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Biomedical subjects

T Itoh

Publications and source records attributed to T Itoh.

At least 451 records · Page 25Linked to original sources
PubMed1998

[Lung cancer accompanying sarcoidosis with diffuse myocardial involvement].

We describe an interesting case of adenocarcinoma of the lung accompanying sarcoidosis with diffuse myocardial involvement. A 69-year-old man had a tumor shadow on chest X-ray films of the right upper lung field. Bronchofiberscopy was performed in Jan. 1997. Because transbronchial biopsy specimens disclosed granuloma, the patient was treated with isoniazid, rifampicin, and streptomycin sulfate for tuberculosis, but did not show any improvement. In March 1997, the patient was examined by an ophthalmologist for blurred vision. He was given a diagnosis of uveitis and referred to us for evaluation because his serum ACE and lysozyme levels were elevated. Bronchofiberscopy was performed again, and a diagnosis of lung cancer accompanying sarcoidosis was made based on the findings of transbronchial biopsy and bronchoalveolar lavage. The disease progressed rapidly, and the patient died 47 days after admission. Autopsy disclosed sarcoid granulomas in cardiac muscle tissue and lung tissue. There have been very few reports on the co-existence of sarcoidosis and lung cancer, and the relationship between the two diseases is unclear.

Adenocarcinoma↗
PubMed1998

Hemodynamics after aortic valve replacement with St. Jude Medical valve for patients with small aortic annulus and severe left ventricular hypertrophy.

BACKGROUND AND AIMS OF THE STUDY: Cardiac function after aortic valve replacement (AVR) for patients with small aortic annulus and increased left ventricular (LV) wall thickness has not been clearly defined. The study aim was to examine a potential relationship between postoperative catheterization data (or radionuclide LV cardiac function) and the size of the aortic valve ring of a small St. Jude Medical prosthesis. METHODS: Sixty-one patients with small prosthesis (< or = 23 mm) were allocated to three groups based on the diameter of the native aortic annulus or aortic valve ring of the prosthesis (group I, 19 mm; group II, 21 mm; group III, 23 mm). Pre- and postoperative cardiac function was evaluated from catheterization data and radioisotope (RI) ventriculography. RESULTS: There were no significant inter-group differences in preoperative pulmonary artery pressures (PAPs), total pulmonary resistance (TPR), LV ejection fraction, peak ejection rate (PER) and peak filling rate (PFR). The mean postoperative PAPs and TPR of group I were significantly elevated in ICU compared with those of groups II or III (PAP: group I, 20+/-5; group II, 17+/-4; group III, 14+/-4 mmHg; p <0.01. TPR: group I, 505+/-268; group II, 316+/-134; group III, 276+/-125 dynes.s.cm-5; p <0.05). Postoperative PAPs and TPR of group I at one month after surgery were decreased, and no significant difference was found between the three groups. Cardiac function by RI study showed that postoperative PER and PFR improved in all three groups compared with the preoperative values. CONCLUSIONS: Postoperative reversibility of PAPs and improvement of PER and PFR in patients with a prosthesis of 19 mm or 21 mm showed that a small-sized aortic SJM valve had hemodynamic advantages. However, careful postoperative management in the ICU must be applied to patients with a small aortic annulus of 19 mm and severe concentric hypertrophy.

Aged↗
PubMed1998

High production of nondisjunction mutants in the offspring of Drosophila melanogaster females exposed to carbon dioxide at meiosis I.

