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Biomedical subjects

T Miki

Publications and source records attributed to T Miki.

At least 523 records · Page 29Linked to original sources
PubMed1995

[Successful surgical treatment of mitral regurgitation associated with anti-phospholipid syndrome and systemic lupus erythematosus].

A 39-year-old woman with the diagnosis of mitral regurgitation was admitted to our hospital for surgical treatment. Cerebral thromboembolism and spontaneous abortion had been repeated in her past history. She was suffered from chronic renal failure associated with systemic lupus erythematosus (SLE) and anti-phospholipid syndrome (APS). An operative procedure was recommended because of the progressive heart failure due to mitral regurgitation. For renal failure, continuous ambulatory peritoneal dialysis (CAPD) was introduced at one month before operation. As the operative procedure, valve replacement using Carpentier-Edwards bioprosthesis (27 mm) was done rather than valve reconstruction, because chordal rupture of posterior leaflet and severe hypertrophy of both leaflets were recognized. During operation, uncontrollable bleeding was not observed. However, platelet transfusion was needed. We use warfarin and antiplatelet agents jointly as postoperative anticoagulant therapy. Thromboembolic episodes have not been observed 4 years postoperatively. Relationship between SLE with APS and cardiac valvular lesions has been focused. The present case was considered to be the interesting case which various devices were necessary to operative management including chronic renal failure, cardiopulmonary bypass, selection of prosthetic heart valve, and postoperative anticoagulant therapy for preventing thrombus formation.

Adult↗
PubMed1995

[Recurrence of transitional cell carcinoma in bilateral upper urinary tracts and ileal conduit with invasion in the abdominal wall around nephrostomy after total cystectomy: a case report].

A case of recurrence of transitional cell carcinoma in bilateral upper urinary tracts and ileal conduit with invasion in the abdominal wall around nephrostomy after total cystectomy is presented. A 33-year-old man with right nephrostomy, after total cystectomy, construction of ileal conduit, bilateral partial ureterectomy and left nephrectomy for transitional cell carcinoma at another hospital was referred to our hospital because of further recurrence in the right renal pelvis and ileal conduit. He had had left nephrostomy before the left nephrectomy was performed. Right nephrectomy and total extirpation of ileal conduit were performed and hemodialysis was started from the day after the operation. However, several weeks later, transitional cell carcinoma was detected pathologically in the left abdominal wall around the left nephrostomy which had been inserted. The renal pelvis was inferred to have leaked urine around the nephrostomy and invasion arose in this region. After radiation therapy he was discharged but he died from recurrence of carcinoma 9 months after the operation. After total cystectomy, examinations by percutaneous puncture of the renal pelvis are very effective for evidence of recurrence in the upper urinary tract. However, we emphasize that the percutaneous technique carries the risk of tumor invasion through the percutaneous urinary tract.

Abdominal Muscles↗
PubMed1995

[An immunohistochemical study of the relationship between p53 expression and the DNA ploidy pattern using image cytometry in colorectal carcinoma].

We studied p53 expression in 46 colorectal carcinomas by immunohistochemistry. We examined the relationship between p53 expression and the pathological findings, the prognosis and tumor proliferative activity by Ki-67 staining or DNA ploidy pattern using an image cytometer. Expression of p53 was observed in 41.3% of carcinomas. No correlation was found between p53 expression and the depth of invasion, lymph node metastasis or Dukes' stage. No difference in survival was found between p53 positive and negative patients after curative surgery. We also studied the DNA ploidy pattern using an image cytometer in 28 carcinomas. Aneuploidy was found more frequently in the p53 positive areas than in the negative ones, but there was no significant difference. The DNA index showed no difference between the p53 positive and negative areas. We examined proliferating activity using Ki-67. There was no difference in the Ki-67 labeling index between p53 positive and negative areas. In the present study, there was no correlation between p53 expression and pathological findings, prognosis, tumor proliferative activity using Ki-67 staining or DNA ploidy pattern. Thus, p53 expression was suggested to have little relationship to grade of malignancy.

Cell Division↗
PubMed1995

[Intermediate to late results of aortic or mitral valvuloplasty by rasping procedure].

