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Biomedical subjects

Y Fujimura

Publications and source records attributed to Y Fujimura.

At least 253 records · Page 14Linked to original sources
PubMed1993

[Surgical treatment of ventricular septal defect associated with Down syndrome].

Twelve patients with ventricular septal defect with Down syndrome (Down group) underwent cardiac surgery. As they had pulmonary hypertension (Pp/Ps > or = 0.5), we chose twenty patients who had pulmonary hypertension (Pp/Ps > or = 0.5) with ventricular septal defect without Down syndrome as control group. After cardiac surgery, Pp/Ps in Down group decreased significantly from 0.81 +/- 0.14 to 0.48 +/- 0.25 (p < 0.01). Cardiac index (l/min/m2) between 24 hours after operation was 3.3-3.8 in Down and 4.1-4.8 in control group (NS). Oxygenation index (mmHg) between 24 hours after operation was 211-266 in Down and 230-314 in control group (NS). Eleven out of 12 patients in Down group had good operative result. One patient was complicated with post-operative pulmonary hypertensive crisis. Low output syndrome and death were not encountered in Down group. We were satisfied with operative results and encourage surgical treatment for ventricular septal defect with Down syndrome.

Child↗
PubMed1992

The interaction of botrocetin with normal or variant von Willebrand factor (types IIA and IIB) and its inhibition by monoclonal antibodies that block receptor binding.

We have recently shown the existence of two distinct forms of botrocetin (one-chain and two-chain), and demonstrated that the two-chain species is approximately 30 times more active than the one-chain in promoting von Willebrand factor (vWF) binding to platelet glycoprotein (GP) Ib. The N-terminal sequence of two-chain botrocetin is highly homologous to sea-urchin Echinoidin and other Ca(2+)-dependent lectins (Fujimura et al., Biochemistry 1991; 30: 1957-64). Present data indicate that purified two-chain botrocetin binds to vWF from plasmas of patients with type IIA or IIB von Willebrand disease and its interaction is indistinguishable from that with vWF from normal individuals. However, an "activated complex" formed between botrocetin and IIB vWF expresses an enhanced biological activity for binding to GP Ib whereas the complex with IIA vWF has a decreased binding activity. Among several anti-vWF monoclonal antibodies (MoAbs) which inhibit ristocetin-induced platelet aggregation and/or vWF binding to GP Ib, only two MoAbs (NMC-4 and RFF-VIII RAG:1) abolished direct binding between purified botrocetin and vWF. This suggests that they recognize an epitope(s) on the vWF molecule in close proximity to the botrocetin binding site.

Antibodies, Monoclonal↗
PubMed1992

Ultrastructural study of M cells from colonic lymphoid nodules obtained by colonoscopic biopsy.

The present study was undertaken to investigate ultrastructurally the epithelium covering lymphoid nodules obtained from colonoscopic biopsies of the human colon and rectum. Colonoscopy using the dye spraying contrast method was performed in nine patients who showed x-ray evidence of lymphonodular hyperplasia. Fifty-two colonoscopical biopsy specimens of lymphoid nodules were obtained from the ascending, transverse, and descending colon and rectosigmoid region. All specimens were observed by light and electron microscopy. Light microscopy disclosed large lymphoid follicles protruding into the lumen with a "dome-type" configuration. These extended to the lamina propria of the mucosa and were associated with a massive lymphoid aggregation extending as far as the muscularis mucosa from the submucosa. The epithelium covering these nodules contained a few goblet cells and many lymphocytes. Observation of the elevated surface at the apex by scanning electron microscopy revealed M cells with sparse microvilli in the dome epithelium surrounded by crypts. Transmission electron microscopy disclosed M cells enfolding many immature or mature lymphocytes and plasmocytes. The M cells had cytoplasmic microvilli (so-called "microfolds") on their surfaces, well-developed tubulovesicular systems, and vacuoles in the cytoplasm. The basic structure of the M cells as observed by scanning and transmission electron microscopy was the same as that of M cells in the Peyer's patches of humans and mice. The apical surface of the colonic lymphoid follicles in Crohn's disease patients was associated with erosions observed by scanning electron microscopy. The erosions proved to be the naked surface of the dome after removal of the epithelium, and many holes from 2.0 to 6.0 microns in diameter were observed on the naked surface. At high magnification, lymphocytes were seen projecting from holes (18%) on the naked surface of the dome. These ultrastructural findings indicate that human colonic lymphoid follicles are very similar to those seen in other species.

Adult↗
PubMed1992

Spontaneous fracture of the odontoid process in rheumatoid arthritis.

