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Biomedical subjects

Y Doi

Publications and source records attributed to Y Doi.

At least 379 records · Page 21Linked to original sources
PubMed1990

[A case of mixed connective tissue disease developed into overlap syndrome of progressive systemic sclerosis, systemic lupus erythematosus, polymyositis and Sjögren's syndrome].

We encountered a patient who developed an overlap syndrome of progressive systemic sclerosis (PSS), systemic lupus erythematosus (SLE), polymyositis (PM) and Sjögren's syndrome (SjS) while we were treating her for mixed connective tissue disease (MCTD). This 42-year-old woman had been photosensitive since 18 years of age. In 1986, Raynaud's phenomenon, swollen hands and arthralgia appeared; therefore, we started to treat this patient based on a diagnosis of MCTD. At that time, her anti-RNP antibody titer was 82,920, but she was negative to anti-Sm antibody. In 1988, she was admitted to our hospital with chief complaints of aggravation of polyarthralgia and myalgia. On physical examination, she showed difficulty in opening her mouth, systemic dermal sclerosis, a decrease in muscular strength and rales. In laboratory tests, her myogenic enzyme level was increased, and she was found to be positive to LE cells, antinuclear antibody, anti-DNA antibody, anti-ENA antibody and anti-SSA antibody. Furthermore, histological features clearly corresponding to those of PSS were found by skin biopsy, myogenic changes by electromyography, evidence of chronic inflammation of the salivary glands by lip biopsy, and proliferative changes in the mesangium were detected by renal biopsy. The concept of MCTD, especially the differences from overlap syndrome, is vague. Therefore we need further study about many cases. Since there have been no reports on cases having sufficient evidence of the development of the overlap syndrome of PSS, SLE, PM and SjS during a course of MCTD, our patient would provide very useful data contributing to the study of MCTD.

Adult↗
PubMed1990

[Progression of coronary atherosclerosis and the non-invasive evaluation in older patients].

To evaluate characteristics of coronary atherosclerosis in older patients and to elucidate the role of dipyridamole myocardial perfusion scintigraphy (DMPS) in the assessment of patients with coronary artery disease, 437 patients (330 men, 107 women, age range 13-85 years) initially underwent coronary angiography (CAG) and DMPS. Coronary risk factors were evaluated in relation to the severity and progression of coronary atherosclerosis. Cardiac events were also evaluated during the follow-up period of 39 +/- 19 months (range 1-77 months). Assessment of five coronary risk factors, including hypercholesterolemia, diabetes, hypertension, positive family history, and history of smoking, was made in 212 patients in relation to the severity of coronary atherosclerosis. In patients with insignificant lesions or single vessel disease, prevalence of hypercholesterolemia and positive family history was lower in older patients (65 years or older) than in younger patients (64 years or younger), but significant difference was not found in prevalence of diabetes, hypertension, and history of smoking. In patients with multivessel disease, there was no significant difference in prevalence of coronary risk factors between the two groups except history of smoking. Repeated CAG was performed in 27 patients during follow-up. Nineteen of them experienced increased symptoms of angina and eight patients newly developed acute myocardial infarction. The patients with increased angina had more risk factors, and majority of them (74%) showed some progression of previously noted severe stenoses in the proximal coronary arteries. In patients with new infarction, 62% of them showed new total occlusions as infarct-related lesions, although there were some patients who showed progression of previously noted severe lesions. DMPS was performed in 437 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[A case of suspected allergic granulomatosis and angiitis with a rapid clinical course of paraplegia].

A 68-year-old man with suspected allergic granulomatosis and angiitis is reported. He had received 10 mg of prednisolone daily since July 1988 for asthma. He abruptly developed muscle weakness of the lower extremities, followed two days later by paraplegia. Six days after the onset of the muscle weakness, he was hospitalized. He showed disturbance of recent memory, disorientation, neck rigidity, paraplegia, mild muscle fasciculation and hypesthesia. He also showed paralytic ileus. Laboratory findings showed leukocytosis (24580/mm3), eosinophilia (56% of the peripheral white blood cells and 19% of the cells in the cerebrospinal fluid), on erythrocyte sedimentation rate of 31 mm/h, and the IgE level of 1200 IU/ml. The ECG showed loss of the r-wave in V1 and V2. A granulomatous lesion anterior to the spinal cord was found on myelography and MRI. Prednisolone was given at a dose of 60 mg daily resulting in improvement of the clinical symptoms and eosinophilia. There was disappearance of the granuloma on MRI performed after prednisolone therapy. Despite the severe manifestation of allergic granulomatosis and angiitis, prednisolone therapy had a marked effect in this patient. The granulomatous lesion anterior to the spinal cord shown by MRI suggested an eosinophilic granuloma, and may have been the etiology of some of the neurological symptoms.

