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Biomedical subjects

C Yutani

Publications and source records attributed to C Yutani.

At least 127 records · Page 7Linked to original sources
PubMed1993

[IgA nephropathy with acute exacerbation of idiopathic interstitial pneumonia: an autopsy case].

A 73-year old man was admitted to the hospital because of dyspnea. His proteinuria was pointed out in 1981. He felt dyspnea after exertion and abnormal chest X-ray shadow was pointed out in 1984. He was admitted to our hospital for further examination for the first time in 1988. He was diagnosed as IgA nephropathy by renal biopsy, and idiopathic interstitial pneumonia (IIP) by transbronchial lung biopsy. Then steroid therapy was begun because of progression of renal dysfunction in November 1990. But thereafter dyspnea, hypoxia and fine diffuse reticulonodular shadow on chest X-ray film was exacerbated. And he died because of respiratory failure. In this case, progression of IgA nephropathy seemed associated with exacerbation of IIP.

Aged↗
PubMed1992

Frequency analysis of signal-averaged electrocardiogram in patients with right ventricular tachycardia.

OBJECTIVES: The purpose of this study was to analyze the frequency content of signal-averaged electrocardiograms (ECGs) in patients with idiopathic ventricular tachycardia of right ventricular origin and in patients with arrhythmogenic right ventricular dysplasia. BACKGROUND: The late potentials in the time domains are usually found in patients with arrhythmogenic right ventricular dysplasia. They are not usually found in patients with idiopathic ventricular tachycardia of right ventricular origin. METHODS: Fast Fourier transform analysis of signal-averaged ECGs was performed with the use of a Blackman-Harris window in 43 subjects: 20 normal volunteers (group I), 12 patients with idiopathic ventricular tachycardia of right ventricular origin (group II) and 11 patients with arrhythmogenic right ventricular dysplasia (group III), and the frequency spectrum was displayed in a three-dimensional graph. Area ratio (ratio of the area under the spectral plot from 40 to 120 Hz to the area from 0 to 120 Hz) was calculated in all subjects. RESULTS: Area ratio was significantly higher in group II than in group I (243 +/- 45 vs. 196 +/- 15, p < 0.01) and significantly higher in group III (396 +/- 51) than in group I or II (p < 0.001). The high frequency components in group II were confined within the QRS complex in the three-dimensional graph, whereas those in group III extended outside the QRS complex. CONCLUSIONS: Frequency analysis of the signal-averaged ECG with fast Fourier transform analysis can detect the high frequency components in patients with right ventricular tachycardia, including idiopathic ventricular tachycardia and arrhythmogenic right ventricular dysplasia.

Adult↗
PubMed1992

Detection of cytomegalovirus DNA in pulmonary specimens: confirmation by in situ hybridization in two cases.

Papanicolaou stained bronchial brush and imprint pulmonary smears containing intranuclear and cytoplasmic inclusion bearing alveolar pneumocytes suggestive of cytomegalovirus infection were destained and reprocessed for in situ hybridization using a biotinylated probe for cytomegalovirus DNA. Two cases were processed in this way. A hybridization signal for viral DNA was noted in each case. However, no reddish brown staining reaction products were noted in any of the control samples. This simple and rapid nonradioactive detection system is a valuable supplement to routine pulmonary cytology for the definitive diagnosis of this virus infection, and this technique is also appropriate for retrospective study.

Cytodiagnosis↗
PubMed1992

Cardiac rupture complicating hemorrhagic infarction after intracoronary thrombolysis.

An 80-year-old woman with acute myocardial infarct received intracoronary thrombolysis by a large dose of urokinase four hours after the onset of chest pain. Despite the patient having no chest pain after intracoronary thrombolysis and her general condition being stable, she died suddenly on the 4th hospital day. Autopsy revealed hemopericardium due to cardiac rupture, which occurred at the center of the transmural hemorrhagic infarction of the anteroseptal wall. The massive hemorrhagic infarction was promoted by reperfusion from thrombolytic therapy. She had also classic risk factors for cardiac rupture, such as hypertension, senility, female gender, and first acute myocardial infarct. Therefore, the present case demonstrated that hemorrhagic infarction increased the incidence of cardiac rupture.

