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Biomedical subjects

H Kishimoto

Publications and source records attributed to H Kishimoto.

At least 145 records · Page 8Linked to original sources
PubMed1994

Time-of-flight MR angiography of portal system and collaterals in portal hypertension using a 2-DFT fast spoiled gradient recalled steady-state precession technique.

MR angiographic examinations were performed in 26 patients. Approximately 30 contiguous fast spoiled GRASS images (8.1/3.1/30 degrees, TR/TE/flip angle) were acquired during single breath-holding for about 35 s, and then new images were reconstructed with maximum intensity projection technique. Spoiled GRASS images (40/12/40) of 2 to 3 slices were taken during breath-holding for about 13 s, and these processes were repeated to obtain about 30 individual images for conventional MR angiography. The new MR angiograms were compared quantitatively and qualitatively with conventional MR angiograms with arterial portography as the gold standard. The new MR angiograms could visualize blood vessels with smooth margins, and provided almost the same anatomic information about the portal vein and collateral vessels as the conventional MR angiograms. Contrast-to-noise ratios between the portal or hepatic vein and liver parenchyma were significantly higher with fast spoiled GRASS images. The new MR angiograms using fast spoiled GRASS images provided useful diagnostic mapping of the collateral venous pathways within a shorter examination time.

Adult↗
PubMed1994

[FIO2 and SpO2 during cardiac surgery in neonates and infants].

Fractional inspired oxygen (FIO2) applied before and after a repair or palliative procedure for cardiac defects along with SpO2 measured by pulse oximeter were reviewed from anesthetic records of 62 neonates and infants. Fentanyl was used for anesthesia, except in cases without i.v. route in which sevoflurane with nitrous oxide in oxygen was used for induction of anesthesia. FIO2 was adjusted using air and oxygen. The lower FIO2 was applied to the patients for a closure of ventricular septal defect, a reconstruction of coarctation or interrupted aortic arch, and pulmonary artery banding, while the higher FIO2 was used for systemic-to-pulmonary artery shunts and the repair of tetralogy of Fallot. In the congenital heart disease with the intracardiac shunt, the magnitude of the shunt flow and hemodynamics can be altered by changing systemic and pulmonary vascular resistance which could be induced by various ways. Since alveolar oxygen tension is a known determinant of pulmonary vascular resistance, an appropriate FIO2 should be applied to each patient with different pathophysiology. A low FIO2 should be set for the cases with nonrestrictive left-to-right shunting, since a high FIO2 may cause a torrential pulmonary blood flow. A high FIO2 is preferable for the cases with right-to-left shunting and a concomitant decreased pulmonary blood flow.

Anesthesia↗
PubMed1994

[Growth of the hypoplastic aortic arch after arch repair for coarctation and interruption of the aorta].

Surgical treatment for a hypoplastic aortic arch associated with coarctation or interruption of the aorta is controversial. We evaluate the changes of diameter of proximal transverse aortic arch after surgery in 28 patients. Proximal transverse aortic arch in all patients was preoperatively 3.5 +/- 0.9 mm (2.5 to 7 mm), and 54 +/- 12% (36 to 84%) to the normal aortic valve dimension (n-AVD: 16.6 X BSA0.6). While postoperative proximal transverse aortic arch was 6.5 +/- 1.8 mm, and 76 +/- 12% to the n-AVD, and significantly grew more than the preoperative arch dimension (p = 0.0001). In 18 patients having two times cardiac catheterization postoperatively, proximal transverse aortic arch was 6.5 +/- 1.6 mm, and 75 +/- 13% to n-AVD on the 1st postoperative examination. On the 2nd examination, the arch was 9.9 +/- 1.9 mm, and 88 +/- 12% to n-AVD, and significantly grew with increasing years (p < or = 0.0003). We concluded that the proximal transverse aortic arch, which was more than 36% to n-AVD in diameter, if not dilated surgically, grew with increasing years after aortic arch repair.

Aorta, Thoracic↗
PubMed1994

[Subaortic stenosis in coarctation or interruption of the aorta--changes of left ventricular outflow tract dimension after aortic arch repair and pulmonary artery banding].

