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Biomedical subjects

Y Iino

Publications and source records attributed to Y Iino.

At least 37 records · Page 2Linked to original sources

Intraoperative assessment of coronary artery bypass graft: transit-time flowmetry versus angiography.

BACKGROUND: Transit-time flowmetry has been used to assess graft status intraoperatively. This study examines the validity of this method by comparing its results with the findings of simultaneously performed graft angiography. METHODS: The left internal thoracic artery (LITA) anastomosed to the left anterior descending artery (LAD) was assessed intraoperatively with both transit-time flowmetry and graft angiography in 30 patients. The patients were stratified into two groups based on intraoperative angiographic findings. In 18 patients (group A), the LITA and the LAD were well filled with contrast medium and the anastomosis was widely patent. In the other 12 patients (group B), spastic LITA or LAD was observed. Postoperative angiography was also performed before discharge from the hospital. RESULTS: The mean graft flow was 44.0 +/- 25.4 mL/min in group A and 23.4 +/- 10.0 mL/min in group B (p = 0.0129). Diastolic-dominant flow pattern was observed in both groups, and the ratio of peak diastolic flow to peak systolic flow and the percent diastolic time-flow integral were not statistically different between the groups. The pulsatility index was almost the same between the two groups and was acceptable in both. Postoperative angiography revealed that all grafts were patent without spasm or anastomotic stenosis. CONCLUSIONS: LITA graft status is satisfactory when high graft flow with diastolic dominance is obtained. When there is vasospasm but no anastomotic problems, decreased graft flow with an acceptable pulsatility index and diastolic augmentation is observed.

Angiography↗

Metastasis of cervical esophageal carcinoma to the temporal bone--a study of the temporal bone histology.

A 49-year-old male developed left abducens nerve palsy as a result of metastatic spread of carcinoma of the cervical esophagus to Rouviere's node and infiltration of the petrous portion of the left temporal bone. Postmortem temporal bone histology revealed that cancer cells had invaded the greater superficial petrosal nerve (GPN), lesser superficial petrosal nerve, tensor tympani muscle (TTM) and the skin covering the anterior wall of the left external auditory meatus. These findings suggest that the carcinoma metastasized from the cervical esophagus to Rouviere's node and directly invaded the middle cranial fossa and then the temporal bone, and further infiltrated the middle ear via perineural invasion.

Carcinoma, Squamous Cell↗

Eosinophils are activated in middle ear mucosa and middle ear effusion of patients with intractable otitis media associated with bronchial asthma.

BACKGROUND: Although patients with intractable otitis media associated with bronchial asthma have extensive accumulation of eosinophils in the middle ear mucosa and middle ear effusion, systematic histological and immunohistochemical studies have not been performed. OBJECTIVES: To clarify the pathogenesis of middle ear diseases, we carried out immunohistochemical studies on middle ear specimens, particularly focusing on the characteristics of accumulated eosinophils. METHODS: Middle ear specimens obtained from eight adult patients and from 17 controls were immunohistochemically stained using monoclonal antibodies against EG1, EG2, mast cell tryptase, IgA and IgE. The concentration of eosinophil cationic protein (ECP) in middle ear effusion samples was also measured. RESULTS: In the asthmatic patients, severe round-cell infiltration was observed in the submucosa and most of the EG1-positive cells were also EG2-positive. In the control patients, the mucosa showed a fibrotic change with a few inflammatory cells, and EG1- or EG2-positive cells were quite few. The expression of IgE was found not only on the surface of mast cells but also within the plasma cells in the asthmatic patients, and the number of IgE-positive cells was about twice as high as that of mast cells. A significantly higher concentration of ECP was noted in middle ear effusion obtained from the asthmatic patients than that from the control patients. CONCLUSION: Most of the eosinophils in the middle ear mucosa and middle ear effusion were activated, resulting in degranulation and release of ECP, and local IgE production occurs in the middle ear mucosa, indicating that the intractable inflammation is closely associated with IgE-mediated late phase response with eosinophil accumulation.

Adult↗

Counteracting regulation of chromatin remodeling at a fission yeast cAMP response element-related recombination hotspot by stress-activated protein kinase, cAMP-dependent kinase and meiosis regulators.

