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Biomedical subjects

T Ota

Publications and source records attributed to T Ota.

At least 199 records · Page 11Linked to original sources
PubMed1995

[A case of eosinophilic pneumonia presenting as hemoptysis, with epithelioid cell granuloma on lung biopsy].

A 60-year-old woman was admitted because of hemoptysis and dyspnea on exertion, which began one month before admission and gradually increased. Chest X-ray film taken on admission showed an infiltrative shadow in and around the left posterior basal segment. Chest CT disclosed peripheral and patchy consolidation with some air bronchograms and interstitial thickening in the left basal segments. Bronchoalveolar lavage fluid contained many red blood cells and abnormally high numbers of eosinophils and lymphocytes. The specimen obtained by CT-guided lung biopsy revealed epithelioid cell granulomas, hemosiderin-laden macrophages, diffuse infiltration of small round cells with a few eosinophils and monocytes in the alveolar septa, and many eosinophils in the intraalveolar exudates. No pathogens of pulmonary eosinophilia were identified and there was no secondary pulmonary eosinophilia. Therefore, we diagnosed eosinophilic pneumonia with no obvious cause. Hemoptysis may have been due to alveolar hemorrhage of eosinophilic pneumonia. The hemoptysis and chest infiltrative shadow disappeared rapidly after the start of treatment with oral prednisolone.

Biopsy↗
PubMed1995

[Clinical feature and pathology of airway disease in Sjögren's syndrome].

Airway disease of Sjögren's syndrome (SjS) has been studied since years ago. Many researchers have thought xerotrachea induced dry cough. Recently it was revealed that there was no xerotrachea but atrophic change and proliferation and growth of blood vessel. Various airway diseases of SjS have been reported, including bronchitis, bronchiolitis and follicular bronchiolitis. Rarely patients may lose their life for them. Patients of SjS without respiratory manifestations often show pulmonary function abnormalities. We compared pulmonary function of SjS and collagen disease without SjS. To our surprise, both of them show obstructive pattern with almost same frequency. Probably it means that obstructive airway diseases are not characteristic for SjS. Recently bronchial hyperresponsiveness in SjS is drawing the attention. Treatment and prognosis of the airway diseases in SjS have been not clarified, so further studies have to be piled up from now on.

Bronchial Hyperreactivity↗
PubMed1995

[Hand-mirror cells acute lymphoblastic leukemia (L3)].

To our knowledge, this report represents the first confirmed case in Japan of a 15-year-old boy with acute lymphoblastic leukemia (ALL).L3 with hand-mirror cells (HMC) in the bone marrow. HMC lymphoid leukemia is an unusual variant of ALL in which the bone marrow lymphoblasts manifest distinctive hand-mirror morphologic features. HMC lymphoblast is characterized by an asymmetric foot-like cytoplasmic process that extends from the portion of the cell, thus giving it the light-microscopic appearance responsible for its name. Besides ALL, HMC has been reported in acute myeloblastic leukemia (AML), blastic crisis of chronic myelogenous leukemia, non-Hodgkin's lymphoma, and infectious mononucleosis. HMC has been reported to be prevalent in ALL.L1 and L2 as compared with L3.

Adolescent↗
PubMed1994

Immunoglobulin light chain class multiplicity and alternative organizational forms in early vertebrate phylogeny.

