Biomedical subjects
Publications and source records attributed to T Aihara.
Multilocular cystic nephroma is an uncommon and usually benign nephroblastic neoplasm. Considering its therapeutic indication, it is important to distinguish this lesion from malignant renal masses. The lesion usually shows a well-encapsulated, multilocular cystic mass on US and CT. Occasionally, imaging studies are not useful for preoperative diagnosis, however, surgical biopsy should be considered for correct pathological diagnosis.
The roles of oxygen free radical (O2-), lipoperoxide (LPO) and free radical scavenger were clinically and experimentally studied in septic and hemorrhagic shock. The reduction of hepatic tissue blood flow (TBF) were equalized in two groups (40-55% of normal level) and rats were subdivided into 3 groups: untreated, normal saline (NS) continuous IV and superoxide dismutase: SOD + catalase (S/c) continuous IV as free radical scavenger. The change of TBF, destruction of mitochondrial structure and elevation of LPO were prevented by S/c in Et shock. No significant effect by S/c was observed in hemorrhagic shock. The neutrophil derived O2- was markedly elevated in Et shock animals as well as septic shock patients but no significant change was noted in hemorrhagic shock animals or non septic shock patient. SOD and catalase were effective for neutrophil derived O2- in septic shock whereas little beneficial effect was noted in hemorrhagic or non septic shock.
In order to evaluate the influence factors on coronary collateral development, we compared various factors between two groups. Group I consisted of the 69 patients performed coronary angiography within 6 hours after the onset of acute myocardial infarction (MI) and Group II consisted of the 56 patients without MI because having good collaterals nevertheless whose one coronary artery was totally occluded or had a 99% stenosis. Group I (24/69, 35%) had a higher frequency of Diabetes mellitus than Group II (11/56, 20%) and had a lower frequency (30/69, 43%) of multivessel disease than Group II (39/56, 70%). The patients having angina duration more than 6 months were more in Group II (37/56, 60%) than in Group I (18/69, 26%). No significant differences existed between these two groups in age, smoke, hyperlipidemia and hypertension. In conclusions, the patients with good collateral have high frequency of multivessel disease and long history of angina pectoris. Diabetes mellitus is a inhibit factor on coronary collateral development.
We studied the effect of the open heart surgery and the thoracic aortic aneurysm surgery on renal, liver and respiratory function and the coagulofibrinolytic system. We also investigated as to whether ulinastatin was effective or not with regard to preventing an organ system failure. The renal function, liver function and the coagulofibrinolytic system were preserved, although there was a greater number of severe cases in the group which used ulinastatin (US group) than in the group that did not use ulinastatin (non-US group). In the US group, PaO2 did not decrease postoperatively. However, in the non-US group, PaO2 decreased significantly after the operation. The variables in relation to using ulinastatin, examined by a stepwise method, included kind of disease, emergency operation, PaO2, BUN and serum plasminogen. The multiple coefficient for these five variables was 0.623 (p less than 0.01) and the contribution was 38.8%. It was suggested that ulinastatin could prevent an organ system failure, especially respiratory failure, after open heart surgery and the thoracic aortic aneurysm surgery.
6-Thioguanine and Neomycin resistant human endometrial carcinoma cells were established from parental HHUA 95 cells in the present study. The karyotype was 46,XX although chromosome abnormalities had been observed occasionally. Cell hybrids between 6-TGr neor 95 and rat immortalized, non-tumorigenic 3Y1 cells were formed to analyze for cosegregation of chromosomes and tumorigenicity. However, the morphology of 3 hybrid clones was a spindle form, similar to the 3Y1 cells. In spite of the consistent presence of human chromosomes, negative anchorage independent growth in these clones suggested that none of the chromosomes involved in fused cells was associated with tumorigenicity of endometrial carcinoma. Loci on a few human chromosomes of a normal cell cause suppression in several hybrid systems. Cell fusion between 6-TGr 95 and normal human fibroblasts (HF) was performed to confirm whether this is also true in endometrial carcinoma. Hybrid cells had four copies of homologous chromosomes (two from each of the parent cells). These had a polygonal appearance, being similar to the HHUA 95 cells. Both anchorage independence and tumorigenesis were negative. Those results suggested that malignant transformation of endometrial cells was the result of multiple genetic changes. In this respect, the loss of genes implicated in the suppression plays an important role in endometrial carcinogenesis.
