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Biomedical subjects

Y Fujimura

Publications and source records attributed to Y Fujimura.

At least 163 records · Page 9Linked to original sources
PubMed1996

Effect of 4G-beta-D-galactosylsucrose (lactosucrose) on fecal microflora in patients with chronic inflammatory bowel disease.

Metabolic interaction between the intestinal microflora and the host has been suggested to play a role in the pathogenesis of chronic inflammatory bowel disease. Elemental or low-fat, low-residual diets in patients with Crohn's disease or ulcerative colitis are reported to decrease anaerobic bacteria and to change the composition of the intestinal microflora. We examined the effect of an indigestible agent, 4G-beta-D-galactosylsucrose (lactosucrose), which is selectively utilized by intestinal Bifidobacterium, on the composition of the intestinal microflora. After the administration of lactosucrose to two patients with Crohn's disease and five patients with ulcerative colitis for 2 weeks, significant induction of the growth of Bifidobacterium was observed, and significant reduction in the population level of Bacteroidaceae was seen. Bowel movements improved in four patients. The intestinal environment, estimated by measuring fecal pH, fecal levels of short-chain fatty acids and putrid products, and the urinary secretion of indican, also improved in these patients. These results suggest that lactosucrose may be useful for patients with chronic inflammatory bowel disease.

Adolescent↗
PubMed1996

Changes in choline acetyltransferase activity and distribution following incomplete cervical spinal cord injury in the rat.

Incomplete cervical spinal cord injuries were produced in rats by placing 10 g or 20 g weight on exposed dura at the C6 level for 5 min (Mild or Moderate injury). These two degrees of the injury resulted in initial motor functional deficits, followed by recoveries. In this study, changes in choline acetyltransferase activity and distribution following the incomplete cervical cord injuries were investigated using radioenzyme assay, and fluorescence microphotometry. We demonstrated that mild injury led to a transient decrease of choline acetyltransferase activity in the compressed spinal cord segment, but showed almost no histologic change at two days after injury. Although a low level of choline acetyltransferase immunofluorescence was found in the ventrolateral anterior horn at two days after injury, it recovered completely by one week after injury. These findings suggest that there was a strong correlation between the transient motor functional deficit and the decrease in choline acetyltransferase activity following mild injury. Moderate injury resulted in persistent low level of choline acetyltransferase activity in the compressed spinal cord segment accompanied by a striking loss of gray matter. On the other hand, at seven, 14 and 28 days after injury, over-expression of choline acetyltransferase activity was found in the neighboring spinal cord segments located both rostral and caudal to the injury, which showed no histologic change. In addition, excessively high levels of choline acetyltransferase immunofluorescence were found in the ventrolateral anterior horn of these segments. A strong correlation was found between the motor functional recovery and the late, excessive high levels of choline acetyltransferase activity in the neighboring regions. These results suggest that cholinergic neurons, especially spinal motor neurons may play an important role in the motor functional recovery following incomplete cervical spinal cord injury.

Animals↗
PubMed1996

Surgical repair of a coronary sinus diverticulum not associated with Wolff-Parkinson-White syndrome.

Diverticulum of the coronary sinus is rare. A 58-year-old man without Wolff-Parkinson-White syndrome underwent repair of a coronary sinus diverticulum accompanies by mitral regurgitation. The coronary sinus diverticulum had been identified 6 years earlier and had enlarged over time. At surgery, the neck of the diverticulum was closed, and the mitral valve replaced with a CarboMedics prosthetic valve (diameter, 29 mm). This the first case report of the surgical repair of a coronary sinus diverticulum not associated with Wolff-Parkinson-White syndrome.

Coronary Angiography↗
PubMed1996

Effect of cardioplegic arrest and reperfusion on coronary reserve and autoregulation.

