PubMed Health⌕ Search

Biomedical subjects

Y Fujimura

Publications and source records attributed to Y Fujimura.

At least 73 records · Page 4Linked to original sources
PubMed1999

The preoperative administration of lentinan ameliorated the impairment of natural killer activity after cardiopulmonary bypass.

The aim of this study was to determine whether the preoperative administration of lentinan, which is used clinically to activate T cell function in cancer patients, prevents the impairment of lymphocyte function after cardiopulmonary bypass (CPB). A total of 25 adults undergoing coronary artery bypass grafting were enrolled in this study. Lentinan (2 mg) was given to 10 randomly selected patients 7 d before surgery, while the other 15 patients were considered as a control. The white blood cell count, percentage of lymphocytes, subsets of lymphocytes, and natural killer cell activity were measured preoperatively, immediately after CPB and 1, 3, and 6 d after surgery. The white blood cell counts and the percentage of lymphocytes were not significantly different between the two groups; however, the percentage of CD4-positive cells in the lentinan group recovered to normal more rapidly than in the control group. Although natural killer cell activity was impaired in the control group after CPB, it maintained a nearly normal level in the lentinan group. The preoperative administration of lentinan for patients undergoing CPB ameliorated the impairment of natural killer activity and promoted the rapid recovery of CD4-positive cells.

Adjuvants, Immunologic↗
PubMed1999

Coronary arteriovenous fistulas with giant aneurysm: two case reports.

Coronary arteriovenous fistulas are rare, particularly in association with coronary aneurysms. Two rare cases of patients with coronary arteriovenous fistulas and giant aneurysmal formation are described. A right coronary fistula that drained into the superior vena cava was demonstrated in one patient. The remaining patient had a documented left coronary fistula that drained into a main pulmonary artery and had evidence of several plexal vessels that transversed through the pulmonary trunk and toward the pericardial reflex. Under cardiopulmonary bypass, the fistulas and plexal vessels were successfully ligated without any injury to the native coronary circulation.

Adult↗
PubMed1999

Experimental study on MRI evaluation of the course of cervical spinal cord injury.

STUDY DESIGN: An experimental study was conducted to evaluate MRI signal changes within the spinal cord after the injury in rats. OBJECTIVES: To clarify the significance of MRI signal changes in the injured cervical cord. SETTING: Tokyo, Japan. METHODS: Cervical spinal cord injury was produced in rats by placing a 20-g, or 35-g weight on exposed dura at the C6 level for 5 min (20 g- or 35 g-compression group). Motor function was evaluated by the inclined-plane method at 2, 7 and 28 days after the injury. T1- and T2-weighted images were produced by the spin-echo method with a static magnetic field strength of 2.0 tesla, at 2 and 28 days after the injury, and then the histopathological examinations were performed. RESULTS: In the 20-g compression group, which recovered from the paralysis at 28 days, MR images were T1 iso signal/T2 high signal 2 days after the injury and T1 iso signal/T2 high signal after 28 days. The changes in MRI signal 2 and 28 days represented edema and gliosis, respectively. In the 35-g compression group, which incompletely recovered from paralysis at 28 days. MR images were T1 iso-signal/T2 low signal surrounded by high signal 2 days after the injury and T1 low/T2 high signal at 28 days. The MRI signal changes 2 and 28 days reflected hemorrhage with edema and cavities, respectively. CONCLUSION: T2 low signal of the spinal cord observed early after injury reflects hemorrhage and may serve as an indicator of a poor prognosis. T1 low/T2 high signals from the subacute to chronic period indicated persistence of paralysis and limited recovery of function.

Animals↗
PubMed1999

Ependymomas of the spinal cord and cauda equina: An analysis of 26 cases and a review of the literature.