Drosophila melanogaster females homozygous for X-linked recessive markers, y and wi, were exposed to CO2 and mated with y+ w+/Y males. The progeny were sampled and inspected for y wi/y wi/Y (XXY) and y+ w+/O (XO) mutants. The frequency of nondisjunction XXY mutants after a 90-min exposure to CO2 increased 100-fold above the control level in the first-day brood but did not increase above the control level in the second to sixth broods, showing that CO2 is an extremely potent inducer of nondisjunction in mature oocytes during meiotic metaphase I but is not harmful to immature oocytes. Nondisjunction-causing damage induced by CO2 in mature oocytes disappeared completely within one day after CO2 treatment, as evidenced by a reduction of the number of XXY mutants to the control level when the mating of CO2-treated females was delayed by one day. CO2-induced nondisjunction is probably due to damage to spindle microtubules in mature oocytes at metaphase I. N2 is a less potent inducer of nondisjunction than CO2. Maternal X-irradiation with 4 Gy did not induce XXY mutants, showing that medium-level radiation does not induce nondisjunction. The results support Gaulden's hypothesis that oxygen deficits and CO2 increases in the microenvironment of mature oocytes can be potent inducers of nondisjunction. The possible relationship to the cluster of Down syndrome seen in Berlin shortly after the Chernobyl accident is discussed.

Aneuploidy↗
PubMed1998

[Beta(+)-thalassemia (-31CapA-->G) homozygosity discovered on the mass medical examination: diagnosis for beta-thalassemia and DNA analysis].

A 44-year-old Japanese male showed a high value of HbF (14.3%) in an assay of glycated Hb (HbA1c) by use of HLC-723GHb II system. The proband was asymptomatic although he was found to be anemic ten years ago. The hematological examination revealed microcytosis, hypochromia and slight reticulocytosis (3.7%). Serum iron level was high (245 g/dl). Blood smear revealed aniso-poikilocytosis with scattered target cells. Hb analysis showed a remarkable increase of HbA2 (8.6%) as well as the high HbF cited above, but no abnormal Hb was detected. The beta/alpha ratio of globin biosynthesis in reticulocytes was decreased to 0.25. DNA sequencing of the beta-globin gene disclosed that the proband was homozygous for beta (+)-thalassemia mutation-31CapA-->G. This mutation was linked to A gamma T gene and haplotype -(-)+2(-)+2-. His parents and two daughters were heterozygous for the mutation. They were anemic and had increased HbA2 levels of 4.36-5.43%. The beta/alpha ratios of globin biosynthesis were 0.61-0.81.

Adult↗
PubMed1998

[Reoperation after aortic valve replacement and root reconstruction].

Between 1984 and 1997, 127 patients in our institution underwent single aortic valve replacement (AVR) with the St. Jude Medical valve (group S) and 11 patients with a porcine pericardial valve (group T). In the same period, 45 patients underwent aortic root reconstruction, among which 39 patients underwent the Bentall procedure using Carrel patch coronary reanastomosis (group B). The other 6 patients were treated with valve-sparing aortic root reconstruction (group V), among which the reimplantation method was used in 4 patients and the remodeling method in 2. The mean and total follow-up periods of the AVR and aortic root reconstruction groups were 6.9 +/- 1.9 year/735 patient-years and 4.9 +/- 3.9/years/196 patient-years respectively. The actuarial overall survival rates in group S and T at 10 years were; 73.8 +/- 7.0% and 85.7 +/- 13.0%, respectively The probabilities of freedom from reoperation at 12 years in group S and T were 97.7 +/- 2.3% and 62.5 +/- 21.3%, respectively. Only one patient in group S required reoperation because of valve thrombosis, while 2 patients in group T underwent reoperation for prosthetic valve endocarditis. The actuarial overall survival rate after aortic root reconstruction at 10 years was 62.6 +/- 9.6%, while that of patients with acute aortic dissection and those who did not were 44.4 +/- 15.7% and 71.7 +/- 11.5%, respectively. The event-free rate at 12 years after aortic root reconstruction (group V+B) was 79.1% +/- 20/9%. The reason for reoperation in the 2 patients who underwent the Bentall procedure were prosthetic valve endocarditis in one and psuedoaneurysm at the right coronary anastomosis in the other. The reason for reoperation in one patient who formed a pseudoaneurysm was likely due to an oversized conduit hole for the Carrel patch coronary anastomosis. One patient in whom the native valve was preserved using the David reimplantation procedure required reoperation because of valve degeneration 17 months after the initial surgery, possibly due to valve rubbing on the vascular conduit because of a modified geometry of the Valsalva sinuses. In conclusion, because of the low rate of long-term mortality and reoperation, the St. Jude Medical valve is an excellent prosthesis for AVR. AVR with a porcine pericardial valve yields favorable results in terms of the low long-term mortality although the incidence of reoperation remains high. Aortic root reconstruction with the Bentall procedure using the Carrel patch method yields acceptable results in terms of long-term mortality and low rate of reoperation, although acute aortic dissection is an incremental preoperative risk factor. The early results of aortic valve-sparing root reconstructive surgery are encouraging, with excellent clinical outcomes and patient quality of life. Nevertheless, the indications for the procedure must be carefully considered.