Left ventricular outflow tract (LVOT) dimension was measured in seven patients with coarctation (CoA) or interruption (IAA) of the aorta before and after aortic arch repair and pulmonary artery banding. The age of patients ranged 3 to 69 (mean 16) days, the weight 3.0 to 3.9 (mean 3.4) kg. Associated cardiac anomalies were VSD in 6, MA and DORV in 1. In five patients compared by ultrasound, preoperative LVOT dimension ranged from 3.5 to 5.0 (mean 4.4) mm with the ratio to the normal aortic valve dimension (n-AVD; 16.6 x BSA0.6) from 54 to 82 (mean 69)%. Postoperative dimension increased 5.0 to 7.4 (mean 5.7) mm and the ratio to the n-AVD increased 65 to 89 (mean 80)%. In three patients compared by LV graphy, preoperative LVOT dimension ranged from 4.0 to 4.5 (4.2) mm and the ratio ranged from 61 to 72 (68)%. Postoperative dimension increased from 4.5 to 6.7 (5.3) mm, and 74 to 80 (78)% to n-AVD after operation. Postoperative pressure gradients between LV and ascending aorta in each patient were 1 to 9 (mean 6) mmHg. In any patients, LVOT obstruction did not advance after aortic arch repair and pulmonary artery banding.

Aorta↗
PubMed1994

Double switch operation in cardiac anomalies with atrioventricular and ventriculoarterial discordance.

Since June 1987, 10 of 19 consecutive patients with atrioventricular and ventriculoarterial discordance (average age 4 +/- 2 years) had undergone a double switch operation with the morphologically left ventricle used as a systemic ventricle. There were two combinations of procedures. Atrial switch combined with arterial switch was used in two patients who had a normal pulmonary valve. Atrial switch combined with ventriculoarterial switch by Rastelli's procedure was used in eight patients with pulmonary stenosis or atresia and a large ventricular septal defect. One early death and two late deaths have occurred in a postoperative follow-up period of up to 4 years. Subsequent problems were mainly related to the results of atrial switch procedures in patients who had a small atrium because of low pulmonary flow, especially in patients with apicocaval juxtaposition. Our experience suggested that the double switch operation would open a new era of definitive surgical treatment in half of the patients with atrioventricular and ventriculoarterial discordance.

Aorta↗
PubMed1994

[Clinical evaluation of endoscopic variceal ligation (EVL)].

From August 1992 through February 1993, we treated 21 patients with endoscopic variceal ligation (EVL). Two patients had a history of the esophageal variceal bleeding, but 19 patients did not have bleeding episodes. To evaluate preventive effect of bleeding, we selected the patients who had grade F2 or red color sign positive varices. We repeated EVL until varices improved into grade F0 or F1 and red color sign negative. The therapeutic goal was sometimes changed according to patient's general condition. No additional therapy was performed to eradicate varices, such as endoscopic injection sclerotherapy. As a result of our therapy, eradication rate was 73.7% and period of hospitalization were 25 +/- 11 days. No major complications were found during and after EVL. EVL affected neither liver function test nor size of gastric varices. Recurrent varices with red color sign were found in 4 patients, but easily controlled by retreatment with EVL. EVL seems to be convenient and effective therapy in our short-term study, and useful for preventive therapy of the esophageal variceal bleeding.

Aged↗
PubMed1993

Negative selection of thymus-dependent CD4+8+ intestinal intraepithelial lymphocytes by internal superantigens.

CD4 and CD8 double-positive (DP) T cells were transiently found in the Peyer's patch of mice 2 to 3 weeks after birth and preceded the appearance of DP intestinal intraepithelial lymphocytes (iIEL). DP iIEL were detected in euthymic-specific pathogen-free mice, but not in athymic and germ-free mice. The pattern of V beta genes expressed on these DP iIEL was similar to that of CD4 single-positive peripheral T cells, which reflected the negative selection by internal superantigens, M1s, and I-E. CD8 SP T cells did not receive such a strict negative selection with these antigens. DP iIEL expressed a high density of T cell receptor alpha beta and CD3 and responded to immobilized anti-CD3 to undergo blastogenesis and de novo IL2 receptor expression. These results indicate that DP iIEL are mature thymus-dependent T cells immigrated to intraepithelial space via the Peyer's patch in response to intestinal antigenic stimulation.

Animals↗
PubMed1993

Comparative analysis of p53 and c-myc expression and cell proliferation in human hepatocellular carcinomas--an enhanced immunohistochemical approach.

