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Biomedical subjects

H Yamabe

Publications and source records attributed to H Yamabe.

At least 235 records · Page 13Linked to original sources

The clinical and prognostic significance of dipyridamole Tl-201 emission computed tomography in patients with dilated cardiomyopathy.

To clarify the clinical significance of regional myocardial perfusion abnormality of the left ventricle in dilated cardiomyopathy (DCM), 20 patients with DCM underwent dipyridamole Tl-201 emission computed tomography (ECT). The subjects were divided into 2 groups: group 1 had (n = 9) reversible defects and group 2 (n = 11) had persistent defects only. Group 2 patients significantly advanced heart failure and significantly poorer prognoses than group 1 (55% vs 11% in 2 years survival rate, p less than 0.05). The echocardiographic left ventricular end-diastolic dimension was larger in group 2 than group 1 (68.3 +/- 8.2 mm vs 61.9 +/- 4.0 mm, p less than 0.05) and % fractional shortening was smaller in group 2 than group 1 (18.0 +/- 4.5% vs 24.5 +/- 6.9%, p less than 0.05). Moreover, 12 of the 13 segments with reversible defect showed fairly well preserved left ventricular wall motion, whereas 35 of 58 segments with persistent defect had severely impaired wall motion (1/13 vs 35/58, p less than 0.01). Dipyridamole Tl-201 ECT demonstrated conclusively that the two types of defects (reversible and persistent) are useful to evaluate not only the abnormal myocardial perfusion but also myocardial damage and the prognosis in DCM.

Aged↗

Reduced chronotropic reserve to the metabolic requirement during exercise in advanced heart failure with old myocardial infarction.

We studied the metabolic and cardiac responses to exercise by expiratory gas analysis in 40 patients with old myocardial infarction and 33 normal sedentary males. On the basis of exercise energy metabolism, the elevation of the respiratory quotient (RQ; RQ = VCO2/VO2) during exercise is caused by the increase of blood lactate due to the augmented anaerobic metabolism. Functional aerobic impairment (FAI) in our study was significantly advanced in the control group and the NYHA functional class I, class II and class III groups, that is, -2.3 +/- 11.2%, +14.8 +/- 10.4%, +27.8 +/- 13.8% and +49.4 +/- 2.8%, respectively. The delta RQ values were similar among all groups; 0.29 respectively. The delta RQ values were similar among all groups; 0.29 +/- 0.06, 0.28 +/- 0.07, 0.27 +/- 0.07 and 0.29 +/- 0.09, respectively. Functional chronotropic impairment (FCI) for the same groups was -0.9 +/- 7.0%, +1.4 6.1%, +3.8 +/- 4.8% and +8.7 +/- 6.0%, and that of the class III group was significantly larger than that of the control group. Thus, in the class III congestive heart failure group, the chronotropic response to the metabolic requirement was impaired in comparison to the control group. It was concluded that the reduced chronotropic reserve was present in NYHA class III patients with old myocardial infarction, and that this mechanism might contribute to a decrease in the pump reserve of the heart, resulting in further impairment of physical capacity in these patients.

Adult↗

Distribution of collagen type IV in soft tissue tumors. An immunohistochemical study.

The distribution of collagen type IV, one of the major constituents of basement membrane, was studied immunohistologically in a series of 103 soft tissue tumors including those of peripheral nerve origin, smooth muscle origin, striated muscle origin, fibrous tissue origin, fibrohistiocytic origin, adipose tissue origin, synovial tissue origin, and blood vessel origin, paragangliomas, alveolar soft part sarcomas, granular cell tumors, and epithelioid sarcomas. Intensely positive staining for collagen type IV was observed in neurilemomas, neurofibromas, malignant schwannomas, and blood vessel tumors. Weakly to moderately positive staining was seen in leiomyomas, angiomyomas, and leiomyosarcomas. In contrast, synovial, fibroblastic and fibrohistiocytic tumors, benign or malignant, were negative. In paragangliomas, granular cell tumors, and alveolar soft part sarcomas, positive staining was evident surrounding nests or clusters of tumor cells. In all tumors, staining for collagen type IV clearly illustrated the vascular pattern.

Collagen↗

Recurrent chromosome abnormalities in adult T-cell lymphomas of peripheral T-cell origin.

