Simultaneous inoculation of donor lymphocyte subsets with transplantation in a rat cardiac allograft model.
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Animals↗
Biomedical subjects
N Ikeda
Publications and source records attributed to N Ikeda.
WinArrhythmia: a Windows based application for studying cardiac arrhythmias.
We have developed Windows-based software for ECG training as a tool in teaching physiology. A standard user interface allows the user to choose which arrhythmia to review. The arrhythmia is drawn in real time with sound beeps synchronized to R waves. The system also presents a brief summary or multiple choice question corresponding to the arrhythmia. A ladder diagram shows how simulate the conduction system, which consisted of 4 modules characterized by 4 parameters: automaticity, refractory period, antegrade- and retrograde-conduction time. This system has proved both useful and effective for training medical students in ECG interpretation of arrhythmias.
Arrhythmias, Cardiac↗
Malignancy associated changes in bronchial epithelial cells and clinical application as a biomarker.
A total of 74 bronchial brushing specimens, 24 from patients with advanced stage cancer, eight from patients with CIS, 31 from patients with atypical metaplasia and 11 from normal subjects were examined for the existence of malignancy associated changes (MAC). Conventional fiberoptic bronchoscopy and fluorescence endoscopy was carried out on every case. Each case was classified according to the highest grade of abnormality diagnosed by bronchial biopsy of the suspect areas. During the endoscopy examination, a bronchial brushing specimen was obtained from a visually normal area very remote from the abnormal area as possible such as the opposite lung or another lobe. The bronchial brushing specimens were fixed, mounted and stained by a DNA specific method and approximately 1500 images of individual nuclei per case were captured by an automated high resolution image cytometry. For each of these images, more than 100 nuclear features such as size, shape and chromatin spatial organization were calculated. Discriminant function analysis revealed nuclear features which differentiated between normal bronchial cell nuclei from the normal subjects and ostensively normal nuclei (MAC cell nuclei) from the lung cancer patients. The best discrimination was achieved when the frequency of individual cells expressing MAC was 50% or greater. With this threshold, 75% of the patients with invasive cancer and CIS were correctly classified. Fifty percent of those with severe or moderate atypia and 35% with mild atypia were also MAC positive. The frequency of cells expressing MAC also increased as the degree of abnormality of the groups increased. MAC may be a useful criterium to determine biological behavior of the intra-epithelial (pre-invasive) neoplasia.
Aged↗
Peripheral non-small cell lung cancers 2.0 cm or less in diameter: proposed criteria for limited pulmonary resection based upon clinicopathological presentation.
Clinical features of peripheral non-small cell lung cancer 2.0 cm or less were retrospectively analyzed. Nodal status and prognosis in relation to tumor diameter and histologic type were investigated in 171 consecutive patients with peripheral clinical T1N0M0 non-small cell lung carcinomas 2 cm or less in diameter and who had undergone surgical resection between 1976 and 1997. Of the 171 patients, 136 had adenocarcinoma, 27 had squamous cell carcinoma, four had large cell carcinoma, three had carcinoid and one had adeno-squamous carcinoma. There was no statistically significant difference in the incidence of stage I cases between adenocarcinoma and squamous cell carcinoma. Lymph node involvement was recognized in 30 (17.5%) patients: ten (5.8%) at N1 nodes and 20 (11.7%) at N2 nodes. Lymph node metastasis was significantly more common in tumors 1.5-2.0 cm in diameter (22%) than in those 1.5 cm or less in diameter (14.0%, P = 0.0490). There was no lymph node metastasis in tumors 1.0 cm or less in diameter. The 5-year survival rates cases with or without lymph node involvement were 63.3 and 75.3%, respectively, showing significant difference (P = 0.0338). The result of the present study suggested that systematic mediastinal and hilar lymph node dissection is necessary even for cases with tumor diameter less than 2 cm. However, if the tumor is within 1.0 cm in diameter, mediastinal lymph node dissection might be dispensable; therefore, these cases are good candidates for video-assisted lobectomy.
Adult↗
Gastrointestinal amyloidosis secondary to hypersensitivity vasculitis presenting with intestinal pseudoobstruction.
