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Biomedical subjects

H Irie

Publications and source records attributed to H Irie.

At least 37 records · Page 2Linked to original sources

Physiological significance of apoptosis in animal virus infection.

In contrast to insect viruses, animal viruses can produce considerable amounts of progeny virus in cells undergoing apoptosis. Nevertheless, viruses in general have acquired the ability to escape apoptosis of infected cells. These facts indicate that the role of apoptosis in virus infection is different in insect virus and animal virus, although both viruses need to avoid apoptosis of the infected cells for a viral life cycle in nature. In animal virus infection, the primary role of apoptosis is considered not to be a premature lysis of the infected cells (and the following abortion of virus multiplication) but to allow the dying cells to be phagocytosed by macrophages. This phagocytosis is able to prevent dysregulated inflammatory reactions at the site of virus infection and to initiate a specific immune response against the infected virus.

Animal Diseases↗

Isolated dissection of the celiac artery--a case report.

Isolated arterial dissection, which occurs with the absence of aortic dissection, has been reported in carotid and renal arteries but rarely in visceral arteries. A case of isolated celiac artery dissection is reported here. A healthy 58-year-old man experienced sudden upper abdominal pain, which continued for several days. A body computed tomogram (CT) showed a multiple low-density wedge-shaped area in the spleen, which was diagnosed as splenic infarction, and an aneurysm with thrombus in the celiac artery. A selective angiogram showed dilatation of the celiac artery with wall irregularity, and proximal occlusion of the hepatic artery. The distal hepatic artery was fed by collateral arteries from the superior mesenteric artery. Splenic infarction was probably due to the embolism from the thrombus in the dissected celiac artery. The absence of other vascular lesions and causes or risks for the arterial dissection would suggest the occurrence of spontaneous dissection. The dissection of visceral arteries should be considered in diagnosing acute abdominal pain.

Abdominal Pain↗

Heat shock protein 72 expression in the right ventricle of patients undergoing congenital cardiac surgery.

While heat shock protein (HSP) 72 is known as a stress protein, there have been no reports of HSP 72 expression in patients who have undergone surgery for congenital heart disease. Fourteen patients (7 males and 7 females) who had undergone surgery for congenital heart disease were studied. The ages of the patients ranged from 2 months to 43 years old (mean 6.5 +/- 10.8 years old; median 3.0 years old). The diagnoses were Tetralogy of Fallot in seven, pulmonary atresia with ventricular septal defect (VSD) in three, complex anomalies in three, and VSD in one patient. Histological study and HSP analysis using Western blots and immunostaining with anti-HSP 72 monoclonal antibody were performed for right ventricular muscle samples resected during the surgery. The histological findings showed hypertrophic changes of ventricular cardiomyocytes in all samples studied. Western blots detected HSP 72 expression of various degrees in all specimens. Immunostaining using monoclonal antibody against HSP 72 showed that the protein was present in the nuclei and cytoplasm of cardiomyocytes. In conclusion, although it is difficult to determine the cause of the "stress" that triggers HSP 72 expression in cardiomyocytes, low O2 saturation and pressure overload might act as a "stress", and the only common factor that induced HSP 72 in every sample was hypertrophy.

Adult↗

MR cholangiopancreatographic differentiation of benign and malignant intraductal mucin-producing tumors of the pancreas.

OBJECTIVE: The purpose of this study was to establish MR cholangiopancreatographic criteria for discriminating benign from malignant intraductal mucin-producing tumors of the pancreas. MATERIALS AND METHODS: Thirty-one patients with 34 intraductal mucin-producing tumors underwent MR cholangiopancreatography. Tumors were classified as either main duct type (n = 10) or branch duct type (n = 24). In patients with the main duct type, the maximum diameter and the location of the main pancreatic duct, the extent of main pancreatic duct dilatation, and the presence of a filling defect were evaluated. For branch duct type, the location and maximum diameter of the cystic lesion, the presence of a filling defect, and the presence of associated main pancreatic duct dilatation were evaluated. RESULTS: In patients with the main duct type, the main pancreatic duct was significantly narrower when associated with benign rather than malignant tumors. All malignant tumors showed diffuse main pancreatic duct dilatation, whereas all benign tumors showed segmental dilatation. Among patients with branch duct type, the cyst was smaller when it was a benign rather than malignant tumor. All but one malignant tumor showed mild associated main pancreatic duct dilatation, whereas benign tumors were not associated with main pancreatic duct dilatation. Filling defects suggested malignancy, although half of the malignant tumors had no filling defects. CONCLUSION: In patients with intraductal mucin-producing tumors of the pancreas, filling defects are indicative of malignancy. Diffuse main pancreatic duct dilatation greater than 15 mm (main duct type), or any main pancreatic duct dilatation (branch duct type), is strongly associated with malignancy.