The prototypic chondrichthyan immunoglobulin (Ig) light chain type (type I) isolated from Heterodontus francisci (horned shark) has a clustered organization in which variable (V), joining (J), and constant (C) elements are in relatively close linkage (V-J-C). Using a polymerase chain reaction-based approach on a light chain peptide sequence from the holocephalan, Hydrolagus colliei (spotted ratfish), it was possible to isolate members of a second light chain gene family. A probe to this light chain (type II) detects homologs in two orders of elasmobranchs, Heterodontus, a galeomorph and Raja erinacea (little skate), a batoid, suggesting that this light chain type may be present throughout the cartilaginous fishes. In all cases, V, J, and C regions of the type II gene are arranged in closely linked clusters typical of all known Ig genes in cartilaginous fishes. All representatives of this type II gene family are joined in the germline. A third (kappa-like) light chain type from Heterodontus is described. These findings establish that a degree of light chain class complexity comparable to that of the mammals is present in the most phylogenetically distant extant jawed vertebrates and that the phenomenon of germline-joined (pre-rearranged) genes, described originally in the heavy chain genes of cartilaginous fishes, extends to light chain genes.

Amino Acid Sequence↗
PubMed1994

Mitral valve replacement after atrioventricular canal repair in adults: report of three cases.

Three cases of adults who required a mitral valve replacement (MVR) following repair of an atrioventricular (AV) canal are presented herein. In adult patients with an AV canal, the deformity of the mitral valve is sometimes too advanced for adequate repair, and therefore, residual mitral regurgitation frequently causes intractable cardiac failure despite appropriate medical management. Thus, for adults with an AV canal associated with severe valvular deformities, MVR should be considered from the initial operation to obtain a significantly better outcome.

Adult↗
PubMed1994

Effect of mitral valve surgery on severely impaired pulmonary function.

To evaluate the effect of surgery on severely impaired pulmonary function associated with mitral valve disease, we examined the relationship between postoperative improvements in pulmonary function and pulmonary circulation in 238 patients who underwent mitral valve surgery. Of these patients 17 met the preoperative criteria for severely impaired pulmonary function: forced expiratory volume in 1 second = FEV1 < or = 1000 ml. They showed average values for vital capacity (VC) of 1343 +/- 203 ml, for % of vital capacity for predicted values (%VC) of 52.0 +/- 6.5%, and for FEV1 of 851 +/- 104 ml. Moderate elevations of mean pulmonary arterial pressure (PAP: 36.2 +/- 10.2 mmHg), mean pulmonary arterial wedge pressure (PAWP: 23.0 +/- 9.6 mmHg), and pulmonary vascular resistance (PVR: 329 +/- 147 dyne.sec.cm-5) were also observed. Postoperatively, 4 of the 17 patients required long-term respiratory support for more than one week, and 3 patients died in hospital; this mortality rate, however, was not significantly different to that of patients with preoperative FEV1 > 1000 ml. In long-surviving patients, pulmonary function improved in the late postoperative period. Significant relationships were recognized between delta FEV1 (delta: postoperative value--preoperative value) and delta PAP, delta PAWP, and delta PVR. The delta VC and delta %VC also correlated significantly with delta PAP, delta PAWP and delta PVR. In conclusion, in patients with mitral valve disease impaired pulmonary function cannot be used to exclude patients from operation. Furthermore, severely impaired pulmonary function should improve with the improvement of pulmonary circulation after surgery.

Adult↗
PubMed1994

Divergent evolution and evolution by the birth-and-death process in the immunoglobulin VH gene family.

Immunoglobulin diversity is generated primarily by the heavy- and light-chain variable-region gene families. To understand the pattern of long-term evolution of the heavy-chain variable-region (VH) gene family, which is composed of a large number of member genes, the evolutionary relationships of representative VH genes from diverse organisms of vertebrates were studied by constructing a phylogenetic tree. This tree indicates that the vertebrate VH genes can be classified into group A, B, C, D, and E genes. All VH genes from cartilaginous fishes such as sharks and skates from a monophyletic group and belong to group E, whereas group D consists of bony-fish VH genes. By contrast, group C includes not only some fish genes but also amphibian, reptile, bird, and mammalian genes. Group A and B genes were composed of the genes from mammals and amphibians. The phylogenetic analysis also suggests that mammalian VH genes are classified into three clusters--i.e., mammalian clans I, II, and III-and that these clans have coexisted in the genome for >400 Myr. To study the short-term evolution of VH genes, the phylogenetic analysis of human group A (clan I) and C (clan III) genes was also conducted. The results obtained show that VH pseudogenes have evolved much faster than functional genes and that they have branched off from various functional VH genes. There is little indication that the VH gene family has been subject to concerted evolution that homogenizes member genes. These observations indicate that the VH genes are subject to divergent evolution due to diversifying selection and evolution by the birth-and-death process caused by gene duplication and dysfunctioning mutation. Thus, the evolutionary pattern of this monofunctional multigene family is quite different from that of such gene families as the ribosomal RNA and histone gene families.

