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Biomedical subjects

C Yutani

Publications and source records attributed to C Yutani.

At least 163 records · Page 9Linked to original sources
PubMed1988

An autopsy case of congenital complete heart block in a newly born of a mother with systemic lupus erythematosus.

An autopsy case of congenital atrioventricular (AV) heart block is described. A newborn infant of a mother with systemic lupus erythematosus died 10 h after birth. Autopsy revealed hematoxylin bodies in the AV node, central fibrous body, and fibrous annulus of the heart. Also, immunoglobulin G (IgG) localization in the hematoxylin bodies was demonstrated by an immunoperoxidase technique. It is suggested that IgG or immune complexes crossed the placenta and that the immune deposition directly injured the cardiac conduction system, causing AV block.

Atrioventricular Node↗
PubMed1988

Nodular regenerative hyperplasia of the liver associated with primary pulmonary hypertension.

Nodular regenerative hyperplasia (NRH), a rare hyperplastic condition of the liver, is reported in two patients with primary pulmonary hypertension (PPH). The first patient was a 26-year-old man who died of PPH and showed multiple NRH without cirrhosis of the liver. The second patient was a 25-year-old man who had a PPH with pulmonary arterial thrombi and NRH of the liver. NRH has been described in association with immune disease, hematopoietic disorder, and diabetes mellitus, so that NRH with PPH is considered to be very rare. Histologic findings of the lungs show typically plexogenic pulmonary arteriopathy in both cases, and the livers of these patients are composed of multiple nodules that are histologically represented by slightly larger hepatocytes arranged in a cobblestone-like fashion, and are ultramicroscopically characterized by massive proliferation of mitochondria. The pathogenetic association of nodular regenerative hyperplasia with primary pulmonary hypertension will be discussed.

Adult↗
PubMed1988

Assessment of severity of cardiac rejection in heterotopic heart transplantation using indium-111 antimyosin and magnetic resonance imaging.

Seven canine donor hearts in which atrial septal defect and tricuspid regurgitation had previously been produced were heterotopically transplanted into the recipients' chest cavities. Indium-111 antimyosin myocardial imaging of the excised heart was performed using a scinticamera. Magnetic resonance imaging was also performed and the T2 relaxation time calculated. Subsequently, these data were correlated with pathological findings, which indicated the degree of rejection. Indium-111 antimyosin uptake was high in moderate and severe rejection, but the T2 relaxation time was prolonged even in mild rejection. Thus indium-111 antimyosin uptake was specific, and the T2 relaxation time was sensitive, for detecting the severity and extent of cardiac rejection. Although ex vivo experimental results have been reported, these new methods allow characterisation and accurate evaluation of myocardial tissue undergoing cardiac rejection.

Animals↗
PubMed1988

Histopathological analysis of surgically resected myocardium in patients with sustained ventricular tachycardia.

Surgical resection of the endocardium and subendocardium often abolishes sustained ventricular tachycardia (VT) in patients with old myocarcial infarct (OMI), unknown myocardial disease, and arrhythmogenic right ventricular dysplasia (ARVD), presumably by interrupting the reentrant pathway. In order to define the morphologic characteristics of histologic components in the reentrant pathway, we carried out histopathological analysis of surgically resected specimens from 17 patients who underwent this procedure. Bundles of apparently viable and hydropic myocardial fibers embedded in dense fibrous and adipose tissues were identified throughout the specimens obtained from OMI, ARVD and idiopathic VT cases. In 3 patients with idiopathic VT, most of the resected areas were composed of ventricular muscle, the components of which appeared histologically similar to Purkinje fibres. In all patients, the abnormal muscle cells were characterized by a loss of contractile elements, hydropic cytoplasm and an elliptic shape. Such an abnormal structure and arrangement of surviving cardiac fibers following tissue injury might play an important role in creating abnormalities of transmembrane potential, leading to the micro-reentrant circuits that give rise to ventricular tachycardias.

Adipose Tissue↗
PubMed1988

A case of hydrops fetalis due to placental chorioangioma.

A case of an infant born in association with a large chorioangioma of the placenta is reported. The mother was complicated with polyhydramnios and premature labor. The fetal complications were congestive heart failure and hydrops fetalis. This case serves to emphasize that it is necessary to examine the placenta in every perinatal autopsy case.

Female↗
PubMed1988

Primary brainstem death: a clinico-pathological study.

A case of primary brainstem death in a man with surgically treated cerebellar haemorrhage is reported. Necropsy revealed extensive necrosis confined to the brainstem and cerebellum. The absence of diabetes insipidus and the persistence of electroencephalographic activity were the characteristic clinical features of the case. This differentiates the condition from so-called "whole brain death". Analysis of three further cases with acute vascular lesions of the brainstem or cerebellum, shown at necropsy, revealed that primary brainstem death with prolonged somatic survival can occur in specific circumstances after surgical intervension.

