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Biomedical subjects

Y Noguchi

Publications and source records attributed to Y Noguchi.

At least 379 records · Page 21Linked to original sources
PubMed1988

[Carcinoma of Papilla Vater with celiac axis stenosis--application of percutaneous transluminal angioplasty].

In a case of carcinoma of Papilla of Vater with angiographically proved celiac axis stenosis, PTA (Percutaneous transluminal angioplasty) was performed to restore sufficient blood flow, followed by standard pancreaticoduodenectomy. This would be the first case to have PTA applied to the cancer-bearing celiac axis stenosis. The patient was 58 year old female, presented with acute abdominal pain and vomiting. DIC revealing protruding defect in the choledochus and hypotonic duodenography showed elevated tumor at Papilla of Vater. Aortography revealed 75% circumferential stenosis at the celiac artery and superior mesenteric angiography visualized all the branches of the celiac axis via dilated pancreaticoduodenal arcades. PTA with Grüntzig Dilaca (4.3Fr), 5 atm for 60 seconds serially every two min for 4 times was performed with the immediate relief of the stenosis down to 25%. Intraoperatively 70-80ml/sec flow confirmed, pancreaticoduodenectomy was done without sacrificing curability. PTA would be superior strategy to restore sufficient blood flow in cases with GI anastomoses, compared with other bypass or reimplantation surgery.

Ampulla of Vater↗
PubMed1988

Tricuspid regurgitation diagnosed by intravenous digital subtraction angiography.

In spite of numerous available diagnostic methods, controversies concerning the precise diagnosis of tricuspid regurgitation (TR) still remain. In right ventriculography, catheter placement may modify tricuspid valvular function. Though noninvasive Doppler echocardiography is a useful method, it is sometimes too sensitive for clinical use. Furthermore, it is not applicable to cases in which ultrasound penetration is limited. In this study, we evaluated TR using intravenous digital subtraction angiography (DSA), which can provide good images even in cases with poorly recorded echocardiograms. For this study, we placed a catheter in the superior vena cava. Cardiac DSA examinations were performed in one hundred and one patients with heart disease. We injected 35 ml of contrast medium at a speed of 18 ml/sec via a catheter introduced in the superior vena cava. DSA images by continuous mode were obtained in the RAO projection for 15-20 sec. Sequential DSA images were observed and analyzed by time-density curves of the regions of interest (ROI) which were placed in the right ventricle (RV) and inferior vena cava (IVC). Doppler echocardiography was performed for 16 cases in which TR was suspected. Of these, phonocardiography with jugular pulse tracing was recorded for 14 and contrast echocardiography were performed for six, respectively. In cases without evidence of TR, regurgitation of contrast medium into the IVC during RV systole was not recorded by the DSA method. In cases of clinically-proven TR, regurgitation into the IVC during RV systole was observed. Thus, this was considered a diagnostic feature of positive TR using the DSA method, and 13 of the 16 cases undergoing Doppler echocardiography were diagnosed as having TR using the DSA method. The severity of TR was categorized as mild, moderate and severe according to analyses of time-density curves. The severity established by the DSA method showed a close correlation with the clinical severity of TR. Doppler echocardiography was negative for TR in two of the 13 cases, but positive for TR in two of the 16 suspected cases only by the Doppler method. In cases of moderate to severe TR diagnosed by the DSA method, jugular pulse tracings showed a regurgitant wave. By contrast echocardiography, TR was evident only in cases of severe TR diagnosed by the DSA method. In conclusion, the DSA method proved useful for diagnosing TR.

Adult↗
PubMed1988

[Type IV Ehlers-Danlos syndrome associated with mitral valve prolapse: a case report].

A 52-year-old male patient with the Ehlers-Danlos syndrome (familial hypermobility of the joints, hyperextensibility of the skin and atrophic cutaneous scars) was evaluated because of a mitral regurgitant murmur. Echocardiography demonstrated marked mitral valve prolapse of the both leaflets and vegetation-like thickening of the anterior leaflet of the mitral valve. Two-dimensional color flow mapping showed severe mitral regurgitation. This patient had also acrogeria-like facial appearance and very thin skin (subcutaneous veins were readily visible). He developed repeated rupture of radial, ulnar and middle cerebral arteries and expired. A histological section of the ruptured ulnar artery demonstrated no infectious process. In view of the joint hyperextensibility, very thin skin, characteristic facial appearance and the spontaneous occurrence of three successive ruptures of peripheral arteries, a diagnosis of Ehlers-Danlos syndrome (type IV) was made. Although mitral valve prolapse is reportedly common in type I, II and III Ehlers-Danlos syndrome, this report emphasizes that it may also occur in patients with type IV Ehlers-Danlos syndrome and the relevant literatures are reviewed.

