Biomedical subjects

K Dohi

Publications and source records attributed to K Dohi.

At least 199 records · Page 11Linked to original sources

PubMed1998

Anorexia nervosa with left atrial failure.

A 14-year-old girl with anorexia nervosa was admitted to our hospital because of severe weight loss. She was 152 cm in height and weighed 27 kg. An echocardiogram demonstrated normal left ventricular contraction and a small left ventricular end-diastolic dimension. Pulsed Doppler transmitral flow demonstrated normal early filling velocities but a complete absence of late diastolic flow after the apparent electrocardiographic P wave, consistent with atrial electromechanical dissociation, so called atrial failure. Six months after admission, her body weight increased to 42 kg. Pulsed Doppler showed a normal transmitral flow pattern in both early and late diastole. We do speculate that atrial failure was related to malnutrition due to anorexia nervosa. Atrial failure can be one of the clinical features of patients with anorexia nervosa.

Adolescent↗

PubMed1998

[The mechanism of donor specific unresponsiveness in renal transplant recipients].

A study was conducted to clarify the mechanism of donor specific immunological unresponsiveness in renal transplant recipients with a well functioning kidney, since this might provide a clue to the nature of donor specific immunosuppression. Peripheral blood lymphocytes (PBL) were obtained from three renal transplant recipients, the donors (mother), the fathers and healthy volunteers as 3rd party and used in the present study. PBL from one of the three renal transplant recipients, which were donor specific unresponsive in MLR (Mixed Lymphocyte Reaction) and CML (Cell Mediated Lympholysis), suppressed the MLR, CML and synthesis of IL-2 from 3rd party PBL in a double chamber assay only when stimulated by the donor PBL. This suppression was abolished by the treatment with CD3 or CD8 antibodies and complement. RT-PCR was performed to investigate the suppressive effect of the recipient's PBL on IL-2 mRNA expression. In the double chamber MLR, expression of IL-2 mRNA by the PBL from 3rd party was also suppressed only when the recipient's PBL were stimulated by the donor PBL. These results indicate that one of the mechanisms responsible for donor specific immunological unresponsiveness is the presence of donor specific suppressor T cells in recipient's PBL and that these cells project suppressive effect on lymphocytes by producing a humoral suppressive factor(s) that suppress the expression of the IL-2 mRNA only when stimulated by donor PBL.

Adult↗

PubMed1998

[Hemodynamics of asymptomatic brain infarction determined by Doppler sonography].

We compared the usefulness of two methods for diagnosing asymptomatic brain infarction: an ultrasonic quantitative flow measurement system (QFM) and a transcranial Doppler arteriography (TCDA). A total of 137 patients (73 men and 64 women) who underwent magnetic resonance imaging of the brain, QFM, and TCDA were enrolled. Their ages ranged from 41 to 83 years (mean age, 63 years). The patients were divided into 3 groups: 45 without cerebrovascular disease (Group N); 40 with asymptomatic brain infarction (Group AS); and 52 with lacunar infarction (Group LI). The mean blood flow in the common carotid artery (CCA-BF) was measured by QFM. The mean blood velocity and Fourier pulsatility index in the middle cerebral artery (MCA-BV, MCA-PI) were measured by TCDA. In Group N, 28 patients were examined twice at a mean interval of 2 years; 19 remained without asymptomatic brain infarction (Group N1), and asymptomatic brain infarction developed in the remaining 9 (Group N2). The 3 groups differed significantly in MCA-PI (N < AS < LI), but not in CCA-BF or in MCA-BV. The MCA-PI in Group N2 was higher than that in Group N1. These results indicate that the Fourier pulsatility index determined by TCDA may be useful for detecting the onset of asymptomatic brain infarction.

Adult↗

PubMed1998

[Assessment of autonomic nervous activity before the onset of paroxysmal atrial fibrillation].

