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Biomedical subjects

Y Hosoda

Publications and source records attributed to Y Hosoda.

At least 163 records · Page 9Linked to original sources
PubMed1994

[A case of fistula-cancer response to arterial chemoembolization].

Arterial chemoembolization was performed three times preoperatively for cancer associated with fistula-in-ano for diminishing the postoperative surgical tissue defect of the perineum. Partial response of the tumor to this treatment was confirmed by computed tomography. A sixty-two-year-old male patient recognized a mass in the perineum one and a half years ago. He had suffered from fistula-in-ano for thirty years. The mass increased its size and formed a tumor in the bilateral buttocks (12 x 9 cm and 9 x 9 cm in diameter). Biopsy specimen showed a moderately differentiated adenocarcinoma. Angiography showed a hypervascular tumor stain. The main feeders to the tumor were the superior rectal artery and bilateral internal iliac artery. Arterial chemoembolization was performed three times through the right and left internal iliac artery with Gelfoam particle. Arterial infusion chemotherapy was added through inferior mesenteric artery and bilateral internal iliac artery with a total 120 mg of adriamycin and 1,500 mg of 5-FU simultaneously. The tumor decreased in size to 44% of the preoperative size by the treatment. A radical operation was performed following the preoperative treatment. Preoperative arterial chemoembolization for cancer associated fistula-in-ano was considered to be helpful for local control.

Adenocarcinoma↗
PubMed1994

[Effect of nicardipine cardioplegia on A-V conduction system in coronary bypass surgery].

The effect of diltiazem and nicardipine cardioplegia on A-V conduction system was analyzed in 75 patients undergoing coronary bypass operation. The dose of these drugs into the crystalloid cardioplegia was 10 micrograms/kg in nicardipine group (n = 29) and 100 micrograms/kg in diltiazem group (n = 46). Among these patients, there was no operative death and no patient required IABP after surgery and there was no difference on the post operative CK-MB level, on the cardiac index and on the pulmonary pressure between two groups. The number of patients who had complete A-V block after release of aortic cross clamping was significantly smaller in nicardipine group than in diltiazem group: 45.7% in diltiazem group vs. 6.9% in nicardipine group at 30 minutes and 21.7% vs. 6.9% at 60 minutes. We conclude that the suppressive effect on A-V conduction system was significantly lower in nicardipine cardioplegia than in diltiazem cardioplegia in the patients undergoing coronary bypass operation.

Angina Pectoris↗
PubMed1994

[Role of serotonin in the progression of pulmonary hypertension].

From 0.5 to 3 days after subcutaneous injection of monocrotaline (MCT) 60 mg/kg, prominent accumulation of platelets in the pulmonary capillaries accompanied with significant elevation of the plasma serotonin level was observed. To clarify the role of serotonin, the in vivo and in vitro effects of the selective 5-HT2 receptor antagonist, DV-7028, on MCT-induced pulmonary hypertension were studied. Oral administration of DV-7028 (10 mg/kg, twice daily) significantly suppressed the MCT-induced elevation of pulmonary arterial pressure, right ventricular hypertrophy and medial thickening of the muscular-type pulmonary arteries which occurred 23 days after MCT administration. The plasma level achieved by oral administration of 10 mg/kg DV-7028 was more than 10(-7) M. The hyperreactivity to serotonin in isolated pulmonary artery segments from MCT-treated rats was significantly reduced by DV-7028 (10(-7) M). The present study suggests that serotonin, released from platelets and accumulated in pulmonary capillaries, contributes to the initiation and/or progression of pulmonary hypertension in MCT-treated rats.

Animals↗
PubMed1994

Racial difference in cardiac sarcoidosis incidence observed at autopsy.

