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Biomedical subjects

Y Inagaki

Publications and source records attributed to Y Inagaki.

At least 253 records · Page 14Linked to original sources
PubMed1990

Coronary artery calcification detected by CT: clinical significance and angiographic correlates.

Cardiac computed tomography (CT) to detect coronary calcification was performed on 161 patients undergoing coronary angiography for proven or suspected coronary artery disease. Among 108 patients in whom coronary calcifications was identified, 90% had significant coronary stenosis angiographically (greater than 75% stenosis), and 80% of 121 patients with significant coronary stenosis showed calcification by CT. The relationship between the calcification site and the significance in stenosis of each vessel was determined. Calcification was present in 133 arteries among 205 stenotic coronary arteries (sensitivity = 65%) as compared with 59 of 439 entire arteries with normal coronary angiograms (specificity = 87%). In the younger age group the sensitivity of calcification for stenosis of each coronary artery was lower and the specificity and predictive value were generally higher than those in the elderly group. These results demonstrate that CT is a valuable procedure for detecting coronary arterial disease, since this examination is easy to conduct, noninvasive, and widely applicable for screening a large population.

Adult↗
PubMed1990

Magnetic resonance imaging of the cardiovascular system: application in function and tissue characterization.

Magnetic resonance imaging (MRI) is a new noninvasive technique for visualization of the cardiovascular system, and is used to evaluate tissue characteristics, cardiac function and blood flow abnormalities, as well as to obtain morphological information. In this paper we presented results of clinical and laboratory research obtained using conventional spin echo MRI with regard to cardiovascular anatomy, tissue characterization and physiology. Furthermore, experience with two new techniques, cine-MRI and volume-selected MR spectroscopy, and their potential clinical usefulness in detecting cardiovascular diseases are documented.

Cardiovascular Diseases↗
PubMed1990

[An assessment of therapeutic effect of hepatocellular carcinoma by the serial changes in serum AFP value].

The therapeutic effect of hepatocellular carcinoma (HCC) was assessed by the serial change of serum AFP value before and after treatment. Subjects were 56 therapies for HCCs in 48 cases, who were diagnosed as inoperative HCCs, and were performed chemotherapy, transcatheter hepatic arterial embolization (TAE) and percutaneous ethanol injection therapy (PEIT). As the indicator of therapeutic effect, the angle (supplement) alpha was used, that was formed by the cross of two lines based on several points of serum AFP value on the hemilogarithm graph before and after treatment respectively. The alpha were distributed from -34 degrees to 118 degrees, and its mean value was 32 +/- 38 degrees (+/-SD). The angle alpha value of cases evaluated as CR or PR was high, and that of PD was low. We could quantitatively assess the effects evaluated as NC by tumor size. The survival curve of group with high alpha value was significantly longer than that of group with low value. It was concluded that this method using angle alpha based on the serial change of serum AFP value was useful for clinical assessment of HCCs treatment.

Aged↗
PubMed1990

Studies of clinically latent cirrhosis.

Nine cases of latent cirrhosis showing normal hepatic functions (eight males and one female with an average age of 49.3 +/- 12.7) were studied clinicopathologically. They accounted for 1.8% of all cirrhotic patients and many of them were positive for HBs antigen and HBe antibody. Of the nine cases, two were complicated by hepatocellular carcinoma. Imaging diagnostic examinations, such as ultrasonography or RI scintigraphy, revealed uneven echo levels and RI distribution in the liver, including both of the two cases associated with hepatocellular carcinoma. Histopathological examination showed inactive or early-stage cirrhosis. These results indicated the importance of non-invasive imaging by abdominal ultrasonography and radioisotope, as screening tests for cirrhosis, especially for middle- and old-aged HBs antigen carriers, even if their liver function tests show normal findings.

Adult↗
PubMed1990

Clinical experience with alumina ceramic transcutaneous connector to prevent skin-exit infection around CAPD catheter.

To prevent skin-exit infection, an important CAPD complication, we developed a transcutaneous connector made of Alumina ceramic. The new connector could be downsized, because an Alumina ceramic is characteristically bio-inert, rigid and non-porous. Our animal experiments with Alumina ceramic in soft tissue demonstrated the outstanding bio-compatibility of this material. The shape of the new transcutaneous connector was of simple cylindrical configuration so as to inhibit macrostress beneath the skin. To make contact with this connector in the body, a silicon tube was made into a Swan-necked catheter with a disk-shaped polyester cuff, which was positioned subcutaneously beneath the transcutaneous connector in order to reinforce adhesion to soft tissue. The silicon tube itself was L-shaped in its outside portion just before reaching the connector. We are now using this new transcutaneous connector made of Alumina ceramic on a CAPD catheter in 8 patients. In the longest case of a patient using it, there has been no skin-exit infection for 12 months. Also, there has been virtually no downgrowth phenomenon in the skin around the connector, and the connector and tissue have remained in very close contact, although fibrous connective tissue has been seen to form in the area.

