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Biomedical subjects

H Yamabe

Publications and source records attributed to H Yamabe.

At least 163 records · Page 9Linked to original sources
PubMed1992

Obstructive jaundice caused by polypoid inflammatory granuloma in a consanguineous case.

Granuloma in the biliary system is a rare condition. The majority of the reported cases concern postsurgical granuloma. We note a patient with obstructive jaundice due to inflammatory granuloma in whom a filling defect was found at the bifurcation of the common hepatic duct by preoperative cholangiography. There have been no reported cases with similar findings. In addition to these features, this case was further characterized by consanguinity, repeated spontaneous abortions, and severe vascular lesions found in many organs that suggested the presence of a hereditary defect.

Bile Duct Diseases↗
PubMed1992

A study on coronary hemodynamics during acetylcholine-induced coronary spasm in patients with variant angina: endothelium-dependent dilation in the resistance vessels.

The epicardial coronary artery of patients with variant angina is hyperreactive to the constrictive effect of acetylcholine, but it is not known whether the coronary microvasculature also constricts in response to acetylcholine. Incremental doses of acetylcholine were injected into the left coronary artery of 57 patients with variant angina and with spasm in this artery. By measuring coronary sinus blood flow, coronary hemodynamic status just before angiographic documentation of spasm was examined. Acetylcholine induced spasm in the left coronary artery in all patients. It also decreased the diameter of the nonspasm artery by 36 +/- 19% from baseline. For all patients, coronary sinus blood flow was 89 +/- 38 ml/min at baseline and increased to 104 +/- 61 ml/min during an acetylcholine-induced anginal attack (p less than 0.01). In 10 patients with spasm in both the left anterior descending and left circumflex arteries (that is, multivessel spasm), coronary sinus blood flow decreased from 84 +/- 21 to 52 +/- 26 ml/min (p less than 0.01). In the other 47 patients with spasm in only one of these two arteries (that is, single-vessel spasm), coronary sinus blood flow increased from 90 +/- 41 to 115 +/- 61 ml/min (p less than 0.01) without change in the rate-pressure product. It is concluded that in patients with variant angina, acetylcholine induces spasm and constriction in the epicardial coronary artery, whereas it dilates the resistance vessels presumably through the release of the endothelium-dependent relaxing factor.

Acetylcholine↗
PubMed1992

Undifferentiated carcinoma of the thyroid gland: sonographic findings.

We report high resolution sonographic (7.5 MHz) findings in four cases of undifferentiated carcinoma of the thyroid gland. Sonographic findings in these four cases included poorly marginated, hypoechoic masses associated with calcifications, and invasion of adjacent cervical structures. A knowledge of the sonographic features of undifferentiated carcinoma of the thyroid gland is of clinical importance, since the tumour has a grave prognosis, quite different from the relatively favourable prognosis of well differentiated thyroid carcinoma.

Adult↗
PubMed1992

Role of endothelium-derived nitric oxide in myocardial reactive hyperemia.

In pentobarbital sodium-anesthetized dogs we investigated the role of the endothelium-derived nitric oxide and adenosine in the regulation of the coronary blood flow during myocardial reactive hyperemia. Repayments of flow debt after 10-, 20- and 60-s occlusion of the left circumflex coronary artery (LCX) were measured before and after infusion of NG-monomethyl-L-arginine (L-NMMA; n = 15), 8-phenyltheophylline (8-PT; n = 5), and both L-NMMA and 8-PT (n = 5) into the LCX. Infusion of L-NMMA (2 mumol/min, for 20 min) reduced repayments of flow debt after 10-, 20-, and 60-s LCX occlusion by 30 +/- 4 (P less than 0.01), 34 +/- 3 (P less than 0.01), and 14 +/- 3% (P less than 0.01), respectively. Infusion of 8-PT (0.75 mumol/min for 15 min) also reduced these repayments of flow debt by 31 +/- 7 (P less than 0.01), 30 +/- 7 (P less than 0.01), and 34 +/- 6% (P less than 0.01), respectively. Simultaneous infusion of L-NMMA and 8-PT significantly attenuated the peak reactive flow rate and reduced repayment of flow debt after 20-s LCX occlusion by 57 +/- 1% (P less than 0.001), and this reduction in repayment of flow debt was significantly greater than each of those by the individual administration of L-NMMA and 8-PT (both P less than 0.01). The suppressive effect of L-NMMA on repayment of flow debt after 20-s LCX occlusion was quickly reversed by the infusion of L-arginine (3 mg/min for 10 min; n = 5).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMed1992

The distribution of the blood flow during exercise in chronic heart failure--compensatory mechanism to the decreased cardiac output.

