Search PubMed⌕ Search

Biomedical subjects

Y Nishimura

Publications and source records attributed to Y Nishimura.

At least 829 records · Page 46Linked to original sources

Bronchial hyperreactivity in patients with mitral valve disease.

To elicit the mechanism of bronchial hyperreactivity (BHR) in chronic heart failure (CHF), a methacholine inhalation test, pulmonary function test, and cardiac catheterization were performed in 19 patients with mitral valve disease (MVD), and the change of severity of BHR before and after mitral valve replacement (MVR) was also examined in seven of 19 patients with MVD. Sixteen of 19 patients with MVD showed significant increase in respiratory resistance in methacholine inhalation test, while all normal subjects did not. The maximal expiratory flow at 25 percent of vital capacity (Vmax25), a parameter of small airway disease, correlated significantly with log cumulative dose producing a 35 percent decrease in respiratory conductance (PD35Grs) (r = 0.536) and the duration of symptoms (r = -0.682). There was a significant correlation between log PD35Grs and mean pulmonary artery wedge pressure (r = -0.466). After MVR, log PD35Grs was significantly improved in all seven operated-on patients, although six patients retained BHR. We conclude that patients with long-term MVD have marked BHR and that BHR in long-term MVD is related to peripheral airway narrowing with organic remodeling, which was not ameliorated with MVR procedure, in addition to pulmonary congestion.

Bronchial Provocation Tests↗

[Urinary incontinence in children with primary vesicoureteral reflux--urinary incontinence and function of refluxing kidney].

The interrelation among urinary incontinence (nocturnal enuresis, urge incontinence), history of urinary tract infection and renal function was investigated in 153 children with primary vesicoureteral reflux who were more than three years old. Of them, 98 children (64%) had the chief complaint of urinary tract infection (UTI) and 43 children (28%), urinary incontinence. Of the children whose chief complaint was UTI, 44 (45%) had incontinence. Thus, 87 children (57%) with VUR had urinary incontinence. Almost all the children who had urinary incontinence and no previous UTI had good renal function. Renal dysfunction was found in children with previous UTI history. These studies on children with primary VUR more than three years old indicate that, although urinary incontinence could be a factor for recurrence of UTI and a probable cause of worsening of renal function, there is no direct correlation between urinary incontinence and renal dysfunction accompanied by VUR.

Adolescent↗

[A case of neurogenic bladder due to arachnoid cyst of the middle cranial fossa].

A 6-year-old girl, with urinary incontinence for the past 3 years, showed an overactive bladder and detrusor-sphincter dyssynergia (DSD) in urodynamic study. An epileptic focus in the right occipital area, as well as a large arachnoid cyst in the left middle cranial fossa was revealed by EEG and intracranial CT. After surgery for the arachnoid cyst, urinary incontinence was improved with disappearance of the epileptic focus in EEG, and an alteration of overactive bladder into normolactive one and improvement of DSD were observed in urodynamic study. It was considered that the urinary incontinence of this case might be associated with the ectopic epileptic focus due to the arachnoid cyst.

Arachnoid↗

[Two cases of neurogenic bladder due to HTLV-1 associated myelopathy (HAM)].

Case-1 (24-year-old female) had complained of slowly progressive urinary incontinence (since 14 years old) and gait disturbance (since 18 years old). A marked pyramidal disorder was observed, and anti-HTLV-1 antibody (1:640) was present in her peripheral blood. She was diagnosed as having HTLV-1 associated myelopathy (HAM). Repeated urodynamic studies (UDS) revealed exacerbation of overactive bladder and detrusor-sphincter dyssynergia (DSD) with the progress of the disease. Case-2 (48-year-old male) had complained of gait disturbance (since 32 years old) and progressive urinary hesitancy (since 46 years old). Physical examination revealed a marked pyramidal disorder. Anti-HTLV-1 antibody (1:200) and ATL-like cells were present in his peripheral blood. He was diagnosed as having HAM. The voiding cystourethrography demonstrated an abnormal change of the bladder wall. UDS revealed overactive bladder and marked DSD. Medications based on adrenocortical steroids and urological cares have improved urinary disturbance, in both cases.

Adrenal Cortex Hormones↗

The absolute configuration of decilonitrose, a sugar component of decilorubicin, is undoubtedly 2,3,6-trideoxy-3-C-methyl-3-nitro-L-ribo-hexopyranose.

