Biomedical subjects
Publications and source records attributed to Y Inoue.
Organically-bound 3H (OBT) concentrations in unhulled rice samples harvested between 1979 to 1991 are reported. The sample reaped in 1979 had the highest OBT concentration. OBT concentrations in the samples yielded recently have been at approximately 1 Bq (L-combustion water)-1 or less.
Two types of recombinant human granulocyte colony-stimulating factor (rhG-CSF) are available, and equally used for mitigation of neutropenia. One is a glycosylated natural product from mammalian cells, and the other a non-glycosylated form from Escherichia coli. Though only minimal adverse effects have been reported for both, we treated two patients with rhG-CSF-induced systemic eruption. Based on these patients, the following should be noted: 1) drug eruption may occur in both types of rhG-CSF without detectable antibodies, 2) intradermal test is useful for determination of the causal drug, and 3) if one rhG-CSF product causes eruption, the alternative one may possibly be safe and effective.
We describe two siblings affected by chronic relapsing thrombotic thrombocytopenic purpura from infancy. The elder brother, a 12-year-old boy had 50 such episodes characterized by acute onset of fever, headache, drowsiness, vomiting, dark urine, thrombocytopenia and anemia. The younger sister, a 6-year-old girl, had 8 episodes with the same clinical manifestations. Petechiae and ecchymoses on the extremities were present throughout their lives. Furthermore, anemia with evidence of red blood cell fragmentation and thrombocytopenia were present chronically. Periodical transfusion of frozen fresh plasma prevented recurrent episodes. These cases suggest that there is a congenital variant of thrombotic thrombocytopenic purpura.
Audiometric data from 76 patients with unilateral sudden deafness and hearing loss of 80 dB or more were studied to statistically assess the relationship between vestibular findings (vertigo and/or dizziness, nystagmus, canal paresis) and hearing recovery in various frequency ranges. Hearing recovery in patients with vertigo and/or dizziness (V(+)) was much poorer than in patients without such findings (V(-)). Concerning hearing recovery in the high frequency range, a significant statistical difference was evident between the V(+) and V(-) group. There were no statistically significant differences in hearing recovery between patients with spontaneous nystagmus or canal paresis and those without.
The usefulness of endoscopic examination for the diagnosis of idiopathic perilymphatic fistula (IPLF) was investigated. Eight patients presenting with unilateral sensorineural hearing loss and vertigo underwent endoscopic examination by the transtubal or transtympanic approach. In 5 out of the 8 patients, transtubal endoscopy was carried out using a superfine flexible endoscope. With this approach, no abnormal findings were visualized. A perilymphatic leak from the round window was observed in 2 patients by means of transtympanic examination using a needle scope. These findings were confirmed in both patients by microscopic observation during tympanotomy. In one patient who was finally diagnosed with IPLF, the transtympanic endoscopy failed to detect perilymphatic leakage. Although incision of the tympanic membrane is necessary for the examination, transtympanic endoscopy is useful for the diagnosis of IPLF. Further improvement of the superfine flexible fiberscope is necessary before transtubal observation of the tympanic cavity can be effectively conducted.
The following results were obtained after serological examination of 11 patients with steroid-responsive SNHL including a case with the aortitis syndrome (Takayasu disease) and sensorineural hearing loss, and 3 cases with positive syphilitic reaction. i) Abnormalities of serum immunoglobulins IgG or IgM level were found in 6 of 11 cases (54.5%), ii) Abnormalities in lymphocyte subsets were found in 7 of 14 cases (50.0%), iii) Immunologic abnormalities were thought to be present in patients with steroid-responsive SNHL and related diseases, but no findings specific to either group were observed.
The evoked otoacoustic emissions (e-OAEs) elicited by both tone-bursts and clicks were investigated in normal-hearing ears of three age groups: young age group (approximately 30 years), middle age group (31-50 years) and old age group (51 years approximately). The pseudothreshold of tone-burst e-OAE at stimulus frequencies between 500 Hz and 2 kHz was significantly elevated in the middle and old age groups compared with that in the young age group. When the relationship between averaged emission cochleograms drawn from the mean pseudothresholds of tone-burst e-OAEs at 6 stimulus frequencies between 500 Hz and 4 kHz and averaged pure-tone audiograms was analyzed, a clear difference was found among the three age groups in a frequency range between 500 Hz and 2 kHz. Total echo power, reproducibility, highest peak power and frequency area peak power up to 4 kHz in click e-OAE significantly decreased in the middle and old age groups compared with those in the young age group. These results indicate the possibility that the function of cochlear micromechanics deteriorates in all cochlear partitions with increasing age, even in normal-hearing ears.