Aged↗
PubMed1990

[Herpes simplex brainstem encephalitis presenting high intensity area on MRI--a case report].

A case of herpes simplex encephalitis with high signal intensity area in brainstem on MRI was presented. A 44 year-old woman suffered from oral aphthous ulcerations in the end of 1988, and then it improved naturally. Oral aphtha appeared again on February 1988 followed by resistant fever to antibiotics and right hemiparesis. She was admitted to our hospital on 25 February 1988. Neurological examination revealed mild consciousness disturbance, neck stiffness, right-side deviation of tongue with dysarthria and right hemiparesis with bilateral plantar extensor reflex. Right hemisensory deficit in all modalities and truncal ataxia was also detected. Some aphthous ulcerations were revealed in oral cavity, but there were no ulcers on genitalia nor uveitis. CSF showed 32 mononuclear cells/mm3, protein 52 mg/dl and glucose 97 mg/dl. CSF culture and india ink stain, and serum autoantibodies were all negative. EEG and CT scan with contrast enhancement showed no significant abnormalities. T2-weighted brain MRI revealed high intensity area in the center of the pons. Anti-herpes simplex virus (HSV) type I antibody titer (FA method) in both serum and CSF were highly positive. Neurological symptoms gradually improved on the therapy of aciclovir and adrenal cortico-steroid. High intensity area in the pons on MRI was also gradually reduced. In this case, complete diagnostic differentiation from neuro-Behçet disease was difficult, but this case did not meet its diagnostic criteria. From the change of anti-HSV antibody titer both in serum and CSF, we diagnosed this case HSV brainstem encephalitis presenting high intensity area in the pons on MRI which has never been reported.

Adult↗
PubMed1990

[Two cases of mediastinal goiter with progressive deviation of the trachea by its growth and their thyroid hormone values in the fluid of the cystic lesions].

We reported two operated cases (a 35-year-old male and 52-year-old male) of mediastinal goiter accompanied by marked tracheal deviation. The two patients did not have any clinical symptoms. CT, MRI, ultrasonography and angiography finding of the two cases are presented. Fluid was obtained from the cystic lesions by ultrasonically guided needle aspiration. The levels of thyroid hormones (T3, T4) in the fluid were not high in comparison with serum levels. Surgical resection was performed on the 35-year-old male case by collar incision and on the 52-year-old male case by median sternotomy.

Adenoma↗
PubMed1990

Microsurgical transvaso-vasostomy.

We report a case of an infertile man treated successfully with microsurgical transvaso-vasostomy. The patient had a normal testicle with an obstructed vas deferens on one side and an atrophied testicle with a normal vas on the other side. We anastomosed the proximal vas from the functioning testicle to the opposite intact vas through the median scrotal raphe. As a result, the patient fathered a child 16 months after operation.

Adult↗
PubMed1990

[Prognosis of elderly patients with mitral valve prolapse: the difference between Japanese and English patients].

Clinical pictures and prognosis in 24 patients (nine males, 15 females) with mitral valve prolapse (MVP) aged 60 years and older were examined at our institution. Valvular redundancy was noted in seven (29%) of the 24 patients. During a follow-up period of 38 +/- 18 months, four patients had mitral valve replacement and one died of congestive heart failure due to severe mitral regurgitation (MR). There was no episode of embolism or sudden death. Among 80 patients (47 males, 33 females) with MVP aged 60 years and older at St. George's Hospital in England, on the other hand, valvular redundancy was noted in 49 (61%) of 80 patients. During the same follow-up period of 39 +/- 28 months, 18 patients underwent surgery and seven patients died of heart failure (31%). There were 11 patients who had embolism (14%), but no sudden death. Although there was no significant difference in the incidence of severe MR in these two groups, valvular redundancy and embolism were less frequent in Japanese patients at our institution than the English patients in St. George's Hospital. These differences should be taken into consideration when one evaluates clinical profiles and prognosis of elderly MVP patients.

Aged↗
PubMed1989

Osteonectin inhibiting de novo formation of apatite in the presence of collagen.