Aluminum Oxide↗
PubMed1990

[Progression to ischemic heart disease in subjects with coronary calcification as evaluated by computed tomography].

It is well known that coronary artery calcification develops in patients with advanced coronary sclerosis. Currently, it can be easily detected by computed tomography (CT). We studied the correlation of CT-detected coronary calcification with its progression to myocardial infarction, and further with the prognosis in various patients who did not have symptoms suggesting ischemic heart disease. The subjects consisted of 241 patients (136 males, 105 females) with a mean age of 61 years, categorized as a calcified coronary artery group (82 patients) and a non-calcified coronary artery group (159 patients). In all the subjects nonenhanced serial cardiac-CT scans were performed with a GECT/T 9800 for detecting coronary calcification. The mean follow-up period was four years in both groups. Among the 82 patients with coronary calcification, four developed myocardial infarction (4.9%) and 14 patients died (17%). Among the 159 patients without coronary calcification, none progressed to myocardial infarction, but 17 patients died unrelatedly (11%). Although there was no significant difference in mortality between the two groups, there was a statistical significance (p less than 0.005) as to the incidence of progression to myocardial infarction. In males, there was no significant difference (13 vs 12%) in mortality between the two groups, but the calcified group had a higher incidence of progression to myocardial infarction than that of the non-calcified group (5.5 vs 0%). In females, the calcified group had higher mortality (26 vs 8.9%) and a more frequent incidence of myocardial infarction (3.7 vs 0%) than did the non-calcified group. In conclusion, patients with coronary artery calcification are likely to develop coronary artery disease rather rapidly, even though asymptomatic. Therefore, detection of coronary calcification by non-enhanced CT is helpful for estimating the prognosis of coronary artery disease.

Calcinosis↗
PubMed1990

[Echocardiography in patients with malignant metastatic neoplasms of the heart and great vessels].

Two-dimensional echocardiography was used to study malignant metastatic neoplasms of the heart and great vessels in 20 patients, 13 males and seven females, whose ages ranged from 15 to 72 years. Five patients had lung cancer; two each had breast cancer, malignant melanoma, hepatoma and one each had gastric cancer, urinary bladder cancer, adrenocortical carcinoma, malignant lymphoma, angiosarcoma, fibrosarcoma, leiomyosarcoma; and two had cancers with unknown primaries. Tumor invasion was demonstrated echocardiographically in the left atrium in one each with breast cancer, fibrosarcoma and gastric cancer; in the right atrium in two with hepatomas; in the right atrium and right ventricle in one patient with adrenocortical carcinoma; in the left ventricle in one with lung cancer; and in the pulmonary artery in one with malignant melanoma. Massive pericardial effusion was observed in 11 of 20 patients; two with pericardial tumors including malignant lymphoma and lung cancer. We conjectured that metastatic tumors in the right cardiac cavities came through the inferior vena cava, and other tumors in the left atrium, left ventricle and pericardium developed from direct extension of the primary lesions. There was an 80% mortality of the patients during the observation period, and the average survival period after the diagnosis of cardiac metastases was 5.5 months. However, one patient was still living after two years of radiation therapy and chemotherapy. Echocardiography proved a useful, non-invasive means for the detection and follow-up observation of metastatic cardiac tumors.

Adolescent↗
PubMed1990

[Current status and therapeutic strategy for hepatocellular carcinoma].

It is reported that the number of hepatocellular carcinoma (HCC) in Japan is increasing and this is mainly due to the increase of HBsAg negative HCC patients with history of blood transfusion. However 80% of HCC patients are positive for HBV related serum markers. HBV DNA is detected by PCR method in 15% of HBsAg negative HCC patients with other HBV marker. These findings indicated that at least 40% of HCC patients in Japan are closely related to HBV infection. Several hypotheses on the mechanism of carcinogenesis by HBV have been proposed, however none of these has yet to be established. The type C hepatitis virus (HCV) reported by Chiron Co. is thought to be the majority of viruses which cause chronic non A non B hepatitis in Europe, United States and also Japan. The rate of anti-HCV in HBsAg negative HCC patients is about 70% in Japan. As strategies for HCC, the following 3 steps should be established; 1) prophylaxis against infection, 2) prevention of progression of liver cirrhosis, and 3) early detection of HCC. Though the role of hepatitis virus in hepatocarcinogenesis has not yet been established, it is thought that HBV and HCV are responsible for about 85% of HCC patients in terms of the development of liver cirrhosis which frequently associates with HCC. A marked decrease of HCC in Japan is forthcoming through the establishment of prophylaxis against HBV and HCV infection.