Aorta↗
PubMed1998

Three-dimensional fast spin-echo MR of the inner ear: ultra-long echo train length and half-Fourier technique.

We compared the image quality of the newly developed ultra-long echo train length (ETL) 3-D fast spin-echo (FSE) and half-Fourier technique, which is performed in less than 3 minutes, with the conventional 3D-FSE imaging technique, which takes 15 minutes, in assessing MR examinations of the inner ear. The new method's images were almost comparable to the conventional 3D-FSE images in depicting anatomic details and pathologic findings. Implementation of the ultra-long ETL and half-Fourier 3D-FSE imaging technique enables acquisition of inner ear MR studies in a vastly reduced time and with high spatial resolution without significant penalty, opening the possibility for low-cost screening of acoustic tumors without contrast enhancement in less than 3 minutes.

Ear Neoplasms↗
PubMed1998

[A case of fulminant myocarditis treated by ABIOMED BVS 5000 biventricular support].

Reported is a case of acute fulminant myocarditis with profound circulatory compromise. The patient was supported with biventricular assist devices (BVS 5000 ; ABIOMED Inc., Danvers, Mass.). The patient had remarkable recovery of ventricular function, which allowed for the removal of the device after 269 hours of support and the recovery to the normal quality of life. This case shows the success of mechanical support to treat potentially fatal disease process.

Adult↗
PubMed1998

[A case report of mycotic aneurysms of descending thoracic aorta].

A rare case of mycotic aneurysms of descending thoracic aorta is presented. A 63-year-old man was admitted with history of persistent high fever and loss of consciousness to our hospital. On admission, there were elevated WBC and CRP. Blood and spinal fluid cultures revealed growth of Streptococcus pneumonia. Despite of antibiotic therapy for meningitis and bacteremia, inflammatory sign continued, and new abnormal shadow appeared on chest X-ray. Chest CT and aortography showed two aneurysms of descending thoracic aorta. In an emergency operation, there was no abscess formation around the aneurysms. Aneurysms were excised en bloc without opening aneurysms followed by in situ Dacron tube graft replacement. The patient has been doing well without infection.

Aneurysm, Infected↗
PubMed1998

[Does dilatation of the sinotubular junction cause aortic regurgitation?: the use of the experimental model and preliminary result].

This study investigated the mechanism of aortic regurgitation caused by dilatation of the sinotubular junction. The canine model of dilatation of the sinotubular junction was used to observe coaptation of the aortic valve using direct imaging by endoscopy. Five adult mongrel dogs (body weight: 20-25 kg) were anesthetized and their hearts and thoracic aortas were extracted en bloc. Aortotomy was performed and an interrupted horizontal mattress suture was placed in each commissure and each sinus of Valsalva at the level of the sinotubular junction. The heart and thoracic aorta were fixed on a table and the interrupted sutures were drawn horizontally. As a result, the aorta of the junction level was dilated. Strain of the interrupted sutures were changed by weights of 20, 25, 50, 70 and 100 points (1 point = 3.5 g). The sites of the retracted sutures were the three commissures and three sinuses of Valsalva. With increased strain of the sutures, the opening of the aortic valve was exaggerated when drawing was done on either all sutures or the commissures. When drawing was done only on the three sinuses of Valsalva, coaptation of the aortic valve was uninterrupted. This study showed that dilatation of the sinotubular junction causes aortic regurgitation, which is mainly due to the outward deviation of the commissures.

