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Biomedical subjects

T Asai

Publications and source records attributed to T Asai.

At least 397 records · Page 22Linked to original sources
PubMed1992

Capillary filling analysis by digital subtraction angiography for vertebro-basilar insufficiency.

Vertebro-basilar insufficiency (VBI) is a vague clinical entity including several symptoms such as faintness, dizziness, vertigo. Millikan and Siekert reported a 'syndrome of intermittent insufficiency of basilar arterial system'. But vascular abnormalities responsible for such symptoms are often hardly diagnosed by conventional angiography, because vertebro-basilar artery systems have many kinds of anomalous congenital origins. Conventional angiography gives us arterial informations such as stenosis, occlusion and malformations, but it often fails to reveal capillary perfusions because of its relatively poor density resolution. Digital subtraction angiography (DSA) is considered to have improved density resolution, and it may enable us to detect vascular perfusions more sensitively in the capillary phase. In this study, we evaluated the usefulness of the capillary filling analysis in digital subtraction angiography for diagnosis of VBI.

Capillaries↗
PubMed1992

Common histopathological processes of phenytoin drug eruption.

Fifteen patients (6 males and 9 females) with phenytoin drug eruptions which ultimately resulted in various skin manifestations were analyzed histopathologically. The following types of skin manifestations were noted; 2 cases of toxic epidermal necrolysis, 2 cases of mucocutaneous ocular syndrome, 6 cases of erythema exudative multiform, 3 cases of lichenoid, and 2 cases of the maculopapular type. All of the biopsied specimens from these different skin manifestations exhibited some of the more common histopathological findings: 1) adhesion of the infiltrated cells to the basal layer of the epidermis, 2) cell infiltration into the epidermis, 3) vacuolation of the basal cells, 4) dyskeratotic cells in the epidermis, and epidermal necrosis. Immunohistopathological examinations in 5 typical cases with different skin manifestations revealed that epidermal cells and infiltrating cells were HLA-DR antigen positive. The infiltrating cells in the dermis consisted of almost equal numbers of CD4+ and CD8+ cells; CD8+ cells were predominant in the cells infiltrating into the epidermis. These findings suggest a possibility that the various clinical features in phenytoin drug eruptions may share some common mechanisms.

Adolescent↗
PubMed1992

Lichen planus annularis: an immunohistochemical study.

Lichen planus annularis is a relatively rare skin manifestation of lichen planus. The mechanisms in the formation of annular lesions are not fully understood. We reported here a 57-year-old female with this disease. The eruption initially occurred as lichen-papules, then enlarged (bean-sized, umbilicated small plaques), and finally developed annular manifestations. We performed immunohistochemical examinations of specimens taken from different types of eruptions. In all specimens, HLA-DR was expressed in the focal keratinocytes adjacent to the dermal HLA-DR positive cell infiltration. Both in the initial papule and in the final annular lesion, expression of ICAM-1 was present only in the keratinocytes above the dermal cell infiltration, similar to HLA-DR. It is of interest that, in the umbilicated small plaques, the peripheral epidermis other than the central site extensively reacted to ICAM-1. LFA-1 expression was most prominent in the mononuclear cells impinging on the dermo-epidermal junction in all specimens. In addition, in the periphery of the umbilicated small plaques, which showed no bandlike dense cell infiltration nor degeneration of basement membrane, TNF-alpha, but not LFA-1, was positive in the infiltrated cells of the upper dermis. These results suggest that expressions of ICAM-1 and TNF-alpha in the peripheral keratinocytes and dermal infiltrated cells are important molecular events in the mechanisms of formation of the annular lesions.

Antigens, CD↗
PubMed1992

Anaesthesia for cardiac surgery in children with nemaline myopathy.

Nemaline myopathy is a rare congenital myopathy associated with skeletal deformities and respiratory complications. Three children with nemaline myopathy who underwent cardiac surgery are described where the heart rate decreased during induction of anaesthesia and body temperature increased during or after the surgery. The anaesthetic implications in the management of patients with nemaline myopathy are discussed.

Anesthesia, General↗
PubMed1992

[Effect of erythromycin on intrapulmonary influx of neutrophils by intratracheal injection of lipopolysaccharide].

