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Biomedical subjects

C Yutani

Publications and source records attributed to C Yutani.

At least 145 records · Page 8Linked to original sources
PubMed1990

Sequential malignant transformation of cardiac myxoma.

We describe a case of cardiac myxoma in a 44-year-old Japanese man, who died after developing metastases in the skin, brain and muscle. A satellite tumor which was attached to the wall of the abdominal aorta induced marked hypertension due to obstruction of the renal arteries. Although the primary heart tumor had typical histological features of benign cardiac myxoma, the recurrent heart tumor, which was partly resected three months before the patient's death, showed apparently malignant characteristics resembling malignant fibrous histiocytoma (MFH). Since the histological features of the initial and recurrent tumors were different, the grade of malignancy was investigated using the cellularity of the tumor as an arbitrary criterion. A gradual but significant increase in the cellularity was observed over the course of five years. Immunohistochemically, tumor cells in the muscle metastasis contained vimentin and factor VIII-related antigen, and multinucleated giant cells in the recurrent heart tumor contained desmin, which is rarely detectable in MFH. Therefore, we considered that the present case represented malignant transformation of benign cardiac myxoma.

Adult↗
PubMed1990

Rupture of atheromatous plaque as a cause of thrombotic occlusion of stenotic internal carotid artery.

We analyzed the clinical profiles and autopsy findings of five patients who died shortly after developing cerebral infarction following thrombotic occlusion of the internal carotid artery. In all five cases, thrombotic occlusion was caused by rupture of the fibrous lining over the gruel of atheroma at the origin of the internal carotid artery showing tight stenosis of the lumen. The mean +/- SD shorter diameter of the lumen at the site of occlusion was 1.5 +/- 0.4 mm. Our results show that an internal carotid artery with tight stenosis of the lumen by atheroma containing gruel harbors a risk of thrombotic occlusion, which may give rise to cerebral infarction by artery-to-artery embolism or by reduced cerebral perfusion.

Aged↗
PubMed1990

A patient with ventricular tachycardia showing remarkable fatty infiltration and lymphocytic myocarditis in the right ventricular wall.

A 14-year-old boy without overt heart disease underwent encircling ventriculotomy and cryoablation because of ventricular tachycardia resistant to antiarrhythmic therapy. Resection of the right ventricular wall with the origin of the ventricular tachycardia was performed on the basis of information obtained by epicardial mapping at operation, and histological examination showed unique findings of remarkable fatty infiltration and lymphocytic myocarditis.

Adipose Tissue↗
PubMed1990

[Progression to the dilated phase of hypertrophic cardiomyopathy in children].

Twenty-three children with hypertrophic cardiomyopathy (HCM) (aged 2 months to 15 years) were followed up for more than four years using thallium myocardial imaging (TMI) and echocardiography. With echocardiography, the left ventricular end-diastolic dimension (LVDd) and fractional shortening (FS) were measured. Perfusion defect (PD) was assessed using TMI. Cardiac catheterization and right ventricular endomyocardial biopsy were performed in 18 patients within one week before or after their TMI. During the follow-up period, two patients showed a marked increase in LVDd and a marked decrease in FS at ages 13 and 16 years, respectively. These two patients were judged to have progressed to the dilated phase. In these two patients, extensive PD was detected in the left ventricular wall on TMI, 15 and 31 months prior to the appearance of the echocardiographic changes, respectively. Right ventricular endomyocardial biopsy at the time of extensive PD revealed marked interstitial fibrosis along with hypertrophy and disarray of myocardial cells. In conclusion, progression to the dilated phase is not a rare event in children with HCM and TMI appears to be a useful tool for early detection of the progression.

Adolescent↗
PubMed1990

[Acute fatal pulmonary embolism: its prevention, diagnosis and treatment].

