Biomedical subjects

M Iwasa

Publications and source records attributed to M Iwasa.

At least 55 records · Page 3Linked to original sources

PubMed1996

Detection of toluene in an adipoceratous body.

A 24-year-old male was found dead in a car left in a river for about 3 months. The cadaver was almost adipoceratous and autopsy findings revealed that there were neither remarkable injuries nor lethal diseases. Toluene, ethanol, 1-propanol, 2-propanol, 1-butanol, dimethyl sulfide, dimethyl disulfide, isovaleraldehyde and n-butyl n-butyrate were detected in the specimens collected at the autopsy by head space gas chromatography/mass spectrometry (GC/MS). The toluene concentrations (micrograms/g) were 31.0 in brain, 10.6 in liver, 5.4 in kidney, 15.0 in skeletal muscle and 187.1 in adipose tissue. The presence of diatom in lung, liver and kidney suggested that death was caused by drowning. So far as we know, this is the first report of detection of toluene in an adipoceratous body.

Adipose Tissue↗

PubMed1996

Induction of apoptotic cell death in rat thymus and spleen after a bolus injection of methamphetamine.

We examined whether methamphetamine (MAP) induced apoptotic cell death in vivo. Male Wistar rats were injected intraperitoneally with 25 mg MAP/Kg body weight and were sacrifice at 4, 8 and 24 h. As early as 4 h after a single dose of MAP, DNA ladder bands representing DNA fragmentation into multiples of the internucleosomal DNA length of about 180 by were observed by gel electrophoresis in thymic and splenic DNA. DNA from control rats injected with 1 ml physiological saline/Kg body weight showed no ladder band patterns. The proportion of fragmented DNA from the thymus increased in a time-dependent manner up to 8 h and faint ladder band patterns were observed at 24 h, indicating that cell death via apoptosis occurred at an early stage and then apoptotic bodies were scavenged. DNA fragmentation in the thymus and spleen induced with MAP was also confirmed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method in situ. In control thymus samples, stained cells were numerous in the cortex but sparse in the medulla. At the boundary area between the cortex and medulla, stained cells were seen as a layer. In the MAP-treated rats, stained cells were increased and dispersed equally in the cortex and medulla. In control spleen samples, stained cells were numerous in all areas excluding the germinal centers. Cells at the germinal centers were stained intensively in MAP-treated rat spleen. Light microscopical analyses allowed us to identify lymphocytes during the course of apoptotic cell death. Electron microscopic studies showed morphological landmarks for the process of cellular apoptosis in both organs e.g. lymphocytes with chromatin condensed into crescents at the periphery of the nuclei and apoptotic bodies. These result indicate that MAP induced cell death of the thymic and splenic lymphocytes via apoptosis.

Animals↗

PubMed1996

Solitary pancreatic metastasis occurring eight years after nephrectomy for renal cell carcinoma. A case report and surgical review.

CONCLUSION: Pancreatic metastasis from renal cell carcinoma is extremely rare. The average time between nephrectomy and the diagnosis of metachronous metastases is reported to exceed 10 yr. Therefore, the initial diagnosis may be neglected in the cases of prolonged disease-free interval. When it does occur simultaneously or metachronously, aggressive surgical resection, when possible, seems to be the most effective treatment for this metastatic lesion. BACKGROUND: An 81-yr-old female patient, who 8 yr previously had undergone right radical nephrectomy for renal cell carcinoma, presented with solitary pancreatic metastasis, which was successfully treated with a distal pancreatectomy. Only 66 cases of clinically diagnosed renal cell carcinoma metastatic to the pancreas are reported in the world literature and 49 of the patients (including ours) underwent a definitive surgical resection. Our case, treated by distal pancreatectomy, and a review of the relevant literature including all reported cases of renal cell carcinoma metastatic to the pancreas, are presented. RESULTS: The patient was well without any evidence of recurrence at 22 mo after the operation.

Aged↗

PubMed1996

Secondary carnitine palmitoyltransferase deficiency in chronic renal failure and secondary hyperparathyroidism.

A 14-year-old girl, having mental and growth retardation with end stage renal disease, was affected by a stroke-like attack. The attack was associated with transient low density areas at both sides of the parietal portion on head CT. Lactic acidosis, hypertrophic cardiomyopathy, angina pectoris-like attacks, hypertension and hyperparathyroidism were also observed and they were supposedly due to mitochondrial cytopathy. No morphological or biochemical abnormalities were found on the mitochondrial respiratory chain. However, muscle carnitine palmitoyltransferase (CPT) activity was significantly low, which was restored to a normal level after hyperparathyroidism was controlled by alphacalcidol administration. Furthermore, we also found two more chronic renal failure patients with secondary hyperparathyroidism, as well as the primary hyperparathyroidism patient showing markedly low muscle CPT activity. These findings suggest the possible contribution of parathyroid hormone to lipid metabolism in skeletal muscle and to the myopathic manifestations often seen in hyperparathyroidism.

