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Biomedical subjects

Y Hirose

Publications and source records attributed to Y Hirose.

At least 217 records · Page 12Linked to original sources
PubMed1993

Detection of postural cerebral hypoperfusion with technetium-99m-HMPAO brain SPECT in patients with cerebrovascular disease.

Seventeen of 19 patients (67 +/- 8 yr, 17 males and 2 females) had more than 75% unilateral stenosis or occlusion of the internal carotid or middle cerebral artery and two patients had carotid endarterectomy that previously had 90% stenosis of the internal carotid artery. They were studied during upright 99mTc-HMPAO brain SPECT. HMPA was injected immediately after arising from a supine position. Patients were classified into Group A (n = 10) with occlusion of the internal carotid or the middle cerebral artery or Group B (n = 9) with more than 75% unilateral stenosis of the internal carotid or the middle cerebral artery and with carotid endarterectomy. Additional cerebral blood flow perfusion abnormalities between upright and supine 99mTc-HMPAO brain SPECT were detected in seven patients in Group A and in only one patient in Group B. Semiquantitative analysis showed that the asymmetric ratios between upright and supine positions changed significantly in Group A from 0.82 +/- 0.15 to 0.89 +/- 0.10 (p < 0.01), but not in Group B, from 0.89 +/- 0.11 to 0.92 +/- 0.12 (ns). Additional perfusion abnormalities were relevant to occlusion of the internal carotid or middle cerebral artery indicated postural cerebral hypoperfusion. We conclude that upright 99mTc-HMPAO brain SPECT visualizes postural cerebral hypoperfusion possibly related to silent cerebral ischemia.

Aged↗
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

[MRI findings in patients with acute autonomic and sensory neuropathy].

Acute autonomic and sensory neuropathy (AASN), characterized by acute onset of extensive autonomic dysfunction and severe sensory deficits, was first described by Colan et al. (1978). We present two female patients with AASN in whom magnetic resonance imaging (MRI) confirmed such findings in the posterior column of the spinal cord. One patient was a 44-year-old woman who developed an upper respiratory tract infection followed in 2 weeks by numbness of the limbs and gait disturbance. There was orthostatic hypotension with syncope, paretic ileus, anhidrosis and urinary retention. There was a loss of sensation over the entire body, including the face, and deep tendon reflexes were generally absent. Neurophysiologic studies showed that sensory nerve action potentials and SSEPs were not evoked in the nerves examined. Sural nerve biopsy demonstrated severe axonal degeneration of the myelinated and unmyelinated fibers. Our second patient, a 27-year-old woman, exhibited similar clinical and laboratory features. The autonomic dysfunction in both patients improved gradually without drug treatment, but the sensory deficits--predominantly a loss of deep sensation--persisted for several years. In both patients, MRI revealed the T2*-weighted high intensity area in the fasciculus gracilis of the posterior column of the spinal cord. Such high intensity areas were present in all spinal segments. The severe and persistent sensory disturbance in these patients may have been caused by a lesion of the posterior column of the spinal cord following the involvement of the dorsal root ganglion cells, or ganglioneuronopathy, as demonstrated by MRI.

Acute Disease↗
PubMed1993

Occurrence of sequential intraocular tumors: malignant medulloepithelioma subsequent to retinoblastoma.

A 13-year-old boy, whose bilateral retinoblastoma had been treated by enucleation (OD) and irradiation (OS), developed anterior staphyloma (OS) necessitating the second enucleation. Histopathological, immunohistochemical and electron microscopic studies revealed malignant teratoid medulloepithelioma of the ciliary body, with demonstrated multipotential histogenesis. This is the first report which demonstrates the development of a second malignant intraocular tumor in an eye previously affected by hereditary retinoblastoma. Careful monitoring of patients who have had hereditary retinoblastoma is necessary because of the potential for a second malignancy.

Adolescent↗
PubMed1993

[Intraoperative plasmapheresis in patients undergoing CABG surgery; effect on intraoperative and postoperative homologous blood transfusion requirements].