Cytogenetic studies were performed on 11 Japanese patients with adult T-cell lymphoma of peripheral T-cell origin. All patients had a histologic diagnosis of diffuse lymphoma, and were treated with intensive combination chemotherapy; their median survival was 6 months. Lymphomas were categorized on the basis of the classification proposed by the Lymphoma Study Group of Japan: 5 patients had the features of pleomorphic lymphoma; 3, mixed lymphoma; 2, large-cell lymphoma; and 1, medium-sized-cell lymphoma. The modal chromosome number of abnormal cells was near-diploid in 7, and hypotetraploid in 4 including 3 patients with pleomorphic lymphoma. Abnormalities of the clonal chromosomes were observed in all 11 patients. A translocation of the short arm of 19 at band 19p13 was found in 2 patients with pleomorphic lymphoma and in one patient each with mixed lymphoma and medium-sized-cell lymphoma. A translocation of the short arm of 14, with a break at band 14p12, occurred in 4 patients with pleomorphic lymphoma. In one patient each with mixed lymphoma and large-cell lymphoma, an extra chromosome 3 was found. The numerical change was unique because their lymphomas were further categorized as "angioimmunoblastic lymphadenopathy with dysproteinemia" and "large-cell immunoblastic lymphoma", respectively. Our findings suggest that characteristic chromosome abnormalities occur in adult T-cell lymphoma, and dividing cells in the tetraploid range tend to be predominant in pleomorphic lymphoma.

Adult↗

Clear cell sarcoma of the kidney. An immunohistochemical study.

Three cases of clear cell sarcoma of the kidney (CCSK) and 5 cases of Wilms' tumor were investigated immunohistochemically to examine the expression of tissue-specific intermediate filaments (cytokeratin, vimentin, and desmin) and myoglobin. In CCSK, tumor cells were negative for cytokeratin, except for occasional tubular structures, and vimentin was demonstrated in only one case. In Wilms' tumor, epithelial components were positive for cytokeratin and stromal cells were positive for vimentin, while no staining was found in blastemal cells for either. Both desmin and myoglobin were negative in all tumor cells except for skeletal muscle cells in Wilms' tumor. In the current study, some neoplastic cells in CCSK were revealed to be of mesenchymal nature, but blastemal cells in Wilms' tumor were not.

Antibodies, Monoclonal↗

Alveolar soft part sarcoma, granular cell tumor, and paraganglioma. An immunohistochemical comparative study.

Five cases of alveolar soft part sarcoma, 5 cases of granular cell tumor, and 6 cases of paraganglioma were investigated immunohistochemically to examine the expression of tissue-specific intermediate filaments (cytokeratin, vimentin, desmin, and glial fibrillary acidic protein (GFAP], actin, myoglobin, and nervous tissue markers (S-100 protein, neuron-specific enolase, and Leu-7). In alveolar soft part sarcomas, some of the tumor cells were positive for desmin, but negative for nervous tissue markers. The tumor cells of granular cell tumors were stained with anti-S-100 protein antibody, but not with anti-neuron-specific enolase antibody. In contrast, the tumor cells of paragangliomas were positive for neuron-specific enolase, but not for S-100 protein except for stellate cells surrounding the tumor cell nests. This immunohistochemical approach was valuable for the differential diagnosis of these three tumors. Furthermore, the complete absence of cytokeratin in all of the tumor cells may be helpful in distinguishing these three tumors from metastatic carcinoma in soft tissue. The histogenesis of alveolar soft part sarcoma is a matter of controversy. The result that besides desmin actin was also demonstrated in some of the tumor cells may support the myogenic origin of this tumor.

Adult↗

Analysis of antibody to neutrophils associated with autoimmune neutropenia: possible recognition of Fc-receptor-related molecules.

The serum of a 50-year-old male with neutropenia and a bout of bacterial infection was studied. Anti-neutrophil IgG antibody was detected by indirect immunofluorescence using a laser flow cytometry system. Purified IgG from our patient's serum did not inhibit chemotaxis of neutrophils, but inhibited rosette formation of neutrophils with ox red blood cells (ORBC) coated with anti-ORBC rabbit IgG dose-dependently. Surface iodination of neutrophils followed by their immunoprecipitation by purified IgG and sodium dodecylsulfate polyacrylamide gel electrophoresis showed a single band that corresponded to 45 kilodaltons. Possibly the IgG antibody in our patient's serum recognizes molecules related to Fc receptors.

Agranulocytosis↗

Cytochemical, immunologic, chromosomal, and molecular genetic analysis of a novel cell line derived from Hodgkin's disease.