Amino Acid Sequence↗
PubMed1994

Variance and covariances of the numbers of synonymous and nonsynonymous substitutions per site.

Nei and Gojobori (1986) developed a simple method to estimate the numbers of synonymous (ds) and nonsynonymous (dN) substitutions per site. In the present paper, we have developed a method for computing variances and covariances of ds's and dN's and of the proportions of synonymous (ps) and nonsynonymous (pN) differences. We also have developed a method for computing the variances of mean dS, dN, pS, pN, without constructing a phylogenetic tree of the genes. We have conducted computer simulations based on simple evolutionary models and have shown that the new method gives good estimates of variances and covariances.

Computer Simulation↗
PubMed1994

[Detection of cytomegalovirus (CMV) antigen for rapid diagnosis and monitoring of CMV diseases in AIDS].

Ten to forty percent of the patients with acquired immunodeficiency syndrome (AIDS) develop sight- or life-threatening cytomegalovirus (CMV) infections. In some patients with AIDS, CMV is detected in the bronchoalveolar lavage fluid (BALF), urine, and other specimens, even when there are no symptoms of CMV disease. An indicator of active CMV infection is needed to facilitate the diagnosis of CMV disease in patients with AIDS or HIV infection and the evaluation of the efficacy of subsequent treatment. The present study was conducted during the period from 1993 to 1994. The subjects consisted of three patients with AIDS and a confirmed diagnosis of CMV disease (one case of retinitis, one case of gastrointestinal disease and one case of pneumonia), and five HIV-positive patients in whom CMV associated disease was ruled out. Those patients were monitored occasionally for the following parameters of active CMV infection and disease: expression of CMV antigen in the nucleus of polymorphonuclear leukocyte (CMV antigenemia), as it was determined with a monoclonal antibody against a lower matrix protein (p65); infectious CMV detected by shell vial method; CMV DNA detected by PCR; anti-CMV antibody titer; and histological findings. CMV p65 antigen was detected in the leukocytes of both the peripheral blood and BALF during the early phase of CMV disease in three out of three cases of the CMV disease group, and this antigen became negative in two out of two cases who responded to the therapy. All the five patients in the CMV-related-disease-negative group were negative for CMV antigenemia.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1994

Accurate contiguous sections without breath-holding on chest CT: value of respiratory gating and ultrafast CT.

OBJECTIVE: To image truly contiguous CT sections without breath-holding, we developed a respiratory-gating device combined with ultrafast CT. The purpose of this study was to evaluate the utility of this system, especially focusing on the contiguity of the images. SUBJECTS AND METHODS: In 37 patients, we obtained respiratory-gated scans and breath-hold scans with 6-mm collimation and 6-mm incrementation (19 patients) and with 3-mm collimation and 3-mm incrementation (18 patients). We compared these two sets of images with respect to quality and contiguity. In nine patients who could not hold their breath because of dyspnea or infancy, we obtained only respiratory-gated scans with 3-mm collimation and 3-mm incrementation. Our respiratory-gating device was composed of a commercial ECG and respiratory monitor, a triggering device, an original amplifier, and an original switching unit. It was designed to control the scan timing of an ultrafast CT scanner at a user-selected level of the respiratory curve obtained with transthoracic impedance plethysmography. RESULTS: The respiratory-gated images were equal in quality to the breath-hold images in 31 of the 37 patients who had both sets of images. In 15 of 19 patients who had 6-mm-thick sections and in 11 of 18 patients who had 3-mm-thick sections, satisfactory contiguous images of bronchi and pulmonary vessels were obtained. Additionally, in seven of the nine patients who could not hold their breath, satisfactory contiguous sections were obtained. CONCLUSION: The respiratory gating system combined with ultrafast CT can provide contiguous CT scans without breath-holding or patients' cooperation. The procedure could improve the diagnostic accuracy of CT, especially in severely ill patients, infants, and senile patients.

