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Biomedical subjects

T Ito

Publications and source records attributed to T Ito.

At least 289 records · Page 16Linked to original sources

Purification of proplatelet formation (PPF) stimulating factor: thrombin/antithrombin III complex stimulates PPF of megakaryocytes in vitro and platelet production in vivo.

In this study, the protein which stimulates proplatelet formation (PPF) of megakaryocytes was purified from normal human plasma using 7 steps procedures. Two different protease inhibitors were identified based on their amino acid sequences, i.e. antithrombin III (AT III) and C1 inhibitor. They were included in high density lipoprotein (HDL). HDL was necessary for AT III to be active in PPF in vitro. The biological effects of the AT III/HDL or thrombin-AT III (TAT)/HDL were studied in vitro. PPF of murine megakaryocytes was stimulated by negative control (BSA) (1.8 +/- 0.3%), AT III (2.0 +/- 0.4%), HDL (1.2 +/- 0.9%), AT III/HDL (14.8 +/- 2.1%) or TAT/HDL (23.3 +/- 3.5%), respectively. TAT/HDL also had a synergistic effect with the mpl ligand, judging by the acetylcholinesterase (AchE) expression of murine megakaryocytes (2.7 fold increase). In vivo subcutaneous administration of AT III alone or TAT for 3 days significantly stimulated thrombocytosis (136% and 144%, respectively, p<0.05) and AT III/HDL showed rapid and further stimulation (150%, p <0.01). These results and the previous studies indicate that megakaryocytopoiesis is regulated by the mpl ligand, while a protease/protease inhibitor complex such as TAT, which is involved in the coagulation cascade associated with platelet consumption, might be one of the regulators in platelet production.

Amino Acid Sequence↗

[Broad old anteroseptal myocardial infarction with coronary aneurysm showing marked improvement of myocardial perfusion by intravenous myocardial contrast echocardiography after successful coronary angioplasty: a case report].

A 56-year-old man with old anteroseptal myocardial infarction was admitted to treat a gradually expanding coronary aneurysm. Coronary angiography demonstrated the aneurysm and delayed flow in the left coronary descending artery. The aneurysm was successfully treated with stenting. Technetium-99m-sestamibi single photon emission computed tomography (SPECT) showed a persistent defect in the anterior infarcted area after stenting. Myocardial contrast echocardiography was performed using SystemFIVE and EchoPAC. Levovist was injected (1 ml, 1.5 ml/sec; bolus + 1 ml/sec; continuous infusion) by Pulsar. Myocardial reperfusion was observed by B-mode and anatomical M-mode before and after intervention. Time-intensity curves from the region of interest positioned within the interventricular septum showed the mean value at plateau increased from 10.8 to 25.1 dB. The persistent defect area demonstrated by SPECT was enhanced by myocardial contrast echocardiography after intervention. Myocardial contrast echocardiography is useful for the assessment of outcome after intervention and evaluation of improved coronary blood flow.

Angioplasty, Balloon, Coronary↗

Rapid N transport to pods and seeds in N-deficient soybean plants.

Non-nodulated soybean (Glycine max (L.) Merr.) plants were cultivated hydroponically under N-sufficient (5 mM NaNO(3)) or N-deficient (0.5 mM NaNO(3)) conditions. (13)N- or (15)N- labelled nitrate was fed to the cut end of the stems, and the accumulation of nitrate-derived N in the pods, nodes and stems was compared. Real-time images of (13)N distribution in stems, petioles and pods were obtained using a Positron Emitting Tracer Imaging System for a period of 40 min. The results indicated that the radioactivity in the pods of N-deficient plants was about 10 times higher than that of N-sufficient plants, although radioactivity in the stems and nodes of N-deficient versus N-sufficient plants was not different. A similar result was obtained by supplying (15)NO(3) to cut soybean shoots for 1 h. The fact that the N translocation into the pods from NO(3) fed to the stem base was much faster in N-deficient plants may be due to the strong sink activity of the pods in N-deficient plants. Alternatively, the redistribution of N from the leaves to the pods via the phloem may be accelerated in N-deficient plants. The temporal accumulation of (13)NO(3) in nodes was suggested in both N-sufficient and N-deficient plants. In one (13)NO(3) pulse-chase experiment, radioactivity in the stem declined rapidly after transferring the shoot from the (13)NO(3) solution to non-labelled NO(3); in contrast, the radioactivity in the node declined minimally during the same time period.

