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Biomedical subjects

Y Hirose

Publications and source records attributed to Y Hirose.

At least 127 records · Page 7Linked to original sources

Noninvasive identification of left ventricular involvements in arrhythmogenic right ventricular dysplasia: comparison of 123I-MIBG, 201TlCl, magnetic resonance imaging and ultrafast computed tomography.

We examined the feasibility of myocardial 123I-MIBG, 201TlCl, magnetic resonance imaging (MRI) and ultrafast computed tomography (UFCT) for the early detection of left ventricular involvements in 15 patients with arrhythmogenic right ventricular dysplasia (ARVD). Radionuclide ventriculography (RNV) and myocardial imaging with 123I-MIBG, 201TlCl, MRI and UFCT were performed in all 15 patients and in 10 normal subjects. The patients' scans were visually interpreted by two nuclear medicine physicians taking into consideration the extent score (ES) and severity score (SS) calculated by using the bull's-eye view in relation to normal data derived from the normal subjects. The left ventricular ejection fraction (LVEF) was measured by RNV. Fourteen (93%) patients showed regional 123I-MIBG defects, while 12 (80%) patients showed regional 201TlCl defects. The ES and SS were higher in 123I-MIBG than 201TlCl (ES: 31.5 +/- 18.5 vs. 17.5 +/- 18.2, p < 0.01, SS: 34.8 +/- 42.2 vs. 16.9 +/- 37.5, p < 0.01). Abnormal UFCT and MRI findings suggesting fatty involvements of the LV myocardium were demonstrated in 7 patients (Group B), while 7 patients showed regional 123I-MIBG defects without abnormal UFCT and MRI findings (Group A). 123I-MIBG was significantly more sensitive than UFCT and MRI (p < 0.05), although one patient, an exception, showed abnormal UFCT findings for the apex of the LV myocardium without abnormal 123I-MIBG and MRI findings. The LVEF, as a measure of LV systolic function, was better preserved in Group A than in Group B (59.3 +/- 3.6 vs. 45.8 +/- 5.8, p < 0.01). The present findings indicated that myocardial imaging with 123I-MIBG sensitively detects myocardial damage in patients with ARVD in the early stage when cardiac systolic function is still preserved.

3-Iodobenzylguanidine↗

The outcome of early surgical management of ruptured posterior circulation aneurysms.

Since 1990, early surgery within 3 days following subarachnoid hemorrhage has been performed routinely in our hospital even for ruptured posterior circulation aneurysms. Our experience with early surgical management of 25 patients with posterior circulation aneurysms, including two patients who underwent endovascular surgery, is reported. Fourteen patients had an aneurysm on the basilar, the posterior cerebral or superior cerebellar artery (BA), and 11 patients had an aneurysm on the vertebral or posterior inferior cerebellar artery (VA). The mortality and morbidity of the BA group were 7% and 29%, respectively, and those of the VA group were 27% and 9%, respectively. In BA, the incidence of symptomatic vasospasm and hydrocephalus was definitely high compared with VA, and the outcome in elderly patients was significantly unfavorable. Early surgery for posterior circulation aneurysms to prevent rebleeding might be considered in selected cases.

Adult↗

Expression of Bax and bcl-2 proteins, regulators of programmed cell death, in human brain tumors.

Expression of Bcl-2, a programmed cell death (PCD)-suppressing molecule, and Bax, the Bcl-2 related PCD-accelerating protein was investigated in varied human brain tumors. Thirty-six cases of human brain tumors comprising 4 astrocytomas, 3 anaplastic astrocytomas, 4 glioblastomas multiforme, 5 medulloblastomas, 1 ependymoma, 2 choroid plexus papilloma, 1 ganglioglioma, 1 central neurocytoma, 4 meningotheliomatous meningiomas, 3 transitional meningiomas, 4 fibroblastic meningiomas, 3 acoustic neurinomas and 1 craniopharyngioma were analyzed for the localization of Bax and Bcl-2 proteins. No relationship between the degree of the histological malignancy and the presence of Bax or Bcl-2 proteins was found in varied human brain tumors. However, it is suggested that reduced expression of Bax protein is necessary for the malignant transformation and progression of the brain tumors, since no histologically malignant brain tumors with positive Bax protein were present. Our findings indicate that the expression pattern of Bax and Bcl-2 may reflect histogenetic difference of each type of brain tumors.

