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Biomedical subjects

M Iida

Publications and source records attributed to M Iida.

At least 379 records · Page 21Linked to original sources

[Gallstone classification and analysis of their constituents].

Macroscopic classification of gallstones as proposed by the Japanese Society of Gastroenterology is based on the presence of characteristic structures on the cut surface. According to this classification, gallstones can be broadly divided into three types: cholesterol gallstones, pigment gallstones and rare gallstones. This classification is widely accepted in Japan because of its clinical applicability. A more accurate classification requires analysis of the constituents of gallstone. In particular, infrared absorption spectroscopy has been utilized for this purpose because it enables a rapid and easy analysis, requiring only small amounts of sample. In the selection of patients with gallstones for non-surgical treatment, such as ESWL and dissolution therapy, qualitative diagnosis is necessary. With this in mind, we have attempted to produce CT-Profile curves of individual gallstones, depicting changes in CT values assessed along cross-sectional lines passing from the center of the stone to their maximum diameters. This method allowed qualitative diagnosis almost of all gallstones.

Bilirubin↗

Large intra-abdominal desmoid tumors in a patient with familial adenomatosis coli: their rapid growth detected by computerized tomography.

A case of familial adenomatosis coli with large intra-abdominal desmoid tumors is described. The patient initially complained of an abdominal mass, which was diagnosed as a desmoid tumor after surgical resection. Further examinations revealed numerous polyps of the colon which were histologically diagnosed as adenomas. Despite intensive medical therapy, the desmoid tumors rapidly increased in size and number, and resulted in abscess and cavity formation that involved the ileum. Although desmoid tumors are classically benign in nature, we consider these tumors to be a therapeutic problem in patients with familial adenomatosis coli.

Abdominal Neoplasms↗

[The influence of pulmonary "venous" compliance on the static pulmonary compliance: a study of patients with left-sided heart disease with normal respiratory function].

In heart diseases, such as mitral stenosis and angina pectoris, the static pulmonary compliance has been reported to be decreased. By definition, the pulmonary "venous" system consists of the pulmonary veins and the left atrium. It plays an important role as the reservoir for the left ventricle. In this laboratory, the pulmonary "venous" compliance (Cp"v") has been evaluated as delta V/delta P of a short segment of the P"V" volume-pressure curve. To evaluate the influence of Cp"v" on the static pulmonary compliance and to speculate about the mechanisms of the reduction in static pulmonary compliance in left-sided heart disease, hemodynamic data and static pulmonary compliance (Cst) were measured in 27 patients with left-sided heart disease. Cst was measured with esophageal balloon technique in a sitting position. The static volume-pressure curve was fitted by a sigmoid model: V = Vm/(1 + e(A-P)/kappa), where kappa is a shape constant and an index of the lung stiffness. The pulmonary blood volume (PBV) was estimated with our own method, using radionuclide (RN) angiocardiography. The mean pulmonary artery wedge pressures (PAW) were measured using a floating catheter. Cp"v" was calculated as the delta V/delta P from the increment of pulmonary "venous" volume (delta V) and that of PAW (delta P) that occurred during passive elevation of the legs. Pulmonary arterial compliance (Cpa) was obtained from an analysis of the diastolic decline in pulmonary arterial pressure wave forms.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗

[The usefulness of three dimensional imaging of the myocardium using three heads SPECT camera (PRISM-3000)].

The SPECT unit using a 3 heads camera (PRISM-3000) has an advantage over the conventional one head camera SPECT unit because it can complete full circle scans (360 degrees scans) within a short time, and because the non-circular orbit of the camera heads fitting the individual form of the body has improved the spatial resolution. In addition, the high speed data processing has reduced the time for scan, enabling the three dimensional imaging system clinically applicable. In the present study, this modern technique was used to examined the myocardium in patients with ischemic heart disease so as to evaluate it for usefulness and depict problem to be solved. In patients with myocardial infarction, images obtained with a PRISM-3000 machine could provide more objective information on infarcts than conventional images. In patients with angina pectoris, delayed images obtained 3 hours after exercise by the new method were superior to conventional ones in power of demonstrating redistribution. The setting of the threshold for ischemic lesions at 40-50% hampers the assessment of the severity of ischemia. A new program should be introduced to solve this problem.

Aged↗

[The long-term follow-up study of Japanese patients with ulcerative colitis].