Adenocarcinoma↗

[Role of apoptosis induced by acute herpes simplex virus].

Apoptosis is induced by acute herpes simplex viral infection in the adrenal cortex, myenteric plexus of the gut, ovary, and liver of mice. Viral replication is closely related to apoptosis. This apoptosis is increased in immunosuppressive regions like the adrenal cortex and liver of macrophag-depleted mice. However, the herpes simplex virus is known to possess US3 gene, which interferes with cell apoptosis. In the liver of macrophage-depleted mice infected with US3 gene-deficient mutant herpes, the apoptosis is confined to within the narrow limits of inflammatory cell infiltration, mainly of neutrophils, and it plays a part in the restriction of virus multiplication. Thus, a possibility exists that apoptosis works as a primitive immunity in herpes simplex virus infection.

Acute Disease↗

[Delayed sternal closure after open heart surgery in neonates and early infants].

Between November 1992 and February 1996, 84 patients (less than 3 months of age) underwent open heart surgery. Among 76 patients except 8 who required mechanical circulatory support, the sternum was left open. The indication of open sternotomy was hypoplastic left heart syndrome in 14 patients and unstable hemodynamics in 4 patients. Three patients died before delayed sternal closure. Delayed sternal closure was carried out in 15 patients with a mean of 4.7 days postoperatively. By the time of sternal closure, blood pressure, left atrial pressure and respiratory parameters improved and inotropics were reduced with the minus fluid balance. One patient died of sepsis 4 days after delayed sternal closure. Delayed sternal closure was effective modality to neonates or early infants after complex open heart surgery.

Cardiac Surgical Procedures↗

MR detection of cytoplasmic fat in clear cell renal cell carcinoma utilizing chemical shift gradient-echo imaging.

We attempted to determine whether cytoplasmic fat in clear cell renal cell carcinoma (RCC) can be identified by chemical shift gradient-echo magnetic resonance imaging (CSI). CSI was performed for 22 clear cell RCCs and 30 other renal tumors (including 16 non-clear cell RCCs), all of which were surgically proven. Signal reduction in out-of-phase images of these tumors was retrospectively evaluated and compared. The signal loss ratio (SLR) was defined and calculated. Fat staining of specimens from 16 tumors was performed and correlated with SLR. SLR was significantly higher in clear cell RCCs than in non-clear cell RCCs (P < 0.001). There was a significant correlation between degree of fat staining positivity of the specimens and SLR (P < 0.01). When signal reduction in out-of-phase images suggested the diagnosis of clear cell RCC, correct diagnosis of this entity was made in resected renal tumors with sensitivity, specificity, and accuracy of 82%, 90%, and 87%, respectively. CSI can demonstrate cytoplasmic fat in clear cell RCCs, which helps to differentiate this entity from other RCCs.

Adenocarcinoma, Clear Cell↗

Pseudolesions of the liver possibly caused by focal rib compression: analysis based on hemodynamic change.

OBJECTIVE: The purpose of this study is to show and analyze the CT appearance of pseudolesions of the liver caused by rib compression and to discuss the possible mechanism on the basis of findings of incremental dynamic CT, CT during arterial portography, and CT hepatic arteriography. CONCLUSION: Focal compression of the liver caused by curved ribs can cause transient focal diminishment of portal venous perfusion without significantly altering hepatic arterial perfusion. Such diminishment may be observed as low-density areas on the early phase of incremental dynamic CT.

Aged↗

MR diagnosis of adenomyomatosis of the gallbladder and differentiation from gallbladder carcinoma: importance of showing Rokitansky-Aschoff sinuses.

OBJECTIVE: We evaluated the MR imaging features of adenomyomatosis of the gallbladder with particular emphasis on Rokitansky-Aschoff sinuses. MATERIALS AND METHODS: MR images of 17 patients with histologically proven adenomyomatosis were retrospectively reviewed. The presence of Rokitansky-Aschoff sinuses was evaluated and analyzed; four T2-weighted (fast spin-echo with a surface coil, with or without breath-holding, fast spin-echo with a phased-array coil with breath-holding, and half-Fourier rapid acquisition with relaxation enhancement with breath-holding) and two contrast-enhanced dynamic pulse sequences were studied. These six pulse sequences were separately rated on a 5-point scale by two radiologists for comparison. Interobserver differences were evaluated. Other MR findings were also analyzed. RESULTS: Among the six pulse sequences studied, three T2-weighted with breath-holding sequences were found to be superior to the other three sequences in showing Rokitansky-Aschoff sinuses. In particular, the half-Fourier rapid acquisition with relaxation enhancement was scored the highest by the two observers and received the highest kappa coefficient in our statistical analysis of the scoring. Diffuse-type adenomyomatosis typically showed early mucosal and subsequent serosal enhancement. Localized adenomyomatosis exhibited homogeneous enhancement, showing smooth continuity with the surrounding gallbladder epithelium. CONCLUSION: MR imaging may be able to provide important information in the diagnosis of adenomyomatosis.

