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Biomedical subjects

Y Iwata

Publications and source records attributed to Y Iwata.

At least 145 records · Page 8Linked to original sources

Altered membrane-dystrophin association in the cardiomyopathic hamster heart muscle.

In the ventricular muscle from 30- to 40-day-old Bio 14.6 cardiomyopathic hamsters, the concentration of dystrophin was about 50% less than the normal controls. Despite its reduced content, extraction of dystrophin from the myopathic muscle into the microsomal fraction was threefold higher as compared to the control. These results suggest that abnormality exists in the association of dystrophin with sarcolemmal membranes in the myopathic muscle. No obvious difference, however, was observed between normal and myopathic myocytes in their immunofluorescence staining patterns.

Animals↗

The mental health consumers' self-help movement in Japan.

Mental health services in Japan are centered on medical treatment, and medical organizations are regarded as the supreme authority. In recent years, however, some resources other than traditional medical treatment have been created. This chapter talks about one of those new resources, consumer self-help.

Community Mental Health Services↗

[Extracapsular tumor invasion in renal cell carcinoma: with special reference to limitation of surgical enucleation].

To elucidate the feasibility of surgical enucleation, the incidence of extracapsular tumor invasion in 30 cases of renal cell carcinoma with a diameter less than 5 cm was examined, based on the classification of extracapsular tumor invasion into three patterns, namely microinvasion, nodular invasion, and daughter tumors. Of the 30 cases of renal cell carcinoma, 22 cases (73%) revealed extracapsular tumor invasion. And the incidence of microinvasion, nodular invasion and daughter tumors was 7 cases (23%), 9 cases (30%) and 6 cases (20%), respectively. But the incidence of these three patterns of extracapsular tumor invasion correlated neither with the size of renal cell carcinoma nor with pT classification. There was a tendency for extracapsular tumor invasion to occur near the renal hilar site of the renal cell carcinoma, where the tumor vessels were rich, penetrated and twined around the tumor capsule, resulting in the disruption of the tumor capsule. These three patterns of invasion was located within 1 cm in distance from the tumor capsules in all cases. In conclusion, because of limited radicality achieved by tumor enucleation even in the case of pT1, partial nephrectomy was recommended in the presence of a normal contralateral kidney.

Carcinoma, Renal Cell↗

[Preoperative embolization using absolute ethanol for renal cell carcinoma--including the questionnaire survey in Japan].

The usefulness of transvascular embolization before radical nephrectomy using absolute ethanol was studied in thirty-two cases with renal cell carcinoma, among them, 30 cases received radical nephrectomy one day after transvascular embolization. And a nation wide questionnaire survey regarding the embolization was also reported. These results were as follows: 1. The infarcted areas were very extensive and among 28 cases examined, 26 cases showed more than 75% of infarct in the whole area of the cortex. 2. Among 32 cases, 22 cases complained of no pain after the embolization using absolute ethanol only by the preventive epidural administration of analgesics. 3. The questionnaire survey showed that the embolization before radical nephrectomy was performed in 62% of the hospitals as a whole, including 81 hospitals (41%) in which the embolization was performed case by case. In the whole of hospitals, 21% performed the embolization principally by evaluating the significance of the embolization. On the other hand, 19% of the hospitals did not perform by the reason of no significance of the embolization on the treatment of renal cell carcinoma. As shown in this questionnaire survey, the significance of the embolization before radical nephrectomy was still debatable in our country. 4. In 62% of the hospitals where the embolization is carried out, as a whole, the period from embolization to the nephrectomy was 3-7 days. And in 42% of the hospitals as a whole absolute ethanol was principally used as an embolizing agent. In conclusion we believe that absolute ethanol was useful and should find further application as an embolizing agent before the radical nephrectomy.

Aged↗

Clinical experience of ceramic cementless total knee arthroplasty in RA and a histological study of the bone-ceramic interface in revision cases.

The Kyoto total knee cementless prosthesis (KC-1) was used in 23 patients with rheumatoid arthritis. Its femoral component is made of alumina ceramics which articulated with a HDP plate supported by a ceramic plate. Although the followup period is short, the postoperative result is not satisfactory, because remarkable sinking of the tibial component was noticed in those patients who have bone atrophy. We had 6 cases of revision so far. Since 1986, we have been using bone cement in all cases of RA in doing TKA.