Aged↗
PubMed1992

Spectral analysis of signal-averaged electrocardiograms in patients with idiopathic ventricular tachycardia of left ventricular origin.

BACKGROUND: The signal-averaged ECG has been used to detect late potentials, and it is considered a noninvasive marker for areas of slow conduction requisite for reentrant arrhythmia. Late potentials are not usually found in patients with idiopathic ventricular tachycardia (VT); nevertheless, fragmented electrograms are often recorded in those patients during endocardial mapping. The purpose of this study was to investigate the spectral content of the signal-averaged ECGs with use of fast Fourier transform analysis (FFT) in patients with idiopathic VT of left ventricular origin. METHODS AND RESULTS: Signal-averaged ECGs were recorded in 12 patients with idiopathic VT originating from the left ventricle (group 1) and 25 age-matched normal volunteers (group 2). Frequency analysis with FFT was performed with a Blackman-Harris window in a segment length of 120 msec from 40 msec before the end of the QRS complex, and the frequency spectrum was displayed in a three-dimensional graph. Area ratio 1 (area of 20-50 Hz/area of 10-50 Hz) and area ratio 2 (area of 40-100 Hz/area of 0-40 Hz) were calculated in all subjects. Late potentials defined by the time domain were negative in all subjects. The area ratios of group 1 were significantly higher than those of group 2. High-frequency components in the three-dimensional graph were confined within the QRS complex. CONCLUSIONS: These results suggest that frequency analysis of signal-averaged ECGs with FFT is an available method for detecting the high-frequency component within the QRS complex in some patients with idiopathic VT of left ventricular origin.

Adult↗
PubMed1992

Histopathological analysis of the mechanisms of intracranial hemorrhage complicating infective endocarditis.

BACKGROUND AND PURPOSE: We conducted the present study to elucidate the pathological mechanisms leading to intracranial hemorrhage complicating infective endocarditis. METHODS: Neurological, neuroradiological, and histopathological analyses were performed in 16 patients (one surgical and 15 autopsy cases), 12 men and four women 26-68 years of age, who had demonstrated central nervous system complications during the course of infective endocarditis. RESULTS: Intracranial hemorrhage was found in all cases; parenchymal hematomas were found in 12 cases, hemorrhagic infarcts in four cases, and primary subarachnoid hemorrhages in two cases. Chronological analysis of neurological examination and computed tomographic scan of the brain confirmed that antecedent cerebral ischemic events had occurred in five of 12 patients showing parenchymal hematomas at autopsy. Hemorrhagic infarct, indicated by petechial or diffuse hemorrhages within the infarct, was seen in another four patients, so that hemorrhagic transformation of the ischemic infarct was confirmed in nine patients. Although mycotic aneurysms were found in five patients, only three of these were ruptured; the other two were occluded with septic emboli. Pyogenic arteritis without aneurysm was found to be distributed in the small cortical arterial branches located in the spaces of cortical sulci, with rupture occurring in five patients. CONCLUSIONS: These results suggest that hemorrhagic transformation of the ischemic infarct due to septic emboli is the most frequent mechanism leading to intracerebral hemorrhage encountered in patients dying of infective endocarditis and that rupture of pyogenic arteritis may be responsible for such hemorrhage in many cases, with ruptures of mycotic aneurysms as an alternative mechanism.

Adult↗
PubMed1992

Vascular responsiveness to angiotensin II and phenylephrine, the tubular function and the prostaglandin, renin-angiotensin system in a patient with Bartter's syndrome.