Adolescent↗

PubMed1995

Malignant melanoma with mesenteric metastasis causing an intrapelvic abscess: report of a case.

We present herein the case of a 66-year-old woman with disseminated malignant melanoma in whom a metastasis in the ileal mesentery ruptured into the peritoneal cavity causing an acute abdomen. The patient suddenly developed lower abdominal pain and a computed tomography (CT) scan of the pelvis confirmed the presence of an intrapelvic abscess. At emergency laparotomy, a 10 x 10 cm ruptured metastatic melanoma was found in the ileal mesentery, which demonstrated no communication with the ileum itself. To our knowledge, no other case of an acute abdomen being caused by the rupture of mesenteric metastatic melanoma lacking any communication with the bowel lumen has ever been reported.

Abdomen, Acute↗

PubMed1995

[One-stage repair of interrupted aortic arch with ventricular septal defect].

Three neonates with type A interrupted aortic arch were successfully repaired through a median sternotomy incision during profound hypothermia and circulatory arrest in the past one year. Two aortic cannulas, a small plastic one (Cardicorp) in the ascending aorta and a long one inserted through the pulmonary artery and patent ductus arteriosus into the descending aorta. Two Pacifico's venous cannulas were inserted into superior and inferior vena cavae respectively. No dissection and encircling were required around three major branches from the aortic arch and both right and left pulmonary arteries. During a cooling phase a large ventricular septal defect was closed followed by circulatory arrest. It was possible to resect a patent ductus arteriosus and mobilize the descending thoracic aorta for anastomosis to the side of the ascending aorta without removal of the aortic cannula in the aorta. New instruments and development of cardiopulmonary bypass could bring a successful one-stage repair of interrupted aortic arch with ventricular septal defect more safely and easily than before.

Aorta, Thoracic↗

PubMed1995

Single photon emission computed tomography to determine effective hepatic blood flow and intrahepatic shunting.

The noninvasive determination of effective hepatic blood flow, intrahepatic shunted blood flow, intrahepatic shunt index, and total hepatic blood flow was investigated by using the sequential single photon emission computed tomography. This method was performed for a period of 10 minutes following an intravenous injection of 99mTc-(Sn)-N-pyridoxyl-5-methyltryptophan and a venous blood sampling. This study comprised 8 healthy volunteers, 16 patients with chronic hepatitis, and 33 patients with liver cirrhosis. The intrahepatic shunt index measured with this method coincided with the intrahepatic shunt index determined by catheterization, indicating the high reliability of this procedure. The effective hepatic blood flow in patients with liver cirrhosis was significantly lower than that in the healthy controls and the chronic hepatitis group. The intrahepatic shunted blood flow was significantly higher in patients with liver cirrhosis compared with the flow in healthy controls. The intrahepatic shunt index was also significantly higher in patients with liver cirrhosis compared with the index of healthy controls and those with chronic hepatitis. No substantial differences were noted in the total hepatic blood flow among the three groups. The effective hepatic blood flow, the intrahepatic shunted blood flow, and the intrahepatic shunt index, correlated with the serum albumin concentration, the serum cholinesterase level, and the plasma indocyanine green attenuation rate. From these results, it was concluded that the present procedure constitutes a reliable and effective method for the noninvasive determination of hepatic blood flows. Consequently, it will be of high clinical value for assessing the functional and the pathological alterations of the liver.

Adult↗

PubMed1994

Prolonged occurrence of Moraxella bovis infection on a restricted heifer farm.

An epizootiologic study was conducted for infectious bovine keratoconjunctivitis (IBK) on a large grassland farm rearing a total of 1,300-1,400 heifers during May to October in both 1991 and 1992. Heifers were examined for infection with Moraxella bovis, and isolation of M. bovis from the affected eyes and from Asian face flies (Musca bezzii Patton et Cragg) swarming on the heifer face was carried out. During the observation period, 10.7% of the heifers in 1991 and 5.3% of the heifers in 1992 were affected with IBK. Eight M. bovis isolates were isolated from the ocular swabs of affected heifers with IBK for 2 years and identified by biochemical examinations and Southern DNA-DNA hybridization, but no M. bovis was obtained from 331 Asian face flies tested. Plasmid profile analysis showed that two plasmids (35-kb and 4.0-kb) were commonly found in all 8 M. bovis isolates. This indicates that M. bovis isolates with the same plasmid profile were widely disseminated on this farm for 2 years.

Animals↗

PubMed1994

[Repair of total anomalous pulmonary venous connection in asplenia syndrome without cardiopulmonary bypass].