The absolute structure of decilonitrose, a sugar component of an antitumor antibiotic decilorubicin was decided to be 2,3,6-trideoxy-3-C-methyl-3-nitro-L-ribo-hexopyranose by synthesis of its methyl beta-glycoside starting from L-rhamnose through the 3-ulose. In the synthetic route, any configurational ambiguities do not exist.

Anthracyclines↗

[Evaluation of specificity of EIA kit (ED-007)].

EIA (Eitest: Eisai) and Gelatin Particle Agglutination: PA (SERODIA: Fujirebio) assays were performed for the detection of HTLV-I antibodies with 10,780 sera from patients since 1986. Eleven point five percent were reactive by both EIA and PA, while 1.1% was PA(+), EIA(-), these PA false positive occurred on low titer. Conversely 0.2% on EIA positive seems PA false negative because of Western blot (WB) positivity. Zero point nine percent was EIA(+), PA(-), of these 80.6% were not inhibited by EIA confirmatory test. The main cause of EIA false positive was due to reactivity of auto antibody with MT-2 cell lysate. We used new EIA (ED-007: Eisai) coated with HTLV-I antigen purified from supernatant of culture medium of MT-2 cell. The results completely matched with EIA confirmatory test and WB. Cut off index value of sera from SLE patients were down to 0.2 (mean +/- SD) from 0.7 +/- 0.4 of Eitest ATL. EIA (ED-007) are probably useful and more specific assays for the detection of HTLV-I antibodies, especially, the sera of patients with autoimmune diseases.

Agglutination Tests↗

[Incidence and clinical significance of the esophageal branches originating from the bronchial artery].

The authors investigated the incidence and extent of angiographic visualization of the esophageal branches originating from the bronchial arteries. Approximately 20% of 371 patients showed considerable blood flow to the esophagus. The left bronchial artery more often gives rise to the esophageal branches. Esophageal complications have been experienced in 8 cases following bronchial artery infusion of Mitomycin C for pulmonary carcinoma. Complications tend to occur in cases showing marked opacification of the esophageal veins or in those which a lesion locates in the peripheral portion of the lung. It is imperative to pay attention to esophageal branches of the bronchial artery in interventional angiography.

Bronchial Arteries↗

[Delayed effects of radiation of patients with germ-cell tumor, with special to cerebral blood flow].

Delayed effects of radiation therapy (RT) on twenty patients with germ-cell tumors, including 17 cases of germinoma, were evaluated with special reference to cerebral blood flow (CBF). All patients except for one of germinoma had craniotomy to verify the tumor histology, then RT followed with a total dose of 39.6 to 60 Gy for each patient. A follow-up study with CT scans and MRI proved not any recurrence of the tumors during the past 14-year period between June, 1975 and April, 1989. On the other hand, CBF was measured by 133Xe inhalation 1 to 14 years after RT. 40% of all patients were below critical values of CBF with higher frequency in the younger. Statistically, the post-irradiated changes of CBF were not related to a total administered dose, grading of brain atrophy, or physical mental developments, but closely related to irradiated volume dose (product of absorbed dose and field, rad.cm3) only for the age ranging from 8 to 15 years at RT. These results suggested that late effects of RT on CBF were more strongly depend upon absorbed dose and field of irradiation to brain in children than in adolescents.

Adolescent↗

[Behavior of anti-cancer drug of transcatheter hepatic segmental arterial chemoembolization using lipiodol mixed with an anti-cancer drug followed by gelatin sponge assessed by Tc-99m pertechnetate].

The behavior of an anti-cancer drug consisting of transcatheter hepatic segmental arterial chemoembolization using Lipiodol mixed with an anti-cancer drug followed by gelatin sponge (segmental Lp-TAE: Seg-Lp-TAE) was assessed in comparison to that of the non-segmental Lp-TAE to whole liver (Lp-TAE) by means of Tc-99m pertechnetate (RI). Injection of Lipiodol mixed with Adriamycin and 740 mBq of RI followed by gelatin sponge was carried out from segmental or subsegmental hepatic artery in 12 cases of hepatocellular carcinoma and from proper or right hepatic artery in 11 cases (9 with hepatocellular carcinoma and 2 with metastatic liver tumor). The distribution and retention of RI were studied from the time activity curves of ROIs in tumor and non-tumor area, and scintigrams at 4 and 24 hours after injection. The integral value ratio of tumor to non-tumor was significantly higher in Seg-Lp-TAE, indicating that es the distribution of RI after Seg-Lp-TAE is selective in the segments where tumor exists. In Seg-Lp-TAE, the T1/2 was higher and the count ratio of tumor to non-tumor was significantly higher at 4 hours and even higher at 24 hours after injection. These results suggest that an anti-cancer drug reinforces the effect on tumor with little adverse effect on normal liver in Seg-Lp-TAE, which is more advantageous to the treatment of hepatocellular carcinoma.

