Search PubMed⌕ Search

Biomedical subjects

T Isomura

Publications and source records attributed to T Isomura.

161 records · Page 9Linked to original sources
PubMed1981

Atypical malignant histiocytosis. Its appearance as a single meningeal tumor or as multiple skin tumors.

We studied two unusual cases of malignant histiocytosis (MH). In one case, a solitary intracranial tumor developed in a 20-year-old man eight months before the characteristic symptoms of MH appeared. In the other, a 73-year-old man had multiple nodular skin lesions four months before malignant histiocytes appeared in his blood. In both, the tumor cells were identified as malignant histiocytes by light and electron microscopic, cytochemical, and cytoimmunological criteria.

Adolescent↗
PubMed1980

Ultrastructure of human hepatocellular carcinoma.

Twelve human hepatocellular carcinomas (HCC) were studied ultramicroscopically. In the aspects of development of cytoplasmic organelles, well differentiated cancer cells were similar to the normal hepatocytes. On the other hand, poorly differentiated HCC cells contained little cytoplasmic organelle except for relatively developed rER and ribosomes. HCC cells showed not only several differentiations but also many degenerative changes, such as fatty metamorphosis, "dark" and "clear" cells, "fingerprint" formation and myelin-like figure, and the ultratructural alterations of the vessels among HCC cells could play one of the most important roles in causing these degenerative changes in human HCC cells.

Adult↗
PubMed1980

Small multiple carcinoid tumors occurring in the ileum with a pseuodcystic liver metastasis.

A 49-year-old woman was admitted to the hospital with a palpable mass in the right hypochondrium. A laparotomy was performed under the clinical diagnosis of a solitary cyst of the liver. The cystic lesion of the liver was removed. Although the histological finding of the cyst wall showed a similarity to hepatocellular carcinoma of trabecular pattern, the tumor cells with uniform nuclei and little mitotic figure were positive for both argyrophil and argentaffin reaction. The pathological diagnosis was metastatic carcinoid tumor of the liver. There was no carcinoid syndrome nor the other clinical symptoms after the operation and various postoperative examination could not reveal a primary site of the carcinoid tumor. The cystic lesion of the liver recurred ten months after the first operation and a second laparotomy was performed to reveal the primary site in the ileum: three submucosal tumors, 0.8, 0.7, and 0.3 cm. in diameter, two of them, however, extended into the muscle wall or subserosa and conclusively, the small lesion of the ileum metastasized into the liver as a large pseudocystic lesion.

Carcinoid Tumor↗
PubMedDate not supplied

Efficacy of gastric blood supply redistribution by transarterial embolization: preoperative procedure to prevent postoperative anastomotic leaks following esophagoplasty for esophageal carcinoma.

PURPOSE: The aim of this study was to evaluate the effect of preoperative redistribution of gastric blood supply on the prevention of anastomotic leakage following surgical reconstruction of the esophagus. METHODS: In 37 patients with esophageal carcinoma, transarterial embolization (TAE) of the left gastric, right gastric, and splenic arteries was preoperatively performed with coils so that gastric blood supply was dependent only on the right gastroepiploic artery. RESULTS: In 34 of 37 patients, preoperative redistribution was successfully performed. The gastric tissue blood flow (TBF) of a gastric tube was higher than in 12 nonredistributed patients. Reduction in the gastric TBF during preparation of a gastric tube was 27.5% in successful patients, in contrast to 68.9% in 12 nonredistributed patients (p < 0.005). CONCLUSION: Preoperative redistribution by TAE reduced the drop in gastric TBF during preparation of a gastric tube and helped prevent postoperative anastomotic leakage in esophageal reconstruction.

Adult↗
PubMedDate not supplied

The Batista operation in patients with dilated cardiomyopathy.

Between December 1996 and October 1998, 34 patients with nonischemic dilated cardiomyopathy (DCM) received cardiac volume reduction surgery. The patients' ages ranged from 14 to 67 years (mean = 48 years) and included 28 males and 6 females. Associated mitral regurgitation was present in 31 patients, tricuspid regurgitation in 19 patients, and aortic regurgitation in 4 patients. We performed a partial left ventriculectomy (PLV) using antegrade intermittent warm blood cardioplegia in 15 patients (group A), and in 19 patients (group B) PLV was performed using the on-pump beating heart technique. In group A, the mean aortic clamping time was 79+/-33 minutes and the total cardiopulmonary bypass time was 155+/-58 minutes. In group B the mean cardiopulmonary bypass time was 121+/-43 minutes. There were eight hospital deaths (five in group A and three in group B). Five of 10 survivors of group A required inotropic support for 13.8+/-25.3 days after the operation, while 5 of 12 survivors in group B required inotropes for 4.2+/-3.1 days. Hospital mortality was 86% in 7 emergent cases and 7% in 27 elective cases. Echocardiographic study showed that the left ventricular ejection fraction improved from a mean of 18.7% to 30.3% and the left ventricular diameter decreased from a mean of 80.2 mm to 62.3 mm after the operation. All 26 hospital survivors were followed for 1 to 20 months. Three patients died at early follow-up because of congestive heart failure, thrombosed valve, and hepatic failure, respectively. Nineteen patients were in New York Heart Association (NYHA) Class I or II and four were in NYHA Class III. In conclusion, cardiac volume reduction surgery is effective when the operative technique and proper judgment of patient selection are established, and emergent operation is avoided.

