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Biomedical subjects

Y Iida

Publications and source records attributed to Y Iida.

At least 109 records · Page 6Linked to original sources
PubMed1996

[One stage operation for ischemic heart disease and abdominal aortic aneurysm with ascending aortic calcification].

A 69-year-old man was referred to us with the diagnosis of abdominal aortic aneurysm (7 cm in diameter). Additionally his coronary arteriogram showed severe stenosis (LMT 75% and #6 99% delay). Because his ascending aorta was calcified severely, double CABG (LITA to LAD and RGEA to PL) was carried out in hypothermic ventricular fibrillation. Abdominal aortic aneurysm was replaced thereafter while the patient was still on cardiopulmonary bypass. His postoperative courses was satisfactory. In cases requiring early operation for both myocardial ischemia and abdominal aortic aneurysm, one stage operation was recommended. When atherosclerotic changes in the ascending aorta were severe, in situ arterial bypass grafting for ischemic heart disease under hypothermic ventricular fibrillation was useful.

Aged↗
PubMed1996

[A case of chronic tuberculous pyothorax associated malignant lymphoma].

The patient was 69-year-old male. He has a history of treatment for tuberculosis by artificial pneumothorax about 47 years ago. He was admitted an another hospital under the diagnosis of tuberculous pyothorax. He was transferred to our hospital because of chest pain and fever. Laboratory findings on the admission were as follows: ESR was 120 mm/hr, CRP was 20.22 mg/dl and other data were almost within normal limits. Chest X-ray showed a massive shadow in the right lower lung field, adjacent to the chest wall. Computed tomography (CT) showed tumor shadow with low density and invasions into the adjacent chest wall. Histological examination of surgically excised tumor biopsy revealed malignant lymphoma. The patient's condition improved and the size of tumor decreased temporarily by chemotherapy. Then, he began to complain of chest pain and high fever, and tumor in the chest wall invaded into the whole chest wall. He died of disseminated intravascular coagulation despite continuing chemotherapy. Postmortem examination revealed the following findings : the tumor existed mainly in the parietal pleura or the chest wall, adjacent to the lesion of pyothorax, and immunohistochemical examination showed that tumor was malignant lymphoma, diffuse, large B-cell type. Recent studies have shown a close association between EBV infection and pyothorax-associated lymphoma. We have to keep in mind the possible development of malignant lymphoma following tuberculous pyothorax, when we see patients complaining of fever or chest pain with tuberculous pyothorax.

Aged↗
PubMed1996

[Successful surgical repair of atrial septal defect associated with mitral regurgitation and tricuspid regurgitation].

A 63-year-old woman with atrial septal defect, mitral regurgitation, and tricuspid regurgitation underwent mitral valvuloplasty with 30 mm Carpentier ring, patch closure of atrial septal defect and tricuspid annuloplasty with 36 mm Carpentier ring. She was doing well now. In this case, preoperative catheterization showed left-to-right shunt ratio of 32% and right-to-left shunt ratio of 51%. The existence of right-to-left shunt was considered to be related to the grade of tricuspid regurgitation. It is concluded that in these cases, surgical repair should be recommended before the onset of severe progressive heart failure.

Female↗
PubMed1995

Clinicopathologic studies of immunologic fecal occult blood test for colorectal cancer.

In our hospital, 83 patients with colorectal cancer underwent the immunologic fecal occult blood test (IFOBT). The positive rate for IFOBT in all patients was 87%. Colon cancers more proximal than the transverse colon were 100% positive. Carcinomas of the ulcerative type showed a significantly higher positive rate than those of the non-ulcerative type (94% vs 73%). Carcinomas penetrating the muscularis or beyond showed a significantly higher positive rate, of 96% (52/54 cases) compared to carcinomas confined to the mucosa or submucosa, which gave positive rates of 64% and 60%, respectively. In the investigation of the 7 patients with colorectal cancer who showed negative results on the IFOBT, IFOBT had been performed only once in of these patients. Accordingly, it was considered necessary to perform IFOBT more than once. The cancers in 5 of these 7 patients were found to be carcinomas confined to the mucosa. This result suggests the advisability of annual IFOBTs. It is also considered necessary to manage patients who show undefinable but possibly positive (+/-) results with caution.

