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Biomedical subjects

F Iida

Publications and source records attributed to F Iida.

At least 109 records · Page 6Linked to original sources

[Triiodothyronine(T3) autoantibodies in a woman with nonthyroidal disorder: a study on preparation of serum IgG fraction employing protein A column chromatography].

A 48-year-old non-goitrous woman, who had undergone cardiac surgery for mitral stenosis under the extracorporeal circulation, showed high levels of serum T3 and free T3 in a recent follow-up study, employing antibody coated-bead RIA for T3 and -Amerlex M particle RIA for free T3. However, other thyroid function tests (T4, free T4, TSH and TBG) were normal. We suspected that thyroid hormone autoantibodies (THAA) in her serum interfered with T3 and free T3 analyses. The presence of THAA was demonstrated by the use of various procedures as follows. Firstly, the patient's serum was directly incubated with 125I-T3 or -T4 analog which did not bind to TBG, followed by B/F separation with polyethyleneglycol, counting the precipitates. Secondly, after the serum was treated with an acid-charcoal solution to remove circulating thyroid hormone, the measurement of THAA was made as stated above. Normal sera were used as controls. Both the non- and acid-charcoal-treated sera showed much higher percentages of 125I-T3 analog precipitation as compared with controls. In the case of 125I-T4 analog, there was no difference between them. In the third study, the presence of IgG antibodies that bound T3 but not T4 was investigated. The IgG fraction of the patient's serum was separated employing a Protein A-Sepharose CL-4B column chromatography. Then, the prepared IgG fraction was purified by a technique of gel filtration chromatography (Sephacryl S 200). Non-purified and purified-IgG fractions both revealed higher binding percentages of 125I-T3 analog than the control IgG fraction and non-IgG fraction of the patient. Furthermore, a good dose response was observed between the binding percentage of 125I-T3 analog and each dose of the patient's serum or IgG fraction. From these observations, it was clarified that this woman had anti-T3 IgG autoantibodies using a Protein A column chromatography with confirmation of gel filtration chromatography.

Autoantibodies↗

Reconstruction of the carotid artery using a temporary shunt during an operation for advanced thyroid carcinoma--a case report.

A case of a patient who required reconstruction of the carotid artery during a radical operation for advanced thyroid cancer is reported herein. The patient, a 64-year-old female who had had three previous operations for thyroid cancer, underwent a two-stage operation. In the first stage, the left cervical lymphnodes were dissected, but as a large metastatic node invading the left carotid artery could not be completely removed, some carcinoma tissue was left attached to the wall of the artery. The second stage involved a temporary shunt being set up between the common carotid artery and the internal carotid artery following heparinization, after which the invaded portion was resected, and the defect patched with a saphenous vein graft. Monitoring with a Doppler flow-meter and EEG were conducted throughout the operation. At present, cancer has recurred in the left submandibular and supraclavicular regions.

Carcinoma, Papillary↗

An evaluation of the intraoperative staining technique using methylene blue for the detection of hyperplastic parathyroid glands.

Intraoperative staining with methylene blue was employed during parathyroid surgery on 50 glands from 13 patients, 5 with primary and 8 with secondary hyperparathyroidism. Forty-seven out of the 50 glands (94 per cent) were visualized by the staining and 2 out of the 13 patients were revealed to have supernumerary parathyroid glands. Since we started using this technique, there have been no cases of persistent hypercalcemia. The results of this study support the clinical usefulness of this staining procedure for detecting hyperplastic parathyroid glands in both primary and secondary hyperparathyroidism.

Diagnosis, Differential↗

Mechanism of pancreatic hypersecretion in dogs with obstructive jaundice.

Pancreatic exocrine function in experimental obstructive jaundice was examined using dogs. Outputs of pancreatic juice, bicarbonate and amylase were greater in dogs with obstructive jaundice than in control dogs. To further examine the hypersecretory mechanism in obstructive jaundice, we examined pancreatic exocrine secretion stimulated by secretin and pancreozymin in both the isolated perfused pancreas and pancreatic dispersed cell culture. The perfused pancreas stimulated with secretin and pancreozymin in dogs with obstructive jaundice showed higher secretion of volume, bicarbonate and amylase than in control dogs. Dispersed pancreatic cells of jaundiced dogs stimulated by secretin and pancreozymin released more bicarbonate and amylase into the media than dispersed cells of control dogs. These data suggest pancreatic hypersecretion in obstructive jaundice is not due to excessive serum levels of secretin and pancreozymin or impaired metabolism of these hormones.