STUDY DESIGN: Retrospective review. OBJECTIVES: To clarify the clinical features of patients with spinal ependymomas and to compare the clinical results between the patients in whom microsurgical technique and spinal cord monitoring were used intraoperatively and the patients in whom they were not used. SETTING: Keio University Hospital, Tokyo, Japan. METHODS: Twenty-six consecutive patients with spinal ependymomas were treated surgically between 1958 and 1995. All patients underwent tumor resection through a posterior approach. Complete tumor resection was possible in 15 patients (57. 7%), and subtotal tumor resection (more than 90%) was done in two patients (7.7%). Only a partial tumor resection (less than 90%) was performed in the remainder of the patients (34.6%). The operative results of the patients were evaluated by the Japanese Orthopaedic Association Scoring System (JOA score) and its recovery rate. RESULTS: The overall average recovery rate was 18.3%. The mean recovery rate was 14.4% in cervical lesion, 11.1% in thoracic lesion and 40% in lumbar lesion. The recovery rate of eight patients with cervical ependymomas who underwent tumor resection under both microscopic surgical procedure and intraoperative spinal cord monitoring was 37.1% although the recovery rate of the rest of the patients was -1.6%. There was a statistical difference between the two groups (P<0.02). The survival rate of patients following complete excision was statistically better compared to that of patients after incomplete resection. CONCLUSION: Both microsurgical technique and spinal cord monitoring are indispensable to achieve total removal of ependymomas and to obtain improvement of neurological recovery.

Adolescent↗
PubMed1999

Total inhibition of high shear stress induced platelet aggregation by homodimeric von Willebrand factor A1-loop fragments.

Under high shear stress, the binding of von Willebrand factor (VWF) A1-loop domain to platelet glycoprotein (GP) Ib alpha occurs as the earliest event in thrombus formation. Therefore recombinant VWF A1-loop fragments could be of therapeutic use in blocking this interaction as competing ligands. We have prepared three homodimeric VWF A1-loop fragments [315 kD Fr III (a homodimer of amino acid [aa] residues 1-1365 of the subunit), 220 kD Fr (a homodimer of aa residues 1-708 of the subunit), and 116 kD Fr (a homodimer of aa residues 449-728 of the subunit) and two monomeric fragments [39/34 kD Fr (a monomer of aa residues 480/481-718 of the subunit] and His-rVWF465-728 (a monomer of aa residues 465-728 of the subunit)], and assessed their potency as inhibitors of botrocetin-induced VWF binding to GPIb alpha and high shear stress induced platelet aggregation mediated by intact VWE All these fragments completely inhibited botrocetin-induced VWF binding to GPIb alpha at a final concentration of 40-200 microM. The homodimeric A1-loop fragments also totally inhibited high shear stress induced platelet aggregation at a final concentration of 0.45-2.0 microM in the following order: 315 kD Fr > or = 220 kD Fr >> 116 kD Fr. In contrast, the monomeric A1-loop fragments were only partial inhibitors of high shear stress induced platelet aggregation even at a final concentration of 20 microM, and their IC50s were 13-39 times higher than those of the homodimers. These results indicate that the homodimeric structure of the A1-loop fragment is important for optimal molecular interaction with GPIb alpha under high shear stress.

Humans↗
PubMed1999

A newly designed adapter for testing an ex vivo mitral valve apparatus.

Few instruments are currently available to test mitral valve function in an ex vivo state due to the technical difficulties involved. To investigate the native ex vivo mitral valve or prosthetic mitral valve with chordae, we developed a mitral valve adapter with an annulus suturing portion and 2 papillary muscle suturing sites that can be changed in angle, direction, and length of chordae. We used this adapter to test an ex vivo mitral apparatus in beagle dogs and evaluated the morphology and function of the mitral apparatus by endoscopy. Our newly designed mitral valve adapter proved extremely useful for examining the ex vivo mitral valve anatomy and function and for testing stentless mitral prostheses with annular-papillary muscle continuity.

Animals↗
PubMed1999

Deletion polymorphism in the gene for angiotensin-converting enzyme is not a risk factor predisposing to abdominal aortic aneurysm.

OBJECTIVE: to establish whether deletion of the angiotensin-converting enzyme (ACE) gene is a risk factor predisposing to abdominal aortic aneurysm (AAA) or not. METHODS: the study included 125 patients with AAA and 153 controls randomly selected from 328 individuals. The control subjects were confirmed not to have an AAA, but matched with the AAA group for age, sex, hypertension, diabetes mellitus, and hyperlipidaemia. The presence of ACE polymorphism was detected by a polymerase chain reaction using DNA extracted from blood. RESULTS: the distribution of ACE genotypes and allele frequencies in the control and AAA groups was not significantly different. CONCLUSION: the deletion polymorphism in the ACE gene is not a risk factor for AAA.

