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Biomedical subjects

H Itou

Publications and source records attributed to H Itou.

31 records · Page 2Linked to original sources

[Collaterals after flow alternation in pelvic arteries: precondition for pelvic reservoir therapy].

To determine the best flow alternation in the internal iliac arteries for regional chemotherapy using a reservoir to treat pelvic malignancies, collateral arteries that arose after arterial flow alternation were evaluated on follow-up pelvic angiographies. Follow-up angiographies were obtained in 11 patients with 21 embolized arteries; six male and five female patients including three with urinary bladder cancer, two with prostate cancer, four with uterine cervical cancer and two with bone metastasis. The interval until follow-up angiography ranged from one to-28 months (mean 8.9 months). Three radiologists interpreted the angiographic results and evaluated collateral vessels. Among 21 embolized arteries, 19 were well occluded, while two were not blocked completely. The two arteries with incomplete embolization did not induce collaterals. Eight internal iliac arteries occluded at the proximal portion enhanced retrogradely via collaterals from the ipsilateral external iliac arteries. Collaterals between the bilateral internal iliac arteries were noted only in four of them. In conclusion, embolization at the proximal point of the internal iliac arteries usually induced collaterals from the ipsilateral external iliac arteries and did not always from collaterals between the bilateral internal iliac arteries, which were necessary for regional chemotherapy. This should be considered when pelvic malignancies are treated with reservoirs.

Adult↗

[Anesthetic management of total en bloc spondylectomy].

We analyzed the anesthetic management of 20 patients with total en bloc spondylectomy (TES) for solitary spinal metastases. Anesthesia was maintained with isoflurane, nitrous oxide in oxygen, and fentanyl in all patients. The duration of anesthesia was 733 minutes, and the amount of bleeding was 5371 ml on the average. During operation, hypovolemic shock occurred in 5 cases and huge hemothorax in 4 cases. Postoperative, huge hemothorax occurred in 6 cases and severe pneumonia in 3 cases. Maintenance of hemodynamic and respiratory function is important in perioperative management of TES.

Adult↗

Functional association between CBP and HNF4 in trans-activation.

CBP functions as a key transcriptional coactivator for a variety of transcription factors. We show here that the hepatocyte nuclear factor 4 (HNF4), a transcription factor in the nuclear receptor superfamily with no defined ligand, is cloned by yeast two-hybrid system using CBP as a bait. GST-pull down assay with nuclear extracts or in vitro translation products revealed that CBP and HNF4 interact with each other at the middle portion (aa 119-375) of HNF4 and two distinct regions (aa 271-451 and 1626-2259) of CBP, respectively, in the ligand-independent manner. Co-transfection experiments indicated that CBP is capable of activating HNF4 site-mediated transcription. These results suggested a functional association between CBP and HNF4 in trans-activation.

Animals↗

[Cerebral infarction due to bacterial emboli associated with methamphetamine abuse].

The number of stimulant-drug addicts has recently been on the rise again, and they are being increasingly encountered in the emergency room. There are also frequent reports of cerebrovascular disorders complicating drug toxicity. These cerebrovascular disorders have included subarachnoid hemorrhage, intracranial hematoma, and a few cases of cerebral infarction. Here, we report the case of a 37-year-old male with drug toxicity, consciousness disorder, and hyperthermia. He was in a coma with a temperature of 43.1 degrees C and blood pressure of 58/35 mmHg when brought to our hospital. His condition worse rapidly deteriorated, and he died the same day. Cerebral infarction caused by gram-positive bacillus embolism, not necrotizing angiitis, was found at autopsy. Because drug addicts, especially stimulant-drug addicts, tend to inject themselves drug under unsanitary conditions, the possibility of this type of complication is always present. This is the first such case ever reported, and is therefore regarded as a rare complication of stimulant-drug intoxication.

Adult↗

[A case of involuntary movements probably produced by low doses of phenytoin intoxication].