Amylases↗

Suppressive effect of ulinastatin on plasma fibronectin depression after cardiac surgery.

Plasma fibronectin, an opsonic glycoprotein, is known to modulate the reticuloendothelial phagocytic clearance of nonbacterial and, possibly, bacterial particulates. The decreased plasma fibronectin levels seen after cardiac surgery have been considered to derive mainly from opsonic consumption. In the present study, we demonstrated that the administration of ulinastatin, a human urinary trypsin inhibitor, to patients after cardiac surgery not only inhibited the postoperative depression of plasma fibronectin levels, but also maintained the plasma fibronectin level within the normal range. This effect apparently resulted from the inhibitory activity of ulinastatin on the proteolytic enzymes released after operation. This result suggests that the decreased plasma fibronectin level noted after cardiac surgery may derive mostly from excessive proteolytic enzymes. Our observation also indicates that the prophylactic administration of ulinastatin to patients undergoing major operations will result in a favorably functional reticuloendothelial phagocytic system.

Cardiac Surgical Procedures↗

Partial resection of atrial septal aneurysm with multiple fenestrations--a case report.

Aneurysms of the interatrial septum are uncommon lesions that are often accompanied by other cardiac anomalies or systemic thrombosis. The authors report 1 case of atrial septum aneurysm that was diagnosed by two-dimensional contrast echocardiography. At surgery a membrane-like, fenestrated aneurysmal protrusion to the right atrium without thrombosis was seen. The atrial septum was closed without using an artificial patch after some of the aneurysm with fenestrations was resected.

Adult↗

Immunohistochemical studies on the localization of fibronectin in human thyroid neoplastic tissues.

Fibronectin (FN) has been considered to be involved in the malignant transformation of cells. It was thus of interest to morphologically study the cell surface distribution of FN in various types of thyroid neoplasms employing immunohistochemical techniques. Immunohistochemical staining using the specific anti-human FN antibody was performed by the avidin-biotin-peroxidase complex procedure. Compared to the staining pattern of normal thyroid tissues (control), differences in staining in malignant thyroid lesions and even in fetal and embryonal adenomas were evident, often on the lateral and basal aspects of the cell membrane. Colloid adenomas, however, showed FN staining on the basement membrane, basically similar to the controls. Moreover, in thyroid carcinoma, different staining patterns relating to each of the histological types were observed. The present investigation demonstrates the heterogeneity of the thyroid neoplasms in terms of FN binding.

Adenocarcinoma↗

[Recent advances in surgical treatment of thyroid carcinoma].

Patients with thyroid carcinoma must be treated considering on the biological behaviour of the tumor. It has been noted that papillary and follicular carcinomas grow very slowly while anaplastic carcinoma very rapidly. Postoperative recurrence rate of differentiated carcinomas was calculated on 390 patients who were followed for over 10 years after various operative procedures. The recurrence rate was closely related to the tumor size rather than operative procedure and was about 10% in carcinoma below 2 cm in diameter for which enucleation or partial thyroidectomy was carried out. Recurrence rate in the remnant thyroid was higher in the group of enucleation and partial thyroidectomy than in the groups of lobectomy and subtotal thyroidectomy. Recurrence in lymph node was found more frequently in the groups of more extended dissection. Operative procedures performed in 97 patients who had recurrence were total removal of the remnant thyroid, extended dissection of mediastinal lymph nodes and combined removal with the trachea and vessels. From these experiences, a criterion of initial operation for thyroid cancer was accomplished. Prophylactic dissection was attempted in recent 193 patients with differentiated carcinoma, and revealed a high frequency of lymph node metastasis, that was 70%. Radiotherapy with 131I was carried out in 21 patients, and regression of metastatic foci was observed in all patients with follicular carcinoma and a half with papillary carcinoma. For anaplastic carcinoma, multidisciplinary treatment was attempted, but no satisfactory effects were obtained.

Combined Modality Therapy↗

Immunohistochemical studies on local antitumor effects of streptococcal immunopotentiator, OK-432, in human solid malignant tumors.