Aged↗
PubMed1999

Increased plasma levels of adrenomedullin in patients with systemic inflammatory response syndrome.

We measured the plasma levels of adrenomedullin (AM), a novel vasodilating peptide, in 89 patients with various forms of systemic inflammatory response syndrome (SIRS) and 13 healthy volunteers serving as controls. Plasma levels of AM in SIRS (burns: 20.5 +/- 3. 2 fmol/ml [mean +/- SEM]; pancreatitis: 13.8 +/- 3.8 fmol/ml; trauma: 14.9 +/- 2.5 fmol/ml; traumatic shock: 41.1 +/- 7.8 fmol/ml; severe sepsis: 59.9 +/- 11.2 fmol/ml; septic shock: 193.5 +/- 30.1 fmol/ml) were significantly increased over those of controls (5.1 +/- 0.2 fmol/ml). The patients with traumatic shock or septic shock especially had higher levels of plasma AM than those with trauma or severe sepsis, respectively. These data showed that in patients with SIRS, plasma AM levels increased in proportion to the severity of illness. Subsequently, we measured the plasma levels of mediators such as tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-8, plasminogen activator inhibitor (PAI)-1, and thrombomodulin (TM) in patients with traumatic shock and septic shock. A significant correlation was observed between plasma AM and TNF-alpha levels in patients with septic shock, suggesting an important role for AM as well as of TNF-alpha in the pathophysiology of inflammation. Plasma AM and IL-8 levels correlated positively with Acute Physiology and Chronic Health Evaluation (APACHE) II score, peak multiple organ failure (MOF) score during the first month and prognosis in patients with septic shock, as did plasma IL-6 levels in patients with traumatic shock. The plasma AM level might serve as a useful marker for evaluating the severity of disease and as an early predictor of subsequent organ failure and outcome in septic shock.

APACHE↗
PubMed1999

Coronary artery bypass grafting in the acute phase after renal transplantation: report of a case.

To the best of our knowledge, only 3 cases of coronary artery bypass grafting (CABG) performed under cardiopulmonary bypass (CPB) on patients in the chronic phase after renal transplantation have been reported in Japan. The first case of a patient who underwent CABG in the acute phase after renal implantation in Japan is herein described. Perioperatively, oral immunosuppressive agents were discontinued and they were given intravenously. Cyclosporin A (Cy-A) was administered via a continuous intravenous infusion in the acute phase after renal transplantation and closely monitored, because the blood concentration of Cy-A can vary a great deal during the perioperative period. This case report serves to demonstrate that as long as appropriate immunosuppressive drugs are perioperatively administered, CABG under CPB can be safely performed on patients who have undergone renal transplantation without subsequent rejection, infection, or renal damage, even during the acute phase.

Administration, Oral↗
PubMed1999

Identification of the binding site for an alloantibody to von Willebrand factor which inhibits binding to glycoprotein Ib within the amino-terminal region flanking the A1 domain.

An alloantibody to von Willebrand factor (vWF) which developed in a Japanese boy with type 3 von Willebrand disease has been characterized. The antibody was non-precipitating IgG and the main subclasses were IgG2 and IgG4. The antibody inhibited completely ristocetin-induced platelet aggregation (RIPA) and high shear stress-induced platelet aggregation (SIPA). Its predominant inhibitory role was focused, therefore, on the interaction between vWF and platelet gycoprotein Ib. The antibody reacted with a 52/48 kDa tryptic fragment of vWF (residues 449-728). No reaction was seen, however, with either a 39/34 kDa dispase fragment (480-718) or a recombinant vWF fragment (residues 465-728). These findings suggested that the essential epitope resided in the amino-terminal flanking region of the Al domain. We synthesized overlapping peptides corresponding to the region containing D3/A1 boundary. A peptide, residues 458-472, bound to the antibody and dose-dependently blocked the antibody binding to the 52/48 kDa fragment. The same peptide neutralized the inhibitory effect of the alloantibody on SIPA. The data are consistent with the presence of an epitope within residues 458-472 which reacted with the 52/48 kDa fragment. Furthermore, the specific component of the antibody, directed against residues 458-472, blocked vWF binding to GPIb in absence of exogenous agonist. Our results suggest that the region flanking the Al domain plays an important role in regulating vWF binding to GPIb.

