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Biomedical subjects

T Iwasaka

Publications and source records attributed to T Iwasaka.

At least 163 records · Page 9Linked to original sources

Simultaneous detection by consensus multiplex PCR of high- and low-risk and other types of human papilloma virus in clinical samples.

A consensus multiplex PCR (CM-PCR) technique was developed to detect high-risk (HPV 16/18), low-risk (HPV 6/11), and over 40 other types of human papillomavirus (HPV), separately but simultaneously, by mixing three pairs of consensus primers in the same PCR mixture, for gene amplification. Simultaneous detection of three groups of HPV DNA provides valuable information for clinical practice and this procedure is simple and convenient for routine laboratory examinations. We detected HPV DNA sequences in plasmid HPV DNA and DNA extracted from tissues of condyloma acuminata and cervical carcinoma and from exfoliated cells of the lower genital tract of healthy Chinese women living in the People's Republic of China. We confirmed that this simple, convenient, and cost-beneficial CM-PCR technique is reliable for the detection of HPV DNA sequences.

Adolescent↗

Immunohistochemical detection of p53 overexpression in formalin-fixed, paraffin-embedded sections of endometrial carcinoma.

OBJECTIVE: In the past, immunohistochemical detection of p53 has been possible only in the case of fresh-frozen tissues. However using CM1 and an enhanced method based on microwave heating and protease digestion enabled the immunohistochemical detection of p53 overexpression in formalin-fixed, paraffin-embedded sections of endometrial carcinoma, although very few positive stainings were obtained without such an enhanced treatment. To evaluate the enhancement method, a comparative study was performed on frozen materials and paraffin-embedded samples. METHODS: Fifty-three frozen materials, including normal endometrial glands, endometrial hyperplasias and carcinomas, and paraffin-embedded samples from the same patients were used in this study. PAb1801 (mouse monoclonal antibody) was used to analyse p53 overexpression in the frozen sections, while CM1 (rabbit polyclonal anti-p53 antibody) was used for the paraffin sections. RESULTS: PAb1801 and CM1 staining on normal endometriums and endometrial lesions showed a significant degree of concordance between frozen and paraffin-embedded materials. CONCLUSION: Enhanced immunodetection of p53 in paraffin-embedded tissues will provide a useful alternative to the usual fresh-tissue assay.

Carcinoma↗

Monitoring urine oxygen tension during acute change in cardiac output in dogs.

To evaluate whether renal blood flow (RBF) can be monitored during acute change in cardiac index, ureter urine oxygen tension (PuO2) and bladder urine oxygen tension (PbO2) were measured in six mongrel dogs. PuO2, cardiac index, and RBF increased after dobutamine infusion and decreased after propranolol infusion. PuO2 had an excellent correlation with RBF (r = 0.94) and a fair correlation with cardiac index (r = 0.50) and mean blood pressure (r = 0.56); RBF had a fair correlation with mean blood pressure (r = 0.52, P < 0.05) but was not related to cardiac index. With multiple-regression analysis, PuO2 was found to be the significant factor related to RBF. PbO2 had a good correlation with PuO2 (r = 0.94) at control levels. Furthermore, when two dogs were added to evaluate relationships among PbO2, PuO2, and RBF, PbO2 had an excellent correlation with PuO2 (r = 0.92) and RBF (r = 0.91). These data indicate that PuO2 is a more sensitive predictor of RBF than cardiac index and mean blood pressure and that PbO2 can be a noninvasive indicator reflecting RBF during acute circulatory change in dogs.

Animals↗

Effect of atrial and ventricular activation interval on hemodynamics during atrioventricular and ventriculoatrial pacing: determination from pressure-volume loops in dogs.

To determine the effect of relative timing of atrial and ventricular activation on hemodynamic indices, we evaluated pressure-volume loops during pacing at 160 beats/min with various atrioventricular intervals in dogs. End-systolic pressure, end-diastolic volume, and stroke volume were reduced during pacing at atrioventricular intervals of 0 ms, compared with 80 ms. These changes were more significant during pacing at atrioventricular intervals of -50 and -100 ms than at 0 ms. During tachycardia, the abnormal timing of atrial contraction leads to unfavorable hemodynamic change and the degree of the changes are determined by the ventriculoatrial activation interval.