To evaluate the blood flow distribution during exercise, 51 patients with chronic heart failure underwent ergometer exercise testing measuring cardiac output and leg blood flow. At the given workrate (10 watts and 25 watts) cardiac index (L/min/m2) was significantly lower in NYHA class III patients than class I patients (at 10 watts, 4.08 +/- 1.05 in class I, 4.01 +/- 1.29 in class II and 3.00 +/- 0.89 in class III, p less than 0.05; I vs III), while leg blood flow (L/min/m2) was similar among 3 groups (at 10 watts, 1.19 +/- 0.32, 1.29 +/- 0.25 and 1.16 +/- 0.29, ns). Consequently, residual blood flow (L/min/m2) was significantly lower in class III than class I (at 10 watts, 2.89 +/- .92 and 2.78 +/- 1.27 and 1.84 +/- 0.71, p less than 0.05: I vs III). The results at 25 watts were similar. Serum noradrenaline was significantly higher in class III patients than class I patients at both 10 and 25 watts. We concluded that in severe heart failure, agreater blood flow is distributed to the working leg muscle as compared with less severe heart failure. And such an increased distribution of blood flow to working leg plays a role to compensate an insufficient cardiac output response in patients with severe heart failure.

Adult↗
PubMed1992

Glomerular epithelial cells secrete a glomerular basement membrane-degrading metalloproteinase.

Cultured rat glomerular epithelial cells (GEC) were examined for their ability to release extracellular matrix-degrading proteinases with [3H]gelatin as substrate. GEC-conditioned media, under serum-free conditions, contained modest amounts of gelatinase activity (1 to 10 U/mg of protein); the activity was maximal at neutral pH, was inhibited by zinc chelators, was not inhibited by tissue inhibitor of metalloproteinase-2, and could not be further activated by trypsin or organomercurials. Gelatin substrate sodium dodecyl sulfate-polyacrylamide gels of GEC-conditioned medium revealed several zones of lysis, with molecular sizes of 150 kd (major band), and 220, 86 to 93, and 52 to 54 kd (minor bands). Northern blot analysis demonstrated that the GEC metalloproteinase(s) were distinct from the 68- to 72-kd type IV collagenase/gelatinase present in mesangial cells or the 92-kd type IV collagenase present in neutrophils. The GEC gelatinolytic activity also degraded insoluble type IV collagen in glomerular basement membrane in a dose-dependent manner. The major metalloproteinase activity responsible for the type IV collagen degradation has a molecular size of 150 kd with a type IV collagen substrate gel. Thus, GEC produce several neutral metalloproteinases, which, by virtue of their substrate specificity, may play an important role in glomerular basement membrane remodeling and in glomerular diseases characterized by alterations in basement membrane permeability.

Animals↗
PubMed1992

[Pseudosarcomatous fibromyxoid tumor of the urinary bladder: a case report].

A 41-year-old man was referred to our clinic for gross hematuria. Cystoscopy revealed a 6 x 5 x 5 cm wide-based tumor located at the dome of the bladder. Pathological diagnosis of the biopsy was pseudosarcomatous fibromyxoid tumor. Microscopically this tumor was composed of spindle cells and myxoid stroma, and immunohistochemical and ultrastructural studies showed benign characteristics of this tumor. Therefore partial cystectomy was performed. It is important to recognize the histological characteristics of this essentially benign condition so that total cystectomy can be avoided.

Adult↗
PubMed1992

[Clinical significance of the stereological estimation of mean nuclear volume in human bladder carcinoma--relation to tumor grade, stage and prognosis].