The effect of bone matrix protein of osteonectin on de novo formation of apatite was studied in a wide range of calcium phosphate solutions in the presence of collagen. In every solution, from which amorphous calcium phosphate, octacalcium phosphate, or apatite precipitated as a possible initial phase, osteonectin at concentrations less than 1 microM retarded the precipitation, subsequent transformation to apatite, and ripening crystal growth of apatite. Collagen present as either reconstituted or denatured form had no effect on the osteonectin-associated reactions as well as osteonectin-free reactions, and no structural correlation was observed between collagen fibrils and any of the calcium phosphates that appeared in our system. Direct measurement of free calcium levels in the solutions suggested that the reduction in calcium activity due to complexing with osteonectin hardly explained the inhibitory activity of osteonectin in retarding the formation of apatite. Instead, our transmission electron microscopic (TEM) observation strongly suggested that the primary mechanism for osteonectin to inhibit the formation of apatite is to block growth sites of calcium phosphates nucleated. The apatite thus formed in the presence of osteonectin showed less resolved X-ray diffraction patterns, partly because of smaller crystallites as suggested by TEM.

Animals↗
PubMed1989

Two cases of hamartoangiomyomatosis with characteristic scintigraphic findings.

Hamartoangiomyomatosis is a rather rare pulmonary disease which occurs in young to middle-aged women. The chief complaint of this disease is dyspnea. The chest X-ray findings of this disease are such complicated features as reticular, reticulogranular, miliary and honeycomb-like shadow. A pulmonary perfusion scintigram was prepared with a scinticamera after intravenous injection of 10 mCi of Tc-99m MAA. The anterior image showed a remarkably reduced bilateral pulmonary blood flow, especially in the middle and lower areas of the lungs. In the upper portions, the blood flow remained relatively sufficient. The posterior and lateral images also gave similar findings. In two cases of hamartoangiomyomatosis, pulmonary perfusion scintigraphy was successful in identifying the characteristic findings of the disease.

Adult↗
PubMed1989

A case of cross stimulation.

Cross stimulation in a dual chamber pacing system, in which the atrial stimulus intermittently captured the right ventricle, occurred immediately after pacemaker implantation in a 71-year-old man. It was prevented temporarily by reducing the pacing rate so that P wave synchronous ventricular (VDD) pacing resulted and by reducing the output of the atrial circuit from 5 to 4 volts. Cross stimulation disappeared spontaneously 14 days after surgery.

Aged↗
PubMed1989

Nuclear Magnetic Resonance Studies of Poly(3-Hydroxybutyrate) and Polyphosphate Metabolism in Alcaligenes eutrophus.

The metabolic pathways of poly(3-hydroxybutyrate) (PHB) and polyphosphate in the microorganism Alcaligenes eutrophus H16 were studied by H, C, and P nuclear magnetic resonance (NMR) spectroscopy and by conventional analytical techniques. A. eutrophus cells accumulated two storage polymers of PHB and polyphosphate in the presence of carbon and phosphate sources under aerobic conditions after exhaustion of nitrogen sources. The solid-state cross-polarization/magic-angle spinning C NMR spectroscopy was used to study the biosynthetic pathways of PHB and other cellular biomass components from C-labeled acetate. The solid-state C NMR analysis of lyophilized intact cells grown on [1-C]acetate indicated that the carbonyl carbon of acetate was selectively incorporated both into the carbonyl and methine carbons of PHB and into the carbonyl carbons of proteins. The P NMR analysis of A. eutrophus cells in suspension showed that the synthesis of intracellular polyphosphate was closely related to the synthesis of PHB. The roles of PHB and polyphosphate in the cells were studied under conditions of carbon, phosphorus, and nitrogen source starvation. Under both aerobic and anaerobic conditions PHB was degraded, whereas little polyphosphate was degraded. The rate of PHB degradation under anaerobic conditions was faster than that under aerobic conditions. Under anaerobic conditions, acetate and 3-hydroxybutyrate were produced as the major extracellular metabolites. The implications of this observation are discussed in connection with the regulation of PHB and polyphosphate metabolism in A. eutrophus.

Journal Article↗
PubMed1989

[Self-setting apatite cement. 6. Possibility as bone substitute].