Animals↗

Clinical significance of S-T segment elevation in lead aVR in anterior myocardial infarction. Assessment by thallium-201 exercise scintigraphy.

The significance of exercise-induced S-T elevation in aVR was studied in 57 patients with recent anterior infarction and single-vessel disease. S-T elevation in aVR was found at peak exercise in 24 patients. Although the initial defect area was similar in the groups with and without S-T elevation in aVR, the redistribution area was larger in the former group (p < 0.01). When three electrocardiographic criteria were used in the multivariate analysis, S-T elevation in aVR was the significant variable related to redistribution in the anterior wall. Thus, S-T elevation in aVR may indicate ischemia of the anterior wall.

Adult↗

Evaluation of factor XIa-alpha 1-antitrypsin in plasma, a contact phase-activated coagulation factor-inhibitor complex, in patients with coronary artery disease.

Excess activated factor XI (FXIa) in plasma indicates increased activation during the contact phase of blood coagulation. To investigate the relationship between such elevations and coronary atherosclerosis, we examined FXIa values in patients with coronary artery disease (CAD) by an enzyme-linked immunosorbent assay method that we developed that detects FXIa in plasma samples as an FXIa-alpha 1-antitrypsin complex (FXIa-alpha 1AT). The presence and extent of CAD were documented by coronary angiography and assessed by a recently developed scoring system for semiquantitative estimation of coronary atherosclerosis. Plasma FXIa-alpha 1AT levels were significantly increased in patients with angiographically proven CAD (13.9 +/- 3.0 micrograms/L, n = 42) compared with age-matched, healthy control subjects (11.9 +/- 1.7 micrograms/L, n = 20) as well as patients with angiographically normal coronary arteries (12.0 +/- 2.3 micrograms/L, n = 25). Moreover, in the total patient population, the FXIa-alpha 1AT level was related to the number of significant coronary artery stenoses as well as to the total coronary score. FXIa-alpha 1AT showed a positive correlation with thrombin-antithrombin III complex, fibrinogen, and Lp(a) and an inverse correlation with apo A-I, as determined by multi-variate analysis. Our studies provide evidence that increased activation of the contact pathway occurs in patients with CAD and is related to the severity of the disease. Although it is unknown whether this abnormality is the cause or the result of the vascular lesion, it may be important for progression of the underlying atherosclerosis or for propagation of the atherosclerotic process itself.

Antithrombin III↗

Effects of single and combined application of anti-cancer drugs on cervical adenocarcinoma. I. Antitumor activity in vitro.

BACKGROUND: Establishment of effective combination chemotherapy regimen for patients with an adenocarcinoma of the uterine cervix has been long-awaited because there has been no documentation concerning chemosensitivity of this tumor against conventional antitumor agents. METHODS: To search for an effective combination regimen, 15 conventional antitumor drugs were tested for growth inhibitory effects on five different cervical adenocarcinoma cell lines. RESULTS: Etoposide, mitomycin C, adriamycin, epirubicin, and vinblastine, were singularly effective. Effects of combination chemotherapy were also tested using the above five antitumor agents plus interferon-gamma. Etoposide, mitomycin C, and interferon-gamma were the most effective when given in combination. CONCLUSIONS: Combined treatment with the above three drugs seems worthy of consideration for clinical application.

Adenocarcinoma↗

[Clinical significance of abnormal high signal intensity of left ventricular myocardium by gadolinium-diethylenetriaminepenta-acetic acid enhanced magnetic resonance imaging in hypertrophic cardiomyopathy].