BACKGROUND: The effects of cardioplegic arrest and reperfusion on the coronary vasculature remain to be characterized. This study was designed to investigate changes in coronary reserve and autoregulation after hypothermic cardioplegic arrest and reperfusion. METHODS: Isolated rabbit hearts were perfused in a retrograde manner with Krebs-Henseleit bicarbonate buffer solution at a pressure of 80 cm H2O. Baseline measurements were performed for (1) coronary flow; (2) vasodilatory response to 5-hydroxytryptamine (10(-7) mol/L) and nitroglycerin (10(-4) mol/L); (3) autoregulatory capacity, quantified as closed-loop gains; and (4) isovolemic left ventricular function. Hearts were then subjected to cardioplegic arrest for 90 minutes. Twenty minutes after reperfusion, measurements were repeated. RESULTS: Coronary flow decreased significantly after reperfusion (6.2 +/- 1.1 versus 5.3 +/- 1.1 mL.min-1.g-1; p < 0.01). The response to 5-hydroxytryptamine as percentage increase of flow decreased significantly after reperfusion (134.0% +/- 12.0% versus 109.1% +/- 6.8%; p < 0.01). However, there was no significant change in the response to nitroglycerin after reperfusion (121.3% +/- 17.6% versus 136.6% +/- 13.3%). The closed-loop gain demonstrated negative values before arrest but became positive after reperfusion, indicating loss of autoregulation after reperfusion. There was no significant change in left ventricular function. CONCLUSIONS: The coronary flow reserve in response to 5-hydroxytryptamine and autoregulation were impaired after cardioplegic arrest and reperfusion, whereas nitroglycerin-induced vasodilatory response and left ventricular function were preserved.

Animals↗
PubMed1996

Granulocyte phagocytic function is impaired during cardiopulmonary bypass.

BACKGROUND: The presence of impaired phagocytic function of the reticuloendothelial system after cardiac operations using cardiopulmonary bypass remains controversial. METHODS: In this study, the phagocytic function of granulocytes in 14 patients undergoing cardiac operations with cardiopulmonary bypass was examined using a chemiluminescence method. Seven patients with abdominal aortic aneurysms served as controls. Electron microscopy also was employed to evaluate morphologic changes. RESULTS: The 14 cardiac patients showed impaired phagocytic function from immediately after operation until 12 hours after the operation. This phagocytic function recovered within 24 hours. The 7 control patients showed no change in phagocytic function during or after the operation. Scanning electron microscopic examination of the cardiac patients' granulocytes revealed the loss of villi on cell surfaces immediately after operation. However, these villi were restored within 24 hours after the operation. CONCLUSIONS: The phagocytic function of granulocytes was impaired in the early postoperative period in patients undergoing cardiopulmonary bypass, and this was probably due to the loss of villi on granulocyte surfaces.

Aged↗
PubMed1996

Nonpolypoid adenomas of the duodenum in patients with familial adenomatous polyposis (Gardner's syndrome).

BACKGROUND: Although duodenal adenomas are very common in familial adenomatous polyposis, we wished to emphasize our experience with finding nonpolypoid adenomas in the duodenum of patients with this disease. METHODS: Duodenoscopy was performed in 23 patients with an established diagnosis of familial adenomatous polyposis or Gardner's syndrome. RESULTS: Endoscopy revealed single or multiple nonpolypoid adenomas of the duodenum in 7 patients (30%). The lesions were smaller than 5 mm and were endoscopically recognized as flat or depressed reddish lesions; one lesion was completely flat and the remaining lesions were flat-topped elevations with a central depression. All of the lesions were histologically diagnosed as tubular adenoma with moderate epithelial atypia. CONCLUSION: These findings suggest that duodenal nonpolypoid adenomas are common in familial adenomatous polyposis or Gardner's syndrome and that careful surveillance endoscopy seems necessary in patients with this disease.

Adenoma↗
PubMed1996

Diabetic ketoacidosis associated with the pheochromocytoma of youth.

