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Biomedical subjects

Y Inagaki

Publications and source records attributed to Y Inagaki.

At least 325 records · Page 18Linked to original sources

Rearranged automated keratometer for newborn infants and patients in the supine position.

To measure corneal curvature in newborn infants and patients in the supine position, we rearranged an automated keratometer, dividing it into two parts, the power unit and the measuring system. The measuring unit was mounted on a universal stand. We observed no difference in measured value between the sitting and supine positions and no difference in maneuverability. We also examined the effect of a speculum in normal adult subjects in the supine position, in which both the strong and the weak radii and the axis of astigmatism were slightly affected. However, there was no significant difference in the mean values of the strong and weak radii of corneal curvature in 22 eyes of infants with corrected gestational ages of 37 to 43 weeks. The examination was carried out with ease. The mean value of corneal curvature was 7.05 mm and the range was 6.63 to 7.74 mm.

Adult↗

Malignant melanoma and extramammary Paget's disease in the same patient.

Axillary Paget's disease was found in a 34-year-old man who died of metastatic malignant melanoma. The primary cutaneous malignant melanoma was diagnosed 6 years before the patient's demise and was confirmed by the presence of melanin, a positive dopa reaction, and immunohistochemical demonstration of S-100 protein in neoplastic cells. Postmortem examination revealed Paget's disease of the axillary skin in addition to widespread metastases of malignant melanoma. Paget cells were positive for periodic acid-Schiff reaction and alcian blue. They were also immunohistochemically positive for carcinoembryonic antigen, but were negative for S-100 protein. This association of malignant melanoma and Paget's disease in the same person has not, to the best of our knowledge, been described before.

Adult↗

Advance of cardiac computed tomography--functional evaluation of the cardiovascular system.

The validity of X-ray CT in the functional diagnosis of several cardiovascular diseases was evaluated. CT was useful for assessing the amount and the characteristics of intrapericardial fluid, and it was also useful for the diagnosis of cardiac tamponade and constrictive pericarditis. A dynamic scan was found to be useful for determining the location, direction and the magnitude of intracardiac shunts, and for differentiating the true lumen from the false lumen in dissecting aortic aneurysms. As direct evidence of myocardial infarction, a filling defect in the infarcted area and late enhancement of the same area on delayed scan were noted. Regional wall motion abnormalities could be demonstrated by ECG gated CT, and other findings such as myocardial thinning, ventricular aneurysm and mural thrombi in the infarcted area were documented.

Aortic Aneurysm↗

Lactic acidosis and hypoglycemia associated with acute leukemia.

A 42-year-old man was admitted because of episodic attack of general malaise. He was lethargic and had a severe lactic acidosis and hypoglycemia. Blood chemistry and endocrinological data were normal. Glucose administration led to an improvement in the hypoglycemia but not the lactic acidosis. At autopsy, there was a massive infiltration of leukemic cells in both kidneys and in liver. Phosphoenolpyruvate carboxykinase, pyruvate carboxylase and glucose-6-phosphatase activities in patient's liver were much the same as in the control liver, but fructose-1, 6-diphosphatase activity was slightly reduced. Since circulatory failure was absent, type B lactic acidosis has to be considered. Since hypoglycemia was associated with acidosis, the severe lactic acidosis in our patient may have been due to an overproduction of lactic acid as well as to an impaired hepatic gluconeogenesis in the presence of leukemic cells.

Acidosis↗

[Magnetic resonance imaging of cardiovascular thrombi].

Magnetic resonance imaging (MRI) was performed for 10 patients with cardiovascular thrombi using a 0.1-Tesla resistive type apparatus (ASAHI MARK-J). In all cases thrombi were clearly imaged by NMR and their shapes closely resembled those imaged by X-ray CT. Mural thrombi located within left ventricular aneurysms of two patients with old anteroseptal myocardial infarction were semilunar in form. A mural thrombus in the right ventricle of a patient with cardiovascular Behcet's disease was also clearly imaged. Mural thrombi within the enlarged left atrium of two patients with mitral valve stenosis and insufficiency were clearly demonstrated in both cross- and longitudinal sections. In three patients with thoracic aortic aneurysm, mural thrombi were recognized within the local dilatations of the aorta. In two patients with dissecting aortic aneurysm, mural thrombi were visualized within false lumen using MRI. Mean T1 values and standard deviations for the left ventricular cavity, the left ventricular wall, and the thrombi were 639 +/- 49, 349 +/- 17 and 316 +/- 84 msec, respectively. Mean T1 values of the thrombi were usually shorter than those of the left ventricular wall. Some supposedly fresh thrombi had longer T1 values, however.