Amino Acids↗

A case of a chronic traumatic thoracic aneurysm 11 years after injury.

A 28-year-old male, who was involved in an automobile accident 11 years previously, was diagnosed as having a chronic traumatic thoracic aneurysm. An enhanced computed tomographic scanning (CT) and three-dimensional CT demonstrated that a thoracic aortic aneurysm of 50 mm in the maximal axis was located at the aortic isthmus and dilated posteriorly. He underwent thoracic aorta graft replacement using Femoro-femoral partial bypass. The surgery was successful and the postoperative course was uneventful.

Accidents, Traffic↗

Surgical treatment of an aneurysm of the aberrant right subclavian artery involving an aortic arch aneurysm and coronary artery disease.

A 55-year-old man presented with clinical signs of an aortic arch aneurysm. Angiography, MRI and CT demonstrated an aortic arch aneurysm and an aneurysm of the aberrant right subclavian artery. Coronary angiography revealed 95% stenosis in the right coronary artery. Right common carotid artery-right subclavian artery bypass, arch graft replacement and coronary artery bypass grafting were performed successfully. The use of internal shunt tube, hypothermic circulatory arrest and selective cerebral perfusion were useful methods in prevention of cerebral ischemia during surgical reconstruction of the aortic arch. To our knowledge, this is the first report in the literature of a successfully managed case with an aneurysm of an aberrant right subclavian artery involving an aortic arch aneurysm and coronary artery disease.

Aneurysm↗

[A case of esophageal carcinoma with multiple liver metastases successfully treated with nedaplatin (NDP) and 5-fluorouracil (5-FU) combined with radiotherapy].

A 78-year-old male patient had esophageal carcinoma with multiple liver metastases. Chemoradiotherapy was performed. The chemotherapy consisted of protracted infusion of 5-fluorouracil (5-FU), combined with infusion of nedaplatin (NDP). Radiation of the mediastinum was administered concomitantly with chemotherapy. The patient showed a complete response (CR) of the primary lesion and a partial response (PR) of the liver metastasis for 11 months. Since liver metastasis recurred after initial treatment, chemotherapy consisting of NDP infusion combined with vindesine sulfate (VDS) infusion was performed. The patient again showed PR. Grade 3 leukocytopenia occurred during treatment, but there were no major toxicities such as thrombocytopenia, nausea, renal dysfunction or esophagitis. Survival time was one year and 7 months. In conclusion, concurrent chemoradiotherapy including NDP is effective and safe for patients with esophageal carcinoma accompanied by multiple liver metastasis. This nonsurgical approach may be an option for standard care in such cases.

Aged↗

[Complete remission of brain metastases from prostate cancer by gamma knife radiosurgery: a case report].

A 59-year-old male visited us with a chief complaint of dysuria. The serum prostate specific antigen (PSA) level was within normal limits, and intravenous pyelography and urethrocystography showed no abnormal findings. Because of his urinary retention, transurethral resection of prostate was performed under a clinical diagnosis of benign prostatic hyperplasia. The pathological diagnosis was poorly differentiated adenocarcinoma of the prostate. Not only combination hormone therapy with goserelin acetate and flutamide, but also intermittent arterial infusion chemotherapy with cisplatin (CDDP) and pirarubicin (THP) using a reservoir system was administered. Additionally total pelvic irradiation was delivered. Magnetic resonance imaging (MRI) demonstrated that his prostate was reduced to less than 50% in size and he had no difficulty in voiding. He suddenly developed dysarthria and hemiplegia 3 months later. MRI and computed tomography (CT) revealed multiple brain metastases. After the gamma knife radiosurgery, neurological findings disappeared and MRI showed dramatic shrinkage of metastatic brain tumors. Metastasis to the pancreas was recognized on CT and he died of multiple organ failure 30 months after his first visit.