Immunocytochemical techniques were used to clarify the local inhibitory effects of a streptococcal immunopotentiator, OK-432, against solid malignant tumor growth. Natural killer (NK) cells and fibronectin were chosen as immunostaining markers to demonstrate the antitumor effects. Immunocytochemical staining was performed by the avidin-biotin-peroxidase complex method. These investigations demonstrated that (1) local administration of OK-432 seems to promote a marked induction of NK cells and fibroblasts around or entering into the cancerous lesions and (2) the cancer cell-killing effect of NK cells and the fibronectin-enriched stromal reaction augmented by the injection of OK-432 suggest at least the possibility of protection against neoplastic growth with invasion and the spread of distant or nodal metastases of solid carcinomas.

Adenocarcinoma↗

Parathyroid imaging: comparison of 201Tl-99mTc subtraction scintigraphy, computed tomography and ultrasonography.

From 1982 to 1985, twenty-nine patients with suspected hyperparathyroidism were examined using 201Tl-99mTc subtraction scintigraphy (Tl-Tc), computed tomography (CT) and ultrasonography (US). For diagnosing neoplasm (adenoma or cancer), the sensitivities of the three procedures were 80 per cent or more, with no statistically significant differences. For diagnosing hyperplasia of the parathyroid glands, CT scan had the highest sensitivity (47 per cent). The most frequent source of error was minimally enlarged glands, weighing less than 500 mg. The second highest source of error was thyroid nodules, such as adenomatous goiter or cancer. Serum calcium and c-PTH levels were significantly higher in those with a parathyroid neoplasm than in those with hyperplasia (p less than 0.01, p less than 0.05, respectively). We concluded that hyperplasia is less easy to detect than neoplasm, and CT scan is superior to Tl-Tc or US scan for localizing hyperplasia.

Humans↗

The usefulness and significance of naso-pharyngo-laryngo-tracheal fiberscopy in thyroid surgery.

The authors conducted naso-pharyngo-laryngo-tracheal fiberscopic examinations before and after thyroid surgery. Preoperative examination included an inspection of vocal cord movement, the compression and deformity of the trachea caused by goiters, changes in the color of the tunica mucosa tracheae, and the presence of tumorous invasion. Postoperatively, this method was employed primarily to determine the presence of recurrent laryngeal nerve paralysis, changes in the tracheal mucosa caused by manipulations in thyroid surgery and in cases in which surgery involved the tracheal wall, and to inspect the treated condition at the original tracheal site and detect the presence of possible recurrences. The manipulations can be easily carried out, causing little pain, and the procedure is economically feasible. Since it can provide more useful information than any other examination method, the active use of endoscopic examination by surgeons themselves at numerous facilities would appear desirable.

Endoscopy↗

[Relationship between biopsy and prognosis of breast cancer].

Clinical data from 131 patients who underwent primary radical operation for breast cancer at the Second Department of Surgery, Shinshu University Hospital during five-years from January 1976 to the end of December 1980 were analyzed to investigate for the relationship between biopsy and prognosis. The incisional biopsy group had a significant higher recurrence rate as compared with the no biopsy group, cytology group and the cancer negative group after excisional biopsy. Although the puncture aspiration cytology group did not show significant difference in recurrence rate, an any more than 3 weeks of interval between puncture aspiration cytology and radical surgery associated with a significant high recurrence rate. This suggests that the interval also exerts an unfavorable influence upon prognosis. Puncture aspiration cytology was recognized to be apt to result in distant metastasis than any other biopsy methods and also it is tended to have a higher recurrence rate in scirrhous and mucinous carcinoma of the breast.

Adenocarcinoma, Mucinous↗

Rare variants of Hodgkin's disease of the thymus: report of two cases and proposal for effective clinical management.

We treated two patients with rare variants of Hodgkin's disease of the thymus. One was a 17-year-old girl with a thymoma-like shadow on the chest X-rays, an increased erythrocyte sedimentation rate and an elevated eosinophil count. Pathologically, a mixed cellularity variant of thymus Hodgkin's disease was evident. The other patient was 22-year-old girl with evidence of mediastinal tumor on the chest X-rays. Pathological examination revealed Hodgkin's disease of the lymphocyte predominance variety. She also had Von der Haeve syndrome. In both cases, Hodgkin's disease was suspected by scintiscanning, using three kinds of radioisotope, 201Thallium-chloride, 67Garium-citrate and 75Selenomethionine. Radical excision of the lesion plus preoperative and postoperative irradiations were carried out. Both are well 6 and 5 years after the treatment, respectively. We propose a new diagnostic procedure and a method of treatment for such patients.

Adolescent↗