A 22-year-old woman developed sudden hepatic encephalopathy and severe intestinal bleeding. She was diagnosed with acute fatty liver and hypersensitivity vasculitis and was successfully treated with whole plasma exchange, methylprednisolone pulse therapy, and transcatheter arterial embolization. Twenty-seven months later, she began complaining of lower abdominal fullness, tenderness, and nausea and vomiting. Histologic examination showed that she had developed gastrointestinal and renal amyloidosis with intestinal pseudoobstruction and proteinuria. The immunohistochemical study of the stomach, rectum, and kidney with anti-amyloid A fluorescent antibody showed that the systemic amyloid deposit was secondary to her underlying disease. This is the first report of amyloidosis occurring secondary to hypersensitivity vasculitis.
Adult↗
Prolonged suppressed thyroid-stimulating hormone levels in hyperthyroidism in a neonate born to a mother with Graves' disease.
We report here a case of neonatal hyperthyroidism born to a mother, whose pregnancy was complicated by poorly controlled Graves' disease. The patient demonstrated exophthalmos and marked goiter at birth, indicating the existence of thyrotoxicosis in utero. The mother's Graves' disease was well controlled in the third trimester, resulting in a slightly lower level of free thyroxine (FT4) in the umbilical cord blood serum; however, thyroid-stimulating hormone (TSH) was undetectable. Thyroid-stimulating hormone remained undetectable for 2 months, while FT4 levels varied in the course. This case suggests that severe and prolonged thyrotoxicosis in utero, due to poor control of pregnancy with Graves' disease, might induce unresponsiveness of the hypothalamo-pituitary system in the newborn.
Female↗
[A clinical study of pulmonary cryptococcosis. The Study Group of Respiratory Mycosis in Kyoto].
During the 7 years from 1990, thirty-two patients (20 in male and 12 in female, mean age; 53 years old) were diagnosed as having pulmonary cryptococcosis. To clarify the essential points for early diagnosis of pulmonary cryptococcosis, we reviewed the clinical records and chest images. Three patients had a past history of pulmonary tuberculosis and eleven patients had underlying disorders such as malignancy, chronic pulmonary diseases and so on, but no HIV infection, which would affect this disease. Eighteen patients did not have any past history nor complications. The symptoms such as cough, sputum, chest pain and fever were generally of low-grade, 14 patients had no symptom at diagnosis. Except of some patients with severe infections and severe underlying disorders, laboratory findings such as inflamatory and nutritious markers were almost within near the normal range. On plain chest X-ray films the distribution of lesions was almost in proprtion to the volume of the lobes. The multifocal nudular and/or infitrative shadows wer observed in about 2/3 cases and single lesion in about 1/3. The width of lesions were minimal except of one case with interstitial pneumonia and two cases with multifocal segmental pneumonia. The cavity lesions were observed in 7 cases and hilar lymphadenopathy in 3 cases. On CT images, the lesions were almost located in the outer zone, the lesions which were adjacent to the pleura were observed in 15 cases. Cavitary lesions were almost smooth in edge and ubiquitous, the walls were also thick. The peripheral air-bronchogram in the nodular/infitrative shadows were observed in three cases. Pulmonary cryptococcosis is air-borne and almost a chronic infection except in AIDS patients, so careful planning for examination is essential with considerations of the characteristics of clinical and imaging features of this infection.
Adult↗
Decreased visual acuity and Diplopia in a patient with münchausen syndrome.
A 20-year-old woman complained of decreased visual acuity in her left eye and diplopia. She had visited several hospitals previously. On examination, her left visual acuity varied, and her squint angle also changed. No organic disorders that could have caused the symptoms were noted. She complained of edema of her left arm. On admission to another hospital, her arm was found bound tightly with tape. She wanted surgery to correct her esotropia but did not expect to improve her quality of life by having it done. We believe that our patient may have Münchausen syndrome and that the decreased visual acuity and diplopia may be a rare association with the syndrome.
Adult↗
Study of the accelerating effect of shikonin and alkannin on the proliferation of granulation tissue in rats.