Two infants with asplenia syndrome underwent repair of total anomalous pulmonary venous connection (TAPVC) without cardiopulmonary bypass (CPB). Both patients had other complex cardiac anomalies; pulmonary atresia, univentricular heart, etc. The first patient previously received a left modified Blalock-Taussig shunt. The common chamber (pulmonary venous confluence) was anastomosed to the right side atrium using a side-biting clamp. Though both patients had good postoperative course immediately after surgery, they subsequently died 43 days and 4 months after surgery, respectively. We conclude that relief of TAPVC can be accomplished without CPB and allowing easier and simpler postoperative care.

Abnormalities, Multiple↗

PubMed1994

[Operative indications and treatment in elderly patients with esophageal cancer].

A recent study indicates that infection of human papillomavirus (HPV) may cause esophageal cancer and that it takes several decades from infection of HPV to developing cancer. Even in early stage esophageal cancer, lymph node metastasis is usually observed in the mediastinum, abdomen and neck regions. As patients with esophageal cancer are potentially in a malnutritional state because of disturbance of intake before treatment, active nutritional support should be performed before and after surgery. An objective nutritional assessment is necessary for nutritional support. The nutritional assessment index (NAI) can be applied to elderly patients because there is no difference in nutritional parameters between elderly and young patients. From the point of view that surgical treatment has limitations concerning complete curability, we employed a remote after loading system (RALS) into a multidisciplinary treatment called the Kochi system, which consists of a combination of surgery, radiation therapy and chemotherapy. This multidisciplinary method of treatment greatly contributes to survival and quality of life of esophageal cancer patients especially in elderly cases.

Aged↗

PubMed1993

A case report of gastric cancer associated with sarcoid reactions in the regional lymph nodes and liver.

Epithelioid cell granulomas identical to those of systemic sarcoidosis are occasionally observed within malignant neoplasms, particularly in the lymphatics draining a primary tumor. These histologic changes have been termed sarcoid reactions and are easily confused with systemic sarcoidosis. This report describes an extremely rare case of gastric cancer accompanied by sarcoid reactions in the regional lymph nodes and liver parenchyma near a tumor metastasis. A 63-year-old woman with advanced gastric cancer was treated by subtotal gastrectomy with dissection of the regional lymph nodes and local excision of the liver tissue involved by metastasis. Microscopic examination of the resected lymph nodes and liver disclosed the presence of sarcoid-like granulomas. The absence of any clinical manifestations and the negative results of the Kveim test, chest radiograph, and laboratory tests, including that for the serum angiotensin converting enzyme excluded the possibility of systemic sarcoidosis. The presence of a sarcoid reaction in the liver parenchyma adjacent to a metastasis has never been reported previously.

Adenocarcinoma↗

PubMed1993

Estimation of local vital reactions in severely burned tissues of guinea pig skin using C3a or C3a desArg as a marker.

We observed changes in levels of anaphylatoxin C3a and/or its desArg (C3a/C3a desArg) peptides in the local site of severely burned skin tissues of guinea pigs using immuno-Western blotting methods. The C3a/C3a desArg peptides, which were probably generated during complement activation, were detected at significant levels from 30 min to 72 h following burn injury in an area limited to 3 mm from the wound edge. Levels of these peptides showed a tendency to be highest in that area 24 h after burn infliction. In postmortem injuries, C3a/C3a desArg peptides could not be detected. These peptides were detected in antemortem wounds up to at least 2 days at 22 degrees C and up to 3 days at 4 degrees C after death, although decreases in levels were found. Lower concentrations of these peptides were also found in postmortem burns in which postmortem hypostasis appeared strongly. These results suggest that, except for injuries of the area with obvious postmortem hypostasis, detection of C3a/C3a desArg can be useful for estimation of vital reactions in many kinds of wounds during inflammation.

Animals↗

PubMed1992

HTLV-I infection in patients with autoimmune thyroiditis (Hashimoto's thyroiditis).

To investigate the possible relationship of HTLV-I virus infection to autoimmune thyroid disease, we examined, firstly, the frequency of HTLV-I seropositivity among patients with Hashimoto's thyroiditis and, secondly, the frequency of Hashimoto's thyroiditis in patients with HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP). Of 144 patients with Hashimoto's thyroiditis in the Tokushima and Kochi Prefectures, Japan, 9 (6.3%) were positive for serum HTLV-I virus antibody 2 of whom were confirmed histologically to have Hashimoto's thyroiditis. This percentage is significantly higher (P < 0.01) than the estimated prevalence (2.2%) of HTLV-I carriers among the general population in this region. Of 9 patients with HAM/TSP, 3 (33.3%), including 2 biopsy-proven cases, had evidence of Hashimoto's thyroiditis. This proportion is apparently much higher than the prevalence (1.7%) of Hashimoto's thyroiditis in the general population. These findings suggest that HTLV-I virus may be related to the development of Hashimoto's thyroiditis.