Adenocarcinoma↗

[A case of motor neuron disease with presenile dementia showing bilateral degeneration of the pyramidal tract on cranial MRI].

A 58-year-old man developed dysarthria followed by a personality change. Subsequently, he developed muscle weakness and atrophy of the left upper and lower limbs, leading to repeated falls when he tried to walk. Neurological examination showed mild dementia, dysarthria, dysphagia, atrophy and fasciculation of the tongue, and muscle weakness and atrophy of all four extremities, particularly on the left side. Deep tendon reflexes were slightly diminished in the upper limbs and slightly exaggerated in the lower limbs without Babinski's sign. Cranial MRI revealed marked atrophy of the medial portions of the temporal lobes, more striking on the right, and T2-weighted imaging revealed symmetrical high-intensity signals from the posterior limbs of the internal capsules to the cerebral peduncles in the midbrain, extending to the pons on the left. 125I-IMP SPECT showed diffuse reduction of RI uptake in the frontal and temporal lobes, which was more marked on the right. We diagnosed this is a case of motor neuron disease with presenile dementia, which Mitsuyama et al. proposed as a new clinical entity, as well as a rare example of bilateral degeneration of the pyramidal tract on cranial MRI.

Alzheimer Disease↗

Quantification of left atrial appendage spontaneous echo contrast in patients with chronic nonalvular atrial fibrillation.

OBJECTIVES: The left atrial (LA) appendage is the most common site of thrombus formation in patients with atrial fibrillation, and integrated backscatter allows the quantiative assessment of LA spontaneous echo contrast (SEC). Integrated backscatter was used to examine the significance of measuring appendage SEC, specifically in relation to echocardiographic variables implying thromboembolism, in patients with chronic nonvalvular atrial fibrillation. METHODS: Fifty-two patients with chronic nonvalvular atrial fibrillation and no prior anticoagulant therapy (35 men, 17 women, mean age 66 +/- 7 years) underwent transesophageal echocardiography with integrated backscatter analysis. The LA and LA appendage integrated backscatter intensity were measured with the regions of interest placed in the LA cavity and the appendage, respectively. The integrated backscatter intensity values for these two chambers (corrected "LA" and "LA appendage" integrated backscatter intensity, respectively) were corrected using values from the left ventricular cavity. RESULTS: The LA appendage integrated backscatter intensity values were available in 44 patients (85%). Overall, the corrected LA appendage integrated backscatter intensity was significantly increased compared with the corrected LA integrated backscatter intensity (2.8 +/- 2.2 vs 2.0 +/- 1.8 dB, p < 0.001). The corrected LA appendage integrated backscatter intensity was inversely correlated with the LA appendage velocity (r = -0.37, p < 0.05), but not with the LA dimension, appendage size, or left ventricular function. The corrected appendage integrated backscatter intensity (4.5 +/- 2.3 vs 2.4 +/- 1.9 dB, p < 0.01) and LA integrated backscatter intensity (3.2 +/- 2.1 vs 1.7 +/- 1.7 dB, p < 0.05) were higher in patients who had LA appendage thrombus (n = 8) than those who did not. With the corrected appendage integrated backscatter intensity set at > or = 2.5 dB, the sensitivity for the presence of appendage thrombus was 88% and the specificity was 64%. CONCLUSIONS: Patients with chronic nonvalvular atrial fibrillation had a denser SEC in the LA appendage compared with SEC in the main LA cavity. The severity of the appendage SEC was influenced by the LA appendage function rather than its size. Quantification of SEC in the appendage, rather than main LA cavity, was more valuable for assessing embolic potential.