Echocardiography↗
PubMed1988

[Phospholipase A2 activity in human cervical tissue at delivery].

Prostaglandins (PGs) play an important role in cervical ripening. It is known that the hydrolytic release of arachidonic acid from phospholipids regulates the rate of PG formation. To study the PG biosynthesis in cervical tissue, phosphatidylcholine containing 14C-arachidonic acid in Sn-2 position was incubated with the 800 X g supernatant of cervical tissue obtained from pregnant women at delivery. The only recognizable radiolabeled metabolite, 14C-arachidonic acid, was found on an autoradiogram of TLC, which corresponded to authentic arachidonic acid. Therefore, phospholipase A2 activity was calculated as the rate of the release of arachidonic acid from phosphatidylcholine under the conditions used. The optimal pH of phospholipase A2 activity in 800 X g supernatant was found to be 7.0. It was found that the addition of Ca2+ increased the enzyme activity. It was demonstrated that the concentrations of DHA-sulfate (DHA-S) and conjugated estrogens were higher in ripened cervical tissue than in non-ripened tissue and that PGI2 and PGE2 production increased following the addition of DHA-S. The effects of steroids mainly derived from feto-placental unit, cortisol, pregnenolone, 20 alpha-dihydroprogesterone, pregnenolone-sulfate, DHA, DHA-S, estrone, estradiol and estriol on arachidonic acid release were also studied in vitro. After the onset of labor. DHA-S was administered to the patients in vivo and their cervical tissues were collected at delivery. It was found that steroids including DHA-S did not affect phospholipase A2 activity under the conditions used. These results indicate that cervical tissue possesses the ability to release arachidonic acid from phospholipid, although this step in PG formation might not be affected by steroids including DHA-S.

Arachidonic Acid↗
PubMed1988

Calcified chronic subdural hematoma. Case report.

A case of calcified chronic subdural hematoma was presented. This patient was a 51-year-old man, who had a dizzy spell with headache and vomiting. He was examined by MR study as well as CT scan. The operation was performed and the calcified subdural hematoma was removed safely. MR study is very useful for the preoperative evaluation.

Calcinosis↗
PubMed1988

[Lymphatic flow of the remnant stomach].

Aiming at establishing an appropriate lymph node dissection for carcinoma of the remnant stomach and of the lower esophageal carcinoma in the status post-gastrectomy, lymphatic flow was investigated clinically as well as experimentally. Nineteen cases of carcinoma of the remnant stomach and 8 cases of esophageal carcinoma after partial gastrectomy were studied. Lymph node metastasis of the remnant stomach carcinoma were more frequently seen at perigastrium, splenic hilum, and along splenic artery. Those further extended to para-aortic and diaphragmatic nodes. Three cases of lower esophageal carcinoma after gastrectomy had massive nodal involvement at perigastrium, as well as intra-thoracic lymph nodes. Experimentally 5-Fu emulsion was injected submucosally under endoscope in 25 dogs and subserosally in 6 rabbits. 5-Fu contents in lymph nodes were measured 30 minutes after injection. The most prominent difference in lymphatic flow from the remnant stomach was increase in ascending flow into intrathoracic lymph nodes through para-aorta. This increment was seen irrespective of Billroth I or II anastomosis. On the contrary, descending lymphatic flow from the lower esophagus into the intra-abdominal lymph nodes was not disturbed by gastrectomy. Cardiac lymph node dissection in rabbits accelerated ascending flow. Those results would indicate the necessity of complete block of ascending flow in cases of the remnant stomach carcinoma and of intra-abdominal lymph node dissection in those of the lower esophageal carcinoma after gastrectomy.

Aged↗
PubMed1987

Early gastric carcinoma with special reference to macroscopic classification.

