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Biomedical subjects

Y Ohtake

Publications and source records attributed to Y Ohtake.

At least 19 recordsLinked to original sources
PubMed1992

[Combined resection of the aorta in a T4 lung cancer under nonheparinized temporary bypass using Anthron tube].

A 63-year-old male had squamous cell carcinoma in the left upper lobe. CT scan suggested the invasion of the tumor into the vertebral body and the descending aorta. Left pneumonectomy and combined aortic resection under the temporary bypass using Anthron tube was performed. The bypass using Anthron tube provides us no systemic heparinization and the procedure is easy. So the danger of massive bleeding during and after the operation can be decreased and the operative time can also be shortened. This procedure may be a great help for carrying out the operation with combined aortic resection more safely and speedily.

Aorta↗
PubMed1991

Molecular cloning of the gamma-glutamylcysteine synthetase gene of Saccharomyces cerevisiae.

The 4.4 kb SphI DNA fragment (GSH1) that complements the gamma-glutamylcysteine synthetase-deficient mutation (gsh1) of Saccharomyces cerevisiae YH1 was cloned into vector plasmid YEp24. Gene disruption of the cloned fragment confirmed that this segment was the same gene as gsh1. Mutant strain YH1 with this plasmid not only restored gamma-glutamylcysteine synthetase (GSH-I) activity but the glutathione content and the growth rate. DNA sequence analysis of the SphI fragment showed that the GSH1 structural gene contained 2034 bp and predicted a polypeptide of 678 amino acids. The deduced amino acid sequence had about a 45% homology to that of rat kidney GSH-I, but a very low homology (about 26%) to that of Escherichia coli GSH-I. Northern analysis showed that GSH1 had been transcribed into an approximately 2.7 kb mRNA fragment. Southern analysis showed that GSH1 mapped at chromosome X.

Amino Acid Sequence↗
PubMed1991

Ventricular assistance by right free wall dynamic cardiomyoplasty following acute right heart failure in canines.

The efficacy of right ventricular assistance provided by electrically conditioned skeletal muscle was studied in 17 canines. The right ventricular free wall was made ischemic and akinetic by ligating all coronary branches supplying it. The latter procedure led to deterioration of hemodynamic parameters. After that, 14 canines were divided into two groups: group 1 (n = 8) was observed without cardiomyoplasty for 2 hours; group 2 (n = 6) underwent right ventricular dynamic cardiomyoplasty with the conditioned left latissimus dorsi. The deterioration in hemodynamic parameters in group 1 showed no further significant change during the period of observation. In group 2, right ventricular function was augmented by cardiomyoplasty, as shown by a significant increase in right ventricular and pulmonary artery pressures. In addition, decreased CVP suggested improved right ventricle (RV) filling. Right ventricular function curves obtained by volume loading in a further group of three canines, group 3, also demonstrated improved right ventricular function. Thus right ventricular dynamic cardiomyoplasty appears to contribute significantly to right ventricular function in a model of acute right heart failure.

Acute Disease↗
PubMed1991

Interrelationship between hepatic ureagenesis and gluconeogenesis in early sepsis.

This study was performed to investigate the interrelationship between gluconeogenesis and ureagenesis during sepsis. In isolated perfused livers, gluconeogenesis was assessed using either lactate or a combination of lactate, glutamine, and alanine as substrate. Ureagenesis was assessed using either NH4Cl or glutamine plus alanine as substrate. NH4Cl stimulated urea production in livers from both septic and sham-operated control rats. Urea release was approximately 1.2 and 2.0 mg urea nitrogen.g-1.h-1 for 1 and 5 mM NH4Cl, respectively, and was equal for both groups. With amino acids as substrate, urea production was significantly greater in livers from septic animals compared with controls. Phenylephrine stimulated urea production in the sham-operated group by about twofold, whereas in the septic group urea release was slightly inhibited. Gluconeogenesis from lactate was inhibited by NH4Cl (1 and 5 mM) in both groups, with no difference between groups. In contrast to enhanced ureagenesis from amino acids in septic rats, gluconeogenesis was decreased by approximately 24% (P less than 0.5). Similarly, phenylephrine (1 microM) stimulated gluconeogenesis by 13 +/- 1 mumol.g-1.h-1 in sham-operated rats but only by 9 +/- 1 mumol.g-1.h-1 in septic rats (P less than 0.02). These results suggest that hepatic gluconeogenic and ureagenic pathways are intact in sepsis but that altered substrate preference and hormone sensitivity may result in decreased gluconeogenesis in the presence of elevated amino acid levels.

Alanine↗
PubMed1991

[Hemopurification in the management of ARDS complicating multiple organ failure].

In the field of critical care medicine, it has been claimed that ARDS often develops as a part of multiple organ failure (MOF). Since multi-modality therapy is necessary in the management of MOF, it is also mandatory even in the management of ARDS. Among the various therapeutic approaches for patients with MOF, hemopurification is one of the most effective therapeutic tools. Various hemopurification methods such as hemodialysis, peritoneal dialysis, hemoadsorption, hemofiltration and plasma exchange have been applied in the management of MOR. However, our recent experiences suggest that continuous hemofiltration (CHF) and/or continuous hemodiafiltration (CHDF) are safest, most easily performed and effective hemopurification in the management of ARDS/MOF. The efficacy of hemopurification in the management of ARDS is summarized as follows. 1) Removal of humoral mediators and causative substances of ARDS following insults such as sepsis and trauma. 2) Treatment of pulmonary interstitial permeability edema which has been claimed to be one of the most important pathological conditions in ARDS. 3) Removal of excess water given as carrier in IVH solution and accumulating in the body. 4) Immunomodulation which has also been considered to be necessary in the treatment or prevention of ARDS.