Brain Death↗
PubMed1988

Idiopathic isolated pulmonary arteritis with chronic cor pulmonale.

Multiple obstructions of the proximal pulmonary arteries were found in a patient with pulmonary hypertension and chronic cor pulmonale without any systemic arterial lesions. An operation to relieve severe stenosis at the right main pulmonary artery provided great clinical improvement. Pathologic examination of the biopsied specimen revealed a nonspecific panarteritis with giant cells consistent with idiopathic isolated pulmonary arteritis.

Arteritis↗
PubMed1988

[Prognosis of primary pulmonary hypertension and its determinants].

Most patients with primary pulmonary hypertension (PPH) die within two to four years of the onsets of their symptoms. However, several reports have described patients with PPH who have lived more than 10 years including a case with regression. We studied prognoses and the various determinants in 21 patients (7 men and 14 women; 18 deceased and three living) with PPH to elucidate its pathophysiology. Age at the onset of the disease varied from 12 to 73 years, with a mean of 29 years. All causes of death were of right heart failure, except for two cases of non-cardiac deaths. The prognoses were as follows: less than one year, two cases; 1-2 years, seven (one living); 2-3 years, five; 3-4 years, two; 4-5 years, one; more than six years, four (two living), with a mean of three years and five months. Pulmonary artery pressure decreased 10 years later (mean pressure, from 54 to 41 mmHg) in one patient, who lived for 13 years, followed by a non-cardiac death. Various clinical and pathological factors, including age at the onset of disease, sex, relationship to pregnancy, immunological abnormalities (4, positive; 17, negative), patent foramen ovale (five, patent; 16, not patent), PaO2, hemodynamic parameters, treatments, pathological subtypes (10, plexogenic pulmonary arteriopathy; two, pulmonary micro-thromboembolism; one, pulmonary veno-occlusive disease) numbers of plexiform lesion/cm2 were examined for prognostic correlations. None of the above factors were found to correlate significantly with prognoses. The only significant correlation was between the cardiac index (r = 0.981, p less than 0.001, n = 6), and total pulmonary resistance (r = -0.894, p less than 0.02, n = 6) in patients with pregnancy-related PPH. There was variability in the state of progression, namely, from rapid progression to regression. Clinically as well as pathologically, PPH may consist of several subgroups. However, whether it is due to differences in etiology or reactions of the disease is not clear. The pregnancy-related cases may comprise a homogenous subgroup within PPH.

Adolescent↗
PubMed1987

Identification of cardiac rejection in heterotopic heart transplantation using 111In-antimyosin.

It is important in heart transplantation to evaluate precisely the extent and location of cardiac rejection. At present, right ventricular endomyocardial biopsy has been used as the gold standard, however, establishment of noninvasive, simple, and easy diagnostic procedure is desired. The canine donor heart, in which atrial septal defect and tricuspid regurgitation had been produced beforehand, was heterotopically transplanted into the recipient's chest cavity. In seven dogs, two to three mCi of 111In-antimyosin was injected intravenously upon cardiac rejection before the heart was excised. 111In-antimyosin myocardial imaging was then performed using a gamma camera. In the same slice, a histopathological rejection score was calculated and divided into mild, moderate or severe injection. The uptake of 111In-antimyosin was significantly higher in moderate and severe rejected myocardium, since this agent produced a specific and selective localization and concentration in areas of myocardial damage. Therefore, this new technique allows the evaluation of therapeutic intervention upon cardiac rejection and may replace right ventricular endomyocardial biopsy.

Animals↗
PubMed1987

Identification of cardiac rejection with magnetic resonance imaging in heterotopic heart transplantation model.

It is important to evaluate the severity and extent of cardiac rejection in heart transplantations. Eight heterotopic heart transplantations using mongrel dogs were performed, and grated magnetic resonance imaging (MRI) of the donor hearts was carried out. High signal intensity was obtained in the rejected myocardium at the time of cardiac rejection, especially from the right ventricular wall to the intraventricular septal wall compared with the left ventricular posterolateral wall. In addition, MRI was performed in the excised heart. High signal intensity was also observed in the same region of the excised donor hearts. The histopathological rejection scores were well in agreement with prolonged T1 and T2 relaxation times; severe and mild rejection of the myocardium were distinguished by the T1 and T2 relaxation times. Our results suggest that MRI is able to visualize the transplanted myocardium undergoing rejection and that the right ventricular wall is more sensitive to cardiac rejection than the left. MRI may allow noninvasive evaluation of the severity and extent of cardiac rejection.

Animals↗
PubMed1987

Histopathological study of hypertrophic cardiomyopathy with progression to left ventricular dilatation.