During a period beginning in 1946 and ending in October of 1978, 1000 cases of solitary early gastric carcinoma were operated on at the Cancer Institute Hospital, Tokyo, Japan. The clinical characteristics and the macroscopic and chronological changes were studied in these cases. Early gastric carcinoma comprised one third of all resected gastric carcinoma. If early gastric carcinoma was divided into two groups, the depressed and the elevated, the former was more common. By location, the depressed type lesions were more frequently seen in the middle third of the stomach and the elevated type lesions in the lower third. By age, distribution of the elevated type lesions showed a peak with a mode at the age of 60 to 69 years and of the depressed type, a plateau with a mode at the age of 50 to 59 years. The relative incidence of the elevated type of gastric carcinoma to the depressed type was one to four. In depth of invasion, the mucosa and the submucosa were equally involved. Lymph node metastases were encountered in 12.7% of early gastric carcinoma cases. The incidence of positive nodes in mucosal carcinoma was 3.4% and that of submucosal lesions was 21.7%. Of the elevated type carcinoma, 20.9% of the cases had positive nodes. The 5-year survival rate of the patients with surgery for cure was 93.8% in contrast to 56.5% of those with palliative resection.

Aged↗
PubMed1987

Endothelial vesicular system in rapid-frozen muscle capillaries revealed by serial sectioning and deep etching.

Endothelial plasmalemmal vesicles were examined in serial sections and in deep-etch replicas of rapid-frozen rat muscle capillary endothelium. Numerous fused vesicles were observed in both preparations. The morphology of the vesicles in rapid-frozen capillaries differed from that in the chemically fixed ones; rapid-frozen vesicles were spherical rather than ovoid, and the necks of caveolae and the connecting portion of fused vesicles were wider than those of chemically fixed ones. In the serial sections, true free vesicles were rarely identified (1.6%). In the deep-etch replicas, some of the cytoplasmic surface of vesicles had a mulberrylike appearance and intracytoplasmic fine fibrils appeared to connect the vesicles either to other vesicles or to the plasmalemma proper. Two transendothelial channels were found among 250 capillary profiles. Almost all endothelial "vesicles" proved to be invaginations of the surface membrane, and chemical fixatives did not seem to induce any substantial membrane fusion. These observations suggest that transendothelial transport of large macromolecules across continuous capillary endothelium is carried out mainly by diffusion through transendothelial channels.

Animals↗
PubMed1987

Aneurysm of patent ductus arteriosus in an adult case: findings of cardiac catheterization, angiography, and pathology.

A 42-year-old male was admitted to our hospital for evaluation of a left precordial continuous murmur. Results of catheterization revealed a step-up of oxygen content in the pulmonary arteries and the calculated left-to-right shunt flow was 40% of the pulmonary arterial flow. Furthermore, aortography unexpectedly revealed an aneurysm of the patent ductus arteriosus. During surgery, the aneurysm was discovered to arise from the frontal wall of the ductus arteriosus, and histological observation showed focal necrosis and mucoid degeneration of the media of the aneurysmal wall in contrast to a thickened intimal fibroelastosis of the adjacent ductal wall. This is presumed to be the first adult case of patent ductal aneurysm ever reported in which antemortem diagnosis and surgical treatment were successfully conducted. Our case may suggest that the fragility of the ductal wall following the structural change in an incomplete closing process is considered as a potential pathogenesis of ductal aneurysm formation.

Adult↗
PubMed1987

Anti-idiotypic antibody as a mirror image of the paratope of the original antibody.

Immunization with 2,4-dinitrophenyl-keyhole limpet hemocyanin (DNP-KLH) produced antibodies with combining sites (paratope) which could accommodate not only the 2,4,6-trinitrophenyl (TNP) antigen but also the 4-hydroxy-3-nitrophenyl (NP) and 4-hydroxy-5-iodo-3-nitrophenyl (NIP) antigens, while immunization with NIP-KLH or TNP-KLH produced antibodies with combining sites which could accommodate only the homologous antigens. Utilizing these cross-reacting anti-hapten antibodies mentioned above, an anti-idiotypic antibody was investigated and characterized. Anti-DNP antibodies (Ab1) cross-reacted with the epitopes TNP, NP or NIP. It was also shown that heterologous anti-anti-DNP antibodies (Ab2) recognized not only the antibody which was produced by immunization with DNP-KLH, but also the antibodies produced by immunization with NIP-KLH, NP-KLH or TNP-KLH. The guinea pig anti-idiotypic antibody which we obtained using murine anti-DNP antibodies (Ab1) as antigen is therefore better defined not as an internal image of the antigen but as a mirror image of the paratope of the immunizing Ab1.

Animals↗