Acute fatal pulmonary embolism is one cause of sudden death which should be guarded against. It is the most often missed diagnosis in sudden death cases within the hospital. Clinical pictures of 10 patients with acute fatal pulmonary embolism proved by autopsy were examined to elucidate the problems of diagnosis, and to look for an effective treatment, and a method of prevention. Common risk factors were old age and immobility due to stroke or postoperative state. Common past histories were hypertension, diabetes mellitus, obesity, atrial fibrillation and hyperlipidemia. Electrocardiogram and echocardiogram showed that in these patients there was definite evidence of acute right ventricular overload. High doses of intravenous urokinase should be given whenever acute cardiovascular collapse develops in such high risk patients. Emergent pulmonary angiogram and pulmonary embolectomy could be life-saving in patients with acute massive pulmonary embolism. Prevention is, however, the best treatment. In addition to anticoagulation medication, frequent change of body position and early mobilization are important precautions to prevent fatal pulmonary embolism developing in such patients.

Acute Disease↗
PubMed1990

[Two cases of cardiac rupture after myocardial hemorrhagic infarct].

Two patients, both of whom were men over 65 years of age who had no history previous myocardial infarcts, had sudden chest pain. One of the men died due to cardiogenic shock on the first day, and the other died on the fourth hospital day. Each autopsy disclosed transmural myocardial infarct with hemorrhage, resulting in cardiac rupture. Hemorrhage was recognized in the necrotic area of the myocardial infarcts. Each cardiac rupture was found in the center of the hemorrhagic infarcts. The ruptures were tear-like slits. The healing process of the infarct was much more delayed in the hemorrhagic area than in the anemic area. These two cases suggest that hemorrhagic infarct may be one of the risk factors of cardiac ruptures.

Aged↗
PubMed1989

Hemodynamic and prognostic value of thallium-201 myocardial imaging in patients with dilated cardiomyopathy.

We studied 70 patients with dilated cardiomyopathy to determine whether extent of perfusion defect on thallium imaging could be related to the hemodynamics and prognosis of the patients. Patients were divided into three groups according to the extent of perfusion defect, i.e., Grade I: no perfusion defect (n = 19), Grade II: apical perfusion defect (n = 22), and Grade III: extensive perfusion defect (n = 29). The patients of Grade III demonstrated marked hemodynamic deterioration compared with those of Grade I and II. Three-year survival rate showed lower value in proportion to the extent of perfusion defect (P less than 0.05). Death from progressive heart failure tended to occur in patients with extensive perfusion defect (P less than 0.05). In patients of Grade III, the perfusion defect extended mainly to the posterolateral segment. Although autopsy studies showed increased fibrosis in the left ventricular wall in these patients, the extension of the fibrosis was not related to that of fibrosis. Moreover, the perfusion defect had regressed in three of 18 patients in the follow-up examination. These results indicate that the extent of perfusion defect on thallium imaging may be of value in non-invasive evaluation and prediction of the prognosis in patients with dilated cardiomyopathy. Distribution of the perfusion defect was, however, not related to that of myocardial fibrosis.

Adolescent↗
PubMed1989

Sodium nuclear magnetic resonance imaging of acute cardiac rejection in heterotopic heart transplantation.

Nuclear magnetic resonance (NMR) imaging was used to measure tissue sodium-23 in the myocardium undergoing cardiac rejection. In six dogs, the donor heart was heterotopically transplanted into the recipient's chest cavity. The dogs were then killed and sodium-23 images of the excised hearts were obtained using a high field (1.5 Tesla) NMR imaging system. Proton NMR imaging of each excised heart was also performed and T1, T2 relaxation times were calculated. Subsequently, these data were correlated with pathological findings of mild, moderate and severe rejection. The correlation coefficients between the rejection score and the T1, T2 relaxation times and sodium NMR signal intensity were 0.79, 0.70 and 0.84, respectively. Severely rejected areas of the myocardium were visualised by increased sodium NMR signals. These findings suggest that an increase of sodium NMR intensity is mainly caused by an increase of intracellular sodium content due to irreversible myocardial necrosis. Sodium NMR allows evaluation of the location and extent of rejection of myocardium after heart transplantation.