Adult↗
PubMed1990

[Portal perfusion defect after percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC)].

Serial changes of intrahepatic portal blood flow were studied before and after percutaneous ethanol injection therapy (PEIT) for hepatocellular carcinoma (HCC). In all eight patients examined, wedge-shaped perfusion defects distal to the tumor were clearly demonstrated by dynamic sequential computed tomography during arterial portography (CT-AP). However, no abnormalities of arterial blood flow were detected in the areas of reduced portal blood flow by enhanced computed tomography (CT), indicating that portal blood flow of the liver was selectively decreased by PEIT. Moreover, histopathological finding of two resected liver tissues after PEIT revealed organized thrombi in the portal veins in the non-cancerous liver tissues distal to the tumors. These findings suggest that decreased segmental portal flow is frequent after PEIT and obstructive vasculitis is caused by the drainage of ethanol injected in the tumor.

Carcinoma, Hepatocellular↗
PubMed1990

[Measurement of myocardial blood flow using N-13 ammonia dynamic PET-theory and methodology].

Positron emission tomography (PET) offers the potential capability of noninvasive measurement of regional myocardial blood flow (RMBF) in man. Because N-13 ammonia exhibits properties which to some extent resemble those of the radioactive microsphere, we developed a first-pass flow method for noninvasive measurement of RMBF. In the present method, RMBF was determined by dividing myocardial activity at time T by arterial input integrated from the injection start to that time, where time T is the endpoint of first circulation of N-13 ammonia. Also in the present method a time-activity curve of left atrium was used as the arterial input function to make the procedure totally noninvasive. To validate the present method, we compared it with the compartment analysis. 5 patients with hypertrophic cardiomyopathy (HCM) and with a considerably thickened ventricular wall, were selected for the comparison between the first-pass flow method and the compartment analysis. The relationship of RMBFs by the two methods was y = 1.8 + 1.097x-0.002037x2 (n = 30, SEE = 5.5), where x (ml/min/100 g) was obtained by the compartment analysis, while y (ml/min/100 g) by the first-pass flow method. The result indicated that both were almost identical in physiological flow range (less than 100 ml/min/100 g), but that the first-pass flow method underestimated RMBF in the higher flow range due to venous leakage of N-13 ammonia. As the conclusion, we could at least measure RMBF of HCM patient in the physiological flow range by the present method. The future extension of the method was discussed.

Ammonia↗
PubMed1990

[PET assessment of myocardial viability with glucose loading and fasting FDG images].

Positron emission tomography (PET) offers the potential capability of evaluating tissue viability. We have studied the changes of myocardial F-18 deoxyglucose (FDG) uptake with glucose loading. In a fasting state (for at least 5 hours) and in a glucose loading state (50 g glucose orally one hour before the study) FDG (74-148 MBq) PET studies were performed for 50-60 minutes in 3 cases. 2 were subjects with anterior myocardial infarction (MI) including one with a ventricular aneurysm (case 1), one with a recent MI (case 2). One was a subject of aortic valvular disease without coronary lesions (case 3). Arterial input function (Ca(t)) and myocardial activity (Cm(t)) were derived from the regions of interest (ROI) on the left atrium and from multiple ROI's circumferentially about the myocardium. Net extraction, FU (Fractional Uptake) = Cm(T)/integral of T0 Ca(t)dt, were calculated. Normal segment (N) showed an increase in FU with glucose loading, but the ischemic segment showed no increase (case 1) or a lower increase (case 2) relative to N. This study shows that the increase in FU with glucose loading suggests the persistence of viable myocardium. In conclusion, myocardial viability may be evaluated by comparing FDG images in a glucose loading state with those in a fasting state.

Adult↗
PubMed1989

[Successful therapy with tegafur and lentinan after TAE for hepatocellular carcinoma--a case report].

A 46-year-old male (performance status 1) with hepatocellular carcinoma (HCC), which diffusely involved the anterior segment of the right lobe, occluded the second portal branch and metastased to the left lobe (stage IV-A), was on combined therapy with TAE of lipiodol (LPD), mitomycin C (MMC) 10 mg and gelatin sponge at the time of angiography on March 16, 1987. Immunochemotherapy with tegafur suppository (Teg sp) 1,000 mg/day and OK432 i.m. was performed for one month after TAE. Instead of OK432, lentinan (LNT) 2 mg in 20% glucose sol. 20 ml i.v./wk was combined with Teg sp 1,000 mg/day from May 13, 1987. Teg sp was reduced to 1,000 mg/2 days from June of the same year, and since then the same therapy of Teg + LNT has been continuing even now. Serum AFP values showing 150 X 10(4) ng/ml at maximum were decreased down to less than 20 ng/ml 13 months after this therapy (total doses: Teg ca. 250 g, LNT 108 mg), remaining still normal. Marked reduction in the size of the lesion (PR) by the therapy has also been proved by the body CT. His PS is now in grade 0. Although in this case the initial steep decline in AFP values was possibly brought about by TAE, the successive antitumor effect indicated by persistent low AFP values may have been mainly due to Teg + LNT. Collection of data on the therapy is needed to clarify this point.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Establishment of a human cell line (HCC-T) from a patient with hepatoma bearing no evidence of hepatitis B or A virus infection.

