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Biomedical subjects

A Itoh

Publications and source records attributed to A Itoh.

At least 217 records · Page 12Linked to original sources
PubMed1990

[A successfully operated case of tetralogy of Fallot with marked left ventricular dysfunction in adult].

Adults, especially high-aged patients with tetralogy of Fallot (TOF) are said to have a higher operative risk than younger ones because of fragility of their myocardium, bleeding from rich collateral circulation to lungs, and other complications such as brain abscess and endocarditis. It is often difficult to determine the surgical risk for total correction in cases of high-aged patients who have such complications. We report a successfully operated high-aged case of TOF with marked left ventricular dysfunction. A 52-year-old male was referred to our hospital because of exertional dyspnea and cyanosis. He had a history of cerebral embolism and meningitis several months prior to admission. On admission, he was NYHA class 3, and cyanosis and clubbed fingers were present. Cardiac catheterization showed a large VSD, 50% over-riding of the aorta and an infundibular pulmonary stenosis. Right to left shunt was 60% and Qp/Qs was 0.38. The left ventricular end diastolic volume index was 109 ml/m2, slightly larger than normal, and the ejection fraction was only 30%. This left ventricular dysfunction was thought to be caused by fibrosis of the myocardium due to longstanding hypoxemia and hypoxemia itself. There is no previous case report dealing with a successful total correction for a high-aged patient with TOF associated with such a severe left ventricular dysfunction. Congestive heart failure in the post-operative period was successfully treated by catecholamine for two weeks. Postoperative cardiac catheterization showed a small left-to-right shunt, and an improvement of left ventricular ejection fraction from 30% to 38%.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1990

[The serial changes of antibody production, macrophage migration inhibition test (MIT) and histopathologic examination in an experimental hypersensitivity pneumonitis in rabbits].

We developed a hypersensitivity pneumonitis model by sensitizing rabbits intratracheally (IT) twice after two subcutaneous sensitizations (SS), and investigated the serial changes in the production of antibody against micropolyspora faeni (Mf), macrophage migration inhibition test (MIT), and histopathologic features. On the third day after the last IT, the proportions of neutrophils in bronchoalveolar lavage fluid (BALF) increased. The antibody levels of Mf specific-antigen in BALF decreased transiently, but those in serum began to increase. The number of AFC in spleen increased rapidly. Histopathologic examination revealed alveolitis and prominent acute pneumonia. On the seventh day after the last IT, the proportion of lymphocytes in BALF, the antibody levels of Mf specific-antigen in BALF, the number of AFC in BALF, and the percent inhibition of MIT were highest. Histopathologic features were characterized by the formation of prominent epithelioid granulomas. On the fourteenth day after the last IT, these features returned to the state of untreated group. These results indicate that the lesions in this HP model are formed by both type III and type IV immune reactions (Coombs-Gall). It was concluded that the seventh day after the last IT was most appropriate for the study of pathophysiology of human HP.

Actinomycetales↗
PubMed1990

[Clinical study of drug accumulation in gastric cancer after preoperative intra-arterial EA'P injection therapy].

In order to deliver a high concentration of anti-cancer drugs in tumor tissue, preoperative intra-arterial injection therapy using Etoposide (VP-16), Pirarubicin (THP-ADM) and Cisplatin (CDDP), was used for 22 patients with resectable advanced gastric cancer. The concentration of VP-16, Adriamycin (ADM) and platinum (Pt) were measured in cancer tissue, normal mucosa and lymphnodes without metastasis at the greater curvature, which were gathered operatively and in serum just before operation. Student's t test was performed with their data. The mean concentration of VP-16 was less than the detectable limit in all tissues and in serum. The mean concentration of ADM in cancer tissue was significantly higher than in normal gastric mucosa, in lymphnodes without metastasis, and in serum. The mean concentration of platinum in cancer tissue was higher than those in lymphnodes, normal mucosa, and serum, but no significant differences were noted among them. It was concluded that the intra-arterial injection of THP-ADM and CDDP was an effective method to maintain a high concentration of ADM and Pt in gastric cancer tissue. However, intra-arterial injection of VP-16 was not useful.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Cardiothoracic ratio and roentgenologic heart size as the indices of body fluid retention in uremics under hemodialysis].