Adenomyoma↗

Vascular changes in hepatocellular carcinoma: correlation of radiologic and pathologic findings.

OBJECTIVE: Our objective was to analyze the hemodynamic properties and vascular supply changes in the carcinogenesis of hepatocellular carcinoma. MATERIALS AND METHODS: Ten nodules (nine patients) (one early, three early-advanced, and six advanced cases of hepatocellular carcinoma) less than 3 cm in diameter were selected from 45 patients (50 nodules) who underwent CT arteriography and CT during arterial portography. These images were correlated with histopathologic findings. Ratios of all microscopically counted (normal hepatic and abnormal) arteries, normal hepatic arteries, and portal veins in each nodule to those in the surrounding liver were calculated. RESULTS: Early hepatocellular carcinoma (one early case and early areas in three early-advanced cases) had low attenuation on CT arteriography and isoattenuation on CT during arterial portography. Advanced hepatocellular carcinoma (six advanced cases and advanced areas in three early-advanced cases) had high attenuation on CT arteriography and low attenuation on CT during arterial portography. In early hepatocellular carcinoma, the ratios of all arteries, normal hepatic arteries, and portal veins were 1.21 +/- 0.07, 0.60 +/- 0.07, and 0.73 +/- 0.06, respectively. In advanced hepatocellular carcinoma, the ratios were 2.66 +/- 0.26, 0.08 +/- 0.04, and 0.07 +/- 0.03, respectively. CONCLUSION: In early hepatocellular carcinoma, the combination of normal hepatic artery degeneration and preserved portal veins results in low attenuation on CT arteriography and isoattenuation on CT during arterial portography. In advanced hepatocellular carcinoma, the combination of neoplastic (abnormal) arterial development by angiogenesis and obliteration of portal veins results in high attenuation on CT arteriography and low attenuation on CT during arterial portography. These findings are a characteristic difference between early and advanced hepatocellular carcinoma.

Aged↗

Systemic lupus erythematosus associated with primary large cell carcinoma of the lung.

The association between systemic lupus erythematosus (SLE) and malignancy has been controversial in the literature. We report a case of lung cancer in a 50-year-old woman with a 4-year history of SLE. She underwent surgery at a pathological stage of T2N2M0, but she eventually died of rapid recurrence of the cancer in the abdomen resulting in massive haemorrhage from the inferior vena cava (IVC). Immunological disorders related to SLE are thought to contribute to rapid progression of the malignancy.

Abdominal Neoplasms↗

[Norwood procedure to hypoplastic left heart syndrome].

Since March 1992, 25 neonates and small infants with HLHS have undergone a modified Norwood procedure. The mean age and weight at operation were 17 days (2 days-2 months) and 2.7 kg (1.6-3.3 kg). Isolated cerebral and/or myocardial perfusion (ICMP) with direct anastomosis of aorta and pulmonary artery was utilized since January 1995 to 16 patients. Under median sternotomy, PTFE graft (usually 3.0-3.5 mm) was anastomosed to the brachiocephalic artery and the arterial cannula was inserted to this PTFE graft. The left carotid and the left subclavian arteries were snared and a clamp was placed on the aortic arch just distal to the brachiocephalic artery. This allowed blood to enter the brain and the coronary arteries, keeping the brain perfused and the heart-beating. After reconstruction of distal aortic arch, a single dose of crystalloid cardioplesia was infused and the rest of the arch was reconstructed. There were 14 early deaths (56%) and 4 late deaths (16%). Bidirectional Glenn procedure was performed to 5 patients with 1 death. Three patients underwent modified Fontan procedure without mortality. Mean aortic cross clamp time was 24 min. and mean ICMP time was 32 min. There was no neurologic complications. In conclusion, isolated cerebral and/or myocardial perfusion may offer an advantage of protecting the brain and myocardium during arch in Norwood procedure.

Aorta↗

Structures of spider toxins: hydroxyindole-3-acetylpolyamines and a new generalized structure of type-E compounds obtained from the venom of the Joro spider, Nephila clavata.

Facile structure determination of acylpolyamines, glutamatergic nerve blocker obtained from the venom of the Joro spider (Nephila clavata) was carried out with the use of micro-column LC/MS and high energy collision induced dissociation (CID) mass spectrometry. 6-hydroxyindole-3-acetyl was proposed previously as a putative partial structure, for the acyl moiety of hydroxyindole-type polyamines (NPTX-1 to -6). The NMR data obtained for NPTX-6, NPTX-687 and hydroxyindole-3-acetic acid which was released by acid hydrolysis of Nephila clavata crude venom extracts proved that the lipophilic head is the 4-hydroxyindole-3-acetic acid. Various hydroxyindole-3-acetyl polyamines were found in N. Clavata venom and characterized by mass spectrometry. As a result, type-E, a new class of generalized acylpolyamine structure was proposed in addition to the previously reported polyamine backbones type-A to -D.

