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Biomedical subjects

T Nishimura

Publications and source records attributed to T Nishimura.

At least 343 records · Page 19Linked to original sources
PubMed1998

Efficacy and limitation of F-18-fluorodeoxyglucose positron emission tomography during fasting to assess myocardial viability in the acute phase of myocardial infarction.

OBJECTIVE: The present study was designed to determine the ability of positron emission tomography (PET) to assess myocardial viability and ischemia in acute myocardial infarction (MI) after reperfusion therapy (thrombolysis and/or coronary angioplasty). METHODS: PET with fluorine-18-labeled fluorodeoxyglucose (FDG) under fasting conditions and thallium-201 single-photon emission computed tomography (TL) were analyzed in 21 patients one week following MI. Myocardial viability was also assessed by regional wall motion using serial analysis of 2-D echocardiography or left ventriculography. RESULTS: Marked uptake of FDG together with a residual perfusion defect were observed in the infarct region in all patients one week post MI. However, in 9 of the 21 patients, the infarct-related coronary artery had no significant stenosis after reperfusion therapy and remained patent in one month post MI suggesting no myocardial ischemia. In contrast, in 4 of the 21 patients the regional wall motion was akinetic and there was a complete defect observed with TL imaging at one month post MI, indicating no viability in the infarct region. CONCLUSIONS: PET using fasting FDG at one week post MI had a limitation to predict myocardial viability or ischemia.

Acute Disease↗
PubMed1998

Mechanism of impaired left ventricular wall motion in the diabetic heart without coronary artery disease.

OBJECTIVE: To elucidate whether impairment of the myocardial free fatty acid (FFA) metabolism and small vessel abnormalities in the myocardium are etiologic or contributory factors of myocardial dysfunction in patients with NIDDM without any significant coronary artery disease. RESEARCH DESIGN AND METHODS: We performed myocardial imaging with 123I-labeled beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP), a branched analog of FFA, and dipyridamole-infusion 201thallium scintigraphy (Dip) in nine patients who demonstrated left ventricular wall motion abnormalities without any significant coronary artery disease and in fifteen control cases. As an index of myocardial FFA metabolism, the heart-to-mediastinum count ratio (H/M) of BMIPP was calculated from the mean count in the regions of interest at the heart and the upper mediastinum. RESULTS: Nine patients with reduced wall motion documented by left ventriculography (LVG), (hypokinetic group) demonstrated significantly lower BMIPP uptake (2.1 +/- 0.2, mean +/- SD) than fifteen patients with normal wall motion (normokinetic group) (2.3 +/- 0.2, P < 0.05). Regional ventricular wall motion observed by LVG, regional BMIPP uptake, and regional redistribution phenomenon (RD) were evaluated for five regions of the left ventricle: anterior, septal, apical, lateral, and inferoposterior regions. Wall motion was abnormal in 24 out of 120 regions. Regional BMIPP uptake was reduced in 47 regions. RD in Dip was observed in 23 regions. In regional analysis, the existence of defect in the BMIPP image showed significant correlation with wall motion abnormality (P < 0.01), but there was no significant relationship between the RD in Dip and regional wall motion abnormality (P = 0.16). Myocardial biopsy specimens obtained from the right ventricle of 20 patients showed no pathologic changes, with the exception of two patients. CONCLUSIONS: Our findings suggest that impairment of myocardial FFA metabolism rather than small vessel abnormalities in the myocardium is responsible for modest left ventricular dysfunction in patients with diabetes.

Adult↗
PubMed1998

Changes in mechanical strength of intramuscular connective tissue during postmortem aging of beef.

We studied changes in mechanical strength during postmortem aging of bovine semitendinosus muscle using intramuscular connective tissue (IMCT) preparations from muscle stored at 4 degrees C. In the preparation, muscle fiber elements were removed, leaving a virtually intact structure of the endomysium and perimysium. The shear-force value of the IMCT preparation remained unchanged up to 10 d postmortem and decreased linearly thereafter. The yield of the perimysial fraction, which was measured as an indicator of mechanical properties of the perimysium, remained almost unchanged up to 14 d postmortem, and decreased gradually thereafter. These results suggest that the mechanical strength of the intramuscular connective tissue changes slowly during postmortem aging of beef; it remains almost unchanged for up to 10 d postmortem and progressively decreases thereafter. Thus, intramuscular connective tissue seems to affect beef tenderization in extended aging.