In fission yeast, an ATF/CREB-family transcription factor Atf1-Pcr1 plays important roles in the activation of early meiotic processes via the stress-activated protein kinase (SAPK) and the cAMP-dependent protein kinase (PKA) pathways. In addition, Atf1-Pcr1 binds to a cAMP responsive element (CRE)-like sequence at the site of the ade6-M26 mutation, which results in local enhancement of meiotic recombination and chromatin remodeling. Here we studied the roles of meiosis-inducing signal transduction pathways in M26 chromatin remodeling. Chromatin analysis revealed that persistent activation of PKA in meiosis inhibited M26 chromatin remodeling, suggesting that the PKA pathway represses M26 chromatin remodeling. The SAPK pathway activated M26 chromatin remodeling, since mutants lacking a component of this pathway, the Wis1 or Spc1/Sty1 kinases, had no M26 chromatin remodeling. M26 chromatin remodeling also required the meiosis regulators Mei2 and Mei3 but not the subsequently acting regulators Sme2 and Mei4, suggesting that induction of M26 chromatin remodeling needs meiosis-inducing signals before premeiotic DNA replication. Similar meiotic chromatin remodeling occurred meiotically around natural M26 heptamer sequences. These results demonstrate the coordinated action of genetic and physiological factors required to remodel chromatin in preparation for high levels of meiotic recombination and eukaryotic cellular differentiation.

Cell Differentiation↗

Effect of macrolides on the expression of HLA-DR and costimulatory molecules on antigen-presenting cells in nasal polyps.

To clarify the basis of macrolide therapy for improvement of chronic sinusitis, we investigated the effect of macrolides on the expression of HLA-DR and costimulatory molecules such as CD54 and CD80 on macrophages in nasal polyps. Nasal polyps taken from 54 patients who had or had not been treated with macrolides were immunohistochemically studied. The percentages of CD68-positive macrophages expressing HLA-DR or CD54 were not significantly different between patients treated with macrolides and those not treated with macrolides. However, among patients exhibiting no atopic predisposition, the number of CD80-positive macrophages was higher in patients treated with macrolides than in those not treated. In addition, the percentage of CD80-positive macrophages was negatively correlated with the percentage of infiltrating eosinophils in the polyps. These results demonstrate that macrophages act as antigen-presenting cells, expressing both major histocompatibility complex II and costimulators, and that the expression of CD80 may play a key role in the immune responses occurring in a nasal polyp. Macrolides may modulate the mucosal immune responses through CD80 expression.

Adolescent↗

Plasticity of chemotaxis revealed by paired presentation of a chemoattractant and starvation in the nematode Caenorhabditis elegans.

While the basic functioning of the nervous system of Caenorhabditis elegans has been extensively studied, its behavioural plasticities have not been fully explored because of the limited availability of assay systems. We report here a simple form of chemotaxis plasticity in this organism: when worms are starved on plates that contain NaCl, their chemotaxis towards NaCl falls dramatically. This conditioning requires both the presence of NaCl and the absence of a bacterial food source, indicating that it is not merely adaptation or habituation, but that it is likely to be a form of associative learning. While chemotaxis towards volatile chemoattractants does not change significantly after conditioning with NaCl, chemotaxis towards other water-soluble attractants does decrease. This suggests that an altered response of a cell or a group of cells specifically involved in chemotaxis towards water-soluble chemoattractants is responsible for the behavioural alteration. The decrease in chemotaxis occurred slowly over 3-4 h of conditioning and returned quickly to the original level when either of the conditioning stimuli, NaCl or starvation, was removed. The application of serotonin partially blocked this reduction in chemotaxis, consistent with the proposed function of this neurotransmitter in food signalling. Using this assay, we have isolated three mutants with reduced plasticity. This assay system expands the opportunities for studying the molecular and cellular mechanisms of behavioural plasticity in C. elegans.

Animals↗

[Surgical results of canal wall reconstruction tympanoplasty in middle ear cholesteatoma].

Materials were 236 ears of 213 patients with middle ear cholesteatoma undergoing canal wall reconstruction during 1993-1998. Subjects were followed up for at least 1 year after final operation. Of 236 ears, 147 (62%) underwent 1-stage operation and 89 ears (38%) required 2-stage operation. Hearing results were successful in 157 ears (67%) based on criteria proposed by the Otological Society of Japan. The success in ears undergoing 1-stage operation was 74% and 54% in ears undergoing 2-stage operation. Postoperative hearing and air-bone gap in the 1-stage group were significantly better than in the 2-stage group. For tympanoplasty, success was 97% in type I, 64% in type III, and 53% in type IV. The likelihood of undergoing 2-stage operation increased with the type of tympanoplasty, from type I to IV. Postoperative hearing was significantly worse in older age groups. Of the 89 ears, 13 (15%) had recurrent cholesteatoma and 29 (33%) had residual cholesteatoma at 2-stage operation. In the 135 in the 1-stage group, recurrent cholesteatoma was observed at follow-up in 13 ears (9.6%). When we analyzed clinical risk factors for both recurrent and residual cholesteatoma in age, gender, otorrhea, types of cholesteatoma, and types of tympanoplasty, no significant factors were seen for recurrent or residual cholesteatoma. These results indicate that canal wall reconstruction tympanoplasty for middle ear cholesteatoma yields relatively good hearing results. However, more effort is needed to reduce the incidence of recurrent and residual cholesteatoma.