Carcinoma↗
PubMed1995

Initial clinical experiences with dopamine D2 receptor imaging by means of 2'-iodospiperone and single-photon emission computed tomography.

Dopamine D2 receptor imaging was performed with 123I labeled 2'-iodospiperone (2'-ISP) and single-photon emission computed tomography (SPECT) in 9 patients: 4 with idiopathic Parkinson's disease, 2 with parkinsonism, 1 with Wilson's disease and 2 with pituitary tumor, and the results were compared with the data for 9 normal subjects. Following an intravenous injection of 123I-2'-ISP, early (within 30 min) and late (between 2 and 4 hr) SPECT images were obtained by means of a multi-detector SPECT scanner or a rotating gamma camera. In normal subjects, early SPECT images demonstrated uniform distribution of radioactivity in the cerebral gray matter and cerebellum reflecting regional cerebral blood flow, whereas late SPECT images showed high radioactivity only in the basal ganglia. All the patients with Parkinson's disease also demonstrated symmetrical basal ganglia uptake in the late SPECT images, but it was diminished in parkinsonism and Wilson's disease. One patient with a growth hormone-producing pituitary tumor had a positive uptake in the tumor. These preliminary clinical data demonstrated that 2'-ISP can be used for SPECT imaging of D2 dopamine receptors and may be of clinical value for the diagnosis and planning of the treatment of neurological diseases.

Adenoma↗
PubMed1995

[125I]iomazenil binding in the brains of spontaneously epileptic rats: an ex vivo quantitative autoradiographic study.

Central benzodiazepine receptor binding was studied in spontaneously epileptic rats (SER) and in their parent strain. Kyoto-Wistar (KW) rats, by ex vivo quantitative autoradiography with [125I]iomazenil. Thirteen-week-old SER developed tonic and absence-like seizures following mild stimulation by tapping at 5 min before injection of the radioligand. When compared with age-matched KW rats, a significant 76% elevation of radioactivity was observed in the SER hippocampus, while there was no difference in hippocampal blood flow obtained using [125I]N-isopropyl-p-iodoamphetamine. Since benzodiazepine receptors act to enhance inhibitory GABA transmission, this finding suggests a possible mechanism for seizure-induced enhancement of inhibition.

Animals↗
PubMed1995

Application of [125I] (S)-5-iodonicotine, a new radioiodinated ligand, in the assay of nicotinic acetylcholine receptor binding in the brain.

[125I](S)-5-Iodonicotine was prepared and its application in the assay of nicotinic acetylcholine receptor binding in the brain was studied. [125I](S)-5-Iodonicotine bound to the rat cortical membrane with high affinity (Kd, 15.0 nm). Various nicotinic cholinergic compounds showed competition with [125I](S)-5-iodonicotine for the binding sites in the rats cortical membrane, and the specificity of its binding was correlated well with that of [H3] cytisine (r = 0.98). These findings suggest that [125I](S)-5-iodonicotine binds to the same sites as [H3] cytisine and indicate that [125I](S)-5-iodonicotine can be applied as a brain nicotine receptor binding assay.

Alkaloids↗
PubMed1995

Augmentation of thyrotropin-induced iodide uptake in FRTL-5 cells by immunoglobulins containing blocking thyrotropin-receptor antibodies under NaCl-depleted conditions.

