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Biomedical subjects

T Toyama

Publications and source records attributed to T Toyama.

At least 109 records · Page 6Linked to original sources
PubMed1993

[A case of radiation-induced chronic constrictive pericarditis developing 16 years after irradiation].

We reported a 51-yr-old female with radiation-induced chronic constrictive pericarditis. At age 29, she had received a mastectomy and postoperative irradiation because of left breast cancer. At age 45, she had syncope and was diagnosed with complete atrioventricular block and a pacemaker was implanted. At that time, pericardial thickening with effusion was noted. The following year, tricuspid regurgitation was noted. On catheter study, a dip and plateau pattern of the right ventricular pressure curve appeared. At age 50, tricuspid regurgitation worsened due to the lead wire of the pacemaker compressing the leaflet, and the pacemaker was reimplanted. However, the following year, she complained of general fatigue and dyspnea and was admitted to our hospital. On 67Ga study, diffuse accumulation in the cardiac region appeared. There was no perfusion defect detected in the left myocardium, but right myocardial damage was suspected by thallium study. In 99mTc-HSA RI angiography, right atrium dilatation appeared and a pericardial halo around the ventricles was seen. She underwent pericardectomy, tricuspid replacement and pacemaker reimplanted, but she died. On autopsy, pericardial thickening and adhesion, right myocardial fibrosis, the fibrotic change of the bundle branches were seen. We reported a case of radiation-induced constrictive pericarditis. Radionuclide studies were useful in diagnosing and following the patient.

Breast Neoplasms↗
PubMed1993

[The significance of 201Tl/123I MIBG (metaiodobenzylguanidine) mismatched myocardial regions for predicting ventricular tachycardia in patients with idiopathic dilated cardiomyopathy].

123I-MIBG (MIBG) regional defects in myocardial regions with preserved 201Tl (Tl) uptake have been observed in patients with idiopathic dilated cardiomyopathy (DCM). To evaluate whether the presence of Tl/MIBG mismatched regions is related to the occurrence of ventricular tachycardia (VT), we performed myocardial dual SPECT imaging with Tl (111 MBq) and MIBG (111 MBq) in 17 patients with DCM, 11 (Gp A) with and 6 (Gp B) without VT. Myocardial dual SPECT imaging was performed at 15 minutes after and 4 hours after the tracer injection. The regional tracer uptake was scored visually in 6 segments of the basal, middle, and apical short-axial images and in 2 apical segments of the midventricular vertical long-axial image by a four-point scoring system (0 = normal, 1 = moderate, 2 = severe and 3 = complete defect). Then, the severity of tracer maldistributions was assessed by the difference between total defect scores (TDSs) of Tl and MIBG (delta TDS). TDS was not different between Gps A and B in both Tl and MIBG images. However, delta TDS was larger in Gp A than in Gp B (13.5 +/- 6.5 vs. 5.8 +/- 3.0, p < 0.05). Also, the number of segments with the mismatched tracer uptake was larger in Gp A than in Gp B (12.5 +/- 3.0 vs. 8.3 +/- 1.5, p < 0.01). In the electrophysiologic study, we found that the fractionated area corresponded to the mismatched region in 3 of 5 patients in Gp A. These results suggest that regional sympathetic denervation is a possible factor which provocates VT, and myocardial dual SPECT imaging with Tl and MIBG is a useful method for predicting VT in patients with DCM.

3-Iodobenzylguanidine↗
PubMed1993

[Transient ischemic dilatation of the left ventricle observed on dipyridamole-stressed thallium-201 scintigraphy].

To assess clinical significance of transient ischemic dilatation of the left ventricle (TID) on dipyridamole-stressed 201Tl myocardial scintigraphy, 110 patients suspected with coronary artery disease, including 13 with normal coronary, 48 with single vessel disease, 30 with 2 vessel disease, and 19 with 3 vessel disease were analyzed. TID was visually and quantitatively assessed calculating the ratio of the area within the left ventricular region on the initial and delayed image (TID ratio). TID was observed in 3 of 1 vessel disease (6%), 5 of 2 vessel disease (17%), and 8 of 3 vessel disease (42%). None of normal coronary artery showed TID. In patients with multivessel disease (MVD), TID was observed more frequently (27%) than in patients with 1 vessel disease (6%) (p < 0.025). Furthermore, the TID ratio tended to be higher (1.15 +/- 0.11) than those with single vessel disease (1.03 +/- 0.03). To identify patients with MVD, TID had a sensitivity of 27% and a specificity of 95%. ECG changes were observed more often in patients with TID than those without TID. Five patients showing TID underwent coronary artery bypass graft surgery, TID disappeared postoperatively in each patient. In conclusion, TID on dipyridamole 201Tl scan seems to be a specific although not sensitive marker for detecting MVD.