The significance of abnormal high signal intensity observed in left ventricular myocardium by gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) enhanced magnetic resonance (MR) imaging in hypertrophic cardiomyopathy (HCM) patients was assessed by comparison with T1-weighted MR imaging, thallium-201 (201Tl) myocardial scintigraphy, radionuclide angiocardiography, M-mode echocardiography, electrocardiography, and chest radiography. The 16 patients were divided into three groups: 8 patients (group I) with abnormal high signal intensity before and after Gd-DTPA enhancement, 4 (group II) with abnormal high signal intensity only after enhancement and 4 (group III) without abnormal high signal intensity. Thallium-201 myocardial single photon emission computed tomography (SPECT) showed 4 of the 8 patients in group I, 3 of the 4 patients in group II and only 1 of the 4 patients in group III had abnormalities of regional 201Tl uptake in the left ventricular myocardium. No significant difference in left ventricular ejection fraction (LVEF) was seen between groups I, II, and III (64 +/- 13%, 67 +/- 17% and 71 +/- 7%, respectively) although three patients of group I had LVEF of less than 55%. Left ventricular peak filling rates (PFR) of groups I and II were significantly lower than that of group III (1.90 +/- 0.44, 2.41 +/- 0.43 and 3.37 +/- 0.48 EDV/sec, respectively). Group I had larger end-diastolic left ventricular dimension (LVDd), significantly larger end-systolic left ventricular dimension (LVDs), and smaller % fractional shortening (%FS) than group III (49 +/- 4 vs 42 +/- 6 mm, 31 +/- 5 vs 22 +/- 4 mm, and 38 +/- 8 vs 49 +/- 4%, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Penetrating injury of the head, neck and chest by a nail-gun: a case report].

A very rare case of directly penetrating injury of the head, neck and chest caused by a nail-gun was reported. A 56-year-old male was admitted to our critical care center due to chest injury. On admission, he showed numbness of the hand & leg, left hemiparesis and hypalgesia. Physical examination disclosed three nails on the left anterior chest, but other wounds or nails were not found. Chest films showed three nails penetrating the lung without reaching the heart, but other nails were found by skull and neck films. One nail had penetrated the cervical canal at the C1 level through the posterolateral cervical region. Two other nails were demonstrated at the right temporal and the left frontal region, Computed tomography revealed no massive cerebral hemorrhage and cerebral angiography showed no extravasation and no passage through main vessels. Emergency surgery was performed uneventfully and the nails in the chest, neck and head were totally removed. He was discharged one month after surgery. Some injuries caused by a nail-gun have been reported in the world literature but in Japan this multiple injury case was the first reported. Since nail-gun injuries can cause multiple damage, systemic X-ray examination was very important.

Cervical Vertebrae↗

Clinical significance of pericardial effusion in Q-wave inferior wall acute myocardial infarction.

To assess the clinical significance of pericardial effusion in Q-wave inferior wall acute myocardial infarction, 185 consecutive patients were examined by means of electrocardiogram, echocardiogram and hemodynamic monitoring. A pericardial effusion was present in 44 patients and was absent in 141 patients. Electrocardiographic right ventricular infarction (> or = 1 mm of ST-segment elevation and Q wave in V4R) was detected in 54 patients, with 20 patients having pericardial effusion. Patients with pericardial effusion had significantly more left ventricular segments with advanced asynergy, lower cardiac output, higher pulmonary artery wedge pressure and higher incidence of right ventricular infarction than those without pericardial effusion. There were 17 in-hospital deaths. Although there was no significant difference in the mortality rate between patients with and without right ventricular infarction, a significantly higher hospital mortality rate was observed in patients with pericardial effusion compared to those without it (23 vs 5%). Pericardial effusion was selected with age and pulmonary artery wedge pressure as important variables associated with hospital mortality by the discriminant analysis. Patients who developed pericardial effusion, regardless of right ventricular infarction, had more extensive myocardial damage, and hence, pericardial effusion was one of the predictors of increased hospital mortality.

Acute Disease↗

Clinical significance of PQ segment depression in acute Q wave anterior wall myocardial infarction.