The most commonly involved organ in sarcoid related death has been reported to be the lung in western countries, while it was the heart in the Japanese autopsy series. In order to verify this different pattern of death, autopsy records were reviewed in two United States institutions and in Japanese nation-wide data. In Japanese, male to female ratio was 1:2 and a high frequency of sarcoidosis in females over 50 years of age was observed. Male to female ratio in Caucasian sarcoidosis autopsy was nearly 1:1. In Afroamericans, it was nearly 1:2, and the age distribution showed that this female predominance was due to a high number of sarcoidosis in females over 40 years of age. The frequency of sarcoidosis in Caucasian autopsies was higher than in Japanese autopsies. The number of involved organs was smaller in Caucasians than in Afroamericans or in Japanese. The incidence of cardiac sarcoid granuloma in Japanese was significantly higher than that seen in Caucasians and Afroamericans. The commonest cause of death in sarcoidosis of Caucasians and Afroamericans was from non-sarcoid diseases, while the major cause of sarcoid-attributed death was pulmonary sarcoidosis in Afroamericans. Japanese showed the highest rate of cardiac sarcoid-attributed death. Possible factors relating to this high incidence of sarcoidosis in elderly females and the racial difference in cardiac sarcoidosis were discussed.

Adolescent↗
PubMed1994

Extensive resection of the bile ducts combined with liver resection for cancer of the main hepatic duct junction: a cooperative study of the Keio Bile Duct Cancer Study Group.

BACKGROUND: It is necessary to elucidate whether extensive resection of the bile ducts combined with liver resection is a feasible and valid procedure for cancer of the main hepatic duct junction. METHODS: Based on a multi-institutional study, resectability rate, operative mortality, long-term survival, and factors contributory to long-term survival were investigated. RESULTS: Between January 1973 and December 1991, a total of 158 patients with this cancer were admitted to Keio University Hospital and six affiliated institutions. Eighty-three (53%) of the 158 patients underwent resection, with seven (8.4%) postoperative deaths. The operations were performed by seven surgeons who were in charge of liver surgery at each respective institution. The 5-year actuarial survival rate of the 83 patients who underwent resection was 20%. Twelve patients survived more than 5 years, and these patients underwent curative resection. Three of the 12 patients were doing well after 10 years. Procedures of liver resection were right trisegmentectomy in two patients and left lobectomy with resection of the right portal vein in one. CONCLUSIONS: It is clear that cancer of the main hepatic duct junction has become a curable disease. The operation is a valid procedure that can be widely practiced by competent surgeons.

Adenocarcinoma↗
PubMed1994

Ultrasonographic abdominal screening of atomic bomb-exposed subjects.

Abdominal ultrasonographic screening for cancer was performed in 6,001 Hiroshima and Nagasaki A-bomb exposed and comparison subjects, all members of the Adult Health Study of the Radiation Effects Research Foundation, formerly the Atomic Bomb Casualty Commission. This study yielded 20 cancers, including 7 hepatocellular, 3 gastric, 3 renal and 2 urinary bladder cancers; one cancer each of the ovary, pancreas, colon and ureter; and one cancer metastatic to the liver, whose primary was unknown. Seventeen of these 20 subjects manifested no symptoms or signs of their disease. A variety of additional tumors, unproven and probably benign, including uterine myomata, and other abnormalities were also detected. Abdominal ultrasonographic screening greatly assisted in the detection of cancers, most of which neither the patients nor their physicians were aware. In this screened fixed population sample the cancer detection rate was 0.33%, exceeding any such rates previously reported in the medical literature.

Abdominal Neoplasms↗
PubMed1994

[Reoperation and PTCA after coronary artery bypass graft].

Since 1984, 1410 patients underwent coronary bypass grafting at Juntendo University Hospital. At the primary operation 797 patients had internal thoracic artery (ITA) graft and 613 patients received only saphenous vein graft (SVG). Reoperation was done in one pt. in ITA group and 10 pts. in SVG group. There were 2 deaths (reoperative mortality 18%). Percutaneous Transluminal Coronary Angioplasty to stenotic SVG was applied to 71 lesions in CABG patients. The primary success rate was 81.7% and restenosis rate was 38.9%. Urgent reoperation was performed on 3 pts. who had PTCA to diseased LAD or stenotic SVG to LAD. Reoperation is technically demanding and is associated with high mortality. Balloon angioplasty may provide a suitable alternative. But high restenosis rate (especially acute stenosis) remains a significant problem, particularly in the pts. with diseased LAD or stenotic vein graft to LAD. Reoperation is another option to relieve the ischemic symptoms in pts. with diseased LAD or stenotic vein graft to LAD.