The present study was carried out to compare the accelerating effect of shikonin and alkannin and to elucidate the expression of CD antigen and histological changes on the proliferation of granulation tissue in rats. Shikonin and alkannin produced a dose-dependent acceleration of the cotton pellet-induced granuloma formation and this accelerating potency of both compounds on the proliferation of granulation tissue was about the same 5 and 10 d after implantation of the cotton pellet. Also, both compounds increased the ratio of CD11b+ cells in the granulation tissue 5 and 10 d after implantation of the cotton pellet. Both compounds increased the expression of CD11b+ cells with granulocytes such as macrophages and histiocytes, and then accelerated the proliferation of fibroblasts and collagen fiber. On the other hand, neither compound increased the ratio of CD3+ cells in the granulation tissue after 5 and 10 d. These results suggest that shikonin and alkannin accelerate the proliferation of granulation tissue induced by the cotton pellet and this accelerating effect may be attributed to an increase in the expression of CD11b+ cells, and the acceleration of the proliferation of fibroblasts and collagen fiber in the granulation tissue.
Animals↗
[A clinical study of causes of death from active pulmonary tuberculosis with chemotherapy].
We evaluated retrospectively the causes of death from active pulmonary tuberculosis by the review of records and chest radiograohs of 364 patients (male 282, female 82) with active pulmonary tuberculosis, who were admitted to our hospital during 1995 to 1998. 43 patients (male 33, female 10) were died under anti-tuberculous chemotherapy. 20 cases were tuberculous death; death from acute progression of tuberculosis without response to chemotherapy (acute progression group) in eight cases and death from debility in spite of partial response to chemotherapy (debility group) in eight cases. 23 cases were died from underlying diseases; death from malignant neoplasmas (malignant group) in nine cases and death from complication of bacterial pneumonia (pneumonia group) in seven cases. In acute progression group, the age (mean +/- SE) was 64.8 +/- 5.2 years old and the survival period from admission was 11.8 +/- 4.2 days. Five cases were laborer or unemployed. This group was characterized with far advanced diseases presenting extensive lung lesions complicated with DIC or hepatic dysfunction, low performance status (PS), severe malnutrition and lymphocytepenia. In debility group, the age was 70.8 +/- 3.9 years old and the survival period from admission was 254.6 +/- 90.7 days. Five cases were laborer or unemployed. This group was characterized with multiple underlying diseases, low PS, previous anti-tuberculous chemotherapy and resistance to INH and/or RFP. In malignant group, the age was 69.3 +/- 3.2 years old and the survival period from admission was 99.9 +/- 21.2 days. This group was characterized with relatively well nourished, relatively good PS in comparison with other groups, and lymphocytepenia. In pneumonia group, the age was 82.8 +/- 1.7 years old and the survival period from admission was 153.3 +/- 54.5 days. This group was characterized with remarkably advanced age, low PS related to underlying disorders of central nervous system. In the causes of death with active pulmonary tuberculosis under chemotherapy, inhomogenous groups were included. Extensive disease, low PS, malnutrition, lymphocytopenia, previous chemotherapy, resistance to INH and/or RFP, and poorer social circumstances seemed to be risk factors for tuberculous death. In contrast, underlying malignant nepolasma, lower PS, and far advanced age were seemed to be the risk factors for non-tuberculous death.
Aged↗
Sudden unexpected death from pulmonary thromboembolism--examination of antemortem chest X-ray.
An autopsy case of a woman who died suddenly from undiagnosed and untreated pulmonary thromboembolism (PTE) on her way home from the hospital is described in this report. She had complained of chest pain and dyspnea on exertion when she visited the hospital and a chest X-ray taken at that time showed remarkable manifestation of right heart failure and PTE, compared with former X-rays taken during previous visits to the hospital. In this report we present the findings of four chest X-rays of this patient, which had been taken both before and after the development of PTE.
Chest Pain↗
Prevention of endotoxin shock through targeting leukocyte adhesion molecules.
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Animals↗
[A case of pulmonary tuberculosis complicated with intracranial tuberculous abscess].