OBJECTIVES: This study was designed to evaluate the clinical significance of PQ segment depression and to examine the frequency of PQ segment depression in infarction-associated pericarditis. BACKGROUND: PQ segment deviation is almost as characteristic as the classic ST segment deviation and is detected in most patients with pericarditis. However, the incidence and clinical characteristics of PQ segment depression in acute myocardial infarction are not defined. METHODS: Three hundred four consecutive patients with acute Q wave anterior wall myocardial infarction were examined carefully by auscultation, electrocardiogram, echocardiogram and chest roentgenogram. The diagnosis of pericarditis was made on the basis of pericardial rub detected by more than two observers during the 1st 3 days after hospital admission. At least 0.5 mm of PQ segment depression from the TP segment observed for > 24 h in both limb and precordial leads was considered diagnostic of PQ segment depression. RESULTS: A pericardial rub was present in 65 patients (21%) and absent in 239 patients. PQ segment depression was detected in both limb and precordial leads in 30 patients (10%): 18 patients with pericardial rub and 12 patients without pericardial rub. On the basis of five clinical variables, multivariate analysis was performed to determine the important variables related to the occurrence of PQ segment depression. Pericardial rub was selected with left ventricular segments with advanced asynergy as a significant factor related to PQ segment depression. There were 31 in-hospital deaths, and a significantly higher hospital mortality rate was observed in patients with PQ segment depression (23% vs. 9%). CONCLUSIONS: Although PQ segment depression was observed in a minority of patients with infarction-associated pericarditis, it was one of the clinical signs of larger infarct size and increased hospital deaths.

Echocardiography, Doppler↗

Difference between women and men in left ventricular pump function during predischarge exercise test after acute myocardial infarction.

To evaluate the difference in left ventricular (LV) pump function during predischarge exercise testing between postmenopausal women and age-matched men with myocardial infarction, global and regional ejection fraction, LV end-diastolic volume, and the ratio of systolic blood pressure to LV end-systolic volume were investigated using radionuclide angiography in 25 postmenopausal women and 37 age-matched men. There were no significant differences in the resting radionuclide angiographic indexes between women and men. Global and regional ejection fraction of noninfarcted area, and the ratio of systolic blood pressure to LV end-systolic volume decreased at peak exercise in women, but these indexes increased in men. Although there was no significant difference in the amount of change in LV end-diastolic volume during exercise between the 2 groups, the amount of increase in LV end-systolic volume was significantly larger in women than in men. The ratio of systolic blood pressure to LV end-systolic volume had a curvilinear relation with LV end-diastolic volume at rest and peak exercise, but the ratio of systolic blood pressure to LV end-systolic volume was larger at any LV end-diastolic volume in men than in women during exercise. Thus, lower global ejection fraction and the ratio of systolic blood pressure to LV end-systolic volume during exercise in postmenopausal women compared with age-matched men indicate that gender may have played an important role in the LV remodeling process.

Aged↗

Quantification of infarct size by thallium-201 single-photon emission computed tomography using the unfolded map method. Comparison with QRS score and angiographic infarct size at 4 weeks after infarction.

A new technique of data processing, the unfolded map method, was used with thallium-201 single-photon emission computed tomography to quantify infarct size in 35 patients with single-vessel disease at 4 weeks after their first myocardial infarction (24 anterior and 11 inferior infarcts), and the results were compared with those obtained by electrocardiography and contrast left ventriculography. The myocardial borders and the infarcted region were defined using the threshold technique and a cutoff value of 55%. Count profile data for each short-axis slice were unfolded zonally into single planes with the same ratio, and their areas were calculated from the slice thickness and radius. Thus, the size of the unfolded map represented the actual left ventricular myocardial area Infarct size was quantitated from the ratio of pixels in the infarcted region to those in the whole map, and the ratio itself was used as the percent infarct size. Although a defect 1 cm in diameter (0.8 cm2) could not be detected in a phantom study, defects > or = 2 cm in diameter (> or = 3.1 cm2) could be measured satisfactorily. The infarct size and percent infarct size determined by the unfolded map method correlated well with the QRS score (r = 0.841 and r = 0.838), the percentage of abnormally contracting segments on left ventriculography (r = 0.835 and r = 0.877), and the ejection fraction (r = -0.835 and r = 0.856). These data indicate that the unfolded map method provides adequate quantification of infarct size, even in the chronic phase, without complicated data processing.

Adult↗

The effect of successful angioplasty on variables of signal-averaged electrocardiogram and ventricular wall motion in patients with a first myocardial infarction.