Adult↗
PubMed1994

[Effects of subcutaneous administration of erythropoietin on autologous blood predonation in open heart surgery: Japanese multicenter double-blinded dose-study].

The effects of subcutaneous administration of recombinant human erythropoietin (EPO) on harvesting autologous blood predonation (ABP) and decreasing homologous blood transfusion (HBT) in open-heart surgery were examined prospectively in 132 patients treated in a 32-institute multicenter study. Single doses of 6000, 12,000, 18,000 and 24,000 unit (IU) of EPO with intravenous iron (40 mg) were administered once a week for 3 weeks with ABP (400 ml/week) before surgery. ABP volume (ml), change of blood hemoglobin level (C-Hb), preoperative net blood hemoglobin increase (delta Hb [g/dl] including ABP, perioperative blood loss (ml), and HBT rate, were as follows; [table: see text] Preoperative reduction of Hb (C-Hb) was less in administration dose of 18,000 IU and 24,000 IU than 6000 IU (p < 0.05). The increase of delta Hb was highest in 18,000 IU and HBT rate was lowest in administration dose of 24,000 IU, however, there was no statistical difference. In conclusion, both 18,000 IU and 24,000 IU of EPO treatment is effective to minimize the progression of anemia according to ABP for open heart surgery.

Blood Transfusion, Autologous↗
PubMed1993

Immunohistologic analysis of the extracellular matrix components of the fibrous stroma of human colon cancer.

In order to elucidate the gross composition of fibrous stroma and to better understand the obstructive nature of advanced human colonic cancers the extracellular matrix components of its stroma were analyzed immunohistologically, emphasizing the process of fibrosis and possible tissue constriction. Collagenous material, identified by Masson's trichrome stain, was distributed mainly in the invasive area, where type I and III collagens and chondroitin 4-sulfate stained intensely in the periacinar area, and further, fibronectin stained. Conversely, in the invasive area away from tumor acini type III collagen stained weakly and fibronectin not at all. Type V collagen and myofibroblasts stained in the periacinar area and did not stain in the invasive area away from tumor acini, the findings of myofibroblasts being prominent in cases with obstructive type carcinomas. In conclusion, the invasive area, especially the periacinar area, displayed signs of active ongoing fibrosis and tissue contraction, which may be responsible for the genesis of obstructing type colonic carcinomas.

Adenocarcinoma↗
PubMed1993

MR imaging findings of tremors associated with lesions in cerebellar outflow tracts: report of two cases.

Two cases with severe tremors were studied by means of electromyograms using surface electrodes and also by magnetic resonance (MR) imaging. The first case was associated with multiple sclerosis and demonstrated a severe postural cerebellar tremor and an alternate activation of antagonist muscles in the right arm. The second case, with hemorrhage in the brainstem, demonstrated a severe tremor at rest and mixed synchronous and alternating activation of antagonist muscles in the left forearm. MR imaging studies localized lesions possibly responsible for these tremors. In the first case a lesion was located in the superior cerebellar peduncle just under the decussation, and in the second case a lesion was found between the red nucleus and the thalamus, with possible involvement of both the cerebellothalamic and nigrostriatal pathways. The first case accords with the theory that a lesion located in the dentate nucleus and its projection can cause severe postural cerebellar tremor. The lesion demonstrated in the second case may be responsible for "cerebellar tremor at rest" or "static (resting) cerebellar tremor."

Adult↗
PubMed1993

Pathophysiology of congenital diaphragmatic hernia. IV: Renal hyperplasia is associated with pulmonary hypoplasia.