Six cases of spontaneous fracture of the odontoid process in rheumatoid arthritis are presented. Fifty-one patients with atlantoaxial subluxation in rheumatoid arthritis underwent surgery between 1981 and 1990. This included six patients (in 10%) who had subluxation accompanied by fracture of the odontoid without apparent trauma. The mean patient age was 58 years and all had a long history of rheumatoid arthritis. No trauma was considered to be the cause of the fracture. This is a fracture caused by erosion and osteoporosis of the odontoid process due to rheumatoid synovitis, aging and steroid therapy. In addition, another cause is a dynamic load produced from the instability accompanying atlantoaxial subluxation working on the odontoid in cervical extension. It is important remember that the odontoid process is susceptible to spontaneous fracture.

Aged↗
PubMed1992

A clinical study of degenerative spondylolisthesis. Radiographic analysis and choice of treatment.

Surgical treatment of degenerative spondylolisthesis in 27 patients by means of anterior lumbar interbody fusion and in 14 patients by means of posterior decompression yielded average degrees of recovery of 77% and 56%, respectively. Preoperative analysis of myelograms, and computed tomographies after myelography indicated that anterior shifting of the inferior articular process of the slipping vertebra was the main factor responsible for compression of the nervous tissue in the early stages of degenerative spondylolisthesis. Patients in these stages should be treated by anterior lumbar interbody fusion. In the later stages of degenerative spondylolisthesis, osteophytes on the superior articular processes of the lower vertebra were an additional factor in compression, and patients should be treated by posterior decompression. Computed tomographies after myelography provided the key images for identifying pathologic processes in degenerative spondylolisthesis and selecting appropriate surgical procedures.

Adult↗
PubMed1992

Epinephrine augments von Willebrand factor-dependent shear-induced platelet aggregation.

BACKGROUND: Shear-induced platelet aggregation (SIPA) is an important mechanism in thrombogenesis. von Willebrand factor (vWF) binding to platelet glycoprotein Ib (GP Ib) has been found to be crucial for platelet aggregation under the high shear force probably generated in stenosed coronary artery. The physiological significance of vWF-dependent SIPA has not been clarified. METHODS AND RESULTS: Blood samples were collected from 23 normal volunteers. SIPA was continuously monitored using a modified cone-plate viscometer adapted for measuring the transmitted light intensity of the material. The effects of low concentrations of epinephrine, ADP, and collagen on SIPA under both low shear (12 dyne/cm2) and high shear (108 dyne/cm2) force were investigated. All agonists tested enhanced SIPA under low shear force, whereas only epinephrine augmented SIPA under high shear force. The maximum extents of SIPA under high shear force in the absence and presence of epinephrine (10 ng/ml) were 37.9 +/- 11.5% and 59.7 +/- 13.9%, respectively. The antagonist of the alpha 2-adrenergic receptor yohimbine (1 microgram/ml) antagonized the effects of epinephrine. The monoclonal antibody NMC-4 against vWF, which was shown to inhibit its binding to GP Ib, completely abolished SIPA under high shear force, even in the presence of epinephrine. However, this antibody only partially inhibited SIPA under low shear force. CONCLUSIONS: Our findings suggest that epinephrine is the agonist that enhances SIPA mediated by vWF through its specific receptor. This may be clinically important because occlusion of the coronary artery often occurs in stenosed atherosclerotic vessels under sympathetic stimulation.

Adrenergic alpha-Antagonists↗
PubMed1992

Remarkable improvement of growth and developmental retardation in Crohn's disease by parenteral and enteral nutrition therapy.

The patient, an 18-yr-old male (admission ht 153 cm, wt 30 kg), had been suffering from growth arrest and intermittent abdominal pain since he was 13 yr old, which was left untreated. Examinations on admission disclosed almost normal pituitary function, while levels of testosterone and somatomedin C were low. Roentgenological examination revealed extensive skip-stenotic lesions and longitudinal ulcers in the ileum, diagnostic of Crohn's disease. Therapy involving high-caloric parenteral and enteral alimentation resulted in a marked increase in both ht and wt, and improvement in roentgenological and colonoscopical findings. The interrelation between Crohn's disease and malnutrition with reference to some reports in the literature is discussed.

Adolescent↗
PubMed1992

[Left ventricular-right atrial communication with a residual ventricular septal defect: a case report of successful VSD patch closure with tricuspid valvuloplasty using folded patch].

A 18-year-old woman with combination of left ventricular right atrial communication (LV-RA communication) and residual ventricular septal defect (VSD) was presented. She underwent the radical operation of atrial septal defect, VSD and infundibular pulmonary stenosis at the age 11 years. Surgery was performed under the diagnosis of LV-RA communication and residual VSD. Two small defect were existed at the septal leaflet of the tricuspid valve, which communicated to left ventricle. The part of patch being used as closure of VSD at the previous operation, including perforated part of the septal leaflet was resected. A folded patch was used to reinforce the residual VSD and valvuloplasty was made using the remaining intact tricuspid tissues. Post-operative clinical course was uneventful. Shunt flow from LV to RA was not demonstrated in the postoperative left ventricular angiocardiography.