We have proposed Rasping procedure as one of the methods of aortic valvuloplasty (A-Rasping) and defined as debridement of the thickened surface of the rheumato-degenerative aortic valve using an electric rasper since 1986. Furthermore, we have extended this technique to mitral valvuloplasty (M-Rasping). The purpose of this study is to evaluate intermediate to late results of valvuloplasty by Rasping procedure. From 1986 to 1994, this method was carried out on 14 patients with mild-to-moderate aortic valve disease in severe mitral valve disease or coronary artery disease, and on 6 patients with mitral stenosis. In A-Rasping group, aortic regurgitation was found in 10 patients and aortic stenosis was found in 4 patients. The degree of regurgitation, the transvalvular pressure gradient, and the pre- and postoperative cardiac function in both group were investigated chronologically by echocardiography. In this series of patients, no hospital mortally including operative death was observed. Furthermore, reoperation for repaired aortic or mital valve was not required. In A-Rasping group, 2 late deaths (14.2%) occurred at 1 year and 4 years after operation. Cause of 2 late deaths was prosthetic valve endocarditis in mitral position. In A-Rasping group, at 1 year after operation, regurgitation was reduced to degree I or less in all patients. However, at the 3rd postoperative year, regurgitation increased to degree II in 2 patients. As compared with the preoperative values, the transvalvular pressure gradient significantly decreased in 4 patients (29.5 +/- 7.6 mmHg vs 12.5 +/- 5.0 mmHg, p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Intrascrotal fibrous pseudotumor accompanied by pelvic kidney with ectopic ureteral opening: a case report].

A case of intrascrotal fibrous pseudotumor accompanied by pelvic kidney with ectopic ureteral opening is reported. The patient was a 65-year-old man with the complaint of swelling of the right scrotal contents. Ultrasonography showed a heterogeneous mass with acoustic shadow from the right epididymis to right spermatic cord. Intravenous pyelography revealed a non-visualizing right kidney. Endoscopic examination was performed because of the right non-functioning kidney and right epididymectomy was performed. Endoscopic findings showed that the ureteral opening existed at 6 degrees of the bladder neck. Retrograde pyelography demonstrated the right kidney in the pelvic cavity. The tumor was stony hard and 30 x 50 mm in size. Pathological diagnosis of the tumor was a fibrous pseudotumor. We reviewed and discussed 22 cases of fibrous pseudotumor, including our case, in the Japanese literature.

Aged↗
PubMed1995

[Two cases of multiple evanescent white dot syndrome examined with indocyanine green angiography].

Two cases of multiple evanescent white dot syndrome (MEWDS) were examined using indocyanine green angiography. Patients were 32 and 45 years old. Both were female. Fluorescein angiography demonstrated early hyperfluorescence corresponding to the white dots. The early phase of indocyanine green angiography showed no abnormal signs, but the late phase disclosed hypofluorescent lesions corresponding to the white dots and even other areas. Each hypofluorescent lesion was punctate and patchy in some areas. The white dots began to fade and returned to the normal color of the fundus from the center to the edge of the lesion. In indocyanine green angiography, the hypofluorescent lesions began to show a normal appearance at the center of the lesion. The indocyanine green angiogram was normal after the white dots had disappeared. The origin of hypofluorescence in indocyanine green angiography was unknown. However, the findings suggest that MEWDS may affect the choroid as well as the retinal pigment epithelium and photoreceptors.

Adult↗
PubMed1995

[A case report of a metaplastic carcinoma of the breast diagnosed by the preoperative needle biopsy].

A case of the metaplastic carcinoma, a rare type of the breast cancer, was reported. A 49-year-old woman noticed the left breast lump. Ultrasonography revealed a well circumscribed hypoechoic mass measuring 3 cm in diameter. The preoperative needle biopsy showed the invasive carcinoma with chondrometaplasia. The modified radical mastectomy along with the lymph node dissection was performed. There have been few reports of the metaplastic breast carcinoma diagnosed preoperatively.

Biopsy, Needle↗
PubMed1995

[Arachnoid cyst with hematoma in the cyst wall].