Antineoplastic Agents↗

[Hilar and mediastinal lymph node metastases from lung cancer; detection with CT and MR imaging].

Sixty-one patients with primary lung cancer, who had CT and MR imaging before surgery, were studied. MR imaging used spin-echo sequences with T1 weighted image and T2 weighted image (C-MRI), and included STIR technique (Stir-MRI). The accuracy of diagnosis of mediastinal lymphadenopathy (regarding 10 mm or larger in short transverse diameter as positive) was 89% by CT, 84% by C-MRI and 89% by Stir-MRI. The accuracy of diagnosis of hilar lymphadenopathy was 42% by CT, 67% by C-MRI, and 75% by Stir-MRI. The accuracy of diagnosis of mediastinal lymph node metastases was 89% by CT, 94% by C-MRI and 96% by Stir-MRI. The accuracy of diagnosis of hilar lymph node metastases was 78% by CT, 87% by C-MRI and 89% by Stir-MRI. The possibility of enhancement of diagnostic accuracy of lymph node metastases from lung cancer was suggested by combining MR imaging included STIR technique with CT.

Adenocarcinoma↗

Elevated serum levels of soluble interleukin-2 receptors in small cell lung carcinoma.

The presence of the soluble form of the interleukin-2 receptors (sIL-2R) was evaluated in the serum of 21 patients with small cell lung carcinoma (SCLC) and 37 patients with non-small cell lung carcinoma (non-SCLC) by means of an enzyme-linked immunosorbent assay. The sIL-2R level was measured serially in patients with SCLC both during and after therapy. The mean serum level of sIL-2R in patients with SCLC was 3.8 times higher than that of 47 healthy controls and was 1.9 times higher than in 37 patients with non-SCLC. Six patients with SCLC had very high levels of sIL-2R, ranging from five to 52 times the mean level observed in normal controls. Tumor cells in the pleural fluid of the patient with highest levels were positive with monoclonal antibodies to IL-2R (CD25), NKH-1, OKDR, and OKT9. A longitudinal study in this patient showed a good correlation between tumor activity and sIL-2R levels. Also, the sIL-2R levels decreased in patients responding to therapy. These results suggest that some SCLCs secrete sIL-2R and that the serial measurements of the serum sIL-2R levels can be used as a noninvasive tumor marker in this disease.

Biomarkers↗

[Motor amusia following a right temporal lobe hemorrhage--a case report].

A 65-year-old female was admitted to our hospital because of left hemiparesis with sudden onset one week before. She was congenitally right-handed. She had been a teacher of Japanese string instrument (samisen) playing and been able to sing Japanese traditional songs well. A tape on which she had recorded her songs one year before the admission also proved her to be a good singer. Neurological examination on admission revealed almost normal findings except for minimal weakness in her left hand fingers. Right temporal lobe hemorrhage was revealed by CT scan. One month after the admission, she complained that she was unable to sing her songs and to play samisen as she used to do. Her intelligence was normal (WAIS VIQ116, PIQ108) and there were no abnormal findings as follows: aprosodia, aphasia, agraphia, memory disturbance, agnosia and ideational, ideomotor, constructional or limb-kinetic apraxia. She could point out her errors while singing. However, musical receptive function was slightly disturbed with tonal memory in Seashore test. When she was asked to sing a song without any instrumental support, she hummed a melody occasionally with wrong pitch, but rhythmically. After hearing a song she knew well, she reproduced it with slight improvement. With the vocal or the instrumental accompaniment, she could sing fairly well. She had some mistakes of pitch while playing a samisen. MRI was performed one year and a half after the brain hemorrhage. It displayed a thin linear of hematoma in the white matter of the right upper temporal and transverse gyrus. It was proved in our case that motor amusia with minimal musical receptive dysfunction could appear following a cerebral lesion and musical function might be independent of intelligence or verbal function.

Aged↗

[Clinical assessment of thermoradiotherapy of breast cancer and cancer of the urinary bladder].