We evaluated the cardiothoracic ratio (CTR) and the roentgenologic heart size (RHS) as the indices of body fluid retention in 31 of uremic patients under hemodialysis. The maximum changes of the roentgenologic thoracic diameter, measured monthly for one year in 31 patients, varied from 10 to 68 mm. The average differences of RHS and CTR between maximum inspiration and forced inspiration in 18 healthy people were 1 mm (RHS) and 2.5% (CTR), respectively, and the change of roentgenologic thoracic diameter was 12 mm. The error of repeated CTR measurements in a period of one year could be estimated more than 2%. In 22 patients the body weight reduction of 1 kg corresponded to a 4 mm decrease of RHS (p less than 0.005) and 1.5% of CTR (p less than 0.05), respectively. In relation to the change of body fluid balance assessed by the change of body weight, RHS showed a higher correlation than CTR. These results could be attributed that RHS was hardly influenced by the respiration, whereas CTR was surprisingly affected. It is concluded that the measurement of RHS is more useful as an index of control of body fluid balance than CTR.

Adult↗
PubMed1989

A treatment trial of delayed sleep phase syndrome with triazolam.

Triazolam causes a phase-shift of the circadian rhythm of locomotor activity in golden hamsters. We attempted to treat two patients with delayed sleep phase syndrome (DSPS) with triazolam. In one male patient we administered triazolam when the sleep phase began to delay after chronotherapy. Triazolam combined with chronotherapy enabled him to normalize and stabilize his sleep-wake cycle. But in the other female patient despite normalization of her sleep-wake cycle, she became depressive and did not continue taking the drug. In some cases triazolam is useful for the treatment of DSPS, but in others, triazolam induces a depressive state.

Adult↗
PubMed1989

Interleukin 1 production by alveolar macrophages is decreased in smokers.

To evaluate the mechanism by which cigarette smoking suppresses pulmonary immune responses, we determined the capacity of alveolar macrophages (AM) to produce interleukin 1 (IL-1 in 32 normal subjects and in 40 patients with pulmonary sarcoidosis. The amount of IL-1 released from LPS-stimulated AM from smokers was significantly decreased compared with that in nonsmokers in both normal and sarcoid groups. The addition of indomethacin to the cultures in 18 normal subjects and in 22 patients with pulmonary sarcoidosis yielded similar results, thus excluding the possibility that this difference resulted from a difference in the amount of cyclooxygenase metabolites released in the culture supernatants. Similar results were obtained by enzyme-linked immunosolvent assay. Because IL-1 is thought to induce the accumulation of T cells at the site of disease and contribute to local cellular and humoral immunity of the lung, our data suggest that the reduced capacity of AM to release IL-1 in smokers affords partial protection against the initiation of immune responses in the lung and the development of granulomatous lung diseases.

Adult↗
PubMed1989

Cine MR imaging in mitral regurgitation: comparison with color Doppler flow imaging.

Cine MR imaging is a new technique that combines short repetition times, limited flip angles, gradient-refocused echoes, and cardiac gating. This procedure was performed in 20 patients in whom mitral regurgitation was shown on left ventriculography, and the results were compared with those of color Doppler flow mapping. In all cases, mitral regurgitation on cine MR imaging was depicted as an area of decreased signal intensity within the left atrium. The extent and severity of the regurgitant jet as seen by the two techniques were classified visually as 4+ (severe), 3+ (moderate), 2+ (mild), and 1+ (minimal). The results of the two methods were the same in 14 (70%) of the 20 patients. In five patients the results differed by one grade and in one patient by two grades. In addition, the maximal intrusion distance and area of the regurgitant jet divided by the area of the left atrium as determined by the two methods were compared. The correlation coefficients between the two methods in regard to the length and area of mitral regurgitation were .74 and .71, respectively. These data suggest that the accuracy of cine MR imaging in assessing the severity of mitral regurgitation is comparable to that of color Doppler flow imaging.

Adult↗
PubMed1989

Inhibitory effect of peptide YY on gastric acid output in rats.