Expression of p53 and c-myc was investigated and compared with cell proliferative activity in a series of 40 hepatocellular carcinomas (HCC), by means of enhanced immunohistochemistry. p53 expression was demonstrated in 5 out of 40 HCC (12.5%) with the incidence increasing in 5 out of 40 HCC (12.5%) with the incidence increasing in proportion to the histological grading of malignancy: thus, 0% of well-differentiated, 6.9% of moderately differentiated and 33.3% of poorly differentiated lesions were positive. The proliferating-cell nuclear antigen (PCNA) labeling index also showed a statistically significant increase with this grading. Distribution patterns of PCNA-positive cell were divided into four types: scatter, marginal, mosaic and diffuse. Four HCC cases, predominantly of the poorly differentiated type, exhibited the diffuse pattern. Generally, p53 overexpression corresponded well with PCNA positivity. In contrast, there was no correlation between c-myc overexpression, found in 19 out of 40 HCC (47.5%), and histological grading of HCC or PCNA labeling index. The distribution pattern of c-myc-positive HCC cells was also different from that of PCNA and p53. Our results suggest that p53 overexpression closely relates to proliferation of HCC cells. Furthermore, there may be a consistent difference in regulatory mechanisms between p53 and c-myc expression in multistep hepatocarcinogenesis.

Adult↗
PubMed1993

Bone mineral density of the radius in patients with ossification of the cervical posterior longitudinal ligament. A longitudinal study.

Radial bone mineral density (BMD) in the distal one sixth and distal one third of the left radius was measured by single-photon absorptiometry (SPA) in patients with ossification of the cervical posterior longitudinal ligament (OPLL). Twenty-three OPLL patients (15 men and 8 women) with mean initial age of 60.1 years were studied longitudinally for mean follow-up period of 3.9 years. Based on roentgenologic findings, the patients were divided into two groups, those with advancing OPLL and those with non-advancing OPLL. The final value of distal 1/6th BMD in the advancing group was significantly lower than its initial value, but no change of the value of the distal 1/3rd BMD was observed in either group. The final value of distal 1/6th BMD/distal 1/3rd BMD ratio in the advancing group was significantly decreased compared with its initial value. These results suggest that, in the advancing OPLL group, trabecular bone mass decreased while cortical bone mass remained unchanged.

Absorptiometry, Photon↗
PubMed1993

Computerized EEG and brain imaging studies in untreated schizophrenic patients: a report of seven cases.

We undertook routine EEG, Z-map, CT and PET scans in seven acute untreated schizophrenics. Routine EEGs showed slower activity in only one case. However, the Z-map showed slower activity in all the cases. CT demonstrated brain atrophy in three of the cases, and PET revealed hypofrontality in two, right hypoparietality in four, and both conditions in one case. There was no relation between CT and PET or the Z-map. However, a significant increase in alpha 1 activity was demonstrated on the Z-map in cases who were found to be the parietal type on PET; this was not conspicuous in the frontal type on PET. Moreover, in three of the patients, the Z-map findings were similar to the lesion indicated on PET.

Adult↗
PubMed1993

Direct identification of lung cancer cells producing granulocyte colony stimulating factor with monoclonal anti-G-CSF antibodies.

This is a case report of an 82-year-old man with squamous cell lung cancer which produced G-CSF. The leukocyte cell count was elevated to 94,400/mm3. The serum G-CSF concentration was also elevated to 351 pg/ml. This is the first report to demonstrate, by application of immunohistochemical staining techniques directly to tumor tissue obtained at autopsy, squamous carcinoma cells which produce G-CSF. The tumor cells were stained with monoclonal anti-G-CSF antibodies.

Aged↗
PubMed1993

Significance of glomerular deposition of plasmin-alpha 2-plasmin inhibitor complexes in various glomerulopathies.

To elucidate the relationship between glomerular deposition of plasmin-alpha 2-plasmin inhibitor complexes (PIC) and renal lesions or dysfunction, 25 patients with various glomerulopathies and various degrees of renal injuries were examined. Glomerular PIC deposition was found in eight patients (group A), and other 17 patients showed no deposition (group B). PIC was found mainly in the mesangium and along the capillary loops. Group A showed significantly more severe hematuria (p < 0.05) than group B. Group A showed a significant decrease in glomerular filtration rate (GFR; p < 0.05): the mean values being 60.8 +/- 39 in group A and 94.5 +/- 32 ml/min in group B. Group A showed a significant decrease in the phenolsulfonphthalein excretion test (p < 0.05). There was no significant difference in the mean values of plasma PIC, D-dimer, and thrombin-antithrombin III complexes (TAT) between two groups. Histologically, group A showed a significantly high incidence of adhesion (p < 0.05), crescentic formation (p < 0.05), endothelial swelling and/or detachment (p < 0.01), tubulointerstitial changes (p < 0.01), and glomerular deposition of platelet factor 4 (p < 0.01). The present study demonstrates that glomerular PIC deposition reflects the existence of activation of coagulation and fibrinolysis within the glomeruli and suggests that glomerular PIC deposition plays a part in the progression of renal injuries in various glomerulopathies.