Quantitative analysis of the malignant potential in cancer cells is a method currently under discussion. Recently the stereological estimation of cancer cells has been utilized in making an objective and quantitative pathological diagnosis. In this study, we estimated the mean nuclear volume (MNV) of untreated bladder carcinomas in 128 patients by stereological methods and attempted to quantitatively analyze the malignant potential of the carcinoma. The MNV was significantly enlarged as the tumor advanced in grade and stage. MNV was largest in grade 3 tumors (340.2 +/- 100.1 microns3) followed by grade 2 tumours (206.2 +/- 90.6 microns3) (P less than 0.01), and grade 1 tumors (130.6 +/- 46.7 microns3) (P less than 0.01). MNV was larger in pT1 tumors (278.2 +/- 126.9 microns3) than in pTa tumors (156.9 +/- 60.5 microns3) (P less than 0.01). MNV was also larger in invasive tumors (T2, T3 and T4: 318.2 +/- 104.0 microns3) than in superficial tumors (Ta and T1: 203.5 +/- 109.2 microns3) (P less than 0.01). Patients were then divided into two subgroups, one with large nuclei (MNV greater than or equal to 197.3 microns3), and the other with small nuclei (MNV less than 197.3 microns3). Survival and disease-free rates in patients with small nuclei (5-year survival rate: 92.9%, 5-year disease-free rate: 24.4%) were significantly better than in patients with large nuclei (5-year survival rate: 58.0%, 5-year disease-free rate: 12.5%). For patients with grade 2 tumors, those with small nuclei had a good survival rate (5-year survival rate: 95.5%), similar to that of patients with grade 1 tumors (5-year survival rate: 95.0%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Geographical aspects of bcl-2 gene involvement in Japanese patients with non-Hodgkin's B-cell lymphomas.

Using three separate bcl-2 probes, we examined involvement of the bcl-2 gene in Japanese patients with non-Hodgkin's B-cell lymphomas. Of 52 patients with follicular lymphoma (FL), 24 had rearrangements. In a group of 50 patients with diffuse lymphoma, three of 32 patients with diffuse large cell lymphoma had rearrangements. The frequency of rearrangements in each of these groups, as detected by both major and minor breakpoint cluster region probes, was compatible with that found in other Far Eastern studies. However, the difference in frequency between the groups studied in the Far East and the West was significant, and these two geographically distinct populations also displayed a difference in the breakpoint distribution. In the immunophenotype study of 33 patients with FL, the expression of CD10 antigen correlated with bcl-2 involvement, whereas none of the other B markers emerged as parameters to distinguish between the two lymphoma groups; those with, and without, the rearrangements.

Humans↗
PubMed1991

Tissue distribution of 2-3 and 2-6 sialyl Lewis A antigens and significance of the ratio of two antigens for the differential diagnosis of malignant and benign disorders of the digestive tract.

The authors investigated the tissue distribution of two kinds of sialylated derivatives of Lewis A (Le(a)) antigen in patients with cancers of the digestive system using specific monoclonal antibodies, and evaluated the significance of determining the 2-3 and 2-6 sialylated Le(a) antigen levels for the diagnosis of cancer. In most specimens from patients with cancers of the pancreas, biliary tract, stomach, and colon, the 2-3 sialylated Le(a) antigen was strongly expressed in cancer cells. However, 2-6 sialylated Le(a) antigen was less frequently expressed in cancer cells. The former is therefore more specific to cancer than the latter. Also, the serum level of the 2-3 sialylated Le(a) antigen was significantly higher than that of the 2-6 counterpart in patients with cancers of pancreas, biliary tract, stomach, and colon. The resulting ratio of serum 2-3/2-6 sialylated Le(a) antigens was frequently high in patients with malignancy and was low in patients with benign disorders of these digestive organs. Therefore, the 2-3/2-6 sialylated Le(a) antigen ratio is a useful for the differential diagnosis of malignant disorders in these organs. However, liver disorders were found to be exceptional in that both antigens were mostly absent in hepatocellular carcinoma (HCC) cells in immunohistologic examination, as well as in nonmalignant parenchymal liver cells. Only the epithelial cells of the intrahepatic bile ducts expressed the 2-6 sialylated Le(a) antigen strongly, and expressed the 2-3 sialylated Le(a) antigen moderately. The levels of both antigens were sometimes high in patients with liver disorders, but the ratio always remained low in patients with HCC as well as benign liver disorders such as cirrhosis or chronic hepatitis. The sialylated Le(a) antigens, which sometimes accumulate in the sera of patients with HCC, were concluded to originate from the epithelial cells of the proliferating small bile ducts, and those serum antigens cannot be considered as evidence for the presence of liver cancer cells.

Antibodies, Monoclonal↗
PubMed1991

A radiotherapeutic experience for localized extranodal non-Hodgkin's lymphoma: prognostic factors and re-evaluation of treatment modality.