Adolescent↗
PubMedDate not supplied

Myocardial inflammatory cell infiltrates in cases of dilated cardiomyopathy: light microscopic, immunohistochemical, and virological analyses of myocardium specimens obtained by partial left ventriculectomy.

OBJECTIVE: Partial left ventriculectomy was introduced for the treatment of refractory dilated cardiomyopathy (DCM). To determine the presence and degree of inflammatory cell infiltrates in DCM and the correlation between the underlying myocardial injury and early clinical outcomes after the operation, we performed histopathological, immunohistochemical, and virological studies of the resected myocardium. METHODS: Posterolateral walls of the left ventricle from 13 idiopathic DCM patients (9 males and 4 females; mean age = 53+/-14 years) were examined. Qualitative and quantitative analyses of the interstitial fibrosis and of the infiltrating inflammatory cells were conducted. For the immunohistochemistry, leukocyte surface markers and antibodies to adhesion molecules and cytokines were used. The histopathological findings were compared with the clinical results, including outcome within 1 year, and pre- and postoperative hemodynamic data. Genomic analysis of the myocardium with polymerase chain reaction was performed for enterovirus, mumps, influenza A, cytomegalovirus, and hepatitis C virus. RESULTS: (1) The three patients who died of cardiac insufficiency after surgery had a higher count of infiltrating inflammatory cells than the eight survivors (32.1+/-10.4 vs 16.3+/-11.9 cells/mm2, p = 0.07). The severity of interstitial fibrosis (percent fibrosis) did not differ significantly between these two groups (28.3+/-15.0 vs 24.0+/-11.7%). (2) In patients who died of myocardial dysfunction, focal accumulations of lymphocytes were common, in which cytotoxic/suppressor T cells and helper/inducer T cells were observed. (3) Enterovirus genome was detected in the myocardium of two patients, both of them died after surgery. CONCLUSIONS: Inflammatory cell infiltrates or active myocarditis appear in some cases to play an important role in the etiology and pathophysiology of clinically diagnosed DCM. There is a possibility that those patients with a more severe or ongoing inflammatory process might have poor outcomes after partial left ventriculectomy.

Adult↗
PubMedDate not supplied

Enterovirus RNA replication in cases of dilated cardiomyopathy: light microscopic in situ hybridization and virological analyses of myocardial specimens obtained at partial left ventriculectomy.

OBJECTIVE: Recently, attention has been focused on enteroviral infection of the heart in the genesis of dilated cardiomyopathy (DCM). To determine the location of enteroviral RNA in the myocardium, we performed light microscopic in situ hybridization (ISH) and virological analyses of myocardial specimens obtained at partial left ventriculectomy (PLV). METHODS: Posterolateral walls of the left ventricle from 26 DCM patients were examined. Myocardial specimens were tested for the presence of enteroviral genomes by polymerase chain reaction (PCR). We selected two age-matched groups (10 patients each) in which enteroviruses were either present (EV-plus group) or not (EV-minus group). For both groups, we examined in situ localization of enteroviral RNA in the myocardium by ISH. RESULTS: In PCR studies, both sense and antisense enteroviral RNA were detected in the myocardium of seven patients in the EV-plus group. The presence of this RNA indicates active viral replication in the myocardium. Five of seven patients who exhibited both sense and antisense enteroviral RNA died early after surgery. On ISH, three patients had evidence of active replication of enteroviral genomes. Viral genomes were present in myocardial lesions, especially in endocardial sites. Viral signals were found in degenerating myocardial cells, interstitial inflammatory cells, and endothelial cells of small vessels. These positive signals were not detected in the myocardium of the EV-negative group. CONCLUSIONS: We detected both sense and antisense enteroviral RNA in various myocardial lesions. This suggests that active enteroviral replication plays a role in the development of myocardial lesions in DCM patients. Active viral replication appears to be a prognostic factor for DCM after PLV. Further study of active viral replication in myocardial lesions will provide information useful for evaluating different therapeutic strategies for DCM.