Adult↗

Free right internal thoracic artery as a second arterial conduit: modification of proximal anastomosis for improvement of graft patency.

The applicability of the right internal thoracic artery (RITA) for coronary artery bypass grafting is higher when used as a free graft than as a pedicled graft. However, the technical difficulty of directly connecting the proximal end of the free RITA to the much larger aorta leads to poor patency. To overcome this technical limitation, we have used a modification that places the proximal end of this artery onto the hood of an accompanying vein graft at the aortic anastomosis instead of directly onto the aorta. We performed isolated coronary artery bypass grafting on 43 patients using the free RITA as a second arterial graft following pedicled left internal thoracic artery grafting. The mean patient age was 60 years and 38 patients were male. There was no mortality and no incidence of morbidity related to free RITA use. Postoperative coronary angiography performed in all patients revealed that all proximal anastomoses were widely patent, making the patency rate of the free RITA 100%. With these encouraging results, the free RITA graft with the described modification is thought to be a more promising second arterial graft with greater versatility than the pedicled graft. The long-term evaluation of a large patient population will determine the significance of this modification.

Adolescent↗

Hearing results after tympanoplasty in elderly patients with middle ear cholesteatoma.

Many reports about the effect of aging on hearing results after tympanoplasty have been published. However, they have not been evaluated comprehensively, i.e. by taking into consideration other aspects which also affect the outcome. In this study, the effect of aging on hearing results after canal wall reconstruction tympanoplasty was assessed in 236 consecutive ears of 213 patients > 20 years old with middle ear cholesteatoma. The elderly group (n = 34), defined as patients > or = 60 years old, was compared to the younger groups in terms of hearing results of postoperative hearing level, hearing gain, A-B gap and change in bone conduction hearing level at 4000 Hz after adjustment for age, gender, staged operation, preoperative hearing level and type of tympanoplasty, all of which affect hearing results, using the generalized linear regression method. Postoperative hearing level and hearing gain were found to be better amongst patients aged 20-29 and 30-39 years than in the elderly group, whilst A-B gap did not differ between all age categories. Within the elderly group, air conduction hearing level was shown to have improved after surgery. Changes in bone conduction hearing level at 4000 Hz were not significantly different between the age groups, suggesting that operative stress, i.e. mechanical stress or ossicular manipulation stress, does not aggravate sensorineural hearing loss in the elderly. We conclude that surgeons should be encouraged to perform tympanoplasty aimed not only at eradicating the lesion itself but also at improving hearing acuity in the elderly.

Adult↗

Highest microvessel count as a long-term prognostic factor in Japanese breast cancer patients.

The aim of this study was to determine whether microvessel density (MVD) could add useful information in predicting the prognosis of breast cancer patients. In our study, MVD was calculated by counting microvessels per x200 field in the highest neovascularized area of the tumor (highest microvessel count, HMC). HMC significantly increased according to the increased number of positive nodes. Higher HMC significantly correlated with worse relapse-free survival (RFS) of patients with negative node, one to three positive nodes in the axilla or with stage I and II tumors. HMC, however, was not predictive for RFS of patients with four or more positive nodes or with stage III tumors. Multivariate analysis revealed that HMC was second only to nodal status and tumor size as being predictive for RFS. These results suggest that HMC could be used in selection of patients with early-stage breast cancer who are at high risk for having occult metastasis.

Adult↗

The Ras-MAPK pathway is important for olfaction in Caenorhabditis elegans.

