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Biomedical subjects

M Iida

Publications and source records attributed to M Iida.

At least 433 records · Page 24Linked to original sources

The value of double-contrast study of the small intestine in immunoproliferative small intestinal disease.

Radiological findings of 2 patients with immunoproliferative small intestinal disease were studied. One of the cases was associated with alpha-chain disease. Both patients complained of severe diarrhea, and diagnosis was made by endoscopic biopsy of the duodenum and jejunum. Double-contrast studies of the small intestine and hypotonic duodenographies in these patients revealed thickened folds and innumerable fine granular elevations without ulcerations or luminal narrowings. Double-contrast studies are one of the most important examinations in the diagnosis of this disorder.

Adult↗

Barium meal study for amyloidosis of the small intestine: measurements on radiograph.

In order to determine barium meal radiographic findings characteristic of amyloidosis, we measured the jejunal diameter, valvular width, and intervalvular distance in 25 patients with small bowel amyloidosis and in 30 control individuals, and compared the two groups with each other. As a result, jejunal diameter demonstrated no difference between amyloidosis cases and controls, while there was a significant difference in valvular width or intervalvular distance between the two groups. Our results indicate that objective estimates of the thickening of the valvulae and the shortening of the intervalvular distance by means of measurements of the given roentgenograms greatly contribute to the clinical diagnosis of this disease.

Adult↗

Ultrasonic and CT findings in penicillin-induced nonpseudomembranous colitis.

The findings of ultrasonography (US) and computed tomography (CT) of the abdomen in two cases of nonpseudomembranous colitis (NPMC) induced by penicillin are described. Both imaging methods revealed diffuse thickening of the colon in patients who were endoscopically diagnosed as suffering from this disease. The clinical and radiographic features of this entity are presented along with a brief review of pertinent literature.

Adult↗

Radiographic demonstration of longitudinal ulcers in patients with ulcerative colitis.

During the past 10 years, 122 patients with ulcerative colitis were diagnosed by double-contrast barium enema and colonofiberscopy with endoscopic biopsy. Among them, five patients (4%) had longitudinal ulcers and eccentric deformities in the colon. Other radiologic findings included thumbprinting (two cases), sacculations (two cases), and inflammatory polyps (four cases). The possibility of the concomitance of ischemic colitis in cases of ulcerative colitis is discussed, due to their radiographic similarities.

Adult↗

Aberrant expression of immunoglobulin light chain isotype in B lymphocytes from patients with monoclonal gammopathies: isotypic discordance and clonal B-cell excess.

A study was made of 29 patients with monoclonal gammopathies to detect aberrations in immunoglobulin (Ig) light chain isotype expression in lymphocytes at various levels of B-cell differentiation, namely, circulating surface Ig positive (SIg+) cells, Ig-secreting cells (plaque forming cells, PFC) and mitogen-induced PFC. By using kappa-lambda analysis, two major phenotypes of aberrant Ig light chain isotype expression were found in circulating B cells at these three levels of differentiation: an absolute increase in B cells bearing the same Ig light chain isotype as that of monoclonal protein (clonal B-cell excess), and a relative decrease in those B cells (isotypic discordance). Isotypic discordance (ID) was found to be essentially negative in patients with monoclonal gammopathy of undetermined significance (MGUS) provided that they were in a stable condition. In myeloma patients, ID was found only in stage I, except for a remission case of stage III (4/7 in stage I, 0/8 in stage II, and 1/6 in stage III). ID was not restricted to a circulating SIg+ cell level but was also demonstrable at a spontaneous or pokeweed mitogen-induced PFC level. However, ID was negative at a PFC level induced by Staphylococcus aureus Cowan I. Clonal B-cell excess (CE) was frequently found in patients with active myeloma but not in stable patients (0/8 in MGUS, 1/7 in stage I, 8/8 in stage II, and 4/6 in stage III). CE was positive not only at a circulating SIg+ cell level but also at a circulating PFC level. Furthermore, patients with CE at a PFC level were found to have a higher proliferating capacity, defined as a percentage labelling index of marrow myeloma cells, than those without CE at a PFC level (P less than 0.02). ID and CE can therefore be considered as useful markers for discriminating between MGUS and myeloma, evaluating the clinical stability and predicting the clinical course.

Antibody-Producing Cells↗

Prognosis and disability of stroke patients after 5 years in Akita, Japan.