Female↗
PubMed1994

[A case of right atrial thrombus associated with idiopathic pericarditis].

A 73-year-old man suffering from exertional dyspnea was admitted to our hospital. Transthoracic echocardiography revealed pericardial effusion. This case was diagnosed as idiopathic pericarditis from laboratory data and pathological findings of the pericardial biopsy. A right atrial mass was detected by computed tomography, transesophageal echocardiography and MRI during conservative treatment. Because of the risk of pulmonary embolism due to the presence of the right atrial mass, removal of the mass was performed. The atrial mass was diagnosed as organized thrombus by pathological examination. It was suggested that the cause of right atrial thrombus was congestion and damage of the right atrial endocardium due to idiopathic pericarditis and atrial fibrillation. This case of a right atrial thrombus associated with idiopathic pericarditis is very rare, and MRI was proven to be very useful in the differentiation of a thrombus from cardiac tumor.

Aged↗
PubMed1994

Studies of protein A and herpes simplex virus-1 induced Fc gamma-binding specificities. Different binding patterns for IgG3 from Caucasian and Oriental subjects.

Herpes simplex virus type 1 (HSV-1) expresses a receptor that binds the Fc portion of IgG. This HSV-1 Fc gamma-binding protein is, like protein A of Staphylococcus aureus, known to bind human IgG1, IgG2 and IgG4 but not IgG3 subclasses. However, IgG3 with the allotype Gm(s+)(t+), prominent in the Oriental population, reacts with protein A. This prompted us to investigate the reactivity of Oriental IgG3 monoclonal myeloma proteins of various allotypes with the HSV-1 Fc gamma-binding protein. Of seven Oriental IgG3 myeloma proteins with allotypes Gm(s+)(t+)(u-)(b+)(g-), Gm(s-)(t-)(u+)(b+)(g-) and Gm(s-)(t-)(u+)(b-)(g+), all reacted with the HSV-1 Fc gamma-binding protein. This was in contrast to negative reactions obtained with three IgG3 myeloma proteins of Caucasian origin with Gm(b+)(g-) or Gm(b-)(g+) phenotypes. The same binding pattern, i.e. binding of IgG3 of Oriental but not of Caucasian origin, was found with protein A. The binding of the monoclonal Oriental IgG3 proteins was again independent of the G3m phenotype. These findings support the concept that the HSV-1 Fc gamma-binding protein A have a similar binding site on the IgG molecule. All monoclonal IgG3 proteins derived from Oriental subjects with or without histidine at position 435 bound to HSV Fc gamma-binding protein. This suggests that Oriental IgG3 myeloma proteins with Gm(s-)(t-) phenotypes have additional critical amino acid residue substitutions important for HSV Fc gamma binding different from those already known.

Asian People↗
PubMed1994

Effect of dynamic cardiomyoplasty on phasic coronary arterial flow velocity in canine hearts.