Animals↗
PubMed1998

Basic and clinical studies on ApoE gene typing by line probe assay (LiPA) as a biological marker for Alzheimer's disease and related disorders: multicenter study in Japan.

The fundamental reagent capability and clinical significance of ApoE gene typing has been investigated. The result of each test shows that the reagent capability satisfied the expected standard. Four-hundred thirty-nine samples classified into three groups (Alzheimer's disease (AD), other types of dementia and nondementia) were measured to examine the clinical significance. The rate of epsilon 4 genotype of each group was 31.5%, 14.6%, 10.4%, respectively. The AD group had a higher rate than the other groups (p < 0.001). The measurement of ApoE genotype is suggested to be useful as one of the guidelines in the diagnosis of AD.

Age Factors↗
PubMed1998

Application of real-time confocal microscopy for observation of living cells in tissue specimens.

Measurement of intracellular Ca2+ concentration ([Ca2+]i) has been a fundamental technique in cell biology. However, most investigations have used cultured or isolated cells as an experimental model, and consequently can provide only limited insight into the mechanisms that operate in tissue in situ. Useful information may be obtained by studying intact tissue specimens. High-speed confocal microscopes that can acquire digital images at video rate have recently been developed. These confocal microscopes which can acquire data in real-time enable [Ca2+]i dynamics of individual cells in intact tissue specimens to be observed. The present paper examines the use of fluorescent microscopy and confocal microscopy for [Ca2+]i imaging of living tissue. We analyzed the dynamics of the duodenal gland, lacrimal gland, intestinal smooth muscles, arterioles, myenteric plexus, and dorsal root ganglion. In these specimens, individual cells exhibited different [Ca2+]i dynamics, and the responses to transmitters/modulators were heterogeneous. In conclusion, real-time imaging provides a useful tool for observing dynamic changes in cells in situ, and it may lead to improve understanding tissue physiology.

Biological Transport↗
PubMed1998

[An operative case of primitive neuroectodermal tumor in the posterior mediastinum].

A primitive neuroectodermal tumor (PNET) is very rare and the prognosis of this tumor is poor. A 32-year-old woman complaining of dysphagia and back pain was admitted to our hospital for the posterior mediastinal tumor. The tumor originated from the muscle layer of esophagus and en bloc resection of the tumor combined with the affected part of esophagus was performed. Histopathological diagnosis of the resected tumor was PNET. She received adjuvant chemotherapy. Eight months after the surgery, recurrent tumors in the right mediastinum and the retrooperitoneal space was resected completely. But after the second surgery, dissemination occurred recurrently. These recurrent tumors revealed high sensitivity for radio-therapy. However, she died of rapid recurrence 22 months after the first surgery. In Japan, our case is the second case of PNET in the posterior mediastinum and the first case of PNET arising from the muscle layer of esophagus.

Adult↗
PubMed1998

Combined thallium-201 myocardial with technetium-99m-HMPAO brain SPECT: myocardial ischemia induced by acetazolamide in severe coronary artery disease.

Since the perioperative mortality of coronary artery bypass surgery is high in patients with cerebrovascular disease, it is crucial to assess a cerebrovascular risk before operation. Acetazolamide (ACZ) was applied to brain SPECT to evaluate the vascular reserve, and ACZ stress brain imaging was useful for predicting perioperative cerebrovascular events. We performed 201Tl myocardial and 99mTc-hexamethyl-propyleneamine oxime (HMPAO) brain SPECT with ACZ stress simultaneously to a patient with severe coronary artery disease and experienced the abnormality of 201Tl myocardial imaging with ACZ, as did that with dipyridamole. Technetium-99m-HMPAO brain SPECT showed no defect. Brain SPECT with ACZ demonstrated the region of poor coronary vascular reserve, which suggested myocardial ischemia induced by ACZ in a patient with severe coronary artery disease.

Acetazolamide↗
PubMed1998

[The relationship between the pathways of the lymphatic drainage into the mediastinal nodes and the survival rate for N2 lung cancers underwent curative resection].