To evaluate the effect of intraoperative plasmapheresis on intraoperative and postoperative homologous blood transfusion requirements, we assigned 89 patients undergoing primary CABG procedure to either the experimental group (plasmapheresis, n = 31, A group) or the control group (traditional method, n = 58, B group). All patients underwent hemodilution by withdrawal of autologous blood before cardiopulmonary bypass. In A group, the average volume withdrawn during plasmapheresis was approximately 948 ml (platelet rich plasma (PRP) and red blood cells). We removed an average of 751 ml of whole blood in B group. The percentage of patients without homologous blood transfusion in A group was 40% versus 32% in B group. The difference was not statistically significant. It was concluded that our method of plasmapheresis was effective in reducing homologous blood transfusion, but it was not more effective than the traditional hemodilution method.

Aged↗
PubMed1993

[In vitro production of gamma/delta T cell clones and their characteristics].

Human TCR gamma/delta cell clones were produced from both CD2-depleted normal peripheral blood mononuclear cells (PBMC) and leukemia and lymphoma cell-predominant PBMC, effusion cells and lymph node cells in in vitro cultures with rIL-1 and rIL-2 and using limiting dilution techniques. These clones were then analyzed as to their cell morphology, phenotype and non-major histocompatibility-restricted cytotoxicity (NMRC) to K562. The results of the cloning from CD2-depleted PBMC showed 112 WT31+ gamma/delta-1- clones, 62 WT31- gamma/delta-1+ clones and 101 WT31- gamma/delta-1- clones. These were produced in 17 serial experiments. The addition of EBV-infected B cell line cells as feeder cells resulted in better production of gamma/delta-1+ and non-T cell clones than that of WT31+ clones. One typical example of the cloning from lymphoblastic lymphoma cell-predominant PBMC resulted in the production of 8 gamma/delta-1+ and 3 WT31+ clones. Most of the clones proven to be gamma/delta-1+ clones had the CD2+ CD3+ CD4(-)-+ CD8(-)-+ TCR delta-1+ beta F1- alpha F1- and delta TCS-1- phenotype, but few clones displayed CD2- or delta TCS-1+ phenotype. These gamma/delta-1+ clones were morphologically large granular lymphocytes, but functionally they did not have NMRC to K562. It is possible to say that TCR gamma/delta clones were rather easily produced from TCR alpha/beta cell-depleted PBMC and effusion cells, and can be used for the study of their nature and characteristics.

Cloning, Molecular↗
PubMed1993

Establishment of a CD4-positive plasmacytoma cell line (AMO1).

A human plasmacytoma cell line (AMO1) was established. The AMO1 cells had the light and electron microscopic characteristics typical of plasmacytoma cells and did not harbor Epstein-Barr virus. These cells expressed cytoplasmic immunoglobulin A kappa and the immunoglobulin heavy-chain gene (JH) and kappa light-chain gene (C kappa) were rearranged. Coexpression of a CD4 antigen and plasma cell antigens (CD38 and PCA-1) was an unusual and sustained feature. Neither the T-cell receptor beta nor the gamma chain gene displayed the rearranged form. Other lineage-specific surface antigens, namely T, B, monocytoid, and myeloid antigens, were all negative in AMO1. In accordance with the surface CD4 expression, polymerase chain reaction analysis indicated constitutive expression of CD4 mRNA, and the cytogenetic findings revealed that AMO1 cells had a derivative chromosome 12, which had a structural abnormality of the short arm carrying the CD4 gene locus. These findings provide strong evidence for the presence of CD4-positive malignant plasma cells and raise the possibility that the CD4 expression in the AMO1 cell line is closely associated with the derivative chromosome.

Biomarkers, Tumor↗
PubMed1993

[Reduction of the amount of perioperative blood transfusion by autotransfusion techniques in valvular heart surgery].

We used autotransfusion in valvular heart surgery and evaluated its effect on perioperative homologous blood requirements. Methods of autotransfusion we used were intraoperative blood salvage using Cell Saver 4 and retransfusion (IAT), postoperative autotransfusion of shed mediastinal blood (PAT), and hemodilutional autotransfusion (HAT). The patients undergoing valvular heart operations were divided into three groups; group 1 (control group), group 2 (using IAT and PAT group), and group 3 (using IAT, PAT, and HAT group). Perioperative homologous blood requirements significantly decreased in group 3 compared to group 1 and group 2. Operations without homologous blood transfusion significantly increased in number in group 3 compared with group 1. In conclusion, autotransfusions described above were useful blood conservation techniques in valvular heart surgery.