In a 39-yr-old female patient with Bartter's syndrome, vascular responsiveness to angiotensin II and phenylephrine was studied. Pressor responses to angiotensin II and to phenylephrine were markedly decreased prior to treatment and were improved by administration of indomethacin, dextran, KCl, captopril, propranolol or pindolol. Moreover, the responses of total peripheral vascular resistance to angiotensin II and phenylephrine were markedly decreased before treatment and were improved by the treatment. A relatively low fractional distal chloride reabsorption was found, and that was not changed after the administration of KCl or indomethacin. The results of this patient were compatible with the primary cause of Bartter's syndrome, defective chloride reabsorption at the loop of Henle, but the possibility of an abnormality in the vascular wall could not be denied.

Adult↗
PubMed1992

Coronary artery embolism with special reference to invasive procedures as the source.

Since 1978, there have been sporadic reports of coronary artery embolism caused by cardiac catheterization, percutaneous transluminal coronary angioplasty, and other invasive procedures. To determine whether coronary artery embolism has increased with the wider application of such procedures, we searched for patients with coronary artery emboli among the autopsy cases with suspected acute myocardial infarction at the National Cardiovascular Center from 1977 to 1990. Of the 28 patients with emboli, 10% of the total autopsy cases of myocardial infarction was confirmed in 18. Infarction was diagnosed clinically in only six of these patients and directly caused the death of 11 of the 18 patients. In contrast to previous reports, where a minority of coronary emboli were caused by instrumentation, 14/28 patients in our series had coronary embolism due to invasive procedures, including eight patients with atheromatous emboli. half of the myocardial infarcts caused by embolism were hemorrhagic. Thus, coronary emboli are not so rare as once thought, and they may increase further with the progress of invasive diagnostic and surgical interventions. The possibility of coronary embolism thus needs to be kept in mind by all clinicians in the cardiovascular fields.

Adult↗
PubMed1991

Cytological detection of atypical cells by routine urinalysis in a cardiovascular center.

During the past 9 yr, 187,529 Sternheimer-Malbin-stained urinary sediments were examined as routine urinalysis specimens from patients attending the National Cardiovascular Center in Osaka, Japan. Abnormal cells were found in 20 patients who did not have clinical diagnoses of malignancy. Malignant cytological changes in 18 patients resulted in a rate of 1 case in 6,751 patients; the two remaining specimens with abnormal cells showed polyomavirus infection. This article describes our experience in the diagnosis of malignant cells of the urinary tract through the cooperation of the clinical and cytological laboratories. Since in Japan, the rate of death for bladder cancer is similar to 1 in 6,751, this method seems to be of great use in the diagnosis of urinary tract malignancies.

Adult↗
PubMed1991

Recurrent epicardial fibrosarcoma which arose 12 years after the first resection.

Primary malignant tumours of the heart are very rare, with an incidence of only 0.0017%-0.03% in consecutive autopsy series. Fibrosarcoma of the heart is also rare, representing only about 0.3% of all cardiac tumours. We observed a case of epicardial fibrosarcoma which developed 12 years after the first resection of an epicardial tumour. A 31-year-old woman was referred to our hospital because of fatigue, nausea and right back pain. She had had surgery to resect an epicardial tumour when she was 19 years old. On admission, there was a huge, heterogeneous tumour on the right inferior side of the heart. At surgery, the tumour was totally resected and a pathological diagnosis of fibrosarcoma was made. The patient was free of symptoms for 6 months, but died of a recurrence 11 months after the operation. It is postulated that the epicardial tumour had only been partially resected and had been latent for a rather long period but began to grow rapidly 12 years after the initial resection.

Adult↗
PubMed1991

Detection of human polyomavirus DNA in Papanicolaou stained smears of urinary sediment by in situ hybridization.

Papanicolaou stained smears of urinary sediment containing inclusion bearing urothelial cells suggestive of human polyomavirus infection were destained and reprocessed for in situ hybridization using a biotinylated probe for human polyomavirus DNA. Seven slides were processed in this way. A hybridization signal for viral DNA was noted in each case, even in smears that had previously been stored for 11 years. This simple and rapid non-radioactive detection system is a valuable supplement to routine urinary cytology for the definitive diagnosis of this virus infection.

DNA, Viral↗
PubMed1991

Cardiac tamponade due to rupture of a subepicardial aneurysm following myocardial infarction.