The system of registering stroke patients was begun in 1963 in Ikawa Town, Akita Prefecture, Japan. The town is located in the northeastern part of the country and in 1975 had a population of 6,427. From 1975 to 1981, 109 patients who suffered their first stroke were registered and were monitored for 5 years. The average annual incidence rates of stroke were 2.8 and 2.0 per 1,000 population in males and females, respectively. Mean age at stroke onset was 63.3 and 71.4 years in males and females, respectively (p less than 0.01). According to the clinical classification of stroke, 76 patients suffered cerebral infarction, 21 cerebral bleeding, and six subarachnoid hemorrhage; six strokes were unclassified. The survival rates were compared by sex, age, and clinical stroke type using Cox's proportional hazards model. The survival rate of female stroke patients was lower than that of males, but not significantly so. The survival rate of stroke patients greater than or equal to 65 years old was significantly lower (p less than 0.01) than that of younger patients. Moreover, the survival rate of patients with cerebral bleeding was significantly lower (p less than 0.01) than that of patients with cerebral infarction. In the analysis of self-care among the survivors, performance of the activities of daily living in older patients indicated significantly less independence (p less than 0.01) in younger patients. Follow-up of new stroke cases showed that age and clinical stroke type were significantly associated with survival and that age was also related to disability of the survivors.

Activities of Daily Living↗

Trends for coronary heart disease and its risk factors in Japan: epidemiologic and pathologic studies.

Epidemiologic and pathologic studies were conducted between 1965 and 1986 to investigate trends for the incidence of coronary heart disease (CHD) and its risk factors in urban and rural populations and to relate the risk factor changes to trends for CHD incidence and pathologic findings. The epidemiologic study included men aged 40-59 years who urban residents of Osaka, clerical and manual workers in Osaka, and rural residents of Akita prefecture. The pathologic study subjects were autopsied men aged 30 and over, admitted to a local hospital in Akita, whose autopsy rate was 88%. From a cohort of 8,835 urban employees between 1975 and 1987, risk factors for myocardial infarction were identified: blood pressure, total serum cholesterol, blood glucose and cigarette smoking all which were compatible with findings in the US and European countries. For rural residents, serum cholesterol was less likely to be associated with the CHD incidence. Little contribution of serum cholesterol to development of coronary heart disease in rural men was supported by the pathologic study showing no significant association between serum cholesterol and the coronary atherosclerosis. Myocardial infarction from urban patients was characterized as massive necrosis in the myocardium with coronary artery stenosis and minimum atherosclerosis of basal cerebral arteries while that from rural men was small scattered necrosis in myocardium with atherosclerosis in both coronary and basal cerebral arteries. There was an increasing trend in the incidence of myocardial infarction in urban men but no change in rural men. The difference in the incidence trend can be attributed in part to differences in pathologic etiology and in blood pressure and serum cholesterol levels. Systematic surveillance is underway in both urban and rural population to clarify future trends for coronary heart disease and its risk factors.

Adult↗

Lipid metabolism in acromegalic patients before and after selective pituitary adenomectomy.

Lipid metabolism was studied in 16 acromegalic patients who all underwent transsphenoidal selective pituitary adenomectomy (SPA). Before the operation, their serum lipid levels correlated with none of the basal levels of serum growth hormone (GH), basal levels of plasma somatomedin-C (SM-C), fasting levels of plasma glucose (FPG), peak levels of plasma glucose (PGp) or basal and peak levels of serum immunoreactive insulin (IRIb and IRIp, resp.) in the oral glucose tolerance test (OGTT), and obesity indices. The serum GH levels as well as plasma SM-C levels in the group with decreased serum high density lipoprotein-cholesterol (HDL-C) differed greatly from those of the normal HDL-C group. However, there was no significant difference in either serum GH or plasma SM-C between groups with and without metabolic abnormality of any other lipid examined. After the operation, the basal levels of serum GH and plasma SM-C decreased significantly. In conjunction with these changes, PGp, serum IRIb, serum triglyceride (TG), non-esterified fatty acid (NEFA) and very low density lipoprotein (VLDL) decreased significantly. In contrast, serum HDL-C increased significantly. However, FPG, serum IRIp, obesity indices, serum total cholesterol (TC) and serum low density lipoprotein (LDL) showed no significant change. There were no significant differences in the levels of any serum lipid either before or after surgery among the diabetic, borderline and normal types defined by the preoperative OGTT patterns. Atherogenic indices (AIs) decreased significantly and returned to normal postoperatively. These results suggest that obesity or secondary diabetes is not a direct cause of hyperlipidemia in acromegaly. The prognosis of acromegaly is affected by arteriosclerotic complications. It is intriguing, therefore, that AIs were normalized by transsphenoidal SPA. Being rather a safe procedure, it can be performed without hesitation, aside from a conservative treatment.