Adult↗

[Renal and cerebral infarctions in a patient with systemic lupus erythematosus without antiphospholipid antibodies].

Renal artery infarction is a very rare complication in patients with systemic lupus erythematosus (SLE), even in patients with antiphospholipid syndrome which often causes thromboembolism: Renal infarctions have only been reported in 4 SLE patients with antiphospholipid antibodies (aPL). Here we report a case of SLE without aPL who accompanied by renal and cerebral infarctions. A 42-year old Japanese woman with 8 year history of SLE manifested by arthralgia, central nervous system symptoms, positive-antinuclear and anti-DNA antibodies was admitted to our hospital for the treatment of progressive lupus nephritis. Physical examinations revealed hypertension (130-160/80-110 mmHg) without pitting pretibial edema. Laboratory evaluations showed proteinuria (3.7 g/day), normal serum creatinine level (0.9 mg/dl), low serum albumin level (2.3 g/dl) and high cholesterol level (317 mg/dl). Old cerebral infarctions were recognized by magnetic resonance imaging. However, hematological and immunological studies revealed that this case has neither a prolonged activated partial thromboplastin time, lupus anticoagulant nor anticardiolipin antibodies. Prednisolone was increased from 30 mg/every other day to 30 mg/day, and oral azathioprine, 50 mg/day, was started for the treatment of lupus nephritis. On the 11th day, she suddenly complained severe abdominal pain, which gradually localized on the right side. Computed tomography of the kidney suggested right renal infarctions, and arteriography of right renal artery confirmed both an obstruction of the ventral branch and a narrowing of the dorsal branch of right renal artery. No intra-cardiac thrombus was demonstrated by echocardiography. Following to the treatment with fibrinolytic agent and anticoagulant, her symptoms have improved.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Study on the usefulness of povidone-iodine obstetric cream with special reference to the effect on the thyroid functions of mothers and the newborn.

The effect of povidone-iodine obstetric cream (OAD cream) on the thyroid functions of mothers and the newborn was investigated in 56 patients. Effects on labour and on the neonatal course of the newborn were also studied. OAD cream was used for disinfection of the vulva and vagina during prenatal obstetric examinations (1-10 times) and at parturition. Bacteriological specimens were obtained before and after use of the OAD cream, and the total iodine, thyroid stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) levels were measured in the maternal blood and umbilical cord blood. The overall bacterial eradication rate for the vulva was 74.7% although the eradication rate for coagulase negative staphylococci was low (23.1%). The overall bacterial eradication rate for the vagina was 56.1% although the eradication rates for Candida albicans and Lactobacillus spp. were low (9.1% and 29.4% respectively). There was no significant difference in the types of delivery or complications of labour and delivery between the group treated with OAD cream and the control group, but the duration of labour was prolonged in the former group. There were no malformations among the newborn, and no difference between the group treated with OAD cream and the control group in regard to body weight and length of the newborn at birth, Apgar score, postnatal gain in body weight, or bilirubin level. The maternal blood levels of total iodine, TSH, and T4 were within the normal ranges both during pregnancy and at delivery, but the level of T3 was slightly elevated at delivery. The umbilical cord blood levels of the total iodine, TSH, and T4 were within normal ranges both during pregnancy and at delivery, but the level of T3 was somewhat elevated. At age six days, the T4 level was normal in all the newborn. TSH was higher than 15 microU/ml in two newborns, but returned to normal levels three week later.

Antisepsis↗

Angiographic and pathological studies on regression of coronary atherosclerosis of FH patients who received LDL-apheresis treatment.