Autonomic nervous activity is involved in the onset of paroxysmal atrial fibrillation, but it is not clear how the sympathetic and parasympathetic nervous systems interact before the onset of atrial fibrillation. Twelve lone atrial fibrillation patients and 10 healthy volunteers were studied using 24-hour Holter electrocardiography monitoring. A total of 17 episodes were analyzed. Autonomic nervous activity was assessed based on the high frequency power (HF) spectrum (HF represents parasympathetic nervous activity) and the ratio to the low frequency power (LF) spectrum (L/H represents sympathetic nervous activity) of heart rate variability during sinus rhythm, and the 24-hour averaged autonomic indices were compared between atrial fibrillation patients and healthy volunteers. Comparative data were obtained 30, 20, 10, and 2 min before the onset of atrial fibrillation for each episode. There were no significant differences in the HF and L/H ratio between the patients and healthy volunteers. There were no significant differences in the HF values before the onset of paroxysmal atrial fibrillation, but the L/H ratio before the onset of atrial fibrillation at 30, 20 and 10 min was 1.03 +/- 0.42, 0.95 +/- 0.50, and 1.32 +/- 0.46, respectively, and just before the episode was 1.73 +/- 0.73, so the Spearman's rank correlation coefficient was 0.43. Basal autonomic nervous activity in patients with paroxysmal atrial fibrillation showed no changes compared with healthy volunteers. Sympathetic nervous activity increased progressively from about 30 min before the onset of atrial fibrillation, but parasympathetic nervous activity showed no significant changes. Therefore, a transient augmentation of sympathetic tone may be important in the onset of atrial fibrillation.

Adult↗

PubMed1998

Relationship of xenogeneic microchimerism to graft outcome in hamster-to-rat lung xenotransplantation.

BACKGROUND: In spite of the progress in allogeneic microchimerism research, few reports have dealt with the biologic relevance of xenogeneic microchimerism after organ xenotransplantation. These experiments were designed to analyze the development of xenogeneic microchimerism and its relationship to graft outcome in hamster-to-rat lung xenotransplantation. METHODS: Golden Syrian hamsters were the donors and Lewis rats the recipients of xenogeneic lung transplantation. Animals were divided into three groups: group 1 were untreated; group 2 received cyclophosphamide (10 mg/kg/day for 6 days) and a short course of FK506 (2 mg/kg/day for 8 days); and group 3 were treated with cyclophosphamide and a long course of FK506 (2 mg/kg/day for 8 days, 1 mg/kg/day for 23 days, and then 0.5 mg/kg/day continuously). Xenogeneic microchimerisms were evaluated by use of polymerase chain reaction with primers specific for the hamster hypoxanthine phosphoribosyl-transferase gene. RESULTS: The median graft survival times for groups 1, 2, and 3 were 3 days (n = 6), 22 days (n = 7), and 96.5 days (n = 6), respectively. In groups 1 and 2, the incidence of microchimerisms declined in parallel with the progression of rejection. In group 3, it changed dynamically, initially declining, then progressively increasing and finally disappearing. CONCLUSIONS: In the short-term graft survivors, xenogeneic microchimerism in the peripheral blood was closely related to graft outcome. However, it showed dynamic changes and finally disappeared in long-term graft survivors, and the incidence of microchimerism at a single time point did not reflect the donor-recipient immunologic status.

Animals↗

PubMed1998

Living related partial liver transplantation for primary biliary cirrhosis--a case report.

An adult living related partial liver transplantation was performed on a 49 year old female with terminal hepatic failure due to primary biliary cirrhosis (PBC). The donor was her 53 year-old sister. A sufficient volume of graft tissue was obtained, which comprised 1.5% of the body weight of the recipient. The recipient had an excellent recovery without any major complications, and was discharged 35 days after the operation. At 15 months after the operation, the patient has shown no signs of rejection while using FK506 and prednisolone as immunosuppressants. The progression of symptomatic PBC can be predicted, and the timing of the transplantation can be easily determined. In addition, the results of liver transplantation for PBC are good. Therefore, adult living related partial liver transplantation is an excellent treatment for primary biliary cirrhosis.