A 75-year-old male was admitted to our hospital with complaints of fever and cough. Chest X-ray showed infiltrative shadows with cavity, and sputum smears were positive for acid-fast bacilli. About 2 months after the initiation of anti-tuberculous chemotherapy, suddenly generalized convulsion occurred. CT of the brain showed the solitary mass with the ring enhancement in the left subcortical area. About 4 weeks later, brain aspiration drainage was performed and pus was aspirated. He was diagnosed as intracranial tuberculous abscess. After the drainage, neurological symptoms disappeared completely and there were no recurrence of abscess. Attention should be called to the complication of intracranial tuberculosis, especially in cases worsened during anti-tuberculous chemotherapy.
Aged↗
A fatal case of hydrogen sulfide poisoning in a geothermal power plant.
An adult man entered an oil separator room to remove waste oil from a vacuum pump in a geothermal power plant. He suddenly collapsed and died soon after. Since hydrogen sulfide gas was detected in the atmosphere at the scene of the accident, poisoning by this gas was suspected and toxicological analysis of sulfide and thiosulfate in blood, brain, lung, femoral muscle was made using the extractive alkylation technique combined with gas chromatography/mass spectrometry (GC/MS). The concentrations of sulfide in these tissues were similar to those previously reported for fatal cases of hydrogen sulfide gas. The concentration of thiosulfate in the blood was at least 48 times higher than the level in control samples. Based on these results, the cause of death was attributed to hydrogen sulfide gas poisoning.
Accidents, Occupational↗
[Epidemiological studies on tobacco smoking and dependence in Hokkaido prefecture--relation to alcoholism].
Self-report symptom profiles for nicotine psychic dependence and nicotine physical dependence were examined in data obtained from 363 male and 82 female smokers. The subjects consisted of 363 healthy volunteer and 82 alcoholics. The questionnaire used in this study, consisted of items of the ICD-10 and DSM-IV. The ratio of nicotine dependence diagnosed according to the ICD-10 criteria was lower in alcoholics (22.0%) than in non-alcoholics (54.4%). A total of 19.4% of alcoholics experienced "progressive neglect of alternative pleasures or interest in favour of smoking"; however, only 2.2% of non-alcoholics had the same experience. Although the ratio of nicotine physical dependence diagnosed using the DSM-IV criteria (nicotine withdrawal), was 4.9% in alcoholics, only 0.3 % of non-alcoholics exhibited nicotine physical dependence. These results indicate that the potential for nicotine dependence is not higher than that for other drug dependence and suggested that nicotine physical dependence potential is not much stronger than that reported among social smokers.
Adult↗
[Clinical evaluation on causes of death in patients with pulmonary tuberculosis during the past 3 years (1994 to 1996)].
We evaluated the cause of death in patients with pulmonary tuberculosis during the past 3 years (1994 to 1996). Of 502 tuberculous patients, 58 (11.6%) patients died. Most of them were aged or under poor nutritional conditions. Of 378 active tuberculous patients, 39 (10.3%) patients died (group A). Of 124 old tuberculous patients or cases with extensive sequelae of tuberculosis, 19 (23.4%) patients died (group B). In the group A, 15 patients died in spite of improvements in tuberculosis lesions. All the intubated patients with active tuberculosis died. In the group B, most of patients died of respiratory failure or pneumonia.
Adult↗
An autopsy case of unusual massive gastrointestinal hemorrhaging.
An autopsy case is presented involving massive gastrointestinal hemorrhaging. A 58-year-old woman was found dead with bloody patches on her body. An autopsy revealed a lacerated wound to the mucosa of the stomach and a sharp fish bone was found among bloody contents within the stomach. The duodenum and small intestines contained abundant tarry contents, but the mucosa of the intestinal tract was intact. The cause of death was certified as hemorrhagic shock due to massive bleeding from a wound to the gastric mucosa inflicted by a sharp fish bone. Therefore the possibility that some foreign body has been swallowed must be considered when forensic pathologists investigate cases with bleeding of unknown origin from the alimentary tract.
Animals↗
Sudden infant death from aspiration of milk due to superior cornual defect of thyroid cartilage.
An autopsy case of a 4-month-old boy who died immediately after being fed by a member of the staff of a day-care centre is described in this report. An autopsy certified that the cause of death was the aspiration of milk. There was no other apparent reason for the aspiration of milk into the trachea except for the left superior cornual defect of the thyroid cartilage. We therefore conclude that it was this defect which led to the aspiration of milk into the trachea.
Animals↗