The administration of peptide YY (PYY: 0.8, 1.6 and 3.2 nmol/kg/h, i.v.) to fasting rats inhibited not only baclofen (2 mg/kg, s.c.)-stimulated gastric acid output and gastric mucosal blood flow, but also pentagastrin (8 micrograms/kg/h, i.v.)-stimulated gastric acid output. PYY (3.2 nmol/kg/h) reduced baclofen-induced acid output more than pentagastrin-induced acid output, i.e., by 61.8 +/- 11.5% compared to 35.3 +/- 8.2%. PYY inhibited acetylcholine (ACh) release from cholinergic nerve endings of gastric body evoked by electrical transmural stimulation (ETS: 1 msec, 10 V, 3 Hz, 30 sec) by 47.2 +/- 3.5%. The mechanism of the inhibitory effect of PYY on gastric acid output seems to involve decreased gastric mucosal blood flow and reduced ACh release from cholinergic nerves.

Animals↗
PubMed1989

The mechanism of acute gastric ulcer after induced hemorrhagic shock.

Changes in gastric mucosal blood flow were investigated for their relationship to gastric mucosal prostaglandin E2 (PGE2) and noradrenaline (NA) in rats with hemorrhagic shock. The results were as follows: 1) Gastric mucosal blood flow and NA decreased after hemorrhage. Gastric mucosal PGE2 initially increased after exsanguination and then markedly decreased. 2) Administration of NA before hemorrhage resulted in an increase of PGE2. However, the PGE2 value for animals receiving NA after hemorrhage was not different from that of non-NA-treated group. 3) Pre-treatment with PGE2 suppressed the reduction in both gastric mucosal blood flow and NA and the development of ulcer. These results suggest that the increase in gastric mucosal PGE2 in the early stage of shock might represent a phenomenon of adaptation by the adrenergic activation, and the decrease in PGE2 in the late stage might result from impaired synthesis of PGE2 due to persistent hypoxia and might be one of the possible factors in ulcer formation.

Acute Disease↗
PubMed1989

[Clinical study of the drug delivery in metastatic liver cancer using bromodeoxyuridine].

As the model of an anti-cancer agent acting at DNA synthesizing phase, BrdU was infused for metastatic liver cancers into the portal vein and/or the hepatic artery. After administration, the liver tumors were resected, and immunohistochemical staining was performed using anti-BrdU monoclonal antibody. Two of 6 portal group tumors were stained. All 4 arterial and 3 arterio-portal group tumors were stained. Therefore, it was proved that metastatic liver tumors had both arterial and portal blood supply. But areas to which BrdU was delivered were only peripheral, and the inmost area was 2 mm from the tumor surface. After the intra-arterial infusion of BrdU suspended in lipiodol, the delivery of BrdU was highly enhanced and 4 of 6 tumors were stained even to the deepest areas. However, one tumor of which the major part was necrotic and one tumor which produced mutin were not stained at all. It was interesting that after intra-arterial administration of BrdU suspended in lipiodol, BrdU was also found in the cytoplasm of normal liver cells.

Antibodies, Monoclonal↗
PubMed1989

Affinity labeling of ACTH receptors in bovine adrenal cortex membranes.

Adrenocorticotropin labeled with 125I at Tyr23 [(125I-Tyr23]ACTH) was prepared by radioiodination of ACTH1-39 followed by reverse phase HPLC purification. When incubated with bovine adrenal cortical membranes, the radioligand bound specifically to a 40-kDa membrane protein as revealed by affinity labeling. This result indicates that the bovine adrenal ACTH receptor, whose identification and characterization have proved difficult, has an Mr of about 40,000.

Adrenal Cortex↗
PubMed1989

[Salivary calculus of the parotid gland: report of a case].

We reported a case of parotid sialolithiasis. A man, aged 72, complained of swelling of the left buccal region accompanied by a sensation of inflammation. On diagnosis of sialolithiasis of the parotid gland, a surgical operation was performed with a small incision in the left cheek region. About one month after the operation, a salivary calculus was discharged spontaneously from the left buccal region. He recovered satisfactory without the formation of a parotid salivary fistula. Morphological observation on the salivary calculus was carried out using the scanning electron microscope (SEM).

Aged↗
PubMed1989

[Cine MR imaging in valvular heart disease].