Adolescent↗

Impaired left ventricular myocardial metabolism in patients with pulmonary hypertension detected by radionuclide imaging.

To assess whether left ventricular myocardial metabolism is affected by the presence of right ventricular pressure overload, we performed 123I-beta-methyl-iodophenyl pentadecanoic acid (123I-BMIPP) and 99Tc(m)-sestamibi (99Tc(m)-MIBI) single photon emission tomography in 24 patients with pulmonary hypertension and in 10 control subjects. The left ventricle was divided into six regions using a short-axis tomogram at the mid-ventricular level. The relative regional uptake (RRU, %) was determined for each region as the ratio of the regional uptake per pixel to the maximum uptake in the six regions. Right heart catheterization was performed to obtain mean pulmonary arterial pressure. 123I-BMIPP uptake in the septum and the adjacent myocardium of the left ventricle was lower in patients with pulmonary hypertension than in control subjects (septal RRU, 75 +/- 6 vs 85 +/- 4%; anteroseptal RRU, 76 +/- 6 vs 86 +/- 3%; posteroseptal RRU, 75 +/- 4 vs 84 +/- 4%; P < 0.001). The reduction in 99Tc(m)-MIBI uptake was confined to the septum in patients with pulmonary hypertension (79 +/- 5 vs 85 +/- 5%; P < 0.05). Interestingly, the septal RRU of 123I-BMIPP and the sum of the septal, anteroseptal and posteroseptal RRUs of 123I-BMIPP were negatively correlated with mean pulmonary arterial pressure (r = -0.70 and -0.55, respectively; P < 0.01). In conclusion, myocardial metabolism in the interventricular septum and the adjacent regions of the left ventricle may be impaired in proportion to the degree of pulmonary hypertension.

Adult↗

Inhibitory effects of dietary protocatechuic acid and costunolide on 7,12-dimethylbenz[a]anthracene-induced hamster cheek pouch carcinogenesis.

The modifying effects of dietary exposure to two natural products, protocatechuic acid (PCA) and costunolide during the development of neoplasms in oral carcinogenesis initiated with 7,12-dimethylbenz[a]anthracene (DMBA) were investigated in male Syrian golden hamsters. All hamsters except those in the test chemical alone and control groups received DMBA (0.5%) in mineral oil to the right buccal pouch 3 times per week for 4 or 6 weeks. At 13 weeks of age, the groups exposed to DMBA were fed diet containing PCA or costunolide at a dose of 0.2 g/kg diet (200 ppm) for 17 weeks. The other groups consisted of hamsters given mineral oil alone for 6 weeks, or given 200 ppm PCA or costunolide alone, or untreated. All animals were necropsied at the termination of the experiment (week 24). PCA or costunolide significantly decreased the tumor burden (P < 0.001-P < 0.05) and the extent of dysplastic areas (%) (P < 0.001-P < 0.05). PCA significantly decreased the mean number of AgNORs/nucleus (P < 0.05). The BrdUrd-labeling index was reduced by dietary administration of test compounds, though not significantly. These results suggest that PCA and costunolide inhibited hamster buccal pouch carcinogenesis and such inhibition may be related to suppression of cell proliferation in the buccal mucosa. It was also found that telomerase activity expressed in neoplastic and preneoplastic lesions of hamster buccal pouch epithelium after DMBA treatment correlated with the histopathological degree of malignancy.

9,10-Dimethyl-1,2-benzanthracene↗

Vibrio sp. strain NM 10, isolated from the intestine of a Japanese coastal fish, has an inhibitory effect against Pasteurella piscicida.