Self-setting apatite cement was investigated to evaluate its use as a possible bone substitute in the rat femur. The implant sites were recovered at intervals up 12 weeks postoperatively and investigated by the use of x-ray diffraction, contact microradiography, light and electron microscopy. By x-ray diffraction analysis, the cement placed for at least one day in the medullary canal of rats was found to be completely converted to a set phase of hydroxyapatite resembling the main inorganic phase of bone. In any specimens prepared at 1, 4, 12 weeks after implantation, no appreciable foreign body response was observed in the tissue around the set cement. At four weeks after implantation the set cement was in tight contact with the newly formed bone which appeared to involve osteocytes in lacunae and osteoblastic cells on its surface. At twelve weeks after implantation, the newly formed bone tended to grow into the interior of the set cement. With scanning electron microscopy, the newly formed bone was found to be directly deposited on the set cement. The newly formed bone consisted of fine needle-like crystals. These results strongly suggest that this cement is well tolerated by bone tissue and osteogenesis when used as a bone substitute. The advantage of the present material as a promising bone substitute is that it can be filled in surgical or traumatic bone defect as a slurry or paste.

Animals↗
PubMed1989

[Indication for coronary revascularization for angina pectoris: correlation with prognosis of medically-treated patients].

To assess the indication for percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG), we studied 93 patients with angina pectoris but without myocardial infarction. All patients had significant stenosis (greater than 50%) in at least one coronary artery, including the left anterior descending artery. Fifty-eight patients received medical treatment (Group I), 12 had PTCA (Group II) and 23 had CABG (Group III). Findings of coronary angiography, treadmill exercise tests and dipyridamole perfusion scintigraphy as well as the frequency of cardiac events during follow-up were assessed in each group. 1. Coronary angiography revealed 1 vessel disease in 38% of the patients in Group I, 58% in Group II, and 13% in Group III; 2 vessel disease in 33%, 25% and 61%; and 3 vessel disease in 29%, 17% and 26%, respectively. 2. Exercise duration with the treadmill test was 4.7 min in Group I, 4.0 min in Group II and 3.7 min in Group III. ST depression (greater than or equal to 1 mm) was induced in 75%, 83% and 95%, respectively. Exercise duration improved from 4.0 to 6.0 min after PTCA and from 3.7 to 4.5 min after CABG. Exercise-induced ST depression also became less frequent; from 83% to 25% after PTCA and from 95% to 32% after CABG. Dipyridamole perfusion scintigraphy showed reversible defects in 86% of the patients in Group I and in all patients in Groups II and III. Reversible defects were observed in 17% of the patients after PTCA and in 21% after CABG. 3. During a mean follow-up period of 26 months, cardiac deaths occurred in one patient (2%) in Group I and 2 (7%) in Group III. Nonfatal cardiac events (myocardial infarction and unstable angina or those necessitating revascularization--late PTCA or CABG) were observed in 12 patients (21%) in Group I, 4 (24%) in Group II and 10 (36%) in Group III. Anginal attacks at least once weekly remained in 12% of the patients in Group I, 19% in Group II and 14% in Group III at the last follow-up. In conclusion, PTCA and CABG appear to be effective methods for improving ischemia and exercise tolerance. However, preventive PTCA and CABG may not be indicated in patients with mild angina, because the prognosis is also excellent in medically-treated patients with angina but without myocardial infarction or left main coronary artery disease.

Adult↗
PubMed1989

[Prognostic significance of large perfusion defects on thallium-201 myocardial scintigraphy in dilated cardiomyopathy].

To evaluate the prognostic significance of perfusion abnormalities, particularly large defects, in dilated cardiomyopathy (DCM), we performed thallium-201 myocardial scintigraphy and 24-hour ambulatory ECG monitoring in 27 patients. The abnormal scintigraphic patterns and the presence of ventricular tachycardia (VT) were correlated with causes of death during a follow-up period of 30.0 +/- 19.4 months. Eight patients had large defects (LD), 11 had multiple small defects (MSD), and eight had no defects (NL). The patients with LD had extensive ventricular akinesis in the region of the perfusion defect, significantly elevated LVEDP (LD 20.6 +/- 7.4 mmHg, MSD 15.5 +/- 7.6 mmHg, NL 10.3 +/- 2.3 mmHg: LD vs NL; p less than 0.01, MSD vs NL; p less than 0.05), and reduced ejection fraction (LD 23.9 +/- 9.1%, MSD 32.7 +/- 7.2%, NL 40.3 +/- 7.7%: LD vs MSD; p less than 0.05, MSD vs NL; p less than 0.01). VT was detected in 11 patients; among whom three had LD, six had MSD, and two had no defects. Among seven patients who died during follow-up (five of heart failure, one sudden death, and one non-cardiac death), five had LD and two had MSD. There were no deaths among patients without defects. Among 11 patients with VT, only one died suddenly. In conclusion, large scintigraphic defects correlated well with severe LV dysfunction, and this is an important variable in predicting outcomes in DCM.

Adult↗