A 71-year-old male died of cardiac tamponade due to cardiac rupture 22 days after onset of acute myocardial infarction. Autopsy revealed rupture of an unusual ventricular aneurysm characterized by abrupt interruption of the myocardium, a narrow neck, a thin fibrous outer wall partially showing myocardial fibers, and lack of adhesion between the epicardium and pericardium. A review of the literature revealed that 11 among 32 autopsy cases of false aneurysm showed a similar morphology to the present case, these being classifiable as subepicardial aneurysm.

Aged↗
PubMed1991

The role of vascular smooth-muscle cells in atherogenesis: phenotypic modulation of the medial smooth-muscle cells in the aortic bifurcation.

To elucidate the mechanism of migration of vascular smooth-muscle cells (SMCs) from media to intima, we have investigated the phenotypic modulation of the medial SMC at bifurcation of the celiac artery in 5 children and 3 young persons using a transmission electron microscope. We counted the number of separated SMCs from the elastic layers, although the medial SMCs are fundamentally attached to the elastic fibers, and are still contractile in their phenotypes. Both proximal and distal portions revealed that SMCs in the media were more or less present in the separated state and were ultrastructurally consistent with the synthetic state of SMC in the proximal area and the contractile state in distal areas. In order to migrate from media to intima, medial SMC should separate from the elastic layers and transform their phenotypes. In this paper, we examined the relationship between vascular SMCs and elastic layers in the media and ascertain that it was responsible for the contribution to the subsequent phenotypic modulation and their migration of medial SMCs.

Adolescent↗
PubMed1990

Chronic dissecting aneurysm of the isolated coronary artery with hemorrhagic myocardial infarction: a rare complication of cardiac operation in a female with Marfan's syndrome.

A 37-year-old female with Marfan's syndrome developed myocardial infarction during a cardiac operation for annuloaortic ectasia and chronic dissecting aneurysm of the aorta. At autopsy, a chronic dissecting aneurysm of the left coronary arterial system (the left main stem, anterior descending branch, first diagonal branch, and circumflex branch) showing a true lumen and a pseudo lumen, which were patent, was found. There was also a hemorrhagic myocardial infarction of the anteroseptal wall and apical portion of the left ventricle.

Adult↗
PubMed1990

Congenital nemaline myopathy with dilated cardiomyopathy: an autopsy study.

A 3-year-old boy with congenital nemaline myopathy had generalized muscle weakness and hypotonia since birth. He developed cardiac symptoms at 2 years of age and died from congestive heart failure. At autopsy, the heart was markedly dilated, involving both ventricles. Rod bodies were recognized not only in skeletal muscles but in cardiac muscles on light and electron microscopy. Desmin and alpha-actinin, which constitute Z-line protein, were shown to localize in the rod structures in both skeletal and myocardial cells by immunohistochemistry. Seven cases of nemaline myopathy with cardiomyopathy have been reported in the literature. All of these patients were over 20 years of age, and the condition appeared mostly in the adult onset and the asymptomatic forms. This is the first infantile case of congenital nemaline myopathy which showed dilated cardiomyopathy with a fatal outcome.

Cardiomyopathy, Dilated↗
PubMed1990

Evaluation of fetal structural heart disease using color flow mapping.

The technique of color flow mapping was used to diagnose 19 cases of fetal structural heart disease from a study group of 104 fetuses. Color flow mapping was 76% effective in detecting the presence of fetal structural heart disease. The colored views of a single stream in the atrioventricular canal were most impressive in cases of complete atrioventricular canal, hypoplastic left heart syndrome, mitral atresia, and tricuspid atresia. The colored views of tricuspid regurgitation were also clear in cases of endocardial fibroelastosis, pulmonary atresia with intact ventricular septum, and Ebstein's anomaly. The use of this technique resulted in the in-utero diagnoses coinciding more closely with the final diagnoses, which were made after birth. This was particularly important in those cases which required immediate management after birth.

Echocardiography, Doppler↗