The usefulness of dynamic cardiomyoplasty has been demonstrated repeatedly, both experimentally and clinically. Although clinical applications of dynamic cardiomyoplasty to ischemic heart disease have been reported, its effect on the coronary blood flow has never been discussed. Therefore, we tested the hypothesis that dynamic cardiomyoplasty might adversely affect coronary arterial blood flow through compression of the coronary arteries during systolic skeletal muscular contraction and incomplete relaxation of the skeletal muscle flap during diastole. Dynamic cardiomyoplasty was performed in seven mongrel dogs with the use of a left latissimus dorsi-muscle flap, paced synchronously with the R wave of the electrocardiogram. A 3F Doppler catheter was placed in the left main trunk of the coronary artery to assess the instantaneous changes of coronary flow velocity by fast Fourier transformation analysis, We compared systolic and diastolic properties during assisted versus unassisted cardiac cycles by calculating the peak velocity and the time-velocity integral. During assisted cardiac cycles, a significant enhancement of coronary arterial blood flow velocity was demonstrated by significant increases in both systolic and diastolic peak velocity (26.9% +/- 6.5%, p < 0.005; 4.0% +/- 1.6%, p < 0.05, respectively) and time-velocity integral (20.9% +/- 4.8%, p < 0.05; 10.0% +/- 4.6%, p < 0.05, respectively). Enhancement of coronary arterial blood flow velocity was associated with an increase in mean aortic pressure (16.4% +/- 1.3%, p < 0.005) and descending aortic flow (67.5% +/- 5.3%, p < 0.005). Also, the improved systolic coronary arterial blood flow velocity was consistent with an increase in systolic aortic pressure (15.8% +/- 1.5%, p < 0.005), and enhancement of diastolic coronary arterial blood flow velocity was associated with an increase in diastolic aortic pressure (8.6% +/- 2.3%, p < 0.01). We concluded that coronary arterial blood flow velocity was increased by the enhancement of cardiac function as a result of dynamic cardiomyoplasty, leading to an increase of coronary perfusion pressure and cardiac output.

Animals↗
PubMed1994

[Surgical repair of aortic dissection associated with compression of true lumen during retrograde perfusion--report of two cases].

Two cases of acute aortic dissection which developed compression of the true lumen due to retrograde perfusion during cardiopulmonary bypass were reported. In the first case, coronary reperfusion could not be achieved when the aortic cross-clamping was removed after Collins' method of aortic dissection. There was no blood flow from the true lumen through the aortic root while the false lumen was distended by the retrograde perfusion. After completion of antegrade perfusion through the arterial cannula inserted into the anastomosed site of the ascending aorta, coronary reperfusion was established and the heart beating could be thereby obtained. In the second case, the false lumen was gradually expanded, and the true lumen was completely obstructed by it. Reexpansion of the true lumen was achieved by initiation of antegrade perfusion through the cannula inserted into the graft replaced in the ascending aorta. Fortunately cerebral and cardiac complications were not found in both cases postoperatively. Compression of the true lumen is rare, but fatal complication that may occur during retrograde perfusion in surgical repair for aortic dissection of Stanford type A. Therefore, it is very important to replace the perfusion cannula in the true lumen of the reconstructed aorta for preventing insufficiency of coronary and cerebral circulation.

Acute Disease↗
PubMed1994

[Clinical study of optimal bypass flow for temporary bypass with centrifugal pump in surgical treatment of aneurysm of the descending thoracic aorta].

Since 1987, 33 patients were operated on for aneurysm of the descending thoracic aorta using temporary bypass with a heparin-coated centrifugal pump and heparin-coated tubes at Kobe University Hospital. Sixteen patients had true aneurysms of the descending thoracic aorta, 7 had thoraco-abdominal aneurysms and 10 had aortic dissection (DeBakey's type III). Heat exchanger and oxygenator were not included in the bypass circuit in all cases. Perfusion time was from 42 to 205 minutes (average 90 minutes). Left heart bypass was established with 1 mg/kg of systemic heparinization in 5, 0.5 mg/kg in 5, and 0 mg/kg in 23 cases. There were no complications such as perioperative embolism, acidosis, or hypothermia. During aortic cross-clamping, the arterial pressure of the lower extremity was maintained over 70 mmHg, but there was no relationship between the distal perfusion pressure and bypass flow. The urine output during temporary bypass was significantly related to the distal perfusion flow by centrifugal pump (r = 0.455, p < 0.01). Seven out of 23 patients who were bypassed under 40 ml/kg/min of distal perfusion flow showed transient renal dysfunction postoperatively, and two developed postoperative renal failure, while the other patients bypassed over 40 ml/kg/min of pump flow stayed in the normal range of the renal function, where there were statistically differences (p < 0.05). Postoperative paresis occurred in 2 patients who were also perfused under 40 ml/kg/min of bypass flow. Therefore, it is concluded that temporary bypass with centrifugal pump is a safe and well acceptable circulatory support in the surgical treatment of aneurysm of the descending aorta.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Development of direct phlebography for surgical intervention of the varix cruris].