Antibody Specificity↗
PubMed1999

[Coronary artery bypass grafting for a patient with angina pectoris and ulcerative colitis].

The implementation of coronary artery bypass grafting for angina pectoris with ulcerative colitis has been rarely reported. A 63-year-old man has a past history of acute myocardial infarction in 1984 and ulcerative colitis since 1988. Coronary angiography and cardiac catheterization showed total obstruction of segment 2, 95% stenosis of segment 6, 75% stenosis of segment 7 and total obstruction of segment 12 with LVEF 23%. Coronary artery bypass grafting was performed under IABP support and cardiopulmonary bypass with aprotinin infusion after an inflammatory reaction of ulcerative colitis was adequately suppressed. Ulcerative colitis was controlled by administering 40 mg of predonisolone during perioperative period.

Angina Pectoris↗
PubMed1999

[A one-staged operation for mitral regurgitation and giant bulla in a patient with severe pulmonary hypertension: report of a case].

A 57-year-old woman was admitted to our hospital for the treatment of mitral regurgitation and giant bulla with severe pulmonary hypertension. A dobutamine-induced test performed preoperatively resulted in a decrease of the systolic pulmonary artery pressure by 30 mmHg. Subsequently, mitral valve replacement and bullectomy were performed concomitantly. The patient recovered from heart failure, and the pulmonary artery pressure clearly decreased during the perioperative period. This case report serves to demonstrate the effectiveness of performing a one-staged operation for mitral regurgitation and giant bulla with severe pulmonary hypertension.

Blister↗
PubMed1999

[Detection and genotype analysis of GB virus C/hepatitis G virus (GBV-C/HGV) in the sera of Japanese patients with hemophilia A].

The recently discovered GB virus C/hepatitis G virus (GBV-C/HGV) has been shown to be scarcely associated with hepatitis, though its possible pathogenesis remains unknown. In previous report, we designed primers for semi-nested reverse transcription-polymerase chain reaction (RT-PCR) to detect 5'-noncoding region of GBV-C/HGV, and screened the sera from 45 patients with liver diseases or on hemodialysis. In this study, we studied the prevalence of GBV-C/HGV infection in the sera from 35 patients with hemophilia A by this RT-PCR method, and also performed sequence analysis for all isolates including those from the non-hemophilic patients previously reported. GBV-C/HGV was detected in 8.57% (3/35) of the hemophilic patients. The isolates from hemophilic patients had several common mutations, and these mutations were also common in the "West African" genotype isolates represented by the prototype GBV-C. However, sequences in the isolates from other positive patients with liver diseases or on hemodialysis were quite different from those in the isolates from hemophilic patients, and those in the "European/American" genotype isolates represented by the prototype HGV. These sequences were consistent with "Asian" genotype. Simple restriction fragment length polymorphism (RFLP) analysis using the restriction enzyme HhaI successfully discriminated these genotypes. In the hemophilic patients, GBV-C/HGV might have been transmitted by transfusions of the imported plasma-derived clotting factor concentrates. Thus the difference in GBV-C/HGV genotype between the hemophilic patients and the others is suggested to be related to transmission route.

Adolescent↗
PubMed1999

[Collection of umbilical cord blood to separate the peripheral blood stem cells during the third stage of labor].