Adult↗
PubMed1993

[Successful chronic daily administration of oral etoposide for a case of adult T cell leukemia].

A 54-year-old woman with leucocytosis and skin lesion was hospitalized and diagnosed as chronic type adult T cell leukemia (ATL) in August 1989. Since her ATL cell count and LDH level increased after hospitalization, oral administration of etoposide was started at a dose of 100 mg/day for seven days. The oral administration of etoposide induced another chronic state of ATL. After 10 months without medication, she was readmitted because of an acute ATL crisis. After daily administration of etoposide at a dose of 50 mg/day, the white blood cell count and serum LDH level decreased to the normal range, and abnormal lymphocytes of peripheral blood disappeared. The low-dose daily administration of etoposide at a dose of 25 approximately 50 mg/day could be maintained over six months. No severe side effects except for alopecia and mild myelosuppression were noted during the treatment. Chronic daily administration of oral etoposide is one candidate for the treatment of ATL in an outpatient clinic.

Administration, Oral↗
PubMed1993

[A case of long surviving inflammatory breast cancer with bone metastasis, treated by intra-arterial infusion chemotherapy followed by extended mastectomy].

Since there is no established therapeutic strategy in the treatment of stage IV breast cancers and there are cases with bone metastases from the breast showing long survival, the authors usually perform due local control in cases with bone metastases. The present case is an inflammatory carcinoma of the breast with bone metastasis for which doxorubicin hydrochloride was administered via the subclavian and internal thoracic arteries followed by extended mastectomy. The patient is being treated with tamoxifen citrate and doxifluridine and shows no other metastasis at this writing, four years and seven months after the mastectomy. Bone scintigraphy of the patient indicated disappearance of the bone metastases. Since there are long surviving cases among those with a poor prognosis involving inflammatory breast cancer with concomitant bone metastasis, it is necessary to treat cases with locally advanced breast cancer by preoperative intraarterial infusion together with mastectomy, ie, sufficient local control.

Bone Neoplasms↗
PubMed1992

[Influence of hypertensive left ventricular hypertrophy on detection of ischemic area with exercise thallium-201 myocardial scintigraphy].

Sixty-four patients with single left anterior descending artery disease having effort angina (group A: 40 patients without hypertension, group B: 10 patients with hypertrophic hypertension, group C: 14 patients with non-hypertrophic hypertension) were assessed the influence of hypertensive left ventricular (LV) hypertrophy on detection of ischemic area. The criterion of hypertrophy by two-dimensional echocardiography was > 12 mm in the wall thickness of interventricular septal or posterior wall. Population in Group B might show low detectability in ischemic area by 201Tl myocardial scintigraphy (positive thallium rate 60%, defect score 2.7 +/- 3.6), and high lung thallium uptake and high frequence of ECG positive among three groups. In semiquantitative analysis, the washout rate of the posterolateral wall and %RD (delayed %uptake-initial %uptake) of the septal wall in patients with Group B were lowest among three groups. However, the washout rate in the septal wall against the posterior wall, and the initial %uptake and the delayed %uptake of the septal wall were not significantly different among three groups. We could conclude that the decreased washout rate in nonischemic area with hypertensive LV hypertrophy might make the ischemic area masked.

Aged↗
PubMed1992

[Thallium-201 scintigraphy after dipyridamole infusion in patients with ischemic heart disease--comparison with maximal exercise].

Myocardial images after dipyridamole infusion (DIP-Tl) were compared with maximal thallium-201 images (Ex-Tl) to determine the utility for detecting coronary artery disease and the ischemic level in ischemic regions. Ex-Tl was performed in 36 patients of angina pectoris (Group 1), and DIP-Tl was performed in 22 patients of angina pectoris (Group 2), who were divided into two groups (Group 2a: 15 patients with low level exercise, Group 2b: 7 patients without low level exercise). Each group had normal controls (41, 27 and 31 people). The detectability of coronary artery by DIP-Tl was almost same with Ex-Tl (sensitivity 85% vs. 86%, specificity 80% vs. 95%). In the case of normal controls, the mean washout rate of group 2b was 44.4%, which was less than other two groups (50.6% for group 1, 48.8% for group 2a). And the mean myocardial/background (M/B) ratio of group 2b was 4.3 less than other two groups (4.7 for group 1, 4.9 for group 2a). In the case of the patients of angina pectoris, washout rate, M/B ratio, initial % uptake and delayed % uptake in the ischemic region were almost same among the 3 groups. This study demonstrates that DIP-Tl is as effective as Ex-Tl, and the ischemic level in the ischemic region is almost same among the 3 groups. But the thallium accumulation in the background of the group 2b is slightly higher than other two groups in the normal controls, so it is suggested that the image after only dipyridamole infusion becomes slightly unclear.