The pathways of the metastases to the mediastinal nodes were determined in each case of 68 N2 lung cancer patients undergoing mediastinal lymph node dissection. The relationship between the pathways of the metastases and the survival rate was examined in the 57 N2 lung cancer patients undergoing curative resection. The results were as follows: (1) The direct metastatic passage to the mediastinal nodes was observed in 32.1% in the right upper lobe. The survival rate of this group was 55.4% (4-year survival rate), and that of cases metastasized to the intrapulmonary and/or hilar nodes as well as mediastinal nodes was 42.4% (3-year survival rate). (2) The dominant lymphatic drainage from the middle lobe and the lower lobes flowed into the subcarinal nodes through the hilar nodes. 75% had involvement of the subcarinal nodes, and 33.3% had involvement of the upper mediastinal nodes. 5-year survival rate of the cases without the upper mediastinal nodes metastases was 59.0%, and that of cases metastasized to the upper mediastinal nodes was 26.7% (3-year survival rate). (3) The dominant lymphatic drainage from the left upper lobe flowed into the subaortic or paraaortic nodes. 5-year survival rate in the left upper lobe was 50.0%. It suggested that the cases metastasized to the mediastinal nodes via the direct passage in the right upper lobe, the cases in the left upper lobe, and the cases metastasized to the subcarinal nodes without the upper mediastinal nodes metastases in the middle lobe and the lower lobes had better prognosis.

Humans↗
PubMed1998

[A case of pulmonary arteriovenous fistula beneath the surface of the lung].

A 19-year-old woman complaining of exertional dyspnea was admitted to our hospital with an abnormal shadow on the left side of the chest. Laboratory examination revealed polycythemia and hypoxemia. Pulmonary angiogram demonstrated a pulmonary arteriovenous fistula beneath the surface of the left S10. Partial resection of the left S10 was performed. The wall of the arteriovenous fistula was flimsy and seemed to rupture easily. The sister of this patient also had a peripheral pulmonary arteriovenous fistula and suffered from repeating epistaxis. Rendu-Osler-Weber disease was diagnosed in both, and the sister underwent partial resection of the right S7, which contained the fistula. Their postoperative courses were uneventful. Hemothorax and hemoptysis are lethal complications of arteriovenous fistulae. In order to avoid the rupture of fistulae, surgical resection is the most reliable treatment. Pulmonary arteriovenous fistulae beneath the surface of the lung should be resected.

Adolescent↗
PubMed1998

SPECT findings in mitochondrial encephalomyopathy.

UNLABELLED: We investigated the alterations in regional cerebral blood flow (rCBF) in mitochondrial encephalomyopathy (MEM), using [123I]N-isopropyl-p-iodoamphetamine (IMP) or 99mTc-hexamethyl propyleneamine oxime SPECT in 10 MEM patients. METHODS: Four of the patients had MEM with lactic acidosis and strokelike episodes (MELAS), 2 had Kearns-Sayre syndrome (KSS), 1 had myoclonic epilepsy with ragged red fibers (MERRF) and 3 had cytochrome C oxidase deficiency (CCOD). Cerebral perfusion reserve was obtained from 6 patients (3 MELAS, 1 MERRF, 1 KSS, 1 CCOD) for a comparative analysis using the split-dose 123I-IMP SPECT method before and after the injection of acetazolamide. RESULTS: All patients with MELAS showed focal hypoperfusion in the parietal and/or occipital lobes. Follow-up studies (3 MELAS patients) revealed extension or improvement in the abnormal perfusion. The hypoperfused lesions were correlated with abnormal CT/MRI findings. Perfusion was normal in 1 MERRF, 2 KSS and 3 CCOD patients, whereas CT/MRI findings in 1 MERRF, 1 KSS and 1 CCOD patient were abnormal. The cerebral perfusion reserve in 3 MELAS patients was decreased significantly compared with that in patients with other types of MEM (MELAS 7.4%, other MEM 33.8%; p < 0.05). CONCLUSION: The rCBF was altered specifically in patients with MELAS, suggesting that brain perfusion SPECT will be useful in diagnosing and assessing such patients. The decreased cerebral perfusion reserve in patients with MELAS may represent an important feature of the pathogenesis of the strokelike episodes. The SPECT findings of patients with other types of MEM (MERRF, KSS and CCOD) were normal.

Adolescent↗
PubMed1998

[Identification of aneuploids in uncultured amniotic fluid cells by interphase fluorescence in situ hybridization].