Antifibrinolytic Agents↗
PubMed1993

Clinico-pathological studies of Amyloid-P component in human glomerulopathies.

Renal tissues from 171 patients with different glomerulopathies and 6 normal controls were examined by an immunofluorescent technique. Specimens were stained in particular with anti-Amyloid P (AP) antisera, and were also stained for immunoglobulins and complement. The intensity and distribution pattern of AP staining were studied. The AP staining revealed a faint/linear pattern in normal controls, and was granular and linear in pathological specimens. The distribution of AP was found to be mesangial, capillary and mesangiocapillary. According to the degree of AP intensity, the patients were divided into two groups: group I (56 patients) exhibiting a faint intensity as seen in the normal controls, and group II (115 patients) with a strong intensity. The histological findings and laboratory data were compared between the two groups as well as among patients with different diseases. The incidence of sclerotic lesions and the amount of proteinuria were significantly higher in group II than in group I. Increased amounts of AP deposition in different glomerular diseases thus appear to be related to a diminished renal function or glomerular damage.

Adolescent↗
PubMed1993

[Surgical management of tetralogy of Fallot with absent pulmonary valve in infancy].

Between November, 1987 and May, 1990, definitive operation was performed in 7 infants for tetralogy of Fallot with absent pulmonary valve. Preoperative respiratory failure was serious in 5 patients and semi-emergency operation was done. Surgical procedure consisted of closure of ventricular septal defect, reconstruction of right ventricular outflow tract using heterograft valved pericardial roll and plication of aneurysmally dilated pulmonary artery with or without pulmonary artery suspension in 5 infants with severe respiratory distress and heart failure, operated on 26 days to 5 months of age. In the other two less symptomatic infants, operated on at 13 months of age, reconstruction of right ventricular outflow tract was performed by transannular bovine pericardial patch with monocusp. There were no operative death and six infants are doing well 6 months to 3 years postoperatively, but one patient died of prolonged respiratory infection and respiratory failure one year after operation. Postoperative pulmonary arteriogram revealed a 42 to 61 (mean 54) percent reduction in right and left pulmonary artery size in 3 patients who underwent extensive plication of pulmonary artery. We suggest that definitive plication with or without suspension of pulmonary artery, together with closure of ventricular septal defect and reconstruction of right ventricular outflow tract is supposed to eliminate air way obstruction.

Bioprosthesis↗
PubMed1993

Chronic parathyroid hormone administration reverses the antihypertensive effect of calcium loading in young spontaneously hypertensive rats.

To investigate the role of parathyroid hormone (PTH) in the development of hypertension, the long-term administration of human PTH (hPTH) was performed in 7-week-old male spontaneously hypertensive rats maintained on a standard calcium diet (1.1% calcium) or a high calcium diet (2.8% calcium). The hPTH was infused subcutaneously at 0.9 U/h over 2 weeks using a minipump. Two weeks after minipump implantation, rat PTH (rPTH) and 1,25-dihydroxy vitamin D (1,25-D) levels were measured and the pressor response to norepinephrine (NE) was examined. Calcium loading both attenuated the development of hypertension and reduced the pressor response to norepinephrine. Chronic hPTH administration accelerated the development of hypertension and increased the pressor response to norepinephrine in rats fed a high calcium diet, but did not affect either parameter in rats fed a standard calcium diet. The serum concentrations of rat PTH and 1,25-D were significantly lower in rats fed a high calcium diet than in those fed a standard calcium diet (rat PTH: 351 +/- 16 v 430 +/- 1 pmol/L; 1,25-D: 125 +/- 19 v 206 +/- 31 pg/mL). Chronic administration of hPTH increased the serum 1,25-D concentration in rats fed a high calcium diet (186 +/- 35 pg/mL), but did not affect that of rats fed a standard calcium diet (165 +/- 16 pg/mL). It is concluded that PTH prevented the antihypertensive effect of calcium loading in young SHR, perhaps by enhancing blood pressure reactivity through causing an increase of 1,25-D.

Animals↗