Between 1966 and 1988, 149 patients were treated with radiotherapy for localized extranodal lymphoma. The average total dose given was 39.8 Gy for low grade disease and 48.7 Gy for all other disease. Of the 149 patients, 60 also received adjuvant chemotherapy. Twenty-four had low grade lymphoma, 109 had intermediate grade disease, and 16 had high grade disease, histologically. The distribution of histological grade and T/B phenotype varied with the primary site. Low grade lymphomas were found mainly in the orbit, and T-cell lymphomas were found in the nasal cavity and nasopharynx. The 5-year survival rates according to tumor location were 89% for oral cavity, 86% for paranasal sinus, 83% for thyroid, 69% for orbit, 47% for Waldeyer's ring (WAR), 44% for testis, 23% for CNS, 21% for nasal cavity and 60% for other sites. Histological grade and T/B phenotype both had prognostic importance. Combined chemotherapy significantly improved the survival rate only for disease with intermediate or high grade histology. Other prognostic factors according to the primary site were the bulk of lymph node for WAR disease, the radiation dose for CNS disease, bone erosion for orbital disease, stridor for disease of the thyroid, and the tumor stage for disease of both the testis and the thyroid.

Adolescent↗
PubMed1991

Endothelium-derived nitric oxide as a mediator of acetylcholine-induced coronary vasodilation in dogs.

To investigate the role of endothelium-derived nitric oxide (NO) in regulation of the tonus of the coronary artery system in vivo, the effect of NG-mono-methyl-L-arginine (L-NMMA), a specific inhibitor of the synthesis of NO from L-arginine, on acetylcholine (ACh)-induced coronary vasodilation was examined in open-chest, anesthetized dogs. At baseline, the infusion of ACh and adenosine into the left circumflex coronary artery (LCX) increased the LCX blood flow. Continuous infusion of L-NMMA (2 mumol/min, for 20 min) into LCX significantly attenuated ACh-induced increase in the LCX flow: percentage increases in the LCX flow by ACh (10 and 100 ng/kg) before L-NMMA were 42.0 +/- 8.7 and 137.3 +/- 12.5%, respectively, whereas those after L-NMMA were 14.0 +/- 4.9 (p less than 0.02) and 88.9 +/- 10.9% (p less than 0.005), respectively. L-NMMA showed no effect on adenosine-induced increase in the LCX flow. After the L-NMMA infusion was terminated, the effect of ACh partially returned to the baseline level. In other dogs, L-arginine (3 mg/min, for 20 min) was administered just after the L-NMMA infusion, which completely reversed the inhibitory effect of L-NMMA on ACh-induced vasodilation. Endothelium-derived NO is a mediator of ACh-induced vasodilation of the coronary resistance vessels in dogs.

Acetylcholine↗
PubMed1991

Case report of amyloidosis-like glomerulopathy with hepatic involvement.

A few cases of nephrotic syndrome with the glomerular deposition of an amyloid-like material which did not stain with Congo red have been documented. But extrarenal deposits have not been previously reported in this disease. We describe here a case of nephrotic syndrome associated with the deposition of an amyloid-like material in the liver as well as in the renal glomeruli. The deposits were made up of fibrillar structures which resembled those of amyloid when viewed through the electron microscope but they did not stain with Congo red. This is the first report of amyloidosis-like glomerulopathy with extrarenal deposits.

Amyloid↗
PubMed1991

The significance of resting thallium-201 delayed SPECT for assessing viability of infarcted regions--comparison with exercise thallium-201 SPECT.

To clarify the clinical significance of resting thallium-201 (Tl) delayed SPECT for assessing the viability of infarcted regions, we studied resting Tl initial and delayed Tl SPECT one week after exercise (Ex) Tl SPECT in 38 patients (40 regions) with old myocardial infarction (OMI) and 35 patients (37 regions) with effort angina pectoris (EAP). Analysis of resting Tl and Ex Tl SPECT divided the patients with OMI into 3 groups. Twenty-three patients whose perfusion defect (PD) on resting delayed image was same as that of Ex delayed image were divided into 12 patients with Ex Tl redistribution (RD) (G1) and 11 patients without Ex Tl RD (G3). Fifteen patients showed a decrease of PD on resting delayed image compared with Ex delayed image (G2). Thirty-five patients with EAP were divided into 18 patients who had no PD on Ex delayed image (G1) and 17 patients whose PD did not disappear on Ex delayed image but disappeared on resting delayed image (G2). The increase of pulmonary artery wedge pressure on Ex was higher in G2 than in G1 of both OMI and EAP (OMI; G1 15 +/- 16 mmHg vs G2 27 +/- 7 mmHg; p less than 0.01, EAP; G1 12 +/- 7 mmHg vs G2 22 +/- 6 mmHg; p less than 0.05). The percent Tl uptake of the PD on Ex Tl initial images was lower in G2 than in G1 of both OMI and EAP (OMI: G1 63 +/- 7% vs G2 55 +/- 9%; p less than 0.05, EAP: G1 72 +/- 7% vs G2 65 +/- 9%; p less than 0.05). That of the PD on resting Tl delayed images was higher in G1 and G2 than in G3 of OMI (G1 78 +/- 7%, G2 74 +/- 8%, G3 41 +/- 10%; G1 vs G3, G2 vs G3 p less than 0.001). The prevalence of akinetic or dyskinetic wall motion on left ventriculography was higher in G2 than G1, and in G3 than G2 (G1 24.3%, G2 52.2%, G3 85.7%; p less than 0.001). Thus, in patients with OMI the decrease of Tl PD on resting Tl delayed images compared with Ex delayed images may indicate severe ischemia induced by stress as well as in patients with EAP, and furthermore the presence of viable muscle. On the other hand, the infarcted region without decrease of Tl PD on resting delayed images may lack viable muscle.