We report a case of diabetic ketoacidosis (DKA) associated with pheochromocytoma in a college student of 22 years of age who was admitted to hospital because of hyperglycemia and hypertension with palpitations and subsequently was found to have an adrenalin and noradrenalin secreting pheochromocytoma. A diagnosis was made and the patient's impaired glucose tolerance and hypertension improved by tumor excision. This is the first reported case of a noradrenalin-predominant pheochromocytoma with associated DKA. Although DKA has been thought not to occur with pheochromocytoma, the possible cause of DKA associated with pheochromocytoma is now described. It is important to point out, as a clinical manager, that severe hypertension is a very unusual concomitant of DKA in young people and is the main indication for further examination.

Adrenal Gland Neoplasms↗
PubMed1996

Management of patients with an incomplete cervical spinal cord injury.

Forty-five patients with incomplete cervical spinal cord injuries were examined as to the mechanism of injury, neurological deficits in the initial stage and differences in treatment. Nineteen (42.2%) were treated non-surgically and 26 (57.8%) surgically. Their injuries could be divided into seven types of cervical spinal cord injury according to Usui's classification. Neurological changes were evaluated with Frankel's grading system. The neurological prognosis was relatively better in those with a unilateral cord injury type, but there was no statistical difference. Thirty-seven patients (82.2%) showed neurological improvement of at least one Frankel grade. There was no statistical difference between the surgical and non-surgical groups regarding neurological improvement, but all who underwent early surgery (within 4 weeks of being injured) improved. Surgical treatment was considered to be indicated for patients with cervical spinal canal narrowing, when satisfactory neurological improvement is not obtained by conservative treatment.

Accidental Falls↗
PubMed1996

Anterior decompression and fusion for ossification of the posterior longitudinal ligament of the upper thoracic spine causing myelopathy: using the manubrium splitting approach.

The effectiveness and problems associated with the operation of anterior decompression and fusion using the manubrium splitting approach for thoracic myelopathy due to ossification of the posterior longitudinal ligament (OPLL) of the upper thoracic spine carried out in nine patients was investigated. They were followed up for 1 year or more following the operation. The severity of the thoracic myelopathy was evaluated using the Japanese Orthopaedic Association score, and the surgical outcome was evaluated using recovery rates. This study includes investigation of the surgical outcome and of any postoperative complications, and radiographic observation of bony union and the progression of OPLL within the area of the anterior decompression. The caudal limit of the anterior decompression achieved by splitting the manubrium was the T3 vertebral body. A recovery rate of 71% was achieved during an average follow-up period of 35 months. Only one transient recurrent nerve palsy, and in another patient cerebrospinal fluid leakage occurred as postoperative complications. Radiographic examinations confirmed bony union in all of the patients, and there was no instance of spinal canal stenosis caused by progression of the OPLL within the area of the anterior decompression. Anterior decompression and fusion by splitting the manubrium was an effective surgical procedure for OPLL of the upper thoracic spine, to achieve a good outcome, however, the extent of anterior decompression was limited.

Adult↗
PubMed1996

Molecular cloning of Elk-3, a new member of the Ets family expressed during mouse embryogenesis and analysis of its transcriptional repression activity.

We isolated a cDNA clone, Elk-3, that encodes a novel Ets transcription factor from 16-day mouse embryos. The deduced amino acid sequence of the protein was homologous to human ELK-1 and SAP-1. This protein, ELK-1, and SAP-1 shared some unique structural properties such as an Ets DNA-binding site in the amino-terminal region, a serum response factor interacting domain and phosphorylation sites of serine or threonine residues in the carboxy-terminal region. Northern blotting weakly revealed that two transcripts of 4 and 2.1 kb are expressed in the adult ovary and lung and a 2.1-kb transcript predominated in 8- to 14-day embryos. We assayed the transcriptional activities of Elk-3 protein on the cytokeratin EndoA enhancer containing Ets binding sites in endodermal cells. Elk-3 protein strongly repressed enhancer activity but did not affect the activity of the basal promoter in the absence of the enhancer. Furthermore, Elk-3 can suppress the activity of Ets-2 as the transcriptional activator on the EndoA enhancer. These data suggested that the Elk-3 gene product plays a role in transcriptional regulation during embryogenesis.