Acromegaly↗

Risk of gastric cancer in patients with non-surgically treated peptic ulcer.

We followed up 2072 patients with unoperated gastric and duodenal ulcer, diagnosed from 1963 to 1975, and evaluated the risk of development of gastric cancer. During the follow-up period of 9-23 years 38 patients had a gastric cancer or died of gastric cancer. The number of gastric cancers in patients with duodenal ulcer (observed/expected = 3:12) was statistically low (p less than 0.01) compared with the number expected from the sex- and age-matched general population. On the other hand, the number of patients with gastric ulcer and the number of those with both gastric and duodenal ulcers was 29 and 6, neither of which differed significantly from the expected occurrence. These results suggest that in peptic ulcer patients the risk of developing gastric cancer is equal to or low compared with that of the general population.

Adolescent↗

[Evaluation of thrombus scintigraphy using 67Ga-deferoxamine-dialdehydestarch-fibrinogen in patients with internal A-V shunt].

We evaluated the diagnosis of thrombus and the effect of antithrombic therapy by using 67Ga-DFO-DAS-Fibrinogen (67Ga-Fbg.) scintigraphy in vivo. The 11 patients with chronic renal failure had the operation of the internal A-V shunt. The two groups were divided the group I (the patients were injected 67Ga-Fbg. within 5 days after the operation of A-V shunt) from the group II (the patients were injected 67Ga-Fbg. from 7 months to 6 years after A-V shunt). We examined 72 h after the injection of 67Ga-Fbg. in all patients. In group I, the scintigraphy showed the deposition of 67Ga-Fbg. in all 5 patients, but 3 patients were given dipyridamole (75-300 mg). The scintigraphy examined 3 weeks after A-V shunt were negative in 2 patients in group I. In group II, the scintigraphy showed the deposition of 67Ga-Fbg. in the two of 6 patients. Within 5 day after A-V shunt, we observed there was the tendency of the thrombus formation. The scintigraphy of 67Ga-Fbg. was useful for the detection of thrombus in vivo.

Adolescent↗

[Pentose phosphate pathway in neuromuscular diseases--evaluation of muscular glucose 6-phosphate dehydrogenase activity and RNA content].

There have been several reports concerning elevated glucose 6 phosphate dehydrogenase (G6PDH), the rate-limiting enzyme of pentose phosphate pathway (PPP), in experimental muscle disturbances. PPP produces ribose, a substrate of RNA, and NADPH which is a cofactor of fatty acid synthesis. PPP also has a role of by-path pathway of glycolysis. Then, we evaluated G6PDH activity and RNA content in biopsied quadriceps muscle. The subjects were muscles from 23 neurogenic amyotrophy, 54 myopathy including 19 progressive muscular dystrophy (PMD), and 10 controls whose muscle was obtained at orthopedic surgery. Neurogenic amyotrophy consisted of 12 amyotrophic lateral sclerosis (ALS), 4 spinal muscular atrophy and 7 peripheral nerve disorders. Myopathy were 3 Duchenne dystrophy, 2 congenital muscular dystrophy, 8 limb-girdle type dystrophy, 6 facio-scapular +-humeral muscular dystrophy, 6 myotonic dystrophy, 6 mitochondrial myopathy, 5 endocrinological myopathy, 3 hypokalemic myopathy, 8 polymyositis and 4 other inflammatory myopathy. The assays of G6PDH and RNA were performed after Glock's and Fleck's methods, respectively. The control values were 3.6 +/- 0.8 nmol formed NADPH/mg protein/min (M +/- SD) in G6PDH and 0.69 +/- 0.17 micrograms/mg non-collagen protein in RNA. Most cases of PMD, as well as some cases of ALS, hyperthyroidism, mitochondria hypokalemic myopathy, inflammatory myopathy showed increased values (beyond M + 2SD of control) both in G6PDH and RNA. There were significant positive correlations between G6PDH activity and RNA content in PMD and motor neuron disease. Myotonic dystrophy showed normal values in both G6PDH and RNA. Half number of cases of mitochondrial myopathy demonstrated increased G6PDH alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Measurement of gamma-interferon in sera and CSF in patients with multiple sclerosis and inflammatory neurological diseases].