We developed a new computer image analysis technique with application of an automatic threshold selection (ATS) algorithm which was successfully used in the quantitative evaluation of a highly complex texture of immunostained brain tissue. We applied this new method for estimation of the volume of the Purkinje dendrites, which were immunohistochemically stained for inositol 1,4,5-trisphosphate receptor protein (P400), and demonstrated a significant reduction of the dendritic arborization of the Purkinje cells of a neurological mutant mouse. Wriggle mouse Sagami, which would appear normal if stained with conventional methods such as H-E and Nissle staining.
A newly developed model of keratoepithelioplasty (KEP) in the rat was used to analyze the effect of anterior chamber-associated immune deviation on the suppression of corneal allograft rejection. The right eyes of Fisher rats received an anterior chamber (AC) injection of lymphocyte suspension from Dark Agouti (DA) rats (DAL group) or phosphate-buffered saline (positive control group). Seven days later, DA corneal lenticules were grafted onto both eyes of the recipients. Delayed type hypersensitivity (DTH) was also assessed in another group of Fisher rats receiving an AC injection of DA lymphocytes in the right eye. Within 15 days, 88% of the eyes in the positive control group demonstrated vigorous epithelial edema, a large area of epithelial defect, and vascularization. By contrast, in the DAL group, only 37% of the eyes showed slight epithelial edema, a small area of epithelial defect, and rare vascularization; suppression of graft rejection was observed in both eyes. DTH assay demonstrated significant suppression in the recipients of the AC injection of donor-type lymphocytes. This study indicates that the AC injection of donor-type lymphocytes prior to corneal grafting suppresses allograft rejection in the rat KEP model, correlative with the suppression of DTH reaction.
Dendritic keratitis occurred during oral acyclovir (ACV) therapy in a 60-year-old man. Corneal stromal edema and iritis were found at his first visit. Herpetic keratouveitis was suspected, based on clinical findings and previous history. Treatment with steroid eyedrops and ACV ointment was initiated. However, ACV [corrected] ointment was changed to oral ACV, since conjunctival ulcer occurred as an adverse effect of the ointment. Subsequently, he received long-term oral ACV medication and steroid eyedrops for recurrent keratitis. The fifth recurrence was also treated with oral ACV and steroid eyedrops. At this time, although the stromal keratitis had improved, there was an outbreak of dendritic keratitis. The lesion healed spontaneously after only a reduction in the steroid. The 50% effective dose (ED)50 of the isolated virus to ACV was 4.4 +/- 0.15 micrograms/ml (mean +/- SD), a level considered ACV-resistant in vitro. The clinical course of this case emphasizes that it is important to consider the route and duration of ACV administration and the use of steroids in the treatment of stromal keratitis or keratouveitis.
The effects of endotoxin on the activities of the major Na(+)-independent amino acid transporters in rat liver (Systems n, asc, L, bo,+, and y+) were studied using using hepatic plasma membrane vesicles (HPMVs). Rats were treated with a single dose of Escherichia coli endotoxin (E. coli lipopolysaccharide 0127:B8 (LPS), 7.5, 15, or 30 mg/kg BW) and HPMVs were prepared by Percoll density gradient centrifugation at various timepoints after LPS administration. Vesicle purity and integrity was established by assay of enzyme markers and identical equilibrium uptakes. The activities of the Na(+)-independent amino acid transport systems y+ and bo,+ (arginine), asc (alanine and cysteine), L (leucine), and n (glutamine) were evaluated by measuring the uptake of radiolabeled amino acids using a rapid mixing/filtration technique. Amino acid uptake by HPMVs consisted of saturable and nonsaturable components. Prior treatment with endotoxin did not alter the activities of Systems n, asc, or L but resulted in a time- and dose-dependent stimulation of saturable arginine transport. Arginine transport increased within 2 h of LPS administration and exhibited a return towards basal levels by 24 h. Nonsaturable uptake (diffusion) in HPMVs was unaltered by LPS treatment. Kinetic analysis of arginine transport demonstrated the presence of both a high affinity and a low affinity carrier. Treatment with LPS resulted in a 73% increase in the Vmax of the high affinity carrier (System y+) and a 25% increase in the Vmax of the low affinity transporter (System bo,+). The data indicate selective stimulation of Na(+)-independent arginine transport in the liver during endotoxemia which may serve to support important arginine-dependent pathways during sepsis.
A 46-year-old female was admitted to our hospital on December 1991 for further examination of an abnormal shadow on chest X-ray. A huge mass in the upper mediastinum and a thin-walled cavitary lesion in the right upper lobe were found by chest radiography and computed tomography. On March 2, 1992, surgical resection was performed with pathological diagnosis of thymoma for the mediastinal mass and pulmonary cryptococcosis for the cavitary lesion. Although ATL cells were not found in the peripheral blood, anti-HTLV-1 antibody was found to be positive. Natural killer cell activity was lower than normal control and other tests of humoral and cell-mediated immunity were normal. Histological examination of the specimens obtained from the thymoma revealed lymphocytic predominance without atypical cells such as ATL cells, but with integration of HTLV-1 proviral DNA. There seemed to be a causal relationship between HTLV-1 carrier state and thymoma. Since there are no reported cases of HTLV-1 carrier associated with pulmonary cryptococcosis and thymoma, we report the first case with a review of the literature.