Adolescent↗
PubMed1992

[A successful treatment of emergent Cabrol's procedure for an acute aortic dissection (DeBakey type I)].

A 38-year-old male was admitted due to severe chest pain. Echocardiography and CT revealed an acute dissecting aneurysm. Cabrol's operation was performed immediately in order to prevent a rupture of the ascending aortic aneurysm and the dissection extending to the heart. Intraoperative trans-esophageal echocardiography was useful to get detailed informations, such as an extent of the dissection and a site of the entry. He was discharged from hospital on 53rd day and returned to society.

Adult↗
PubMed1992

[Surgical treatment of myocardial ischemia with cardiogenic shock].

We evaluated the results of surgical treatment of myocardial ischemia with cardiogenic shock in ten patients. Seven of 10 patients survived after surgery. Other three patients died of multiple organ failure (two patients) or severe left ventricular power failure (one patient). Two patients with previous infarction survived. Lesions in the group of survivors after surgery were left main trunk (LMT) disease in one patient, three vessel disease (3VD) in two, 2VD in two and 1VD in two patients. All nonsurvivors had LMT disease. Two patients died in whom preoperative electrocardiography (ECG) had shown Q wave. No significant difference in periods from onset to start of cardiopulmonary bypass (CPB) and from onset to recanalization was found between survivors and nonsurvivors. CPB time and aorta cross-clamp time in survivors were similar to those in nonsurvivors. At 24-hour after operation, pulmonary capillary wedge pressure in survivors showed significantly low value compared to that in nonsurvivors (12.8 +/- 3.9, 19.3 +/- 1.5 mmHg, respectively, p less than 0.05). Four patients out of seven survivors were in 1 of Forrester's classification, two in 2 and one in 3. Of three nonsurvivors, one were in 3 and two in 4. We conclude that mortality related to three risk factors: (1) LMT disease, (2) Q wave in preoperative ECG, and (3) hemodynamic state at 24-hour after operation.

Acute Disease↗
PubMed1992

[Corrected transposition of the great arteries with associated tricuspid valve incompetence--report of a case of successful tricuspid valve replacement].

A 36-year-old woman with corrected transposition (C-TGA) of great arteries with associated systemic atrioventricular valve (A-V valve) regurgitation was presented. Cineangiography revealed that the right sided ventricle was morphologic left ventricle, and left sided ventricle was morphologic right ventricle. In addition, severe systemic A-V valvular regurgitation (Sellers IV) was demonstrated. Under the diagnosis of C-TGA with associated A-V valvular regurgitation, left sided atrioventricular valve replacement was performed using 29 mm SJM valve. Left sided atrioventricular valve was tricuspid valve (TV). A part of the anterior tricuspid leaflet and two pieces of papillary muscle was resected. Postoperative course was uneventful. The pathological findings indicated that valvular tissue had myxomatous degeneration.

Adult↗
PubMed1991

Carbohydrate analysis of human von Willebrand factor with horseradish peroxidase-conjugated lectins.

Human von Willebrand factor (vWF) immobilized on a polyvinylidene difluoride membrane was subjected to binding assay with a series of horseradish peroxidase-conjugated lectins. The protein was reactive with concanavalin A, Ricinus communis agglutinin 120, wheat germ agglutinin and Ulex europaeus agglutinin I (UEA-I) but not with peanut agglutinin before sialidase treatment. These reactivities were consistent with the major oligosaccharide structure reported except for UEA-I. The reactivity with UEA-I was greatly decreased after digestion of the protein with either alpha-L-fucosidase or peptide-N-glycosidase F, but no significant decrease was observed after mild alkaline treatment or delipidation. vWF and UEA-I have been independently used as a good marker for human endothelial cells. Our results indicate that vWF itself contains UEA-I reactive sugar chains in its Asn-linked oligosaccharides.

Carbohydrates↗
PubMed1991

The promoter of the endo A cytokeratin gene is activated by a 3' downstream enhancer.

Mouse cytokeratin EndoA is an intermediate filament subunit of the type II cytokeratin class which initiates expression in trophectoderm cells of blastocyst during embryogenesis. To identify the regulatory elements of the endo A gene, we constructed a series of CAT expression vectors and transfected them into PYS-2 cells. We found an enhancer element locating 1 kb downstream from the endo A gene which acts on both the endo A and SV40 promoters. This enhancer consists of six direct repeated sequences with homology to the PEA3 motif in polyoma virus alpha enhancer core. In undifferentiated F9 embryonal carcinoma cells, expression of the construct containing the enhancer was not detected. These results indicate that one of the regulatory mechanisms of endo A gene expression is the 3' downstream enhancer.

Animals↗