We have found recently that Graves' immunoglobulins (Igs) are more active under NaCl-free conditions to increase iodide uptake in FRTL-5 thyroid cells. The present study was designed to examine the effect of blocking-type thyrotropin (TSH)-receptor antibodies (TR-abs) in the same assay. FRTL-5 cells were incubated with crude Ig fractions from 13 patients with primary hypothyroidism having blocking TR-abs and 100 mU/l bovine TSH in NaCl-free Hanks' balanced salt solution (HBSS) supplemented with 274 mmol/l sucrose (HBSS(-)-sucrose) to keep isotonicity for 3 days, followed by the determination of 60 min of 125I uptake in the cells. Thyrotropin alone increased the uptake to 3.3- to 5.2-fold of the basal. When the highest concentration (250 ml serum equivalent (eq.)/l) of the Ig was used, the TSH-stimulated 125I uptake was decreased to 0-42% in 11 of the 13 cases. When the lower concentrations (0.4-50 ml serum eq./l) were used, however, 125I uptake was enhanced (1.4- to 11.4-fold) unexpectedly in all 13 cases. Such an enhancement was specific to blocking TR-abs, because the effect was duplicated by the purified IgG but not by Igs from 10 healthy control subjects or from three TR-ab-negative hypothyroid patients. When Graves' Igs, instead of TSH, were used as a stimulator, the similar stimulatory effect of the Ig with blocking activity was observed on the 125I uptake induced by three Graves' Igs but not on the response to one Graves' Ig. These Igs alone displayed no stimulating activity. When isotonic 5H medium was used instead of HBSS(-)-sucrose, effects of these 13 Igs were only inhibitory on the TSH-stimulated 125I uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Aortic valve replacement for rheumatoid aortic valve regurgitation].

Valve replacement for aortic regurgitation in patient with rheumatoid arthritis was rare in Japan. We report a successful case in which aortic regurgitation necessitated aortic valve replacement. A 62-year-old woman was admitted for shortness of breath, chest pain and progressive edema. She had been treated for rheumatoid arthritis for more than ten years using steroids. The aortic valve was successfully replaced by a prosthetic mechanical valve. The histopathological examination of the excised aortic valve demonstrated rheumatic nodules in the right- and non-coronary cusp. It was supported that these changes caused shrinkage of cusp and resulted in aortic regurgitation. This patient was discharged on the 20th postoperative day. There was no evidence of detachment of the prosthetic valve.

Anti-Bacterial Agents↗
PubMed1995

[A successful case of ischemic cardiomyopathy associated with left ventricular aneurysm and mitral regurgitation].

A 67-year-old female patient underwent a left ventricular aneurysmectomy and mitral valve replacement for ischemic cardiomyopathy. The replacement was done through left ventricle rather than left atrium. She had heart failure of NYHA class IV despite aggressive medical therapy. Preoperative examination revealed a left ventricular aneurysm and mitral regurgitation of grade II with markedly reduced ventricular function (LVEF 17%). Mitral valve replacement through left ventricle preserving chorda of the mitral valve is a promising method to eliminate regurgitation and shorten the cardiac ischemic time.

Aged↗
PubMed1995

[Treatment of acute type A aortic dissection with onset of the right coronary insufficiency].

This is a case report of the successful treatment for acute type A aortic dissection with onset of the right coronary artery (RCA) obstruction due to compression of the dissected lumen. A 50-year-old man, who had been received medical therapy for hypertension for seven years, was admitted with profound cardiogenic shock. The ECG demonstrated complete A-V block and acute myocardial infarction (AMI) of right ventricle and inferior wall. Coronary catheter intervention was scheduled because intra-aortic balloon pumping was not effective, and arteriogram revealed aortic dissection, coronary insufficiency and aortic regurgitation (grade I). Soon after inflation of a perfusion catheter at the origin of RCA, elevation of arterial blood pressure and recovery to sinus rhythm were brought successfully by the coronary reperefusion. Replacement of the ascending aorta involving the intimal tear without surgical closure of RCA ostium, aortic valve resuspension and coronary artery bypass grafting with saphenous vein to RCA were performed 11 hours after the onset, and the postoperative course was uneventful. Although aortic dissection with onset of AMI was uncommon, it is suspected that the generalizing of catheter intervention for AMI increases awareness of such cases and it is emphasised that the application of perfusion catheter as an emergency procedure for the illness like this case is useful to preserve hemodinamic stability until the surgical treatment.

Aortic Dissection↗
PubMed1995

SPECT imaging of dopamine D2 receptors with 2'-iodospiperone.