The heart of seven cases of fatal congestive heart failure with dilated left ventricle, developing in 5 patients with symptomatic hypertrophic cardiomyopathy (HCM) and 2 patients with histologically widespread disarray of both ventricles, was morphologically investigated. These 7 cases showed myocardial widespread disarray and massive fibrosis, the mean percent area of fibrosis was 40.6% and 59.4% at upper and lower levels of left ventricles, respectively. Fibrosis was most extensive in the lateral wall, and followed by anterior, posterior and interventricular walls. The severity of cell infiltration in left ventricle was completely matched to that of fibrosis and was most extensive in subepicardial area followed by middle and subendocardial areas of left ventricle. The intima and medial thickness of intramural small arteries in the fibrotic areas was significantly larger (p less than 0.05) than that of nonfibrotic areas, which suggested that the effect of intramural small artery was not essential for pathogenesis of massive fibrosis.

Adolescent↗
PubMed1987

Uhl's anomaly as a result of progression to ventricular dilation from hypertrophic cardiomyopathy.

A 17-year-old female with clinically diagnosed Uhl's anomaly died of intractable congestive heart failure, liver cirrhosis, and protein losing gastroenteropathy. Cardiac catheterization, echocardiography and nuclear angiography proved to be valuable in making the diagnosis. At autopsy, there was widespread myocardial disarray and extensive fibrosis of both ventricles which led to, in particular, almost total absence of the myocardium of the right ventricle. The present case implicated that certain case of Uhl's anomaly might be related to widespread myocardial disarray and extensive fibrosis, which is known as idiopathic cardiomyopathy.

Adolescent↗
PubMed1987

Autopsy findings in two patients with homozygous familial hypercholesterolemia. Special references to apolipoprotein B localization and internalization defect of low density lipoprotein.

We have experienced two autopsy cases of familial hypercholesterolemia of type IIa homozygote, one was a 21-year-old female with a defect in the internalization of low density lipoprotein which is thought to be the first autopsy report in the world, and the other was a 31-year-old male with a receptor negative for low density lipoprotein. Autopsy findings, in addition to marked skin xanthomatosis, disclosed reversed distribution of the aortic atherosclerosis, diffuse atherosclerotic narrowing of coronary arteries which led to myocardial necrosis, xanthomatous aortic and mitral valve, and much less severity of cerebral arteries rather than that of aorto-coronary atherosclerosis. We have examined the apolipoprotein B accumulation on these aortas, coronary arteries, and cardiac valves, which showed better correlation between apolipoprotein B deposit areas and preferential accumulation of Alcian blue positive areas suggested to contain sulfate glycosaminoglycan, and documented very rare localization of renal and osseous xanthomas in a patient with internalization defect of low density lipoprotein.

Adult↗
PubMed1987

The trend of coronary heart disease and its risk factors based on epidemiological investigations.

Changes in the incidence of coronary heart disease (CHD) in the past 20 years have been observed in workers in the city and residents in rural areas and the risk factors of CHD studied. Findings show that the incidence of CHD in the residents in rural areas has hardly changed, and remains still low. However, the incidence of CHD in workers in the city has recently shown a tendency to increase. Furthermore, a study of CHD risk factors shows that in the rural areas residents hypertension has a strong influence on the incidence of CHD, while the role of serum total cholesterol is weak. In the city workers a high serum total cholesterol has become a risk factor. Therefore, it appears that the incidence of CHD caused by hypertension and by hypercholesterolemia are mixed in Japan. At present it appears that the influence of hypertension is becoming weaker, while the influence of hypercholesterolemia is becoming stronger. The resulting balance between them may be expressed as a rise and fall of CHD in Japan at present.

Adult↗
PubMed1987

Histopathological study of acute myocardial infarction and pathoetiology of coronary thrombosis: a comparative study in four districts in Japan.

To clarify the patho-etiologic factors of Japanese myocardial infarction, a comparative pathological study of myocardial infarction in the Osaka, Akita, Wakayama, and Hokkaido districts, and an extensive histopathological study of 94 autopsy cases with acute myocardial infarct (AMI) in less than 4 weeks at Osaka were carried out. Although AMI in Akita was highly complicated by hypertension, AMI in Osaka was associated with a history of diabetes mellitus and hypercholesterolemia, especially in the young generation (under 59 years of age); hypercholesterolemia was related to the occurrence of AMI. Moreover, in spite of increases in transmural myocardial infarct (TMI) in Osaka, Hokkaido and Wakayama, Akita showed an equal ratio of TMI and subendcardial myocardial infarct. In AMI in Osaka, significant stenosis (more than 75% stenosis) of the coronary artery was of the same grade between the proximal and distal portions in the epicardial coronary artery. AMI in Akita, however, showed more severe stenosis in the proximal than the distal portion. A high incidence (88.3%) of thrombosis formation corresponding to the site of infarction was observed in AMI in Osaka. Moreover, ruptured atheromatous plaques were identified as being responsible for 62.6% of the coronary thrombosis cases, and a high incidence (70.0%) of foamy cell infiltration was disclosed. Thus, it can be concluded that ruptured atheromatous plaque is a major factor in the progression of coronary atherosclerosis and/or thrombosis, which might be due to the process of plaque softening.

Adult↗