To determine the appropriate treatment for patients with varix cruris, we performed three different methods of phlebography including direct phlebography, and compared their findings by each phlebography. Conventional ascending phlebography was taken routinely and initially in all limbs (n = 120). "Direct phlebography" developed by us was then indicated, when the visualization of the deep vein system was unclear by conventional ascending phlebography. This method was useful for the clear opacification of the deep vein system, and also was able to visualize the deep femoral vein clearly. After the precise diagnosis of varix cruris, descending phlebography under the Valsalva maneuver at supine position was carried out for the evaluation of the deep vein insufficiency. According to these phlebographic findings, conventional stripping with or without sub- or suprafascial ligation of communicating vein was indicated to saphenous typed varix cruris. The valvuloplasty to the highest valve in superficial femoral vein was carefully added in eight limbs which showed the significant reflux by added in eight limbs which showed the significant reflux by the descending phlebography. This valvuloplasty was remarkably contributed to the immediate healing of the stasis ulcer without recurrence. And compression sclerotherapy was selected to some patients with branch typed varix cruris.

Adolescent↗
PubMed1994

Right ventricular dysfunction after major pulmonary resection.

Right ventricular performance was assessed by thermodilution in 20 patients at rest and during exercise before and after lobectomy or pneumonectomy. The right ventricular ejection fraction was significantly decreased on the first postoperative day (0.36 +/- 0.34), the second postoperative day (0.34 +/- 0.04), and the third postoperative week (0.37 +/- 0.06) relative to the preoperative right ventricular ejection fraction value (0.43 +/- 0.07, p < 0.05). The right ventricular end-diastolic volume index was significantly increased by the second postoperative day (130 +/- 24 ml/m2) compared with the preoperative value (112 +/- 20 ml/m2). A significant decrease in the right ventricular stroke volume index was observed after operation, with a significant increase in heart rate considered necessary to maintain cardiac output. Pulmonary arterial pressure, the pulmonary vascular resistance index, and central venous pressure were unaltered over time. Indices of left ventricular function (that is, cardiac index, arterial pressure, and pulmonary arterial wedge pressure) were also preserved throughout the postoperative period. To explain the right ventricular dysfunction, ergometric exercise values were compared and the heart rate, pulmonary arterial pressure, central venous pressure, pulmonary vascular resistance index, and right ventricular end-diastolic volume index were all higher and the right ventricular ejection fraction lower during exercise after the operation. However, indices of left ventricular function remained unchanged. Significant elevations in pulmonary arterial pressure and the pulmonary vascular resistance index only during exercise occurred. These findings indicate that changes in right ventricular function at rest compensate for the increase in right ventricular volume, but adequate compensation does not occur during exercise, with a resultant increase in pulmonary arterial pressure and the pulmonary vascular resistance index. This suggests that a change in afterload may be the main determinant of the deterioration in right ventricular pump performance during exercise. We speculate that the main cause of right ventricular dysfunction after major pulmonary resection might be the changes in right ventricular afterload. The right ventricle may play an important role serving as a "reservoir" for afterload.

Aged↗