Animals↗
PubMed1998

Osteolysis model with continuous infusion of polyethylene particles.

Several in vivo studies have investigated bone to implant interface tissues after a single injection of wear particles into animal joints. However, in the clinical setting, wear debris are generated continuously rather than periodically. Histomorphologic findings and the gene expression of bone resorbing cytokines in reactive membranes were analyzed in response to continuous infusion of polyethylene particles with an osmotic pump. In this model, it took only 6 weeks for proliferative fibrous tissue to form, which penetrated the subchondral bone to communicate with the bone marrow. In addition, tartrate resistant acid phosphatase positive osteoclastlike cells were found in empty lacunae. According to the analysis of gene expression, only tumor necrosis factor alpha messenger ribonucleic acid was expressed specifically in the fibrous tissue of rats infused with particles from 4 weeks after surgery. This finding suggests that tumor necrosis factor alpha may play a major role in fibrous tissue formation and osteoclastic bone resorption caused by wear debris around implants. In addition, this in vivo model seems useful for investigating the mechanism of membrane formation and associated bone resorption around implants in a situation more similar to human prostheses than in conventional models.

Animals↗
PubMed1998

[Donor leukocyte transfusion as treatment for relapsed chronic myelogenous leukemia after allogeneic bone marrow transplantation].

Three patients with relapse (two molecular and one cytogenetic relapse) after allogeneic bone marrow transplantation (BMT) for chronic myelogenous leukemia (CML) were treated with donor leukocyte transfusion (DLT). Two had complete molecular remission, which persisted 16 and 20 months after treatment. The performance status of all patients was 90-100%. Mild chronic GVHD was observed in one patient as a side effect of DLT. One patient with cytogenetic relapse required three infusions to attain molecular remission and this suggests the importance of cell numbers to infuse in DLT. Positive anti-nuclear antibody was observed in the effective cases and elevation of IgE in all cases after DLT. These abnormal laboratory findings may suggest a relationship between GVHD and GVL. DLT may be effective therapy for patients with CML who relapse after BMT. Further controlled studies are necessary to determine the optimal number of cells to infuse, interval and frequency of DLT.

Adult↗
PubMed1998

[Influence of acute aortic dissection on long-term results of aortic root reconstruction in patients with Marfan's syndrome].

Objective of this study is to evaluate influence of acute aortic dissection on long-term results of aortic root reconstruction in patients with Marfan's syndrome. 19 patients who underwent consecutive aortic root reconstruction between 1985 May to 1998 February were retrospectively reviewed. Patients who associated acute aortic dissection at the time of operation (group D, n = 7) were compared long-term results with those who did not (group non-D, n = 12). Mean follow-up period was 5.1 +/- 3.2 years and longest follow-up term was 12.5 years. In each group early postoperative death was found in one patient. In-hospital mortality in each group were respectively; 14.2% and 8.3%. Late deaths were found in four patients who all belonged to group D, respectively caused by; rupture of thoracoabdominal aneurysm, DIC after subsequent thoracoabdominal surgery, sepsis due to prosthetic valve endocarditis, and sudden death. Actuarial overall survival rate including operative death in D and non-D group were respectively; 0.0 +/- 0% at 6.6 years and 91.1 +/- 8.0% at 12 years. Overall cumulative survival rate was 56.6 +/- 14.0%. Freedom from cardiovascular events, in D and non-D group were respectively; 0.0 +/- 0% at 6.6 years and 60.0 +/- 25.3%, and freedom free form dilatation of residual aorta were respectively; 0.0 +/- 0% at 6.6 years and 100.0 +/- 0% at 12 years. Freedom from subsequent cardiovascular surgery in group D, group non-D and over-all patients were respectively; 0.0 +/- 0% at 6.6 years, 60.0 +/- 25.3% at 12 years and 42.6 +/- 20.2%. In this study, acute aortic dissection in Marfan's syndrome significantly increased late cardiovascular events including dilatation of residual aorta, subsequent aortic surgery and late mortality. On the other hand, excellent long-term results after aortic root reconstruction were found in non-dissection Marfan's syndrome. Considering high incidence of late dilatation of residual aorta, simultaneous total arch replacement with aortic root reconstruction is recommended in acute dissecting Marfan's syndrome. Whereas, preventive simultaneous arch replacement is not required in non-dissecting Marfan's syndrome because of less postoperative vascular events.

