminal amino acid sequences of tokaracetin subunits showed a high degree of identity with those of alboaggregin-B. These results suggest that this new platelet antagonist may be a useful tool in the development of specific inhibitors of the vWF-GPIb interaction.

Amino Acid Sequence↗
PubMed1995

Flavocetin-A and -B, two high molecular mass glycoprotein Ib binding proteins with high affinity purified from Trimeresurus flavoviridis venom, inhibit platelet aggregation at high shear stress.

Two high molecular mass proteins, flavocetin-A and flavocetin-B, were purified from Trimeresurus flavoviridis venom. On polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, the apparent molecular mass of flavocetin-A and -B were 149 and 139 kDa, respectively, under nonreducing conditions. On reduction, flavocetin-A showed two distinct subunits (17 and 14 kDa), and flavocetin-B three distinct subunits (17, 15 and 14 kDa). At 1 microgram/ml, flavocetin-A and -B (flavocetins) inhibited the von Willebrand factor (vWF)-dependent aggregation of fixed human platelets. However, flavocetins (10 micrograms/ml) had no effect on ADP- and collagen-induced platelet aggregation in PRP. Flavocetins (3 micrograms/ml) also inhibited shear-induced platelet aggregation at high shear stress. Furthermore, flavocetin-A completely inhibited the aggregation of and ATP release from washed platelets stimulated with a low concentration of thrombin. Flavocetin-A specifically bound to platelet with high affinity (Kd = 0.35 +/- 0.13 nM) at 21,500 +/- 1760 binding sites per platelet. The N-terminal amino acid sequences of the subunits of flavocetin-A show a high degree of homology with those of echicetin, botrocetin, alboaggregin-B and factor IX/factor X-binding protein. These results suggest that flavocetins may be a useful tool for further investigation of the GPIb-vWF interaction.

Adenosine Triphosphate↗
PubMed1995

Protein tyrosine phosphorylation in human platelets induced by interaction between glycoprotein Ib and von Willebrand factor.

The interaction between von Willebrand factor (vWF) and glycoprotein Ib (GPIb) induced by ristocetin or botrocetin resulted in associated platelet aggregation, protein tyrosine phosphorylation (PTP) of a 64 kDa protein, as detected by a monoclonal antibody against phosphotyrosine (PY-20), and intracellular Ca2+ elevation that is largely dependent upon Ca2+ influx in human platelets. It is of interest that 75-80, 97 and 125 kDa proteins which are strongly tyrosine-phosphorylated in platelet activation induced by thrombin and other agonists were not detected. Neither vWF nor a coaggregating agent (ristocetin or botrocetin) alone induced aggregation, [Ca2+]i elevation or the 64 kDa PTP. NMC-4, an antibody which inhibits both ristocetin- or botrocetin-induced vWF binding to GPIb, abolished the appearance of the 64 kDa PTP as well as other responses, suggesting that it is specifically induced by the GPIb-vWF interaction. Aspirin, or ONO-3708, a competitive inhibitor of thromboxane A2, did not modify the 64 kDa PTP, while [Ca2+]i elevation was moderately suppressed. Depletion of extracellular Ca2+ or RGD peptides suppressed neither the 64 kDa PTP nor aggregation. H-7, a protein kinase C inhibitor, did not inhibit the 64 kDa PTP, while staurosporine, a potent protein kinase inhibitor, inhibited the 64 kDa PTP and Ca2+ influx, but not aggregation, in a dose-dependent manner. It is suggested that the 64 kDa PTP is associated with platelet aggregation induced by the interaction between GPIb and vWF.

Alkaloids↗