We report on the most recent data confirming the angiographic and pathological efficacy of LDL-apheresis for coronary atherosclerosis of a familial hypercholesterolemia (FH) patient using collected data of a large number of cases and especially of one autopsy case. Changes in coronary artery stenosis have been assessed angiographically in 37 FH patients in the LDL-Apheresis Regression Study (LARS) group of 13 institutions in Japan. Definite regression was observed in 21 segments by visual and computer analysis. Fourteen of 37 patients (37.8%) who had received LDL-apheresis treatment in combination with cholesterol-lowering drugs had at least one regressed segment without any progressed segment. We pathologically examined at autopsy the coronary arteries in one FH patient who had received long-term LDL-apheresis therapy before death. The results revealed the process of scarring of atheromatous plaque, suggesting pathological regression correlated with the angiographic regression shown in serial angiograms taken during LDL-apheresis treatment. It was further suggested that the formation of an eccentric thickened wall lesion rich in collagen fiber prevented atheromatous plaque from tearing off. Such tearing off might lead to an acute coronary event. Aggressive cholesterol-lowering therapy based on LDL-apheresis can induce both angiographic and pathological regression in coronary atherosclerosis of FH patients.

Adult↗

Sibling cases of primary biliary cirrhosis associated with polymyositis, vasculitis and Hashimoto's thyroiditis.

Primary biliary cirrhosis (PBC) was diagnosed in two siblings, a 42-year-old male and his 49-year-old sister. Furthermore, they were complicated with three types of autoimmune diseases: polymyositis, Hashimoto's thyroiditis and vasculitis of the right axillary artery. Although PBC is often associated with other autoimmune diseases, reports of the association with polymyositis and vasculitis syndrome are rare. Familial clustering of PBC with autoimmune diseases is also rare.

Adult↗

[The analysis of nuclear organizer regions of astrocytomas with various histologic malignancies].

Nucleolar organizer regions (NORs) correspond to the loops of DNA which encode the ribosomal RNA. Acid proteins related to NORs can be stained by the silver colloidal technique (AgNORs). Since the configurations of AgNORs may be related to the protein metabolism or the proliferative activity of the cell, we tried to evaluate the corelationship between the morphology of AgNOR and the histologic malignancy in astrocytic tumors. For the quantitative evaluation the histographic pattern of AgNORs was analysed. Twenty-seven surgical specimens of astrocytomas (astrocytoma; 7 Cases, anaplastic astrocytoma; 9 cases, glioblastoma; 11 cases) were examined. The average of the means of AgNOR count in astrocytoma, anaplastic astrocytoma, glioblastoma were 1.68, 1.85 and 2.76 respectively. The averages of standard deviations (S. D.) of AgNOR count were 0.87, 1.03 and 1.26, respectively. In those tumors, the AgNOR histograms were flattered and the means and S. D. increased significantly as the malignancy increased. We speculate that the increased number and variations of AgNOR count could be a reflection of phenotypic alterations of astrocytoma cells such as cellular anaplasia and pleomorphism.

Astrocytoma↗

[Fundamental study on levofloxacin in the field of obstetrics and gynecology].

We performed a fundamental study on levofloxacin (LVFX, DR-3355), a new synthetic antimicrobial agent, in the field of obstetrics and gynecology. Concentrations in serum and intrapelvic genital organs (various regions in the uterus, ovary and oviduct) were determined following single oral administration. The transport of LVFX into genital tissues was found to be good, with the tissue levels of 0.64-2.13 micrograms/g after oral administration of 100 mg and 0.77-4.86 micrograms/g after administration of 200 mg. These tissue levels of LVFX were higher than those in serum and exceeded the MIC90 values against most causative organisms isolated from the lesions of obstetric and gynecological infections. These data indicate that LVFX should be useful in the field of obstetrics and gynecology.

Administration, Oral↗

Simple and accurate determination of methylpyrazines in biofluids using high-performance liquid chromatography.

The determination of six methylpyrazines was performed using high-performance liquid chromatography (HPLC). Methylpyrazines were simultaneously extracted and injected onto a silica gel column with a syringe-type minicolumn packed with diatomaceous earth granules. The extraction-injection solvent used was dichloromethane and the mobile phase solvent for HPLC was dichloromethane containing 0.08% of 1.65 M ammonia solution and 0.5% of methanol. Methylpyrazines were detected using an ultraviolet detector set at 275 nm. Linear relationships between the amount of sample and peak height were confirmed from 50 ng/ml to 10 micrograms/ml of the biofluids. When an aliquot of 10 microliters of biofluid was introduced to the minicolumn, the detection limit of methylpyrazines was as low as 30 ng/ml with each pyrazine derivative. The method is simple and accurate and is thus applicable to pharmacokinetic studies which are performed on animals. The results showed that the possible pharmacological effects of methylpyrazines might be evaluated pharmacokinetically using this newly developed technique.