UNLABELLED: SPECT imaging of dopamine D2 receptors was performed using 123I-labeled 2'-iodospiperone (2'-ISP). METHODS: Iodine-123-2'-ISP was administered to 12 normal subjects. Serial SPECT scans were obtained in six normal subjects for kinetic studies and static SPECT images were obtained in four normal subjects. Two additional normal subjects had serial whole-body imaging to calculate radiation dosimetry. RESULTS: Serial SPECT scans demonstrated rapid initial brain uptake followed by gradual washout from the cerebral cortex and cerebellum, while the activity in the basal ganglia was stable for 2 hr and gradually decreased thereafter. There was fast clearance of blood activity with rapid conversion of 2'-ISP to the hydrophilic metabolites. The basal ganglia-to-frontal cortex ratio increased with time and plateaued between 2 and 4 hr postinjection. The basal ganglia-to-frontal cortex ratio obtained during this period demonstrated an age-dependent decrease similar to other D2 ligands. CONCLUSION: 2'-ISP can be used for mapping dopamine D2 receptors in human brain with SPECT. The relatively high background activity, however, suggests that further modification of the compound may be needed prior to widespread clinical use.

Adult↗
PubMed1995

[A case of mitral regurgitation due to partial papillary muscle rupture whose etiology was unknown].

The etiology of the papillary muscle rupture includes myocardial infarction, trauma, hypertension, myxomatous degeneration, endocarditis etc. We report a case of partial papillary muscle rupture whose etiology was unknown, in a 77-year-old woman. The preoperative catheterization and coronary angiography showed severe mitral regurgitation and no significant coronary stenosis. And we recognized the mass waving into the left atrium in systole with the echocardiogram. At surgery, we repaired the mitral valve by resecting quadrangular areas of the posterior leaflet including the attachment of the torn papillary muscle. Additionally a number 28 Carpentier-Edwards mitral annuloplasty ring was sewn in place. In pathologic specimen, there were focal fibrosis, necrotic muscle, lymphocytes, and no vegetation.

Aged↗
PubMed1995

[Effects of carbon monoxide produced during laparoscopic surgery].

One of the complications of laparoscopic surgery is carbon monoxide (CO) production under the use of electro-cautery. We studied 11 patients undergoing laparoscopic urological surgery. The concentrations of CO in peritoneal cavity and carboxyhemoglobin (HbCO) in arterial blood were measured before the operation under laparoscopy, during the use of electro-cautery and after the operation. The concentration of CO in peritoneal cavity reached 78 ppm during the use of electro-cautery but the HbCO level was unchanged. In the study on laparoscopic cholecystectomy (LC) performed previously, we had found no change of HbCO. The increase of CO on LC was more pronounced than in the present study. The concentration of CO in peritoneal cavity might be more dependent on the intensive use of electro-cautery than on operation time. Additionally the frequency of the insertion and extraction of the instruments through the trocar could have influenced it. CO could also be produced in the carbon dioxide cylinder. It should be investigated since it might contaminate the operating room.

Adult↗
PubMed1994

Glycation of human beta 2-microglobulin in patients with hemodialysis-associated amyloidosis: identification of the glycated sites.

beta 2-Microglobulin (beta 2M) is a major component forming amyloid deposits in patients with hemodialysis-associated amyloidosis (HAA), a serious complication of long-term hemodialysis. Recently, we demonstrated that beta 2M modified with the Maillard reaction is a definite constituent of amyloid deposits in patients with HAA. Our further study demonstrated that this modified beta 2M induces not only chemotaxis of monocytes but also secretion of tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 from macrophages, suggesting the potential link of glycation of beta 2M by the Maillard reaction to the pathogenesis of HAA. The present study was undertaken to identify the glycated site(s) of beta 2M purified from long-term hemodialysis patients as well as beta 2M incubated with glucose in vitro. Borotritide-treated beta 2M was cleaved by endoproteinase Lys-C, and peptides were isolated by reverse-phase high-performance liquid chromatography, followed by amino acid sequence analysis and fast atom bombardment mass spectrometry to identify the glycated site. The glycated sites of beta 2M formed in vivo were found to be almost the same as those of glycated beta 2M in vitro. The primary glycated site was the alpha-amino group of the amino terminal isoleucine. Other minor sites were the epsilon-amino groups of Lys-19, -41, -48, -58, -91, and -94. Computer graphics of the three-dimensional structure of beta 2M suggested that the high specificity for the glycated site at Ile-1 may be explained by its high solvent accessibility and the nearby imidazole group of His-31 as an acid-base catalyst of the Amadori rearrangement.

Adult↗