Animals↗
PubMed1989

Primary leiomyosarcoma of the inferior vena cava with Budd-Chiari syndrome.

A 44-year-old Japanese woman with leiomyosarcoma of the inferior vena cava is reported. She presented with Budd-Chiari syndrome and died of hepatic failure about 3 months after the onset of symptoms. The tumor arose from the middle segment of the inferior vena cava, occluded the inferior vena cava and projected into the right atrium. A total of 28 cases of Budd-Chiari syndrome due to primary leiomyosarcoma of the inferior vena cava are reviewed.

Adult↗
PubMed1989

Histopathological study of aorto-coronary bypass grafts with special reference to fibrin deposits on grafted saphenous veins.

A histopathological study was performed on 36 patients (60 grafts) who had undergone aorto-coronary bypass graft (ACBG) surgery 0 to 99 months prior to death. The following pathologic changes were found: 1) The thickness of diffuse intimal proliferation in the ACBG progressed with time from graft surgery to death. 2) The media became atrophic and the adventitia was increased slightly in thickness. 3) Fibrin deposits were found in 20 patients on/in the intimal thickenings of the vein graft walls and 7 patients showed incorporated fibrin in the thickened intima even one month after surgery. 4) Atherosclerosis, identified as intimal foam cell accumulation or frank plaques, was seen in only 3 patients 4 years after surgery. Fibrointimal proliferation occurred with relatively greater frequency in patients with fibrin deposits (P less than 0.001). Although it is well known that mural thrombi in vein grafts manifest fibrointimal proliferation, our results suggest that fibrin deposits might be responsible for intimal thickening even one month after graft surgery.

Aged↗
PubMed1989

Hemorrhagic infarct of the brain without a reopening of the occluded arteries in cardioembolic stroke.

We examined the brains of 14 patients (four men and 10 women, mean age 68.9 years) who died from brain herniation after cardioembolic stroke with persistent occlusion of the internal carotid-middle cerebral arterial axis. Our examination showed hemorrhagic infarct in seven patients and pale infarct in the other seven, contradicting the commonly proposed pathophysiologic mechanism for the development of hemorrhagic infarct that the opening of previously occluded vessels makes an infarct hemorrhagic. Analysis of blood pressure after stroke revealed one or more surges of arterial hypertension or rapid rise of blood pressure in patients with hemorrhagic infarct without a reopening of the occluded artery. Such arterial hypertension was not always present in patients with pale infarct. Hemorrhage into an infarct with persisting occlusion of the proximal artery is assumed to occur when the involved blood vessels are exposed to the force of arterial blood pressure from the leptomeningeal collaterals. This occurs when arterial blood pressure rises after stroke in the presence of efficient leptomeningeal collaterals and before occlusion of these collaterals by a swollen cerebral hemisphere containing a large infarct.

Adult↗
PubMed1989

Giant cell pneumonia caused by varicella zoster virus in a neonate.

A premature male neonate, born at the 25th gestational week, developed pneumonia six days after delivery and died. Postmortem examination of the lungs revealed giant cell pneumonia with intranuclear inclusion bodies; varicella zoster infection was confirmed by immunoperoxidase stain using monoclonal antibody to varicella zoster virus and electron microscopic examination. In previously reported necropsy cases of numerous giant-cell formation in the lung is not mentioned. Therefore, the unusual features prompting this report include the absence of skin lesions in this mother and infant and the presence of giant cell pneumonia, not previously reported in varicella zoster infection.

Antibodies, Monoclonal↗
PubMed1989

[Gallium-67 imaging in patients with myocarditis in childhood and youth].