Vibrio sp. strain NM 10 with an inhibitory activity against Pasteurella piscicida K-III was isolated from the intestine of a spotnape ponyfish (Leiognathus nuchalis). This bacterium efficiently produced an antibacterial substance after growth at 20 degrees C for 24 h on 1/5 PYBG agar prepared with 50% seawater at pHs of 7.5 to 9.0. The antibacterial substance was heat labile and proteinaceous, with a molecular mass of less than 5 kDa, possibly a bacteriocin or a bacteriocin-like substance.

Animals↗

Kinetics of fibroblasts in ulcer healing in rats: interference with indomethacin.

OBJECTIVE: The authors reported that the repair of submucosal tissue is important in ulcer healing. The kinetics of fibroblasts have not been well known in gastric ulcer healing. The effect of subcutaneous administration of indomethacin (1 mg/kg) to submucosal tissue was also examined. METHOD: Immunohistological staining was done using the antibodies for the proliferating cell nuclear antigen prolyl 4-hydroxylase and alpha-smooth muscle actin in acetic acid induced gastric ulcers in rats. The terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-biotin nick end labeling method was also employed. RESULTS: The granulation tissue consisted predominantly of lymphocytes in indomethacin-treated rats. In the control group, proliferative cell nuclear antigen positive cells were at their peak 5 days after ulcer formation (day 5). Prolyl 4-hydroxylase positive fibroblasts were maximal on day 10. Alpha-smooth muscle actin positive myofibroblasts were few on day 5 and increased on day 15. In terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate-biotin nick end labeling, positive cells were sporadically seen on days 20 and 30. In indomethacin-administered rats, the fibroblasts proliferated weakly. The numbers of prolyl 4-hydroxylase and alpha-smooth muscle actin positive spindle-shaped cells were fewer and their appearance delayed. Nick end labeling positive cells were few before day 30 and sporadically observed on days 50 and 80. CONCLUSION: The results indicate that fibroblasts differentiated into several phenotypes and finally underwent apoptosis.

Acetic Acid↗

Syntheses and antifungal activity of dl-griseofulvin and its congeners. III.

Several congeners (1b-g), with novel substituents on the benzene ring of griseofulvin, were prepared by the application of a synthetic method developed by us. Antifungal activity of these congeners decreased in order of dl-griseofulvin (1a) = 1d > 1b, c >> 1e-f (inactive). The relationship between the antifungal activity and the position or kind of substituents on the benzene ring of griseofulvin is discussed.

Antifungal Agents↗

Antiphospholipid syndrome complicated by thrombosis of the superior mesenteric artery, co-existence of smooth muscle hyperplasia.

A 37-year-old woman underwent an emergency operation at our hospital because of severe abdominal pain and ileus. Most of her small intestine and ascending colon were observed to have become necrotic due to occlusion of her superior mesenteric artery (SMA). Pathological findings of the resected intestine revealed that her SMA was completely thrombosed 2 cm distal from its origin with smooth muscle proliferation. Post-surgical blood analysis of her pre-operative serum was positive for lupus anticoagulant and antinuclear antibodies. She noticed vaginal bleeding due to missed abortion on the 31st day after the operation. We diagnosed her acute abdominal pain to be that of antiphospholipid syndrome associated with her pregnancy.

Abdominal Pain↗

Cerebellar infarction with hydrocephalus caused by spontaneous extracranial vertebral artery dissection--case report.

A 38-year-old male suffered sudden onset of rotational vertigo without headache. Consciousness disturbance developed on the 3rd day after the onset. Computed tomography showed cerebellar infarction with obstructive hydrocephalus. External ventricular drainage was performed. Angiography showed bilateral extracranial vertebral artery dissection. Antiplatelet therapy was given. Repeat angiography showed improvement of the dissection. His neurological deficits completely resolved. Vertebral artery dissections may cause both lateral medullary or cerebellar infarction and hydrocephalus due to the cerebellar infarction manifesting as various symptoms so careful evaluation and treatment are required.

Adult↗

Successful removal of meningioma of the pineal region after embolization.