Adolescent↗
PubMedDate not supplied

Interactive fusion of three-dimensional images of upper abdominal CT and FDG PET with no body surface markers.

The aim of this study was to propose and validate a new method of making fused images from CT and FDG PET images for the upper abdominal area with no body surface marker. PET and CT were carried out in patients with pancreatic cancer (N = 5) and mass-forming pancreatitis (N = 2). First, we determined the midsagittal plane from PET and CT data. From the difference in location of the midsagittal planes, rotations of Y (from back to front) and Z axes (from foot to head) and X translation (from right to left) were calculated. An upper pole of the kidney was determined from PET and CT data. It showed Y and Z translations. The images of the three-dimensional data sets were fused on a workstation. Reproducibility was assessed with randomly misaligned PET and CT data sets. Pancreatic cancer and its lymph node metastases were identified easily on fused images. In reproducibility assessment, the average error of rotation was 0.77 degree. The average errors of translation were 3.43, 4.70, and 9.23 mm on the X, Y, and Z axes, respectively. In conclusion, this PET/CT image registration technique is feasible and practical. It allows precise anatomical assessment of normal and abnormal FDG accumulation.

Aged↗
PubMedDate not supplied

Late pathological changes of Carpentier-Edwards porcine bioprostheses in the mitral position.

Eighty-nine patients received mitral valve replacement with Carpentier-Edwards porcine bioprostheses between 1975 and 1983. Eighty-three patients (93.3%) were followed up after the operation; early death (within one month of operation) occurred in 6 patients and late death in 2 patients. After the operation, 64 survivors (85.3%), who did not require reoperation, exhibited improved symptoms according to the NYHA functional class. Of the 6 patients (6.7%) who required reoperation, 5 patients underwent reoperation 50 to 85 months after the implantation. Pathologically, all the removed valves showed degeneration of collagen and elastic fibers, no host endothelialization and mild to moderate infiltration of inflammatory cells. Thrombus in the left atrium was detected in one case. Destruction of the cusps was seen in three cases and calcification of the cusps developed in three cases. In general, the Carpentier-Edwards porcine bioprosthesis provided good clinical improvement over the periods studied. However, morphological changes of the bioprosthetic valve, such as destruction collagen and elastic fiber, and inflammatory cell infiltration of the cusps, seems to occur more frequently with the passage of time. We therefore suggest that patients with this prosthesis should be followed carefully, particularly at late intervals after implantation.

Adult↗
PubMedDate not supplied

Distal and proximal dissection of an abdominal aortic aneurysm.

A case of abdominal aortic aneurysm in which dissection developed in retrograde fashion into the thoracic aorta is reported. The aortogram showed findings similar to DeBakey Type-IIIb dissection. No intimal tear was seen in the thoracic aorta; however, the origin of the intimal tear was found in the abdominal aorta. Renal hypertension also developed due to distal dissection of the right renal artery. Closure of the primary intimal tear, partial closure of the false channel and removal of the right kidney were performed therefore, reattachment of vessels was not required. This was the first case in which a primary tear was seen in the abdominal aorta in our 37 surgical cases of dissecting aortic aneurysm. Three cases of retrograde dissection of abdominal aortic aneurysm have been reported in the English literature as far as we have determined. The importance of accurate detection of the origin of the intimal tear is emphasized.

Aortic Dissection↗
PubMedDate not supplied

Effect of dose of cyclosporine or FK506 and antithrombotic agents on cardiac allograft vascular disease in heterotopically transplanted hearts in rats.

BACKGROUND: We compared the severity of cardiac allograft vascular disease in rats treated with cyclosporine or FK506 and studied the effect of antithrombotic agents on cardiac allograft vascular disease. METHODS: One group each was treated with 2 and 5 mg/kg/day of cyclosporine. Two other groups were injected with heparin and dipyridamole, respectively, in addition to cyclosporine. Four other groups were similarly divided by dose of FK506 (0.1 or 0.25 mg/kg/day) and concomitant anticoagulant treatment. RESULTS: Grade of rejection and percentage stenosis of coronary arteries were lower in groups with high doses of immunosuppressive agents or with heparin. Major histocompatibility class II antigens were expressed by the endothelium of grafted hearts, and IgM and C3 were deposited in the intimal and medial layers in all groups except those administered the higher doses of immunosuppressive drugs. However, no remarkable differences in density of major histocompatibility class II antigens were found between groups demonstrating expression of these antigens. On the other hand, the intensity of IgM or C3 expression grew significantly as coronary stenosis increased in severity. CONCLUSIONS: A significant difference in severity of cardiac allograft vascular disease was not found between the groups treated with cyclosporine and FK506, and cardiac allograft vascular disease was almost entirely suppressed when doses of cyclosporine and FK506 sufficient to suppress graft rejection were administered. Our findings also showed that concomitant heparin administration reduced the extent of allograft rejection and the incidence of cardiac allograft vascular disease.