Adult↗
PubMed1992

[Detectability of diagonal branch disease by 201TlCl exercised myocardial scintigraphy].

The detectability of diagonal branch disease in 10 patients (five with angina pectoris, five with myocardial infarction) with isolated diagonal branch lesions (more than 75% luminal stenosis in coronary angiography) was reviewed. In exercised 201TlCl myocardial scintigraphy, chest pain occurred in four of 10 patients, electrocardiographic change indicating myocardial ischemia was seen in four, and diagonal branch lesion was detected in only four patients by planar images. In contrast, diagonal branch lesions were detected in 10 of 10 patients by SPECT (single photon emission computed tomography). In planar images, perfusion defects appeared high in the anterolateral, posterolateral, and anterior walls of the left ventricle. In SPECT images they appeared high in the anterior to anterolateral wall. The extent of diagonal branch lesions could be quantitatively evaluated by coronary territory maps developed from unfolded maps of exercised SPECT. The mean ratio of the extent of diagonal branch lesion to left anterior descending branch territory was 24.7%, and the extent of myocardial infarction was significantly larger than that of angina pectoris (p < 0.05). In conclusion, SPECT is useful for detecting diagonal branch lesions and can quantitatively show the extent of these lesions by coronary territory map.

Aged↗
PubMed1992

[Raise up 99mTc-HMPAO brain SPECT for detecting the changes in cerebral perfusion pressure].

99mTc-HMPAO crossed the blood brain barrier instantly in proportional to cerebral blood flow. Raise up stress and supine resting 99mTc-HMPAO with brain SPECT was devised for detecting abnormal response in the changes of cerebral perfusion pressure. Asymmetric ratio in the middle cerebral artery area in patients with internal carotid artery occlusion (n = 5) was changed significantly from 0.82 +/- 0.06 to 0.90 +/- 0.06 and that of normal (n = 5) was not changed from 0.94 +/- 0.03 to 0.95 +/- 0.01. Raise up 99mTc-HMPAO brain SPECT enhanced the detectability in abnormality of regional cerebral blood flow and visualized the dys-autoregulated area during blood pressure falls.

Blood Pressure↗
PubMed1992

[Growth rate of abdominal aortic aneurysms as measured by Computerized tomography].

To evaluate the growth rate of abdominal aortic aneurysms, sequential computed tomography (CT) examinations were performed on 125 nonoperated patients (M/F 101/24, mean age 67 +/- 8 years, 129 lesions) at intervals of at least 6 months. Growth rates of aneurysms were obtained by subtracting the first from the last diameter and adjusting for examination interval. Mean growth rate was 0.28 +/- 0.26 cm/year. Aneurysms with an initial diameter exceeding 4 or 5 cm showed significantly faster growth than smaller aneurysms. There was no significant correlation between growth rate and atherosclerogenic factors, but systolic blood pressure was significantly higher in patients whose aneurysms ruptured. Our study showed quantitatively that aneurysms with a large diameter have a rapid growth rate, the growth rate of infrarenal aneurysms is significantly faster than that of suprarenal aneurysms, and blood pressure control is important to prevent rupture.

Adult↗
PubMed1992

Visualization of posture-dependent cerebral blood flow in a patient with Takayasu's disease by means of 99mTc-HMPAO brain single photon emission tomography.

A case of Takayasu's disease in a 22-year-old woman who complained of severe fainting attacks is presented. Bilateral obstruction of the cervical arteries was confirmed by digital subtraction angiography. Preoperative technetium-99m hexamethylpropylene amine oxime brain SPET in the sitting position showed bilateral hypoactivity in the temporoparietal areas. Subtraction brain SPET showed slightly increased activity in the lying position. The patient has had no fainting attacks since bypass surgery. Postoperative 99mTc-HMPAO brain SPET in the sitting position showed normal activity except in the right temporoparietal area. This area was filled in the lying position. 99mTc-HMPAO brain SPET is the only technique that can visualize the cerebral blood flow in any position, this capability deriving on the fact that the distribution of 99mTc-HMPAO in the brain is fixed in the first 2-3 min following injection. The use of both sitting and lying 99mTc-HMPAO brain SPET is very useful for detecting an abnormality (i.e. an inhomogeneous response due to the fall in perfusion pressure) that could not be seen if the cerebral blood flow were to be assessed only in the lying position.