It is well known that arachnoid cysts can be associated with chronic subdural hematoma. We report a case of an arachnoid cyst in which the hematoma was located in the cyst wall. A 23-year-old male was found by chance to have an arachnoid cyst in the left middle fossa. We followed him up, because he had no symptoms. Two years after the initial examination, he began to complain of severe headache. MR image showed a hematoma located in the anterolateral space of the cyst. On operation, we found that arachnoid membranes had covered the hematoma. We removed the hematoma and tore the inner wall of the cyst so that cerebrospinal fluid in the cyst could flow easily into the basal cistern. Pathological examination revealed arachnoid-like tissues outside the hematoma capsules. Since the hematoma was wrapped all over by arachnoid tissues, it was considered that the hematoma was located in the outer wall of the cyst. About the mechanism of hematoma formation in this case, we suppose that some force could have split the outer wall of the cyst, and bloody fluid seeping through the wall membranes may have collected in the wall itself.

Adult↗
PubMed1995

[Double cancers of renal cell carcinoma and testicular seminoma: a case report].

A case of metachronous presentation of renal cell carcinoma and testicular seminoma is reported. A 48-year-old man underwent left radical nephrectomy for a renal tumor on September 4, 1991. Pathological examination revealed clear cell carcinoma with no capsular penetration. There was no evidence of distant metastases. During postoperative follow-up, he noticed a painless left testicular induration in July, 1994. Serum human chorionic gonadotropin beta subunit as a tumor marker was elevated. Left radical orchiectomy was performed on October 17, 1994. Pathological examination revealed an anaplastic seminoma localized within the testis. Chest X-ray was normal and CT of the abdomen demonstrated no evidence of retroperitoneal lymphadenopathy. The patient was diagnosed as clinical stage I left testicular seminoma. He was free of disease 8 months postoperatively. Including our case, 15 cases of clinically detected double cancers of renal cell carcinoma and testicular germ cell tumor have been reported worldwide. This is the first case of a metachronous presentation of these two cancer types preceded by renal cell carcinoma.

Carcinoma, Renal Cell↗
PubMed1995

[Study on different imaging time of late 201Tl thyroid imaging to differentiate malignant from benign thyroid nodules].

This study was undertaken to clarify better time to initiate the late 201Tl thyroid imaging to differentiate malignant thyroid nodules from benign ones. Thyroid images were obtained at 5 min, 1 and 3 hr after i.v. injection of 74 MBq of 201Tl chloride. The early (5 min) and late (1 or 3 hr) 201Tl images were compared in pathologically proven 38 malignant and 48 benign nodules of 83 patients. The lesion activity (LA) on the early image was visually graded as no uptake (-), slight uptake less than the surrounding thyroid tissue uptake (STTU) (+/-), uptake equal to the STTU (+), and uptake more than the STTU (++). The change of LA relative to the STTU from the early image to the late image was visually graded as decreasing (D), unchanged (U) or increasing (I) pattern when the LA was (+/-) to (++). The benign or malignant possibility at 1 hr and 3 hr in each lesion pattern was as follows: When the LA was (-) or D, the benign possibility was 95% (35/37) and 85% (39/46). When the LA was I, the malignant possibility was 96% (27/28) and 91% (21/23). When the LA is U, the diagnosis was equivocal: malignancy; 43% (9/21) at 1 hr and 59% (10/17) at 3 hr. The positive LA had a tendency to decrease with time irrespective of tumor character. The 1 hr image was statistically better than the 3 hr image as a late image. Comparative diagnosis of 5 min and 1 hr images with the criteria of I and U lesions being malignant and others being benign seems to be the best not to overlook malignant nodules: negative predictive value 95% and sensitivity 95%.

Diagnosis, Differential↗
PubMed1995

[Molecular genetics of myotonic dystrophy].