To elucidate the long-term outcome of the ulcerative colitis we analyzed 124 patients suffering for more than 10 years concerning the long-term prognosis, cumulative rate of colectomy, cumulative risk of cancer development and cumulative survival rate. Long-term prognosis were divided to three categories as good, fair and poor, according to present disease activities, social availability and subjective judgement. One hundred and twenty four patients were divided to 66 patients with good prognosis, 27 fair and 31 poor (2:1:1). The rate of patients having active disease at each year were followed-up annually for 10 years according to final three categories of the prognosis. The serial curve of annual rate of having active disease of the patients with poor prognosis was the highest, fair prognosis the second, good prognosis the lowest. The factors affecting the final prognosis were the period before initiation of proper treatment, the severity of the first attack or the elder age (> 40 year old) at the first attack. Twenty six patients were undergone colectomy in relation to ulcerative colitis. The cumulative colectomy rate was 16.5% at 10 years and 38.5% at 15 years after the onset. Malignant disease or severe dysplasia of the colon developed in 4 patients 10 to 14 years after the onset. Cumulative survival rate was equal to the expected survival curve during 16 years. The main causes of death were intracranial hemorrhage and colorectal malignant disease.

Adolescent↗

[The partial resection of lung with MULTIFIRE ENDO GIA 30 under the thoracoscopy].

MULTIFIRE ENDO GIA 30 was a newly auto suture developed by US surgical c.o., A 27-year-old man was admitted for right spontaneous pneumothorax in our hospital. We performed the partial resection of lung with this new auto suture under the thoracoscopy. Condition of patient after operation was very good, and he could discharge in short hospitalization. We concluded that this new auto suture was entirely reversible and safety.

Adult↗

Histologic follow-up of ampullary adenomas in patients with familial adenomatosis coli.

BACKGROUND: The major duodenal papilla is a common site of extracolonic adenoma in patients with familial adenomatosis coli (FAC). However, there have been no reports which have systematically discussed histologic change in atypia of ampullary adenomas with time by their location in the papilla. METHODS AND RESULTS: The major duodenal papillae of 23 patients with FAC were followed endoscopically and histologically for an average of 7.7 years (range, 1 year to 14 years 7 months). Tubular adenomas were detected histologically in 17 of the 23 patients at the first (14) or following examinations (3). They occurred in the orifice and/or ampulla in 11 patients and in the surface of the papilla in 8 patients. Three of the 11 orifice and/or ampulla adenomas contained moderate to severe atypia. There was no histologic change in atypia or malignant transformation during the follow-up period. CONCLUSIONS: In the patients with FAC, the major duodenal papilla had adenoma, i.e., precancerous lesion, at a high incidence (74%), and it is reported that the ampulla of the papilla tended to have extracolonic carcinoma. Therefore, it is necessary to follow duodenal papillae of patients with FAC carefully and take biopsy specimens repeatedly from various sites, especially from the orifice or ampulla even if the papilla seems to be normal.

Adenoma↗

Analysis of bone metastasis of prostatic adenocarcinoma in 137 autopsy cases.

Metastatic frequency to various organ sites in 137 autopsy cases with histologically confirmed prostatic adenocarcinoma was examined retrospectively. Bone lymph node metastases were observed in 81% and 82.5% of the cases, respectively. Lung and liver metastases were noted in 46.7% and 30.7% of the cases respectively. Statistical analysis of the inter-relation among metastases to the bones, lymph nodes, lungs and liver revealed that 83.2% of cases with lymph node metastasis also had bone metastasis. Sixty out of 64 cases with lung metastasis also presented with bone metastasis. There was a significant correlation of metastases between bones and lymph nodes, bones and lungs, and lymph nodes and lungs. Although approximately 88% of cases with liver metastasis also had bone metastasis, this relationship was not statistically significant. there was a statistically significant relationship between lung metastasis and specific sites of bone metastases, i.e. vertebrae, ribs, and sternum. Using the Cochran-Mantel-Haenszel statistical method, we found that the metastatic combination between lung and bone was significantly related in cases with or without lymph node metastasis. These observations suggest that the Batson's vertebral system might play an important role in the metastatic spread of prostatic adenocarcinoma either to the bones or lungs.

Adenocarcinoma↗

Radiographic features in ischemic jejunoileitis: serial changes and comparison with pathologic findings.

Serial radiographic examinations of the small intestine, including double-contrast studies, were performed in 13 patients with ischemic jejunoileitis, nine with the stricturing form and four with the transient form. Thumbprinting was observed in five (38%) patients and thickening of the folds in four (31%) at the acute stage of the disease. Tubular narrowing with irregular contours and dilated proximal bowel was observed in six (46%) patients and appeared on day 27 or later. Pathologic findings of the resected specimen in eight patients with the stricturing form revealed annular stricture with relatively shallow ulcers; the irregular contours of the tubular narrowing on radiographs were consistent with a granular or nodular appearance and/or multiple fissures on pathologic study. Eccentric deformity and sacculation were demonstrated in only one patient with the stricturing form. In addition, double-contrast study revealed small ulcers in three (23%) patients. Our results indicate that radiographic findings accurately reflect the clinical course and pathologic findings in this disease.