The Ras-MAPK (mitogen-activated protein kinase) signal transduction pathway is well known to control cellular proliferation and differentiation in response to extracellular signals, but its other functions are less understood. In Caenorhabditis elegans this pathway regulates several developmental events, such as vulval induction and progression of meiosis, but its function in the nervous system is unknown. Here we report that the Ras-MAPK pathway is involved in olfaction in this organism. Mutational inactivation and hyperactivation of this pathway impairs efficiency of chemotaxis to a set of odorants. Experiments in which let-60 ras was expressed using a heat-shock promoter and a cell-specific promoter show that a normal activity of LET-60 Ras is required in mature olfactory neurons. Application of the odorant isoamylalcohol to wild-type animals leads to the activation of MAP kinase in olfactory neurons within 10 seconds. This induction is dependent on the function of the nucleotide-gated channel TAX-2/TAX-4 and the voltage-activated calcium channel subunit UNC-2. These results suggest a dynamic regulatory role for the Ras-MAPK pathway in perception and transmission of sensory signals in olfactory neurons.

Animals↗

Atypical cystic lobule of the breast: an early stage of low-grade ductal carcinoma in-situ.

The authors describe the characteristics of atypical cystic lobules (ACLs), which represent a step in the formation of low-grade ductal carcinoma in-situ. The authors define ACLs as a proliferation of luminal cells showing low-grade cytological atypia without architectural atypia. ACLs were compared with conventional hyperplasia, low-grade ductal carcinoma in-situ, and lobular neoplasia. 1) In about 40% of the cases, atypical cystic lobules merged with fully established micropapillary/cribriform ductal carcinoma in-situ. 2) Immunohistochemical staining for hormone receptors, keratin nineteen, and cyclin D1 revealed that atypical cystic lobules demonstrate a consistent immunophenotype, which differs from that of normal lobules and benign lesions and matches the one of low-grade ductal carcinoma in-situ. 3) ACLs are sometimes calcified. Osteopontin-positive histiocytes infiltrated all Kossa-positive (type II microcalcification) cribriform and comedo-type carcinomas and ACLs. The similarities in cytological and immunohistochemical features, the close proximity of the two types of proliferation, and the similarities with respect to calcification suggest that atypical cystic lobules represent an early stage in the formation of certain types of low-grade ductal carcinoma in-situ.

Breast↗

Sudden hemorrhage of the breast caused by breast cancer: a case report and review of the literature.

A rare case of sudden hemorrhage caused by breast cancer is reported. A 71-year-old woman noted bleeding from her left breast. Physical examination of the left breast showed a localized open cavity accompanied by bleeding and coagulation. The patient had no history of breast trauma or anticoagulation therapy. Incisional biopsy followed by histological examination resulted in a diagnosis of granulation tissue with no cancer cells present. Mammography and ultrasonography indicated probable breast cancer. As a result, a second incisional biopsy was performed, which suggested invasive ductal carcinoma without histological skin invasion. A modified radical mastectomy was performed under a diagnosis of stage II breast cancer. Breast cancer with sudden hemorrhage is rare. We review the literature and discuss the cause of this unusual manifestation.

Aged↗

Trends of IL-6 and IL-8 levels in patients with recurrent breast cancer: preliminary report.

BACKGROUND: We reported that IL-6 and IL-8 levels at the beginning of treatment are predictive indicators of response to therapy and prognosis of patients with recurrent breast cancer. The aim of this study was to investigate the trend of IL-6 and IL-8 levels in heavily pretreated patients with recurrent breast cancer. METHODS: Cytokine level trends in 12 patients heavily pretreated with anthracyclines were studied. Patients were divided into two groups according to the objective response. There were 5 partial response (PR)/no change (NC), and 7 progressive disease (PD) patients. Blood was taken every four weeks. IL-6 was measured by chemiluminescent enzyme immunoassay. IL-8 was measured by ELISA. RESULTS: The pretreatment level of IL-6 in the PR/NC group (11.0+/-2.1 pg/ml) was significantly lower than that (15.3+/-2.7 pg/ml) in the PD group. However, there was no difference in IL-8 level between the PR/NC group (12.5+/-5.5 pg/ml) and the PD group (11.5+/-1.1 pg/ml). IL-6 levels in the PR/NC group were maintained within normal levels or decreased to within normal levels after treatment, while levels of IL-6 in the PD group gradually increased until the time of patient death. A decrease in IL-8 level after treatment was observed in only one patient in the PR/NC group. Mild increase of IL-8 levels was observed in the PD group. CONCLUSION: Continuous elevation of IL-6 levels indicates poor prognosis in heavily pretreated patients with recurrent breast cancer. Combination therapy including agents that reduce IL-6 levels will be a new strategy for aggressively treating recurrent breast cancer.

Antibiotics, Antineoplastic↗