The correlation among three variables of late potentials (LPs) obtained by signal-averaged electrocardiography (SAECG) and improvement of ventricular wall motion estimated by echocardiography were studied in 66 patients with a first acute myocardial infarction (MI). Patients with bundle-branch block, intraventricular conduction delay, multi-vessel disease, previous MI, repeat percutaneous transluminal coronary angioplasty (PTCA), or evidence of reinfarction during a 6-month follow-up were excluded. A total of 66 patients was divided into two groups, with (Group 1: n = 27, age 56 +/- 11) or without (Group 2: n = 39, age 61 +/- 10) improvement of ventricular wall motion. Three variables of LPs and ventricular wall motion index (WMI) estimated and scored by echocardiography at admission (WMI 1) and at 6 months after MI (WMI 2) were compared in each group. In Group 1 (WMI 1 vs. WMI 2, p < 0.002), 20 of 27 patients underwent successful angioplasty; in Group 2 (WMI 1 vs. WMI 2, p = NS), 7 of 39 patients had successful emergency angioplasty. There were significant differences in three variables of LPs between the time of admission and at 6 months after MI in Group 1 but not in Group 2. Higher incidence of LPs and greater frequency of successful emergency PTCA were found in Group 1 compared with Group 2. These results suggest that because myocardial ischemia is reversed by successful angioplasty, ventricular wall motion is improved and the arrhythmogenic substrate that generates LPs is stabilized electrically. Stunned or hibernating myocardium may be the arrhythmogenic substrate that generates LPs.

Adult↗

Detection of human papillomavirus types 16 and 18 in primary and in metastatic lesions of cervical carcinomas.

Human papillomavirus (HPV) types 16 and 18 are most prevalent in cervical carcinomas and are also present in metastatic sites. Thirty-six patients with lymph node metastases were examined for the possible presence of HPV 16 and 18 DNA sequences in the primary tumors as well as in metastatic lymph nodes. Polymerase chain reaction (PCR) analysis revealed the presence of the genome of HPV type 16 (HPV 16) in 17 tumors (47%) and that of HPV type 18 (HPV 18) in 2 tumors (6%), while 17 tumors (47%) were negative for both types. Of the 17 HPV 16-positive patients, 15 metastatic lymph nodes were also positive and 2 were negative. In 2 patients positive for HPV 18, the metastatic sites were negative. All the 17 patients negative for HPV in the primary tumors were also negative for HPV 16 and HPV 18 in the metastatic lymph nodes. These data confirmed the positive correlation of HPV DNA status between primary and metastatic tumors. However, the discrepancy in 11% of cases was attributed to presence of heterogeneous clones in the primary tumor.

Adult↗

Right ventricular ejection fraction during exercise in patients with recent myocardial infarction: effect of the interventricular septum.

To investigate the effect of interventricular septum (IVS) on right ventricular function during exercise, radionuclide angiocardiography was performed in 50 patients with recent myocardial infarction. Twenty-five patients had involvement of IVS according to thallium uptake in IVS (group I), and 25 patients were free of IVS involvement (group II). Although there was no statistical difference between the two groups in right ventricular ejection fraction (EF) at rest (45% +/- 10% vs 48% +/- 8%), patients in group I had significantly lower left ventricular (LV) EF (40% +/- 11% vs 53% +/- 11%, p < 0.01) and larger LV end-diastolic volume (129 +/- 46 vs 106 +/- 31 ml, p < 0.05) than those in group II. All parameters increased significantly during exercise in both groups, but patients in group I had significantly lower exercise right ventricular EF (50% +/- 10% vs 56% +/- 9%, p < 0.05), LVEF (44% +/- 11% vs 56% +/- 13%, p < 0.01), and larger LV end-diastolic volume (155 +/- 44 vs 129 +/- 37 ml, p < 0.05) than those of group II. Significant correlations were observed between right ventricular EF and LV end-diastolic volume at rest and during exercise (r = -0.48, p < 0.05, and r = -0.68, p < 0.01, respectively) in group I, but right ventricular EF correlated with LVEF only at peak exercise (r = 0.65, p < 0.01). In contrast, right ventricular EF did not correlate with any variables at rest or during exercise in group II.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