Recently, "low dose and long term" erythromycin (EM) treatment has been reported as effective on chronic lower respiratory tract disease, including diffuse panbronchiolitis (DPB). However the effective mechanism of EM is still obscure. In this study, we investigated the effect of EM on intrapulmonary influx of neutrophils by intratracheal injection of lipopolysaccharide (LPS), and the following results were obtained. 1) The intrapulmonary influx of neutrophils was significantly suppressed (p less than 0.001) in mice intraperitoneally injected with EM at 5 mg per animal 2 hr before intratracheal injection of LPS (control group: 6.5 +/- 0.8 x 10(5) vs EM-treated group: 1.7 +/- 0.3 x 10(5)), but not 10 hr before lung challenge. This inhibition was observed at 6 hr after lung challenge, and became maximum with 84% suppression at 24 hr. 2) The intrapulmonary influx of neutrophils was not affected when EM was injected intraperitoneally daily for 3, 7, or 14 days, and lung challenge was performed 24 hr after the final administration of EM. 3) The number of neutrophils in the peripheral blood was not affected by EM. These results suggest that EM treatment impairs the capacity for pulmonary inflammation by reducing, at least in part, the migration of neutrophils to inflammatory sites.

Animals↗
PubMed1992

Application of ozone disinfection to remove Enterococcus seriolicida, Pasteurella piscicida, and Vibrio anguillarum from seawater.

Survival of bacterial fish pathogens, including Enterococcus seriolicida, Vibrio anguillarum, and Pasteurella piscicida, in ozonated seawater was determined in a batch system. Bacterial counts of all fish pathogens decreased at more than 0.040 to 0.060 mg of total residual oxidants (TROs) per liter, whereas no decrease in viable counts was observed at less than 0.018 to 0.028 mg of TROs per liter. The 99% inactivation point was achieved at concentrations of 0.111 mg/liter for E. seriolicida, 0.063 mg/liter for P. piscicida, and 0.064 mg/liter for V. anguillarum within 1 min. Moreover, the mean 99 and 99.9% killing concentration-contact time (C.t) products were 0.123 and 0.186 mg.min/liter for E. seriolicida, 0.056 and 0.084 mg.min/liter for P. piscicida, and 0.081 and 0.123 mg.min/liter for V. anguillarum, respectively. However, the mean 99 and 99.9% C.t products for the mixed population in coastal seawater were 0.200 and 0.621 mg.min/liter. These results strongly suggest that ozone treatment at more than 1.0 mg of TROs per liter for several minutes is able to disinfect seawater for mariculture efficiently.

Animal Husbandry↗
PubMed1992

High correlation in antibody titers between the Sabin-Feldman dye test and an enzyme-linked immunosorbent assay detecting immunoglobulin G antibodies to the nucleoside triphosphate hydrolase of Toxoplasma gondii.

An enzyme-linked immunosorbent assay to detect immunoglobulin G antibodies against nucleoside triphosphate hydrolase, which is a specific and dominant antigen of Toxoplasma gondii, was developed, and the sensitivity and specificity of the test were compared with those of the Sabin-Feldman dye test. One hundred percent agreement was observed in comparative study between those tests on 37 positive and 50 negative human sera. Antibody titers in the enzyme-linked immunosorbent assay test, which were expressed as the reciprocal of the highest positive dilution of serum, were just 100 times those in the dye test on 81% (30 of 37) of the positive sera.

Animals↗
PubMed1992

Characterization of Japanese isolates of Aujeszky's disease virus by restriction endonuclease cleavage patterns, virulence in mice and thymidine kinase activity.

Twenty four cloned isolates of Aujeszky's disease virus collected from outbreaks of Aujeszky's disease from 1981 through 1989 in Japan were characterized by their restriction endonuclease (RE) cleavage patterns, virulence for mice and thymidine kinase (TK) activity. All of the isolates belonged to Type II of the four types classified by Herrmann et al. (1984). Based on the number and migration rate of the restriction fragments, the isolates were divided into 7 groups with Bam HI, 9 groups with Kpn I, 3 groups with BstE II and 2 groups with Sal I. The results indicate that the RE analysis, especially with Bam HI and Kpn I, provides useful epidemiological information about field isolates of Aujeszky's disease virus. All of the isolates showed virulence for mice ranging from 6.9 to 63.0 (PFU/LD50). It was interesting that the Nagano S87 strain, which had the highest virulence for the mouse, showed unique RE cleavage patterns with four enzymes. On the other hand, ara-T-resistant, TK-negative strain, was avirulent for mice (greater than 10(6.4) PFU/LD50). All of the isolates investigated in this study showed TK activity by the thymidine plaque autoradiography.

Animals↗
PubMed1992

Effect of interferon (IFN) on refractory idiopathic thrombocytopenic purpura: administration of 6 million units of recombinant IFN alpha-2b.