Bilirubin↗

PubMed1998

Immunoradiometric assay for the N-terminal fragment of proatrial natriuretic peptide in human plasma.

Recently, the N-terminal fragment of proatrial natriuretic peptide (N-terminal proANP) has been proposed as a marker of chronic congestive heart failure. In this study, we established a two-step immunoradiometric assay using monoclonal antibodies and synthetic N-terminal proANP (1-67) as a standard. It allows us to measure plasma N-terminal proANP in only 4 h without prior extraction. The detection limit of this assay was 15 pmol/L for a 100 microL sample of plasma. Within-run CVs ranged from 1.7% to 2.9% and between-run CVs ranged from 4.2% to 5.1%. The dilution curves of plasma samples showed good linearity and analytical recovery was 89-104%. The mean (+/-SD) N-terminal proANP in plasma of 33 healthy subjects was 188 (+/-71) pmol/L and 1030 (+/-411) pmol/L in 25 patients with heart failure. Our immunoradiometric assay is rapid and precise enough for routine determination of N-terminal proANP in human plasma.

Antibodies, Monoclonal↗

PubMed1998

[A case of Bartter's syndrome with chronic renal failure due to chronic interstitial nephritis].

We report a case of 45-year-old women with Bartter's syndrome and concomitant renal dysfunction. In 1986, the patient demonstrated muscle weakness and serum potassium levels as low as 1.1 mEq/l. She was suspected of having Bartter's syndrome because of hypokalemia, metabolic alkalosis, hyperreninemia, hyperaldosteronism and normotension. Pretibial edema developed in 1989 for which she received 40 to 100 mg/week of furosemide intermittently for the next 5 years. Her serum potassium level ranged from 1.5 to 3.9 mEq/l. In 1991, her serum creatinine level rose to 2.1 mg/dl, then continued to increase gradually. She was admitted to our hospital in 1994 for evaluation of the renal dysfunction. Decreased creatinine clearance (44 ml/min) and a defect in urinary concentrating capacity (Fishberg's test, 370 mOsm/kg.H2O) were detected. Renal biopsy revealed juxtaglomerular cell hyperplasia. These findings resulted in the diagnosis of Bartter's syndrome. The renal biopsy also showed diffuse interstitial fibrosis and marked tubular atrophy. We postulate in this case that long-term hypokalemia due to Bartter's syndrome and the administration of furosemide led to chronic interstitial nephritis and renal dysfunction.

Bartter Syndrome↗

PubMed1998

Examination of serum class I antigen in allograft recipient rats--origin and control of serum class I antigen.

We examined the appearance of DA type (RT1Aa) class I antigen in the serum of rats that had received isogeneic or allogeneic liver grafts (DA into DA, DA into LEW, PVG into DA, PVG into F1 hybrid (DAxPVG). Recipient LEW rats were given either one injection of the anti-CD8 mAb, OX-8, following thymectomy or anti-CD4 mAb (cocktail of OX-35 and OX-38) following thymectomy 3 days prior to liver grafting. We also tested the serum RT1Aa antigen titer of F1 (DAxPVG) recipients after PVG spleen transplantation and the serum RT1Aa antigen titer in the DA rat after hepatectomy and cyclosporin treatment. Replacement of DA liver by PVG lowered transiently the serum level of RT1Aa antigen to 70% of that in normal DA serum shortly after liver transplantation. However, this titer increased gradually over the level in normal DA serum. A PVG spleen graft to an F1 hybrid recipient resulted in death due to typical GVH disease between 13 and 24 days after spleen transplantation. The RT1Aa antigen titer increased to several times more than that in normal F1 serum throughout the observation period. LEW recipients of DA liver died at 9-11 days (9.8 +/- 1.1 days) due to acute liver rejection. In this combination, the serum level of RT1Aa increased until day 8, reaching a maximum (four times) on day 4. Deletion of either CD8+ or CD4+ T cells by anti-CD8 or anti-CD4 MAb in this transplantation prolonged the survival times of liver grafts for up to 26.8 +/- 8.4 and 35.6 +/- 17.9 days, respectively. In the anti-CD8 or anti-CD4 MAb- treated recipients, the serum titer of DA class I antigen was not elevated and there were no differences between the two. Hepatectomy in combination with cyclosporin induced a higher titer of liver-derived class I antigen in the serum as long as liver regeneration proceeded. These results suggest that the liver is the principal source of serum class I antigen in rats. Rejection, GVH reaction and liver regeneration increased the serum class I antigen from transplanted liver or host tissue. It is unlikely that this is due to cleavage of membranous class I antigen by class I- reactive CD8+ T cells.