A human hepatoma cell line, designated HCC-T, was established. The tumor was surgically obtained from a Japanese male patient with hepatocellular carcinoma (HCC) arising in a cirrhotic liver that had supposedly developed from nonAnonB (NANB) chronic hepatitis. HCC-T exhibited a typical morphology of epithelial cells in culture. Population doubling time was 24 hours and HCC-T cells had characteristics of malignant cells demonstrated by the ability to grow in a soft agar medium and transplantability to nude mice. The histologic condition of the tumor transplanted to a nude mouse showed similarity to the original tumor. A chromosome analysis showed that there were ten identifiable marker chromosomes and sex chromosomes with its modal number of 64. Alpha-fetoprotein (AFP) production was demonstrated by direct immunofluorescence study, but albumin or hepatitis B surface antigen were not detectable. The integration of hepatitis B viral DNA was not demonstrable in the genome of HCC-T cells or the original hepatoma.

Aged↗
PubMed1989

[A case with hepatocellular carcinoma with complete remission due to gamma-IFN therapy].

A 65-year-old male was admitted to our hospital with the aim of closer examination of SOL in cirrhotic liver. By abdominal echography, CT and angiography etc., he was diagnosed as LC with multiple HCC, one in S5 about 2.0 cm, another in S1 about 5.0 cm in diameter, and other four small nodules in right lobe. We treated him with recombinant gamma-IFN at dose of 1.6 X 10(7) units/day for 5 consecutive days biweekly. Although until two months the tumours were gradually enlarged in size, then they became smaller, and at five months later after the beginning of gamma-IFN therapy the tumor stains in angiogram disappeared. Then we performed the surgical treatment. Both macro and microscopical findings of tumor specimens in S5, 2. 2 X 2.0 X 1.9 cm in size, showed complete necrotic tissue. Additionally the yellowish small tumor was found on surface of S8, and it was adenomatous hyperplasia histologically.

Carcinoma, Hepatocellular↗
PubMed1989

Putative precursors of endothelin have less vasoconstrictor activity in vitro but a potent pressor effect in vivo.

Endothelin (ET-21) induced a sustained contraction of rat thoracic aortae (EC50 = 2.65 x 10(-10) M) in vitro, and caused a potent pressor effect in vivo after intravenous administration to rats. In contrast, the precursor deduced from porcine cDNA coding ET-21 (pET-39) had 100-fold less contractile activity in vitro (EC50 = 3.26 x 10(-8) M), and so did the precursor from human cDNA (hET-38) (EC50 = 1.48 x 10(-8) M). However, both pET-39 and hET-38 caused almost the same dose-dependent pressor effects as ET-21 in vivo. After intravenous bolus injection at 1 nmol/kg, ET-21 caused an initial transient drop of the arterial pressure, and then induced a gradual pressor effect. On the other hand, hET-38 caused only a gradual rise of the arterial pressure. There may be different mechanism(s) for ET-21 and hET-38 which induce changes in the arterial pressure in vivo.

Angiotensin II↗
PubMed1989

The effect of nitroglycerin ointment on exercise-induced angina: a multicenter trial.

The efficacy of nitroglycerin ointment was determined by treadmill exercise testing through a randomized, double-blind crossover trial with placebo in 22 patients with chronic stable exertional angina. On different days, 3 cm of nitroglycerin ointment (NGO, 18 mg) and placebo ointment were applied over the epigastric region, followed by the exercise test 1 hour later. The maximal exercise time was 459 +/- 124 seconds after application of placebo and 510 +/- 113 seconds after application of NGO, and the exercise time to 1 mm of ST-segment depression was significantly extended to 297 +/- 110 seconds after placebo and 366 +/- 134 seconds after NGO (p less than 0.01, p less than 0.001, respectively). ST-segment depression at the endpoint of exercise was significantly reduced from 2.4 +/- 1.2 mm to 1.5 +/- 0.7 mm after application of NGO (p less than 0.01). There was no difference in rate-pressure product at the endpoint of exercise between placebo and NGO. Adverse reactions were elicited in 5 of 22 patients. The results of this present study suggest that NGO is effective in the treatment of exertional angina.

Aged↗