Cine MR Imaging was carried out using FLASH (fast low angle shot) which employees TE of 16 msec and TR of 30-40 msec. Regurgitant jet was visible as discrete area of low signal intensity extending from the incompetent valve into the respective cardiac chamber. In 20 patients with mitral regurgitation, the correlation of the length and area of mitral jet by cine MR and color doppler mapping was 0.74 and 0.71, respectively. Cine MR imaging is a promising modality for detection and quantification of valvular heart disease.

Aged↗
PubMed1989

[Sepsis in patients with hematological diseases].

Sepsis is one of the important complications on the treatment of severe hematological diseases. In this report, we analyzed sepsis in 309 patients with hematological diseases who were admitted to the First Department of Internal Medicine of Yokohama City University Hospital from 1979 to 1986. Positive blood culture were found in 17.8% (55/309 cases) and total positive cases were 73 including recurrent patients. Positive rate by underlying diseases was 30.3% in acute leukemia, 20.8% in chronic myelocytic leukemia, 17.2% in aplastic anemia, 8.0% in multiple myeloma, 6.0% in malignant lymphoma and 6.5% in others. The organisms causing sepsis were as follows; gram negative bacilli 56.4%, gram positive organisms 34.6%, fungus 6.4% and anaerobic bacteria 2.6%. Pseudomonas aeruginosa was found in 19.2%. The mortality rate of patients with sepsis was 34.2% (25/73 cases). The significant prognostic factors in patients with sepsis were the degree of neutropenia, duration of neutropenia (500 less than microliters), the species of organisms, simultaneous complication with shock and the site of other infections.

Hematologic Diseases↗
PubMed1989

[Clinical study of platinum accumulation in gastric cancer after preoperative intra-arterial injection of cisplatin].

In order to deliver a high concentration of CDDP in tumor tissue, we attempted to infuse CDDP intra-arterially for preoperative patients with resectable gastric cancer. Thirty-two patients (21 males and 11 females) were treated. The concentration of platinum was measured in cancer tissue, normal mucosa, lymph nodes without metastasis at the greater curvature. These were gathered operatively and in serum just before operation. The serum concentration of free-CDDP was also measured. Student's-t test was performed with the data. After intra-arterial injection of 60 mg CDDP, the mean concentration of platinum in cancer tissue was 1.11 +/- 0.45 microgram/g and after intravenous injection of 40 mg CDDP that was 0.30 +/- 0.11 microgram/g. After intra-arterial injection of 40 mg CDDP, the mean concentration of platinum in cancer tissue was 0.64 +/- 0.12 microgram/g, which was significantly higher than in normal gastric mucosa (0.27 +/- 0.06 micrograms/g) or serum (0.37 +/- 0.10 micrograms/ml) (p less than 0.025). The mean concentration of platinum in cancer tissue was higher than in the lymph nodes (0.45 +/- 0.10 micrograms/g), but there was no significant difference. In sera the concentrations of free-CDDP were all under the detectable limit. It was concluded that intra-arterial injection therapy of CDDP was an effective method to maintain a high concentration of CDDP in gastric cancer tissue.

Cisplatin↗
PubMed1989

[Experimental studies on drug uptake by metastatic liver tumor after intra-arterial, intraportal and intravenous administration of BrdU].

To compare the pharmacological advantage of intra-arterial, intraportal and intravenous administration of anticancer drug for metastatic liver tumor, BrdU was administered to rabbits with metastatic liver tumor of VX2 from various routes and taken up into the nuclei of tumor cells. Both one-shot injection and continuous infusion (30 min) of BrdU was performed from celiac artery, portal vein or peripheral vein. In some rabbits, the portal vein or the celiac artery was ligated to form one blood supply to the liver. After the administration of BrdU, the liver was removed. The samples were stained by the immunohistochemical procedure using monoclonal antibody to BrdU. The result was that the drug uptake of small metastatic liver tumor by both arterial and portal one-shot injection was good, and the uptake following intra-arterial injection of BrdU was superior to its intraportal injection in large metastatic tumor. However, only peripheral cells of large tumor took up BrdU after intra-arterial injection and inner cells of large tumor did not take up BrdU after any continuous infusions. The intraportal and intravenous administration of BrdU without ligation of celiac artery had the same effect as its intra-arterial administration.

Animals↗