Animals↗

PubMed1998

Examination of serum amyloid A protein in kidney transplant patients--comparison of serum amyloid A and C-reactive protein for monitoring the occurrence of renal-allograft-related complications.

Serum amyloid A (SAA) is an inflammation-reactive protein, like C-reactive protein (CRP). In this study, we examined SAA levels in the sera of kidney transplant patients with acute rejection (N = 12), chronic rejection (N = 60) and cytomegalovirus (CMV) infection complications and compared them with serum CRP levels in terms of sensitivity and reactivity. The SAA and CRP showed almost similar kinetics in 10 patients within 2 months of kidney transplantation. However, in 2 patients SAA responded more sensitively to CMV infection and acute rejection. SAA increased significantly 10-fold relative to its baseline levels. The SAA levels also increased along with those of serum creatinine levels. Our experiments clearly showed that SAA and CRP responded sensitively to several stimuli with elevated serum levels including surgical trauma, acute allograft rejection and infection. However, the reactivity and sensitivity of SAA was clearly higher than those of CRP in patients with viral infections, on steroid therapy and undergoing chronic allograft rejection, suggesting that monitoring SAA levels provides more useful information than monitoring CRP.

Biomarkers↗

PubMed1998

Tumor localization studies and surgical treatment in patients with insulinoma.

In the present study, we retrospectively reviewed thirteen consecutive patients with insulinomas including 2 reoperations at our department for insulinomas, from the viewpoint of preoperative localization studies, surgery and long term follow-up. The results of the preoperative localization studies proved to be percutaneous transhepatic portal venous sampling (PTPVS) 6/7, angiography 8/15, ultrasonography (US) 6/11, endoscopic ultrasonography (EUS) 4/4, computed tomography (CT) 3/10, and magnetic resonance imaging (MRI) 2/2. The tumor was visualized by intraoperative ultrasonography (IUS) in 6 of 6 patients (100%). Six patients underwent enucleation, 6 patients underwent distal pancreatectomy, 2 patients underwent subtotal (80%) distal pancreatectomy, and one patient a pylorus preserving pancreaticoduodenectomy (PPPD). Two patients, one of whom belonged to the MEN-I group, underwent reoperations because they had multiple adenomas. The development of iatrogenic diabetes occurred in the case of 3 patients. These results suggest that the use of selected preoperative localization studies (PTPVS and probably EUS) may be very helpful for detecting insulinoma, and that IUS is an essential part of the operative exploration for insulinoma. Our data may further indicate the need for an aggressive surgical procedure in the case of multiple adenoma or insulinoma in MEN-I.

Adult↗

PubMed1998

A case of abdominal aortic aneurysm associated with systemic lupus erythematosus.

A case of abdominal aortic aneurysm associated with systemic lupus erythematosus (SLE) is reported. A 45-year-old woman with a 18-year history of SLE was admitted with severe lumbago radiating to the bilateral inguinal region. CT and DSA showed a dumbbell shaped true aneurysm of the abdominal aorta. An aorto-biiliac Y shaped graft replacements was performed. SLE is rarely associated with aneurysm of the great arteries. We could find only 4 reports of abdominal aneurysm associated with SLE. Common features were the young age of the patient, the long term of the systemic disease, and administration of corticosteroid therapy for a relatively long period of time. We speculate that atherosclerosis, hypertension, and corticosteroid may all work in concert, possibly together with aortic wall involvement or vasculitic damage, to produce the rare abdominal aneurysm in SLE.