Five patients (six courses) with refractory idiopathic thrombocytopenic purpura (ITP) were given 6 million units of recombinant interferon (IFN) alpha-2b in 12 doses to achieve an improved response rate compared to previous studies using 3 million units. From the initial IFN administration, the platelet count increased from a pre-treatment level of 20.7 +/- 17.7 x 10(3)/microliters (mean +/- SD) and reached its first peak in weeks 2 or 3 of therapy (p < 0.05). In week 5, the platelet count made its second and maximum peak (66.5 +/- 57.9 x 10(3)/microliters; p < 0.05). A relatively good response of the platelet count (an increase to > 50 x 10(3)/microliters) was observed in three patients (four courses) out of five. These responses were not much faster or more improved than in previous reports, and a dose of 6 million units may be too large to treat some ITP patients. The platelet-associated IgG level showed a tendency to be reduced with IFN therapy. The mechanism for the increase of the platelet count may be the modification of platelet autoantibody production.

Adult↗
PubMed1992

[The use of a Swan-Ganz catheter with a fast-response thermistor for the measurement of right ventricular performance during anesthetic management of pheochromocytoma].

We used a Swan-Ganz catheter with a fast-response thermistor to measure the right ventricular ejection fraction (RVEF) during the anesthetic management of two patients with epinephrine-dominant pheochromocytomas. Pre-operatively, one patient received alpha adrenergic blocking agents (prazocine, doxazocine) to control the blood pressure but the other patient did not receive any agents. In the latter patient who did not receive alpha adrenergic blocking agents, right ventricular function was depressed post-operatively in the recovery room. The importance of preoperative preparation with alpha adrenergic blocking agents was confirmed by the reductions in RVEF and RVEDVI (right ventricular end-diastolic volume index) after resection of the tumor. Not only left heart monitoring but also right heart monitoring with RVEF and RVEDVI are recommended for the proper management of a patient with pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1992

The effects of different techniques of internal mammary artery harvesting on sternal blood flow.

We investigated chest wall blood flow in a canine model to determine if the technique used to harvest the mammary artery has a differential effect on residual chest wall blood flow. Eight dogs underwent bilateral internal mammary artery mobilization; one artery was harvested as a pedicle and the other was harvested as a skeletonized vessel. Residual blood flow to the chest wall distribution of each artery was measured with radioactive microspheres. Chest wall blood flow was significantly decreased from preharvest levels after internal mammary artery mobilization regardless of the technique used. Tissue blood flows decreased to 46.9%, 22.1%, and 41.2% of baseline values for the manubrium (p < 0.01), sternum (p < 0.001), and ribs (p < 0.05), respectively. Residual sternal blood flow on the side of the skeletonized vessel was significantly greater than on the side of the pedicle graft (2.60 +/- 0.68 versus 1.27 +/- 0.27 cm3/min/100 gm, p < 0.001). We conclude that minimization of tissue mobilization during internal mammary artery harvesting may reduce sternal devascularization. This finding may have clinical significance with respect to lowering the incidence of sternal wound complications in coronary bypass surgery using the internal mammary artery as a bypass conduit.

Animals↗
PubMed1992

[Estimation of pulmonary vascular permeability by indocyanine green in permeability pulmonary edema].

In this study we attempted to estimate pulmonary vascular permeability by indocyanine green (ICG). Permeability pulmonary edema was produced in 9 adult dogs by injecting 0.08 ml/kg oleic acid. We injected 50 mg ICG intravenously in 18 dogs (9 dogs with pulmonary edema and 9 control dogs). We measured the time course of ICG concentrations in pulmonary arterial blood, ICG concentration of peripheral lung tissue, tissue/serum ICG concentration ratios, and wet/dry lung weight ratios. The following results were obtained. The time course of ICG concentration in pulmonary arterial blood showed peak values at 2 minutes and became constant at 5 or 10 minutes after injection. The ICG concentration in peripheral lung tissue, tissue/serum ICG concentration ratios, and wet/dry lung weight ratios in the pulmonary edema group were significantly higher than those in the normal group. There was a strong linear correlation between wet/dry lung weight ratio and ICG concentration in peripheral lung tissue, with correlation coefficients of r = 0.936 (p < 0.01) in the right lung and r = 0.901 (p < 0.01) in the left lung. From these results, we conclude that estimation of pulmonary vascular permeability by ICG is a useful method.

Animals↗
PubMed1992

Gastric microcirculation and acute gastric mucosal lesions in patients with hepatic cirrhosis.