The purpose of this communication was to find out the factors influencing the late patency ratio of coronary artery bypass grafts of 42 patients in our institution. The following results were obtained: 1. The size of the measured diameters of coronary arteries and the graft flow rates were correlated well to the late patency ratio (p less than 0.05). 2. The regular physical exercise trainings were significantly important to keep patent grafts (p less than 0.01). 3. In blood serum studies, serum uric acid levels were significantly lower (p less than 0.05), the average mean HDL cholesterol levels were much higher (p less than 0.001) and the ratio of total cholesterol to HDL cholesterol were significantly lower in the group with late patent grafts than with grafts occluded. Therefore, we found out the variables affecting graft patency ratio which were examined by a stepwise method were the diameter of the coronary artery, regular physical exercise training, the average of lower serum uric acid levels and higher HDL cholesterol levels. The multiple coefficient for these four variables was 0.562 (p less than 0.001) and the contribution was 31.6%. According to the base of this studies, we have concluded that postoperative regular physical exercise, low fat and restricted calorie intake were very important to keep the late patent grafts in long-term follow up period after coronary bypass surgery.
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To ascertain the correlation between arteriosclerosis obliterans (ASO) of the lower extremities and coronary artery disease (CAD), 69 patients with lower extremity ASO were observed. Based on clinical symptoms, the patients were categorized as group A: 52 with intermittent claudication and group B: 17 with angina pectoris. All patients underwent angiography of both lower extremities and the heart. Results were as follows: 1. In group A, 33 patients had significant coronary stenosis with single (16 cases), double (12 cases) and triple (five cases) vessel disease. Sixteen patients had histories of myocardial infarction and two had vasospastic angina. In group B, 15 patients had significant coronary stenosis with single (five cases), double (six cases) and triple (four cases) vessel disease including two cases involving the left main trunk. Six patients had histories of myocardial infarction and two had vasospastic angina. 2. Electrocardiography revealed that 37 patients in group A and 14 patients in group B had abnormal ECGs as abnormal Q waves and ST-T changes. However, 10 patients in group A and three patients in group B had significant coronary stenosis despite their normal ECGs. 3. According to the sites of stenotic lesions, all 69 patients with ASO were classified in four types; as diffuse, pelvic, ilio-femoral and femoral. The incidence of CAD did not differ among these four types. 4. In group A, 38 patients experienced revascularization of ASO; 36 cases by bypass grafting, and two by percutaneous transluminal angioplasty (PTA). Ten patients received cardiac revascularization including three cases with coronary artery bypass graft (CABG) and seven cases with percutaneous transluminal coronary angioplasty (PTCA). In group B, 13 patients received revascularization of ASO with bypass grafting. Eleven patients had coronary revascularization including seven cases with CABG and four cases with PTCA. 5. Fourteen of the 69 patients received revascularization for both ASO and CAD. In conclusion, there is a highly significant coincidence of CAD in patients with ASO, and CAD is often silent. These data indicate that routine coronary angiography is necessary for detecting and preventing CAD in all patients with ASO. Coronary artery revascularization, especially PTCA, can be indicated prior to lower extremity revascularization.
In the Saitama prefecture in Japan, VMA (vanillyl mandelic acid) screening spot test for detection of neuroblastoma has been performed in 173,046 infants in the years 1981-1986 and 15 infants were found to have neuroblastoma. Two infants had mediastinal tumors and the remainder 13 had intraabdominal tumors. Only 7 infants had palpable masses. Although CT was documented to be the best imaging procedure to provide sufficient information for treatment, conventional radiographic examinations of the chest and abdomen, and abdominal ultrasonography were able, as initial imaging procedures, to detect reasonably small neuroblastomas in infants with a positive VMA screening test.
Responsiveness of single inferotemporal (IT) neurons to a tone as a start or warning signal in each test trial was investigated in monkeys performing visual discrimination of 4 patterns. It was found that the same IT neurons were responsive to both auditory signal and visual discriminanda with different response characteristics from each other. The activity of IT neurons for the auditory signal in the visual discrimination paradigm reflects an engagement process in attention to the visual discriminanda.