Amino Acid Sequence↗
PubMed1996

Classification and treatment of axis body fractures.

We have classified 31 cases of axis body fracture by the type of bony injury depicted in radiographic images into the following four types: avulsion, transverse, burst, and sagittal fractures. The results of treatment in these types were retrospectively analyzed. In all of nine cases of avulsion fracture and two cases of transverse fracture, bone union was obtained by nonoperative treatment. All three cases of burst fracture healed, one by nonoperative treatment, and the remaining two by C2/3 anterior interbody fusion. Bone union was also obtained in all of the 17 cases of sagittal fracture, which included nonoperative treatment in 15 cases, and transoral atlanto-axial fusion in the remaining two cases. because many axis body fractures are inherently stable injuries, the authors normally select nonoperative treatment as initial therapy. However, in sagittal fractures, eight patients had sequelae of nuchal pain caused by osteoarthrosis of the atlanto-axial joint. As a result of these findings, the authors deem it appropriate to utilize atlanto-axial fusion when severe malalignment of the atlanto-axial joint is recognized.

Adult↗
PubMed1996

Genotypes and multiple infections with hepatitis C virus in patients with haemophilia A in Japan.

Hepatitis C virus (HCV) RNA was tested for, and HCV genotypes determined, in 96 patients with haemophilia A in Japan. Of 88 patients aged > or = 10 years, 74 (84%) were positive for HCV RNA at a frequency higher than that in patients aged less than 10 years (one of eight, 13%, P < 0.001). Genotype I/1a was detected in 30(40%), II/1b in 12 (16%), III/2a in eight (11%), IV/2b in five (7%) and V/3a in 12 (16%); mixed infection with HCV of two different genotypes was identified in the remaining nine (12%). This distribution was markedly different from that in 767 Japanese HCV carriers without haemophilia, in whom II/1b accounted for the majority (68.7%), I/1a was rare (0.5%), V/3a was absent, and mixed infection was observed rarely (1.3%). Mixed infection was transient in all of the seven haemophilic patients who were followed for 1 to 7 years. One of them was infected with genotype II/1b and an unclassifiable genotype, which showed nucleotide sequence similarity to genotype 4c from Zaire (82% homology in the E1 gene) and to 4a from Egypt (91% homology in a part of the NS5b region). In this patient, HCV of genotype II/1b disappeared while that of group 4 survived during a 4-year observation period. These results indicate different epidemiology of HCV genotypes in Japanese haemophiliacs, attributable to HCV contaminating factor VIII imported in the past, and an increased opportunity in haemophiliacs for mixed infection with HCV of different genotypes.

Adolescent↗
PubMed1996

Pathogenesis of aphthoid ulcers in Crohn's disease: correlative findings by magnifying colonoscopy, electron microscopy, and immunohistochemistry.

BACKGROUND: The mechanism of ulceration in Crohn's disease remains unknown. AIMS: To clarify the role of the follicle associated epithelium (FAE) of colonic lymphoid nodules in the formation of ulcers in Crohn's disease. METHODS: After identification of colonic lymphoid nodules and aphthoid lesions by magnifying colonoscopy, 76 biopsy specimens were obtained from 10 patients with Crohn's disease and three patients with colonic lymphoid hyperplasia. This study correlated magnifying colonoscopic, electron microscopic, and immunohistochemical findings of biopsy specimens. RESULTS: In Crohn's disease, scanning electron microscopy of lymphoid nodules surrounded by a red halo without visible erosions by magnifying colonoscopy, showed surface erosions 150-200 microns in size. These lymphoid nodules with red halos had small erosions either light microscopically or electron microscopically in 18 of 21 specimens (86%). Correlation of scanning and transmission electron microscopy showed residues of FAE including M cells at the edges of the erosions. In immunohistochemical studies, HLA-DR antigen was limited in M cells of FAE in the patients with lymphoid hyperplasia without inflammatory bowel disease. In Crohn's disease patients in remission, however, HLA-DR antigen was strongly expressed over the entire FAE of lymphoid nodules with a red halo endoscopically, while the expression was weak and irregular in the mucosa surrounding the lymphoid nodules. HLA-DR was strongly expressed in the entire inflamed colonic mucosa in the active stage. CONCLUSION: The red halo appearance surrounding lymphoid follicles seems to precede visible aphthoid ulcers and suggests that ulcerations in Crohn's disease originate from FAE, possibly related to its physiological role as a portal of entry for potentially pathogenic agents.