Animals↗
PubMedDate not supplied

The effect of the addition of albumin to cardioplegic and preservation solutions on the isolated rat heart.

This experimental study evaluates the effect of the addition of albumin to cardioplegic and preservation solutions on isolated rat hearts. Male Wistar rat hearts were arrested with a 4 degrees C crystalloid cardioplegic solution. All hearts were immersed for 8 hours in a 4 degrees C Euro-Collins solution. They were divided into four groups: group I, the cardioplegic solution was used for cardiac arrest, and the 4 degrees C Euro-Collins solution did not contain albumin; group II, the cardioplegic solution was adjusted to an albumin concentration of 3%; group III, the preservation solution contained 3% albumin; and group IV, both the cardioplegic and the preservation solutions contained 3% albumin. The cardiac output for group IV increased more than that for any other group (p < 0.05 or p < 0.01). The total concentration of creatine kinase-MB at 30 minutes after reperfusion in group III decreased less than that in groups I and II. The level of myocardial adenosine triphosphate in group IV was better preserved than that in any other group; the myocardial calcium content in group IV decreased compared to the other groups. However, no significant difference between groups III and IV was found. The level of malondialdehyde as a measure of lipoperoxide values showed significant differences between groups I and IV and groups II and IV at 5 minutes after reperfusion (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMedDate not supplied

Improvement of postoperative graft patency rate for coronary revascularization.

For coronary artery revascularization, the long term patency rate of internal thoracic artery (ITA) is excellent and arterial conduit for coronary bypass grafting (CABG) has been actively pursued. Application of the right gastroepiploic artery (GEA) is on the increase but, the patency of the GEA graft is more technically demanding than that of ITA. To improve early postoperative graft patency for coronary artery bypass grafting (CABG) for arterial graft, we modified the technique for anastomosis and demonstrated the patency by postoperative angiogram in 26 consecutive patients receiving CABG. The graft was anastomosed to the coronary artery using two 8-0. Prolene sutures for arterial graft and 7-0 Prolene sutures for saphenous vein (SV) graft. The heal and toe sides of the graft were sutured separately by the parachute technique (double parachute technique), followed by running suturing and typing at bilateral sides. The number of distal anastomoses was 3.4/patient and 44 arterial grafts and 40 SV grafts were used for coronary revascularization. Arterial grafts consisted of 33 ITAs, 9 GEAs, and two inferior epigastric arteries. The angiograms taken 10 to 14 days after operation demonstrated 100% patency rate of arterial grafts and 39 out of 40 SV grafts were patent. The overall patency rate in the early postoperative period was 98.8% The "double parachute" technique for CABG is highly accurate anastomosis with good visualization and the patency rates for all kinds of grafts were found to have improved.

Adolescent↗
PubMedDate not supplied

Screening helical CT for mass screening of lung cancer: application of low-dose and single-breath-hold scanning.

PURPOSE: To investigate the usefulness of helical CT with low-dose and single-breath-hold scanning for lung cancer screening. MATERIALS AND METHODS: Twenty-four helical CT scans of the lung were performed using various parameters in 10 healthy volunteers. The effects of tube current and pitch were evaluated by assessment of image quality and detection of simulated nodules. Screening helical CT was performed at 120 kVp, 50 mA, 1 sec/rotation, 10 mm collimation, and a pitch of 2.0 in 110 patients. The ability of this method to detect nodules and masses, focal parenchymal opacities, and diffuse fibrotic changes was evaluated using conventional CT as the gold standard. RESULTS: A reduction in tube current to 50 mA did not significantly change the assessment of image quality or detection of simulated nodules. Although these factors were degraded by increasing the pitch, there was no significant difference between 1.5 and 2.0. Screening helical CT permitted the entire lung to be scanned with ease during a single-breath-hold in all patients. This method detected 177 of 196 nodules and masses (87 of 91 lesions greater than 5 mm in diameter), 54 of 57 focal parenchymal opacities, and 15 of 15 cases with fibrotic changes. CONCLUSION: Screening helical CT with low-dose and single-breath-hold scanning shows promise for lung cancer screening.

Adult↗