A 69-year-old female presented with a meningioma of the pineal region manifesting as gait disturbance and mental dysfunction. Magnetic resonance imaging revealed a homogeneously well-enhanced circumscribed round mass of about 5 cm in diameter in the pineal region. Angiography demonstrated that the tumor was fed mainly by the bilateral middle meningeal arteries (MMAs), and preoperative intravascular embolization was performed through the bilateral MMAs using estrogen-alcohol and polyvinyl acetate. The tumor was very soft and easily totally resected via the right occipital transtentorial approach. Preoperative embolization is a very useful technique to facilitate removal of deep-seated tumors.

Aged↗

Occlusive cerebrovasculopathy after internal radiation and bleomycin therapy for craniopharyngioma--case report.

A 34-year-old female presented with occlusive cerebrovasculopathy without definite ischemic symptoms and regrowth of a cystic tumor in the third ventricle. She had been treated for a craniopharyngioma 19 years previously by internal irradiation with 198Au colloid combined with intracavitary administration of bleomycin via an Ommaya reservoir. Cerebral angiography demonstrated complete occlusion of the clinoid portion of the left internal carotid artery and stenosis of the left posterior cerebral artery, and numerous transdural anastomoses which had developed after craniotomy. Endoscopic management achieved collapse of the cystic tumor. No treatment for the occlusive cerebrovasculopathy was necessary because of the collateral blood supply. Careful follow-up examinations to detect occult cerebrovasculopathy after such treatment is recommended.

Adolescent↗

Effective treatment with low-dose methotrexate pulses of a child of mixed connective tissue disease with severe myositis refractory to corticosteroid.

A 13-year-old girl with mixed connective tissue disease (MCTD) was described. She visited our hospital with recurrent parotid gland swelling, arthritis, and myositis. Sclerodactyly and Raynaud's phenomenon were also defined, and the laboratory findings of high titers of antinuclear antibody (speckled type), positive anti-RNP antibody, positive rheumatoid factor, and hypergammaglobulinemia suggested the diagnosis of MCTD associated with Sjögren syndrome. The muscle weakness and the increased levels of CK prompted us to examine the muscle biopsy and to perform the electromyography, both of which suggested severe muscle inflammation. The siarography and lip biopsy indicated definitively the association of Sjögren syndrome. Corticosteroid therapy including methyl-prednisolone pulses was started, but the effects were limited. The addition of low-dose methotrexate effectively lowered the levels of CK, and gradually improved the muscle strength. Thus, low-dose methotrexate therapy is recommended to the patients with MCTD who have severe myositis refractory to corticosteroid.

Adolescent↗

[The roles of various media in the decision making processes for recycling behavior: a path analysis model].

This study researched the effects of cognitive variables on recycling behavior, as well as effects of various media of influence on the cognition and behavior. According to Hirose (1994), the decision making process for recycling consists of two steps. The first leads to goal intention of an ecological lifestyle. The second is related to behavior intention of recycling in line with the goal intention. Mass media, such as newspaper and TV, are thought to influence beliefs about environmental problems, including three determinants of goal intention: perception of seriousness, responsibility, and effectiveness. Personal media, such as personal contacts with pro-environmental activists, are thought to influence evaluation of behavior, including three determinants of behavior intention: evaluation of feasibility, cost and benefits, and social norms. Local media, such as municipal announcement and circular, are hypothesized to have a mixed effect of the two. Path analysis indicated that goal intention affected recycling behavior through behavior intention. Effects of the three media of influence on the cognitive variables were also consistent with the hypothesis.

Behavior↗

[A 36-year-old woman with acute onset left hemiplegia and anosognosia].