Adult↗

A comparative study of once-a-day morning and once-a-day bedtime administration of 40 mg famotidine in treating duodenal ulcers.

A randomized controlled study comparing once-a-day morning and once-a-day bedtime administration of 40 mg famotidine in treating duodenal ulcers was carried out in 99 Japanese patients. Endoscopic examinations were performed at the baseline and repeated at 3-week intervals until healing was confirmed. Eighty-two patients fulfilled the evaluation criteria (38 in the morning group and 44 in the bedtime group). In 13 of these patients the antisecretory effects of these regimens were also assessed by 24 h intragastric pH monitoring. The healing rates were 66% after 3 weeks and 95% after 6 weeks in the morning group, and 57% after 3 weeks and 80% after 6 weeks in the bedtime group. The differences were insignificant between the two groups, but there was a higher healing rate tendency after 6 weeks in the morning group (0.05 less than P less than 0.10). Regarding pain subsidence, there were no significant differences between the two groups. Both treatments were significantly superior to the control group in increasing 24 h intragastric pH. The morning regimen was significantly superior to the bedtime regimen in suppression of daytime acidity. On the contrary, the bedtime regimen was significantly superior to the morning regimen in suppression of nocturnal acidity. These findings suggest that suppression of nocturnal acidity is important but not essential to promote duodenal ulcer healing and suppression of daytime acidity is equally important. Thus, once-a-day morning administration of 40 mg famotidine seems to be at least as effective as once-a-day bedtime administration of 40 mg famotidine in treating duodenal ulcers.

Adult↗

Effect of rat CINC/gro, a member of the interleukin-8 family, on leukocytes in microcirculation of the rat mesentery.

Rat cytokine-induced neutrophil chemoattractant (CINC) is a member of the IL-8 family, and its human counterpart is gro/MGSA but not IL-8. We ascertained that chemically synthesized CINC was comparable to native CINC/gro with regard to chemotactic activity for rat neutrophils and studied the effect of synthesized CINC/gro on circulating leukocytes in microvascular vessels of rat mesentery. Exposure of rat mesentery to 10(-8)M authentic CINC/gro induced neutrophil adherence to and extravasation from postcapillary venules (PCVs) but not from capillaries or arterioles. CINC/gro concentrations as low as 10(-10) M were effective in causing neutrophil adherence. Neutrophils adhered to thin PCVs (mean diameter, approximately 25 microns) after exposure to CINC/gro for 15 min. The mean diameters of the PCV with adherence of neutrophils after exposure to CINC/gro for 30 and 60 min were 37 and 43 microns, respectively. The diameters of PCV with extravasation of neutrophils also increased in a time-dependent manner. The starting position of adherence of neutrophils was approximately 25-50 microns away from the upper junction of two vessels and remained virtually unchanged during exposure to CINC/gro for 60 min. However, the distance from the start to the end of neutrophil adherence increased in a time-dependent manner. The effect of CINC/gro on adherence and extravasation of leukocytes was neutrophil specific since other leukocytes such as lymphocytes and monocytes were not identified among the adherent and extravasated leukocytes.

Animals↗

Esophageal ulcer complicated by Reiter's syndrome. A case report.

A 40-year-old woman with Reiter's syndrome had low-grade fever, a psoriasislike eruption on feet and hands, and multiple esophageal ulcers. She had keratoderma blennorrhagica, aseptic vaginitis, and ileosacral arthritis, but no ocular lesions. The patient was HLA-B27 negative. Radiographic and endoscopic examinations of the upper gastrointestinal (GI) tract showed multiple round or irregularly shaped small ulcers in the middle and distal portion of the esophagus. One month later, all esophageal ulcers disappeared spontaneously. A case like this of Reiter's syndrome with esophageal involvement has not been reported before.

Adult↗

Inflammatory fibroid polyp of the stomach. Report of three unusual cases.

Three patients with inflammatory fibroid polyp (IFP) of the stomach underwent operation with a diagnosis of submucosal tumor, polyp, and intramural tumor of the stomach, respectively. Resected specimens grossly showed a deep ulcer accompanied by surrounding upheaval, a sausagelike polyp 6.5 cm long, and a pedunculated tumor with a short pedicle, respectively. Histologic examination showed that each lesion was typical of IFP of the stomach, with a mixture of fibroblasts and thin-walled blood vessels, and further by an intense infiltrate of eosinophils. These cases indicate that IFP of the stomach can vary in gross appearance. Practitioners and pathologists must remember that not only a polypoid lesion, but also a pedunculated or even ulcerated lesion, in the gastric antrum may be IFP.

Adult↗

Level of neutrophil chemotactic factor CINC/gro, a member of the interleukin-8 family, associated with lipopolysaccharide-induced inflammation in rats.