A novel cell line, KM-H2, was established from the pleural effusion of a patient with Hodgkin's disease of mixed cellular type. Multiple phenotypic studies were carried out with this cell line. Acid phosphatase and nonspecific esterase activities were detected. Rosette formation with T lymphocytes and the receptors for C3b and Fc portion of IgG were positive. Among the antigens tested with a total of 22 monoclonal antibodies defining hematopoietic cell subsets or lineages, Ki-1, Leu-M1, MCS1, HLA-DR, and OKT9 antigens were found to be positive. The other antigens reportedly specific for T cells, B cells, natural killer (NK) cells, monocytes, interdigitating reticulum (IR) cells and dendritic reticulum cells were negative. These phenotypic features were identical to those of the Sternberg-Reed (SR) and Hodgkin (H) cells in the fresh materials reported by other researchers. Moreover, the KM-H2 cells and the parental pleural effusion cells shared several structural chromosome anomalies. These findings indicated that the KM-H2 cells are derived from the SR and H cells. Molecular genetic analysis of the KM-H2 cells disclosed that the human immunoglobulin JH gene was rearranged but not the JK gene, and that the human T cell receptor beta chain gene was of the germline type. Based on these properties of the KM-H2 cells, Hodgkin's disease may be derived from a cell lineage other than T cell or B cell.

Adult↗

Sarcoma-like mural nodules combined with a microfocus of anaplastic carcinoma in mucinous ovarian tumor.

A case of mucinous ovarian tumor with sarcoma-like mural nodules, one of which coexisted with a microfocus of anaplastic carcinoma, was studied by light, electron microscopic, and histochemical examinations. The case suggested that the formation of sarcoma-like mural nodules may be the result of the proliferation of undifferentiated mesenchymal cells which exist beneath the mucinous epithelium by some stimulation like hemorrhage in the cyst wall. Histologically, the mononucleated cells composing the sarcoma-like mural nodules had epithelioid characteristics, particularly at the areas where the covering mucinous epithelium had already detached. The case also suggested that the findings of epithelioid characteristics in the sarcoma-like mural nodules themselves do not imply these nodules to be anaplastic carcinoma, but merely an epithelioid differentiation from undifferentiated mesenchymal cells, namely one of reactive products. However, the existence of a microfocus of anaplastic carcinoma combined with the sarcoma-like mural nodule necessitates a careful histologic analysis of mural nodules for the treatment of patients and the determination of the prognosis.

Adenocarcinoma, Mucinous↗

Carcinoma of the pancreas with endocrine component in childhood. A case report.

A case of pancreatic tumor in a six-year-old girl is presented. The tumor had histologic characteristics of acinar cell carcinoma with endocrine component. Grossly, it was encapsulated and attached to the tail of the pancreas, measuring 8 cm in the greatest diameter. Histologically, the tumor was composed of medium-sized tumor cells, with mild pleomorphism showing mainly acinar structures. Many of these tumor cell contained fine granules that were periodic acid-Schiff positive, diastase resistant, and positive with dimethylaminobenzaldehyde nitrite strain for tryptophan, and some contained granules that were positive with Grimelius stain and positive with peroxidase-antiperoxidase technic for gastrin. Electron microscopy revealed two types of membrane-bound granules in the tumor cells. The larger granules measured 400-700 nm in diameter and appeared to be zymogen granules, while the smaller ones measured 100-200 nm in diameter and appeared to be neuroendocrine granules. Some cells contained both granules. The postoperative course of the patient was excellent, and she was alive and well 13 years after operation. This may be the second reported case of acinar-endocrine cell tumor of the pancreas.

Carcinoma↗

Exercise capacity correlating to exercise hemodynamics in coronary artery disease.

Forty-seven patients with coronary artery disease characterized by angina pectoris and/or old myocardial infarction underwent two maximal exercise tests, the supine ergometer test and the upright treadmill test, to study the relationship between exercise capacity and exercise hemodynamics. Subjects were divided into 3 groups: Group I (n = 19) achieved 25 or 50 watts, Group II (n = 15) achieved 75 watts and Group III (n = 13) achieved 100 or 125 watts. During ergometer exercise, the mean pulmonary capillary pressure elevated by 25.3 +/- 8.3 mmHg in Group I, 20.8 +/- 8.8 mmHg in Group II and 12.0 +/- 8.4 mmHg in Group III; the Group III value was significantly smaller than the other groups. The stroke volume index decreased by 3.6 +/- 8.8 ml/m2 in Group I, and increased by 10.9 +/- 8.7 ml/m2 in Group II and 10.7 +/- 14.7 ml/m2 in Group III. Thus, the impaired exercise capacity correlated with the abnormal exercise hemodynamics and its severity. In addition, the exercise capacity in the treadmill test was comparable to that in the ergometer test. It was concluded that the impaired exercise capacity in the both supine and upright exercise tests was well related to the development of abnormal exercise hemodynamics in patients with coronary artery disease.

Adult↗