We report a 36-year-old woman with right hemiplegia, anosognosia, and rapidly deteriorating course. She was well until the end of January, 1995 when she had an onset of fever, sputum, and cough. A 5 x 5 tumor was found in her left lower lobe. She was admitted to the Pulmonary Medicine on May 24, 1995 when she was 36-year-old. General physical examination was unremarkable. Bone scintigraphy revealed increased uptake in the skull, sternum, right scapula, vertebrae, right femur, and in ribs. Cranial CT scan revealed a large mass lesion in the right frontal subcortical region with central low density and peripheral high density areas, and small low density lesions in the right thalamic area and in the right posterior frontal region; ring enhancement was observed in the latter two lesions. On the second day of admission, she noted left-sided weakness which improved by corticosteroid treatment. On June 17, there was a sudden onset of left hemiparesis and a neurologic consultation was asked. Upon neurologic examination, she appeared somnolent but could understand verbal commands. She showed constructional apraxia, neglect of the left hemisphere, and anosognosia. Cranial nerves were unremarkable. Motor-wise, she showed flaccid left hemiplegia. Deep tendon reflexes were exaggerated on the left and the plantar response was extensor bilaterally. Nuchal stiffness was noted. Her cranial CT scan on June 17 revealed enlargement of the right frontal mass lesion. The subsequent course was complicated by DIC and progressive worsening of her consciousness. On June 18, she was comatose and pupillary light reflex was lost. She developed Cheyne-Stokes respiration and expired on that evening. The patient was discussed in a neurological CPC, and the chief discussant arrived at the conclusion that the patient had a primary adenocarcinoma in the lung with multiple metastases including the brain. The fulminant terminal course was ascribed to hemorrhage within the tumor and subsequent central type of transtentorial herniation. Opinions were divided regarding the cause of hemorrhage; some participants thought hemorrhage was caused by DIC. Post-mortem examination revealed an adenocarcinoma arising at the S6 segment of the left lung with multiple organ metastases. In the brain, a huge hemorrhagic metastasis was found in the right frontal lobe and a non-hemorrhagic metastasis in the right thalamic region. Probably, the size of the metastases influenced the occurrence of hemorrhage. The direct cause of the death was transtentorial herniation.

Adenocarcinoma↗

[Activation of endothelium in cardiac surgery: the circulating levels of soluble E-selectin as a marker of the activation of endothelium].

Cardiopulmonary bypass (CPB) is associated with a whole body inflammatory response which may have detrimental consequence resulting in post perfusion syndrome. Adhesion molecule E-selectin plays a pivotal role in the inflammatory response, especially in the interaction of endothelium and neutrophils. Soluble form of E-selectin (sE-selectin) is thought to be a marker of endothelial activation. To evaluate the activation of endothelium during CPB with heparin coated and un-coated extracorporeal circuits, we measured plasma levels of sE-selectin, tumor necrosis factor alpha (TNF alpha), and neutrophil elastase in 16 patients having coronary artery bypass grafting. sE-selectin plasma concentration increased during or after CPB. Significantly lower maximum levels of sE-selectin are observed in patients perfused with heparin coated extracorporeal circuits. Maximum values of sE-selectin correlated with plasma levels of TNF alpha and neutrophil elastase in each patient. These observations suggest that endothelium is activated by extracorporeal circulation in cardiac surgery, and this activation was attenuated by heparin coating of extracorporeal circuits.

Aged↗

[Effect of hemodilution with dextran and albumin on activated clotting time (ACT)].

Hemodilution with colloid solution is known to influence blood coagulation. To evaluate the effectiveness of hemodilution on ACT, 156 patients undergoing elective coronary artery bypass grafting were studied. Patients were divided into three groups (Group I of 52: without hemodilution, Group II of 52: normovolemic hemodilution with Dextran 40, Group III of 52: albumin and lactated Ringer solution). Systemic heparin was given (300 IU.kg-1. ACT was measured by Hemochron 400 and maintained higher than 400 seconds with supplemental dose of heparin. Sampling was performed after induction in Group I, after hemodilution in other groups, after heparin administration, was after start of CPB. More supplemental dose of heparin were required to achieve the lower limit of ACT (400 seconds) in the group I. The ACT at any sampling point was significantly higher in the group II and III than in the group I. In conclusion, hemodilution with dextran and albumin increased ACT values and heparin effect.

Adult↗

[Anesthesia for bronchial stenosis treated by balloon catheter dilatation].

We experienced three cases of successful balloon catheter dilatation for bronchial stenosis under general anesthesia. There was no problem for two patients, but the third patient planned for stent insertion had bronchiomediastinal fistula. This procedure is generally performed under local anesthesia but more safely done under general anesthesia with muscle relaxants considering operative failure by bucking, pain of patients and prolonged procedure.

Anesthesia, General↗