Hemofiltration↗
PubMed1990

Rapid conversion of the new angiotensin converting enzyme inhibitor ramipril to its active metabolite in rats.

The rate of conversion of ramipril (Hoe 498), a new angiotensin converting enzyme (ACE) inhibitor, to its active metabolite was compared with that of enalapril. After intravenous administration to rats, ramipril was very rapidly deesterified to its active moiety, ramiprilat. The ratio of the active metabolite level to the prodrug level in plasma at 5 min after administration was 10.7 for ramipril, which was about 5 times the ratio for enalapril. The in vitro conversion rates of ramipril were higher than those of enalapril in all rat tissue homogenates examined, including the liver, a main site of metabolism. The apparent Km values of ramipril and enalapril in the liver were 190 and 710 mumol/l, respectively, suggesting that ramipril has a higher affinity for esterase than enalapril. In conclusion, ramipril was superior to enalapril in efficiency of conversion to the active metabolite.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1989

[Clinical evaluation of SPECT in cerebrovascular disease].

In 131 patients with cerebrovascular disease, regional cerebral blood flow was determined by 123I-IMP (N-isopropyl (123I)-iodoamphetamine) or 99mTc-HM-PAO (99mTc (d, l)-hexamethyl propyleneamine oxime) SPECT and findings were compared with those of X-CT or MRI. The perfusion deficit detected by SPECT was larger than the deficit by X-CT or MRI in every cases. The perfusion deficit area was more clearly demonstrated by SPECT than by X-CT or MRI in patients with acute cerebral infarction. The hypoperfusion area determined by 123I-IMP SPECT was wider than that by 99mTc-HM-PAO SPECT. The crossed cerebellar diaschisis was observed in 56 out of 131 cases (43%). The results of operation were quantitatively evaluated by 123I-IMP SPECT in 25 patients.

Aged↗
PubMed1989

[Perioperative water and electrolyte metabolism and its abnormalities in aged patients].

The number of aged surgical patients is increasing due to the increase of aged people in the general population. Aged surgical patients above 65 years of age constituted about 30% of all ICU patients in our institution. Perioperative care for aged patients has now become one of the most important clinical activities in the ICU. The perioperative management for those aged patients should be performed with great care because these patients have some abnormalities in water and electrolyte metabolism. Aged patients showed decreased blood levels of atrial natriuretic peptide (ANP) and decreased creatinine clearance even in the preoperative period. The ANP level and the creatinine clearance showed significant negative correlation, indicating that one of the reasons for impaired renal function among aged patients could be the decreased ANP level in blood. The intraoperative insults to the aged surgical patients undergoing radical operation for esophageal cancer tended to be smaller compared to that in the younger patients. Intraoperative infusion volume and urinary output were also smaller in the aged group compared to those in the younger group. The postoperative infusion therapy in the ICU mainly consisted of intravenous hyperalimentation with decreased Na content and the transfusion of fresh frozen plasma. This regimen should be more suitable for the aged patients. Even though the aged and the younger group received the same infusion therapy during their postoperative ICU stay up to the 7th day, the aged patients showed the tendency of Na and Cl retention and increase in anion gap. However, these abnormalities in water and electrolyte metabolism were not so severe as to cause clinical symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Prognostic value of serum osmolality gap in patients with multiple organ failure treated with hemopurification.

Serum osmolality gap (OG), the difference between measured and predicted serum osmolality, has been shown to be an excellent parameter to express the amount of conventionally unmeasurable middle-molecular-weight substances. OG was determined on 29 patients with multiple organ failure (MOF) treated with or without hemopurification. OG significantly increased in proportion to the increase in the number of failed organs and correlated well with APACHE II score. Nonsurvivors showed persistently high OG. OG decreased with plasma exchange and hemoadsorption, but not with hemodialysis, indicating that pathogenic factors can be removed effectively with plasma exchange and hemoadsorption. The patients with OG greater than 20 mOsm/kg-H2O had very little possibility of survival. These results indicate that OG is an easily determinable, effective parameter to evaluate the severity of the patients' condition, efficacy of hemopurification in removing pathogenic middle-molecular-weight substances, and the prognosis of the patient in the treatment of MOF.

Hemoperfusion↗
PubMed1988

[Metabolic abnormalities and nutritional management in postoperative multiple organ failure].

Despite its importance, very little has been known on metabolic abnormalities in the patients with postoperative multiple organ failure (POMOF). The present study was undertaken to investigate the metabolic abnormalities and to establish effective nutritional management on these patients. Systemic energy metabolism and hepatocellular mitochondrial function were studied with indirect calorimetry and arterial ketone body ratio measurements on 30 POMOF patients treated between 1984 and 1985. The POMOF patients were hypermetabolic and their hepatic mitochondrial function was impaired. Their caloric intake was depleted for the limitation in administrable water volume due to renal failure. Some of them could not utilize exogenous glucose given by total parenteral nutrition (TPN). To overcome these problems, on 26 POMOF patients treated between 1986 and 1987 continuous hemofiltration (CHF) was applied to remove excess water and ATP-Mg was administered to improve hepatic mitochondrial function during TPN. The sufficiency rate of energy intake (caloric intake/energy expenditure) was improved from 73.3 +/- 14.7% to 92.0 +/- 8.1% with simultaneous CHF and the hepatic mitochondrial function was also improved with ATP-Mg resulting in better utilization of exogenous glucose. These results indicate that CHF and ATP-Mg administration are effective adjunctive treatments in the nutritional management for POMOF.

Adenosine Triphosphate↗