Adult↗
PubMed1992

Interleukin-7 (IL-7)-induced proliferation of CD8+ T-chronic lymphocytic leukemia cells.

Interleukin-7 (IL-7) is a growth factor for pro-B cells, pre-B cells, and thymocytes and is known to induce the proliferation of normal human peripheral T cells. Moreover, human B and T acute leukemia cells with immature surface markers proliferate in response to IL-7. Here we describe a case of T-chronic lymphocytic leukemia, in which the leukemic cells showed a proliferative response to human recombinant IL-7 in vitro. The patient was a 74-year-old woman with anemia and thrombocytopenia, whose bone marrow was fibrosed and infiltrated with pathologic cells. Surface markers of the leukemic cells were CD2(+), CD3(+), CD5(+), CD7(+), CD8(+), and CD4(-). Both T-cell receptor beta-chain and gamma-chain genes were found to be rearranged by immunogenotypic analysis. The leukemic cells proliferated in response to IL-7 dose dependently. The DNA synthesis of CLL cells was stimulated by not only IL-7 but also IL-2 and IL-4. The IL-7-induced proliferation was not inhibited by antibodies to IL-2 receptors or the anti-IL-4 antibody. These findings indicate that IL-7 may induce the proliferation of peripheral CD8+ T cells, even on its pathological counterpart.

Aged↗
PubMed1992

Hepatocellular carcinoma with extrahepatic primary neoplasms.

We experienced seven cases of hepatocellular carcinoma (HCC) with extrahepatic primary malignant neoplasms (PMNs), which accounted for 7.5% of 93 HCC cases in our department during a 5.5-year investigation period. No common characteristics of the seven patients with extrahepatic PMNs in terms of age, sex, computed tomographic (CT) features of hepatocellular carcinoma, or presence of liver cirrhosis were evident. One of the seven cases had triple PMNs. Extrahepatic PMNs were found in various organs: stomach, colon, kidney, lung, larynx, and esophagus. Attention to extrahepatic organs should be undertaken in the management of HCC. Two patients in hepatic coma died 4 and 6 months after the diagnosis of HCC due to the advanced HCC, and accompanying extrahepatic malignancies were not the primary cause of death.

Adult↗
PubMed1992

Aortic aneurysms: growth rates measured with CT.

Because of a lack of information about the rates of growth of aortic aneurysms, such rates in thoracic and abdominal aortic aneurysms were determined. One hundred seventy-one patients with atherosclerotic aortic aneurysm managed nonoperatively were followed up for more than 6 months with sequential computed tomography (CT). There were 211 aneurysms (thoracic aortic, 82; abdominal aortic, 129). The growth rates of thoracic and abdominal aortic aneurysms were 0.42 and 0.28 cm/y, respectively. Aneurysms at the aortic arch (n = 34) grew at a faster average rate (0.56 cm/y) than aneurysms arising at other levels, even when the rate was corrected for the initial diameter. It is recommended that thoracic aortic aneurysms, especially aortic arch aneurysms, be followed frequently with CT examination of size.

Adult↗
PubMed1992

Percutaneous trigeminal rhizotomy and percutaneous cordotomy under general anesthesia.

Most percutaneous procedures for the treatment of pain are done under local anesthesia and considerable pain can be involved. If the patient is elderly or confused because of severe pain, it is difficult or impossible to perform these procedures successfully. We treated 3 elderly patients with trigeminal neuralgia and 1 patient with severe bone pain due to metastatic osteosarcoma in the lumbosacral region by percutaneous trigeminal rhizotomy and percutaneous cordotomy under general anesthesia with intratracheal intubation. We conclude that percutaneous trigeminal rhizotomy and percutaneous cordotomy can be safely done under general anesthesia.

Aged↗