Aortic Aneurysm, Abdominal↗

PubMed1998

[A case of polyangiitis overlap syndrome].

A 47 year old man was admitted to a local hospital because of fever and severe epigastric pain. Laboratory examination showed eosinophilia (9,812/microliter) and an elevated serum IgE level (934 IU/ml). Multiple hemorrhagic gastric ulcers and a left adrenal tumor was also found. The gastric ulcers were resistant to conservative therapy. On the eighth hospital day, total gastrectomy and left adrenalectomy were performed. Surgical specimens from the stomach and adrenal gland showed necrotizing angiitis with infiltration of eosinophils, and thrombus formation. Eosinophilia was persistant to the treatment by corticosteroid and immunosuppressant. Thereafter polymononeuropathy in lower limbs and necrotizing lesions in toes developed and were resistant to medication and gangrionic block. According to the clinical and pathological findings, we made diagnosis of this case as polyangiitis overlap syndrome with some features of Allergic granulomatous angiitis and Polyarteritis nodosa.

Churg-Strauss Syndrome↗

PubMed1998

Factors affecting postoperative prognosis in the solitary-nodule type of hepatocellular carcinoma: experience of 132 cases in our institute.

A retrospective analysis of clinical and pathological factors was performed on 132 surgical cases with solitary-nodule type HCC in our hospital. The overall cancer-free survival rates after 1, 3 and 5 years were 82.2%, 42.3% and 26.5%, respectively. With univariate analysis, the significant prognostic factors for survival were tumor size, cancer cell infiltration of the fibrous capsule of the tumor (fc-inf), invasion into portal vein (vp), and intrahepatic metastasis (im), while significant prognostic factors for non-recurrence were tumor size, fc-inf, vp, im, Edmondson-Steiner's classification and perioperative blood transfusion. With multivariate analysis for recurrence, significant factors were vp, clinical stage (CS), and perioperative blood transfusion. Therefore, prognostic factors for long-term survival in surgical cases of HCC are thought to be good hepatic function, absence of portal invasion, and avoidance of perioperative blood transfusion if possible.

Adult↗

PubMed1998

Indications for palliative reduction surgery for hepatocellular carcinoma with multiple intrahepatic metastases.

We evaluated the efficacy of and the indications for palliative reduction surgery as a procedure to improve the prognosis of hepatocellular carcinoma (HCC) patients with multiple intrahepatic metastases. From January 1986 to October 1997, 25 HCC patients with multiple intrahepatic metastases who underwent necessary palliative reduction surgery due to advanced disease, were participated in the study. The 1-, 3-, 5-year survival rates of 25 patients with reduction surgery were 54.7%, 29.9%, 22.4%, respectively. Moreover, the 1-, 3-, 5-year survival rates of patients with some postoperative supplemental treatment were 68.8%, 41.2% and 30.9%, respectively. All 6 patients who had been alive for more than 3 years had had primary tumors with diametric sizes of approximately 5 cm and had undergone, at most, one segmentectomy. These patients received postoperative supplemental treatments. The indication for palliative reduction surgery for HCC patients with multiple intrahepatic metastases was patients with a relatively small primary tumor (around 5 cm) which could be removed by one segmentectomy or less.

Aged↗

PubMed1998

Effect of the angiotensin-converting enzyme inhibitor enalapril on post-transplant erythrocytosis.