Gallium-67 (Ga-67) myocardial imaging was performed in 19 patients (1 month to 21 years of age) with proven or suspected myocarditis. The anterior images, 48 hrs after the intravenous administration of 0.5-2.0 mCi Ga-67 citrate, were analysed using a computer. Regions of interest were set on the heart, lungs and background, excluding the sternum and vertebrae. The uptake of Ga-67 was evaluated quantitatively by the ratio of the average count of the heart to the average count of the lung (H/L). When the H/L value was higher than 130% the cardiac uptake of Ga-67 was designated positive. Histological examination was performed in 11 patients who underwent right endomyocardial biopsy. The patients were categorized according to their clinical findings. Group 1 consisted of 11 patients with clinical symptoms of dilated cardiomyopathy, six of whom had arrhythmias or elevated serum CPK-MB levels (group Ia) in the acute stage of the disease, and the remaining five had neither (group Ib). Group 2 consisted of eight patients with dysrhythmias but without heart failure. Four had elevated serum CPK-MB levels (group IIa), but the remaining four did not (group IIb). All patients in the group Ia had positive Ga-67 uptakes, and three patients in the group Ib had negative uptakes. The H/L values were significantly higher in the group Ia than in the group Ib (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

[Pathoetiological aspects of mitral valve prolapse].

Myxomatous lesion of the mitral valve, a major pathological factor in mitral valve prolapse (MVP), was analyzed in 33 cases with idiopathic MVP, 34 with secondary MVP, 30 with hypertension, 11 with right ventricular hypertrophy, and 28 control subjects. Area of the myxomatous lesion expressed as a percent area in the cross-section of each valve leaflet was obtained in each zone. With the increasing age, the % area increased particularly in the posterior leaflet and the area expanded from the rough zone to the basal zone. Compared with other conditions, the mitral valve in idiopathic MVP had extensive myxomatous lesion of 50% or more in the % area. Histologically, this area showed diffusely distributed lesion from the fibrosa to the ventricularis, disappeared collagen fibers, and disrupted elastic fibers irregularly located. Electron-microscopically, these disruption or disappearance were replaced by young mesenchymal cells. It was concluded that the increase in a myxomatous lesion is the essential pathological finding in idiopathic MVP, but this lesion may be developed secondarily in other conditions, though not so extensive.

Adult↗
PubMed1988

Immunocytochemical demonstration of glial fibrillary acidic protein in imprint smears of human brain tumors.

Papanicolaou-destained imprint smears from 24 brain tumors were investigated by means of avidin-biotin-peroxidase complex method (ABC) with the use of monoclonal antibodies against glial fibrillary acidic protein (GFAP). Positive staining reaction to GFAP antibody has been demonstrated in cells from the following tumors: astrocytoma, anaplastic astrocytoma, glioblastoma multiforme, mixed glioma, and ependymoma. The reaction for GFAP was negative for the following tumors: medulloblastoma, neurilemmoma, melanoma, hemangioblastoma, and metastatic tumors. In astrocytoma, the cell bodies and processes were positive with delicate fibrillary patterns; in anaplastic astrocytoma, cytoplasm and the processes were intensively stained. In glioblastoma multiforme, the staining patterns were also mixed, and the short, thickened processes were characteristic. Use of both a smear preparation and the immunoperoxidase staining technique is of great value in diagnosis of tumors of the central nervous system.

Antibodies, Monoclonal↗
PubMed1988

Immunocytochemical localization of carcinoembryonic antigen in cerebrospinal fluid with metastatic carcinoma of the stomach: report of four cases.

A study was undertaken to evaluate the cellular findings of gastric carcinoma in cerebrospinal fluid (CSF). Immunocytochemical localization of carcinoembryonic antigen (CEA) was performed on four cases of metastatic gastric carcinoma cells in CSF samples. A positive peroxidase-antiperoxidase (PAP) reaction was obtained in all cases, with intense staining for CEA in the CSF samples as well as in the paraffin-embedded tissue sections from the primary gastric tumors. Cellular morphology and the results of immunoperoxidase staining can be studied simultaneously. We believe that the PAP method for CEA increases diagnostic accuracy of cytology in the CSF.

Aged↗