We endoscopically investigated gastric microcirculation using a laser-Doppler flowmeter and acute gastric mucosal lesions (AGML) during a 3-year follow-up period in patients with hepatic cirrhosis. Gastric microcirculation tends to decrease in patients with hepatic cirrhosis, especially when gastric mucosal hemorrhage or mucosal petechiae are observed endoscopically. Total gastric resection was performed for gastric hemorrhage due to AGML in three patients, two of whom had good liver function--Child's grade A--and survived more than 5 years with a good quality of life, but one patient with Child's grade C experienced poor quality of life and died within 2 years after surgery. We conclude that decreased gastric microcirculation plays a role in the occurrence of AGML in patients with hepatic cirrhosis. Total gastric resection should be carefully considered for hemorrhagic gastritis in patients with Child's grade C hepatic cirrhosis.

Acute Disease↗
PubMed1992

Experience with twenty-eight cases of systolic anterior motion after mitral valve reconstruction by the Carpentier technique.

Systolic anterior motion of the mitral valve with left ventricular outflow tract obstruction after Carpentier-type mitral reconstruction with ring annuloplasty has led some surgeons to abandon an otherwise successful repair or to avoid use of a rigid ring. To assess the long-term significance of such motion, we studied 439 patients undergoing Carpenter mitral reconstruction at our institution between March 1981 and June 1990. The hospital mortality rate was 4.8% (21/439) overall and 3.7% (9/243) for isolated mitral reconstruction. Systolic anterior motion was found in 6.4% (28/438) after the operation, and 2.3% (10/438) had a coexisting left ventricular outflow tract gradient (mean 53 mm Hg). Of the 28 patients with systolic anterior motion, 27 (96.4%) had leaflet prolapse, 17 (60.7%) had undergone more than a 3 cm resection of the posterior leaflet, and two (7.1%) had preexisting idiopathic hypertrophic subaortic stenosis. All patients were treated medically, 14 with negative inotropic agents. Follow-up echocardiograms at a mean of 32 months demonstrated the disappearance of systolic anterior motion in 13 of 28 patients (46.4%) and resolution of the outflow tract gradient in 10 of 10 (100%). At follow-up only one patient was in New York Heart Association class III or IV and required reoperation for rheumatic mitral insufficiency. These data demonstrate that systolic anterior motion after Carpentier mitral reconstruction with ring annuloplasty is not prevalent and should be managed medically in most cases. Associated left ventricular outflow tract obstruction resolves with medical treatment.

Cardiac Surgical Procedures↗
PubMed1992

[Multiple myeloma in a patient in remission from malignant lymphoma].

A 71-year-old man was admitted because of right cervical lymph node swelling in February 1986. Lymph node biopsy revealed that he suffered from diffuse, large cell malignant lymphoma. Immunological staining showed lymphoma characterized by B cell markers, IgG, kappa type. Bone marrow aspiration, revealed no evidence of lymphoma and 0.2% plasma cells. The clinical stage was IIA. The patient was treated with the CHOP regimen (doxorubicin, cyclophosphamide, vincristine and prednisolone), which achieved complete remission. In October 1988, he was re-admitted because of a subcutaneous abscess, and biopsy of the inguinal lymph node showed reactive lymphadenitis. Although he improved with antibiotic therapy, laboratory date on admission showed monoclonal gammopathy. Serum immunoelectrophoresis demonstrated a monoclonal bow of IgA kappa type, and bone marrow aspiration revealed hypercellularity with an increased number of plasma cells (76.8%). The patient was diagnosed as having multiple myeloma, and combination chemotherapy was begun. He now attends the out-patient department at our hospital. The development of multiple myeloma has not been reported previously during a course of malignant lymphoma. Although the association of these two B cell neoplasias was unknown, in this case both showed the characteristic of kappa type light chains. This case may provide information concerning tumor cell origin.

Aged↗
PubMed1991

Collateral circulation in Kawasaki disease with coronary occlusion or severe stenosis.

Forty patients with Kawasaki disease with severe coronary sequelae were investigated. All had at least a 90% reduction in the diameter of the major coronary artery. Collateral vessels were seen in 32 of 33 (97%) patients with total occlusion. All patients with severe stenosis but not total occlusion had no or poorly developed collateral vessels. Analysis according to the presence or absence of collateral vessels showed no significant differences in the results of treadmill stress testing and myocardial imaging between these two groups. In patients treated surgically, the abnormalities recognized by these tests were normalized or improved when the bypass was patent. These data indicate that collateral circulation in patients with Kawasaki disease cannot be seen angiographically unless there is total occlusion and the presence of collateral circulation cannot provide protection against stress-induced myocardial ischemia.

Arterial Occlusive Diseases↗