Animals↗

Clinicopathological study of pulmonary giant cell carcinomas with reference to prognosis of patients.

Giant cell carcinomas of the lung have been notorious in fulminant clinical courses. Thus, this report describes two exceptionally favorable cases among six cases of giant cell carcinoma of the lung. Their histopathological features are a sharply-demarcated tumor of Stage I, absence of vascular permeation of the cancer cells, prominent lymphoid and plasma cell infiltration in the tumor tissue, and lymph follicle formation in the surrounding tissues. Another case with a Stage II tumor showed the same histopathological findings as the above two cases with the exception of lymphatic permeation of the cancer cells. This patient expired about one year after undergoing an operation. As conventional controls, the remaining three cases with Stage III tumors showed an alveolar extension of tumor cells and vascular permeation. There was a fulminant course after the operation. Notwithstanding similar intervals from their clinical onset to operation in the 4 cases other than Cases 4 and 6, their stages showed considerable variations. Hence, each histopathological feature might have substantiated the different clinical courses following the operation. Electron microscopy of three of the cases indicated double-membrane-bound blisters with intermediate junctions in the bizarre giant cells, and cancer cell differentiation toward both glandular and squamous directions.

Aged↗

An ultrasound-guided stereotactic apparatus for intracranial mass lesions.

One of disadvantages of conventional stereotactic operation for intracranial mass lesions is that it is basically a blind procedure even if the operation is performed in a gantry of a CT scan. High resolution ultrasound image gives real-time information on intracranial pathology such as bleeding, remaining cyst fluid or haematoma. The authors report an ultrasound guided stereotactic apparatus which gives real-time images of the lesion during operation.

Biopsy, Needle↗

Bilateral versus unilateral percutaneous high cervical cordotomy as a surgical method of pain relief.

The present report is concerned with the results of bilateral percutaneous high cervical cordotomy (60 patients) compared with those of unilateral cordotomy (161 patients). The result of pain relief is classified into 4 grades based on Hitchcock's criteria; grade 1: complete pain relief, grade 2: almost complete pain relief with slight residual pain, grade 3: persisting pain, but tolerable, grade 4: persisting pain, untolerable. In cases of bilateral cordotomy (60 patients), 76% of the cases showed grade 1, 19% being grade 2, 3% being grade 3 and 2% being grade 4. On the contrary, the unilateral cordotomy (161 patients) showed less impressive results, particularly in grade 1, namely, grade 1 being 64%, grade 2 being 18%, grade 3 being 14% and grade 4 being 4%. Clinically acceptable results (grade 1 plus grade 2) were, therefore, obtained in bilateral cordotomy (95%) as compared with unilateral cordotomy (82%). The difference in pain relief between bilateral and unilateral procedure observed in the present investigation is contrary to that reported previously by others. The possible explanation for less impressive result in regard to grade 1 of unilateral cordotomy is that unilateral cordotomy was performed in this series to alleviate the major side of patient's pain, followed by latent pain on the other side postoperatively, which is not uncommon phenomenon in cancer pain. Whereas all of the bilateral cordotomies were done either for midline pain or bilateral pain, unilateral cordotomy gave satisfactory pain relief in some cases of midline pain. Midline pain, therefore, does not necessarily require bilateral cordotomies from a clinical point of view.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A case of prominent hepatic cholestasis developing to hepatic failure in lambda-AL amyloidosis.

We report a case of lambda-AL amyloidosis which manifested prominent hepatic cholestasis. The patient was a 71-year-old Japanese male who was admitted to our hospital because of abdominal distension and jaundice. Laboratory examination revealed a marked deterioration of liver function with cholestasis. Gastric biopsy revealed amyloid deposition. Under a diagnosis of primary amyloidosis he was treated with corticosteroid and dimethylsulfoxide. However, jaundice progressed, renal function deteriorated rapidly, and he died two weeks after admission. Autopsy revealed a profound deposition of lambda-AL amyloid not only in the liver but also in the kidneys, spleen, lungs, heart and intestine.

Aged↗