The peak incidence of ventricular fibrillation in acute myocardial infarction usually occurs during the first hours after the onset. Electrophysiological changes immediately after the onset have been studied in animal models, but are still incompletely understood in humans. For clarification of the characteristic features of ventricular arrhythmias during acute myocardial ischemia, ventricular arrhythmias were studied in 81 patients with vasospastic angina pectoris induced by ergonovine. Ventricular arrhythmias occurred in 45 of these patients, including ventricular tachycardia in 15, and ventricular fibrillation requiring repeated DC defibrillation in two patients. Most ventricular extrasystoles occurred before the ST segment reached maximum elevation, while reperfusion arrhythmias were less common. In many patients the coupling intervals varied, and the configuration was multiform. It is concluded that ventricular arrhythmias occurring during ergonovine-induced coronary spasm show different characteristics from those occurring during chronic ischemia. As the arrhythmias in this study seem, in some ways, to resemble arrhythmias occurring at the onset of myocardial infarction, the results might provide useful information on ventricular arrhythmias in myocardial ischemia in humans.
The relationship between inverted U wave in leads V5 and II and the location of myocardial ischemia was studied in 52 positive patients and in 50 negative patients with ergonovine provocation test. Development of a biphasic or negative U wave, or increased negativity of U wave (inverted U wave) was observed in 15 of 17 patients with spasm in only the right coronary artery (RCA), in 6 of 8 with spasm in only the left anterior descending artery (LAD), in 2 of 8 with spasm in only the left circumflex artery (LCx), and in 23 of 24 with spasm in two or more vessels. Of 52 positive patients in the ergonovine provocation test, 46 (88.5%) had inverted U wave. Of these, 17 (32.7%) had inverted U wave without discernible ST deviation. Of 50 negative patients, 2 had inverted U wave. Inverted U wave in lead V5 was frequently seen in patients with spasm of LAD, but this finding was not uncommon in spasm of RCA or LCx. On the other hand, inverted U wave in lead II was frequently seen in spasm of RCA and LCx, but not in spasm of LAD. These findings suggest that inverted U wave in lead V5 is not specific for myocardial ischemia due to spasm of LAD and that inverted U wave in lead II is specific for spasm of RCA and LCx.
Unusually increased CT density of the liver parenchyma after administration of cis-diaminedichloro platinum (II) (CDDP) is presented. This patient has neither a history of blood transfusion nor of iron overload. Therefore, CDDP which includes the heavy metal, Platinum, in its molecule was considered to be the only agent responsible for increasing the CT density.
Dynamic computed tomography (CT) was performed in nine patients with enlarged bronchial arteries documented by arteriography. Plain and contrast-material-enhanced CT scans of two more patients with prominent bronchial arteries were retrospectively reviewed. The study was conducted to determine visibility of the bronchial artery with CT and to depict the anatomic relationship of its mediastinal portion to surrounding structures. The mediastinal portion of the bronchial artery was successfully outlined as nodular or linear densities on all dynamic CT scans. The right bronchial artery was confirmed to arise from the medial wall of the thoracic aorta, whereas the left arises from the anterior wall. Because of its retroesophageal location, the enlarged right bronchial artery can compress the posterior wall of the esophagus. It is postulated that the left bronchial artery occasionally traverses the aorticopulmonary window, recognized as nodular or linear densities below the aortic arch on CT scans.
Blood flow in tumor masses was detected with 2D-Doppler color flow mapping in 3 cases; a pancreatic carcinoma in a sixty-five-year-old woman, a renal cell carcinoma in a sixty-two-year-old woman, and a chemodectoma in a sixty-six-year-old woman.
The effects of physical exercise training after coronary artery bypass grafting on recovery of cardiac function and graft patency were studied in 115 patients. The patients were divided into Group I (N = 60) with and Group II (N = 55) without a scheduled rehabilitation program. The rate of graft patency was 98% in Group I and 80% in Group II. After operation, the exercise cardiac index and stroke index were significantly higher in Group I than in Group II. The exercise stroke index increased significantly in Group I, but not in Group II. The variables affecting graft patency, examined by a stepwise method, included double product, cardiac index, stroke index, and left ventricular end-diastolic pressure during postoperative exercise conditions, and postoperative exercise training. The multiple coefficient for these five variables was 0.459 (p less than 0.01). Our findings suggest that physical exercise training should be started as early as possible after coronary artery bypass grafting to improve graft patency and recovery of cardiac function.
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