The hypothesis of this article is that growth of the fetal lung is stimulated by a pulmonary growth factor (PGF) produced by the kidneys, which is modulated by a feedback signal from the lungs, a pulmonary-derived renotropin (PDR). In the fetus with pulmonary hypoplasia (PH), the lungs may maximally stimulate this feedback loop to release more PDR, resulting in continual stimulation of the kidneys and renal enlargement. If such a schema plays a role in the pathophysiology of PH, newborn infants with congenital diaphragmatic hernia (CDH) or chronic amniotic fluid leak (CAFL) should have enlarged kidneys. To investigate this hypothesis, we created models of CDH in fetal lambs and CAFL in fetal rabbits, and then analyzed lung (Lu) and kidney (K) growth. When compared to controls, newborn CDH lambs had significantly smaller lungs and larger kidneys. The lungs were hypoplastic as defined by either decreased lung weight/body weight (LuW/BW), lung DNA/body weight (Lu DNA/BW), or lung total protein/body weight (LuTP/BW) (P < .01). Renal hyperplasia was confirmed by KW/BW, K DNA/BW (P < .01), and KTP/BW (P < .05). An inverse relationship between lung size and kidney size could be described by the equation KW/BW = 1.04 - 0.12 LuW/BW (r = -.75). The CAFL model in newborn rabbits produced severe oligohydramnios when compared with controls (P < .01). This resulted in fetuses with smaller lungs and larger kidneys as compared with those of controls. The lungs were significantly smaller and more hypoplastic than controls when compared by LuW (P < .01), LuW/BW (P < .01), Lu DNA/BW (P < .05), and Lu TP/BW (P < .01).(ABSTRACT TRUNCATED AT 250 WORDS)

Amniotic Fluid↗
PubMed1993

Role of 5-hydroxytryptamine in the progression of monocrotaline induced pulmonary hypertension in rats.

OBJECTIVE: The aim was to clarify the role of serotonin (5-hydroxytryptamine, 5-HT) in monocrotaline induced pulmonary hypertension. METHODS: Plasma 5-HT levels, pulmonary capillary platelet count, and vascular responsiveness to 5-HT were evaluated in the model. The effects of the selective 5-HT2 receptor antagonist, DV-7028, on the development of pulmonary hypertension were also investigated. RESULTS: Plasma 5-HT was raised 12 h to 3 d after monocrotaline administration (60 mg.kg-1), coinciding with accumulation of platelets in the pulmonary circulation. Isolated pulmonary arteries showed hyperreactivity to 5-HT at 14 and 21 d after monocrotaline. Administration of DV-7028 (20 mg.kg-1 x d-1) attenuated the increase in pulmonary arterial pressure, right ventricular hypertrophy, and medial thickening of the pulmonary arteries. CONCLUSIONS: The present study suggests that 5-HT released from platelets contributes to the initiation and progression of monocrotaline induced pulmonary hypertension.

Animals↗
PubMed1993

The renin-angiotensin-aldosterone system and hematologic changes during pulsatile and nonpulsatile cardiopulmonary bypass.

The effects of pulsatile and nonpulsatile cardiopulmonary bypass using a roller pump on levels of vasoactive hormones and hematologic changes were studied in 32 patients subjected to elective primary coronary artery bypass graft surgery. Seventeen patients had nonpulsatile perfusion (nonpulsatile group) and 15 patients had pulsatile perfusion (pulsatile group) during the period of cardiac arrest. Vasoactive hormones (plasma renin, angiotensin II, aldosterone, epinephrine, and norepinephrine) were measured in these patients. In order to clarify hematologic changes, plasma free hemoglobin, number of platelets, platelet factor 4, and beta-thromboglobulin were measured. There were no significant differences between the pulsatile and nonpulsatile groups with regard to vasoactive hormones and damage of platelets. In the pulsatile group, however, the rise of plasma free hemoglobin levels was significantly higher than that in the nonpulsatile group during and after cardiopulmonary bypass. We did not see the benefit of pulsatile perfusion using a roller pump on vasoactive hormones. Evidence of increased hemolysis with pulsatile flow was demonstrated in our cases.

Aldosterone↗
PubMed1993

Interleukin 2 and interferon-gamma augment anticolon antibody dependent cellular cytotoxicity in ulcerative colitis.