The gene for myotonic dystrophy (DM) was found to be an expansion of an unstable CTG repeat located in the 3'-UTR of the putative protein kinase gene. In the general population 5 approximately 37 copies of the repeat are present, but in DM patients the repeat number varies from 50 up to thousands of copies. We have determined the copy number of the CTG repeat and made a haplotype using the closely linked markers to the CTG repeat in 93 Japanese DM families. The absolute linkage disequilibrium was observed in patients from both populations, between the DM gene and the linked markers. These data strongly suggest a common origin of Caucasian and Japanese DM alleles. The genetic analysis of apparently sporadic occurrence of DM in a family in which two asymptomatic members have been shown to have a number of repeats corresponding to premutation alleles, 44 and 46 CTG alleles. These data strongly suggest that (CTG) 19 approximately 37 may act as a predisposing allele for successive DM generations and that there is a premutation allele for DM, as predicted in a multistep model for etiology of this disorder.

Alleles↗
PubMed1994

Survey of complications of indocyanine green angiography in Japan.

PURPOSE: We evaluated the safety of indocyanine green for use in fundus angiography. METHODS: We sent a questionnaire concerning complications of indocyanine green to 32 institutions in Japan, which were selected on the basis of the client list from the Topcon Company, which manufactures the indocyanine green fundus camera. RESULTS: Ophthalmologists at 15 institutions responded, reporting a total of 3,774 indocyanine green angiograms performed on 2,820 patients between June 1984 and September 1992. Before angiography, intradermal or intravenous indocyanine green testing, or both was performed at 13 of 15 institutions. For three patients, the decision was made not to proceed with angiography after positive preangiographic testing. The dosage of indocyanine green used for angiography varied from 25 to 75 mg, depending upon the institution. There were 13 cases of adverse reactions (0.34%), ten of which were mild reactions such as nausea, exanthema, urtication, itchiness, and urgency to defecate, and did not require treatment. Also recorded were one case of pain of the vein, which required treatment, and two cases of hypotension. The two hypotensive patients required treatment for shock. CONCLUSIONS: A comparison of frequency of adverse reactions to indocyanine green with the previously reported frequency of such reactions to fluorescein sodium indicated that indocyanine green is a safe as fluorescein for use in angiography.

Aged↗
PubMed1994

Characterization of cDNAs species encoding the Tat protein of caprine arthritis encephalitis virus.

Two distinct species of caprine arthritis encephalitis virus (CAEV) tat cDNAs were isolated early after infection of a Himalayan tahr cell line. Sequence analyses predicted that one cDNA (pCEV/e1) represented a polycistronic transcript that encodes Tat and Rev as well as an N-terminally truncated transmembrane protein and a protein, designated X, whose function is unknown; whereas the other cDNA (pCEV/f1) encodes Tat and the env gene products. pCEV/e1 trans-activated a CAEV LTR-chloramphenicol acetyltransferase reporter gene in goat synovial membrane cells. This activity was shown to be encoded by the Tat open reading frame by analysis of a deletion mutant. Because the pCAEV/f1 insert was unstable in plasmid form, its Tat activity could not be convincingly demonstrated. The target sequences for Tat within the CAEV LTR were localized to the U3 region which, when placed in either orientation upstream of heterologous promoters, was able to confer responsiveness to Tat.

Amino Acid Sequence↗
PubMed1994

Calcium modulates the cyclin D1 expression in a rat parathyroid cell line.

We have used a rat epithelial parathyroid cell line (PT-r) to study the expression and regulation of D-type cyclins. In PT-r cells the cyclin D1 gene is the most abundantly expressed, being transcribed in at least two mRNAs whose levels oscillate during the cell cycle. We also screened a cDNA library prepared from PT-r cells with the human cyclin D1 probe and isolated its rat homologue. Cyclin D2 and D3 mRNAs are both represented in PT-r cells but the former one is only barely detectable. Moreover, the oscillation of cyclin D3 transcript is slightly delayed when compared to cyclin D1 and D2. Since extracellular calcium inhibits parathyroid cell proliferation, we looked for the effect of the ion on the expression of cyclin D genes in PT-r cells. Increasing amounts of calcium in the incubation medium reduced the expression of rat cyclin D1 and D2. The effect appears to be cell-specific and probably mediated through the inhibition of mitogenic signalling pathways.

Amino Acid Sequence↗