Coronary Disease↗
PubMed1992

[Usefulness of 201Tl myocardial scintigraphy after dipyridamole infusion in patients with atherosclerotic vascular disease].

To determine the utility for detecting ischemic heart disease (IHD), Dipyridamole thallium myocardial images (DIP-Tl) have been performed in the 103 patients with atherosclerotic vascular disease who can't exercise fully. Of 103 patients, there were 36 patients with arteriosclerosis obliterans (ASO), 31 patients with aneurysm of the abdominal aorta (AAA), 24 patients with aneurysm of the thoracic aorta (TAA) and 12 patients with dissecting aortic aneurysm (DAA). Clinical evidence of IHD was found in 20 patients with ASO, 10 with AAA, 7 with TAA and 4 with DAA respectively. Positive evidence of DIP-Tl was identified in 66% of 41 patients who had clinical evidence of IHD, and particularly in the patients with AAA (80%) and ASO (65%). On the other hand, in the patients without clinical evidence of IHD, positive evidence of DIP-Tl was identified in 19% of 62 patients and particularly in the patients with AAA (39%). In all patients, the percentage of the positive DIP-Tl ratio was 38%. And, when the 38% patients of the positive DIP-Tl were added to the patients of the negative DIP-Tl who had clinical evidence of IHD, almost half patients (51%) were considered to be complicated with IHD. This study suggests that the atherosclerotic vascular disease is highly complicated with IHD and DIP-Tl is useful to detect IHD.

Aged↗
PubMed1991

[Clinical value of thallium-201 reinjection after delayed imaging in patient showing incomplete or no redistribution].

To asses clinical value of Tl-201 (Tl) reinjection after delayed imaging, 30 patients who showed incomplete or no redistribution in stress-delayed Tl myocardial scintigraphy were studied. Of 76 myocardial segments with incomplete or no redistribution on the delayed images, 29 segments (38%) showed improvement of Tl uptake after Tl reinjection. Reinjection was considered effective in 24 segments (32%) where no or little redistribution were observed on the delayed images but improved after reinjection. The contrast ventriculography showed less wall motion abnormality in the segments with improvement after reinjection than that without improvement after reinjection (regional wall motion score: 2.55 +/- 0.50 vs. 0.59 +/- 0.97 p less than 0.01). History of myocardial infarction was also significantly less in the former (p less than 0.05). We conclude that Tl reinjection is useful in cases showing no or equivocal redistribution on the delayed images.

Coronary Disease↗
PubMed1990

[Longitudinal analysis of the development of pulmonary function in childhood].

In order to evaluate, longitudinally, the development of pulmonary function in childhood, maximal expiratory flow volume (MEFV) curves, height, and weight of 441 fourth grade school children were measured in 1980, and again two and four years later. The same instruments were used to measure pulmonary function, height, and weight in all three surveys. In addition, pulmonary function tests were performed by the same examiner in all three surveys. Three hundred and twenty five children had acceptable results for MEFV curves at all of three surveys. Two simple linear models were fitted to the distribution of pulmonary function measurements. One has age, height, functional level of the individual child, and the interaction of age and height as explanatory variables. In the other model, the natural logarithm of pulmonary function measurements was considered as a dependent variable, and age, height, and functional level of the individual child were employed as explanatory variables. The models explained the distribution of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal expiratory flows (MEFs) quite well both in males and in females. These results suggest that the development of FVC and FEV1 against height was not linear, and that age was an independent contributor to the development even after adjusting for height. Tracking in the development of MEFs as well as FVC and FEV1 was observed, suggesting that functional development of MEFs for an individual child could be evaluated accurately utilizing percentile curves as in the case of FVC and FEV1.

Adolescent↗
PubMed1989

Bottle-feeding can prevent transmission of HTLV-I from mothers to their babies.

Breast-feeding is a major factor in the vertical transmission of human T-lymphotropic virus type I (HTLV-I). We studied whether such transmission may be prevented by bottle-feeding. HTLV-I infection was detected by both HTLV-I antigen and antibody tests. Thirty bottle-fed babies were examined 24 months after birth; only one was found to be HTLV-I antigen-positive. This infection rate was lower than that for breast-fed babies in whom HTLV-I antigen was detected in 24 of the 31 24-month-old babies born to HTLV-I positive mothers in a previous study. These results suggest that most vertical transmission of HTLV-I is attributable to breast-feeding and can be prevented by bottle-feeding.