We report the diagnosis of aneuploids in uncultured amniotic fluid cells by the use of interphase fluorescence in situ hybridization (FISH). About a dozen of cases was studied to detect chromosome aneuploids (trisomies 13, 18 and 21, and monosomy X), especially those in the perinatal period. Results of FISH experiments in each specimen were compared with those of conventional chromosome analysis, and showed no discrepancy between them in most cases. FISH analysis revealed that four 18-trisomies had two different cells, one of which showed two fluorescence signals and the other three signals, the result indicating a maternal cell contamination. Thus, special attention should be paid when FISH analysis is adopted to the diagnosis in uncultured amniotic fluid cells in order to avoid misdiagnosis that may originate in maternal cell contamination.

Amniotic Fluid↗
PubMed1998

Basic and clinical studies on the measurement of tau protein in cerebrospinal fluid as a biological marker for Alzheimer's disease and related disorders: multicenter study in Japan.

The development of a diagnostic marker for earlier and more accurate clinical diagnosis of Alzheimer's disease (AD) is essential to identify AD patients during life unequivocally. The purpose of this study was to investigate the basic performance and clinical significance of tau level measurement in the cerebrospinal fluid (CSF) using an enzyme-linked immunosorbent assay (ELISA) developed by Innogenetics. The ELISA system showed reliable reproducibility and good linearity. For clinical studies, the CSF samples from a variety of patients (n = 332) were examined. They were classified into the four groups: Alzheimer's disease (AD); neurodegenerative disease (ND); cerebrovascular diseases (VD); and a neurological control (NC) group. The CSF-tau levels for AD, ND, VD and NC were 426 +/- 234 pg/ml, 239 +/- 157 pg/ml, 216 +/- 136 pg/ml, and 188 +/- 103 pg/ml, respectively. The CSF-tau level of the AD group was significantly higher than that of the other groups (p < 0.001). The CSF-tau levels increased during follow-up. The measurement of the tau level in CSF is shown to be a useful marker to confirm a clinical diagnosis of AD.

Aged↗
PubMed1998

[A comparison of a 3 day course with a 2 week course of oral prednisolone in patients with chronic asthma].

To investigate an appropriate duration of short course of a oral prednisolone (PSL), we compare the results of a 3 day course of PSL (3D) with those of a 2 week course of PSL (2W) in 20 patients with chronic asthma. All subjects had been inhaling beclomethasone dipropionate (BDP, mean daily dose: 1325 micrograms), and had been self-monitoring their peak expiratory flow rate (PEF) for at least 6 months. Mean +/- SE of the best PSL-induced PEF in 2W (2W-best) was not different from that in 3D (397 +/- 29 and 356 +/- 23 L/min, respectively, p = 0.26). Mean weekly morning PEF/2W-best before and 1, 2, 3 and 4 weeks after PSL was 60, 76, 80, 76 and 76% in 2W, and 63, 73, 67, 67 and 65% in 3D, respectively. Both changes over the course of time were significant. The frequency of emergency room visits and/or unscheduled hospital visits was not significantly different between 2W and 3D. However, both the frequency of use of inhaled beta 2 agonists and the symptom score significantly decreased only in 2W. Seven patients (35%) did not need additional oral PSL during the 4-week period after initiating 3D, and among these patients, emergency room visits and/or unscheduled hospital visits were completely controlled. In conclusion, although the effect of 3D was inferior than that of 2W, it was a sufficient duration in 35% of the patients, and thus, may be appropriate as a initial duration of rescue course of oral steroids.

Administration, Oral↗
PubMed1998

[Two cases of solitary peripheral pulmonary arterial aneurysm].

We report two very rare cases of solitary peripheral pulmonary arterial aneurysm. Case 1: An 83-year-old man treated for myocardial infarction died of multiple organ failure and hemoptysis. Autopsy disclosed rupture of a pulmonary arterial aneurysm 1.5 cm in diameter in the right A3. Case 2: A 75-year-old man was found to have a pulmonary arterial aneurysm, 3 cm in diameter of the right A1. Surgical treatment was not indicated, because of severe pulmonary emphysema. The aneurysms in these two cases were idiopathic: (1) there were no histologic findings that would implicate specific chronic inflammation. (2) the period from the occurrence of secondary pulmonary hypertension to hemoptysis was short, and there was no (3) history of trauma.

Aged↗
PubMed1998

Iodine-123-iomazenil and iodine-123-iodoamphetamine SPECT in major cerebral artery occlusive disease.