Acute Disease↗
PubMed1998

[Heerfordt's syndrome remitting without corticosteroid therapy].

A 25-year-old woman presented with low-grade fever, uveitis, and bilateral swelling of the parotid glands. Her older sister had a history of sarcoidosis. A chest X-ray film showed bilateral hilar lymphadenopathy. The low-grade fever persisted after admission. Ga scintigraphy showed abnormal uptake in the parotid glands and hilar lymph nodes bilaterally. Sarcoidosis was diagnosed histologically after epithelioid cell granulomas without caseous necrosis were found in a specimen obtained by transbronchial biopsy. Heerfordt's syndrome was the final diagnosis. Six days after admission, left facial and left trigeminal nerve paralysis developed. The symptoms remitted without steroid therapy and, as of eight months after discharge there had been no evidence of recurrence.

Adult↗
PubMed1998

Renaturation of recombinant human neurotrophin-3 from inclusion bodies using a suppressor agent of aggregation.

Escherichia coli has been widely used in the production of recombinant proteins. One of the drawbacks inherent in this method is that the proteins produced in the cells often form inactive inclusion bodies. Usually, the inclusion bodies can be separated from other cell components, solubilized by denaturants such as guanidine hydrochloride or urea, and then renatured through a refolding process such as dilution or dialysis. However, it has been shown that biologically active recombinant human neurotrophin-3 cannot be obtained at high yield by this procedure due to aggregation and precipitation of the protein. We applied the refolding process using the aggregation suppressor L-arginine in the renaturation of neurotrophin-3, and obtained biologically active neurotrophin-3 at high yield from the inclusion bodies. Consequently, about 10 mg of purified neurotrophin-3 was prepared from 1 litre of culture broth.

Amino Acids↗
PubMed1998

Aortic complications after aortic valve replacement in patients with dilated ascending aorta and aortic regurgitation.

BACKGROUND AND AIMS OF THE STUDY: Postoperative aortic complications of aortic dissection or enlargement of the ascending aortic develop in patients with aortic valve replacement (AVR) and dilated ascending aorta. This clinical study aimed to demonstrate the incidence of aortic complications after AVR in patients with dilated ascending aorta, and to clarify the surgical indication and approach for dilated ascending aorta and aortic regurgitation. METHODS: A total of 82 patients who underwent AVR between 1985 and 1997 were allocated to two groups according to the preoperative diameter of the ascending aorta. A dilated ascending aorta with diameter > or = 40 mm was seen in 38 patients (group I), and a small ascending aorta with diameter < 39 mm in 44 patients (group II). Group I patients were further allocated to two subgroups: 12 patients underwent aortoplasty (group IA) and 26 did not (group IB). Event-free rates of aortic complications and survival rate were compared between groups I and II. RESULTS: Postoperative aortic dissection during the follow up period occurred in four hypertensive patients in group I (one in group IA, three in group IB); no aortic dissection was seen in group II. Freedom from all aortic complications at 10 years after surgery was 75 +/- 10% in group I and 100% in group II (p < 0.05). The cumulative survival rate at 10 years was 59 +/- 11% in group I (group IA: 71 +/- 18%, group IB: 51 +/- 14%) and 95 +/- 4% in group II (p < 0.05). CONCLUSIONS: Patients with a dilated ascending aorta (> or = 40 mm diameter) were more likely to encounter complications of the aortic dissection or enlargement after AVR than those with a small ascending aorta. Surgery to prevent aortic dissection or enlargement must be selected in patients with mildly dilated ascending aorta and hypertension.

Adult↗