Aged↗

Doppler evaluation of systolic and diastolic heart failure in patients with cardiomyopathy.

BACKGROUND AND OBJECTIVES: Analysis of transmitral flow with Doppler echocardiography can currently evaluate left ventricular diastolic function noninvasively and easily. In addition, measurement of pulmonary venous flow and left atrial appendage flow clarifies not only left ventricular diastolic function but also left atrial systolic function in patients with left ventricular systolic failure and diastolic failure. METHODS AND RESULTS: Doppler echocardiography was used to investigate the differences in left ventricular diastolic dysfunction. In patients with systolic heart failure, left atrial dysfunction due to afterload mismatch to the left ventricle was related to the reduction of transmitral atrial filling wave in a restrictive pattern. In contrast, in patients with diastolic heart failure, transmitral flow seldom indicated a restrictive pattern because left atrial systolic function was preserved even with high pulmonary wedge pressure. CONCLUSIONS: Left ventricular diastolic dysfunction is somewhat distinct between patients with left ventricular systolic failure and patients with left ventricular diastolic failure. Atrial reversal flow in pulmonary vein has the potential to predict left ventricular filling pressure in patients with diastolic failure.

Cardiomyopathies↗

[Intestinal permeability in Crohn's disease and effects of elemental dietary therapy].

Enteral intake of non-metabolic monosacharide and disaccharide, followed by measurement of the urinary excretion ratio of the two, is a method used to investigate intestinal permeability. L/R ratio (lactulose/1-rhamnose urinary excretion ratio) is considered an indicator of permeability of the small intestine. An increased L/R ratio is caused by mucosal disorders of the small intestine. The L/R ratio in all patients (n = 92) with Crohn's disease was 0.079 +/- 0.081 (mean +/- S.D.), which was significantly higher than the value in normal controls (0.027 +/- 0.009, n = 20, p < 0.05). In 39 patients with Crohn's disease, we assessed intestinal permeability before after treatment with an elemental diet, and during remission. The L/R ratio was 0.120 +/- 0.092, before treatment and 0.065 +/- 0.097 after treatment (p < 0.05), showing increased intestinal permeability before elemental dietary treatment. During remission, the L/R ratio was 0.035 +/- 0.028; this did not differ significantly from the value obtained after treatment. We conclude that intestinal permeability is useful for investigating disease activity in patients with Crohn's disease.

Adolescent↗

[A case of isolated tricuspid regurgitation caused by a dilated tricuspid annulus treated by ring annuloplasty].

Isolated tricuspid regurgitation is rare. A 64-year-old man was admitted to our hospital with a complaining of shortness of breath and edema of lower extremities. Chest X-ray showed remarkable cardiomegaly (cardiothoracic ratio, 73%). Echocardiogram demonstrated severe tricuspid regurgitation and dilated right atrium. At operation, the tricuspid annulus was severely dilated about 7 cm in diameter, and all leaflets of tricuspid valve were intact. Prosthetic ring annuloplasty with a 32 mm Carpentier-Edwards ring was performed. Postoperative course was uneventful. Four weeks after operation he was discharged from the hospital and he is now leading a normal life. Careful follow up for long time is essential in this case.

Dilatation, Pathologic↗

[Long-term results of Rygg's monocusp ventricular outflow patch for the reconstruction of right ventricular outflow tract in tetralogy of Fallot].