Adolescent↗
PubMed1996

Changes in the distribution of nerve conduction velocities in diabetics.

To examine which of the faster or slower large myelinated nerve fibers (alpha fiber group) are affected earlier by diabetes mellitus (DM), the distribution of nerve conduction velocities (DCV) and conventional sensory nerve conduction velocities (SCV) in the median nerve were measured in 10 male DM patients aged 35-58 (mean 50) years. The patients had suffered from DM for 0-30 (mean 11) years; their fasting blood sugar (FBS) levels were 105-363 (mean 219) mg/100 ml. The DCV was expressed by the conduction velocities below which 10, 20, ......, 80 and 90% of active fibers lie (V10, V20, ......, V80 and V90 velocities, respectively). In DM patients, the V30 to V90 velocities of the DCV as well as the SCV were significantly smaller than those of age-matched male controls. The results of multiple regression analysis indicated that FBS was inversely related to V50 to V90 velocities; duration of the disease was also significantly related to V80 and V90 velocities. These data suggest that faster nerve fibers are more susceptible to DM than slower fibers are; changes in conduction velocities of the faster fibers are closely associated with FBS and duration of DM.

Adult↗
PubMed1996

[Surgical treatment for ruptured aneurysm of distal arch or aortic arch: report of three cases].

We experienced three cases of surgery for ruptured aneurysm of the distal aortic arch (2 cases) or aortic arch (1 case). A 59-year-old man who was diagnosed as distal arch aneurysm ruptured to the pericardial cavity underwent graft replacement of the aneurysm and reconstruction of a left subclavian artery under selective cerebral perfusion (SCP). This patient had left hemiplegia postoperatively. A 73-year-old man who was diagnosed as an aneurysm of distal arch and descending aorta ruptured to left pleural cavity underwent graft replacement of the aneurysm and reconstruction of a left subclavian artery under SCP, and died of severe left ventricular failure possibly due to preoperative myocardial ischemia. A 70-year-old man who was diagnosed as a saccular aneurysm of aortic arch ruptured to mediastinum underwent resection of the aneurysm and patch plasty of the aorta under SCP. The postoperative course was uneventful. We discussed the approach to aneurysm, adjunctive method and surgical precedures from standpoint of our ruptured three cases.

Aged↗
PubMed1996

[Early and late results of pericardiectomy for constrictive pericarditis].

Seven patients (4 males and 3 females: age 1 to 71 years old) who underwent operations for constrictive pericarditis from 1980 were reviewed. The median sternotomy approach was used without cardiopulmonary bypass. The pericardial flap was excised just anterior to both phrenic nerves. The postoperative hemodynamic improvement was good, especially in cardiac index (from 2.30 to 3.30 l/min/m2). Two patients were operative death. One was metastasis to pericardium from gastric cancer and another was multiple organ failure due to sepsis. Long-term survival was 3 to 13 years. One patient was dead at nine years after operation. Others were in New York Heart Association Class 1 or 2 in the long-term period after surgery. We conclude that our method can lead to good cardiac functional results and long-term good results. Our report wishes to emphasize early diagnosis and operation.

Adult↗