Non-randomized clinical trials of thermoradiotherapy for breast cancer and carcinoma of the urinary bladder were reported. Thermoradiotherapy was useful for breast cancer treatment in term of (1) increased local control for locally advanced tumors and (2) possibility of reducing dose of irradiation for recurrent tumors following radiotherapy. Tumor response to thermoradiotherapy was dependent on tumor volume and maximum or minimum tumor temperature. Thermoradiotherapy was also effective as a preoperative-treatment for urinary bladder cancer. The incidence of down-staging and degeneration of tumors was significantly higher in thermoradiotherapy than in radiotherapy. These effects were temperature dependent. Patients with T 3-4 NOMO or Grade 3 tumors treated with thermoradiotherapy showed a tendency of increased survival compared with those treated with radiotherapy alone.

Adult↗

[Anomalous origin of the right pulmonary artery from the ascending aorta: a report of three cases].

Three patients with anomalous origin of the right pulmonary artery from the ascending aorta were reported. Case 1 was a 16-day-old girl with the right pulmonary artery arising from the base of the ascending aorta. Division and direct anastomosis of the anomalous vessel to the pulmonary trunk were successfully performed. Case 2 was a 4-month-old girl with the kinked and stenotic right pulmonary artery arising from the distal ascending aorta. At the time of surgery, however, the right pulmonary artery had been completely occluded and the pulmonary hypertension of the main pulmonary trunk had been disappeared. The chest was closed without any corrections. Case 3 was a 17-month-old girl with the stenotic right pulmonary artery arising from the distal ascending aorta. The stenotic lesion of the right pulmonary artery was longitudinally incised and anastomosed with the PTFE graft in an end-to-end fashion, followed by the end-to-side anastomosis of the graft and the pulmonary trunk.

Aorta↗

[Cerebellar AVM--clinical analysis of 14 cases].

The authors report on their experience with 14 cases of cerebellar arteriovenous malformation (AVM), with emphasis on their clinical symptoms and treatment problems. The incidence of cerebellar AVM was 7.5% in all cases of intracranial AVM. Twelve of them presented with hemorrhages, one with a headache and one with a focal neurological deficit related to the "steal" phenomenon. Three out of 4 poor risk patients with intracerebellar hematoma recovered well after their operations. Thus, we can say that surgical treatment should be performed even if the patient's state seems hopeless. The nidus was located at the vermis in 7, at the cerebellar hemisphere in 5, and at the tonsil in 2 cases. The surgical approach to the superior surface of cerebellum or the tonsil near the brainstem became a problem. In our series, all surgically treated cases were approached through the suboccipital route with the patient in the prone position and the surgical results were favorable. On the other hand, one case which underwent conservative treatment died due to rebleeding. Thus, as the follow-up mortality with conservative treatment is higher and the results of surgery are better, surgical treatment should be attempted. Preoperative MR imaging is one of the useful methods used to determine whether an excision is possible without significant deficit, especially in cases in which the AVM is located near the brain stem. In our series, two patients had concomitant aneurysms related to feeding arteries. Another interesting case of a neonate who had a small tonsillar AVM is reported.

Adult↗

Treatment of murine SCC VII tumors with localized hyperthermia and temperature-sensitive liposomes containing cisplatin.

The release of cisplatin (CDDP) encapsulated in temperature-sensitive unilamellar liposomes to murine SCC VII carcinoma by localized hyperthermia and the effects of the treatment on tumor growth were studied. A transition temperature of the temperature-sensitive liposomes containing cisplatin (LIP-CDDP) was 41 degrees C. Twenty-four hours after injection of LIP-CDDP, the heated tumors (42 degrees C, 60 min) contained 3.3 times more CDDP than the unheated tumors receiving free CDDP. Although the uptake of liposome-associated CDDP by liver was approximately threefold greater at 1.5 h after injection than uptake of free CDDP, it decreased about 50% over a 24-h period. No difference in uptake of the two forms of CDDP by kidney was observed. The combination of LIP-CDDP and localized heating at 42 or 43 degrees C was more effective relative to the amount of CDDP in delaying tumor growth than that of free CDDP and hyperthermia. Treatment with LIP-CDDP plus local heating resulted in a dose-modifying factor of 5.3 when compared with free CDDP and no hyperthermia. The dose-modifying factor was 2.8 when treatment with LIP-CDDP and heat was compared with treatment with free CDDP and heat. Thus CDDP could be released selectively from the temperature-sensitive liposomes by heat and resulted in both a greater uptake of the drug and a delay in tumor growth.

Animals↗