Thirty surviving patients after corrective surgery for tetralogy of Fallot with right ventricular outflow tract reconstruction (RVOTR) using monocusp ventricular outflow patch (MVOP) were reviewed retrospectively to determine the long-term results. The age at operation ranged from 2 to 55 years with a mean of 19 years, and follow-up extended to 18.2 years (cumulative: 345.4 patient-year). There were 4 late deaths (1.2% per patient-year), and the cumulative survival rate was 85.3% at 18 years after the corrective surgery. Eight patients (2.3% per patient-year) required intracardiac reoperations mostly resulted from problems after RVOTR with MVOP, such as recurrent stenosis of right ventricular outflow tract (3 cases) or pulmonary valvular incompetence (4 cases). In addition, one patient underwent balloon angioplasty for the recurrent stenosis located in the distal end of MVOP. Freedom from surgical or catheter reintervention for the MVOP-related complication was 60.6% at 18 years after the corrective surgery. MVOP caused compression of the pulmonary artery at the distal end of the anastomosis and reoperation in a younger patients quite early after the corrective surgery. Like other transannular patches, tissue failure and degeneration of MVOP were inevitable, and resulted in severe pulmonary valvular incompetence that required the valve replacement in 4 patients (1.3% per patient-year). Freedom from pulmonary valve replacement was 71.2% at 18 years after the corrective surgery. As long-term results, our experiences emphasize the need for an innovative transannular patch that possesses significantly better long-term durability.

Adolescent↗

[A case of bronchioloalveolar cell carcinoma with bilateral diffuse interstitial infiltrative shadow during the treatment of Takatsuki's disease].

A 54-year old man treated with Takatsuki's disease was referred to us complaining of cough and excessive sputum. A chest roentgenogram showed bilateral diffuse interstitial infiltrative shadow. Chest CT showed banding shadows around the bronchioles and lobule-septum thickening in the right middle and both lower lung fields, and many small nodules in both lower lung fields. The histological diagnosis was adenocarcinoma replaced with one layer of bronchiolar epithelium, and partly bronchiolo-alveolar carcinoma. The patient received 3 courses of combination chemotherapy with docetaxel and cisplatin. After chemotherapy, the chest CT showed no change. The clinicopathological characteristics of this rare case included adenocarcinoma mixed with bronchioloalveolar carcinoma, in which radiography showed bilateral diffuse interstitial infiltrative shadow.

Adenocarcinoma↗

[Brain metastases from esophageal cancers: clinical features and treatment results].

Metastatic brain tumors from esophageal cancer are relatively rare. We analyzed the clinical features and results of treatment in 14 cases of brain metastases from esophageal carcinoma. The average time to diagnosis of brain metastases in the 11 patients with metachronous lesions was 13 months. The average age of patients at the diagnosis of brain metastasis was 65 years. Most patients had T4 or N1 disease at the time of diagnosis of esophageal cancer. Performance status of grade 3 was most frequent at the time of diagnosis of brain metastasis. Treatment for brain metastases was surgery followed by radiation in five cases, radiotherapy alone in seven cases, and conservative treatment in two cases. The median survival time of all patients from the treatment of brain metastases was 2 months, with only one patient alive after more than one year. Improvement in neurological symptoms was demonstrated in 42% of cases. These extremely poor treatment results reflect the fact that most patients at the time of diagnosis of brain metastasis had poor performance status and the presence of extracerebral metastases. Therefore, a short-course, high-dose-per-fraction treatment for brain metastases from esophageal cancer should be selected from the viewpoint of quality of life.

Adult↗

[Intraoperative coating of tumor surface using fibrin glue as a prophylaxis for cancer cell detachment].

With the aim of preventing cancer cells from becoming detached and spreading into the abdominal cavity by operative procedures during surgical resection of cancer infiltrating into gastrointestinal serosa, the exposed area of the serosa in mice was coated with fibrin glue, a biological tissue adhesive, prior to resection. We then determined whether the coating could reduce the detachment and spread of cancer cells during the surgical procedure, and thus be capable of inhibiting the occurrence of peritonitis carcinomatosa. In vitro experiments demonstrated that the fibrin glue uniformly and strongly coated the exposed area of cancer, and furthermore, that the presence of fibrin glue coating significantly reduced the number of cancer cells which became detached. As a result of using this glue, the number of deaths due to peritonitis carcinomatosa among assay mice was significantly decreased. It is therefore considered that coating the exposed area of cancer with fibrin glue inhibits cancer cells from being detached and spread during an operation, and thus can be an effective means of preventing the recurrence of peritonitis.

Animals↗