A 49-year-old woman, who presented gait disturbance, orofacial dyskinesia, choreoathetosis and slightly cloudy consciousness, was admitted to our hospital on February 7, 1986. She had a slight fever and sore throat for the previous ten days. She had been treated for hypothyroidism as well as migraine with abnormal electroencephalogram since age 47, and was given a daily dosage of 70 mg phenytoin, 80 mg phenobal, and 125 mg dried thyroid. On admission, she was somnolent, and her speech was slurred. There were choreoathetosis of all extremities, orofacial dyskinesia, horizontal nystagmus, and dysdiadochokinesis with impaired heel-knee and finger-nose test. She could not only walk but also stand by herself. The plasma level of phenytoin was above 40 micrograms/ml (normal: 10 to 20 micrograms/ml). The plasma level of phenobal was normal. T3 was 0.76 ng/dl (normal: 0.96-1.92). T4 was 3.3 micrograms/dl (normal: 5.1-12.8). Biochemical screening, liver and kidney function tests were normal. Cerebrospinal fluid, ECG, chest X-rays and brain CT were normal. Electroencephalogram showed 5 to 6 Hz moderate voltage theta waves with artifacts of electromygram due to orofacial dyskinesia. After phenytoin was discontinued, the dyskinetic movement and gait disturbance disappeared, and her consciousness became alert in parall with reduction of plasma level of phenytoin. We suggested that acute phenytoin intoxication due to low dosages of phenytoin might be precipitated by upper respiratory infection and that involuntary movements in this case might be related to hypothyroidism.

Administration, Oral↗

[A case of aortitis syndrome with anastomoses from left coronary artery to bronchial artery].

We reported a case of aortitis syndrome with about 10-year course from onset. The patient was a 44-year old female suffering from a cardiac failure. The angiogram revealed presence of aortic regurgitation, The angiogram revealed presence of aortic regurgitation, pulmonary vascular lesions, anastomosis from left coronary artery to bronchial artery and hypervascularity of bronchial artery. We considered the anastomosis from left coronary artery to bronchial artery as a collateral blood flow for the ischemic lesions of the lung. We abandoned aortic valve replacement because of the severe pulmonary vascular lesions and of the pulmonary dysfunction.

Adult↗

[Anemia in patients on continuous ambulatory peritoneal dialysis (CAPD)].

Inhibitors of erythropoiesis found in the blood of uremic patients have been implicated as some of the causes of anemia in chronic renal failure. As a treatment to remove the inhibitors, continuous ambulatory peritoneal dialysis (CAPD) is thought to be more effective than hemodialysis. Some researchers have reported that CAPD has improved anemic state in hemodialysis patients. However, there have been some cases of severe anemia seen in CAPD patients. To access the effect of the CAPD, we have performed serial examination on hemoglobin (Hb) and hematocrit (Ht) in 5 uremic patients under CAPD treatment. Hb levels in 4 and Ht in 3 of 5 patients have been known to be increased. One patient was shown to have no increment on the levels of Hb and Ht. On the other hand, further investigation has been down to access the effect of the recombinant human erythropoietin (r-HuEPO: Chugai pharmaceutical) on anemic patients, in whom no effect was noticed by treatment of CAPD. One severe anemic patient, who had been undergoing the treatment of CAPD for two years, was given r-HuEPO intravenously. The patient showed the increment on the levels of Hb and Ht, and the decreases on the levels of serum iron and ferritin. However, the patient has developed hypertension. In conclusion, CAPD was known to be not always effective for the increment of Hb and Ht, while r-HuEPO was very effective for the improvement of severe anemia in CAPD patients which enabls them to lead better social life for them.

Adult↗

Analysis of PCR microchimerism induced by intrathymic inoculation of donor alloantigens in rats.

Intrathymic injection of donor alloantigens (splenocytes) was performed in rat heart transplantation to induced tolerance. In our experimental protocol, male (BN rats, RT1n) heart allografts were transplanted to female (LEW rats, RT1(1)) recipients in order to detect the existence of Y-chromosomes in recipients' tissues using the polymerase chain reaction (PCR) after the establishment of microchimerism. The mean survival time (MST) of male heart allografts was prolonged by the thymic injection protocol. PCR analysis of the Y-chromosomes of these recipients showed that splenocytes inoculated into the thymus still remained after as long as 30 days, while none of the cells that originated from the donor were never detected in the peripheral blood. On the other hand, our previous study demonstrated that the donor-specific Y-chromosomes could be detected in all the tissues of the females (peripheral blood, lymph nodes, spleen, and liver) except for thymus, of the sex-mismatched rat liver transplantation without thymic injection. Completely inconsistent results were deduced from two of our experiments, but the present study demonstrated that thymic clonal deletion played a major role in the prolongation of allograft survival after intrathymic injection of donor alloantigens.

Animals↗