Chromatography, Liquid↗

Herpes simplex virus hepatitis in macrophage-depleted mice: the role of massive, apoptotic cell death in pathogenesis.

Infection with herpes simplex virus or hepatitis viruses can lead to fulminant hepatitis, but there is controversy about the underlying conditions needed for such disease. To investigate how the impairment of host defences might be involved, macrophages were depleted by administration of silica to mice before intravenous injection with herpes simplex virus type 1 (HSV-1). Such mice died rapidly and their livers were yellowish and shrunken (acute yellow atrophy), and occasionally grossly haemorrhagic. Small foci of apoptotic cells developed in the liver lobules; these rapidly became confluent and zonal over time. The overall lesion pattern was similar to massive hepatic necrosis, and there was extensive HSV replication in the liver lesions. In the liver, DNA fragmentation characteristic of apoptosis followed the time course of HSV-1 propagation. These findings suggest that one of the underlying conditions for fulminant viral hepatitis may be inadequate macrophage response, and that the massive hepatic damage, often defined as cell necrosis, may actually be apoptosis of liver cells subsequent to virus infection.

Alanine Transaminase↗

Optimal MR cholangiopancreatographic sequence and its clinical application.

PURPOSE: To determine the appropriate acquisition parameters for magnetic resonance cholangiopancreatography (MRCP) with a half-Fourier rapid acquisition with relaxation enhancement (RARE) sequence; to determine the optimal MRCP technique by comparing half-Fourier RARE, steady-state free precession (SSFP) two-dimensional (2D) fast spin-echo (SE), and three-dimensional (3D) fast SE sequences; and to clarify the usefulness and limitations of MRCP in diagnosing pancreatic abnormalities. MATERIALS AND METHODS: Half-Fourier RARE MRCP images with varying parameters were compared by using a phantom. Duct conspicuity and contrast-to-noise ratios (C/Ns) were compared for the four MRCP techniques in a phantom and healthy volunteers. The optimal MRCP technique was used to study healthy volunteers and clinical cases. Receiver operating characteristic (ROC) curves were created for data analysis. RESULTS: A 5-mm-thick section without intersection gap was appropriate for half-Fourier RARE MRCP. Only half-Fourier RARE MRCP could depict a 1-mm duct. C/N was the highest with half-Fourier RARE, followed by 3D fast SE, 2D fast SE, and SSFP sequences. ROC curve analysis revealed no interobserver differences, and the area under the curve for detection of strictures of the main pancreatic duct was as high as 0.89. CONCLUSION: Half-Fourier RARE MRCP has the highest contrast and spatial resolution among the four techniques studied and may play an important role in diagnosing pancreatic abnormalities.

Adult↗

Autoimmune pancreatitis: CT and MR characteristics.

OBJECTIVE: Our goal was to elucidate the CT and MR imaging characteristics in patients with autoimmune pancreatitis, which is a reversible chronic pancreatitis with an autoimmune cause. CONCLUSION: On CT and MR imaging, a capsulelike rim, which is thought to correspond to an inflammatory process involving peripancreatic tissues, appears to be a characteristic finding of autoimmune pancreatitis. Also, diffuse pancreatic enlargement along with hypointensity on T1-weighted MR images and delayed enhancement on dynamic CT and MR studies are other features of this disorder.

Aged↗

Value of MR cholangiopancreatography in evaluating choledochal cysts.

OBJECTIVE: The aim of this retrospective study was to clarify whether MR cholangiopancreatography (MRCP) is a suitable replacement for ERCP in evaluation of the choledochal cyst. MATERIALS AND METHODS: Sixteen patients (six adult and 10 pediatric) with choledochal cysts underwent MRCP using a half-Fourier acquisition single-shot turbo spin-echo sequence. Extent of the cyst, defects within the biliary tree, and presence or absence of the anomalous junction of the pancreaticobiliary duct were evaluated. Findings were compared with those of ERCP. RESULTS: MRCP better defined the proximal biliary tree than did ERCP in two patients. Defects within the biliary tree were diagnosed correctly on MRCP in eight patients; however, two defects within the distal common bile duct were missed in pediatric patients. The presence of the anomalous junction of the pancreaticobiliary duct was revealed accurately by MRCP in all adult patients but was revealed accurately in only four of the 10 pediatric patients. CONCLUSION: MRCP appears to offer diagnostic information that is equivalent to that of ERCP for assessment of choledochal cysts in adults. In pediatric patients, MRCP should not replace ERCP; however, MRCP can play an important role as a noninvasive examination and should be considered a first-choice imaging technique for evaluation of choledochal cysts.

Adult↗