Post-transplant erythrocytosis (PTE) is increasingly recognized as a complication of kidney transplantation. In this study we report the effect of the angiotesin-converting enzyme (ACE) inhibitor enalapril on hematocrit (Ht) and erythropoietin in four patients with PTE. Four renal allograft recipients with Ht greater than 51% were studied. Treatment was initiated with enalapril administered orally at a dose of 2.5 mg/day. All the patients had an increase of hemoglobin (Hb) (17.7 +/- 0.64 g/dl), Ht (54.5 +/- 1.29%) and red blood cell count (RBC) (584 +/- 19.2 x 10(4)/microliter). All patients responded to enalapril in 8 weeks with a significant decrease of Hb, Ht, and RBC. In one patient, the downward trend was more rapid and sustained, and treatment had to be discontinued to prevent the development of anemia. Serum erythropoietin showed normal in all four patients and remained unchanged during the study, even after discontinuation of enalapril treatment. Serum creatinine remained relatively stable throughout the study. These results suggest that PTE may not be dependent upon circulating erythropoietin and that enalapril treatment may be an effective treatment of PTE without renal dysfunction.

Adult↗

PubMed1998

Thoracoscopic microwave coagulation therapy for hepatocellular carcinoma.

Thoracoscopic microwave coagulation therapy (MCT) is a new therapeutic approach for hepatocellular carcinoma (HCC) in segments VII and VIII, which allows minimal access to the tumor and complete tumor ablation. In this study, four patients with HCC in segments VII and VIII underwent thoracoscopic MCT as a less invasive therapeutic option due to advanced liver cirrhosis and/or severe complications. Tumor sizes ranged from 15 to 30 mm in diameter and the tumors were well differentiated in 2 patients, moderately in one and poorly in one patient. Microwave irradiation was performed at an 80 W output with a 60-sec duration via a thoracoscopic route and the total duration ranged from 4 to 24 min (mean: 17 min). Patients recovered rapidly to preoperative conditions and no mortality was occurred. Complications were observed in one patient, including pleural effusion and fever elevation, but were cured conservatively. Postoperative computed tomography (CT) showed complete tumor ablation with a cancer-free margin, which is thought to be equivalent to a limited hepatic resection. This preliminary study suggests that thoracoscopic MCT might be a new, less invasive option providing a cure for HCC in segments VII and VIII in patients with advanced liver cirrhosis and severe complications.

Aged↗

PubMed1998

[Carotid artery atherosclerosis in patients with myocardial infarction].

This study investigated carotid artery atherosclerosis in patients with myocardial infarction. One hundred and two patients with acute myocardial infarction [Group MI: male 86, female 16, mean 62 (range 43-79) years] and 55 normal subjects matched for age and sex with negative responses to exercise electrocardiogram testing (control group: Group C) were included. Patients in Group MI were divided into 3 subgroups according to coronary angiographic findings as follows: 57 patients with one-vessel disease (Group I: mean 59 years), 34 with 2-vessel disease (Group II: mean 64 years), and 11 with 3-vessel disease (Group III: mean 64 years). Intima-media complex thickness (IMT) of the bilateral common carotid arteries (15 mm proximal to the bifurcation) and the internal carotid arteries (15 mm distal to the bifurcation) were measured by high-resolution B-mode ultrasonography, and the sum of maximum IMT of the bilateral carotid arteries (sigma IMT) were calculated. sigma IMT was significantly greater in Group MI (2.5 +/- 0.5 mm) than in Group C (1.8 +/- 0.3 mm), sigma IMT was 2.5 +/- 0.5 in Group I, 2.6 +/- 0.5 in Group II, and 2.7 +/- 0.4 mm in Group III. There was a significant positive correlation between sigma IMT and the number of involved vessels (tau = 0.45, p < 0.01). The percentage of patients with carotid artery atherosclerosis was 2% in Group C, 63% in Group MI, 54% in Group I, 68% in Group II, and 82% in Group III (p < 0.001). This study suggests that carotid artery atherosclerosis in patients with myocardial infarction is frequently complicated and severe, and more frequently complicated in patients with severe coronary artery disease.

Adult↗