We examined whether gamma-interferon (gamma-IFN) can be detected in serum and CSF of patients with multiple sclerosis and other inflammatory neurological diseases. Gamma-IFN was assayed by solid phase radioimmunoassay on the forward sandwich principle. In 7 serum samples in acute stage of multiple sclerosis without corticosteroid, in 2 CSF samples in acute stage, gamma-IFN was not detected. In stable stage there was no case with positive gamma-IFN. The patient with tuberculous meningitis showed high titer in CSF but not in serum. One case with herpes zoster meningitis, one case out of 2 aseptic encephalitis showed positive gamma-IFN in CSF. In one case with Vogt-Koyanagi-Harada disease, gamma-IFN was detected both in serum and CSF. One case with Neuro-Behçet syndrome showed positive gamma-IFN in CSF. No gamma-IFN was detected in 2 cases with Guillain-Barré syndrome, one case with Crow-Fukase syndrome, Fisher syndrome, 2 cases with polymyosits. gamma-IFN in CSF was detected in meningitis and encephalitis, but not in serum. This suggests that the locally infiltrating cells produce gamma-IFN. However, we could not detect gamma-IFN in either CSF or serum of patients with multiple sclerosis. Negative results of gamma-IFN in patients with multiple sclerosis can be interpreted in 2 ways. 1. The half life of gamma-IFN is very short in vivo, and the level of gamma-IFN may not be detected at the time of sampling. 2. Generalized augmentation of gamma-IFN production may not be observed but locally infiltrating cells or astrocytes might produce gamma-IFN.(ABSTRACT TRUNCATED AT 250 WORDS)

Behcet Syndrome↗

The value of push-type jejunal endoscopy in familial adenomatosis coli/Gardner's syndrome.

Push-type jejunal endoscopy using a long forward-viewing duodenofiberscope was performed in 10 patients with familial adenomatosis coli/Gardner's syndrome. Jejunal polypoid lesions were detected in nine of the 10 patients (90%). The lesions appeared sessile, whitish, and measured 3 mm or less in diameter. Histologic findings of the biopsy specimens from these polypoid lesions revealed tubular adenoma in all nine patients. In addition, this method led to the detection of duodenal adenomas in one patient, in whom duodenofiberscopy with the side-viewing instrument revealed no polypoid lesions in the bulb and second portion of the duodenum. In view of these results, we recommend that push-type jejunal endoscopy, as well as side-viewing duodenofiberscopy, should be added to the usual preoperative examinations done in patients with this disease.

Adenoma↗

[A case of thymolipoma on the cervicomediastinal area].

Thymolipoma is a very rare mediastinal tumor. We reported a case of 52-year-old female with thymolipoma which was located in the cervicomediastinal area. The chest X-ray film revealed an abnormal shadow in the superior mediastinum. Computed Tomography (CT) clearly showed the existence of a large mass in the left side of the trachea. The angiogram showed that there was a stenosis on the left brachiocephalic vein. On June 13, 1988, median sternotomy was performed. A large tumor, about 5.5 x 13 x 5.5 cm, was found arising from the left cervical area. This tumor was excised completely and thymolipoma was diagnosed histopathologically. The post-operative course was very satisfactory.

Female↗

Granular cell tumor of the esophagus: endoscopic ultrasonographic demonstration and endoscopic removal.

A 35-yr-old Japanese man with a granular cell tumor of the esophagus that was removed by endoscopic polypectomy is presented. Radiography and endoscopy showed a 20 x 12 mm sessile protrusion in the distal esophagus. Endoscopic ultrasonography demonstrated the hypoechoic mass in the submucosa without continuity to the muscularis propria. The lesion was successfully treated by endoscopic polypectomy without complications. The cross-sections of the resected specimen were quite in agreement with the ultrasonographic findings. Endoscopic ultrasonography is valuable to assess the exact location and extent of the tumor, and to determine the indication for endoscopic polypectomy.

Adult↗