Aged↗
PubMed1991

Lymphoproliferative disorders of the thyroid gland: radiological appearances.

Images of lymphoproliferative disorders of the thyroid by ultrasonography (US), computed tomography (CT), 99Tcm and 67Ga scintigraphy were analysed in eight patients (two men and six women, aged 42-83 years). Seven patients were diagnosed as having primary lymphoma and one plasmacytoma. Ultrasound revealed a solid mass with homogeneous and very low echogenicity clearly distinguishable from residual thyroid tissue in five patients, diffuse hypoechoic goitre in one and multiple irregular hypoechoic nodules in both lobes in the patient with plasmacytoma (Case 8). Computed tomography demonstrated a focal low-density area in six cases of lymphoma and decreased density throughout the gland in the other two patients. 99Tcm scintigraphy showed hemilobar enlargement with decreased and uneven trapping, cold area or complete lobar defect in six patients with lymphoma and no trapping in the case of plasmacytoma. 67Ga scintigraphy demonstrated high accumulation in lymphoma and faint accumulation in the case of plasmacytoma. Radiological manifestations with a focal lesion were considered typical and diagnostic of primary thyroid lymphoma, while in one case with diffuse infiltration through the whole gland, the differential diagnosis from Hashimoto's thyroiditis could not be made. In the final case, cells infiltrated diffusely to form islands with patchy distribution among well preserved follicles, correlating with the multiple hypoechoic areas observed by US.

Adult↗
PubMed1991

Embryonal carcinoma of the testis after acute myelomonocytic leukemia: a case report.

A case of embryonal carcinoma of the testis after acute myelomonocytic leukemia is reported. The interval between the initial diagnosis of leukemia and the appearance of embryonal carcinoma was almost three years. Although the patient had received neither irradiation nor alkylating agents, the case is regarded as one of secondary malignancy. Possible contributing factors are discussed.

Adolescent↗
PubMed1991

[Blood flow redistribution and exercise intolerance in chronic heart failure].

We examined blood flow redistribution during exercise and its significance on exercise intolerance in chronic heart failure. Sixty-three patients with chronic heart diseases underwent symptom-limited maximal multistage exercise using a supine ergometer. We measured oxygen intake (VO2) and cardiac index (CI) using Fick's principle and leg flow with the thermodilution method at rest and during exercise. Patients were categorized in 5 groups according to their VO2 max; i.e., control group (n = 12), having normal right-sided cardiac pressure during exercise; A group (n = 8), having an abnormal right-sided pressure elevation, but normal exercise tolerance VO2 max greater than 20 ml/min/kg; B group (n = 19) VO2 max 20-15; C group (n = 17) also 15-10; and D group (n = 7), VO2 less than 10 ml/min/kg. At maximal exercise, the CI max and leg flow max were similar between the control and A groups; whereas, they decreased in the order of groups B, C and D. The ratio of leg flow/CI increased by 5 times from rest to maximal exercise in all groups, although the values at rest and at maximal exercise were similar among all groups. The relationship between CI and leg flow during exercise was linear in each individual patient. The coefficient of this regression line was extremely high (r = 0.98 +/- 0.02). Therefore, we calculated each regression line, leg flow = (a).CI +/- (b), with the gradient (a) as an index of blood flow redistribution to working skeletal muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