Bottle Feeding↗
PubMed1989

Effect of freeze-thawing breast milk on vertical HTLV-I transmission from seropositive mothers to children.

Breast feeding is known to be a major cause of vertical transmission of HTLV-I from mothers to her children. The infectiousness of HTLV-I in breast milk was reported to be lost during freezing and thawing processes. We therefore administered frozen-and-thawed breast milk of HTLV-I carriers to their babies. Among the 13 babies given the frozen-and-thawed breast milk (now 12 months of age), no infection has been found yet. This result suggests that freezing and thawing of breast milk is a promising method for the prevention of vertical HTLV-I infection to breast-fed babies.

Breast Feeding↗
PubMed1988

[Clinicopathological study of oligodendroglioma with special reference to immunohistochemical investigation].

The present study was undertaken to evaluate the utility of pathologic features and specific immunohistochemical studies in estimating the prognosis of oligodendroglioma. The pathological diagnosis of an oligodendroglioma was made on HE stained-sections according to WHO classification. Sixteen oligodendrogliomas, twelve mixed oligoastrocytomas and ten anaplastic oligodendrogliomas were immunotested by the peroxidase-antiperoxidase (PAP) method with anti-GFAP serum, anti-S-100 serum and anti-MBP (Myelin basic protein) serum and by the avidin biotin peroxidase-complex (ABC) method with anti-vimentin serum and ant-Leu 7 monoclonal antibody. GFAP positive cells were interpreted as reactive astrocytes, neoplastic astrocytes and neoplastic oligodendrocytes, S-100 positive cells were interpreted as reactive astrocytes and neoplastic astrocytes. Leu 7 positive cells were found in only one case of anaplastic oligodendroglioma. Anti-Leu 7 could not be considered as a specific marker for oligodendroglioma. Of the anaplastic oligodendroglioma 60% displayed MBP positively and 70% displayed vimentin positively. NSE positive cells were found in a few anaplastic oligodendrogliomas. The present study has not so far uncovered any marker that is restricted to oligodendrogliomas. However GFAP may be useful to assess the extent of reactive astrocytes and neoplastic astrocytes in the oligodendroglioma or mixed oligoastrocytoma. MBP and vimentin will help to determine the malignancy of oligodendroglioma.

Adult↗
PubMed1987

Transmission of adult T-cell leukemia retrovirus (HTLV-I) from mother to child: comparison of bottle- with breast-fed babies.

HTLV-I is commonly believed to be transmitted from HTLV-I seropositive mothers to infants via breast milk. In 11 of 24 breast-fed infants born to HTLV-I seropositive mothers, HTLV-I antigen-positive cells were detected in peripheral blood samples obtained 12 months after birth. In sharp contrast, they were detected in only one of 11 bottle-fed infants of HTLV-I seropositive mothers. Thus bottle-feeding appears to be an effective method to avoid HTLV-I transmission from HTLV-I seropositive mothers to infants.

Antigens, Viral↗
PubMed1986

Primary infection of Japanese infants with adult T-cell leukaemia-associated retrovirus (ATLV): evidence for viral transmission from mothers to children.

Primary infection with adult T-cell leukemia virus (ATLV) was investigated by follow-up studies on 16 ATLV-seropositive mothers and their breastfed infants in an ATLV-endemic area of Japan. Maternal antibody to ATLV decreased in all the infants, and was detectable in only three of 12 infants tested 6 months after birth. Reappearance of the antibody 9-18 months after birth was observed in only four of the 16 infants. The ATLV-bearing cells in peripheral blood were detected in all 16 mothers after delivery. None of the 16 infants showed ATLV-bearing cells in peripheral or cord blood sampled at birth, or 1, 3 or 6 months after birth. However, virus-bearing cells in the blood became detectable 9-18 months after birth in 13 of the 16 infants. Maternal antibody and virus-bearing cells were never detected in a control group of seven infants of ATLV-seronegative mothers. These findings provide evidence for the high incidence of primary ATLV infection during early infancy among infants born to ATLV-seropositive mothers and suggest maternal viral transmission. Furthermore, samples of breast milk from all 12 seropositive mothers examined contained cell-associated ATLV capable of being transmitted to peripheral leucocytes of neonates. This finding suggests that one of the possible maternal transmission routes of ATLV is via breast milk.

Adult↗