In order to collect the umbilical cord blood for the separation of peripheral blood stem cells, obstetrician have to get the document of informed consent from the pregnant women for the umbilical cord blood donation during pregnancy. After the fetal delivery, umbilical cord blood is easier collected from the umbilical vein of the placenta in utero than that of the delivered placenta. After the sterilization of umbilical cord, the special bag attached with tube and needle is more useful to collect the blood disinfectively and abundantly than the syringe. Blood stem cells should be separated as soon as possible after collection, but umbilical blood may be stored in the refrigerator until 24 hours after the collection, if the immediate separation is impossible. There is the positive correlation between the collected blood volume or the preserved hours until the separating management and the separated stem cells. Hearing on the health of the child should be followed until 6 months after delivery.

Cell Separation↗
PubMed1999

[Is left ventricular regional wall motion after CABG influenced by cardioplegic protection?].

This clinical study was conducted to determine whether different techniques of cardioplegic protection reflected left ventricular regional wall motion after CABG. A total of 43 patients with more than 90% stenosis of the LAD (seg 6 and/or 7) before CABG, who had patent grafts were allocated to two groups: namely, the crystalloid group, comprised of 23 patients given cold crystalloid cardioplegia and topical ice slush, and the blood group, comprised of 20 patients given tepid blood cardioplegia delivered intermittently antegrade. Each group was divided into two subgroups according to whether the left ventricular regional wall motion showed no change or deterioration after CABG. We also examined the relationship between the grading of the collateral artery before CABG and the postoperative ventricular regional wall motion. The number of patients who showed deterioration after CABG was higher in the crystalloid group than in the blood group (p = 0.008). Moreover, patients in the crystalloid group whose collateral artery had been graded as 0 before CABG tended to show deterioration of left ventricular local wall motion after CABG (p = 0.07). Whereas those patients in the blood group did not. In conclusion, the incidence of deterioration after CABG was higher in the crystalloid group than in the blood group.

Aged↗
PubMed1999

[Dose the administration of low-dose aprotinin contribute to an anti-inflammatory effect in coronary artery bypass grafting?].

A study was conducted to determine whether the administration of low-dose aprotinin contributed to an anti-inflammatory effect in coronary artery bypass grafting. Levels of the inflammatory cytokines; IL-6, IL-8, and GEL, were measured before and after cardiopulmonary bypass, then 1, 3 and 6 days after coronary artery bypass grafting, in a group of patients given aprotinin (n = 7) and a control group (n = 15). A comparison of the levels of all these inflammatory cytokines between the two groups revealed no significant difference at any time point. This indicates, that low-dose aprotinin did not contribute to an anti-inflammatory effect in coronary artery bypass grafting.

Aged↗
PubMed1999

Shear-dependent functions of the interaction between soluble von Willebrand factor and platelet glycoprotein Ib in mural thrombus formation on a collagen surface.

Recent flow studies have clearly established the function of von Willebrand factor (vWF) in initial platelet adhesion, in which the interaction of surface-immobilized vWF with platelet glycoprotein (GP) Ib, particularly at high shear rates, leads to the transient capture of flowing platelets onto the surface. This interaction is thought to trigger activation of platelet GP IIb/IIIa, leading to irreversible platelet adhesion and subsequent mural thrombus growth. The role of vWF-GP Ib interaction in secondary thrombus growth remains to be clarified, however. In this study, time-course images of the thrombus formation process were obtained using a whole blood flow system that allows real-time visualization of fluorescence-labeled platelet thrombus formation. The system employs a collagen-coated surface in a parallel plate flow chamber mounted on an epifluorescence microscope, which is then subjected to computer-assisted image analysis. In perfusion of blood preincubated with anti-vWF antibody NMC-4, which blocks the vWF-GP Ib interaction in solution, neither primary platelet adhesion nor subsequent thrombus growth on a collagen surface was detected at high shear rates (> or = 1210/s). In addition, even under experimental conditions in which initial platelet adhesion normally occurred, NMC-4-treated blood perfusion showed an apparent defect of secondary thrombus growth at the same high shear rates. The overall process of thrombus formation at low shear rates (< or = 340/s) was not affected by specific blockers of the vWF-GP Ib interaction. These findings indicate that, in addition to the interaction of surface-immobilized vWF with GP Ib in platelet adhesion, the interaction of soluble vWF with GP Ib is required for secondary thrombus growth selectively at high shear rates.

Antibodies, Monoclonal↗