From February 1987 to January 1994, we operated on 24 patients with coarctation of the aorta (CoA) and 9 patients with interruption of the aortic arch (IAA). A policy of staged repair was followed, consisting of reconstruction of the aortic arch with pulmonary artery banding and ligation of the ductus arteriosus in the first stage and intracardiac repair with pulmonary artery band removal in the second stage. In recent cases an extended aortic arch anastomosis was performed using a heparin-coated "shunt tube" between the pulmonary artery and the descending aorta to maintain blood flow to the lower half of the body during aortic cross-clamping. The use of the shunt increased intraoperative urine output (p < 0.05). This technique may allow patients whose condition is poor to undergo aortoplasty more safely. One patient died. This patient had CoA and total anomalous pulmonary venous return, who underwent a one-stage repair, in violation of our policy (early mortality 3.0%). There were two interim deaths before the second stage repair. At present, 18 patients have undergone staged intracardiac repair, including VSD closure (14 cases), Jatene's procedure (1), Ratelli's procedure (1), Damus-Kaye-Stansel (DKS) procedure (1), total cavo-pulmonary connection (TCPC) + DKS procedure+annuloplasty of a common atrioventricular valve (1). There were two early deaths and one late death following intracardiac repair, all in patients with IAA plus VSD.
We encountered a 63-year-old man whose dry cough due to interstitial pneumonia had been successfully with an anti-thrombin drug, argatroban, which was given to treat exacerbated Buerger's disease. We therefore prospectively evaluated fibrinogen, fibrin-degradating product D-dimer, thrombin anti-thrombin III complex, and plasmin anti-plasmin complex in patients with interstitisal lung diseases. In a preliminary study, we found that some patients actually had elevated levels of these markers. These findings suggested that increased coagulability was involved in the pathophysiology of interstitial pneumonia. In this study, we measured the levels of serum-soluble thrombomodulin as a marker of endothelial cell damages that lead to hemostasis. We found that serum levels of thrombomodulin were high in about 35% of patients with sarcoidosis, interstitial pneumonia associated with collagen diseases, or idiopathic interstitial pneumonia. Furthermore, these levels decreased as the patients' conditions improved. Although further evaluation is needed, these results suggest that endothelial cell damage and hemostasis are involved in the pathophysiology of interstitial pneumonia.
A sixty-year-old male patient with caries of the cervical spine suffered from cardio-respiratory arrest outside the hospital. Laryngeal mask was inserted into his pharynx and he was brought to the emergency department of our hospital under CPR by emergency paramedical staffs. Endotracheal intubation was tried three times with a Macintosh laryngoscope but was unsuccessful. His neck was difficult to extend and his epiglottis was not visible at all (X-ray photograph showed the fusion and the significant backward protrusion of his cervical spine). EGTA and Combitube were tried but in vain. At last Bullard intubating laryngoscope with videocamera system was operated. An endotracheal tube was easily inserted into his trachea with it and effective cardiopulmonary resuscitation was managed under reliable airway maintenance. These facts indicate that Bullard intubating laryngoscope is valuable at the emergency department and it should be always available there.
Color Doppler imaging was performed to evaluate the venous stasis in 39 orbits, including 9 optic neuropathy orbits, of 20 patients with dysthyroid ophthalmopathy and 22 orbits of 11 healthy subjects. The superior ophthalmic vein (SOV) was detected in 26 dysthyroid ophthalmopathy orbits and in 13 control orbits. The blood flow in the SOV was in the anteroposterior direction in 20 dysthyroid ophthalmopathy orbits and in 13 control orbits. Reversed flow, ie, the flow in the posteroanterior direction, was seen in 6 dysthyroid ophthalmopathy orbits and in none of the control orbits. In dysthyroid ophthalmopathy orbits, the blood flow in the SOV was reversed in 5 (36%) of the 14 orbits with apical orbital crowding observed on computed tomography, which means there was compression of the optic nerve by enlarged extraocular muscles, as compared to in 1 (4%) of the 25 orbits without apical orbital crowding (P < 0.05). The percentage of the orbits having reversed flow in SOV was 44% of dysthyroid ophthalmopathy orbits with optic neuropathy as opposed to 7% of those without optic neuropathy (P < 0.05). Reversed blood flow in the SOV strongly supported the existence of severe venous stasis in the orbits, which may be related to the development of dysthyroid optic neuropathy.