Adult↗

[Magnetic resonance imaging of cardiovascular diseases: advantages of coronal and sagittal planes].

The usefulness of coronal and sagittal sections of the cardiovascular system by magnetic resonance imaging was evaluated. Coronal, sagittal and transverse spin echo scans using ECG-non-gating and gating during systole and diastole were performed for five normal volunteers, 91 with heart diseases (25 valvular disease, 28 ischemic heart disease, 14 cardiomyopathies, 14 congenital malformations, four pericardial diseases, and six others) and 32 patients with aortic abnormalities (17 aneurysms, 10 dissections and five others) using a 2.5 KGauss unit. Cardiac gating necessitated six to eight min per scan, but it was mandatory to obtain clear images of the details. On the other hand, in most of the aortic abnormalities, diagnostic images were obtained by the ECG-non-gating technique which required only about 2.5 min per scan. Coronal and sagittal sections were useful for estimating the entire shape and size of each cardiac chamber and intracardiac thrombi, the extent of postinfarctional wall thinning and cardiac aneurysms, and hypertrophy or narrowing of both the ventricular outflow tracts and apex. These planes were particularly useful, and more contributory than transverse planes for detecting inferior myocardial damage such as infarction. A few coronal and sagittal scans were sufficient to diagnose extensive lesions of the aorta, such as atherosclerosis, dissections and the aortitis syndrome. Local lesions such as coarctation, supravalvular aortic stenosis, annulo-aortic ectasia and aneurysm, especially those originating in the inferior wall of the aortic arch were easily discovered. Since the main arteries, such as the innominate, left common carotid, left subclavian and renal arteries, were clearly demonstrated by coronal images, coronal scans were considered more useful than transverse ones for observing the relationship between these arteries and dissections or aneurysms of the arch and of the abdominal aorta.

Coronary Disease↗

[A case of pentalogy of Fallot with numerous collaterals evaluated by magnetic resonance imaging: a report of an adult case].

In this report, the diagnostic value of magnetic resonance imaging (MRI) was compared with that of two-dimensional echocardiography, computed tomography and cardiac catheterization in a patient with pentalogy of Fallot who survived to her fortieth year. The advantages and disadvantages of MRI in diagnosing the present case were as follows: The cardiovascular system, with the exception of atrial septal defect, was evaluated precisely. Collateral vessels were detected using MRI, but impossible with other non-invasive methods. MRI was particularly suitable for imaging the cardiovascular system because of the high contrast between the lower intensity signal of the blood and higher intensity signal of the myocardium and blood vessel walls. Using MRI, data acquisition time was 1.5 min per section. Gated MRI required more time for data acquisition. However, various oblique tomographic projections and very clear static images could be obtained using gated MRI. MRI should be one of the best diagnostic techniques for diagnosing congenital heart disease.

Adult↗

[Positron computed tomography for myocardial uptake of N-13 ammonia in patients with hypertrophic cardiomyopathy: a preliminary study].

In the present study, positron computed tomography (PCT) was used to evaluate the myocardial uptake of N-13 ammonia in patients with hypertrophic cardiomyopathy (HCM). Eight subjects including two normal persons, four patients with HCM, and two with old myocardial infarction (OMI) were selected for the study. N-13 ammonia was administered intravenously as a bolus and, commencing with the tracer injection, serial 30-second PCT scans were performed. The results were summarized as follows: The first scan exhibiting cardiac blood pool images revealed a reduced left ventricular cavity in the HCM subjects. After clearance of N-13 from the cardiopulmonary vasculature, the left ventricular myocardium was clearly visualized and an increased myocardial mass with characteristic morphology was demonstrated in the HCM subjects. Detailed analysis of the time-activity curves of the blood pool and myocardium derived from these serial scan images disclosed two uptake phases in the uptake mode of N-13 ammonia. In the initial phase within three minutes, the myocardial uptake of N-13 was rapid in the normal and OMI subjects, whereas its significant delay was observed in the HCM subjects. This may reflect an abnormal initial extraction of N-13 ammonia in the HCM patients compared with the other subjects. Subsequently, in the second phase, which was characterized by a gradual increase of N-13 in the myocardium, the HCM subjects revealed higher uptake ratios than did the others. This may indicate an increased extraction of metabolites of N-13 ammonia during the second phase. These preliminary results underscore the usefulness of dynamic PCT with N-13 ammonia for the assessment of HCM.