In vitro effects of cytokines and therapeutic drugs on antibody dependent cellular cytotoxicity (ADCC) mediated by anticolon antibody were investigated in serum samples from patients with ulcerative colitis. A 51Cr release assay was used to examine ADCC activity with the colon cancer cell line, colo 205, as the target and peripheral blood mononuclear cells as the effector. High ADCC activity was shown in 13 of 32 (41%) patients with ulcerative colitis. This ADCC activity was inhibited by protein A treatment of the serum samples. Interleukin 2 (IL2) activated effector cells could enhance ADCC activity, but interferon-gamma (IFN-gamma) or tumour necrosis factor-alpha (TNF-alpha) had no effect on the cytotoxic activity of effector cells. Treatment of target cells with IFN-gamma increased the vulnerability of these cells to ADCC with a large increase of intercellular adhesion molecule-1 (ICAM-1) expression on their surface. Monoclonal antibodies to ICAM-1 inhibited this IFN-gamma enhanced ADCC activity. Interestingly, prednisolone (PSL) reduced ADCC activity, but sulphasalazine (SASP) or 5-aminosalicylic acid (5-ASA) did not. These results suggest that IL2 and IFN-gamma could enhance colonic epithelial cell injury mediated by the ADCC mechanism in ulcerative colitis and that ADCC enhanced by cytokines is restored by PSL treatment.

Adolescent↗
PubMed1993

Epiretinal membrane of proliferative diabetic retinopathy: an immunohistochemical study.

Nineteen cases of epiretinal membrane (ERM) in proliferative diabetic retinopathy were studied using immunohistochemical methods. Antibodies against type I-IV collagen, fibronectin (FN), glial fibrillary acidic protein (GFAP), vimentin and the monoclonal antibody (MAB) against human Müller cells were used to examine the membranes. Type II collagen was found on one side of the ERMs in 95% of the cases. The other types of collagen, FN and vimentin were also identified in most cases. Müller cells (GFAP- and MAB-positive) were found in 2/19 cases (11%), and astrocytes (GFAP-positive but MAB-negative) were found in 10/19 cases (53%). These results suggest that type II collagen (vitreal collagen) may act as a scaffolding in the formation of ERMs and that glial elements of the ERMs consist mainly of astrocytes.

Adult↗
PubMed1993

Expression of thrombomodulin in patients with spontaneous occlusion of the circle of Willis.

BACKGROUND AND PURPOSE: We examined the expression of thrombomodulin, a recently isolated anticoagulant protein, in endothelial cells from patients with spontaneous occlusion of the circle of Willis (cerebrovascular moyamoya disease) to determine whether lack of the expression of thrombomodulin might lead to the thrombogenicity in patients with this disease. METHODS: The intracranial internal carotid arteries, the external carotid arteries, and the vertebral or basilar arteries from 12 autopsied patients who had this disease and eight control autopsied patients were examined immunohistochemically by using the antiserum against human thrombomodulin. RESULTS: All of the endothelial cells from the patients with this disease and from the control patients were positive for thrombomodulin. Immunoelectron microscopy also disclosed normal localization of thrombomodulin on the luminal plasma membrane. Immunohistochemically, we could find no significant differences in the expression of thrombomodulin among the arteries examined in this study. CONCLUSIONS: We conclude that as far as we investigated immunohistochemically, the thrombogenicity in this disease is almost unlikely to depend on the abnormal expression of thrombomodulin.

Adolescent↗
PubMed1993

A possible masking effect of tinnitus. Evaluation of CNV audiometry.

To determine whether tinnitus has a masking effect similar to that of general external sounds, the hearing threshold shift when the tinnitus was changed by intravenous administration of lidocaine was measured by contingent negative variation (CNV) audiometry. In a preliminary study, the reliability of CNV audiometry was evaluated in 12 patients with tinnitus. The reproducibility of CNV audiometry was confirmed, based on repeated measurements of CNV audiometry at the tinnitus frequency. The threshold difference between CNV audiometry and pure tone audiometry was -0.76 +/- 1.35 dB, and a high statistical correlation between the threshold of CNV audiometry and pure tone audiometry was evident. The CNV threshold shift at tinnitus frequency after lidocaine injection was measured in 89 ears. In the tinnitus-decreased group, the CNV threshold decreased (4-6 dB) in 22% of cases; however, in the tinnitus-unchanged group, the CNV threshold was little changed. These findings suggest that tinnitus may have a masking effect as is the case with external sounds.

Audiometry, Evoked Response↗