Rat cytokine-induced neutrophil chemoattractant (CINC), which is a counterpart of human gro and belongs to the interleukin-8 family, has been quantified by a new sandwich enzyme-linked immunosorbent assay. Administration of lipopolysaccharide (LPS) into an air pouch performed by subcutaneous injection of air caused inflammation and severe neutrophil infiltration. After the LPS injection, changes in the concentration of CINC/gro, chemotactic activity, and the number of neutrophils in the air pouch exudate were determined. The chemotactic activity of neutrophils was augmented before practical neutrophil infiltration. More than half of the chemotactic activity was neutralized by the antisera. The time kinetics of the level of CINC/gro coincided with the changes in chemotactic activity. The maximal level of rat CINC/gro was 85 ng/ml, which is sufficient to cause neutrophil migration in vitro and in vivo as described previously. These data suggest that rat CINC/gro is a functional chemoattractant for neutrophils in LPS-induced inflammation in rats.

Animals↗

Anisakiasis of the colon: radiologic and endoscopic features in six patients.

The radiologic and endoscopic findings in six patients with anisakiasis of the colon were analyzed. The diagnosis was based on the demonstration of Anisakis larvae at radiography or on elevated serum levels of antibodies to this parasite. All patients reported abdominal symptoms 12-23 hours after the ingestion of raw fish. Double-contrast barium enema examination, performed 2-4 days after the onset of syptoms in all the patients, revealed that the right side of the colon was frequently affected by edema, which was radiographically demonstrated as luminal narrowing and thumbprinting. In addition, the worm was shown at radiography in four patients. Colonoscopy, performed 1-7 days after the onset of symptoms, revealed edematous mucosa, characterized by narrowing and multiple smooth and round protrusions, in all four of the patients studied, but it failed to demonstrate the worm in any patient. The authors believe that the demonstration of these features, together with a history of raw fish ingestion, is essential for the diagnosis of this disorder.

Adult↗

Salmonella colitis: assessment with double-contrast barium enema examination in seven patients.

To completely rule out the possibility of ulcerative colitis, Crohn disease, and other diseases, the authors analyzed the radiographic findings at double-contrast barium enema examination performed in seven patients with colitis caused by Salmonella organisms. In all patients, bacteriologic confirmation of nontyphoid Salmonella infection and radiographs of the upper gastrointestinal tract were obtained. Total colonoscopy was performed in five patients and sigmoidoscopy in one patient. In all patients, the radiographic findings were retrospectively analyzed. The descending colon and sigmoid colon were affected in six patients, whereas the rectum was affected in none. The findings included fine mucosal granularity (seven patients), loss of haustration (six patients), many fine ulcerations (five patients), and multiple ulcers (two patients). The radiographic features simulated those of ulcerative colitis, except for absence of rectal abnormality. It is concluded that double-contrast barium enema examination is useful for detection of fine mucosal changes.

Adolescent↗

Giant air cell of the petrous apex: a possible cause of facial hypalgesia.

A giant air cell of the left petrous apex was found in a 23-year-old man with ipsilateral facial hypalgesia. The size of the giant air cell depicted on computed tomography was 1.5 x 2.0 x 2.0 cm. A coronal T1-weighted magnetic resonance image showed that the trigeminal nerve was compressed superomedially by a large signal void area that was probably a result of excessive pneumatization of the petrous apex. It is suggested that the facial hypalgesia was caused by the compression by the giant air cell of the petrous apex on the trigeminal nerve.

Adult↗

[Clinical and microbiological study of factors determining effective scaling and root planing].

The aim of the present study was to monitor longitudinally the clinical and microbiological parameters after root debridement in order to determine the factors affecting successful and unsuccessful results. Nine patients with moderate and severe periodontitis participated. Four sites of single root with over 5-mm periodontal pockets in each quadrant were selected. The oral hygiene was controlled in all patients, then root debridement was performed without anesthesia at the three sites of the quadrants every two weeks during eight weeks. The clinical parameters consisted of plaque index, gingival index, probing depth, clinical attachment level, bleeding on probing, tooth mobility and the value of gingival crevicular fluid (GCF). The microbiological parameters such as percentages of cocci, motile rods, non-motile rods and spirochetes and the number of microorganisms were examined and the percentages of black pigmented Bacteroides (BPB) and Actinobacillus actinomycetemcomitans as well as the number of anaerobic colonies were counted. The results demonstrated that a reduction in the probing depth was observed in all sites except four. The successful sites clinically showed a decrease of the probing depth and GCF value and, microbiologically, reduced percentages of the spirochetes and BPB. The results indicated that the decrease of the probing depth and GCF under 50 Periotoron units in coincidence with the bacterial reduction can be used to determine the successful response of root debridement.

Adult↗