Adult↗

[Do giant negative T waves represent apical hypertrophic cardiomyopathy? Left ventriculographic and cardiac biopsy studies].

Whether giant negative T waves (GNT) of 1 mV or greater represent the electrocardiographic characteristics of idiopathic cardiomyopathy, particularly apical hypertrophic cardiomyopathy, is controversial. To clarify this point, a comparative study was conducted for 57 persons with GNT (GNT+ group) and 57 persons of hypertrophic cardiomyopathy with either asymmetric septal hypertrophy or diffuse hypertrophy of the ventricular wall in the absence of GNT (GNT- group). Patients with cerebral vascular accidents, myocardial infarctions, valvular heart disease, myopericarditis, and implanted pacemakers were excluded from the study because these patients' ECGs may show GNT. Left ventriculograms were investigated at end-diastole in the right anterior oblique projection. The GNT+ group showed a spade-like configuration indicating a marked reduction in the lumen of the apical cavity in 25 cases (43.9%); a kidney or banana-like configuration indicating the inferior wall bulging into the left ventricular cavity in its mid-zone in eight cases (14.0%), and an oval configuration which indicated no deformity of the left ventricular cavity in 24 (42.1%). The spade-like configuration was also seen in four cases (7.0%) of the GNT- group. A study of ventricular wall thicknesses based on left ventriculography showed that 25.5% of cases with GNT did not have concomitant apical hypertrophy. Generally, the GNT+ group cases had a significantly thicker anterior left ventricular wall and apical hypertrophy compared to the GNT- group. The hypertrophic states of the apical wall and anterior wall of the left ventricle correlated well. The GNT+ group included a significantly larger percentage of patients who were middle aged and older than did the GNT- group, and the frequency of accompanying hypertension was significantly higher in the former. The confirmed or suspected familial occurrence of cardiomyopathy (CM) was observed in 32 cases (56.1%) of the GNT- group, and in 18 cases (31.6%) of the GNT+ group, i.e., the incidence was significantly lower in the GNT+ group. In an endomyocardial biopsy study, 40 cases (70.1%) of HCM without GNT had bizarre myocardial hypertrophy with disorganization (BMHD). The incidence of BMHD in the GNT+ group was 21/57 (36.8%)-significantly lower than in the GNT- group. In the GNT- group, there was no significant difference in the incidence of BMHD between relatively young and old patients or between patients with and without accompanying hypertension; whereas, in the GNT+ group, it was significantly lower among those with accompanying hypertension and in older patients than in those without accompanying hypertension and in younger patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

The usefulness of x-ray computed tomography for the diagnosis of myocardial infarction.

Conventional and enhanced computed tomographic (CT) examinations were performed in 103 patients with myocardial infarction for evaluation of the diagnostic usefulness of CT. After intravenous bolus injection of contrast material, an initial filling defect and late enhancement of the infarcted myocardium appeared on the cardiac CT images. These two findings were direct evidence of myocardial infarction; the former was found mostly in the patient with recent myocardial infarctions, and the latter was recognized both in those with recent and those with "remote" infarctions. Wall thinning at the site of infarction was found by enhanced CT mostly in patients with anteroseptal or extensive anterior infarctions, and was rarely found in patients with inferoposterior infarctions. Left ventricular aneurysms and ventricular thrombi were found by enhanced CT in 39 and 23 of the 103 subjects, respectively, and the sensitivity of CT in detecting intracardiac thrombi was higher than that of two-dimensional echocardiography. Calcification of the myocardium and pericardial effusion associated with myocardial infarction were also detected by conventional nonenhanced CT. Thus, cardiac CT was found to be a useful test in evaluating patients with myocardial infarction.

Adult↗