UNLABELLED: Iodine-123-iomazenil (IMZ) is a SPECT ligand for central-type benzodiazepine receptors, which are located only on neurons. We evaluated the feasibility of using IMZ SPECT for identifying neuronal damage in patients with the chronic phase of thrombotic cerebral ischemia. METHODS: We studied 15 patients with angiographically-confirmed unilateral severe occlusive lesions (occlusion or > 70% stenosis) in the carotid system. IMZ SPECT images obtained 180 min after injection of 167-222 MBq IMZ were analyzed. The regional cerebral blood flow and perfusion reserve were evaluated for comparison with IMZ SPECT findings, using the split-dose 123I-iodoamphetamine (IMP) SPECT method, coupled with intravenous injection of 1 g acetazolamide. On both SPECT images, the count ratio of the affected to the nonaffected whole MCA territory (A/NA ratio) and of the contralateral to the ipsilateral cerebellar cortex (C/I ratio) were determined. RESULTS: The A/NA ratio with IMZ was significantly higher than that with IMP (94.5% +/- 6.2% versus 91.4% +/- 6.6%, p < 0.005), although a significantly positive correlation was found between these two ratios (r = 0.854, p < 0.0001). The C/I ratio with IMP was decreased significantly in 5 patients compared with that in normal subjects, whereas the C/I ratio with IMZ was decreased in only 1 patient. There was no significant correlation between the A/NA ratio with IMZ and the perfusion reserve in the affected MCA territory. In 2 of 5 patients with a decreased A/NA ratio (<90%) with IMZ, decreased blood flow with preserved perfusion reserve and cerebral hemispheric atrophy were observed, which suggested the influence of neuronal loss due to chronic ischemia. CONCLUSION: These findings indicate that IMZ SPECT, which provides new information regarding neuronal damage after ischemic insult to the brain, is useful for evaluating thrombotic cerebral ischemia.

Amphetamines↗
PubMed1998

Surgical outcome on combined procedures of lens extraction, intraocular lens implantation, and vitrectomy during removal of the epiretinal membrane.

BACKGROUND AND OBJECTIVE: The authors evaluated the outcome of combined procedures of lens extraction, intraocular lens implantation, and vitrectomy during procedures for the removal of the epiretinal membrane, and attempt to clarify which factors affected the outcome of surgery. PATIENTS AND METHODS: Surgery for the removal of the epiretinal membrane was performed and a 2-year follow-up program was maintained for 32 eyes at the authors' clinic during the past 5 years. The combined procedure was undertaken in 15 eyes, whereas a simple vitrectomy was performed in 17 eyes. Results were analyzed by postoperative ophthalmoscopic and slit-lamp examinations for visual acuity and complications. RESULTS: Six months after surgery, visual acuity improved similarly in both groups. But, 2 years after surgery, 11 eyes (65%) that underwent a simple vitrectomy showed decreased visual acuity due to the advancement of cataracts. The postoperative visual acuity at 6 months correlated to preoperative visual acuity, and the advancement of cataracts tended to correlate inversely to the age of the patients. Major complications did not occur in any of the cases. CONCLUSION: Earlier surgical management is better for treatment of the epiretinal membrane, and a combined procedure has advantages in cost reduction and is less troublesome, especially for elderly patients.

Adult↗
PubMed1998

Fluorine-18-fluorodeoxyglucose PET identification of cardiac metastasis arising from uterine cervical carcinoma.

Cardiac metastasis of uterine cervical carcinoma is rare. We describe a patient with a past history of uterine cervical carcinoma who presented with metastasis to the heart, lungs and distant lymph nodes 3 yr after surgery and chemotherapy. Since the patient complained of chest pain and demonstrated electrocardiogram abnormalities, we performed echocardiography, electron beam CT and MRI, which revealed a tumor in the right ventricular wall. The tumor was assessed by 67Ga scintigraphy and 18F-fluorodeoxyglucose (FDG) PET scanning. The mean differential 18F-FDG uptake ratio of the tumor was 7.9, suggesting malignancy, which was later confirmed by myocardial biopsy. Information about the extent of the tumor and partial necrosis within it was provided by 18F-FDG PET. Although both radionuclide imaging techniques also detected metastatic lesions in the lungs and lymph nodes, 18F-FDG PET scanning detected small lesions more sensitively than 67Ga scintigraphy.

Adult↗