Adult↗

PubMed1992

A new marker for estimation of bloodstain age by high performance liquid chromatography.

The applicability of a new marker for estimation of bloodstain age by reverse-phase high performance liquid chromatography (HPLC) is described. Using a microBondasphere C18 column with a two step linear gradient of 10.5-46.25% acetonitrile in 0.1% trifluoroacetic acid, an intriguing peak (unidentified) at a retention time of about 5 min was observed on chromatograms from human adult bloodstains and designated as 'X'. The area of this peak, which could be detected in extracts of bloodstains, but not in their fresh whole blood, increased with time. The ratios of the X area to heme area in bloodstains stored at room temperature and 4 degrees C for up to 52 weeks old linearly correlated with stain age by plotting on a double logarithmic scale. In bloodstains exposed to fluorescent light at room temperature, the regression equation calculated from the ratios (Rx) and the ages of stains in weeks (W) is ln(1000.Rx) = 1.1084 + 0.3937.ln(7.W), and the coefficient of correlation (r) is 0.9776 (n = 144, P < 0.001). When stains were stored at 37 degrees C, the ratio transformed into logarithms correlated linearly with stain age. The regression equation describing the relationship in bloodstains exposed to fluorescent light at 37 degrees C is ln(1000.Rx) = 2.4477 + 0.0866.W (r = 0.9826, n = 144, P < 0.001). The results of the present study suggest that the HPLC method may be applicable to the estimation of bloodstain age.

Adult↗

PubMed1992

Complement component C3a or C3a desArg as a new marker for estimation of local vital reactions in incised skin wounds.

The anaphylatoxin C3a or its desArg form (C3a/desArg) generated during complement activation could be detected in the vicinity of incised skin wounds of guinea pigs using immunoblotting methods. The C3a/desArg peptides were detectable immediately after injury in local sites up to 3 mm from the wound edge. In subsequent determinations of up to at least 3-day-old antemortem wounds, the maximum concentration of these peptides was largely localized up to 6 mm from the wound edge at 2 h after injury. In postmortem wounds, however, these peptides were undetectable. When they were released in antemortem wounded tissues they could be detected up to 1 day at 22 degrees C after death. These results suggest that the detection of C3a/desArg in wounds using immunoblotting methods can be useful for distinguishing ante- from postmortem wounds.

Animals↗

PubMed1992

Hashimoto's thyroiditis in HTLV-I carriers.

We describe two HTLV-I virus carriers who have biopsy-proven Hashimoto's thyroiditis. The first patient, a 64-year-old female, has had goiter and hypothyroidism since the age of 56. The second patient, a 66-year-old male, developed hyperthyroidism and goiter at the age of 44, but at present he is hypothyroid. Both patients are positive for anti-thyroid antibodies and anti-HTLV-I virus antibody. Findings of the thyroid biopsy specimens were consistent with Hashimoto's thyroiditis. These data suggest that Hashimoto's thyroiditis develops in HTLV-I carriers who have no clinical evidence of HAM/TSP.

Aged↗

PubMed1992

[Closure of ventricular septal defect of interrupted aortic arch with left ventricular outflow obstruction].

Leftward shift of the infundibular septum (IS) in interrupted aortic arch (IAA) with ventricular septal defect (VSD) often develops significant left ventricular outflow obstruction (LVOTO). Seven-day-old boy with 2.6 kg body weight underwent the two-stage operation for this anomaly. The aortic arch was interrupted between the left common carotid and the left subclavian artery. At the first stage, a 5 mm GORE-TEX graft was used to connect the interrupted arch, and pulmonary artery banding was performed. In closure of VSD at the second stage, IS was penetrated by stitches for the VSD patch to left ventricular outflow tract. IS with leftward shift could be pulled toward right ventricular side with patch fixation and LVOTO was prevented by this method.

Abnormalities, Multiple↗

PubMed1992

[Closure of ventricular septal defect in atrioventricular discordance with double outlet right ventricle: a case report of modification of de Leval technique].

A modification of De Leval technique for closure of ventricular septal defect (VSD) in atrioventricular discordance (AVD) with double outlet right ventricle (DORV) was reported. A 2-year-and-8-month-old boy underwent total repair for this anomaly. The first two stitches for closure of VSD were placed on the lower margin of the defect in which conducting tissues were not situated. Next remained stitches for closure of the defect could be continued toward upper margin of VSD in the morphologically right ventricular side of VSD while pulling the just previous stitches with good exposure and ease. We concluded that this modification was useful for making safe De Leval technique for closure of VSD in AVD.

Child, Preschool↗